pred_label
stringclasses 2
values | pred_label_prob
float64 0.5
1
| wiki_prob
float64 0.25
1
| text
stringlengths 148
1.01M
| source
stringlengths 39
45
|
|---|---|---|---|---|
__label__cc
| 0.748056
| 0.251944
|
Sandi Toksvig quits Great British Bake Off after three years as host
Coconut bakewell tart
No-bake peanut butter cheesecake
How to... decorate dough
Fault Line Cakes
Marble Cakes
Naked Cakes
10 Minutes With
In the Kitchen With
Baking Heaven
Cake Decorating Heaven
Tag archive for ‘Fun’
By Food Heaven On Friday, January 10th, 2020
A transparent lemon meringue pie amazes the internet
Innovative chef James Dempsey shared his amazing creation on Instagram last month A chef based in Leeds has created a lemon meringue pie with a difference – it’s see-through! The pie is made using a normal More...
A sponge cake that is a little too realistic?
A sponge cake has been created in Japan that is a literal sponge – that’s right, the washing up kind! Professional animator and amateur baker Takahiro Shibata shared his creation online. He said he wanted More...
By Food Heaven On Monday, December 2nd, 2019
Mary Berry is back with a Royal Christmas special!
Mary Berry and the Duke and Duchess of Cambridge will join forces for a special Christmas programme Announced over the weekend, ‘A Berry Royal Christmas’ is described as a “special Christmas party” More...
By Food Heaven On Thursday, November 28th, 2019
Hairy Bikers in new baking show: The Real Willy Wonkas!
The Hairy Bikers are to star in a new baking show The Real Willy Wonkas The Hairy Bikers new show will focus on chocolate, featuring seven confectioners competing to win their own bar in the shops. David and Si More...
There’s now a Baby Yoda Cake, and it’s too cute!
Following the reveal of Baby Yoda from a new Disney Plus TV Show, the internet has gone wild for how cute he is Baby Yoda may have already been adopted by the internet and found a way into our hearts, but now he More...
By Food Heaven On Tuesday, November 19th, 2019
Baking shows to fill the Bake Off hole in your life
Tuesday evenings feeling empty? The Great British Bake Off has come to an end for another year, but that doesn’t mean there are no more baking shows to watch… There are many cooking shows about, but More...
By Food Heaven On Friday, October 18th, 2019
Cake falls to the ground on Belgian Bake Off
The Belgian version of The Great British Bake Off featured quite the disaster, as a cake falls to the ground Bake Off Vlaanderen (Bake Off Flanders), is the Belgian edition of Bake Off and is currently in its third More...
By Food Heaven On Wednesday, October 16th, 2019
Baked Beans cupcakes: Heinz’s limited edition cupcakes
But you have to be quick! The baked beans cupcakes are only available until the 20th of October! If you’re in London this week you can pick up a range of Heinz condiment flavoured cupcakes from selected Hummingbird More...
By Food Heaven On Thursday, October 10th, 2019
Bride’s wedding cake looked like “turkey with leprosy”
We love a good cake fail here at Baking Heaven HQ, and this is a good one! A bride has been reportedly left heartbroken when the cake she ordered turned up looking more like a lopsided “turkey with leprosy”. We’ve More...
By Food Heaven On Wednesday, October 2nd, 2019
A Chicken McNuggets cake? The cake fooling the internet…
Mardie Jennings has baked a cake so realistic it fooled her friends Taking six hours in total, Mardie’s cake looks just like a box of McDonalds Chicken McNuggets. She posted her creation online and many couldn’t More...
Free From Heaven
Anthem Publishing Ltd
|
cc/2020-05/en_middle_0097.json.gz/line1407186
|
__label__wiki
| 0.53336
| 0.53336
|
Seattle Genetics: "Now the Hard Work Begins"
Front-line Hodgkin lymphoma turns out to be a tough market to crack.
Brian Orelli
(TMFBiologyFool)
Oct 30, 2018 at 2:50PM
Dr. Orelli is a Senior Biotech Specialist. He has written about biotech, pharmaceutical, and medical device companies for The Motley Fool since 2007. Follow @BiologyFool
Seattle Genetics' (NASDAQ:SGEN) third-quarter year-over-year revenue increase was something most biotechs would happily take. But sales of Adcetris, Seattle Genetics' only drug, missed management's guidance, causing shares to fall substantially.
Seattle Genetics results: The raw numbers
Year-Over-Year Change
Income from operations
($45.6 million)
Data source: Seattle Genetics.
What happened with Seattle Genetics this quarter?
Adcetris sales in the U.S. and Canada, where Seattle Genetics sells the drug, were up 60% year over year, thanks to its approval earlier this year to treat patients with front-line stage III and IV Hodgkin lymphoma. But the $127 million in the quarter fell short of management's guidance for sales of $130 million to $135 million.
Royalty revenue, which mostly comes from overseas sales of Adcetris by Seattle Genetics' partner Takeda Pharmaceutical, was up 36%. The drug was recently approved for front-line Hodgkin lymphoma in Japan, which triggered a $10 million milestone payment, and is up for expanded approval in other regions, including the EU, which should accelerate the growth of royalties next year.
Seattle Genetics and Takeda got another clinical trial win for Adcetris in the phase 3 Echelon-2 study in front-line peripheral T-cell lymphoma, where the drug produced a 34% reduction in the risk of death.
The earnings in the year-ago quarter included a large one-time accounting gain associated with warrants held by Seattle Genetics that allow it to buy additional shares of its partner Immunomedics. Investors should continue to expect a loss for the foreseeable future as the company spends the profits from Adcetris on its pipeline candidates.
What management had to say
"We got the early adopters, now the hard work begins," Seattle Genetics CEO Clay Siegall said of the move into front-line Hodgkin lymphoma.
Siegall thinks front-line peripheral T-cell lymphoma based on the Echelon-2 (E-2) study will be easier to crack than front-line Hodgkin lymphoma because of characteristics of the current treatments, CHOP and ABVD, respectively. (CHOP and ABVD are acronyms for chemotherapy cocktails.)
"The difference there being that with E-2 and CHOP, CHOP is nowhere near as effective as ABVD is, so that's something I think doctors will see really fast because they know they're not getting a high cure rate like they were with ABVD," Siegall said.
Management guided for fourth-quarter Adcetris sales in the U.S. and Canada to be in the range of $128 million to $133 million, which isn't much more than the $127 million in the recently completed quarter. Hopefully management is sandbagging a little after missing guidance this quarter.
Seattle Genetics is shooting for submitting the data from Echelon-2 to the Food and Drug Administration in November, and investors will get to see the full data set at the American Society of Hematology meeting in December.
Beyond Adcetris, Seattle Genetics' pipeline is moving along. The most advanced drug, enfortumab vedotin for urothelial cancer, is scheduled to read out data from a pivotal trial in the first quarter of next year, which could put it on track for an approval in late 2019 or early 2020.
NASDAQ:SGEN
Are Biotech Stocks Due for a Correction in 2020?
Why Seattle Genetics Stock Skyrocketed 102% in 2019
2 Healthcare Stocks That Doubled in 2019 and Can Still Go Higher
2 Things That Will Propel Seattle Genetics’ Stock Even Higher in 2020
A $20 Billion Sweet Spot in Biotech
Seattle Genetics: "Now the Hard Work Begins" @themotleyfool #stocks $SGEN Next Article
|
cc/2020-05/en_middle_0097.json.gz/line1407188
|
__label__cc
| 0.648629
| 0.351371
|
It’s been a while since a wrote a blog post, now the season is over it seems like the right time for my last one of the year. Last weekend I went out to Belgium with John Barclay for some Kermesses. The last races of the year, just for a bit of fun and some hard efforts in an attempt to win a race.
We left on Saturday morning (the morning of the race) with enough time to spare to comfortably make the race start (4pm). However due problems at the tunnel there were 3 hours + delays. This would have left us over an hour late for the race start let alone changing into kit, signing on and maybe a short spin before the start. John being John wasn’t fazed, he had brought along his stash of letter hangers allowing us to get onto the tunnel with the delayed time of a much earlier train.
This meant we were still over an hour behind schedule but more at less in with a chance with making it to the start of the race. We made it through the barcode scan during the train journey with the classic “I don’t know where it has gone” tactic and headed for Lichtervelde.
We arrived, signed on, got changed in the area outside the men’s/women’s toilet in a small pub before rushing back to sort out our bikes and pin on numbers. We arrived at the start line with less than a minute to the start feeling very unprepared.
The race started in the dry, it had been raining quite a lot but had stopped just in time making life a lot easier before the race. Tom (Gloag) being used to arriving late to the start of a race was driving the bunch from the gun and causing some splits behind. I on the other hand was feeling slightly odd, having been in the car 15mins before the start I didn’t feel like I was in a race at all.
Leo set off up the road with one other on the second lap with the bunch very aware of the possibility of it staying away due to the speed they disappeared up the road. I didn’t want Leo to come back but on the other hand I wasn’t satisfied just sitting in the bunch waiting for something to happen. Having found my legs and just about found my racing head I set off to try and bridge the gap.
I brought a few riders with me but a group of four formed pretty quickly. The bunch wasn’t too happy about this group getting away as they stayed close behind for at least a lap before the elastic broke. By this point my legs were feeling really good. We were just catching sight of Leo and Mathew up the road as we accelerated out of corners, giving us extra motivation to push on.
We caught up with them 5 or 6 laps in. And from there it was just a case of rolling through and keeping the pace high. I went for 2 primes and tried way too hard for one that I didn’t end up getting but seeing as it was €10 per lap I thought it would be worth some effort.
We came into the sprint having watched each other closely for the last lap, me and Leo hadn’t made any plans for the finish apart from Leo eyeing out an attack from the 2nd to last corner which I would happily let go if it happened. I wanted to be first or second going into the last corner as it was only 200m from the line and with a wet surface and some drain covers the first rider can take it at a greater speed. I took the corner first and looked to my left before opening my sprint. Vito (A Belgian rider and the eventual winner) went up the inside and rode away from me with ease, with Leo just behind me leaving us 2nd and 3rd, not what we wanted but good enough, with the knowledge that we could try again tomorrow.
The next day the weather was awful, we spent the morning in the car before getting some lunch and then hiding from the rain again. As classic British people brought up with British racing we all wondered if the race would go forward as there was a lot of standing water, and it was WET. But we were in Belgium and it takes a lot for them to cancel a race.
We managed to leave it quite tight when getting changed even though we had arrived hours in advance, but we had enough time for a spin before lining up much to Johns amusement.
The race started fast as normal. The course was quite twisty making it hard to get the power out before hitting another corner meaning people had a lot of energy due to the pace not being very high. This made it hard to get away. Tom (Gloag) went up the road with one other in the first half of the race before the rain started picking up again. The bunch behind started to fracture and people were working more in an attempt to bring the race back together. Me and Leo sat back to allowing Tom to hold his gap and used it as an excuse not to work. With about 35km to go Thomas was caught and the race exploded. The rain was so heavy, stinging your skin and spraying your eyes until you couldn’t see a thing.
Me and Leo once again manged to make the front split, with 9 of us up the road. We worked together for the remaining laps. Attacks kicked off with 1 to go, a Fortè rider pushed on and with a team mate in the group, he got a gap quite quickly before Leo also kicked on. Both me and the other Fortè rider controlled the group behind before I decided to give a kick a go to try and secure 3rd or bridge to Leo in an attempt to win. I went and was followed by another, we worked together riding hard, slowly watching Leo come closer. However, the bunch behind wasn’t having the top 4 places ride away and Leo was riding very strongly up the road holding us all off so we were brought back before sitting up for a group sprint. Leo was chasing the Fortè rider up the road slowly getting closer and closer in what looked like a grim effort. Behind I was just catching my breath for the sprint where I ended up coming 6th. Not what I was looking for but happy that I went for the win rather than sitting in a relying on a decent finish from the group that I was already in.
So that ends the 2018 season, I have had a great year. Doing much better than I could have ever had imagined coming into the year. That is thanks to Epic coaching who have coached me all year keeping me on top form for my main goals and hopefully will continue helping me towards some susses next year. John Barclay, along with Dave and Iain for providing so many opportunities this year in Belgium which has really made this year a success and has given me the experience that I need if I want to be on the top step at some big races next year. And also, Pedal Potential who have provided monetary support allowing all this to happen!
On to some training…
|
cc/2020-05/en_middle_0097.json.gz/line1407190
|
__label__wiki
| 0.562871
| 0.562871
|
Home » reviews » I, Robot (review)
I, Robot (review)
Fri Jul 16 2004, 10:09pm | comments off
Robot Monster
There’s a running joke in I, Robot about so-and-so being the “dumbest smart person ever” and some other guy being the “dumbest dumb person ever.” This is ironic, because I, Robot may well be the dumbest movie-that-thinks-it’s-smart ever.
That bit of irony is unintended, but surely there’s something more deliberate behind the Irony! of Will Smith’s cop, Del Spooner, suffering from an irrational prejudice against the androids who’ve taken over all manner of menial work in the year 2035. Resenting the ‘bots is totally understandable, in the same way that it was totally understandable that the buggy-whip manufacturers and coachmen and stable-sweeper-outters resented the Model T for putting them out of business a hundred years ago. But it’s more than that for Spooner, who’s something of a bastard child of Lethal Weapon‘s Martin Riggs and The Terminator‘s Kyle Reese. Oh, sure, his daddy lost his job to a damn dirty robot, but Spooner just doesn’t trust the things. So when Spooner spots a robot running down a busy Chicago street carrying a lady’s handbag as the film opens, he “naturally” assumes that the robot has stolen the purse and is running guiltily from the scene of the crime. Why Spooner would “naturally” assume such a thing has no explanation at all beyond that nagging, irrational feeling he has about the machines, because no robot has never committed so much as a jaywalking offense. It’s comparable to you assuming that your toaster formulates the malicious intent to deliberately burn your toast every morning.
It’s supposed to get a laugh, this black-man-with-a-badge-and-a-gun finally getting to be irrationally suspicious of some-one/thing lower in the cultural scheme of things than he would have been, oh, 31 years earlier. It’s sweet revenge: If Spooner’s grandfather could get pulled over by a cop for driving while black, then Spooner can sure as hell attempt to arrest a souped-up toaster for running while robotic. And it does get a laugh, unless you think about the context — in which case it prompts a bewildered “WTF?!” instead, for it makes no damn sense at all.
Director Alex Proyas (Garage Days, Dark City) doesn’t want you think about context — in fact, he’d prefer it if you didn’t. Ditto screenwriters — I use the term loosely — Jeff Vintar (Final Fantasy: The Spirits Within) and Akiva Goldsman (A Beautiful Mind). They want you to “naturally” sympathize with Spooner, because no matter how little sense he makes, he will “naturally” turn out to be right about that nagging feeling… so “crazy” Spooner conveniently also serves to confirm the general unease much of the audience will have about technology, never mind that most of them will be toting cell phones with more computing power than the space shuttle or that enough computing cycles went into the film’s CGI to figure pi to a billion decimals. Hey, if funky-cool Smith (Bad Boys II, Men in Black II) thinks Science Has Gone Too Far, it must be true! Never let it be said that a shoot-’em-up summer flick might dare to challenge our preconceived notions.
No, it wouldn’t do to explore something science fictional that we haven’t really seen onscreen before… like the fact that an enormous segment of the population has been put out to pasture by the arrival of robots who collect the garbage and walk the dogs and deliver overnight packages and wait on tables in divey diners. The world of Chicago in 2035 doesn’t look all that different from the world we know today, except that the cars are a little rounder and the buildings are a little taller and everything’s a little shinier. Proyas and Co. don’t even bother to play with the tremendous possibilities inherent in our, the audience’s, assumption, along with Spooner, that that robot really had actually mugged some little old lady as a way to, you know, get us to reconsider, oh, how we might react differently to technology that has a face or how we’re willing to believe the worst about a situation, or just the human tendency toward the kneejerk reaction at all. Clever screenwriters could have explored these things and still worked in some shootouts and car chases and stuff blowing up real good.
Instead, I, Robot breaks new cinematic ground in the realm of speculative scientific philosophy… for 1953. It consciously and deliberately evokes everything from Brazil and Blade Runner to The Terminator and Robocop to 2001: A Space Odyssey and The Twilight Zone, but only as jokes, as references in the production design, even in plot points. Hell, even the cheesiest episode of Star Trek: The Next Generation in which Data pondered his positronic brain had more a-ha! moments than this future-gasm of an action movie. Proyas is only interested in making you laugh or think “Wow, that’s cool!” or jump out of your seat for reasons that, when you think about them, make no damn sense at all. But there’s cars that drive themselves and electronic crime-scene tape and a videogame-esque car chase/battle sequence with the inorganic CGI robot army from Star Wars: Episode I gone haywire, so what kind of sense does it have to make, anyway?
Still, some of the idiocy is just too much to take. Like this: Spooner’s friend Dr. Alfred Lanning (James Cromwell: Space Cowboys, The Green Mile), who just happens to be the scientific genius behind these phenomenally useful yet entirely nondisruptive-to-the-economy robots, is dead, has committed suicide, and Spooner is on the case. Half a day after his death, Spooner goes to Lanning’s glorious old mansion, which is full of beautiful furniture and expensive-looking scientific equipment and wondrous art and a cute furry cat… and Spooner is apparently completely unsurprised to discover that a gigantic destructo-robot has been positioned outside the manor and is programmed to demolish the place on the morrow. When Lanning’s close coworker, Dr. Susan Calvin (Bridget Moynahan: The Recruit, The Sum of All Fears), hears of this, she also is thoroughly unperturbed. Now, forget the fact that Spooner has his doubts that Lanning killed himself, suspects murder, and that the dead man’s house could be full of possible clues to his killer. When somebody dies in 2035, his house and all his belongings, no matter how valuable either sentimentally or monetarily, and even his pets are demolished almost instantly as a matter of course, and everyone is fine with that? You could make an entire movie about how every distant relation of Lanning’s came out of the woodwork to lay claim on a piece of his estate, seeing as how they’re all so poor now that his damn robots put them out of work and so really need just one Old Master painting, ain’t it ironic?
Of course, the whole destructo-robot thing is just an excuse to have someone reprogram the thing to destroy the house while Spooner is in it, cuz he’s getting too close to the truth about something or other. While the Terminator-Transformer thingie smashes and attacks and roars and does all sorts of big loud destructo things from which Spooner (and the cat) Just Barely Escape In The Nick Of Time, all you can think is, This makes no fucking sense at all.
But hey! Enjoy this gratuitous Will Smith shower-scene butt shot! Woo-hoo! (Don’t worry: there’s a gratuitous shower scene featuring Bridget Moynahan, too.)
MPAA: rated PG-13 for intense stylized action, and some brief partial nudity
|
cc/2020-05/en_middle_0097.json.gz/line1407191
|
__label__wiki
| 0.728159
| 0.728159
|
Galion Inquirer on Facebook
Galion Inquirer on Twitter
Posted on June 25, 2015 by Galion Inquirer
Graders drop heartbreaker to Monarchs, 6-5
Local Sports, Sports
FLAT ROCK, Mich. — Galion’s losing skid is now at four consecutive games after the Graders dropped a 6-5 heartbreaker to the Lake Erie Monarchs on Thursday evening at Flat Rock Field.
It marked the third evening in a row that Galion lost by two runs or less.
Galion (4-10) held a 3-0 lead in the third inning after pushing two runs home in the second frame and another in the third. However, the Monarchs (6-10) scored a solo run in the bottom of the third and then tied the game at three in the home half of the fourth.
The Graders regained the lead at 4-3 in the top of the fifth, but the home side rallied again, plating two runs in the seventh to grab a 5-4 edge. Galion tied the game in the top of the eighth, but Lake Erie scored what proved to be the game-winning run in the bottom of the inning.
Jacob Britt led the Monarchs offense, going 3-for-4 and driving in a pair of runs. Mark Skonieczny finished 2-for-4 and scored twice. Jake Shepski and Dazon Cole each had two hits and scored a run. Jason Gasser doubled and scored a run. Aaron Aucker drew two walks and scored a run.
Monarchs reliever Jeremy Kravetz (1-2) earned the win after working 3-1/3 innings. He gave up one run on three hits, and had a strikeout and a walk.
Jordan Kesson picked up his second save of 2015 after pitching a scoreless ninth inning. Galion’s Hunter Clanin recorded a basehit off of Kesson, but the Graders were unable to capitalize after Clanin moved to second on an error. Kesson had one strikeout.
The Graders chased Lake Erie starter Alex Wagner after five innings. Galion hitters rapped seven hits and scored four runs on Wagner. He finished with four walks and two strikeouts.
Clanin went 3-for-4, scored two runs and drove in a run to lead the Graders. Alexander Malinsky went 2-for-4 with a double and scored a run. Tyler Ocker finished 1-for-3 with two RBI and scored a run.
Colton Carney went 1-for-4 and recorded his team-leading 10th RBI of the season. Mark Delas walked and scored a run. Brandon Wright had two hits.
Galion reliver Brody Basilone (0-2) took the loss. He worked 3-2/3 innings and gave up three runs on six hits. Basilone struck out five batters and walked one.
Trent Downs started for the Graders and pitched 4-1/3 innings. He surrendered three runs on six hits and recorded four walks and three strikeouts.
Galion and Lake Erie will play again on Friday at James D. Heddleson Field in Heise Park. First pitch is set for 7:05 p.m.
The Graders will play host to the Xenia Scouts on Saturday at 7:05 p.m.
46 South Main Street,
Mt. Gilead OH, 43338
Follow @GalionNews
Hi! A visitor to our site felt the following article might be of interest to you: Graders drop heartbreaker to Monarchs, 6-5. Here is a link to that story: https://www.galioninquirer.com/sports/689/graders-drop-heartbreaker-to-monarchs-6-5
|
cc/2020-05/en_middle_0097.json.gz/line1407198
|
__label__wiki
| 0.865811
| 0.865811
|
CEREMONY TO COMMEMORATE 100 YEARS SINCE THE SINKING OF FIRST WORLD WAR MINE SWEEPING TRAWLER
By Mr White
Centenary Events and Armed Forces Days, Educational, Events, News, War Feature, WWI
Publish on WordPress
A century ago, on the last day of April 1917, a rare steam fishing trawler – HMT Arfon - fitted out as a mine sweeper for the Royal Navy during the First World War, rapidly sank off the Dorset coast after striking a mine with the loss of 10 of the crew of 13. To commemorate this event, Bryan and Martin Jones, who discovered the wreck in 2014, brought descendants of three of the crew of HMT Arfon from Yorkshire to lay wreaths near the site of her sinking at St Aldhelm’s Head, near Swanage on the centenary of her loss on Sunday.
Last summer, HMT Arfon was given special protection by the Department for Culture Media and Sport on the advice of Historic England. HMT Arfon was built in 1908 in Goole, East Riding of Yorkshire and worked out of Portland Harbour Naval Base during the First World War, sweeping mines laid by German U-boats along the inshore shipping lanes off the Dorset coast for three years before it sank. It is exceptionally well preserved with the trawler’s key features such as its mine-sweeping gear, deck gun, portholes and engine room still intact on the seabed off St Alban’s Head.
The commemoration ceremony involved the beautifully-restored steam whistle, recovered from the wreck of HMT Arfon prior to its protection, being sounded for the first time since the sinking in 1917, when it was used to signal the code for ‘MINE.’ The names of the 10 crew that perished were read out in addition to the names of the three survivors. A group of more than 20 descendants were present for the unveiling of an information board, funded by Historic England, about HMT Arfon and its loss. Garry Momber, Director of the Maritime Archaeology Trust was also present.
Martin Jones (Swanage Boat Charters) with the whistle his team recovered from the wreck of the Arfon.
Martin Jones, the Historic England appointed licensee of the wreck, relates how he and his son Bryan discovered this important wreck site: “In 2013, by pure luck, whilst on a diving trip to another wreck, I spotted an anomaly on the sea bed. I marked the position on the GPS, but it was not until 2014 that my son, Bryan Jones, dived the site for the first time.”
Following ongoing research by Bryan Jones and local maritime historian Dave Wendes, which included visits to the National Archives at Kew, they proved it to be the lost wreck of the Arfon. The wreck lay undiscovered for 97 years in remarkably good condition, largely due to the fact that it now lies in a depression in the seabed at 43 metres.
The Maritime Archaeology Trust have also now launched an online dive trail which has been funded by Historic England. Derived from more than 10,000 images collected by the Trust’s divers over 2016 and early 2017, the commemorative dive features a guided 3D tour of Arfon as she lies on seabed today. It tells the story of the crew and their vessel through interactive information points, audio and videos, images, animations and 360 underwater panoramas of the wreck (see http://3d-tours.uk/arfon).
The 3D tour of the wreck of HMT Arfon. Accessible at: http://www.3d-tours.uk/arfon
Alison James, maritime archaeologist for Historic England said: “The new interpretation panel and virtual dive trail to commemorate the sinking of the Arfon will allow non-divers to find out much more about this fascinating wreck site.”
The steam whistle and other artefacts raised from HMT Arfon will be taken to Southampton where The Maritime Archaeology Trust plans to scan them so they can be examined in detail and virtually restored to the wreck as part of the commemorative website. The Trust are also planning further dives in 2017 that will keep adding to the virtual tour as part of their Heritage Lottery Funded Forgotten Wrecks of the First World War project (http://forgottenwrecks.org).
In relation to working with the relatives of the crew lost on HMT Arfon 100 years ago, Martin says “I have found it enormously rewarding sharing the information with the descendants of three of the crew and meeting them all on the centenary commemoration.”
He continues, “We would like to thank Historic England and the Maritime Archaeology Trust for the enormous amount of work that they have contributed to this project and we hope the Arfon will be left in its pristine condition and respected for its rarity and historical value for many years to come.”
About the MAT
The Maritime Archaeology Trust is a registered charity with over 20 years’ experience in research, investigations and pioneering techniques for the study of marine cultural heritage. Originating the South of England as the Hampshire and Wight Trust for Maritime Archaeology, we have grown from our regional roots to an internationally renowned authority on maritime archaeological issues and research.
We are proud of all of our work. This is why our fundraising efforts and donations are reinvested into delivering and developing education and outreach programmes to help inform the public about this rich area of cultural heritage.
Additional information about the MAT can be found at http://maritimearchaeologytrust.org; about the HLF Forgotten Wrecks of the First World War project (2014-2018) at http://forgottenwrecks.org.
Log In / Register to comment
Your comment has been sent for approval. You will receive an email when it gets approved. Got It!
Search for a name in our archive
Search over 23 Million records
Join 1175 other followers
You are now following this blog.
Get the latest from our blog in your favourite RSS reader or direct to your browser by using our RSS feed below:
British Military History Quiz
From Source to Screen - The Journey of a Record
The true story of the ‘Christmas Truce’
WW1 Medical Military Records Available Online - Search Now!
70 years ago come Saturday, 15th August 1945, Emperor Hirohito informs his people that Japan has surrendered.
Meet the Experts: Forces War Records Web Manager Neil White talks about his grandfather, who served in Burma in World War Two.
Soldiers of the Great War 1914-18 'Getting started researching your military ancestor'
Case study - Paul's story
WW2 Italian Prisoner of War Camp Records Released
Forces War Records On Who Do You Think You Are Live
1914 1944 air raid aircraft animals arctic convoy auction awards battle of britain blitz bomber command campaign medal centenary christmas churchill countdown to war cwgc dambusters d-day diary of the great war east african army events family genealogy family history family search family tree forces war records gallantry genealogy graves great war home front index kms bismarck lancaster luftwaffe medal medals media memorial mh106 military genealogy mons museum navy neil oliver normandy poster pow press raf records relic remembering remembrance research restored rfc royal air force second world war sinking soe somme south east asia command spitfire trenches updates victoria cross video war diaries war diary who do you think you are live world war one world war two ww1 ww2 wwi wwi centenary wwii youtube
|
cc/2020-05/en_middle_0097.json.gz/line1407202
|
__label__cc
| 0.737519
| 0.262481
|
Modern Car Guide 1944: Electrical Parts
E. Willoughby
Modern Car Guide 1944: Electrical Parts - PDF - 17.9MB
This handbook is an excellent resource for those interested in the workings of cars, or for those who have an interest in early model cars.
The 'Modern Car Guide: Electrical Parts of a Car' was written by E.P. Willoughby in 1944. It is the fourth volume in what was a series of publications named "The Modern Car Easy Guide Series".
This particular volume focuses on presenting and explaining the intricacies of the electrical parts and systems of a car.
This ebook is a the same as the CD version from Archive Digital Books Australasia which is available from Gould Genealogy & other retailers. This CD contains high quality scanned images of the whole original volume, and has been bookmarked for easy navigation. Pages can be searched, browsed, enlarged and printed out if required.
Modern Car Guide 1944: Electrical Parts - CD
Archive Digital Books Australia
(1944) 2009
|
cc/2020-05/en_middle_0097.json.gz/line1407207
|
__label__wiki
| 0.518369
| 0.518369
|
Scroll to see our Corporate Website
Information note and consent regarding cookies - This website uses its own technical cookies and third party cookies (technical and profiling) in order to improve your browsing experience and provide you a service in line with your preferences. If you click on this banner or close this window or access any element underlying this banner, you'll provide consent regarding cookies. If you want to learn more or prefer to withdraw consent for all or some of these cookies read our Cookie Policy
Hello, it appears that you are using a version of Internet Explorer (IE 11 or older) for which our website is no longer optimized; please consider updating it to newer versions or alternatively consider alternative browsers. Thank you, the generali.com team.
Discovering Generali
Download Center Contact US
Environment and Strategy
Our activities and business model
Historical pictures
Posters and advertising
The Generali Group Historical Archives
Group libraries
Pure-Risk Cover
Before Taking Out a Life Insurance Policy
Damage to property
Before Taking Out a Property and Casualty Policy
Insurance Product Distribution and Claims Management
Insurance for Companies
Insurance Products with social and environmental value
NPS: improving clients’ experience
Insurance for dummies
Generali’s approach to emerging risks
Charter of Sustainability Commitments
Innovation in order to grow
External commitments
Employees engagement
Investing in our people
Social Dialogue
European Works Council
Remuneration and incentives
We innovate for our people
A life-time partner to our customers
Listening to and satisfying customers
Distributors: the value of our networks
We innovate for our customers
Responsible investments
Incorporating ESG issues into investments
Responsible investment funds
Commitment to the climate
SRI network
Voting activities
Living the community
How we contribute
We innovate for society
Our commitment to the environment & climate
Group Policy for the Environment and Climate
Public commitments
Performance and Reporting
Data and performance
How we report
Sustainability indices and ratings
Diverse and inclusive
Our people’s stories
Your development with us
Openings for Graduates and Students
Investing in Generali
Performance by segment
Performance by country
Share information & analysts
Key share figures
Tickers and indices
Shareholding calculator
Debt composition and maturity
Credit analysts
Contacts for institutional investors
Contacts for retail shareholders
Executives interviews
Macroeconomic and insurance research
Main European companies
Administrative liability
Related-party transactions
Role, functions and activity
Meetings and attendance
Risk and Control Committee
Related party transactions Committee
Remuneration and Appointments Committee
Corporate Governance, social and environmental Sustainability Committee
Investments Committee
Strategic Operations Committee
Statutory Auditors
External Auditors Firm
Insider stock trading
List of insiders
Relations with institutions
Internal control & risk management
Internal control functions
AGM 2019 live streaming
AGM 2019 SMEI program
Generali Group / Discovering Generali / All / Letters from Bruxelles
Alert this page
Corporate & Group
Letters from Bruxelles
Pensions expenditure
Ageing in good health also means growing old with a dignified existence, guaranteed by adequate pension cover. In 2016, the expenditure for all types of social protection in EU-28 accounted for 19.1% of GDP with pensions alone reaching 10.2%. Pension provision and healthcare represented over two thirds (67.3%) of this spending. In 2015, expenditure for old age pensions was on average €14,288 per beneficiary in the EU.
In EU-28 the per capital spending in 2015 was an average of 8,229 PPS (this estimate includes 2014 figures for Poland). PPS (Purchasing Power Standards) are indicators calculated by Eurostat with the aim of eliminating differences between purchasing powers among the different EU member states. These countries have different pricing levels for goods and services, and therefore the PPS are calculated to ensure the comparability of prices of goods and services in the various EU countries. The highest per capita spending was recorded in Luxembourg (14,988 PPS), around six times higher than the lowest recorded (Romania with 2,504 PPS).
Source: EUROSTAT
EU-28 pensions expenditure in 2015 amounted to 12.8% of GDP (2014 figures for Poland). Among the EU member states, the percentage of pensions expenditure was particularly high in France (15.1%), and in many southern EU countries such as Portugal (14.9%), Italy (16.5%) and Greece (17.8%). At the opposite extreme, 6.8%-8.0% were recorded in the three Baltic member states, in Malta, and Ireland was even lower (5.5%).
https://public.flourish.studio/visualisation/339958/
Pension expenditure per beneficiary varies according to the type of pension involved. In 2015, the aggregate expenditure per beneficiary on old age pensions was estimated at €14.3 thousand in EU-28 (2014 figures for Poland). A slightly higher than average expenditure was recorded for old age pensions claimed early (€14.1 thousand per beneficiary) or for early retirement (due to reduced working capacity), with average expenditure of €13.9 thousand per beneficiary. Expenditure on part-pensions, in the meantime, averaged only €2.9 thousand per beneficiary, much lower than for any other form of pension as the beneficiaries of this type of pension also receive income from employment. In 2016, pensions expenditure per beneficiary in old age pensions (the most common type) varied among EU member states from €1.8 million in Bulgaria to €26.6 million in Luxembourg. In PPS terms, the average expenditure per beneficiary reached the peak of 19.9 thousand PPS in Austria, higher than Luxembourg (19.7 thousand PPS), whilst the lowest level was recorded in Bulgaria (4.3 thousand PPS).
Given this situation, through the Social Protection Committee, in 2017 the European Commission issued a report centred on adequacy and sustainability (sustainability referring to the physical and financial balance between assets and liabilities in pension schemes) of pensions in the EU. The Commission wrote that, in order to be sustainable in the long term, public pension schemes have to be able to absorb the effects of population ageing without destabilising the finances of member states. In this respect, recently in there have been years when this sustainability saw an improvement: six member states (Belgium, Luxembourg, Germany, Malta, Slovakia and Slovenia) were able to significantly increase their public pension expenditure, whilst in others (Denmark, France, Italy, Latvia and Croatia) there was a decline which “could imply significant risks for future adequacy of incomes in old age”. The Committee’s report concludes that in “in Member States where public pension costs are reducing, the expansion of private pensions would be expected to cover a large part of the possible gaps in adequacy” and that in any event “efforts to promote the development of cost-effective vehicles for complementary retirement savings would need to be stepped up in several of these countries” (EU - European Semester Thematic Factsheet - Adequacy and sustainability of pensions, Brussels, 31/10/2017).
Letters from Bruxelles Demographic change and health expenditure
Letters from Bruxelles Growth and saving
Pensions, a sustainable future Daniel Gros, Director of the Centre for European Policy Studies: “No emergency: technology and health will extend working life”
Long term care The ageing population increases the risk of non-self-sufficiency: the role of insurance companies
2 minute survey
Generali is one of the largest global insurance and asset management providers. Established in 1831, it is present in 50 countries in the world, with a total premium income of more than € 66 billion in 2018. With nearly 71,000 employees serving 61 million customers, the Group has a leading position in Europe and a growing presence in Asia and Latin America. Generali’s ambition is to be the life-time partner to its customers, offering innovative and personalized solutions thanks to an unmatched distribution network.
© Assicurazioni Generali S.p.A. - FISCAL CODE 00079760328 AND GROUP VAT NO. 01333550323
|
cc/2020-05/en_middle_0097.json.gz/line1407208
|
__label__cc
| 0.637227
| 0.362773
|
HomeLectures
Morality and the Mammalian Brain
Patricia Churchland
Self-caring neural circuitry embodies self-preservation values, and these are values in the most elemental sense. Whence caring for others?
The compelling line of evidence from neuroendocrinology suggests that in mammals, and possibly birds, caring for others is an adaptation of brainstem-limbic circuitry whereby what counts as 'me' extends to include offspring—'me and mine'. Oxytocin is at the hub of the intricate network adaptations. In some species, strong caring for the well-being of others may extend also to include kin or mates or friends or even strangers, as the circle widens.
Two additional interdependent evolutionary changes are crucial for mammalian sociality/morality: (1) modifications to the reptilian pain system that, when elaborated, yield the capacity to evaluate and predict what others will feel, know and do, and (2) learning, strongly involving imitation, linked to social pain and social pleasure that regulates the acquisition of the clan’s social practices and the emergence of a conscience tuned to these practices.
Social problem-solving, including policy-making, is probably an instance of problem-solving more generally, and draws upon the capacity, prodigious in humans, to envision consequences of a planned action. In humans, it also draws upon the capacity for improving upon current practices and technologies.
Unlike other mammals, humans have developed highly complex language, and highly complex cultures. This means that our sociality, and consequently ours systems of ethical values, have become correspondingly complex.
Braintrust: What Neuroscience Tells Us About Morality
In 2010, Patricia Churchland gave a single Gifford Lecture, “Morality and the Mammalian Brain”. This lecture provided an introductory framework, grounded in neuroendocrinology, for her book Braintrust: What Neuroscience Tells Us about Morality, released the following year. Evidence of her intent to provide a fully-orbed, naturalistic account of morality can be seen in Churchland’s bibliography which spans twenty-four pages; each chapter of the book heavily engages research in a variety of disciplines.
Patricia Churchland - Morality and the Mammalian Brain
Video of Patricia Churchland - Morality and the Mammalian Brain
|
cc/2020-05/en_middle_0097.json.gz/line1407211
|
__label__cc
| 0.70478
| 0.29522
|
The pile sat there Wednesday morning, like a tiny mountain of mush, in the middle of Weld County Road 72, still smoldering from a fire, emitting vapors reminiscent of a holiday trip to the dump.
Driver Bill Holtz stood by, waiting for another truck to come from the office to pick up his stack of stenchified stuff and continue its journey toward the landfill. Meanwhile, the huge pile of smoking garbage lay in the center of the dirt county road, and State Trooper Brian Williams was waiting nearby to make sure nobody tried to drive through it. The trash stopped traffic, both physically and aromatically, for about an hour.
The garbage adventure began about 10 a.m. Wednesday, when Holtz, a driver for Waste Management of Fort Collins, finished his Greeley route and was driving north on U.S. 85 toward the dump east of Ault.
“Then I saw smoke coming from the back of the truck, and I knew I had to get off the highway,” Holtz said. He pulled onto Weld County Road 72, drove east for about a block and stopped his smoking trash truck.
Holtz said he tried to extinguish the blaze with the truck fire extinguisher, “But that was like spittin’ in the wind,” Holtz said, wanting to use a more colorful phrase to express his frustration with the burning batch of bilge.
Finally, someone called the Eaton Fire Department.
“When we got there, flames were shooting from under the top of the truck,” said Eaton Fire Lt. Doug Dowdy. “In order for us to extinguish it, he had to dump it on the road.”
So Holtz pulled the big handle, and the smokin’ load of rubbish hit the road.
The pile contained the trash from 50 homes and businesses: coffee cans and soup cans and bleach bottles and beer bottles, bike frames and bike wheels and bike handlebars, potatoes, cabbages, eggs and carrots all decorated the road.
The pile included boxes from produce companies, boxes from computer companies, boxes from McDonald’s. There were mattresses and carpets and carpet pads and carpet liners.
Twenty-eight cubic yards of odoriferous refuse.
Eaton firefighters used little water to extinguish the fire, so the tainted water wouldn’t run off into nearby irrigation ditches.
Damage to the garbage truck was only the scorched paint, but fire officials said that could amount to $2,000.
No specific cause was found for the fire. Something that was discarded either was still smoldering or something was fanned into flames.
After Holtz waited a considerable time beside the moldy mountain, another truck and loader arrived from Waste Management, and the perilous pile was loaded and taken to the landfill.
However, any driver passing on Weld County Road 72 in the next couple of days likely will still catch a hint of the aromatic accumulation. The pile is gone, but the melody lingers on.
|
cc/2020-05/en_middle_0097.json.gz/line1407214
|
__label__wiki
| 0.515509
| 0.515509
|
Greif DoubleGreen™ COEX 10L Wins 2014 IAIR Sustainability Award
DELAWARE, Ohio (Oct. 15, 2014) - Greif (NYSE: GEF, GEF.B), a global leader in industrial packaging products and services, has been recognized with the 2014 IAIR Sustainability Award. The recognition cited Greif's long-standing commitment to developing innovations in industrial packaging and services that help global companies meet their measureable sustainability goals. IAIR organizers specifically cited Greif's advances in innovative material development and its DoubleGreen™ COEX 10L stackable jerry can, one of the first multilayer 10-liter plastic jerry cans made from renewable sugarcane.
"At Greif, we are focused on how sustainability drives innovation and improves outcomes for our customers. Companies are increasingly asking their supply chain partners to help them measure and reduce their environmental footprint, while protecting their products," said Eduardo Simoniello, vice president and general manager of Greif Latin America. "It's an honor to be recognized for developing industrial packaging that uses renewable plant materials. Our commitment to sustainable practices is long-standing and will continue to be at the forefront of Greif's culture of innovation."
The DoubleGreen COEX 10-liter jerry can incorporates green polyethylene that is derived from sugarcane ethanol and exceeds 50 percent of the total packaging composition. A Life Cycle Assessment (LCA) commissioned by Greif shows that the DoubleGreen COEX 10-liter jerry can is able to reduce CO2 emissions at a level of approximately 50 percent as compared to the traditional jerry can. Its stackable design eliminates the need for carton boxes for transportation, improves inventory management cost, removes the necessity for printing a duplicate label and optimizes the recycling process.
DoubleGreen is also UN certified, which means that Greif's customers will not need to worry about managing or paying for the UN Certification process themselves. The jerry can is produced by Greif in Brazil.
The IAIR Awards®-Excellence in Global Economy & Sustainability (www.iairawards.com) took place on Oct. 10, 2014 in Milan.
Greif is a world leader in industrial packaging products and services. The company produces steel, plastic, fibre, flexible, corrugated, multiwall and reconditioned containers, intermediate bulk containers, containerboard and packaging accessories, and provides blending, filling, packaging and industrial packaging reconditioning services for a wide range of industries. Greif also manages timber properties in North America. The company is strategically positioned in more than 50 countries to serve global as well as regional customers. Additional information is on the company's website at www.greif.com.
About IAIR and IAIR AWARDS
IAIR is a leading research institute and a global independent publisher, headquartered in Milan, Italy. IAIR AWARDS is one of the world's leading ranking and prize for excellences in global economy and sustainability.
|
cc/2020-05/en_middle_0097.json.gz/line1407215
|
__label__cc
| 0.745883
| 0.254117
|
The Pros and Cons of Social Proof for Seduction
By Alek Rolstad
In a PM, one of our readers asked the following question:
“I know there is a lot of material out there that covers this stuff. However I also know you must do things differently. For example you're probably the only seducer I've read who says you don't care about social proof. To me this makes it clear that you have incredible seduction skills, as you actually overcame this barrier. This is insane to me because so often in bars I feel like girls aren't responding to me well because I don't have social proof. And when I have girls with me they're much warmer.”
This is a an important thing to take note of, because a lot of pick-up and seduction material out there, especially when it comes to club game, emphasizes how status plays a huge role. The reader is right: I do not care that much about social proof or social status in the club. Still, I believe social proof can be an incredible tool of seduction.
So without any further ado, allow me to break this all down.
About the Author: Alek Rolstad
Alek Rolstad launched his pickup career at age 14, an early starter and seduction savant. His unique style of game focuses on “sex talk”: a way to make sex the primary topic of conversation. Sex talk lets the user excite girls rapidly, and filter for girls open to fast, raunchy, kinky one-night stands and sex. You can learn from Alek, the master and originator of sex talk himself, by booking a 1-hour phone consultation with him.
BOOK CALL WITH ALEK
|
cc/2020-05/en_middle_0097.json.gz/line1407217
|
__label__wiki
| 0.789986
| 0.789986
|
The First Apple Watch Prototype Was Just an iPhone With a Velcro Strap
By Kelsey Campbell-Dollaghan on at
Another day, another tidbit about the secretive design process that led to the creation of Apple Watch: This morning, Wired’s David Pierce describes the inner workings of the product teams that designed it.
The story is full of anecdotes. For example, Apple’s design team admits that the Watch was an attempt to “fix a problem it created”: getting people to look at their phones less. But most interesting are his insights into the actual prototyping process. Pierce describes the first prototype, an iPhone that had a to-scale outline of the Watch on its screen so users could run the early software on a touchscreen. How did they fake the “digital crown?”
Pierce explains on Wired:
[T]hey made a custom dongle, an actual watch crown that plugged into the bottom of the phone through the cord jack. In a sense the first true Apple Watch prototype was, like 10,000 Kickstarter projects, just a weird iPhone case with a strange accessory sticking out of it.
Another interesting nugget: How the Taptic Engin, —which delivers tiny taps to your wrist based on the Watch’s notifications, evolved into its own form of interface design. This so-called “Watch-specific synaesthesia” became a way for Apple’s designers to use tactile feedback in a far more specific and nuanced way than ever before:
What does a tweet feel like? What about an important text? To answer these questions, designers and engineers sampled the sounds of everything from bell clappers and birds to lightsabers and then began to turn sounds into physical sensations.
Which makes this the second time lightsabers were used as inspiration for the Apple Watch. That we know of. Read the entire feature over on Wired.
Image: Apple
taptic engine
Kelsey Campbell-Dollaghan
|
cc/2020-05/en_middle_0097.json.gz/line1407219
|
__label__wiki
| 0.652275
| 0.652275
|
Razer Blade Stealth Review: Compact, Powerful, Beautiful (and Pink!)
By Alex Cranz on at
If you opt to go for the quartz version of the new Razer Blade Stealth, you may be distracted by the pink. The keys, the trackpad, the bezels – hell, even the desktop is pink. Not “rose gold” like an Apple product, but pink like a Barbie box in the toy aisle. But do me a favour and look past the pink (the Stealth is also available in black) and focus on the rest of the redesign of Razer’s smallest laptop. Thanks to some smart aping from Dell, some serious power under the hood, and a uniquely Razer approach to the industrial design, the new Razer Blade Stealth is a compact wonder.
Up to now, the Stealth has been a solid laptop: a little too expensive, not quite refined, and clearly inspired by Apple and Dell. Late last year Razer introduced a big redesign. Now the 13-inch laptop has thinner bezels, like the ones Dell’s popularised, and hard edges, like the Razer Blade 15, or something from Microsoft.
It’s also much pinker than Apple’s version of pink.
The external redesign, and particularly the bezels, go a long way towards making this feel like a laptop worth its price tag. Dell’s XPS 13 has created a race amongst laptop makers – with everyone trying to shrink their bezels like Dell does. Smaller bezels means the same size display with a much smaller footprint. The Stealth is smaller than its predecessor and shares a footprint almost identical to that of the MacBook Pro.
The keyboard is similar in size to smaller 13-inch laptops like the XPS 13 and MBP, too, but Razer’s keyboard has a customisable backlight with a claimed 16.8 million colours available and a wide variety of brightness levels, too. The keys are also some of the best I’ve used on a laptop. My high-water mark for a laptop continues to be the keys found on Lenovo’s ThinkPad X1 series, but the Stealth’s keys have a lower profile and are much quieter without sacrificing too much of the typing experience. The only downside to the keyboard is the right shift key, next to the up arrow button. If you’re used to the up arrow key on the bottom row and the shift on the second row, you can expect a day or two of annoying mistypes before you nail it down.
It’s a minor complaint. The same goes for my issue with the display. Razer opted for a standard (and bright) 1080p display, but it feels about a year or two out of date next to the higher resolution displays Huawei and Apple are packing into similarly priced laptops. I doubt Razer will ever load the base Stealth with a 3,000 by 2,000 display like Huawei does because no games would support it, but man, it would be a bold move – maybe even bolder than an all pink laptop.
The caveat with all Razer laptops is the price. It’s almost always too much, and the Stealth doesn’t change that, but it makes a more compelling case than previous Razer laptops. There are three ways to buy the new Stealth. It starts at £1,300 for an Intel 8th-gen i7 processor, 256GB SSD, and 8GB of RAM. Hopping up to £1,500 tacks on an additional 8GB of RAM and an Nvidia MX150 discrete GPU (this is the version we tested). Finally, for £1,800 you up the storage to 512GB and move from a matte 1080p display to a glossy 4K display.
Razer squeezed not one, but two cameras, into the bezel, as well as a whole mess of microphones.
The MX150 is well on its way to being two years old at this point, but it’s still really uncommon in slick 13-inch laptops. Lenovo and Asus make smaller laptops with this GPU, but they’re pretty lame looking. Only Huawei, and now Razer, seem to have any interest in putting the MX150 in an attractive laptop. Maybe more importantly, adding the GPU instantly adds power.
Don’t expect to play Far Cry 5 at 60 frames per second, but Overwatch with graphics set to High still managed 57fps in our tests, and Civilization VI ran almost three times better on the Stealth as it did last year’s XPS 13. I spent the entire weekend playing Thronebreaker, which slows to a crawl when I play on an integrated GPU from Intel, but it played smoothly with the MX150.
In a sea of silver and grey and black laptops, the pink quartz edition of the Razer Blade Stealth stands out.
The speakers pumped out the music and the voices in the game with pleasing clarity, which was impressive because they had to overcome the din of the laptop’s fans. This thing runs loud when playing games. It also runs for a long time. In our battery rundown test, in which we stream YouTube video after setting the display’s brightness to 200 nits, the Stealth lasted 10 hours and 11 minutes. That’s just above average for the processor and display type, but impressive for a “gaming” laptop, with most of them typically crapping out well below 8 hours.
The Razer Blade Stealth is a proper laptop for all occasions, and in many ways, it’s a much better laptop than the XPS 13, which is around £1,400 with a similar config to what we tested (minus the GPU and 8GB of RAM), and the Huawei Matebook Pro X. And instead of mixing in with a sea of silver laptops that all seem to look like a MacBook from afar, the Stealth stands out. You’re paying a premium for style, but sometimes that’s okay.
It comes in pink now! (UK availability for the Quartz version is TBA)
The optional Nvidia MX150 shouldn’t be optional. Get it and enjoy gaming on a small laptop again.
The keyboard is one of the best I’ve used on a laptop in ages, but its weirdly placed Shift key is annoying.
Battery life is mighty respectable at 10 hours and 11 minutes, and the display gets bright enough for use in direct sunlight.
SPEC DUMP
Windows 10 • 13.3-inch 1920 x 1080 LCD display with Intel Core i7-8565U CPU/8GB of RAM/256GB SSD or 13.1-inch 1920 x 1080 LCD display with Intel Core i7-8565U CPU/16GB of RAM/256GB SSD with Nvidia MX 150 GPU or 13.3-inch 3840 x 2160 LCD touch screen with Intel Core i7-8565U CPU/16GB of RAM/512GB SSD • 3.5mm jack • 1x USB-C • 1x Thunderbolt 3 port • 2x USB-A 3.1 ports • 802.11 a/b/g/n/ac wi-fi • 720p front camera with .infrared Windows Hello • Bluetooth 5.0 • RBG backlit keyboard • 53.1 Wh battery • 11.99 x 8.27 x 0.58 inches • 2.89 pounds
razer blade stealth
Alex Cranz
|
cc/2020-05/en_middle_0097.json.gz/line1407220
|
__label__wiki
| 0.933763
| 0.933763
|
Watch A Queen Bee Mate With A Drone In Mid-Flight
jordan kushins
Apiphobes, look away now. Everyone else, you're about to see an incredible close-up of a queen bee getting busy in mid-air. Spoiler alert: the drone dies in the end. All hail the queen.
The clip comes courtesy of More Than Honey, a new film that examines the increasingly persistent buzz surrounding the worsening plight of honeybees. There's no known explanation for the widespread Colony Collapse Disorder, which has decimated over half of the 2.4 million beehives in the US alone over the past decade — a terrifying number made even more so by the fact that 80 per cent of our plant life depends on bee pollination (this is what grocery shelves would look like without their help).
In order to snag the footage they were after — a staggering 105 hours worth in 35 days — the crew employed a "bee-whisperer". This unconventional staffer kept tabs on 15 chosen colonies and anticipated their "important events", like storing pollen and building wax, so that the hives could be transported into a purpose-built studio in Austria and these scenes could be properly recorded when the time was right.
In an interview with the Honeybee Conservancy, director Markus Imhoff discussed the difficulties of capturing these insects in action. "The mating queen was the biggest challenge: we spent days on a scaffolding tower attracting drones with queen pheromones," he explains. "Her wedding flight, which was 36 seconds, took more than 10 days — and we only actually saw it one and a half times."
And while it may seem terrifying to see these swarms up close, after viewing the trailer it's actually far more haunting to see their lifeless bodies en masse. Here's hoping that answers, and solutions, arrive soon. [PopSci]
Everything We Know About The John Wick TV Show
Leah Williams 20 Jan 2020 3:27 PM
John Wick was an absolute phenomenon when it released in 2014, and basically relaunched Keanu Reeves' film career. It was followed by two excellent sequels, but that's not all - in 2017, it was confirmed that John Wick would spin off into its own TV show. Since then, we've only heard whispers about the fabled series, but what we do know is rather exciting.
|
cc/2020-05/en_middle_0097.json.gz/line1407221
|
__label__wiki
| 0.609695
| 0.609695
|
Home » What's On Glasgow West End: cinema, clubs, theatre, music, events, festivals, community and more » James Robertson, 14 March, 2016, Creative Conversations University of Glasgow Chapel 1 p.m.
James Robertson, 14 March, 2016, Creative Conversations University of Glasgow Chapel 1 p.m.
Creative Conversations – University of Glasgow Chapel
James Robertson is a poet and award-winning novelist. He is also a publisher of poetry and of children’s books in Scots which provide a lively introduction to Scots-language literary heritage. James Robertson was Writer in Residence at Brownsbank Cottage, former home of Hugh MacDiarmid from 1993-1995, and was first Writer in Residence for the Scottish Parliament (October 2004). His Voyage of Intent (2005) is a book of sonnets and essays written from his experiences during this residency.
His novels are The Fanatic (2000); Joseph Knight (2003), winner of both the Saltire Scottish Book of the Year Award and the Scottish Arts Council Book of the Year Award; and The Testament of Gideon Mack (2006). His latest novel is And The Land Lay Still (2010), which charts 60 years of change in Scotland and won the 2010 Saltire Society Scottish Book of the Year Award.
literature.britishcouncil.org/writer/james-robertson
Monday 14th March, 1pm, Glasgow University Chapel, James Robertson
University Chapel, West Quadrangle, Main Building Gilmorehill Campus, University of Glasgow, Glasgow G12 8QQ
Milngavie Makers Market, Saturday 19 March, 2016. 1 – 5 p.m.
Jenni Fagan, Creative Conversations, University of Glasgow Chapel 21 March, 2016 1 p.m.
This section: Books, Talks, Poetry Events, What's On Glasgow West End: cinema, clubs, theatre, music, events, festivals, community and more
Filed under: Books, Talks, Poetry Events, What's On Glasgow West End: cinema, clubs, theatre, music, events, festivals, community and more
Wrest and Maz O’Connor, Celtic Connections review Fionnuala Boyle
Winter Tree Identification Workshop
Luca Manning & Fergus McCreadie Celtic Connections
John Inglis Exhibition New Collages 2016 – 2019 Compass Gallery
Celtic Connections & Fallen Angels Club: Danni Nicholls
Isobel Campbell Isobel Campbell with Hannah Fisher & Sorren Maclean and Nina Violet Celtic Connections
Celtic Connections: SHHE SHHE + GRISLY FAYE Hug and Pint
Rachael Dadd, The Glad Cafe Celtic Connections
The Wandering Hearts and Zoe Graham, Celtic Connections
Mobilising for COP 26 – Climate, Justice, Jobs Glasgow
|
cc/2020-05/en_middle_0097.json.gz/line1407224
|
__label__cc
| 0.614938
| 0.385062
|
Pray for Lesotho on Sunday, May 18, 2014
By Mark Behle on May 12, 2014
Lectionary Selection: Acts 7:55–60
Prayers for Lesotho:
This day we lift up in prayer our partner church in Lesotho, the Lesotho Evangelical Church in Southern Africa (LECSA). We give thanks for their past 50 years of ministry since “coming of age” under Basotho leadership in 1964 after being nurtured by the Paris Evangelical Missionary Society since 1833. We pray for strong leaders who can lead the LECSA forward in the next 50 years, leaders who will have the courage to stand firm in faith with a willing spirit of forgiveness even in the face of persecution. We pray also that more men and women will hear Your call to serve in pastoral ministry among the Basotho people. We ask for your special blessing upon:
Rev. Nelson Posholi, who this month begins serving as the LECSA Executive Secretary. May he be guided in his service with wisdom and understanding.
Rev. Gilbert Ramatlapeng, who returns to parish ministry after serving as the LECSA Executive Secretary for the past four years.
Rev. Simeon Masemene as he continues serving as Moderator of the LECSA.
We ask these prayers in the name of Jesus. Amen.
Mission Stewardship Moment from Lesotho:
Pastoral ministry is of vital importance in nurturing the next generation of followers of Christ. Educating future pastors and evangelists in the Lesotho Evangelical Church of Southern Africa (LECSA) takes place at Morija Theological School. According to the school’s Director, Rev. Bernard Kometsi, one of the problems faced by the institution has been the scarcity of textbooks. Thanks to support from Global Ministries over the past two years, the school has been able to add significantly to its supply and also purchase books for the library. Although the school is relatively small, with anywhere from 30-50 students enrolled at a time, books are expensive and often not available even in neighboring South Africa. At the front of the school’s chapel are the words from Romans 11:14, “How can they hear without someone preaching to them?” In a similar vein, one could say, “How can seminarians study without books?” When you support the work of Global Ministries, your gifts do make a difference! Thank you!
(Prayer and Mission Moment by Mark Behle)
Mission Partners in Lesotho:
Christian Council of Lesotho
Lesotho Evangelical Church
More information on Lesotho:
http://globalministries.org/africa/countries/lesotho/
Global Ministries Missionary in Lesotho:
Mark Behle serves with the Lesotho Evangelical Church in Southern Africa and works in their planning office. He is working to identify development projects, assist the church in preparing project proposals and coordinating project implementation. He also works with the denomination’s Planning Commission.
Africa lesotho
Marco Cable
lcable@dom.disciples.org
|
cc/2020-05/en_middle_0097.json.gz/line1407227
|
__label__wiki
| 0.509094
| 0.509094
|
Info for buyers & sellers
How much rent can I get?
Charlestown48 Kirkdale Drive
48 Kirkdale Drive
Perfect for a Growing Family
This spacious family home is packed with potential! In a highly sought after location, the home is in an elevated position overlooking bush reserve. Offering a modern kitchen and bathroom, it's ready to move in, yet still offers plenty of scope to add value.
Large open plan lounge and dining, plus informal meals area off kitchen
Modern kitchen with stainless steel appliances and dishwasher
Three large bedrooms, all with built in robes, ceiling fans and air conditioners
Sleek, upmarket bathrooms
Double garage with internal access
Covered entertaining area out the back, and grassy yard with enough room for kids and pets
Downstairs you'll find a second bathroom, plus separate rumpus/living area. This area has yet to be renovated, so it's a blank canvas, brimming with possibilities! It would make a great media room, or separate accommodation for teenagers or in laws. Offering separate access via French doors out the front, it would also be an ideal home business or office, or easily converted into a separate flat for a second income.
This property is in a quiet, leafy location close to parks and walking trails. It's also just three minutes to Charlestown Square and five minutes to Westfield Kotara so you can enjoy the convenience of a central location! This home really has it all, and must be seen to be believed!
All information contained in this listing is provided to Global Property by the third parties, and is intended as a guide only. No warranty is given as to it's accuracy and purchasers should rely on their own inquiries.
Get to know Charlestown
Charlestown is an area that has and continues to have rapid growth. Originally surveyed in April 1876 the first subdivision was Ida Street, Pearson Street, Milson Street and Frederick Street. Charlestown was recently identified in the NSW Regional Strategy 2006 – 2031, as a key economic centre for the Hunter Region. The continuing development growth of Charlestown, is securing it to be the largest business centre within the Lake Macquarie City. The growth in terms of shopping, apartments, and new land release is huge. The completion of the many new developments is certainly providing the benchmark many other areas are trying to replicate. Being approx 4km2 in size, the area is serviced by 40+ parks covering around 14% of the total area. Having a wide cross section of the market, this area consists of 4 primary schools - Charlestown Primary, Charlestown South Primary, Charlestown East Primary and the St Joseph's Convent Primary School. The primary public school students can follow onto the nearby Whitebridge High School, whilst the catholic primary school students follow onto St Mary's High School at Gateshead or St Pius X High School at Adamstown. The Pacific Highway runs through the centre of Charlestown leading north and south, this provides easy access to Newcastle and the Port Stephens area or down to Gosford through to Sydney. Charlestown offers a number of recreational activities such as sporting fields, netball courts, sports clubs and pubs, library, a heated swimming pool, dance studios and a neighboring golf course, all support the community and provide the necessary services. There is also the Fern Lee Track in neighboring Dudley/White bridge which provides an excellent walking & cycling track. This is an area in high demand through, revitalization of one of the regions most central locations it accommodates all of your needs. Strong growth, services at your door, first class shopping, a key economic centre, minutes to beaches & lakes, tranquil walking tracks, all adding to the great value with an excellent growth prospect.
Learn more about Charlestown
Anthony Birt
Email Anthony
Shaun Fallins
Email Shaun
Land Size 607 Sqm
About Global Property
Global Property has been helping buyers, sellers and landlords in Lake Macquarie & Newcastle since 2002. We offer a totally independent brand, high profile marketing and leading edge technology. A local business with community ties, and a strong track record of results, your home is in safe hands with Global.
Careers at Global Property
© Copyright - Global Property 2020. Website by Agentpoint
|
cc/2020-05/en_middle_0097.json.gz/line1407228
|
__label__wiki
| 0.603686
| 0.603686
|
Akers Biosciences Completes Study on First Rapid Breath Test for Oxidative Stress
Test Demonstrates 99.5% Correlation With Reference Laboratory Method
August 18, 2016 07:00 ET | Source: Akers Biosciences, Inc.
THOROFARE, NJ--(Marketwired - Aug 18, 2016) - Akers Biosciences, Inc. (NASDAQ: AKER) (AIM: AKR), (the "Company" or "Akers Bio"), a developer of rapid health information technologies, announces the results of a study of the Company's BreathScan OxiCheck™ test ("OxiChek™"), the first disposable breath test to rapidly determine levels of oxidative stress in the body -- an indicator of the overall health and wellbeing of a person.
The study was performed in Philadelphia, PA, under the supervision of Adam C. Sobel M.D., Director, Medical of Akers Bio. The results were highly successful with a correlation between OxiChek™ and the standard reference laboratory blood testing method (TBARS) of 99.5%. The study demonstrated a reproducibility of 100%, meaning the test results from the same lung simulator had zero variation after multiple repeats. The study further demonstrated an intra-subject variation ranging from 1.61% to 14.87%, indicating a narrow variation upon multiple repeat tests by the same human subject.
OxiChek™ is a general wellness product from Akers Wellness™, intended to measure indicators of oxidative stress in exhaled breath. Unlike current laboratory testing methods that test only a few free radicals using an invasive blood draw -- and have a turnaround time of 7 to 10 days -- Akers Bio's rapid OxiChek™ test detects a broad spectrum of free radicals contained in a person's exhaled breath in just a few minutes.
OxiChek™ works with BreathScan Lync™, the new bluetooth-enabled reading device from Akers Wellness™, to enable users to track their results via a mobile device. It can be used to promote, track and/or encourage choices, such as use of nutritional supplements which, as part of a healthy lifestyle, may help to reduce the risk of certain chronic diseases or conditions.
Raymond F. Akers, Jr. PhD, Co-founder and Chief Scientific Director of Akers Bio, said: "Once again a study has demonstrated an exceptionally high correlation between an Akers Bio rapid breath test and an established reference laboratory blood test. This further underpins the value which we believe lies within our proprietary breath testing technology which we have always believed would very closely mirror blood testing for certain biomarkers.
"We are very excited about these particular study results for OxiChek™. Not only do they demonstrate the effectiveness of our test for oxidative stress, but the comparison to the standard reference laboratory test -- blood vs breath -- is remarkable. Add to this the results of an earlier study that showed a significant correlation between OxiChek™ results and the age of the test subjects, and we believe that we have a powerful tool for the expansive health and wellness and anti-aging industry."
John J. Gormally, Chief Executive Officer of Akers Bio, added: "I am delighted with the outcome of this study. Our work in demonstrating the efficacy of the OxiChek™ test strongly underpins the commercialization strategy for this exciting new product from Akers Bio. We have just begun selling OxiChek™ through our recently appointed distributor Aero-Med, which is targeting the anti-aging, functional and integrative health and wellness treatment practitioner market in the US; and we are also in active discussions with other distribution partners for OxiChek™ with capabilities within other target markets."
BreathScan OxiChek™ and other Akers Bio health and wellness tests do not require US FDA clearance and are being marketed now in the US and other territories covered by the Company's international distribution network.
About Akers Biosciences, Inc.
Akers Bio develops, manufactures, and supplies rapid screening and testing products designed to deliver quicker and more cost-effective healthcare information to healthcare providers and consumers. The Company has advanced the science of diagnostics while responding to major shifts in healthcare through the development of several proprietary platform technologies. The Company's state-of-the-art rapid diagnostic assays can be performed virtually anywhere in minutes when time is of the essence. The Company has aligned with major healthcare companies and high volume medical product distributors to maximize product offerings, and to be a major worldwide competitor in diagnostics.
Additional information on the Company and its products can be found at www.akersbio.com. Follow us on Twitter @AkersBio.
Cautionary Statement Regarding Forward Looking Statements
Statements contained herein that are not based upon current or historical fact are forward-looking in nature and constitute forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Such forward-looking statements reflect the Company's expectations about its future operating results, performance and opportunities that involve substantial risks and uncertainties. These statements include but are not limited to statements regarding the intended terms of the offering, closing of the offering and use of any proceeds from the offering. When used herein, the words "anticipate," "believe," "estimate," "upcoming," "plan," "target," "intend" and "expect" and similar expressions, as they relate to Akers Biosciences, Inc., its subsidiaries, or its management, are intended to identify such forward-looking statements. These forward-looking statements are based on information currently available to the Company and are subject to a number of risks, uncertainties, and other factors that could cause the Company's actual results, performance, prospects, and opportunities to differ materially from those expressed in, or implied by, these forward-looking statements.
Akers Biosciences, Inc.
Raymond F. Akers, Jr. PhD
Co-founder and Chief Scientific Director
Taglich Brothers, Inc. (Investor Relations)
Email: cs@taglichbrothers.com
finnCap (UK Nominated Adviser and Broker)
Adrian Hargrave / Scott Mathieson (Corporate Finance)
Steve Norcross (Broking)
Vigo Communications (Global Public Relations)
Ben Simons / Fiona Henson
Email: akers@vigocomms.com
BreathScan OxiCheck
View Image: S
|
cc/2020-05/en_middle_0097.json.gz/line1407229
|
__label__cc
| 0.749642
| 0.250358
|
BMus/BSc (Hons) Electronic Music, Computing and Technology
Order a prospectus Book an open day
WG34
A-level: BBB
BTEC: DDM
IB: 33 points overall with Three HL subjects at 655
3 years full-time; 4 years full-time with the third year spent on a placement in a relevant industry or institution; 6 years part-time
Imagine being able to create your own tools for performance. Or develop your own instruments, interactive installations or reactive sound design. This interdisciplinary programme gives you that opportunity.
Why study BMus/BSc Electronic Music, Computing and Technology at Goldsmiths?
Alongside developing your own musical practice, you will learn to create custom software that can be used to further your artistic goals and to pioneer the future of electronic music. You'll learn electronic music composition, production and performance with software design and digital signal processing.
After your first year, you can choose to pursue a more technical or artistic path of study, leading to either a Bachelor of Music (BMus) or a Bachelor of Science (BSc) degree.
The degree is designed to meet the opportunities, challenges and intellectual demands presented by careers in the arts and creative industries, in music technology and in audio, music and media-related computing. You'll develop understanding across the broad fields of creative practice, computer science, and musical research.
You'll study with a wide range of academics, including internationally established composers, performers, writers, and computing experts. Most importantly, you will be able to participate in, and benefit from, two of the most dynamic and exciting departments - Music and Computing - that Goldsmiths has to offer.
If you have specific questions about the degree, contact Freida Abtan.
What you'll study
This degree allows you to identify and develop your strengths and interests by choosing various specialist options in the Departments of Music and Computing.
In your second year, you'll select from one of four possible pathways through the programme, which will determine the award of either BMus (Hons) or BSc (Hons):
Pathway 1 (BSc): 50:50 Music:Computing in Year 2 and Computing Major Project in Year 3
Pathway 2 (BSc): Computing focus in Year 2 and Computing Major Project in Year 3
Pathway 3 (BMus): 50:50 Music:Computing in Year 2 and Music Major Project in Year 3
Pathway 4 (BMus): Music focus in Year 2 and Music Major Project in Year 3
Year 1 (credit level 4)
In your first year you'll study the fundamentals of computer programming, contemporary music and music technology.
You will study the following compulsory modules:
Introduction to Programming – Part 1
This course will introduce you to the fundamentals of programming and object orientation, including the following basic ideas of programming, including: variables, memory and assignment statements, control through conditional statements, loops, functions and procedures, objects and classes, instance variables and methods, arrays, user interaction interaction between objects, inheritance, and polymorphism.
Numerical Maths
This module introduces fundamental numerical tools to support computational and algorithmic inquiry, and to enable effective computational experimentation.
explain the need for different number systems
understand what a prime number is and perform arithmetic modulo prime bases
appropriately use combinations of trigonometric or special functions
represent abstract locations in vector coordinate systems, and derive and apply transformation matrices
Sound and Signal
In this module you will learn the technical fundamentals of computing techniques used in digital media with a particular focus on sound and music computing.
The topics you will cover include applying and manipulating digital audio media for interactive contexts, sound synthesis theory and fundamentals, basic signal analysis techniques, and rudimentary digital signal processing in an audio buffer.
You'll practice this knowledge through a series of practical and creative exercises, undertaken throughout the module, and will undertake this using appropriate procedural environment with supported audio libraries.
Approaches to Contemporary Music
The aim of this module is to introduce you to the styles you will encounter, the debates you will need to consider and the critical skills you will require in studying western musics of the period 1900 to the present.
While exploring musical repertoires of various kinds, from classical to popular (and beyond), the module will:
investigate the ways this music has been thought and written about
explore historical cultural contexts
develop your skills in critical reasoning, conducting research and presenting written argument
You will be encouraged to think about relationships between musicians, their works, and their contexts, and to engage as they do with appropriate ideas from such disciplines as historical studies, sociology, cultural studies, ethnomusicology and musical analysis.
Music Computing 1
Introduces the overarching themes of music computing: how computers listen and analyse sound and music, how they can generate musical and sonic processes and structures, and how they can render these patterns as sound and music. You develop an understanding of the origins and development of computer-aided composition and computer-based electronic music, presented in a short series of repertoire-based case studies.
Live Performance Systems
Electronic Music Composition and History
In your second year, you'll take the following compulsory module:
This module introduces advanced concepts in music computing as applied to analytic study and creative practice. Methods, concepts and wider implications of music information retrieval and computer-based musicology are explored with reference to notated scores, MIDI data and audio. We also explore the application of artificial intelligence (AI) to music, improvised performance and live DSP. You'll develop your expertise in a music programming language, and learn how to interface audio systems with AI modules. A key concern is the interaction between users and performers and computer music systems in a real-life setting. You'll develop an understanding of practical and aesthetic issues in the production and presentation of such work.
Depending on your chosen pathway, you will study the following compulsory modules:
Pathways 1 and 3
Sonic Art Techniques
This module enables you to acquire fundamental skills in the use of studio equipment and software which are relevant to experimental electronic music and electroacoustic composition. These include recording techniques, sound editing and mixing, digital audio processing and use of MIDI. You will also be introduced to a range of experimental electronic/electroacoustic repertoire and associated compositional approaches.
Indicative repertoire:
Pierre Schaeffer - Quatre études de Bruits (Four Studies in Noise) (1948)
Karlheinz Stockhausen - Gesang der Jünglinge (1956)
Steve Reich - It's Gonna Rain (1965)
Alvin Lucier - I Am Sitting In A Room (1969)
Jonathan Harvey - Mortuos Plango, Vivos Voco (1980)
This module is a co-requisite for L2 Sonic Art Practice , and a pre-requisite for L3 Phonography and Live Electronics.
Basic proficiency in the use of studio equipment and software including the mixing desk, recording media, effects processors, Apple Mac computer, ProTools and Audiosculpt.
Detailed knowledge of selected approaches to contemporary electroacoustic composition
An ability to evaluate by listening electroacoustic music, demonstrating an awareness of compositional method and structure.
Sonic Arts Practice
Following Sonic Art Techniques, this module explores the experimental creative possibilities of the studio. Historical and current directions in computer music and sonic art are considered, including acousmatic music, phonography, text-sound composition, algorithmic composition and plunderphonics, with reference to aesthetic issues, historical and cultural contexts and most importantly compositional techniques. You will be introduced to non-real time software for analysing and transforming sound, including Audio Sculpt, Sound Hack and Metasynth. You are encouraged to develop your understanding and technical skills in the production of one substantial composition and a reflective commentary about one pivotal work by an established composer/sound artist.
The co-requisite for this module is Level 2 Sonic Art Techniques.
Popular Music Production
This module highlights a range of recording techniques and music technology, focusing on sequencing, sampling, multi-track recording, use of a mixing desk, audio and digital effects and microphones. In addition the module introduces the key aesthetic concepts which underlie contemporary production techniques and emphasises the creative importance of recording and technology in popular music. This module will also seek to enable you to explore and develop imaginative and innovative production techniques in a supportive environment, and ultimately set them upon a path to developing their own voice and identity as composer/producers.
Systematic understanding of key music software
Ability to sequence and sample music
Systematic knowledge of basic studio recording technology
Understanding of the creative use of music technology in popular music
Understanding of the key aesthetic concepts that underlie production techniques
Perception and Multimedia Computing
This module aims both to build on the skills and competences developed in the technical modules in the Creative Computing Programme at Level 4, as well as the critical and creative awareness fostered in the Introduction to Creative Practice module. Providing knowledge and skills to be used in exploratory fashion in the Creative Projects, this module will also allow you to develop your own creative practice in general. It will provide you with a detailed appreciation of human visual and audio perception, allowing you to explain the limitations of your own sensory gamut, and to be able to exploit similarities and differences between observers perceptual systems.
You will learn the fundamentals of signal processing and systems, including a programming language suited to the signal processing domain, and how they are applied in typical multimedia applications; andwill then be shown how to combine these signal processing techniques with an understanding of perception to produce multimedia information retrieval systems.
Visual perception: cones, rods and the eye; optical illusions; colour vision; colour spaces and
profiles; motion perception and Gestalt psychology.
Animation: approaches to animation; perception in video and film; making animations; visualisation.
Sound, hearing and music: sound and the ear; frequency, pitch and harmony; melody; rhythm;
digital audio formats and compression.
Signals: the nature of signals; special signals; audio signals and sampling; frequency, amplitudend phase; the Fourier representation.
Systems: linearity and time-invariance; impulse responses and convolution; spectral analysis;
convolution by spectrum multiplication.
Audio and image filtering: EQ; filter design; subtractive synthesis; echo and reverberation; resampling; image representation; two-dimensional convolution and image effects.
Multimedia information retrieval: retrieval, fingerprinting
Principles and Applications of Programming
This module covers:
Program development on a primary (Java) and secondary platform (Android)
Fundamental data structures and algorithms
Computational complexity, run-time efficiency
OO design and implementation
General features of programming languages eg type, abstract data types, the memory model, virtual machines, scope
Specific language features: primitive and reference types, class and instance variables, overloading, string manipulation, input and output streams, serialisation, internet connectivity, error handling, generics, threads, memory management
Advanced software techniques: concurrency, internet programming, GUI and event driven programming
Pathway 2 (Computing focus)
Perception and Multimedia Programming
This module aims both to build on the skills and competences developed in the technical modules in the Creative Computing Programme at level 4, and on the critical and creative awareness fostered in the Introduction to Creative Practice module; and to provide knowledge and skills to be used in exploratory fashion in the Intermediate Creative Practice and in your own creative practice in general. It will provide you with a detailed appreciation of human visual and audio perception, allowing you to explain for yourselves the limitations of your own sensory gamut, and to be able to exploit similarities and differences between observers’ perceptual systems.
You'll learn the fundamentals of signal processing and systems, including a programming language suited to the signal processing domain, and how they are applied in typical multimedia applications; you will then be shown how to combine these signal processing techniques with an understanding of perception to produce multimedia information retrieval systems.
This module provides you with the opportunity to develop your own creative projects through a variety of means, by focussing on a particular approach, task, concept and platform. It will also take you through the entire production process, from user centred design, to proposal development and implementation. This will re-enforce abilities in project management, planning, critical awareness and design that you need to develop in order to create better software and creative projects.
You will be working individually and/or in groups to conceive, develop and produce finished practical software projects in creative computing, making the fullest possible use of your creative and programming skills. Each project is uniquely specified to allow you the fullest possible creative choice. Projects are mentored by the module leader to ensure that they are at the appropriate level, and to provide you with specific programming and practical suggestions where required. All student projects must feature the creative use of digital media technologies through applied programming.
In addition to allowing you to develop your skills in a chosen area of interest, this unit encourages you to make coherent judgments regarding the application of your computing skills as you develop and reinforce your technical knowledge through creative projects.
Pathway 4 (Music focus)
For Pathway 4, you will also select optional modules to the value of 45 credits, from a list of available Music electives.
Depending on your chosen pathway, you'll take one of these two core modules (this choice determines the name of the final award, either BMus or BSc):
Major Project: Music (60 credits)
Major Project: Computing (60 credits)
You'll also select a total of 60 credits from an annually approved list of optional modules, which will vary depending on your pathway.
For Pathways 1 and 2, you choose modules to the value of 45-60 from Computing and 0-15 credits from Music.
For Pathways 3 and 4, you choose modules to the value of 45-60 credits from Music and 0-15 credits from Computing.
Computing modules
Advanced Audio-visual Processing
This course extends the principles of creative engineering for use in arts, games, and more general interaction scenarios so that students can develop their own projects through the use of computational approaches to audiovisual processing. The lessons will be taught using Javascript or C++. It is recommended that students have some experience with using Processing and some background in digital audio and/or digital image manipulation before taking this course. We will spend the first few sessions exploring Digital Audio Signal Processing. This will cover synthesis, sequencing, filtering, sample loading and playback, panning and rudimentary analysis. Following this we’ll be looking at audiovisual interaction using video and 3D graphics.
Provides a broad overview of topics in securing computer-based resources, especially the information stored on hardware and controlled by software. We explore core concepts of computer security, including attacks and control, and various techniques for the protection of computer-related assets. Covers topics including computer security, attacks and control, elementary cryptography, cryptosystems, security control models, security problems and protection in operating systems, in databases and data mining, and in networks, security management and administration, legal and ethical issues: patents, copyrights and trademarks, and prosecution.
A machine is artificially intelligent when it manages to perform a task that we thought, until the machine proved capable, required human intelligence. Afterwards, we recalibrate our definition of intelligence.
Ai is a broad field and includes many disciplines and ideas. But a new technique is taking over.
Machine learning, an AI technique, has been around for a while. A special machine learning practice known as Deep Learning is revolutionising AI. It is everywhere - or will be soon.
Simply, AI ≈ DL.
We will learn how to build DL programs - known as models - and train them on huge datasets. We will be using TensorFlow, Google's important DL resource. TensorFlow, in turn, is programmed using Keras, a high-level Python library. We will write Keras DL code in Jupiter notebooks and plot graphs with another Python library, matplotlib. Finally, our programs will rely on Python's special library for numerical calculation - Numpy
Introduces the theory and practice of neural computation. Covers the principles of neurocomputing with artificial neural networks widely used for addressing real-world problems such as classification, regression, pattern recognition, data mining, time-series prediction. We look at supervised and unsupervised learning. We study supervised learning using linear perceptrons, and non-linear models such as probabilistic neural networks, multilayer perceptrons, and radial-basis function networks. Unsupervised learning is studied using Kohonen networks. We provide contemporary training techniques for all these neural networks, and knowledge and tools for the specification, design, and practical implementation of neural networks.
Tutor: Dr Nikolay Nikolaev
Physical Computing 1
Physical Computing is of increasing interest to artists, musicians, choreographers and other creative practitioners for the creation of novel artworks and also for forms of computational interaction between these objects and people. There are many other applications of Physical Computing, for example in museums, ubiquitous and embedded computing, robotics, engineering control systems and Human Computer Interaction.
A physical environment may be sonic, tangible, tactile, visually dynamic, olfactory or any combination of these. In this module, you will learn how the environment, which is essentially continuous, can be monitored by analogue electrical and mechanical sensors. Computers, however, are digital machines programmed by software. One element which you will focus on, therefore, is the interface between the digital and the analogue.
This study will encompass basic physics, electronics, programming and software engineering. The practical objective of this module is the development of the skills you will need for designing and building interactive physical devices.
This module provides you with advanced skills in designing interactive systems and an in-depth understanding of emerging practico-theoretical developments in interaction design.
The module is delivered as a series of workshops, lectures and seminars where you're introduced to a range of key technical skills for making interactive platforms, and develop an understanding of the role of prototyping though the embedding of technical work in the pursuit of a series of design briefs.
You'll be able to then use these technologies in your projects, and develop an understanding of the roles of software and hardware development.
Provides you with theoretical knowledge of basic and advanced machine learning algorithms and statistical techniques utilised in the process of discovery of hidden patterns in potentially large volumes of data. Practical data mining will be introduced through both algorithm implementation in Java and data mining software utilisation for knowledge discovery in data from various fields of activity.
Data Visualisation and the Web
A large amount of data is available in electronic resources, both offline and online. This module will give a broad introduction to techniques for gathering data from electronic sources, such as databases and the internet. It will cover both fundamental ideas and the use of some of the most important currently available tools. The module will also present tools and ideas for more effectively using the internet to communicate, visualise and generate news stories.
Data and Machine Learning for Creative Practice
The module will expose students to state-of-the-art techniques, tools, and open questions related to creative uses of data, signal processing, and machine learning. The emphasis will be on developing hands-on skills using these techniques in creative projects, and on exploring the creative potential of these techniques.
Specifically, students will learn about topics including:
Representations and feature engineering for sensor data, audio data, image and video data, social media data, etc.
Signal processing techniques for working effectively with this data (e.g., perceptual audio and video features, smoothing filters,
onset detection)
Communication protocols for working with real-time data (e.g., OpenSoundControl, Web Sockets, serial)
Applications of classification to creative and interactive contexts: e.g., human pose recognition, activity recognition, semantic
audio analysis
Applications of regression to creative and interactive contexts: e.g., creating continuous gestural controllers and multimodal
mappings (such as music visualisations, gesturally-controlled instruments)
Applications of temporal modeling to creative and interactive contexts: e.g., gesture recognition, temporal analysis of music or
Current topics in signal processing and machine learning in music, art, and other creative industries (e.g., Google's "Deep
Dream," chat bots, image style transfer)
Tools for working with data, signal processing, and machine learning in creative projects, including tools for real-time data
Reasoning about fundamental questions in machine learning and data mining, including e.g., how can an algorithm learn from
data? What feature representations should we use for a given problem? How do we know whether one algorithm is better than
another?
Music modules
Minimalism and Postminimalism
This module assesses the history, techniques and aesthetics of musical minimalism in the context of contemporary cultural practice. The period covered ranges from its prehistory in the output of such composers as Satie, through its early maturity in the work of Young, Riley, Reich and Glass, to some of the manifestations of their heritage in the music of such younger composers as Pärt, Branca and Skempton.
A detailed understanding of the main general movements in minimalist sculpture and painting in this period.
A detailed understanding of the main movements in musical minimalism and postminimalism in this period.
A systematic understanding of the compositional theories and practices of the composers discussed.
A systematic understanding of the processes of change (technically and aesthetically) and how historical judgements are made.
Ability to question historical judgements and values.
Ability to use primary and secondary sources discerningly.
Ability to use an appropriate technical methodology and vocabulary in written work.
The art of phonography is regarded by some as a recent phenomenon; however the recording, editing and juxtaposing of 'real world' sounds within an artistic context can be claimed to be as old as the technology such practice utilises, and likewise there are as many aesthetic approaches to working with such materials as there are composers working within this genre.
This compositional module will creatively explore the domain of field recording, including the use of recorded sounds in documentary, acoustic ecology and sound art. It will theoretically and practically tackle the salient issues and simultaneously build up the technical skills required in the practice of phonography.
A detailed understanding of the techniques involved in phonography through hands on experience of a range of field recording techniques.
A detailed understanding of current as well as historical precedence of phonography.
An awareness of the salient aesthetic, political and ecological issues that underline phonographic practice.
An ability to record, edit and juxtapose 'real world' sound within a critical framework.
A critical understanding of the notion of context and site-specific practice.
The pre-requisite for this module is Level 2 Sonic Art Techniques.
Creative Orchestration and Arrangement
This module aims to familiarise you with standard principles of orchestration and arrangement as found in various forms of late twentieth century music – concert composition and orchestral transcription, film scoring, and jazz/popular music studio arranging - drawing from a diversity of source material.
It examines the idiomatic use of orchestral instruments and instrumental groups, standard techniques of orchestration and orchestral transcription, and offers creative resources for arrangement.
The module helps you develop the conceptual and analytical tools to ‘reverse engineer’ techniques of orchestration and arrangement in scores and recordings. Teaching takes place through lectures, workshops, tutorial groups, and through online resources, both on the VLE, and at external sites. You will be encouraged to contribute to a database of significant examplars of instrumental use, of specific techniques, and of creative arrangement.
The pre-requisite for this module is Level 2 Arranging in Jazz and Popular Music.
Music/Modernities
‘Manhattan’, Le Corbusier wrote in 1935, ‘is hot jazz in stone and steel’. The architect wasn’t alone in imagining both built and sounding constructions as articulating a singular design for future living, but what were these modernist ideals that you could touch as well as hear? The theorist Charles Jencks would later date the death of that dream to 1972, and the detonation of the modernist Pruitt-Igoe housing project in St Louis, Missouri – a citation that would become as ubiquitous in the cliché-happy postmodern era as that of John Zorn, the composer-improviser who traded in cut-ups and cartoons and who, in the words of Susan McClary, ‘revelled in the rubble’ of a once-proud Western cultural edifice. Futurism and referentiality, confidence and anxiety, from the solid to the fragmented and on to the airlessly virtual: now, in the twenty-first century, music of all kinds flits around the borderless internet, meshing with other media forms in endlessly mutable networks. Does the work of a composer like Jennifer Walshe – whose operas are based on video game footage, and who, in multiple personae, performs musics ranging across drone, telepathic improvisation and Irish dada sound poetry – sound a digitised post-postmodernity? This module explores notions of the modern, postmodern and post-postmodern in music of all kinds and culture more broadly, considering classic and emerging characterisations of each moment; warily though - you are encouraged to think around illiquid periodisations, and to construct nimble ideas on the creative and theoretical uses made of the new and the old, the human and the machine, the local and dematerialised, the fast and the faster, across music’s modernities.
1. A developed knowledge of musical theories and practices associated with modernism, postmodernism and a putative ‘post-postmodernism’.
2. A developed ability to read musical activity in light of wider social and cultural processes, and vice versa.
3. A developed ability to carry out research.
4. A developed ability to present complex critical thinking and arguments in written form.
Narrative, Representation and Popular Song
This module aims to engage with theories of representation and narrative in order to understand how the popular song uses words and music to convey information about, comment upon and tell stories about the world. It will be concerned with fiction as much as realism; social intervention as much as imaginative escapism.
The module will combine theoretical reflection with detailed case studies. Although the main focus will be on songs composed over the past seventy years, it will also consider various historical legacies (particularly the lyrical and musical influence of folk ballads and the blues). The module is concerned with analysing how lyrics and music work together and students will be expected to familiarise themselves with and draw from a wide range of theoretical perspectives including discourse theory, music semiotics, musicology, literary theory and theories of realism.
Case studies will be approached via individual songs, groups of songs that comment on specific events, and specific themes/ issues. The module will be delivered via a combination of lectures, seminars and non-assessed group presentations.
A knowledge of a wide range of musical, lyrical and vocal strategies used by musicians, singers and songwriters when communicating ideas about the world.
An understanding of various rhetorical devices (music, verbal, literary) deployed in songs of social commentary and observation.
Familiarity with a range of theoretical perspectives and conceptual models that can be drawn on when analysing the popular song.
An understanding of the ways that performed songs work across and play with the conventional distinctions between realism and fiction.
An understanding of how musical and verbal meanings are shaped by varied politicised contexts of reception and interpretation.
Musical Structure and Understanding
This module provides an overview and critique of methods for analysing Western art music from 1750, and examines to what extent analysis might inform the understanding of performer and/or listener. By studying how theory-based analysis can illuminate meanings in music, we can see also how analytical tools are the output of specific social contexts.
The module develops analytical skills of a selected method or set of methods, and reviews concurrent criticism of these approaches. The module relates musical form and structure to performance, considering by what means an analytical approach can enrich the performer’s execution and the listener’s apprehension/participation. The exact methods and materials explored will depend on the expertise of the lecturer but typical examples might include: analyses of non-Western repertoires; reflection on the semiotics of ‘topics’ in Classical music and 18th-century performance practice; how 19th-century programme music resists and depends on abstract structure to generate a narrative; how different analytical approaches might shape in, different ways, the registral, temporal, and dynamic contours latent in the score.
the understanding of contrasting methods for analysing music
the application of analysis to notated music
the illumination of how analytical knowledge strengthens abilities in listening and playing
the acquisition of tools to critique methods of musical analysis
Psychological Approaches to Music
This module aims to provide an introduction to the study of music psychology. Lectures will focus on the perception, cognition and neural basis of musical understanding, the perception of musical structure and emotions and theories about music’s evolutionary roots. The scientific methods used in research will be explored in a lab-based class. Student evaluation will be made on the basis of a written assignment selected from a pool of questions.
This module is offered in collaboration with the Department of Psychology.
Teaching style
This programme is taught through a mixture of lectures, tutorials, workshops and laboratory sessions. You’ll also be expected to undertake a significant amount of independent study. This includes carrying out required and additional reading, preparing topics for discussion, and producing essays or project work.
The following information gives an indication of the typical proportions of learning and teaching for each year of this programme*:
Year 1 - 21% scheduled learning, 79% independent learning
Year 3 - 3% scheduled learning, 97% independent learning
How you’ll be assessed
You’ll be assessed by a variety of methods, depending on your module choices. These include coursework, examinations, group work and projects. If you opt for an industrial placement year, your placement tutor will assess your work. If you complete the placement year successfully, you earn the endorsement 'with work experience' on your degree certificate.
The following information gives an indication of how you can typically expect to be assessed on each year of this programme*:
Year 1 - 81% coursework, 10% written exam, 9% practical
Year 2 - 88% coursework, 13% written exam
Year 3 - 100% coursework
*Please note that these are averages are based on enrolments for the traditional pathway in 2018/19. Each student’s time in teaching, learning and assessment activities will differ based on individual module choices. Find out more about .
Credits and levels of learning
An undergraduate honours degree is made up of 360 credits – 120 at Level 4, 120 at Level 5 and 120 at Level 6. If you are a full-time student, you will usually take Level 4 modules in the first year, Level 5 in the second, and Level 6 modules in your final year. A standard module is worth 30 credits. Some programmes also contain 15-credit half modules or can be made up of higher-value parts, such as a dissertation or a Major Project.
Download the programme specification. If you would like an earlier version of the programme specification, please contact the Quality Office.
Please note that due to staff research commitments not all of these modules may be available every year.
We accept the following qualifications:
International Baccalaureate: 33 points overall with Three HL subjects at 655
Access: Pass with 45 Level 3 credits including 30 Distinctions and a number of merits/passes in subject-specific modules
Scottish qualifications: BBBBC (Higher) or BBC (Advanced Higher)
European Baccalaureate: 75%
Irish Leaving Certificate: Three HL subjects with 655
An A-level, or equivalent, qualification in Music or Music Technology is preferred, although we also accept applicants without a formal qualification in music who can demonstrate relevant knowledge and experience.
You should also normally have at least Grade B/Grade 6 at GCSE Mathematics.
We also accept a wide range of international qualifications. Find out more about the qualifications we accept from around the world.
If English isn’t your first language, you will need an IELTS score (or equivalent English language qualification) of 6.0 with a 6.0 in writing and no element lower than 5.5 to study this programme. If you need assistance with your English language, we offer a range of courses that can help prepare you for degree-level study.
At interview stage you'll be asked to present a portfolio of relevant recent work.
These are the fees for students starting their programme in the 2020/21 academic year.
Home - full-time: £9250
EU - full-time: £9250
International - full-time: £16700
If your fees are not listed here, please check our undergraduate fees guidance or contact the Fees Office, who can also advise you about how to pay your fees.
It’s not currently possible for international students to study part-time if you require a Tier 4 student visa, however this is currently being reviewed and will be confirmed in the new year. Please read our visa guidance in the interim for more information. If you think you might be eligible to study part-time while being on another visa type, please contact our Admissions Team for more information.
If you are looking to pay your fees please see our guide to making a payment.
In addition to your tuition fees, you'll be responsible for any additional costs associated with your course, such as buying stationery and paying for photocopying. You can find out more about what you need to budget for on our study costs page.
There may also be specific additional costs associated with your programme. This can include things like paying for field trips or specialist materials for your assignments. Please check the programme specification for more information.
