9 research outputs found
Early versus later response to treatment in patients with community-acquired pneumonia: analysis of the REACH study
No full textBACKGROUND:
Key goals in the treatment of CAP include early response to treatment and achievement of clinical stability. The US FDA recommends early response endpoints (72 hours after initiation of treatment) in clinical trials for the treatment of community-acquired bacterial pneumonia. REACH (REtrospective Study to Assess the Clinical Management of Patients With Moderate-to-Severe Complicated Skin and Soft Tissue Infections [cSSTI] or CAP in the Hospital Setting) was a retrospective observational study, providing current data on the clinical management and resource burden of CAP in real-life settings in European hospitals. This analysis reviews the characteristics and outcomes of patients showing early positive response to treatment (time to clinical stability [TCS] ≤4 days, as assessed by Halm's criteria) compared with patients with later positive response (TCS >4 days).
METHODS:
Patients were adults, hospitalized with CAP (2010-2011) and requiring in-hospital treatment with intravenous antibiotics.
RESULTS:
Of the 2039 patients included in REACH, 585 (28.7%) had TCS assessed by Halm's criteria: 332 (56.8%) showed early response (median 3.0 days), and 253 (43.2%) showed later response to treatment (median 7.0 days). Use of Halm's criteria varied across participating countries, ranging from 0% (Belgium) to 49.1% (UK). Patient characteristics and relevant medical history were similar between the two groups. There were no notable differences in initial antibiotic therapy between groups, except that more early responders had been treated with amoxicillin-clavulanate and amoxicillin monotherapy (22.6%; 7.5%, respectively) than later responders (5.9%; 1.2%, respectively). Initial treatment modification and re-infection or recurrences were less frequent in early responders compared with later responders (14.2% and 3.3% vs. 34.8% and 5.9%, respectively). Early responders had a shorter duration of hospitalization (mean 9.4 ± SD 7.0; median 8.0 days vs. mean 15.6 ± SD 10.5; median 12.0 days, respectively), lower rate of ICU admission (3.3% vs. 21.3%) and shorter duration of ICU stay (mean 6.2 ± SD 5.7; median 4.0 days vs. mean 10.4 ± SD 10.1; median 8.0 days, respectively) compared with later responders. Mortality was low in both groups.
CONCLUSIONS:
Achieving early clinical stabilization in CAP (≤4 days) is associated with improved outcomes, lower requirement for initial treatment modification or readmission and lower resource use, compared with a later response
Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain
No full textJosep Darbà,1 Nuria Pérez-Álvarez,2 Lisette Kaskens,2 Susana Holgado-Pérez,3 Jill Racketa,4 Javier Rejas5 1Universitat de Barcelona, Barcelona, Spain; 2BCN Health Economics and Outcomes Research, Barcelona, Spain; 3Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; 4Global Health Economics and Outcomes Research, Pfizer Inc., Collegeville, PA, USA; 5Health Economic and Outcomes Research Department, Pfizer Alcobendas, Madrid, Spain Background: The purpose of this study was to assess the cost-effectiveness of bazedoxifene and raloxifene for prevention of vertebral and nonvertebral fractures among postmenopausal Spanish women aged 55–82 years with established osteoporosis and a high fracture risk. Methods: A Markov model was developed to represent the transition of a cohort of postmenopausal osteoporotic women through different health states, ie, patients free of fractures, patients with vertebral or nonvertebral fractures, and patients recovered from a fracture. Efficacy data for bazedoxifene were obtained from the Osteoporosis Study. The perspective of the Spanish National Health Service was chosen with a time horizon of 27 years. Costs were reported in 2010 Euros. Deterministic results were presented as expected cost per quality-adjusted