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Traditional fixed markets in Mexico are multiple-vendor markets permanently housed in a fixed location. They go by a variety of names such as "mercados públicos" (public markets), "mercados municipales" (municipal markets) or even more often simply "mercados" (markets). These markets are distinct from others in that they are almost always housed in buildings owned and operated by the local government, with numerous stands inside rented by individual merchants, who usually sell, produce and other basic food staples. This market developed in Mexico as a way to regulate pre Hispanic markets called tianguis. These tianguis markets remain in Mexico, with the most traditional held on certain days, put up and taken down the same day, much the way it was done in Mesoamerica.

These fixed mercados can be found in any town of any size in Mexico. Often, they are accompanied one or more days per week by tianguis, which set up around the main building. However, the largest, best developed and most numerous fixed markets are in Mexico City, which has over 300, 80 of which are specialty markets dedicated to one or more classes of merchandise, such as gourmet food, plants, cut flowers, candy etc.

Traditional fixed markets and tianguis
"Lo recorrí por años enteros, de mercado a mercado, porque México está en los mercados". (I went from market to market for years, because Mexico is in its markets.) - Pablo Neruda In every city, town or village in Mexico, there is a traditional market designed to meet basic needs. These can be called by different names. In municipal seats, the main market for the area is called the municipal market. In many areas of Mexico City, "mercados". Most reflect the area's culture and folklore and some are works of art. The municipal president of Tuxtla Gutiérrez, Yassir Vázquez was quoted saying that "Public markets are a live example of our culture" during a meeting of market merchants in the Chiapas capital. The meeting was part of efforts to improve and expand the system of these markets statewide.

These traditional markets are a variation of tianguis, or open air markets, which have been an important part of commerce since pre Hispanic times. The difference is that traditional tianguis are held on specific days, with individual vendors setting up and taking down their stalls on the same day. Like tianguis, traditional fixed markets have stands occupied by various individual merchants, and tend to sell the same kinds of products: produce, groceries and other basic necessities. The difference is that the fixed markets operate every day, and individual stands are rented and occupied in much the same way as a store is. The fixed market has its origin in various attempts to replace tianguis with markets that can be better regulated. However, the tianguis were never replaced. Many tianguis, especially in rural areas, now operate in conjunction with the fixed markets to expand on variety of merchandise available.

In addition to their permanent nature, another important aspect of mercados is that the maintenance and operating costs of the buildings are subsidized by or paid for by the government. Rent, when it is charged, is nominal. Around seventy five percent of these markets are located in middle and lower income neighborhoods. Twenty three percent are located in upper income neighborhoods and two percent in areas considered extremely poor.

The most complete anthropological study of how a Mexican fixed market operates was done by Bronislaw Malinowsky and Julio de la Fuente in the 1930s in the city of Oaxaca. The study focused on how the central market of the city worked with the rural communities of the surrounding area. It determined that, for the most part, the relationship had not changed much since before the Conquest in both its economic and social structure. In many areas, local markets, with the abundance of colors, odors, flavors and meanings, represent a synthesis of culture and history of a region, especially that related to commerce that community has with others, according to Amalia Attolina, ethnohistorian at the INAH. In many areas of the country, these traditional markets still constitute a meeting area and a form of social cohesion. Another indication of the market's cultural continuity is the presence of shrines in almost all traditional markets. In Aztec times, these were to deities such as those related to commerce. Today, most are dedicated to the Virgin Mary or Christ.

Mexico City has the most markets for its size but traditional markets are an important part of economy in most of the country. The State of Mexico has 652 such markets, 64.8% of which are in the eastern half of the state. This traditional form of commerce provides 65% of residents' foodstuffs even though other types of stores such as supermarkets have been growing. The city of Toluca has various markets including 16 de Septiembre, Miguel Hidalgo and Jose María Morelos y Pavón and the largest, the Central de Abasto wholesale food market, the second largest in the country after its equal in Mexico City.

Mexico City has the greatest number and variety of both tianguis and fixed markets. and  important in the supply chain of basic foodstuffs. The city has 317 public markets with 70,000 vendors, and more than 1,000 tianguis along with 314 self-service stores such as supermarkets. The traditional fixed market model has been expanded to the food distribution at the wholesale level, with the Central de Abastos and La Nueva Viga seafood markets  handing foodstuff with an approximate value of 90 billion pesos each year.