We offer a wide range of scholarships and bursaries, and our careers service can also offer advice on finding work during your studies. Find out more about funding your studies with us.
Our degrees aim to equip you with a wide range of skills to meet the current demands of industry and increase your career prospects.
Industrial placement year
The degree includes an optional Industrial Placement Year between the second and third year of study. This offers you the invaluable opportunity to develop the practical skills and real world experience that is sought after by employers. You're supported throughout your placement year by a placement tutor, who provides you with guidance and liaises between you and your employer.
The programme is designed with careers in music technology and music computing in mind. It fosters the development of interdisciplinary understanding across the broad fields of computer science, creative practice and musical research, and is designed to meet the opportunities, challenges and intellectual demands presented by careers in the culture industries, in music technology and in audio, music and media-related computing.
Many of our graduates choose careers in fields related to their musical knowledge: teaching, performing, arts administration, music librarianship, publishing and retailing, record companies and production, or technical work in radio or television. You can read more about careers options after graduating on our Music skills and careers page.
Find out more about employability at Goldsmiths.
BMus (Hons) Music
This degree reflects the diversity and excitement of music in the 21st century, taking in everything from classical music to contemporary jazz and electronic practices, and gives you the opportunity to mix performance, composition and research.
BMus (Hons) Popular Music
This ground-breaking degree embraces popular music in its many forms from the mainstream to the underground and puts exploration and experimentation in creative practice at the heart of the degree.
View more programmes
Related content links
Undergraduate scholarships and bursaries
We offer a range of scholarships, bursaries and fee waivers for new undergraduate students. These offer additional financial support for your studies, and they don't have to be paid back.
Open days, tours and country visits
Accommodation at Goldsmiths
Support with your future career
University statistics for this course
|
cc/2020-05/en_middle_0097.json.gz/line1407234
|
__label__cc
| 0.742024
| 0.257976
|
About The GFG
The GFG Team
GFG Patrons
The Good Funeral Guild
Accreditation: About
GFG Prepaid Funeral Plan
Choosing a Funeral Director
Planning the Funeral
Do it all Yourself
Your Legal Rights and Responsibilities
Direct Disposal
Natural Burial and Green Funerals
Hearses
Music and Poetry
Marking the Spot
What to do with the Ashes
Start a Community Funeral Service
Recommended Directory
Archives Select Month October 2019 (2) September 2019 (12) August 2019 (6) July 2019 (1) June 2019 (3) April 2019 (1) March 2019 (1) February 2019 (3) January 2019 (1) December 2018 (2) November 2018 (1) October 2018 (5) September 2018 (2) August 2018 (4) July 2018 (3) June 2018 (2) May 2018 (4) April 2018 (2) March 2018 (4) January 2018 (4) December 2017 (5) November 2017 (2) October 2017 (11) September 2017 (20) August 2017 (4) July 2017 (2) June 2017 (3) May 2017 (1) April 2017 (6) March 2017 (1) February 2017 (3) January 2017 (2) December 2016 (3) November 2016 (6) October 2016 (9) September 2016 (24) August 2016 (6) July 2016 (5) June 2016 (10) May 2016 (11) April 2016 (14) March 2016 (10) February 2016 (13) January 2016 (2) May 2015 (1) April 2015 (2) March 2015 (3) February 2015 (2) January 2015 (6) December 2014 (13) November 2014 (11) October 2014 (29) September 2014 (21) August 2014 (9) July 2014 (17) June 2014 (17) May 2014 (25) April 2014 (16) March 2014 (24) February 2014 (23) January 2014 (34) December 2013 (24) November 2013 (32) October 2013 (30) September 2013 (43) August 2013 (18) July 2013 (19) June 2013 (20) May 2013 (18) April 2013 (23) March 2013 (42) February 2013 (65) January 2013 (99) December 2012 (49) November 2012 (95) October 2012 (83) September 2012 (82) August 2012 (106) July 2012 (122) June 2012 (92) May 2012 (65) April 2012 (89) March 2012 (120) February 2012 (108) January 2012 (123) December 2011 (87) November 2011 (84) October 2011 (64) September 2011 (48) August 2011 (19) July 2011 (27) June 2011 (36) May 2011 (28) April 2011 (29) March 2011 (30) February 2011 (28) January 2011 (38) December 2010 (30) November 2010 (34) October 2010 (34) September 2010 (42) August 2010 (17) July 2010 (19) June 2010 (34) May 2010 (40) April 2010 (33) March 2010 (42) February 2010 (30) January 2010 (28) December 2009 (14) November 2009 (22) October 2009 (20) September 2009 (16) August 2009 (6) July 2009 (9) June 2009 (15) May 2009 (12) April 2009 (11) March 2009 (12) February 2009 (9) January 2009 (11) December 2008 (4) November 2008 (9) October 2008 (10) September 2008 (12) August 2008 (3) July 2008 (2)
Categories Select Category Academia and death (24) ADRT (4) Age UK (1) alternative funerals (54) Anatomical Pathology Technician (2) Animals (5) Archaeology (5) Arranging a funeral (19) Art and death (132) ashes (59) Assisted dying (12) Assisted suicide (37) Atheism (11) Attitudes to dead bodies (97) Attitudes to death (238) Attitudes to older people (12) Babyloss (1) Bastards (9) bereavement (48) Bereavement support (1) bicycle hearse (1) Bloggledegook (6) Body donation (3) Books (17) bureaucracy (12) burial (30) burial at sea (5) burial depth (10) Burnout (2) Care homes (5) Carla (3) celebrants (118) cemeteries (29) ceremony (112) Children (17) Children and funerals (6) Christian belief (6) CMA Market Investigation (1) Co-op (51) Co-operative Funeralcare (113) coffins (136) Committal (3) Community funerals (8) Continuing consciousness (6) Coroners (1) cremation (67) crematoria (83) Cryomation (9) Dead people’s rights (20) death and funerals (46) Death Cafe (11) Death education (17) Death masks (8) Death; Good death (32) Definitions of death (1) Dementia (3) Digital will (4) Dignity (54) direct cremation (27) Divorce (2) DIY funeral (34) Dress codes (12) dying (30) Embalming (47) End of life doula (1) End-of-life issues (62) Environment (1) Etiquette (9) eulogy (25) euthanasia (25) Exit (4) Fairways Partnership (2) family funeral directors (18) Fashion (1) Featured (7) Films about death (1) Formality vs informality (25) Franchise (2) FSCSR (8) funeral (99) Funeral ‘advice’ website (1) funeral arranger (1) funeral cost (120) funeral cost; richard sage (2) funeral customs (119) funeral directors (269) funeral facts (1) Funeral flowers (8) funeral food (19) Funeral franchise (1) Funeral markets study (4) funeral music (195) Funeral Partners (6) funeral photography (7) funeral plans (48) funeral poetry (18) funeral poverty (10) funeral pyres (42) funeral reformers (46) Funeral training (1) funeral trends (87) Funeral venues (6) funeral wishes (8) Funerals (4) funerals and the environment (1) Funerals for animals (2) Funerals for the unborn (4) funerals in other cultures (83) Funeralzone (1) Gangster funerals (20) Ghosts (7) Good books (14) Good death (23) Good Funeral Awards (85) Good Funeral Guide (2) Good Funeral Guild (2) Grave digging (2) green funeral (29) Grief (79) Headstones (1) Hearses (59) Hero (6) History (5) home funerals (48) Hospice (5) Hospice Funerals (5) Humanists (28) Humour (122) Ideal Death Show (3) Immortality (10) independent funeral directors (20) infant funeral (1) Integrity (1) Interfaith (1) Jane’s Walk (1) Janne Parviainen (8) Jazz funeral (3) Joy of Death (2) Legal rights (11) Living funerals (3) LM Funerals (4) Lonely funerals (5) Longevity (23) Marketing (32) media’s view of funerals (1) medical interventions in dying (12) memento mori (5) MEMO (2) Memorial service (8) memorialisation (140) Memorialising (19) MemorialTags (1) Minister (1) Mouth suture (1) Movies (3) multimedia (2) music (293) National Association of Funeral Directors (20) natural burial (66) Natural Death Centre (14) NFFD (1) no service by request (7) Nokanshi (5) obituary; epitaph (19) onlie memorial sitonlime memorial sites (1) onlime memorial sites (14) open-air cremation (34) Organ donation (4) Ossuary (6) Paranormal deathbed experiences (2) Party (2) Pauper funerals (9) perceptions of funeral directors (16) Personalisation (10) pet cemeteries; pet and owner burial (4) Pet funerals (11) Plan your own funeral (18) Poetry (33) Post mortem photos (8) pre-need plans (21) previous partner (2) prisons (12) Probate (2) Processions (13) Progressive funeral directors (5) Psychoactive drugs (4) Public Health funeral (4) Queer funerals (1) Quotes (61) Re-use of graves (2) Reasons to go to a funeral (9) Regulation (6) Regulation of the funeral industry (4) Religious funerals (62) Requiem Mass (14) research (3) resomation (6) Richard Sage (19) Rights of the bereaved (6) Ritual (18) Safe Hands Funeral Plans (1) SAIF (13) scandals (22) Secular approaches to death (29) self-deliverance (18) sex and death (14) Shrine (1) shroud (9) Social Fund Funeral Payment (9) something for the weekend (23) spiritualism (2) suicide (10) Tahara (4) Taste (4) The future of funerals (31) Thoughts of a funeralgoer (34) TR (1) traditional funerals (13) Transitus (3) Transparency (1) Transparency of ownership (7) tributes (4) Tweets (19) uber undertakers (12) Uncategorized (475) Vigil (1) viking funeral (16) Virtual funeral (3) visiting (3) What do we die of and when? (5) what does dying feel like? (28) Why I do it (3)
Cybertwaddle
Charles Cowling 0 Comments Like Uncategorized
There are very few funeral directors in the UK with a web presence. Many of those who do fail to understand that the job of a website is twofold: first, to offer a relationship of warmth and trust; second, to proclaim capability and professionalism. A good many undertakerly websites simply
Charles Cowling 0 Comments Like funeral directors , sex and death
Today’s papers have enjoyed this story—the ones you’d expect, the funloving Sun and the _____________ (supply your own adjective) Daily Mail. It’s a story which emanates, so it seems, from the Wales News Service, whose website offers this enticement: “Have you been betrayed by your man? Or did you get
You are currently browsing the The Good Funeral Guide blog archives for the day Friday, April 24th, 2009.
Accreditation: Apply Now
Accreditation: Frequently Asked Questions
Accreditation: Recommended Funeral Directors – more details
Accreditation: Themes and Topics
Corpsenet
For Funeral Directors
GD Home page
Listing Success
Recommended Burial Sites
Recommended Crematoria
Recommended Funeral Directors
Recommended Purveyors
About The Good Funeral Guide
What They Say About The Book
Test Subpage
Final Rides
Tombstones and Ashes
The Good Funeral Guide Blog
Academia and death (24)
ADRT (4)
alternative funerals (54)
Anatomical Pathology Technician (2)
Art and death (132)
ashes (59)
Assisted dying (12)
Assisted suicide (37)
Attitudes to dead bodies (97)
Attitudes to death (238)
Attitudes to older people (12)
Babyloss (1)
Bastards (9)
Bereavement support (1)
bicycle hearse (1)
Bloggledegook (6)
Body donation (3)
bureaucracy (12)
burial (30)
burial at sea (5)
burial depth (10)
celebrants (118)
Ossuary (6)
ceremony (112)
Children and funerals (6)
Christian belief (6)
CMA Market Investigation (1)
Co-op (51)
Co-operative Funeralcare (113)
coffins (136)
Committal (3)
Community funerals (8)
Continuing consciousness (6)
Coroners (1)
cremation (67)
crematoria (83)
Cryomation (9)
Dead people's rights (20)
death and funerals (46)
Death Cafe (11)
Death education (17)
Death masks (8)
Death; Good death (32)
Definitions of death (1)
Digital will (4)
Dignity (54)
direct cremation (27)
DIY funeral (34)
Dress codes (12)
Embalming (47)
End of life doula (1)
End-of-life issues (62)
eulogy (25)
euthanasia (25)
Fairways Partnership (2)
family funeral directors (18)
Films about death (1)
Formality vs informality (25)
FSCSR (8)
funeral (99)
Funeral 'advice' website (1)
funeral arranger (1)
funeral cost (120)
funeral cost; richard sage (2)
funeral customs (119)
funeral directors (273)
Funeral Partners (6)
funeral facts (1)
funeral food (19)
Funeral franchise (1)
Funeral markets study (4)
funeral music (195)
funeral photography (7)
funeral plans (48)
funeral poetry (18)
funeral poverty (10)
funeral pyres (42)
funeral reformers (46)
Funeral training (1)
funeral trends (87)
Funeral venues (6)
funeral wishes (8)
funerals and the environment (1)
Funerals for animals (2)
Funerals for the unborn (4)
funerals in other cultures (83)
Funeralzone (1)
Gangster funerals (20)
Good books (14)
Good death (23)
Good Funeral Awards (85)
Good Funeral Guide (2)
Good Funeral Guild (2)
Grave digging (2)
green funeral (29)
Headstones (1)
Hearses (59)
home funerals (48)
Hospice Funerals (5)
Humanists (28)
Ideal Death Show (3)
independent funeral directors (20)
infant funeral (1)
Jane's Walk (1)
Janne Parviainen (8)
Jazz funeral (3)
Joy of Death (2)
Legal rights (11)
Living funerals (3)
LM Funerals (4)
Lonely funerals (5)
Longevity (23)
media's view of funerals (1)
medical interventions in dying (12)
Memorial service (8)
memorialisation (140)
Memorialising (19)
MemorialTags (1)
Mouth suture (1)
National Association of Funeral Directors (20)
natural burial (66)
Natural Death Centre (14)
NFFD (1)
no service by request (7)
Nokanshi (5)
obituary; epitaph (19)
onlie memorial sitonlime memorial sites (1)
onlime memorial sites (14)
open-air cremation (34)
Paranormal deathbed experiences (2)
Pauper funerals (9)
perceptions of funeral directors (16)
Personalisation (10)
pet cemeteries; pet and owner burial (4)
Pet funerals (11)
Plan your own funeral (18)
Post mortem photos (8)
pre-need plans (21)
previous partner (2)
Processions (13)
Progressive funeral directors (5)
Public Health funeral (4)
Queer funerals (1)
Re-use of graves (2)
Reasons to go to a funeral (9)
Regulation of the funeral industry (4)
Religious funerals (62)
Requiem Mass (14)
resomation (6)
Richard Sage (19)
Rights of the bereaved (6)
Safe Hands Funeral Plans (1)
SAIF (13)
scandals (22)
Secular approaches to death (29)
self-deliverance (18)
sex and death (14)
Social Fund Funeral Payment (9)
something for the weekend (23)
Tahara (4)
The future of funerals (31)
Thoughts of a funeralgoer (34)
traditional funerals (13)
Transitus (3)
Transparency of ownership (7)
tributes (4)
uber undertakers (12)
viking funeral (16)
Virtual funeral (3)
What do we die of and when? (5)
what does dying feel like? (28)
Why I do it (3)
© 2019 The Good Funeral Guide. All Rights Reserved
Website by Peter Fox Design
This website also uses cookies that can’t be disabled through this tab and will need to be disabled manually. The blog itself uses a commenting system by wpDiscuz which uses a cookie to remember some of the information you put in to save you inputting it every time. It also helps prevent comment spam.
The blog may also feature embedded items such as youtube videos which can set cookies to identify your device and approximate location to optimize bandwith and tailor ads as handled by google.
Our Directory also sets some cookies for the Map to function based on your selection and preferences.
Unfortunately the scripts for these features cannot be placed here for you to disallow the cookies manually, therefore the button on this tab will have no affect.
However if you wish to disable these cookie, you will need to disallow them manually in your browser.
For Google Chrome – Please follow this guide and add this website to the cookie block list: https://support.google.com/accounts/answer/61416?co=GENIE.Platform%3DDesktop&hl=en
Safari: https://support.apple.com/kb/ph21411?locale=en_US
If you need any support with this, or use a different browser you can contact us for advice.
|
cc/2020-05/en_middle_0097.json.gz/line1407235
|
__label__wiki
| 0.959184
| 0.959184
|
Indian Pastor Beaten by Hindu Extremists While Praying Vows to Continue Sharing Gospel: 'My Lord is Ever Victorious'
By Morning Star News ( [email protected] ) Sep 04, 2017 10:12 AM EDT Comment
India is ranked 17th on Open Door USA's World Watch List of countries where Christians face the most persecution. AP Photo
A band of Hindu extremists who had snuck into a house-church service beat a pastor with steel rods and sticks, one of them yelling that they would stop if he shouted, "Hail, Lord Ram [Jai Sri Ram]!"
"I remained mum," pastor Harjot Singh Sethi, 26, told Morning Star News. "I did not even squeal from pain. My mouth was shut as they beat me."
He suffered serious head and leg injuries in the Aug. 16 attack in Dabli Rathan village, Hanumangarh District, in Rajasthan state.
"I am glad the Lord considered me worthy to share His pain," he said. "I don't have to be treated special or elevated because I am persecuted. My Lord was crucified, His disciples were persecuted, and violence against Christ-followers is not a new thing. This was to come."
The young pastor and eight other Christians were attacked on the terrace of the home of Madan Lal Arora, where 20 people had gathered for worship. Police Station House Officer Jagdish Prasad said the assailants were members of the Hindu extremist group Bajrang Dal.
"While the pastor and the Christians were praying, Bajrang Dal activists accused them of [forced] conversions and started beating them," Prasad told Morning Star News. "We were able to detain six of the accused, and the investigation is on."
Pastor Sethi, of Jalandar District in Punjab state, was visiting Arora, a schoolteacher in Rajasthan.
"It was first planned that we would conduct the prayers in our house, but by evening believers from other villagers had already arrived, so we left the entrance gate open for any more to join us," Arora's daughter, Shikha Arora, told Morning Star News. "It was just 40 minutes into worship. I sang hymns with my friends standing in front of the gathering, and I noticed two men seated right before me. I did not know they came to attack. They sat quietly when we were singing."
Pastor Sethi had risen to speak and was bowed in prayer when two men pushed through the congregation of 20 and attacked him, she said.
"When the two started beating the pastor, their group waiting outside the house also got upstairs, and they brought steel rods and wooden sticks," Shikha Arora said. "We pleaded with them, 'Please don't beat our pastor. What did he do? What did we do to you people? Did he speak against any leader or any religion? Why are you beating him?' They beat us too."
The pastor told Morning Star News he couldn't understand where the 10 people who began beating him had come from.
"One man slapped my wife and pushed her, and she fell down," he said. "Women from the gathering came to surround us to protect us from the assailants, but the assailants beat them too. It has been two weeks, but there is still a sharp pain in my head even as I talk to you at this moment."
A convert from a Sikh family, Pastor Sethi said he had led services at the house on two previous occasions.
"As a Christian, I will not take the defeat; my Lord is an ever-victorious King. His gospel will be preached among them," he said. "We are going to share the gospel in that region with the government's permission soon - we are making arrangements for it."
He and other Christians went to the Hanumangarh Sadar Police Station, where he bled for 90 minutes while officers registered a First Information Report (FIR) without even taking statements from them, he said. They put his age as 40 in the FIR.
"Can you see it? Even the police are afraid of the Bajrang Dal," he said. "They slapped sections from the Indian Penal Code with lighter punishments on them. The Bajrang Dal people arrived, and they spewed derogatory, extremely foul words against Christ, the believers and me too. They could not spare the women either. The police did nothing to stop them."
The Hindu extremist who ordered him to shout, "Hail Lord Ram" while they beat him is roaming free, he added, though the assailant posted videos of the attack on Facebook.
SHO Prasad told Morning Star News that the scene at the police station was tense.
"It took us some time to get the pastor out and admit him in the hospital, the police station was mobbed by Hindu activists," Prasad said. "The Bajrang Dal are very aggressive groups. We did not want things to go out of hand."
Lilian Grace, recently elected to the Rajasthan Minority Commission, told Morning Star News that the government body condemns the attack.
"Miscreants in the society who cannot rise to fame by doing good works are resorting to violent acts to spread hate," she said. "The pastor suffered injuries in head and his leg is fractured, the believers around also were beaten. Soon after I received the call, I alerted the police authorities and the collector. The pastor was admitted in the hospital."
Pastor Sethi said he wanted his church to understand that if is the Lord's will, they must submit to God's will and not renounce Christ in the face of violence.
"My heart is rejoicing over Psalm 91, my Lord is my fortress, my refuge, my salvation, what more do I want?" he said.
Shikha Arora said the attack reminded her of a verse in a Punjabi Christian song, which sang as tears flowed down her cheeks: "Prabhu tumhare dard mein humein bhi shaamil karo [Lord, please let me also partake in Your pain]."
"Our faith in Christ multiplied, we are ready for anything," she said. "Anything for Christ."
Share this on Facebook () Tweet
Tags : India, Hindu extremist anti-Christian violence in India, Hindu, prayer, Persecution, Pastor
Top Bible Verses About Homosexuality Used In Same-Sex Marriage Debate
4 Keys to Experiencing a Breakthrough in Your Life
Korie Robertson on How She and Willie Adopted Rebecca Robertson from Taiwan: 'We Fell in Love With Her'
MLK Day 2017: 11 Powerful Christian Quotes from Martin Luther King, Jr.
Tim Tebow's Fiancée Demi-Leigh Nel-Peters Shares How Sister with Disability Reflects God's Faithfulness (Interview)
15 Valentine's Day Bible Verses for Cards, Gifts, and Love Letters
Do Loved Ones in Heaven Look Down on Us? Pastors Billy Graham, Greg Laurie, John Piper Respond
Image of Jesus in 'Heaven Is for Real' Painted by 'God-Taught' Young Girl Akiane Kramarik (Pictures)
Tim Tebow's Fiancé Demi-Leigh Nel-Peters Mourns Death of 13 Y/O 'Angel' Sister: 'Our Loss is Heaven's Gain'
Billy Graham's Granddaughter Slams Franklin Graham for Political Views, Says He Should 'Stick' to Ministry
Francis Chan Identifies Main Reason Chinese Underground Church is 'Unstoppable' Despite Persecution
China Closes One of Beijing's Largest Churches Amid Ongoing Crackdown on Christianity
Pastor and Wife Who Inspired 'All Saints' Movie Share How Myanmar Refugees Saved a Dying Church (Exclusive)
Chris Pratt Gives Glory to 'Lord and Savior Jesus Christ' at 2017 Teen Choice Awards (Video)
Jim Carrey Paints Stunning Picture of Jesus Christ: 'He's Accepting of Who You Are' (Video)
Mark Wahlberg Says Focusing on Christian Faith Makes Him A 'Better Person'
Andrew Garfield Says Playing Missionary in Martin Scorsese Film 'Silence' Taught Him About Jesus Christ
|
cc/2020-05/en_middle_0097.json.gz/line1407237
|
__label__wiki
| 0.829547
| 0.829547
|
Steinway Mansion nyc steinway hall nyc steinway pianos nyc steinway & sons pianos history nyc
Steinway & Sons Piano Company History & Legacy
Exclusive Coverage Of The Steinways, Factory, Mansion, History & Legacy
Special Section Dedicated To Our Coverage Of The Steinway Mansion In Astoria.
Exclusive Coverage Of The Steinway Mansion Sale
Updated April 2017 / March 8, 2014 / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
Queens Buzz didn't expect to become so engrossed in one issue so soon in its development. But the sale of the Steinway Mansion represents the preservation of perhaps the most important remaining remnant of 19th century Queens, and is attached to the legacy of a family that was influential in shaping the borough of Queens.
The more we dig, the more we find, so stay tuned as this section will likely double in size sometime in 2011. And in following the stories we write, you'll obtain greater insight into Queens history, the Steinway & Sons legacy and the emergence of the borough of Queens to become the largest borough in New York City. These stories are presented chronologically, starting with the most recent posting.
NYC History: Steinway Mansion Real Estate Development Queens NYC
Update on the Steinway Mansion in Astoria Queens
Visionary Investor Makes Good on Development but Still no Announcement of his Plans for the Steinway Mansion
September 12, 2016 / NYC Neighborhoods & History NYC / News Analysis & Opinion / Gotham Buzz NYC.
On May 3rd, 2014 the Halberian Family sold the Steinway Mansion to Steinway Mansion LLC for $2.65 million. In the two and a half years since, the new Steinway Mansion owner parceled the property into a eleven additional smaller lots and built eleven two story commercial buildings on each. We watched as the owner quietly developed the property, likely in line with his plans while making the investment.
Just over a year ago I visited the site and took some photos, which momentarily revealed the resplendent glory of the old mansion, overlooking the East River and distant Rikers Island and Bronx shores. The new owner had cut away most of what remained of the Steinway Mansion yard to make way for the new buildings at a height on a level with 42nd and 41st Streets. The construction site seemed well maintained and the historic mansion structure appeared to be treated respectfully both last year, and as I learned in my most recent trip, also since.
The photo above was taken in August of 2015.
Northern Ditmars Neighborhood Real Estate Development
Last weekend I returned to the site to shoot photos and see what was happening. I came in along 42nd Street, and for a moment I wondered if I had gotten my coordinates wrong, as the street had been transformed. The emptiness on the street of the construction site of a year ago had been filled in with a number of spanking new buildings lined along the street with what appeared an exacting precision. The photo to your right shows roughly the same space in September 2016 as was shown in the August 2015 photo above.
A year ago, 42nd Street was an empty, slightly soiled, commercial industrial hub. But on my visit this year the street took on a wholly different appearance with the new buildings / storefronts. There were eight new buildings along 42nd Street, with red brick exteriors complemented by black trim and large floor-to-ceiling paned storefront windows, which I believe could also serve as garage doors. It almost seemed like these new edifices could as easily become art galleries, as manufacturing locales and / or storage facilities.
Click here to read the rest of our report about the Steinway Mansion real estate development in Northern Ditmars, Astoria.
NYC History: Steinway Hall Moves From 57th Street Location
Steinway Hall Moves 14 Blocks South
Second Manhattan Move In As Many Centuries / International Center of Photography Moves To Bowery
January 5, 2015 / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
The Steinway & Sons Piano Company sold Steinway Hall on 57th Street last year for a reported $195 million, and then sold the piano company which has called Astoria Queens its home for about 150 years.
Steinway Hall was just across the street from Carnegie Hall, which made moving the very large but delicate and valuable pianos into and out of Carnegie Hall less complicated. Steinway Hall is moving into what has been the Midtown home of the International Center of Photography along 6th Avenue and 43rd Street. The International Center of Photography is moving to a new location in the Bowery near the New Museum which is at 235 Bowery near Prince Street.
Steinway Hall has been located on 57th Street since 1925 when Steinway & Sons Piano Company moved from their first location on 14th Street. Steinway Hall has been a mix of history and art as it was designed by Warren & Wetmore, one of the architectural firms that collaborated on the re-design of the Beaux-Arts Grand Central Terminal a dozen years earlier [1913]. Grand Central Terminal was first erected in 1871.
Steinway Hall is expected to open in this location in 2016, following the re-design of the space. The International Center of Photography is expected to open in mid 2015.
Click here for our report on Steinway Hall moves from its 57th Street location in Midtown Manhattan NYC.
NYC History: Steinway Mansion Under Contract
Steinway Mansion Under Contract To Private Buyer
Historic Mansion Was Built By Early NYC Technologist & Later Bought By Renaissance Man
Great Opportunity For Queens Officials To Act On Their Speeches About Nurturing Culture, Historic Preservation & Tourism
March 12, 2014 / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / News & Opinion / Gotham Buzz.
Well, the saga is almost over. NYC and Queens government officials are about to let slip into private hands, the greatest historical relic of the 1800's in Queens. And what could have been - and could still be - one of the greatest historic sites / historic tourist attractions of Queens. The Steinway Mansion is under contract to be purchased by a private buyer.
Imagine yourself hanging out on the mansion grounds, sipping tea or drinking wine on a nice sunny summer day ...
It's not that Queens and NYC government officials haven't had a chance to save it. The historic mansion, which was landmarked for its historic signficance decades ago [landmarking prevents changes to outside of the structure], came on the market in August of 2010. The asking prices has been between $2 and $4 million, which given that far smaller homes with no significance are already selling for over $1 million in the Astoria neighborhood, it seemed like a reasonable asking price.
Click here to read the rest of our report about the Steinway Mansion Under Contract. The story includes photos and links to other stories we've done over the years about the Steinway Mansion and it's inhabitants and their endeavors. The story also includes the business case for taking the Steinway Mansion public and transforming it into a museum / cultural destination for all of Queens, NYC & the world.
Steinway Musical Instruments for Sale & Offer Made by Kohlberg
Offer Made For Steinway & Sons Piano
Kohlberg & Co Bids For Steinway Musical Instruments
July 23, 2013 /Astoria / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / News & Opinion / Gotham Buzz..
Kohlberg & Company offerred $438 million for the Steinway Musical Instruments Company, owner of Steinway & Sons Piano in Astoria. The 160 year old company, Steinway & Sons Piano, was founded in Manhattan in 1853.
Kohlberg & Co Make Offer for Steinway Musical Instruments
The Steinway & Piano Company has changed hands a couple of times over the past 160 years, once being acquired by CBS Television, and later being acquired by Selmer Musical Instruments.
The Kohlberg & Co tender offer includes a provision allowing other companies to bid for the Steinway shares by mid August, but to date we have not heard of any other competitive suitor. The deal is expected to close in the third quarter of this year.
The business of making Steinway Pianos by hand, is not without its challenges. But inspite of the marketplace realities - some of which we detail below - Kohlberg & Co told the NYT that they will continue to build artesanal musical instruments. Since many of the artesanal Steinway Pianos are made right here in the Astoria section of Queens; we can only hope that Kohlberg & Company will live up to their statement.
Steinway & Sons Piano Company History
The sale of the company follows on the heels of the sale of the 88 year old Steinway Hall in June of this year. In 1925 Steinway Hall was built across from Carnegie Hall on 57th Street in Manhattan - replacing a prior version of itself further south on 14th Street.
The hand made Steinway Pianos have been made for about a century and a half in the U.S. in Astoria, Queens; and in Germany near the founders' home town. As mentioned above, Steinway & Sons Piano still make the hand crafted Steinway Pianos in a factory near the northern end of Steinway Street in the Astoria neighborhood of Queens. Click this link to view a story about the making of a Steinway Piano in Astoria.
The Steinway Musical Instruments Company had merged Steinway Pianos in with a portfolio of other brand name musical instruments. The company portfolio of products includes brand name saxaphones, trumpets, French horns, clarinets, trombones and drums.
Click here for the rest of our report about the proposed sale of the Steinway & Sons Piano Company / Steinway Musical Instruments.
Steinway & Sons Piano Factory Sale
July 23, 2013 / Astoria Neighborhood / Queens Business / News & Opinion / Gotham Buzz.
Kohlberg & Co Offer
Click here for the rest of our report about the proposed sale of the Steinway & Sons Piano Company.
Steinway Mansion Contents Auctioned
Will The Historic Site In Astoria Be Next?
April 23, 2011 / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
I attended the Steinway Mansion contents auction on Saturday, March 27th, down at Capo Auction on Queens Blvd in Long Island City. It was the first of two auctions wherein the contents of the Steinway Mansion, collected over a lifetime by Michael Halberian, were to be auctioned off. The second auction is Saturday, April 30th starting at 11 am and going well into the afternoon.
On March 27th there were over 600 items auctioned, where bidding started in the hundreds to thousands of dollars. In addition to the hundred or so buyers who appeared at the auction house, bids were also taken over the internet.
The photo to your right is of the Indian statue that once stood on the grounds of the Steinway Mansion, with the bidders shown through the doors while the auction was in session in March.
The Steinway Mansion
All Talk & No Actions By City Officials
April 2011 / NYC Neighborhoods & History NYC / Steinway Mansion & Historic Houses in NYC / Gotham Buzz NYC.
Steinway Piano & Sons / Smithsonian Diaries
The importance of William Steinway on New York City's and Queens development is quite remarkable. He was a Commissioner of the NYC Transit while it was working underground subway lines, he was the first to start digging tunnels underneath the East River, Steinway Hall preceded Carnegie Hall which was the forerunner to establishing New York City as a cultural center, he once owned the land that would one day become LaGuardia Airport, and he was politically connected as a good friend of president Grover Cleveland ... oh, and one of the founding family members of Steinway & Sons Piano Company which continues to operate a plant in Astoria over 150 years later.
The Smithsonian Institution in Washington DC initiated a project spanning more than ten years during which more than 2,500 pages of William Steinway's Diary was put online. About 40 people came up to view the mansion in March of 2011. If the Smithsonian Institution thinks the Steinway Mansion is historically significant, shouldn't we at least explore options to aquiring the mansion?
The photo at right shows a page from the Steinway Diaries which are on display at the Smithsonian in Washington, D.C. The Greater Astoria Historical Society aided the Smithsonian in gathering information for the exhibit.
The Steinway Mansion was built by Benjamin Pike Jr. Benjamin Pike Jr. was a ingenious businessman and one of the first marketers in this country to sell scientific instruments by catalogue. He made a fortune selling the latest technology, much of which was imported from England and France, but through which pioneers could obtain telescopes, microscopes, surveying equipment and a whole range of other instruments, including batteries, projectors and magnetic instruments used for medical and health purposes. Look at the house in the photo to your right. The Steinway Mansion is the most significant and one of the last, if not the last of the 'country mansions' still standing in Queens. Do you really think we should allow this historic site to be gutted and turned into corporate offices?
The Steinway Mansion has the potential to become a magnet through which tourists might begin altering their vacation plans to explore NYC’s most diverse borough. From the Dutch Kills / Queens Plaza subways [the public transit connection for these hotels], the Steinway Mansion is about a seven minute subway ride and a 15 minute walk.
NYC & Queens officials could leverage the Steinway name, to lure tourists ever so briefly into the borough of Queens. And then let the residents, restaurants, shops and other cultural attractions of Queens work their charm on these intrepid travelers. Queens currently gets very little of the tourist dollars spent by a portion of the 48 million visitors who come to NYC. Isn't it time we begin to claim a small portion of our rightful share?
Steinway Mansion Contents Went To Auction
But at present there isn’t anything being done to acquire the Steinway Mansion. Everyone is for saving it, but nobody does anything.
The collection of historic artifacts collected through a lifetime by the late Steinway Mansion owner, Michael Halberian, began auction on March 26, 2011 and will be completed on April 23rd at the Capo Auction House on Queens Blvd in Long Island City.
Queens Tourist Attractions For 20 Hotels - Opinion
What’s interesting to me is that Queens has the opportunity to capture a share of the NYC tourism market by luring a portion of the tens of thousands of hotel guests who will stay overnight at these Queens hotels. One of the investments Queens and NYC government officials seem reluctant to explore, let alone actually do, is to develop a plan to transition the Steinway Mansion [and by association the Steinway Piano Factory, Steinway Street and the Ditmars area] into an important NYC tourist destination.
I’ve personally spoken to nearly all relevant government officials including the Mayor, Queens Borough President, City Council Members, and NYS and U.S. Representatives. So far there's been a lot of verbal support and no concrete action.
Steinway Hall NYC
Steinway Hall In NYC
19th Century Queens Pioneers With Big Ideas
Steinway & Sons Legacy Permeates NYC & Queens
December 7, 2010 / NYC History & Neighborhoods / Gotham Buzz NYC.
In our effort to inform Gotham Buzz readers about the full historical significance of the Steinway Mansion, we traveled into Manhattan to take a tour of Steinway Hall when it was still in its second - and most long standing - location.
We visited Steinway Hall, which is located on 57th Street between 6th and 7th Avenues, and which is owned by Steinway & Sons pianos - some 85 years later. Once again, I stepped through a time warp, similar to the one into which I stepped when I visited to the Steinway piano factory and more recently the Steinway Mansion, both of which are located in Astoria in Queens.
Steinway Hall was built by Steinway & Sons piano company in 1925, following the erection of Carnegie Hall, which had just supplanted the old Steinway Hall located on 14th Street, as NYC's cultural centerpiece.
Click here to read more about Steinway Hall in NYC including numerous photos, or click this link to visit the Steinway Mansion section of Gotham Buzz NYC.
Benjamin Pike Built Steinway Mansion & was early Direct Marketer of Scientific Instruments
Who Was Benjamin Pike?
Steinway Mansion Builder Made A Mint as a 19th Century Direct Marketer of Scientific Instruments
April 17, 2011 / Astoria / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / Gotham Buzz NYC.
I had a rare opportunity to meet someone who was well acquainted with the story of Benjamin Pike Jr. Benjamin Pike Jr. was the man who built the mansion that was lived in for over fifty years by the Steinways of Steinway & Sons Piano in Astoria. During my efforts to report this story, I had here-to-fore found it very difficult to find much published about Benjamin Pike. Hence you can imagine my delight when I met Deborah Jean Warner, who had once curated an exhibit dedicated to the Steinway Mansion founder, at the Smithsonian Institution.
Deborah has curated many exhibits about the history of physical sciences and is the author of several books. Deborah's work in 19th century scientific instruments lead her to curate the Pike exhibit. When it comes to selling scientific instruments in America in the 19th century, Benjamin Pike Jr. was an innovator who loomed large.
Click here next week to read our full report about Benjamin Pike Jr., the founder and owner of the Pike Mansion, which later came to be known as the Steinway Mansion in Astoria.
Steinway Diaries at Smithsonian Institute: William Steinway Diaries Smithsonian
The Steinway Diaries at the Smithsonian
Smithsonian Institute Brings 19th Century Queens Alive
Time Is Running Out - Steinway Mansion Contents Being Auctioned
February 19, 2011 / Astoria / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / Gotham Buzz NYC.
On Monday, March 7th at 7 pm the Greater Astoria Historical Society will be hosting the Smithsonian Institution’s presentation of the William Steinway Diaries.
These diaries are a first person account written by one of the most influential people in the emerging American metropolis of New York City in the latter half of the 19th century. The diaries begin in 1861 around the time of William Steinway’s first wedding [and the beginning of the American Civil War] and continue throughout the rest of his life, terminating only weeks before he died in 1896.
I had the opportunity to talk with Bob Singleton, Executive Director of the Greater Astoria Historical Society in anticipation of the Smithsonian Institution’s presentation of the Steinway Diaries on March 7th. He took me through some of the interesting things to investigate using the online project that was the Smithsonian’s “largest and longest-running volunteer research efforts”. A copy of one of the transcribed pages from the Smithsonian's Steinway Diaries website is shown inset in a photo of the Steinway Mansion in Astoria.
The general public is welcome to the March 7th presentation, and it is highly recommended that you purchase / rsvp tickets in advance. Click here to read our look into the William Steinway Diaries.
Steinway Mansion Owner Dies: Michael Halberian Obituary
Michael Halberian: 1927 - 2010
Steinway Mansion Owner Dies
December 30, 2010 / Astoria Queens / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / Gotham Buzz NYC.
Michael Halberian, owner of the Steinway Mansion in Astoria, died Monday evening around 7 pm. We have unofficial reports that he died of cardio obstruction pulmonary disorder. Michael turned 83 in November.
Michael is survived by two children, Michele Kazarian and John Halberian [wife Stephanie]; his sister, Rosemary; five grandchildren including Jackie and Katie Kazarian and Christopher, Meg and Jack Halberian; and neices and nephews.
Services will be held at 2 pm at the Armenian Church of the Holy Martyrs in Bayside. The church is located on the corner of Horace Harding Expressway [LIE] and Oceania Boulevard.
Click the links below to learn more about the life of Michael Halberian and the historical Steinway Mansion for which he so loved and cared. Michael is shown standing in front of the Steinway Mansion in the photo above circa the 1930's. Click here to go to the Michael Halberian Obituary or click this link to go to the Steinway Mansion series section of this site.
Steinway Mansion: Open House Historic Mansions NYC
Enchanted Evening At The Mansion
Steinway Mansion Strikes Resonant Chord
October 20, 2010 / Astoria / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / Gotham Buzz NYC.
It was a cool quiet moonlit evening as I made my way down the lonely street leading up to the Steinway Mansion. As I passed through the century old Italian wrought iron gates, I found white Japanese paper lanterns lit by candles leading into the yard. I followed them around the side of the house, and eventually right up to the front porch. But I couldn't go in, at least not yet.
The mansion looked so serene and quiet, even as over one hundred people enjoyed the cocktail party going on inside. The grey granite exterior soaked in the silvery moonlight, as the white trim glowed luminously. I stood there for a while, just breathing in each moment ... until someone came up behind me and said, "We really should buy this for ourselves." We then laughed, knowing that that would never happen.
But there was a yearning in my heart that the Steinway Mansion would be bought by some level of government, so that I, along with everyone else in Queens, could continue to enjoy this beautiful home, for the rest of our days. It dawned on me later, that perhaps I'd caught the Jack Halberian fever, and fallen in love with a 19th century Queens home and legacy that have no peers.
Click this link to view this report, along with quite a number of photos taken at the cocktail party dedicated to a Steinway Mansion open house / for sale.
Steinway Mansion: Bloomberg Administration Failure Inaction on Historical Preservation in NYC
Mayor Invited for Cocktails at Steinway Mansion
Vallone Invites Mayor To Visit Mansion Before Making Decision
October 7, 2010 / Astoria / NYC Neighborhoods & History NYC / Steinway Mansion History & Steinway Hall NYC / Gotham Buzz NYC.
What an evening! It started with an interesting journey through some of the Steinway & Sons history by local historian Bob Singleton and was followed by a rousing speech by City Council Member Peter Vallone. Then the mansion was opened up to some 70 or 80 people who had been invited to ‘Help Save The Steinway Mansion’. The photo to your left shows Peter Vallone and historian Bob Singleton standing on the steps of the Steinway mansion talking to community members who wish to preserve the Steinway mansion.
It's been said that President Grover Cleveland visited this historic treasure in the 1880’s as a guest of Henry Steinway. And Mayor Ed Koch made a visit to the Steinway Mansion as guest of Michael Halberian. Click here to read more about Mayor Bloomberg’s invitation to the Steinway Mansion in Astoria later this month.
Vallone Urges City To Purchase Steinway Mansion
Van Bramer Supports The Measure With 2nd Letter
Updated October 2, 2010 / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
On Friday, September 17th, City Councilman Peter Vallone visited owner Michael Halberian at the Steinway Mansion which is currently up for sale. According to Kim Parshley, one of the realtors handling the sale of the home, Peter was so impressed by the historic significance of the mansion and the countless historic artifacts pertaining to NYC collected by Halberian, that he has made a request to the city to purchase the site for posterity.
On September 30th City Councilman Jimmy Van Bramer, who represents nearby Sunnyside publicly supported the measure and followed up by sending a letter of his own to the Mayor, urging the Steinway Mansion purchase.
Click here to read our first report on the history of the Steinway Mansion.
Help Save The Steinway Mansion
Fall 2010 / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
The Steinway Mansion is up for sale. It was built in the 1850's, is made of granite, has 27 rooms on four floors [counting the crows nest or basement] and contains over 150 years of Queens and NYC history.
The Steinways of Steinway Piano & Sons were leading Queens citizens who at one time owned the property that is now LaGuardia Airport, began a tunnel under the East River that is now the tunnel for NYC subway lines, and essentially put the neighborhood of Astoria on the map via their piano factory company town. The Steinway Mansion is already a landmark. The Steinway piano factory already attracts hundreds, if not thousands of visitors annually.
Purchasing this landmark would not only preserve an important piece of our history, but also has the potential to increase tourism in Queens by enhancing its attractiveness as an historic and cultural center - all of which is also good for commerce. Click this link to read our report / view our photos of the Steinway Mansion For Sale in Astoria Queens. The photo above is of a skylight in the study of the Steinway Mansion.
Help Peter, Michael & Jimmy Save The Steinway Mansion For Queens NYC
Please email City Councilman Peter Vallone at vallone4ny@gmail.com and Jimmy Van Bramer at jvanbramer@council.nyc.gov to let them know you support their efforts to Save The Steinway Mansion.
Please copy the following government officials on the email: Councilman Daniel Dromm at dromm@councilnyc.gov; City Council Speaker Christine Quinn at quinn@council.nyc.ny.us and Queens Borough President Helen Marshall at info@queensbp.org.
You may also call 311 to register your interest in having the Steinway Mansion preserved by the city for the people of Queens and everyone else.
Steinway Mansion For Sale by Owner Michael Halberian
Steinway Mansion Up For Sale
Lincoln Era Mansion & Queens History To Be Sold
August 20, 2010 / NYC Boroughs Neighborhooods & History NYC / Gotham Buzz NYC.
On Wednesday afternoon I set to work on this story after returning from a fascinating four hour visit with Michael Halberian, owner and whose family occupied, the Steinway Mansion for the past 82 years. The mansion is located in Astoria, just north of 19th Avenue on 41st Street [map link provided at end of story].
I felt like I'd stepped through a time warp, back into the late 19th and early 20th centuries. The visit connected me to one of the legendary centerpieces of Queens history - the Steinway family and the mansion they occupied during their golden years ... but the mansion's history neither starts nor ends there.
Michael regaled me with anecdotal tales supported by the many books off his shelves, or by pointing to numerous remnants of the past, kept in pristine shape in this beautiful old Astoria mansion on the hill overlooking the East River.
Click here to read more about the Steinway Mansion For Sale In Astoria Queens.
Steinway & Sons Piano Factory History & Tours Astoria Queens NYC
Steinway & Sons Piano Factory Tour
History and Tour of the Steinway & Sons Piano Factory in Astoria NYC
January 13 & 22, 2009 / Steinway & Sons Piano Factory History / NYC Neighborhoods & History NYC / Gotham Buzz NYC.
I had the opportunity to take a wonderful trip back in time without even leaving the borough. I traveled through a time warp, back into 19th century American, when technology was merging with craftsmanship to create the foundations of the modern world we lived in throughout the better part of the 20th century. In 1875 Steinway & Sons bought 400 acres of land in what used to be Long Island City prior to its merger with Manhattan and Brooklyn to form New York City. The factory is located at the northern tip of Astoria Queens, as one would guess, near Steinway Street. Tours are given weekly throughout the school year but cameras are not allowed.
Invention Of The Piano
We started the tour in an upstairs conference room where there’s a plaque showing the piano was invented in 1711 by Bartholomew Cristofori [d. 1731]. He modified the plucking of strings, as is done by the harpsichord, to create the piano, which strikes the strings. The piano is both a percussion [striking] and stringed instrument.
German Furniture Maker Steinway & Sons
Heinrich Steinway, the company’s founder was born in Germany. He grew up in the furniture making business and he began applying those skills to piano making in the early 1800’s. In 1849, one of his sons came to America, and a year later most of the rest of the family followed.
Click here to read the rest of our story, including photos of the Steinway Factory History & Tours in NYC.
Astoria Neighborhood Links
Click on these advertisements for promotions, discounts and coupons by retailers and restaurateurs in Astoria and nearby Queens.
|
cc/2020-05/en_middle_0097.json.gz/line1407238
|
__label__cc
| 0.569157
| 0.430843
|
Crime, justice and law
Seizures of drugs in England and Wales, financial year ending 2019 second edition
Contains figures for seizures of drugs made by local police forces and the UK Border Force.
Last updated 7 January 2020 — see all updates
Ref: ISBN 978-1-78655-937-1, Home Office Statistical Bulletin 31 19 PDF, 1.65MB, 28 pages
This file may not be suitable for users of assistive technology. Request an accessible format.
If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email alternativeformats@homeoffice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.
Seizures of drugs in England and Wales, financial year ending 2019: data tables second edition
ODS, 192KB
This file is in an OpenDocument format
Pre-release access list for: Seizures of drugs in England and Wales, financial year ending 2019
PDF, 81.4KB, 1 page
The data relate to all drugs controlled under the Misuse of Drugs Act 1971 and Psychoactive Substances Act 2016. The number and quantity of seizures made can be affected by police and Border Force activity and changes in recording practices, as well as changes in the drugs market. Therefore, the number and quantity of drug seizures each year should not be taken as an indicator of drug prevalence in England and Wales.
If you have any comments about this release please contact us at crimeandpolicestats@homeoffice.gov.uk.
Seizures of drugs in England and Wales: user guide
Home Office statisticians are committed to regularly reviewing the usefulness, clarity and accessibility of the statistics that we publish under the Code of Practice for Statistics.
Last updated 7 January 2020 + show all updates
Following the initial release of data, some corrections were received from Border Force which affected data on seizures of fentanyl and fentanyl analogues. Revisions have therefore been made to Summary Table 1, Summary Table 4, Area Table 1, Area Table 3, Appendix Table 3 and Appendix Table 4 and Chapter 2 and 3 of the publication.
Seizures of drugs in England and Wales statistics
Policing statistics
Alcohol and drug statistics
|
cc/2020-05/en_middle_0097.json.gz/line1407239
|
__label__wiki
| 0.847924
| 0.847924
|
Detroit Tigers 7, Houston Astros 3: Zimmermann strong, Fulmer not
Jordan Zimmermann overcomes nail issue to pitch three scoreless innings as Tigers improve to 9-6 in exhibition
Detroit Tigers 7, Houston Astros 3: Zimmermann strong, Fulmer not Jordan Zimmermann overcomes nail issue to pitch three scoreless innings as Tigers improve to 9-6 in exhibition Check out this story on Freep.com: https://on.freep.com/1puEsNj
Anthony Fenech, Detroit Free Press Published 4:17 p.m. ET March 16, 2016
Tigers 7, Astros 3
Mar 16, 2016; Kissimmee, FL, USA; Detroit Tigers manager Brad Ausmus (left) and a trainer run to the mound to check on their pitcher during the third inning of a spring training baseball game against the Houston Astros at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros starting pitcher Brad Peacock (41) throws a pitch during the first inning of a spring training baseball game against the Detroit Tigers at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Detroit Tigers second baseman Ian Kinsler (3) fields a throw from short for the force out during the third inning of a spring training baseball game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros right fielder George Springer (4) hits a single to right field during the third inning of a spring training baseball game against the Detroit Tigers at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros starting pitcher Cesar Valdez (64) calls off the pitcher and fields a ground ball at first base during the third inning of a spring training baseball against the Detroit Tigers game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Detroit Tigers starting pitcher Jordan Zimmermann (27) throws a pitch during the first inning of a spring training baseball game against the Houston Astros at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros right fielder George Springer (4) catches a fly ball off of the bat of Detroit Tigers second baseman Ian Kinsler (3) (not pictured) to end the first inning during a spring training baseball game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros center fielder Carlos Gomez (30) dives back into first base before the tag from Detroit Tigers left fielder John Mayberry Jr. (64) during the second inning of a spring training baseball game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros center fielder Carlos Gomez (30) reacts to being hit by a pitch during the second inning of a spring training baseball game against the Detroit Tigers at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Detroit Tigers second baseman Ian Kinsler (3) throws to first but not in time as Houston Astros right fielder George Springer (4) slides into second during the third inning of a spring training baseball game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Houston Astros first base coach Rich Dauer (48) talks with umpire Hunter Wendelstedt (21) about his call on a pick off play during the fourth inning of a spring training baseball game at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Houston Astros starting pitcher Brad Peacock (41) throws a pitch during the first inning of a spring training baseball game against the Detroit Tigers at Osceola County Stadium. Reinhold Matay, USA TODAY Sports
Mar 16, 2016; Kissimmee, FL, USA; Detroit Tigers starting pitcher Jordan Zimmermann (27) throws a pitch during the first inning of a spring training baseball game against the Houston Astros at Osceola County Stadium.(Photo: Reinhold Matay, USA TODAY Sports)
At Osceola County Stadium, Kissimmee, Fla.
What happened: The Detroit Tigers beat the Houston Astros, 7-3. … Jordan Zimmermann threw three shutout innings, despite pitching two with a nail issue. … Bryan Holaday hit his fourth home run of the spring and Ian Kinsler hit his third. … There were no injuries.
Starting off: Zimmermann struck out the side in the first inning, then hooked a nail on a seam while throwing a changeup in the second inning. He finished his outing, but ditched the changeup. “Slider was much better today, I threw a few good ones and the curveball, I yanked a couple of those but I also threw a few good ones,” he said. Zimmermann allowed no runs on two hits, struck out three and hit two batters.
At the plate: Holaday hit his fourth home run of the season in the second inning, a two-run shot. He went 2-for-3. … Kinsler and rookie outfielder Mike Gerber hit solo home runs. … Tyler Collins tripled.
On the mound: Michael Fulmer was touched up for two runs on three hits and a walk in 2 1/3 innings. The big blow was a two-run double by Jonathan Singleton. … Drew VerHagen and Bobby Parnell each pitched scoreless innings.
Overheard: “I felt like it was coming out good, no issues,” Zimmermann said about his changeup. “So I’m getting close.”
Three stars: 1. Holaday, 2. Zimmermann, 3. Kinsler
Up next: Thursday vs. St. Louis Cardinals in Lakeland.
Contact Anthony Fenech: afenech@freepress.com. Follow him on Twitter @anthonyfenech.
Download our Tigers Xtra app for free on Apple and Android devices!
|
cc/2020-05/en_middle_0097.json.gz/line1407241
|
__label__cc
| 0.554637
| 0.445363
|
Home›Destinations›Europe›Ireland›Counties Galway, Westmeath and Offaly›Galway›Best Nightlife
Best Nightlife in Galway
Nightclubs in Galway tend to be wastelands until 11pm, and then packed up until 2am when most close. Expect to pay cover charges in a range of about €5 to €20, which doesn't include drinks. There are plenty of options if you've got dancing on your mind, including Halo, 36 Abbeygate St. Upper (tel. 091/565976; www.halonightclub.com) and Karma, Eyre Square (tel. 091/500330; www.karma.ie), both of which are popular with a young, twenty-something crowd. In nearby Salthill, new dance clubs with hot guest DJs are popping up all the time. One reliably good option is Liquid (tel. 091/527155).
Fridays and Saturdays are gay nights at the Attic @ Liquid, Liquid, Salthill (tel. 091/527155).
A half-hour drive from Galway, Dunguaire is a splendid 16th-century castle where, in the summer, you can attend a medieval banquet with a show featuring works by Irish writers like Synge, Yeats, and Gogarty. Banquets cost €56 adults, €42 children 9 to 12 years old, €28 children 6 to 8 years old. Call tel. 061/360788 or visit www.shannonheritage.com for reservations. Dunguaire is in south County Galway on the Ballyvaughan road (N67), near Kinvara, approximately 26km (16 miles) from Galway. The castle is open to visitors daily from 10am to 5pm, after which there are two banquet seatings -- one at 5:30pm and one at 8:45pm. Banquets are held every night from May to September; many nights book up months in advance.
The creative theater group, Druid Theatre, performs in two venues in Galway -- in a recently refurbished, former grain warehouse at Chapel Lane (tel. 091/568660; www.druidtheatre.com), and at the Town Hall Theatre (tel. 091/569777; www.tht.ie). Performances are unique and original, focusing on Irish folk dramas and Anglo-Irish classics. This is widely viewed as one of Ireland's best theaters, and so its shows are frequently either sold out or on tour; book well in advance. Tickets run €15 to about €40. The Town Hall Theatre also hosts an eclectic program of concerts and film screenings.
Frommer's Ireland 2020 Buy Now
|
cc/2020-05/en_middle_0097.json.gz/line1407243
|
__label__wiki
| 0.992142
| 0.992142
|
Charles Brumfield
Charles Francis Brumfield (1872-1918) was the sixth son of Henry and Julia Brumfield and husband of Margaret Brumfield.
The graph displays the other subjects mentioned on the same pages as the subject “Charles Brumfield”. If the same subject occurs on a page with “Charles Brumfield” more than once, it appears closer to “Charles Brumfield” on the graph, and is colored in a darker shade. The closer a subject is to the center, the more "related" the subjects are.
Minimum number of subjects Show related subjects that appear on at least this number of pages in common with Charles Brumfield.
People → Julia's Children
People → Charles Brumfield Family
All references to Charles Brumfield
All references to Charles Brumfield in pages that do not link to this subject
34 pages refer to Charles Brumfield
Show pages that mention Charles Brumfield in all works
Friday, February 15, 1918 — Charles
Friday, March 1, 1918 — Charles Brumfields
Friday, March 15, 1918 — Charles
Memoranda (ii) — Charles Brumfield
Monday, February 25, 1918 — Charles
Monday, January 7, 1918 — Charles
Monday, March 4, 1918 — Charles
Monday, March 18, 1918 — Charles
Saturday, December 28, 1918 — Charles
Saturday, February 16, 1918 — Charles
Saturday, March 2, 1918 — Charles
Saturday, March 16, 1918 — Charles
Saturday, March 23, 1918 — Charles Brumfield
Sunday, February 3, 1918 — Charles
Sunday, February 10, 1918 — Charles
Sunday, January 27, 1918 — Charles
Sunday, March 17, 1918 — Charles
Sunday, March 24, 1918 — Charles Brumfield
Thursday, February 28, 1918 — Charles
Thursday, January 3, 1918 — Charles
Thursday, January 10, 1918 — Charles
Thursday, March 7, 1918 — Charles Brumfield
Thursday, March 21, 1918 — Charles Brumfields
Tuesday, February 5, 1918 — Charles
Tuesday, March 19, 1918 — Charles
Wednesday, February 13, 1918 — Charles
Wednesday, March 13, 1918 — Charles Brumfields
Wednesday, March 20, 1918 — Charles
Monday, March 24, 1919 — Charles Brumfield
Thursday, December 11, 1919 — Charles
7 subjects refer to Charles Brumfield
Margaret Brumfield — Charles Brumfield
Doris Brumfield — Charles
Aubrey Brumfield — Charles
Emmett Brumfield — Charles
Lillian Brumfield — Charles
Charles Francis Brumfield, Jr. — Charles
Janie Brumfield — Charles
|
cc/2020-05/en_middle_0097.json.gz/line1407244
|
__label__cc
| 0.717096
| 0.282904
|
Ciremai
June 17, 2016 December 5, 2019 Andy
Elevation: 3,078 m (10,098 ft)
Prominence: 2,792 m
Ribu category: Sangat Tinggi
Province: Jawa Barat (West Java)
Google Earth: kml
Rating: (17 votes) Add your rating
Other names: Ciremay, Ceremai, Cereme, Careme
Eruptions: 1698, 1772, 1775, 1805, 1937-38, 1951
Bagging It!
A solitary giant, this Ribu is the highest peak in West Java province and one of the most popular hikes in Indonesia. The starting points for the hike are 2 to 3 hours by car or public bus to the south of Cirebon, which itself is easily accessible from Jakarta by train. There are three starting points and it is easy to ascend by one route and descend the other. The Apuy route is the best as it starts at a higher elevation (approx 1,200 m). The crater is both deep and impressive, and a full circuit of the rim can be done in about one and a half hours.
Apuy: take a bus or car to Maja, and from there continue by car or motorbike via Argapura to the beautiful village of Apuy. A neighbouring village is called Cibuluh – which may be better known. The road climbs steeply and is a little rough as you get to the lower part of Apuy village, and it may be necessary to hire a local motorbike taxi (ojek) to for the last 3 to 4 kilometres because car access might be impossible. There are official National Park porters and guides available in Apuy, if you ask. The trail from Apuy is in good condition and is steep, but shorter and easier than from Linggarjati which starts only a few hundred metres above sea level. The ascent should take 5 to 7 hours. After following a cement track which snakes up the hillside between fields of onions and potatoes you will reach the entrance to Ciremai National Park which is a cement shelter (1,442m) next to a small pond. There are five posts and it takes approximately one hour between each of them: Pos I (1,638m) a stone shelter beyond crop fields and just prior to entering the forest, Pos II Perempatan Lima (1,910m), Pos III Tegal Mawasa (2,156m), Pos IV Tegal Jamuju (2,321m) and Pos V (Sanghiang Rangkah, 2,561m). At 2,832m the Apuy route joins with the Palutungan route. Pos VI (2,948m) is a the best spot to camp, being just above a small extinct side crater called Goa Walet (Swallows’ Cave) and just 20 minutes from the crater rim. You may find a small amount of water inside the Swallows’ Cave. There are one or two places to camp on – or just below – the rim itself but it is pretty exposed. The rim itself is reached at an elevation of around 3,050m.
Linggarjati (Cibunar): closer and easily accessible from Cirebon by the bus to Kuningan but over 2,000 metres of elevation gain required. A long, tough climb (or descent). Get off the bus at Linggarjati and then take a motorbike taxi (ojek) or mini-bus to the starting point at Cibunar. This ascent is very popular, but can be very dusty before entering the forest and the trail is heavily eroded in many places. The ascent should take 7 or 8 hours; there are porters and guides available in Linggarjati. Given the accessibility of Linggarjati it is a good option to descend this route after ascending from Apuy, though it’s a long way down.
Palutungan: From Cirebon, take a mini-bus to Cisanatana, and then an ojek (motorbike taxi) to Palutungan. This route meets the Apuy route at around 2,830m.
Assuming you reach the crater rim from the Apuy/Palutungan route there is a cement pillar on the rim just a hundred metres to the left (north) and if you follow the rim clockwise you will reach the highest point of Ciremai (and West Java) in just over 20 minutes. Some sections of the rim are too bushy or too narrow (or both) for hikers to be able to follow the absolute top so you have to drop down on the small, overgrown trail from time to time. The highest part of the rim is marked with a cluster of red bricks and further along with the remains of some kind of sensor equipment. A full circuit of the rim can be made in about one hour and a half, but not many people do this and it is better to do it the other way around (reaching the summit close to the end of the circuit). Several sections of the trail do not offer much in the way of panoramas but for – the most part – the views to Slamet, the north Java coast and the many hills of West Java are spectacular.
If doing a full circuit, we would recommend doing it anti-clockwise, as the first half of the trail is frequently used because you must pass this way to get from the Apuy/Palutungan route to the Linggarjati route. Key points (in anti-clockwise order) are as follows. Puncak Sunan Mataram (3,058m according to the sign) which is a flattish, exposed area with space for 5 or 6 tents on the rim itself and with great views down to Waduk Darma (Darma Reservoir), another ten minutes and you’ll be at a mini-top with great views over the crater. After this, the trail gets bushier and passes under the highest parts of the rim and past a couple of spots suitable for a tent or two and with great views of Gunung Slamet in the distance. Another ten minutes and you will be at Puncak Panglongokan (3,027, according to the sign) which is close to the area where you descend on the Linggarjati route and features a cement pillar. Further along the rim the trail gets rougher and you will need to clamber over a few dead branches and under low bushes. The views here of Ciremai crater are particularly good. After a minor drop to a superb viewpoint over the edge of the rim there is a very narrow section which you must be very careful on. Following this, the overgrown trail leads fairly gently up onto the highest section of rim. This section has two or three spots of equal height, the first being where the broken equipment lies and the final being where the red bricks are. The latter is a far, far better viewpoint, particularly of the other peaks of West Java notably the pyramid-shaped Cikuray, steaming Papandayan and the great mass of tops north of the Bandung plain. Another couple of minor ups and downs and you will be at the cement pillar just north of where the Apuy and Palutungan routes reach the rim.
Bagging information provided by Andy Dean (2009), updated thanks to John Hargreaves (September 2011), and Dan Quinn (April 2013).
Getting there: To get to Cirebon from Jakarta, the best option is an executive class train from Gambir station. The journey takes 3 hours. To reach Majalengka (the nearest town to Apuy) from Jakarta by car takes about 5 or 6 hours.
Accommodation: There are some hotels in Cirebon, but not a huge selection. For the Apuy route, try Hotel Sederhana Baru or Putra Jaya in Majalengka. In Linggarjati, try Sangkan Indah.
Guides and GPS Tracks: Want a PDF version for your phone? Looking for a guide? Need GPS tracks and waypoints? Gunung Ciremai information pack can be downloaded here.
Permits: You are required to register at the starting points. At Apuy it costs Rp 8,500 per person (September 2011). The mountain is often closed during Ramadan.
Water sources: None on any of the routes except sometimes a small amount in Swallows’ Cave. Take plenty with you.
Travel insurance: We recommend World Nomads insurance, which is designed for adventurous travellers with cover for overseas medical, evacuation, baggage and a range of adventure sports and activities including mountain hiking.
Local Average Monthly Rainfall (mm):
Origins and Meaning
The name Cereme or Ciremai is derived from the Sundanese word for Otaheite gooseberry or Malay gooseberry. (Wikipedia, 2011)
Wikipedia. 2011. Mount Cereme. Accessed from http://en.wikipedia.org/wiki/Mount_Cereme
Jawa Barat Sangat Tinggi. permalink.
Pulau Besar
Ili Labalekang
36 thoughts on “Ciremai”
Ciremai is closed until early next month (i.e for all of Ramadan). A strange time of year to close a mountain – the more typical January and February would be a much better choice, especially for those of us who enjoy a period when less hikers are around.
https://www.thejakartapost.com/travel/2019/05/11/mount-ciremai-closed-for-hikers-until-early-june.html
I tried to climb from Apuy today but was informed mount Ciremei is closed till next year due to forest fires started by trekkers cooking
Matthew McDonnell says:
Did a 1-day summit via Apuy on 28-Feb-2019. Description by moderator is great, as always, so I’ll just leave a few thoughts:
1. Getting to the mountain: Getting to Ciremai was quite enjoyable. I took the first train from JAK to Cirebon. My motobike rental was waiting for me at the Cirebon station (Oke Rental, WA +6285724198194), so logistics were a breeze. I highly recommend the early train, as it will allow for some lunch and some batik shopping (the batik in Cirebon is amazing), before heading to Cigugur (a ~2 hour drive through some absolutely stunning scenery)
2. No need to camp: We started at approx 1:45am (if memory serves me well) and finished around noon, traveling at a reasonable pace.
3. Accommodation: I showed up to Pak Edan’s place and there was no problem, as I was the only guest. Pak was extremely hospitable and helped me arrange a guide for the next day. I would still recommend arranging the particulars in advance, however, as I had to wait for him to return home from some errands before we could organize the particulars of my stay and guide. Also, Pak’s English is quite limited, so staying there would require at least a minimal amount of B.Indo. fluency (not his fault, this is the desa after all).
4. For a guide: I used Pak Adang (WhatsApp +6285324965044). Pak Adang was very professional- he knows the trail and the area well, he comes well-prepared in terms of both food and equipment, and he’s a beast on the trail- fitness is not an issue whatsoever. My favorite part is Pak Adang is very passionate about keeping the mountain clean and he repeatedly picked up trash left behind by less mindful hikers. Pak Adang, you rock! Unfortunately for new arrivals to Indo, Pak Adang speaks no English, so you will need someone in the group who has a basic fluency in B.Indo.
Happy climbing. Stay safe.
simplysepti says:
Ciremai….
anyone welcome…
Rob D'Eon says:
Just back from a climb up Ciremai. It was a one-day, up and back mission from the Apuy “basecamp” (see GPS track). All went relatively well in terms of logistics. However, it was a long weekend (Independence Day), so, VERY CROWDED with the usual hordes (thousands) of chain-smoking, noodle-eating teenagers that frequent Gunungs these days. Given its popularity with said group, I would strongly advise against holiday weekends here. Another con was the extreme dust. The trail is extremely dry (bring lots of water), and being core dry season, the dust (made infinitely worse by 1000+ teenage stomping feet) was virtually unbearable. For relatively long stretches, it was literally just walking through a dust cloud that made breathing and seeing difficult. Not sure what to do about that. Wet season would not be an option since that would simply turn everything into a mud bath. The trail itself is very steep in many places, turning the dust/dirt into very treacherous slippery slopes. It would be easy to get hurt. All in all, to be completely honest, not an entirely pleasant experience on this particular day. However, the top and crater is quite beautiful, with great views, and it was a clear blue-sky day. So, if you could somehow get the trail to yourself, a couple days after rain to keep the dust down, on a nice day, it could be wonderful!
A bit of information to add to the storyline:
THE APUY TRAILHEAD/START: is referred to locally as “basecamp” (GPS = S6.91570/E108.37036 [WGS 84]; elev 1460 m). That’s the official start of the trail, and entrance gate, with the usual gong-show of warungs and arches over the trail. We had to purchase a ticket, and go through a park gate. We (2 foreigners) paid 50,000 Rp each. I have no idea if that is the real rate or not. But it seemed like that is what the teenagers were paying, but seems high. Given the crowd chaos, I was not in a mood to negotiate.
VEHICLE ACCESS: If you are coming in a car/driver, you cannot drive to basecamp. Well, you probably could, but for some reason the approach to basecamp is via ojek (motorcycle taxi), or those little pick-up trucks you see in the Kampongs. Our driver, coming from Cirebon, brought us to Apuy (AKA locally as “Agramukti” and/or “Argapura” it seems). GPS = S6.91094/E108.35831; elev 1165 m – basically just a street corner in a kampong. From here we jumped on an ojek for 30,000 Rp each, to get us to basecamp. The ojek drivers will approach you the minute you open the car door. You could walk to basecamp if you wanted via the same access, but it would likely be a 2-hr hike up a concrete road/trail through vegetable fields, with the traffic of people being shuttled to basecamp. Not advisable, unless you really have all the time in the world. Coming back is the same, in reverse. There is no shortage of ojek/truck drivers at basecamp shuttling people back and forth to Apuy.
GUIDE: absolutely no need for a guide. If you can get yourself to basecamp (as described above), the trail is obvious and you would really have to try very hard to get lost. We didn’t have a guide, and it was 100% fine. That said, organizing a car with guide from Cirebon to get you through the access logistics would relieve the stress of getting to basecamp. Or maybe just tell the guy to get you to basecamp, then wait for you there to return? The point is that the actual trail is very obvious.
TRIP STATS: Total hiking time, basecamp to crater to “south summit”, return = 8 hrs (4.5 hrs to crater rim). We were a bit stressed about time at the top, so we didn’t do the crater rim hike, but it looks great. If you are keen and fit and have the time, it would be a nice add-on (plan an extra 1.5 hrs?). That said, when you pop out on the rim, where the metal railings and flags are, there is an obvious, well-worn rim trail going to the right and up to the “south summit” (10 mins – see summit notes below). The drive from Cirebon to Apuy took 2.5 hours. It’s not an obvious place to get to. So you either need a driver/guide who actually knows the place, or use the GPS location (above) + google maps to guide you.
THE SUMMIT: According to all accounts and the “bagging it” description above, the true summit is on the north side of the crater (i.e., going to the left when you get to the rim). At the “south summit” we went to (i.e., going to the right when you get to the rim), there is a cement pillar with a sign “Puncak Ciremai, 3078 m”, and my GPS recorded the elevation as 3075 m – either way, great views!
OTHER MISC INFO: No water on route, bring lots. There is cell coverage at basecamp, but not on the trail. Total vertical climb from basecamp to summit is approx. 1600 m. Despite a beautiful hot Indonesian day, it was cold and windy at the top. BRING WARM CLOTHES for the top.
Having done all the obvious treks that are possible to do from Jakarta in a regular weekend, I have been investigating lesser-known ranges, particularly those of historical merit. One particularly good example is Gunung Tilu (1,076m) east of Kuningan, very close to the border with Central Java. This is not to be confused with the much higher Gunung Tilu (2000m+) near Pangalengan south of Bandung.
At the top of Gunung Tilu near Kuningan is a ‘batu tulis’ (inscribed rock) better known as ‘batu naga’ (dragon rock). Looking at photos online, there are actually two menhirs, once of which includes a mad-looking creature a bit like a dragon. Local researchers suggest these date back to the 14th century. I went to the area this weekend, but for a couple of reasons did not do the hike to the top. I will be back another time hopefully. The following information may be of use to those considering going there (but don’t go until at least June or July 2018 and even then try to confirm you can do the hike in advance).
I got a train to CIrebon on Friday night and stayed in the Aurora Baru hotel. Great choice, close to the newly-improved train station and good value for money. The next morning, I got a Grab Bike without much trouble, as usual a chap looking at the Rp170,000 and not realising quite how far from Cirebon this area actually is! It took us two hours, going via Kuningan, but you could probably go via Babakan/Ciledug too (better for those driving, or indeed getting the train to Babakan – the Tegal Bahari stops there a couple of times a day an there are other economy trains to consider if they suit your schedule).
The trail starts in the hamlet of Banjaran, beyond Desa Jabranti, basically at the end of the road that leads up into the hills west of Gunung Tilu. We were quite shocked to find large sections of road washed away by recent landslides (March 2018), with planks of wood and simple temporary wooden bridges constructed for motorbike users. Getting a car within 3 or 4km of Banjaran might prove impossible for the next few months.
Very friendly folk in these villages, particularly Pak Carnadi (0858 72093714) who has worked in many different provinces and knows Indonesia very well indeed. Well, he told me that there was also a landslide area up on the trail to Gunung Tilu and Batu Naga, and that nobody had been up recently and it might be difficult to get a guide. We walked up to Pak Lurah’s house, but he was not home, and nobody there thought it possible to get up to see the rocks and back down in one day, as an alternative route would need to be cut to avoid the landslide section. Fair enough. There were a couple of photos of the rocks in his house, but there are no signs for ‘obyek wisata’ or anything like that, but it is apparently visited by local student groups every month or so (assuming normal conditions).
So, we had a coffee back at Pak Carnadi/Jarnadi?’s house before I got an ojek back down to the main road and another to Babakan station where I waited for 5 hours for my train to Jakarta!
So, I will be back another time. I recommend getting there as early as possible (before 8am ideally). It only takes 3 hours up and 2 back down (estimated), but it is good to be coming back down by lunchtime, especially if you have a train to catch. I would call Pak Carnadi above to see if the trail is open, and also how close you can drive a car to the village (even in ideal conditions you will have to walk for the last 2kms or so as it is very narrow).
Banjaran is around 620m above sea level, so a relatively pleasant temperature, and not too much elevation gain required.
I will be back!
mayescol says:
hi, thank you for this information. May I ask if mount ciremai is open on June 15-17?
No reason why it shouldn’t be, but finding a guide might be difficult.
Tien Doan says:
Some note for those are going, please bring along mosquitoes repellant, not sure anyone have mentioned but on the summit, i went there in sunny day in November, that time the surrounding flower in bloom, thousands thousands of flies that look smaller and a bit like mosquitoes and look strange , they are everywhere, on the flowers, on the flag, on my hand, on my hair 🙁
other than that, the view are stunning, the nature is so beautiful since the flowers are in bloom, a bit cloudy at some points which make it more scenery
Frank Creedon says:
You can get an angkot from Cirebon to Majalengka then another one most of the way to Argapuro, then get an ojek to Apuy. Took 3 hours from Cirebon to Apuy. There is a place to stay in Apuy. You can go by ojek to Pos 1, register at Pos 1 & get your entry permit. They were open at 5:30 AM when I was there. This is one of the easier 3000M gunungs, straightforward via the Apuy route. Took 3 hours 20 mins. up to the crater rim, then did the circuit in 1H 20″, total 7 hrs up & down via Apuy including breaks to talk to people. The crater circuit is well worth doing, be careful as parts involve exposed but easy scrambling although a lot of it can be bypassed. Nearly everyone just goes to the crater rim & very few go on to the true summit.
Zoran says:
I’m planning to climb gunung Ciremai this weekend.
I’ve read you completed the full ascent-descent in 7 hours only ! In the description above it is written the ascent “should take 5 to 7 hours” by itself. This is far less.
I don’t know if it is reasonable to do the full trip in 1 day only. I’m 25 years old, in good physical shape and used to climb mountains (I’m Swiss).
Did you do the trip alone or with a local guide ? Did you returned to Apuy or another destination ? Last question: did you climb to the highest point ?
Thank you for your answers =)
Hi Zoran,
how was your climb
I did solo, 5 hours up, 2 hours down, i stayed in Puri Elsas hotel,they helped me to get one motorbike, i started at 6, reach there at 7, i reached summit at 12, back to base at 2pm, all good, i dont bring anything,just some snack, so it was very light
another ribu attempt.another failure.
i have decided that there should be a hall of shame for people who get to 20 failed ribus before 20 successes.of course it was all of my own undoing and a dodgy knee.
i had climbed tampomas the previous evening and went directly to apuy. after a few different forms of transport i arrived at apuy around 12.00pm.i had a choice to make. either hang around until the next day and rest or get going and camp somewhere on the way up.in hindsight i should of rested up and tryed the next daywith a guide .my knee was already hurting from tampomas. i couldnt really find anyone in apuy to help. one guy offered to give me a lift up to pos 1 so i took it saving me probably 1 hour of hiking on farm tracks.i had planned to find a guide and maybe a porter but knowone put their hand up so i just went off by myself.when i got to pos 2 there were people coming down and they were warning me it was a long way to go.i was looking at a sign that said puncuk and i thought it was strange that they would spell puncak wrong. had the locals at pos 2 not been there to tell me that puncuk is another mountain i probably would of gone up the wrong trail. when will i learn that you dont do these ones without a guide.as i entered the forest the clouds opened up and i spent the next 3 hours getting drenched.the trail then became a waterfall and some of the gullys became almost impassable due to the slipperyness. i got up to pos 5 and was totally spent.with only half an hour left of light in the day i decided to make camp.overnight my knee was telling me this was all wrong and the fact that i hadnt seen anyone on the mountain except for the locals at pos 2 made me feel rather lonely.also having no phone reception and hearing rustling in rubbish outside my tent from animals didnt help.at daylight i got out and looked up at the summit and knew that i had to make the correct decision and abandon the climb. i was at 2500 meters and still had 500 height meters to go.my knee ( it band syndrome) wasnt good and going alone would have been too risky. so i lipmed my way back down to apuy and made my way back to bandung with my tail between my legs.
its a real shame because unlike my last indonesian trip up gede where i felt like i was getting ripped off by everyone and just seemed surrounded by bad people, i had very positive experiences this time. i found the people from bandung to apuy very helpful. i got rides from people and they didnt expect anything in return.the landscape around ciremai is great.the apuy trail in dry weather would of be fine. lots of wildlife( monkeys,pigs ,etc..).
one thing i noticed thats been mentioned in other posts is the bottles of urine.they wernt hanging on trees. but just in bottles on the ground.
lessons hopefully learned
dont go alone.
if you have dodgy knees dont try and do to many gunungs over consecutive days.even if its only a small one like tampomas.
ill be back to give ciremai another try when the dry season starts.
Here’s a report from Chris on his second attempt….
“after my last effort in april i was haunted by not reaching the
summit. so i went back last week and bagged ciremai without too many
dont underestimate how long it will take you by transport to get
there. i thought it would take me 3 hours to majalenka from bandung(
which was last time) this time it took 8 hours.the bus had to take a
detour around sumedang due to road repairs. 8 hours for 80km is not
fun. in apuy at the park office next to the mosque i asked for a
porter and one showed up within 10 mintues. this made a huge
difference. what took me 5 hours to get to pos 5 last time only took
me 3.and 4 hours to the crater edge.not carrying a 20kg bag and no
rain helped alot. both times on the mountain somewhere between pos 2
and 3 i saw a large mob of white faced monkeys jumping around the
trees so look out for them. added advantage of having the porter(
think his name is ojat) is that he will drive you on his scooter up to
pos 1 saving you a hour.he also brought a machete and chopped down a
heap of wood to make a fire at the campsite( pos 6 goa walet). when
you reach the crater rim to bag the real summit trust the advice from
dan,andy etc . at first i was worried thinking id have to take
dangerous risks walking along the crater edge to get there , but after
the concrete pillar you will find a overgrown path maybe 20 meters
below that will take you right around. just look for the red bricks on
the more roundish hump on the cirebon side and you know you are on the
summit.from goa walet back down to pos 1 where the scooter is only
took 3 hours. it is steep and for me a total knee destroyer.as a bule
be prepared to take alot of photos with the locals.
still lots of bottles of piss lying around. do not make the mistake of
drinking it thinking its gatorade.
its a nice climb.nice views.worth while but i think my favourite part
is the traveling between majalenka and apuy.the countryside is
stunning with some rocky outcrops of hills. theres a nice parang
looking one near kadipaten and also saddle mountain near maja.locals
in this area are very friendly.
also keep in mind that july is the month of ramadan where the muslims
cant eat between 4am and 6 pm so expect some understandably lazy
guides and porters around indonesia during this time.”
If we climb Ciremai and use guide, do we suppose provide the guide with tent,sleeping bag and food ? or we just bring supply for ourselves ?
dony says:
just climbed this mountain via Palutungan on 7-8 april, unfortunately the weather was really bad. Started the hike at 6.30 am, we’re built a camp about 100 meters above Sanghyang Ropoh Pos and got rain from 3 pm until 5 am next morning, we’re failed to reach the summit as the weather at dawn was terrible. windy, misty and ice rain. Maybe next time we’ll get something better..
bon viveur says:
I know what you mean Dan but you are actually missing the point – we are guests in their country and that is the way they do things so just grin and bear it buddy – or go somewhere quiet. If you want to do your head in try Bali, particularly around Ubud, if you want to know what real noise is about in a religious context, for there it can go on all night – and they are Hindu!
But the compensation is Ciremai, the views and the solitude when you move away from the well worn tracks.
Have you tried walking with the Ciremai Hash House Harriers – every Sunday they leave at 6.00 a.m. from Cirebon for varied walks around the mountain of about 12km and an annual walk up to the summit using less frequented paths – and they are happy to provide transport. If you want any more info just let me know
I appreciate your comment but with that reasoning where do you draw the line? We are all inhabitants of the same planet.
I don’t personally live in or near Cirebon but I’m sure there are others out there that would be keen. Presumably you have a website people can ask Mr Google about.
Climbed this mountain for the second time at the weekend, with Java Lava. It took quite a while to get out of Jakarta on Friday night (much better to go by train to Cirebon) so we didn’t arrive in Majalengka til almost 3.30am. Wake up call was at 5am!
If we weren’t lucky with traffic we were certainly very lucky with the weather – no rain except light rain on the way down. A handful of us made a complete circuit of the crater rim – very worthwhile indeed. Wind was very light so most of the group actually camped on the crater rim.
The guides/porters from the National park team at Apuy were excellent. Friendly and fast. Very much better than in previous years when they drank from our water supplies which is a very serious matter considering there is basically no water to be found on the mountain.
On the way up I did spot a tiny stream to the left of the trail between Pos 1 and Pos 2 which would be worth a try in an emergency or during the wet season.
Another good thing was the lack of plastic bottles filled with urine and tied to trees which people have previously reported (perhaps on other routes only?) due to the ‘holiness of the mountain’ which would be offended if urine fell directly to the ground but not if bottles of piss were left hanging from trees. Thankfully this bizarre practice seems to be ending.
A fair bit of ‘Allahu Akbar’ (God is Great!) being shouted at dawn, which is a little off-putting to non-Muslims but I tried to counter it with a bit of Socrates Akbar!
Why should subuh (the dawn call to prayers for Muslims)be a little off-putting to non-Muslims Dan? – didn’t you realise that the Cirebon area is widely regarded as the birthplace for the spread of Islam in Indonesia and the area continues to be more Islamic than a lot of other areas in Java. I would hope that all visitors would respect the religious practices and beliefs of their hosts and not regard them as threatening or off-putting in any way.
Just because of the volume, actually. Really, really loud. I know it wouldn’t be appreciated the other way around either at such high volume. Live and let live, you know, but don’t force it on others, whatever the religion.
Decky chan says:
Ciremei is a virgin mountain in java.
Surprised at your opening comment that there is not a huge selection of hotels in Cirebon. I can think of at least 30 in all different price ranges – how many do you need for a huge selection?
It’s unlikely to be slippery in the dry season(usually April-October) and as for the litter please bear in mind that, sadly, most Indonesians regard the ground everywhere as a trash can!
According to Java Lava (who have been planning a hike up Ciremai for the last few weeks), forest fires on the slopes of the mountain has meant that there is currently no access for hikers. It has been incredibly dry recently. Presumably it will be open again by mid-October.
Hi – does anyone have the mobile number for a guide for ciremay please?
Paul L says:
Hi Kath, try the Resources>Guides section of this website
https://www.gunungbagging.com/guides/
Dony Adityo says:
i’ve climbed this mountain on june 2010, linggarjati trail was really tough, i’m also have to bring 8 litres of water, what a hell for skinny senior high school student like me.. haha!
John Hargreaves says:
We climbed Ciremai last weekend- 10th to 11th September- starting from Apuy and descending to Cibunar (Linggarjati).
On Friday we travelled by car from Jakarta to Majalengka via the Bandung toll road. This was about 4.5 hours journey- 2.5h to Cileunyi, a further 1h to Sumedang and another 1h plus to Majalengka, enigmaticaly described on the Nelles map of Java as a “nice town”. In Majalengka we stayed at Hotel Sederhana Baru, which has clean rooms for Rp250,000 or tatty rooms for Rp125,000. We just arrived in time to find the rumah makan Padang before 21.00, when everything in Majalengka seems to shut.
On Saturday morning we proceeded toward Maja- follow the main road through Majalengka and turn right at the roundabout (no sign) at the east end of town. From Majalengka to Maja is about 20 minutes. Turn left immediately after the bus terminal in Maja to ascend to Apuy. The road is good for 5km but then deteriorates- not good for sedans. At Argapura village continue straight rather than following the main road round to the left and cross the valley to reach Apuy. We took 40 minutes from Maja to Apuy (alt. 1220m).
In Apuy we paid Rp8,500 for the various tickets required from Pak Memeng and looked for guides/ porters. Getting here early would be an advantage; when we arrived at 08.00 we were told that many potential porters had already left to work in the fields. Eventually though we negotiated a price and set off with our guide Pak Jaja.
The first part of the climb followed a broad farm track, and then a path through vegetable fields until after an hour we reached Pos II, a solid stone shelter at 1654m, having somehow bypassed Pos I. Different websites seem to disagree about the altitudes of the various Pos; on our visit they were all marked with fresh-looking red-on yellow painted signs, so the altitudes should be accurate. Pos III was at 2156m, Pos IV 2321m, Pos V 2561m. All these are just campsites with no shelter.
The hike itself was a pleasant and typical Javanese forest hike on a good path, steep but seldom requiring use of hands and not slippery at all. The overcast sky kept the temperature cool, but never cold.
The birds in the forest were remarkably bold, often perching right beside the trail. We also heard a troop of lutung in the trees near pos III, though they remained hidden among the foliage. The forest undergoes the usual transition from leafy evergreens in the lower montane forest to dwarf shrubs and mosses on the upper slopes.
After Pos V the mountain’s volcanic nature becomes more apparent, with the trail emerging onto a ridge with ravines on either side and the top fleetingly visible among the swirling clouds. The old trail appears to have subsided and a new path is being worn above the edges of the old path, requiring more careful foot placement than on the lower slopes.
At 2823m altitude, the Apuy trail joins up with the Palatungan trail coming from the south, then continues to pos VI at 2948m. At Pos VI there are several flat, though somewhat gravelly pitches, where we set up our tent. Goa Walet is directly below Pos VI; although it looks sheltered, some campers who had slept there the night before reported that it was a wind funnel.
Total distance climbing time, including long stops and lunch, was 7 hours from Apuy to Pos VI, but fast movers could easily cut that by a couple of hours.
We enjoyed a cold, but clear night with a full moon, beautiful stars and about a dozen camping companions.
After breaking camp just before dawn, we set out at 5.20 Sunday morning for the crater. From Pos VI it’s only 20 minutes to the rim. The trail is steep but hand supports are available and there is none of the volcanic scree that makes the summit sections of mountains like Slamet and Rinjani such a challenge.
After sunrise at 5.45, we cooked a leisurely, wind-free breakfast on a broad, flat section of the crater rim and admired the view. While the nearby villages were visible the far distance was hidden under cloud cover, with only a handful of mountains peeking out. To the southwest was what I took to be Gunung Sawal, with several other Tasikmalaya area mountains nearby, and in the western distance what I guess were the 2000m mountains north of Bandung. Toward central Java, only Slamet was visible, imposing itself far above the cloud line.
The crater of Ciremai itself is not the most spectacular, but it does have craggy sides, active fumaroles and a small milky white lake to provide good color contrast.
The Apuy path emerges on the west edge of the crater, while the Linggarjati path emerges on the east. We toured anti-clockwise around the south edge of the crater to reach it. The rim path sometimes stays on the rocky edge or sometimes dips down into the vegetation outside the crater rim, avoiding the knife-edge parts!
After 40 minutes and 1,8km we reached the painted signs at the top of the Linggarjati path, only to realise that the actual summit of the mountain is atop a hump on the north side of the crater. With true Gunungbagging style dedication, we therefore continued around the crater rim to bag the summit, a rather rougher section of path seemingly much less trodden- perhaps the approach around the north west edge is more used.
At the northeast corner of the crater rim is a small campsite, after which the trail drops down about 20m outside the lip. You have the option of staying on the lower path, which drops annoyingly a full 50m below the rim, or climbing back up to the crater edge, which involves a jagged rock section for 20 or 30 meters but then improves. We went to the summit on the lower path and returned on the upper path; either way it’s about 30 minutes from the top of the Linggarjati path to the summit. On the north side of Ciremai you get to see the range of jagged and intriguing hills that lie between Rajaguluh and the Java Sea.
The first section of the descent on the Linggarjati path made a bad impression, a steep, dusty drop down a stony gulley with frequent need for hand support. Although the dust and gradient gradually become less severe once you enter the forest at about 2600m altitude, the path still compares unfavorably to the Apuy trail; it’s steeper, dustier, messier and strewn with litter at the campsites that crop up every 100m or so of descent. Even once you enter the pleasant pine forest and cacao plantation at about 1000m altitude, civilization still lies far below you. Only after a further 200m descent to Cibunar do you finally get to guzzle mineral water to your heart’s content and find an ojek down to Linggarjati. Descent time from the crater rim to Cibunar was 5 hours.
The one advantage on the Linggarjati side is that you can visit the hot springs resort at Sangkanhurip to rest your weary limbs. Sangkan Indah is a nice hotel with a pool open to the public for Rp10,000; Alinda is a good Sundanese restaurant (but bring your own beer from the hotel or from a shop in the village.)
Overall, Ciremai, if you climb from the Apuy side, can be recommended as a rewarding weekend- with pleasant forest, a good trail and a scenic crater. The trail on the Linggarjati side though, had less appeal. From any side, keep in mind the absence of water sources. We carried 3 liters each, which was barely sufficient for the two days.
Handjono says:
In Apuy you can stay overnight in pak Ubuh’s house. Pak Ubuh also takes care of the registration. He and his son can take you to the summit.
Try to get to Apuy before 9:00 pm otherwise you could lose your way. No one to ask in the night.
At least along the Apuy trek to the summit, you are not supposed to name any animal with its name. If you talk about monkey, you do not say “monkey”. If you talk about snake, you do not say “snake”. And so on. Otherwise you would invite bad weather or some other obstacles.
Apuy approach is the shortest as Apuy is 1400m and the trek is straightforward.
Palutungan approach is longer as Palutungan is 1100m and the trek is meandering at places. Palutungan is close to Kuningan, and Kuningan is a sizeable town.
Linggarjati is 500m, but the trek is quite straightforward. Since the distance is not so far, you will know how steep it is.
Hi Handjono – do you have a hp number for Pak Ubuh please?
Hi Kath. Pak Ubuh’s number is 0858 642 454 59. Other than pak Ubuh there are other guides in Apuy, just ask the shop owner near the mosque.
ciremai pos says:
welcome to one of Misterous Mountain
Do you have any recommendations for guides/places to stay nearby?
tubagus faisal says:
I stayed in sangkanurip a hot spring at the foot of Mount Ciremai, its a resort near Kuningan city. From there we rent an old landrover to palutungan then climbed the mountain, no water source in the mountain, so bring a lot of water is recommended
Zac Dylan says:
I tried to climb this moutain a couple of years ago but only had 2 days to do it. there 2 famous routes to the summit.The well known route from Kuningan, and the Oh My God! route.It is well advised to take the regular route if you are pressed for time. However The Oh my God route is very rewarding as it is filled with some of the most beautifully preserved jungle I have seen in that part of Java.
I visited the Apuy park entrance today and was informed the Mountain is closed due to forest fires and will not open again till next year
So i visited a waterfall and purchased a 50 KG sack of spuds
|
cc/2020-05/en_middle_0097.json.gz/line1407246
|
__label__wiki
| 0.73266
| 0.73266
|
Last Meals of 23 Famous People Gallery
Last Meals...
There is something fascinating about last meals. Eating is something we do multiple times on a daily basis; it is what gives us life. Surround yourself with chefs, cooks, and culinarily inclined guests at a dinner party, and you may very well be presented with a particular question: "What would you want for your last meal on Earth?" Some will choose indulgent dishes like oysters, lobster, and foie gras, while others will instead favor comfort foods from their childhood or simple dishes from home, like spaghetti pomodoro, steak, and mashed potatoes, Mom's meatloaf, or homemade biscuits.
In reality, very few people - at least those who aren't on death row- actually have the opportunity to choose their last meals before they die. When you learn the last meals of people who died suddenly, it can add eeriness to otherwise mundane foods. Was the dish the cause of their death? Was it a special occasion? Was it an odd combination of dishes? Maybe the fascination with the idea of the last meal is that is gives us insight into an otherwise unknown area of life.
Few people would be interested in the daily breakfast, lunch, or dinner of somebody who remains alive - but after death, characters are often mythologized and looked at under a new light. Knowing that Julia Child had French onion soup just before she died certainly emphasizes and even enhances the role she was so famous for as an American cook and writer popularizing French cuisine in the United States.
Will these last meals surprise you, or will they reinforce famous reputations? Read on and discover the last meals eaten by 23 famous people throughout history.
Left: CNN; Right: Nick Parfjonov/Wikimedia Commons
In 399 B.C., a jury of Athenians selected death for Socrates as punishment for impiety and corrupting the youth of the city. The philosopher was taken to the nearby jail where his sentence would be carried out. Athenian law prescribed death by drinking a cup of poison hemlock.
Left:C Messier/Wikimedia Commons;Right:shutterstock.com
On August 12, 30 B.C., in Alexandria, Egypt, Cleopatra watched her husband Mark Antony breath his last (just after, the story goes, finishing a glass of wine). The distraught Cleopatra then ate a handful of figs, according to historical conjecture, and either chased them with a poisonous concoction of hemlock, wolfsbane, and opium, or subjected herself to the deadly bite of an asp.
