GLYNASE PresTab Tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Patients should be retitrated when transferred from MICRONASE or Diabeta or other oral hypoglycemic agents.
There is no fixed dosage regimen for the management of diabetes mellitus with GLYNASE PresTab Tablets. In addition to the usual monitoring of urinary glucose, the patient's blood glucose must also be monitored periodically to determine the minimum effective dose for the patient; to detect primary failure, ie, inadequate lowering of blood glucose at the maximum recommended dose of medication; and to detect secondary failure, ie, loss of adequate blood glucose lowering response after an initial period of effectiveness. Glycosylated hemoglobin levels may also be of value in monitoring the patient's response to therapy.
Short-term administration of GLYNASE PresTab may be sufficient during periods of transient loss of control in patients usually controlled well on diet.
The suggested starting dose of GLYNASE PresTab is 1.5 mg to 3 mg daily, administered with breakfast or the first main meal. Those patients who may be more sensitive to hypoglycemic drugs should be started at 0.75 mg daily. (See PRECAUTIONS Section for patients at increased risk.) Failure to follow an appropriate dosage regimen may precipitate hypoglycemia. Patients who do not adhere to their prescribed dietary and drug regimen are more prone to exhibit unsatisfactory response to therapy.
Patients should be retitrated when transferred from MICRONASE or other oral hypoglycemic agents. The initial daily dose should be 1.5 mg to 3 mg. When transferring patients from oral hypoglycemic agents other than chlorpropamide to GLYNASE PresTab, no transition period and no initial or priming dose are necessary. When transferring patients from chlorpropamide, particular care should be exercised during the first two weeks because the prolonged retention of chlorpropamide in the body and subsequent overlapping drug effects may provoke hypoglycemia.
Some Type II diabetic patients being treated with insulin may respond satisfactorily to GLYNASE PresTab. If the insulin dose is less than 20 units daily, substitution of GLYNASE PresTab 1.5 mg to 3 mg as a single daily dose may be tried. If the insulin dose is between 20 units and 40 units daily, the patient may be placed directly on GLYNASE PresTab Tablets 3 mg daily as a single dose. If the insulin dose is more than 40 units daily, a transition period is required for conversion to GLYNASE PresTab. In these patients, insulin dosage is decreased by 50% and GLYNASE PresTab Tablets 3 mg daily is started. Please refer to Titration to Maintenance Dose for further explanation.
When colesevelam is coadministered with glyburide, maximum plasma concentration and total exposure to glyburide is reduced. Therefore, GLYNASE PresTab should be administered at least 4 hours prior to colesevelam.
The usual maintenance dose is in the range of 0.75 mg to 12 mg daily, which may be given as a single dose or in divided doses (See Dosage Interval Section). Dosage increases should be made in increments of no more than 1.5 mg at weekly intervals based upon the patient's blood glucose response.
No exact dosage relationship exists between GLYNASE PresTab and the other oral hypoglycemic agents, including MICRONASE or Diabeta. Although patients may be transferred from the maximum dose of other sulfonylureas, the maximum starting dose of 3 mg of GLYNASE PresTab Tablets should be observed. A maintenance dose of 3 mg of GLYNASE PresTab Tablets provides approximately the same degree of blood glucose control as 250 mg to 375 mg chlorpropamide, 250 mg to 375 mg tolazamide, 5 mg of glyburide (nonmicronized tablets), 500 mg to 750 mg acetohexamide, or 1000 mg to 1500 mg tolbutamide.
When transferring patients receiving more than 40 units of insulin daily, they may be started on a daily dose of GLYNASE PresTab Tablets 3 mg concomitantly with a 50% reduction in insulin dose. Progressive withdrawal of insulin and increase of GLYNASE PresTab in increments of 0.75 mg to 1.5 mg every 2 to 10 days is then carried out. During this conversion period when both insulin and GLYNASE PresTab are being used, hypoglycemia may occur. During insulin withdrawal, patients should test their urine for glucose and acetone at least three times daily and report results to their physician. The appearance of persistent acetonuria with glycosuria indicates that the patient is a Type I diabetic who requires insulin therapy.
GLYNASE PresTab Tablets should be added gradually to the dosing regimen of patients who have not responded to the maximum dose of metformin monotherapy after four weeks (see Usual Starting Dose and Titration to Maintenance Dose). Refer to metformin package insert.
With concomitant glyburide and metformin therapy, the desired control of blood glucose may be obtained by adjusting the dose of each drug. However, attempts should be made to identify the optimal dose of each drug needed to achieve this goal. With concomitant glyburide and metformin therapy, the risk of hypoglycemia associated with sulfonylurea therapy continues and may be increased. Appropriate precautions should be taken (see PRECAUTIONS Section).
Daily doses of more than 12 mg are not recommended.
Once-a-day therapy is usually satisfactory. Some patients, particularly those receiving more than 6 mg daily, may have a more satisfactory response with twice-a-day dosage.
GLYNASE PresTab Tablets are not recommended for use in pregnancy or for use in pediatric patients.
The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. This warning is based on the study conducted by the University Group Diabetes Program (UGDP), a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. The study involved 823 patients who were randomly assigned to one of four treatment groups (Diabetes, 19 (Suppl. 2):747–830, 1970).
UGDP reported that patients treated for 5 to 8 years with diet plus a fixed dose of tolbutamide (1.5 grams per day) had a rate of cardiovascular mortality approximately 2 1/2 times that of patients treated with diet alone. A significant increase in total mortality was not observed, but the use of tolbutamide was discontinued based on the increase in cardiovascular mortality, thus limiting the opportunity for the study to show an increase in overall mortality. Despite controversy regarding the interpretation of these results, the findings of the UGDP study provide an adequate basis for this warning. The patient should be informed of the potential risks and advantages of GLYNASE PresTab and of alternative modes of therapy.
There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with GLYNASE PresTab or any other anti-diabetic drug.
Bioavailability studies have demonstrated that GLYNASE PresTab Tablets 3 mg provide serum glyburide concentrations that are not bioequivalent to those from MICRONASE Tablets 5 mg. Therefore, patients should be retitrated when transferred from MICRONASE or Diabeta® or other oral hypoglycemic agents.
All sulfonylureas including GLYNASE PresTab are capable of producing severe hypoglycemia. Proper patient selection and dosage and instructions are important to avoid hypoglycemic episodes. Renal or hepatic insufficiency may cause elevated drug levels of glyburide and the latter may also diminish gluconeogenic capacity, both of which increase the risk of serious hypoglycemic reactions. Elderly, debilitated or malnourished patients, and those with adrenal or pituitary insufficiency, are particularly susceptible to the hypoglycemic action of glucose-lowering drugs. Hypoglycemia may be difficult to recognize in the elderly and in people who are taking beta-adrenergic blocking drugs. Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose lowering drug is used. The risk of hypoglycemia may be increased with combination therapy.
When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection or surgery, a loss of control may occur. At such times it may be necessary to discontinue GLYNASE PresTab and administer insulin.
The effectiveness of any hypoglycemic drug, including GLYNASE PresTab, in lowering blood glucose to a desired level decreases in many patients over a period of time which may be due to progression of the severity of diabetes or to diminished responsiveness to the drug. This phenomenon is known as secondary failure, to distinguish it from primary failure in which the drug is ineffective in an individual patient when GLYNASE PresTab is first given. Adequate adjustment of dose and adherence to diet should be assessed before classifying a patient as a secondary failure.
Treatment of patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency with sulfonylurea agents can lead to hemolytic anemia. Because GLYNASE PresTab belongs to the class of sulfonylurea agents, caution should be used in patients with G6PD deficiency and a non-sulfonylurea alternative should be considered. In post marketing reports, hemolytic anemia has also been reported in patients who did not have known G6PD deficiency.
Patients should be informed of the potential risks and advantages of GLYNASE PresTab and of alternative modes of therapy. They also should be informed about the importance of adherence to dietary instructions, of a regular exercise program, and of regular testing of urine and/or blood glucose.
In initiating treatment for type 2 diabetes, diet should be emphasized as the primary form of treatment. Caloric restriction and weight loss are essential in the obese diabetic patient. Proper dietary management alone may be effective in controlling the blood glucose and symptoms of hyperglycemia. The importance of regular physical activity should also be stressed, and cardiovascular risk factors should be identified and corrective measures taken where possible. Use of GLYNASE PresTab or other antidiabetic medications must be viewed by both the physician and patient as a treatment in addition to diet and not as a substitution or as a convenient mechanism for avoiding dietary restraint. Furthermore, loss of blood glucose control on diet alone may be transient, thus requiring only short-term administration of GLYNASE PresTab or other antidiabetic medications. Maintenance or discontinuation of GLYNASE PresTabs or other antidiabetic medications should be based on clinical judgment using regular clinical and laboratory evaluations.
Therapeutic response to GLYNASE PresTab Tablets should be monitored by frequent urine glucose tests and periodic blood glucose tests. Measurement of glycosylated hemoglobin levels may be helpful in some patients.
The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta adrenergic blocking agents. When such drugs are administered to a patient receiving glyburide, the patient should be observed closely for hypoglycemia. When such drugs are withdrawn from a patient receiving glyburide, the patient should be observed closely for loss of control.
An increased risk of liver enzyme elevations was observed in patients receiving glyburide concomitantly with bosentan. Therefore concomitant administration of GLYNASE PresTab and bosentan is contraindicated.
Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. When such drugs are administered to a patient receiving glyburide, the patient should be closely observed for loss of control. When such drugs are withdrawn from a patient receiving glyburide, the patient should be observed closely for hypoglycemia.
A possible interaction between glyburide and ciprofloxacin, a fluoroquinolone antibiotic, has been reported, resulting in a potentiation of the hypoglycemic action of glyburide. The mechanism of action for this interaction is not known.
Studies in rats at doses up to 300 mg/kg/day for 18 months showed no carcinogenic effects. Glyburide is nonmutagenic when studied in the Salmonella microsome test (Ames test) and in the DNA damage/alkaline elution assay.
No drug-related effects were noted in any of the criteria evaluated in the two-year oncogenicity study of glyburide in mice.
Reproduction studies have been performed in rats and rabbits at doses up to 500 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to glyburide. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Prolonged severe hypoglycemia (4 to 10 days) has been reported in neonates born to mothers who were receiving a sulfonylurea drug at the time of delivery. This has been reported more frequently with the use of agents with prolonged half-lives. If GLYNASE PresTab is used during pregnancy, it should be discontinued at least two weeks before the expected delivery date.
Gastrointestinal Reactions: Cholestatic jaundice and hepatitis may occur rarely which may progress to liver failure; GLYNASE PresTab Tablets should be discontinued if this occurs.
Dermatologic Reactions: Allergic skin reactions, eg, pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions occurred in 1.5% of treated patients during clinical trials. These may be transient and may disappear despite continued use of glyburide. If skin reactions persist, the drug should be discontinued.
Hematologic Reactions: Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia (see PRECAUTIONS), aplastic anemia, and pancytopenia have been reported with sulfonylureas.
Metabolic Reactions: Hepatic porphyria and disulfiram-like reactions have been reported with sulfonylureas; however, hepatic porphyria has not been reported with glyburide and disulfiram-like reactions have been reported very rarely.
Overdosage of sulfonylureas, including glyburide, can produce hypoglycemia. Mild hypoglycemic symptoms, without loss of consciousness or neurological findings, should be treated aggressively with oral glucose and adjustments in drug dosage and/or meal patterns. Close monitoring should continue until the physician is assured that the patient is out of danger. Severe hypoglycemic reactions with coma, seizure, or other neurological impairment occur infrequently, but constitute medical emergencies requiring immediate hospitalization. If hypoglycemic coma is diagnosed or suspected, the patient should be given a rapid intravenous injection of concentrated (50%) glucose solution. This should be followed by a continuous infusion of a more dilute (10%) glucose solution at a rate which will maintain the blood glucose at a level above 100 mg/dL. Patients should be closely monitored for a minimum of 24 to 48 hours, since hypoglycemia may recur after apparent clinical recovery.
Some patients who are initially responsive to oral hypoglycemic drugs, including glyburide, may become unresponsive or poorly responsive over time. Alternatively, glyburide may be effective in some patients who have become unresponsive to one or more other sulfonylurea drugs.
In addition to its blood glucose lowering actions, glyburide produces a mild diuresis by enhancement of renal free water clearance. Disulfiram-like reactions have very rarely been reported in patients treated with glyburide.
Single dose studies with GLYNASE PresTab Tablets in normal subjects demonstrate significant absorption of glyburide within one hour, peak drug levels at about two to three hours, and low but detectable levels at twenty-four hours.
Bioavailability studies have demonstrated that GLYNASE PresTab Tablets 3 mg provide serum glyburide concentrations that are not bioequivalent to those from MICRONASE® Tablets 5 mg. Therefore, the patient should be retitrated.
In a single-dose bioavailability study (see Figure A) in which subjects received GLYNASE PresTab Tablets 3 mg and MICRONASE Tablets 5 mg with breakfast, the peak of the mean serum glyburide concentration-time curve was 97.2 ng/mL for GLYNASE PresTab Tablets 3 mg and 87.5 ng/mL for MICRONASE Tablets 5 mg. The mean of the individual maximum serum concentration values of glyburide (Cmax) from GLYNASE PresTab Tablets 3 mg was 106 ng/mL and that from MICRONASE Tablets 5 mg was 104 ng/mL. The mean glyburide area under the serum concentration-time curve (AUC) for this study was 568 ng × hr/mL for GLYNASE PresTab Tablets 3 mg and 746 ng × hr/mL for MICRONASE Tablets 5 mg.
Mean serum levels of glyburide, as reflected by areas under the serum concentration-time curve, increase in proportion to corresponding increases in dose. Multiple dose studies with glyburide in diabetic patients demonstrate drug level concentration-time curves similar to single dose studies, indicating no buildup of drug in tissue depots.
In a steady-state study in diabetic patients receiving GLYNASE PresTab Tablets 6 mg once daily or GLYNASE PresTab Tablets 3 mg twice daily, no difference was seen between the two dosage regimens in average 24-hour glyburide concentrations following two weeks of dosing. The once-daily and twice-daily regimens provided equivalent glucose control as measured by fasting plasma glucose levels, 4-hour postprandial glucose AUC values, and 24-hour glucose AUC values. Insulin AUC response over the 24-hour period was not different for the two regimens. There were differences in insulin response between the regimens for the breakfast and supper 4-hour postprandial periods, but these did not translate into differences in glucose control.
The serum concentration of glyburide in normal subjects decreased with a half-life of about four hours.
In single dose studies in fasting normal subjects who were administered glyburide (MICRONASE Tablets) in doses ranging from 1.25 mg to 5 mg, the degree and duration of blood glucose lowering is proportional to the dose administered and to the area under the drug level concentration-time curve. The blood glucose lowering effect persists for 24 hours following single morning doses in nonfasting diabetic patients. Under conditions of repeated administration in diabetic patients, however, there is no reliable correlation between blood drug levels and fasting blood glucose levels. A one year study of diabetic patients treated with glyburide showed no reliable correlation between administered dose and serum drug level.
The major metabolite of glyburide is the 4-trans-hydroxy derivative. A second metabolite, the 3-cis-hydroxy derivative, also occurs. These metabolites probably contribute no significant hypoglycemic action in humans since they are only weakly active (1/400th and 1/40th as active, respectively, as glyburide) in rabbits.
Glyburide is excreted as metabolites in the bile and urine, approximately 50% by each route. This dual excretory pathway is qualitatively different from that of other sulfonylureas, which are excreted primarily in the urine.
Sulfonylurea drugs are extensively bound to serum proteins. Displacement from protein binding sites by other drugs may lead to enhanced hypoglycemic action. In vitro, the protein binding exhibited by glyburide is predominantly non-ionic, whereas that of other sulfonylureas (chlorpropamide, tolbutamide, tolazamide) is predominantly ionic. Acidic drugs such as phenylbutazone, warfarin, and salicylates displace the ionic-binding sulfonylureas from serum proteins to a far greater extent than the non-ionic binding glyburide. It has not been shown that this difference in protein binding will result in fewer drug-drug interactions with glyburide in clinical use.
The PresTab Tablet can be divided in half for a more flexible dosing regimen. Press gently on the score and the PresTab Tablet will split in even halves.
Diabeta is a trademark of Hoechst-Roussel Pharmaceuticals, Inc.