These traditional markets have been under pressure since the 20th century by newer forms of retailing, such as supermarkets, chain stores and convenience stores. This is especially true in urban areas, with about eighty percent of all food sales in Mexico City now done in supermarkets and similar outlets. Traditional fixed markets remain most viable in small rural towns, where the social network is strongest and options are limited. The system of a fixed public or municipal market along with a weekly tianguis, is an important part of the economy and food distribution of rural areas. These are how most people in rural areas buy, sell, and sometimes trade to obtain necessities. However, the traditional markets still remain in many of the country's largest cities. One factor in favor of these markets is that the difficulty of getting around by car in the city, increases demand for outlets close to home. Wholesale markets such as the Central de Abastos are most often the source of the products sold in other forms of commerce, such as corner stores. While supermarkets are considered modern and more sanitary, the traditional fixed market still offers better prices. In 2007 and 2008, sales in traditional markets and tianguis rose between 40 and 44 percent, with sales in lower socioeconomic areas rising between 50 and 53 percent. The most likely reason for this is the economic downturn, which forced families to economize.

However, these traditional markets, especially in major cities, face serious problems. In the past thirty years, there has been no new construction of this type of market in Mexico City, and existing ones have fallen into disrepair. While most of these older markets have had upgrades in gas, electric and drainage, as well as fire extinguishers installed, sixty percent are in danger of fire due to faulty electrical wiring. Many have insect and rodent infestations. Many of these markets are in unsafe areas, with drug addicts, alcoholics, and delinquents.

The operation of these markets has also declined. In Mexico City, about 65% of permits that merchants have to operate in these public markets have some sort of irregularity. None of these markets have adequate sanitary measures for meat. Meat and dairy products sold in tianguis and fixed markets are not regulated or inspected according to the Centro Universitario de Ciencias Exactas e Ingenierías (CUCEI). Contaminants such as Salmonella and E. coli have been detected in products tested by this organization. Since 1997, Mexico City authorities have not carried out inspection in businesses selling groceries of any type in the city. Federal authorities only have jurisdiction in the states.

Since these traditional fixed markets are filled with individual vendors, there are some disadvantages. One main disadvantage of the markets is that it is filled with small vendors, who cannot purchase in bulk like supermarkets. Another, is the inability to pay with anything other than cash. Not only are most vendors not able to take debit or credit cards, they also cannot receive a type of tax exempt food coupon called vales, which many workers receive with their regular salary. However, the Mexico City government in 2010 authorized their employees to use their "vales" at fixed public markets as a move to support this traditional retail outlet.

Traditional fixed markets in the city have been steadily losing their client base. One reason for this is that many have moved out of inner cities where these markets are into the suburbs. Over fifty percent of those who do shop at these markets are over the age of thirty five, with younger and more affluent shoppers preferring supermarkets, which are generally cleaner and better maintained. Markets that have had supermarkets or other chain stores open nearby have seen sales drop as much as fifty percent. This has led to the abandonment of many fixed market stalls and about twenty percent of these markets in the Mexico City area have been abandoned altogether. Although still important, the percentage of foodstuffs sold through basic markets has declined to only about twenty percent in Mexico City. Of the 317 markets, 248 offer fresh produce. Many stands have been replaced by those selling prepared foods such as tortas, juices, unlicensed movies and music, and other items.

Similar problems with empty stalls and lack of maintenance can be found in fixed markets from the north, such as in city of Durango where eighty percent of stands are empty and in the south, such as in Mérida, Yucatán where number have been completely abandoned, and for much the same reason, competition from self-service stores and convenience stores.

Major markets in Mexico

These traditional fixed market, whether they are called mercados públicos, mercados municipales or simply mercados, operate essentially the same in the entire country. However, Mexico City has the greatest number and variety of both tianguis and fixed markets. The city has 312 traditional fixed markets with cover an areas of about 60,000 m2.

The city's largest general retail traditional market is La Merced, located just east of the historic center of Mexico City. It was a tianguis for many years, before the federal government decided to build a permanent structure for it in the 19th century. By the mid twentieth century, it was the main wholesale market for the city. However, this market became too small to handle the wholesale volume for the growing city. The wholesale function was then moved to the Central de Abastos in Iztapalapa in 1982. However, La Merced remains the largest and one of the busiest in the city.