life-year (QALY), and probabilistic results were represented in cost-effectiveness planes. Results: In deterministic analysis, the expected cost per patient was higher in the raloxifene cohort (€13,881) than in the bazedoxifene cohort (€13,436). QALYs gained were slightly higher in the bazedoxifene cohort (14.56 versus 14.54). Results from probabilistic sensitivity analysis showed that bazedoxifene has a slightly higher probability of being cost-effective for all threshold values independent of the maximum that the National Health Service is willing to pay per additional QALY. Conclusion: Bazedoxifene was shown to be a cost-effective treatment option for the prevention of fractures in Spanish women with postmenopausal osteoporosis and a high fracture risk. When comparing bazedoxifene with raloxifene, it may be concluded that the former is the dominant strategy. Keywords: osteoporosis, bazedoxifene, raloxifene, vertebral, nonvertebral, fracture, efficacy, cost
Alzheimer's disease: The strength of association of costs with different measures of disease severity
No full textPDB6 Baseline Characteristics, Weight and Glycaemic Change Among Patients in the United Kingdom with Type 2 Diabetes Mellitus (T2DM) Prescribed a New Antidiabetic Treatment Class in a Real World Setting
No full textPIH25 Clinical and Economic Outcomes Associated with Early Combined Estrogen and Progestogen Hormone Therapy for Post-Menopausal Women
No full textPIH23 Economic Impact of Breast Pain and Bleeding among Women Prescribed Estrogen Plus Progestogen Hormone Therapy
No full textPDB84 Weight change and health care resource use (HCRU) in english patients with type 2 diabetes mellitus (T2DM) initiating a new antidiabetic drug class
No full text‐2 inhibitor dapagliflozin treatment versus standard diabetes therapy on cardiovascular and microvascular outcomes
No full text3
No full textUPWARD.
Vas off tbo fac-stala teat ilim-ae-, lbs •****-■ et
Ibe rtonaeloea i«il>,->;
* Bowl* «« rite from tbe lower, urdlf tb* Msb-
•r tlUi.i.
Wm It not betier to lliv-tT liero un tb« bills ot
our bitvmt
Oa ibe enttt tlopt*. win by our let hen, wtro It
ll- *. Well 10 ten tin'
Hay. 't.i iU t-ontarl ot l*-*rn«-* tistuas* tor esss
»ii'. ut tfs.linr.
Ht.U.t.iI of maul and Ignoble, lest kin t» tbe
I-rab ihan the plain.
tUU it be 1.1,1 thit we halleJ. fain to be doce
With o.. -miln-i,
laslorioua lose ot our Istbert, coaUot lo Inherit
tbelr i-Oar
I.'t -et, with tjot-t hearts desBtcd It tbe trduo-jt
briaat-. oo toe-gee,
(limb lower' [i> .'i.uni tjnirr.it nor feint on
I l>c upttsrJ we.**.
Tiirouci. the t..;i- rvc ere now rn-Imin-, our children will I'l-liiff lht> itron*--r,
Ti;.-.: -til] win trlumiiln loniorrow ii iiahcti we
bete «t ti,.:. *-■.*;.
-A. C, Uarttn In '..-I Word*.
DESERTERS' REMARKABLE FEATS.
ISs-
tDevleea of Ilritli.li gotdlcra
crape From Ibe Array.
To desert fnim either the .army or tbe
navy In ■-,■■ the easiest tiiiiiic In tbe world,
and even when nt-eomplbhcd tbe culprit
li.-**. iu dally fear uf being ret-apturrd
and sentenced tu a heavy leitu of tropris-
nnnicr.t. Then-fore Ibe device* employed
by some ilcs-i-tiers an* aa ingenious an
they nit* exciting, although titer ennuol
In* euil.J to Ik* alwaya eruvvned with sue-
.'•!■«. For sheer audacity the case uf an
!ri-<ti M-ldU'.- tvbii jlci-ertcd In a south
«xtM lowo cenne ■ ■ •ni■■ ■>-■< would be banl
to l-e&t. Just at that time a number of
desertions had occulted in the neighborhood, uud iIn* ntilhnrilir-t were therefore
uiHiHUiilly sharp In prevent further of-
•nrra uf ittlee nature. Hut the man In
p,e-ttloii -I-.'-*-. illHMiilitlied' with roldtrring
i.-.d. baric** a nUtnbtir of friends in ihe
town who *■.*--.-• di"|-«M>'il i« help Ida ami
In .: - -...-.-. ,-m -1 of* nu unusually large
ir.od.t-i:-.;. <-r pluck, remlvid to delay hi*
n tini i» civil life nn longer, •
Out. I'.-.iiiiiii*-; early he t-!ip|H*d out of
l.nniiek-t uv.il inmli* his way lo a friend's
he*-*-** without being seen. Arriving then-.