Note: This article is subject to changes when new deals are announced.
Who wears what in the English Premier League? Which apparel brands are dominating on the Premier League pitches? Are most shirt and sleeve sponsors gambling companies?
Below we answer those questions and more by giving you an overview of the sponsors – kit, shirt and sleeve sponsors – of the 2018/2019 Premier League clubs.
The 20 Premier League teams are sponsored by six different clothing brands. We will see Adidas, Puma, New Balance, Nike, Umbro and Under Armour on the Premier League pitches this year. In 2017/2018 there were eight different brands sponsoring Premier League kits, while there were 10 in 2016/2017.
Adidas is the main kit supplier with six teams. Manchester United, Watford, Leicester City and the three promoted sides Cardiff City, Fulham and Wolverhampton Wanderers are all sponsored by the German brand.
Adidas takes over from Puma, who held that title last season. Puma sponsors four teams. They lost both Leicester City and Huddersfield Town, to respectively Adidas and Umbro. However, they added Crystal Palace to their Premier League portfolio that already contained Arsenal (who will switch to Adidas in 2019), Burnley and Newcastle United.
Nike once again supplies four Premier League teams: Brighton & Hove Albion, defending champions Manchester City, Chelsea and Tottenham. With the latter three the American brand sponsors three of the 'traditional' and also last year's top six.
English manufacturer Umbro has four teams in their portfolio, one more than last season: Bournemouth, Everton, Huddersfield Town and West Ham United. New Balance and Under Armour each sponsor one team.
Four teams have switched brands for the upcoming season, including Crystal Palace from Macron to Puma, Wolverhampton Wanderers from Puma to Adidas and Huddersfield and Leicester from Puma to Umbro and Adidas respectively.
Gambling companies remain a favourite partner for clubs when it comes to shirt sponsorships. Nine out of 20 Premier League clubs will feature a gambling company on the front of their shirts this season. That is one more than last year. Two of the three clubs that were promoted have a gambling shirt sponsor. Burnley switched from one gambling sponsor (Dafabet) to another (Laba360) this year.
It is notable that none of the traditional top 6 has a betting or gambling logo on their shirtfronts. Gambling companies are likely willing to pay more than most non-gambling companies to partner 'smaller' clubs, while 'big' clubs have more options to choose from.
Even if they do not have a gambling shirt sponsor, all clubs seem to partner with gambling companies. Some of them even have deals with more than one firm.
Besides the gambling partners, four shirt sponsors are active in the financial service industry. While the rest of the shirt sponsors could be categorised as being active in the airline, automotive (2), duty-free shop, telecommunications or tourism (1) sector.
The companies come from around the world, with a majority having their headquarters in Asia and Europe.
Last season was the first time Premier League clubs were allowed to have sleeve sponsorships. But not all clubs had one. Arsenal for example did not, because of contractual obligations. This year the Gunners will display a 'Visit Rwanda' logo on their sleeve, which caused some controversy when it was first announced.
Manchester United will also debut a sleeve sponsor in 2018/19. Manufacturing and hospitality company Kohler will be visible on the Red Devils' sleeves.
Promoted side Wolves will have a first in sports sponsorship with the logo of a cryptocurrency exchange platform, CoinDeal, on their sleeve.
Note: Clubs will be added when the sleeve sponsor is official.
The Premier League starts in the weekend of August 11.