The largest market in Mexico City is the Central de Abastos wholesale food market, which is located alongside the La Nueva Viga wholesale seafood market in the southeast of the city. The complex is located on a property that extends , with more than 2,000 businesses that sell principally fruit, vegetables, meat and some processed foods in a main building that covers . The Central de Abastos itself commercializes more than 30,000 tons of food products daily, representing 80% of the consumption of the 20 million people in the Mexico City metropolitan area.

The La Nueva Viga seafood market next door alone handles about sixty percent of all that is consumed in the country of Mexico. This market commercializes 1,500 tons per day and was built in the 1990s to replace the older La Viga Market, although the latter still operates. The next largest market is the Mercado del Mar in Zapopan, Jalisco, which commercializes about ten percent of all the seafood sold in Mexico. The governor of the state of Baja California and the Comision Nacional de Acuacutura y Pesca (Conapesca) is working on a project to open a wholesale seafood market in the state to compete with the La Nueva Viga and Mercado del Mar markets. One reason to put such a market here is that the seas around the Baja California peninsula produces about 75% of the country's seafood.

Mexico City has about eighty specialty markets partially or fully dedicated to one or few classes of items. The San Juan Market in the historic center specialized in gourmet foods such as the best produce and expensive and unusual meats and cheeses. Mercado Jamaica was opened in 1957 on chinampa land along Canal de la Viga. It is best known for the sale of cut flowers and ornamental plants with a large section dedicated to produce. Mercado de Sonora sells dishes, live animals and party items, but it is best known for its sections dedicated to herbal medicines and the occult. La Lagunilla has a building dedicated to furniture and another to clothing. This market is also known for its Sunday antiques market. Other specialty markets include one dedicated to candy in Candelaria and an ornamental plant market in the ecological reserve in Xochimilco.

A number of markets are considered historic places. The Abelardo L. Rodriguez Market is located in the historic center of Mexico City, just northeast of the main plaza, or Zocalo. It was built in 1934 as a prototype for a more modern marketplace and has a number of unusual features such as day care and an auditorium. However, the markets most distinctive feature is the approximately 1,450 square meters of wall and ceiling space covered in murals. These murals were painted by students of Diego Rivera and under his supervision. The works mostly reflect socialist themes, such as the exploitation of workers, peasants and miners, the fight against Nazism and fascism, and racial discrimination. Earthquakes, time, humidity and vandalism took their toll on the murals from the time they were painted. Restoration of the murals began in 2009.

Most markets are located in middle and lower income neighborhoods. One exception is the Michoacán Market, located in one of the more prestigious neighborhoods of Mexico City, Colonia Condesa. It is located between Michoacán, Vicente Suárez and Tamaulipas streets where three colonias (official neighborhoods) intersect. It is the only mercado that provides services three, Colonia Condesa, Colonia Hipódromo and Colonia Hipódromo Condesa. These are residential neighborhoods, with some office buildings. They are considered cosmopolitan, with Art Deco and other architecture from the 1930s and 1940s, along with a number of modern structures. It is an upper income neighborhood although it has had problems associated with urban decay. While the market sells foodstuffs retail, most of its sales are to the many restaurants in the area and nearby. La Paz in the center of Tlalpan has been around for about 110 years. It has 161 stands with everything from food to clothes and some esoteric products.

History of retail markets

Mesoamerican markets

Mexican traditional fixed markets and a number of other business practices have their origin in pre Hispanic or Mesoamerican trade and markets. Archeological evidence has shown that the Olmecs were probably the first culture with a system of trading networks that spread over what is the center of Mexico. Later cultures with vast trading networks include the Teotihuacans and the Maya. Local products as well as those obtained from trading networks were distributed through local markets called "tianguis" (Nahuatl for "market"), generally set up on certain days. Mesoamerican markets were based on the trading of items, with certain very valuable items such as cacao beans serving as currency. This type of market consists of a number of stands set up by vendors, on a plaza, often designed for that purpose. Often these merchants as well as tradesmen and other business were grouped together by product or service. There were also specialized markets in certain products such as salt in Atenantitlan, dogs in Acolman and slaves in Azcapotzalco and Iztocan.