be> ■jduttd •>'( hit mttfarhe ami. donulng
■ |ioUce-*aiane *;nifor.-.i. boldly jmnmu.i'l
.tl ilie main mi-ceis uf ibe town, lie yen*
..f-mi..-*-■■> lutm-d lii bartacka aad knew
thai tl:i* totr. minding rouutry wna is'lng
Mi'iir.-d In the Impc* uf liudlug lilui. Ou
-me iMit-sioii hi** renrcdnt came up t
1.1:.i .ii.0 miked lilui If Ih* had seen or
heard iiliyll!io2 uf thr tni-.-dng man. nml
he of iiimim- ill:..I lliat be bad no), but
be wnukt l*e*i*|i his eyca open. For mors
thnli a forlniclil he preserved .till* din
guise Without It Itclng peuetrmed even by
ll:e |Nill«*t- itH'iimelvt--., nml he then calmly
left the tmvu Minn the hue and cry had
autMhteit MHiien-hat. Ni*verthehi*-< liln eu-
lerpri-t- f-jtiic lu nuuslit, fur he was ar-
rtetcd in ii-yin-: lo work bla par-nage lack
to In-lnml.
Seunt*ly tew* nudai'loiiK wna Ihe nn*e
employed by another dis-uitixfied win of
Mm-, and in this case likewise it pmved
fnllle. He hap'-eiied to know that a rer-
tmin publican in tlw* town was In anytldiie
tint olHaent •jin-uiiiftani-e*. for he rlttlte-tl-
ibi* l:nu*e n*-:Hlnrly. nnd from rrmarks
dropnrd ai odd time*, dboorercd that the
ptiblh-nn oai* heavily in debt to a Scotch
npirll imT'-hnnt. One niuriiini: rtK srion an
the piiblieati opened his doors the soldier
arrived, after having tin*t disguised blm*
tH'lt with a t-iiinl nnd wig and donned
eivilion attire. With him eame a friend.
■who agrectl In nd as a n-prc-sentalive uf
ihe law. nml he promjilly tnhl Ihe ■rtou-
isliiil ptihlleaittliiit lie had onten* to leave
a mnn in pofs'i-sloii iiiilexfi tin* kiiiii owing lo the Scotch spirit merchant rrti*
pnld-to him then* and then. Tho publican
of eoiin-e cnidd not pay. no the deserter
woo -in-iMcr-i! upon him nml llve-l In hi-
honsr and nt hi- cx|n*i-«p for morr than a
week tiefon* tlie d*?t*eptlen was dlscorcnd.
IVrhnpi the most SUCCCSaful deserter.
for n lime, win William Oetirad, Thmugh
one of Ida cninradi-n he heard "f it mini
whose eon had gone to Australia gold
mining nnd had apparently d.-*api>cnrcd.
for nothing more had been heanl of hint.
though |he paniil still Ulieved he would
- .•.' him ;i:-;ii;i. 1'oHl ;nl I hiTi-furi- lilt ll|KUI
ihe iiigenioin* Idea of li-nving ihe nrniy by
Kteallli ami. going to ihe man. Informing
him that Ik was the minting mm. Am bin
knowk-dge of Australia was considerable
lu- tue.t no time In pulling blw plan Into
cxcciui-'i*. and the part-m. believing in
l.ii.i despite the ftuppo*>cd alteratkin In his
appearance, prnvtdetl Idm wilh a home
and. money galore, o oommodity he eon*
fr-wjt-d lie lacked. Bnt. unfortnnately for
lilui, at tlie cud uf IH ni-uiiln- .lie real kuu
iiimuiI up. nnd whnt followed can Ix'lter
be Imagined than described.—London
Hcglmeut.
naaletieo. Ill* Death.