Left:shutterstock.com;Right:istockphoto.com
On May 5, 1821, while in exile on the island of St. Helena, the erstwhile emperor of France ate liver and bacon choOn May 5, 1821, while in exile on the island of St. Helena, the erstwhile emperor of France ate liver and bacon chops, sautéed kidneys in sherry, shirred eggs with cream, and garlic toast with roast tomatoes before breathing his last.ps, sautéed kidneys in sherry, shirred eggs with cream, and garlic toast with roast tomatoes before breathing his last.
Left: National Gallery of Art/Wikimedia Commons;Right:istockphoto.com
On April 14, 1865, before heading out to watch the play "Our American Cousin" at Ford's Theater, President Lincoln dined on mock turtle soup, roast Virginia fowl with chestnut stuffing, baked yams, and cauliflower with cheese sauce.
On June 25, 1876, Colonel Custer ate roasted buffalo steaks, beans with molasses, roasted wild corn, and prairie hen before recklessly leading a battalion of the 7th Cavalry into disaster at the Battle of the Little Bighorn. Custer and his entire detachment were killed.
Left:Library of Congress/Wikimedia Commons;Right:istockphoto.com
In the early morning of December 30, 1916, Grigori Rasputin ate honeyed cakes, Madeira wine, black bread, and assorted Russian hors d'oeuvres (most of which had been poisoned) at the home of Prince Felix Yusupov in St. Petersburg. When the poison failed to kill the mad monk, Yusupov and his associates shot him repeatedly and dumped his body in the river.
Left:Wikimedia Commons;Right:shutterstock.com
On April 30, 1945, holed up in his bunker underneath a shattered Berlin, Hitler ate spaghetti with "light sauce" (although some biographers say he had lasagna) - almost certainly meatless, as he was a vegetarian. Shortly after the meal (which had presumably not been vetted by his personal food taster), Hitler and Eva Braun, whom he had married less than 40 hours earlier, went into a private room and took their own lives.
Left:Heinrich Hoffman/Wikimedia Commons;Right:istockphoto.com
On the evening of January 30, 1948, Gandhi enjoyed one of his standard healthy dinners - goat's milk, cooked vegetables, oranges, and a concoction of ginger, sour lemons, and strained butter mixed with aloe juice - before he was assassinated by Hindu nationalist Nathuram Godse.
Left:Wikimedia Commons;Right:istockphoto.com
On September 30, 1955, a few hours before he fatally crashed his Porsche Spider near Cholame, California, the actor and heartthrob allegedly stopped by a roadside diner and ate a slice of apple pie with a glass of milk.
Left:eBay/Wikimedia Commons;Right:shutterstock.com
On July 2, 1961, at his house in Ketchum, Idaho, "Papa" ate a New York strip steak, baked potato, Caesar salad, and no doubt a healthy pour of Bordeaux before taking his own life with a shotgun.
Left:Lloyd Arnold/Wikimedia Commons;Right:istockphoto.com
On the morning of November 22, 1963, JFK ate breakfast in his room at the Hotel Texas in Fort Worth. According to the hotel's executive chef, Otto Druhe, he served the president "coffee, orange juice, two boiled (five-minute) eggs, some toast, and marmalade on the side." The president's entourage then left for downtown Dallas, where they were scheduled for a 1 p.m. luncheon to take place directly after Kennedy's motorcade made its way through town. Kennedy was shot at 12:30 p.m.
Left:White House Press Office (WHPO)/Wikimedia Commons;Right:istockphoto.com
On September 18, 1970, around 3 a.m, Jimi Hendrix's girlfriend Monika Dannemann prepared him a tuna fish sandwich in her London flat. At 11:27 a.m., the guitar virtuoso was discovered alone and unconscious. Hendrix was pronounced dead at the hospital about an hour later. He was 27.
Left:A.Vente/Wikimedia Commons; Right: Shutterstock.com
On August 16, 1977, the King downed four scoops of ice cream and six chocolate chip cookies at his Graceland mansion in Memphis. After that, he went to bed, and then got up a few hours later to go to the bathroom, where he suffered a heart attack
Left:Metro-Goldwyn-Mayer, Inc./Wikimedia Commons ; Right:istockphoto.com
On December 8th, 1980, Lennon enjoyed a corned beef sandwich with the plan to have a larger meal once he got home. Sadly, on his return, the former Beatle was gunned down by Mark David Chapman outside his apartment.
Left:Flickr/its all about rock/CC BY-SA 4.0;Right:Shutterstock.com
On the night of March 5, 1982, the actor and comedian ate a bowl of lentil soup in the kitchen of the Rainbow Bar and Grill in Los Angeles before returning to his bungalow at the Château Marmont hotel where he died of a drug overdose
Left:Flickr/tonynetone/CC BY 4.0 Right:istockphoto.com
On February 4, 1987, the flamboyant entertainer ate a bowl of Cream of Wheat with half and half and brown sugar. He died from an AIDS-related illness at age 67.
Left:Allan Warren/Wikimedia Commons;Right:istockphoto.com
On August 31st, 1997, before her tragic accident, Diana enjoyed a meal of Dover sole, vegetable tempura, and a mushroom and asparagus omelette at the restaurant L'Espadon inside the Ritz Paris.
Left:Nick Parfjonov/Wikimedia Commons;Right:istockphoto.com
On May 14, 1998, in Los Angeles, California, Ol' Blue Eyes ate a grilled cheese sandwich before dying, at age 82, in the company of his wife, Barbara.
Left:20th Century Fox/Wikimedia Commons;Right:istockphoto.com
On August 13, 2004, Julia Child - appropriately - ate a bowl of French onion soup before her death at age 92.
Left:Courtesy of PBS;Right:istockphoto.com
On December 30, 2006, the former president of Iraq was executed by hanging. Reports say his last meal consisted of boiled chicken and rice with hot water mixed with honey. He was offered cigarettes as well, but refused.
June 25th, 2009, the King of Pop enjoyed a last meal of spinach salad with chicken breast before dying of acute propofol and benzodiazepine intoxication.
Left: Zoran Veselinovic/Wikimedia Commons;Right:istockphoto.com
On June 19, 2013, while vacationing in Rome, James Gandolfini had dinner at the outdoor restaurant of the Boscolo Exedra Roma hotel. The Sopranos actor, 51, reportedly consumed a lot of alcohol, along with two orders of fried king prawns and a plate of foie gras. He died shortly afterward of a massive heart attack.
Left:Everett Collection/Shutterstock.com;Right:Shutterstock.com
On June 8, 2018 celebrity chef, writer and television host Anthony Bourdain committed suicide in his hotel room at Le Chambard , a five-star hotel in the village of Kaysersbery in the Alsace region of France. Though his last meal is not known, Bourdain's last Instagram post-a photo taken at Le Petit Venise in Colman, France, depicting a huge plate of braised pork knuckle, horseradish sauce, sauerkraut and cervelas sausage - uploaded four days before his death, caused the restaurant to become something of a pilgrimage destination for fans of Bourdain, which is no surprise when one considers the many different ways Anthony Bourdain changed the food world.
You Won't Believe These 10 Crazy Chef Feuds
The Sorta Weird Diet Habits of Your Favorite Celebrities
35 Places in LA Where You're Likely to Spot Celebrities
25 Foods and Drinks That (Might) Help You Live Longer
These 25 Celebrities Tried to Break Into the Food World - And Failed
Left: Dreamstime; Right: instagram/Anthony Bourdain
The Best Food and Drink in Texas for 2019
Retro Snack Foods That Are Primed For a Comeback
A Guide to the 25 Most Popular Hanukkah Foods
Top 50 Things to Do in Florida That Aren't Disney or the Beach
The most Instagrammable cherry blossom spots
Places Dangerous Bacteria Is Growing in Your Home
|
cc/2020-05/en_middle_0097.json.gz/line1407258
|
__label__wiki
| 0.943716
| 0.943716
|
Lake Stevens quarterback Tre Long is comforted by head coach Tom Tri late in the fourth quarter of the 4A state football championship game against Union on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens falls in 4A title game
Union dominates in the 2nd half en route to a 52-20 win over the Vikings on Saturday night.
by Cameron Van Til
Tuesday, December 4, 2018 3:18pm
SportsFootballHigh school sportsLake Stevens High School
TACOMA — For much of the first half, the Lake Stevens football team traded scores and offensive fireworks with Union’s high-powered attack.
But while the Vikings’ dynamic offense eventually came undone with turnovers and an inability to sustain drives, the Titans kept on rolling.
Top-seeded Union delivered an onslaught of 38 unanswered points and dashed third-seeded Lake Stevens’ title dreams with a 52-20 victory over the Vikings in the Class 4A state championship game Saturday night in the Tacoma Dome.
Vikings’ offense stalls in 2nd half of championship game defeatDec 1, 2018
Notebook: Former GP coach guides Union to first-ever state titleDec 2, 2018
“They just made plays and we didn’t,” Lake Stevens coach Tom Tri said. “We (needed to) find a way to move the chains and take care of the ball. Those turnovers killed us, and then we broke down. … (Union) had all the momentum, and we couldn’t find a way to get it back.”
The Vikings (13-1) had no answer for Union’s diverse array of playmakers, who shredded Lake Stevens’ defense with nine plays of 20-plus yards. The Titans (14-0) amassed 552 yards of total offense, falling just 12 yards shy of the 4A title-game record.
Two-way standout Jojo Siofele totaled 291 yards from scrimmage and four touchdowns on just 15 offensive touches, helping lift Union to its first state title in the 12-year history of the Vancouver school. The senior playmaker caught nine passes for 177 yards and three touchdowns, and also rushed for 114 yards and a score.
Senior quarterback Lincoln Victor masterfully orchestrated the Titans’ attack, completing 18 of 23 passes for 326 yards and a 4A title-game record five touchdowns. Darien Chase, a recent University of Nebraska signee, added five catches for 127 yards and a score.
“We didn’t come out and play very well tonight, but give a lot of credit to Union,” Tri said. “They came out with a great game plan. … They had size, speed and depth that we couldn’t overcome.”
After opening the game with a three-and-out, the Vikings found the end zone on three straight possessions, scoring on a pair of Dallas Landeros touchdown runs sandwiched around a perfectly designed 26-yard play-action pass from Tre Long to Kasen Kinchen. Landeros’ second touchdown gave Lake Stevens a 20-14 lead less than two minutes into the second quarter.
That was the last time the Vikings scored.
Union held Lake Stevens scoreless on each of its next eight possessions, shutting out the Vikings for the game’s final 34 minutes. Lake Stevens totaled 435 yards of offense, but was held 28 points below its season scoring average entering the night.
“We didn’t execute,” Vikings left tackle Devin Kylany said. “And then when we did, we shot ourselves in the foot with penalties and turnovers. To win a game against a good football team, we can’t do that.”
The offensive struggles began with a turnover midway through the second quarter. Long hit Ian Hanson for a 45-yard completion over the middle, but as the senior receiver was running after the catch, Union jarred the ball free and recovered the fumble. It was one of four turnovers for Lake Stevens.
“Tipped balls, dropped balls, penalties, turnovers,” Tri said. “Hard to move the chains when you’re not taking care of the ball. And that was the difference tonight. We just stopped doing what we had done all year long to get to this point.
“So I guess you’ve just gotta tip your hat to Union, because they obviously did a good job of forcing turnovers and getting us out of our game plan.”
The Vikings trailed just 24-20 at halftime and opened the third quarter with a big defensive play by freshman Drew Carter, who intercepted Victor on the first snap of the third quarter to give Lake Stevens the ball in Union territory.
However, the Vikings failed to capitalize, turning the ball over on downs. It was the first of three consecutive Lake Stevens drives that ended on failed fourth-down attempts.
“We just didn’t execute in the second half,” Long said. “We couldn’t seem to get any momentum or get into any rhythm.”
Early in the third quarter, Siofele hauled in a short pass from Victor and raced down the left sideline for a 56-yard touchdown to push Union’s lead to 31-20. It marked the first time all season Lake Stevens had faced a two-possession deficit in the second half.
The Vikings responded with a 14-play drive, but the lengthy possession stalled at the Titans 34 with another turnover on downs. Union then marched downfield and scored on a 10-yard Victor-to-Siofele touchdown pass, extending the lead to 38-20 early in the fourth quarter.
Lake Stevens later committed three fourth-quarter turnovers, and the Titans added on to put the contest firmly out of reach.
“We shot ourselves in the foot too much,” Long said, “and then they wore us down.”
The Vikings’ powerful rushing attack entered the night averaging nearly 260 yards per game and 7.8 yards per carry, but managed just 126 yards and 4.5 yards per attempt against Union’s defense.
Long finished 22-of-34 passing for 309 yards, one touchdown and two interceptions. Kinchen led Lake Stevens with nine catches for 123 yards and a score.
The loss marked a bitter end to a success-filled season for the Vikings, who claimed their sixth consecutive Wesco 4A crown and reached the state championship game for the first time since 1994.
It was the third runner-up finish in the state playoffs for Lake Stevens, which also suffered title-game losses in 1994 and 1985. The Vikings have never won a state-playoff title.
“It’s kind of just mixed emotions,” Lake Stevens senior defensive lineman Brandyn Roberts said. “I’m overall happy (about) the season, but it’s just tough right now.”
Click here for box score
Lake Stevens’ Dallas Landeros scores a touchdown in the first quarter of Saturday’s game in Tacoma. (Andy Bronson / The Herald)
Lake Stevens’ Devin Kylany tries to bring down Union’s Alex Vallejo after a fumble recovery in the first half of the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald)
Union head coach Rory Rosenbach points to his kicker after a field goal put Union ahead 24-20 over Lake Stevens at the end of the first half of the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald)
Lake Stevens running back Dallas Landeros rolls in for a touchdown during the first half of the 4A state football championship game against Union on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald)
Lake Stevens’ Isaiah Harris (right) celebrates a fumble recovery in the first quarter against Union in the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Union’s Isaiah Jones is tackled by a host of Lake Stevens defenders during the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens’ Tre Long rushes with Union defenders closing during the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens’ Kasen Kinchen (right) runs after a reception with Union’s Daron Ulrich closing during the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Union’s Darien Chase tries to make a catch in the end zone with Lake Stevens’ Kasen Kinchen (rear) and David Carter defending during the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens’ Dallas Landeros runs the ball with Union’s Darien Chase trailing during the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens’ Logan Bruce-Jones and Lake Stevens’ Ian Hanson react late in the Vikings’ loss to Union in the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens’ Wyatt Hall stands dejected late in the fourth quarter of the 4A state football championship game against Union on Dec. 1, 2018, at the Tacoma Dome. (Kevin Clark / The Herald)
Lake Stevens head coach Thomas Tri consoles quarterback Tre Long near the end of the game as the Vikings lost to Union 52-20 in Washington Div. 4A high school football championship, Saturday, Dec. 1, 2018, in Tacoma, Wash. (Andy Bronson / The Herald via AP)
Lake Stevens head coach Thomas Tri reacts as Union scores a touchdown as the Vikings lost to Union 52-20 in Washington Div. 4A high school football championship, Saturday, Dec. 1, 2018, in Tacoma, Wash. (Andy Bronson / The Herald via AP)
Lake Stevens’ Jager Hill holds the second-place trophy with teammates afterthe Vikings’ lost to Union 52-20 in the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald via AP)
Union players celebrates as Lake Stevens’ Ian Hanson walks off the field looking up at the scoreboard as Lake Stevens lost to Union 52-20 in the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald)
Union’s Lincoln Victor is taken down by the Vikings’ defense, but not before gaining a first down as Lake Stevens lost to Union 52-20 in the 4A state football championship game on Dec. 1, 2018, at the Tacoma Dome. (Andy Bronson / The Herald)
Q&A with Meadowdale girls basketball player Camryn Cassidy
Questions and answers about Seattle’s new hockey team
Silvertips weekend wrap: Three wins in three days
Everett put on the defensive clamps, allowing just two goals and collecting two shutouts
Lake Stevens senior earns title at prestigious Viking Invite
Wyatt Hall captures the 285-pound title in a tournament filled with top-tier wrestling programs.
Former Marysville Pilchuck star looking for shot in NFL
After being forced to medically retire at UW, Austin Joyner is making himself available for the NFL draft.
Ducks rally, stun Huskies on late 3 in overtime
Washington lets a 16-point second-half lead slip away in a 64-61 loss to No. 8 Oregon.
Silvertips rout rival Thunderbirds
Seven different Everett players record multi-point nights in an 8-0 win over Seattle.
E-W stuns Getchell with furious rally, game-winning 3-pointer
Senior Bryan Bunyatipanon hits the winning shot as the clock expires in the Warriors’ 60-57 win.
Battle steps up big in UW’s win over Oregon State
The former Marysville Pilchuck star gets his first-career start and sparks the Huskies’ victory.
Lakewood hoops star breaks his coach’s all-time scoring record
Alex Jensen, a rare four-year team captain, has helped turn the Cougars’ program into a contender.
Prep stars for Saturday, Jan. 18
Prep stars of the night for Saturday, Jan. 18: Wyatt Hall, Lakes… Continue reading
Prep results for Saturday, Jan. 18
Prep results for Saturday, Jan. 18: BOYS BASKETBALL Wesco 4A Monroe 73,…
Prep stars of the night for Saturday, Jan. 18: Wyatt Hall, Lakes…
WSU wins on day it retires Klay Thompson’s jersey
Isaac Bonton scored a career-high 34 points and…
|
cc/2020-05/en_middle_0097.json.gz/line1407260
|
__label__wiki
| 0.969956
| 0.969956
|
Five fire engines called to Broxbourne Park Lane house after fire breaks out
The road was closed while firefighters worked at the scene
Charlotte Page
No-one was believed to be inside the property (Image: Chris Readman)
Five fire engines were called to a residential road in Broxbourne this morning after reports of a house fire.
The emergency services were called to a property on Park Lane shortly before 8.15am (Monday, February 5).
Resident Chris Readman, who lives just three doors away from the property, first heard sirens while he was getting dressed upstairs.
He said: “I was due to go into work late today due to a doctor’s appointment.
“I heard sirens upstairs whilst I was getting dressed and I thought it was police sirens.
Photos show fire crews at house on Park Lane in Broxbourne
“When I looked there were fire engines spread eagle.
“I was surprised to see fire engines and what drew my attention was cars from Cock Lane along Park Lane being turned around.”
Pictures taken by Mr Readman shows smoke rising from the top of the property and at least two fire engines assisting at the scene.
He added that the road had been silent just moments before when his wife left for the school run.
Crews from Cheshunt, Hoddesdon and Hertford attended (Image: Chris Readman)
“It just shows you how quickly it happened,” he added.
A spokeswoman for Hertfordshire Fire and Rescue said: “We were called to reports of a fire in a detached property in park lane at 8.06am.
Eight fire engines deployed after 'explosion' at Stevenage care home
“Two fire engines were originally sent to the scene and another three were later deployed.
“There were two from Cheshunt, one from Hoddesdon and two from Hertford.
“The fire was out by 8.45am, and no-one was believed to be inside when we got the call."
Hertfordshire Fire and Rescue Service
|
cc/2020-05/en_middle_0097.json.gz/line1407262
|
__label__wiki
| 0.774976
| 0.774976
|
Clear skies. Low 22F. Winds N at 5 to 10 mph..
Clear skies. Low 22F. Winds N at 5 to 10 mph.
The RWE Niederaussem lignite-fired power station releases steam, behind two renewable energy producing wind turbines in Bergheim, Germany, Monday, Jan. 13, 2020. Germany plans an entirely coal phase out and to shut down all remaining coal-fired plants by 2038.
Martin Meissner
The sun rises behind high voltage pylons near Schwieberding, Germany, Wednesday, Jan. 15, 2020 (Sebastian Gollnow/dpa
Sebastian Gollnow
Luisa Neubauer, Fridays for Future activist, talks to journalists after she met Joe Kaeser, CEO of Siemens, in Berlin, Germany, Friday. Jan. 10, 2020. After the meeting Kaeser said the company takes the activists' concerns seriously.
Young activists bid to join climate case at top German court
BERLIN (AP) — Nine young climate activists are seeking to join a lawsuit before Germany's top court that aims to force the government to do more to combat global warming.
The activists are backed by environmental groups such as Greenpeace who say Germany's current plan to reduce greenhouse gas emissions by 55% over the next decade isn't good enough.
Their lawyer, Remo Klinger, told reporters in Berlin on Wednesday that the plaintiffs want Germany's Federal Constitutional Court to add their lawsuit to a pending case submitted in 2018 and rule whether fundamental rights are being breached.
Environmental groups accuse the German government of shying away from “easy” measures that would significantly cut emissions of planet-heating carbon dioxide, such as introducing a universal speed limit, ending subsidies for heavily polluting cars and easing regulations for on-shore wind farms.
Get today’s top stories right in your inbox. Sign up for our daily newsletter.
Civil Rights Violations
|
cc/2020-05/en_middle_0097.json.gz/line1407263
|
__label__cc
| 0.619563
| 0.380437
|
Exploring cultures and communities – the slow way
What is hidden europe magazine?
Our current issue
Purchase copies or subscribe
Online access to archive
Europe in pictures
Who writes for hidden europe magazine
What others say about the magazine
Letter from Europe
Home / Letter from Europe / Lastovo (Croatia)
Lastovo (Croatia)
— Issue 2013/19 posted by hidden europe on 1 Jul 2013 —
At ten o'clock yesterday evening, well after the sun had dipped below the waters of the Adriatic, the car ferry arrived in Ubli. The little port at the south-west corner of the island of Lastovo has a hangdog sort of feel. Long before sunrise today, there was the usual morning bustle around the pier at Ubli as folk gathered for the 4.30 am ferry back to Split. During the few night-time hours that the ferry rested at the quayside at Ubli, something changed quite irrevocably on the island of Lastovo. By becoming part of the European Union, Lastovo reconnected with its past in a way that finds no parallel in any other inhabited island in southern Croatia.
article summary —
This is the 300th issue of our newsletter. To mark this milestone, we report on a community that captures the spirit of hidden europe - it is a remote spot, a place on the edge of things, yet this morning it lies at the very heart of Europe.
Dear fellow travellers
At ten o'clock yesterday evening, well after the sun had dipped below the waters of the Adriatic, the car ferry arrived in Ubli. The little port at the south-west corner of the island of Lastovo has a hangdog sort of feel, but it's a good place to sit on the quayside, watch the last of the evening sun and await the arrival of the ferry.
Ubli is not the centre of the world, nor even the centre of the island of Lastovo. The only town is about a dozen kilometres away, on the north side of the island. But 'town' is a word one should use provisionally in this context, for the entire island of Lastovo only has 800 souls. Over half of the Lastovans live in the principal settlement - which has the same name as the island. But that 'capital' is really just a wee slip of a place.
The car ferry from Split to the island runs twice daily at this time of year, taking around five hours for the journey to Ubli. This surely makes Lastovo one of the remotest islands in Croatia - and, as of this morning, it becomes one of the remoter outposts of the European Union.
Long before sunrise today, there was the usual morning bustle around the pier at Ubli as folk gathered for the 4.30 am ferry back to Split. During the few night-time hours that the ferry rested at the quayside at Ubli, something changed quite irrevocably on the island of Lastovo. By becoming part of the European Union, Lastovo reconnected with its past in a way that finds no parallel in any other inhabited island in southern Croatia.
For Lastovo has an extraordinarily complicated geopolitical history. The island was the westernmost of the possessions of the Republic of Ragusa, a small but distinguished maritime state that, having seceded from Venice in 1358, maintained her independence until 1808. Ragusa will be familiar to readers under its modern name of Dubrovnik.
Napoleon's troops forced Lastovo into submission. Within a space of a few years, Lastovo was part of the French Empire and had a spell under British rule before becoming part of the Habsburg Empire in 1815. Under the Treaty of Rapallo in 1920, the island was awarded to Italy and then, after the Second World War, it became part of Yugoslavia. With Croatian independence in October 1991, yet another flag fluttered over Lastovo.
No surprise, perhaps, that the residents of this island in the middle of the Adriatic take a relaxed view of geopolitics. Empires come, empires go. Living so far from the mainland, the islanders' allegiance to any authority is always provisional. The Croatian capital in Zagreb seems far, far away when you sit on the quayside at Ubli. But, like many maritime communities with long histories, Lastovans have far horizons. They, perhaps more than others in Croatia, will take membership of the European Union in their stride.
Nicky Gardner and Susanne Kries
(editors, hidden europe magazine)
Posted in Moments
source: https://www.hiddeneurope.co.uk/lastovo-croatia
This article was published in Letter from Europe.
Nicky Gardner and Susanne Kries manage hidden europe, a Berlin-based editorial bureau that supplies text and images to media across Europe. Together they edit hidden europe magazine. Nicky and Susanne are dedicated slow travellers. They delight in discovering the exotic in the everyday.
← Hercules in Lazio
Remembering Miss Jemima →
Leaving the Tatras
I discovered yesterday that the traveller wanting to take a train out of Zakopane is hardly spoilt for choice. Early birds can opt for the 03.27 to Kraków. Then the next departure from the resort in the Tatra mountains of southern Poland is not ...
Poland mourns
hidden europe notes
The Sunday after Easter was for years known as Low Sunday in the Roman calendar, but Pope John Paul II changed that arrangement ten years ago, when he renamed the Sunday in the Easter Octave, calling it Divine Mercy Sunday. Today is Divine Mercy ...
Southbound: Europe's car trains
hidden europe 31
In the early days of train travel, landed gentry and the well-to-do made arrangements with local rail companies to convey their horses and carriages on board the trains. Europe's car trains are the modern day incarnation of the same arrangement, a ...
About online access
FAQ online access
Overview texts online
Our Letter from Europe is published about thrice monthly and reports on issues of culture and travel. Sign up to receive every new issue “hot off the press” by e-mail.
Storm Brendan
Scottish Island Flights
Lyria Ruffles Swiss Feathers
A Tale of Two Lakes
Crossing the Water
borders Croatia events history identity island communities Mediterranean and Adriatic
hiddenEurope
hidden europe is a travel magazine with a twist. We specialise in offbeat places and criss-cross the continent to bring our readers some of Europe’s very best travel writing.
Arctic history: polar quest for Nobile
Copyright © hidden europe 2005–2020. All Rights Reserved.Website last updated: Friday, January 17, 2020
|
cc/2020-05/en_middle_0097.json.gz/line1407264
|
__label__cc
| 0.593798
| 0.406202
|
Let’s ditch the silos: towards an integrated agri-food policy framework
By Don Buckingham Mar. 27, 2019
By adopting a whole-of-government approach and rolling out a strategy for strong economic and environmental performance, the export potential of Canada’s agriculture and agri-food sector can be realized.
Agriculture Minister Marie-Claude Bibeau should be part of a whole-of-government approach to grow Canada’s agriculture and agri-food sector, says Don Buckingham. The Hill Times photograph by Andrew Meade
The Canadian government has identified the agriculture and agri-food sector as an engine of growth, with some pretty ambitious targets over the next decade. The 2017 Barton Report by the government’s Advisory Council on Economic Growth proposed that Canada should boost its agriculture exports by $11-billion and its agri-food exports by $19-billion by 2027.
Agricultural innovation key to sector growth
Standing up for Canadian farmers and their families
There’s a world of opportunity for Canadian agriculture and food
Asia: farming’s new frontier
Changes south of the border offer both challenges and opportunities for sustainable agriculture in Canada
Explore, analyze, understand
Inside Ottawa Directory – 2019 Edition
The handy reference guide includes: riding profiles, MPs by province, MP contact details, both Hill and constituency and more.
Related Policy Briefings
Short and informative analyses on policy challenges that bring background and recommendations to policymakers, journalists and the general public.
Read policy briefing
Biotech Policy Briefing
|
cc/2020-05/en_middle_0097.json.gz/line1407266
|
__label__wiki
| 0.909716
| 0.909716
|
Flinders’ renewable frontier
The Flinders Island community can look forward to a secure and cleaner energy future thanks to its new Hybrid Energy Hub.
Officially launched today, the hub will transform the island’s power supply and provide another exceptional renewable showcase for remote communities around Australia and the world.
Flinders Island has historically been dependent on diesel generation. The hub technology will make it 60 per cent renewably-powered, on average, using wind and solar. When there’s enough wind and sunshine to do so, the island will be 100 per cent renewably-powered for considerable periods of time.
The CEO of Hydro Tasmania, Steve Davy, said the result is less diesel usage, lower energy production costs, lower emissions, and a further boost for Flinders’ clean and sustainable reputation.
“This is Tasmanian innovation bringing clean energy to isolated communities,” Mr Davy said.
“The Flinders Island Hybrid Energy Hub gives islanders a secure and cleaner future – consistent with the community’s vision of becoming permanently 100 per cent renewable in the future.
“We take pride in supporting Tasmanian communities and a clean, sustainable energy future – both at a big-picture and grassroots level,” he said.
The Flinders Hub is able to harness more renewable energy from a 900 kilowatt (kW) wind turbine and 200 kW solar array by using unique enabling technologies and an advanced control system that will manage the fluctuating mix of wind, solar and diesel power in a stable, secure and reliable way - as proven in previous projects on King Island, at Coober Pedy, and on Rottnest Island.
The enabling technologies on Flinders include a 750 kilowatt / 266 kilowatt-hour battery, an 850 kilovolt-ampere flywheel, and a 1.5 megawatt dynamic resistor.
The $13.38 million Flinders Island Hybrid Energy Hub project was made possible by support of $5.5 million from the Australian Renewable Energy Agency (ARENA).
|
cc/2020-05/en_middle_0097.json.gz/line1407270
|
__label__cc
| 0.699898
| 0.300102
|
C-CAP Competition at ICE
Yesterday, 20 high school students from across New York City gathered at ICE for a competition for scholarships to attend culinary school.
March 28, 2012 by ICE Staff
The two-hour challenge was part of Careers through Culinary Arts Program (C-CAP), a program teaching high school students the skills they need for a career in the culinary industry. ICE President Rick Smilow was a long-standing member of the program’s board of directors. Within a two-hour time limit, each competitor prepared, from memory, a two-course French meal —Hunter’s Chicken with Turned, Sautéed Potatoes and Crepes with Pastry Cream and Chocolate Sauce.
The students presented plates of each dish to the judges including ICE Director of Culinary Arts Mike Handal, author and TV personality Sara Moulton, Executive Sous Chef David Chavez of Bouchon Bakery, Executive Chef Matt Hoyle of Nobu 57, Chef Kevin Lasko of Park Avenue Winter, C-CAP Founder and Chairman Richard Grausman and C-CAP President Susan Robbins.
The judges took careful notes on each student’s organization, sanitation, timing, cooking skills, taste, and presentation. In addition, the students were all interviewed giving them a chance to explain how a culinary education would change their lives. It was an incredibly impressive year and Chef Mike told the students, “Any of you would be welcome back at ICE with open arms to come and study with us. It would be a real pleasure.” Moulton told them she was “proud to see so many women among the competitors.”
Also among the attendees were several C-CAP alumni, including Berenice Cabera who came to ICE after participating in the C-CAP program in high school and is now working at Dos Caminos.
The results of the competition will be revealed to participants at the annual C-CAP Awards Breakfast on Thursday, April 5. We can’t wait to see some of the students here at ICE in the very near future!
Institute of Culinary Education
12.05.19 Culinary Arts
Finding Umami with a Fermented Mushroom Dish
Mod 5: The Glamour of Garde Manger
Testing Texture with Goat Cheese and Beets
|
cc/2020-05/en_middle_0097.json.gz/line1407277
|
__label__cc
| 0.741026
| 0.258974
|
Hamilton's Alyssa Lester commits to Calvin
Hamilton all-state volleyball player Alyssa Lester officially committed to Calvin College last week.
The senior libero was the anchor of a Hamilton team that reached the state quarterfinals.
She joins a Calvin team that is a perennial national power in NCAA Division III.
“I went to watch finals and saw Calvin. I went to one of their overnight camps. It was just one of those things that you see and fall in love with,” she said. “I love the way their girls work together, their school. It was really just a perfect fit.”
|
cc/2020-05/en_middle_0097.json.gz/line1407280
|
__label__cc
| 0.54553
| 0.45447
|
Home Broadway Lin-Manuel Miranda Announces He is Leaving Hamilton
Lin-Manuel Miranda Announces He is Leaving Hamilton
Karen Murphy Terry
Lin-Manuel Miranda and Javier Munoz
Lin-Manuel Miranda will depart the Broadway production of his Tony-winning musical Hamilton on July 9, producers have announced. Javier Muñoz, who has served as the standby for Alexander Hamilton since the earliest days of the production, will take over the role full time beginning July 7. Muñoz will perform seven performances a week, with a yet unnamed alternate playing the remaining show.
Miranda received 2016 Tony Awards for Best Book and Best Score for his work on Hamilton, which had its world premiere in 2015 at the Public Theater. The show was nominated for a record 16 Tony Awards and won 11, including the top honor, Best Musical.
Source: Theatremania
Javier Munoz
Previous articleJeremy Howard & Adam Ray Join New Cast of CW ‘MadTV’ Revival
Next articleExclusive: ‘Nerve’ Trailer Debut Starring Emma Roberts & Dave Franco
|
cc/2020-05/en_middle_0097.json.gz/line1407282
|
__label__wiki
| 0.652586
| 0.652586
|
Mysore Hostels
Mysore : of 8 Hostels available
8 Hostels in Mysore, India
When do you want to stay in Mysore?
Roambay Hostels
Set in Mysore, 1.8 km from Mysore Palace, Roambay Hostels features a shared lounge, garden and views of garden.... More...
The Mansion, 1907
The Mansion', as the name suggests was built as a big residence for a well known businessman more than a 100 years ago in 1907.... More...
Zostel Mysore
Zostel Mysore is conveniently located in Zostel Mysore.... More...
Come to Sonder and experience the best service a hostel can offer.... More...
The Bunkers Ashram Mysore
The Bunkers Ashram is located in Mysore.... More...
Tusker House Hostel
Situated in Mysore, within 5 km of Mysore Palace, Tusker House Hostel provides accommodation with a shared lounge and free WiFi.... More...
Aishwarya Residency
No rating 18
The Aishwarya Residency is ideally situated in the heart of the city, a flourishing new center of business and culture.... More...
Aishwarya Suites
No rating 2
Aishwarya Suites is ideally situated on Rajamarga which leads the Dussehra Procession just in front of this luxurious hotel.... More...
The enchanting city of Mysore is a much-loved gem in India’s southwest state of Karnataka. Nicknamed the City of Palaces, it’s bursting with royal heritage and opulent sights. Travellers can visit the sacred Hindu temple on top of Chamundi Hills, shop for silk in the exquisite emporiums and wander the colourful Devaraja market selling spices, incense and essential oils. The sandalwood-scented city is also the birthplace of Ashtanga yoga and has a thriving wellness scene with organic health cafés, traditional Ayurveda treatments and meditation ashrams.
Mysore hostels are a welcoming mix, all within easy reach of the city’s majestic sights. You can stay in a converted Indian mansion, an ashram dorm house or a colonial-style bungalow with an acre of lush lawn. Choose a hostel in Mysore with a roof terrace and join a morning yoga class or look out for those with games to borrow and bikes in the backyard. Most places have free Wi-Fi and breakfast is included at some. You’ll find many hostels in Mysore have communal areas to meet and hang out with other travellers.
The city’s central palace complex is in Agrahara, the most historic part of Mysore that's dotted with heritage buildings and temples. Along the main Sayyaji Rao Road you’ll find the landmark Dufferin clock tower and a bustling market. Gokulam is the leafy northern suburb known as the yoga district and has many Ashtanga schools, vegetarian cafés and coconut water stalls. The picturesque Brindavan gardens in the Mandya District are 20km to the north of the city.
A tour of the city’s palaces will take in the ornate, light-bulb decorated Mysore Palace of the Wodeyar Dynasty and Jaganmohan Palace, a grand three-story building that’s also home to the Jayachamarajendra Art Gallery. At Chamundi Hills, you can climb up the thousand steps of the pilgrim path to see the spectacular views of the city below. In the foothills, Karanji Lake is a pretty oasis where you can take a boat on the water and wander the park among roaming peacocks and an array of butterflies.
Bangalore’s Kempegowda International Airport is the nearest major airport to Mysore. The quickest way to make the 170km journey is on the Shatabdi Express train from Bangalore City Junction station, taking around 2 hours. When in Mysore, auto rickshaws are a popular way to get around and can be picked up on the street, or from the pre-pay counter at the train station or bus stand.
Top rated hostels in Mysore
9.6 Roambay Hostels Mysore
9.3 The Bunkers Ashram Mysore Mysore
9.1 Sonder Mysore
9.1 The Mansion, 1907 Mysore
8.6 Zostel Mysore Mysore
We have 8 hostels in Mysore with an average rating of 9.3 based on 144 reviews 8 of 8 properties available in Mysore
About Mysore
|
cc/2020-05/en_middle_0097.json.gz/line1407291
|
__label__wiki
| 0.539891
| 0.539891
|
BLLA’s Stay Boutique Live – Investment Edition
Home/BLLA’s Stay Boutique Live – Investment Edition
By Isabel Crowther|2019-06-24T18:42:29-04:00June 19th, 2019|
Stay Boutique™ | June 19, 2019
June 19, 2019 – New York – Stay Boutique Live – the Investment Edition review.
The decision to invest starts with an informed or instinctual confidence in future positive returns. Showcased at the 2019 Stay Boutique Investment Conference, there are abundant reasons to believe in the fast-evolving community of boutique ideas, products, and services. Held on June 5th at the Times Center in New York City, the seventh annual edition of the one-day event,
produced by the Boutique and Lifestyle Leaders Association (BLLA), was as fearless and disruptive as the boutique space itself.
Heralding the boutique movement as “a new cultural renaissance and reimagination of tradition,” BLLA co-founder and COO, Ariela Kiradjian, emphasized the critical role of education
in understanding the multi-pronged investment opportunities under the boutique umbrella.
There was much to learn. As the playbook on backing boutique continues to develop, the overall prospectus, founded in the fun and innovation of hotels and hospitality and now branching out into a wider sphere, offers plenty to inspire smart investors. Diverse exhibitors at the event, including accountants, credit card providers, law firms and bedding companies, demonstrated
how boutique attracts attention.
Most compelling was the insight provided by the day’s panelists and speakers. From leading hoteliers and hospitality consultants to lifestyle company founders and CEOs, this boutique brain trust shared authoritative accounts of why and how to invest in boutique.
Headlining the powerhouse speakers list was the “Godfather of Boutique,” Ian Schrager. Having pioneered the boutique concept with late partner Steve Rubell in the 1990’s, Schrager, returning after speaking at not only the inaugural Stay Boutique Investment Conference in 2013 but for 5
of the 7 years following, exemplified the conference’s high-grade appeal. Schrager was acknowledged for his strong support of BLLA and Stay Boutique over the years during his interview by Jonathan Falik.
Smart money is one play. In the boutique world, however, savvy capital also goes into people,
culture, community, experience and emotion, producing a robust mix of tangible and intangible
returns. Exciting, too, is how proven ideas from hospitality and hotels synergistically apply to the
wider marketplace.
BLLA Founder and CEO, Frances Kiradjian, stated: “We are gathering together to continue our
theme of being unapologetic for heralding the attributes of the boutique community at the same
time as we celebrate the term that we coined, The Modern Renaissance of Boutique.”
Here are some of the many reasons to believe in boutique.
A Sense of Arrival, A Sense of Place, A Sense of Belonging
With 35 years of global experience in opening and repositioning luxury hotels and resorts, Jean-
Luc Naret, CEO of Paris-based La Réserve Hotels and Spas, reaffirmed key fundamentals for
investing in boutique hotels. Referencing the brand’s palatial La Réserve Hotel and Spa Paris,
which in reviving a Napoleanic-era mansion awakened a once “dead” neighborhood to world-
class acclaim prioritizes location, personalization, and uniqueness. Citing Schrager’s example, Naret believes in being “a bold pioneer” in targeting locations yet to come into vogue. Invest in a distinct identity and don’t be a copycat—customers want original concepts. “Cheap becomes expensive” when you inevitably must fix under-investing in high-quality décor, linens, and amenities. “Be memorable and Instagrammable,” said Naret. “Donewell, a boutique property will stay relevant and stand the test of time.”
In the increasingly noisy boutique hotel space, a well-planned, well-curated F and B program offers the most tangible reach to customers. Scott Gerber, principal and CEO of NYC-based
hospitality Gerber Group believes that boutique hotels need to keep the scene’s pulse active.
”Today, if I blindfolded you and put you in a hotel room, you would have no idea what brand you
were in,” he said. “Bars and restaurants become a differentiating factor.” F and B also serves the critical quotient of “localizing” a boutique space.
Julia Heyer, founder and managing director of NYC-based Heyer Performance, said that investing in a restaurant concept should establish a unique story for the brand in its market
while also attracting locals because “people who stay in boutique hotels usually want to go
where the locals go.” Local examples include the NoMad and Ace Hotels, which “changed the landscape and attracted a local following” to a formerly forbidden stretch of Broadway in Midtown Manhattan.
Another arbiter of cultural times and tastes is Charles Khabouth. Founder in 1982 of Toronto-
based INK Entertainment, Canada’s leading lifestyle and entertainment company, Khabouth’s
ever-evolving lifestyle enterprises including nightclubs, F and B and festivals. In crossing over into hospitality with his smash hit Bisha Hotel, which like La Réserve, became the “heart and soul” of its Toronto neighborhood, Khabouth figured locals in the equation. “You don’t want to be
shunned by locals,” he said, “and so it’s crucial to invest in being seen as being part of your
destination.”
Guy Masnik, L.A.-based partner and vice chair, JMBM’s Global Hospitality Group, knows from experience that failing to invest in people is a certain misfire. “It starts in the underwriting process,” said Chris Green, CCO of third-party operator Chesapeake Hospitality, interviewed by
Masnik at the event. “When building the asset, you always look at the hard costs, but what
people really don’t spend enough time on, which we’ve spent our (61-year) history on, is the soft
side. Making sure that people are not only connected to the process, but they are well trained to do what they have to do, understand why we are doing what we have to do, and the outcome that is expected for that service, and how they benefit that outcome.”
Investing in people takes many forms. When Hurricane Irma slammed the Turks & Caicos Islands in 2017, Mark Durliat, co-founder and CEO of Grace Bay Resorts, raised funds to help
employees of the luxury all-suite Grace Bay Club repair their homes. Earlier, Durliat had committed to supporting a school on a remote nearby island and helping to grow the local
tourism economy. “We are a hand-made company,” said the globetrotting industry veteran.
From investors and suppliers to staff and customers, “managing relationships” is priority one.
”We look for like-minded people to join us and help nurture the brand.” It’s an ethos that is expanding the boutique universe. Inspired by the “human connection” she experienced in hotels, Michelle Cordeiro Grant, founder and CEO of Lively, “reverse engineered” the creation of her innovative lingerie line by directly involving women in building the brand. “While we are a digital company in the boutique space, we started with human connection and human impact,” said Grant. “And we stick to our core value and purpose, which is to inspire women.”
Platforms for social good and social responsibility are finding rich cultivation in the boutique ecosystem. Examples include London-based Inhabit Hotels, conceived by third-generation hotelier Nadira Lalji based on wellness and sustainability principles for restoring both people
and the planet.
Alchemy, Not Algorithms
In line with BLLA’s definition of “boutique” as “any brand whose products or services are centralized around experience and cultural development,” the field thrives on emotional
connections that enhance customer engagement while also driving the bottom line.
In a time of increasingly savvy and aware consumers, the bar for “experience” keeps rising.
Rosie Toumanian, senior trend analyst with global innovation tracker TrendWatching, described
an “Expectation Economy” in which best-in-class companies like Amazon and Venmo have ”heightened all customer expectations for authentic local experiences for all boutique brands.”
This is creating “expectation transfer that crosses price points and borders regardless of industry.”
While this acts as competitive pressure, boutique brands have room for experimentation and
even failing. As several speakers noted, this is a distinctive advantage over branded hotels,
which are driven by stricter productivity and efficiency standards.
Industry veteran Richard “Boz” Bosworth, general partner and CEO of JC Hospitality, LLC, is
spearheading the complex relaunch of the Hard Rock Hotel & Casino Las Vegas into the Virgin
Hotels brand. For him, “no stop signs” is the most significant difference between corporate and boutique business structures. “The fun of the boutique space is the flexibility and control you have over your asset,” said Bosworth. “I believe that the boutique space really defines
possibility.”
Boutique drives innovation. Nathan Kivi, CEO of HotelierCo, is pioneering a crowdfunding model
for the development of boutique hotels. Absolut Art is “democratizing” the art buying process by lowering the bar to entry and price points, helping hotels and other brands to invest in this
signature element for cultural programming.
Experiences, above all, must be authentic. “That’s our core value proposition,” said Tom
Lewand, CEO of Shinola, whose “multi-concept” expansion of the boutique goods brand
includes the new Shinola Hotel in Detroit.
For Ian Schrager, current as ever with his Edition and Public hotels, creating “the magic” defines
boutique. “It gave me a leg up with Studio 54, and I rely on that same approach today,” said the
inveterate innovator and provocateur, who believes that booking a hotel room “should be like
ordering an Uber.” He is bullish on boutique. “Hospitality is permeating every aspect of business, from commercial office space to living space,” said Schrager. “We were the inspiration for WeWork, for example. Like Facebook, your business is not just the hotel, it’s the customer, and everything the customer does, wants and purchases are part of that elevated experience. It’s pervasive, it’s ubiquitous, and I find it very gratifying.”
That sounds like high investor confidence which can equate to believing in the here, the now
and the future of boutique!
Thank you to the Sponsors of the conference for their outstanding support to the boutique community!
About Stay Boutique™
Affiliate of the established BLLA (Boutique & Lifestyle Leaders Association), Stay Boutique™ is a media platform dedicated to the advancement of the boutique hospitality and concept communities and cultures. We believe that the term "boutique" applies to any brand whose products or services are centralized around experience and cultural development. Stay Boutique™ offers a space in which experience and lifestyle creators can converse, collaborate, learn, acquire investment, teach, inspire, and more; all within an environment that emulates the boutique structure.
About Boutique & Lifestyle Leaders Association (BLLA)
BLLA is the world's most innovative and progressive organization dedicated to the luxury independent boutique lifestyle industries. The association connects the world's most dynamic executives with cutting edge business and operational insight. BLLA's membership benefits allow access to the world's leading minds in the space through events, research and education. Our mission is to provide leadership and opportunities for global recognition and connections to the world's best companies, investors and developers. All resulting in strategic interactions and access to information that helps people and organizations thrive. Join the movement that BLLA gave birth to in 2009 and become a part of something that is truly unique, exciting and inspirational. www.blla.org.
bllablla stay boutique liveian schrager
|
cc/2020-05/en_middle_0097.json.gz/line1407292
|
__label__wiki
| 0.91676
| 0.91676
|
Home>New Songs>Mike Will Made It Songs> YG & Mike WiLL Unite For "Heart Of A Lion"
YG & Mike WiLL Unite For "Heart Of A Lion"
Scott Dudelson/Getty Images
Mike Will Made It Feat. YG
not feeling it
15 MEH
21 NOT FEELING IT
44 MAKE IT STOP
Von Miller's pulse sets the tempo.
Mike WiLL Made It and YG's new track comes in collaboration with Adidas. The two artists joined the brand to create a pre-game anthem Super Bowl 50 MVP Von Miller, who supplied his heartbeat for the track. Building the beat around Miller's pulse during training, Mike WiLL creates a sub-bass punch that's as physical as it gets. Meanwhile, YG supplies motivating rhymes that should get anyone preparing for a big game the inspiration they need.
“I’ve always been a fan of adidas and how they create, and they’ve been a fan of my work, so we came together with Von Miller to create something,” said Mike WiLL of the project. “It’s really all about Von Miller working out - they recorded his heartbeat and asked if we could do something with that… so I took the approach of finding a tempo from his BPM and built from there. Finding something new and fresh and different, like I always do when I go in the studio and work.”
A portion of the song was previously heard in an Adidas commercial, but the full track has now been shared by Mike on his SoundCloud. The track follows YG and Mike's Ransom 2 collaboration, "Gucci on My," which also featured contributions from 21 Savage and Migos.
Mike WiLL Made It has hinted that he's hard at work with Rae Sremmurd on their upcoming third full length SremmLife 3. The brothers released the WiLL-produced "Perplexing Pegasus" this summer. It's one of many productions from Mike this year, which include Kendrick Lamar's Hot 100 No. 1 "Humble" and Yo Gotti and Nicki Minaj's top ten hit "Rake It Up."
YG is expected to release his Just Re'd Up 3 project alongside DJ Mustard later this year. He just wrapped up a tour with Kendrick Lamar.
Stream Mike's 2017 solo album Ransom 2, featuring collaborations with Big Sean, Young Thug, Gucci Mane, 2 Chainz, Migos, Rihanna, Chief Keef and more.
Quotable Lyrics:
The heart of a lion, I ain't lyin'
With no effort, I ain't tryin'
When time get rough, I ain't cryin'
That's that shit that get me inspired
next song in today list Roll In Peace (Kodak Black Remix)
Mike Will Made It YG
The Weekend Debuts New R. Kelly Remake on OVO Sound Radio
Listen To Travis Scott's Remix Of Kodak Black's "Roll In Peace"
SONGS YG & Mike WiLL Unite For "Heart Of A Lion"
|
cc/2020-05/en_middle_0097.json.gz/line1407293
|
__label__cc
| 0.647784
| 0.352216
|
This section refers to the functionality available to on-premise customers of SpiraTeam. If you are using the cloud / hosted version of SpiraTeam, please refer to section 3.11.4 (TaraVault Configuration) instead.
SpiraTeam® is capable of integrating with a variety of Version Control (VC) / Software Configuration Management (SCM) tools such as Git, Subversion, CVS and TFS. This allows you to browse the source code repositories using the SpiraTeam web interface, and more importantly link revisions in these tools to artifacts in SpiraTeam. This provides the end-to-end traceability from code commits/check-ins to the tasks, incidents and requirements that necessitated the code change.
The information on using the various version control providers for SpiraTeam® and the steps for configuring the provider-specific settings are described in the SpiraPlan/Team Version Control Integration Guide.
To configure a version control provider, you need to click on the Administration > Integration > Version Control link in the Administration navigation to bring up the list of configured version control providers:
By default the only provider listed will be the TestVersionControlProvider which is used for demonstration purposes only, and can be deleted from a production system by clicking on the “Delete” button to the right of it.
Name: The name of the version control provider that you’re adding. This needs to match the name of the Plug-in DLL file that you’re using (see the SpiraPlan/Team Version Control Integration Guide for more details on your specific tool)
Description: The description is for your use only, and does not affect operation of the plug-in.
Active: If checked, the plug-in is active and able to be used for any project.
Connection Info: This field holds the root of the repository for any project accessing the plug-in, unless overridden in the Project Settings. Use the syntax that is described for your tool in the SpiraPlan/Team Version Control Integration Guide)
Login / Password: The user id and the password of the user to use while accessing and retrieving information from the version control system.
Other Fields: The other fields (Domain, Custom1 – Custom5) are provider-specific and will be described in the appropriate section of the SpiraPlan/Team Version Control Integration Guide.
When finished, click the “Insert” button and you will be taken back to the Version Control integration list page, with new provider listed as an available plug-in:
To edit the settings for an existing version control provider, click on the “Edit” button next to the name of the provider and you will be able to edit the same settings that were shown above when you first created it.
Now, you may want to change some of the settings on a per-project basis. For example you may have different repositories that you want to link to each project. You still enter the base settings for the provider as illustrated above, but then you can override specific settings for each project.
To do this, click on the “Project Settings” button next to the provider in question:
The first thing you need to do (regardless of whether you’ll be overriding any of the settings) is to make the provider active for the current project. To do this, change the toggle to “Yes” and click [Save]:
Now you can decide whether you want to override any of the default settings for this project. Any field left blank will automatically get its settings from the default values entered earlier. In the example above, we have specified a project-specific repository path, login and password. Once you have correctly configured the project, click [Save] to commit the changes.
To improve performance, SpiraTeam will cache some of the data it receives from the version control provider. Normally SpiraTeam will know when to update the cached data based on changes made in the version control system automatically. However sometimes you may wish to flush the cached data completed, to do this, click on the [Clear Cache] button.
You are now ready to use SpiraTeam® in conjunction with the version control tool you selected. For details on how to use the Source Code integration features of SpiraTeam, please refer to the SpiraTeam® User Manual.
|
cc/2020-05/en_middle_0097.json.gz/line1407298
|
__label__cc
| 0.684636
| 0.315364
|
Physics Letters B
Items from 1 to 20 out of 22 results
Admixture of quasi-Dirac and Majorana neutrinos with tri-bimaximal mixing
S. Morisi, E. Peinado
Physics Letters B > 2011 > 701 > 4 > 451-457
We propose a realization of the so-called bimodal/schizophrenic model proposed recently. We assume S4, the permutation group of four objects as flavor symmetry giving tri-bimaximal lepton mixing at leading order. In these models the second massive neutrino state is assumed quasi-Dirac and the remaining neutrinos are Majorana states. In the case of inverse mass hierarchy, the lower bound on the neutrinoless...
Search for supersymmetry in pp collisions at s=7 TeV in final states with missing transverse momentum and b-jets
G. Aad, B. Abbott, J. Abdallah, A.A. Abdelalim, more
Results are presented of a search for supersymmetric particles in events with large missing transverse momentum and at least one heavy flavour jet candidate in s=7 TeV proton–proton collisions. In a data sample corresponding to an integrated luminosity of 35 pb−1 recorded by the ATLAS experiment at the Large Hadron Collider, no significant excess is observed with respect to the prediction for Standard...
Self-consistent description of proton radioactivity
L.S. Ferreira, E. Maglione, P. Ring
Proton radioactivity from spherical nuclei is described by a fully self-consistent calculation based on relativistic density functionals derived from meson exchange and point coupling models. The experimental data are well reproduced and a strong evidence of the effects of configuration mixing is found for nuclei away from the N=82 magic number.
Physics Letters B > 2011 > 701 > 4 > IFC
Stress–energy connection and cosmological constant problem
Durmuş A. Demir
We study gravitational properties of vacuum energy by erecting a geometry on the stress–energy tensor of vacuum, matter and radiation. Postulating that the gravitational effects of matter and radiation can be formulated by an appropriate modification of the spacetime connection, we obtain varied geometrodynamical equations which properly comprise the usual gravitational field equations with, however,...
S-duality of D-brane action at order O(α′2)
Mohammad R. Garousi
Using the compatibility of the DBI and the Chern–Simons actions with the T-duality transformations, the curvature corrections to these actions have been recently extended to include the quadratic B-field couplings at order O(α′2). In this paper, we use the compatibility of the couplings on D3-brane with the S-duality to find the nonlinear RR couplings at order O(α′2). We confirm the quadratic RR couplings...
Conformal quantum mechanics as the CFT1 dual to AdS2
Claudio Chamon, Roman Jackiw, So-Young Pi, Luiz Santos
A (0+1)-dimensional candidate theory for the CFT1 dual to AdS2 is discussed. The quantum mechanical system does not have a ground state that is invariant under the three generators of the conformal group. Nevertheless, we show that there are operators in the theory that are not primary, but whose “non-primary character” conspires with the “non-invariance of the vacuum” to give precisely the correlation...
Scalar and pseudoscalar Higgs production in association with a top–antitop pair
R. Frederix, S. Frixione, V. Hirschi, F. Maltoni, more
We present the calculation of scalar and pseudoscalar Higgs production in association with a top–antitop pair to the next-to-leading order (NLO) accuracy in QCD, interfaced with parton showers according to the MC@NLO formalism. We apply our results to the cases of light and very light Higgs boson production at the LHC, giving results for total rates as well as for sample differential distributions,...
Regular black holes in UV self-complete quantum gravity
Euro Spallucci, Stefano Ansoldi
In this Letter we investigate the role of regular (curvature singularity-free) black holes in the framework of UV self-complete quantum gravity. The existence of a minimal length, shielding the trans-Planckian regime to any physical probe, is self-consistently included into the black hole probe itself. In this way we obtain to slightly shift the barrier below the Planck length, with the UV self-complete...
Yangian symmetry in deformed WZNW models on squashed spheres
Io Kawaguchi, Domenico Orlando, Kentaroh Yoshida
We introduce a deformation of the Wess–Zumino–Novikov–Witten model with three-dimensional squashed sphere target space. We show how with an appropriate choice of Wess–Zumino and boundary terms it is possible to construct an infinite family of conserved charges realizing an SU(2) Yangian. Finally we discuss the running of the squashing parameter under renormalization group flow.
Thermal relaxation of charm in hadronic matter
Min He, Rainer J. Fries, Ralf Rapp
The thermal relaxation rate of open-charm (D) mesons in hot and dense hadronic matter is calculated using empirical elastic scattering amplitudes. D-meson interactions with thermal pions are approximated by D⁎ resonances, while scattering off other hadrons (K, η, ρ, ω, K⁎, N, Δ) is evaluated using vacuum scattering amplitudes as available in the literature based on effective Lagrangians and constrained...
General relativity and quantum mechanics in five dimensions
Paul S. Wesson
In 5D, I take the metric in canonical form and define causality by null-paths. Then spacetime is modulated by a factor equivalent to the wave function, and the 5D geodesic equation gives the 4D Klein–Gordon equation. These results effectively show how general relativity and quantum mechanics may be unified in 5D.
First spectroscopy of 66Se and 65As: Investigating shape coexistence beyond the N=Z line
A. Obertelli, T. Baugher, D. Bazin, S. Boissinot, more
We report on the first γ spectroscopy of 66Se and 65As from two-neutron removal at intermediate beam energies. The deduced excitation energies for the first-excited states in 66Se and 65As are compared to mean-field-based predictions within a collective Hamiltonian formalism using the Gogny D1S effective interaction and to state-of-the-art shell-model calculations restricted to the pf5/2g9/2 valence...
Charged gravastars admitting conformal motion
A.A. Usmani, F. Rahaman, Saibal Ray, K.K. Nandi, more
We propose a new model of a gravastar admitting conformal motion. While retaining the framework of the Mazur–Mottola model, the gravastar is assumed to be internally charged, with an exterior defined by a Reissner–Nordström instead of a Schwarzschild line element. The solutions, obtained by exploiting an assumed conformal Killing vector, involve (i) the interior region, (ii) the shell, and (iii) the...
Quantum black hole and the modified uncertainty principle
Barun Majumder
Recently Ali et al. (2009) [13] proposed a Generalized Uncertainty Principle (or GUP) with a linear term in momentum (accompanied by Planck length). Inspired by this idea we examine the Wheeler–DeWitt equation for a Schwarzschild black hole with a modified Heisenberg algebra which has a linear term in momentum. We found that the leading contribution to mass comes from the square root of the quantum...
Forward–backward asymmetries of the bottom and top quarks in warped extra-dimensional models: LHC predictions from the LEP and Tevatron anomalies
Abdelhak Djouadi, Grégory Moreau, François Richard
Within the paradigm of warped extra dimensions, third generation quarks are expected to be the most sensitive to effects beyond the Standard Model. The anomalies observed at the LEP and Tevatron colliders in the forward–backward asymmetries of the bottom (AFBb) and top (AFBt) quarks can thus be seen as early signatures of warped extra-dimensional scenarios. We propose a realization of such a scenario,...
Spiky strings on NS5-branes
Sagar Biswas, Kamal L. Panigrahi
We study rigidly rotating strings in the near-horizon geometry of a stack of Neveu–Schwarz (NS) 5-branes. We solve the Nambu–Goto action of the fundamental string in the presence of a NS–NS two form (Bμν) and find out limiting cases corresponding to magnon and spike like solutions.
Studying very light gravitino at the ILC
Shigeki Matsumoto, Takeo Moroi
A collider signal with a stable gravitino of O(10) eV mass at the International Linear Collider (ILC) experiment is investigated. Such a light gravitino is generally predicted in the low-scale gauge mediation scenario of the supersymmetry breaking. We particularly focus on the case that the next lightest supersymmetric particle is stau, which eventually decays into a gravitino and a τ-lepton. With...
Coupling of Brans–Dicke scalar field with Horava–Lifshitz gravity
Joohan Lee, Tae Hoon Lee, Phillial Oh
We look for a Brans–Dicke type generalization of Horava–Lifshitz gravity. It is shown that such a generalization is possible within the detailed balance condition. Classically, the resulting theory reduces in the low energy limit to the usual Brans–Dicke theory with a negative cosmological constant for certain values of parameters. We then consider homogeneous, isotropic cosmology and study the effects...
Aharonov–Bohm effect in a draining bathtub vortex
Sam R. Dolan, Ednilton S. Oliveira, Luís C.B. Crispino
We study planar waves in a circulating, draining fluid flow, which: (i) exhibit an analogue of the Aharonov–Bohm (AB) effect in Quantum Mechanics; (ii) obey a Klein–Gordon equation on an ‘effective spacetime’ which resembles the Kerr spacetime of General Relativity; and (iii) may be observed in the laboratory using gravity waves in a shallow basin. We describe a modified AB effect which depends on...
SUPERSYMMETRY (2)
(2+1)-DIMENSIONAL ROTATING ACOUSTIC HOLE (1)
ADS/CFT (1)
AHARONOV–BOHM EFFECT (1)
BRANS–DICKE THEORY (1)
CAUSALITY (1)
CHARM TRANSPORT (1)
CONFORMAL QUANTUM MECHANICS (1)
CONFORMAL SYMMETRY (1)
COSMOLOGICAL CONSTANT (1)
COULOMB-ENERGY DIFFERENCES (1)
D-BRANE (1)
D-BRANES (1)
DIFFRACTIVE PROCESSES (1)
DISCRETE SYMMETRIES (1)
DRIP-LINE (1)
EQUATION OF STATE (1)
EXTRA DIMENSIONS (1)
FLAVOR SYMMETRIES (1)
FORWARD–BACKWARD QUARK ASYMMETRIES (1)
GENERAL RELATIVITY (1)
GLUINO (1)
GRAVASTAR (1)
GRAVITATIONAL CONSTANT (1)
GRAVITINO (1)
HORAVA–LIFSHITZ GRAVITY (1)
HOT HADRONIC MATTER (1)
ILC (1)
INTEGRABILITY (1)
KALUZA–KLEIN EXCITATION OF THE GLUON (1)
MULTIPLE-COMMUTATOR MODEL (1)
NEUTRINO HIERARCHY (1)
NEUTRINO MASSES AND MIXINGS (1)
NEUTRINOLESS DOUBLE BETA DECAY (1)
NEUTRINOLESS DOUBLE BETA DECAYS (1)
NLO (1)
NUCLEAR DENSITY FUNCTIONAL THEORY (1)
PARTON SHOWER (1)
PROTON RADIOACTIVITY (1)
QUANTUM GRAVITY (1)
QUANTUM SCHWARZSCHILD BLACK HOLE (1)
QUASIPARTICLE RANDOM-PHASE APPROXIMATION (1)
RESONANT NEUTRINOLESS DOUBLE ELECTRON CAPTURE (1)
S-DUALITY (1)
SBOTTOM (1)
SCATTERING (1)
SQUASHED SPHERE (1)
STAU (1)
STRESS–ENERGY CONNECTION (1)
TOP QUARKS (1)
TRI-BIMAXIMAL MIXING (1)
TWO-PION CONTINUUM (1)
ULTRARELATIVISTIC HEAVY-ION COLLISIONS (1)
WAVE FUNCTION (1)
WHEELER–DEWITT QUANTIZATION (1)
WZNW MODEL (1)
YANGIAN (1)
ΧC(0+)→Π+Π− DECAY (1)
|
cc/2020-05/en_middle_0097.json.gz/line1407300
|
__label__cc
| 0.576848
| 0.423152
|
Iranian Labour News Agency
Monday 30 Dey 1398 | 17:37
Code: 743102 2019/03/24 10:51:49 A
خانه | Politics
Envoy lauds good ties between Iran, China
Iranian ambassador to China on Sunday lauded the high-level relations between Tehran and Beijin in all fields.
Iran and China enjoy cordial relations and the level of their relations was promoted in the past Iranian calendar year (ended March 20, 2019), Mohammad Keshavarz-Zadeh said.
He made the remarks in a ceremony held to celebrate Nowruz with the presence of Iranians residing in China.
The Persian New Year is celebrated across the world by various countries, particularly Afghanistan, Albania, Azerbaijan, countries falling within the Former Yugoslavia, Republic of Macedonia, India, Iran, Kazakhstan, Kyrgyzstan, Tajikistan, Turkey and Turkmenistan. It was registered as an Intangible Cultural Heritage of Humanity in 2009 by the UN.
Elsewhere in his remarks, the envoy referred to the Iranian Parliament Speaker Ali Larijani's recent visit to China and expressed the hope that the bilateral agreements between the two states be implemented in the near future.
Commenting on the recent meeting of two countries' joint economic commission, he voiced hope that the obstacles on the way of improvement of two countries' cooperation are removed.
Keshavarz-Zadeh described the recent sanctions against Iran as unprecedented in the past four decades and noted that in spite of sanctions, Iran can become self-sufficient in all fields.
Enemy plots against Iran are doomed to failure and they will not succeed in their efforts to disappoint people, he added.
The US president announced early May that Washington would pull out of Iran nuclear deal and reinstate sanctions, which had been lifted under the accord.
The first round of the sanctions snapped back into place in August, with the second round, targeting the energy and oil sectors, took effect on November 5.
This is while other signatories to the deal (i.e. Britain, France, Germany, China and Russia) have thus far criticized Washington's unilateral move and repeatedly renewed their commitment to the deal.
iran China
Linked News
Iran, China resume financial transactions
Iran, China to use national currencies in trade
Iran-China exchange volume hits $37b
Iran eager to bolster strategic ties with China
Iran-China trade transactions reach to $66 million
Iranian Lawmaker says we are working on a plan to withdraw from NPT
By “Maximum Pressure” policy Trump will lose domestic supporters; U.S professor told
Spox reminds France of Persian Gulf's correct name
Iran parliament to decide about Iran’s cooperation with IAEA
Meeting on political, strategic aspects of Lt.Gen. Soleimani's assassination to be held
AASAAM News CMS.
|
cc/2020-05/en_middle_0097.json.gz/line1407304
|
__label__wiki
| 0.560583
| 0.560583
|
Tucker: The Man and His Dream (1988)
PG | 1h 50min | Biography, Drama | 12 August 1988 (USA)
The story of Preston Tucker, the maverick car designer and his ill-fated challenge to the auto industry with his revolutionary car concept.
Arnold Schulman, David Seidler
Jeff Bridges, Joan Allen, Martin Landau | See full cast & crew »
Watch Free on IMDb TV
Rachel Maddow Scores Record-Breaking Ratings With Lev Parnas Interview
Long live the queen! Olivia Colman joins tiny group of actors with a 3-for-3 Golden Globe record
Brad Pitt has entered the Golden Globe record books (twice) with his supporting actor win
Francis Ford Coppola Filmography
priit
Oscar Nominated Movies from 1988
Search for "Tucker: The Man and His Dream" on Amazon.com
Title: Tucker: The Man and His Dream (1988)
Decades of the 20th Century as Setting
Best Jeff Bridges Movie
Dangerous Visionaries
Engineering Beauty
Favorite Real Life Inventor Biopic
In which car would you like to ride?
Nominated for 3 Oscars. Another 8 wins & 6 nominations. See more awards »
Gardens of Stone (1987)
Drama | Romance | War
A Sergeant must deal with his desires to save the lives of young soldiers being sent to Viet Nam. Continuously denied the chance to teach the soldiers about his experiences, he settles for trying to help the son of an old Army buddy.
Director: Francis Ford Coppola
Stars: James Caan, Anjelica Huston, James Earl Jones
Rumble Fish (1983)
Crime | Drama | Romance
Rusty James, an absent-minded street thug struggles to live up to his legendary older brother's reputation, and longs for the days when gang warfare was going on.
Stars: Matt Dillon, Mickey Rourke, Diane Lane
The Rain People (1969)
When a housewife finds out she is pregnant, she runs out of town looking for freedom to reevaluate her life decisions.
Stars: James Caan, Shirley Knight, Robert Duvall
The Cotton Club (1984)
Crime | Drama | Music
The Cotton Club was a famous Harlem nightclub. This is the story of the people who visited this club as well as the people who ran it, and the film is generously peppered with the jazz ... See full summary »
Stars: Richard Gere, Gregory Hines, Diane Lane
Tetro (2009)
Bennie travels to Buenos Aires to find his long-missing older brother, a once-promising writer who is now a remnant of his former self. Bennie's discovery of his brother's near-finished play might hold the answer to understanding their shared past and renewing their bond.
Stars: Vincent Gallo, Alden Ehrenreich, Maribel Verdú
Peggy Sue Got Married (1986)
Peggy Sue faints at a high school reunion. When she wakes up, she finds herself in her own past, just before she finished school.
Stars: Kathleen Turner, Nicolas Cage, Barry Miller
The Rainmaker (1997)
An underdog lawyer takes on a fraudulent insurance company.
Stars: Matt Damon, Danny DeVito, Claire Danes
One from the Heart (1981)
Drama | Musical | Romance
A couple has a fight after living together 5 years in Las Vegas. They go out and celebrate 4th of July, each with a new partner. Breakup?
Stars: Frederic Forrest, Teri Garr, Raul Julia
Youth Without Youth (2007)
A love story wrapped in a mystery. Set in World War II Europe, a professor is changed by a cataclysmic event and explores the mysteries of life.
Stars: Tim Roth, Alexandra Maria Lara, Bruno Ganz
Dolemite Is My Name (2019)
Biography | Comedy | Drama
Eddie Murphy portrays real-life legend Rudy Ray Moore, a comedy and rap pioneer who proved naysayers wrong when his hilarious, obscene, kung-fu fighting alter ego, Dolemite, became a 1970s Blaxploitation phenomenon.
Director: Craig Brewer
Stars: Eddie Murphy, Keegan-Michael Key, Mike Epps
The Laundromat I (2019)
A widow investigates an insurance fraud, chasing leads to a pair of Panama City law partners exploiting the world's financial system.
Director: Steven Soderbergh
Stars: Gary Oldman, Antonio Banderas, AJ Meijer
The Conversation (1974)
Drama | Mystery | Thriller
A paranoid, secretive surveillance expert has a crisis of conscience when he suspects that a couple, on whom he is spying, will be murdered.
Stars: Gene Hackman, John Cazale, Allen Garfield
Jeff Bridges ... Preston Tucker
Joan Allen ... Vera
Martin Landau ... Abe
Frederic Forrest ... Eddie
Mako ... Jimmy
Elias Koteas ... Alex Tremulis
Christian Slater ... Junior
Nina Siemaszko ... Marilyn Lee
Anders Johnson ... Johnny
Corin Nemec ... Noble (as Corky Nemec)
Marshall Bell ... Frank
Jay O. Sanders ... Kirby
Peter Donat ... Kerner
Dean Goodman ... Bennington
John X. Heart ... Ferguson's Agent
Based on a true story. Shortly after World War II, Preston Tucker is a grandiose schemer with a new dream, to produce the best cars ever made. With the assistance of Abe Karatz and some impressive salesmanship on his own part, he obtains funding and begins to build his factory. The whole movie also has many parallels with director Coppola's own efforts to build a new movie studio of his own. Written by Reid Gagle
based on real person | man | united states of america | usa | police officer | See All (167) »
When they tried to buy him, he refused. When they tried to bully him, he resisted. When they tried to break him, he became an American legend. The true story of Preston Tucker.
PG | See all certifications »
Tucker: The Man and His Dream See more »
City Hall - 1 Dr. Carlton B. Goodlett Place, San Francisco, California, USA See more »
$3,709,562, 14 August 1988
Lucasfilm See more »
70 mm 6-Track (70 mm prints)| Dolby (35 mm prints)
Martin Landau was nominated for supporting actor. The following year he was nominated for best actor in Woody Allen's Crimes and Misdemeanors. Both Woody Allen and Francis Ford Coppola, both legendary at this point, worked on New York Stories in 1989. See more »
When the car crashes on the test track, the rear bumper comes off. Moments later when the damaged car drives away, the rear bumper is fine. See more »
Preston Tucker: Isn't that the idea? To build a better mouse trap?
Abe: Not if you're a mouse!
Photographs of the real Preston Tucker appear during the closing credits. See more »
2018 Blu-ray Disc release features a newly-film introduction to the film by director Francis Ford Coppola. See more »
Referenced in Family Guy: Tom Tucker: The Man and His Dream (2012) See more »
The Music Goes Round and Round
Music by Edward Farley and Mike Riley
Lyrics by Red Hodgson
Courtesy of Chappell & Co., Inc.
Tucker: The Man and His Dream
17 June 1999 | by Coxer99 – See all my reviews
Underrated film about dreams and desire in the mind of Preston Tucker as he looked to create the car of the future. He faced hardship and defeat at the hands of politicians and other automakers. (Namely the Big Three) Bridges delivers Tucker with great heart and devotion while Landau (Oscar nominee) stands out as Tucker's friend and partner. Dean Stockwell makes a small cameo as Howard Hughes.
|
cc/2020-05/en_middle_0097.json.gz/line1407306
|
__label__cc
| 0.727881
| 0.272119
|
Home > Society > Indian Food > Indian Sherbets
Indian Sherbets, Indian Beverage
Indian Sherbets encompass refreshment and cooling personified, with remarkable ingredients. It is a very common drink during any family gatherings.
Somaras
Indian Sherbets are the traditional beverage of India. It is typically prepared from fruits, herbs as well as flower petals. Sherbet and Lassi are considered as coolers and are meant to provide refreshment from the hot Indian summer. They are also served on festive occasions when guests are treated with snacks and sweets accompanied by these rejuvenating drinks.
History of Sherbets in India
Sherbet is a popular Middle Eastern and South Asian, sweet chilled drink that is prepared from fruits or flower petals. Sherbets were introduced in India by the invading Turks and Persians and were originally consumed in large quantities because they replaced the large loss of body water which occurs in the tropical climate of India. For this reason, sherbets are still offered as refreshment in India.
Significance of Sherbets in India
Sherbets are a symbol of celebration and are often consumed at weddings, dinner parties, banquets and similar events. Indian beverages comprehend a significant portion of the Indian food section. In fact, a traditional Indian meal is considered incomplete without sherbet. The umpteen recipes, fruits, even vegetables employed to serve a sherbet is absolutely blissful. The humid Indian summers can be turned into a chilled atmosphere, by a mere drinking of sherbets. The sweet, salty, tangy or chilli taste of Indian sherbets, topped with ice, brings a serene effect to the mind.
It is a ritual in India, when anyone comes home, not to let them go without having anything. So these drinks are very handy and are prepared just in few minutes and can be served to the visitors. A lot of Indian households keep a stock of home-made sherbets meant to be served to family members and guests during the summers. These summer drinks mainly contain ingredients that can help the body cool down to survive the soaring temperature outside. Common ingredients used in summer drinks in India include lime juice, water melon, mint, cucumber and sometimes even curd. Every region has their traditional specialty.
Preparation of Sherbets
The sherbets can be easily prepared at home with readily available ingredients. The fruits that are used to prepare Sherbets are like, raw mango, melon, lemon, watermelon or even a drink prepared with tamarind and asafoetida makes Indian sherbets illustrious worldwide. Any Indian household keeps a handy stock of ingredients needed to make drinks like ‘Chaas’, ‘Lassi’, ‘Kairi ka Pani’, etc., especially on hot summer days.
Recently Updated Articles in Indian Food
• Amchur
Amchur is the dried or dehydrated product prepared from unripe mango flesh in the form of peeled slices.
• Desserts of Assam
Desserts of Assam are simply delicious. Rice is the main ingredient of Assamese sweets. Various types of Pithas heighten the Bihu Festival in Assam.
• Jigarthanda
Jigarthanda is a special drink of Madurai, Tamil Nadu state. It is a perfect refreshment drink for summer season. The drink was introduced and named by the Mughals.
• Ker Sangri ki Sabzi
Ker Sangri ki Sabzi is a traditional Rajasthani dish made with dried Ker berry and Sangri beans. This dish is best enjoyed with a traditional meal of roti, dal and steamed rice.
• Rosemary Leaves
Rosemary Leaves in dried form act as spice as well as flavouring agent. It possesses a fragrant equivalent to tree. Rosemary is a woody herb. It can also be used to improve skin, help hair growth, prevent infection and speed wound healing.
Subscribe to Free E-Magazine on Society
|
cc/2020-05/en_middle_0097.json.gz/line1407308
|
__label__wiki
| 0.928932
| 0.928932
|
Trump faces impeachment this month as Pelosi gives go-ahead
House speaker instructs judiciary committee to draft articles of impeachment
Thu, Dec 5, 2019, 14:57 Updated: Thu, Dec 5, 2019, 22:41
Suzanne Lynch in Washington
US House of Representatives speaker Nancy Pelosi has announced that articles of impeachment are to be drawn up against US president Donald Trump. Video: C-Span
US House Speaker Nancy Pelosi announcing that articles of impeachment are to be drawn up against US president Donald Trump. Photograph: Andrew Harrer/Bloomberg
US president Donald Trump faces an impeachment vote as early as this month after the top Democrat in Congress ordered that charges against him should proceed.
House of Representatives speaker Nancy Pelosi announced she was directing the House judiciary committee to draft articles of impeachment – a key stage in the impeachment of a president – stating that Mr Trump had “seriously violated the constitution”.
“The facts are uncontested. The president abused his power for his own personal political benefit at the expense of our national security,” she said in a televised press conference. “If we allow a president to be above the law we do so surely at the peril of our republic. In America no one is above the law.”
The announcement makes it all but certain that Mr Trump will be impeached, with a vote in the 435-member House of Representatives likely before Christmas.
With Democrats in the majority, a resolution to impeach the president over his dealings with Ukraine is expected to pass. But the development also opens up the prospect of a bruising trial in the Senate early next year. With a two-third majority needed in the Senate to convict the president, Mr Trump is unlikely to be removed from office given that his Republican party holds 53 of the 100 Senate seats.
Fintan O’Toole: Trial runs for fascism are in full flow
Trump accused of betraying public trust in impeachment trial
How the impeachment of Donald Trump will influence the election
....This will mean that the beyond important and seldom used act of Impeachment will be used routinely to attack future Presidents. That is not what our Founders had in mind. The good thing is that the Republicans have NEVER been more united. We will win!
— Donald J. Trump (@realDonaldTrump) December 5, 2019
The impeachment process centres on allegations that Mr Trump abused his power when be asked Ukrainian president Volodymyr Zelenskiy to investigate former vice president Joe Biden and his son Hunter, who served on the board of a Ukrainian company when his father was in office. Democrats have argued that this involved a quid pro quo, whereby Mr Trump withheld promised military aid in exchange for announcing the investigations.
Mr Trump is only the fourth US president in history to face impeachment.
Andrew Johnson and Bill Clinton were impeached, but not convicted in the subsequent Senate trial. Richard Nixon resigned before an impeachment vote was held after he lost the support of his party in Congress over the Watergate affair.
Asked if he was concerned about the impact of a possible impeachment on his legacy, Mr Trump said “not at all”. “It’s a hoax. It’s a hoax. It’s a big fat hoax,” he told reporters on Thursday.
But in a sign that the White House is planning a combative approach if the process moves to a Senate trial, Mr Trump declared on Twitter that the “do-nothing Democrats” were seeking to impeach him over “NOTHING”, adding “We will win!”
He also suggested in a tweet that Democratic politician Adam Schiff, a key figure until now in the impeachment process, as well as Joe and Hunter Biden and others could testify, raising the prospect that Republicans – who will control the Senate process – could call them as witnesses.
Mr Trump accused Ms Pelosi of having a “nervous fit” after she chastised a reporter on Thursday who asked if she hated the president.
“As a Catholic, I resent your using the word ‘hate’ in a sentence that addresses me. I don’t hate anyone. I was raised in a way that is a heart full of love and always pray for the president,” she said, adding: “I still pray for the president. I pray for the president all the time.”
Clinton prosecutor Ken Starr joins Trump impeachment team
Solemn tones in US Congress as Donald Trump goes on trial
White House broke law in blocking aid to Ukraine, watchdog finds
Iran says Europe yielding to ‘high school bully’ Trump in nuclear row
US military resumes joint operations with Iraq, officials say
Joe Biden represents a welcome portal to the past for US allies
Warren and Sanders clash puts gender in the spotlight
US House votes to send Trump impeachment charges to Senate
Pelosi names prosecutors for Trump Senate impeachment trial
New details emerge of Trump’s pressure campaign on Ukraine
Phil Hogan arrives in Washington for crunch EU-US trade talks
Elizabeth Warren: Sanders said in 2018 a woman could not win White House
Donald Trump retweets fake image of Pelosi in front of Iranian flag
Read more about the Donald Trump administration
Solidarity running in Paul Murphy’s constituency ‘hard call to make’ - Boyd Barrett
5 Navigating the health insurance maze and finding the best deal
|
cc/2020-05/en_middle_0097.json.gz/line1407310
|
__label__wiki
| 0.765242
| 0.765242
|
Iskcon History
What is ISKCON?
Who started IKCON?
Centers Around The World
Iskcon –Visakhapatnam
How it began at vizag
Distinguished visitors to vizag
More visiting places
Mid Day Meal
Jail & hospital preaching
KGH-FREE DORMITORY
VIZIANAGARAM EXTN. CENTER
Bhakthi Yoga Residential Summer Camp
CHILDREN & YOUTH PREACHING
Sunday feast
GOSHALA(Cow Protection)
Nitya Puja
Daily TV Programme
BSS – Bhaktivedanta Sunday school
Life-Membership
Spiritual-Yatra
Sunday-Love-Feast
Temple Construction
SPECIAL SEVA
NITYA SEVA
Mandir Nirman Seva
+ 91 98481 98614,
iskconvizag@gmail.com
Panihati Chida-dahi Utsava
Offer Seva Help line number 9963332660 Temple Timings Morning: 7:30am to 12:30pm, Evening: 4:00pm to 8:30pm Updated Lectures How to become a life member Life Member Ship
Panihati is the name of a village located in the state of West Bengal, on the banks of River Ganges (10 miles north of Kolkata). It was one of the leading trade centres in earlier days when the river route was the main means of communication. A special rice variety called Peneti was imported at this place from Jessore in East Bengal. Probably the name Panihati might have been derived from this trade connection. Once upon a time this place was the centre of worship of the Buddhist Tantrics and the Kapalikas. But later, in the sixteenth century, when Sri Chaitanya Mahaprabhu appeared to propagate the Sankirtana Movement, Panihati became a major centre of the Gaudiya Vaishnavas. The residential quarters of Sri Raghava Pandita (one of the associates of Chaitanya Mahaprabhu) still exists in Panihati.
The Festival of Punishment
The Supreme Personality of Godhead, Sri Krishna, appeared as Sri Chaitanya Mahaprabhu at Sridhama Mayapura (a quarter in the city of Navadvipa) in Bengal, in the year 1486 AD. The purpose of His incarnation was to establish the Yuga-dharma – the congregational chanting of the holy names of the Lord. Lord Balarama appeared as Nityananda Prabhu, and many other eternal associates of the Lord appeared at that time to join His mission. Srila Raghunatha dasa Gosvami was one of them.
Srila Raghunatha dasa Gosvami was a devotee of the highest order. He displayed a spirit of renunciation and detachment from the material world at a very early age. He wanted to leave home and join Sri Chaitanya Mahaprabhu in His mission. But Chaitanya Mahaprabhu asked him not to do so and assured that Krishna would deliver him soon from the clutches of maya. Two years later, Nityananda Prabhu came to Panihati and stayed there. Raghunatha dasa, who was staying in the nearby village of Srikrishnapura took permission from his father Govardhan Mazumdar and went to Panihati to meet Nityananda Prabhu.
At Panihati, he saw Nityananda Prabhu sitting on a rock under a banyan tree on the banks of the River Ganges. He was surrounded by many devotees. Raghunatha dasa was hesitant to approach the Lord and paid obeisances from a distance. But some of the devotees noticed him and informed Nityananda Prabhu. Nityananda Prabhu called Raghunatha dasa and said “Raghunatha dasa! You are hiding like a thief. Now I have caught hold of you. Come here. I shall punish you today.’’ Then Lord Nityananda forcibly caught him and put His lotus feet on Raghunatha’s head. He ordered Raghunatha to celebrate a big festival and serve all the devotees – with yogurt and chipped rice.
Raghunatha dasa immediately sent his men to the nearby villages to purchase all kinds of eatables. They brought chipped rice (chida), milk, yogurt, sweetmeats, bananas, sugar and other eatables. The chipped rice was soaked in milk. Half of that was then mixed with yogurt, sugar and bananas. The remaining half was mixed with condensed milk and flavoured with clarified butter and camphor. All the devotees received two earthen pots, one with chipped rice mixed with yogurt and another with chipped rice mixed with condensed milk.
The Chida-dahi Mahotsava is celebrated every year in commemoration of this wonderful pastime. This festival is also known as Danda Mahotsava (the Festival of Punishment). It is celebrated on the thirteenth day of the bright moon in the month of Jyeshta (May-June). To this day, pilgrims visit Panihati to celebrate the Chida-dahi Festival.
ISKCON Vizag celebrates this festival every year with grand abhisheka for Their Lordships Nitai Gauranga, followed by a boat festival and distribution of chida-dahi maha-prasadam. Watch this video for glimpses of the festival.
The temple pond is decorated beautifully with colourful flowers floating on its calm ripples. The utsava Deities of Sri Sri Nitai Gauranga are carried from the main temple hall to the pond in a pallakki decorated with flowers. An abhisheka is performed with milk, curd, ghee, honey, jaggery water and exotic fruit juices. The Deities also take a dip in the pond and are offered flowers as part of the abhisheka. The abhisheka is followed by a grand arati, after which the Deities are taken for a boat ride (Theppotsava) in the temple pond. Varieties of preparations are made by mixing chipped rice with condensed milk, yogurt, sugar, bananas, mangoes and assorted savouries, just like Raghunatha dasa prepared for the devotees. These are then offered to the Deities of Nitai-Gauranga and distributed to the assembled devotees.
Sri Nityananda Trayodashi - Feb 7 2020
Sri Gaura Purnima - Mar 9 2020
Sri Rama Navami - Apr 2 2020
Sri Narasimha Caturdashi - May 6 2020
Panihati Chida-dahi Utsava - Jun 4 2020
His Grace Samba Das Prabhu
President & Project Director
Isckon Vizag
ISKCON TEMPLE
Hare Krishna Land, Sagar nagar,
Visakhapatnam-530045, Andhra Pradesh, INDIA
About ISKCON
A. C. Bhaktivedanta Swami Prabhupada
Founder of ISKCON
|
cc/2020-05/en_middle_0097.json.gz/line1407311
|
__label__cc
| 0.694904
| 0.305096
|
Ramadhaan
IslamicTeachings.org
Fiqh Q/A Support
How Does the Heart Fasts?
By SAFAH, September 3, 2010 in Ramadhaan
SAFAH 42,265
Religion:Muslim
LocationJANNAH (inshaAllah)
‘And if anyone believes in Allah, (Allah) guides his heart (aright)’ (64:11).
The guidance of the heart is the basis of all guidance, the law of all success, the origin of every deed and head of every action. The Prophet saws said:
‘Truly there is a piece of flesh in the body which, if it be wholesome, the whole body will be healthy and which, and if it be diseased the whole body will be diseased. Truly it is the heart.’
Thus the goodness of your heart is the guarantee of your happiness in this world and in the hereafter. Likewise, its corruption is the surest way to destruction, the extent of which only Allah knows.
‘In this, behold, there is indeed a reminder for everyone whose heart is wide-awake - that is [everyone who] lends ear with a conscious mind’ (50:37).
Every creature has a heart. In reality though they are two hearts, a heart that is alive and pulsating with the light of faith. It is filled with intense conviction and God-consciousness. The other is a dead heart, covered and diseased with every wreckage and rubbish.
Allah Almighty says concerning the hearts of the foolish folk:
‘In their hearts is disease, and so God lets their disease increase’ (2:10).
‘But they say, “Our hearts are already full of knowledge.” Nay, but God has rejected them because of their refusal to acknowledge the truth: for, few are the things in which they believe’ (2:88).
Allah also says:
‘Will they not, then, ponder over this Quran? — or are there locks upon their hearts?’ (47:24).
‘And so they say, [as it were:] “Our hearts are veiled from whatever thou callest us to, [O Muhammad,] and in our ears is deafness”’ (41:5).
From all these verses we learn that the hearts can become ill, they can be covered, locked and they die. The enemies of Allah have hearts in their bosoms but they do not perceive with these hearts. Hence the Prophet saws used to say:
‘O dispenser of hearts make my heart firm in Your religion.’
The heart of the believer fasts during Ramadan and outside of Ramadan. The fasting of the heart is done by emptying it of all corrupt material such as destructive forms of polytheism, false beliefs, evil suggestions, filthy intentions and degenerate thoughts. The heart of the believer is adorned with the love of Allah. It knows its Lord by His names and His qualities as He has described Himself. This heart explores with a discerning eye the lines of His names and qualities and the pages of Allah’s making in the universe and the books of His creations.
The believer’s heart is filled with a brilliant light which does not allow any darkness to remain with it. It is the light of the eternal message, the divine teachings, and the omnipotent laws. To it is added the natural light upon which the servants of Allah were created. Thus two great lights come together.
‘Light upon light! God guides unto His light him that wills [to be guided]; and [to this end] God propounds parables unto men, since God [alone] has full knowledge of all things’ (24:36).
The believer’s heart glows like a lamp, shines like the sun and sparkles like the morning light. It increases in faith whenever the believer listens to the verses of the Quran, it grows in conviction when it contemplates, and increases in guidance when it reflects. The believer’s heart abstains from pride because it breaks its fast. Pride does not reside in the heart of a believer because it is unlawful. The abode and dwelling place of pride is the heart. Hence, if it enters any heart, that person will become afflicted, foolish, arrogant and frivolous.
Allah Almighty says in a hadith Qudsi: ‘Pride is my upper garment and grandeur is my lower one, whoever contests with me for them I will punish him.’
The Prophet saws himself said:
‘Whoever shows arrogance to Allah, He will humble him, and whoever is humble to Allah, He will raise him in station.’
The heart of the believer fasts and abstains from egotism. Egotism is when the individual sees himself as perfect, better than others and in possession of good qualities that are not found in anyone else. This is destruction in its most naked form. The Prophet saws said:
‘Three things which are totally destructive: a person’s self-centredness and conceit, his reluctance to obey and his following of his desires.’
The cure for this self-importance is to look at one’s own faults, one’s many shortcomings, thousands of sins and misdeeds that one has committed, wrongs that one has done and forgotten but the knowledge of which are with Allah in a book. For Allah is not led astray nor does He forget.
The heart of the believer fasts and abstains from envy because it lowers righteous deeds, puts out the light of the heart and stops its progress toward Allah the Most High. Allah says in the Glorious Quran:
‘Do they, perchance, envy other people for what God has granted them out of his bounty? (4:54).
And the Prophet saws said:
‘Do not envy one another; do not inflate prices one to another; do not hate one another; do not turn away from one another; and do not undercut one another.’
The Prophet informed one of his companions three times that he would be among the people of Paradise. When he was asked about what was it that earned him a place in Paradise, the man said:
‘I do not sleep with envy, grudge or deceit in my heart for any Muslim.’
Are there any hearts that would, therefore, fast like the learned. The fast of the learned has a yearning for the Most Merciful Lord of the worlds. Their hearts fast at all times and in the early hours of morning they seek forgiveness.
O Allah guide our hearts to the straight path and make it firm on faith, O Lord of the worlds
|
cc/2020-05/en_middle_0097.json.gz/line1407312
|
__label__cc
| 0.659358
| 0.340642
|
Home » Posts Tagged "Jumeirah"
Pera Palace Hotel Jumeirah
Pera Palace Hotel, Jumeirah overlooks the magnificent view of the Golden Horn and is located in the cosmopolitan Tepebaş district of Pera once known as the “Little Europe”.
Istanbul Pera Palace Hotel, Jumeirah appoints designer Anouska Hempel
Pera Palace Hotel, Jumeirah announces it has retained renowned hotelier and interior designer, Anouska Hempel, to design new concepts for the public areas and two Presidential suites of the luxury museum hotel. Scheduled for completion by mid-2013, the project will aim to enhance the Belle Époque feel of the hotel and take guests on a journey back in time. Anouska aims to display the feminine side of Patisserie de Pera’s Art Nouveau...
Jumeirah Restaurants’ Franchise to Open in Istanbul
Jumeirah Restaurants LLC, the branded restaurant division of Jumeirah Group, has signed two franchise agreements that will see Urbano, its Italian restaurant concept that is at Souk Al Bahar in Dubai, open soon in Kuwait, Bahrain, Oman and Turkey. Jumeirah Restaurants signed a licensing agreement with a key Food & Beverage market leader in Bahrain to open Urbano restaurants in Kuwait, Oman and Bahrain. The first Urbano in Bahrain...
Jumeirah to operate Pera Palace Hotel in Istanbul
Jumeirah Group, the Dubai-based luxury hotel company and a member of Dubai Holding, has signed a management agreement with Demsa Group, a leading Turkish company specialising in the luxury and fashion retail industry and representing 13 global brands, to operate the Pera Palace Hotel in Istanbul, Turkey. Jumeirah Group will assume management of the luxury museum hotel from 01 May 2012 and the property will be known as Pera Palace...