The most active trading routes were along the Mexican Plateau centered on the Valley of Mexico, whose lakes make transportation of goods easier using boats. The largest Mesoamerican trade network and market system was developed by the Aztecs, who brought valuable goods from distant lands such as jade, cotton, cacao, and precious metals. The main plaza of Tenochtitlan, which roughly corresponds with the Zocalo, was the city's main market at first. This became insufficient and after taking over Tlatelolco, the main market for the area was shifted to there, due to its easy access to lake and canal transportation though La Lagunilla, a small cove. The most important markets were located in Tenochtitlan, Tlatelolco, Azcapotzalco and Tacuba. The largest was Tlatelolco followed by Tenochtitlan, where not only commercial activity took place, but political activity as well. The Tlalteloco market drew between 20,000 and 25,000 people each day to buy and sell. Every five days, was "market day", drawing between 40,000 and 45,000 people as there would be a far greater variety of merchandise. These markets sold everything from basic foodstuffs, to slaves, to exotic items from distant lands to precious metals such as gold.

In the past and the present, traditional Mexican markets reflect the local culture both in what they sell and in how they are sold. Many pre Hispanic elements survive to this day, relatively unchanged. A "tianguis" refers to a market of stalls set up for the day by vendors and taken down at night. More traditional tianguis are periodic, usually weekly, but tianguis in cities may be set up and taken down each day. Small businesses and trades can still be found grouped together in certain areas of cities and markets with specialties, such as Mercado de Sonora, still exist. Pre Hispanic markets has altars inside them for the gods, a practiced continued, but with altars usually to the Virgin Mary or Christ. While these practices are still strongest in former Mesoamerican areas, tianguis and other market practices can be found in various parts of the country.

Colonial period and establishment of fixed markets

The Spanish conquest of the Aztec Empire mostly did not change commerce patterns in Mesoamerica. Tenochtitlan, renamed Mexico City, remained the center of the economy, with traders bringing merchandise from all the same regions as before. Markets remained outdoor affairs, with individual temporary stalls set up in plazas. Cacao beans would remain as a form of currency until as late as the beginning of the 19th century. Within the Valley of Mexico, the lakes and canals remained the main way of getting goods, especially agricultural products to market in the city and would remain so until their drainage would make them disappear by the end of the 19th century. One exception was that the great Tlatelolco market never recovered from the conquest and disappeared, replaced by the Mercado de San Juan, which was first located in the area where the Palacio de Bellas Artes is now, and then moved to the main square of the rebuilt city, today called the Zocalo.

The main changes brought to commerce by the Spanish initially was the introduction of the wheel, which expanded trade routes and the variety of products regional markets could offer, the introduction of coins and the introduction of crops, animals and other merchandise from Europe. The last made the biggest impact. As early as 1541, indigenous peoples were growing, selling and consuming crops such as radishes, lettuce, pomegranates, peaches, quince, apples and figs. Many craft technologies, such as glazed pottery were also produced and sold; however, the most prized items in colonial markets would be manufactured items from Spain. Another change was the introduction of new agricultural techniques, which diminished the amount of human labor needed. This would create an indigenous and mestizo class of tradesmen in carpentry, pottery, canoe making, locksmithing, ironworkers and much more. As in the markets of old, these new craftsmen would group together into certain sections of town. Carpenters, locksmiths and ironworkers were found on Tacuba Street, sheepskins were prepared and sold in La Palma neighborhood, tanners in San Hipólito and San Sebastián and potters were found on Santa María street. However, not all businesses grouped together. Tailors, bacon makers, shoemakers, bricklayers, bakers and bars selling pulque tended to disperse.

What are now the traditional public retail markets found in Mexico were the result of efforts to regulate and replace tianguis with more modern forms of commerce. The first regulatory step came in 1580, when grain producers were prohibited from selling directly to the market. Instead, they were required to sell to the colonial government, which then stored the grains in large warehouses called pósitos or alhóndigas to sell to the general market.