A a'onhy professor nut iced n horse
with what Hcenicd to be a very singular
hone formation In one of ils legs. The
animal wan attached to a dilapidated
cart and driven by a burly coster.
The pi-ofi****or spoke to tbe man and.
after making n brief examination of tbe
protubcrancr. concluded by MTlng:
"When your borne diet*, I should like
that leg for scientific examination, ttring
It tu my house, and I will give you halt a
sovereign for It."
Two linura later, on reaching home, he
found a lone, awkwanl bundle in the ball,
which on bring opened proved lo contain
tbe leg of the horae.
"Yon cce, sir," thc owner of the horse
remarked, with a pectdlagiouk In his eye,
* Hhi' old -o-;... be iliril."- I.miilun Tit-Hits.
watt Has* HIm.
"I shall one blm fur -libel," said tbe man
who la matins; lai-a** sums of money out
of the credulity of tbe n-asaes.
"For whatr'
"He called me « common awlndlcr. It's
pretty hard for a msn who has worked as
bard as I bare to he original to be referred to as 'common.' "—Washington Star.
rssaenget—What time does the next
train to out?
Ballrosd Man—Six-ten, raa'am.
rassongti— lmpoaelble.
Ballroad Man—Why Impoaeible?
Pa sac beer—Why, man, ajx-ten fe *-?*
schedule time for leer*--
TO I
A PUBLIC SPEAKER.
Tern Sbaalel Talk aa Tkaa«li Parfe-M-
■r at Baae Be-far* a« A«aivBc->.
In nianaging his voice the speaker
wben he la enraged In campst conversation commonly and naturally falls Into
the beat tone and manner•*-**->public
speaking. Suppose you are nttlaa? about
a tabic with a doxen frlenda and some
subject ia started In wblcb you are deeply interested. You. engage in an earnest
and serious dfclojpic with one of tbem at
the other end of the table. Vou are perfectly at esse, not caring tu the least
for your manner or tone of voice, but
only fur your thought. Thc tone you
adopt then will ordinarily be the best
tone for you In public speaking;. Vou
can, however," learn from lenchere or
friendly critics lu avoid any harsh or
disagreeable fashion of speech tbat you
may have fallen Into and that may he
habitual lo you In private con venal Ion.
Next, never strain your vocal organs
by attempting to fill spaces which are
too br-*-' for yon. Speak as loudly and
distinctly aa you can do easily and let
the more distant portion-, uf your audience tn. Vou will find in that way very
Boon tbat your voice will increase in
compasa and power and you will do better than by a habit of straining the voice
beyond Ita natural capacity. Re careful
lo avoid fal-iitn. Shun imitating tbe
tricks of speech uf other orators, even of
fHiiimis nml siicccssful uraiur*. Tin-.-
may do for Ihem, but not fur you. Vou
KiU-do-Uo heller hi attempting.toJniU
i;iti- the trlcka of apecch of other men Ic
public speaking than In private speak*
inc.
Never make a gesture for the sake of
making one. I l-eticve that most of tbe
succettsfu) siK-nkcr-t whom I know would
Hud It hard lu tell yon whether Mn-y
themselves make gestures -or mil, they
art! to alwolutely iiucun-tcliuiK In the matter. Hut with gestun-s an with voice get
teachers or friendly critics lo point out to
you any bad habit you may fall into. I
think it would l>e well if our young public n|K*nkers, c»|*eeinlly preachers*, would
hnve competent Instructors nud critics
among their auditor*, after ihey enter
their profession lo give tin-in the benefit
uf such ulmervutinn** nml ••iiiiiixi'I ns muy
be suggested In that way.—Scribners.