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Presented Testimony for RHCA | The Catholic Church's stance on abortion hurts women
June 1, 2018 by TWP
One week ago, tomorrow, Ireland, one of the most historically Catholic countries had a vote to make abortion legal. It passed by an overwhelming majority. It would seem that the citizens of Ireland know three things; 1. That women will only achieve equality when they have control over their reproduction and 2. That women deserve access to safe and legal medical health care procedures, such as abortion. 3. The Catholic Church's stance on abortion hurts women.
Right now, in America it is clear that there may be a tomorrow where women will lose their rights to safe and legal abortion. Contrary to what Speaker Mattiello and President Ruggerio may wish to believe, conservative states such as Iowa are passing restrictive abortion bills with their true goal to have them challenged at the Supreme Court, in effect a challenge to Roe v Wade. Our President has stated numerous times that he is now a supporter of the pro-life cause and we know that if given the very real chance, he will appoint another conservative pro-life judge to the supreme court bench.
The reality of this is; tomorrow in Rhode Island, women may have to resort to Pre-Roe days to receive the healthcare that they will access regardless of if abortion is illegal. In the pre-Roe days, it is estimated that 1,000 to 5,000 women died annually of unsafe, illegal abortions (Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v Wade by Carole Joffe). For the opponents of the RHCA, who say they are pro-life, we would like to remind them that women's lives have value and we deserve the right to not place ourselves in imminent danger when accessing a medical procedure. We know that when abortion is illegal, women die. Passing of the RHCA would ensure that the women in our state would have access to safe and legal abortion and contraception regardless of what happens federally. It would keep our bodies safe and ensure that we have the ability to control the outcome of our lives, financially, emotionally and physically.
Our tiny state was founded on a belief in religious freedom. Our country was founded on a separation of church and state. In RI, it would seem that the stronghold of the Catholic church, and its long arm of influence is a major prohibitor for this bill being brought to floors of the House and Senate for a vote. Is every RI citizen a person of the Catholic faith? We know this to not be true. Our state is home to people from multiple faiths, many of which do not prohibit women from making personal medical decisions about their own bodies. So why then does our state, with its history of religious freedom allow the Catholic Church the power through political pressure to impose its doctrine on all of the other people of differing religions? Is this a true separation of church and state?
If Rhode Island is a democracy, then our leaders would be doing their jobs by representing the sixty three percent of our state, (a majority) who support access to reproductive health care. They would respect the women that they represent as equals, able to make medical decisions for their own bodies without government interference. They would act pro-actively to keep RI women's bodies safe. They would ensure that the women in our state have control over their economic, emotional, and physical lives. They would separate their personal religious beliefs (and fear of retribution from the leaders of The Church) from their responsibilities to their constituents and not impose them upon us. "Democracy begins with people having full ownership of their bodies" –Gloria Steinem.
If Rhode Island is a democracy then our leaders have the ultimate obligation to ensure a tomorrow where Rhode Island women have full ownership of their bodies by bringing the RHCA to the floor of both houses for a vote.
Written by Mara Trachtenberg
for The Woman Project's submitted testimony on May 31, 2018
Full set of videos of the testimony.
Filed Under: Actions, Writing Tagged With: Abortion, Dr Merima Ruhonita, legal abortions, Lynette Labinger, Mary Ann Sorrentino, Mattiello, Representative Edie Ajello, RHCA, Roe v. Wade, Ruggerio, Senator Gayle Goldin, Senator Sue Sosnowski, written testimony
Want to get involved but don't like the common ways done in politics? That is why TWP got started! Join us in an ARTIVIST action! We need your support to thrive and make our voices heard!
The Womxn Project (TWP) is a non-profit organization in Rhode Island focused on building a strong, feminist, community-based movement to further human rights of Rhode Islanders by using art and activism to advance education and social change. TWP stirs social awareness and invites political action to inclusively further womxn's rights through creative advocacy campaigns and collaborative art projects. Read More...
Pie-Corner Talks Episode Guide
Episode #5: Humble Pie
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Welcome to Comfort Inn SeaTac Airport Hotel, a great choice of hotels in Seatac WA. Turn to us when looking for hotels near Central Washington University and hotels near downtown Seattle WA. Plus, Angle Lake is within walking distance when you stay with us.
Other attractions and points of interest near our Sea-Tac Airport shuttle hotel include Westfield Southcenter Mall, the Port of Seattle Cruise Ship Terminal and Highline Community College. We're also a quick drive from the famed Space Needle, the impressive Chihuly Garden and Glass and unique Sky View Observatory as well as Safeco Field, CenturyLink Field, Key Arena at Seattle Center and Pike Place Market.
Amenities sure to enhance any stay with us include free airport transportation, free wifi, an exercise room, a business center and guest laundry facilities. Plus, we provide a free hot breakfast with many of your favorite items. In-room amenities include coffee makers and hair dryers. Some rooms have a microwave and refrigerator.
What more could you want from your Seatac WA hotel? We're here for you when you need a great accommodations experience for business or pleasure at Comfort Inn SeaTac Airport. May we be of service to you?
Looking for the best choice of business hotels in Seatac, Washington? Need an affordable choice in hotels near downtown Seattle WA? When you're looking for a place for your business needs, you'll find a pleasant, comfortable and affordable experience at our Comfort Inn. Ours is an affordable Sea-Tac Airport hotel where everything is designed with every kind of traveler in mind. It's also right where you want to be to enjoy the many other attractions and points of interest in the area if you have some downtime. Why not book a room now? We want to be your home away from home in the Seattle area at our Comfort Inn.
Stay with us and leave your car on our property while you fly. We offer long-term parking at our Sea-Tac Airport shuttle hotel. While there are other Seatac, Washington hotels that also provide that service, none come with the Comfort Inn and Suites commitment to excellence, which includes great comfort, convenient and amenities. When looking for hotels in Seatac WA or near Seattle, choose our hotel and get airport park and fly options that will save you money, time and hassles. Nothing means more to us than providing a great experience for you and your family or colleagues, and that starts with our free airport transportation and available long-term parking options.
For the best hotel deal on group booking, choose our convenient and affordable Comfort Inn. No other hotels in Seatac WA provide a better rate for one night or several and for one room or many. With prices of everything as they are these days, you need to save any way to can. If you're looking for Sea-Tac Airport motels that can offer you an affordable hotel stay as well as the comfort and convenience you deserve, we're here for you. In fact, we're here no matter why you're visiting the area. We believe that you won't find any other hotel in the surrounding area that better meets your needs while being as easy on your pocketbook.
Seatac hotels near the Light Rail Link station aren't all the same. Neither are hotels near Central Washington University. But you already know that if you've stayed in the area before. The fact that you're looking for something better means you must have had a bad experience before. As the best of the motels near Seattle WA, we want to serve you. Why not book a room with us and see how you can have a comfortable stay at a price that fits within any budget and still access easily the very best of what this area has to offer?
This website is owned and maintained by Comfort Inn SeaTac Airport, a licensed user of certain proprietary trademarks and service marks of independent franchisees of Choice Hotels International, Inc.