Istanbul welcomes International Tulip Festival Apr 15, 2012
Topkapi Palace Museum attracts record visitors Feb 15, 2014
Hagia Sophia, Topkapı again Turkey’s top tourist attractions Sep 16, 2015
|
cc/2020-05/en_middle_0097.json.gz/line1407316
|
__label__cc
| 0.663928
| 0.336072
|
Event Item
Home > Newsroom > Forthcoming events > Reputation round-table
The Reputation Game: Roundtable discussion
Date:21 November 2017 - 21 November 2017
Time:18:00 - 20:30
Location: Kantar, 6 More London Place, Tooley Street , London, SE1 2QY
Solution: Reputation PR Monitoring and Evaluation
Join us at our upcoming round-table discussion.
The subject will be reputation in its broadest sense, and will be based on a new book The Reputation Game: The Art of Changing How People See You, authored by David Waller, former FT Lex Column writer and now a partner at FTI Consulting, and Rupert Younger, co-founder of Finsbury and the Oxford University Centre for Corporate Reputation at the Said Business School.
It’s based on research and case studies, including key interviews with Jay-Z, LinkedIn co-founder Reid Hoffman and Man-Booker prize winner Hilary Mantel.
The wide ranging discussion will be with Rupert and David, and chaired by Matthew Jervois, Senior Director Kreab and Chairman of the CIPR, Corporate and Financial Group.
Find more information and reserve your place here
|
cc/2020-05/en_middle_0097.json.gz/line1407318
|
__label__wiki
| 0.534607
| 0.534607
|
Dr. Izzy’s Sound News
Inside The Law
Pain Free with Dr. Dharam Mann, MD
Dear Joel
Jersey Shore Online
Home Jackson Dashcam Video Of Fatal Jackson Crash Released By Authorities
Dashcam Video Of Fatal Jackson Crash Released By Authorities
Jennifer Peacock
JACKSON – After receiving numerous Open Public Records Act requests for the footage, Ocean County Prosecutor Joseph D. Coronato agreed to release the dashcam video from July 5 of a fatal motorcycle crash in Jackson.
The prosecutor’s office said it was “important that the release of the video should be accompanied with the preliminary investigative facts of the investigation to assure proper context.”
Authorities used the dashcam video, taken by a Jackson Police patrol car, to determine the cause of the crash.
At 10:20 p.m. July 5, Anthony Griffin, 22, riding a 2004 Yamaha 999 motorcycle, failed to stop for a red traffic light at Brewers Bridge Road and South New Prospect Road. The patrol activated its lights and followed Griffin, who accelerated for 10 seconds approaching Oak Drive before striking the driver’s side door of a 2008 Hyundai Elantra.
Eric Larson, 24, of Jackson, was driving that car, making a left-hand turn on South New Prospect Road.
Griffin was pronounced dead on the scene.
Larson was taken to Jersey Shore University Medical Center in Neptune, then listed in critical condition.
“Larson continues to struggle with recovery from significant injuries incurred in the crash,” the prosecutor’s office said.
A GoFundMe page has been set up to help pay for Larsen’s medical expenses.
Ocean County Prosecutor's Office
Previous articleD-Day Vet Given Key To City
Next articleMassachusetts Man Wanted For Child Porn Captured In Ocean County
Ocean County native Jennifer Peacock is a community journalist and photographer. She’s written for weekly and daily newspapers in New Jersey, New York, Pennsylvania and Virginia for more than 20 years. She left Micromedia Publications in 2019 to pursue other interests.
American Legion Makes History
Man Files Suit Against Six Flags After Serious Injury
County Approves New Contracts For Senior Services
Jersey Shore Online, powered by Micromedia Publications. Seven weekly newspapers in Ocean & Monmouth. Breaking news, community events and affordable advertising solutions for over 20 years. Publishers of The Toms River, Manchester, Berkeley, Brick, Jackson, Southern Ocean & Howell Times. EST. 1995. Reach us at 732-657-7344.
Contact us: news@jerseyshoreonline.com
© 1995-2020 Micromedia Publications, Inc.
|
cc/2020-05/en_middle_0097.json.gz/line1407322
|
__label__wiki
| 0.900996
| 0.900996
|
Halle's A-Z: We asked, and boy did she answer...
By InStyle.com
Jeffrey Mayer/WireImage
"I can play the flute! I played in high school. I also paint-so, mixed media."
Eric Charbonneau/WireImage
"A lock of my mother's hair from her first haircut, when she was a little girl. I've placed it in a piece of art called Angel Hair. It's her hair in a frame with hair pins and a net. It looks sort of lyrical."
David Aguilera/SplashNewsOnline.com
"I did one and I'd do more, if it was instrumental in bringing the character to life. I'm really comfortable with my body."
Quitting Bad Habits
Patrick Rideaux/Rex
"When I got pregnant, I stopped drinking diet soda because of the caffeine and aspartame."
See more of Halle's chic pregnancy style.
Charley Gallay/Getty
"'Isn't She Lovely' by Stevie Wonder has been playing a lot in our house. And for some reason, that song keeps coming up on my iPod too-even though it's on shuffle. We're like, 'It's a sign! It's a girl!'"
Baxter/Abaca
"The best trip I ever took was traveling around the country through all 50 states when I was Miss Teen All-American. I was 17, and it was such an education to be able to experience the people, the food and the vibe of each state. The Southern states had the best food… everything fried!"
Ultimate Indulgence
"To be left alone and not followed around! Where nobody saw what I was wearing, and I could be free of anyone noticing me."
Jon Furniss/WireImage
"I wear a lot of Versace. The designs allow a woman to look sexy without feeling trashy. Versace knows how to push that limit right up to the edge."
At left: Halle dons a daring Versace dress at the London Film Festival.
BauerGriffin
"If I could have a superpower, like the X-Men, it would be teleporting. One day I'd be in L.A., then, all of a sudden, I'd be in Rome. Or I'd love to go to five different countries in a day. That would be fantastic."
Zen Moment
"I used to relax with a glass of wine. Now a good massage goes a long way to help me de-stress and detox."
MORE HALLE Check out Halle's chic pregnancy style; see her transform from sweet teen to stunning star; and watch a video clip for even more.
1 of 10 Hidden Talents
2 of 10 Keepsake
3 of 10 Nude Scenes
4 of 10 Quitting Bad Habits
5 of 10 Song
6 of 10 Trip
7 of 10 Ultimate Indulgence
8 of 10 Versace
9 of 10 X-Men
10 of 10 Zen Moment
|
cc/2020-05/en_middle_0097.json.gz/line1407326
|
__label__cc
| 0.619644
| 0.380356
|
Home Forums > Religion, Faith, and Theology > Comparative Studies >
One Unfolding Process
Discussion in 'Comparative Studies' started by 9Harmony, Jul 30, 2007.
9Harmony goin' with the flow...
I originally posted this in the Baha'i forum, but it has gotten no responses there...so posting it here as well...as it's primarily a comparative religion topic to begin with...
As human's, with a life span of 80-100 years if we're lucky, it's understandable that we view religion in light of our frame of reference. But...
If we step way back and view history in light of many centuries to millenia increments...we begin to realize that the surges of progress in civilizations took place between the different prophets...I'm by no means an expert, but the way I see it, due to our capacity at the time, as a whole, whether or not we adhere to any particular prophet/religion, entire civilizations rose and radiated this knowledge outward, affecting everyone within range, we have all benefited from the spirit infused by the impetus they provided.
"...the existence of an unseen force at work in human history is no less plausible and no less scholarly as an explanation for events than it is to consider the influence of unseen forces at work in the natural world (e.g. gravity)"...John S. Hatcher, The Ocean of His Words p 27
"...The study of religion is inseparable from the study of human history. Conversely, human history, when correctly understood, is nothing more or less than tracing evidence of the Divine Will intervening systematically in human affairs to force an "ever-advancing civilization..."" Ibid, p. 63-64
"the ordinary human artist is a product of history (in varying degrees), the prophet is the producer of history..." Ibid, p 64
“...As the human race in all its diversity is a single species, so the intervention by which God cultivates the qualities of mind and heart latent in that species is a single process. Its heroes and saints are the heroes and saints of all stages in the struggle; its successes, the successes of all stages…” -“One Common Faith” p. 23
This is an interesting link, it's animated, showing the time frame and spread of some of the major religions.
http://www.mapsofwar.com/ind/history-of-religion.html
It's interesting to me, in that it shows how each was for the most part confined regionally. And from a Baha'i perspective this is due to the means available at the time to allow each to spread. And despite all obstacles, it also shows how God's Word has touched every part of the globe through one source or another.
11:9 They shall not hurt nor destroy in all my holy mountain: for the earth shall be full of the knowledge of the LORD, as the waters cover the sea. (King James Bible, Isaiah)
I know it is not fully accurate as some religions aren't depicted. But to me it shows a nice glimpse of how God's Will is unfolding progressively.
"Know thou, O Prince, that whenever the world declineth in virtue and righteousness; and vice and injustice mount the throne, then come I, the Lord, and revisit My world in visible form, and mingle as a man with men, and b my influence and teachings do i destroy the evil and injustice, and re-establish virtue and righteousness. many times have i thus appeared; many times hereafter shall i come again." -Krishna, Bhagavad Gita
"I am not the first Buddha who came upon the earth, nor shall i be the last, in due time another Buddha will arise in the world, a Holy One, a supremely enlightened one...an incomparable leader of men...He will reveal to you the same eternal truths which I have taught you." -Gautama; the Buddha
"I have much more to say to you, more than you can now bear. But when He, the Spirit of Truth, comes, He will guide you into all truth." John 16:12-13 (NIV)
"Do not think that i have come to abolish the Law or the Prophets...but to fulfill them." Matthew 5:17 (NIV)
"We believe in what hath been sent down to us [Qur'an] and hath been sent down to you [the Torah or the Gospel]. Our God and your God is one, and to His are we self-surrendered." - Mohammed; Qur'an 29:45
*"Come, come again, whoever, whatever you may be, come. Heathen, fire-worshipper, sinner of idolatry, come. Come even if you have broken your penitence a hundred times. Ours is not the portal of despair or misery, come." (Mevlana Celaleddin-i Rumi)*
*"In whatever way men approach me, in that way do I assist them; whatever the path taken by mankind, that path is mine." (Bhagavad-Gita, iv, 11).*
"Those who are confident of their faith are not threatened but enlarged by the different faiths of others." (Sir Jonathan Sacks, Chief Rabbi of the British Commonwealth)
*"My heart has become receptive of every form. It is a meadow for gazelles, a monastery for monks, an abode for idols, the Kaba of the pilgrim, the tables of the Torah, the Qur'an. My religion is love--wherever its camels turn, Love is my belief, my faith." (Muhyiddin Ibn `Arabi)*
“However innumerable sentient beings there are, I vow to save them. However inexhaustible the defilements are, I vow to extinguish them. However immeasurable the truth is, I vow to expound it. However incomparable enlightenment is, I vow to attain it!” (Bodhisattva Vow)
"The living spirit grows and even outgrows its earlier forms of expression... This living spirit is eternally renewed and pursues its goal in manifold and inconceivable ways throughout the history of humanity. Measured against it, the names and forms which have been given to it mean very little; they are only the changing blossoms on the stem of the eternal tree." (Carl Jung)
"I believe Christ is in all the cultures--Krishna in Hinduism, Zeus of the Greeks--in every age there has been a Christ-Consciousness. This is not necessarily the Jesus we Christians embrace, but Christ-Consciousness meaning the consciousness of a God who redeems and who is beneficent; who loves everything and everybody. He is not the sole property of any one religion." (Bishop Carlton Pearson) - Interview with Integral Yoga Magazine
“You, the Ultimate Reality, are All in All. Atheism confesses the ineffability of Your Essence. Polytheism personifies Your manifold Attributes. Monotheism witnesses the unity of Your Being. In every God-Ideal an emanation of You shines forth. The heart receives of You as much as it can contain. When the heart is supple it is capable of every form. Then Your manifestations surpass the limitations of belief.” (Pir Zia Inayat Khan)
*“The Absolute created the universe for the purpose of Delight. The Absolute, i.e. the Omnipresent Reality wished to extend its Delight of Being to objects. The Divine manifested a universe in division and duality to enable the greatest multiplicity and possibility of forms. The ultimate purpose in life is to discover the delight of being through our higher consciousness; thus fulfilling the purpose for which the Divine manifested a universe of forms; further diffusion and dissemination of the Original Delight into the universe.” (Sri Aurobindo)*
"Truth is one, the wise call it by different names." (Rig Veda)
"It is, therefore, an inadequate recognition of the unique station of Moses, Buddha, Zoroaster, Jesus, Muhammad—or of the succession of Avatars who inspired the Hindu scriptures—to depict their work as the founding of distinct religions.
Rather are they appreciated when acknowledged as the spiritual Educators of history,and the animating forces in the rise of the civilizations through which consciousness has flowered...what honors them is the soul's unconditioned surrender of its will to the transformative influence they mediate..."
One Common Faith, p 33-34 (Commissioned by the Universal House of Justice, 2005)
9Harmony, Jul 30, 2007
lunamoth Episcopalian
Are pagan religions, wicca, druidism, ancient Greek Gods etc. part of the one unfolding religion?
lunamoth, Jul 31, 2007
China Cat Sunflower Nimrod
What is the culmination of this one unfolding process? Is it that all religions merge into one meta religion, or is it that religion is discarded as a now unneeded vehicle?
China Cat Sunflower, Jul 31, 2007
Tao_Equus Interfaith Forums
9harmony: It's interesting to me, in that it shows how each was for the most part confined regionally. And from a Baha'i perspective this is due to the means available at the time to allow each to spread. And despite all obstacles, it also shows how God's Word has touched every part of the globe through one source or another.
The animation link calls itself Maps of War. You could say that the hypocrisy of the 'word' has infected every part of humanity with the disease of division and war.
Tao_Equus, Jul 31, 2007
lunamoth said: ↑
I believe they each have their place in the big picture.
China Cat Sunflower said: ↑
imho...it's the realization that there actually is only One God, once we arrive at that realization, wars in the name of religion would cease. As everyone would finally realize we are all on the same team.
Tao_Equus said: ↑
yes, it's interesting that that link is about religious wars...it's funny how people can look at the same thing and see things completely differently.
I wouldn't say that it's hypocrisy of the 'word', but the hypocrisy of the followers of the 'word' that are responsible.
But of course God knew that we would behave in this way, and ultimately God's Will will prevail.
wil UNeyeR1
I think it just nice to be part of the process.
I truly appreciate that.
wil, Jul 31, 2007
wil said: ↑
9Harmony, Aug 2, 2007
Postmaster New Member
I think this idea is very powerful. I don't have to worry about people doing things differently from me.
Postmaster, Aug 5, 2007
9Harmony said: ↑
What a great link 9Harmony. Puts it all into perspective a little.
Muslimwoman, Aug 12, 2007
fourgrtkidos New Member
I can't say it any better.
I am hoping this will happen soon. Maybe if we can start to see the Divine in a different light than the typecast images our individual religions imprint in our minds........
One can dreammmmm
fourgrtkidos, Oct 10, 2007
Here is a wonderful new online study guide for "One Common Faith", a publication commissioned by the Universal House of Justice in 2005.
Changeless Faith | Home
9Harmony, Nov 6, 2008
|
cc/2020-05/en_middle_0097.json.gz/line1407331
|
__label__cc
| 0.514599
| 0.485401
|
Find all available International Schools in Tokyo:
All languages English (40) French (2) Japanese (2) German (1)
IB and Catholic curriculums
Seisen International School
CurriculumsIB and Catholic
Yearly fees: from: ¥2,130,000
to: ¥2,270,000
Email the school admissions@seisen.com
Other Schools in Tokyo
Nishimachi International School
International curriculum, Ages 5 to 15
Yearly fees, ¥2,502,000
Deutsche Schule Tokyo Yokohama
German curriculum, Ages 3 to 18
Tamagawa Academy (K12) and University
IB curriculum, Ages 12 to 18
38 more schools in Tokyo
from: ¥2,130,000
School fees range in JPY valid for the academic year 2019/2020
Address: 12-15 Yoga 1-chome, Setagaya-ku, Tokyo 158-0097 Japan
Important notes about this school
The school provides education to girls only for Grades 1 to 12. Kindergarten is coeducational.
36% : 64%
Max. number of students per class
Kindergarten, Gr 1 and Gr 2 have teaching assistants.
Native English speaking teachers
Yes, we provide English as an Additional Language (EAL) classes.
French, Japanese & Spanish
Kg - Gr 12 all use technology in their classrooms. Kg and Elementary school have desktops and iPads in their classrooms. All Gr 6-12 students are required to bring their own laptops to school.
Do teachers assign homework to their students?
Yes, everyday
Approximate hours of homework given
Gr 9: 90 minutes, Gr 10: 100 minutes, Gr 11; 12: 120 minutes for IBS subjects; 180 minutes for IBH subjects
Yes, all students are required to wear the school uniform.
Yes, some students are wait listed since some grades are full.
Applicants must take an assessment test, followed by a family interview with the Principal.
English reading comprehension, English writing and math.
Deadline for registration (new academic year)
Re-registration for enrolled students is completed in late March / earlyApril.
Students can join after academic year begins
We accept new students throughout the academic school year.
Percentage of students who pursue further education post-graduation
100% of our graduates proceed to a higher educational institution after their graduation.
MAP, IGCSE, PSAT, SAT & IB exams
Results in these examinations
Well above world average.
Do students practice religion at the school? What religion?
Yes, we are a Catholic school and religion is part of the curriculum. All students have the opportunity to attend Catholic masses during the school year.
How does the school accommodate non-religious students or students of a different religion?
We are an international school so we welcome students of all religions and races. We offer Multifaith religion classes to the non-Christian students.
Yes. There are 11 school buses that we share with St. Mary's International school.
We have two Learning Support Specialists, one for K-gr 6 students and another for gr 7-12 students.
Our learning support specialists mainly provide remedial support to students who are falling behind in math or English.
We also have an outside speech therapist who works with our younger students once a week.
The school supports gifted, able and talented students
We do not provide specific support to such students, however from grade 8 we offer math at different levels and students are encouraged to challenge themselves through academic clubs.
Student access to education psychologist
No, but we have two counsellors, one for Kg and elementary and another for middle and high school. We also have an academic counsellor for high school students.
School begin at 8:30 for K-grade 6 students and for grade 7-12 students, school begins at 8:20.
School finish time
School finishes at 15:00 for Kg students and at 15:20 for grade 1-12 students.
Supervised care before/after school
We have after school activities for Kg-grade 6 students.
For grade 7-12 students, extra curricular activities can be in the morning or after school.
All activities are supervised.
Academic clubs: brain bowl, debate, math, MUN, Firebird (science club), speech
Experiential learning: car mechanics,cross stitching entrepreneurship, fashion design, horticulture, jazz band, journalism, library science, outreach robotics, video production well-being, writing center, yearbook
Fine art clubs: vocal ensembles, instrumental groups, show choir, drama
Sports: badminton, basketball, cross country, futsal, soccer, swimming, tennis, track & field, volleyball
Student Council & Coordinators
Yes, students can bring lunch from home or have school lunch.
Food alternatives for special dietary needs (ie. vegan, kosher, halal etc)
Music and dance for K-grade 3 students.
PE for K-grade 10 students.
We have an outdoor sports field and a gymnasium
Yes, we have sports teams and they compete against other international schools in the Kanto plain region, and in Far East tournaments.
Seisen, a Catholic international school educates future world citizens to become men and women for others and with others, in the spirit of Jesus Christ. Our guiding principles are based on the tradition of learning and service handed down from Saint Raphaela Mary, the founding member of the Handmaids of the Sacred Heart of Jesus.
Our guiding principles: educate women for social and cultural transformation, nurture faith development, shape international mindedness and celebrate international diversity, side with the poor, reach out to the world with hospitality and hope, act a leaven for worldwide community building, reverence creation and share all that we are and have.
Challenging students in their learning and inspiring them to live and act on the basis of their faith and values.
Seisen students are expected to be risk takers, collaborators, reflective inquirers, knowledgeable, compassionate, principled, leaders, global minded and religious.
Through the Montessori, PYP, MYP, IGCSE, and IBDP programs, students are provided opportunities to become active and independent learners. Our social justice service trips in the developing world offer transformative and on-going educational opportunities.
|
cc/2020-05/en_middle_0097.json.gz/line1407332
|
__label__wiki
| 0.670024
| 0.670024
|
Stolen Voices, Buried Secrets
Lethal Liaison
Season 2 • Episode 2
A San Diego family is in shock when their 22-year old daughter and her baby are found strangled in her apartment. The horrible nature of this crime makes investigators and the community wonder - what animal would kill a mom and her baby?
The Beefcake and The Beauty Queen
It’s love at first sight for a young New Jersey couple until jealousy and suspicion of infidelity lead to a string of bitter arguments after their wedding. The beautiful bride turns vicious when she stabs her husband and he nearly loses his life.
Wives with Knives
Fourth Time's A Charm
A New York City mother of four meets the man of her dreams until he starts using drugs and repeatedly abusing her. Just when she thinks he’s gotten rid of his demons, he brutally attacks her and in a fight for her life she stabs him to death.
The Scorned Socialite
A woman with several failed marriages thinks the fourth time’s the charm when she meets a suave, older man. He provides her with a lavish lifestyle but she soon accuses him of having an affair. When he asks for a divorce, she stabs him in the back.
Stripped to the Bone
A beautiful but misguided young woman becomes a stripper and ends up publicly tarnishing her reputation. The incident leads to a string of bad relationships until one night, she stabs her lover during a fight that turns physical and winds up in jail.
Pills, Poison and Payback
When teenage mother Sarah Saunders meets Tommy he seems too good to be true. But months into their relationship, he becomes controlling and she wants out. After trying to poison Tommy, she plunges a knife into his head but miraculously, he survives.
Lonely and Lethal
Lori McLuckie never felt like she fit in with society. She hoped to gain some self-confidence in a new city. She meets Andrew and thinks he's her soulmate, until he attacks her and her unborn child. She fights back by bludgeoning and stabbing him.
Dangerous Devotion
Jameelah is studying her way out of urban Baltimore. She falls for James, a drug dealer. Incarceration can’t separate them, and they get married. When reunited the relationship becomes volatile. Jameelah stabs James five times in a fit of rage.
Silent Secrets
It's love at first sight for Jonathan & Courtney who are both deaf. The honeymoon is short-lived when Courtney leaves him for her ex-husband. Jonathan turns to another woman. When Courtney finds out, a fight ends with Jonathan dead from a stab wound.
The Serial Playboy
Sherrse Gaines falls for first love, Greg. But when he cheats, she leaves him. Then she meets Steve who is unfaithful too. Sherrse takes him back but continues to play the field. Steve gets jealous and attacks Sherrse. She fights back with scissors.
Demons, Drugs and Darkness
Annette Hernandez is plagued by mental demons and addiction. After stabbing Cameron, she finds out she’s pregnant.They reunite but Annette can’t keep her demons at bay and the couple split. She starts dating but after a fight, Tony ends up dead.
Monica Fairview is a sugar daddy addict who dates men like Rob to keep her living in luxury. But Rob’s need for total control and Monica’s penchant for drama spins the couple into a physical quarrel that ends with Monica stabbing Rob in the back.
When a Biker Comes to Bible Study
Lydia Salce falls for her co-worker. But when she gets pregnant, she kicks him to the curb. She meets Michael and thinks he's the one. When she confronts him about his partying ways, she claims to defend herself by stabbing him repeatedly.
The Blues and the Blades Don't Mix
When Crystal Johnson believes her boyfriend is cheating on her, she stabs him with a kitchen knife. Crystal finds love again with another man but when she suspects he's also a cheater, he too ends up on the wrong side of her blade.
Love is a Gamble
Carol Singh immigrates to New York from Suriname hoping to live the American dream, which includes getting married. But when her jealous boyfriend Dave becomes increasingly violent, a fight with in the kitchen leaves Dave dead and Carol behind bars.
After a successful run as a cocaine smuggler in 1980's Fort Lauderdale, Donna Buchanan gets caught up with an older gentleman named Charlie. But Charlie, is an enabler and abuser. After years of misery, Donna snaps and stabs Charlie 54 times.
The Sexual Misfit
Krista Clark is a social misfit who's been shunned her entire life. She uses sex to win attention from men. She meets Tim and thinks she’s found it. But when that relationship unravels, Krista's frustration reaches a bloody breaking point.
|
cc/2020-05/en_middle_0097.json.gz/line1407333
|
__label__wiki
| 0.825751
| 0.825751
|
Ricardo S. Sanchez
Former United States Army Lieutenant General Ricardo S. Sanchez served as commander of coalition ground forces in Iraq from June 2003 to June 2004. When he retired on November 1, 2006, Sanchez was the highest-ranking Hispanic in the U.S. Army, culminating thirty-three years of military service. He now lives in his home state of Texas.
Ricardo S. Sánchez es teniente general retirado del Ejército de los Estados Unidos y sirvió como comandante de la coalición de tropas en Irak de junio de 2003 a junio de 2004. Era el hispano de mayor rango en la Armada cuando se retiró el 1ro de noviembre de 2006, culminando treinta y tres años al servicio del Ejército de los Estados Unidos. Actualmente, Sánchez vive en Texas.
Are you a Ricardo S. Sanchez fan?
Sign up now for Ricardo S. Sanchez alerts, including news and special offers.
Thank you for signing up to receive news about Ricardo S. Sanchez.
Thank you for your interest in Ricardo S. Sanchez!
*This is a promotional service of HarperCollins Publishers, 195 Broadway, New York, NY 10007, providing information about the products of HarperCollins and its affiliates. By submitting your email address, you understand that you will receive email communications from Bookperk and other HarperCollins services. You may unsubscribe from these email communications at any time. If you have any questions, please review our privacy policy or email us at [email protected]percollins.com.
Works by Ricardo S. Sanchez
Wiser in Battle
by Ricardo S. Sanchez
En tiempos de guerra
|
cc/2020-05/en_middle_0097.json.gz/line1407344
|
__label__wiki
| 0.692263
| 0.692263
|
Morinaga Milk to again consider business merger with snack-maker Morinaga & Co.
Kyodo
Online: Jul 16, 2019
Dairy producer Morinaga Milk Industry Co. is mulling setting up an advisory panel of outside experts with an eye toward exploring business integration with snack-maker Morinaga & Co., sources close to the matter said Tuesday.
The move came as a Singapore-based investment fund, a Morinaga Milk shareholder, demanded the company reconsider integrating their businesses after merger talks between the two Japanese companies with shared origins failed in March 2017 due to differing views on streamlining measures and management personnel.
Lone Alpha Capital Management Pte., established last summer, has a nearly 4 percent stake in Morinaga Milk and is likely to have also acquired a stake in the snack company, the sources said.
The introduction of an advisory panel, which will examine business strategies and give advice to the company’s board of directors, is among proposals made by the investment fund.
Though Morinaga Milk and Morinaga & Co. both have been posting solid earnings, their operations are heavily dependent on the domestic market, which is likely to dwindle due to Japan’s declining population.
A growth plan in documents with more than 100 pages compiled by the investment fund and presented to Morinaga Milk this spring criticized the company for scrapping the merger plan in 2017 which was evaluated highly by the market. A copy of the documents were obtained by Kyodo News.
It also pointed out that Morinaga & Co. is the best partner for Morinaga Milk, considering the synergies anticipated through the streamlining of domestic plants and logistics facilities as well as improvement of efficiency in research and development.
Morinaga Milk Industry was spun off from Morinaga & Co. in 1949. Morinaga & Co. is its leading shareholder with a stake of 10.6 percent as of March.
The investment fund refrained from commenting on the matter, while Morinaga Milk confirmed it had received the fund’s opinion.
“We are considering various options to improve our corporate value, but we will first consider strengthening our health and nutritional food business, functional ingredient businesses and overseas operations that are key areas of our growth strategy,” a Morinaga official said.
LATEST BUSINESS STORIES
What was once thought limited to the realm of animation is set to become reality in Yokohama this fall when an 18-meter mobile Gundam robot steps into action. Fans of the iconic anime ser...
Restaurant operator Skylark to end 24-hour operations by April
Major restaurant chain operator Skylark Holdings Co. said Monday it will end around-the-clock operations by April due to a labor shortage and falling demand for such services. The operat...
Mitsubishi Electric data likely compromised in massive cyberattack blamed on Chinese group
Mitsubishi Electric Corp. said Monday it was hit by a massive cyberattack and that information on government agencies and business partners may have been compromised, with a Chinese group believ...
Morinaga Milk Industry Co., morinaga & Co.
|
cc/2020-05/en_middle_0097.json.gz/line1407358
|
__label__wiki
| 0.672172
| 0.672172
|
tv-movie recaps.
TV-MOVIE RECAPS.
Power Season Finale Recap: St. Patrick’s Go Godfather And Attempt to Settle All Family Business
In last night’s season finale of Power, the St. Patrick family went scorched earth in an attempt to avenge Raina’s death and settle family business. You Can’t Fix This was emotional, engaging, and the St. Patrick’s will never be the same.
The episode opens in the aftermath of Raina’s murder at the hands of dirty undercover cop Ray Ray. At this point, only Tariq knows who committed the murder and he is consumed by guilt and ultimately vengeance. Tariq has become a master liar and uses his skills when questioned at the police station. The other set of footprints mentioned by the investigator belong to Ray Ray and Tariq needs to settle that score.
Tariq’s evolution as a character has been remarkable this season. In truth it has been happening ever since Shawn was killed but the curve really accelerated this year. For most of the season many of us wanted to see him get clipped for all the lying, disrespect, and overall sucker behavior. But Tariq is a new man now. Gone is the innocent kid from season one. His coming of age marred by tragedy, his parents’ fall from grace, and his indoctrination into “that life.”
Ghost and Tasha are faced with the worst horror imaginable, the death of their child. In the parking garage scene before entering their penthouse, we see a tremendous amount of emotion, and Omari Hardwick and Naturi Naughton acted brilliantly in this scene. Throughout the series’ run, the Hardwick and Lela Loren (Angela) on screen chemistry gets a lot of praise, and rightfully so. But, Hardwick and Naughton really have a special on screen dynamic, and because of who their characters are and what they’ve been through; it has a different level of richness.
Speaking of family bonds, nothing like tragedy to get the gang back together. One of the enduring themes of this series is the power of family. In the end, when everything is at its worse, and you have nowhere to turn family is all you got. For better or worse. This particular family is built on a criminal enterprise, which of course adds its own set of drama.
How dope was it to see Ghost and Tommy back together, dressed in all black everything, gun toting and laying waste to everyone in their path? Ghost’s initial thought that the Jimenez cartel was behind the hit was proven incorrect when he and Tommy used the nail gun to torture Uriel. Imagine getting literally nailed to a chair and then shot in the head?
Part of the problem with acting solely off assumptions and half-truths, particularly if you’re in a state of revenge, is the collateral damage. Uriel has nothing to do with Raina’s death but Ghost does find out he was behind killing Julio at the behest of Dre. Stick a pin in that storyline.
Meanwhile, back at the penthouse Tasha is holding down the fort while Ghost is out on the revenge tour. Their spot is filled with family members offering condolences, and Tasha’s new lover Terry Silver drops by. Nice of him to pay his respects but anybody see it as kind of disrespectful that he professes his love to Tasha the day after her daughter gets killed? Silver does say as much, so I guess we can’t be too hard on him. Love won’t be denied and all that.
It was interesting watching the Terry and Tasha scene, specifically when he asked her if she knows anything. Terry knows Ghost is a criminal, and I’ve always thought he’s suspected Tasha had some level of involvement. He finds out later in the episode when Tasha choses protecting Tariq instead of being his lover.
Ghost takes a brief stop on his killing spree to make “funeral arrangements” and meets up with Councilman Tate and the charlatan church minister. You all saw the shakedown coming right? Tate may not be a criminal in the most literal sense but he is a shady dude. Using Raina’s death as an opportunity to create a media narrative is foul. Tate also seems adept at pulling the moral high ground card on Ghost, telling him innocent men’s daughters sleep safely in their beds at night. That moment with Tate and the minister registered in Ghost’s subconscious. The death of his daughter obviously means he will never be the same, but it also means the past will never escape him. The dream he once had of going legit is dead and maybe for the first time he truly believes that.
When Tommy learns the identity of Raina’s killer from Kanan and informs Tasha who the intended target was, she goes into full mama bear mode. I’ve always enjoyed the way Power frames these moments. The eerie music in the background and all the machinations going through her head was tremendous. The sequence of finding out the news, asking the assembled guests if they’ve seen Tariq, the realization he went to the office and the search for the gun was brilliant. Then calling Ghost only to realize his cell is in the desk. Tasha will go to the ends of the earth to protect her son, and she does, enlisting the help of an unlikely ally.
Angela is now the head of the eastern district’s criminal division and that means trouble for the St. Patrick clan. Maybe not in the short term, but in the long run it will be problematic. Angela helps Tasha locate Tariq because he’s Ghost’s son. Despite their complicated relationship Angela still loves Ghost and will do just about anything to help him. She warns Ghost at the beginning of the episode not to do anything to jeopardize his future and she tells Tasha the same thing when she asks for help in locating Traiq.
The moral predicament that the series places Angela in is interesting. She knows Ghost’s family and wants to help, but she is an assistant United States attorney. Her mission is to uphold justice and prosecute offenders of the law. Angela, like most of the characters in the series, lives in a gray world. There is a clear right and wrong, but life isn’t lived in black and white. The choices made have consequences, and actions that seem right in the moment often have unintended negative repercussions.
The episode builds toward a pivotal moment in Washington Heights, a neighborhood in upper Manhattan. Tariq is on a mission to kill Ray Ray; Ghost is on his way to do the same, when he sees his son entering the building. Tommy and Tasha arrive on the scene as well. This was one of the most powerful moments in the show’s four-year run. Tariq gets the revenge he sought and killed Ray Ray.
In this moment Tariq sees the family unit in a way he knew was there but is now undeniable. He knows what his father and Tommy are going to do with the body; he knows they are escaping law enforcement. The moment it all comes together is when Tariq and Tasha are back at the apartment and they stop in the basement to burn his clothes (evidence) in the furnace. Tasha then gives him explicit instructions on how to scrub himself from all the residue linking him to the murder. This was such a powerful moment for mother and son. We may not have liked Tariq for much of the season, but dude is a man now.
One of the things I enjoy about the way Courtney Kemp manages the series, is the subtle winks and smiles she has with the audience. She senses when “we need a win” and she gave it to us at the end of the episode. The sight of Ghost, Kanan and Tommy in the car together plotting their takedown of Dre was perfect. An excellent way to end the episode and set us up for what is to come in season 5.
This episode was tremendous, the perfect way to end the season and leave the audience with anticipation for what’s to come. Obviously the major plot point will be the triumvirate (Ghost, Kanan, and Tommy) trying to take down Dre. What a meteoric rise for Dre this season. He is the new super bad on the show. Now that he is in with the Jimenez cartel and has a solid group of primeras, taking him down won’t be so easy.
When the authorities begin to investigate the death of Ray Ray, what evidence will they find? The only bullets fired were from Tasha’s gun. Will the ballistics match to anything? Angela suspects Ghost is responsible. Will she start a crusade to bring him down or is she barking up the wrong tree? If she finds out it was Tariq, what does she do? Maria is back and is telling tales about Ghost killing Miguel Alvarez all the way back in the pilot episode, how will that play out? For now, Ghost, Kanan and Tommy are aligned, with the introduction of Tommy’s Italian connections, how long before things start getting muddled?
A few extra thoughts:
Angela to the eastern district team: “Under my leadership we will become a paragon of criminal interdiction.” Buttoned up, boss Angela is back.
Saxe to Angela: “The teenage daughters of legit businessmen don’t get gunned down in cold blood outside a Sadie Hawkins dance.” Do they even have Sadie Hawkins dances anymore?
Saxe: “This is evidence of criminal involvement. You ignore it; it’s your funeral. Well, the little girl’s really.” Angela: “Get out.” Saxe: “Too soon?” Angela: “Now!” Saxe has some of the best one-liners on the show. He’s that smug asshole co-worker we all know. Well, unless you’re that co-worker. LOL.
Kanan to Tommy: “Ya’ll still beefin’? Might want to get a marriage counselor or something.”
NYC note. As you know, I love pointing this stuff out. The St. Patrick’s live in the West Village. One of the best and most expensive neighborhoods in the city, their address is 222 Perry Street. Not an actual physical address. The building numbers don’t get that high. 222 would essentially be in the Hudson River. The building we have seen for years as the exterior of the St. Patrick’s penthouse is in fact the 32-story Milan condominium on the east side, 300 E. 55th to be exact. If there are any fans of the CW teen drama Gossip Girl, you’ll know that’s also the exterior of Serena Van Der Woodsen’s family home as well.
Father Callahan: “It’s God’s will.” Tommy: “Fuck God’s will. If I wasn’t high on the shit this never would’ve happened.” Callahan: “Well, I can’t absolve you from snorting your own product.” Love the image of Tommy knowing he’s about to do dirt, and done dirt, in confessional. It’s a proven trope in pop culture, but most murderous villains have some affinity for the church/religion.
Did Tasha curve Terry when he said I can either be your lover or your lawyer?
Damn, I hope we see a lot more of Alicia Jimenez next season.
What do ya’ll think? Get at me on twitter @jshector Please share with your friends and people you think would enjoy the show.
This will obviously be the last recap until next season begins. I want to thank all of you for riding with me this season. Recapping this show is a labor of love and I do this for the people. Keep reading BSO and following me for unique content in sports, entertainment and pop culture.
|
cc/2020-05/en_middle_0097.json.gz/line1407359
|
__label__cc
| 0.70397
| 0.29603
|
Language:تحديد لغة:
Call us:+968 24 696452
اتصل بنا:+968 24 696452
Guide To study Abroad
6 reasons to choose IDP
Why Choose IDP?
Project Management Courses
Fashion Design Courses
Data analysis Courses
Artificial Intelligence Courses
The IELTS Test
IELTS Support
IELTS Muscat
IELTS UKVI Muscat
Developing your soft skills
Find Internship Abroad
University of Massachusetts - Amherst
About University of Massachusetts - Amherst
UMass Amherst is one of the major public research universities in America. Nestled in idyllic Amherst, Massachusetts, the campus is consistently ranked among the top public research universities in the nation, and offers a rich cultural environment in a rural setting close to major urban centers.
UMass Amherst, the Commonwealth's flagship campus, offers a full range of undergraduate, graduate and professional degrees. With over 100 major subject areas leading to bachelor's degrees, 77 master’s and 48 doctoral programs, UMass Amherst offers a vast array of educational opportunities for full and part-time students, both on and off-campus. Interdisciplinary majors, online learning, the Five College Interchange and internships and international study add to the opportunities.
Student Affairs and Campus Life are a nationally-recognized team of student affairs educators dedicated to excellence, innovation, and social justice. The university work with campus and community partners to support successful educational experiences both in and out of the classroom. Through its programs and services, students have the opportunity to explore their interests through a wide array of events and activities, connect with a diverse community of students, staff, and faculty, and be challenged to actively engage in building skills to preparing students to become strong and successful in the world beyond college.
Student Engagement & Leadership cultivates student learning by providing opportunities for leadership, recreation, connection and engagement in and beyond UMass. These opportunities promote a sense of pride, empowering students to take ownership of their UMass experience in accordance with their values and beliefs. Involvement is hands-on, whether it is running a meeting, playing a sport, planning an event, or attending a political rally. Student Engagement & Leadership is fueled by student energy. By participating in one of hundreds of student groups, students will increase their organizational and team building skills while enjoying opportunities for friendship, leadership, and community service.
UMass Amherst, located in Amherst, Massachusetts, sits on nearly 1,450-acres in the scenic Pioneer Valley of Western Massachusetts, 90 miles from Boston and 175 miles from New York City. The campus provides a rich cultural environment in a rural setting close to major urban centers.
IELTS is accepted at University of Massachusetts - Amherst
Member of New England Association of School and Colleges
42.38676, -72.53005 300 Massachusetts Avenue,Amherst,Massachusetts,01003 United States
Address: 300 Massachusetts Avenue, Amherst, Massachusetts, 01003 United States
Amherst Massachusetts 300 Massachusetts Avenue
UMass Amherst, located in Amherst, Massachusetts, sits on nearly 1,450-acres in the scenic Pioneer Valley of Western Massachusetts, 90 miles from Boston and 175 miles from New York City. The campus provides a rich cultural environment in a rural setting close to major urban centers. https://images1.content-gbl.com/commimg/myhotcourses/institution/profile/myhc_244069_320px.jpg University of Massachusetts - Amherst https://www.idp.com/oman/universities/university-of-massachusetts-amherst/iid-us-00142/
Find more about IELTS
Speak to IDP counsellor
Mechanical Engineering courses
Sales And Marketing Courses
Australia student visa requirements
Canada student visa requirements
UK student visa requirements
New Zealand student visa requirements
US student visa requirements
Ireland student visa requirements
SIGN IN CALL NOW ENQUIRE
|
cc/2020-05/en_middle_0097.json.gz/line1407368
|
__label__wiki
| 0.549951
| 0.549951
|
Session #
Day, Date, Time, Location
Ill and idle: Exploring the nexus between functional disengagement and mental illness in adolescents and young adults
American Ballroom - North
Discovering New Brain Circuits in Early Psychosis
American Ballroom - Center
Challenges and Opportunities in Quality of Care in Early Psychosis: Improving Outcomes at the System Level and Patient Level
American Ballroom - South
Identifying patient sub-groups with specific needs within early intervention programs: developing personalized intervention on the basis of data stemming from clinical programs around the world.
Treatment for Youth at Clinical High Risk for Psychosis: What next?
From Static to Dynamic Models of the Onset of Mental Disorder
Findings on Strategies for Reducing the Duration of Untreated Psychosis in the United States
Early Intervention in Bipolar Disorder
Youth at Risk for Serious Mental illness: The Canadian Psychiatric Risk and Outcome Study (PROCAN)
Career Development: Key for Recovery in Young People with First Episode Psychosis But Can an Integrated IPS Model of Supported Education and Employment Work?
How can we prevent psychosis? An examination of primary vs secondary approaches to prevention
Trauma and psychosis: What we know and how to move forward
Specialized early intervention services and duration of untreated psychosis – is there an interaction?
Computer-aided diagnostic and prognostic tools in the early recognition of psychosis: findings from the multi-site European PRONIA study
Electrophysiological markers of psychosis risk and conversion: A view from the North American Prodrome Longitudinal Study (NAPLS 2)
Cultural Influences on Care for First Episode Psychosis in Yogyakarta, Indonesia
International application of fidelity scales for first episode psychosis services
Implementation and integration of digital therapies in secondary care mental health services
New Directions for Cognitive Remediation in Early Psychosis
Using Serious Games and Virtual Reality to prevent and treat mental health problems in young people
Youth/Peer Participation and Leadership in Early Intervention Services & Research: Towards the Future
Mission Creep: Will widening the range of ages and diagnoses in Early Intervention in Psychosis teams, without new resources, undermine their mission and dilute their methods, intensity and outcomes to the point of no difference?
Active and Passive Data from Daily Life: Applications at Different Levels of Analysis for Prediction and Early Intervention
The need of effective interventions for first episode psychosis in adolescents and young adults
Comprehensive coordinated care programs in Asia and Brazil: Short-term outcome results
The Neurobiology of Conversion to Psychosis – Emerging Findings from the SHARP Study
The relationship between relapse and medication discontinuation on long-term outcome in first episode psychosis
Transdiagnostic approaches to distinguishing between various stages and types of psychopathology in adolescents
Symposium Session 1
Monday, October 8, 1:00 - 2:30 pm, American Ballroom - North
Chair: Srividya Iyer, McGill University
Speakers: Sloan Huckabee, Colm Healy, Joanna Henderson, Srividya Iyer
Though the vulnerabilities and disadvantages of youths not in employment, education or training (NEET) are widely acknowledged, little mental health research has focused on the conditions that precede youths disengaging from school or work; how and to what extent such disengagement intersects with mental illness; and how early functional disengagement impacts overall outcomes. This symposium addresses these knowledge gaps. Sloan describes the post-secondary outcomes of young adults with emotional and behavioral disorders. Using data from an American longitudinal epidemiological study, she illustrates the interplay of sociodemography, diagnoses and outcomes in youths who had psychiatric disorders by age 16. Healy presents an Irish community-based investigation of the effects of childhood psychotic experiences on global functioning. Compared to children who reported no psychotic experiences, those who did had poorer functioning that persisted into early adulthood. Notably, their underlying global vulnerability extended beyond diagnosable disorders. Henderson shows that NEET youths presenting at Canadian clinical and non-clinical services were likelier to have concurrent mental health and substance use concerns, legal troubles and crime/violence problems; be in unstable housing situations; and need welfare aid. Iyer paints a picture of NEET youths at a Canadian early psychosis program having longer prodromes characterised by unrelenting illness and plummeting premorbid adjustment. This, along with longer durations of untreated psychosis, suggests that NEET youths follow a distinct trajectory of clinical and functional decline. Finally, Cannon (discussant) will situate these findings within what is currently known about youth mental illness and functioning, and highlight their services, research and policy implications.
Talk 1 Young adult outcomes for youth with emotional and behavioral disorders with impairment by the age of 16 years
Sloan Huckabee1, William E Copeland2, Maryann Davis3; 1Transitions to Adulthood Research Center, University of Massachusetts Medical School, 2Psychiatry and Behavioral Sciences, Duke University Medical Center, 3Department of Psychiatry, University of Massachusetts Medical School
The poor post-secondary outcomes reported for students with emotional and behavioral disorders (EBDs) have included high rates of school dropout and low rates of participation in post-secondary education and post-school employment. While some studies have used longitudinal datasets to examine this group’s outcomes in youth, several questions remain. To address these, we analyzed a subset of data (collected at the 26-year mark) from the Great Smoky Mountains Study of Youth (GSMS). GSMS is an ongoing longitudinal epidemiological study of the development, need for, and use of mental health services in children in North Carolina. We calculated the sociodemographic characteristics of youths without psychiatric disorders who had emotional disturbances, behavioral disturbances, or both emotional and behavioral disturbances. We also examined the young adult outcomes of individuals identified with psychiatric disorders by age 16. The subgroup identified as having EBDs by age 16 (27.5% of GSMS participants) was broken down by type of disorder. In line with previous studies, more males than females had EBDs by 16. Low socioeconomic status, having a step parent, coming from a single-parent family and spending time in foster care were significantly related to EBD occurrence, with the latter two being particularly strong influences. There were statistically significant differences between youths with and without EBDs by age 16 in high school completion rates, working less than part-time hours, not contributing to rent and being poor at age 26. We also noted sociodemographic and outcome differences based on disorder types. These observations and their implications will be discussed.
Talk 2 Childhood psychotic experiences are associated with persistently poorer global functioning throughout adolescence and into early adulthood
Colm Healy1, Donal Campbell1, Mary Clarke1, Ian Kelleher1, Mary Cannon1; 1Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Psychotic experiences (PEs) are commonly reported in childhood and have been associated with mental disorder and poorer global functioning. While it is understood that individuals who report PE in childhood appear susceptible to future mental disorder, little is known about the effects of childhood PEs on future functioning. We investigated the effects of childhood PEs on global functioning from childhood into early adulthood. 52 participants from a community sample completed all three waves of the ‘Adolescent Brain Development’ study (T1x̄Age:11.69, T2x̄Age:15.80 T3x̄Age:18.80). At each phases, participants completed a clinical interview assessing PEs, mental disorder and global function. Fixed-effects repeated measures models, adjusting for mental disorder and gender were used to investigate differences in current (C-GAF) and most sever past (MSP-GAF) global functioning between those with and without childhood PEs. The analyses revealed that those with history of PEs had significantly poorer C-GAF scores (p<.001) and MSP-GAF scores (p<.001) than controls. Simple-effects analysis indicated that poorer functioning was evident during childhood (C-GAF: p=.002; and MSP-GAF: p<.001), adolescence (C-GAF: p<.001; and MSP-GAF: p=.011) and early adulthood (C-GAF: p=.002; and MSP-GAF: p=.095). There was no significant effect of time or interaction. The results demonstrate that children who report PEs have persistently poorer functioning and this is evident up to at-least early adulthood. The long-term association between childhood PEs and global functioning highlights the underlying global ‘vulnerability’ in children reporting PEs which extends beyond diagnosable mental disorder. Children who report PEs should be monitored closely throughout adolescence and young adulthood.
Talk 3 Disengagement from employment, education and training in a multi-sectoral sample of service-seeking Canadian youth: Mental health and substance use profiles
Joanna Henderson1,2, Lisa D. Hawke1,2, Gloria Chaim1,2; 1Centre for Addiction and Mental Health, 2University of Toronto, Department of Psychiatry
Background. Youth who are not engaged in employment, education or training (NEET) are vulnerable to a diversity of health, economic and psychosocial challenges. While the NEET metric is widely used internationally, there is a lack of research describing Canadian NEET youth. Objective. This study explored the characteristics of NEET youth in a cross-sectoral sample of service-seeking youth in Canada, across clinical and non-clinical service sectors. Aspects examined included the proportion of NEET youth, their mental health and addictions concerns, gender differences, and other factors distinguishing them from their non-NEET peers. Method. A total of 2,576 youth were assessed using the GAIN-Short Screener and a sociodemographic information form. Results. Among youth seeking services across a diversity of sectors, 26.8% were NEET. NEET youth demonstrated a greater risk of unstable housing situations, more legal system involvement, and more reliance on government financial assistance. They were also more likely to endorse crime/violence problems, substance use problems, and concurrent mental health and substance use concerns than their non-NEET counterparts. Gender-based differences were also observed. Discussion. Since many youth presenting for services across both clinical and non-clinical sectors are NEET, youth-serving agencies within and outside of the mental health and addictions sectors should be prepared to offer a wide range of services to address their diverse needs. Further research should examine interventions and integrated models of care to address the youth’s mental health and addictions needs, their lack of engagement in employment, education and training, and their other diverse areas of need.
Talk 4 A NEET distinction: Youths not in employment, education or training follow different pathways to illness and care in psychosis
Srividya Iyer1,2,3, Sally Mustafa3, Jai Shah1,2,3, Ridha Joober1,2,3, Martin Lepage1,3, Ashok Malla1,2,3; 1Department of Psychiatry, McGill University, 2ACCESS Open Minds/Esprits ouverts, Douglas Mental Health University Institute, 3Prevention and Early Intervention Program for Psychosis (PEPP-Montreal)
Among youths presenting at specialised early intervention (SEI) services for psychosis, those Not in Employment, Education or Training (NEET) may have experienced longer periods of functional decline and mental health problems. They may also have difficulties accessing SEIs due to disadvantages associated with being NEET. These issues have not been investigated in first-episode psychosis. Our aims were therefore to document the prevalence of NEET status in a first-episode psychosis sample, and to investigate baseline differences between NEET and non-NEET groups in terms of demographics, symptomatology, pre-psychosis illness course and treatment delays. Data for 416 youths entering a catchment-based Canadian SEI service were analysed. NEET and non-NEET groups were compared on demographics (e.g. gender); symptomatology (e.g., negative symptoms); pre-psychosis course (i.e., premorbid adjustment, prodrome); and duration of untreated psychosis (DUP). NEET individuals (39% of sample) were likelier to be male, have schizophrenia-spectrum psychosis and have higher negative symptom scores than non-NEET individuals. They had longer prodromes and were likelier to remain ill after the first psychiatric change, until the onset of psychosis. Although both groups had similar premorbid adjustment earlier, the NEET group’s adjustment dropped in late adolescence. NEET youths had longer DUPs despite making more help-seeking attempts. In conclusion, NEET status was thrice as prevalent in our sample as in the Canadian populace. The NEET group followed a distinct trajectory of persistent symptoms and functional decline towards an eventual intersection of psychosis and NEET status. The systemic delays that NEET youths encounter indicate a need for better-targeted early identification efforts
Question and Answer Period
Discussant: Mary Cannon, Department of Psychiatry, Royal College of Surgeons in Ireland
Monday, October 8, 1:00 - 2:30 pm, American Ballroom - Center
Chair: Alan Breier, Department of Psychiatry, Indiana University School of Medicine, Indiana Psychotic Disorders Program, Prevention and Recovery Center for Early Psychosis
Speakers: Anil Malohtra, Dost Ongur, Tom Hummer, René Kahn
Disruptions in brain circuits is a primary process that appears to underlie the pathophysiology of psychotic disorders. Recent developments in connectome imaging provide powerful tools to interrogate the functional and structural integrity of circuits that exist both within and between brain networks. New information from connectome imaging has promise for elucidating new circuits, treatment approaches and genetic risk for early psychosis. This symposium will focus on new functional and structural brain circuit findings in early psychosis. Anil Malhotra will present resting state (rsfMRI) and structural data from two cohorts of first episode schizophrenia patients participating in double blind clinical trials involving the second generation antipsychotics (SGAs) aripiprazole and risperidone to identify neuroimaging predictors of treatment response. Dost Unger will focus on rsfMRI data and compare within and between network connectivity in early stage bipolar and schizophrenia. Tom Hummer will distinguish brain circuit characteristics of functional connectivity within and between distinct brain networks in patients with early-phase psychosis. Rene Kahn will examine genetic predisposition by assessing connectome organization in children at familial high risk for bipolar and schizophrenia. Together, these presentations will further illuminate the altered brain organization responsible for early psychosis.
Talk 1 Detection and Replication of Neuroimaging Biomarkers of Treatment Response in First Episode Schizophrenia
Anil Malohtra1, Philipp Homan1, Deepak Sarpal2, Miklos Argyelan1, Lauren Hanna1, Jaun Gallego3, Philip Szeszko4, Todd Lencz1, Delbert Robinson1; 1Zucker School of Medicine at Hofstra/Northwell, 2University of Pittsburgh, 3Weill Cornell Medical College, 4Icahn School of Medicine
The first episode of psychosis may be the most critical period in the life of an individual with schizophrenia, and remains the most opportune time for the study of key mechanisms that influence treatment response and outcome. We have assessed two cohorts of first episode schizophrenia patients participating in double blind clinical trials involving the second generation antipsychotics (SGAs) aripiprazole and risperidone to identify neuroimaging predictors of treatment response. For our analyses, we utilized 1) seed-based rs-fMRI analysis to examine the relationship between pretreatment functional connectivity and response to SGA treatment and 2) hierarchical linear modeling (HLM) to model individual symptom trajectories and tested for a relationship between parahippocampal thickness and treatment response. In our first analysis, a striatal connectivity index was established as a predictor of SGA treatment response in first episode patients (n=41) and replicated in a second sample (n=40). The HLM work yielded a model in which parahippocampal thickness successfully predicted response to SGA treatment in first episode patients (n=37) as well as in an independent replication data set of first episode patients treated with risperidone (n=33). As both resting state MRI measures and measures of cortical thickness significantly predicted antipsychotic drug response in discovery data sets, as well as in two independent replication cohorts, these data suggest that identification of biomarkers of antipsychotic drug response is feasible in first episode patient populations. Next steps will include combining modalities to more robustly predict response to help develop more effective intervention strategies for first episode psychosis.
Talk 2 Resting State Functional MRI Studies of Early Psychosis
Dost Ongur1; 1McLean Hospital, Harvard Medical School
Brain connectivity abnormalities have been reported in individuals with psychotic disorders both in first episode and chronic illness. But it is not clear how these abnormalities emerge and progress and how they relate to symptom formation. To address these questions, our group has been collecting resting state functional MRI (rsfMRI) data on a 3 Tesla Siemens Trio scanner from patients with first episode psychosis at McLean Hospital’s early psychosis clinic McLean OnTrack as well as from matched healthy comparison subjects. Participants are men and women between the ages of 18 and 30. We recruit patients with bipolar disorder with psychosis, schizoaffective disorder, and schizophrenia and assess them clinically and with cognitive testing at each visit. Most patients in our studies are receiving antipsychotic medications. All are scanned at baseline and at 1 and 2 years follow up. To date, we have scanned over 50 patients at baseline as well as over 30 healthy controls. 30 patients have returned for 1 year and 15 for 2 year scans. Initial analyses indicate that first episode patients show the same reduction of connectivity in the frontoparietal control network we previously reported in chronic psychosis (Baker et al JAMA Psychiatry 2014). The pattern is similar in individuals with schizophrenia and bipolar disorder. We observe a significant correlation between mania severity and reduced connectivity within the ventral attention network. In ongoing analyses, we are conducting sliding window analyses and single-subject based cortical parcellation.
Talk 3 Abnormal Functional Network Connectivity in Early Phase Psychosis
Tom Hummer1,2, Matthew Yung1,2, Joaquin Goni3, Michael Francis1,2, Susan Conroy1,2, Nikki Mehdiyoun1,2, Alan Breier1,2; 1Department of Psychiatry, Indiana University School of Medicine, 2Indiana University Psychotic Disorders Program, 3Purdue University
Characterizing dysconnectivity in psychosis patients can be advanced by understanding the interactions of functional networks. This investigation aims to distinguish network characteristics of functional connectivity in patients with early-phase psychosis (EPP) both within and between distinct brain networks. EPP subjects (n=56, within four years of treatment initiation) and matched controls (n=32) underwent resting-state fMRI. Time-series data underwent advanced processing and scrubbing methods to minimize noise. For each subject, gray matter was segmented into 278 regions, and organized into nine distinct a priori networks: visual, somatomotor, dorsal attention, ventral attention, limbic, frontoparietal, default mode, subcortical, and cerebellum networks. Network connectivity properties were defined by the mean and variance of correlations of all regions within the same network (e.g. visual-visual) and between distinct networks (e.g. visual-limbic). Connectome measures, including global efficiency and within-module z-scores, were also calculated. Global efficiency was higher in the control group, reflecting consistently stronger connectivity. The control group had higher connectivity between limbic and default mode networks and multiple other networks, but no within-network connectivity differences were found. The variance of between-network connections was generally higher in patients, particularly for connections with ventral attention network regions. In addition, patients with longer illness duration had greater variability in their network connectivity patterns. Thus, lower functional connectivity in EPP, relative to controls, was largely present between distinct networks, suggesting poor inter-network communication. Higher variance of between-network connectivity in patients suggests disorganized communication patterns that align inconsistently with typical functional networks, disruptions that may increase as the disorder progresses.
Talk 4 The Connectome in Young Offspring of Patients with Schizophrenia and Bipolar Disorder
René Kahn1,2, Guusje Collin1, Lianne Scholtens1, Manon Hillegers1,3, Martijn van den Heuvel1; 1UMC Utrecht, 2Icahn School of Medicine, 3Erasmus MC
Background: Emerging evidence suggests disruptions in the wiring organization of the brain’s network in schizophrenia and bipolar disorder. As the importance of genetic predisposition has been firmly established in these illnesses, children (offspring) of patients constitute an at-risk population. This study examines connectome organization in children at familial high risk for psychosis. Methods: Diffusion-weighted MRI scans were collected from 127 non-psychotic offspring, aged 8 to 18 years (13.5 years on average), of a parent diagnosed with schizophrenia (SZ-offspring; N = 28) or bipolar disorder (BD-offspring; N = 60), and community controls (N = 39). Resting-state fMRI scans were available for 82 subjects. Anatomical and functional brain networks were reconstructed and examined using graph theoretical analysis. Results: SZ-offspring were found to show connectivity deficits of the brain’s central rich club system relative to both controls and BD-offspring. The disruption in anatomical rich club connectivity in SZ-offspring was associated with increased modularity of the functional connectome. In addition, increased coupling between structural and functional connectivity (SC-FC coupling) of long-distance connections was observed in both SZ- and BD-offspring. Conclusions: This study shows lower levels of anatomical rich club connectivity in non-psychotic young offspring of schizophrenia patients. This finding suggests that the brain’s anatomical rich club system is affected in at-risk youths, reflecting a connectome signature of familial risk for psychotic illness. Moreover, finding no rich club deficits in offspring of bipolar disorder patients suggest a differential effect of genetic predisposition for schizophrenia versus bipolar disorder on the developmental formation of the connectome
Discussant: Martha Shenton, Departments of Psychiatry and Radiology, Brigham & Women's Hospital, Harvard Medical School
Monday, October 8, 1:00 - 2:30 pm, American Ballroom - South
Chair: Aristotle Voineskos, Centre for Addiction and Mental Health, University of Toronto
Speakers: Michael Birnbaum, Nicole Kozloff, George Foussias, Philip Tibbo
Research evidence continues to point to the need for accessible, comprehensive care for young people with psychotic disorders in order to improve their long-term trajectories. In this 90-minute symposium, we review challenges and opportunities to improve quality at various points along pathways to care for youth with psychosis. Michael Birnbaum will present on the role of the internet and social media in early identification, outreach, and engagement of youth and families in psychosis treatment. Nicole Kozloff will present on the care youth with psychosis receive following a first presentation to the emergency department, exploring factors associated with access to timely follow-up. George Foussias will present on implementation and outcomes of standardized, measurement-based care protocols in a large early psychosis intervention program, including a qualitative exploration of youth and family experiences of this style of care. Phil Tibbo will present on the development of order sets for treating early phase psychosis at the national level and their implementation. Each presenter will allow a few minutes for audience questions. Finally, John Kane, an expert in researching and implementing comprehensive care for first episode psychosis, will facilitate a group discussion on how the presentations can guide patient-, program- and system-level improvements to increase the reach and effectiveness of early psychosis intervention.
Talk 1 Factors Influencing the Duration of Untreated Psychosis: Patient and Family Perspectives
Michael Birnbaum1,2,3, Asra Rizvi1,2,3, Keren Faber1,2,3, Aristotle Voineskos4,5, John Kane1,2,3; 1The Zucker Hillside Hospital, 2The Zucker School of Medicine at Hofstra/Northwell, 3The Feinstein Institute for Medical Research, 4Centre for Addiction and Mental Health, 5University of Toronto
The emphasis on reducing the duration of untreated psychosis has highlighted the complex barriers to expeditiously accessing appropriate services. The internet and social media may prove to be critical resources for expediting help-seeking and facilitating treatment initiation in prospective patients and families with first-episode psychosis. 269 participants between the ages of 15-35 were interviewed with the Pathways to Care for Psychosis Questionnaire designed to retrospectively explore trajectories to care emphasizing online resources used to obtain information about emerging psychiatric symptoms and inform the decision to seek care. Ninety-four percent (n=253) use social media regularly and spend approximately 2 hours online daily. Social media use predates illness onset and continues throughout illness emergence. The Internet was the most used resource for information gathering while symptoms were emerging. A minority (22.9%) shared their concerns over social media. Seventy-nine percent state that they would like to receive mental health help via the internet and social media. Internet based resources are part of daily life for youth with first-episode psychosis. Information gathered online plays a role in help-seeking and may represent a proactive step towards treatment initiation. Online activity continues throughout the duration of untreated psychosis offering the prospect for earlier intervention. Youth with and without mental illness express positive attitudes towards novel internet and social media based outreach and engagement efforts.
Talk 2 Care for Youth with Psychosis following Acute Presentation: A Population-Level Study
Nicole Kozloff1,2, Binu Jacob1,3, Aristotle Voineskos1,2, Paul Kurdyak1,2,3, Nicole Kozloff; 1Centre for Addiction and Mental Health, 2University of Toronto, 3Institute of Clinical and Evaluative Sciences
Given the importance of reducing barriers to treatment for young people with psychosis, we review recent population-level data on access to care and present findings on care received by youth first presenting to acute services for psychotic disorders. We identified youth aged 16-24 across Ontario, Canada with a first emergency department (ED) presentation for psychotic disorder between 2010 and 2013. Following discharge from the ED, we examined psychiatrist visits, mental health-related primary care visits, ED revisits, and psychiatric admissions over 1 year. We modelled time to outpatient psychiatry visit using Kaplan-Meier curves and predictors of care within 30 days and 1 year using Cox proportional hazard regression. 2875 youth had a first presentation to the ED over the study period and 812 (28.2%) were discharged to the community. Among discharges, 325 (40.0%) received no outpatient mental healthcare within 30 days; factors associated with psychiatric aftercare included neighbourhood income (highest vs. lowest income, HR = 1.48, 95% CI 1.05-2.09), rural residence (HR = 0.46, 95% CI 0.31-0.70), and recent mental healthcare (outpatient psychiatrist visit: HR = 1.89, 95% CI 1.50-2.37; psychiatric admission: HR = 0.71, 95% CI 0.52-0.98). One year following first ED visit for psychosis, 105 (12.9%) youth still had not received any outpatient mental healthcare, 416 (51.2%) had returned to the ED and 334 (41.1%) had a psychiatric admission. Many youth first presenting with psychotic disorders to acute services do not receive timely mental health follow-up. These findings may guide improvements in pathways to care for youth with psychosis.
Talk 3 Standardized Measurement Based Care in Early Psychosis: Effects on Care in Hospital, Service Utilization, and Engagement
George Foussias1,2, Juveria Zaheer1,2, Janaki Joshi1, Steve Hawley1, Rebecca Metcalfe1, Dielle Miranda1, Crystal Baluyut1,2, Saima Aiwan1, Aristotle Voineskos1,2; 1Centre for Addiction and Mental Health, 2University of Toronto
Consistent delivery of comprehensive early psychosis intervention (EPI) in real-world clinical services remains a challenge despite established EPI practice standards. Across other areas of medicine, integrated care pathways (ICPs) that provide a multidisciplinary outline of coordinated measurement-based care have been associated with better patient outcomes. ICPs, however, are rarely employed in mental health services. To address this, our team developed an ICP for early psychosis that was implemented in a real-world first episode psychosis outpatient clinic (FEPC) in an academic tertiary care mental health centre. This study evaluated the implementation and effectiveness of this early psychosis ICP, as well as the experience of patients and their families of such an ICP. Of 74 patients admitted to the FEPC over a 13-month period, 55 patients (74%) received at least one ICP assessment. Significantly fewer patients dropped out of care after enrollment in the ICP compared to those patients that did not (15% versus 37%, chi2 = 4.34, p = .037). Patients enrolled in the ICP also exhibited lower emergency department presentations (9% vs 18%) and rehospitalizations (5% vs 18%) although these differences were non-significant. A qualitative exploration of patient (n=15) and family (n=8) experiences of this ICP identified a highly integrated service as a key component in engagement and recovery, and revealed positive attitudes toward scales and measures, with formalized assessment tools enabling the tracking of treatment progress. These findings suggest that such ICPs for early psychosis care are implementable and acceptable in real-world settings, and may improve EPI outcomes.
Talk 4 Adoption and Utilization of Order Sets for Early Psychosis: A National Experiment in Standardization
Philip Tibbo1, Thomas Hastings2, Andrea Bardell3, Nicola Banks4, Howard Margolese5; 1Dalhousie University, 2McMaster University, 3University of British Columbia, 4Canadian Consortium for Early Intervention in Psychosis, 5McGill University
Successful treatment of early phase psychosis (EPP) requires an organized, recovery oriented mental health system with clear standards, policies and coordinated services. The Canadian Consortium for Early Intervention in Psychosis (CCEIP), a national organization of clinicians and researchers dedicated to improving quality of care in EPP, have developed two clinician order sets based on international, national and provincial standards, guidelines and quality based procedures, to be used in outpatient or inpatient settings. Order sets are evidence-based checklists which translate the latest medical information into a structured and actionable document that clinicians can put into practice at the point of care. Using a cloud-based platform, CCEIP developed and tested order sets for: 1) Initiation of Treatment for and 2) Optimization of Treatment for Early Phase Psychotic Disorders. These order sets are aimed to improve adherence to best practice, treatment outcomes, quality of care through data tracking and feedback, consistency and efficiency of care, in addition to reducing cost of care and medical errors. A discussion around the use of order sets, presentation of the 2 developed order sets and their referenced tools, and data from a national accredited performance assessment program on use of these orders sets will be presented. This data will include dashboard results of widespread usage, quantifiable insights into EPP health care practice including real-time use data on ordering (care) trends as well as implications/assumptions.
Discussant: John Kane, The Zucker Hillside Hospital, The Zucker School of Medicine at Hofstra/Northwell, The Feinstein Institute for Medical Research
Monday, October 8, 1:00 - 2:30 pm, Staffordshire
Chair: Philippe Conus, Deprtment of Psychiatry, CHUV, Lausanne University, Switzerland
Co-Chair: Amal Abdel Baki, CHU Montreal, Canada
Speakers: Clairélaine Ouellet-Plamondon, Amal Abdel-Baki, Philippe Golay, Philippe Conus
There are many early intervention programs around the world and most of them aim at providing specific care for the early phase of psychotic disorders. While this is a valid focus, early psychosis samples are composed of a wide variety of patient profiles and subgroups of patients may have distinct needs. Although generic elements of early intervention programs may fit most of the patients, clinicians should adapt treatment to these specific needs and develop personalized intervention. Data stemming from clinical naturalistic prospective follow-up often provide very detailed information on which it is possible to base the identification of such cinical sub-groups of patients. In this symposium we will present the results of clinical researched based on the prospective follow up of various early intervention programs in Canada, Switzerland and Australia. These data allow the identification of subgroups of patients defined on the basis of premorbid or clinical characteristic and who have specific needs in terms of clinical intervention.
Talk 1 Interventions for comorbid addiction disorders within early psychosis program: using results from a prospective longitudinal study to improve services for specific needs
Clairélaine Ouellet-Plamondon1, Amal Abdel-Baki1; 1CHU Montreal, Canada
Background: Co-occurring substance use disorders (SUD) are very common (about 60%) in first episode psychosis and associated with poor symptomatic and functional outcomes. After 2 years of follow up in early intervention service (EIS), about a third of FEP patients have persistent SUD despite motivational and harm reduction philosophies. Homelessness history, borderline personality and the severity of SUD at baseline have been associated with persistent misuse at 2-year follow up. Methods: Based on SUD trajectories and factors associated with SUD persistence in FEP, we developed and integrated FEP-SUD program within our EIS including evidence-based interventions targeting SUD and its associated factors. Results: We will describe the different components of this ‘à la carte’ program tailored to offer interventions corresponding to each patient characteristics and needs at different time points in their trajectory. Preliminary results and pilot data of different interventions of this program (including pharmacological strategies as well as psychosocial treatments) will be presented. Outreach case management interventions, injectable antipsychotic medication, peer support, supervised housing as well as “housing first” program, manualised individual intervention (including motivational and CBT strategies) as well as group and family systemic psychotherapy and, for the more severe cases, treatment orders for mandatory inpatient therapy for SUD will be described. Conclusions: Treating comorbid SUD with FEP is challenging. However different strategies must be offered early in the course of illness to help modify their trajectory. Although it is an heterogeneous group, personalized addiction treatment plans can be built to improve FEP outcome.
Talk 2 Homeless first episode psychosis youth may benefit from a specialised assertive community intervention team
Amal Abdel-Baki1, Virginie Doré-Gauthier1, Isabelle-Sarah Lévesque1; 1CHU Montreal, Canada
Background: Psychosis is associated with homelessness and conversely homelessness increases psychosis risk, the young being at higher risk. In Montreal inner city early intervention service (EIS), 29% of the first episode psychosis (FEP) cohort experienced homelessness. Non-affective psychosis, male gender, lower education, drug abuse and cluster B personality disorder were associated with homelessness. Homeless participants had worse symptomatic and functional outcomes, longer hospitalisations and were more likely to use emergency services despite regular EIS services. The Centre Hospitalier de l’Université de Montréal created in 2012, an intensive assertive community intervention team (AICIT) offering specialized care for homeless FEP (HFEP), aiming to offer to this clientele, individualized treatment integrating specialized and intensive care for early psychosis, housing support as well as substance use disorder (SUD) and outreach interventions. Objectives: Explore the impact of the addition of an IACIT to an EIS. Methods: 2 years-longitudinal study comparing the outcome of HFEP followed by both the EIS and IACIT since 2012 to a historical cohort of HFEP followed only by the EIS between 2005 and 2011. Results: HFEP followed by the EIS+IACIT attained housing stability more quickly and spent less time hospitalised than HFEP followed only by the EIS (RR 2.38, p=0.017). HFEP with cocaine misuse were less likely to attain housing stability (RR 0.25, p=0.04). Symptomatic, functional and SUD outcomes between the two groups were similar. Conclusion: HFEP outcome may be improved by the addition of IACIT to EIS as they have special expertise in quitting homelessness in collaboration with community organisations.
Talk 3 Migration in patients with early psychosis is a two-sided coin: findings from a three year prospective study
Philippe Golay1, Philipp Baumann1, Laure Jaton1, Romeo Restellini1, Nadir Mebdouhi1, Philippe Conus1; 1TIPP program, Département de Psychiatrie CHUV, Lausanne University, Switzerland
Aim: Most early psychosis programs treat high ratios of migrants, given they display higher rates of psychosis than the indigenous population. There are however limited studies on this topic in early psychosis programs (EP) and less is known about outcomes. The aim of this study was to compare the premorbid, baseline and outcome profile of patients according to migration (M) and migration in psychosocial adversity (MIA) in order to explore if there were differences suggesting particular needs in terms of treatment in these patients group. Methods: 257 early psychosis patients aged 18-35 years old were followed-up prospectively over 36 months. MIA (29.6%) and M (17.9%) were compared to patients who were born in Switzerland (NM). Results: The profile of MIA was characterized by lower socio-economical level for equal level of education, higher unemployment and forensic history rates, high prevalence of trauma and worse functioning at baseline. MIA patients also had lower global functioning during the follow-up. M patients had a better premorbid adjustment and experienced similar outcomes as the NM group. Conclusions: Results are compatible with the hypothesis that migration in adversity is a potential determinant of functional impairment in early psychosis. The fact that patients who migrated in other contexts have a better outcome is consistent with evidence showing that some migrants are more resilient. Patients who experienced migration in adversity may have specific needs in terms of intervention considering they are more vulnerable, less integrated and have a higher likelihood to have been exposed to trauma.
Talk 4 Personality disorder among youth with first episode psychotic mania: An important target for specific treatment?
Philippe Conus1,2, Melissa Hasty2, Craig Macneil2, Sue M Cotton2, Michael Berk3, Linda Kader2, Aswin Ratheesh2, Andrew Chanen2,4; 1Treatment and Early Intervention in Psychosis Program (TIPP), Service of General Psychiatry, Department of Psychiatry CHUV, Lausanne University, Switzerland, 2Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia, 3Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, 4Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
Objectives: Personality disorder (PD) comorbidity is common among patients with bipolar disorder and has been shown to negatively impact on outcome. However, little is known about this comorbidity in the early phases of BD. We aimed to examine the prevalence and impact of PD comorbidity on outcome in a cohort of youth with first episode mania (FEM) with psychotic features. Methods: Seventy-one patients with FEM aged 15 to 29 and treated at the Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia, were assessed at baseline, 6, 12, and 18 months as part of a randomized controlled trial of olanzapine and chlorpromazine as add-on to lithium in FEM with psychotic features. This study involved secondary analysis of trial data. Results: A comorbid clinical PD diagnosis was made in 16.9% of patients, antisocial and narcissistic PD being the most common sub-types. Patients with PD comorbidity had higher rates of readmission to hospital, lower rates of symptomatic recovery and poorer functional levels at 6 months, but these differences were not maintained after 12 and 18 months. Conclusions: In the early phase of bipolar disorders, patients with PD comorbidity display a delay in reaching symptomatic and functional recovery and are more likely to need hospital readmissions. These observations suggest specific intervention might be needed in order to improve short-term treatment efficacy in this subgroup.
Chair: Jean Addington, University of Calgary
Co-Chair: Matcheri Keshevan, Harvard University
Speakers: Jean Addington, Kristin Cadenhead, Michelle Friedman-Yakoobian, Scott Woods
The main focus of treatment for youth at clinical high risk (CHR) of psychosis has been to prevent transition to full-blown psychosis. However, there are other targets that have been considered less often such as attenuated psychotic symptoms, negative symptoms, social functioning, and cognition. Although the literature is promising there are many areas that are not impacted by current treatments in particular social functioning which is of concern since many of these young people continue to have poorer social functioning even when they do not make the transition to psychosis and attenuated psychotic symptoms have remitted. The first presentation (Addington) will present a critical overview of some of the promising areas of psychosocial treatment (such as cognitive behavior therapy, social skills training, cognitive remediation, and family focused therapy) and pharmacotherapy. The other three presentations will review the most recent research, highlight the features of the interventions and describe future goals for making the intervention more effective. The second presentation (Cadenhead) will focus on group-based CBT and social skills training to address social functioning. The use of cognitive remediation will be addressed in the third presentation (Friedman-Yakoobian). The fourth presentation will offer a critical examination of the current use of antidepressants in the CHR population (Woods). Finally, the discussant (Keshavan) will summarize the extant findings and propose a potential treatment algorithm for CHR.
Talk 1 Meta-analytic Review of Treatment Options for CHR youth
Jean Addington1, Daniel Devoe1; 1University of Calgary
The main focus of psychological treatment for youth at clinical high risk (CHR) of psychosis has been to prevent transition to full-blown psychosis and less often attenuated psychotic symptoms. However, in addition to the attenuated psychotic symptoms, these young people often present with negative symptoms, as well as other comorbid disorders. They typically have cognitive difficulties that are intermediate to healthy controls and individuals with full-blown psychosis. Many have poor social and role functioning. Through a series of network and pairwise meta-analyses this presentation reviews all treatment studies to date including cognitive behavior therapy (CBT), family intervention, cognitive remediation, integrated psychological treatment and a range of pharmacotherapies and includes outcomes such as transition, attenuated psychotic symptoms, negative symptoms, cognition and social and role functioning. There are some positive results in support of CBT in preventing transition to psychosis and reducing attenuated psychotic symptoms. None of the treatments reviewed appear to have an impact on negative symptoms or social functioning, which is of concern since many of these young people continue to have poorer social functioning even when they do not make the transition to psychosis and attenuated psychotic symptoms have remitted
Talk 2 Cognitive Behavioral Social Skills Training for Youth at Clinical High Risk for Psychosis: Recovery Through Group (ReGroup)
Kristin Cadenhead1, Jean Addington2, Barbara Cornblatt3; 1University of California at San Diego, 2University of Calgary, 3Zucker Hillside Hospital, New York
The majority of youth at clinical high-risk (CHR) for psychosis do not develop a psychotic syndrome but rather continue to have fluctuating subthreshold symptoms, poor social and role functioning. There are no specific treatments for these functional difficulties. However, Cognitive Behavioral and Social Skills Training (CBSST) significantly increases the frequency of social functioning activities compared to treatment as usual or supportive therapy in chronic schizophrenia. The ReGroup study is a three-site, longitudinal study aimed at testing the effectiveness and feasibility as well as mediators and mechanisms of action of a manualized CBSST intervention targeting functional difficulties associated with CHR for psychosis. The goals of the study are 1) to examine whether CBSST compared to a psychoeducation improves functioning and 2) to determine whether reduction in defeatist beliefs and improvement in social competence mediate change in psychosocial functioning. Participants are randomized to: CBSST, an 18-week group comprised of three modules; 1) Cognitive Skills; 2) Social Skills; 3) Problem Solving, or a psychoeducation group. We have demonstrated the feasibility of CBSST treatment in CHR youth and determined that it is easy to train therapists and assure reliability of the intervention through weekly supervision. Participants enjoy the intervention and are less likely to drop out of the study after starting group. CBSST can be readily disseminated to clinical community practice with proper training and supervision. This study will provide insights into approaches to halt or mitigate the pathological process and advance our understanding of risk prediction
Talk 3 Cognitive Remediation for Youth at Clinical High Risk for Psychosis
Michelle Friedman-Yakoobian1; 1Harvard University
Cognitive difficulties, including deficits in psychomotor speed, memory, attention, reasoning, and social cognition are key rate-limiting factors to functional recovery from psychotic disorders. These deficits appear to be present, in milder form, in children and adolescents who later go on to develop schizophrenia, as well as in individuals who are identified as being at clinical high risk (CHR) for psychosis. Compelling evidence for effectiveness of psychosocial approaches to cognitive remediation in schizophrenia gives rise to the question of whether these approaches could be useful in ameliorating and/or preventing cognitive deficits in youth at CHR for psychosis. To date, a handful of studies using various cognitive remediation approaches in individuals at CHR have begun. This talk will provide an overview of extant literature in this area and will discuss current and future directions for the role of cognitive remediation in treatment for youth at CHR.
Talk 4 Antidepressant Medication Use in Attenuated Psychosis Syndrome: Community Selection and Outcome
Scott Woods1, Jean Addington2, Carrie Bearden3, Kristin Cadenhead4, Tyrone Cannon1, Barbara Cornblatt5, Daniel Mathalon6, Diana Perkins7, Larry Seidman8, Ming Tsuang4, Elaine Walker9, McGlashan Thomas1; 1Yale University, 2University of Calgary, 3UCLA, 4UCSD, 5Zucker Hillside Hospital, 6UCSF, 7UNC, 8Harvard University, 9Emory University
Antidepressants (ADs) are commonly used in DSM-5 Attenuated Psychosis Syndrome (APS) and other clinical high-risk syndrome (CHR) patients (Woods et al Schizophr Res 2013), but there is a dearth of efficacy data. The observational NAPLS-2 study offered an opportunity to investigate outcomes of community practice in this population. NAPLS-2 CHR patients were evaluated at baseline and six-monthly intervals with the Scale Of Psychosis-risk Symptoms (SOPS), SCID, the Calgary Depression Scale for Schizophrenia (CDSS), and the Global Assessment of Functioning (GAF). Six-month outcomes were described according to a “course specifier” classification (Woods et al Schizophr Res 2014). 360 CHR patients enrolled in the first half of NAPLS-2; 106 met APS criteria, were AD-naive at baseline, and completed 6-month assessment. 27 of these began AD during the first six months; average AD duration was 3.1±2.5 months. AD starters had higher baseline scores on CDSS (p<0.001) and were somewhat more likely to have comorbid current major depression (p=0.105). Six-month outcomes for AD starters vs nonstarters were: psychosis 4 vs 10%, progression 52 vs 53%, persistence 30 vs 19%, and remission 15 vs 18% (gamma=0.134, p=0.466). CDSS change did not differ between groups (F=0.1, p=0.806), nor did SOPS or GAF scores. Available data from the full NAPLS-2 and partial NAPLS-3 samples will be presented. Community selection of APS patients to begin AD medication appeared driven by depression severity and diagnosis, but AD starts seemed to confer little benefit. Randomized studies are needed.
Discussant: Matcheri Keshevan, Harvard University
Chair: Barnaby Nelson, Orygen, The National Centre of Excellence in Youth Mental Health
Co-Chair: Jessica Hartmann, Orygen, The National Centre of Excellence in Youth Mental Health
Speakers: Hok Pan Yuen, Marieke Wichers, Jessica Hartmann, Johanna Wigman
Prediction studies in early psychosis and related research has generally relied on one-off sampling of cross-sectional data (i.e., a "snapshot" of clinical state and other risk markers at study entry). A new approach is emerging based on the view that psychopathology is an evolving, dynamic picture, particularly in the early stages of disorder, and that predictive modelling may therefore be maximised by taking these temporal changes into account. This approach to prediction research in psychopathology draws on cross-disciplinary models of complex systems and advances in statistical modelling. This symposium consists of presentations illustrating this emerging paradigm in prediction research, consistent with the “broadening the scope” theme of the conference. Hok Pan Yuen will present joint modeling analysis of longitudinal clinical variables in an ultra high risk for psychosis cohort. Dr Wichers will present novel empirical support for the presence of early warning signals in anticipation of critical transitions in depressive symptomatology. Dr Hartmann will present data relating to early warning signals (psychopathology and circadian activity) from a cohort study of young people at risk of a range of mental disorders. Dr Wigman will present findings from a new diary study (daily recordings of psychopathology) mapping individual symptom networks and the predictive value of these for course/outcome. This next generation of prediction studies may more accurately identify people at highest risk of disorder progression or relapse, which clearly has important treatment implications, such as stratifying patients to particular treatments and introducing methods for identifying early warning signs of mental state deterioration.
Talk 1 A Novel Approach to Developing A Prediction Model of Transition to Psychosis: Dynamic Prediction Using Joint Modelling
Hok Pan Yuen1, Andrew Mackinnon2, Patrick McGorry1, G. Paul Amminger1, Jessica Hartmann1, Miriam Schäfer 1, Connie Markulev1, Suzie Lavoie1, Barnaby Nelson1; 1Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, 2Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne
Introduction Joint modelling (JM) is a promising new statistical methodology which can use data from both study entry and subsequent follow-up assessments to develop prediction models of psychosis onset in ultra-high risk (UHR) individuals. The practical implication is that the prediction provided by these models could be updated as new information about patients’ clinical state is obtained and appropriate treatment could be implemented accordingly. This study aimed to test the potential benefits of joint modelling to dynamically predict the onset of psychosis in UHR individuals. Method Data from the NEURAPRO intervention study was used. This study was a multi-centre placebo-controlled randomized trial of the effect of omega-3 polyunsaturated fatty acids on risk of transition to psychotic disorder in UHR individuals. The sample size was 304. Study assessments were conducted monthly during the first 6 months and then at months 9 and 12. There were in total 40 known cases of transition to psychosis. Candidate predictor variables consisted of demographic characteristics assessed at intake as well as repeated measurements of clinical variables. Results Compared with the conventional approach of using only baseline data for prediction of psychosis, JM prediction showed significantly better sensitivity, specificity and likelihood ratios. The JM approach yielded sensitivity of 82.8%/specificity 72.4%, whereas the baseline-data only model yielded sensitivity of 69.0%/specificity 73.8%. Conclusions Incorporating time-dependent variables into predictive models has the potential to improve the prediction of onset of psychosis and hence to help in providing timely and personalized treatment to patients.
Talk 2 Can we obtain personalized early warnings for symptom transitions? Novel empirical support for a complex system approach in psychopathology.
Marieke Wichers1, Marieke Schreuder1, Arnout Smit1, Evelien Snippe1; 1Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
Introduction: Clinically, it is highly relevant to be able to foresee sudden rises in psychopathology. However, person-specific symptom transitions are extremely difficult to predict. Complex system theory offers a novel possibility to estimate the likelihood of such transitions and expects the presence of rising early warning signals (EWS) in anticipation of sudden symptom transitions. We aimed to replicate the first study1 that revealed empirical support for this and, second, to further translate this idea to personalized models. Methods: Adolescent participants were recruited via the East Flanders Twin register. This novel sample consisted of 239 participants with SCL-90 baseline and follow-up measures. At baseline they underwent experience sampling (ESM). Second, a set of ESM case-studies were conducted in patients tapering their antidepressant medication. These were followed for > 4 months with >5 measurements per day to capture possible sudden transitions in symptoms and the precise period before those transitions. Results: We replicated the results of the first group-level study1. The level of EWS in ESM items on depressed mood states was associated with follow-up increases in symptom severity (down: β=0.10, SEβ=0.03, p<0.001; listless: β=0.09, SEβ=0.04, p<0.001). Furthermore, in the individual time-series cases, rising EWS were observed in anticipation of sudden transitions. Conclusions: The current group-level and individual-level studies supported the hypothesis that critical transitions in psychopathology can be foreseen by observing changes in EWS, also in individual time-series of data. This has major relevance for applications in clinical practice. 1 Leemput, Wichers et al. Proc Natl Acad Sci USA 111(1):87–92.
Talk 3 Tipping points – predicting transitions to mental illness and remission in at-risk young people
Jessica Hartmann1, Marieke Wichers2, Patrick McGorry1, Barnaby Nelson1; 1Orygen, the National Centre of Excellence in Youth Mental Health, University of Melbourne, 2Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
With more than half of mental disorders emerging by the age of 24, it is of utmost importance to be able to predict which help-seeking young people are at greatest risk of mental health deterioration. Mental health has increasingly been conceptualised as a complex system characterised by phase transitions, preceded by early warning signals. The aim of the current study is to predict ‘tipping points’ in mental health in at-risk young people by means of an early warning signal called ‘critical slowing down’. Using ecological momentary assessment in combination with actigraphy, N=10 help-seeking young people aged 12-24 are followed for four months to capture transitions to full-threshold disorder in real-time. The young people, part of a larger cohort study, are at pluripotential risk for developing full-threshold disorder (depression, psychosis, mania and borderline personality disorder) within a short (12-month) time frame. We present on this ongoing pilot study investigating critical slowing down in psychopathology (mood states and attenuated psychotic symptoms) and actigraphy preceding transitions from at-risk state (stage 1b) to full-threshold state (stage 2) or to remission (State 0). We expect to find an increase in temporal autocorrelation at-lag-1, variance and skewness in mood states and circadian activity prior to a transition. Data collection is expected to be completed by time of presentation. This new framework may represent a paradigm shift from static prediction approaches to dynamic, individualised models of psychosis prediction and may inform the development of new clinical identification tools and early and individualised interventions to prevent such transitions.
Talk 4 Mirorr Mirorr on the wall, who’s the most ‘at risk’ of all?
Johanna Wigman1, Sanne Booij1; 1Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
Background: Course and outcome of early psychotic symptoms are difficult to predict, hampering timely intervention. Research relies heavily on diagnostic categories, group-level comparisons and assessment of static symptom levels. However, symptoms may wax, wane, change individually or cross diagnostic borders. Adding a more personalized as well as a more transdiagnostic dimension to the model may provide a valuable step forwards. Methods: The new Mirorr study investigates this. Mirorr follows N=100 individuals (age 18-35), divided over four subgroups with increasing psychopathological severity (i.e. subsequent clinical stages). Mirorr is a diary study, assessing a broad range of transdiagnostic symptoms for 90 consecutive days that are then mapped into individual networks of interacting symptoms. Comparison of these networks across different stages as well as within-person comparison of symptom networks over time are investigated. Network characteristics will be used to predict clinical and functional outcome after one, two and three years. Mirorr is currently running and results of the study so far will be presented. Results: Preliminary results indicate differences in symptom networks between subgroups. Characteristics of these symptom networks of individuals in different clinical stages will be presented, and associations with psychopathology and functioning. Of particular interest are structure (e.g. density) of the symptom networks, differences therein and the specific role of psychotic experiences. Discussion: Research and clinical practice may benefit from a more personalized, dynamic, transdiagnostic perspective. Mirorr exemplifies how this may help to capture the complex nature of psychopathology and its development.
Discussant: Barnaby Nelson, Orygen, The National Centre of Excellence in Youth Mental Health
Chair: Susan T. Azrin, National Institute of Mental Health, Bethesda, MD, USA
Speakers: Steven R. Lopez, Vinod H. Srihari, Cameron S. Carter, Leslie Marino
The World Health Organization recommends that treatment for psychosis begin within 3 months of symptom onset. However, dozens of studies worldwide have observed an average delay of 2 years between appearance of psychotic symptoms and treatment initiation. Two meta-analyses and the U.S. Recovery After an Initial Schizophrenia Episode-Early Treatment Program have established that duration of untreated psychosis (DUP)—the time from psychosis onset to treatment initiation—is correlated with poor clinical and functional outcomes. Early psychosis treatment programs are increasingly available in the U.S., but many in need are missing this critical opportunity. Accordingly, the National Institute of Mental Health (NIMH) launched a research program to identify sources of early psychosis treatment delay and test practical and innovative strategies for reducing DUP in the U.S. This symposium features findings from a selection of these studies. Steven Lopez will report on the impact of a community-based, multi-level, bilingual psychosis communication campaign for U.S. Latinos on help seeking, DUP and treatment continuation. Vinod Srihari will report findings from the trial of Mindmap—a population-based, multi-element, early psychosis detection campaign—on help seeking and DUP. Cameron Carter will present results from his trial assessing whether adding a novel, technology-enhanced early psychosis screening tool to standard provider education for early psychosis increases early psychosis identification and reduces DUP. Leslie Marino will present findings on a comprehensive set of DUP predictors for nearly 800 individuals enrolled in early psychosis treatment programs. Susan Azrin will discuss these findings and implications for developing practical DUP reduction strategies.
Talk 1 Towards Decreasing the Duration of Untreated Psychosis in a Minority Community: The Case of US Latinos
Steven R. Lopez1, Alex Kopelowicz2, Jodie Ullman3, Maria Santos1, Maya Kratzer1; 1University of Southern California, 2University of California Los Angeles, 3California State University San Bernardino
We conducted a 2-year, multifaceted bilingual communication campaign for US Latinos regarding psychosis. We assessed whether the duration of untreated psychosis (DUP) decreased during the campaign more than during the 15-month historical control condition preceding the campaign. Patients with first episode psychosis were recruited from a public outpatient and inpatient mental health unit in the Los Angeles area. Inclusion criteria were: ages 16-65, having a psychotic disorder not due to a medical condition or substance use, and self-identifying as Latino. Exclusion criteria were: having taken antipsychotic medication for more than a year or not understanding the informed consent procedures. Three DUPs were measured: onset to first seeking any services for the disorder (DUP1), first prescription for antipsychotic medication (DUP2), and taking medication for at least 3 months (DUP3). The DUPs were highly skewed; therefore, analyses were conducted on transformed measures. We found no significant mean differences between the campaign condition (n=57) and the control condition (n=46) for the DUP measures. Significant differences in the variance of DUP1, but not for DUP2/DUP3, were found. There was a significantly smaller variance for the campaign than for the control. The variance of DUP1 was also smaller for those residing within the targeted community than in surrounding communities, and for those born in the US versus Latin America. That the variance differed for DUP1 but not DUP2/DUP3 suggests that the campaign influenced families’ contribution to DUP but not professional networks. Recommendations to increase the impact of DUP reduction campaigns for minority communities are discussed.
Talk 2 Mindmap – A Quasi-Experimental Test of Early Detection of Psychosis in the U.S.