THE EJn*TY NESTS.
HOMES AT WHOSE DOORS LOVE AND
DEATH HAVE KNOCKED.
Slrtlhrr Kneel- Itr m rr tt all f |M .laclf-t
itoom. Where Jaek la -.ot. bat What
T-.o-.td Yob Haver — A Sew Hook
CJprnm a, tbe Old «nr ClOHSi ■■<
Llf<- Go*rS OSU
I lunl s rmlfut onre nf my atm.
Ah, L*i'pv. Itapt1*' 1-
IliKi.i -Iraiiy 1 luteal Un----, l.ui wbea tbe/
Tbey ept-tad out tbeir -tinge to fl-.
Wc Amrri'SD parrnta are spared tbe
sense of Inevitable separation which is
Integral in KnglUh homer-. Our broader
hind, our newborn luduntried, our yet
formative condition, leave tin n hope that
our boys may tlud work near at baud.
We do not begin to sum up our chances
-of iutluencaln India and Africa and Canada while curly beads yet lie un the nursery pillow and to defiue a "suitable education" for this or thnt "aervice" while
tho 'tittle onca nre'still building lltw-k-
buiiscn on the flour. After maturity It Is
a run* thing in Knglaud tu find a sun under hi-, father's roof, still rarrr that
from a large fondly there are not many
emigrants, and it la a t-Hmax uf family
Joy If once in £0 years a father and
mother can see their living children gathered nl-'itt their totiti-, united t-crbapi at
aomcdcar.fCBtlvi "
CHURCH AND CHURCHMAN.
Thc lirat Christian Science church was
orgntii*.cd In i-****■ i nml the second four
renrx later.
St. Paul's cathedral ban a dome 112
feet In diameter. St. 1'eter's. Itotnc, L*>
1311 feet serosa.
The eagle In Kplscopal churchc-i -.up-
port-* thc liH-lurn, liccauselhe engle ts the
nnttinil enemy of the -.erpcut.
In a sailors' church lu finn Francisco
the pulpit hi a r-nuiplcte reproduction uf
ihe stern uf a notctl clipH*r. and alter
•wrvlccs on Sunday ti*a i> provided fur
sailors who attend.
In the Vidtrd Stales ttierc Is one church
.(.'IT (K-ople. I'-..-ii.si ban one for
one for every
million people attend church, in the Cnitcd State-* every
Sunday.
the city of Heidelberg, fieroiany.
there ts a church, called ihe Church of |tw
Holy IJhoftl. which i» unlijue in its way.
tielng Ihe only ehiirch in the world' In
which .the Protestant mid Catholic services are held til the same time, a partltien
wall through the center t-eparafmg the
two -congregation*-.
The laic I>r. Thomas K. Bcechcr of
niti:ir-i. N. Y.. was one of the wo*-* charitable of men. Nearly all of Id-, •pi.riixi
Income Wan given awny. nml when hi-
eoti^rcgiitinn thought lo Improve bis appearance by --ending him an overcoat the
gift wns turned over tu a In-ggar. Another coat was at'tincc pnwntc-J and a
promise; exacted that it be retained.
for cverr '".'17 people. Bon
every ityuo, Minneapolis
l.OVVt. Twetityfour mill
Sleep.
Sleep Is the renting time of e-.n»eioiiB-
lip-tn. Tlie more Relive mid energetic tlic
wakitig life uf the normal individual hu«
lieen. the deeper will be his sleep. A
man exhausted pby-*ically or mentally recuperates ih..-.- portion* of In- brain in
which are lociititl Ihe' oonten pn-^iidtng
over Ihe exhaur-ted funclion>* during the
•deepi)!-; |n;iii'il. In thew exhausted uerve
eetiters Ihe iineoiiKciounnesK Is deeper iliiiu
elsewhere. In order thai Ihe rest may he
more complete.