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Cleveland Clinic appoints two executives to new posts
SHANNON MORTLAND
The Cleveland Clinic has appointed two of its executives to new leading positions within the system. Dr. Marc Harrison, who most recently was the Clinic's director of medical operations and vice chairman of professional staff affairs, has been named chief medical operations officer. In his new role, he will continue to oversee medical and clinical operations in addition to heading physician alignment and integration initiatives throughout the health system. William "Bill" Peacock III, whose latest role at the Clinic was executive director for operational support services, has been named chief of operations. Under his new title, he'll be responsible for the system's facilities and services. Together, they will be charged with making the Clinic more efficient, reducing expenses and coordinating all efforts to improve operations and the medical delivery system. David Strand, the Clinic's chief operating officer, announced this month he will be leaving the Clinic to return to his home state of California. His duties have been split between the new positions occupied by Dr. Harrison and Mr. Peacock.


As part of All Together Now, the festival supported the new commission from Hannah James – Jig Doll.
This was Hannah's first solo project that combines her musical and dance talent. Jig Doll was premiered at the 2015 festival.


US – Nielsen has released its Shopper Essentials Suite, a web-based data visualisation and analysis tool to gain insight on shopper behaviour across retail channels and categories.
It will give clients a simple online platform to help them make real-time decisions about consumer shopping preferences.
The Shopper Essentials Suite brings its Store Choice Drivers and Category Shopping Fundamentals together on a single platform and expands insight to the ecommerce space with Digital Shopping Fundamentals, available for the first time.
Store Choice Drivers gives an analysis of why shoppers choose one store over another and how they engage with these stores in-store and; Category Shopping Fundamentals helps clients understand what may drive category purchase decisions and how to help influence these decisions pre-store and in-store; and Digital Shopping Fundamentals allows clients to understand shoppers' ecommerce path to purchase by looking at the online shopper and e-tailer environment.
Hin-Lo Lau, vice-president consumer and shopper analytics US, Nielsen said: "We're providing clients with the confidence to take swift, decisive action to cultivate business both online and offline.
"For manufacturers this means you are equipped with the confidence to build stronger relationships with your retailer partners, and win over shoppers. If you're a retailer, it's about growing your customer base through category activation in-store and digitally. "


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Erlanger-Elsmere Grade School Boys' Basketball League
The Erlanger-Elsmere Grade School Boys' Basketball League still has an opening for two schools that would each be interested in placing one 4th grade team and one 5th grade team into the league. To be admitted into the league, a school must be able to enter a team at both grade levels. The entry fee is $600.00 per team, and it must be paid upon acceptance into the league and no later than July 25, 2017. Games are played at Lloyd High School on Saturday mornings from November through February. Teams will play an 11-game regular season schedule with an all-inclusive, season-ending tournament to follow.
For more information, please call R. K. Tyler at 859.640.3404.