Vinod H. Srihari1,2, Maria Ferrara1,2, Fangyong Li3, Shadie Burke1,2, Emily Kline4,5, Jessica M. Pollard1,2, John D. Cahill1,2, Sinan Guloksuz6, Glen McDermott7, Scott W. Woods1, Larry Seidman4,5, Matcheri Keshavan4,5; 1Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA, 2Program for Specialized Treatment Early in Psychosis (STEP), New Haven, CT, USA, 3Yale Center for Analytical Sciences, Yale School of Public Health, 4Harvard Medical School, 5Program for Prevention and Recovery in Early Psychosis (PREP), Boston, MA, USA, 6Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands, 7Red Rock Branding, New Haven, CT, USA
BACKGROUND: The Specialized Treatment Early in Psychosis (STEP) program has delivered coordinated team-based first-episode services (FES) since 2006 in New Haven. In 2015, STEP launched a 4-year early detection (ED) campaign (Mindmap), adapted from the Scandinavian TIPS approach, to shorten Duration of Untreated Psychosis (DUP) in a 10-town catchment (population 400,000). METHODS: Mindmap’s social-ecological model targets demand (delays in identifying illness and help-seeking) and supply (delays in referring to and providing FES) side constituents of DUP. Mindmap uses mass and social media messaging, professional detailing, and rapid triage of referrals. DUP is classified as the time between the onset of psychosis and initiation of antipsychotic treatment (DUP1) and FES care (DUP2). A control FES (PREP, Boston) supports the quasi-experimental design. The campaign was launched in 2015, after a one-year baseline. A selective interim analysis follows. RESULTS: The number of help-seeking attempts (HSAs) varied between 1-24, without a statistically significant reduction at STEP: median (Quartile 1- Quartile 3): 2 (1-3) at baseline vs. 1 (1-2) at 32mos (p=0.19). DUP1 trended downward at STEP: median (Q1-Q3): 153 (17 – 339) days at baseline to 40 (15-141) days at 32mos (p=0.06). No significant reduction in DUP2 at STEP is yet evident: median (Q1-Q3): 332 (52 – 521) days at baseline to 184 (62-470) days at 32mos (p=0.70). At PREP both DUP1 & DUP2 remain unchanged and comparable to baseline levels at STEP. CONCLUSION: Mindmap has shown promise in reducing delays to care. Additional measures of impact with comparisons across sites will be presented.
Talk 3 A Technology-enhanced Intervention to Reduce the Duration of Untreated Psychosis through Rapid Identification & Engagement
Cameron S. Carter1, Tara A. Niendam1, Rachel Loewy2, Mark Savill2, Monet Meyer1, Adi Rosenthal1, Kevin Delucchi2, Tyler A. Lesh1, Haley Skymba1, Daniel Ragland1, Howard H. Goldman3, Richard L. Kravitz4; 1Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA, USA, 2Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, CA, USA, 3Department of Psychiatry, University of Maryland School of Medicine, USA, 4Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
The present cluster-randomized controlled trial assesses whether adding a novel technology-enhanced screening using the Prodromal Questionnaire-Brief version (PQ-B) to standard provider education identifies more individuals with first episode psychosis (FEP), earlier in their illness. Twenty-two sites were randomized within 3 strata [community mental health, CMH (N=10), middle/high schools, SCH (N=8), primary care, PC (N=4)] to an Education alone (TAU) vs Education + Electronic Screening (Active)]. Active sites screened individuals ages 12-30 referred those who passed a liberal PQ-B cut off score for phone evaluation. TAU sites referred individuals for phone evaluation based on clinician judgment. Phone evaluations assessed eligibility for FEP services and duration of untreated psychosis (DUP). Active sites effectively implemented electronic screening. Of the 822 individuals screened at Active sites between June 2015 and July 2017, 43.2% scored above the cutoff (mean ±SD PQ-B score=21.25±20.75). One in 8 individuals who completed the tablet were identified with threshold psychosis. Across Active and TAU sites, 511 individuals were identified, 422 agreed to be referred, and 319 completed a phone interview: 33.23% reported attenuated and 36.68% fully psychotic symptoms. Active sites identified significantly more individuals with threshold psychosis (p<.001) than TAU. DUP was relatively short in both groups (186 days in Active and 195 days in TAU). No difference in days of DUP was observed across arms. Preliminary results show the feasibility of electronic screening across various community settings and a 3.5 times higher identification rate for electronic screening of self-reported psychosis spectrum symptoms than clinician-based identification alone.
Talk 4 Pathways to Care for Young Adults with First Episode Psychosis in a Coordinated Specialty Care Program
Leslie Marino1,2, Melanie Wall1,2, Jennifer Scodes1,2, Hong Ngo1,2, Ilana Nossel1,2, Iruma Bello1,2, Thomas Smith1,2, Lisa Dixon1,2; 1Columbia University Medical Center, 2New York State Psychiatric Institute
PURPOSE: Substantial research has demonstrated that a longer duration of untreated psychosis (DUP) is associated with poorer outcomes among young adults with early non-affective psychosis. As federal funding has expanded access to evidence-based coordinated specialty care (CSC) in the US, little is known about factors influencing the pathway to care and DUP in non-research treatment settings. This study explores the pathway to care and predictors of time to OnTrackNY, New York state’s CSC program. METHODS: The sample includes 779 individuals ages 16-30 within two years of onset of non-affective psychosis enrolled in OnTrackNY at 19 sites as of September 2017. Multivariate analyses tested the association between the primary outcome of time from onset of psychosis to intervention (OnTrackNY) and a comprehensive list of predictors within the admission assessment domains of demographic and clinical characteristics; social and occupational functioning; suicidality/violence/legal problems; service utilization; family characteristics; and prior mental health contacts. RESULTS: The mean time to treatment was 231.18 days (SD=187.66) with a median of 169 days (5.63 months). In multivariate analyses, current school participation (p=.005) and at least one psychiatric hospitalization (p<.001) were associated with shorter time to intervention, whereas when first service contact is hospitalization (p=.006) or an outpatient visit (p<.001), compared to ER visit, time to intervention is longer. CONCLUSIONS: Engagement in school and the early mental health service contacts can predict the pathway to care and time to early intervention services in a cohort of young adults with early psychosis. This has implications for efforts to reduce DUP.
Discussant: Susan T. Azrin, National Institute of Mental Health, Bethesda, MD, USA
Chair: Craig A Macneil, EPPIC, Orygen Youth Health, Melbourne, Australia
Speakers: Aswin Ratheesh, Philippe Conus, Craig Macneil, Sue Cotton
Bipolar Disorder can be a serious, ongoing and recurrent mental health difficulty that can impact considerably on individuals, families and society. This symposium will focus on some of the challenges presented while working with individuals that have this diagnosis, while focussing also on the significant potential opportunities of early intervention with this population. Specific challenges to early intervention work in bipolar disorder include; lack of guidelines for early intervention, difficulties in the development of engagement and insight, and limitations to the evidence base for psychosocial therapies for this population. However, the symposium will also discuss the development of guidelines for early intervention in bipolar disorder, techniques to improve insight and engagement, and the development of RECOVER, a randomised controlled trial of a specialised psychological intervention for bipolar disorder.
Talk 1 Does guideline concordant care improve the outcomes for youth with early stage bipolar disorders?
Aswin Ratheesh1,2, Ming Fang, Christopher Davey, Michael Berk3, Patrick McGorry, Sue Cotton2; 1Orygen Youth Health, 2Orygen, the National Centre of Excellence in Youth Mental Health, 3Deakin University
Background: Youth with early stage Bipolar Disorders (BD) typically receive care in generic mental health services or youth early psychosis services. The lack of specific guidelines for their care could lead to heterogeneous and non-standardised care. We aimed to examine whether concordance with available guidelines was associated with better outcomes over 10-24 months of prospective follow-up. Methods: We conducted a file-audit study of all participants aged 15-25 years with BD I or II referred to a tertiary youth mental health service in Melbourne, Australia between 01/01/2014 and 30/06/2015. Concordance with three guidelines were established using a checklist developed for this purpose. All items relating to youth, early stage BD and care within an early intervention service were selected. A guideline concordance score was developed for each file. The primary outcome selected was the Global Assessment of Functioning scale score at the point of discharge (10-24 months from initial referral). We propose to examine the relationship between the discharge GAF scores and guideline concordance scores using linear regressions, controlling for a) age, b) gender, c) baseline illness severity, d) baseline GAF score and e) type of BD diagnosis. Results: Of the 90 participants selected, half had a BD I diagnosis and were treated in the early psychosis clinic, while the remaining had a BD II diagnosis and received care from the mood disorders clinic. Results from the regression analyses will be presented. The results could have implications for the development of a specific guideline for youth with early stage BD.
Talk 2 The Challenges of Engagement and Insight in Bipolar Disorder: Data and Recommendations
Philippe Conus1; 1Centre Hospitalier Universitaire Vaudois, Switzerland
Over the last 20 years, numerous programs for early intervention in psychosis have developed. Although their structure may differ according to the context in which they are implanted, mental health professionals working in these setting are usually faced with very similar challenges. There are globally 2 main issues to be resolved. The first one is to engage young patients, including those with a diagnosis of bipolar disorder, who are often reluctant to receive treatment. We suggest that this this can be assisted though organizational strategies, specific engagement techniques, and by providing interventions that target factors known to be linked with increased risk of disengagement. The second is to promote the development of insight, which is not only an aim but also a subtle therapeutic process. In this talk we will describe these various strategies through the example of TIPP, an early intervention program implanted in Lausanne, Switzerland in 2004. TIPP has treated more than 600 patients, over a three-year treatment period, many of whom have experienced mania, having achieved a disengagement rate of less than 5%.
Talk 3 Early Intervention for Bipolar Disorder: The Role of Psychological Interventions
Craig Macneil1, Melissa Hasty1, Kate Filia2, Aswin Ratheesh1, Philippe Conus3, Michael Berk4, Sue Cotton2,5; 1Early Psychosis Prevention & Intervention Centre, Orygen Youth Health, 35 Poplar Road, Parkville, VIC 3052, Melbourne, Australia, 2Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia, 3Treatment & Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, 1008 Prilly, Switzerland, 4IMPACT Strategic Research Centre, School of Medicine, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia, 5Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia, 3052
Bipolar disorder generally has its onset when an individual is in their late teens, a critical developmental phase. While the research evidence often suggests that outcomes can be poor in bipolar disorder, some emerging evidence indicates that psychological interventions may be at their most effective early in the course of the disorder. This paper will report on the limited evidence base for early intervention in bipolar disorder, and describe the development of a specialised psychosocial intervention designed for young people following a first manic episode. This intervention is currently being tested in a National Health & Medical Research Council-funded, randomised controlled trail (RECOVER). Specifically, RECOVER aims to examine the efficacy of a six month, manualised psychological intervention on symptomatic and functional outcomes of young people immediately following a first manic episode. It focusses on engagement, shared formulation, balancing sleep and activity, engaging families, and supporting functioning, while also attending specifically to unhelpful schema that may maintain bipolar symptoms. Challenges in working with this population, and developmental modifications that may be required will be discussed, while acknowledging the strengths and opportunities presented when working with young people early in the course of bipolar disorder.
Talk 4 RECOVER: a randomised controlled trial of a tailored psychological intervention for first episode bipolar disorder
Sue Cotton1,2, Craig Macneil1,2,3, Henry Jackson4, Greg Murray5, Aswin Ratheesh1,2,3, Michael Berk1,2,6,7,8, Andrew Chanen1,2,3, Kate Filia1,2, Melissa Hasty1,2,3, Christopher Davey1,2,3, Barnaby Nelson1,2,3; 1Centre for Youth Mental Health, The University of Melbourne, 2Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia, 3Orygen Youth Health, Parkville, Australia, 4Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia, 5Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia, 6School of Medicine, Deakin University and Barwon Health, Geelong, Australia, 7The Florey Institute of Neuroscience and Mental Health, Parkville Australia, 8Department of Psychiatry, The University of Melbourne, Parkville Australia
Background: People with bipolar disorder too commonly experience deficits in functional recovery, despite symptomatic recovery and exemplary school performance. The outcome of this is poor long-term functional outcomes. Applying psychological therapies alongside pharmacology may be useful in improving functional outcomes. Our group has led growing international interest in a staged approach to understanding illness trajectories of bipolar disorder with different psychological and pharmacological therapies required for the different stages of illness. Intervention in the early stages may potentially reduce the burden and risk associated with the disorder, and mitigate its impact on normal developmental trajectories. To date, however, there is a limited evidence base psychological therapies available to young people with early BD. Methods: RECOVER is an RCT of a refined existing psychological intervention, to be delivered in addition to treatment as usual at two specialist early intervention services in Melbourne. 122 young people in the early stages of BD-I will be recruited. The RECOVER intervention will be delivered over a 6 month period. Assessments will be conducted at baseline, 3, 6, 9, 12, 15, and 18 months. Results: The trial design will be discussed in depth. Conclusion: To date, there is a limited evidence base for psychological therapies available to young people with early BD. Therefore, the findings of this project will provide definitive evidence that early psychological intervention in the course of BD can reduce the symptomatic, vocational, relationship and psychological impact that is seen in entrenched disorder.
Chair: Olga Santesteban-Echarri, University of Calgary, Calgary, Alberta, Canada
Co-Chair: Paul Metzak, University of Calgary, Calgary, Alberta, Canada
Speakers: Kali Brummitt, Jean Addington, Olga Santesteban-Echarri, Paul Metzak
In the early psychosis field there has been a major focus on those at clinical high risk for psychosis. Despite the fact that the majority of mental illnesses arise in youth, and early treatment of mental health issues is vital to reducing poor outcomes, less attention has been paid to understanding the risk for serious mental illness (SMI), which includes psychotic disorders, bipolar disorder and recurrent major depression. The Canadian Psychiatric Risk and Outcome Study (PROCAN) is a longitudinal study investigating the clinical, social, and neurobiological factors that may lead to SMI in youth, with the aim of developing an algorithm that can predict which youth will move from undifferentiated symptoms to a diagnosable mental illness. PROCAN is currently following 243 young people (aged 12-25) who may be at risk for the later development of SMI. This symposium will present various aspects of PROCAN. The first talk presents the staging model developed by McGorry and Hickie, used in PROCAN and the recruitment and retention strategies to identify these young at-risk individuals. The second talk presents the baseline differences in clinical symptomatology, neurocognition and social and role functioning between youth in the different stages and how they compare to healthy controls. The third talk discusses the impact of familial relationship styles on mental health and examines the stage-related differences in family functioning and communication. The fourth talk outlines the functional brain imaging measures that have been used in PROCAN and presents data outlining differences in brain activity at baseline.
Talk 1 Overview of and Referral Pathways to the Canadian Psychiatric Risk and Outcome Study (PROCAN)
Kali Brummitt1, Jean Addington1; 1University of Calgary, Calgary, Alberta, Canada
This presentation will first present the clinical staging model used in PROCAN. Secondly, an overview of the study which includes demographics of the sample and measures used will be given. Since the project is focused on adolescents and young adults who may be presenting with mixed symptom patterns or brief or undifferentiated symptoms several months or even years before the development of a diagnosable mental illness, it is important to find ways to identify these young people early so that we can learn more about the factors that may predict later mental illness and offer early intervention. Studies in the clinical high risk for psychosis population have identified strategies on recruitment, but there is little to help with a more general at-risk population. Thus, thirdly, we will present tracking data of the referral sources of all PROCAN participants and compare them by age and by the clinical stage. Referrals were evenly split by gender and age. Most referrals, however, were in stage 1b, individuals who met criteria for an attenuated syndrome, the majority of which were referred by community mental health services. In contrast stage 1a participants with distress, mild anxiety and depression were more often self- or family referred. Implications of referral pathways for identifying youth at risk will be discussed.
Talk 2 Clinical Symptoms and Functioning of Youth at Risk for Serious Mental Illness
Jean Addington1; 1University of Calgary, Calgary, Alberta, Canada
In the Canadian Psychiatric Risk and Outcome Study (PROCAN), using McGorry and Hickie’s clinical staging model, our sample included 42 healthy controls (HCs), 41 youth with a family risk of mental illness (stage 0), 52 distressed youth with mild depression and anxiety and 108 with attenuated psychiatric syndromes, the majority of whom met criteria for being at clinical high risk for psychosis. In order to determine if the criteria for these different stages were useful and made sense, the groups were first compared on a range of clinical measures and secondly on social, and neurocognitive functioning. Stage 0 participants did not differ from healthy controls on any clinical measure. Stage 1a differed from HCs and Stage 0 in anxiety, depression, rumination, anhedonia, negative symptoms and negative beliefs about the self. Stage 1b participants presented with significantly more severe symptoms than all other groups in anxiety, depression, anhedonia, attenuated psychotic symptoms, negative symptoms and negative beliefs about the self and from HCS and stage 0 in anhedonia and rumination. These results suggest that the clinical staging of our sample was a good fit. In terms of social functioning, Stage 1a and 1b participants both differed from the HCs and stage 0 participants. Interestingly, in examining neurocognition, only the stage 1b group differed significantly from the HCs and stage 0 participants in IQ and in the speed of processing, attention, working memory domains from the MATRICS. Thus, the staging model is further supported with neurocognitive and social functioning performance.
Talk 3 Family Communication and Family Functioning in Youth at Risk for Serious Mental Illness
Olga Santesteban-Echarri1; 1University of Calgary, Calgary, Alberta, Canada
Family flexibility and cohesion are at times impaired in families of first-episode psychosis patients compared to healthy controls (HCs). Furthermore, family functioning may be important even before the onset of illness. A positive family environment may be related to a decrease in symptoms and improved functioning in youth at clinical high-risk for psychosis. However, little is known about earlier stages of risk and the importance of the family environment for youth at-risk for serious mental illness (SMI).In the PROCAN study, we examined family functioning from the Circumplex Model of Family Systems in a large sample of youth at-risk for SMI. Family functioning was evaluated with the Family Adaptability and Cohesion Evaluation Scales-IV (FACES-IV) for 41 youth with a family history of SMI (Stage 0), 52 distressed youth with early mood and anxiety symptoms (Stage 1a), 105 youth with subthreshold psychotic symptoms (Stage 1b), and 42 HCs. Results from multivariate linear regression analyses showed that participants in Stage 1a and Stage 1b significantly differ from HCs in all the family functioning scales. Furthermore, participants in Stage 0 differed from participants in Stage 1b; and similarly, participants in Stage 1a differed in all the scales from participants in Stage 0. Therefore, family functioning appears to be impaired in youth at-risk for SMI who present with early signs of mood, anxiety or subthreshold psychotic symptoms.
Talk 4 Overview of the Functional Neuroimaging Measures in the PROCAN Study
Paul Metzak1, Signe Bray1, Glenda MacQueen1; 1University of Calgary, Calgary, Alberta, Canada
Although the onset of serious mental illness (SMI) primarily occurs in youth, there have been few studies examining the neurobiological correlates of SMI prior to a formal diagnosis. In the PROCAN study we have employed McGorry and Hickie’s clinical staging model as the basis for assessing changes in brain activity in youth at risk for SMI. As SMI is a broad category encompassing multiple discrete illnesses, the functional MRI tasks that we have selected activate multiple brain networks that are known to be impacted in psychiatric illness. The three tasks selected were: 1) a monetary incentive delay task, which targets reward networks, 2) an N-back working memory task, which targets cognitive control and dorsal attention networks, and 3) an emotional Go-NoGo task, which targets emotional and inhibitory control networks. Participants also underwent a resting state scan, which enables a task free assessment of multiple brain networks. Each participant performs these tasks upon recruitment, twelve months after recruitment, and upon conversion to a diagnosable SMI. Preliminary results from the Anhedonia task indicate that symptomatic participants display differences in basal ganglia activity relative to healthy volunteers and those at familial high risk.
Symposium Session 10
Chair: Luana R Turner, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA, The UCLA Aftercare Research Program, Los Angeles, USA
Co-Chair: Wenche ten Velden Hegelstad, TIPS Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
Speakers: Wenche ten Velden Hegelstad, Daniëlle van Duin, Nanna Briem, Eóin Killackey
The exploration of career goals is a natural part of youth development, yet this period is often delayed and even bypassed for many young people who experience psychosis. Further, how can a career come to fruition without the corresponding educational attainment? Thus, focusing on supported education (Sed), as part of career development and recovery is an essential next step in early intervention. The Individual Placement and Support (IPS) Model is the most evidenced-based model of supported employment. Accordingly, testing the integration of Sed within this model has merit. At IEPA 10 in Milan, Italy an international pilot study was formed to assess the feasibility and validity of an integrated fidelity scale for supported employment and education (SEE) using the current IPS fidelity scale. This symposium will, first, report on the preliminary results of this collaboration including the successes and challenges. Second, it will report on potential reasons for poorer outcomes using IPS for Sed, validity issues regarding the adapted integrated scale, and possibilities for improving validity. Third, it will describe the coordination of the international collaboration between Norway, The Netherlands, Australia, Iceland, the U. K., Germany, Chile and the U. S. while navigating different public policy and regulations. Finally, this symposium aims to highlight the importance of collaboration to improve career outcomes and recovery in first episode psychosis. To conclude, there will be a discussant period at the end exploring future directions of Sed and relevant clinical needs to help youth effectively reach their career goals.
Talk 1 School-and JobPrescription: An Approach Integrating IPS for Employment and Education for People with First Episode Psychosis
Wenche ten Velden Hegelstad1, Inge Joa1,2, Lena Heitmann3, Jan Olav Johannessen1,2, Johannes Langeveld1; 1TIPS Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway, 2Network for Medical Sciences, University of Stavanger, Stavanger, Norway, 3School and JobPrescription, Stavanger University Hospital, Stavanger, Norway
Background: Individual Placement and Support (IPS) is an effective intervention for supported employment (SE), however, less so for education (Sed). School and JobPrescription in Norway are part of an international collaborative adapting the original IPS intervention and fidelity scale to include Sed. Method: This study was a quasi-experimental historical matched controls (N=33+33) study with a one–year intervention and two-year follow-up. The IPS-team was trained in educational facilities, curriculums, regulations, and financial resources and was rated on fidelity (April 2016, October 2017). Primary outcomes were hours enrolled in employment or education. Results: Thirty participants completed the intervention. SE scores remained stable (99 and 98 of 125) whilst Sed scores dropped (102 and 99 of 125). Fourteen participants (47%) attained competitive employment >20hrs/week post intervention, compared to 2 in the control group. Fifteen (50%)were in education >20hrs/week compared to 5 (17%) in the control group. However, 1-year post termination differences had waned. The control group had attained the same level of education, however had missed one year. Conclusion: Time-unlimited support was restricted due to funding. This may explain why results waned over time.
Talk 2 Does Cognitive Remediation Enhance the Vocational Recovery of Young People with First Episode Psychosis Using Individual Placement and Support? Results of the CREW Study: A Multisite Randomized Controlled Trial in The Netherlands
Daniëlle van Duin1,2,3, Hans Kroon2,3, Wim Veling4, Jaap van Weeghel1,3; 1Phrenos Center of Expertise, 2Trimbos Institute, 3Tilburg University, 4University of Groningen, University Medical Center Groningen
Background: Young people with psychosis have similar vocational ambitions as their healthy peers. However, psychosis and related problems make their vocational participation lower (Hendriksen et al, 2012). Individual Placement and Support (IPS) can improve vocational functioning in this group. However, 40-50% motivated to participate vocationally cannot succeed when offered IPS. Cognitive impairments may be one obstacle (McGurk et al., 2004). Cognitive remediation (CR) has demonstrated improvement in cognitive functioning for first episode psychosis (FEP). Some studies also indicate the efficacy of CR in daily functioning, provided that CR is combined with psychiatric rehabilitation to boost effects (Wykes et al, 2011; McGurk et al, 2007). The present multisite-study investigated whether CR can enhance the effect of vocational rehabilitation using IPS in competitive employment and mainstream education for FEP. Method: Seventy-three people with FEP either received IPS-enhanced with computerized CR (Circuits), or IPS in combination with an active control intervention (computer games). Follow-up assessments were conducted at 6 and 18 months to see whether patients improved vocationally (hours worked in regular employment or education), in cognitive functioning, symptoms, empowerment and self-stigma. Results: Preliminary results of the study will be presented.
Talk 3 Individual Placement and Support In ICELAND: Collaboration Between Landspitali University Hospital and VIRK Vocational Rehabilitation Fund
Nanna Briem1, Hlynur Jónasson2, Hildur Ævarsdóttir1, Halldora Jonsdottir1; 1Landspitali University Hospital, Reykjavik, Iceland, 2VIRK Vocational Rehabilitation Fund, Reykjavik, Iceland
Background: In 2012 a project began to implement the Individual Placement & Support (IPS) model into vocational rehabilitation for young people with psychosis in Reykjavik. The study was a collaborative project between Laugarasinn; a specialized unit for early intervention in psychosis and VIRK-Vocational Rehabilitation Fund, a private foundation where all the major unions and employers of the Iceland labor market are members. In November 2013 the first client began competitive employment via IPS and the project has gradually developed into one of the most important aspects of the rehabilitation-program for young people with first onset psychosis. In the last year the project has expanded to an inpatient psychosis unit and a dual diagnosis program. Method: Eighty-seven clients have received IPS services with an IPS team of three IPS workers from VIRK and IPS supervisors from three teams at Landspitali University Hospital. Integration of supported education (Sed) services is currently underway using the original IPS fidelity scale adapted for Sed. Results: Fifty-three of 103 clients (50%) are currently receiving IPS services and preliminary results regarding outcomes from the project will be presented.
Talk 4 Solid Foundations for Career: IPS, Education and Youth Mental Health
Eóin Killackey1,2, Kelly Allott1,2, Gina Woodhead4, Judy Ring3; 1Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, 2Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, 3Travencore School, Department of Education and Training, Parkville, Victoria, 4Orygen Youth Health, Parkville, Victoria
Background: Individual Placement and Support (IPS) is a proven intervention in helping people with psychotic illness return to, or enter into, work. In applying IPS to younger populations with First Episode Psychosis (FEP), education was seen as an equally valid outcome. However, educational outcomes were not significantly better in IPS groups compared to controls. This has been confirmed in meta-analyses of IPS in FEP. Hence, we conducted a pilot study of IPS adapted so as to have only education as a focus (IPSed). Method: 19 young people attending Orygen Youth Health in Melbourne were recruited and given access to IPSed. Results: 18 of the 19 participants had a positive outcome and either completed their course or completed prerequisite units to continue to the next level of their course. Conclusion: IPS has not been superior for education. There are a number of possible reasons for this. Firstly, that IPS was designed as an employment intervention and the IPS Fidelity scale reinforces this. Secondly, IPS workers often come from employment backgrounds and may not have the expertise to address educational goals. Finally, it may be that youth mental health services have historically included education as part of their developmental world-view, and so finding an effect above this is difficult. Results of our pilot study suggest that a singular focus on education may produce excellent outcomes. This result needs to be replicated but also raises questions about IPS for education in populations of young people with mental illness.
Discussant: Jaap van Weeghel, Phrenos Center of Expertise, Tilburg University
Tuesday, October 9, 1:00 - 2:30 pm, American Ballroom - North
Chair: Mary Cannon, Royal College of Surgeons in Ireland, Dublin, Ireland
Co-Chair: Olesya Ajnakina, Institute of Psychiatry, Psychology and Neuroscience, Kings College London
Speakers: Hannah Jongsma, Olesya Ajnakina, Kristine Engemann Jensen, Robin Murray
Mental health has lagged behind physical health in terms of focus on prevention. To date, the emphasis has been on secondary approaches to prevention of psychosis using early detection and early intervention models. But is this really the most effective approach? It may be time to move to a primary or population-based prevention focus. This symposium will present new data relating to both primary (population-based) and secondary (early intervention) approaches to prevention of psychosis. Data will be presented from epidemiological studies of first episode psychosis and large population-based and register-based studies. Hannah Jongsma will present data from the EU-GEI study showing an association between greater owner-occupancy levels and lower incidence of psychosis and increased risk for psychosis among minority groups. Hannah also will show that risk for psychosis incidence extends beyond young adulthood. Olesya Ajnakina will show that “At risk mental state” approach may not be as useful for prevention of psychosis as had been originally hoped. Kristine Engemann Jensen will report that childhood exposure to green space is a novel protective factor for psychosis, showing the importance of the built environment for mental health. Sir Robin Murray argues that we should harness public health and political measures to prevent psychosis. He shows that 24% of psychosis cases could theoretically be prevented by eliminating use of high-potency cannabis use in the population. Professor Andreas Meyer-Lindenberg will draw on these findings, and insights from his own work, in discussing how we can develop a new prevention-focused paradigm of research on psychosis.
Talk 1 Preventing psychosis: what can we learn from a large multicentre European incidence study?
Hannah Jongsma1, Craig Morgan2, Peter Jones1, James Kirkbride3; 1Department of Psychiatry University of Cambridge, 2Society and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, 3PsyLife Group, Division of Psychiatry, University College London
The incidence of psychotic disorders varies across social and environmental gradients at both an individual and a population level. However, the factors underpinning this are unclear. We conducted a population-based study of the incidence of non-organic adult ICD-10 psychotic disorders across the 17 catchment areas in the six countries (England, France, Italy, Netherlands, Spain, Brazil). Crude incidence rates were standardised to the 2011 England and Wales Census population to account for population differences in age, sex and ethnicity. Multilevel Poisson regression was carried out to investigate variance in incidence between catchment areas by latitude, population density, and percentage of unemployment, owner-occupied houses and single-person households. We identified a total of 2,774 cases over 12.94 million person-years at risk, leading to a crude incidence of 21.4 per 100,000 person-years (95%CI=19.4-23.4). By age 35, 68% of male cases had presented to services, compared with 51% of female cases. Poisson regression revealed higher rates of all psychotic disorders in minority groups (IRR=1.6, 95%CI=1.5-1.7), and an association between greater catchment area-level owner-occupancy and lower incidence (IRR for a 10% increase: 0.8, 95%CI=0.7-0.8). A higher population density was associated with an increased incidence of psychosis in England (IRR=1.2, 95%CI=1.1-1.2) and Netherlands (IRR=1.9, 95%CI=1.4-2.6), and was associated with a lower incidence in Italy (IRR=0.7, 95%CI=0.6-0.8). Services focused on early intervention should not have an upper age limit as half of all female (and 32% of male) cases present after age 35; future examinations of variance should be locally informed and take socioenvironmental risk factors into account.
Talk 2 Is the At Risk Mental State approach an effective method of preventing psychosis onset? A retrospective study of a UK mental health programme
Olesya Ajnakina1, Craig Morgan2, Charlotte Gayer-Anderson2, Sherifat Oduola3, François Bourque2, James MacCabe1, Paola Dazzan1, Robin Murray1, Anthony David1; 1Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, 2Society and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, 3David Goldberg Building, Institute of Psychiatry, Psychology & Neuroscience, Kings College London
Little is known about patients with a first episode of psychosis (FEP) who had first presented to prodromal services with an “at risk mental state” (ARMS) before making the transition to psychosis. We set out to identify the proportion of patients with a FEP who had first presented to the prodromal services in the ARMS state. We further sought to compare FEP patients with and without prior contact with prodromal services. In this study 338 patients aged ≤37 years who presented to mental health services between 2010 and 2012 with a FEP were employed. The data on pathways to care, clinical and socio-demographic characteristics were extracted from the Biomedical Research Council Case Register for South London and Maudsley NHS Trust. Over 2 years, 55 (16.3% of 338) young adults presented with FEP and had been seen previously by the prodromal services. Of these, 14 (4.1% of 338) had met criteria for the ARMS when seen in a prodromal service and 41 (12.1% of 338) were already psychotic. The true ARMS patients were more likely to enter their pathway to care via referral from General Practice, be born in the UK and to have had an insidious mode of illness onset than FEP patients without prior contact with the prodromal services. In the current pathways to care configuration, prodromal services are likely to prevent only a few at-risk individuals from transitioning to psychosis even if effective preventative treatments become available.
Talk 3 Experiencing childhood closer to green space is linked to lower schizophrenia risk
Kristine Engemann Jensen1,2, Carsten Pedersen2,3,4, Constantinos Tsirogiannis5, Preben Bo Mortensen2,3,4, Jens-Christian Svenning1; 1Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Denmark, 2Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Fuglsangs Alle 4, 8210 Aarhus V, Denmark, 3National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, Fuglsangs Alle 4, 8210 Aarhus V, Denmark, 4The Lundbeck Foundation Iniative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Fuglsangs Alle 4, 8210 Aarhus V, Denmark, 5Center for Massive Data Algorithmics, MADALGO, Aarhus University, Department of Computer Science, Aarhus University, The IT-park, Åbogade 34, DK-8200 Aarhus N, Denmark
Background Less green space in urbanized areas, where schizophrenia risk is high, could point to green space as an important factor. Green space is hypothesized to positively influence mental health and could mediate schizophrenia risk through noise and particle pollution removal, stress relief or other unknown mechanisms. However, the effect of green space on schizophrenia risk has not been disentangled from that of urbanization and it is unclear if different measures of green space associate differently with risk. Methods We used satellite data from the Landsat program to quantify green space for Denmark in 30×30m resolution for the years 1985-2013. The effect of quantity and heterogeneity of green space and urbanization at place of residence on schizophrenia risk was estimated using cox regression from a longitudinal population-based sample of the Danish population (943027 persons). Schizophrenia risk was controlled for age, sex, parental education, salary, and employment status. Results Living at the lowest amount of green space was associated with a 1.52-fold increased risk of developing schizophrenia compared to persons living at the highest level of green space. The strongest protective association was observed during the earliest childhood years and closest to place of residence. Conclusion Green space decreases schizophrenia risk independent of urbanization - consequently pointing to green space as a new environmental risk factor for schizophrenia. This study supports findings from other studies highlighting the natural environment as an important factor for human health, and points to a new methodological framework that combines epidemiological studies with big data approaches.
Talk 4 It is time to take a Public Health Approach to Prevention of Psychosis
Robin Murray1, Marta Di Forti2, Evangelos Vassos2, Harriet Quicgley1, Antonella Trotta2, Diego Quattrone2, Victoria Rodrigues1, Craig Morgan; 1Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, 2MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, 3Society and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
Background The main attempt to prevent the development of psychosis has been through clinics for people at clinical high risk. Such an approach is useful for research but can never reach the majority of individuals who will become psychotic. Biological markers could be used to identify individuals with unusual vulnerabilities e.g. those with copy number variations. However, identifying those with such markers is unlikely to impact on the majority of cases, and as yet no useful interventions are available. How therefore to prevent psychosis? Methods Data will be presented from 3 studies of first onset psychosis which used similar methods of ascertainment and assessment of cases and controls across 16 sites in 5 European countries. Results The polygenic risk score accounted for the greatest variance in caseness; those with scores in the highest quintile were 7 times more likely to be a psychotic case than those in those lowest quintile. Attributable fraction analyses indicated that if no one was exposed to child abuse and use of high potency cannabis, then 16% and 24% respectively of psychosis in South-London could be prevented. There are differences in the incidence of psychosis between Northern and Southern Europe. Conclusions Similarly to preventive approaches for hypertension or obesity where members of the general population are encouraged to take exercise and reduce their calorie intake, attempts should be made to influence society’s patterns of consumption of high-potency cannabis and educate them on impact of childhood abuse in a bid to prevent development of psychosis.
Discussant: Andreas Meyer-Lindenberg, Central Institute for Mental Health, Mannheim, Germany
Tuesday, October 9, 1:00 - 2:30 pm, American Ballroom - Center
Chair: David van den Berg, Parnassia Psychiatric Institute, The Hague, The Netherlands
Co-Chair: Amy Hardy, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, U.K.
Speakers: Sandra Bucci, David van den Berg, Mark van der Gaag, Amy Hardy
Childhood adversities are associated with psychosis, and empirical evidence investigating the causal mechanisms underlying this association is accruing (Bentall et al, 2014; Gibson et al, 2016; Hardy, 2017; Varese et al, 2012). People with psychosis are at an increased risk of revictimisation and are more likely to experience a range of post-traumatic stress difficulties, which negatively influences functional and clinical outcomes. In line with these findings, best practice guidelines recommend trauma and PTSD are routinely assessed in psychosis services, including Early Intervention, and that therapy is offered when indicated. Unfortunately, it is rare for trauma and PTSD to be recognised in psychosis services, preventing access to psychological treatments. The challenge is to effectively disseminate trauma-informed practice within frontline EIP services to ensure people’s needs are met. This symposium will reflect on progress and challenges in the area, illustrating our current theoretical understanding, clinical trial evidence, and routine service developments. Sandra Bucci will provide an overview of research highlighting the complex and multiple pathways from trauma to psychosis. David van den Berg will present the long-term results of a randomised controlled trial of trauma-focused treatment (TFT) for PTSD in psychosis. Mark van der Gaag will present on cost-effectiveness of TFT in psychosis. Amy Hardy will describe initiatives aiming to implement and build on these research findings in the early intervention in psychosis services of a National Health Service Trust in inner city London. The discussion will focus on how to move forward into the realm of early intervention and prevention.
Talk 1 Psychological mediators of the association between childhood adversities and psychosis
Sandra Bucci1, Jessica Williams1, Filippo Varese1, Katherine Berry1; 1Division of Psychology and Mental Health, University of Manchester, U.K.
Background: Risk for psychosis has been linked to a range of adverse life experiences and circumstances. Particular interest has been given to the relationship between psychosis and exposure to potentially traumatic life events in childhood to identify the impact of socio-environmental precursors to psychosis. This talk will report on a series of studies our group have conducted exploring psychological mediators of the relationship between childhood adversities and psychosis. Methods: We present findings from a systematic review, which identified 36 papers, comprising 9,057 participants with psychotic disorders and 58,782 non-clinical participants. Results: Despite great variation in the mediators considered and the methodological and analytic quality of the primary studies, our synthesis suggests the relationship between childhood adversity and psychosis is mediated by a several “families” of mediating variables including post-traumatic sequelae (e.g. dissociation, PTSD symptoms), affective dysfunction and dysregulation, and maladaptive cognitive factors (e.g. self-esteem and beliefs and concepts about the self and others; and miscellaneous (neuroticism and mastery; mindfulness; proximal life stressors). We have also conducted a series of studies investigating mechanisms involved in explaining the trauma-psychosis link, including attachment, particularly the role of disorganised attachment, and dissociative processes, and present findings from these studies in this talk. Discussion: The importance of the five different (but not independent or mutually exclusive) families of mediators considered in our work should be examined by future research employing appropriate modelling methods to better disentangle the contribution of these different processes.
Talk 2 Long-term outcomes of long overdue trauma-focused treatment in psychosis
David van den Berg1, Paul de Bont2, Berber van der Vleugel3, Carlijn de Roos4, Ad de Jongh5,6, Agnes van Minnen7,8, Mark van der Gaag1,9; 1Parnassia Psychiatric Institute, The Hague, Netherlands, 2Mental Health Organisation GGZ Oost Brabant, The Netherlands, 3Community Mental Health Service GGZ Noord-Holland Noord, 4Mental Health Organisation Rivierduinen, Leiden, The Netherlands, 5Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, 6School of Health Sciences, Salford University, Manchester, UK, 7Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands, 8PSYTREC Psychotrauma Expertise Center, Bilthoven, The Netherlands, 9VU University Amsterdam and EMGO Institute for Health and Care Research, Department of Clinical Psychology,
Background: Both childhood trauma and posttraumatic stress increase the odds of developing psychosis. Trauma focused treatments were found to reduce PTSD at 6-month follow-up in individuals who had, on average, been suffering from psychosis for 17.7 years and from PTSD for 21 years (van den Berg et al, 2015). In this RCT, participants in the control condition received their TFT of choice after the 6-month follow-up assessment. The prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR) groups were also assessed at 12-month follow-up. Methods: we compared the long-term outcomes for PE and EMDR with the 6-month outcomes to test whether the effects endured on the long term (n=85, = 78.8%). Results: Positive effects of both PE and EMDR on clinician-rated PTSD, self-rated PTSD, depression, paranoid-referential thinking, and remission from schizophrenia were maintained up to 12-month follow-up. Negative posttraumatic cognitions declined further in PE and were stable in EMDR. A significant decline in social functioning was found, whereas reductions in the interference of PTSD symptoms with social functioning were maintained. Discussion: Treating posttraumatic stress symptoms after 21 years is feasible and has long-term neutral to positive side-effects on symptoms of psychosis. Many factors other than PTSD, influence social functioning in this group and 8 sessions of therapy are not enough to enhance social recovery. A next step is to attend to symptoms of posttraumatic stress in young people with emerging symptoms of psychosis. As societies, we should invest more in the primary prevention of childhood trauma.
Talk 3 Cost-effectiveness and cost-utility for treating trauma in psychosis
Mark van der Gaag1,2, Paul de Bont3, Berber van der Vleugel4, Carlijn de Roos5, Ad de Jongh6,7, Agnes van Minnen8,9, David van den Berg2; 1VU University Amsterdam and EMGO Institute for Health and Care Research, Department of Clinical Psychology,, 2Parnassia Psychiatric Institute, Den Haag, The Netherlands, 3Mental Health Organization (MHO) GGZ Oost Brabant, The Netherlands, 4Community Mental Health Service GGZ Noord-Holland Noord, 5MHO Rivierduinen, Leiden, The Netherlands, 6Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, 7School of Health Sciences, Salford University, Manchester, UK, 8Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands, 9PSYTREC Psychotrauma Expertise Center, Bilthoven, The Netherlands
Background: The treatment of posttraumatic stress disorder (PTSD) in patients with a psychotic disorder is feasible, effective and safe. But the costs and benefits of trauma-focused treatment (Eye Movement and Desensitization Reprocessing therapy (EMDR) or Prolonged Exposure (PE) therapy) from a health economics and a societal perspective are unknown. Methods: All costs were recorded and both therapy conditions EMDR and PE were compared to the waiting list condition on “losing the classification of PTSD” according to DSM-IV-TR and on “gaining one Quality Adjusted Life Year (QALY)”. Results: Both therapies are cost-saving in losing the diagnosis of PTSD and in gaining one QALY. This is true for the health care costs and for the societal costs. Detailed outcomes will be presented at the conference. Discussion: The treatment of PTSD in people with psychosis has now been recommended in guidelines as being effective and safe. Policymakers, health care providers and insurance companies are encouraged to implement the therapies as they are also cost-saving in most cases, even in the short term of six months.
Talk 4 The ‘Talking Trauma’ project: Implementation of trauma-informed care in Early Intervention in Psychosis services
Amy Hardy1,2, Sarah Swan2, Jonathan Bradley2, Claire Thompson2, Suzanne Jolley1,2; 1Institute of Psychiatry, Psychology & Neuroscience, King's College London, 2South London & Maudsley NHS Foundation Trust
Background: The United Kingdom’s National Institute for Health and Care Excellence guidelines for psychosis and schizophrenia recommend that trauma and PTSD should be routinely assessed in Early Intervention for Psychosis services and, when indicated, therapies for posttraumatic stress disorder and other reactions to trauma provided (NICE, 2014). This is based on research indicating higher rates of trauma and posttraumatic stress reactions in this clinical group compared to the general population, and emerging evidence of the effectiveness of trauma-focused talking treatments (de Bont et al, 2015; van den Berg et al, 2015). However, effective implementation of the guidance is dependent on addressing barriers and opportunities from a range of stakeholder perspectives, multidisciplinary staff training and supervision, and an audit cycle to evaluate trauma-informed practice. Methods: The ‘Talking Trauma’ audit aims to address these needs, using interviews and surveys with service users and staff, together with case note review, and is being conducted across the psychosis services of a National Health Service Trust in inner city London. Results: A summary of the audit findings to date will be provided, followed by plans for further service development. Discussion: Implementation in early intervention in psychosis services is challenging but feasible. Attention needs to be directed towards establishing and maintaining a culture of trauma-informed care, to support effective case management and access to trauma-focused therapy.
Discussant: Lucia Valmaggia, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, U.K.
Tuesday, October 9, 1:00 - 2:30 pm, American Ballroom - South
Chair: Nikolai Albert, Mental Health Centre Copenhagen, Copenhagen University
Co-Chair: Merete Nordentoft, Mental Health Centre Copenhagen, Copenhagen University
Speakers: Nikolai Albert, Robert Heinssen, Eric YH Chen, Ashok Malla
The focus of the early intervention services developed across the globe has been to improve the treatment and outcome of patients with a first episode of psychosis. There are ideally two complementary strategies for achieving this, I.e, providing a comprehensive phase specific specialized treatment and actively reducing duration of untreated psychosis through multiple systemic interventions. Unfortunately only a few programs have been able to do both while for majority of jurisdictions have failed to integrate the two components. As a result patients in areas that have concentrated on reduction of DUP may still be treated in community health centers and patients in areas where specialized early intervention teams are operating are still experiencing a long DUP prior to treatment. Logically it should be possible to integrate the two components of EI; however, systemic barriers may be difficult to break down. In this symposium we will explore if there might be a positive mediating effect on the effect of the specialized early treatment by DUP reduction. The early intervention hypothesis suggested that the early years of illness were especially receptive to interventions, and in this symposium we want to explore if this hypothesis is supported by examining the role of DUP as a moderator of treatment effect. This symposium will bring together an international field of experts presenting data from some of the largest trials in the world. • JCEP, Prof. Eric Chen • PEPP-Montréal, Prof. Ashok Malla • RAISE prof. Robert Heinssen • OPUS II Ph.D. Nikolai Albert
Talk 1 The Effect of Duration of Untreated Psychosis and Treatment Delay on the Outcomes of Prolonged Early Intervention in Psychotic Disorders - a subgroup analysis of the OPUS II trial
Nikolai Albert1, Marianne Melau1, Heidi Jensen1, Lene Halling Hastrup2, Carsten Hjorthøj1, Merete Nordentoft1,3; 1Copenhagen Mental Health Centre, 2Psychiatric Research Unit, Region Zealand, 3University of Copenhagen
The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. In the main trial, we did not find an effect on the main outcome, negative symptoms, of prolonging the SEI treatment from 2 to 5 years. In this post-hoc analysis, participants were dichotomized based on DUP, treatment delay and time from first symptom until start of SEI treatment. The participants with a short DUP (< 3 months) showed a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment (<6 months) there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual so long as it is provided in the early years of illness and not just in the early years after diagnosis.
Talk 2 Duration of Untreated Psychosis Moderates Clinical Outcomes and Cost-Effectiveness in First Episode Psychosis Treatment Programs
Robert Heinssen1; 1National Institute of Mental Health
The Recovery After an Initial Schizophrenia Episode initiative evaluated the feasibility, effectiveness, and scalability of a multi-element, team-based approach to first episode psychosis care in the United States. The Early Treatment Program comparative effectiveness trial (RAISE-ETP) enrolled 404 participants from 34 community centers in 21 states; clinics were randomly assigned to provide specialized early intervention services (NAVIGATE; N=17) or usual community care (N=17). The median duration of untreated psychosis (DUP) among participants was 74 weeks. After 24 months, NAVIGATE recipients experienced greater improvements in quality of life, psychopathology, and involvement in work or school compared with patients in community care. In addition, NAVIGATE was more cost-effective than typical treatment. Median DUP was a significant moderator of treatment effects on quality of life and overall symptoms, but not on employment or school attendance. Patients with shorter DUP derived substantially more benefit from NAVIGATE compared to those with longer DUP, and participants in community care. For NAVIGATE patients with DUP <74 weeks, average annual treatment costs were 15 percent lower compared to the annual cost of typical care. Together these findings underscore the importance of complementary approaches for improving FEP outcomes. In 2013, the National Institute of Mental Health launched research initiatives to test feasible strategies for reducing DUP and achieving rapid referral of persons with FEP to specialized treatment programs. The focus, methods, and preliminary findings from 10 funded projects will be presented, along with implications for reducing DUP in ~200 specialized early intervention clinics now established in the United States.
Talk 3 4-year outcome of a specialized early intervention treatment for adult onset psychosis (JCEP): a randomized controlled trial
Eric YH Chen1, Christy LM Hui1, Sherry KW Chan1, WC Chang1, Edwin HM Lee1; 1Department of Psychiatry, The University of Hong Kong, Hong Kong
Despite advances in treatment of psychotic disorders, functional decline remains a prominent obstacle in the recovery pathway. Early intervention (EI) services worldwide have focused timely treatment on the first few years (i.e. critical period) of the disorder to prevent patients from developing long-term disabilities. However, the optimal intervention model and length remain unknown. The Jockey Club Early Psychosis (JCEP) Project delivered a specialized EI service for adult-onset first-episode psychosis patients aged 26 and 55 in Hong Kong. Using a randomized controlled trial, 360 patients were randomly assigned to receive either 4-year of EI treatment (n=120), 2-year of EI treatment (n=120), or 4-year of standard care (n=120). Clinical, functional and neurocognitive assessments were conducted at baseline, 6 months, and yearly until 4 years. By 4 years, it was found that the 4-year EI group had better cognitive outcome than the standard care group; and also better functional and cognitive outcome than the 2-year EI group. Subgroup analysis revealed that patients with longer duration of untreated psychosis (DUP) (≥94 days) benefited substantially more from 4-year EI, compared to 2-year EI. Patients with longer DUP who received 4-year EI had better functioning and cognitive outcome, while no additional benefit was observed in patients who had shorter treatment delay. JCEP evaluated the impact of EI by extending its duration to the entire 4 years. The consequence and implication of prolonged treatment to cover a longer hypothesized critical period will be discussed in this presentation.
Talk 4 Delay in initial treatment may limit the benefit of even extended early intervention service: results from a RCT
Ashok Malla1,2, Jai Shah1,2, Manish Dama1,2, Srividya Iyer1,2, Ridha Joober1,2, Amal Abdel-Baki3,4, Sherezad Abadi2; 1McGill University, 2Douglas Mental Health University Institute, 3Université de Montréal, 4Centre Hospitalier Universtaire de Montréal
Longer duration of untreated psychosis (DUP) has a negative influence on short and long term outcome in first episode psychosis (FEP) and may limit benefits of specialized early intervention services. It is not clear if this effect would persist even when the early intervention service is extended beyond the initial two years. We report here post-hoc analysis of the results of a large RCT comparing effectiveness of an extended early intervention service (EEIS) to Regular Care, following two years of initial EIS. The results of the principal analyses on the primary outcome (length of positive, negative and total remission) favoured the EEIS. Using a DUP ≤ 12 weeks (as per the literature) cut-off 217 patients were split into two groups and examined if longer remission in patients randomized to an EEIS was associated with shorter DUP. Patients with DUP ≤ 12 weeks (median for the sample), treated in an extended EIS experienced significantly longer remission for positive (β = 0.35; p <0.01), negative (β = 0.38; p <0.01), and total symptoms (β = 0.36; p = 0.01) compared to regular care. However, for patients with DUP > 12 weeks, no such difference emerged between the two treatment conditions. For those with DUP between 12-24 weeks, only length of remission for positive symptoms (but not negative) showed a borderline significance (β = 0.37; p = 0.05). These findings suggest that reducing DUP may be essential to getting the most benefit from a specialized EI service even in an extended EI service.
Discussant: Jan Olav Johannessen, Stavanger University Hospital
Tuesday, October 9, 1:00 - 2:30 pm, Staffordshire
Chair: Stephen Wood, Orygen, University of Melbourne
Co-Chair: Nikos Koutsouleris, Ludwig-Maximilians University Munich
Speakers: Lana Ilankovic-Kambeitz, John Gillam, Rachel Upthegrove, Paolo Brambilla
Despite five decades of quantitative research into early phases of psychoses, early recognition still depends on a human expert. Unfortunately, the availability of clinical services that provide this expert knowledge is not the only limitation. Early recognition is also a unique clinical challenge - accurately estimating the risk profile of an individual with diverse, frequently nonspecific psychopathology, leading to biased reasoning given different clinical traditions and gut feeling. Recently, opportunities to address the clincial challenge have emerged with machine learning, multi-site prospective study designs and international collaborations merging into a powerful methodology for precision psychiatry. Previous studies have provided preliminary evidence regarding the feasibility of stratifying at-risk and first-episode patients according to the odds of adverse outcomes by extracting candidate predictive models from diverse data. Candidate models are under further validation and analysis based on multi-site datasets collected within the NAPLS, PRONIA, PsySCAN and PNC projects. Should candidate markers generalize well, the outcomes would translate into significant increases in predictive and prognostic certainty. Such progress would allow for individualized risk-based stratification of patients and clinical trials, novel targets for drug development and tools for individualized neuromonitoring of preventive treatments. The symposium will present new data from the PRONIA project which has collected clinical, neurocognitive, blood-based and MRI data from 1600 persons in at-risk and early stages of psychoses and mood disorders, and healthy controls. PRONIA is currently generating machine-learning markers intended to predict clinically relevant outcomes, identify vulnerable subgroups and combine data for diagnosis and prediction across heterogeneous domains.
Talk 1 Using neuroimaging data to predict functional outcome in early spectrum psychosis
Lana Ilankovic-Kambeitz1; 1Ludwig-Maximilian-University
The growing knowledge about enduring functional impairment and disability in psychosis and in high risk (CHR) patients encouraged us to search for prognostic biomarkers to individually predict functional and clinical outcome independent of a subsequent transition to full-blown psychosis or remission of symptoms after psychosis. We aim to elucidate structural and functional brain determinants and potential modifiers of functional outcome trajectories in early stages of psychosis. We have employed Multivariate Pattern Analysis (MVPA) in the PRONIA discovery sample to predict functional outcomes of recent onset psychosis (ROP) patients and CHR patients after 12 months of naturalistic treatment, based on the patients' structural neuroimaging measures. The Global Functioning: Social and Role scale (GF:S, GF:R) were used to determine good or poor outcome status at the follow up examination. Volume-based pattern classification predicted good vs. poor outcome status at follow-up in CHR patients with accuracy levels of up to 77% as determined by leave-site out cross-validation. The neuroanatomical prediction signature mapped to volume increments in cortical areas pertaining to the default-mode and central executive network whereas volume reductions were located in hub regions of the salience network and the temporal cortices. The detection of CHR and psychosis individuals with specific brain alterations associated with poorer outcome at follow-up may help identifying a critical group of at-risk persons, who irrespective of diagnostic thresholds require clinical treatment and therapeutic support. In the next step, we are planning to employ functional resting state (rs) analysis to predict functional outcome in the same group of patients.
Talk 2 Data fusion and prediction of outcome in early psychosis
John Gillam1,2; 1Orygen, 2University of Melbourne
In order to extract the most powerful predictive models from data collected within the PRONIA study, diverse information sources must be combined. For each subject, neurocognitive, neuroimaging and clinically observed data has been collected that is intended to provided the basis for the development of predictive models for use in individualised diagnosis and prediction. While a number of approaches may be considered in the combination of data from a diverse range of sources, here, we investigate a two-stage learning approach. An initial step produces a single (probabilistic) outcome for each modality and a second step combines these outcomes to generate a final estimate of the target class. Neurocognitive and neuroimaging data, collected as part of PRONIA, were considered as features for prediction of clinically observed global function, measured at the same time-point. Each neurocognitive test was considered as an independent modality, as were each of a range of MRI-based neuroimaging measures. Using the same target-class (a global assessment of function score less than 65), different approaches to model generation were conducted for each modality using repeated, nested, cross-validation in both stages in order ensure robust estimates of generalisation. The framework of the two-stage learning process is described, and initial results are presented for each approach to classifier-learning considered for both the first and second layer of learning outcomes. An exploration of the contribution to the final prediction from each of the input data streams is discussed and the extension of this approach to structured data-fusion and prediction is considered.
Talk 3 Specificity of depression phenomenology, and neurobiology, in clinical high-risk and first episode psychosis
Rachel Upthegrove1,2; 1University of Birmingham, 2Forward Thinking Birmingham & Birmingham and Solihull Mental Health Foundation Trust
Major depressive disorder (MDD) is one of the most common mental disorders and is also the most common co-morbidity seen with other mental disorders. In schizophrenia the prevalence of depressive disorder is around 40%, reaching over 50% in groups at clinical high risk (CHR) for psychosis. It is unclear whether these expressions of depression are distinct from MDD without co-morbidity. To further understand the symptom profile of depression in emerging mental disorders, we present data from the PRONIA study (an EUFP7 funded 8 centre study; n=716) to compare CHR, recent onset psychosis (ROP), and recent onset depression (ROD). Using clinical, demographic, and neuroimaging data, and machine learning with Neurominer®, we attempted to classify participants on the basis of their depressive presentation. Data from BDI-II symptom endorsement suggests a 'classical depression phenotype' corresponding to Becks 'cognitive triad'; "life is pointless, future hopeless, self as worthless" may separate depression in ROD from that seen in ROP. Data will also be presented on the CHR group, together with analysis of structural MRI examining correlates with highly weighted classifying symptoms in and across all three groups. When given early in the course of illness, interventions have the greatest potential impact, and characterization and accurate diagnosis of depression in emerging mental disorders is an important goal. This study suggests it may be possible to accurately identify depression in different diagnostic categories, including major depressive disorder, psychosis and clinical high risk, and that neuroimaging holds potential to add to diagnostic accuracy in complex co-morbid disorders.
Talk 4 Prediction of functioning using neurocognitive features in subjects with clinical high risk (CHR), recent onset psychosis (ROP) and recent onset depression (ROD)
Paolo Brambilla1,2; 1University of Milan, 2The University of Texas Health Science Center at Houston
In this work, a relationship between functioning and neurocognitive evaluations has been investigated using machine learning. The analyses were carried out on the neuropsychological scores in 707 subjects with clinical high risk (CHR), recent onset psychosis (ROP), recent onset depres-sion (ROD) and healthy controls (HC). Subjects were not divided in classes but the prediction has been considered as dealing with a continuum in terms of global functioning. Subjects with incomplete data were excluded from the analysis. The measures of Global Functioning (GF) social and role, which quantify how effectively the person is functioning in their everyday life, were used to predict the difference in functioning at baseline (T0) and at 9 months follow up (T1) in respect to lifetime. Then, 38 features drawn from the PRONIA cognitive battery (PCB) on the basis of a priori knowledge were entered into a model that was evaluated with machine learning methods implemented with Neurominer. The non-informative features were pruned and the data were scaled. The model under-went 10x10 cycles of internal cross-validation (CV1) and 10x10 cycles of cross-validation against an outer portion of the sample (CV2) that, at each cycle, did not enter the CV1. The results showed that the model could reliably predict a drop in social and role functioning at T0 with respect to both life and past year (p<0.01), and GF social could be predicted (p=0.03).
Discussant: Paola Dazzan, Institute of Psychology Psychiatry & Neuroscience, Kings College London
Chair: Susanna Fryer, University of California - San Francisco, San Francisco VA Healthcare System
Co-Chair: Ricardo Carrion, Hofstra Northwell School of Medicine
Speakers: Susanna L. Fryer, Ricardo E. Carrión, Sylvia B Guillory, Margaret Niznikiewicz
Identifying biologically-based predictors and mechanisms related to the development of psychosis is critical to early detection and disability prevention efforts. The multi-site North American Prodrome Longitudinal Study combined baseline neurobiological assessment with longitudinal clinical follow-up of adolescents and young adults identified as clinical high risk (CHR) for developing psychosis. This session will present data on electrophysiology studies from the NAPLS 2 cohort with a focus on highlighting baseline electrophysiological markers that relate to 24-month clinical outcomes including, but not limited to, transition to psychotic spectrum disorders. Dr. Fryer from the University of California, San Francisco (UCSF) will present data from the mismatch negativity (MMN) paradigm, focusing on the relationship between measures of predictive coding at baseline and clinical outcomes 24 months later. Dr. Carrión from Hofstra Northwell School of Medicine will present a study on the functional impact of these MMN deficits by discussing interrelationships among MMN, negative symptoms, and cognitive and social functioning. Dr. Guillory from the Ichan School of Medicine at Mount Sinai will present a study comparing MMN and P300 functioning in CHR individuals with and without comorbid autism spectrum diagnoses including the extent to which this comorbidity influences biomarker relationships to conversion status. Dr. Niznikiewicz from Harvard Medical School will present findings on the gamma-band auditory steady-state response in youth at CHR for psychosis compared to healthy controls and conversion-based analyses within CHR. Dr. Mathalon from UCSF is the electrophysiology lead for NAPLS and will serve as the session’s discussant.
Talk 1 Experience-dependent strengthening of auditory prediction signals in youth at clinical high risk for psychosis: Effects of clinical outcome and conversion
Susanna L. Fryer1,2, Peter Bachman3, Aysenil Belger4, Ricardo Carrión5, Erica Duncan6, Jason Johannesen7, Margaret Niznikiewicz8, Brian Roach2, Jean Addington9, Kristin Cadenhead10, NAPLS Consortium, Daniel H. Mathalon1,2; 1University of California, San Francisco, 2San Francisco VA Healthcare System, 3University of Pittsburgh, 4University of North Carolina, 5Zucker Hillside Hospital, 6Emory University, 7Yale University, 8Harvard Medical School, 9University of Calgary, 10University of California, San Diego
The mismatch negativity (MMN) event-related potential (ERP) is an auditory prediction error signal elicited by the violation of the expectation that a standard, frequent sound will repeat. Repetitions of standards strengthen this prediction signal, and produce an increasing electrophysiological signature, the “repetition positivity” (RP). The RP reflects strengthening of experience-dependent short-term plasticity. Here, we examine the RP elicited by a MMN paradigm in youth at clinical high risk for psychosis (CHR; n=450) and healthy controls (HC; n=241) from the North American Prodromal Longitudinal Study-2. After 24 months of clinical follow-up, CHR participants (n=244) were categorized by clinical outcome status into subgroups that: i) transitioned to psychosis (CHR-Transition, n = 54), ii) did not transition but remained symptomatic (CHR-Symptomatic, n = 112), and iii) did not transition and reached symptom remission (CHR-Remission, n = 78). The RP (100-200 ms post-stimulus) to successive standards (2, 3, 4-5, 6-7, 8-10, >10 repetitions) was assessed at baseline. Significant group differences in RP amplitude were detected based on clinical outcome (Group*Standard interaction, p <.001). Follow-up tests revealed CHR-Transition had significantly smaller baseline RPs to late standards (>10 repetitions), relative to HC and CHR-Remission participants, who did not differ from each other. Similarly, the CHR-Symptomatic group, which did not differ from the CHR-Transition group, had smaller baseline RPs to late standards relative to HC and CHR-Remission groups (all follow-up p’s <.05, FDR-corrected for multiple comparisons). These results implicate deficits in short-term auditory cortex plasticity as a risk factor for psychosis that is sensitive to clinical outcome.
Talk 2 Determinants of Poor Social Functioning in Individuals at Clinical High Risk for Psychosis: Modeling the impact of Early Auditory Processing Deficits, Neurocognition, Social Cognition, and Negative Symptoms
Ricardo E. Carrión1, Barbara A. Cornblatt1, Peter Bachman2, Aysenil Belger3, Erica Duncan4, Jason Johannesen5, Margaret Niznikiewicz6, Brian J. Roach7, Jean Addington8, Kristin Cadenhead9, NAPLS Consortium, Daniel H. Mathalon7,10; 1Zucker Hillside Hospital, 2University of Pittsburgh, 3University of North Carolina, 4Emory University, 5Yale University, 6Harvard Medical School, 7San Francisco VA Healthcare System, 8University of Calgary, 9University of California, San Diego, 10University of California, San Francisco
Recent research in patients with schizophrenia has demonstrated complex relationships between early auditory processing deficits, neurocognition, social cognition, negative symptoms, and social functioning. However, the interrelationships and impact of these variables on social (i.e., interpersonal relationships) functioning impairments prior to the onset of the illness is unclear. The present study used a structural equation modeling (SEM) approach to integrate these factors to determine the specific determinants and pathways that lead to poor functioning in a large sample of treatment-seeking individuals at clinical high-risk (CHR) for psychosis. Participants were 765 CHR individuals enrolled and prospectively followed in the North American Prodrome Longitudinal Study (NAPLS2). We evaluated several theoretically based models with pathways starting from mismatch negativity (MMN) deficits to functioning. The intervening variables included neurocognitive performance, social cognition, and negative symptom levels. Social functioning was assessed with the GF:Social scale. Prodromal symptoms were assessed using the Scale of Prodromal Symptoms (SIPS/SOPS). Model estimation was performed using AMOS v16. A final trimmed model revealed that early auditory information processing (MMN) had a direct effect on neurocognition, neurocognition had a direct effect on negative symptoms, and both neurocognition and negative symptoms had direct effects on social functioning. The direct effect from social cognition to functioning was not significant. Our findings reveal a complex relationship between MMN reductions, neurocognition, negative symptoms and social outcomes in individuals at CHR for psychosis. These results may have implications for early intervention strategies that aim to improve functional trajectories in young individuals at high risk of developing psychosis.
Talk 3 Atypical P300, but not MMN, amplitude differentiates conversion patterns in psychosis prodrome with versus without comorbid autism spectrum disorder
Sylvia B Guillory1, Eva Velthorst1, Peter Bachman2, Aysenil Belger3, Ricardo Carrión4, Erica Duncan5, Jason Johannesen6, Margaret Niznikiewicz7, Kristin Cadenhead8, Jennifer Foss-Feig1, NAPLS Consortium, Daniel H. Mathalon9; 1Icahn School of Medicine at Mount Sinai, 2University of Pittsburgh, 3University of North Carolina, 4Zucker Hillside Hospital, 5Emory University, 6Yale University, 7Harvard Medical School, 8University of California, San Diego, 9University of California, San Francisco
Autism spectrum disorder (ASD) and schizophrenia are distinct disorders. However, atypical sensory and attentional processing characterizes both, and psychosis symptoms exist disproportionally in ASD. Electrophysiological markers that characterize schizophrenia, including P300 and mismatch negativity (MMN) amplitude reductions, are present in individuals at clinical high-risk (CHR) for psychosis. Whether these markers are: present in ASD individuals showing CHR profiles and/or predictive of conversion is unknown. We investigated P300 and MMN response and sensitivity to psychosis conversion across CHR groups with (CHR/ASD+) and without(CHR/ASD−) comorbid ASD. Electrophysiological data were analyzed from 305 NAPLS-2 CHR patients (14 CHR/ASD+; 291 CHR/ASD−). We examined P300 amplitude to infrequent Target(10%) and Novel distractor(10%) stimuli from visual and auditory oddball tasks, and MMN response for duration(5%), frequency(5%), and duration+frequency(5%) deviants. P300 amplitude to Novel visual stimuli was smaller in CHR/ASD− converters(n=71) than CHR/ASD− non-converters(n=220), but larger in CHR/ASD+ converters(n=4) than CHR/ASD+ non-converters(n=10) (Modality×ASD×Converter Interaction, F=3.57;p=.06). For auditory and visual Target stimuli, whereas P300 amplitude was similar for CHR/ASD+ non-converters and all CHR/ASD− individuals, CHR/ASD+ converters had larger P300 amplitudes (ASD×Converter interaction, F=12.12;p=.001). For MMN, there were no significant amplitude differences between groups (Conversion,p=0.31; ASD,p=0.57) or deviant type (p=0.56). Results revealed dissociable P300 amplitude profiles to visual and auditory target and novel stimuli in CHR patients that differentially predicted conversion to psychosis, depending on ASD status. MMN did not differ by ASD status. These findings suggest attentional orienting is differentially affected in CHR patients with ASD, whereas pre-attentive sensory memory is similar in CHR with and without ASD.
Talk 4 40 Hz-centered ASSR measures distinguish between healthy control and clinical high risk individuals in the NAPLS sample
Margaret Niznikiewicz1,2, Peter Bachman3, Aysenil Belger4, Ricardo Carrión5, Erica Duncan6, Jason Johannesen7, Brian J. Roach8, Jean Addington9, Kristin Cadenhead10, NAPLS Consortium, Daniel H. Mathalon8,11; 1VA Boston Healthcare System, 2Harvard Medical School, 3University of Pittsburgh, 4University of North Carolina, 5Zucker Hillside Hospital, 6Emory University, 7Yale University, 8San Francisco VA Healthcare System, 9University of Calgary, 10University of California, San Diego, 11Univeristy of California, San Francisco
Purpose: Abnormalities in gamma-band auditory steady-state response (ASSR) are an index of dysfunction in neural oscillations associated with GABAergic interneuron function and related to cognitive dysfunction in schizophrenia (SZ). A robust finding in SZ, they are regarded as one of its biomarkers. However, it is not clear if this abnormality is present already in individuals at clinical high risk for psychosis (CHR) and whether it distinguishes between those who will convert to schizophrenia and those who will not. As part of the NAPLS study we examined ASSR at both baseline and post-stimulus time-windows to address this important question. Materials and Methods. 439 CHR and 236 healthy controls (HC) were tested on the ASSR paradigm using 20, 30, and 40 Hz click-trains. Baseline power was examined within -200-0 msec window. The inter-trial phase coherence (ITC) was examined within 1. 0-200 msec post-stimulus latency window to interrogate early gamma-band response and 2. 200-500 msec post-stimulus window, to interrogate late gamma-band response. Results: For 40Hz click stimulation but not for 20 or 30 Hz, the baseline power was larger in CHR than in HC at both Fz (p=.04) and Cz (p=.04). In contrast, reduced ITC was observed for 40 Hz click-trains for latency windows of 200-300 msec (p=0.006), 300-400 msec (p=0.023) and 400-500 (p=0.34), (i.e., late gamma-band response). No measure distinguished between CHR-converters and non-converters. Conclusions: These results suggest that measures of baseline power and of ITC at 40 Hz distinguish between HC and CHR but are not sensitive to the conversion status.
Discussant: Daniel Mathalon, University of California - San Francisco, San Francisco VA Healthcare System
Chair: Byron J. Good, Harvard Medical School
Speakers: Byron J. Good, M. A. Subandi, Nida Ul Hassanat, Carla Raymondaleas Marchira
This panel grows out of two decades of collaboration between researchers from Harvard Medical School and Gadjah Mada University in Yogyakarta, Indonesia, focusing on first episode psychotic illness. Studies range from epidemiological research on the incidence and nature of onset of first episode/first contact psychoses; intensive ethnographic studies of individual cases followed over time, family responses and care for illness, and interaction with traditional healers; clinical studies, linking cultural phenomenology with clinical rating scales, and intervention studies focused on developing, evaluating, then scaling up psycho-educational interventions for families caring for a person with psychotic illness. Rather than addressing individual studies, this panel will provide a brief overview of the context and history of this program of research, followed by four presentations examining specific issues, drawing from the larger body of research: 1) the social and cultural influences on onset and long-term outcomes of illness, with a particular focus comparing very rapid and slow onset psychoses; 2) cultural phenomenology and care-seeking, providing both case studies and quantitative data; 3) the social course of illness, based on intensive longitudinal studies; and 4) evaluation of psycho-educational interventions for families of persons with psychotic illness, designed for the local social and cultural setting, and preliminary efforts to scale up such interventions through the primary health care system. The panel thus links studies of cultural phenomenology and psychosocial interventions of first episode psychosis. Though not generalizable to all of Indonesia, this research provides important data from Indonesia, the world’s fourth most populous nation.
Talk 1 The Place of Acute Onset in the Cultural Patterning of First Episode Psychosis in Java
Byron J. Good1, M. A. Subandi2, Carla Marchira2, Mary-Jo DelVecchio Good1; 1Harvard Medical School, 2Gadjah Mada University
From the beginning of our ethnographic and clinical research in 1996, the Yogyakarta team began identifying very rapid onset psychoses as unexpectedly common. This led to a series of studies investigating their cultural phenomenology, prevalence, the nature of prodromal features, and eventually to the relationship between acuteness of onset and long-term outcomes. Purpose: The overall aim of paper will be to present data about the nature and prevalence of acute onset illness among first episode first contact psychoses in Java, and to ask how the nature of onset relates to care-seeking and long-term course of illness. Methods: Data are drawn from ethnographic studies, an epidemiological study (of 304 first episode psychoses appearing for treatment in Yogyakarta in 6 months), an intensive set of 30 in-depth interviews with individuals and their care providers, and a 12 year follow-up of the 30 intensive cases. All data are retrospective studies of persons in first episode who have already contacted services. Findings: Our findings indicate that this is a real phenomenon, that as many as 36% of cases escalate from first appearance of psychotic symptoms to acute psychosis in a two week period, and that rapidity of seeking treatment is directly related to rapidity of onset. Small case studies indicate diversity in outcomes on follow-up. A 12 year follow-up of 30 intensive cases will be reported. Conclusion: Relevance of these studies for diagnostic issues, for studies of DUP and outcomes, and for the importance of cross-cultural research will be discussed.
Talk 2 Cultural Understandings of Illness and Care-Seeking Behavior among Caregivers of First Episode Psychosis in Java, Indonesia
M. A. Subandi1, Carla Marchira1, Mary-Jo DelVecchio Good2, Byron J Good2; 1Gadjah Mada University, 2Harvard Medical School
The cultural understanding of illness among caregivers of first episode psychotic persons is a crucial issue. Not only does it influences caregivers’ care-seeking behavior and length of time until receiving medical treatment (known as DUP, the Duration of Untreated Psychosis), but also in turn predicts outcome of illness. Purpose: This paper aims to explore cultural understanding and care-seeking behavior among caregivers of psychotic patients in Java Indonesia. Methods: Data for this paper were taken from several studies conducted by our research group in Yogyakarta, Indonesia. Methods of data collection include an epidemiological survey, ethnographic fieldwork, in depth interviews, and an intervention program. Findings: Results of analyses within and across studies indicate that caregivers employed diverse cultural explanatory model in understanding psychotic illness. Local cultural understandings, including possession and forms of black magic, were among the most common initial concepts used by family members in relation to psychosis. This echoes broader cultural beliefs in Java. However, it was not uncommon that caregivers also understood illness in psychological terms (frustration, dissapointment, and stress) and using medical explanations. Caregivers’ understanding of illness also changed over time, following the changing course of illness. Both models of illness and rapidity of care-seeking is also related to acuteness of onset. Conclusion: It is important for mental health providers, as well as those designing systems of care, to understand the diversity and changing nature of caregivers cultural understandings of psychotic illness.
Talk 3 The “Social Course” of the Early Phase of Psychotic Illness in Yogyakarta, Indonesia
Nida Ul Hassanat1, Mahana Sofiati Utami1, Carla Marchira1, M. A. Subandi1, Mary-Jo DelVecchio Good2, Byron J. Good2; 1Gadjah Mada University, 2Harvard Medical School
The concept “course of illness” for schizophrenia has primarily focused on clinical course. Social experience and cultural interpretations are also critical to understanding the course of schizophrenia. Purpose: This paper introduces the concept of “social course of illness,” as distinct from clinical course, to focus attention on what factors influence the development over time of the experience of psychotic illness, social functioning and social impairment, and family experiences, and uses the concept to explore the diverse courses of illness of a small cohort of persons with first episode psychosis in Yogyakarta, a center of Javanese culture in Indonesia. Methods: Eight patients with first-episode psychosis were interviewed approximately eight times each over three years, beginning 2001. Narrative data about illness experiences and care-seeking, cultural understandings of the illness, clinical ratings, data on social functioning, and qualitative data on stigma and social response, were all recorded. A follow-up study of these patients is currently underway. Results: Data from this study suggest that clinical symptoms and social processes influence each other, and that "clinical course” and “social course” may follow different patterns. It also suggested that both clinical course and social course vary widely from one individual to another, and that clinical impairment and social impairment are not always directly related. Conclusion: This research suggests the importance of reconceptualizing the early course of schizophrenic illnesses, and that culturally sophisticated social interventions should accompany clinical interventions to limit social impairment associated with psychotic illness and contribute to recovery.
Talk 4 The Effectiveness of a Brief Interactive Psychoeducational Intervention for Persons Living with First Episode Psychosis and Family Caregivers in Yogyakarta, Indonesia
Carla Raymondaleas Marchira1, Iran Suprianto1, M. A. Subandi1, Mary-Jo DelVecchio Good2, Byron J. Good2; 1Gadjah Mada University, 2Harvard Medical School
Psychoeducation of persons living with psychotic illness and their family caregivers is a long-standing and effective means of providing information and support that benefits both families and those living with illness. However, cultural adaptation of psychoeducation and integration into routine care in settings with very low mental health resources is rare. Purpose: This presentation aims to describe outcomes of an investigation of the effectiveness of a culturally-adapted, brief interactive psychoeducation intervention for family caregivers in Java, and to study the feasibility of integrating such interventions into routine mental health services provided by primary health care providers. Methods: An experimental study was conducted with pre-test and post-test assessments with 100 persons living with first episode psychotic illness and their family caregivers. Families were randomly assigned to intervention and control groups, and psychiatric residents were trained to administer 4 weekly interactive psychoeducation sessions with modules adapted for the local cultural setting. When the intervention was found to be feasible and effective, a program was developed to train staff in three primary health centers to provide a similar intervention for individuals and families registered with the primary health care center. Findings: The initial intervention was found to be feasible and effective, particularly in increasing Knowledge of Schizophrenia of family members and reducing rehospitalization. Training of primary health care workers was found to be feasible and effective. Conclusion: Adapting psychoeducation for individuals with psychotic illness and family caregivers is feasible and can be integrated into primary health services in low resource settings.
Discussant: Eric Y H Chen, Dept of Psychiatry, Hong Kong University
Chair: Donald Addington, University of Calgary
Speakers: Marianne Melau, Ilana Nossel, Janet Durbin, Eóin Killackey
First episode psychosis services have been shown to be effective in several large randomized controlled studies in different health care systems. There is a growing consensus as to the essential components of such services and fidelity scales have been developed to assess the degree to which services deliver the essential evidence based components. Fidelity scales can be used for assessing implementation of new programs, ensuring quality of existing programs and by funders for setting standards. The international health challenge is now to broaden access to first episode psychosis services and to ensure that existing services continue to deliver evidence based care. Fidelity scales are one of the tools that can be used to support access to quality services, but their application is challenging. Several fidelity scales are now available, and are being applied in the United States, Italy, Canada, Denmark, and Australia. In this symposium we will examine the challenges of large scale application of fidelity scales. Speakers will illustrate how these challenges are being overcome and fidelity scales are being applied in the United States, Canada, Australia, and Denmark. Mental health services have been slower to measure access and quality of services than other health services. Developing the systems required to support evidence based quality assessment for first episode psychosis services can lead to broader application in other aspects of mental health services.
Talk 1 Introducing program fidelity scales for Specialized Early Intervention in Denmark.
Marianne Melau1, Nikolai Albert1, Merete Nordentoft1; 1Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark
The evidence-based Specialized Early Intervention (SEI) has in Denmark grown to be a nationwide service for young adults’ experiencing a first episode psychosis. The implementation of the program was carried out without the use of fidelity measures. To rectify this, we developed and tested out a Danish fidelity scale for SEI teams, and for the first time we did a nationwide assessment of the quality and program fidelity of the SEI teams in Denmark. We found the fidelity scale to be a feasible and easy manageable tool for collecting fidelity data, and by using a multimodal approach we got a good understanding of how multidisciplinary teams interact and manage various aspects of a patient's treatment. Totally 96% (n = 22) of the SEI teams participated and all in all 59 % (n = 13) fulfilled the criteria for program fidelity in a satisfactory level. We found that there was high variability between SEI teams according to the structural domain of the fidelity scale. By contrast, we found great homogeneity between the teams in terms of item referring to treatment. This mapping of SEI teams’ program fidelity in Denmark makes it obvious that at a national level, there is an urgent need for a more systematic approach to training and supervision, with a centralized development of educational material, provision of training and organization of supervision. The study revealed a fragile organization of the educational activities. Models for implementation of continuous fidelity measurements will be discussed
Talk 2 Assessing Fidelity to the OnTrackNY Coordinated Specialty Care Model
Ilana Nossel1, Sarah Piscitelli,1, Susan Essock2, Franco Mascayano2, Lisa Dixon1; 1New Yoirk State Psychiatric Institute, 2Columbia University
OnTrackNY, New York State’s coordinated specialty care (CSC) program, has grown rapidly to 22 sites, highlighting the importance of scalable fidelity assessments. Our approach evolved in phases, using three information sources. We first relied on findings from high-touch training activities. Second, we used client- and program-level data on care processes and outcomes solicited quarterly from teams which are tabulated centrally, generating reports that teams receive. Third, building on Addington’s FEP Fidelity Scale, we added site visits, including chart reviews, team meeting observation and staff, participant and family member interviews. Our scale has 25 domains, comprised of 94 sub-items, 48 from data and 46 from site visit. Each domain includes one “critical sub-item” essential for fidelity. We completed a pilot study (2 sites) focusing on assessing the incremental value of site visits. Both programs had high fidelity, meeting expectations in 23/25 domains. Data items addressed team functioning and outcomes over the past year. Raters identified items that were sub-threshold, required clarification, or had gaps; these were validated and supplemented with information from the site visit. Ten domains were heavily or solely scored based on site visit including assertive outreach, treatment planning, client preferences/ shared decision making, and trauma. Eligibility and enrollment, crisis services, care processes, metabolic monitoring, and peer services had critical items that relied on site visit. Final scores reflect all information sources; raters discussed discrepancies between sources and reached consensus. Conclusion: Site visits can be a useful adjunct to regular summaries of administrative data used to monitor implementation fidelity.
Talk 3 Conducting Fidelity Assessments in Ontario Early Psychosis Intervention Programs: Evaluation of a Pilot Implementation Initiative
Janet Durbin1, Avra Selick1, Gordon Langill2, Donald Addington3, Chiachen Cheng4; 1Centre for Addiction and Mental Health, 2Canadian Mental Health Association, 3University of Calgary, 4Northern Ontario School of Medicine
Ontario Canada is home to about 50 Early Psychosis Intervention (EPI) programs, and a sector wide network of providers (EPION - Early Psychosis Intervention Ontario Network) who work collaboratively to improve quality of care. Ontario released EPI program standards in 2011 but adherence is unknown. In the fall of 2016, EPION partnered with Centre for Addiction and Mental Health (CAMH) to pilot a novel fidelity review process using the First Episode Psychosis Fidelity Scale (FEPS-FS). Three-person assessor teams of volunteer EPI staff (2) and CAMH implementation specialists (1) conducted 2-day site visits to assess fidelity. Assessor teams were supported through training, tailored data collection tools and post-visit rating consensus meetings with an expert. Fidelity reports included quality improvement suggestions as well as fidelity ratings and related explanations. Nine programs were reviewed. Qualitative data were collected from assessors and sites to assess value, feasibility, and quality of this fidelity assessment process. Overall feedback was positive. Assessor team members brought complimentary skills to the process. Programs valued having front line assessors who understood the clinical experience, and assessors valued learning about and from peer programs. The process required a steep learning curve, but assessor confidence increased with their second review. Using a validated, standardized scale gave weight to the assessment although some adaptations may be needed for Ontario context. Some rating challenges were encountered, and the time commitment was greater than expected. In our presentation we will further discuss Ontario-specific challenges and explore feasibility of continuing this approach.
Talk 4 Challenges, initial outcomes and results from the application of a fidelity model to first episode psychosis services in Australia
Eóin Killackey1, Kristi van der El1, Heather Stavely1, Patrick McGorry1; 1Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
Background: In the 2010 Australian Federal Budget funding was committed to establish a first episode psychosis (FEP) service system based on the EPPIC model. This system was established by 2016. A fidelity scale, the EPPIC Model Integrity Tool (EMIT), was developed to measure the adherence to the model of the 6 clusters delivering the FEP services. Method: The EMIT is an 80-item assessment tool that maps onto the 16 core components of the EPPIC model. The tool is administered via on-site interviews with staff and young people as well as accessing documents, policies and data around client flow and service. Results: The first two rounds of fidelity assessments occurred in June/July and September/October 2017. Brief results around these assessments will be presented. These data give an initial snapshot of the adherence of the sites to the EPPIC model. The implementation of the tool cast light on a number of challenges that need to be addressed and these will also be discussed. The utility of the feedback from assessment as a means to identify areas in need of improvement will also be discussed. Conclusions: Model fidelity is an increasingly recognised way to ensure that programs based on evidence continue to deliver high quality outcomes, and avoid drift from the model. This presentation will demonstrate the outcomes from the first two rounds of application of the EMIT, associated challenges and ways in which fidelity testing can help services to improve their support of young people with early psychosis.
Chair: Sandra Bucci, University of Manchester
Speakers: Sandra Bucci, Shon Lewis, Andrew Gumley, John Torous
The acceptability of digital tools in secondary mental healthcare appears acceptable, with promising results regarding efficacy. However, implementation of digital tools within mental health services is problematic. Without considering issues around implementation during the early stages of the development and delivery of digital tools, it is unlikely that these approaches will be disseminated beyond research studies and into mental healthcare services. This symposium brings together some of the world’s key research centres currently engaged in research evaluating integration of digital tools into secondary care mental health services. Bucci will present findings from qualitative and quantitative work regarding mental health staff and service user views on the facilitators and barriers to implementing digital tools into secondary care services. Lewis will then present findings from the ClinTouch/CareLoop trial, a smartphone software system built into the electronic care records of two large UK NHS Trusts targeting active symptom monitoring, symptom self-management and early detection of relapse in early psychosis. When built into clinical management workflows to enable personalised alerts of symptom deterioration, the system has the potential to promote earlier intervention for relapse. Gumley will present the protocol for EMPOWER, an end-to-end self-management system for psychosis being trialled in the UK and Australia. Gumley will discuss issues regarding medical device registration and engaging clinical teams in using the self-management system. Finally, using normalisation process theory, Lobban will report on a study identifying critical factors impacting on the implementation of an online peer supported self-management intervention for relatives of people with SMI.
Talk 1 Staff and service user perspectives of digital technology for early psychosis
Sandra Bucci1, Rohan Morris1, Christine Barrowclough1, Natalie Berry1, Gillian Haddock1, Shon Lewis1, Dawn Edge1; 1Division of Psychology and Mental Health, University of Manchester
Digital technology has the potential to transform the way people engage with mental health services. Findings from trials suggest that digital tools are feasible, with promising findings regards efficacy. However, research to date has largely ignored stakeholder and service user perspectives of these systems. Our group has explored both early psychosis service users' and staff subjective views of the use of mobile technology in the mental health setting. Framework analysis revealed a variety of barriers and facilitators to implementation of digital tools into the secondary care setting, including issues regarding the acceptability of technology in mental health, technology increasing access to, and augmenting, mental health support, issues around data protection, privacy and security of information, whether digital interventions are used as an adjunct to, or replacement for, usual care, and factors related to digital tools affording greater empowerment, control and choice than routine care. More specifically, service users' views said digital tools could enhance access to care by extending the reach of services to one’s natural environment and facilitating open and honest communication. Digital systems were also viewed as progressive, modern and relevant and potentially de-stigmatising. Digital tools were perceived as facilitating empowerment, affording patients meaningful choice and the opportunity to take active control of their healthcare. While staff share some of these views, they expressed more concerns around data security, risk management and workload flows. This talk will conclude with findings on the acceptability of a randomised controlled trial of a smartphone app used within UK early intervention services.
Talk 2 Smartphone-enhanced symptom management and relapse prevention: A randomised controlled trial
Shon Lewis1, Paolo Fraccaro1, Matthew Machin1, Richard Hopkins1, Caroline Sanders1, Zhimin He2, Charlotte Stockton-Powdrell1, John Ainsworth1, Pauline Whelan1, Til Wykes2; 1Division of Psychology and Mental Health, University of Manchester, 2Institute of Psychiatry, Psychology & Neuroscience
Improving recovery from acute symptoms and preventing relapse are two major challenges in psychosis. We previously developed a smartphone-based personalised technology to monitor symptoms in real time, which showed good acceptability, reliability and validity for active remote monitoring of symptoms. We now report an RCT testing its efficacy when embedded into the ICT systems of mental health services. Participants with early psychosis/SMI received a semi-random beep 2-4 times per day on their smartphone app and answer 14 key symptom rating items using a touchscreen slider. Responses are uploaded wirelessly in real time to a central server and build into a graphical readout on the handset. This was built into an end-to-end system in two NHS Hospital Trusts to stream data into ECRs and enable detection by the clinical team of SMI EWS when key symptoms exceeded a personalised severity threshold. 81 people were randomised to either active symptom monitoring or TAU. PANSS positive subscale score showed a significant mean reduction in treatment over 12 weeks in the early psychosis group. EWS alerts generated by the system occurred in 92% of cases and blind comparison with electronic case record data suggested good sensitivity and lower specificity, with clear indications of how to adjust the gain of the system to improve future event-detection efficiency. When the symptom-monitoring system was built into clinical management workflows to enable personalised alerts of symptom deterioration, it was shown to have potential use in promoting earlier intervention for relapse.
Talk 3 Implementation of a digital software system for recovery from psychosis early signs
Andrew Gumley1, Simon Bradstreet1, Stephanie Allan1, John Farhall2, John Gleeson3, Matthew Machin4, Maria Lambrou2; 1Institute of Health and Wellbeing, University of Glasgow, 2La Trobe University, Melbourne, Australia, 3Australian Catholic University, School of Psychology, Melbourne, Australia, 4University of Manchester
The detection and prevention of relapse in people who experience psychosis is important. EMPOWER is a complex intervention which is harnessing digital technology to identify risk of relapse in psychosis, and establish a pathway towards relapse prevention. This talk will report on findings from three stakeholder groups. Staff across Community Mental Health services in NHS Greater Glasgow and Clyde, UK and NorthWestern Area Mental Health, Melbourne, Australia were invited to participate, as well as service users with experience of psychosis and families and carers. The constructivist grounded theory approach was utilised to address the aims of the study. In total we conducted 25 Focus Groups (7 with service users, 5 with carers and 13 with staff). These Focus Groups comprised 23 service users, 38 carers and 86 mental health staff. All three groups reported the utility of early warning signs as a tool towards relapse prevention. However, each group differed in their conceptualisation of risk and their relative power to manage perceived risk. These perceptions of risk were closely linked to their roles and relationships with each other. Barriers and facilitators to implementation were conceptualised as existing at the level of service provision (e.g. staffing levels), fit with existing practice (e.g. potential relationships changes) and personal level of acceptability and making sense (e.g. access to one's own wellbeing data is useful). Results suggest several important factors for consideration when implementing self-monitoring via mobile phones for psychosis.
Talk 4 Integrating smartphone tools into clinical care: evolving regulatory, legal, and clinical workflow issues
John Torous1, Luis Sandoval1, Matcheri Keshavan1; 1Harvard Medical School, Boston, Massachusetts, USA
While efforts to improve the engagement and efficacy of smartphone app and sensors for psychosis patients continue to increase their clinical utility and validity, real world uptake remains lows. Drawing upon recent literature searches, consultation with attorneys, monitoring of healthcare legislation, and our team’s experience piloting smartphone apps for early course psychosis patients, this session will explore current barriers and opportunities to increase uptake of these digital tools in clinical care. While a review of United States case law reveals no legal precedent for mental health app liability, recent federal legislation offers insights into new means to certify apps as healthcare devices and differentiate clinical apps from a plethora of general wellness apps. Reviewing qualitative feedback our team’s three-month pilot of smartphone monitoring for patients with psychosis, we will discuss the resulting consensus on a need for better integration of app data with electronic medical records, better clinical summaries of data, and further education on mobile health technologies. Reviewing recent survey data from 100 patients with psychosis, we will also discuss the views and concerns of service users regarding privacy and safety for smartphone apps. Finally, we will review our team's smartphone ongoing research and integration efforts that aim to incorporate the principles discussed in this talk.
Discussant: Amy Hardy, Institute of Psychology, Psychiatry and Neuroscience, Kings College London
Chair: Michelle Friedman-Yakoobian, Center for Early Detection, Assessment and Response to Risk, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School
Co-Chair: Shaun Eack, School of Social Work and Department of Psychiatry University of Pittsburgh
Speakers: Joseph Ventura, Christopher Bowie, Shaun Eack, Michelle Friedman-Yakoobian
Cognitive impairments begin early in the high risk period for psychosis and persist throughout the course of illness, leading to significant functional disability. Literature on interventions targeting neurocognition and social cognition in early course psychosis is growing and showing promising results. Effectiveness, predictors, mechanisms, and moderators of these interventions and how they relate to the pathophysiology of early course psychotic disorders is just beginning to be explored. Presenters will share emerging data on novel interventions designed to improve neurocognition and social cognition in patients with early psychosis or those at clinical high risk. Christopher Bowie will present on efficacy and effectiveness of cognitive remediation in patients with early versus long-term psychotic illness. Joseph Ventura will present data on the impact of cognitive remediation on social functioning, and negative and positive symptoms in first episode schizophrenia. Shaun Eack will present on 10-year follow-up data on cognitive enhancement therapy for early course schizophrenia. Michelle Friedman-Yakoobian will describe an adaptation of cognitive enhancement therapy for individuals at clinical high risk for psychosis. Sophia Vinogradov will be the discussant for this symposium and will comment on current progress and future directions for this work.
Talk 1 Cognitive Remediation Can Improve Negative Symptoms and Social Functioning in First-Episode Schizophrenia: A Randomized Controlled Trial
Joseph Ventura1, Kenneth Subotnik1, Denise Gretchen-Doorly1, Laurie Casaus1, Michael , Boucher1, Gerhard Hellemann1, Keith Nuechterlein1,2; 1Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 2Department of Psychology, University of California, Los Angeles
Background: Meta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include additional benefits for schizophrenia patients such as negative and positive symptom reduction and improvements in functioning. Method: A RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9 years and mean education of 12.3 years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6 months and then booster sessions over the next 6 months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning. Results: Using GLMM, improvements over 12 months were found favoring CR for SANS Expressive Symptoms (p<.01), which was composed of Affective Flattening (p<.01) and Alogia (p=.04), and for SANS Experiential Symptoms (p<.01), composed of Avolition /Apathy (p=.04) and Anhedonia / Asociality (p<.01). Improvements were also found for the BPRS Positive Symptom Factor (p=.04) composed mostly of reality distortion (p<.01). CR was associated with improvements in social functioning (p=.05) as compared to HBT. Discussion: We confirmed that the beneficial effects of CR appear to extend beyond cognition to improvements in negative and positive symptoms, and social functioning in early course schizophrenia patients. These results suggest that cognitive remediation might have an impact at an early point in the illness when the reduction of risk factors for chronicity is most critical for promoting recovery.
Talk 2 Training Cognition in Psychosis: Effects of Perceptual Training and Executive Functioning Training Methods as a Function of Age
Christopher Bowie1, Michael Best1; 1Queen’s University
Several approaches to enhancing cognition have been used during the evolution of cognitive remediation for psychosis. The cognitive target of training differs across studies, from targeted to broad. Targeted training of perceptual skills has replicated effects on brain function, but less support for broader generalization than training of executive skills. Few studies have directly compared training across these dimensions. In this study, patients with psychosis were randomized to receive either perceptual skills training or executive functioning training, three sessions per week for three weeks with a therapist, and daily for 12 weeks with independent at-home training. Pre- and post-treatment measures included neurophysiological functioning, cognitive abilities, functional competence, and everyday functioning outcomes. Data from 70 patients with psychosis, including a subgroup with first-episode psychosis, will be compared both across training modalities and length of illness. At the time of the abstract, all participants have been enrolled in the trial with a last assessment date in March 2018.