This is the (-est apprrcinted when ts*e
rcniemlicr ihe effect of aleep upon the
brain' uf n person wbo has rmOenel In*
tense grief. When such a person sleeps
grief In completely forgot ten; no dreams
recall .the mUfunuiw. Tlie 4-attte of-tho
ancient lireeki* fiudi ita exact -.-ounler-
I'.n i. Kveu on awakening It U a little
time l-c'i.t-' the exact nature of the nn-
fortune can 1-e n-mcml-cml. At ficet
thrre ts a vngtie. uneasy feeling of menial
MiilTi'i-lug. a sensntinn uf sorrow, a rcall-
xntion lliat n poll hai* hecu sprend orrr
the life, bill Ita exact nature Is located
only by a distinct mental effort.—Health
Culture.
Aa (Hid uuir Pariah.
Tbe parie.li of t*p]>er Eldon, tn Ilantr.
Knglaud. Ik probably unique among the
parislien uf the I'nin-il Klngdnui. It la
sliiiutcd about Ave uillea from Itamaey
and boasls a iiopulotlnn nf len. The village church stands la the center ot the
farmyard of one of tbe two liousca in the
parish, and tbe farmyard Is also Ihe village cemetery.- The building daiee from
the elerenth century am) contains a reading desk, communion table ami raila and
live pews, but dnea not hoaat a pulpll.
The living (a of thc annual value of ?--."■,
but there la not at present an tncumlieot.
Occasionally a derrxman will visit ibe
district or pass through on a walking
tour. Tbe belt will then In* rung, and tbe
parishioners will attend on impromptu
nervlce.
Tbe TMtlltaer'a ffarr-a-w Eaeaaye*.
"I rather fancy this." said Mlaa Tbur-
I.o-I. trying on a very girlish hat.
"Well." remarked the milliner unguardedly, "that would he becoming to young
ladlpa of o certain age."
"And you mean to aay my age la uncertain?**
"Well, er—-yes. Until a young 'woman
ret* to be 24 or 25 ber age Is alwaysou-
certaln. That bat'a too old for you."
TO IE A PUBLIC SPEAKER.
Yet without this Impending certainty
of nlisolute separation hamting over ua
the family circle brrakx all too soon, and
fi ■>!.'. that moment there in n vacant room
In the lately overcrowded bntncslcad ami
a change In Ihe moiht-r*-! life and heart
which is to remain always. The Utile'
chtiml-cr, hardly large enough fur the
Htrmif*, active lad to move about In, the
place hitherto so hard to keep tidy nnd
orderly, look-i dctudale enough now that
he has gone to rchool; the old worn cap,
picked up a th.iii-.-tini timet* in unlikely
places, bang** from ihe peg. a sort of
mark of ownership, while for nine mouths
nut of \- he is living under new liillu-
cnecH and lenrnlnx tu be cheery ami happy and overflowing with wholc-imc- inter*
mis, forgetful uf whnt once made up to
him the sum of his dcrircs.
lie will love on—90 year-; hence j-crhnpa
love heller thiui ever licfore the rouf under which he was born and tin* moiher
who gave him his lire—but his place lu the
home nest is vncanl. Henceforth home Is
an Incident, not the center of existence.
School, e-sBeke, work, marring--—SO the
future unroll-* its plan. Mother may kneel
U-i-jde the narrow hoylKh l-ed nnd carry
him, nx mother-* will, forever In her heart,
hut <lnck*K room Is only hit* In name.
Ami hm sisters, so united, yet po
Ktnuigely unlike In taste nml looks and
prcd]lection*, how hnnl to realize that
they nri* gone! The elder, riiothcr-itstcr,
so helpful iu family cri*-**-, »o uulhorita-
tlve nnd i*o i-lioug io intlucncc, without
whom nothing wns complete, nuthltig de-
elded, can it be that she will only COWS
hack nn a guest uud the family life go on
without her? And fair, Khrlitklug Allegra.