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Irsay: Andrew Luck's shoulder will be 'completely healed' for next season
Posted 8:48 PM, March 27, 2017, by Mike Chappell, Updated at 08:50PM, March 27, 2017
INDIANAPOLIS, IN - AUGUST 20: Andrew Luck #12 of the Indianapolis Colts is seen on the sidelines during the game against the Baltimore Ravens at Lucas Oil Stadium on August 20, 2016 in Indianapolis, Indiana. (Photo by Michael Hickey/Getty Images)
INDIANAPOLIS, Ind. – Amid the influx of free agents and the retention of selected players, one name stands above the rest when discussing the Indianapolis Colts' off-season: Andrew Luck.
The franchise cornerstone and highest-paid player in NFL history – he's the $140 million quarterback, remember? – underwent surgery in mid-January to address a lingering injury to his right shoulder.
Worry not, insisted owner Jim Irsay. While the Colts won't hasten Luck's return, they expect him to be ready for the start of the season.
"We are not going to be rushing him,'' Irsay told Colts.com Monday during a break from the NFL owners meetings in Phoenix. "We are going to make sure, obviously, that the shoulder has to be ready and the doctors are going to give full approval before he starts putting real reps on it.
"This is going to be a real benefit in the long run. We really feel that he's going to be completely healed for the season and he's going to have a great season.''
Irsay added the Colts might carry an additional quarterback in training camp if they decide it's prudent to ease Luck's preseason workload. The other QBs on the roster are Scott Tolzien and Stephen Morris.
The Colts open their off-season conditioning program April 17 with the organized team activity (OTA) portion set for May. It's uncertain how much throwing Luck will be allowed to do before training camp opens in late July.
Luck has dealt with an unspecified injury to his right shoulder for the better part of the last two seasons. It's believed he initially was injured in week 3 of 2015 at Tennessee and aggravated it at some point last season.
Luck appeared on the injury report each week last year with a variety of injuries: right shoulder, right elbow, right thumb, left ankle and a concussion. He suffered the concussion Nov. 20 against the Titans that kept him out of the Nov. 24 game against Pittsburgh. Of the team's 48 practice reports, he was a full participant 24 times, limited 19 times and held out entirely on five occasions.
Despite the rash of injuries that limited his practice time, Luck pieced together an elite season. He passed for 4,240 yards with 31 touchdowns and 13 interceptions. He set career highs in completion percentage (63.5) and yards per attempt (7.8).
Luck also has thrown a touchdown pass in 23 consecutive games, the NFL's longest active streak.
"I don't think people realized how much he had to work to get ready to play each week . . . it was very mentally draining to get ready,'' Irsay said.
The surgery, he added, "went great. The labrum, the bicep (were) pristine. There was no problem there. Things could not have gone better, up to this point, from a medical standpoint. But we are going to be depending on our medical people and the doctors in how we pace him into things.''
Luck attempted to downplay his physical well-being after the Colts closed last season with a 24-20 win over the Jacksonville Jaguars.
Asked if fans should be concerned about his shoulder, he responded, "No, I do not think so.''
He was more distressed over the Colts finishing 8-8 for a second straight season and missing the playoffs in consecutive seasons for the first time since 1997-98.
"Disappointed in myself,'' he said. "I feel like I could have done better and maybe have helped this team end with a different record, but the reality is we didn't. There are certainly some games I feel like I could have played better and you go around the locker room and everybody is going to say that.
"Close the chapter on this season, this year of the Colts, and hopefully we can start a new one in better fashion.''
That hinges on Luck making a full recovery in time for the season-opener in early September.
Filed in: Colts, Sports
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Another Colts' Super Bowl parade? Jim Irsay: It will happen
Colts taking it slow and easy with Andrew Luck's strained calf
Colts' overriding roster objective: eliminating 'weak links'
Previewing the Colts' offensive line ahead of training camp
Frank Reich's objective: Take a good Colts' run game and make it great (or at least top-5)
Colts aren't in panic mode as strained calf continues to keep Andrew Luck out of practice
Ebron hosts football camp, connects with young Colts fans
Previewing Indianapolis Colts training camp: Quarterbacks
Colts' Dwight Freeney to be inducted into Ring of Honor on Nov. 10
On Colts' health front, all signs positive for Jack Doyle, Clayton Geathers, Deon Cain


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text:
Q: Cant return variable in recursive function javascript HI guys im  creating a Phonegap program that is using a javascript function to return the values colected in the database , the problem is that i cant return the values becouse they are in a recursive function , everytime a call the main function it doesnt retusn anything
the code is:
function exporta_imoveis(){
  var db = window.openDatabase("Ithomes", "1.0", "Cordova Demo", 200000);
  db.transaction(function coletandovisitas(tx){
    alert('Coletando imoveis no BD local ');
    tx.executeSql('SELECT * FROM IMOVEIS', [], function percorrendolinhas(tx, results){
      var len = results.rows.length;
      var array_retorno = new Array();
      for (var i=0; i<len; i++){
        array_retorno[i] = results.rows.item(i);
      }
      return array_retorno;
    }, function err(){ alert('erro ao coletar') } );
  },function erro(){ alert('erro ao coletar dados dos imoveis') }, function acerto(){ alert('Dados dos imoveis coletadas com sucesso')} );
}

I need to get the value of array_retorno variable, please help

A: The problem you're experiencing has nothing to do with recursion but with asynchronous functions. The function percorrendolinhas that you pass to executeSql will get executed when your database action is finished but the rest of your mainfunction will probably be executed first. Therefore you should use a callback:
function exporta_imoveis(callback){
  var db = window.openDatabase("Ithomes", "1.0", "Cordova Demo", 200000);
  db.transaction(function coletandovisitas(tx){
  alert('Coletando imoveis no BD local ');
  tx.executeSql('SELECT * FROM IMOVEIS', [], function percorrendolinhas(tx, results){
    var len = results.rows.length;
    var array_retorno = new Array();
    for (var i=0; i<len; i++){
      array_retorno[i] = results.rows.item(i);
    }
    callback(array_retorno);
  }, function err(){ alert('erro ao coletar') } );
  },function erro(){ alert('erro ao coletar dados dos imoveis') }, function acerto(){ alert('Dados dos imoveis coletadas com sucesso')} );
}

You can call your function now in the following way:
exporta_imoveis(function (array_retorno) {
   //do something with array_retorno
});

A: I'm a bit confused by the names and what you're trying to achieve, but if you pass a callback as follows:
function exporta_imoveis(callback){
  var db = window.openDatabase("Ithomes", "1.0", "Cordova Demo", 200000);
  db.transaction(function coletandovisitas(tx){
    alert('Coletando imoveis no BD local ');
    tx.executeSql('SELECT * FROM IMOVEIS', [], function percorrendolinhas(tx, results){
      var len = results.rows.length;
      var array_retorno = new Array();
      for (var i=0; i<len; i++){
        array_retorno[i] = results.rows.item(i);
      }
      callback(array_retorno);
    }, function err(){ alert('erro ao coletar') } );
  },function erro(){ alert('erro ao coletar dados dos imoveis') }, function acerto(){ alert('Dados dos imoveis coletadas com sucesso')} );
}

you should then be able to do:
exporta_imoveis(function(array_retorno) {
  // here you will have array_retorno, do what you need on it
});

If you don't want to pass a callback function then @MBillau is an alternative approach.
Just a pointer about how you could simplify the structure: try to use named functions defined outside the portion of code where the main logic is, like so:
function coletandovisitas(tx){
  alert('Coletando imoveis no BD local ');
  tx.executeSql('SELECT * FROM IMOVEIS', [], function percorrendolinhas(tx, results){
    var len = results.rows.length;
    var array_retorno = new Array();
    for (var i=0; i<len; i++){
      array_retorno[i] = results.rows.item(i);
    }
    callback(array_retorno);
}

function exporta_imoveis(callback){
  var db = window.openDatabase("Ithomes", "1.0", "Cordova Demo", 200000);
  db.transaction(coletandovisitas, function err(){ alert('erro ao coletar') } );
  },function erro(){ alert('erro ao coletar dados dos imoveis') }, function acerto(){ alert('Dados dos imoveis coletadas com sucesso')} );
}

Seems like a bit more clear.