The establishment of the Zocalo as the main market square meant that commercial development in Mexico would begin here and then spread outward to the rest of the territory. This also meant that the square would be a crowded, chaotic mass of stalls, with various attempts to clear it over the colonial period, with little long-term success. This is because despite all the attempts by civil and religious authorities to control the markets, the indigenous market never disappeared. By the end of the 16th century, a number of indigenous markets were permitted to set up, so that these people could sell their own products, especially in areas then far outside Mexico City such as Tacubaya.  Eventually, they began to sell in the main plaza in Mexico City, weekly at first, then daily.

Attempts to regulate the tianguis commerce in the Zocalo led to the establishment of several formal markets. However, these markets would never eliminate tianguis commerce in the plaza. The first formal market was the El Parían in 1703, after a major fire in the city. It was originally established as a common market, with all of the Zocalo's vendors inside. However, the building was not large enough, and the structure's space requirements pushed remaining outside vendors into the areas belonging to the cathedral and government building. This market then became space for the various guilds of the city to market their wares. By the end of the 18th century, it would become the market for the upper Spanish and Criollo classes, selling imported merchandise such as that brought be the Manila Galleon. This was the market's height. After this time, it would slowly decay until it was demolished in 1843.

With the upscaling of the El Parián market, vendors selling to commoners were pushed into two other markets, El Baratillo and El Volador. The El Baratillo was established in 1793, initially with the name of Cruz del Factor. It was on the Zocalo as well, and specialized in handcrafts, secondhand items and food to the lower classes. It was also known for the sale of stolen merchandise as well. Over time, this market would draw thieves and other delinquents and have a reputation for being dangerous. This market would eventually be moved to an area now called Tepito. The first market established off the Zocalo was the El Volador at the end of the 18th century where the Supreme Court of Mexico is now. It was the first market run similarly to traditional retail markets of today, and became the main market for the city after the El Parián and El Baratillo disappeared.

As the colonial period continued, more fixed markets and more regulated tianguis were established outside the Zocalo, including Santa Catarina and La Lagunilla. The Zocalo itself would have several commerce centers. These would include the Portales de Mercaderes, the Portales las Flores and Portales la Diputacion, stores affixed to several of the main buildings surrounding the Zocalo. However, the Zocalo would remain filled with vendors until the 20th century. At the end of the colonial era, markets and tianguis in the city were grouped into three categories. One corresponded to the area in and around the Zocalo. The second most important group of markets was on the periphery of the first group. There were groups of fixed stands made of wood in places such as the plazas of Santa Catarina Mártir, La Cruz del Factor and Las Vizcaínas. The third group consisted on non permanent stands even further away from the center of the city. These included the tianguis of Jesús, La Cal, Santa Ana, Carbonero, Mixcalco and others. During the last century of colonial rule, "estanco" or government monopolies were established on the production and commercialization of certain products, such as tobacco, gunpowder, playing cards, cured hides, salt, mercury and ice (which was brought by mule cart from the Iztaccíhuatl and Popocatépetl volcanos).

Traditional market practices for Mexico were established and best developed in Mexico City. After the Conquest, other areas in Mesoamerica continued their traditional commerce patterns, with Spanish authorities then regulating them and building fixed structures. In areas outside of Mesoamerica, such as Jalisco, there was no major pre Hispanic market system, so that of Mexico City would be transplanted in the new areas. Guadalajara's market history began on the plaza of the Teatro Degollado when the city's general market was established in 1606, following the Mesoamerican tradition of "market day" every five days as a tianguis. After a fire in 1795, covered vending stalls called "portales" were built of adobe and stone for the market. Later a "Parián" market, much like the one in Mexico City was established, with the portales demolished in 1855. Like in Mexico City, the various markets and merchants were often segregated by district, with soap producers in Zacoalco, boot makers in Sayula, chairs and tapestries in Atoyac and cheese in Tizapán. Following Mexico City, merchants adopted the fixed market system to make themselves more visible to the public. Modern markets were built in the city in the late 19th and early 20th centuries including Mercado Corona in 1891, Mercado Libertad or San Juan de Dios in 1896, Mercado Alcalde in 1897, Mercado Mexicaltzingo in 1900 and Mercado Sebastián Allende in 1905. Some others were built later, such as Mercado Zalatitlan in 1920 and Mercado IV Centenario in 1941. However, this city would abandon the traditional market model fairly early in favor of supermarkets and chain stores. New such markets were not constructed again until the 1960s, and then only in new neighborhoods created by the growth of the metropolitan area.