nlvvayx timid aud unwilling lo take re-
-.poii-Aitriliiy, how tmpo-*siMe to Ih-Ucvc
that sbe bun ns*umcd tht* hradi-blp of n
rtmnsef's hou-M^hohl and'taken ui*un hcr-
M'lr without u tremor the conuoi of a
family of her own. Ami stormy Kate, the
imislerful victor nn so many tleliK bow
strangely her trochlea look an they hang
Upon her wall. How dearly idle loved
ihem, ih;---- tokens of triumph on many
a hard won field! .Vet now she lo -outciit
with decorous driven nml walks mid no
longer court-- ihe brown check which Ihe
mill kihWil. Softly ihe mother gOOS fiom
room iu mom and closes the door* after
her. Tlie dear old hous,-. no recently too
full I-. offer ho*pit.ilit--, has nhuuda'it
guot room now. A lender wonder rise*.
in her heart. Allegra doej. not send fur
her once dear pitiurctt nor for the inuudo-
iiti hanging disunetl. Kate bltln her divide
her "clicks*" and racketa nmong the children. Vcn, they un* gone!
TT-.e mrtJirr'* lot, try dear.
**be -jolli In iajn*;tit artot-; ,
Her lei i " i • -*. iu ttKTt*. ;. tear.
To Icir-tut-J il-cn to lose.
In yrt*another wny Stent rhnmliers are
created in the old humte. Still, indeed, is
loe place where (he tiugust nml nil powerful iingel has stood, tender yet Inflexible'
he whom no mnn may letdst. Who shall
nay what that departure ut to the man
and womnn wlio called that child their
own? What a chill fillx tbe onee warm
nest! Vet I: may Ik* thut the outgoing of
a young life. Up home by the Strength of
the divine uieKseiigcr tu—n« the broker
l!.-:trl Im-M.-V.-.** - |.l:i.-.■*."' ■•m:-ri'V:l(i1i* l,,-:iii-
ty mid peace, leaven g*lesa sorrowful loue-
littc-j*- In tbe home than when wilting feet
too away joyously to walk in vrtrtb's
rough paths, so full uf po-wible tnisadven*
lure. No duuger of 111 tfdiugs of error or
of misfortune coming back from that fur
shore. Of one the heart may aay. "Fur
him 1 fed uo fear." Of this child, uo
nnxiou-t thought can ever arise.
Must parental hearts count themselves*
but faint lypcs of tbe eternal Fatherhood;
tbe happiest of honiea ore bur reflection...
dim and imperfect, of ihe paradise where
love has no Impart eel Ions. The silence
made by the death "angel is not without
occasional 'Interruptions of sweet eehoeti
nf unearthly* muelc. soothing and full uf
peace. The emptiness of the chamber
from whence he liaa borne a child hai
often a spiritual fullness which coinfort--
;i mother's., grief. -There eumes times
when her'Mraiued ears hear soft rustlings of angctio wluga. Tlie spot from
whence her child's soul took flight has
ever a sense of companionship to Iter.
This room Is not like those others from
which ber girls wrnt out to abare ibe
"fair lot tbat maldena choose."
Ko for on the side of those wbo lose,
but tt la not all which we can nee. "To
bear, to nurse, to rear, to love*'—yen, all
true, aud yet as .rue the poet's pathetic
floH*. wblcb has a sound of tears In it—
"m lose!" Hut what would wc have?
ftlven our choice, wbat would wc ask?
Whnt U the r-uui of our endeavor? What
the ultimate cud of our travail ami strife?
Sinviy nut In .keep the lives, brought to
fully perfected strength ssd df-rclopmcu*.
tn abortive cunmietueut In the Inclosttre
of a too narrow space. Above alls surely
not tn bold back a soul ripe for >i-'<—■•■
sctlrity in a aorruwtcsa worid.-
raa ShealS Talk aa Tknaah Pa*-faa4-
I-* cat Keaaa tot-fort- an Ae-Jiesre.