A: I think you can move var array_retorno = new Array(); outside of the exporta_imovis function. Right now you cannot access the data because that variable only exists in the scope of your coletandovisitas function - as soon as you leave this function, the variable goes away.

redpajama_set_name: RedPajamaStackExchange


text:
Stop Packing Abscesses!
By Damian Baalmann, M.D.
Written by Damian Baalmann, M.D. and reviewed by Dustin Leigh, M.D.
A 49 year-old, previously healthy female presents to your emergency department with chief complaint of a boil on her left thigh. Otherwise, the patient denies any fevers, chills, systemic symptoms. The patient first noted this boil 3 days ago and it has since grown in size and is painful to touch. Vitals reveal that she is normotensive, not tachycardic, afebrile and satting well on room air. Exam reveals 4-cm tender, fluctuant, erythematous nodule on the lateral aspect of the mid left thigh. No apparent overlying cellulitis or lymphadenopathy and the rest of the physical exam is within normal limits. Quick look with bedside ultrasound confirms your suspicion of a non-loculated, cutaneous, drainable abscess. Your nursing staff has kindly already brought lidocaine/epinephrine, a scalpel, 25-gaugle needle, syringe, normal saline, and for some reason, packing supplies to the bedside.
To Pack or Not To Pack
Abscesses are the most common dermatological conditions managed by emergency physicians. [1] Treatment of an abscess is drainage and may involve irrigation, primary versus secondary closure, and antibiotic treatment. The intricacies of the techniques (large incision vs small incision), irrigation, closure, and antibiotic treatment are generally case dependent and not supported with robust literature and will not be discussed in this post. The topic of this post is whether to pack or not to pack cutaneous abscesses. Historically, cutaneous abscesses have been packed sterilely with wicks to promote epithelial lining of the abscess cavity and to prevent entrapment of the bacteria in the abscess. Typically, the patient would then be instructed to return to the emergency department for repacking or sent home with packing materials to self-pack until the wound has healed.
It has been argued that there is no evidence-based science behind packing of cutaneous abscesses that have been incised and drained. Because of this lack of evidence, two randomized controlled trials have somewhat recently been performed.
O'Malley et al. performed a RCT of 48 patients in 2009. All 48 patients had abscesses <5-cm and were incised, drained, had loculations broke-up, and washed as per provider discretion. Additionally all patients were given antibiotics and pain medicine. Twenty-three of these patients were assigned to a packing group whose abscesses were packed with iodoform gauze and 25 patients to a non-packing group whose abscesses were covered with sterile gauze and tape. Primary outcome was need for intervention at return visit 48-hours after enrollment and there was no significant difference between the groups. Secondary outcomes included pain scores pre-procedure, post-procedure, and 48 hours post-procedure. While there was no significant difference in pre-procedure pain, there was significantly higher pain in the packed group in both the post-procedure and 48 hour post-procedure groups. Additionally, the packed group took on average 2.19 more Percocet pills (p=0.03) than their non-packed counterparts. [2]
Kessler et al. performed a RCT of 57 pediatric and adult patients (average age: 18y/o) in 2012. In this study, patients underwent I&D in a somewhat standardized fashion and 29 patients were randomized into a packing group and 28 were randomized to non-packing. Some were lost to follow-up, but the rest were re-evaluated at 48 hours, 1 week, and 1 month. Failure rates at 48 hours were high in both groups (70% in the packed group and 59% in the non-packed group) but were not significantly different. There was also no significant difference in need for interventions, reoccurrence of abscesses, pain differences, and return to the emergency department. [3]
In 2011, Schmitz et al surveyed 350 emergency medicine providers regarding abscesses and found that 91% of these providers still packed abscesses following I&D. [4]
Upon our review of the current literature we found insufficient evidence to support routine packing of subcutaneous abscess. While most studies have been small with few RTC's there does not appear to be evidence of increased recurrence of abscesses when not packed. However, multiple studies do identify increased patient discomfort. There is probably no benefit to packing cutaneous abscesses as it does not appear to prevent reoccurrence of abscesses or decreasing further intervention at follow-up. There is probably harm with packing abscesses as may be an associated increase in pain post-procedure and at 48-hour follow-up. Bottom line: do not pack cutaneous abscesses.
Case Revisited
You opt to not reach for the packing gauze on the table and send the patient out after I&D. After return instructions are given, she leaves with an understanding to return if worsening or not improving.
Want to know more about abscesses? Check out this great review article about "Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus" [5]
Niska, R., F. Bhuiya, and J. Xu, National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. National health statistics reports, 2010(26): p. 1-31.
O'Malley, G.F., et al., Routine packing of simple cutaneous abscesses is painful and probably unnecessary. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2009. 16(5): p. 470-3.
Kessler, D.O., A. Krantz, and M. Mojica, Randomized trial comparing wound packing to no wound packing following incision and drainage of superficial skin abscesses in the pediatric emergency department. Pediatric emergency care, 2012. 28(6): p. 514-7.
Schmitz, G., et al., The treatment of cutaneous abscesses: comparison of emergency medicine providers' practice patterns. The western journal of emergency medicine, 2013. 14(1): p. 23-8.
Singer, A.J. and D.A. Talan, Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus. The New England journal of medicine, 2014. 370(11): p. 1039-47.
deshandrap11
@deshandrap11
Posts: 1 Joined: Sep 10, 2018
Posted by deshandrap11 @deshandrap11, Sep 9, 2018
I had the iodoform packing and it came out three incisions in my left arm what should i do to care for the wound after gauze has come out ? The wound is deep should i still bandage it after soaking in antibacterial soap?
kaylid96
@kaylid96
Posted by kaylid96 @kaylid96, Sep 27, 2019
In reply to @deshandrap11 "I had the iodoform packing and it came out three incisions in..." + (show)- (hide)
Jump to this post
Did it hurt when you had to pull out the packing? Should I do it myself like they said, or does it hurt to bad? should I go back to the and let them do it?


Spectrum (Radio New Zealand National, 12.15pm). It's 150 years since Gabriel Read started the gold stampede in New Zealand. Read heard there was gold in them thar hills so he headed east from Tasmania and staked a claim on a lonely spur behind Evans Flat. As he dug a hole in the stream, he later wrote, "the gold was shining like the stars in Orion on a dark and frosty night". Within months, thousands of hopeful diggers had turned Gabriels Gully into a shantytown built more on hopes and dreams than on any real promise of a fortune. In Gabriel's Gold, Deborah Nation joins descendants of the miners in Gabriels Gully near the Central Otago township of Lawrence in commemoration.
The Sunday Feature (Radio New Zealand National, 4.07pm). Despite the brave efforts of Rosa Parks, who refused to switch seats on a bus in Montgomery, Alabama, and started the movement that led to racial integration in the US, some things haven't changed much. Back of the Bus: Mass Transit, Race and Inequality looks at the re-emergence of equal access to transport as a civil rights issue for Blacks and Latinos in America.
Music Alive (Radio New Zealand Concert, 8.00pm). The New Zealand School of Music Christchurch Earthquake Benefit Concert took place in Wellington's Ilott Theatre on April 8 and was dedicated to friends and colleagues devastated by the February earthquake. Violinist Martin Riseley, head of strings at the NZSM, was raised in Christchurch and viola player Donald Maurice has many links with the city. They were joined by the New Zealand String Quartet's Helene Pohl (violin) and Rolf Gjelsten (cello) in a performance of Garden City resident John Ritchie's String Quartet. The programme also featured Chris Cree Brown's Inner Bellow, for solo clarinet and electronic sounds, performed by Christchurch clarinettist Gretchen Dunsmore. NZSM jazz staff were joined by Christchurch Jazz School's Darren Pickering (piano) and Ted Meager (drums) to perform works by Christchurch musicians. On the night of the concert Meager's drums were still locked in the red-stickered Christchurch Jazz School.
Nine to Noon with Kathryn Ryan (Radio New Zealand National, 10.45am). Kevin Milne – our relentless enforcer of the fair go – begins part one of an eight-part adaptation of his autobiography, The Life and Times of a Brown Paper Bag, this morning. From London news hack in the 1970s to Officer of the New Zealand Order of Merit for all-round broadcasting fabulousness in 2007, Milne has had his highs and lows, both personal and professional. And there's a brown paper bag in there somewhere.
Music Alive (Radio New Zealand Concert, 8.00pm). Tonight it's the New Zealand première of Christopher Blake's Northland Panels, performed by Peter Scholes and the Auckland Chamber Orchestra and recorded in the Auckland Concert Chamber. This is the first time the four parts of the work – Angel at Ahipara, Night Journey to Pawarenga, Christ at Whangape and Anthem on the Kaipara – have been performed together. All are inspired by images by renowned photographer Robin Morrison.