Independence to the present
After the end of the Mexican War of Independence in 1821, the markets initially had momentum as restrictions against imports were lifted and other measures to free the market had a positive effect. However, for much of the 19th century, the country's political instability would hamper market development and food distribution, with most remaining sold in small tianguis with large, formal markets only in the largest cities. The economic situation began to stabilize in the latter 19th century, especially the last decades under the Porfirio Díaz regime. This government took steps to begin to regulate and modernize the food distribution system by establishing official monopolies called tendajones or estanquillos.

In 1844, a new building was constructed for the El Volador market. The market would be destroyed and terminated by fire in 1870. A number of major markets in Mexico City were either established or formalized during this time. In 1850, the new Mercado de San Juan, also called Iturbide, was inaugurated. The first permanent structure now known as La Merced was constructed between 1861 and 1880. This structure was built to house much of the commercial activity in the area, as well as absorb the vendors of El Volador, which had closed. At this time, the area was still along a major canal called La Viga, filled with docks to receive incoming merchandise to the city from Xochimilco, Chalco and Texcoco. By 1887, there were nine main markets in the capital. In the north, there were the Santa Catarina, Santa Ana and Guerrero markets; in the south, the Mercado de San Juan; in the east La Merced and San Lucas and in the west Dos de Abril and San Cosme. By the end of the century, these were joined by the La Lagunilla market in 1893, the Loreto Market in 1889, and Martínez de la Torre in 1895. At this time as well, more modern forms of commerce would begin to appear in Mexico, such as the establishment of department stores, led by Liverpool and Palacio de Hierro, which still exist.

Mercado Juárez was opened in 1912, the last major market to open before the Mexican Revolution brought market development to a halt. The war disrupted food production and distribution with the abandonment of haciendas, lack of manpower in the agricultural sector and the disruption of transportation systems. With the exception of the Abelardo L. Rodríguez market in 1934, there were no new markets constructed in Mexico City, other than small ones for newly established neighborhoods in the growing city. Outside of Mexico City, formal markets were still be introduced to replace older tianguis. The installation of fixed structures to replace tianguis did not always go well. In Xalapa, Veracruz a new, modern and at the time, spacious market was built and promoted in the 1940s to replace the weekly market at the Plazuela del Carbón. However, at first no one would go and shop there, making it a distinct failure. It took fifteen years of efforts to make the market accepted and profitable.

In the 1950s, the government began to replace a number of markets, which were stalls made of wood and lamínate, with modern buildings. During the presidency of Adolfo López Mateos (1958-1964) eighty eight markets were constructed in Mexico City. Mercados sobre ruedas (markets on wheels) was a concept implemented in 1969, to give agricultural producers a means to sell directly to consumers. The idea was that an association of producers could seek permission to sell their produce in a particular spot on a particular day of the week. However, many of these associations became dominated by intermediaries rather than by the farmers themselves, as the producers could not spend many days selling their merchandise. Today, "mercados sobre ruedas" is used to refer to informal street vendors who sell in large groups but generally can be found every day in the same location, rather than on market days, such as tianguis. According to INEGI, about 23 percent of the population earns money in the informal economy, with includes the mercados sobre ruedas and tianguis.

During the rest of the 20th century, commercialization patterns for food and other staples were strongly influenced by the United States, with the introduction of concepts such as supermarkets and convenience stores. The current retail situation in Mexican cities varies widely. On one end, there are a myriad of small corner stores (called mesceláneas, expendios de abarrotes or tienditas) and on the other are major supermarket and department chains such as Comercial Mexicana, Walmart, Liverpool and others. These types of markets now account for eighty percent of food sales in Mexico City. The appearance of supermarkets has diminished the sales in many markets. For example, sales at the market in Colonia Industrial were cut by half when a supermarket opened nearby in 2009. Although mercados usually have better prices and fresher produce, the rundown conditions of many is one factor why many consumers prefer supermarkets.