In managing his voice tbe speaker
when, he ta engaged tn cnniest couvcrwi-
tion rommuuly ami naturally falta Into
tbe iH-st tunc nml manner for public
speaking. Buppas-- yuu are altllug about
a tabic with a dozen friends aod some
tnbje-ct ta started in which you are deep*
ly interesled. Vou engage in an earnest
and serious dialogue' wltb one uf Ihem at
Ihe other Apt! uf the table, Vou are per*
fietly nl ease, not curing In the least
fur your manner or tone of voice, but
mly fur yuur thought. The torn* you
adopt then will urdlnarlly be tbe \- -:
lone fur you in public speaking. Vou
can. however, li-arn from teacher* of
friendly critics lo nvuid any harsh or
disagreeable fufldou nf siHtn-h tliat you
amy have fallen into nnd tbat may In*
habitual |o you iu private conversation.
Next, never strain your vocal organs
by attempting to fill spaces which are
loo large for you. Speak as loudly ami
JiMinclly as you can do easily and let
the more distant portions nf your audience p". Vim will Itml In lhat way very
*oou 'that your voice will Increase lu
rompns-i nml power and you will do bel*
tee thnn by a habit uf straining the vulce
beyond Its natural capacity. IU- careful
to avoid fu!-.-ii... Shun Imitating the
tricks of spoccli of other orators, even of
famoiiK ami xucce-u-fut orators. These
may do for them, but not fur yuu. Vnu
.will-(lu no better in ntU-mpiiiig to Imitate tlic-trickx uf siK-ech of other men In
public speaking than In private apeak-
ing. f
Never make a gei>tnre for the sake of
making one, -I believe ihnt most uf ihe
successful *|K>nkcri- whom l know would
Hud It hnrd lo tell you whether they
themselves watte gestures ur not, they
are mo nb->oluiely uncom-ehitis In tbe mailer. Bui with gesture-* as with voice get
teacher* or fricudly critic* lo point out to
you any Uid habit you may fall lnl. I
think It would U- well If our young public ft-icakcr-., cxpecinlly preachers, would
have competent Instructors and erlltej
r.moug Ihelr auditors after ihey enter
their profession to give them the brncllt
if such ohtervailuns nmt.conn«ct-as may
be Buggc*icd in lhat way.—Scribner'a.
CHURCH AND CHURCHMAN.
The flrsl Christian Ri lence church wns
urgaulKcd In ' l->-7 nml tlie ttccoml four
rears later.
St. Paul's cathedral has a dome 111!
feet In diameter. St. IVter's. Home, i"
180 feel aero*-*.
The eagle in KpUcopnl churcho* sup*
porta ihe Ictt.ini, because the engle Is (he
natural enemy uf the serpent.
In n sitllort.' church iu Sun Frnuci«co
the pulpit l-t ii complete reproduction of,
the stern of a i-olcd clip-K-r, ami after
Ml (tors ba Sunday tea U providitl for
•tailors who attend.
In the United $tAtM then' Is one church
for every '.'■'■• t |H-ople. tlontoii hux utie for
I every 1,000. allnneaiHilla one for every
j l.-'-'ilga Tu*eiity-ruur million people at*
; 'end itiuiah iu the I'liltcd States every
Sumlay.
I In the city .if Hcidcll-crg. Ccnu.iuy.
there 1* n church, ealted the Church of ibe
Holy i.hoM. which W uni<]iie iu it» wny.
iK-iiiu- the only church In the world in
j which the I'mtctuniii nml Catholic services are held ot the same time, n purtitieii
wnli through the nrnter'* separating Ihe
\ :wo coiigrcg-itinii-i.
i Tbe laic I ic, Thomas K. Beecber of
* l-liiiir.i. N. V., nras one uf ihe m..-t chnr-
[dflllTe uf men. Ncurly nil of bis ¥!!..-.'«'
[income wns given awny, nml when hi*.
ixingregntlnn thought lo Improve Ids' up-
[pearatice by fending him nn over-oat the
: rift was turned over lo n brggar. An-
>lhcr coot waa at UOCC procnied and n
:>r-niii*t- Min teil that It