text:
Philanthropy and the Destructive Illusion of "Leveling the Playing Field"
by Vu Le, on 8/24/18 8:00 AM
Image by StockSnap on Pixabay
A few months ago a program officer and I were talking about the lack of funding that goes to communities-of-color-led nonprofits (only about 10% of philanthropic dollars go to organizations of color). He shook his head in sympathy and frustration, sipping on his coffee. "There has to be a way to level the playing field," he said. This was probably the third time that quarter I had heard that phrase uttered by a funder.
This concept of "Leveling the Playing Field" is very present in our sector in our society, like cats or skinny jeans, and we don't really question it at all. We assume that it is a good thing. If we just make it so that competitions are "fair," then the people/groups with the most merit, the best ideas and proposals, will win. If we can just make the field more even, then everyone will be able to play the game and everything is good.
This philosophy has led some thoughtful funders to accept applications in Spanish or other languages, accept handwritten applications, or accept non-written formats such as videos or photos. (Although, how effective is this last one when my one-man show, The Agony and Ecstasy of Capacity Building, has never resulted in funding?).
Those practices are great, but can they level the playing field? Can the funding field ever be "level"?
I say no. The funding field can never ever truly be leveled, and the hopeful belief that it can has been preventing us from making profound changes in funding practices that would lead to resources going to the communities that are most affected by injustice. I know it is nice to believe that we can achieve an even, fair, unbiased competitive process, but the reality is that the combination of unconscious biases, the capacity paradox, and unequal access to relationships with funders will make sure that there is no possible way we can truly reach a state where all organizations, including ones led by marginalized communities, can "fairly" compete for funding:
Unconscious biases: All of us are unconsciously biased in one way or another. There have been lots of studies on this. For example, the often-cited one showing that resumes with black-sounding names in an experiment are significantly less likely to move to the interview round, even though the resumes are exactly the same as the ones with white-sounding names.
If we did a similar experiment (and we should) where we have the same grant proposals, but some are from organizations perceived to be more "mainstream," and others with organizations perceived to be more "minority," I'm pretty sure we will have similar results. This does not mean that people are bad—because, again, all of us have unconscious biases (Find out yours through this online test designed by Harvard)—but we all need to acknowledge that our implicit biases will ensure that we will never ever be completely objective when determining which organizations to fund.
Capacity Paradox: Even if the field were perfectly level, it does not mean that everyone will be able to compete equally. Organizations have different levels of capacity. Some have a team of development and grantwriting staff while others have one or two or no paid staff in total. Some have staff who are well-trained in fund seeking; others rely on volunteers who have never written a grant proposal before. Some nonprofit leaders have authored dissertations; others are starting to learn English. To expect them to compete with each other is like expecting someone who hasn't eaten in 12 days to race against a well-fed, trained, and rested person. It doesn't matter if the tracks are "level." Even giving the hungry person a head start may not be enough to compensate.
The sad thing, if we want to extend the analogy, is if these two people are competing for food. Winner gets to eat, which creates a horrible cycle where the starving person continues to starve. Sadly, that's exactly what it's like in our current funding system, where the Capacity Paradox is the default: organizations that do not have capacity to get resources continue to struggle to get resources to develop their capacity, no matter how "fair" we try to make the race.
Unequal access to relationships: Relationships are critical in sector. The best services, programs, collaborations, boards, office culture—everything—are grounded by strong relationships. I have seen many amazing program officers develop strong and trusting professional relationships with nonprofit leaders from marginalized communities, leading to critical funding for these communities.
But still, the reliance on relationships can be extremely harmful. The competition for relationships is just as inequitable as the competition for money, and smaller, grassroots organizations led by marginalized communities will simply not have as much time or as many staff to devote to developing relationships with funders. When the ED is literally unloading sacks of potatoes to give to hungry families, as I saw a colleague do when I was checking in on her one day, it is hard for them to find the extra time or energy required to form strong relationships that may lead to funding.
The combination of these and others reasons, such as cultural differences in communication, ensure that we will never be able to reach this "level playing field" in the funding landscape no matter how hard we try. The belief that a level playing field is achievable often results in bizarre situations, such as my organization, a capacity building and leadership org, once having to compete with a preschool program for the same fund.
More seriously, the belief is dangerous because it weaves an illusion of equity and allows us to be complacent. Accepting applications in another language is great, but will it actually lead to profound organizational or systems changes that true equity requires?
Again, I say no. If a rule or process is inequitable to begin with, making exceptions instead of trying to change the rule or process still reinforces the inequity.
So what's the alternative? The solution that true equity demands is to create entirely new fields, fields that are targeted specifically for the communities that are most affected by systemic injustice. Funders must help figure out which communities are experiencing the most inequity, then target significant long-term funding specifically toward organizations and movements that are visibly led by and serving those communities, demonstrated by the majority of their board and staff, not just their clients, being from those communities.
What does this look like? Here are some examples:
If your foundation cares about the tragically high rates of missing Native women, then create a significant, multi-year fund that can ONLY be accessed by organizations led by Native/indigenous people to address this critical issue. Make it very clear that every applicant must have at least 75% of their board and staff be Native. Disqualify all organizations from consideration that do not meet this basic criterion.
If your foundation cares about the horrifically high rates of black men being unjustly incarcerated, then create a significant, multi-year fund that can ONLY be accessed by organizations led by and serving the black community. Make it very clear that every applicant must have at least 75% of their board and staff be black. Disqualify all organizations from consideration that do not meet this basic criterion.
If your foundation wants to address the constant employment discrimination faced by people with disabilities, then create a significant, multi-year fund that can ONLY be accessed by organizations led by people with disabilities. Make it very clear that every applicant must have at least 75% of their board and staff be people with disabilities. Disqualify all organizations from consideration that do not meet this basic criterion.
If your foundation cares about the potential political and economic ramifications of the undercounting of immigrant and refugee residents in the upcoming 2020 Census, then create a significant, multi-year fund that can ONLY be accessed by organizations led by immigrants and refugees. Make it very clear that every applicant must have at least 75% of their board and staff be immigrants and refugees. Disqualify all organizations from consideration that do not meet this basic criterion.
You get the idea. 75% is a number I threw out there, based on my general belief that 75% is a decent percentage to say that an organization is legitimately led by certain communities, but we can debate over that. There are plenty of valid exceptions; for example, a community may be small so may not yet be able to reach this 75% threshold of board/staff representation, yet they are clearly led by and serving that community.
What I don't want to debate is the tedious and predictable argument that leaders from marginalized communities have been hearing from funders for decades:
"Well, we can't invest significant, multi-year funding in y'all because you don't have the capacity. You don't have strong financial and other systems to handle large investments. Here's 10K to help you hire a consultant to develop a strategic plan that will likely never be implemented because we won't fund staffing. Please apply again; next cycle we accept applications in slam poetry format to make it more accessible to diverse applicants!"
This attitude has been trapping nonprofits led by marginalized communities in the Capacity Paradox, and then these same funders often complain about the lack of diversity in the sector.
It's frustrating. Honestly, the leaders from marginalized communities that I have been talking to are really sick and tired of competing in foundations' "fair and open processes" that have historically been leading to the dismal rates of philanthropic dollars going to communities of color (1.4% going to black-led orgs, 1.48% going to Latinx-led orgs, one-half percent going to Native/Indigenous-led orgs). Philanthropy's "fair and open" grantmaking process is a destructive illusion that has been perpetuating the very inequity philanthropy is trying to solve.
This pervasive and harmful "level playing field" belief needs to end. The playing field will never be level. EVER. Stop hoping it will be. And even if it does for some miraculous reason become level, it would still further the default Hunger-Games-based model of funding distribution that is fundamentally bad.
Do not try to level the playing field. Create new fields. And let's start ending competition-based grantmaking altogether. Just as nonprofits do not generally force our clients to compete with one another to get services, but rather we target services to the individuals and families who most need help, funders must do the same thing. Stop forcing us to compete with one another in a misguided attempt to appear "fair," and do the hard work of identifying where the greatest needs are, providing significant funds to community-led organizations and movements, treating them as partners, and helping them to succeed.
Vu Le's column, Point of Vu, appears monthly in the GuideStar Blog. This article is a cross-post of an August 19, 2018, piece from his blog, Nonprofit ... And Fearless. Vu Le is a writer, speaker, vegan, Pisces, and the executive director of Rainier Valley Corps, a nonprofit in Seattle with the mission of developing and supporting leaders of color to strengthen the capacity of communities-of-color-led nonprofits and foster collaboration between diverse communities to effect systemic change.
Topics: Diversity, Equity, and Inclusion DEI