Talk 3 Ten Year Durability Effects of Cognitive Enhancement Therapy in Early Course Schizophrenia
Shaun Eack1, Jessica Wojtalik1, Matcheri Keshavan2; 1School of Social Work and Department of Psychiatry University of Pittsburgh, 2Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School
Background: The purpose of this investigation was to examine the long-term trajectories of cognitive, functional, and clinical outcomes following Cognitive Enhancement Therapy (CET) in early course schizophrenia. Methods: Schizophrenia outpatients from a 2-year randomized clinical trial of CET applied in the early course of the illness are completing a 10-year post-treatment follow-up study. Participants from the original trial have completed a comprehensive battery of cognitive, functional, and clinical assessments identical to those in the original trial. Composite indexes were calculated for processing speed, neurocognition, social cognition, functioning, and symptomatology. Linear growth curve models were used to examine longitudinal durability differences in these five domains 10-years following treatment with either CET or an Enriched Supportive Therapy (EST) comparison treatment. Results: Social-cognitive ability favoring CET was stable across the 10-year follow-up period, with continued evidence of group separation and little evidence of erosion of efficacy. Some reduction in functioning was observed in both groups after completing treatment (all p < .001), but after 10 years patients in CET retained a higher level of functioning over the follow-up period. Finally, group separation favoring CET in symptomatology continued to persist relative to EST over the course of 10-year follow-up. Conclusions: Although these data are considered preliminary, the results suggest that CET is an effective treatment that contributes to long-term and stable improvements in cognition and functional outcome in people with schizophrenia treated in the early course of the illness.
Talk 4 Cognition for Learning and Understanding Everyday Social Situations (CLUES) for Youth at Clinical High Risk for Psychosis
Michelle Friedman-Yakoobian1, Matcheri Keshavan1; 1Center for Early Detection, Assessment and Response to Risk (CEDAR), Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School
Cognitive remediation approaches, especially those that are accompanied by intensive psychosocial rehabilitation, have shown promise for improving cognition and functional outcomes in individuals with schizophrenia. The movement of the field towards earlier detection and treatment of those at risk for psychosis has prompted questions about whether these approaches, when applied to youth at risk for psychosis, may have the capacity to reduce or prevent cognitive decline and associated functional disability. One approach that has shown promise for improving cognition and functioning in individuals with schizophrenia is cognitive enhancement therapy (CET), which is an intensive, individualized program that combines drill and practice cognitive training with group based skills training for enhancing neuro and social cognitive functioning. CET has been associated with improved cognition and role functioning in clients with chronic and early course schizophrenia. This talk will describe a modification of CET aimed for youth at clinical high risk (CHR) for psychosis. This program, named CLUES (Cognition for Learning and for Understanding Everyday Social Situations), has been modified to meet the unique developmental needs of a younger population of individuals at CHR. An overview of CLUES will be provided and data from an initial feasibility and small RCT will be shared and discussed.
Discussant: Sophia Vinogradov, University of Minnesota Medical School
Chair: Lucia Valmaggia, King's College London, Institute of Psychiatry, Psychology & Neuroscience
Speakers: Sophie Browning, Charlotte Gayer-Anderson, Merete Nordentoft, Gary O' Reilly
Being online has become an integral part of our daily life, and the majority of young people spend large part of their time interacting with new technologies, whether it is at school, to play games, to communicate with each other, or to relax. In this symposium, we explore how new technologies can be applied for the prevention and in the treatment of mental health problems. CUES-ED combines traditional teaching methods with new interactive technologies to build resilience in 7-10 years olds school children. The REACH study and the Danish High Risk study, have integrated Virtual Reality in the assessment of mental health problems to measure the real-time response to social interactions and to identify liability and resilience factors to emerging mental health problems in children and teenagers. To conclude we will present Pesky gNATs, a computer based intervention which integrates CBT with serious games to help children and young people experiencing anxiety and depression.
Talk 1 CUES-Ed: A universal early intervention programme for primary school children to promote wellbeing and resilience and to de-stigmatise mental health problems
Sophie Browning1, Debbie Plant1, Anna Redfern1, Karen Bracegirdle1, Suzanne Jolley2; 1South London and Maudsley NHS Foundation Trust, 2King's College London, Institute of Psychiatry, Psychology & Neuroscience
Difficulties meeting the need for mental health care amongst children and adolescents has led to increasing interest in resilience-building programmes delivered in public health settings. CUES-Ed is a universal clinician-led, school classroom-based programme for 7-10 year olds, rooted in cognitive behavioural therapy (CBT) and models. The central theme is ‘keeping our brains amazing’ by looking after our physical wellbeing; learning that thoughts, feelings and behaviour are interconnected; and building practical skills to help children manage life’s ups and downs. Uniquely, CUES-Ed also includes a focus on unusual perceptual experiences which have been associated with a range of adverse mental health outcomes. Sessions are delivered in a highly active and engaging way and the programme creatively utilises a range of innovative new technologies that help make abstract concepts more concrete and memorable. Our visually strong and recognisable branding and characters also help promote mental health in a positive way. Routine service evaluation has yielded promising findings in terms of pre-post improvements in general wellbeing, and in emotional and behavioural difficulties for those children scoring in the borderline or clinical ranges. Children self-reported an increased repertoire of coping strategies. Feedback from children, parents and teachers indicates that CUES-Ed is acceptable and subjectively helpful. Future developments include incorporating elements from our CUES (Coping with Unusual ExperienceS for Children) CBT manual, to adapt CUES-Ed for a clinical CAMHS population.
Talk 2 Validation of self-reported paranoid thoughts amongst adolescents using Virtual Reality
Charlotte Gayer-Anderson1, Gemma Knowles1, Stephanie Beards1, Maria Rus-Calafell1, Craig Morgan1, Lucia Valmaggia1,2; 1King's College London, Institute of Psychiatry, Psychology and Neursocience, 2South London and Maudsley NHS Foundation Trust
Background: Studies of suspiciousness about others in early adolescence have relied almost exclusively on self-report measures, with high resulting prevalence estimates (~30-45%). Virtual reality (VR) has successfully been used in adult samples to discriminate more precisely between potentially rational perceptions of threat, and unfounded paranoia. Using the first laboratory method for capturing the experience amongst adolescents, we are assessing the extent of agreement between self-report and interview measures of paranoia and low-level paranoia towards neutral avatars in a VR environment. Methods: Self-report and interview data on low-level paranoia are being collected from adolescents as part of a new cohort study, REACH (Resilience, Ethnicity and AdolesCent mental Health). Around 200 adolescents from REACH will be invited to enter a VR school canteen populated by neutral characters, and will be assessed on positive, neutral, and negative thoughts about the avatars. Results: Current pilot data (n=29) provides suggestive evidence that higher levels of negative thoughts towards the neutral characters was associated with feeling lonely (β 4.04, p 0.045), generalized anxiety (β 8.04, p 0.001), and depression (β 6.45, p 0.001). There was no association between VR-rated paranoid thoughts and self-report paranoia (β 0.27, p 0.851). Additional data will be available at the time of the conference. Conclusions: There is a need for simple and effective methods to accurately identify those with paranoia since these experiences are associated with increased distress and poor functioning in the short-term, and a range of severe mental health problems in the long-term. VR could be one such method.
Talk 3 Use of Virtual Reality to identify liability to social anxiety and paranoid ideas in the Danish High Risk and Resilience study
Merete Nordentoft1,2, Anne Søndergaard1,2, Maja Gregersen1,2, Nicoline Hemager1,2, Kerstin Jessica Plessen2,3, Niels Ole Mors2,4, Anne A. E. Thorup1,2,3; 1Mental Health Center Copenhagen, Psychiatric Research Unit, Mental Health Services, Capital Region of Denmark, University of Copenhagen, 2The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), 3Child and Adolescent Mental Health Center, Research Unit, Mental Health Services, Capital Region of Denmark,& University of Copenhagen, 4Research Department P, Aarhus University Hospital, Risskov, Denmark
The Danish High Risk and Resilience Study - VIA7 is a representative nationwide cohort study of 522 7-year old children of parents with schizophrenia, bipolar disorder or neither of these disorders. The children and their parents were thoroughly examined, when the children were seven years old. We are now reassessing all the children at age 11 and their families. In self-reports, high risk children more often report being bullied, but it is uncertain whether this is a sad fact or a marker of aberrant attributional style. A standardized social situation in a virtual reality scenario will help us to identify any liability to social anxiety and paranoid ideas. Therefore, we have developed a Virtual Reality (VR) scenario, which is a sensitive, standardised and direct measure of liability to anxiety, and paranoid ideas, which can be subtle signs of emerging mental disorders. VR can increase validity of assessments, by standardizing the exposure. Preliminary results from the first 200 children will be presented This VR format has the potential to become a crucial element in cognitive behavioural treatment of phobia, PTSD, social withdrawal and paranoid ideas, because exposure is considered as a very valuable element in cognitive behavioural therapy. However, exposure in real life can be hard to organize, and the VR animation allows exposure to challenging situations in an immersive, but also protected and controlled environment. The difficulty of the exposure can be changed, e.g. patients can be exposed to more hostility or higher levels of laughter.
Talk 4 Pesky gNATs! A CBT Computer Game and App for Young People with Anxiety or Depression.
Gary O' Reilly1; 1School of Psychology, University College Dublin.
This paper will describe Pesky gNATs, a computer assisted Cognitive Behaviour Therapy (CBT) intervention for young people aged 9 years or older experiencing anxiety or low mood. Pesky gNATs is designed to assist mental health professionals to deliver a CBT intervention filtered through the ideas of developmental psychology and learning theory, packaged within a computer game, played within the supportive context of a therapeutic relationship. Pesky gNATs has three components: (1). A computer game that delivers a child friendly CBT intervention. The game is played in session by a young person along-side a mental health professional. The game has seven levels, each delivering a single component of a customized developmentally appropriate CBT intervention, designed to be the equivalent of a standard treatment session in length to play. The CBT concepts in each game level are related and build on each other over the course of the programme. (2). A mobile app - freely available to any young person playing the game to download to their smartphone or tablet. The Pesky gNATs App supports the young person’s application of the CBT ideas they learn in session to their everyday life at home and school. (3). An on-line training suite for mental health professionals allowing them to train to use our programme and download it to their work computer. This paper will also describe the evidence supporting Pesky gNATs and our plans for its future development.
Chair: Nev Jones, University of South Florida
Speakers: Sascha DuBrul, Vanessa Klodnick, Stephanie Allen, Tamara Sale
Across mental health services research, increasing emphasis has been placed on the importance of involving youth and young adults with lived experience across the areas of program development, service implementation and research. Both peer-led research and research on peer or youth-led service components in early intervention nevertheless remain under-researched and under-represented in both the scientific literature and academic conferences. The goal of this symposium is to showcase four exemplary peer-led and/or peer-involvement focused projects from the US and UK in order to increase the visibility of youth/peer research leadership and its transformative potential. These presentations span research on the underlying mechanisms of peer support for young adults (DuBrul), emerging best practices in young adult peer supervision (Klodnick), the role of service user involvement in addressing implementation gaps in early intervention services (Allen) and in seeding innovation (EASA Young Adult Leadership Council). The symposium chair will begin with a brief overview of the international landscape of peer involvement in research and program development, followed by the four presentations, and concluding with a group Q & A.
Talk 1 What Makes a 'Peer'? Deconstructing Young People's Perceptions of Shared Experiences & Identities to Inform Peer Support in Early Intervention
Sascha DuBrul1; 1New York State Psychiatric Institute, NY, NY, USA
Purpose: In both the peer support literature and in practice, it is generally assumed that shared experience of specific diagnoses, mental health challenges and/or treatment are the primary basis for a shared "peer" identity and that these shared experiences in turn serve as primary drivers of the effectiveness of peer support. The goal of the service user led project described in this presentation was to investigate the extent to which both young adult service users and peer specialists working in early intervention (EI) settings in fact center shared mental health experiences versus other potentially salient aspects of shared identity including age, shared interests, background adversity, race/ethnicity and sexual orientation or gender identity. Methods: We conducted a mixed methods research project including a survey (n = 50) and interviews (n = 15) with both young adult current/former service users and peer specialists working in EI. Results: Our data suggest that there are a wide range of views on the perceived subjective importance of shared treatment or diagnostic experiences among young adults, with some interview participants expressing strong disidentification with their diagnoses or identities as a "service user" and a preference for relationships and mutual support premised on other (non mental health related) categories. Conclusion: We will discuss implications of our findings including the potential for mutual support interventions that foreground shared experiences, identities and/or interests unrelated to diagnosis, symptoms or treatment and propose next steps vis-a-vis both service development and research.
Talk 2 Developing Effective Supervision Practices & Processes for Young Adult Peer Mentors in Massachusetts
Vanessa Klodnick1; 1Thresholds Research, Chicago, IL, USA
Purpose: To boost engagement and ensure services are young person-informed, peer support is becoming increasingly common in transition-age youth mental health programs. Supervision is key for young adult peer support on-the-job success. However, what supervision looks like for young adult peers varies widely. Methods: Massachusetts successfully integrated Young Adult Peer Mentoring (a Medicaid reimbursable service) statewide for 14-21 year olds with mental health challenges. Through a partnership with the University of Massachusetts Transitions to Adulthood Center for Research and Thresholds in Chicago, supervision principles, practices, online and in-person trainings, and a guidebook were developed for Young Adult Peer Mentor supervisors. Results: Over 100 supervisors participated in on-line webinars, in-person trainings, and community of practice calls between 2015 and 2017. Participant feedback was exceedingly positive, calling for additional tools, which led to the development of a Young Adult Peer Supervision Guidebook. The trainings and guidebook help supervisors to effectively use the working alliance, reflective supervision, strategic use of self, and self-care in order to provide culturally attuned, developmentally focused supervision to peers. The trainings and guidebook are available at: http://www.cbhknowledge.center/yapm-supervisor-tool-kit. Conclusions: Advances in young adult peer supervision theory, practice, and processes in Massachusetts have implications for child and adult serving systems and providers. Research is needed to evaluate the impact of supervisor development initiatives within transition-age youth serving programs in Massachusetts and beyond.
Talk 3 Addressing the Research to Practice Gap through Co-Production & Service User Leadership in Early Psychosis Intervention Research
Stephanie Allen1; 1University of Glasgow, Glasgow, United Kingdom
Purpose: Digital technologies offer much promise in delivering psychosocial interventions for early psychosis. However, many interventions that appear to work within the context of a clinical trial fail to become part of everyday practice. This failure to implement seemingly successful interventions into routine practice wastes money and time, and also raises concerns that people are unable to access interventions that could improve their wellbeing. Implementation can be more successful if we take greater account of users' experience and engage in collaborative practice (Gillard et al., 2016). Collaborating with service users and valuing their experiential knowledge can help anticipate structural implementation barriers relevant to service users alongside those experienced by staff. Methods: EMPOWER is a digital intervention which aims to enhance control and promote recovery for people with psychosis (including those using early intervention services) through the early identification of potential relapse. Service user involvement has been key to the development of the intervention. Implementation of EMPOWER is also supported by peer support workers. In addition, a service user researcher is evaluating the implementation process as part of an ongoing cluster randomised controlled trial. Findings: This talk will offer reflections from the service user evaluator on how direct user involvement can not only make interventions more relevant for people with psychosis but also potentially develop a more valid understanding of the implementation process. Conclusions: Service user involvement in early intervention research and development has the potential to significantly impact the form interventions take and the questions we ask in evaluating them.
Talk 4 From Participatory Leadership to Participatory Research: Integrating Lived Experience into the Evidence Base for Early Intervention
Tamara Sale1; 1Early Assessment and Support Alliance (EASA) Center for Excellence, Oregon Health Sciences University, Portland, OR, USA
Purpose: Responding to the need to increase the meaningful involvement of youth/young adults, the EASA Young Adult Leadership Council (YALC) was created in 2013 to provide direction and feedback to Oregon’s statewide early psychosis dissemination effort. Methods: YALC members have prioritized improving rapid identification and early engagement in EASA, and used their own experiences to inform policy development, research, clinical training and practice. YALC's interest in reducing early drop-out and increasing initial engagement led to the EASA Connections research study in which EASA graduates and participants worked with researchers and EASA clinicians to design and develop a peer-oriented web resource and investigate its impact on new individuals entering the EASA program. Findings: EASA Connections is in the final stages of testing. The iterative process in which YALC generated priorities informed by data and understanding of the EASA program, launched a separate participatory research process, and participated in the development and implementation of the research, provides a template for similar bodies in other programs. In addition, the Leadership Council has spearheaded the use of iterative feedback to develop policy recommendations and feedback for practice guidelines, written materials and trainings, in a fashion which may begin to inform the field about how such leadership groups can integrate lived experience, quality improvement, research and policy advocacy to maximize the impact and effectiveness of early psychosis efforts. Conclusion: EASA's experiences underscore the impact of young adult leadership and the importance of incorporating such mechanisms in EI.
Chair: Alan Rosen, Brain & Mind Centre, University of Sydney, Institute of Mental Health,University of Wollongong, Australia
Co-Chair: Patrick McGorry, Orygen Youth Mental Health Centre, University of Melbourne, Australia
Speakers: Alan Rosen, Katherine Boydell, Peter Byrne, Patrick McGorry
Does the evidence support having Early Intervention (EI) teams which cover wider diagnoses and age groups, or does it still only squarely support having discrete early intervention teams for young people with first episodes of psychosis? Meanwhile, triage and initial counselling services as a "one-stop-shop" or "clearing house" for assessing and assisting with all mental health disorders in young people, or exploratory programs for EI's of other disorders and other age-groups may be promising. However, they require further evaluation at this stage, for evidence of better outcomes. Should we enhance and resource EIP teams for young people to allocate a minority of extra places (say 10-15%) for severe high intensity disorders of a wider spectrum of psychiatric diagnoses which require a similar approach (as for psychosis) whether in ultra high risk states, acute early episodes requiring intensive mobile community care and assertive rehabilitative/recovery work? eg major affective disorders, disabling anxiety states, and severe eating disorders. This would not denature the clinical and functional teamwork protocols, and therefore should not diminish outcomes for first episode psychoses. Further, should trauma specific care be provided in common to most severe disorders? These approaches are consistent with Rosen, McGorry, Byrne and Goldstone chapter in Tasman A et al, eds, “Psychiatry” current 4th edition textbook, Wiley, 2016, on early Intervention across multiple disorders and age-groups, Byrne & Rosen, eds, "Early Intervention in Psychiatry : EI of nearly everything for better mental health" Blackwell-Wiley, 2014, and McGorry, EI: Mission Cramp Vs Mission Creep, ANZJP, 50, 11:1033-1035.
Talk 1 Will widening the range of ages and diagnoses in Early Intervention in Psychosis teams dilute their methods and outcomes? How specific, how focussed, how intensive, and how pure in diagnosis, purpose and age-group criteria do these teams need to be to achieve consistently better outcomes?
Alan Rosen1,2; 1Brain & Mind Centre, University of Sydney, Australia, 2Illawarra Institute of Mental Health, University of Wollongong, Australia
Does the evidence support having Early Intervention (EI) teams which cover wider diagnoses and age groups, or at this stage does it still only squarely supports having discrete teams for early intervention teams for young people with first episodes of psychosis? Meanwhile, triage and initial counselling services as a "one-stop-shop" or "clearing house" for assessing and assisting with all mental health disorders in young people, or exploratory programs for EI's of other disorders and other age-groups may be promising. However, they require further evaluation at this stage, for evidence of better outcomes. At the same time, perhaps we should consider EIP teams for young people reserving a minority of places (say 10-20%) for severe high intensity disorders of a wider spectrum of psychiatric diagnoses which require a similar approach (as for psychosis) whether in ultra high risk states, acute early episodes requiring intensive mobile community care and assertive rehabilitative/recovery work. eg post-traumatic, major affective disorders, disabling anxiety states, and severe eating disorders.This would not denature the clinical and functional teamwork protocols and therefore should result in equivalent outcomes as for first episode psychoses. Training, working and supervising to evolving fidelity criteria for evidence based early interventions and service delivery systems, as well as contextual considerations, like agegroup specific and friendly facilities and practices, and home visits and social system intervention to engage, educate and elicit collaboration with both individuals and families, may be more crucial to success than procedural purity.
Talk 2 Women over 25+ years with first episode psychosis: A rationale for extending early intervention in psychosis services [or should we provide specific FEP teams for this age-group]?
Katherine Boydell1,2; 1Black Dog Institute, School of Psychiatry, University of New South Wales, Australia, 2Child Health Evaluative Sciences, The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Canada
Psychotic disorders are serious mental disorders resulting in significant human and economic impact. Early intervention for individuals with psychosis is effective in enabling better clinical and functional outcomes, however, most specialist services in early intervention in New South Wales, Australia work within an upper age limit of 25 years. We identify the need to explore help-seeking (pathways to care) and care-receiving narratives (experiences of services/supports) of 70% of women (in NSW, Australia) who experience a first episode of psychosis (FEP) when over 25 years of age and who are, therefore, frequently excluded from specialist early intervention. There is little research on this group and consequent lack of an evidence-base to inform service design and delivery. What is clear is that: 1) a significant proportion of women experiencing FEP are excluded from specialist early intervention services as they are over the arbitrary age limit, 2) these women’s specific needs are not addressed by general or youth services, and 3) the failure to provide specialist treatment has deleterious effects for them and their children. We provide an overview of the need to examine these women’s help-seeking and care-receiving experiences via mixed methods in order to understand how to best support women at home, school/work, and within their community, and inform practices in mental health, education/employment and welfare service settings. Specific evidence-based knowledge translation strategies will be suggested to ensure that findings meaningfully impact stakeholders and influence health-care practices and policy and redress the inequity of healthcare experienced by this group of women.
Talk 3 Whither and Where Next for Early Intervention Teams in the UK?
Peter Byrne1,2,3; 1Royal London Hospital, East London NHS Foundation Trust, England, 2Royal College of Psychiatrists, UK, 3Centre for Health Policy, University of Strathclyde, UK
Many London EI teams are now seeing adults into their 30s. I have come across some females (late 30s and 50+) who had psychotic depression and were complex, They had great results thanks to flexible EI team working; but can this work continue to be extended without more resources? What about working with vulnerable infants and young children? On the other hand does this trend represent the potential serial diluting of the EIP model in the NHS, England, by extending the scope of the EIP teams to cope with both wider age groups (beginning with teams stretching to 18-36 and some to 18-65) and all mental health diagnoses and all high risk states. This presentation will explore the pro's and con's of these developments, and review their impacts so far. In addition, there are new requirements to meet intake deadlines and comprehensive delivery requirements in return for nominal new enhancements for their trusts based on the National Access & Waiting Time Policy Standard. Is this resulting in real stabilization and further constructive development of EI teams, or is this an acceptance of an offer of a Faustian Pact under pressure, or resignation to having to comply with an unpalatable deal that they can’t refuse? Firstly, will this enhancement really come back to EI teams? ? In reality are they just being asked to do more, more superficially with less resource? Secondly will it denature the culture & skills of a service which is vulnerable young-person friendly & developmentally focussed?
Talk 4 Has Mission Creep crept into Early Intervention? Beware a reversion to the former status quo of superficial and unfocussed services.
Patrick McGorry1,2; 1Orygen Youth Mental Health Centre, University of Melbourne, Australia, 2International Association for Youth Mental Health, Australia
Dementia Praecox was named thus for a reason. Most cases appear in young people though a minority of cases do present later in life, some after youth onsets with very long DUPs. The AESOP study data, which seems to have prompted the unfortunate move of inducing early intervention services in some countries to fall for the “3 card trick” of adding in older patients without more resources. Instead of creating a developmentally appropriate model for this subgroup, the successful and cost effective EI model has been undermined in a reversion to the status quo. Much more sensible would have been adding resources and making the EI model available to a range of complex syndromes where working intensively to EI protocols and specialist expertise are required. This would build a specialist youth mental health model to integrate horizontally with EIP services and vertically with youth friendly primary care and also with acute youth mental health care including inpatient services. While over-relying on the AESOP study which is out of kilter with most of the literature, and possibly over-estimating the proportion of disabling FEP’s emerging in older age groups, Lappin et al (2016) legitimately argue for EI provision for FEP’s starting over 25 or even 35. They also suffer from delayed access and outcomes that are equally as poor as in younger individuals with FEP, which are likely to be improved by more intensive and sustained EIP care. The question is how to do it, without disrupting clearly evidence-based EIP youth-friendly services.
Discussant: Peter Jones, Professor of Psychiatry, University of Cambridge UK, President IEPA
Wednesday, October 10, 1:00 - 2:30 pm, American Ballroom - North
Chair: Kristen A Woodberry, Beth Israel Deaconess Medical School, Harvard Medical School
Co-Chair: John Torous, Beth Israel Deaconess Medical School, Harvard Medical School
Speakers: Sarah Lynch, Kristen A Woodberry, Zuzana Kasanova, John Torous
The proliferation of smartphones has launched a new era of research providing insight into the dynamics and underlying mechanisms of mental health and mental illness. In this symposium, we will illustrate the potential of different types of digital data and levels of analysis for predicting and intervening in symptom patterns, risk, phenotypes, and trajectories. Sarah Lynch, MSW, will present the clinician’s perspective, illustrating how time-lagged analysis of daily affect and psychosis ratings can inform clinical intervention, from psychoeducation to psychopharmacology. Kristen Woodberry, MSW, Ph.D., will expand on this, examining how symptom dynamics may improve on static predictors in the early stages of mood and psychotic disorders. Preliminary experience sampling data from youth ages 15-25 with psychotic spectrum disorders will illustrate different patterns of affect and psychosis variability. Zuzana Kasanova, Ph.D., will discuss the association of reward-oriented behavior in daily life and striatal reward-related dopamine release in the lab using data collected in healthy volunteers and first degree relatives of patients with psychosis. John Torous, M.D., will illustrate how a combination of smartphone active data (surveys and voice samples) as well as passive data (geolocation, accelerometer, call/text logs) can be combined to create a digital phenotype of early psychosis. Using freely available and open source research apps, the talk will feature examples and discuss the ethics, implementation, and analysis of digital phenotyping data. Finally, Inez Myin-Germeys, Ph.D., will discuss the overall implications of different digital data and levels of analyses for the science of early intervention.
Talk 1 Using daily diary data to guide differential treatment of affect and psychosis in early course psychotic disorders
Sarah Lynch1; 1Maine Medical Center
Background: The interplay between affect and psychosis is often complex during the first years of a psychotic illness, particularly in adolescents and young adults. Determining the primary target of treatment can be challenging, particularly with weekly or less frequent self-report. Methods: Participants of a specialized first episode psychosis program rated affective and psychotic symptoms on a daily basis over multiple weeks of treatment. Auto-, cross-lagged, and between symptom correlations are calculated. Results: Statistical correlations augment visual graphs to illustrate periods of stability, instability, and temporal sequencing in affect and psychosis. Clinical examples will highlight the use of these data in patient or family psychoeducation, clinical problem solving, and the selection of primary and secondary treatment targets. Discussion: Individual tracking of symptoms within and across multiple days can highlight predictive shifts, not only in levels of affect or psychosis, but also in the degree to which they vary and relate. Temporal analyses of symptom dynamics could help individuals and their clinicians recognize early warning signs and alter treatment targets, priorities, or strategies to improve symptom management and clinical outcomes over time.
Talk 2 Within and between day variability of affect and psychotic-spectrum symptoms in psychotic-spectrum and healthy youth
Kristen A Woodberry1,2, Kelsey Johnson1, Sarah Lynch3, Anna Cloutier3, Douglas Robbins3; 1Beth Israel Deaconess Medical Center, 2Harvard Medical School, 3Maine Medical Center
The majority of major mental illnesses emerge between ages 15 and 24. Yet initial symptoms, typically subtle disruptions of both affect and thought, are precursors of a range of serious disorders including schizophrenia spectrum, bipolar, borderline personality disorders, and severe depression and anxiety. There have been efforts to identify specific symptoms or combinations of symptoms, demographic variables, and biomarkers predictive of later disorder, particularly schizophrenia. However, there has been little research capturing the temporal sequence or variability of affect and unusual thoughts during the early phases of mental illness and across different trajectories. Preliminary experience sampling data from youth ages 15-25 with and without psychotic spectrum disorders will illustrate different patterns of variability in affect and psychosis within and across days and weeks. The author will highlight the potential relevance of different measures of variability (e.g., intensity and valence, positive to negative affect shifts), temporal variations (moment-to-moment, day-to-day, week-to-week), periods of stability and instability, and the temporal sequencing and relationships of affect and psychosis over time. Improving on static predictors of mood and psychotic disorders, dynamic data could transform clinical formulation and treatment planning with high risk youth, leveraging digital data for personalized medicine approaches to early intervention.
Talk 3 Striatal Dopaminergic Modulation of Reward Learning Predicts Daily-Life Reward-Oriented Behavior in Individuals at a Familiar Risk for Psychotic Disorder
Zuzana Kasanova1; 1Leuven University
Abnormalities in reward learning in psychotic disorders have been proposed to be linked to dysregulated subcortical dopaminergic (DA) neurotransmission, which in turn is a suspected mechanism for predisposition to psychosis. We therefore explored the striatal dopaminergic modulation of reward processing and its behavioral correlates in individuals at familial risk for psychosis. We performed a DA D2/3 receptor [18F]fallypride PET scan during a probabilistic reinforcement learning task in 16 healthy first-degree relatives of patients with psychosis and 16 healthy volunteers, followed by a six-day ecological momentary assessment study capturing reward-oriented behavior in the everyday life. We detected significant reward-induced DA release in bilateral caudate, putamen and ventral striatum of both groups, with no group differences in its magnitude nor spatial extent. In both groups alike, greater extent of reward-induced DA release in all ROIs was associated with better performance in the task, as well as in greater tendency to be engaged in reward-oriented behavior in the daily life. These findings suggest intact striatal dopaminergic modulation of reinforcement learning and reward-oriented behavior in individuals with familial predisposition to psychosis. Furthermore, this study points towards a key link between striatal reward-related DA release and pursuit of ecologically relevant rewards out in the real world.
Talk 4 Towards Digital Phenotyping for Relapse Prediction in Schizophrenia
John Torous1,2, Ian Barnett3, Patrick Staples3, Luis Sandoval1, JP Onella3, Matcheri Keshavan1,2; 1Beth Israel Deaconess Medical Center, 2Harvard Medical School, 3Harvard School of Public Health
The SMART study is a pilot investigation into digital phenotyping for schizophrenia and related psychotic disorder. Utilizing the Beiwe platform that runs on patients' personal smartphones, the app can collect active data in the form of surveys and passive data in the form of real time GPS, accelerometer, anonymized call/text logs, screen use time, power status, and other features. The goal of the SMART study was to 1) assess feasibility of this method of data collection in participants with schizophrenia and 2) collect pilot data regarding the utility of digital phenotyping to aid in relapse prediction in schizophrenia Patients in active treatment and with a diagnosis of schizophrenia or a related psychotic disorder were recruited and asked to use the Beiwe app for up to 3 months. We used anomaly detection methods to calculate relapse risk based on the smartphone passive data as well as survey responses. 17 research participants used the smartphone app for up to 3 months. Three research participants experienced a clinical relapse that was recorded by the app. No participants experienced any adverse event or negative outcomes during the course of the study related to app use. While these pilot results preclude reporting on the sensitivity and specificity of digital phenotyping in relapse prediction, they do suggest this method is acceptable to patients with schizophrenia and related disorders. Our group is currently conducting a larger scale study to better characterize this method of relapse prediction.
Discussant: Inez Myin-Germeys, Leuven University
Wednesday, October 10, 1:00 - 2:30 pm, American Ballroom - Center
Chair: Celso Arango, Department of Psychiatry, Hospital Universitario Gregorio Marañón, Universidad Complutense, CIBERSAM
Speakers: Celso Arango, Brian O’Donoghue, Olga Puig, Sophia Vinogradov
For the last few decades, clinical research has focused on improving early detection and treatment for young people with psychosis. Finding effective psychosocial treatments, designed to improve coping and assist in stress reduction, has been a crucial goal in this context. In particular, current evidence supports the effectiveness of two kinds of interventions: psychotherapy (mainly CBT, Family Therapy, and Psychoeducation) and cognitive remediation. However, some controversial questions still remain: Within psychotherapy, there is some debate about the differential effectiveness of discrete psychological interventions as compared with early intervention services. In contrast, within cognitive remediation, the debate revolves around the different methods of work, fundamentally the classic ones (paper-and-pencil task/top down) vs. other more basic ones (bottom-up processing). The differential effectiveness of these interventions in different age groups (e.g., adolescents vs. adults) also remains unclear. This symposium aims to provide a global vision of the different psychotherapeutic approaches for the young population with psychosis. We will present data from a discrete psychoeducational intervention (the PIENSA program), exploring its long-term benefits; from a specialized clinical center “the Early Psychosis Prevention and Intervention Centre (EPPIC),” searching for the differential therapeutic needs in adolescents vs. young adults; and from two discrete, methodologically different cognitive remediation therapies (one top-down and one bottom-up), exploring their effects on both cognition and functioning in adolescents and young people with early-onset psychosis.
Talk 1 LONG-TERM EFFECTS OF AN INTERVENTION FOR ADOLESCENTS WITH EARLY ONSET PSYCHOSIS AND THEIR FAMILIES. THE PIENSA PROGRAM
Celso Arango1, María Mayoral1; 1Hospital Universitario Gregorio Marañón, Universidad Complutense, CIBERSAM
Early specialized care may improve short-term outcomes in first-episode psychosis. We implemented a psychoeducational group program (PIENSA) and showed that it helped adolescent patients and their families manage crises, improved patients’ negative symptoms, and increased their involvement in social activities in the short-term. However, it was unclear whether the benefits persist over time. Objective: To investigate whether the beneficial effects of a structured psychoeducational group program for adolescents with early-onset psychosis and their families, observed immediately after the intervention, were maintained two years later. Method: The current study examines the two-year longitudinal efficacy of a randomized controlled trial based on a structured psychoeducational problem-solving group intervention for adolescents with early-onset psychosis and their families (PE) compared with a non-structured group intervention (NS). We analyzed whether the differences found between PE and NS after the intervention persisted two years later. Results: At the two-year follow-up, 89% of patients were able to be reassessed. In the PE group, 13% of patients visited the Emergency Department as compared with 50% in the NS group (p=0.019). However, no statistically significant differences were found between the two groups in terms of negative symptoms or number and duration of hospitalizations. Conclusions: A psychoeducational group intervention showed sustained effects on diminishing the number of Emergency Department visits two years after the intervention. However, improvement in negative symptoms is not maintained. We will present the new actions implemented by the PIENSA team in order to enhance the long-term effects of our intervention.
Talk 2 SYMPTOMATIC AND FUNCTIONAL OUTCOMES OF YOUNG PEOPLE WITH AN EARLY ONSET PSYCHOTIC DISORDER
Brian O’Donoghue1,2,3, Patrick McGorry1,2; 1Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia, 2Centre for Youth Mental Health, University of Melbourne, Australia, 3Orygen Youth Health, 35 Poplar rd, Parkville, VIC 3052, Australia
It has been suggested that early onset psychosis (before the age of 18) may represent a more severe variant of the disorder as a number of studies have indicated a poorer outcome in this sub-group. However more recent evidence has suggested that those with early onset have a more favourable course of illness and outcome. Methods: This study was conducted at the Early Psychosis Prevention and Intervention Centre (EPPIC) and included all young people aged 15 to 24 who presented with a first episode of psychosis (FEP) in a defined catchment in Melbourne between 01/01/11 and 31/12/13. The management at EPPIC includes psychopharmacology, cognitive behavioural therapy and psychosocial interventions. Results: A total of 544 young people presented with a FEP during the three year period and 37.1% had an onset before the age of 18. Young people with an early onset psychotic disorder were more likely to be female, be born in Australia, have a diagnosis of Psychosis NOS and less likely to have a concurrent substance abuse disorder. 42% of young people with early onset psychotic disorder experienced a relapse following symptomatic remission, which was comparable to those with a later onset. Functional outcomes were superior in those with an early onset, with 60% returning to either school or work by the time of discharge, compared to 50% of those with a later onset. Conclusions: These results indicate that with the appropriate management, young people with an early onset of a psychotic disorder can have positive outcomes.
Talk 3 TREATMENT OF COGNITIVE IMPAIRMENT IN ADOLESCENTS WITH EARLY-ONSET SCHIZOPHRENIA THROUGHT COGNITIVE REMEDIATION THERAPY
Olga Puig1; 1Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic of Barcelona, 2014SGR489. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
Early-onset schizophrenia (EOS), defined as the manifestation of psychotic symptoms prior to 18 years of age, is a less common and phenotypically more severe form of the disorder, and implies generalized neurocognitive impairment. Cognitive remediation therapy (CRT) is a strategy-learning approach targeting cognitive deficits with the ultimate goal of improving functional outcome. The height neural plasticity during childhood and adolescence suggests that they may be "sensitive periods" to treatment effects but it is also possible that having EOS may confer damage that reduces the ability of the brain to benefit from CRT. Objetive: To examine the efficacy of CRT in improving cognition and functional outcomes in a sample of symptomatically stable but cognitively disabled adolescents with EOS. Methods: Randomized, controlled trial of individually delivered CRT plus treatment-as-usual (n=25) compared with treatment-as-usual (TAU, n=25). Clinical symptoms and cognitive and functional performance were assessed before and after treatment in both groups and after 3 months in the CRT group. Results: After CRT, significant improvements were found in verbal memory and executive functions. The derived cognitive composite score showed an improvement after the treatment and this change was reliable in more than two-thirds of the treated patients. Improvements were also found after CRT in daily living and adaptive functioning, and in family burden. Cognitive but not functional changes were maintained after 3 months. Conclusion: Cognitive and functional improvements can be achieved through CRT in adolescents with EOS but additional strategies may be needed to enhance the durability of functional gains.
Talk 4 Neuroscience-informed Cognitive Training in Early Phases of Schizophrenia Using Mobile Devices
Sophia Vinogradov1, Ian Ramsay1, Bruno Biagianti2, Rachel Loewy3, Melissa Fisher1, Dan Mathalon3, Sisi Ma1, Dan Ragland4, Tara Niendam4, Cam Carter4; 1Department of Psychiatry, University of Minnesota, 2Department of Psychiatry, UCSF, and Positscience, Inc, San Francisco, 3Dept of Psychiatry, UCSF, 4Dept of Psychiatry, UC Davis
The cognitive deficits that characterize patients with schizophrenia are present in the prodrome, worsen as the illness progresses, and predict functional outcome. Cognitive dysfunction thus must be a primary target for aggressive early intervention in in early phases of schizophrenia. We report on behavioral and imaging data from a randomized controlled trial of targeted auditory-system training (AT) in participants with recent onset schizophrenia (N=144, mean age 21 years). These findings begin to point to personalized psychiatry approaches. 1. Auditory training subjects demonstrated significant improvements in Global Cognition, Verbal Memory, and Problem-solving compared to computer games control subjects. Training-induced cognitive gains at 40 hours showed significant associations with improved auditory processing speed at 20 hours. 2. Global Cognition showed durable improvements at 6-month follow-up. Within the AT group, Global Cognition improvement after training was significantly correlated with positive symptom improvement at 6-month follow-up. 3. Baseline auditory MMN was significantly reduced in participants and associated with worse Global Cognition. MMN did not show changes after AT and exhibited trait-like stability. Greater deficits in double-deviant MMN predicted greater gains in Global Cognition in response to AT. 4. Change in Global Cognition was significantly related to change in left thalamus volume in the AT group. Greater symptom severity at baseline reduced the likelihood of response to AT both with respect to improved cognition and change in thalamic volume. 5. A model selection and regression analytic approach (LASSO) identified baseline Global Cognition, education, and gender in a model predictive of improvement on cognition following AT.
Wednesday, October 10, 1:00 - 2:30 pm, American Ballroom - South
Chair: Young Chul Chung, Chonbuk National University Medical School, Jeonju, Korea
Co-Chair: Rodrigo Bressan, PRISMA Clinic - Universidade Federal de São Paulo (UNIFESP)
Speakers: Helen Lee, Ary Gadelha, Tomoyuki Funatogawa, Sung Wan Kim
Young people with psychosis suffer from diverse psychosocial difficulties such as impaired social relationships, low self-esteem, unemployed or poor academic performance, financial difficulties, etc. To help them recover psychosocial impairments, Western countries had developed coordinated special care programs consisting of multidisciplinary teams. These special programs can not be provided adequately in routine psychiatric service in Asia and Brazil. However, there has been emerging interest in early psychosis in Asia and Brazil recently, and several initiating programs have been launched: ILBOSCO in Japan, MindLink in Korea, Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA) in Brazil, and --- in Singapore. We have encouraging short-term results on outcome after delivering coordinated programs in each country. The implications of these findings will be shared and discussed in terms of implementing optimal strategies targeting young people with psychosis.
Talk 1 The Effectiveness of Case Management Service in the Singapore Early Psychosis Intervention Programme (EPIP)
Helen Lee1, Swapna Verma1, Peter Wong1; 1Early Psychosis Intervention Programme, Institute of Mental Health, Singapore.
EPIP was the first clinical service to start psychiatric case management in Singapore. In the beginning, our case management model was adopted from other developed countries, but gradually our care model has evolved with the changing healthcare landscape and resources’ allocation and taking into account our users’ literacy in mental health. We have moved away from emphasizing medication compliance and adherence to doctors’ appointments to focusing more on identification of clients’ strengths and empowering them to be active participants of their own recovery. Our clients’ satisfaction rate has been consistently good and 75% of our clients returned to school or are gainfully employed upon discharge from our programme (Verma, et al., 2012). Recently we conducted a qualitative study to explore the perspectives of clients and caregivers on case management with the intent to understand the salient aspects of case management from their perspective. Focus group discussions (FGD) were conducted with 47 clients and 19 caregivers. The main themes that emerged were: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, client empowerment and strength building, education on illness, support and problem solving. A second phase quantitative study is currently underway that looks at validating a scale on the quality of case management in an Early Intervention service.
Talk 2 Prevention and the opportunity to transform mental health care in Brazil – The history of PRISMA clinic
Ary Gadelha1, Rodrigo Bressan1, Graccielle Cunha1, André Zugman1; 1PRISMA Clinic - Universidade Federal de São Paulo (UNIFESP)
Almost ten years ago, prevention in mental health was rarely debated in Brazil. A group of volunteers and young researchers of Federal University of São Paulo (UNIFESP) created a research program to deliver an intervention at public schools aimed at foster identification of subjects at-risk for psychosis. This research demanded to structure a service to provide care to subjects at-risk identified at schools. In 10 years, the PRISMA clinic screened around 300 subjects, identified 40 subjects at-risk for psychosis or bipolar disorder, with a conversion rate of 10% over two years. Besides research, PRISMA became part of the psychiatry residency program at UNIFESP, allowing new psychiatrists the opportunity to get In contact with the prevention paradigm. Recently, PRISMA became part of the National Centre for Prevention In Mental Health to test pilot interventions for at-risk subjects and allow later implementation in other parts of Brazil.
Talk 3 Integrated approach to mental health among Adolescents and Young Adults generation.
Tomoyuki Funatogawa1, Naoyuki Katagiri1, Takahiro Nemoto1, Masafumi Mizuno1; 1Toho University Department of Neuropsychiatry, Tokyo, Japan
The Toho University Omori Medical Center is located in Ota, a city with a population of about 700,000 located in the southern area of the Tokyo Metropolitan region. In 2007, we established a comprehensive treatment center for young people with psychiatric problems, consisting of a Youth Clinic, which specialises in the treatment of young people with an at-risk mental state for psychosis (ARMS), a Child and Adolescent Clinic, which specialises in the treatment of developmental disorders and school-age problems, and Il Bosco, which is a special day-care service for individuals with early psychosis. Il Bosco aims to provide early intervention to prevent the development of full-blown psychosis in individuals with ARMS and to provide intensive rehabilitation to enable patients with first-episode psychosis (FEP) to return to school and community life. So far, 247 patients with a mean age of 21.2 years and a mean GAF score of 48.2 at the baseline have used this facility. The contents of the daily programs are specifically designed for promoting the brain plasticity of young patients and providing them with an environment where they can obtain relief and support without the stigma of psychiatric disease. About two-thirds of the patients have already achieved their own goals to ‘restart’ their lives after attending the one-year program. The drop-out rate was quite low (16.8%). At present, we provide the same programs for ARMS and FEP patients at Il Bosco. However, we propose to start more phase-specific and need-specific services which are indispensable for early psychiatric interventions in the future.
Talk 4 Comprehensive early intervention services for young individuals with psychosis in Korea
Sung Wan Kim1; 1Chonnam National University Medical School; Mindlink, Gwangju Bukgu Community Mental Health Center
In Korea, mental health services are typically characterized by low accessibility to psychiatric treatment, high caseloads, and a relatively large incidence of inpatient care. The duration of untreated psychosis (DUP), which is related to a poor prognosis for patients with schizophrenia, is comparatively long in Korea relative to that of Western countries and may be attributed to the high level of stigma associated with psychosis and psychiatric treatment. Recently, early intervention services for young individuals with psychotic disorders have begun in Gwangju, Korea. We developed a Korean version of group CBT consisting of metacognitive training, cognitive restructuring, life style modification, and stress management. In addition, we developed and launched a smartphone application for cognitive–behavioral case management and symptom monitoring. Group CBT had a positive effect on the quality of life, attitude toward treatment, perceived stress, and suspiciousness of patients with early psychosis. These effects were particularly significant in patients with a short DUP. A smartphone application for case management was useful for young individuals with early psychosis. Furthermore, mean number of admissions and bed days were decreased after use of special early intervention service. This study may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis in Asian countries.
Chair: Margaret Niznikiewicz, VA Boston Healthcare System, Harvard Medical School
Co-Chair: Guusje Collin, Beth Israel Deaconess Medical Center, Harvard Medical School
Speakers: Elisabetta C. Del Re, Ofer Pasternak, Guusjie Collin, Yingying Tang
The Clinical High Risk (CHR) phase of schizophrenia is the period of imminent risk for psychosis when cognitive and social functioning begin to decline. The CHR phase typically occurs during adolescence extending into young adulthood, a time period when major changes in the brain’s structural and functional organization support cognitive and behavioral development. Disruptions in these processes may give rise to brain and neurocognitive abnormalities and, ultimately, conversion to psychosis. In this symposium, we examine the neurobiology of conversion using multimodal imaging data from a unique sample of medication-naïve adolescents and young adults who meet criteria for CHR, and age- and gender-matched healthy controls (HC). This sample was acquired as part of the SHARP (Shanghai At-Risk for Psychosis) study, a longitudinal NIMH-funded research program developed at the Shanghai Mental Health Center in collaboration with a multidisciplinary Harvard/MIT research team. In four presentations, we will report on different imaging data acquired in the SHARP sample, including structural MRI, diffusion-weighted MRI, resting-state fMRI, and event related potentials. Together, the findings provide important preliminary insights into the neurobiology of conversion as documented by structural, functional and neurophysiological brain changes in CHR relative to HC, with some changes occurring in CHRs who converted to psychosis but not in those who did not. Discussant Martha Shenton, a leading international expert on neuroimaging in schizophrenia, will conclude the session by interpreting the findings presented in our symposium into the broader schizophrenia literature and moderating a discussion on brain changes taking place in the transition to psychosis.
Talk 1 Morphometric Analyses of SHARP Clinical High Risk for Psychosis Subjects
Elisabetta C. Del Re1,2, William S. Stone3, Yingying Tang4, Tianhong Zang4, Susan Whitfield-Gabrieli5, Jijun Wang4, Larry J. Seidman3,6, Nikos Makris6, Margaret A Niznikiewicz2, Robert W McCarley2, Martha E. Shenton1,2; 1Brigham and Women's Hospital, Harvard Medical School, 2Veterans Affairs Boston Healthcare System, 3Beth Israel Deaconess Medical Center, Harvard Medical School, 4Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 5McGovern Institute for Brain Research, Massachusetts Institute of Technology, 6Massachusetts General Hospital, Harvard Medical School
Purpose: Frontal and temporal lobes are often affected in schizophrenia. Here we hypothesized that cortical thickness (CT) and/or surface area (SA) and integrity of several white matter tracts related to frontal and temporal lobes, alone or in aggregate, distinguish CHR converters (CHR-C) from CHR non-converters (CHR-NC). Materials and methods: Magnetic resonance images and clinical/cognitive data were acquired in 92 healthy controls (HC), 130 CHR-NC and 22 CHR-C at the Shanghai Mental Health Center, China, as part of the NIMH-funded SHARP research program. Assessment of 9 temporal and 11 frontal regions from the two lobes in both hemispheres, as well as the superior longitudinal (SLF), arcuate (AF), extreme capsule (ECFS), and uncinate (UF) white matter tracts was carried out by using an internal pipeline developed at the Psychiatry Neuroimaging Laboratory (PNL), Brigham and Women's Hospital, HMS. Results: Temporal lobe: The posterior region of superior temporal sulcus and Heschl’s gyrus CT were smaller in CHR-C compared to CHR-NC (p=0.027) and NC (p=0.002). Middle temporal gyrus (MTG) CT was also smaller in CHR-C than HC (p=0.004) with trend level findings for CHR-NC (p=0.098). Frontal lobe: The pars triangularis CT was smaller in CHR-C vs CHR-NC (p=0.02) and HC (p=0.012). In CHR-C, CT of MTG correlated with Verbal Learning (rho=0.64; p=0.002) and Visual Memory Tests (rho=0.6, p=0.004). These correlations were not present in HC or CHR-NC. Analyses of tractography data are in progress. Conclusion: Results indicate that language circuits are among the earliest regions affected in schizophrenia and distinguish CHR-C from CHR-NC.
Talk 2 Microstructural White Matter Alterations in Clinical High Risk Subjects from the SHARP Project
Ofer Pasternak1, Yingying Tang1,2, Marek Kubicki1, Yogesh Rathi1, Tianhong Zhang2, Zhenying Qian2, William S Stone3, Susan Whitfield-Gabrieli4, Robert W McCarley5, Martha E. Shenton1,5, Jijun Wang2; 11. Brigham and Women’s Hospital, Harvard Medical School, 2Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3Beth Israel Deaconess Medical Center, Harvard Medical School, 4McGovern Institute for Brain Research, Massachusetts Institute of Technology, 5Veterans Affairs Boston Healthcare System
Purpose: Recent free-water diffusion MRI studies suggest co-occurring extracellular changes, measured by free-water (FW), and microstructural cellular changes, measured by fractional anisotropy of tissue (FAt). The extracellular changes reveal a widespread extent during first psychotic episode, and lower levels during chronic stages of the illness. Cellular changes were limited in the first episode stage, and were more widespread in the chronic stage. These findings led to the hypothesis that FW increases may reflect an acute brain response to psychosis, while FAt may reflect a continuous process of accumulating damage. What is not yet clear is the presentation of these abnormalities prior to the onset of psychosis. Materials and methods: Using 3T diffusion MRI data from the SHARP study we explored white matter alterations in 50 individuals at clinical high risk (CHR) for psychosis who were largely medication-naïve, and 50 matching healthy controls (HC). Results: CHR subjects showed significantly reduced FAt (p=0.020), but no changes in FW (p=0.137). FAt was positively correlated with age (p=0.018) in HC, but not in CHR (p=0.290). Conclusion: Our findings suggest that cellular changes precede the onset of psychosis and may reflect altered neurodevelopmental processes in CHR. As no differences in FW were observed, we predict that FW increases will emerge as an acute response in this CHR sample, closer to the onset of psychosis. We therefore plan to follow-up on these findings in longitudinal analyses to investigate both FW and FAt between individuals who convert to psychosis compared to those who do not convert.
Talk 3 Abnormal Modular Organization of the Functional Connectome Predicts Conversion to Psychosis in Clinical High Risk Youth
Guusjie Collin1,2,3, Larry J. Seidman1,4, Matcheri S. Keshevan1, Zhenghan Qi5, William S. Stone1, Tianhong Zhang6, Margaret A Niznikiewicz7, Martha E Shenton3,7, Jijun Wang6, Susan Whitfield-Gabrieli2; 1Beth Israel Deaconess Medical Center, Harvard Medical School, 2McGovern Institute for Brain Research, Massachusetts Institute of Technology, 3Brigham and Women’s Hospital, Harvard Medical School, 4Massachusetts General Hospital, Harvard Medical School, 5University of Delaware, 6Shanghai Mental Health Center, Shanghai Jaio Tong University School of Medicine, 7Veterans Affairs Boston Healthcare System
Purpose: Prodromal symptoms progressing into psychosis may involve a functional reorganization of the connectome. In this study, we performed a functional connectome analysis in a large group of adolescents and young adults at Clinical High Risk (CHR) for psychosis. We aimed to assess whether, and if so how, baseline connectome organization distinguishes CHRs that go on to develop psychosis. Materials and methods: A total of 251 subjects, including 158 CHRs and 93 matched healthy controls (HCs), participated in this study. Prodromal symptoms and cognition were assessed using validated procedures. MRI scans were processed with Freesurfer v6.0 and CONN v17.d software to produce functional connectome maps that were analyzed using Louvain community detection. For each CHR, we assessed how similar their modular organization was relative to a group-averaged HC network using the rand similarity coefficient. Results: Modular connectome organization of CHRs who developed psychosis was significantly less similar to HCs than CHRs who did not convert (F(1,154) = 7.14, p = 0.008). Superior and medial temporal and ventromedial prefrontal regions were most abnormal in terms of modular assignment. Furthermore, Kaplan-Meier analysis showed reduced psychosis-free survival in CHRs with abnormal baseline connectome organization, with an approximately 3-fold risk of conversion to psychosis. Cox regression analysis indicated that modular connectome organization, gender, and IQ predicted time to conversion. Conclusion: Abnormal functional connectome organization precedes the onset of psychosis and is associated with increased conversion rates in CHRs. Our results suggest that a reorganization of the functional connectome may accompany the manifestation of psychosis.
Talk 4 Abnormal Mismatch Negativity Duration at Baseline Distinguishing Remitted from Ron-remitted Clinical High Risk for Psychosis Individuals
Yingying Tang1, Tianhong Zhang1, Junjie Wang1, Lihua Xu1, Zhenying Qian1, Matcheri S. Keshavan2, Susan Whitfield-Gabrieli3, Martha E Shenton4,5, William S. Stone2, Margaret A. Niznikiewicz4, Jijun Wang1; 11. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 2Beth Israel Deaconess Medical Center, Harvard Medical School, 3McGovern Institute for Brain Research, Massachusetts Institute of Technology, 4Veterans Affairs Boston Healthcare System, 5Brigham and Women's Hospital, Harvard Medical School
Purpose: Mismatch negativity (MMN) indexing pre-attentive sensory processes has been considered a candidate biomarker for predicting transition to psychosis in clinical high risk for psychosis (CHR) individuals. However, in Asian CHR population, the MMN association with psychosis has been less explored. The present study, a part of the Shanghai At-Risk for Psychosis (SHARP) program, examined whether the MMN duration amplitude at baseline can distinguish between remitted non-converters (those who got better) and non-remitted individuals (who included those who converted to psychosis (i.e., converters) and those who remained symptomatic) a year later. Materials and Methods: 104 CHR subjects meeting the Structural Interview for Prodromal Syndromes criteria (Chinese version) and 90 healthy controls (HCs) were tested on the auditory MMN duration paradigm. CHR subjects were grouped into 53 remitted individuals defined as getting clinically better and 51 non-remitted individuals defined as remaining symptomatic, or converting to psychosis, based on their clinical symptoms and functional scores at one-year follow-up. MMN amplitude was analyzed using an ANOVA at midline (Fz, Fcz) with a between-factor of group (remitted CHR, non-remitted CHR and HCs). Results: Group differences were significant (p=0.004) with non-remitted CHR showing less negative MMN amplitude than HC (p=0.0029) and remitted CHR not different from HC (p=0.88) Non-remitters had significantly reduced MMN amplitude relative to remitters (p=0.007). Conclusions: These results suggest that MMN duration amplitude is not only abnormal at baseline in the CHR phase in non-remitters but also distinguishes between CHRs who remitted and those who did not remit one year later.
Discussant: Martha Shenton, Brigham and Women’s Hospital, Harvard Medical School, VA Boston Healthcare System
Chair: Eric YH Chen, University of Hong Kong
Speakers: Lex Wunderink, Christy Hui, Sherry Chan, Swapna Verma
Psychotic disorders are characterized by a relapsing course of illness, poor recovery and even treatment resistance. Although maintenance treatment can help prevent relapse, the long-term use of antipsychotics carries substantial side effects. Without much empirical data on the long-term effects of medication discontinuation and relapse, the decision to discontinue or continue medication in first-episode psychosis (FEP) patients who have been free of positive symptoms for a period of time poses a clinical dilemma. Using long-term follow-up data in patients with FEP from The Netherlands and Hong Kong, important questions on factors leading to poor outcome will be examined. The first speaker will discuss what predicted relapse; the relationship of relapse and 7-year outcome; and if negative symptoms predicted relapse, whether medication strategies would make a difference in reducing relapse rates, in FEP involved in a dose-reduction/discontinuation trial. The second speaker will investigate the effect of early medication discontinuation on 10-year clinical outcome in FEP who were previously involved in a medication discontinuation (placebo) trial. The role of early relapse in mediating discontinuation and outcome will also be discussed. Using a case-control first episode cohort followed up for 12 years, the third speaker will examine how the early clinical characteristics such as early relapse and planned medication discontinuation would affect the long-term outcome of recovery, treatment resistance, and suicide. The last speaker will present data from a survey in Singapore, looking at clinicians’ views on medication discontinuation in remitted FEP.
Talk 1 Predicting Relapse and Outcome in First Episode Psychosis: Impact of Negative Symptoms, and Personalized Low Dose versus Maintenance Antipsychotic Treatment
Lex Wunderink1,2, Jan van Bebber2, Sjoerd Sytema2, Nynke Boonstra1, Rob Meijer3, Hanneke Wigman2; 1Friesland Mental Health Services, Leeuwarden, The Netherlands, 2University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, 3Dept of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
Relapse of psychosis indicates worse functional outcome. The aim of current treatment strategies is relapse-prevention, though neither predictors of relapse nor causation of functional decline have been established. If relapse were a consequence of a decline-related confounder, preventing relapse might only partly impact upon decline. We hypothesized baseline negative symptoms to predict both functional deficits and relapse risk. Analyzing 7-years follow-up data of a first episode cohort involved in a dose-reduction/discontinuation trial, we examined: 1) what predicted relapse, 2) what predicted functional outcome and 3) if baseline negative symptoms (BNS) predicted relapse, whether medication strategies would make a difference reducing relapse rates. Relapse was predicted by baseline negative symptoms and duration of untreated psychosis. The more relapses, the less recovery. No relapses yielded recovery in 18/36 patients, 1 relapse: 8/32, 2 relapses: 4/21 and ≥3 relapses: 0/14. However, baseline negative symptoms were a better predictor of functional outcome (pseudo partial correlation [pr]=.90) than number of relapses (pr=.64) or treatment strategy (pr=.57), although all predictors had unique contributions. Within maintenance treatment more negative symptoms showed higher relapse rates. Within high or low negative symptom groups, relapse rates were equal across both treatment strategies. Negative symptoms not only predicted non-recovery, but also relapses during 7-years follow-up. Apparent consequences of relapse, mainly non-recovery, have to be partially attributed to baseline negative symptoms. Relapse prevention by (low-dose) maintenance treatment does not seem effective, since relapse rates were equal across arms and mainly dependent on negative symptoms.
Talk 2 The 10-year clinical outcome of early medication discontinuation in remitted first episode psychosis
Christy Hui1, William Honer2, Edwin Lee1, Sherry Chan1, Wing Chung Chang1, Eric Chen1; 1University of Hong Kong, Hong Kong, 2University of British Columbia, Vancouver, Canada
Whether to discontinue or continue antipsychotics medication in remitted first-episode psychosis is a difficult clinical decision. Consistent short-term evidence suggests that maintenance medication is effective in relapse prevention. However, long-term outcome data are lacking; with only one open-label study suggesting better recovery outcome in patients who had early dose reduction/discontinuation. We examined the long-term effect of early medication discontinuation in a remitted first-episode psychosis cohort in Hong Kong. We followed-up 178 first-episode psychosis patients who had previously participated in a 12-month randomized controlled trial on medication discontinuation (placebo) or continuation (quetiapine). Following the trial, all patients received usual psychiatric care. Poor clinical outcome was defined as a composite of persistent psychotic symptoms, a requirement for clozapine, or suicide at 10 years. We found no significant differences between patients who were successfully traced after 10 years (n=142) and those who were not (n=36) in terms of their basic demographics, symptoms and functioning at baseline. At 10 years, more patients in the early discontinuation group (35 of 89, 39%) had poor clinical outcome than patients in the maintenance group (19 of 89, 21%) (P<0.01). Relapse during the randomized trial had partly mediated the significant relationship between early medication discontinuation and poor outcome (P=0.003). In first episode psychosis with a full initial response to antipsychotic treatment, continued need for maintenance medication is important for the first three years after starting treatment, so as to prevent relapse, and to decrease the risk for a poor long-term outcome.
Talk 3 Predictors of long-term outcomes of first episode schizophrenia-spectrum disorders
Sherry Chan1, Christy Hui1, Edwin Lee1, Wing Chung Chang1, Eric Chen1; 1University of Hong Kong, Hong Kong
Despite of the improvement in intervention, long term outcomes of patients with schizophrenia has not improved much. Early clinical characteristics has been suggested to predict the long-term outcomes. The current study is to look at predictors of early clinical characteristics including relapse and planned discontinuation of antipsychotic medications to long-term outcomes including suicide, treatment resistance and recovery in patients with schizophrenia-spectrum disorders. Apart from basic demographics, information of baseline clinical condition including positive and negative symptoms, duration of untreated psychosis (DUP), suicidal attempts during DUP; clinical characteristics during the first three years including number of relapse, number hospitalization, compliance, suicidal attempts, planned discontinuation of antipsychotic medications were obtained from clinical record review. The review was conducted at monthly basis with standardized entry form with operational definitions. Suicide information was obtained at 12-year follow up of 1400 patients. Results suggested number of relapse, premorbid functional impairment and compliance predicted suicide in year 4 to 12 (p=0.002), whereas suicide attempts in DUP and first three years predicted suicide in year 1-3(p=0.004). Among the 1400 patients, 165 patients were considered treatment resistant by 12-year follow up. Use case-control study approach with control patients who were randomly identified among the 1400 patients matched with diagnosis of patients with treatment resistance. A total of 290 patient control was identified. Results suggested patients with treatment resistant had younger age of onset, lower years of education, poorer premorbid adjustment, more number of hospitalization and relapse during the initial three years of treatment than the patient control.
Talk 4 Perception towards medication discontinuation in remitted first-episode psychosis among clinicians
Swapna Verma1, Chun Ting Chan1, Christy Hui2, Eric Chen2; 1Institute of Mental Health, Singapore, 2University of Hong Kong, Hong Kong
Aim: A survey was carried out in 4 countries across Asia (Hong Kong, Singapore, Japan, and Korea) to investigate the views of clinicians towards the issue of medication discontinuation in remitted patients with first episode psychosis (FEP).The current presentation will be from the results from Singapore. Methods: An online questionnaire was sent to clinicians (Psychiatrists, Psychologists, Case Managers) in Singapore. The questionnaire contained three sections: direct questions probing at views on medication discontinuation in remitted FEP patients, case vignettes to assess decision-making in applied situations, and a checklist of criteria for discontinuing medication. Results: 82 participants of whom 70.6% were Psychiatrists completed the questionnaire. We found that majority believed that (i) 21-40% of remitted first episode psychosis patients can discontinue medication, (ii) patients should remain on medication for 1-2 years following absence of psychotic symptoms, and (iii) the monitoring process after discontinuing medication should be for 12-24 months. 47.6% of clinicians were unsure about whether quality of life is better in those symptom-free patients who remain on antipsychotics versus those who stop. “Having good social support” and “able to cope with stressful situations” were considered the most important criteria when making a decision about medication discontinuation. Conclusions: The results reflect the ambiguity in clinicians about medication discontinuation in patients with FEP arising mainly from lack of clear guidelines on one hand, and patients’ desire to stop medication on the other.
Chair: Marieke Schreuder, University Medical Center Groningen
Co-Chair: Robin Groen, University Medical Center Groningen
Speakers: Robin Groen, Jessica Hartmann, Lars Pieper, Marieke Schreuder
The progression from early psychopathological symptoms to severe disorders is typically heterogeneous. For instance, adolescents who initially report similar symptoms might later meet the criteria of qualitatively distinct disorders and vice versa. Insight in the route from prodromal symptoms to severe disorders is crucial for early diagnosis and treatment. The course of symptoms over time is best captured by designs that involve time series data in adolescents, who are by definition vulnerable for first-onset complaints. Since symptom trajectories tend to transcend diagnostic boundaries, such designs require a transdiagnostic approach. The current symposium includes four studies that all fulfilled these criteria and adopted innovative methods in order to improve our understanding in the characteristics of different stages of psychopathology (e.g. increased risk, mild symptoms and severe symptoms). Robin Groen presents findings on whether patterns of symptom co-occurrence differ across varying levels of symptom severity, using a transdiagnostic network approach. Jessica Hartmann will complement these findings by introducing CHARMS (Clinical High At-Risk Mental State) criteria that aim to distinguish between different stages of disorders. Moreover, the potential of ecological momentary assessments (EMA) to signal adolescents’ current symptom severity and their vulnerability for future psychopathological symptoms will be outlined. Lars Pieper will discuss how EMA-based symptom clusters may improve the early identification of disorders. Finally, Marieke Schreuder will show that specific mood dynamics might reveal the nature of upcoming symptoms. This work will outline how a complex dynamic system’s approach to psychopathology may allow us to anticipate the emergence of certain symptom clusters.
Talk 1 Continuity in patterns of co-occurring symptoms across psychopathology severity levels
Robin Groen1, Johanna Wigman1, Marieke Wichers1, Catharina Hartman1; 1University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, the Netherlands
Early stages of psychopathology frequently manifest as a ‘mixed bag of symptoms’, which may develop into increasingly specific symptom patterns over time as mental ill-health progresses. However, high comorbidity rates in diagnosed individuals do not support this notion of specificity. Using a transdiagnostic, network approach, we investigated symptom co-occurrence in groups with increasing psychopathology severity. As such, we aimed to address the question whether there is continuity in heterogeneous symptom patterns across severity of psychopathology. For that purpose network connectivity and communities were examined in psychopathology symptoms across groups of different severity. Four groups were derived based on a diagnostic interview conducted at age 19 (n=1933; TRAILS cohort). For each group a separate symptom network was estimated. Symptoms were measured by items of the Adult Self Report (ASR). Pairwise comparisons across groups showed a significant difference (p = 0.014) in overall network structure between the two lowest severity groups, but no other differences between the groups. Although minor differences existed in the types of network communities, most community structures replicated across groups. The consistency between groups in overall network strength, and in number and type of communities suggests that patterns of co-occurring symptoms across various levels of severity are more similar than different from each other. Hence we tentatively conclude that continuity in the patterns of symptom combinations exist across severity levels. This contrasts with the idea of increasing specificity in symptom combinations as psychopathology gets more severe.
Talk 2 Broadening the scope: A pluripotential at-risk mental state
Jessica Hartmann1, Barnaby Nelson1, Rachael Spooner1, G. Paul Amminger1, Andrew Chanen1, Aswin Ratheesh1, Christopher Davey1, Patrick McGorry1; 1The National Centre of Excellence in Youth Mental Health, Orygen, Australia
Similar to cancer staging in general medicine, the clinical staging model in psychiatry aims to define current stage of disorder development and assist in treatment selection. Clinical stages range from a pre-symptomatic at-risk state (Stage 0) to severe, unremitted illness (Stage 4). The CHARMS criteria (Clinical High At-Risk Mental State) aim to identify young people at pluripotential risk (Stage 1b) of a range of full-threshold (Stage 2) disorders, including severe depression, psychosis, mania, and borderline personality disorder. The CHARMS study is an ongoing cohort study of help-seeking young people aged 12-25 attending youth mental health services in Melbourne, Australia. New referrals meeting the CHARMS criteria are allocated to CHARMS+ (Stage 1b); referrals under CHARMS threshold are allocated to CHARMS- (Stage 0-1a). Transition status and clinical/functional outcomes are re-assessed at 6 and 12 months. To date, a sample of N=73 participants has been recruited: N=49 (67%) met CHARMS criteria at baseline. At 6 months, 32% of CHARMS+ have transitioned to Stage 2 with a slight increase to 37% at 12 months follow-up. There were no transitions in the CHARMS- group. Our initial results indicate that the CHARMS criteria can be applied in the context of a youth mental health service and may validly identify help-seeking young people at risk of progressing to serious mental disorder. This study is the first to introduce and validate a set of clinical criteria to identify a broader ‘at risk’ patient population, and represents an important advance from the UHR for psychosis approach.
Talk 3 Symptom Expression of Depression and Anxiety in Daily Life: Results of the BeMIND Study
Lars Pieper1, John Venz1, Catharina Voss1, Katja Beesdo-Baum1; 1Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
Mental problems and illnesses represent an enormous personal, social and societal burden, as they frequently emerge in late childhood/early adolescence and are often unrecognized or inadequately treated. So, for example, depression and anxiety can affect every area of life, including but not limited to health, physical activity, sleep, eating behaviors and social relationships. This contribution aims to describe (1) how DSM-5 depression and anxiety reflect in daily life mood and behaviour and (2) how different pattern of symptom expressions in daily life can predict future depression and anxiety episodes. Analyses base on data from the Dresden BeMIND study, an epidemiological cross-sectional and prospective-longitudinal study on the development of psychopathology. Among other assessments, a community sample of 1180 adolescents and young adults (age 14-21 years) from Dresden (Germany) completed a clinical diagnostic interview and took part in a four day ecological momentary assessment study including measures of current affective states (e.g. symptoms of depression and anxiety, energetic arousal, valence, calmness, positive/negative mood), social interactions, eating and sleeping behaviour and objective/subjective measures of physical activity. One year follow-up data on psychopathology is available from approximately 800 participants. Data show for example that depressive study-participants engaged more often in online social interactions and not in real life. Quality of social interactions decreased with depression severity. Depressed people were less physical active in their spare time. It will be discussed how the identification of symptom clusters can help to improve early recognition of mental disorders and lead to preventive action at an early stage.
Talk 4 Anticipating the direction of future shifts in psychopathology using early warning signals
Marieke Schreuder1, Johanna Wigman1, Catharina Hartman1, Marieke Wichers1; 1University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, the Netherlands
Recent studies revealed that shifts from mild to severe psychopathological symptoms are preceded by particular mood dynamics (EWS). The present study aimed to extend earlier findings by examining whether EWS may reveal not only the likelihood of psychopathological shifts but also their direction. In other words, do EWS predict the symptom cluster (e.g. depression, psychosis, etc.) that will develop? We analysed transdiagnostic time series data retrieved from the TWINS-scan study, which included adolescent twins from the general population. EWS were inferred from daily mood ratings acquired through the experience sampling method (ESM). We selected adolescents who reported higher symptom severity at one year follow-up compared to baseline in at least one of the domains of interest (depression, anxiety, paranoid ideation and somatization). This resulted in four subsamples (N=166-192). Multilevel models confirmed that EWS in mood states predict the direction of upcoming shifts in psychopathological symptoms in all domains except for somatization. For instance, the association between EWS in mood states and shifts towards depression was most pronounced for feeling down (β=0.10, p<0.001) and listless (β=0.09, p<0.001). Similarly, shifts towards anxiety and paranoid ideation were preceded by EWS in feeling anxious (β=0.09, p<0.01) and insecure (β=0.08, p<0.01) mood states, respectively. EWS thus not only revealed the likelihood of future distress, but also indicated the domain involved in this distress. EWS might therefore considerably contribute to early diagnosis and treatment. Such clinical applications of EWS however require replication of the above findings on an intra-individual level, which is currently in progress.
|
cc/2020-05/en_middle_0097.json.gz/line1407369
|
__label__wiki
| 0.614696
| 0.614696
|
Press Releases 2012International Financial Data Services (Canada) Anno unces Support of GICSERV
International Financial Data Services (Canada) Anno unces Support of GICSERV
International Financial Data Services (IFDS) Canada, a leading provider of technology and outsource services to the financial services industry, announced today their intention to support Fund SERV’s GICSERV GIC origination and settlement standards as part of their servicing solutions for Canadian deposit taking institutions. FundSERV, GICSERV and the GIC origination and settlement standards are provided by FundSERV, Inc.
IFDS recently announced the introduction of a new technology and operations outsource solution focused on the needs of deposit taking institutions, launching summer 2012. The IFDS Deposit Servicing solution will provide a low cost, innovative and reliable alternative to traditional ‘in-sourced’ solutions. In addition, the IFDS solution will support existing automated sales channels including GICSERV, FundSERV, CANNEX, and will support client named account orders through branch, direct sales and deposit brokers.
“As a founding FundSERV Member, we are pleased to be able to offer banks, credit unions and trusts companies one of the simplest, fastest and lowest cost platform options that support the GIC Dealer community,” said Debralee G. Goldberg, President & CEO, IFDS Canada.
“IFDS has been a key supporter of FundSERV and has historically been a driving force in standardizing Canada’s mutual fund purchase and settlement environment,” said Brian Gore, President of FundSERV. He further stated “IFDS’ support of the GICSERV initiative confirms our belief that Canadian financial institutions are looking to improve efficiencies and reduce costs for their GIC and deposits processing."
IFDS continues to be recognized for innovative solu tions, technology, and most recently for its corporate social responsibility. IFDS won the “Best Use of Technology” award for two years consecutively in 2009 and 2010 at the Canadian Investment Awards and was recognized with “Most Innovative Project of the Year” at the 2011 ICFA Americas Service Provider Awards. IFDS was also honoured by the 2011 Stevies American Business Awards for “Corporate Social Responsibility" and for being the "Most Innovative Company of the Year.”
About FundSERV
FundSERV Inc. is a leading provider of electronic business services to the Canadian investment industry. Established in 1993, FundSERV is the most efficient investment transaction processing system in the world. Today, the Company's focus is on the data standards and security infrastructure t hat will enable the industry to continue to apply technology for the ultimate benefit of the Canadian investing public. The company serves more than 700 organizations and their business units and provides online access to over 10,000 investment fu nd instruments. The Company also supports the committees and working groups that address issues and develop electronic data and security standards for the industry.
IFDS Canada creates the technology and service solutions the financial industry is built on. Leading investment and insurance providers trust IFDS Canada for their award-winning record-keeping platform and back office services. For more than 30 years, IFDS Canada’s knowledge, experience, financial strength and advanced technology have enabled their clients around the globe to achieve their business goals and their investment in the future will help them continue to lead the way.
IFDS | Tobi McGrory, Senior Vice-President, Marketing and Communications & Product Management
T +1 416-506-8006 | E This email address is being protected from spambots. You need JavaScript enabled to view it.
International Financial Data Services (“IFDS”):
Is a 50/50 joint venture between affiliates of Boston-based State Street Corporation, the world’s leading provider of services to institutional investors, and DST Systems Inc., a Kansas City, Missouri-based leading provider of shareholder accounting services and proprietary systems.
IFDS is today recognized as the world’s leading provider of investor record keeping and transfer agency solutions on a BPO (Business Process Outsourcing) and ASP (Application Service Provision) basis. Our services are provided to a wide range of global collective investment, wealth management and platform clients, supporting over 18.5 million accounts for over 200 organizations, over 8,500 share classes and with over 3,500 experienced staff based in four locations (Canada, Ireland, Luxembourg & United Kingdom). Figures as December 31, 2011.
State Street Corporation:
State Street Corporation (NYSE: STT) is one of the world's leading providers of financial services to institutional investors including investment servicing, investment management and investment research and trading. With $21.8 trillion i n assets under custody and administration and $1.9 trillion* in assets under management at December 31, 2011, State Street operates in 29 countries and more than 100 geographic markets.
*This AUM includes the assets of the SPDR Gold Trust (approx. $63 billion as of December 31, 2011), for which State Street Global Markets, LLC, an affiliate of State Street Global Advisors serves as the marketing agent.
DST Systems, Inc.:
DST Systems, Inc. provides sophisticated information processing solutions and services to support the global asset management, insurance, retirement, brokerage, and healthcare industries. In addition to technology products and services, DST also provides integrated print and electronic statement and billing solutions through DST Output. DST's world-class data centers provide technology infrastructure support for financial services and healthcare companies around the globe. Headquartered in Kansas City, MO., DST is a publicly-traded company on the New York Stock Exchange.
IFDS | State Street | DST Systems
IFDS Successfully Converts Sun Life Global Investments' Suite of Mutual Funds to its Proprietary Platform
27 Mar 2017:
DST to Acquire Remaining Interest in Joint Ventures, BFDS and IFDS U.K., from State Street
01 Feb 2017:
Home Trust Selects IFDS Canada to be its High Interest Savings Solutions Provider
02 Nov 2016:
Equitable Bank Selects IFDS Canada as their Primary High-Interest Savings Solutions Provider
DST and IFDS Launch a General Data Protection Regulation Checklist
15 Dec 2015:
IFDS announces senior appointments in UK Funds Solutions business
Mawer Appoints IFDS Canada to be their Primary Transfer Agency and Service Solutions Provider
26 Oct 2015:
Excel Funds, Leader in Emerging Market Funds, Appoints State Street, IFDS to Provide Range of Investment Servicing Solutions
IFDS appoints Mohan for new platform COO role
24 Aug 2015:
IFDS to expand Scotland operations
02 Jun 2015:
IFDS to provide full array of technology and administrative solutions for Sun Life Financial
07 Apr 2015:
IFDS to recruit for new jobs in Ireland
05 Jan 2015:
IFDS makes senior appointments to its Luxembourg transfer agency business
Virgin Money appoints IFDS as its exclusive provider of third party fund administration services
IFDS appoints financial technology expert innovator to lead digital product development efforts
New direct-to-consumer portal from IFDS provides online access to Castle Trust investors
IFDS Canada announces leadership change
State Street Expands Transfer Agency Business in Asia with New Appointments
State Street Launches Transfer Agency Operations in Taiwan
IFDS Appoints Simon Moorhead as Global Chief Information Officer
IFDS / CWC Research Study - Call My Bluff! - Fund Share Pricing after Rebates
Boston Financial celebrates 40 years of industry leadership
Boston Financial to provide blue sky administration services
IFDS Earns Coveted “Exceptional” Accreditation From ‘Investors in Customers’
BFDS announced the results of its 3rd annual FIA Survey
IFDS achieves new international standard for business continuity management
IFDS unveils business restructure including Simon Hudson-Lund as Executive Chairman
Boston Financial Manager Awarded for Outstanding Community Service
SVM transitions transfer agency services to IFDS
IFDS announces re-registration milestone
Transamerica Selects State Street and Boston Financial for Investment Servicing
IFDS retains highest accreditation by Investor in Customers for third year running
Cindi Boudreau Joins Boston Financial
IFDS / State Street awarded “European Transfer Agent of the Year” for third year running
IFDS Named a Business Intelligence Leader in the 2012 Ventana Research Leadership Awards
IFDS wins prestigious administration award for 6 th year running
IFDS appoints Florence Denis as Luxembourg COO
IFDS wins “Client Relationship Manager of the Year” a t Custody Risk Americas Awards
GLG transitions transfer agency services to IFDS
International Financial Data Services (Canada) Anno unces Support of CANNEX
International Financial Data Services (Canada) Announces Technology and Service Solution for Canadian Deposit Taking Institutions
Boston Financial Hires Jim Mock as Vice President of Sales
IFDS aligns European management structure to enhance global offering for new and existing clients
Boston Financial Introduces Financial Intermediary Administration Solution
Amie Khondo
akhondo@ifdsgroup.com
PR Archive
|
cc/2020-05/en_middle_0097.json.gz/line1407370
|
__label__wiki
| 0.581228
| 0.581228
|
Published: April 15, 2014, 12:21 pm
Tags: Lifestyle, Health
Bye bye biopsy
Playing hide and go seek, or playing the piano, when 3-year-old Kadin is around, Grandma Roz is always playing something.
"I am blessed by all my grandchildren, but this one's got me," Roz Sobel told Ivanhoe.
She's needed the distraction. A few months ago, doctors found a lump on Roz's mammogram. It was a scary moment for a woman whose mother, grandmother, sister, cousin, and niece all had breast cancer.
"My family has a horrible history," Roz said.
Typically—women like Roz will need a painful needle biopsy to determine if the lump is cancerous, but she took part in a clinical trial testing a new technology called opto-acoustics.
"The thought is that this will help us determine what's cancer and what's not," Paulette Lebda, MD, Breast Radiologist, The Cleveland Clinic, told Ivanhoe.
An ultrasound with a laser is used to look at the distribution of oxygenated and deoxygenated blood in the lump. It's essentially a blood map for doctors.
"Usually, benign breast masses can have a different blood profile, or blood map, than cancerous masses," Dr. Lebda said.
Studies have shown the technique could reduce the number of biopsies by 40-percent, which was music to Roz's ears.
It turned out her lump was caused by a dog jumping on her, not cancer.
"They knew right then and there that it was from the dog," Roz explained.
With the opto-acoustics technology, there's no radiation, no needle, no pain, and no risk to the patient. The technique is being studied in a clinical trial at 16 centers around the country. It will not replace mammograms, but may decrease the need for invasive biopsies by distinguishing cancerous from noncancerous breast masses through imaging.
Copyright 2014 by Ivanhoe Broadcast News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
|
cc/2020-05/en_middle_0097.json.gz/line1407372
|
__label__wiki
| 0.961068
| 0.961068
|
Millennium Elementary School
17830 S. 84th Avenue
Ms. Julianne Cosentino, Principal
Fees / Online Payments
Login to School Messenger
Textbooks/Resources
Principal and Office Personnel
Enrichment / P.E. Team / Media Center
Special Services Team
Building Support Staff
District Instructional Support Staff
John A. Bannes
16835 S. Odell Avenue
Fernway Park
7846 W. 163rd Street
Virgil I. Grissom
John A. Bannes Elementary
Fernway Park Elementary
Helen Keller Elementary
Christa McAuliffe Elementary
Millennium Elementary
Virgil I. Grissom Middle School
Contact D140
District Virtual Backpack
Kirby School District 140 boundaries are established by the Board of Education on the recommendation of the Superintendent and are evaluated on an annual basis. Pupils must attend the school in the attendance area in which they reside. Descriptions of the individual elementary and middle school boundaries are listed below and District maps can be viewed by clicking Elementary School Boundaries or Middle School Boundaries.
To view a directory of the elected officials which represent our District, please visit the Cook County Clerk's Office - Directory of Elected Officials. Type in your address to reveal the name of your representatives and your elementary and high school districts.
John A. Bannes Elementary School
167th Street south to 175th Street from Harlem Avenue to 80th Avenue.
163rd Street south to 171st Street between 80th Avenue and 84th Avenue
Paxton Avenue south of 167th Street
Wexford, Lismore, Kildare Cts north of 167th Street
Fernway Park Elementary School
159th Street south to 171st Street between 86th Avenue (Village of Tinley Park boundary) and 88th Avenue
163rd Street south to 171st Street between 88th Avenue and LaGrange Road
163rd Street south to 167th Street between La Grange Road and 100th Avenue
Helen Keller Elementary School
159th Street south to 167th Street between 76th Avenue and 80th Avenue
163rd Street south to 165th Street between Olcott Avenue and 76th Avenue
159th Street south to 162nd Place between 80th Avenue and 84th Avenue
South side of 167th St, east of Paxton Avenue to Centennial Park
159th Street south to 171st Street between 84th Avenue and 86th Avenue (Village of
Tinley Park boundary)
171st Street south to 175th Street between 84th Avenue and LaGrange Road
175th Street south to 179th Street between 89th Avenue and LaGrange Road
179th Street south to 183rd Street between 90th Avenue and LaGrange Road
171st Street south to 175th Street between 80th Avenue and 84th Avenue
175th Street south to 179th Street between Harlem Avenue and 89th Avenue
179th Street south to 183rd Street between Harlem Avenue and 90th Avenue
Grissom Middle School
From 171st St south to 183rd St, east of the Commonwealth Edison Power Line R.O.W. (right of way) to Harlem Ave.
From 171st St North to 159th St, east of the Tinley Park border with Orland Park to Harlem Ave., with the exception of the area north of 163rd St to 159th St, and east of 76th Ave.
From 171st St south to 183rd St, west of the Commonwealth Edison Power Line R.O.W. (right of way) to 104th Ave.
From 171st St north to 159th St, west of the Tinley Park border with Orland Park to 104th Ave., with the exception of the area east of 88th Ave. and north of Meadowview Dr / 163rd St.
If you have any questions or need additional information about school boundaries, please call our District office at 708-532-6462.
Millennium School
Follow us on Facebook! (opens in new window)
Follow us on Twitter! (opens in new window)
*Martin Luther King, Jr. Day - No School
Choir Practice Groups A & B
Jan 21, 2020 7:05 AM - 7:50 AM
Boy's Basketball Practice
5Essentials Survey Link
Martin Luther King, Jr. Day - No School Monday, January 20th
Important Calendar Information Regarding Pulaski Day
Follow us on Facebook (opens in new window) (opens in new window)
Follow us on Twitter (opens in new window) (opens in new window)
© Kirby School District 140 All rights reserved. | Website by Campusuite & Rhyolite Design
campus-suite
|
cc/2020-05/en_middle_0097.json.gz/line1407373
|
__label__wiki
| 0.669557
| 0.669557
|
Meexo Is the Uncreepy Dating App You Might Actually Consider Using
By Davey Alba 2012-03-10T00:27:23Z
Online dating can be creepy, and that's just a fact. But Meexo—a new app selected as a finalist for the SXSW Accelerator Competition—wants to change that assumption. CEO and co-founder Romain David walked me through a demonstration this afternoon, and I have to admit that the way the app is built is surprisingly thoughtful, even sensitive to a lady's usual apprehensions when it comes to the online dating space.
Here's the first thing that's different about Meexo: The platform is completely mobile. "We wanted ownership of a smartphone to be the lowest common denominator," David said to me. Thus, the app does away with the entire website portion of a social network, offering users the dating experience exclusively on the phone.
Meexo also emphasizes privacy. "Each person's account is tied to their particular device," David explained, "and they're only allowed to make one account per device—although they can sign in through multiple devices." This acts as a safeguard against people making multiple accounts and posting fake photos and details about themselves. And when a person messages another within the network, no actual phone number is shared—so there's no risk of getting that crazy 4 AM phone call from stalker types.
But what about the biggest reason people still recoil from online dating like it's the plague—the fear of being discovered by someone they know? Meexo addresses that issue, too. You can connect the app to your Facebook account (other social networks to come) in a kind of reverse "find friend" feature. The app uses this data to ensure sure your contacts never accidentally come across your profile. Ah, those mortifying moments: eliminated.
What's more, the more a user explores the app and selects profiles they're interested, the more the app learns about one's dating preferences, and the more it matches the user up with their type. David described it to me as the "Pandora" of online dating—that is, the app gets smarter the more you use it.
The app also attempts to solve the problem of getting too many messages from others, especially women from interested men. When users join the network, they receive virtual currency, but spend some of it when they message other people. This forces them to be more selective about who they (virtually) approach—although replying to a message costs nothing. But what if you need more credits? Taking a leaf from the Dropbox incentive, those who convince others to join the network via their personalized code get their credits boosted.
Lastly, Meexo includes a number of extra geeky features to help kick off those awkward first conversations. For instance: comparing music tastes. When you and your partner both have your phones out, you can place them side by side and connect them via Bluetooth. Meexo scans both libraries on the phones and starts an animation of the cover art of songs or albums you share, floating seamlessly from one screen to the other. It's a detail nerds (ahem, admittedly, me) would definitely appreciate. And in the future, David tells me, their engineers plan to add in other ways to view what you have in common with a potential match—mutual contacts, for instance.
Meexo isn't perfect. It's iOS-only, there's no way to uncouple a profile from a device (besides a tedious manual process), and you can only block your Facebook friends for now. But in a world where online dating still carries a stigma, Meexo makes a sincere effort to do things better.
The app went live yesterday, and is available in the iTunes Store for free.
Top 15 Productivity Apps for Your Tablet
9 Must-Have Games for Your Tablet
|
cc/2020-05/en_middle_0097.json.gz/line1407377
|
__label__wiki
| 0.529112
| 0.529112
|
What I learned from firing a gun
Safety instructor Steve Wier gestured toward the firearms and issued a challenge: “If you don’t point one of these at me today, I will be stunned.”
What I learned from firing a gun Safety instructor Steve Wier gestured toward the firearms and issued a challenge: “If you don’t point one of these at me today, I will be stunned.” Check out this story on ldnews.com: http://ldne.ws/2a5ojdu
Daniel Walmer, danielwalmer@ldnews.com Published 10:09 a.m. ET July 22, 2016 | Updated 11:31 a.m. ET July 22, 2016
Daniel Walmer, a reporter for the Lebanon Daily News, shoots an AR-15 rifle with a Silencerco Hybrid suppressor at Lanco Tactical's Suppressor Day at the Lebanon County Police Combat Pistol Club on Sunday July 10, 2016.(Photo: Jeremy Long, Lebanon Daily News)Buy Photo
I got an opportunity to shoot my first firearms at Lanco Tactical's suppressor event.
It wasn't that scary and was actually pretty fun.
However, I wouldn't want to rely on my ability to use a gun for defensive purposes unless I had been trained.
Glocks, handguns designed for concealed carry, and other firearms lay on a table in the rural Millcreek Township home of Enck’s Gun Barn owner Bob Enck.
Safety instructor Steve Wier gestured toward them and issued a challenge: “If you don’t point one of these at me today, I will be stunned.”
It sounded silly. After I told Enck I was working on a story about first-time gun owners, he graciously invited me to take a one-on-one training course free of charge. Why would I point a weapon at his instructor?
Over the course of the more than four-hour July 18 training, however, he had to wave to me several times to move the muzzle away from his body. My mind was on other things — how to grip a handgun properly, for example.
LEBANON DAILY NEWS
Their first firearm
Yes, I was a rookie. In fact, I pulled the trigger for the first time on guns ranging from simple handguns to AR-15s just days earlier at a July 10 event showcasing suppressors at the Lebanon County Police Combat Pistol Club’s range in North Annville Township. The event was sponsored by Elizabethtown-based Lanco Tactical, which generously invited me to try out their weapons.
I know what you’re probably thinking if you’re a gun owner: he’s one of “those people” who believes all firearms are frightening and dangerous.
My background is actually a bit more complicated than that: I wasn’t raised around guns, but my father grew up as a hunter, considering them a normal part of life. In fact, I’m similar to many people gun store owners say enter their shops on a regular basis: unfamiliar with guns but not opposed to owning one if I someday feel the need.
To the extent I had any apprehension about firing a gun, it did not take long for familiarity to breed contempt of their danger unless I kept safety at the forefront of my mind. In fact, trying to hit the steel targets was flat-out fun. It just didn’t seem possible that this moderately heavy mechanical tool could kill a person if they were standing on the other side.
“It's like blaming your pencil for a misspelled word.”
Nathan Lamb, President of Lanco Tactical
Lanco Tactical President Nathan Lamb insisted that, contrary to my more gun-phobic friends, there is nothing magical about the hunk of metal that causes violence.
“It’s like blaming your pencil for a misspelled word,” he said.
Sure, but pencils aren’t used to kill, and aside from fourth grade bullies poking annoyed victims, they are rarely part of any malicious action. It just seems rational that a shooting device should be treated with more respect than a writing device.
That leads me to one final point (no pencil puns intended): Second Amendment advocates say that your right to purchase a gun is not contingent on undergoing safety and training classes.
"I wanted that responsibility": Women flock to Lebanon-area gun stores
But having a right to do something doesn’t mean you should.
After gaining an appreciation for the complexities of firing a gun, I realized that purchasing a firearm for defensive purchases and never learning how to use it is at least a complete waste of cash.
Daniel Walmer, a reporter for the Lebanon Daily News, shoots a Smith & Wesson .22-caliber compact pistol with a Silencerco Osprey Micro suppressor at Lanco Tactical's Suppressor Day at the Lebanon County Police Combat Pistol Club on Sunday July 10, 2016. (Photo: Jeremy Long, Lebanon Daily News)
As Wier – a former biology teacher – explained, the body’s sympathetic nervous system makes it more difficult to perform relatively complicated tasks like operating a firearm in an emergency. That’s where training can create muscle memory, making it more likely that you will operate a gun properly in a defensive situation like a home invasion.
National Rifle Association Executive Vice President Wayne LaPierre famously said after the Sandy Hook Elementary School shooting in 2012 that “the only thing that stops a bad guy with a gun is a good guy with a gun.” That should at least be amended to “a good guy with a gun who knows how to use it.”
We’re all better off if people who own guns know how to use them safely. Hopefully, this something on which gun rights and gun control advocates can agree.
Read or Share this story: http://ldne.ws/2a5ojdu
Fear and frustration after two pedestrians hit
|
cc/2020-05/en_middle_0097.json.gz/line1407382
|
__label__cc
| 0.682517
| 0.317483
|
Idle Bars 2
() Connected Limited connection Disconnected Not Connected Remote Only Error Connected Syncing
% Cloud Saves are enabled for this game!
Look for this icon for status and other games with cloud saves.
Favorite
p+-Playlist
Tired of ads on Kongregate? You can now be Ad-Free! Learn more about KONG PLUS »
Your game will start after this message (close)
Report Cinematic Bug...