References

Retail markets in Mexico


It's a frightful beginning, is it not? I had many plans of grand adventure on this Saturday, out and about, scurrying to checkmark my to-do lists.
But the whole summer has gone by without my wooden flagpole hanging off the deck. When one of the fasteners released the bottom end of the flag, I took the whole pole inside, wishing to decorate it with designs and generally flowering it up a bit. Why today? Partially due to the sadness of the coming memorial day; partially because I have been thinking about the creative process and maybe even a bit of the privacy of it.
With each day, I marvel at the peace. My son even remarked at the absence of conflict and strife during one of those conversations which parents flip to have with their children. Or, really it is those types of conversations which anyone wants to have with another human being in which it feels like you talk through your whole world in a matter of minutes that stretch to hours. It is the talk of comfort and understanding with ones philosophy and beliefs, mixed with laughter and a few tears. It is one of those invaluable conversations in which the world around you feels all right. (And as a parent, you want to savor every loving morsel, talk even more all the while with a secret dread that you do not wish to say the wrong thing.. My secret mom prayer: Please G~d, guide me so I don't muck this up!) Yet, in those kind of conversations, a person's heart knows that there is never any wrong thing to say.
It was one of those conversations you have side-by-side with another human being. Oh, the face-to-face ones are grand as well, but the side-by-side ones? Well, it is as if for one precious life's moment, two paths are not joined together, but they are actually journeying, if only for a bit, together, in the same direction.
In these days of peace, I told my son as well, that a person's motivation changes. It should not seem so difficult to live ones life, as gentle as usual, but not in response to crisis, fear, hostility or anything negative. What happens when ones life becomes a manifestation of ones own heart? That should not seem so different. A gentle heart, made stronger and wiser by the turns of life, is now learning how to express itself, how to maintain, and how to navigate in this new world.
I haven't worked with tools or wood really since last fall when I was hurrying to block the windows at the building. Four southern exposure, second story windows, each approximately 100 inches by 120 inches needed to be boarded in preparation for the coming Wisconsin winter. So I climbed ladders, teetered in front of open, second story spaces to construct frames that were both strong enough to withstand the outside gusts of wind and strong enough to carry the weight of the wood necessary to cover the openings; yet, were also light enough that I could handle them alone.
And I did it. It wasn't pretty. It wasn't "This Old House" perfect. But I learned of saws and hammers and drills. At least as much as I could handle at the time.
Today, with the memorial of tomorrow's happenings, I wanted to work on the flagpole. I knew it would never be as I imagined it, but I started. I started a project for me. I know how silly and pathetic the story is, but for me, I am unsure that I even realize how large a step it was. I grabbed my sandpaper to smooth the weathered wood. (Equally important – I returned it to my workbench!) I began to color it with markers because honestly, I knew I had enough 'umpf' in me for the project, but I was not confident I would actually clean any brushes.
I began. I began. I began!
Hours later I have a flagpole with poppies, Blackeyed Susans, vines and all sorts of symbols of my choosing; completed, then hung back in its spot by my son.
In many ways the whole day reminds me, again of my 'knee lessons'. I remember how walking and running sideways made my legs stronger to move forward….