text:
require 'pact/matchers'
require 'pact/consumer/request'
require 'pact/mock_service/interactions/interaction_mismatch'
require 'pact/consumer_contract'
require 'pact/mock_service/response_decorator'
require 'pact/mock_service/interaction_decorator'
require 'pact/mock_service/request_handlers/base_request_handler'

module Pact
  module MockService
    module RequestHandlers

      module PrettyGenerate
        #Doesn't seem to reliably pretty generate unless we go to JSON and back again :(
        def pretty_generate object
          begin
            JSON.pretty_generate(JSON.parse(object.to_json))
          rescue
            object.to_s
          end
        end
      end

      class InteractionReplay < BaseRequestHandler
        include Pact::Matchers
        include PrettyGenerate

        attr_accessor :name, :logger, :expected_interactions, :actual_interactions, :verified_interactions, :multiple_interactions_handler

        def initialize name, logger, session, cors_enabled = false, stub = false
          @name = name
          @logger = logger
          @expected_interactions = session.expected_interactions
          @actual_interactions = session.actual_interactions
          @verified_interactions = session.verified_interactions
          @cors_enabled = cors_enabled
          @multiple_interactions_handler = stub ? HandleMultipleInteractionsFoundForStub : HandleMultipleInteractionsFound
        end

        def match? env
          true # default handler
        end

        def respond env
          find_response request_as_hash_from(env)
        end

        private

        def find_response request_hash
          actual_request = Pact::Consumer::Request::Actual.from_hash(request_hash)
          logger.info "Received request #{actual_request.method_and_path}"
          logger.debug pretty_generate request_hash
          candidate_interactions = expected_interactions.find_candidate_interactions actual_request
          matching_interactions = candidate_interactions.matching_interactions actual_request

          case matching_interactions.size
          when 0 then handle_unrecognised_request actual_request, candidate_interactions
          when 1 then handle_matched_interaction matching_interactions.first
          else
            handle_more_than_one_matching_interaction actual_request, matching_interactions
          end
        end

        def handle_matched_interaction interaction
          HandleMatchedInteraction.call(interaction, verified_interactions, actual_interactions, logger)
        end

        def handle_more_than_one_matching_interaction actual_request, matching_interactions
          multiple_interactions_handler.call(actual_request, matching_interactions, verified_interactions, actual_interactions, logger)
        end

        def handle_unrecognised_request actual_request, candidate_interactions
          HandleUnrecognisedInteraction.call(actual_request, candidate_interactions, actual_interactions, logger)
        end

        def logger_info_ap msg
          logger.info msg
        end

      end

      class HandleMultipleInteractionsFound

        extend PrettyGenerate

        def self.call actual_request, matching_interactions, verified_interactions, actual_interactions, logger
          logger.error "Multiple interactions found for #{actual_request.method_and_path}:"
          matching_interactions.each do | interaction |
            logger.debug pretty_generate(Pact::MockService::InteractionDecorator.new(interaction))
          end
          response actual_request, matching_interactions
        end

        def self.response actual_request, matching_interactions
          response = {
            message: "Multiple interaction found for #{actual_request.method_and_path}",
            matching_interactions:  matching_interactions.collect{ | interaction | request_summary_for(interaction) }
          }
          [500, {'Content-Type' => 'application/json'}, [response.to_json + "\n"]]
        end

        def self.request_summary_for interaction
          summary = {:description => interaction.description}
          summary[:provider_state] if interaction.provider_state
          summary[:request] = Pact::MockService::RequestDecorator.new(interaction.request)
          summary
        end
      end

      class HandleMultipleInteractionsFoundForStub

        extend PrettyGenerate

        def self.call actual_request, matching_interactions, verified_interactions, actual_interactions, logger
          logger.warn "Multiple interactions found for #{actual_request.method_and_path}:"
          matching_interactions.each do | interaction |
            logger.debug pretty_generate(Pact::MockService::InteractionDecorator.new(interaction))
          end
          response actual_request, matching_interactions, verified_interactions, actual_interactions, logger
        end

        def self.response actual_request, matching_interactions, verified_interactions, actual_interactions, logger
          logger.warn "Sorting responses by response status and returning first."
          interaction = first_most_successful_interaction(matching_interactions)
          HandleMatchedInteraction.call(interaction, verified_interactions, actual_interactions, logger)
        end

        def self.first_most_successful_interaction matching_interactions
          matching_interactions.sort{ |i1, i2| Pact::Reification.from_term(i1.response.status) <=> Pact::Reification.from_term(i2.response.status) }.first
        end
      end

      class HandleUnrecognisedInteraction

        def self.call actual_request, candidate_interactions, actual_interactions, logger
          interaction_mismatch = interaction_mismatch(actual_request, candidate_interactions)
          if candidate_interactions.any?
            actual_interactions.register_interaction_mismatch interaction_mismatch
          else
            actual_interactions.register_unexpected_request actual_request
          end
          log interaction_mismatch, logger
          response interaction_mismatch
        end

        def self.response interaction_mismatch
          response = {
            message: "No interaction found for #{interaction_mismatch.actual_request.method_and_path}",
            interaction_diffs:  interaction_mismatch.to_hash
          }
          [500, {'Content-Type' => 'application/json'}, [response.to_json + "\n"]]
        end

        def self.interaction_mismatch actual_request, candidate_interactions
          Pact::MockService::Interactions::InteractionMismatch.new(candidate_interactions, actual_request)
        end

        def self.log interaction_mismatch, logger
          logger.error "No matching interaction found for #{interaction_mismatch.actual_request.method_and_path}"
          logger.error 'Interaction diffs for that route:'
          logger.error(interaction_mismatch.to_s)
        end

      end

      class HandleMatchedInteraction

        extend PrettyGenerate

        def self.call interaction, verified_interactions, actual_interactions, logger
          actual_interactions.register_matched interaction
          verified_interactions << interaction
          response = response_from(interaction.response)
          logger.info "Found matching response for #{interaction.request.method_and_path}"
          logger.debug pretty_generate(Pact::MockService::ResponseDecorator.new(interaction.response))
          response
        end

        def self.response_from response
          [response.status, (Pact::Reification.from_term(response.headers) || {}).to_hash, [render_body(Pact::Reification.from_term(response.body))]]
        end

        def self.render_body body
          return '' if body.nil?
          body.kind_of?(String) ? body.force_encoding('utf-8') : body.to_json
        end
      end
    end
  end
end

redpajama_set_name: RedPajamaGithub


text:
Frederik van Oranje-Nassau, zie aldaar.
Cultureel Maçonniek Centrum 'Prins Frederik', een vrijmetselaarsmuseum, -bibliotheek en archief van de Orde van Vrijmetselaren onder het Grootoosten der Nederlanden
Prins Frederik (batterij), voorheen de "Batterij aan den hoek van Barend Kribbing"
Fort Prins Frederik, een fort in de Stelling van het Hollandsch Diep en het Volkerak

redpajama_set_name: RedPajamaWikipedia