To play games on Kongregate,
you must have Javascript enabled!
To play this game on Kongregate, you must have a current version of Adobe’s Flash Player enabled.
Install or enable Adobe Flash Player
Alternatively, we also recommend the SuperNova! Plugin for Chrome as an easy way to enable Flash content in the browser.
Diamonax
l Favorite Favorites
i Game bug
Flag this game
A fun minimalist idle game with colorful bars and relaxing music! Can you buy every bar? Can you get…
A fun minimalist idle game with colorful bars and relaxing music! Can you buy every bar? Can you get every achievement? Try it out now!
Play with the mouse.
The game saves your progress, but doesn’t progress while offline.
In case the p…
In case the progress doesn’t get saved, please check whether your browser’s “local storage” is enabled, or use a modern browser.
: Want to join my private chat room? Join/Ignore
#{extraIconType} Kongregate Plus #{extraIconTags} Friend #{game_character_name} Mobile
Leave private chat
Leave guild chat
Change chat rooms
See friends online
Room info & help
Favorite this room
Set status: Away
Register now to save your earned badges, chat with other players, and share your progress with your friends.
Become a Kongregate member for free!
Sign up now to save your badges, points and progress. You'll also be eligible for free video games and prizes!!! (Already a member?)
We encountered a problem. Please try again.
Password (min. 10 characters)
January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Username (4-16 characters)
I have read and agree to the Privacy Policy, User Agreement and Cookie Policy
Parent or guardian email address Your parent or guardian must review and agree on your behalf to register
You’re now level #{level}!
Earn #{points_away} more points to reach level #{next_level}! Congratulations, you've reached Kongregate's level cap!
* 3.3 1,360
+Add Tags
l Favorite
Game By:
t Published Sep. 08, 2018 with gameplays
! Flag
|
cc/2020-05/en_middle_0097.json.gz/line1407384
|
__label__wiki
| 0.88119
| 0.88119
|
Application (1) Apply Application filter
Emblematic Network (1) Apply Emblematic Network filter
Keolis awarded a new bus contract in Geraldton, Western Australia
22-08-2019Keolis’ Australian subsidiary Keolis Downer has been awarded a new contract by Western Australia Public Transport Authority to operate buses in Geraldton, a city 450km north of Perth (Western Australia) with a population of around 40,000 residents.
Australia: Keolis adds light rail to its multimodal transport network in Newcastle ahead of schedule
02-18-2019 Keolis’ Australian subsidiary Keolis Downer, has started operating Newcastle’s new light rail service as part of the city’s multimodal transport network. Operations are starting ahead of schedule, giving local residents and visitors the opportunity to benefit from the new service sooner than expected. This new milestone reinforces Keolis’ presence in Australia where it has introduced and operated light rail networks, buses, on-demand transport and autonomous electric vehicles since 2009. It also illustrates Keolis’ commitment to support the delivery of seamlessly integrated, shared mobility systems that revitalise cities and makes them more enjoyable and more liveable
Gold Coast light rail: the star performer of the Commonwealth Games transport plan
04-24-2018 updated on 05-22-2018G:link, the tram network operated by Keolis Downer and GoldlinQ played a central role in the Queensland Government transport plan, carrying more that 1.1 million passengers. G:link operated 24/7 with services running every six minutes during peak periods.
Keolis Downer hired and trained more than 350 extra staff to ensure the service ran smoothly
How to successfully transport thousands of passengers during Melbourne’s major events
Keolis Downer, operator of Yarra Trams, is currently delivering services to peak patronage across its network, with Melbourne’s major events season underway.
Auvergne Mobilité
Auvergne Mobilité app
Transport app for the Auvergne region, central france
Journey planner and timetables: the auvergne mobilité app, by your side whenever you travel
All the key solutions in your pocket:
Plan a journey, starting out immediately or at a later time. Auvergne Mobilité suggests the best route for your journey using all modes of public transport (bus, train, tram, etc.), walking, personal or bike-share bicycle. Wait times, number of changes, travel distance and intermediary stops: all the information you need to make an informed choice.
Display the journey route and stops on a map and track your progress.
Check the next bus, train or tram arrival times or timetables for your networks by selecting a route or stop.
Store your favourite stops to make your everyday timetable searches easier.
Check announcements for current or planned service issues.
Discover Auvergne: plan journeys and check the timetables across more than a dozen transport networks throughout the region.
This app was developed by Kisio for the Auvergne region. It is only available in French.
|
cc/2020-05/en_middle_0097.json.gz/line1407388
|
__label__wiki
| 0.739135
| 0.739135
|
Notably Texan
The Blacklands Café
Lions After Dark
Lions Roar
Outdoors w/ Luke Clayton
North by Northeast
John Kanelis
Blacklands Café Interviews
Convo
Crawfish Nachos
NoTex Interviews
KETR's Editorial Integrity
Public Media Code of Integrity
Give to KETR
Loyalty Circle
Donate Your Car!
Underwrite on KETR
Development Advisory Board
KETR
President Trump Defends Incendiary Tweets
By Ayesha Rascoe & David Greene • Jul 30, 2019
Originally published on July 31, 2019 10:37 am
This morning, President Trump doubled down on his recent incendiary tweets about Baltimore City and about Democratic Congressman Elijah Cummings who chairs the House Oversight Committee. The president spoke a short while ago as he was leaving the White House.
PRESIDENT DONALD TRUMP: Those people are living in hell in Baltimore. They're largely African American. You have a large African American population. And they really appreciate what I'm doing, and they've let me know it.
GREENE: NPR's Ayesha Rascoe is at the White House and joins me now to talk about this. Good morning, Ayesha.
AYESHA RASCOE, BYLINE: Good morning.
GREENE: So the president, we should say, has faced a whole lot of criticism for his comments on Twitter on these subjects, including from a Republican - the governor of Maryland, Larry Hogan. So how did he respond to that criticism this morning?
RASCOE: Well, President Trump's pretty much rejected all of the criticism, and he claimed that African Americans have been calling the White House in large numbers at one point, and that residents of Baltimore had been calling the White House, he said, in the thousands, and that they were very happy with what he was saying.
He repeatedly said that there had been all of this corruption in Baltimore, and that all of this federal money had been taken and misused. And he said that he felt like that's what Elijah Cummings should be dealing with. Here's more of what he said about that.
TRUMP: What Elijah Cummings should do is he should take this oversight committee, bring them down to Baltimore, and invest all of the - and really study the billions and billions of dollars that's been stolen.
RASCOE: Now he offered no evidence of money being stolen or why he was saying that money had been stolen. And so he had - and he also offered no evidence that all these people have been calling and or - so he didn't offer anything to back that up.
But that does get to the point that Cummings is leading all of these investigations into the Trump administration and their conduct. And part of this seems to be that President Trump is not really happy with the oversight that Cummings is conducting.
GREENE: Well, there's also the timing of this - right? - and some questions about the politics here. I mean, this comes as the Democratic 2020 candidates are getting ready to take the stage tonight for another round of debates. Is - I mean, is this the president just continuing to try and claim the narrative and claim the airwaves?
RASCOE: He's definitely getting on the airways by saying these sorts of things about Baltimore's - you know, that quote about saying that people are living in hell. By using that type of imagery, he is forcing people to look at him, to talk about him and to talk about what he's saying.
And sure, when you have these Democrats on the stage these next two nights, that might be less attention on him. So this is a way for him to make sure that he is being talked about and that maybe that he's driving the conversation because the Democrats will have to talk about this.
And he did go after Joe Biden a bit today, saying that he had lost a step. And so he's using this to kind of further that aim.
GREENE: And we should say he also defended his pick for director of national intelligence, current Republican Congressman John Ratcliffe, this morning.
RASCOE: Yeah, he said that he's a brilliant man. And he also said that he picked him before the Mueller hearing, or that he had talked to him about this position before the Mueller hearing, so kind of trying to disconnect it from that.
GREENE: NPR White House reporter Ayesha Rascoe at the White House this morning. Ayesha, thanks as always.
RASCOE: Thank you. Transcript provided by NPR, Copyright NPR.
© 2020 88.9 KETR
Open Records/CPB Compliance
|
cc/2020-05/en_middle_0097.json.gz/line1407389
|
__label__wiki
| 0.613565
| 0.613565
|
MyKFH | Sign in
About KFH
Property Solicitors
The costs involved in buying a property
Negotiating and making an offer
Instructing a property solicitor
Buyers' FAQs
View all buyers' resources
House prices and property data
Council tax data
London's lifestyle zones
The renting process
Costs and fees involved
Securing a property to rent
Choosing the type of let
Tenants' FAQs
View all tenants' resources
Renewals department
Leasehold Extensions
The costs involved in selling a property
What documents are required?
Negotiating and considering offers
Information that needs to be disclosed
Sellers' FAQs
View all sellers' resources
Long Term Lets
The letting process
Costs and fees involved in letting a property
Understanding the rental yield
Landlords' rights and responsibilities
Short let guide for landlords
Landlords' FAQs
View all landlords' resources
Block and Portfolio Management
Corporate and Relocation Services
Surveying and Professional Services
Buyers' resources
Tenants' resources
Sellers' resources
Landlords' resources
London area information
Careers at KFH
Search by train or tube stations
Search by nearby schools
Residential online portal
Thinking about selling your property?
Thinking about letting your property?
Finding corporate tenants
London area guides
Area guide for Angel
Back to London area information
Sold data
Select search type:
Change page Area guide Map Sold data Council tax Transport Schools
Angel overview
A guide for this area is not currently available.
However, you can still view local area information using the corresponding tabs above:
The nearest available guide to this location is:
Properties for sale in Angel Properties to rent in Angel
KFH branch finder
We have 60 branches across the Capital.
Enter postcode or location:
Enter full postcode:
KFH services
Block and Estate Management
Corporate PRS
KFH resources
Private investors' and developers' resources
Search Search options
Search Search by street, postcode or location
Draw search Draw your search area on a map
Map search Search by London region
Tube / train Search by tube or train station
Schools Search by nursery or school
Near me Search for properties nearby
Enter location(s) Add one or more search locations within London, or leave blank to search Londonwide
Month Week
£0 £200,000 £225,000 £250,000 £275,000 £300,000 £325,000 £350,000 £375,000 £400,000 £425,000 £450,000 £475,000 £500,000 £525,000 £550,000 £600,000 £650,000 £700,000 £750,000 £800,000 £850,000 £900,000 £950,000 £1,000,000 £1,250,000 £1,500,000 £1,750,000 £2,000,000 £2,500,000 £3,000,000 £4,000,000 £5,000,000
£200,000 £225,000 £250,000 £275,000 £300,000 £325,000 £350,000 £375,000 £400,000 £425,000 £450,000 £475,000 £500,000 £525,000 £550,000 £600,000 £650,000 £700,000 £750,000 £800,000 £850,000 £900,000 £950,000 £1,000,000 £1,250,000 £1,500,000 £1,750,000 £2,000,000 £2,500,000 £3,000,000 £4,000,000 £5,000,000 No max
£0 £750 £850 £1,000 £1,100 £1,200 £1,300 £1,400 £1,500 £1,600 £1,700 £1,800 £1,900 £2,000 £2,100 £2,200 £2,300 £2,400 £2,500 £2,750 £3,000 £3,250 £3,500 £3,750 £4,000 £4,500 £5,000 £6,000 £7,000 £8,000
£750 £850 £1,000 £1,100 £1,200 £1,300 £1,400 £1,500 £1,600 £1,700 £1,800 £1,900 £2,000 £2,100 £2,200 £2,300 £2,400 £2,500 £2,750 £3,000 £3,250 £3,500 £3,750 £4,000 £4,500 £5,000 £6,000 £7,000 £8,000 No max
Studio 1 2 3 4 5 6 7
to maximum bedrooms
Studio 1 2 3 4 5 6 7 8+
Long let
Short let (up to 6 months)
Managed by KFH
Show All Furnished Part furnished Unfurnished
Highest price first Lowest price first Most recently added
GBP (£) USD ($) EUR (€)
Include new homes
Include properties under offer and contracts exchanged
Thank you for the support and professional service you provided us in ensuring the smooth sale of our flat. You constantly communicated with us which was great as we knew what was happening every step of the way.
James and Beatriz R - Seller
Thanks for the outstanding professionalism and communication demonstrated. It was a truly smooth and well guided process.
Luis L - Seller
We are very happy with the professional way in which you have dealt with us. Your quick responses are always reassuring especially as we are based in Italy. You are very knowledgeable in all aspects of the property market.
Dominic A - Landlord
Our mortgage offer was issued very quickly and all my questions were promptly addressed. KFH demonstrated their knowledge of the mortgage market, saved my time by addressing several lenders and always kept me up-to-date about the progress and what was needed from my side. Thank you for giving me the peace of mind to focus on what only I can do in the process.
Marina B - Buyer
View testimonial 1
Read more testimonials Leave a review
Please leave your feedback below. For complaints, please contact clientliaison@kfh.co.uk
Please enable javascript to complete this form
Mr Mrs Ms Miss Dr Prof
-- Please select -- Acton Balham Battersea Battersea Park Bayswater Beckenham Belsize Park Blackheath Brockley Bromley Brook Green Canada Water Catford Chislehurst Chiswick Clapham Clapham Common Clerkenwell Crouch End Crystal Palace Dulwich Village Ealing Earls Court Earlsfield East Dulwich Finchley Forest Hill Fulham Fulham and Chelsea Hammersmith Hayes Highgate Holland Park Islington Kennington Kingston Lee London Bridge Marylebone Muswell Hill New Homes North and Central London New Homes South East London and North Kent New Homes West and South West London Peckham Rye Putney Raynes Park South Kensington Southfields Southgate St Johns Wood Streatham Tooting West Dulwich West Hampstead West Putney West Wickham Wimbledon
About me*:
-- Please select -- Buyer Seller Landlord Tenant Investor
Return to top of the content
Kinleigh Folkard & Hayward
Head Office KFH House 5 Compton Road Wimbledon London SW19 7QA
Find a KFH branch
KFH careers
London property market blog
Completely London magazine
onthemarket.com
See all our properties on www.onthemarket.com
Client money protection (CMP) provided by ARLA.
Terms of use Privacy policy Modern slavery act Gender pay gap reporting
© 2020 Kinleigh Limited. 'Kinleigh Folkard & Hayward is the trading name of Kinleigh Limited.
Registered in England 913323. Registered office KFH House, 5 Compton Road, Wimbledon, London, SW19 7QA. VAT number 647 8742 89
We use cookies to give you the best possible online experience. If you continue, we'll assume you are happy for your web browser to receive all cookies from our website. Learn more
Min price £0 £200,000 £225,000 £250,000 £275,000 £300,000 £325,000 £350,000 £375,000 £400,000 £425,000 £450,000 £475,000 £500,000 £525,000 £550,000 £600,000 £650,000 £700,000 £750,000 £800,000 £850,000 £900,000 £950,000 £1,000,000 £1,250,000 £1,500,000 £1,750,000 £2,000,000 £2,500,000 £3,000,000 £4,000,000 £5,000,000
Max price £0 £200,000 £225,000 £250,000 £275,000 £300,000 £325,000 £350,000 £375,000 £400,000 £425,000 £450,000 £475,000 £500,000 £525,000 £550,000 £600,000 £650,000 £700,000 £750,000 £800,000 £850,000 £900,000 £950,000 £1,000,000 £1,250,000 £1,500,000 £1,750,000 £2,000,000 £2,500,000 £3,000,000 £4,000,000 £5,000,000 No max
Min price (pcm) £0 £750 £850 £1,000 £1,100 £1,200 £1,300 £1,400 £1,500 £1,600 £1,700 £1,800 £1,900 £2,000 £2,100 £2,200 £2,300 £2,400 £2,500 £2,750 £3,000 £3,250 £3,500 £3,750 £4,000 £4,500 £5,000 £6,000 £7,000 £8,000
Max price (pcm) £750 £850 £1,000 £1,100 £1,200 £1,300 £1,400 £1,500 £1,600 £1,700 £1,800 £1,900 £2,000 £2,100 £2,200 £2,300 £2,400 £2,500 £2,750 £3,000 £3,250 £3,500 £3,750 £4,000 £4,500 £5,000 £6,000 £7,000 £8,000 No max
Min bedrooms Studio 1 2 3 4 5 6 7
Max bedrooms Studio 1 2 3 4 5 6 7 No max
The Kinleigh Folkard & Hayward website uses the latest technology to give you the best possible experience, unfortunately your browser doesn't support these technologies.
Click here to upgrade to a modern browser
|
cc/2020-05/en_middle_0097.json.gz/line1407390
|
__label__wiki
| 0.522847
| 0.522847
|
Home » The Godfather just lateraled to a law firm (055)
The Godfather just lateraled to a law firm (055)
By Bill Henderson on July 1, 2018
Posted in BigLaw, Legal Innovation, Legal Ops
Is legal operations a discipline or a job within a legal department? The market just provided an answer.
Last Friday, David Cambria, the Godfather of legal operations, left his secure post at ADM (#46 on the Fortune 500) to become Global Director of Legal Operations at Baker McKenzie. To be clear, Cambria’s title is not another name for “Chief Operating Officer,” an established role in law firms that focuses on internal cost and efficiency. This is an outward-facing role designed to attract and cement client relationships.
Per the press release:
Cambria will be responsible for ensuring that the strategies for pricing, legal project management, and other commercial activities are closely matched to increasingly sophisticated client needs and expectations. He brings a unique “voice of the client” to the leadership of Baker McKenzie and will work directly with major clients to both help shape delivery of the Firm’s services and to assist clients in addressing the development of their own operations.
It is hard to predict whether this is the beginning of a trend, or a one-and-done experiment. It all depends on whether the desired benefits show up within a reasonable period of time. In this instance, there are only two certainties: (1) Cambria is being compensated for the risk, and (2) the Fortune 500 will take him back if the boulder gets too heavy or the mountain gets to steep.
This is also a valuable learning opportunity for everyone else. This is because David Cambria is both an innovator and opinion leader within the legal operations field. As discussed in the foundational posts on diffusion theory, these attributes, particularly when combined, accelerate adoption.
Cambria’s move threw a wrench into our editorial calendar. Nonetheless, it was too significant to ignore. This post attempts to answer three questions relevant to this important industry milestone.
1. If legal ops is a discipline, where will it get maximum traction?
“Legal operations is a multidisciplinary field where professionals collaborate to design and build systems to manage legal problems.” That was my conclusion back in 2015 as I observed three legal innovators — Connie Brenton at NetApp, John Alber at Bryan Cave, and Andrew Sieja at Relativity — all solving similar types of problems, albeit at different points in the supply chain. See Henderson, “What the Jobs Are,” ABA Journal, Oct. 2015.
A couple of weeks ago, we analyzed the ULX Partners, UnitedLex-DXC, and ElevateNext deals. See Post 053. But in retrospect, one question drove the whole 4,200 word essay: “where will legal operations get maximum traction?” Is it BigLaw, NewLaw, legal departments, or legaltech? Several hundred legal innovators with the technical skills to deliver better-faster-cheaper are very interested in the answer. What they long for is a stable, resource-rich environment where they can build the systems that are already in their heads.
Thus, BigLaw tends to drive innovators nuts, as it struggles to play an essentially perfect hand: (1) longstanding relationships with industry-leading clients; (2) a business that requires very little operating capital yet generates significant cash and profits; (3) an established brand that makes it the safe choice against upstart new entrants. See Post 039 (discussing Innovator’s Dilemma within law firms); Post 053 (discussing psychology that precedes law firm failure); see also MacEwen, TomorrowLand 26 (2017) (discussing the very real possibility that some firms “would rather fail than change”).
NB: This post frames a structural problem from the perspective of organizational clients. For this group of clients, the problem of lagging productivity is leading to market-based responses, including the hiring of David Cambria by a BigLaw firm. For individual clients in the PeopleLaw sector (roughly one-quarter of the legal market and shrinking), lagging legal productivity manifests itself through self-representation or people failing to seek any type of legal-based solution. See The Decline of the PeopleLaw Sector 037; Legal Services and the Consumer Price Index (CPI) (042). In short, these are two distinct problem sets. Improving PeopleLaw is an important topic that we will continue to focus on. Just not today.
There are three contenders to create the new paradigm for organizational clients:
Legal departments through more legal operations and in-sourcing;
Law firms by skillfully playing their superior hand; or
NewLaw, which has data, process, and technology as its core competency but has the challenge of being new and unfamiliar.
Right now, I see no clear winner. Yet, from a human capital perspective, the solution set is the same for all three.
2. Is there is human capital model for legal ops?
Yes. David Cambria and his legal operations colleagues are “legal integrators.”
Below is a graphic first generated by Bill Mooz and I in the fall of 2015. The occasion was a presentation to a group of legal operations professionals in Chicago led by David Cambria. See Creating Legal Integrators (Sept. 2015). David was curious about the curriculum of the Tech Lawyer Accelerator (which Mooz founded) and wanted to understand its connection to legal operations.
The legal integrator model we created contains the DNA of the original partner-associate pyramid. But it has also moved on, reflecting the types of human capital needed to deliver both bespoke one-to-one legal services and one-to-many systematized/productized legal solutions.
Bespoke lawyers remain at the top of the model. But is the top more important than the center? The green center portion is where systems are built to optimize cost, quality, and effort. It is also where expert sourcing decisions get made. This requires a skill set that includes not only substantive legal knowledge but systems thinking, statistics, accounting, finance, and technological literacy. (BTW, there are many allied professionals without law degrees who also thrive in the green zone.)
In this version of the model, I break legal integrators and legal operators into two, with the former excelling at design and strategy and the latter excelling at execution, change management, and continuous improvement. Integrators and operators are yin and yang to each other. Some professionals have these skill sets in exact equal proportion. But that is rare. This is why legal operations is much more a team sport than traditional lawyering.
The rarest legal professional, however, is the bespoke lawyer who understands what is happening in the green and why it is crucial to his or her long-term prosperity. In all likelihood, closing this communication gap will be a substantial part of David Cambria’s new job.
3. What is the law firm strategy that requires the talents of legal integrators?
Several years ago I was hired to give a presentation on the future of the legal profession to an elite AmLaw 25 law firm. The responsibility of shepherding my presentation fell to a small committee of junior partners. Although they claimed that my future-oriented observations were interesting, they really wanted to understand the future of their own firm. They had spent a decade focused on making partner and were now playing catch-up. Well, that was a pretty big change order. Yet, I was happy for the stretch assignment and did my best to deliver.
The graphic below is one of the models that came out of that effort.
The key point is that an elite law firm has a choice to make — a choice based on endowments where, for most firms, the dye has already been cast. When a firm has a top of the pyramid strategy, it is focused on transformative events where (a) the outcome really matters and (b) the C-suite executives don’t want to be second guessed. Top of the pyramid can also apply to clients engaged in ongoing complex financial transactions, particularly when legal fees are rolled into the deal and paid for by third parties. A handful of firms fit the top of the pyramid model, and many more would like to be part of this ultra-elite group. To become a top of the pyramid firm, however, you’ll need a time machine.
An alternate strategy is the traverse the pyramid model. Firms that traverse the pyramid can handle large complex projects that include sophisticated bespoke lawyering along with a large volume of operational and commoditized work that is connected to it. It is particularly valuable when the legal work is global in nature. General contracting this work is complex and cumbersome. Thus, clients are willing to play a premium for a law firm to bundle it together. But a premium is not the same as a blank check. Thus, traverse the pyramid firms need to build and maintain sophisticated systems and staffing models.
Baker McKenzie is a credible traverse the pyramid firm, but there are many others. For all of them, the biggest challenge to execution is the large portion of the line partners, and occasionally lawyers in leadership, who struggle to grasp the strategy. Specifically, the core strategic tenet of this model is that work in the operational and commoditized zones can be re-engineered in ways that improve quality and the client experience while also driving down overall production costs. This is a formula for larger and more stable profit margins. It is also why the traverse the pyramid model requires an investment in legal integrators and operators: they can deliver a “whole product solution,” see Post 024 (discussing power of whole product solutions), that is highly defensible and sticky. Once in place, the barriers to entry are (1) brand, (2) geographic footprint, and (3) the large number of client touch points.
However, when line partners are presented with this strategy, they are often drawn to the tip of the small blue triangle because it signifies bespoke legal services at $900 to $1400 an hour. Many seem to be unaware that the operational and commodity work can be done at 30-40% profit margin with very little partner oversight and that, from a business perspective, that is a profoundly good thing. Stated another way, the partners seem to want a model that preserves their ability to sell their own time at a premium price. The traverse the pyramid strategy, however, is designed to build a highly profitable legal services business with a moat around it.
Perhaps partners are stuck in this mindset because, for the last generation or two, compensation structures have rewarded revenue, which is easiest to rack up when partners and pricey associates do all the work. Or it may be the craft satisfaction of personally creating something they believe to be perfect. Regardless, for the Cambria bet to payoff, Cambria needs to overcome this mindset so, when the time comes, he can push more work down the pyramid in ways that delight clients, cement relationships, and improve the firm’s long-term financial prospects.
One of the core insights of the organizational innovation posts, see Posts 015–017, is that, even in law firms, size is correlated with innovation. This is because size brings with it resources, diversity of talent, and more opportunities to run trials, etc. On balance, these benefits tend to outweigh the challenges of implementation within a larger firm, albeit diffusion theory can also help with the latter. See Post 017 (management roles need to switch between initiation and implementation).
It is hard to believe, but large firms are truly capital constrained. See Post 053. However, if all a firm can muster is 1-2% of revenues for innovation efforts, $2.7 billion (Baker McKenzie’s current revenues) yields a lot more than $350 million (the revenue of the firm currently ranked #100 in the AmLaw league tables). This is why David Cambria went to Baker McKenzie — the strategy just might work.
What’s next? See Studying leadership before the big test, Part I (056)
Tags: Baker McKenzie, David Cambria, Godfather, human capital, legal ops
Read more about Bill Henderson Bill's Linkedin ProfileBill's Twitter Profile
A roadmap to build a tech team to support legal operations (135)
Optimizing Legal Ops in law firms (116)
Guest contributor David Cunningham (115)
Legal tech platforms through the years (108)
Microsoft's Legal Department just invested in Business Design Thinking (104)
The editor of Legal Evolution is Bill Henderson, Professor of Law at Indiana University Maurer School of Law where he holds the Stephen F. Burns Chair on the Legal Profession.
Bill is a prolific author and lecturer on the legal market. His industry accolades include ABA Journal Legal Rebel (2009), National Law Journal 100 most influential lawyers in America (2013), and National Jurist most influential person in legal education (2014 and 2015). Bill is also a Fellow of the College of Law Practice Management, and co-founder for the Institute for the Future of Law Practice.
Bill’s academic work can be found on SSRN. For additional information, please see Bill’s personal webpage.
Jae Um is the Director of Pricing Strategy at Baker McKenzie worldwide. She is also the Founder of Six Parsecs, a cutting-edge market insight company focused on the legal industry, and a regular contributor to The American Lawyer.
Evan Parker, Ph.D., is the Founder of Parker Analytics LLC, a data-driven consultancy focused on talent, diversity, and strategy. Parker Analytics is also the official analytics partner to the Leadership Council on Legal Diversity.
Dan Rodriguez is the Harold Washington Professor at Northwestern University Pritzker School of Law, where he also served as dean from 2012 to 2018. He is chair of the ABA Center for Innovation, past president of the Association of American Law Schools (AALS), and Council Member of the American Law Institute (ALI).
LinkedIn RSS Twitter
Jason Barnwell
Assistant General Counsel, Microsoft
Jason's Linkedin ProfileJason's Twitter Profile
Lucy Bassli
Founder & Principal, InnoLegal Services
Lucy's Linkedin ProfileLucy's Twitter Profile
Dan Currell
Former Managing Director, AdvanceLaw
Dan's Linkedin ProfileDan's Twitter Profile
Chief Technologist, Tanenbaum Keale LLP
Kenneth's Linkedin Profile
Topics Select Category Bar Associations BigLaw Book Excerpts Book Reviews Crossing the Chasm Data Points Diffusion Theory Diversity Editor notes Event Announcement Founder Stories In-House Legal Departments Institute for the Future of Law Practice Last Miler’s Club Lawyer Development Lawyer Regulation Leadership Legal Education Legal Innovation Legal Ops Legal Productivity Problem LegalTech NewLaw PeopleLaw Public Resources Reader resources Talent Taller Corn
Evan Parker takes home two LexBlog awards for outstanding writing (134)
The Simple Guide to Legal Innovation (133)
Lucy Bassli’s new book (132)
Losing my cynicism (131)
Algorithmic Society
Amazing Firms, Amazing Practices
Computational Legal Studies
eLawyering Blog
In Search of Perfect Client Service
Law Sites
Legal Mosaic
Legal Watercooler
Lopsider
rethinking.legal
Richard Granat
Strategic Legal Technology Blog
Law School Café
TaxProf
Bucerius Center on the Legal Profession
CODEX – Stanford Center for Legal Informatics
Georgetown Center for the Study of the Legal Profession
Harvard Center on the Legal Profession
Stanford Center on the Legal Profession
Stewart Center on the Global Legal Profession (Indiana)
Legal Evolution
About this Public Benefit Corporation
Legal Evolution is a Public Benefit Corporation (PBC) formed under Delaware law. Our mission is to provide high quality public education on the changing nature of the legal services market. We seek to benefit all industry stakeholders by combining relevant academic theory with data-driven analysis and carefully drawn examples of successful innovations. For additional information, please contact the Editor.
Copyright © 2020, Legal Evolution PBC All Rights Reserved.
|
cc/2020-05/en_middle_0097.json.gz/line1407393
|
__label__wiki
| 0.571034
| 0.571034
|
Supreme Court clarifies solvency test
Chapman Tripp
New Zealand August 9 2017
The Supreme Court this week provided clarification on the extent to which a disputed damages claim should be taken into account when deciding whether a “company is unable to pay its due debts".
At issue was whether the enquiry should be limited to those debts that were or were shortly to become legally due, or whether a more practical and commercial approach be taken? We look at the decision.
In David Browne Contractors Ltd v Petterson1, a voidable transaction case under section 292 of the Companies Act 1993, the Supreme Court opted for the latter approach, following case law from Australia and the United Kingdom.2
In short, the ability of a company to pay its due debts is to be assessed objectively, taking a “practical business perspective". The assessment should include future and contingent debts where there is “sufficient certainty" that liability will crystallise in a reasonable timeframe. The exact timeframe that is relevant will depend on the nature of the company's business.
The company in question welded pipes. Some of those welds failed, leading to a sizeable claim from its customer. After receiving that claim, the company decided to repay substantial advances to related creditors, confirming in the process the directors' belief that the company was solvent.
The directors were aware that the claim, if upheld, would render the company insolvent. But the directors concluded the company was solvent because, they said, the claim was disputed, there were off‑sets available and insurance would cover most of the loss if required.
Importantly, the Supreme Court saw the solvency test as an objective one. The genuineness or otherwise of the directors' belief was not relevant. Instead, what mattered was whether a reasonable director in their position would have come to the same conclusion.
On the facts of this case, the Court said the directors had no reasonable basis for omitting the claim from an assessment of solvency. Specifically, expert independent reports available at the time supported the claim, the directors could not point to any set-off sums and no legal advice was taken at the time as to whether the contract works policy would cover the claim. Later legal advice was that insurance cover was not available.
The recipients of the payments argued in the Supreme Court that such a broad and commercial assessment would mean that even unmeritorious claims would need to be considered. The Court rejected this argument, confirming that the relevant perspective is that of a “reasonable and prudent business person". In particular, “specious claims" do not need to be considered. Nor would claims with a “credible defence". Ultimately the question is whether or not there is “sufficient certainty those claims would crystallise into a debt legally due within a reasonably temporarily proximate timeframe".
The Supreme Court's approach is unsurprising, given the relatively recent and high authority to the same effect in Australia and the United Kingdom.
It is also consistent with the policy aim of the voidable transaction regime, which targets advantages obtained by creditors relative to the results in a liquidation. Claims provable in a liquidation include, of course, future and contingent claims, as well as those that have already become legally due for payment.
While the Court was not directly considering the solvency test in section 4 of the Companies Act, it did see that test as relevant. We expect that this decision would be influential in any case on the section 4 test, at least in relation to the cash flow aspect of that test. The factors discussed in this case should therefore be considered in other contexts where the solvency test is applied, such as in authorising dividends.
Chapman Tripp - Michael Arthur, Michael Harper, Daniel Kalderimis and Hamish Foote
Cover pricing in construction tenders: a risky business *
All care, all responsibility - duties of an alternate director *
How much should you pay your regulator? Have your say on MED's proposed fee scale *
Parent company made to pay its subsidiary's debts *
Lien vs security interest - who wins? *
Gender pay gap – is reporting enough?
Related New Zealand articles
Predicting the future: Assessing solvency and contingent liabilities in New Zealand *
Due debts and contingent liabilities *
When is broke broke? A UK Supreme Court perspective *
Restructuring & Insolvency in the Bahamas * - Bahamas
Court of Appeal rejects mechanistic balance sheet test for insolvency * - United Kingdom
High Court holds solvency statement invalid, reduction of capital and distribution unlawful and directors in breach of duty and personally liable * - United Kingdom
Rebekah J Poston
“I find the articles on the Lexology newsfeed very relevant and up to date on a variety of topics of interest to my areas of practice. The authors are reliable and current on the topics about which they opine. Even when several law firms write on the same topic, I can often glean new viewpoints and perspectives from the different firms. The headings are also helpful because they briefly and accurately describe the topic and enable me to quickly and efficiently decide what I may or may not want to read in more detail."
|
cc/2020-05/en_middle_0097.json.gz/line1407398
|
__label__cc
| 0.691828
| 0.308172
|
SALT LAKE CITY (801) 895-4232 | CLEARFIELD (801) 876-5155 |
TREATMENT OPTIONS & PRICING
EFFECTIVE LICE TREATMENT
Lice Clinics of America Opens New Treatment Center In Clearfield
October 1, 2017 /in Head Lice /by lcaleah
Clinic will provide free treatments October 4th using FDA-cleared medical device
Clearfield, Utah
As National Lice Prevention Month wraps up, Lice Clinics of America celebrates by offering free lice treatments on October 4 at its newest clinic in Clearfield. The Clearfield clinic is the second Utah location for the company, which operates more than 300 urgent-care clinics in 34 countries.
Lice Clinics of America (www.liceclinicsutah.com) provides screening, diagnosis and treatment options for people infested with head lice. The clinic is staffed by certified operators of the AirAllé device, an FDA-cleared medical device invented at the University of Utah that kills head lice and lice eggs using just heated air.
The clinic is managed by Holly Horrocks, who saw firsthand the impact lice had on children while doing humanitarian work in the Dominican Republic as a Weber State University student. “Although we don’t see the high level of infestation rates here as we did in Honduras, 2-5 percent of school kids here in the U.S. have lice. So there are plenty of lice to go around,” Horrocks said. “And with 98 percent of the lice in the U.S. being Super Lice, parents are having a tough time treating infestations on their own. They don’t realize that the pesticide products they are buying at the store aren’t working anymore.”
Horrocks has been making the rounds at schools, shelters and pediatrician offices to let them know about the clinic’s services. “We want people to know we are here for them. We provide a full range of science-based treatment options for every budget, and we guarantee everything we do.” Horrocks said. “Offering free treatments on our opening day is a way we can do something even more for the community here in Davis County.”
The Clearfield clinic is located at 540 East Antelope Drive, Suite 108, in Clearfield. The clinic will provide free lice treatments on a first-come, first-served basis from 9 a.m. to 4 p.m. on Wednesday, October 4th. After that the clinic will be open by appointment only. AirAllé treatments take about an hour, and come with a 30-day guarantee when all family members are treated or screened for head lice.
The other Utah clinic is located in Murray.
With clinics in 34 countries, Lice Clinics of America (www.LiceClinicsOfAmerica.com) is the largest network of professional head-lice-treatment centers in the world. Lice Clinics of America and AirAllé (www.airalle.com) are brands owned by Larada Sciences, Inc., which is headquartered in Murray, Utah.
Back-to-School Head Lice Prevention Checklist from Lice Clinics of America – Salt Lake City August 25, 2019
Modern Lice Treatment and the AirAllé July 19, 2019
Lice Clinics of America – Utah Supports Moms for Mother’s Day May 10, 2019
Lice Clinics of America® – Utah Honors Teachers and School Nurses in May with Free Screenings May 6, 2019
Earth Day Alert from Lice Clinics of America® – Utah April 22, 2019
154 East Myrtle Ave., Suite 101, Murray, UT 84107
info@liceclinicsaltlakecity.com
540 East 1700 South (Antelope Drive), Suite 108, Clearfield, UT 84015
info@liceclinicsclearfield.com
Follow Our Clinics
Follow Lice Clinics of America
Beaver, Box Elder, Cache, Carbon, Daggett, Davis, Duchesne, Emery, Garfield, Grand, Iron, Juab, Kane, Millard, Morgan, Piute, Rich, Salt Lake, San Juan, Sanpete, Sevier, Summit, Tooele, Uintah, Utah, Wasatch, Washington, Wayne, Weber
BEAR RIVER CITY, BINGHAM CANYON, BOUNTIFUL, BRIGHAM CITY, CACHE JUNCTION, CENTERVILLE, CLARKSTON, CLEARFIELD, COALVILLE, COLLINSTON, CORNISH, CROYDON, DEWEYVILLE, DRAPER, DUGWAY, ECHO, EDEN, FARMINGTON, FIELDING, GARDEN CITY, GARLAND, GRANTSVILLE, HENEFER, HERRIMAN, HILL, HONEYVILLE, HOOPER, HOWELL, HUNTSVILLE, HYDE PARK, HYRUM, KAMAS, KAYSVILLE, LAKETOWN, LAYTON, LEWISTON, LOGAN, MAGNA, MANTUA, MENDON, MIDVALE, MILLVILLE, MORGAN, MURRAY, NEWTON, NORTH ODGEN, NORTH SALT LAKE, OAKLEY, OGDEN, PARADISE, PARK CITY, PEOA, PLYMOUTH, PORTAGE, PROVIDENCE, RICHMOND, RIVERSIDE, RIVERTON, ROY, RUSH VALLEY, SALT LAKE CITY, SANDY, SMITHFIELD, SNOWVILLE, SOUTH JORDAN, STOCKTON, SYRACUSE, TOOELE, TREMONTON, TRENTON, WELLSVILLE, WEST JORDAN, WEST VALLEY CITY, WILLARD, AND WOODS CROSS
See All US Locations
AirAllé Treatment
*RE-TREATMENT POLICY: In the unlikely event of treatment failure – we will re-treat you for FREE.
†Scientific Study - see page 2 for FDA CLEARANCE
Copyright © 2015 - 2020 Lice Clinics of America. All rights reserved.
How to Prevent Head Lice at Summer Camp Consumer Reports Challenges Pesticide Lice Treatments
|
cc/2020-05/en_middle_0097.json.gz/line1407400
|
__label__wiki
| 0.80697
| 0.80697
|
The Beatles soon after their arrival in Washington on 13 February 1964 outside the Coliseum where they were scheduled to perform before a sell-out audience. Photo: Central Press/Getty Images
Who’s your favourite Beatle?
3 min read . Updated: 22 Jan 2018, 12:17 PM IST Livemint
It's almost a tie for the Mint Lounge team and it's not John Lennon
mint-india-wire BeatlesPaul McCartneyRingo StarrGeorge HarrisonJohn LennonBest BeatleWho is the Best BeatleThe Beatles
I have never heard anyone who can pack in as much optimism, buoyancy, romance, flamboyance, sentimentality and sweetness in one voice.
—Somak Ghoshal
McCartney, because he’s the least cool Beatle. Lennon had irony, Harrison detachment, Starr slapstick, whereas McCartney radiated a palpable, un-hip desire to please. Plus, he was the best multiinstrumentalist in the band by some distance.
—Uday Bhatia
He was the only Beatle who was the closest to admitting his love for football; surprising because The Beatles come from Liverpool—home to Everton and Liverpool FC. In 2008, McCartney said if he had to choose between the two, he would go with the Toffees. He did say that he would support both since “It’s all Liverpool," but “if it comes to the crunch, I’m Evertonian."
—Nitin Sreedhar
Eternally grateful to John Lennon for giving us Imagine, but my heart is with McCartney for Hey Jude. It’s a song that magically surfaces in my life, in dark as well as happy times. It’s personal. I love the way McCartney sings it in the 1968 video. So earnest. And that puppy face.
When I saw them on the TV for the first time— almost instantly—my eyes fell on McCartney. Later on, as I learned more about the four, McCartney appeared to be the goofier, fun-loving one. He wrote one of my favourite songs, Hey Jude. There is profound beauty in the song’s simplicity, which also reveals glimpses of McCartney’s sensitive side. It is why he shall forever remain a favourite.
—Radhika Iyengar
Harrison, because two of my top 5 Beatles songs—Here Comes The Sun and While My Guitar Gently Weeps—were written by him. The former makes for a charming making-up-after-a-fight song, which I tend to need quite often. Plus, the hair.
—Anindita Ghose
McCartney once described The Beatles as “four corners of a square—without any of those corners, you collapse". But as the Martin Scorsese documentary Living In The Material World showed, it can be really confining for every individual. More so for Harrison, the songwriter, who was overshadowed by the prolific songwriting “company" of McCartney and Lennon. In 1970, he came out with All Things Must Pass.The title track could have been a statement about The Beatles or even life in general.
—Pradip Kumar Saha
Harrison for organizing the mammoth Concert for Bangladesh in 1971 and
raising millions for the war-affected people of a country he’d never been to. Here was a rock star who wasn’t afraid to bare the private person ahead of the public persona.
——Shamik Bag
I’d say George Harrison but I’d be hard-pressed to say why.
—Neha Dara
Right now, I’m feeling fuzzy about Ringo Starr. He always said he was lucky to be in The Beatles. I feel that The Beatles were lucky to have him. He is the finest drummer in pop. His drum parts are
intricately composed and add the right colour to the songs. Just listen to She Said She Said, Rain, In My Life or A Day In The Life.
—Bibek Bhattacharya
The cultural sonic world is so suffused with The Beatles that their songs have met my ear drums, though I never consciously sought out their music. This may be heresy to Beatlemaniacs, but I do recall being bowled over by the rich harmonies of Because. One line has acquired particular meaning for Delhiites, given the constant dwelling under the city’s smoggy grey skies: “Because the sky is blue it makes me cry/Because the sky is blue, ah".
—Tanuj Kumar
My favourite is Lennon because I envied deviants during my mildly rebellious teenage years. Also because his quotes made me look good in slam books: “It’s weird not to be weird."
—Vatsala Chhibber
It’s futile trying to escape the cliché when I say that Lennon’s songs have been a part of the continuing soundtrack of my life. This extends from the Imagine singalongs of my early teens to the impassioned Working Class Hero of college days.
Currently, I’m obsessing over Lennon and Yoko Ono’s public and private demonstrations of love, their hair, and romance in black and white.So, my earworm of the week is Oh Yoko.
—Diya Kohli
|
cc/2020-05/en_middle_0097.json.gz/line1407407
|
__label__wiki
| 0.736871
| 0.736871
|
Shift shape. One in ten billion. Make sure your name is omni-barrelled and you change it every day...
Louise Ashcroft
Experimental Futurology: A semi-real, semi-fictional story about three Canary Wharf men.
Louise Ashcroft, 2015.
Martin Shipman was made redundant on 1st April 2015. I hardly knew the guy, I mean I didn't know him at all, but I'd taken a keen interest in him since I found his Citibank ID card at the bottom of the chrome escalators in Jubilee Place. Dough-grey face staring up at me, thrusting against the stark metal teeth of its mechanical impaler; like the Freudian slip, slip, slipping of his ‘Pigtronix Infinity’ guitar loop pedal, applied to the twitchy transition from player to zombie in his Xbox apocalypse edition of Dead Rising 3.
I picked the security pass up but never returned it.
Fascinated by his realness, I Looked Martin Shipman up on LinkedIn.
I visited Phoenix Heights, his mixed-tenure apartment block overlooking Millwall Dock, and thought I'd caught sight of him several times while loitering on the DLR platform at rush hour, enjoying the grind of frantic bodies sliding against mine; a reluctant group hug.
Martin Shipman's LinkedIn page says he is on sabbatical. He has told his former colleagues he is taking a gap year in Jamaica. Only the fervour and regularity with which he updates the photographs of himself in tropical paradise betray this; revealing his cut, paste, clone technique to any keen observer such as myself who shares his interest in Photoshop 6.0 (with its patented liquify effect and 'venus in furs' coding). I print each profile picture out and magnify them so that every pixel covers my entire palm.
Digital rip. RIP.
Amie Hughes-Gage in accounts tweets: 'Just watched the police finally remove that poor bankers body, 4 and half hours later with only a white sheet over him.'
Hetal Patel tweets: 'The 9th floor roof of JP Morgan is visible from my office window. For a long time the body was left cordoned & unattended'.
In my dreams, Shipman's body is made of mercury - like walking through Heron Quay. Hall of mirrors. Distorted. Visual auto-tune repeating the hook "You can't break fluid, it's already broken".
It wasn't his body though - it belonged to a 21-year-old American intern. Comforted by the sight of the corpse, the tragedy made Martin's own last day feel less final. He'd become too distanced from his body to think of destroying it, anyhow.
Shipman looped the revolving doors eight times on the way out of 25 Canada Square because he knew he wouldn't be able to do that every day any more. In graph theory, a loop (also called a self-loop or "buckle") is an edge that connects a vertex to itself.
The feeling of hysteria mingled with futility reminded Martin of the same day the previous year when his colleagues had set his stress squeezer in jelly, recreating that famous scene from TV sitcom The Office in which Tim sets Gareth's stapler in jelly. At the time, Martin laughed it off, but he had found the object intensely emotional, and thought about it most days after that. Something about the proximity of the textures of the jelly and the foam of the stress squeezer caused his nerves to tingle.
Martin Shipman is friends with SneakyPete Bailey who is the Deputy Manager of Coral betting shop in Canada Square. The men share an interest in experimental futurology. In February 2014, SneakyPete gave Shipman a book entitled 'The Giant Book of the Unknown' which he bought from that shop in Manchester where the owner has Victorian wooden hands and gives a free banana with every purchase. He had been in Manchester because Chelsea were playing City in the FA cup. Every time SneakyPete says something sensitive or philosophical (which is surprisingly often) he follows it with a put down like 'not that I give fuck'.
SneakyPete thought his mates would rip the piss out of him if they knew he was an intellectual, but secretly Mike ‘The Walrus’ Quinton and Lee Gobbins were both studying medieval history at night school. None of them ever discussed these pursuits though, because they didn't want to look gay.
Martin Shipman doesn’t like reading, except in languages he can’t understand. He is an avid collector of corporate stress squeezers. Likes the rare ones best. His top three (in order of preference) depict: a floret of broccoli, the former prime minister Gordon Brown, and a realistic human prostrate promoting a cancer charity. He likes them for the same reason that he collects chewing gum - because they evidence the obsoleteness of the human body.
Stress squeezers reintroduce physicality to the office worker in an aesthetic form, now that the only necessary movements are fingers on a keyboard or a touchscreen.
Gum reintroduces chewing as a leisure activity in an age where the stomach has been outsourced to industrial processes and where protein shakes, lattes and smoothies are king.
Shipman is Facebook friends with Rob Rhinehart, a software developer from L.A. who has invented a food powder that contains all the necessary human nutrients; provoking the Wall Street Journal to ask the pseudo-rhetorical question 'Is this the end of food?'. The product is named after the 70s Sci-fi film 'Soylent Green', in which the eponymous food supplement is made from human remains.
Like Rob Rhinehart, Martin is a software developer. His job title had been 'lead architect' at Citi Bank. He liked his job title because the word lead could be read as lead, like the metal, lead architect, which always conjured in his mind an absurd vision of buildings made out of the softest metal.
Martin is particularly sensitive to the aesthetics of materials. He had once slipped over on the remains of a crayfish and avocado wrap. These were the menace of Canary Wharf - the equivalent of South London's ubiquitous fried chicken bones, but with even less mastication involved.
Shipman felt the slippage of his own identity as he left the Citigroup Tower for the last time, clutching a box of stress squeezers. His reflection marbling the buildings around him, turning his Marks and Spencers Savile-Row-inspired washable suit into metallic goo, as though made from silver-hallide film stock with too much gelatin emulsion, so that the images slid off into solution. A kaleidoscopic montage reminiscent of news-reels from 2008; sacked bankers, grasping boxes of desk clutter as though clinging to the driftwood of a shipwreck.
Even in his prime, Shipman was much less macho than SneakyPete, whose raw masculinity was performed through a series of Facebook profile pictures in which he is either: holding a machete, making a crude hand gesture or swigging a can of Carling. The frequency with which these images are posted is directly proportional to the soppy, public dedications he makes to his wife Dian, who he has been married to for eight years. On the 22nd November 2012, SneakyPete updates his Facebook status to “I love my wife more than life itself, she is my queen”… followed by the comment “and I would take out any cunt that even spoke different to her”.
Back home, in his one bedroom apartment at Phoenix heights, Martin Shipman updates his Facebook status to “Leaving drinks at the Slug #gonnagetmessy #payoff #canarywharf #playboybanter”. In reality, Shipman goes straight home and spends the evening alone, repeatedly listening to an electro track, which he forgets the name of, but describes as: 140 BPM heartfelt bro-step instrumental with autotuned hook, smooth synths, wobble bass and aggressive breakdown in the bridge, followed by a vocal drop of ‘Oh My God!’ before the launch into a barrage of growling dub-basses, uplifting house synth-lines, and a fresh, sharp thorax leading to a spikey jabbering bass muddled by clever variations in tempo, and the creepy euphoria of the vocal ‘I want to kill everybody in the world’.
For Shipman, this track is the elegant waste disposal unit of sonic culture - tracing a line from American rock n roll to Jamaican sound system clashes, South London dubstep, and Californian Nu Metal; then mashing these all up together. The structure of the track reminded him precisely of the skip outside Astons wine bar after the fire. Early noughties interior squeezed into one dusty, drippy cube, out the back, by the quayside - you know, Astons, where that party boat 'Absolute Pleasure' is moored - the one they hired out for the IT departments annual meeting.
For Martin, absolute pleasure was achieved in less conventional ways. He'd spent a childhood gazing at fly-tipping sites around the Woodpecker estate in Lewisham. 1998, watching the estate's demolition. Pegasus tower falling down and replaying in the mind like epileptic audio equaliser bars.
Martin experiences a peculiar feeling of synaesthesia whenever he stares into rubble. Perhaps this is because the utter uselessness of detritus makes it somehow luxurious - not in the way that Radox adverts are luxurious, but in the way that art is. Beyond function. Shipman denies this – for him, art is like instant mashed potato and over-evolved fingers; symptoms of civilization's ridiculous crescendo.
I first encountered Martin’s friend SneakyPete Bailey when I noticed in a photo on Meetup.com that they met at Aston's wine bar a couple of summers ago. They were both tagged in photos on Meetup.com/Canary-Wharf-Nightlife alongside Paul Cosens (a corporate hypnotherapist) and his wife Polly (a Taiwanese activist). Polly and Paul met at university in Liverpool before reconnecting again in London through a Neuro Linguistic Programming workshop they both attended. Last week I spent a day repeatedly watching Paul and Polly’s wedding video on Youtube; a lovely ceremony at St Oswald’s in Shropshire’s third largest town of Oswestry.
Having researched Cosens, Shipman and Bailey for several months, I have begun to imagine the development of their friendship. In my recurring dream, they have stayed in touch and formed a club which meets regularly to discuss ‘experimental futurology’, a term that means either gambling, the after-life or commodities trading, depending on which of the men you are talking to and when.
The trio have adopted the motto 'Humilitate homo salvatur, superbia aberrat', which they stole from his holiness Pope Francis who they all follow on Twitter.
Paul Cosens has printed the motto onto A4 paper, adorned it with clip-art deities, and laminated it for use in his forthcoming confidence-building workshop at HSBC.
SneakyPete Bailey has booked an appointment at TJ’s Inks in Rainham, where he will have the phrase tattooed on his right arm above the Chelsea shield and the image of winged foetuses commemorating his wife Dian’s miscarriages.
Like Paul and SneakyPete, Martin Shipman has no interest in the semantic content of their latin motto, but enjoys reciting its syllables in a rhythmic chant, finding the abstract nature of the phrase so poignant that he is compelled to add it to the spreadsheet named ‘Martin’s favourite five-worded statements’, where it ranks second - beaten only by the phrase 'this sentence has five words'.
'Humilitate homo salvatur, superbia aberrat'.
It didn’t matter that none of them knew what it meant. It kept them together.
|
cc/2020-05/en_middle_0097.json.gz/line1407412
|
__label__cc
| 0.73381
| 0.26619
|
Louth councillors plant special tree for Queen’s 90th birthday year
Mayor of Louth Eileen Ballard and her fellow councillors unveil the tree.
James Silcocks
Published: 14:02 Tuesday 06 December 2016
Last Thursday the Mayor of Louth, Councillor Eileen Ballard, assisted with the planting of a tree to round up celebrations for the Queen’s 90th birthday year.
The planting of the oak tree, purchased by Louth Town Council’s special project funds, took place in Hubbard’s Hills in a prime position on the edge of the top meadow area.
The tree planting completes the events organised by Louth Town Council in honour of the Queen, which have included holding a well-attended birthday party for residents aged 90 years and over and joining in the national beacon lighting events.
In the photograph above, the Mayor can be seen with the tree alongside Councillor Sue Crew, Councillor David Wing, and Councillor Andrew Leonard - who is also the chairman of Hubbard’s Hills Trust.
• Visit www.louthtowncouncil.gov.uk for more information.
|
cc/2020-05/en_middle_0097.json.gz/line1407413
|
__label__cc
| 0.676632
| 0.323368
|
PINGZINE
Ping! Zine Web Hosting Magazine
Ping! Zine Web Hosting Magazine - Issue 82
Unlimited access to Ping! Zine Web Hosting Magazine along with 5,000+ other magazines, newspapers and premium stories with Magzter Gold subscription
Get Only Ping! Zine Web Hosting Magazine
Gift Ping! Zine Web Hosting Magazine
Publisher:PINGZINE
Category:Technology
Frequency:Monthly
Magazine Description: The Industry’s Most Respected and Widely Read Web Hosting Magazine! Celebrating over Ten Years… Ping! Zine is the Industry’s Premier Voice for both Service Providers and End Users. Since 2002, Ping! Zine has been offering an exciting and entertaining magazine about the Internet, Technology and Web Hosting Industry. Ping! Zine offers Informative stories and articles for your business, Investigative Reports in the Internet Technology Industry, Information that keeps you Competitive, How-To’s in Security & Server Maintenance and Lots of General FUN. Ping! Zine features a diverse range of technical and practical articles in each issue. We also provide an archive of all past issues on our website. Whether you want to enjoy the convenience of surfing through the articles while on-line or sitting in your favorite chair reading the latest issues, Ping! Zine is available for you.
Innovation & Tech Today
USBE & Information Technology
AppleMagazine
Techlife News
PC Gamer US Edition
RotorDrone
|
cc/2020-05/en_middle_0097.json.gz/line1407417
|
__label__wiki
| 0.679517
| 0.679517
|
Lurie Children's Blog After Treatment for BPS, Leonie and Her Family are Breathing Easier
After Treatment for BPS, Leonie and Her Family are Breathing Easier
At just 28 weeks, Libby had an uneasy feeling about her pregnancy with her daughter, Leonie. She felt her stomach was measuring much larger than it should be at this point in the pregnancy. To ensure everything was okay with Leonie’s health as well as Libby’s, she went for an emergency ultrasound. “I started feeling sick because I knew something was wrong,” Libby said.
Libby was right. There was an alarming rate of fluid building up in Leonie’s chest and abdomen, as well as Libby’s uterus. An abnormality was found during the ultrasound. “My whole life had changed in 24 hours,” Libby said. The next step was having a fetal MRI done at Lurie Children’s and The Chicago Institute for Fetal Health to get a closer look at the mass on Leonie.
Following the MRI, Dr. Aimen Shaaban, along with the fetal care team sat down with Libby and her husband, Christian, to explain what was going on with their baby. “They told us they were building a theory through the images and made it more simplistic for us to understand,” Christian said. Leonie was diagnosed with bronchopulmonary sequestration, known as BPS for short, with non-immune hydrops. BPS is an abnormal mass in the chest cavity, which causes heart failure. Non-immune hydrops is the cause of the fluid build-up inside of Leonie and Libby. “Basically, this meant Leonie was dying inside of me,” Libby said.
“Dr. Shaaban walked us through everything. He would always make sure we were completely included in the conversations with doctors and professionals,” said Christian. “The fetal care team went over all the scenarios with us and continuously interacted with us to get us prepared.” Libby and Christian decided the best option for them was to treat Leonie with a fetal thoracoamniotic shunt to drain the fluid from Leonie.
Leonie with Dr. Shaaban.
Right before Libby was about to undergo this surgery, Dr. Shaaban had noticed Leonie has been making progress draining the fluid on her own and opted to not follow through with the surgery for the sake of the baby’s health. The non-immune hydrops was gone. Leonie’s diagnosis was now just BPS. For Libby and Christian, this news was a relief. “We never knew if we could celebrate because we did not know what the next day would hold,” said Libby.
To drain the remaining fluid in the baby’s chest, Libby had a fetal thoracentesis. Approximately 70 milliliters was drained from the baby’s chest and one and a half liters of fluid were drained from Libby’s uterus. Thankfully, this procedure did not have to be repeated. Things appeared to be looking up for the Domnik family.
It was finally time for Leonie to come into this world. Leonie made it full term, as Libby was induced at 37 weeks. Immediately after birth, Leonie was transferred to Lurie Children’s to monitor the mass and her overall health. “I’ll never forget the day after Leonie was born. Dr. Shaaban came into our room to say how happy he was for us. It was like a friend coming in to visit, not a doctor,” Christian said.
The last step in Leonie’s journey was to remove the mass from her lungs. When she was 4 months old, Dr. Shaaban removed the mass, leaving Leonie with no impact except a scar. Libby still recalls the reassuring words Dr. Shaaban said to her before surgery. “We don’t need to be dwelling on the negatives. Looking at Leonie is all the proof we need.”
Leonie is now seven months old and healthy as can be. She just had her last check up with Dr. Shaaban. The bond the family has formed with Dr. Shaaban is something they will cherish for the rest of their lives. Libby and Christian’s favorite moment from this experience was when Dr. Shaaban revealed Leonie was a girl. They are forever grateful for all Dr. Shaaban has done for their family.
Leaving Lurie Children’s was a bittersweet feeling for Libby and Christian. “I feel like I graduated from the worst time of my life,” Libby said. “We couldn’t be any more lucky and unlucky at the same time.”
Learn more about The Chicago Institute for Fetal Health
Overcoming Multiple Hurdles, Toddler Finally Free to Breathe on Her Own
Stepping Up to Give Back – Patient with Brain Tumor to Participate in Aon’s Step Up For Kids
"This is Surreal": New Breakthrough Therapy for Cystic Fibrosis Gives Family Hope
Game-Changing Discovery Leads to Earlier Diagnosis of Kawasaki Disease
|
cc/2020-05/en_middle_0097.json.gz/line1407420
|
__label__wiki
| 0.619613
| 0.619613
|
New In Town: Marriott’s Luxury Collection Opens Reges Resort & Spa On Turkey’s Aegean Coast
by Apeksha Bhateja | July 11, 2019
Turkey has been in a tough spot for a while—with the Arab spring, civil unrest, and fighting on its border on the Syrian side. Tourism has taken a hit, but the country hopes for stability. And amidst the political and financial woes, happy news came from its western side. Marriott announced the opening of Reges Resort & Spa in Çeşme, on the Aegean coast, just eight kilometres from the Greek island Chios via ferry. After Bodrum and Ankara, this is the third Luxury Collection property in the country.
Image Credits: Reges Resort & Spa in Çeşme
A Crown On The Coast
Located on the Aegean Coast, Reges, a Luxury Collection Resort & Spa, is designed to resemble a crown when viewed from above. Named after the Latin word for king, Rex, the resort promises to serve modern luxury to world travellers, in a regal style. Spanning two kilometres on the Boyalık Bay, Reges is home to 93 guestrooms and 11 suites, all bathed in natural light from the floor-to-ceiling windows, with the views of the sparkling waters just outside. Nature enters the rooms in other ways too, with gold-dipped leaves and peacock feathers, and the neutral decor that is energised with hints of turquoise. The en suite bathrooms are done in marble with gold fixtures to bring touches of its Turkish heritage, but the modern comforts (rainfall showers and Byredo luxury amenities) are part of the parcel, too.
Borrowing more from the region, the resort offers Aegean cuisine along with international flavours at its two restaurants, Safran and Hemera. The plates have a little bit of the Aegean coast on them, from herbs grown in the in-house garden to the use of the native mastic gum. When in Turkey, a must-try is the Turkish hammam and the 1,400-metre-square Spa Centre offers this traditional experience with steam and sauna. In addition, the spa also features six massage rooms with private bathrooms. In the evening, guests can dip their feet in one of the two swimming pools with cabanas, or go for a quiet walk on the private beach.
There’s plenty to do when you leave the crown, too. A short distance away is the city centre with charming boutiques, nightclubs, and a 16th-century castle, which is now an archaeological museum. Çeşme’s next door neighbour is the town of Alaçatı, located nine kilometres away, mushrooming with outdoor cafes, waterfront restaurants, and hip beach clubs. Plan a beach day at the secluded Kum Beach, or the popular Ilica Beach once you’re here. Çeşme is also big on water sports, so you can go kitesurfing or windsurfing here.
Price: Starts at INR 28,300 per night
Featured Image: Reges Resort & Spa in Çeşme
© 2020 LUXEVA PVT LTD
By entering your email address, you agree to our privacy policy.
|
cc/2020-05/en_middle_0097.json.gz/line1407421
|
__label__wiki
| 0.969054
| 0.969054
|
Brian Jean 'disappointed' in Calgary Pride decision to bar UCP from parade - Macleans.ca
Brian Jean ‘disappointed’ in Calgary Pride decision to bar UCP from parade
Last weekend Pride organizers rejected the United Conservative Party’s request to join the Calgary parade
Fromer Wildrose leader and current United Conservative Party leadership candidate Brian Jean speaks at a campaign stop in Calgary, Alta., Tuesday, April 28, 2015.THE CANADIAN PRESS/Jeff McIntosh
CALGARY – A leadership candidate for Alberta’s new conservative party says he hopes organizers of the Calgary Pride parade will reconsider and allow the party to participate.
Brian Jean, who was Opposition leader in the legislature, said Monday he is disappointed with a decision by organizers on the weekend to reject the United Conservative Party’s request to join the parade. They said the party doesn’t have a clear policy stance on issues such as sexual diversity.
Jean said he had asked to march in the parade and has always championed diversity and tolerance.
“I have many family members who are gay and I know the community. Frankly I’m just disappointed,” Jean said after outlining his education platform as part of the leadership race.
“Possibly they’ll have a change of heart and hopefully they will. This is all about uniting people and putting aside differences and divisiveness.”
RELATED: Jason Kenney launches bid to lead Alberta’s United Conservative Party
Jean’s campaign organizers said that while plans are not firm, he is aiming to attend as a spectator.
Organizers have invited party members to take a workshop on topics such as sexual health and gender diversity. Calgary Pride president Jason Kingsley did not immediately respond to a request for comment.
The party says interim leader Nathan Cooper will attend the parade as a spectator and all members of caucus have been invited to join him.
“While we are disappointed to not be participating in this year’s parade, we respect the organizing committee’s decision and look forward to showing our support for Calgary’s LGBTQ community as spectators,” said caucus spokeswoman Samantha Johnston in an email.
“Plans to attend a course offered by the Calgary Sexual Health Centre are in motion and final scheduling is being confirmed.”
Jason Kenney, former federal cabinet minister and leadership candidate for the new party, does not plan to attend.
“Mr. Kenney is always happy to attend events to which he is invited,” said campaign spokeswoman Annie Dormuth in a statement. “We have not received an invitation to this event.
RELATED: Alberta’s Wildrose and PCs approve merger of two parties
“On Sept. 3rd, (Kenney) is committed to attending and speaking at several large multicultural community events to which he has been invited.”
Fellow leadership candidate Doug Schweitzer said he will come watch the parade with his family and other supporters.
“It’s important that all Albertans know that their leaders are there and that they’re supportive of different communities across Alberta,” said Schweitzer, who has made social progressive issues a key plank in his platform.
“Obviously we have a lot of work to do to build trust with the LGBTQ community.”
Jeff Callaway, who is also running to lead the party, said he had originally planned to march in the parade, but will probably go as a spectator.
“Treating people fairly and respectfully is just part of the foundation of our party, as it should be for any political party,” said Callaway.
The UCP was created last month after members of the Progressive Conservative and Wildrose parties voted overwhelmingly to join forces. A new leader is to be picked in October. That’s to be followed by a founding convention.
Both the PCs and Wildrose had strained relationships with the LGBTQ community.
The Wildrose party lost the 2012 general election in part due to its refusal in the campaign’s final days to sanction a candidate who once warned gays to repent or face eternity in hell’s “lake of fire.”
The PCs faced a backlash in government over their handling of gay-straight alliances before passing legislation acceptable to all sides in early 2015.
By law, students in any school can now form gay-straight alliances if they wish. The alliances are peer support networks designed to help young people better understand each other and to help LGBTQ students feel welcome.
Kenney has been criticized for urging that parents, in some circumstances, be told if their children attend a gay-straight alliance. Critics say that could out kids before they are ready and put them at risk of family estrangement or worse.
Brian Jean
Calgary Pride
Jason Kenney
United Conservative Party
|
cc/2020-05/en_middle_0097.json.gz/line1407422
|
__label__wiki
| 0.690754
| 0.690754
|
New Hampshire Lawmakers Vote to Allow Baby on Beer Label
The New Hampshire House is pushing back on Gov. Maggie Hassan's veto of a bill related to depicting minors on alcohol advertisements. State law prohibits references to minors in alcohol advertising. Earlier this year, the Legislature passed a bill removing that part of the law.
CONCORD, N.H. (AP) — The New Hampshire House is pushing back on Gov. Maggie Hassan's veto of a bill related to depicting minors on alcohol advertisements.
State law prohibits references to minors in alcohol advertising. Earlier this year, the Legislature passed a bill removing that part of the law.
Rep. Keith Murphy, who owns a Manchester bar, sponsored the legislation because he wanted to be able to sell Founders Breakfast Stout, a beer brewed in Michigan that features a baby on the label.
Hassan says changing the law will undermine New Hampshire's efforts to fight underage drinking.
House members disagreed Thursday, hitting the necessary two-thirds threshold to override the veto. The state's Liquor Commission would have to approve or deny labels under the law.
Senators must also vote on whether to override the veto.
|
cc/2020-05/en_middle_0097.json.gz/line1407424
|
__label__cc
| 0.548959
| 0.451041
|
Are humans really responsible for climate change?
By Canuck100, December 30, 2018 in Federal Politics
bush_cheney2004 2,937
Defining Canada With American Culture
Location:USA! USA! USA!
19 minutes ago, ReeferMadness said:
It is pretty simple. The most difficult part is getting people to stop denying the change and looking for excuses why it shouldn't affect them. Stanford University Mark Jacobson has done research that finds:
Denying ? Keep thinking that all you have to do is convince people to believe in the climate alarmist religion of pending doom. Far from denying, climate change is not only being acknowledged but recognized for adaptation opportunities, just as civilization has adapted before.
Stanford will not convince anybody who hasn't already swallowed the Leap Manifesto Kool-Aid®.
bcsapper 1,133
Location:Ilkley Moor. No hat.
Just now, ReeferMadness said:
Well. We're all gonna die then. Let's just give up.
Good thing you're not one of those "alarmists".
Do I have to repeat what I posted to eyeball? Don't give up! Get it done. Report back when the CO2 starts dropping.
I'm not an alarmist. I'm a realist.
ReeferMadness 20
Location:Between Venus and Mars
Just now, bush_cheney2004 said:
I think Dunning and Kruger might have been reading the nonsense you write when they had their insights.
Stop using the term "denying" for a different narrative that you refuse to accept....that is denying.
The U.S. has invested far more into climate change R&D than Canada can even imagine.
1 minute ago, bush_cheney2004 said:
Every time you get involved in a discussion, it culminates in the logical equivalent of you chanting U-S-A!! Find a new schtick so I don't have to block you.
2 minutes ago, ReeferMadness said:
You can't block reality....Canada has lagged behind the U-S-A is GHG emissions reductions despite all the virtue signaling. Furthermore, the U.S. has spent billions on climate and environmental data collection and analysis for decades with tools that Canada simply does not have.
Denying my ass.....
Zeitgeist 328
1 hour ago, ReeferMadness said:
Europe has much higher gas prices. The last I checked, they hadn't degenerated to abject poverty. In Norway, over half of new vehicles sold are EVs. Maybe Norway is a total hellhole. Or maybe they're just smarter than we are. Maybe they've figured out that the higher one time costs of EV's is offset by much lower operating costs.
What I'm advocating for is that people living today don't have the right to f*ck up the planet for people who are going to live 50 years from now. Regardless of whether it raises their cost of living. Do you have a problem with that?
It's ironic that right wingers refer to people who listen to climate scientists as "climate alarmists" and then light their hair on fire at the thought of making changes that will improve everyone's life. Just a few years ago, there was a guy on here who insisted that using renewable energy would send us back to the stone age.
Who are the real alarmists?
Distances are much shorter in Europe and the standard of living is lower almost everywhere. Most people in European centres rent in a form of indentured servitude to the class system. Few people own second properties and most of the land has been owned by a rich few for centuries. Yes, the coffee and architecture are better.
People immigrate here from Europe for the higher standard of living. I’m glad you chose the exception to the rule, Norway, which is a rich country due to its oil. I think fighting climate change is important, but we can’t compromise growth too far, as that is the single biggest contributor to human progress in terms of raising living standards, including education and the kind of technological innovation that will really make a difference to emissions. We do need climate policy, but I suggest doing things that both reduce emissions and improve productivity and quality of life, such as building faster and more frequent light and heavy rail mass transit, complete communities (where employment is available locally and energy production is available locally using tech like geothermal heating and solar shingles), and incentivizing lower energy use through tax breaks.
Don’t hurt consumers at the pumps where we already pay twice the price Americans pay for our own oil and don’t shut down our resource sector, which is Canada’s bread and butter, no matter how advanced our manufacturing becomes. The tax revolt is just getting started. The fall election will be very telling.
Canada can have a sensible climate action plan that can be expanded when our trading partners commit to similar actions. Otherwise our businesses won’t be able to compete in the global marketplace and we won’t attract the brightest immigrants. Don’t you see the game here? Under leaders like Trump it’s all about making/letting other countries make all the sacrifices. Naive Trudeau plays right into it. We need the big players to get on board or it’s almost a waste of money for Canadians to fight climate change. That’s the sad truth.
Edited May 27, 2019 by Zeitgeist
eyeball 1,075
Skookum Member
Location:Earth
42 minutes ago, bcsapper said:
Tell them! Get it all fixed. Report back when they all reduce their activity so GHG levels start to fall.
I never realised it would be so simple.
It'll be simpler to just wait until we hit 600 - 800 ppm and everyone between 40° north and 40° south dies, maybe that'll give us a clue.
Army Guy 608
Done like dinner......
Location:New Brunswick
Interests:Boating, fishing ATVing, and Family
Europe has much higher gas prices but then again they don't have a chioce, which European country is producing enough fossil fuels to be self efficient....Not very many, most are reliant on Russian or middle eastern fuel , Higher gas prices has not deterred them from driving...They still build large motors such as V8, or V16 in the British side, Germany has the autobahn, where you can drive your as fast as it will go , now thats got to be good for the environment..
Are EV cheaper to maintain, batteries don't last forever, all the other components don't last forever either, and when you offset the price of the car to start with are you really ahead of the game, or is it a social thing.
When you can get the other Billions of people on the planet on the same page maybe people will give a shit about what happens 50 years for now, you buy what ever car you want , live the way you want, You can preach all you want, but until everyone is on the same page, I think your wasting your time... ....but even if Canada went dark today, it would make very little difference in the worlds environmental health...
Must be a lot of right wingers around the globe, you liberals had the last 4 years to make changes, and what was done, Carbon tax, which hold on did sweet f*** all to the environment...collect the tax then give everyone back more than they put in, was that not the liberal line....not a plan for reduction , or use that money on R&D for alt fuel tech, or alt power projects...not tax break on things like solar or wind power. nothing for the liberals....even the greens are changing there minds they gone from not one more barrel produced out of the oil sands, to the new slogan lets burn our own oil instead of foreign oil.....
Just now, eyeball said:
Yes, but I hopefully we get a clue quickly. A Harvard study has shown that levels over 1000 ppm lower certain types of cognitive abilities - the very ones that we'll need to deal with climate change!
11 hours ago, GostHacked said:
That's quite derogatory. And simply unnecessary.
I think both of you need to rethink how you post.
In the last couple of months did you find god or something gost, I could pull a few post with you and Charles that were border line nasty , or as you put it, simply unnecessary...
48 minutes ago, eyeball said:
At last we're on the same page. Isn't it nice when we all agree?
Same page? We're not even in the same book - we barely speak the same language. It's not really surprising in our brave new world of alt-facts, alt-science and alt-reality.
I think the story about the Tower of Babel is a good allegory to the global civilization we're seemingly trying to build. At least the people in Babel tried to co-operate.
Edited May 27, 2019 by eyeball
Its definitely a matter of thinking about thinking. The analogy of the Elephant and the Rider comes to mind. I struggle with it and I doubt there's very few individuals in the world who don't.
Sure we are. We both know no-one's going to a damn thing about it until it's too late. It might be already.
We also know the reason for inaction rests squarely with right-wing conservatives.
The stupidest most belligerent fuckers in the known universe.
No it doesn't. It helps assuage guilt and fear to blame some group one doesn't like, but really, what is happening is the inevitable result of a growing population with advancing technology on a planet with finite resources and a dominant species that couldn't cooperate its way out of a wet paper bag.
Edited May 28, 2019 by bcsapper
OftenWrong 1,318
Blind chicken
Location:Ronnie
Interests:Typewriter maintenance
Just for that we're not going to help at all. Out of spite.
No it doesn't.
AFAIC it does.
It helps assuage guilt and fear to blame some group one doesn't like,
It sets the record straight so future generations know who not to listen to. I predict that climate change inaction will result in a long period of some grotesque sort of alt-left dominance for the same reason alt-right populism is on the rise now. The pendulum will swing back and when it does I fear it will probably do so with a vengeance that makes Mao's cultural revolution look benign in comparison.
but really, what is happening is the ineviatable result of a growing population with advancing technology on a planet with finite resources and a dominant species that couldn't cooperate its way out of a wet paper bag.
No, what's happening is that right-wing conservatives have chosen to be obstinate, stubborn and backward thinking and mostly out of pure spite. Certainly not because of science, evidence and knowledgeably informed expertise.
The future will be very dark, very bleak and very brutal. Probably a lot like most of our first million years but without a planet for the taking.
By "dominant species" you mean the British, right?
I agree, they have ruined everything. Damn you James Watt, you were the antichrist.
1 minute ago, OftenWrong said:
A marker pen and a map. Sorry about that!
There is no "too late"....there is simply what will be...que sera sera.
Human beings suffered and died far more from natural and man made disasters long before "climate change".
Sure, but we didn't think "hey, let's not bother with antibiotics and electricity. We've been sick and cold before".
1 minute ago, bcsapper said:
...and both of those contribute to climate change. You can't parse human development that way.
4 minutes ago, bush_cheney2004 said:
It has nothing to do with parsing. It has to do with lemmings.
|
cc/2020-05/en_middle_0097.json.gz/line1407425
|
__label__cc
| 0.528296
| 0.471704
|
Report: Containers Lost Due to Parametric Rolling
By The Maritime Executive
Welding Operation Starts Fire on Golden Ray Wreck
Thieves Steal from Barge Twice in One Day
Eight Abducted from Trawler Off Sabah
Addressing Flooding Along Navigable Waterways
By Harry Valentine 12-07-2019 05:05:45
In recent years, high water levels and flooding has occurred along several of North America’s navigable waterways. While some of the flooding occurred during the early spring as winter snow and ice began to melt, other recent occurrences of flooding and near flooding have resulted from unseasonably high levels of rainfall. Beginning some 2,000 years ago, the engineers of the Mayan empire developed methods by which to reduce flooding along some rivers.
Practically every year during early spring, flooding occurs along sections of the Mississippi River and requires suspension of commercial navigation. Springtime high water levels along the St Lawrence Seaway has on occasion, delayed the annual opening of the ship navigation season between Montreal and the Great Lakes. Extreme high springtime water levels that have resulted in flooding have occurred along smaller navigable rivers such as the Ottawa River and Richelieu that flow into the St Lawrence River. Seasonal flooding also occurs on the Red River that flows from North Dakota into Canada and into Lake Winnipeg.
At the present time, people who own waterfront property located around Lake Ontario and along the Upper St Lawrence River have organized into protest groups, the result of extremely high water levels that have caused flooding at waterfront homes along with related property damage. They have directed the protest at the International Joint Commission that oversees and manages water levels between the Great Lakes and Montreal. It is possible that changing weather patterns and a warming Arctic region are producing unusually high levels of precipitation and leaving conservation and regulatory agencies unprepared to manage the changes.
Reducing Water Flow
Many centuries ago, engineers of the Mayan empire built rock dams along the tributaries of rivers at high elevation to reduce and even prevent flooding along rivers at lower elevation. The strategy allowed Mayan farmers to cultivate food crops in the fertile land at the lower elevations, next to and near the rivers. There may be scope to re-introduce the Mayan method at the present day on a massive scale, to reduce water volume flow rate from high elevation to lower elevation in regions that experience downstream flooding, with additional potential to combine the Mayan method with modern permaculture.
Permaculture is a method by which water is transferred directly from above ground level deep underground into the level of groundwater, using pipes connected to an excavated underground cavern. Across the north regions of North America, the winter ice cover and frozen soil near the surface prevents water from melting snow and ice from seeping deep underground. Instead, that water trickles toward small streams that flow into tributaries of rivers that become prone to flooding. During the warm summer, several of the same regions that experienced severe springtime flooding later experience summer drought and a lack of groundwater.
Permaculture Experiment
There would be scope in northern rural locations to undertake an experiment involving springtime permaculture, to divert water from melting snow and ice deep into the ground at locations that have low summertime groundwater levels. Prior to the spring melting, a well or vertical bore hole would be drilled deep into the ground at a low point along drainage ditch, to install upper and lower plastic (PVC) pipes. The upper 20-foot (six-meter) long pipe would be solid tube while the lower level pipe would be of equal diameter and have holes drilled into its circumference, along its length.
It would be commercially available pipe that would be wrapped in fine plastic mesh to keep out sand. When installed, it would extend from just under 20 feet below surface to 100 feet depth. The top of the solid tube would protrude above the ditch floor, with a hood installed above it to collect water and keep out dirt. As melting occurs during spring, water would flow into the vertical pipe and permeate into the deep earth to add to the groundwater. A successful result would provide a precedent for large scale implementation of the permaculture concept.
Combined Concept
The Mayan mini-dam concept proved workable over a period of 1,500 years for reducing flooding at lower elevations. Likewise, the permaculture approach has also proven successful in moving water through an almost impermeable frozen surface to deep underground into a low water table. Combining permaculture and Mayan concepts would involve connecting pairs of horizontal pipes to each Mayan style mini-dam installed along a stream. Each horizontal pipe would connect to multiple extended depth vertical permaculture pipes installed deep into the earth, to transfer large amounts of water from each Mayan min-dam deep into the groundwater.
A single experimental installation would demonstrate the volume of potential downstream flood water that could be diverted into the groundwater at each upstream location. The combination of a time-proven ancient Mayan flood control method and a modern permaculture concept is potentially workable. It could form the basis by which to implement the concept on a widespread basis in regions with low water tables, provided that different regulatory bodies and tribunals can find basis for cooperation. Implementation of the concept requires new cooperation involving the International Joint Commission along with state and provincial environmental and natural resources agencies.
Citizens’ Participation
Many cities internationally such as Chennai, India encourage homeowners and landlords to invest in water storage tanks to store water on their properties. During summer, many North American cities ask citizens to restrict water usage. In such cities, authorities encouraging citizens to store spring melt water and rain water in storage tanks and in permaculture would contribute both to reducing downstream flooding as well as sustaining vegetation growth in urban areas. The cumulative result of several hundred thousand citizens taking such initiative translates into significant reductions in the volume of water accumulating at flood zones.
Elected authorities in rural areas can give citizens permission to install vertical permaculture pipes along drainage ditches in rural areas, to transfer spring time melt water and flood water from surface level to deep below ground surface. Authorities could also give citizens permission to build small Mayan mini-dams along small river streams, to slow water volume flow rate and also install pipes that transfer water from the mini-dams, through the still-frozen ground into deep level earth. The combined effort of thousands of small groups could manifest into significant reductions of flooding at the lower elevations.
Alternative Perspective
The Ottawa River is navigable between Ottawa and Montreal. During the spring of both 2018 and 2019, severe flooding occurred along the Ottawa River. However, a consultant who evaluated the flood situation rejected calls for the construction of upstream reservoirs along the Ottawa River to reduce flooding downstream. To the south and east of Montreal, the Richelieu River that experienced severe flooding during the 2019 spring, flows from Lake Champlain to the St Lawrence River. To the south of Lake Ontario, rivers flow from several “finger” lakes into Lake Ontario and Erie Canal.
The Richelieu River springtime situation adds credence to the suggestion that rejects construction of upstream reservoirs to reduce downstream flooding. However, the Mayan approach involves building small dams along the tributaries and streams that flow into rivers and into upstream lakes. A test or experiment involving the combination of Mayan mini-dams and permaculture that directly transfers melt water into the deep groundwater would provide information on the amount of potential floodwater that such a concept would transfer into the groundwater in regions that have a deep water table.
Water Diversion
While some regions in North America experience high water levels in lakes and streams, other regions experience severe water shortages and prompted initiatives in water diversion. In the north-central USA, one aspect of the Garrison Diversion plan calls for a summer time diversion of some water from the Missouri River into the Red River, to support commercial agriculture. The topography to the southwest of Lake Superior could allow for diversion of lake water over to the headwaters of the Mississippi River and then into the Red River, whenever lake water reaches excessive levels.
During periods of excess high water levels on the Upper Great Lakes, a flow restriction based on inflatable technology and installed at the northern entrance of the St Clair River would reduce water flow into Lake Erie. High volume turbine-based hydraulic pumps installed between Lakes Superior and Huron would pump water into Lake Superior, as water transfers from Lake Superior to the Red River. As politically repulsive as water diversion may be to political activists, it offers a possible method by which to respond to excess height water levels on the Upper Great Lakes.
Predictable Weather Pattern
While weather patterns can be unpredictable, some weather trends can actually be reliable. One such reliable trend involves wintertime northern snow and ice melting after the end of winter and causing water levels to rise along rivers and downstream lakes, with most of the water flowing into the ocean. Despite frozen ground, it is technically possible using permaculture piping, to transfer a percentage of springtime melt water into the earth that is below the layer of frozen ground and especially in regions where the summertime water table is low. The piping would do its job every spring season.
Winters that involve excess snowfall would increase melting after springtime temperature rises, resulting in flooding along rivers and in the lower lakes. Methods to slow water flow rate along tributaries and transfer water deep underground, also transfer water from draining ditches to deep underground in areas with low water tables offers the possibility of reducing the severity of flooding along some rivers. During warmer weather, a slightly higher water table could provide additional groundwater to sustain agricultural production in some regions. There is going to be need for widespread discussion in regard to possible implementation of such methods.
There are possible methods by which to divert a percentage of springtime melt water away from rivers and lakes that would be prone to flooding. Around the North American Great Lakes region, it will be up to state, provincial and national tribunals, conservation agencies and regulatory agencies to decide as to whether to implement methods by which to transfer upstream melt water to bypass the frozen layer of ground and go into the deep groundwater.
The opinions expressed herein are the author's and not necessarily those of The Maritime Executive.
Vehicles Damaged on Ro-Ro, Drivers Pose Risk
ICS: Age Discrimination is No Joke
Keel Laid for Royal Canadian Navy’s Future Joint Support Ship
Confined Spaces: The Initial Test of the Atmosphere
EDITORIALS TOP STORIES
Rebuttal: Meeting IMO's Effluent Standards with Electrolytic Treatment
Buffalo’s “White Hurricane” and the Final Hours of Light Vessel 82
City of Xiamen Leads the Way in Addressing Ocean Plastic
India Backs Away from Southeast Asia Trade Deal
By The Maritime Executive 01-19-2020 05:39:55
The U.K. Marine Accident Safety Board (MAIB) has released its investigation report into the collapse of three container bays and loss of 137 containers from CMA CGM G. Washington during heavy weather while on passage from Xiamen to Los Angeles on January 20, 2018. The investigators concluded that the collapse of all three bays probably occurred during the 20° rolls. The amplitude of the rolls exceeded the ship’s estimated roll limits and were almost certainly the consequence of parametric rolling (where...
Tugs & Salvage
FirstCoastNews has reported that a fire started on the wreck of the ro-ro Golden Ray in St. Simons Sound on Sunday. Contractors were welding inside the ship when the fire started. It was contained within the hull and quickly put out by the contractor's fireboat, according to an Altahama Riverkeeper spokesperson. The 20,000 dwt Golden Ray partially capsized on September 8 while heading outbound from the Port of Brunswick with 4,200 vehicles on board. All crewmembers were rescued safely, though...
A towed barge was robbed twice on January 18 while underway in the eastbound lane of the Singapore Strait. In both incidents, the thieves stole scrap metal but did not confront the crew. At about 1129 hrs, tug boat Kim Hock Tug 9 towing barge LKH 2882 was en route from Singapore to Vietnam when seven perpetrators were sighted on the barge. The perpetrators escaped in two or three sampans upon seeing another tug Kim Hock Virgo approaching them. Later that...
The ReCAAP ISC has issued an incident alert after the abduction of eight crewmen from a fishing boat off Sabah, Malaysia. The Philippine Coast Guard reported that six gunmen dressed in black suits with masks used a gray speedboat with twin engine (40 HP) to abducted the eight from the Malaysia-registered fishing trawler SSK 00543. The trawler was found abandoned on January 17 at about 1500hrs approximately four nautical miles off the coast. On January 18, the Malaysian authorities reported...
Piracy News
Salvage News
© Copyright 2020 The Maritime Executive, LLC. All rights reserved.
|
cc/2020-05/en_middle_0097.json.gz/line1407428
|
__label__wiki
| 0.811527
| 0.811527
|
https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvMzMyOTQ1LTcwMDYzL3doaWNoLXBoeXNpY2FsLWZpbmRpbmdzLXN1Z2dlc3QtYW5reWxvc2luZy1zcG9uZHlsaXRpcy1hcw==
Drugs & Diseases > Rheumatology > Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy Q&A
Which physical findings suggest ankylosing spondylitis (AS)?
Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD more...
Chronic involvement of the spine eventually can lead to decreases in ROM and fusion of the vertebral bodies. Involvement of the cervical and upper thoracic spine can lead to fusion of the neck in a stooped forward-flexed position (see the images below). This position can significantly limit the patient’s ability to ambulate and look straight ahead.
Patient with ankylosing spondylitis affecting cervical and upper thoracic spine. Patient's spine has been fused in flexed position.
View Media Gallery
Posterior view of patient with ankylosing spondylitis affecting cervical and upper thoracic spine. Patient's spine has been fused in flexed position.
Passalent LA, Soever LJ, O'Shea FD, Inman RD. Exercise in ankylosing spondylitis: discrepancies between recommendations and reality. J Rheumatol. 2010 Apr. 37(4):835-41. [Medline].
Jones SD, Koh WH, Steiner A, Garrett SL, Calin A. Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. J Rheumatol. 1996 Mar. 23(3):487-90. [Medline].
Mengshoel AM, Førre O. Pain and fatigue in patients with rheumatic disorders. Clin Rheumatol. 1993 Dec. 12(4):515-21. [Medline].
van der Linden S, van der Heijde D. Ankylosing spondylitis. Clinical features. Rheum Dis Clin North Am. 1998 Nov. 24(4):663-76, vii. [Medline].
Collantes-Estevez E, Cisnal del Mazo A, Munoz-Gomariz E. Assessment of 2 systems of spondyloarthropathy diagnostic and classification criteria (Amor and ESSG) by a Spanish multicenter study. European Spondyloarthropathy Study Group. J Rheumatol. 1995 Feb. 22(2):246-51. [Medline].
Dougados M, van der Linden S, Juhlin R, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991 Oct. 34(10):1218-27. [Medline].
van der Heijde D, Spoorenberg A. Plain radiographs as an outcome measure in ankylosing spondylitis. J Rheumatol. 1999 Apr. 26(4):985-7. [Medline].
Naredo E, Batlle-Gualda E, García-Vivar ML, García-Aparicio AM, Fernández-Sueiro JL, Fernández-Prada M, et al. Power Doppler ultrasonography assessment of entheses in spondyloarthropathies: response to therapy of entheseal abnormalities. J Rheumatol. 2010 Oct. 37(10):2110-7. [Medline].
Vinson EN, Major NM. MR imaging of ankylosing spondylitis. Semin Musculoskelet Radiol. 2003 Jun. 7(2):103-13. [Medline].
Geijer M, Gothlin GG, Gothlin JH. The clinical utility of computed tomography compared to conventional radiography in diagnosing sacroiliitis. A retrospective study on 910 patients and literature review. J Rheumatol. 2007 Jul. 34(7):1561-5. [Medline].
Van Royen BJ, De Gast A. Lumbar osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. A structured review of three methods of treatment. Ann Rheum Dis. 1999 Jul. 58(7):399-406. [Medline]. [Full Text].
Shih LY, Chen TH, Lo WH, Yang DJ. Total hip arthroplasty in patients with ankylosing spondylitis: longterm followup. J Rheumatol. 1995 Sep. 22(9):1704-9. [Medline].
Cawley MI, Chalmers TM, Ball J. Destructive lesions of vertebral bodies in ankylosing spondylitis. Ann Rheum Dis. 1971 Sep. 30(5):539-40. [Medline]. [Full Text].
Hanson JA, Mirza S. Predisposition for spinal fracture in ankylosing spondylitis. AJR Am J Roentgenol. 2000 Jan. 174(1):150. [Medline].
Hunter T. The spinal complications of ankylosing spondylitis. Semin Arthritis Rheum. 1989 Dec. 19(3):172-82. [Medline].
Sutherland RI, Matheson D. Inflammatory involvement of vertebrae in ankylosing spondylitis. J Rheumatol. 1975 Sep. 2(3):296-302. [Medline].
van der Linden S, van der Heijde D. Clinical aspects, outcome assessment, and management of ankylosing spondylitis and postenteric reactive arthritis. Curr Opin Rheumatol. 2000 Jul. 12(4):263-8. [Medline].
Schlosstein L, Terasaki PI, Bluestone R, et al. High association of an HL-A antigen, W27, with ankylosing spondylitis. N Engl J Med. 1973 Apr 5. 288(14):704-6. [Medline].
Brewerton DA, Hart FD, Nicholls A, Caffrey M, James DC, Sturrock RD. Ankylosing spondylitis and HL-A 27. Lancet. 1973 Apr 28. 1(7809):904-7. [Medline].
Caffrey MF, James DC. Human lymphocyte antigen association in ankylosing spondylitis. Nature. 1973 Mar 9. 242(5393):121. [Medline].
Alvarez I, López de Castro JA. HLA-B27 and immunogenetics of spondyloarthropathies. Curr Opin Rheumatol. 2000 Jul. 12(4):248-53. [Medline].
McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. 1998 Oct 3. 352(9134):1137-40. [Medline].
Muñoz-Villanueva MC, Muñoz-Gomariz E, Escudero-Contreras A, et al. Biological and clinical markers of disease activity in ankylosing spondylitis. J Rheumatol. 2003 Dec. 30(12):2729-32. [Medline]. [Full Text].
Palazzi C, Olivieri I, D'Amico E, Pennese E, Petricca A. Management of reactive arthritis. Expert Opin Pharmacother. 2004 Jan. 5(1):61-70. [Medline].
McGonagle D, Emery P. Enthesitis, osteitis, microbes, biomechanics, and immune reactivity in ankylosing spondylitis. J Rheumatol. 2000 Oct. 27(10):2302-4. [Medline].
O'Neill TW, Bresnihan B. The heart in ankylosing spondylitis. Ann Rheum Dis. 1992 Jun. 51(6):705-6. [Medline]. [Full Text].
Khan MA. Update on spondyloarthropathies. Ann Intern Med. 2002 Jun 18. 136(12):896-907. [Medline].
Wordsworth P. Genes in the spondyloarthropathies. Rheum Dis Clin North Am. 1998 Nov. 24(4):845-63. [Medline].
Reveille JD. The genetic basis of ankylosing spondylitis. Curr Opin Rheumatol. 2006 Jul. 18(4):332-41. [Medline].
Brionez TF, Reveille JD. The contribution of genes outside the major histocompatibility complex to susceptibility to ankylosing spondylitis. Curr Opin Rheumatol. 2008 Jul. 20(4):384-91. [Medline].
Brown MA. Breakthroughs in genetic studies of ankylosing spondylitis. Rheumatology (Oxford). 2008 Feb. 47(2):132-7. [Medline].
Reveille JD, Ball EJ, Khan MA. HLA-B27 and genetic predisposing factors in spondyloarthropathies. Curr Opin Rheumatol. 2001 Jul. 13(4):265-72. [Medline].
Jaakkola E, Herzberg I, Laiho K, Barnardo MC, Pointon JJ, Kauppi M, et al. Finnish HLA studies confirm the increased risk conferred by HLA-B27 homozygosity in ankylosing spondylitis. Ann Rheum Dis. 2006 Jun. 65(6):775-80. [Medline].
Reveille JD, Arnett FC. Spondyloarthritis: update on pathogenesis and management. Am J Med. 2005 Jun. 118(6):592-603. [Medline].
van Gaalen FA, Verduijn W, Roelen DL, Böhringer S, Huizinga TW, van der Heijde DM, et al. Epistasis between two HLA antigens defines a subset of individuals at a very high risk for ankylosing spondylitis. Ann Rheum Dis. 2012 Aug 21. [Medline].
Ebringer A. The relationship between Klebsiella infection and ankylosing spondylitis. Baillieres Clin Rheumatol. 1989 Aug. 3(2):321-38. [Medline].
Timms AE, Crane AM, Sims AM, Cordell HJ, Bradbury LA, Abbott A, et al. The interleukin 1 gene cluster contains a major susceptibility locus for ankylosing spondylitis. Am J Hum Genet. 2004 Oct. 75(4):587-95. [Medline].
Maksymowych WP, Rahman P, Reeve JP, Gladman DD, Peddle L, Inman RD. Association of the IL1 gene cluster with susceptibility to ankylosing spondylitis: an analysis of three Canadian populations. Arthritis Rheum. 2006 Mar. 54(3):974-85. [Medline].
Burton PR, Clayton DG, Cardon LR, Craddock N, Deloukas P, Duncanson A, et al. Association scan of 14,500 nonsynonymous SNPs in four diseases identifies autoimmunity variants. Nat Genet. 2007 Nov. 39(11):1329-37. [Medline].
Rahman P, Inman RD, Gladman DD, Reeve JP, Peddle L, Maksymowych WP. Association of interleukin-23 receptor variants with ankylosing spondylitis. Arthritis Rheum. 2008 Apr. 58(4):1020-5. [Medline].
Rueda B, Orozco G, Raya E, Fernandez-Sueiro JL, Mulero J, Blanco FJ, et al. The IL23R Arg381Gln non-synonymous polymorphism confers susceptibility to ankylosing spondylitis. Ann Rheum Dis. 2008 Oct. 67(10):1451-4. [Medline].
Karaderi T, Harvey D, Farrar C, Appleton LH, Stone MA, Sturrock RD, et al. Association between the interleukin 23 receptor and ankylosing spondylitis is confirmed by a new UK case-control study and meta-analysis of published series. Rheumatology (Oxford). 2009 Apr. 48(4):386-9. [Medline].
Layh-Schmitt G, Colbert RA. The interleukin-23/interleukin-17 axis in spondyloarthritis. Curr Opin Rheumatol. 2008 Jul. 20(4):392-7. [Medline].
Hammer RE, Maika SD, Richardson JA, et al. Spontaneous inflammatory disease in transgenic rats expressing HLA-B27 and human beta 2m: an animal model of HLA-B27-associated human disorders. Cell. 1990 Nov 30. 63(5):1099-112. [Medline].
Khare SD, Luthra HS, David CS. Animal models of human leukocyte antigen B27-linked arthritides. Rheum Dis Clin North Am. 1998 Nov. 24(4):883-94, xi-xii. [Medline].
Lories RJ. Animal models of spondyloarthritis. Curr Opin Rheumatol. 2006 Jul. 18(4):342-6. [Medline].
Braun J, Bollow M, Remlinger G, et al. Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum. 1998 Jan. 41(1):58-67. [Medline].
Trontzas P, Andrianakos A, Miyakis S, et al. Seronegative spondyloarthropathies in Greece: a population-based study of prevalence, clinical pattern, and management. The ESORDIG study. Clin Rheumatol. 2005 Nov. 24(6):583-9. [Medline].
De Angelis R, Salaffi F, Grassi W. Prevalence of spondyloarthropathies in an Italian population sample: a regional community-based study. Scand J Rheumatol. 2007 Jan-Feb. 36(1):14-21. [Medline].
Taurog JD. The mystery of HLA-B27: if it isn't one thing, it's another. Arthritis Rheum. 2007 Aug. 56(8):2478-81. [Medline].
Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007 Apr 21. 369(9570):1379-90. [Medline].
Feldtkeller E, Khan MA, van der Heijde D, et al. Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis. Rheumatol Int. 2003 Mar. 23(2):61-6. [Medline].
Dincer U, Cakar E, Kiralp MZ, Dursun H. Diagnosis delay in patients with ankylosing spondylitis: possible reasons and proposals for new diagnostic criteria. Clin Rheumatol. 2008 Apr. 27(4):457-62. [Medline].
Rezaian MM, Brent LH. Undifferentiated spondyloarthropathy: Seven-year follow-up study of 357 patients. Arthritis Rheum. 2001. 44:S93.
Lee W, Reveille JD, Davis JC Jr, et al. Are there gender differences in severity of ankylosing spondylitis? Results from the PSOAS cohort. Ann Rheum Dis. 2007 May. 66(5):633-8. [Medline].
Singh DK, Magrey M. Racial Differences in Clinical Features and Co-morbidities In Ankylosing Spondylitis in the United States. J Rheumatol. 2019 Sep 1. [Medline].
Braun J, Pincus T. Mortality, course of disease and prognosis of patients with ankylosing spondylitis. Clin Exp Rheumatol. 2002 Nov-Dec. 20(6 Suppl 28):S16-22. [Medline].
Ringsdal VS, Helin P. Ankylosing spondylitis--education, employment and invalidity. Dan Med Bull. 1991 Jun. 38(3):282-4. [Medline].
Wordsworth BP, Mowat AG. A review of 100 patients with ankylosing spondylitis with particular reference to socio-economic effects. Br J Rheumatol. 1986 May. 25(2):175-80. [Medline].
McGuigan LE, Hart HH, Gow PJ, Kidd BL, Grigor RR, Moore TE. Employment in ankylosing spondylitis. Ann Rheum Dis. 1984 Aug. 43(4):604-6. [Medline]. [Full Text].
Lehtinen K. Working ability of 76 patients with ankylosing spondylitis. Scand J Rheumatol. 1981. 10(4):263-5. [Medline].
Verstappen SM, Watson KD, Lunt M, McGrother K, Symmons DP, Hyrich KL. Working status in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford). 2010 Aug. 49(8):1570-7. [Medline]. [Full Text].
Gran JT, Skomsvoll JF. The outcome of ankylosing spondylitis: a study of 100 patients. Br J Rheumatol. 1997 Jul. 36(7):766-71. [Medline].
Guillemin F, Briançon S, Pourel J, Gaucher A. Long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis. Possible predictive factors. Arthritis Rheum. 1990 Jul. 33(7):1001-6. [Medline].
Leirisalo-Repo M. Prognosis, course of disease, and treatment of the spondyloarthropathies. Rheum Dis Clin North Am. 1998 Nov. 24(4):737-51, viii. [Medline].
Carette S, Graham D, Little H, Rubenstein J, Rosen P. The natural disease course of ankylosing spondylitis. Arthritis Rheum. 1983 Feb. 26(2):186-90. [Medline].
Sampaio-Barros PD, Bertolo MB, Kraemer MH, et al. Undifferentiated spondyloarthropathies: a 2-year follow-up study. Clin Rheumatol. 2001. 20(3):201-6. [Medline].
Mattey DL, Dawson SR, Healey EL, Packham JC. Relationship Between Smoking and Patient-reported Measures of Disease Outcome in Ankylosing Spondylitis. J Rheumatol. 2011 Dec. 38(12):2608-15. [Medline].
O'Shea FD, Riarh R, Anton A, Inman RD. Assessing back pain: does the Oswestry Disability Questionnaire accurately measure function in ankylosing spondylitis?. J Rheumatol. 2010 Jun. 37(6):1211-3. [Medline].
Calin A, Porta J, Fries JF, et al. Clinical history as a screening test for ankylosing spondylitis. JAMA. 1977 Jun 13. 237(24):2613-4. [Medline].
Rudwaleit M, Metter A, Listing J, et al. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum. 2006 Feb. 54(2):569-78. [Medline].
Sieper J, van der Heijde D, Landewé R, Brandt J, Burgos-Vagas R, Collantes-Estevez E, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis. 2009 Jun. 68 (6):784-8. [Medline].
Martin TM, Smith JR, Rosenbaum JT. Anterior uveitis: current concepts of pathogenesis and interactions with the spondyloarthropathies. Curr Opin Rheumatol. 2002 Jul. 14(4):337-41. [Medline].
Ali A, Samson CM. Seronegative spondyloarthropathies and the eye. Curr Opin Ophthalmol. 2007 Nov. 18(6):476-80. [Medline].
Burgos-Vargas R. The juvenile-onset spondyloarthritides. Rheum Dis Clin North Am. 2002 Aug. 28(3):531-60, vi. [Medline].
Tse SM, Laxer RM. Juvenile spondyloarthropathy. Curr Opin Rheumatol. 2003 Jul. 15(4):374-9. [Medline].
Zeidler H, Mau W, Khan MA. Undifferentiated spondyloarthropathies. Rheum Dis Clin North Am. 1992 Feb. 18(1):187-202. [Medline].
Amor B, Dougados M, Mijiyawa M. [Criteria of the classification of spondylarthropathies]. Rev Rhum Mal Osteoartic. 1990 Feb. 57(2):85-9. [Medline].
Rasker JJ, Prevo RL, Lanting PJ. Spondylodiscitis in ankylosing spondylitis, inflammation or trauma? A description of six cases. Scand J Rheumatol. 1996. 25(1):52-7. [Medline].
Dihlmann W, Delling G. Discovertebral destructive lesions (so called Andersson lesions) associated with ankylosing spondylitis. Skel Radiol. 1978. 3:10-6.
Agarwal AK, Reidbord HE, Kraus DR, Eisenbeis CH Jr. Variable histopathology of discovertebral lesion (spondylodiscitis) of ankylosing spondylitis. Clin Exp Rheumatol. 1990 Jan-Feb. 8(1):67-9. [Medline].
Lipton S, Deodhar A. The New ASAS Classification Criteria for Axial and Peripheral Spondyloarthritis. Medscape Medical News. Available at http://www.medscape.com/viewarticle/776097_5. Accessed: November 4, 2014.
Rudwaleit M, van der Heijde D, Landewé R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011 Jan. 70(1):25-31. [Medline].
Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009 Jun. 68 (6):777-83. [Medline].
van der Heijde D, Landewé R. Imaging in spondylitis. Curr Opin Rheumatol. 2005 Jul. 17(4):413-7. [Medline].
[Guideline] Mandl P, Navarro-Compán V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015 Apr 2. [Medline]. [Full Text].
Ruof J, Stucki G. Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review. J Rheumatol. 1999 Apr. 26(4):966-70. [Medline].
Dougados M, Gueguen A, Nakache JP, et al. Clinical relevance of C-reactive protein in axial involvement of ankylosing spondylitis. J Rheumatol. 1999 Apr. 26(4):971-4. [Medline].
Anwar F, Al-Khayer A, Joseph G, Fraser MH, Jigajinni MV, Allan DB. Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis. Eur Spine J. 2011 Mar. 20(3):403-7. [Medline]. [Full Text].
Baraliakos X, Hermann KG, Landewé R, Listing J, Golder W, Brandt J, et al. Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau inversion recovery (STIR) sequences. Ann Rheum Dis. 2005 Aug. 64(8):1141-4. [Medline].
Hermann KG, Landewé RB, Braun J, van der Heijde DM. Magnetic resonance imaging of inflammatory lesions in the spine in ankylosing spondylitis clinical trials: is paramagnetic contrast medium necessary?. J Rheumatol. 2005 Oct. 32(10):2056-60. [Medline].
Kim NR, Choi JY, Hong SH, Jun WS, Lee JW, Choi JA, et al. "MR corner sign": value for predicting presence of ankylosing spondylitis. AJR Am J Roentgenol. 2008 Jul. 191(1):124-8. [Medline].
Maksymowych WP, Chiowchanwisawakit P, Clare T, Pedersen SJ, Østergaard M, Lambert RG. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: evidence of a relationship between inflammation and new bone formation. Arthritis Rheum. 2009 Jan. 60(1):93-102. [Medline].
Zochling J, van der Heijde D, Burgos-Vargas R, et al. ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2006 Apr. 65(4):442-52. [Medline].
Halm H, Metz-Stavenhagen P, Zielke K. Results of surgical correction of kyphotic deformities of the spine in ankylosing spondylitis on the basis of the modified arthritis impact measurement scales. Spine (Phila Pa 1976). 1995 Jul 15. 20(14):1612-9. [Medline].
Hunter T, Dubo HI. Spinal fractures complicating ankylosing spondylitis. A long-term followup study. Arthritis Rheum. 1983 Jun. 26(6):751-9. [Medline].
Carron P, Varkas G, Renson T, Colman R, Elewaut D, Van den Bosch F. High rate of drug-free remission after induction therapy with golimumab in early peripheral spondyloarthritis. Arthritis Rheumatol. 2018 May 27. [Medline].
Lewis R. TNF Inhibitor Induces Drug-Free Remission in Early Spondyloarthritis. Medscape Medical News. Available at https://www.medscape.com/viewarticle/897894?src=soc_fb_180612_mscpedt_news_mdscp_arthritis&faf=1. June 11, 2018; Accessed: June 12, 2018.
Cimzia (certolizumab) [package insert]. Lake Park Drive Smyrna, GA: UCB, Inc. April 2019. Available at [Full Text].
Escalas C, Trijau S, Dougados M. Evaluation of the treatment effect of NSAIDs/TNF blockers according to different domains in ankylosing spondylitis: results of a meta-analysis. Rheumatology (Oxford). 2010 Jul. 49(7):1317-25. [Medline].
Wanders A, Heijde D, Landewe R, et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum. 2005 Jun. 52(6):1756-65. [Medline].
Sieper J, Klopsch T, Richter M, Kapelle A, Rudwaleit M, Schwank S, et al. Comparison of two different dosages of celecoxib with diclofenac for the treatment of active ankylosing spondylitis: results of a 12-week randomised, double-blind, controlled study. Ann Rheum Dis. 2008 Mar. 67(3):323-9. [Medline]. [Full Text].
Chen J, Liu C. Is sulfasalazine effective in ankylosing spondylitis? A systematic review of randomized controlled trials. J Rheumatol. 2006 Apr. 33(4):722-31. [Medline].
Clegg DO, Reda DJ, Weisman MH, Blackburn WD, Cush JJ, Cannon GW, et al. Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis. A Department of Veterans Affairs Cooperative Study. Arthritis Rheum. 1996 Dec. 39(12):2004-12. [Medline].
Clegg DO, Reda DJ, Abdellatif M. Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondylarthropathies: a Department of Veterans Affairs cooperative study. Arthritis Rheum. 1999 Nov. 42(11):2325-9. [Medline].
Braun J, Pavelka K, Ramos-Remus C, Dimic A, Vlahos B, Freundlich B, et al. Clinical efficacy of etanercept versus sulfasalazine in ankylosing spondylitis subjects with peripheral joint involvement. J Rheumatol. 2012 Apr. 39(4):836-40. [Medline].
Inman RD, Maksymowych WP. A double-blind, placebo-controlled trial of low dose infliximab in ankylosing spondylitis. J Rheumatol. 2010 Jun. 37(6):1203-10. [Medline].
Braun J, Davis J, Dougados M, et al. First update of the international ASAS consensus statement for the use of anti-TNF agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2006 Mar. 65(3):316-20. [Medline].
Braun J, Baraliakos X, Golder W, et al. Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum. 2003 Apr. 48(4):1126-36. [Medline].
Gorman JD, Sack KE, Davis JC Jr. Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med. 2002 May 2. 346(18):1349-56. [Medline].
Davis JC, Van Der Heijde D, Braun J, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum. 2003 Nov. 48(11):3230-6. [Medline].
van der Heijde D, Dijkmans B, Geusens P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum. 2005 Feb. 52(2):582-91. [Medline].
Braun J, Landewé R, Hermann KG, et al. Major reduction in spinal inflammation in patients with ankylosing spondylitis after treatment with infliximab: results of a multicenter, randomized, double-blind, placebo-controlled magnetic resonance imaging study. Arthritis Rheum. 2006 May. 54(5):1646-52. [Medline].
Gengenbacher M, Sebald HJ, Villiger PM, Hofstetter W, Seitz M. Infliximab inhibits bone resorption by circulating osteoclast precursor cells in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis. 2008 May. 67(5):620-4. [Medline].
van der Heijde D, Kivitz A, Schiff MH, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2006 Jul. 54(7):2136-46. [Medline].
Inman RD, Davis JC Jr, Heijde D, Diekman L, Sieper J, Kim SI, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum. 2008 Nov. 58(11):3402-12. [Medline].
Medscape News. FDA clears certolizumab (Cimzia) for ankylosing spondylitis. Medscape. Available at http://www.medscape.com/viewarticle/812822. Accessed: October 18, 2013.
Landewé R, Braun J, Deodhar A, Dougados M, Maksymowych WP, Mease PJ, et al. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study. Ann Rheum Dis. 2013 Sep 6. [Medline]. [Full Text].
Furst DE, Breedveld FC, Kalden JR, Smolen JS, Burmester GR, Emery P, et al. Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2006. Ann Rheum Dis. 2006 Nov. 65 Suppl 3:iii2-15. [Medline].
Kelly JC. Ankylosing Spondylitis: Prolonged Anti-TNF Stops Damage. Medscape Medical News. Jun 22 2013. Available at http://www.medscape.com/viewarticle/808219. Accessed: July 30, 2013.
Haroon N, Inman RD, Learch TJ, Weisman MH, Lee M, Rahbar MH, et al. The Impact of TNF-inhibitors on radiographic progression in Ankylosing Spondylitis. Arthritis Rheum. 2013 Jul 1. [Medline].
Baeten D, Sieper J, Braun J, Baraliakos X, Dougados M, Emery P, et al. Secukinumab, an Interleukin-17A Inhibitor, in Ankylosing Spondylitis. N Engl J Med. 2015 Dec 24. 373 (26):2534-48. [Medline].
van der Heijde D, Cheng-Chung Wei J, Dougados M, Mease P, Deodhar A, Maksymowych WP, et al. Ixekizumab, an interleukin-17A antagonist in the treatment of ankylosing spondylitis or radiographic axial spondyloarthritis in patients previously untreated with biological disease-modifying anti-rheumatic drugs (COAST-V): 16 week results of a phase 3 randomised, double-blind, active-controlled and placebo-controlled trial. Lancet. 2018 Dec 8. 392 (10163):2441-2451. [Medline].
Deodhar A, Poddubnyy D, Pacheco-Tena C, Salvarani C, Lespessailles E, Rahman P, et al. Efficacy and Safety of Ixekizumab in the Treatment of Radiographic Axial Spondyloarthritis: Sixteen-Week Results From a Phase III Randomized, Double-Blind, Placebo-Controlled Trial in Patients With Prior Inadequate Response to or Intolerance of Tumor Necrosis Factor Inhibitors. Arthritis Rheumatol. 2019 Apr. 71 (4):599-611. [Medline]. [Full Text].
Chen J, Liu C, Lin J. Methotrexate for ankylosing spondylitis. Cochrane Database Syst Rev. 2006 Oct 18. CD004524. [Medline].
van Denderen JC, van der Paardt M, Nurmohamed MT, de Ryck YM, Dijkmans BA, van der Horst-Bruinsma IE. Double blind, randomised, placebo controlled study of leflunomide in the treatment of active ankylosing spondylitis. Ann Rheum Dis. 2005 Dec. 64(12):1761-4. [Medline].
[Guideline] Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol. 2015 Sep 24. [Medline]. [Full Text].
[Guideline] Smolen JS, Schöls M, Braun J, Dougados M, FitzGerald O, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. 2018 Jan. 77 (1):3-17. [Medline]. [Full Text].
van Denderen JC, Visman IM, Nurmohamed MT, Suttorp-Schulten MS, van der Horst-Bruinsma IE. Adalimumab significantly reduces the recurrence rate of anterior uveitis in patients with ankylosing spondylitis. J Rheumatol. 2014 Sep. 41(9):1843-8. [Medline].
van der Heijde D, Dougados M, Davis J, Weisman MH, Maksymowych W, Braun J, et al. ASsessment in Ankylosing Spondylitis International Working Group/Spondylitis Association of America recommendations for conducting clinical trials in ankylosing spondylitis. Arthritis Rheum. 2005 Feb. 52(2):386-94. [Medline].
Zochling J, Braun J. Assessments in ankylosing spondylitis. Best Pract Res Clin Rheumatol. 2007 Aug. 21(4):699-712. [Medline].
Zochling J. Assessment and treatment of ankylosing spondylitis: current status and future directions. Curr Opin Rheumatol. 2008 Jul. 20(4):398-403. [Medline].
Blizzard DJ, Penrose CT, Sheets CZ, Seyler TM, Bolognesi MP, Brown CR. Ankylosing Spondylitis Increases Perioperative and Postoperative Complications After Total Hip Arthroplasty. J Arthroplasty. 2017 Mar 27. [Medline].
Dagfinrud H, Kvien TK, Hagen KB. The Cochrane review of physiotherapy interventions for ankylosing spondylitis. J Rheumatol. 2005 Oct. 32(10):1899-906. [Medline].
Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev. 2008 Jan 23. CD002822. [Medline].
Zhao Q, Dong C, Liu Z, Li M, Wang J, Yin Y, et al. The effectiveness of aquatic physical therapy intervention on disease activity and function of ankylosing spondylitis patients: a meta-analysis. Psychol Health Med. 2019 Sep 2. 1-12. [Medline].
Goodman SM, Zhu R, Figgie MP, Huang WT, Mandl LA. Short-term Total Hip Replacement Outcomes in Ankylosing Spondylitis. J Clin Rheumatol. 2014 Oct. 20(7):363-8. [Medline].
Hidding A, van der Linden S, Gielen X, et al. Continuation of group physical therapy is necessary in ankylosing spondylitis: results of a randomized controlled trial. Arthritis Care Res. 1994 Jun. 7(2):90-6. [Medline].
Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008 May. 75(3):291-4. [Medline].
Kraag G, Stokes B, Groh J, Helewa A, Goldsmith C. The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis--a randomized controlled trial. J Rheumatol. 1990 Feb. 17(2):228-33. [Medline].
This 15-year-old female patient presented with recent onset of right-sided low back pain. Plain radiography findings were normal.
MRI of the same patient whose radiography findings were normal (previous image). She underwent further evaluation, including MRI. The MRI (short tau inversion recovery [STIR]) showed increased sinal intensity in the right sacroiliac joint, revealing sacroiliitis. Other laboratory study findings were essentially normal. The patient was started on indomethacin and rapidly improved.
Anteroposterior radiograph of sacroiliac joint of patient with ankylosing spondylitis. Bilateral sacroiliitis with sclerosis can be observed.
Anteroposterior radiograph of spine of patient with ankylosing spondylitis. Ossification of anulus fibrosus can be observed at multiple levels, which has led to fusion of spine with abnormal curvature.
Anteroposterior radiograph of spine of patient with ankylosing spondylitis. Ossification of anulus fibrosus at multiple levels and squaring of vertebral bodies can be observed.
Anteroposterior radiograph of spine of patient with ankylosing spondylitis.
Anteroposterior (left) and lateral (right) radiographs of patient with ankylosing spondylitis.
Radiographs of hand (top) and arm (bottom) of patient with peripheral involvement of ankylosing spondylitis. Fusion of joint spaces and deformity can be observed.
Sagittal MRI of thoracolumbar spine of a patient with ankylosing spondylitis. Degenerative disc disease and bridging osteophytes can be observed at multiple levels.
Radiograph shows vertebral fracture in patient with ankylosing spondylitis.
This radiograph of the lumbar spine of a patient with end-stage ankylosing spondylitis shows bridging syndesmophytes, resulting in bamboo spine.
This radiograph of the cervical spine of a patient with ankylosing spondylitis shows fusion of vertebral bodies due to bridging syndesmophytes.
ASAS Classification Criteria for Axial Spondyloarthropathy.
ASAS Classification Criteria for Peripheral Spondyloarthropathy.
Family of spondyloarthropathies and HLA-B27 associated diseases
Lawrence H Brent, MD Associate Professor of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center
Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, American College of Rheumatology
Disclosure: Stock ownership for: Johnson & Johnson.
Anand Patel, MD Fellow, Department of Rheumatology, Temple University Hospital
Anand Patel, MD is a member of the following medical societies: American College of Rheumatology, Pennsylvania Rheumatology Society, Philadelphia Rheumatism Society
Ruchika Patel, MD Attending Physician, Division of Rheumatology, Einstein Medical Center
Ruchika Patel, MD is a member of the following medical societies: American College of Physicians, American College of Rheumatology, Philadelphia Rheumatism Society
Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital
Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa
Rajni Kalagate, MD Resident Physician, Department of Internal Medicine, Albert Einstein Medical Center
Rajni Kalagate, MD is a member of the following medical societies: American Academy of Pediatrics, Indian Medical Association
Jason C Eck, DO, MS Assistant Professor, Department of Orthopedics and Physical Rehabilitation, UMass Memorial Medical Center
Jason C Eck, DO, MS is a member of the following medical societies: American Osteopathic Academy of Orthopedics, American Osteopathic Association, International Society for the Study of the Lumbar Spine, and North American Spine Society
Disclosure: Medtronic Honoraria Speaking and teaching
Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine
Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology
Scott D Hodges, DO Consulting Surgeon, Department of Orthopedic Surgery, Center for Sports Medicine and Orthopedics
Scott D Hodges, DO is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Medical Association, American Osteopathic Association, American Spinal Injury Association, North American Spine Society, Southern Medical Association, Southern Orthopaedic Association, and Tennessee Medical Association
Disclosure: Medtronic Royalty Consulting; Biomet Spine Royalty Consulting
S Craig Humphreys, MD Orthopedic Spine Surgeon, Department of Orthopedic Surgery, Center for Sports Medicine and Orthopedics
S Craig Humphreys, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Medical Association, American Spinal Injury Association, North American Spine Society, Southern Medical Association, Southern Orthopaedic Association, and Tennessee Medical Association
James F Kellam, MD Vice-Chair, Department of Orthopedic Surgery, Director of Orthopedic Trauma and Education, Carolinas Medical Center
James F Kellam, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Orthopaedic Trauma Association, and Royal College of Physicians and Surgeons of Canada
Kristine M Lohr, MD, MS Professor, Department of Internal Medicine, Center for the Advancement of Women's Health and Division of Rheumatology, Director, Rheumatology Training Program, University of Kentucky College of Medicine
Kristine M Lohr, MD, MS is a member of the following medical societies: American College of Physicians and American College of Rheumatology
William O Shaffer, MD Professor, Vice-Chairman and Residency Program Director, Department of Orthopedic Surgery, University of Kentucky at Lexington
William O Shaffer, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, International Society for the Study of the Lumbar Spine, Kentucky Medical Association, Kentucky Orthopaedic Society, North American Spine Society, Southern Medical Association, and Southern Orthopaedic Association
Disclosure: DePuySpine 1997-2007 (not presently) Royalty Consulting; DePuySpine 2002-2007 (closed) Grant/research funds SacroPelvic Instrumentation Biomechanical Study; DePuyBiologics 2005-2008 (closed) Grant/research funds Healos study just closed; DePuySpine 2009 Consulting fee Design of Offset Modification of Expedium
|
cc/2020-05/en_middle_0097.json.gz/line1407433
|
__label__wiki
| 0.700379
| 0.700379
|
Enter your details and we'll call you back at the requested time. Alternatively, talk to one of our team.
Please note we will respond to your request during working hours only.
call within 1 hourcall within 2 hourscall tomorrow
About Cambridge
Languages Close
Chinese, Mandarin
My Event Log in
Parking in Cambridge
Although many venues will be able to offer some parking, albeit sometimes limited, we strongly recommend using public transport to arrive in Cambridge where possible.
100 car parking spaces available at DoubleTree by Hilton Cambridge City Centre on a first-come, first-served basis. Chargeable at £3.00 per hour Monday to Friday when entering between 7am and 2pm or £2.50 per hour at all other times. Chargeable at £2.50 per hour on Saturday and Sunday. Special rates available for associated conferences with Meet Cambridge. For enquiries, please contact Amit Joseph, Amit.joseph@hilton.com or call 01223 259988 – please be aware that spaces cannot be reserved.
Holiday Inn Cambridge, just 3 miles from the city centre has 200 car parking spaces and facilities for coaches. For further details please contact the hotel on 0871 942 9015 option 2 for the Meetings & Events Department.
Cambridge City Council are responsible for most of the parking in Cambridge and details can be found here of the main car parks. However, please note that Cambridgshire County Council is responsible for the Park and Ride service.
Cambridge City Council can offer group parking rates at Park Street; Grafton East; Grafton West and Queen Anne car parks. To book, or for more information see the Cambridge City Council website.
Wilberforce Road Athletics Ground is available for parking at times. For more details please contact the Bookings and Memberships Assistant at University of Cambridge Physical Education Centre Tel: +44 (0) 1223 336997 or E-mail:bookings@sport.cam.ac.uk
The Rugby Ground have parking spaces in their front parking area on non-match days.
For more details please contact Nykki Webber, Administrative Officer and Development Executive CURUFC, Tel: +44 (0) 1223 354131 and E-mail: nykki.webber@curufc.com
Coach Parking provision can be found at Madingley Road Park and Ride and Cowley Road Golf Course. There are drop off points on Queen’s Road and Trumpington Road.
More About Cambridge
Cambridge Walking Tours
A guided walking tour is the best way to see Cambridge, discover the city's secrets and history.
Event Support Services
A comprehensive directory of contacts for additional event services.
Information about filming and photography in Cambridge.
How the University Works
Find out all about the relationship between the University of Cambridge and its Colleges.
If you're unable to use public transport , we've got some useful contacts for parking in the city.
Social programme or team building event, we'll help you find an activity to suit.
Great access by road, rail and air. Information to help you and your delegates.
Venue Membership
Residential Schools, Summer Schools and Group Travel
Agencies & PCOs
Associations and Societies
Large Events
© 2020 Meet Cambridge
+44 (0)1223 768740 Registered in England.
|
cc/2020-05/en_middle_0097.json.gz/line1407434
|
__label__wiki
| 0.539054
| 0.539054
|
ca ca
Mercer 365™
Employee Benefits Consulting and Brokerage
Total Health Management
Innovative Employee Benefits Design
Benefits Plan Analytics
Discover Mercer Invest Wise™
Global Investments Research Perspectives
Defined Benefit Plans Turning to the Digital Age
Executive Compensation: Analysis of the Top 60 TSX Companies
Pharmacare For All: A Risky Proposition?
Mercer Careers
MEDIAN CEO TOTAL DIRECT COMPENSATION REMAINS FLAT AMONG TOP COMPANIES LISTED ON TSX: MERCER
Total compensation for all TSX60 CEOs flat year-over-year, with considerable variation by sector
Same incumbent CEO total compensation up by an average of 6%
Increased usage of Environmental, Social and Governance metrics in executive pay packets
Mercer's latest analysis of CEO compensation finds that median reported pay for top Canadian CEOs remained flat between 2017 and 2018. This analysis is based on the top 60 listed companies on the TSX in 2018 – called the TSX60.
While total reported pay for all TSX60 companies remained flat between 2017 and 2018, same incumbent CEOs saw their Total Direct Compensation (TDC) rise by an average of 6%. Long-term incentives increased by 5%, and base salaries increased by 2%. Short-Term Incentives remained static.
These numbers belie considerable variation from sector to sector. Median CEO pay rose 7% in the Energy sector and 8% in Materials, but declined 5% in Financials.
Organizations taking a broader view of performance – Our analysis found that, in determining their executive incentive plans, organizations are increasingly using a holistic view when measuring performance. Half of the TSX60 use three or more metrics when determining bonus payouts under their Short-Term Incentive Plan (STIP), with one third having made recent changes to that plan to better measure performance in today’s business landscape.
Although profitability and earnings metrics continue to be the most prevalent metrics, with earnings metrics having a weighting of just over 50% of the total bonus, thanks to growing pressure from shareholders and other stakeholders, companies are increasingly leveraging Environmental, Social and Governance (ESG) metrics as part of their executive compensation plans. Mercer conducted a spot survey in May 2019 that found that one-third of North American companies surveyed used ESG metrics, with Canadian organizations twice as likely to use them as American organizations.
Long-Term Incentives Plan increasingly including Performance Share Units – Our analysis finds that most TSX60 companies still use a combination of two vehicles – typically Stock Options and Performance Share Units – with an increase in the weighting of Performance Share Units.
“No matter what sector your company is in, getting executive compensation right is critical to ensuring the person in the driver’s seat is performing at their best,” said Luc Lapalme, Principal with Mercer.
Luc Lapalme is available to discuss these findings and related topics for a story or further background. For more information, visit https://www.mercer.ca/en/our-thinking/career/tsx60-executive-compensation.html.
Mercer delivers advice and technology-driven solutions that help organizations meet the health, wealth and career needs of a changing workforce. Mercer’s more than 23,000 employees are based in 44 countries and the firm operates in over 130 countries. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), the leading global professional services firm in the areas of risk, strategy and people. With 75,000 colleagues and annualized revenue approaching $17 billion through its market-leading companies including Marsh, Guy Carpenter and Oliver Wyman, Marsh & McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit www.mercer.ca. Follow Mercer on Twitter @MercerCanada.
Mercer Canada
Heather Nairn
@Heather Nairn
Mercer Marsh Benefits™
© 2020 Mercer (Canada) Limited. All Rights Reserved.
|
cc/2020-05/en_middle_0097.json.gz/line1407438
|
__label__cc
| 0.633304
| 0.366696
|
Charities Conference
Our one day charities conference has been specifically designed for partners and senior managers with responsibility for a number of charity clients.
The topics covered are:
Charity Commission Regulatory Update
Hot Topics in Charity Accounts
VAT Update
Direct Taxes
Plus hear from a charity about what they need from you.
CPD hours: 6
CPD Hours:
Full conference agenda
WELCOME AND INTRODUCTION BY CONFERENCE CHAIRPERSON
Nigel Davies or Amie Woods, Charity Commission
Amie Woods/Nigel Davies will identify key developments in Charity Commission guidance, the latest research findings and lessons from key Commission cases for charities and practitioners.
DIRECT TAXES UPDATE
Jon Sparkes, Bishop Fleming
Jon will provide an update on the latest Direct Tax issues for charities including:
Legislative and case law update
Common risk and problem areas
The future of charity taxation
Peter Herbert, Insight Training
Despite the fact that the FRS 102 SORP is now well established, there still seems to be an abundance of new rules that affect charity reports and accounts. This session will explain all the recent developments and also clarify existing rules in a number of common problem areas. Feedback from charity regulators on problem areas will partly inform this session.
INDEPENDENT EXAMINATIONS - TO TICK OR NOT TO TICK?
Andrew Paul, Mercia Group Ltd
It is three years since the Charity Commission updated the CC32 guidance to Examiners but there is still a lot of confusion over how much work is actually required for an Independent Examination.
Andrew’s session will briefly review the 13 directions but will focus on practical examples of what Examiners should be doing to ensure compliance while remaining efficient.
CHARITY PERSPECTIVE
Hear direct from a charity about what support and assistance they need from you.
Fraud Advisory Panel
This session will review any relevant changes to legislation and case law decisions affecting charities’ VAT affairs over the past few years that are new or may have been forgotten. We will explore the VAT issues around property construction and rental that have arisen in practice in the recent past, and how to minimise any adverse effects of buying a property where the vendor has opted to tax.
The session will also focus on when charities can receive supplies of goods and services free of VAT, or at the reduced rate of 5% and remind delegates when their charities might be considered to be making taxable supplies, possibly requiring registration. VAT issues around fundraising events will also be addressed.
TRUSTEES DUTIES ROUNDUP
Louise Dunford, LD Consultancy Ltd
As always, there is a lot to consider where trustees are concerned and their duties are many, varied and always changing. Louise’s session will look at an overview of responsibilities and recent areas of focus for the Charity Commission with a particular reference to sales of land and payment of trustees.
CLOSE OF CONFERENCE
Louise Dunford
Louise has since 1987 been continuously involved in training and consultancy, both for professional firms and for commercial organisations. Until recently she also worked as an associate senior lecturer at the University of Portsmouth where she was mainly engaged on postgraduate teaching on the MBA, MA Personnel Management and MA Business Law, and she retains an active relationship with the University, having taught on their IPD courses in Grand Cayman and Guernsey. Louise specialises mainly in aspects of practical employment law, company law and on professional negligence, and has published widely in leading academic and professional journals.
Peter Herbert
Peter qualified as a chartered accountant with KPMG. He worked for The Financial Training Company for 6 years, the last three as a senior manager in the London office, responsible for developing courses for corporate clients. Peter presents courses to accountancy firms, companies and financial institutions. Peter's areas of technical expertise are financial reporting, auditing and practice regulation. He also writes and delivers financial analysis and personal development programmes for a range of blue chip and private companies.
Andrew Paul
Andrew joined Mercia in 1999 as part of the Audit and Accounts technical team and lectured on Practical Training Workshops, Paper and Paperless Audit Manual courses and undertook Peer Reviews. He has also been a Training Event Manager.
At the end of 2012 Andrew left Mercia to work In Rwanda for six months, helping to build the capacity of finance teams working in the healthcare sector with the US Charity Partners in Health. On returning to the UK, Andrew held the post of Finance Manager for Compassion UK, a £30m+ income Charity.
Andrew returned to Mercia in Autumn 2014 as part of the Audit and Accounts technical team.
Andrew retains lots of contacts in the charity sector and is a regular volunteer at events such as London Olympics 2012 and Glasgow 2014 Commonwealth Games as well as being a keen Leicester Tigers supporter.
Nigel is Head of Accountancy Services at the Charity Commission and Joint Chair of the Charities SORP Committee. He oversees the team who cover all accountancy aspects of operational and inquiry activities for the Commission. He leads the Commission on accountancy related collaborations with umbrella organisations, professional accountancy institutes and technical panels and working parties. He regularly speaks at events and publishes articles on charity accountancy matters. He responds on behalf of the Commission to IPSASB and IASB consultations.
Amie Woods
Amie joined the commission in March 2016 as the Deputy Head of Accountancy Services. Amie oversees the work of the team of accountants who cover all accountancy aspects of operational and inquiry activities for the Commission. Amie is a certified accountant with a background in financial and forensic investigation and regulation.
Malcolm Greenbaum
Malcolm was previously Director of Finance and Taxation Programmes at BPP Professional Education and has delivered IFRS, US GAAP, UK Tax and VAT training to a multitude of organisations world-wide since 1992. \He has particular experience in delivering bespoke training programmes to multi-nationals in the financial services, transport and energy sectors as well as delivering UK tax and VAT update programmes to accounting and law firms.He is passionate about training and his enthusiasm ensures that the participants enjoy the learning experience whilst gaining knowledge through their engagement in the sessions and through encouraging them to ask questions and discuss practical issues they may have.
Jon Sparkes
Jon is a Chartered Accountant and Chartered Tax Adviser with more than 20 years experience. He spent 9 years with a ‘Big 4’ firm during which he was part of their Charities Network advising a range of national and international charities and not for-profit organisations including higher and further education institutions, private schools, charitable training providers and other charities.
He is now Bishop Fleming’s charity tax specialist working with their academy clients on tax issues such as non-primary purpose trading, setting up trading subsidiaries and Gift Aid.
One Day Conference
|
cc/2020-05/en_middle_0097.json.gz/line1407439
|
__label__wiki
| 0.837351
| 0.837351
|
Health Care “Transformation” Announcement Leaves Front-line Workers with more Questions than Answers
"With so little transparency for staff and patients, [MGEU members] feel like the government is making it up as they go along." MGEU President addresses reporters yesterday to discuss the next wave of changes coming to health care.
The government announced yesterday that it’s moving forward with further changes to Manitoba’s health care system — but front-line workers remain in the dark as to how these changes will actually be implemented.
“Our members — workers like the health care aides and paramedics and lab technologists who deliver health services to Manitobans day-in and day-out — are telling me that with so little transparency for staff and patients, they feel like the government is making it up as they go along. Anxiety is high as they juggle heavy workloads without knowing what their future may hold,” says MGEU President, Michelle Gawronsky.
Currently, services are funded by the Health department and organized through five Regional Health Authorities (RHAs), three provincial health organizations, and civil service facilities like Selkirk Mental Health Centre and Cadham Provincial Laboratory. Yesterday’s announcement confirmed that the following services will be transferred to Shared Health from the RHAs and Manitoba Health by April 1, 2019:
Health Sciences Centre;
EMS services currently delivered directly by RHAs (excludes municipal EMS services like Winnipeg, Brandon, and Thompson);
Medical Transportation Coordination Centre;
Diagnostic imaging;
Lab services (including the former DSM and Westman Lab); and
Some, as yet unspecified, food and laundry services.
Other services and organizations were identified for future, possible transfer to Shared Health, including Selkirk Mental Health Centre, Cadham Provincial Laboratory, and Addictions Foundation of Manitoba. While the government would provide no detail on how or when this would happen, officials did indicate that transfer of these additional services/organizations would not be part of the first wave of transfers to be completed by April 1, 2019.
Gawronsky says that if yesterday’s announcement made one thing clear it’s that more MGEU members will have to take part in disruptive and costly representation votes. That’s because rural MGEU Emergency Medical Service (EMS) professionals and dispatchers with the Medical Transport Coordination Centre (MTCC) will now share the same employer as Technical/Professional members — Shared Health — as of April 1, 2019. Because they will all be Shared Health employees, they will all be forced to participate in union representation votes being held throughout the province some time in the next year. The government has not yet said when or how these votes will take place.
Since Bill 29, The Health Sector Bargaining Unit Review Act, was first introduced over a year ago, the MGEU and other unions have repeatedly told the government that representation votes would achieve nothing in terms of improving patient care.
“But in the end, they ignored the unions’ recommendations for how we could all avoid the expense and distraction and decided to move ahead with the votes anyway,” Gawronsky said. “MGEU will continue pressing government for the answers our members deserve at this time of so much uncertainty in the health care system.”
Members impacted by today’s announcement are encouraged to visit CareComesFirst.ca to read more about Bill 29 and the representation votes.
|
cc/2020-05/en_middle_0097.json.gz/line1407441
|
__label__wiki
| 0.721809
| 0.721809
|
You Won't Believe These 20 Award-Winning Photos Were Taken on an iPhone
By Sophie Kleeman
Beautiful photography is often thought to require deluxe equipment — thousand-dollar lenses, sophisticated cameras, complicated editing software. But sometimes all you need is an iPhone and a good eye to produce a stunning shot.
Case in point: the winners of this year's iPhone Photography Awards, who came from more than 120 different countries and competed in 20 categories, including animals, food and people. The competition has been around since 2007, when the first iPhone was released, and has very few rules: The images must be taken on an iPhone, iPod or iPad, and they can't be altered using desktop programs like Photoshop (so, app with filters are OK). The jury then examines each entry based on "artistic merit, originality, subject and style."
After scrolling through the winning shots, it was hard to believe they were all taken using a device many of us hold in our pockets.
"This year's entries were especially impressive ranging from intimate, thought-provoking moments to stunning, captivating imagery," Kenan Aktulun, the competition's creator, said in a press release. "We'd like to congratulate all of our winners who once again showed the ability of the iPhone to take astonishing photographs."
Below are the first-place winners in each category:
Photographer of the Year: Micha? Koralewski, Kozieg?owy, Poland
Micha? Koralewski/IPPA
"His face was the first thing I noticed, so expressive and beautiful in its own way. It was like an open book. You could almost read his life story from the wrinkles."
Abstract: Ben Schuyler, Seattle, Washington
Ben Schuyler/IPPA
Animals: Sephi Bergerson, Goa, India
Sephi Bergerson/IPPA
Architecture: Christian Frank, Stuttgart, Germany
Christian Frank/IPPA
Children: Jeremy Kern, Washington, D.C.
Jeremy Kern/IPPA
"Children who are waiting to be seen were peeking through the window curious to get a glimpse of the foreign doctor teams [at a clinic in Haiti]. I had been playing with them through the window most of the day and decided to take a picture. I pointed the camera which was at waist-level and snapped. Although it took little planning, I think it is a beautiful image of these inquisitive kids."
Flowers: Amy Paterson, Cape Town, South Africa
Amy Paterson/IPPA
"These are proteas, which is our national flower and a type of fynbos that has adapted to fire over millions of years. It's embraced fire as part of its ecology and many of these species would become extinct without it."
Food: Xu Lin, Qing Dao City, China
Xu Lin/IPPA
"This photo was taken in the middle of Yangtze River where people dry the fish they catch and transform them into delicious cuisine. Taking pictures is a daily routine to me — like a diary. I hope my pictures can let people see a different world."
Landscape: Chris Belcina, Cooper City, Florida
Chris Belcina/IPPA
Lifestyle: Fabio Alvarez, Pichincha, Ecuador
Fabio Alvarez/IPPA
Nature: Yvonne Naughton, La Conner, Washington
Yvonne Naughton/IPPA
"The photo was taken on one of my daily morning dog walks on Snee Oosh beach last October. It was a moody Pacific Northwest day with a thick fog lingering on the beach. There had been heavy dew overnight so the spiderwebs which covered rocks, logs and bushes shone like strands of diamonds."
News/Events: Jesse Alkire, Chicago, Illinois
Jesse Alkire/IPPA
Others: Jose Luis Saez Martinez, Valencia, Spain
Jose Luis Saez Martinez/IPPA
Panorama: Andre Malerba, Woodstock, Vermont
Andre Malerba/IPPA
People: Song Han, Chengdu, China
Song Han/IPPA
"What inspires me most is the whole context of a city rather than a single scene. Taking photos with the iPhone makes it more convenient and flexible to observe and create."
Portrait: Daniele Colombera, Los Angeles, California
Daniele Colombera/IPPA
Seasons: Heather Goss, Grand Haven, Michigan
Heather Goss/IPPA
"Over 12 feet of snow for the season and Lake Michigan iced over all the way across to Chicago. I spent a lot of time riding along the frozen shores of Lake MI in the brutal cold to admire the beauty of it all.The Grand Haven pier is one of my stops along the shore."
Still Life: Cindy Buske, Lynnwood, Washington
Cindy Buske/IPPA
Sunset: Robert Radesic, Pula, Croatia
Robert Radesic/IPPA
Travel: Ahmed Saeed, Cairo, Egypt
Ahmed Saeed/IPPA
"In December 2014, a friend and I spent a few days in Aswan's Nubian village Gharb Sehel. It's a beautiful place with colorful houses, kind warm people and mesmerizing views of the Nile. We were exploring the outskirts of the village when I stumbled upon this one of so many beautiful houses."
Trees: Ruairidh McGlynn, Edinburgh, United Kingdom
Ruairidh McGlynn/IPPA
Check out a full list of the winners here.
|
cc/2020-05/en_middle_0097.json.gz/line1407443
|
__label__wiki
| 0.581373
| 0.581373
|
Your house is haunted. What's a home seller to do?
By Michigan Radio Newsroom • Oct 31, 2014
Credit Morguefile
It's that time of year when we think about things going bump in the night.
So what if you believe a real ghost has taken up residence in your house and you want to move away? Do you need to tell potential buyers about your uninvited guest?
Michigan law is hazy when it comes to the seller's duty to disclose non-physical or so-called psychological defects of property, according to Gregg Nathanson, a Michigan real estate lawyer. Haunted houses would fall into that category of property.
Nathanson said state law says real estate brokers do not have a duty to disclose psychological property defects. But the statute is silent whether sellers have the duty to disclose.
"The way you would normally disclose it is you would fill out something called a Seller's Disclosure Statement which is required under Michigan law," Nathanson said. "And then it would be up to you to fill it out to the best of your knowledge. So it would be a question of whether you believe it's haunted or not."
But since Michigan courts have not ruled on a seller's duty to disclose psychological defects, Nathanson said it's not clear if you have to reveal that pesky ghost.
If you are a buyer with a special worry about ghosts, your best bet is to ask directly if the house is haunted. Nathanson said in the face of a direct question, both sellers and brokers have to answer truthfully or decline to answer.
Seller's Disclosure
|
cc/2020-05/en_middle_0097.json.gz/line1407445
|
__label__wiki
| 0.685495
| 0.685495
|
DNR & MSU to track deer in hopes of learning more about chronic wasting disease
By Steve Carmody • Feb 4, 2018
Michigan wildlife officials are launching a five-year study to see if deer movement is spreading a serious disease.
Since 2015, 58 cases of Chronic Wasting Disease have been identified in the state. CWD attacks the brain of infected animals, resulting in death. The outbreak started near Lansing, but has spread to other areas.
MSU professor David Williams is fitting deer with collars to see if their movements are increasing their contact with infected herds.
Two more Michigan deer test positive for Chronic wasting disease
By Steve Carmody • Jan 20, 2017
Two more deer have tested positive for Chronic Wasting Disease in Michigan.
The two female deer are from a farm in Mecosta County, north of Grand Rapids. The farm has been quarantined and other deer are being tested for CWD.
State wildlife officials are investigating to see if the source of the infection can be determined.
CWD can be transmitted directly from one animal to another, or indirectly through the environment.
Efforts to curb Chronic Wasting Disease will continue in 2016
By Steve Carmody • Dec 24, 2015
Michigan wildlife officials are closing out a year of battling chronic wasting disease in the state’s free-ranging deer.
The first case of Chronic Wasting Disease turned up in Ingham County in April. By the end of the year, a total of four confirmed cases of the fatal neurological illness were confirmed, among the nearly four thousand deer that were tested.
In order to decrease the chances of CWD spreading, Gov. Snyder this week signed a law extending a ban on feeding wild deer.
The beginning of firearm deer season marks next phase in Chronic Wasting Disease probe
By Steve Carmody • Nov 15, 2015
Firearm deer season is underway today in Michigan.
The hunt is giving state wildlife officials a chance to expand the search for more cases of chronic wasting disease.
In April, a 6 year old doe tested positive for CWD, a fatal neurological disease. It was the first case of a free ranging deer coming down with the disease. Since then, two more deer have tested positive. All three deer were from Ingham County and were related.
State urges hunters to help keep deer disease out of UP
By Virginia Gordan • Nov 12, 2015
The Michigan Department of Natural Resources has launched an education campaign to try to keep chronic wasting disease from spreading to the Upper Peninsula.
The disease affects the central nervous system and is always fatal to white-tailed deer, mule deer, elk, and moose, according to the DNR. And there is no known treatment.
Investigation of Chronic Wasting Disease shifting
By Steve Carmody • Sep 6, 2015
State wildlife officials are shifting their investigation into Chronic Wasting Disease in deer in mid-Michigan.
The Department of Natural Resources has examined the brains of roughly 600 deer since the first case of CWD was confirmed in Ingham County in May. In all, three have tested positive for the fatal neurological disease.
A third Michigan deer tests positive for Chronic Wasting Disease
By Steve Carmody • Aug 6, 2015
Another free-ranging Michigan deer has tested positive for Chronic Wasting Disease.
“This news is not surprising,” said Dr. Steve Schmitt, DNR wildlife veterinarian. “The good news is that all three deer came from the same small area.” All three deer are related and were found in a one mile radius in Ingham County.
CWD is a fatal neurological disease that affects deer, moose and elk. It is not a threat to humans.
Another Michigan deer tests positive for chronic wasting disease
State officials say a second mid-Michigan deer has tested positive for a fatal neurological disease.
“Finding this second positive deer is disappointing, however, not unexpected,” said DNR Wildlife Division Chief Russ Mason.
The second deer was discovered about a mile from where the first deer was found in Ingham County. Wildlife officials are genetically testing the two deer to determine if they are related.
|
cc/2020-05/en_middle_0097.json.gz/line1407446
|
__label__wiki
| 0.845364
| 0.845364
|
Toolshed: Assessing Triple-A park factors
New Las Vegas, San Antonio locales impact PCL stats, prospects
Sean Murphy and the Las Vegas Aviators took advantage of the hitter-friendly confines of their new stadium in 2019. (Las Vegas Aviators)
By Sam Dykstra / MiLB.com | November 8, 2019 10:00 AM
Not all offensive jumps are created equal.
As has been widely documented, there was an offensive explosion in Triple-A this season with Pacific Coast League clubs averaging 5.9 runs per game and their International League counterparts averaging 5.2, up from 5.0 and 4.2, respectively, in 2018. A primary driver of this offensive uptick was the switch to the Major League baseball. But while every Triple-A player utilized the same ball, they weren't playing in the same environments. Some were in extreme hitters' parks, even by Triple-A standards, while others were working mostly in friendlier confines for pitchers.
Toolshed last reviewed Triple-A park factors in 2016, so it's high time to return to the subject, especially after a year of movement in the PCL. Notably, Triple-A's western circuit dropped Colorado Springs, replacing it with San Antonio. In addition, a new ballpark opened in Las Vegas, meaning the 51s/Aviators replaced a hitters' park (Cashman Field) with an even more extreme hitters' park (Las Vegas Ballpark).
The following are the park factors for the Pacific Coast League, first for the 2019 season and then an average over the past three seasons. In the second table, Las Vegas is split into two groups to illustrate the difference between the two stadiums, while Colorado Springs and San Antonio are included separately. The scales for the run, homer and hit factors are constructed so 100 equals average -- anything above favored hitters while anything below was more helpful to pitchers.
Pacific Coast League -- 2019
Las Vegas 124 153 122
El Paso 123 106 114
Albuquerque 121 120 112
Reno 114 95 114
Omaha 101 111 103
Oklahoma City 101 91 100
Salt Lake 101 100 110
Iowa 101 105 98
Nashville 100 78 100
Memphis 97 100 99
New Orleans 92 111 92
Fresno 90 92 90
San Antonio 89 82 98
Sacramento 85 91 88
Tacoma 83 81 85
Round Rock 82 87 85
Pacific Coast League -- 2017-19
Colorado Springs '17/18 133 115 108
Las Vegas '19 124 153 122
Las Vegas '17/18 113 115 109
Salt Lake 107 99 111
Omaha 96 113 97
San Antonio '19 89 82 98
Memphis 86 97 93
Nashville 85 63 92
New Orleans 85 63 92
The first thing that stands out is how the two stadium changes impacted the PCL landscape. The league traded one of its most homer-happy parks, located in the high altitude of Colorado Springs, for something more down to Earth in San Antonio. As a result, the collective ERA of Brewers Triple-A hurlers went down from 4.60 at Colorado Springs in 2018 to a league-best 4.15 this season with San Antonio.
Las Vegas became even more hitter-friendly in its new home, something that may have not seemed possible given how balls used to fly out of Cashman Field. As a team, the Aviators posted a .531 slugging percentage and a .902 OPS this season -- the highest single-season marks for an individual club since at least 2005. A big reason for that may be the new ball, but another explanation is certainly the new stadium. To further the point, Las Vegas pitchers gave up a league-high 145 homers at home this season, compared to only 79 on the road. According to BaseballParks.com, the elevation at Cashman was 1,995 feet; while at Las Vegas Ballpark, it's 3,041 feet. A climb to a higher locale while staying in the dry desert air is a good way to get a jump in offense.
Lastly, El Paso made headlines for setting a modern PCL record with 258 home runs as a team, eight more than Vegas. But the slightly above-average 106 home-run park factor indicates the Chihuahuas didn't receive as big a boost from Southwest University Park as one might imagine. In fact, El Paso sluggers actually hit more long balls on the road (130) than they did at home (128) over equal 70-game samples in 2019.
Prospects affected
Carter Kieboom: The Nationals' top prospect certainly enjoyed a solid season at the plate during his time with Triple-A Fresno in 2019, finishing with a .303/.409/.493 slash line and 16 homers in 109 games en route to capturing PCL end-of-season All-Star honors. But it's also worth wondering what the infielder could have done if he'd spent his season mostly playing in another PCL locale. Kieboom hit a stunning .346/.453/.571 on the road compared to a more meager .261/.364/.415 at home with 10 of his 16 taters coming away from Fresno. His actual performance lies somewhere in the middle, but it's something to keep in mind for anyone perusing the PCL leaderboards in the cold of winter.
Kyle Tucker: The 22-year-old Astros outfielder knew a thing or two about playing in Fresno in 2018, only to move to another pitcher-friendly stadium when Houston switched its affiliation to Round Rock this season. Like most, Tucker's Triple-A home run production jumped -- from 24 to 34 in 2019, but most of those came on the road. Twenty-one of the 34, in fact, were dingers away from Round Rock's Dell Diamond. As the three-year model shows, Round Rock and Fresno have played pretty similarly over the longer term, but unluckily for Tucker, Fresno was a tad more homer-friendly in 2019 than the spot he got to call home in his second spin through Triple-A.
Sean Murphy: Because of knee injuries, the A's No. 3 prospect didn't spend a heck of a lot of time with Las Vegas, but his splits were stark all the same. Murphy slugged .736 in 14 games at home while producing a decent .537 slugging percentage in 17 games on the road. His 1.064 home OPS appropriately dropped nearly 300 points to .888 away from Sin City as well. The backstop's defensive work remains the primary driver of his value as a prospect, but this is another way of of keeping his offensive growth at the Triple-A level in context.
Now onto the other Triple-A circuit...
International League -- 2019
Charlotte 127 164 115
Louisville 118 95 112
Scranton/Wilkes-Barre 109 104 101
Gwinnett 106 83 108
Columbus 104 121 96
Rochester 104 111 100
Syracuse 97 90 96
Norfolk 95 84 100
Lehigh Valley 95 76 106
Durham 95 109 95
Buffalo 94 112 100
Indianapolis 94 85 96
Pawtucket 85 104 85
Toledo 83 74 91
International League -- 2017-2019
Lehigh Valley 106 102 106
Durham 101 103 99
Buffalo 96 94 99
Norfolk 85 75 92
Charlotte, Charlotte, Charlotte.
There's no way to talk about park factors and the IL without addressing the elephant in the league: BB&T Ballpark. The Knights opened the stadium in 2014, and offense has taken off in downtown Charlotte ever since. In 2019 alone, Knights batters belted 127 homers in their friendly confines, compared to only 81 on the road. Pitchers had it even more extreme. Charlotte hurlers gave up 130 dingers at home, as opposed to nearly half that at 73 away. Only Albuquerque pitchers (133) allowed more long balls at home in 2019. Basically, the Knights enjoy -- well, their level of enjoyment might vary by position -- playing in a PCL park at home and taking on fairer IL parks everywhere else in their own league.
In other spots, the IL might stand out more for pitching advantages than those given to the hitters, even in a big offensive season like 2019. Toledo batters hit 100 homers on the road but only 55 at home this past season -- the biggest home-to-road drop for an offensive unit this season. Elsewhere, Norfolk has been the more pitcher-friendly park in recent years. Tides batters went yard 145 times at home over the past three seasons, compared to 84 more (229 total) on the road over that same span. Norfolk pitchers, meanwhile, have fared better, giving up 189 dingers at home in those three seasons, a drop of 30 from the road total of 219.
Luis Robert: Robert's ascent to Triple-A was much anticipated, and there's no doubting that MLB.com's No. 3 overall prospect prospered at the Minors' top level, batting .297/.341/.634 with 16 homers and a 136 wRC+ in 47 games. But here's the thing -- Minor League wRC+ is weighted for league factors, but not park factors. Perhaps it would be different if the fact that Robert posted a .337/.394/.695 slash line at home in Charlotte compared to a .262/.289/.579 on the road was taken into effect. If his overall numbers in Triple-A were more like the road line, we would probably be talking about him differently heading into a likely 2020 Major League debut, though the slugging numbers were still strong. But as the old adage goes, you can only hit where you are. And when Robert was in BB&T Ballpark, he hit quite well indeed.
Offseason MiLB include
Ryan Mountcastle: The Orioles' No. 4 prospect earned plenty of praise for his 2019 season, namely he received IL MVP honors after hitting .312 with 25 homers and an .871 OPS in 127 games with Norfolk. What's more astonishing is that he did that while calling an extreme pitchers' park home, and moreso, he did that with splits that favored playing at the Tides' Harbor Park. Fifteen of Mountcastle's 25 long balls came at home this season, and he slugged .574 there compared to .481 on the road. Camden Yards is a pretty fair park, and it would have been fun to see what the right-handed slugger could have done with a call to Baltimore at some point late in the summer. Alas, that will have to wait for 2020.
Coming Toledo attractions: Much has been said about the Tigers' deep arsenal of arms at the Double-A level in 2019, led Top-100 prospects Casey Mize, Matt Manning and Tarik Skubal. What happens when all three, as well as Alex Faedo and Joey Wentz, head to Triple-A Toledo next summer? Likely good things, at least in terms of numbers. While Detroit's prospect arms adjust to life with the Major League/Triple-A ball, they can relax knowing Toledo's Fifth Third Field conceded 17 percent fewer runs and 26 percent fewer homers than the average IL park in 2019. That should be particularly useful to Mize and Skubal, who give up their fair share of fly balls compared to those on the ground.
Sam Dykstra is a reporter for MiLB.com. Follow and interact with him on Twitter, @SamDykstraMiLB. This story was not subject to the approval of the National Association of Professional Baseball Leagues or its clubs.
|
cc/2020-05/en_middle_0097.json.gz/line1407450
|
__label__cc
| 0.593904
| 0.406096
|
Introducing: The World's Most Relaxing Color & How To Use It In Your Bedroom
mbg Sustainability Editor By Emma Loewe
Emma Loewe is the Sustainability Editor at mindbodygreen and the author of "The Spirit Almanac: A Modern Guide To Ancient Self Care."
Image by People Images
Are you into bright teal or hot pink? Forest green or sky blue?
G.F. Smith, a papermaker in the U.K., recently asked 26,000 participants across 100 countries questions like these and spent months poring over the data. Working in tandem with the University of Sussex, they then compiled a comprehensive report on how people around the world react to certain colors.
"When we are children, everyone has an answer to the question 'What's your favourite colour?'" the authors wrote of the inspiration behind the study. "But something changes as we reach adulthood. Our favourite colour becomes less important as a statement of identity, and many of us never think about [it] again."
The choices they got spanned the rainbow, but greens and blues came out as the most popular colors overall. Interestingly enough, in one of the first color surveys ever recorded at the Chicago World's Fair in 1893, the majority of respondents also liked the color blue the most.
Upon further analysis, researchers identified one explanation for why the hue is such a timeless favorite. When we look at the color blue—especially navy blue—it makes us feel calm and lowers our heart rate, according to their analysis.
What's so relaxing about navy blue?
Now is a good time to mention that everyone has different reactions to colors, so what's soothing to one person might be triggering and unpleasant for another. Speaking for the collective, though, G.F. Smith has a few guesses as to why dark blue can be so calming for so many.
First off, more saturated colors tend to be associated with excitement, so it makes sense that something subdued and easy on the eyes like a navy would fall more on the relaxing side. Plus, the associations we have with certain colors largely shape how we react to them. Dark blue is the color of natural landscapes like the open ocean and a starry sky—both of which can call to mind nighttime and rest. The biology of the brain could also play a role: Some colors are easier to process than others, which can dictate how we receive them.
How can I work some more navy into my life?
The study doesn't go so far as to name the exact shade of dark blue that's most relaxing, so it's up to you to find one that speaks to your tastes. Once you've found your dream color (we're partial to this Shasta Lake tone from BEHR), here are a few ways to add it to your sleep space.
Make an accent wall.
We featured professional declutterer Kyle Quilici's San Francisco studio in our Holistic Home Tour series because it shows how a few thoughtful design touches can make a small space feel much larger. She was on to something when she painted her studio alcove a rich, deep blue. This accent wall makes a statement without being overwhelming.
If your bedroom is also on the smaller side, you'll want to be extra cautious when working with darker colors like this one. A little goes a long way, and too much can make the room feel claustrophobic.
Give your furniture and accessories a fresh paint job.
Breathe some new life into that white dresser or mirror with a fresh coat of navy paint. Painting old pieces adds a quick pop of color, and it's a lot cheaper (and more Earth-friendly) than ordering something brand-new.
Update your gallery wall.
Add subtle hints of calming blue to your wall displays by giving your frames a new paint job, opting for art that incorporates the color, or hanging photography of expansive open ocean scenes or dark, clear skies.
Make sure you can see the color from your bed.
Did you catch mbg's recent article about the most important place at home to design with intention? It's the area across from your bed since it's likely the first one you see when you wake up in the morning and the last you take in before you go to sleep. So be sure to play around with adding some dark blue within your pillow's line of sight—or use a well-placed mirror to get it there.
Emma Loewe mbg Sustainability Editor
Emma Loewe is the Sustainability Editor at mindbodygreen and the co-author of the best-selling book, The Spirit Almanac: A Modern Guide To Ancient Self Care, which she wrote alongside...
How To Control Anxiety
With Ellen Vora, M.D.
9 Signs It's Time To End A Friendship (Because Sometimes You Just Have To)
Alyssa "Lia" Mancao, LCSW
GABA: What Is It?
Circuit Training May Be The Ultimate Exercise, And Here's Why
Lectin Foods: Avoid Lectins & Heal Your Gut
https://www.mindbodygreen.com/articles/why-navy-blue-is-officially-the-worlds-most-relaxing-color
|
cc/2020-05/en_middle_0097.json.gz/line1407451
|
__label__wiki
| 0.900795
| 0.900795
|
MNN.com > Earth Matters > Animals
Pigs and humans share more genetic similarities than previously believed
New genetic analysis reveals hidden evolutionary relationship between pigs and primates.
Bryan Nelson
September 28, 2015, 2:48 a.m.
Like humans, pigs have heavy eyelashes. (Photo: Jean/flickr)
Pigs share a number of surprising comparable traits with humans. For instance, we both have hairless skin, a thick layer of subcutaneous fat, light-colored eyes, protruding noses and heavy eyelashes. Pig skin tissues and heart valves can be used in medicine because of their compatibility with the human body. Medical students often practice suturing on pig's feet.
Most of these shared traits are likely due to convergent evolution, happenstance; they aren't the sign of close ancestry. But new genetic analysis suggests that pigs and primates may actually share a hidden evolutionary relationship after all, reports Phys.org.
The new study focused on genetic elements called SINEs (short interspersed elements). SINEs, which make up about 11 percent of human DNA, were once considered "junk DNA," but researchers have now come to believe that analyzing these elements could glean important hints about mammalian evolutionary history.
The most common SINE in humans is called the Alu transposable element. That's important because it is derived from the small cytoplasmic 7SL RNA, and that's important because 7SL RNA is also the source for a common swine SINE, according to the latest research. This would be an unlikely coincidence. Essentially, it lends evidence to the idea that pig and primate evolution have some close parallels that were previously hidden using more conventional genetic analysis.
The upshot of all of this, according to the study's author, is that the suidae family (that is, the swine family) could conceivably be grouped into a family that is otherwise mostly inhabited by primates, at least in terms of 7SL RNA-derived SINEs.
What evolutionary story might this tell about the relationship of pigs and primates? For now, phylogeneticists can only speculate. But it goes to show that our relationships to our animal brethren are often closer than first appearances may suggest. Despite the great diversity of life, there is a string connecting us all together — a string that geneticists are only beginning to learn how to unravel.
Bryan Nelson ( @@brynelson ) writes about everything from environmental problems here on Earth to big questions in space.
Lungs from genetically modified pigs could soon be used to save human lives
What did the first snakes look like? New evolutionary analysis offers surprising hints
Viral attacks reveal evolutionary secret
Related topics: Animal Research, Science
New genetic analysis reveals a hidden evolutionary relationship between pigs and primates.
|
cc/2020-05/en_middle_0097.json.gz/line1407454
|
__label__wiki
| 0.630686
| 0.630686
|
Samsung debuts Galaxy S3
Samsung last night announced the anticipated Galaxy S III, the handset number one’s latest flagship smartphone.
Headline features of the device include its 4.8-inch HD Super AMOLED display – at the launch event in London, the company noted that while the screen is 22 percent bigger than that in the Galaxy S2, the bezel around the case has been narrowed, so that “the unit did not get much bigger.”
JK Shin, president and head of the IT & Mobile Communications division at Samsung, said that the device offers the “most seamless, natural and human-centric mobile experiences.”
This includes S Voice, a speech recognition technology intended to compete with Apple’s Siri. It also has face detection technology, which can keep the screen awake if a user is reading without making any other input to the device.
The Galaxy S III is powered by Android 4.0. It has an 8-megapixel main and 1.9 megapixel front camera.
It is set for launch on 29 May, initially in Europe, before being rolled out to the rest of the world – the launch was dubbed “the largest in Samsung’s mobile history,” across 296 operators in 145 countries. An LTE variant is also set to follow for the US, Japan and China.
So far, Samsung has provided few details of the processor powering the device, other than that it will be quad-core. Some reports have previously suggested that the LTE version will swap this for a dual-core chip, as HTC has done with its flagship One X device.
Previous ArticleDeNA: Taking social games across borders
Next ArticleUK NHS Trust awards remote monitoring contract
Steve Costello
Steve works across all of Mobile World Live’s channels and played a lead role in the launch and ongoing success of our apps and devices services. He has been a journalist...More
Samsung names new mobile chief
Samsung SDS, Syniverse pen blockchain pact
Samsung expects lower profit fall on rising chip prices
GalaxyGalaxy S IIILeadMBBSamsung
|
cc/2020-05/en_middle_0097.json.gz/line1407455
|
__label__wiki
| 0.560901
| 0.560901
|
Sexual and reproductive healthcare in Choloma, Honduras.
© Christina Simons/MSF
Honduras has experienced years of political, economic and social instability, and has one of the highest rates of violence in the world. This has great medical, psychological and social consequences for the population.
We treat victims of violence, including sexual violence. We work with the Honduran Ministry of Health on our servicio prioritario, or priority service, project which offers emergency medical and psychological care to victims of violence.
Our medical treatment for rape includes post-exposure prophylaxis to prevent HIV infection and provide protection against other sexually transmitted infections, hepatitis B, and tetanus.
For victims of sexual violence, we provide mental healthcare which includes counselling, group therapies and psychological first aid.
The broken American dream: Violence on the Central American migration route
outpatient consultations
individual mental health consultations
people treated after incidents of sexual violence
Honduras: 2018 International Activity Report
VIEW THE REPORT
"I feel guilty"
"I'm 13 years old and I'm pregnant"
"The MSF psychologist explained to me that what I suffered was a sexual attack"
The story of 13-year-old Estela*, from Choloma, Honduras, is representative of many of the young patients we care for in our projects in Tegucigalpa and Choloma, in Honduras, and Reynosa, Mexico.
Year MSF first worked in the country
Topic All Topics Access to medicines Antibiotic resistance Attacks on medical care Central American Migration Child health Cholera Cyclone Idai & Southern Africa flooding DRC Ebola outbreaks Ebola and Marburg Epidemics and pandemics Hepatitis C Hepatitis E HIV/AIDS Kala azar Kunduz hospital attack Lake Chad Crisis Malaria Malnutrition Measles Mediterranean migration Meningitis Mental health Natural disasters Neglected diseases Non-communicable diseases Refugees, IDPs and people on the move Rohingya refugee crisis Sexual violence Sleeping Sickness Snakebite Social violence and exclusion Surgery & trauma care Tuberculosis Vaccination War and conflict Women's health Yellow fever
Year All Years 2019 2018 2017 2016 2015 2014 2013 2012 2010 2009 2006 2002 1998
“People here are deeply affected by violence, especially women”
Voices from the Field 29 Oct 2018
Tending deep wounds in Mexico
Central American Migration
"Leaving the country to seek asylum is often the only option for survival"
A year in pictures 2017
“We have gone from seven deliveries each month to more than 30”
Project Update 10 Oct 2017
Forced to flee Central America's Northern Triangle: A Neglected Humanitarian Crisis
Report 12 May 2017
An estimated 500,000 people a year flee violence and poverty in El Salvador, Guatemala, and Honduras, heading north through Mexico to find safety. The levels of violence in the region are comparable to that of war zones MSF has worked in for decades.
Sexual violence affects millions of people, brutally shattering the lives of women, men and children. It is a medical emergency, but there is often a dire lack of healthcare services for victims.
Where we work, we may see people with a mental illness or confronting distressing situations, such as violence, loss or displacement. Mental health support can be crucial to help people cope.
Nearly 800,000 people die each year from HIV/AIDS, while nearly 2 million people become newly infected with the virus.
|
cc/2020-05/en_middle_0097.json.gz/line1407459
|
__label__wiki
| 0.713031
| 0.713031
|
Any Price (4257) Under $100 (3724) $100-499 (460) $500-4,999 (69) $5,000-19,999 (2)
European Decorative Arts
100 British Glasses at Asprey
London: Asprey & Company, 1985, circa. Softcover. Tannish ill. wraps. 64 pp. 100 color and bw ills. Illustrations of some England's finest, most elegant and rare glass ever produced. More
100 Years of Georg Jensen: Magnificent Silver from The Rowler Collection
New York: Christie's, 2005, January 19. Softbound. Glossy color wraps. 325 pages listing, illustrating and describing 444 lots in vivid color. A vital reference on Georg Jensen silver, produced to facilitate the sale of the largest collection in private hands. More
20th Century Ceramic Designers in Britain
Woodbridge, England: Antique Collectors' Club Ltd, 2001. Hardcover. Blue cloth with color illustrated glossy dustjacket. 391 pp., 420+ illustrations, most of them in color. Focuses on British ceramics designers of the 20th century, including major female designers such as Clarice Cliff and Susie Cooper. This guide also covers those on..... More
20th Century Furniture and Decorative Arts, including Glass, Lamps, Pottery and Metalwork from the Art Nouveau, Arts and Crafts, Art Deco, and Modern Movements
Boston, Massachusetts: Skinner, Inc., 2000. Softcover. Color illus. wraps; 88 pp.; Profusely illustrated in bw. Accompanied sale 1973, held February 5, 2000.408 lots listed. More
Ars Ceramica (Periodical set, 1984-2000, incompl.) (ISSN 1043-3317)
New York: The Wedgwood Society of New York, 1984-2000. KAVE. Softbound. 11 loose issues. An incomplete but substantial run of this periodical dedicated to Wedgwood and the ceramic arts. Present are 11 vols./issues. 1-9 (1984-1992), 14 (1997/1998) and 16 (1999/2000). More
Ars Ceramica Number 26, 2010
New York: The Wedgwood Society of New York, 2014. CAVE. Softbound. White & illus. wraps. 72 pp., BW and color illus. One single issue of this periodical. Contains these articles: A Bust of Alexander the Great / Harwood A. Johnson -- Bacchus in Cambridge: Models and Copies / Nancy H...... More
Ars Ceramica Number 5, 1988
New York: The Wedgwood Society of New York, 1988. KAVE. Softbound. Colorful illus. wraps. 52 pp. Well-illustrated. Includes articles: The Earliest English Salt-Glazed Stoneware / Hugh Tait -- George Bullock's Ceramics / Alison Kelly -- Figures and Conversations / Norman Stretton -- Thomas Lakin in Staffordshire and Yorkshire / Harold..... More
THE ART OF BREGUET, An Important Collection or 204 Watches, Clocks and Wristwatches
Geneva: Habsburg, 1991. Hardbound. Green cloth with gilt title and color illustrated dustjacket. 479 pp., profusely illustrated in color. Text is in English.A luxurious catalogue packed with great essays and information on these watches and their owners. This is an auction catalogue for a sale that was held on April..... More
The Art of Patek Philippe: 300 Legendary Watches
Geneva, Switzerland: Habsburg, Feldman, 1989. Hardbound. Gilt embossed burgundy cloth with color pictorial dust jacket. 283 pp., prrofusely illustrated in color. Text is in English and Japanese. Issued in conjunction with a 1989 auction that celebrated 150 years of watchmaking by the firm of Patek Philippe. Includes a brief history..... More
The Art of the Goldsmith and the Jeweler
New York: A La Vieille Russie, 1968. Softcover. White and color-illustrated wraps, teal writing on spine. 139 pp. 23 color, 299 BW plates. Exhibit for the benefit of the Young Women's Christian Association of the City of New York, held November 6, November 23, 1968. More
The Art of Timekeeper: Masterpieces from The Winthrop Edey Bequest
New York: The Frick Collection, 2001. Softbound. Color illustrated black wraps. The Art of the Timekeeper: Masterpieces from the Winthrop Edey Bequest features a group of thirteen clocks and eight watches selected from a larger, multi-faceted gift—many of which are on view for the first time. Ranging in date from..... More
Autograph Letters and Historical Documents: Maggs 1449
London: Maggs Bros. Ltd., 2011. Softbound. Burgundy/BW pictorial wraps, unpaginated; approx. 100pp, several BW illustrations. This is a catalog published by Maggs Bros. Ltd, a rare books, first editions, manuscripts and autographs specialist in London. This volume contains numerous historical documents in reference, from Rudyard Kipling to Sir Winston Churchill..... More
Bal D'Enfants
Paris: Maison Marinet / Hautecoeur, circa 1850? Hardcover. Green library buckram. 14 color plates. Bals D'Enfants may or may not be the correct title, but it was used by the library for cataloguing and place on the volume during the binding process. The book contains a series of 14 illustrations..... More
Bow Porcelain 1744-1776: A Special Exhibition of Documentary Material to commemorate the bi-centenary of the retirement of Thomas Frye
London: Trustees of the British Museum, 1959. First. Softcover. Color illustrated wraps, 55 pp., portrait frontispiece, and 55 bw illustrations. Issued in conjunction with a 1959-1960 exhibition. "The history of the Bow porcelain factory and its wares has yet to be written. The actual site of the Bow factory was..... More
Cahiers de la Ceramique du Verre et des Arts du Feu, no. 18
Sevres: Societe des Amis du Musee National de Ceramique, 1960. Softcover. White stapled wraps with cream dust jacket, color illus. laid on front, variously paginated,numerous bw illus. and color tipped-in plates. Text is in French. One single issue of this periodical. Articles: L'art de la faience a Moustiers-Sainte-Marie / Arthur-Jean..... More
Cahiers de la Ceramique du Verre et des Arts du Feu, no. 5 (Hiver 1956-1957)
Sevres: Societie des Amis du Musee National de Ceramique, 1956, 1957. Softcover. Plain, white glossy paper wraps; manila wrappers with color illus. tipped on; navy blue lettering; blue silk string binding. [55]pp. Numerous bw illus. with color plates tipped in. Text in French. Article summaries in English. Articles cover the..... More
Cahiers de la Ceramique et des Arts du Feu, no. 11
Sevres: Societe des Amis du Musee National de Ceramique, 1958. Softcover. White stapled wraps with cream dust jacket, color illus. laid on front, variously paginated,numerous bw illus. and color tipped-in plates. Text is in French. One single issue of this periodical. Article summaries in English. Articles: Influence de l'Extreme-Orient sur..... More
Cahiers de la Ceramique et des Arts du Feu, no. 6
Sevres: Societe des Amis du Musee National de Ceramique, 1957. Softcover. White stapled wraps with cream dust jacket, color illus. laid on front, variously paginated,numerous bw illus. and color tipped-in plates. Text is in French. One single issue of this quarterly periodical. Articles are: Les Schoelcher et la porcelaine: Paris..... More
CAHIERS DE LA CERAMIQUE, DU VERRE ET DES ARTS DU FEU #19
1960. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). More
1960. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on Mahommedan Ceramics and Reflexions Concerning a Crib in Verre File. More
1961. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on Moslem Glassmaking in the 8th, 9th and 10th Centuries; Saint-Verain Blue; The Bailiwick of Amont Cradle of the Art of Earthenware in Franche-Comte in..... More
1961. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on French Ceramics At Industrial Exhibitions in the First Half of The 19th Century; A New Stained Glass Window by Marc Chagall; An Exceptional Majolica..... More
1961. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on Exhibitions of Irania Art in The Petit Palais and the Museum of Art and Archeology in Toulton; Strass Stones and their Inventor; Italian Earthenware..... More
1961. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on The American Collection in The National Museum of Ceramics: Pre-Columbian Andean Specimens; A Fragment of Coptic Glass and two Groups of Mediaeval Glass; Effects..... More
1963. Softbound. Cream printed wraps with color plate tipped-on cover. Includes an English summary of the articles (which are written in French). Main articles are on Ancient Earthenware From Montpellier 16th - 18th Centuries; Eighteenth Century Wisniowiec Earthenware Stoves in The Chateau of Wawel; The Manufacture of Glass after Two..... More
|
cc/2020-05/en_middle_0097.json.gz/line1407461
|
__label__cc
| 0.562925
| 0.437075
|
Home / Series / Millennium
Action, Drama, Science-Fiction, Adventure
3seasons/67episodes/1996 - 1999
NetworkFOX
De serie is beëndigd
Runtime:45 min1996 - 1999 (Ended)
Genres:Action, Drama, Science-Fiction, Adventure
Network:FOX
Frank has a special ability to see into the minds of serial killers. Working for a mysterious organization called the Millennium Group, who take a special interest in serial killers and the millennial end of the world prophecy.
During the first season, Frank lives with his wife Catherine and daughter Jordan in Seattle. The show focuses on Frank's work as a profiler. The first season focuses most of Franks' time trying to solve serial murder cases.
During the second season, the show primarily on Frank's relationship with the Millennium Group. After separating from his wife after a violent rescue of her from a stalker. Frank learns that the Millennium Group is a secret society that believes that the world is coming to an end. During this season, Frank spends much of his time working with Millennium Group member Peter Watts and fellow investigator Laura Means.
After the death of his wife at the end of the second season, Frank severs all connection with the Millennium Group and returns to work with the FBI. With the help of special agent Emma Hollis, he begins to investiagate the Millennium Group itself.
Catherine Black
Jordan Black
Lt. Bob 'Bletch' Bletcher
Agent Emma Hollis
Klea Scott
To episodes
There are no reviews of the series Millennium.
Populair comments (0)
|
cc/2020-05/en_middle_0097.json.gz/line1407472
|
__label__cc
| 0.691795
| 0.308205
|
Pentagon Reportedly Mulls Large JSF Cut
Posted by Colin Clark on September 19, 2011
National Harbor: The Pentagon is reportedly weighing the benefits and risks of slashing 100 planes from the planned purchase of 2,443 Joint Strike Fighters.
Steve Burbage, Lockheed Martin’s executive vice president in charge of the JSF program, said at the Air Force Associaton’s annual conference that he wasn’t aware of any such discussions. Burbage repeated standard Lockheed warnings that cuts would slow the ramp-up to production rates where the company benefit from economies of scale.
My colleague Andrea Shalal-Esa, of Reuters, broke the story. Her story contained no details, such as which versions of the plane are on the chopping block. The easiest cut would be to the Air Force’s buy, which is far and away the largest at 1,763 planes. But Air Force Secretary Mike Donley fenced off the JSF from major cuts in his keynote speech this morning.
“With a fighter fleet now averaging 22 years old and with two decades of declining fighter force structure, modernizing our aging and smaller fighter force depends on the fifth generation capabilities of the Joint Strike Fighter. Simply put, there is no alternative to the F-35 program. It must succeed. Similarly, developing the Long Range Strike family of systems, including the new bomber, is essential to maintaining conventional long range strike capabilities into the future,” Donley said.
Those remarks, of course, do not rule out the Office of Secretary of Defense stuffing large JSF cuts down the services’ throats. I asked Donley after his speech this morning about hte likelihood of large cuts to the F-35 program, before news of the century cut broke. “The message today is that, at the strategic level this remains a cirical program for the U.S Air Force,” he said, noting that the service would “tweak” the program year by year.
In conversations with several industry sources here at AFA one thing became clear. Rumors about program cuts are everywhere. With the end result of the Super Committee’s decisions getting to the Pentagon just a few weeks before the budget is supposed to be released, it is unlikely large cuts will be made to the 2013 budget. They would be too difficult to plan and be terribly disruptive. Look for the big cuts to begin rolling in during 2014. Hopefully by then the U.S. economy will have begun to recover.
@CategoryFeature @MainPageFeature Air Warfare F-35JointStrikeFighter lockheed martin Tom Burbage
A very powerful video with a very powerful message. Choos...
Your first week of basic training
|
cc/2020-05/en_middle_0097.json.gz/line1407474
|
__label__cc
| 0.683703
| 0.316297
|
Products & Performance Morgan Stanley Investment Funds Fixed Income Emerging Markets Corporate Debt Fund
Share Class : A AH (EUR) AHX (EUR) AR AX B BH (EUR) BHX (EUR) BX C CH (EUR) CHX (EUR) CX I IH (EUR) N SHX (EUR) Z ZH (EUR) ZHX (EUR)
SHARE CLASS :
A AH (EUR) AHX (EUR) AR AX B BH (EUR) BHX (EUR) BX C CH (EUR) CHX (EUR) CX I IH (EUR) N SHX (EUR) Z ZH (EUR) ZHX (EUR)
Pricing & Performance
Fund Facts
Asset Class: Fixed Income
Morningstar Category:1 EAA Fund Global Emerging Markets Corporate Bond
Fund Launch Date: 07-Mar-2011
Fund Base Currency: USD
Fund Assets (Bn):
as of 17-Jan-2020 1.6 USD
Net Asset Value:
as of 17-Jan-2020 26.41 USD
Share Class Launch Date: 27-Jun-2019
Share Class Assets (MM):
as of 17-Jan-2020 6.91 USD
CUSIP: L6526M373
Bloomberg: MSEMCNU LX
Sedol: BK5SNT8
Fees & Expenses 3
Max Entry Charge: 0.00 %
Ongoing Charges: 0.11 %
Management Fee: 0.00 %
Minimum Initial Investment: 0 USD
Minimum Subsequent Investment: 0 USD
To generate income and the long term growth of your investment.
Seeks to maximise total return, measured in U.S. dollars, primarily through investments across the credit spectrum of debt securities of corporate issuers, together with investing in debt securities of government and government related issuers located in emerging markets. The Fund intends to invest its assets in emerging market corporate debt securities that provide a high level of current income, while at the same time holding the potential for capital appreciation.
Duration (years)
Share Class Base Currency
As of 12/31/2019 | As of 12/31/2019 |
Past performance is not a reliable indicator of future results. Returns may increase or decrease as a result of currency fluctuations. All performance data is calculated NAV to NAV, net of fees, and does not take account of commissions and costs incurred on the issue and redemption of units. The sources for all performance and Index data is Morgan Stanley Investment Management. Please click here for additional performance disclosures and important information, which should be reviewed carefully.
As of 31-Dec-2019
As of 17-Jan-2020
Currency: USD EUR
Past performance is not a reliable indicator of future results.
Risk and Reward Profile As of 17-Jul-2019
Lower Risk
Lower Rewards
Higher Rewards
The risk and reward category shown is based on historic data.
Historic figures are only a guide and may not be a reliable indicator of what may happen in the future.
As such this category may change in the future.
The higher the category, the greater the potential reward, but also the greater the risk of losing the investment. Category 1 does not indicate a risk free investment.
The fund is in this category because it invests in fixed income securities from emerging markets and the fund's simulated and/or realised return has experienced medium rises and falls historically.
The fund may be impacted by movements in the exchange rates between the fund's currency and the currencies of the fund's investments.
This rating does not take into account other risk factors which should be considered before investing, these include:
The value of bonds are likely to decrease if interest rates rise and vice versa.
The value of financial derivative instruments are highly sensitive and may result in losses in excess of the amount invested by the Sub-Fund.
Issuers may not be able to repay their debts, if this happens the value of your investment will decrease. This risk is higher where the fund invests in a bond with a lower credit rating.
The fund relies on other parties to fulfill certain services, investments or transactions. If these parties become insolvent, it may expose the fund to financial loss.
There may be an insufficient number of buyers or sellers which may affect the funds ability to buy or sell securities.
Investment in Fixed Income Securities via the China Interbank Bond Market may also entail additional risks, such as counterparty and liquidity risk.
There are increased risks of investing in emerging markets as political, legal and operational systems may be less developed than in developed markets.
Past performance is not a reliable indicator of future results. Returns may increase or decrease as a result of currency fluctuations. The value of investments and the income from them can go down as well as up and investors may lose all or a substantial portion of his or her investment.
The value of the investments and the income from them will vary and there can be no assurance that the Fund will achieve its investment objectives.
Investments may be in a variety of currencies and therefore changes in rates of exchange between currencies may cause the value of investments to decrease or increase. Furthermore, the value of investments may be adversely affected by fluctuations in exchange rates between the investor’s reference currency and the base currency of the investments.
Composition 4 As of 31-Dec-2019
Asset Breakdown
(% of Total Net Assets)
Quasi-Sovereign 2.44
Corporates 93.93
Industrial 5.92
Financials 28.76
Oil & Gas 12.65
Consumer 10.68
Diversified 1.47
TMT 7.03
Infrastructure 2.15
Metals & Mining 4.27
Pulp & Paper 0.56
Transport 1.70
Real Estate 9.30
Utilities 9.44
Cash 3.10
May not sum to 100% due to rounding.
Geography4 As of 31-Dec-2019
Geographic Allocation (% of Total Net Assets)
China 8.97
Brazil 7.38
Mexico 6.60
India 4.83
United Arab Emirates 4.80
Colombia 4.29
Turkey 4.18
Indonesia 4.18
Peru 4.01
Other 47.69
Holdings As of 31-Dec-2019
Top 10 Issuers (% of Total Net Assets)
Saudi Arabian Oil Co. 2.21
YPF S.A. 1.36
Teva Pharmaceutical Finance Neth 1.22
Ihs Netherlands Holdco Bv 1.11
Sinopec Group Overseas Development 2018 1.07
Petrobras Global Finance Bv 1.07
Sands China Ltd 1.05
Llpl Capital Pte. Ltd. 1.04
Hunt Oil Company of Peru Llc (Lima Branc 0.98
Abu Dhabi National Energy Co. 0.96
These securities and percentage allocations are only for illustrative purposes and do not constitute, and should not be construed as, investment advice or recommendations with respect to the securities or investments mentioned.
Download full Holdings
Portfolio Characteristics As of 31-Dec-2019
Interest Rate Duration (years) 4.34
Average yield to maturity (%) 5.04
Number of holdings 233
Team members may be subject to change at any time without notice.
Insights by Global Fixed Income Team
In many ways, October was a continuation of the developments that started in September. Yet the Global Fixed Income Team now believes fixed income markets have reached a fork in the road: Either data will get better as geopolitical risks recede, or we will return to trade war concerns and deteriorating economic fundamentals.
Fund Analysis
Fund Overview
MS INVF Prospectus
MS INVF Annual Report
MS INVF Semi-Annual Report
MS INVF Shareholder Notice – Brexit
MS INVF Product Notice: Data Protection Notification
** Calendar Year Return (%) is available by selecting the fund name in the pricing table.
Please visit our Glossary page for fund related terms and definitions.
Performance data quoted is based on average annualized returns and net of fees.
The source for all performance and index data is Morgan Stanley Investment Management Limited.
Past performance is not indicative of future results. The value of the investments and the income from them can go down as well as up and an investor may not get back the amount invested. Returns may increase or decrease as a result of currency fluctuations. Performance data for funds with less than one year's track record is not shown. Performance is calculated net of fees. YTD performance data is not annualised. Performance of other share classes, when offered, may differ. Please consider the investment objectives, risks, charges and expenses of the fund carefully before investing. The prospectus and key investor information document (KIID) contains this and other information about the fund. Please read the prospectus and KIID carefully before you invest.
1 The Morningstar Rating™ for funds, or "star rating", is calculated for managed products (including mutual funds, variable annuity and variable life subaccounts, exchange-traded funds, closed-end funds, and separate accounts) with at least a three-year history. Exchange-traded funds and open-ended mutual funds are considered a single population for comparative purposes. It is calculated based on a Morningstar Risk-Adjusted Return measure that accounts for variation in a managed product's monthly excess performance, placing more emphasis on downward variations and rewarding consistent performance. The top 10% of products in each product category receive 5 stars, the next 22.5% receive 4 stars, the next 35% receive 3 stars, the next 22.5% receive 2 stars, and the bottom 10% receive 1 star. The Overall Morningstar Rating for a managed product is derived from a weighted average of the performance figures associated with its three-, five-, and 10-year (if applicable) Morningstar Rating metrics. The weights are: 100% three-year rating for 36-59 months of total returns, 60% five-year rating/40% three-year rating for 60-119 months of total returns, and 50% 10-year rating/30% five-year rating/20% three-year rating for 120 or more months of total returns. While the 10-year overall star rating formula seems to give the most weight to the 10-year period, the most recent three-year period actually has the greatest impact because it is included in all three rating periods. Ratings do not take into account sales loads.
The Europe/Asia and South Africa category (EAA) includes funds domiciled in European markets, major cross-border Asian markets where material numbers of European UCITS funds are available (principally Hong Kong, Singapore and Taiwan), South Africa, and selected other Asian and African markets where Morningstar believes it is of benefit to investors for the funds to be included in the EAA classification system.
© 2020 Morningstar. All Rights Reserved. The information contained herein: (1) is proprietary to Morningstar and/or its content providers; (2) may not be copied or distributed; and (3) is not warranted to be accurate, complete or timely. Neither Morningstar nor its content providers are responsible for any damages or losses arising from any use of this information. Past performance is no guarantee of future results.
2 JP Morgan CEMBI Broad Diversified Index a global, liquid corporate emerging-markets benchmark that tracks U.S.-denominated corporate bonds issued by emerging-markets entities.
3 Entry Charge is a maximum possible figure. In some cases you might pay less, you can find this out from your financial adviser. Ongoing Charges reflect the payments and expenses incurred during the fund's operation and are deducted from the assets of the fund over the period. It includes fees paid for investment management (Management Fee), trustee/custodian, and administration charges. The Minimum Initial Investment/Minimum Subsequent Investment amounts may be in US Dollars (or the Euro Yen or Sterling equivalent of the US Dollar amount). For more information please see the Charges and Expenses section of the prospectus.
4 May not sum to 100% due to rounding. Cash & Equivalents are defined as the value of assets that can be converted into cash immediately. These include commercial paper, open FX transactions, Treasury bills and other short-term instruments. Such instruments are considered cash equivalents because they are deemed liquid and not subject to significant risk of changes in values.
|
cc/2020-05/en_middle_0097.json.gz/line1407475
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.