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Ask the expert: Children's lunchboxes
Infants and pre-school children
Ask the expert: Children's lunchboxes
By Ellen Hoggard, writer at Nutritionist Resource
Published on August 30th, 2016
Making a healthy lunchbox for your child isn't always easy and it's even more difficult when they refuse to eat certain foods. We ask Nutritionist Resource member and children's dietitian, Angharad Banner, to share her thoughts.
As an experienced children's dietitian, what would you suggest parents could add to their child's lunchbox as a 'sweet treat'?
"Variety is key to keep it exciting (as they tend to want chocolate!). Flapjacks, fruit muffins, currant buns or tea cakes, Welsh cakes, plain or fruit-based cakes, scones and pancakes are all good options if eaten in moderation.
Flavoured rice cakes, cereal bars, dried fruit such as raisins, mango or apple are also good choices. You could also try adding a small bag of plain popcorn or dried fruit crisps for a bit of a crunch."
Many parents will lean towards crisps as the savoury snack portion of the lunchbox, what other foods could be included?
"I tend to talk about 'better' crisp options, such as small (under 100 Kcal/bag) bags, such as French Fries, Hula Hoops, Quavers or prawn crackers, though these should not feature every day. Alternatives could be mini breadsticks with cheese spread or dips, cheese and crackers, mini pitta strips and dips, cheese sticks, Mini Cheddars and Twiglets."
We tend to stick to habit, for example, the main part of lunch may be a ham or cheese sandwich with white bread. What alternatives would you suggest to encourage variety?
"Choose different types of bread and rolls, including wraps and pitta bread. Use shaped cookie cutters for sandwiches. Alternatives to bread include quiche, sausage rolls, vegetable frittata and vegetable muffins."
What do you find are the most common problems parents come to your for?
"As a dietitian, I see a whole range of clinical conditions, ranging from allergies and weaning, to fussy eating and eating disorders. Many clients simply want to know their children's intake is appropriate and balanced, providing the necessary nutrients for growth and development."
We see you're an ambassador for Jamie Oliver's Food Revolution, how do you think schools can help parents better understand children's nutrition? Do you think more needs to be done?
"I've been very happy to go into my local school on a number of occasions to run workshops and assemblies on a voluntary basis as both a paediatric dietitian and a Jamie Oliver Ambassador, as I am also passionate about increasing awareness of and improving childhood nutrition.
Schools could make use of and signpost free online nutritional advice, such as Change4Life and the downloadable fact-sheets produced by the British Dietetic Association."
Angharad's tips
If they insist on chocolate, focus on little treats. Instead of a regular bar, consider portion size and buy the 'fun size' bars.
Blueberries are a good alternative for sugary sweets as they are sweet, colourful and a source of vitamin C.
Instead of soft drinks, encourage water. To make it more exciting, add a coloured straw.
To reach more of your child's five-a-day, make a homemade fruit smoothie using a maximum of two portions of fruit. Try to limit these to once or twice a week as they are high in natural fruit sugars.
For a fun twist, make your own pizza using English muffins topped with sliced tomato and grated cheese – these are great for the kids to do themselves!
Infants and pre-school children Digestive problems Diarrhoea Crohn's disease Balanced diet
Written by Ellen Hoggard
Ellen is the Content Manager for Memiah and writer for Nutritionist Resource and Happiful magazine.
Search for a nutritionist that can help with Infants And Pre-school Children
Starting your child on solid foods
Congratulations on the safe arrival of your baby. You have made it through the newborn stage, witnessed the first...
Aliya Porter
What is a healthy gut microbiome and how do I get one?
Firstly, you may be asking what is a microbiome? Let us start by removing the jargon. Simply put, our gut...
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We see 'no refined sugar' frequently boasted about on the packets of our favourite 'healthy' food products, but...
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redpajama_set_name: RedPajamaCommonCrawl


text:
/*
 * Licensed under the Apache License, Version 2.0 (the "License");
 * you may not use this file except in compliance with the License.
 * You may obtain a copy of the License at
 *
 *      http://www.apache.org/licenses/LICENSE-2.0
 *
 * Unless required by applicable law or agreed to in writing, software
 * distributed under the License is distributed on an "AS IS" BASIS,
 * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
 * See the License for the specific language governing permissions and
 * limitations under the License.
 */
package org.onosproject.provider.snmp.alarm.impl;

import com.btisystems.pronx.ems.core.snmp.ISnmpSession;
import java.util.Collection;
import org.onosproject.incubator.net.faultmanagement.alarm.Alarm;
import org.onosproject.net.DeviceId;

/**
 * @deprecated 1.5.0 Falcon, not compliant with ONOS SB and driver architecture.
 */
@Deprecated
public interface SnmpDeviceAlarmProvider {
    /**
     * Implemented by device specific implementations which query the current
     * alarms from a device.
     * @deprecated 1.5.0 Falcon
     * @param snmpSession SNMP Session
     * @param deviceId device identifier
     * @return device alarms
     */
    @Deprecated
    Collection<Alarm> getAlarms(ISnmpSession snmpSession, DeviceId deviceId);
}

redpajama_set_name: RedPajamaGithub


Home Columns Will good farms pass the baton?
Will good farms pass the baton?
Last week, a busload of Pennsylvania farmers visited three dairy farms in eastern Ohio as part of a dairy profitability tour. I caught up with the group when it stopped at Jack and Susie Lora's farm just outside of Salem.
The group also toured Paradise Valley Farms, home of the Paul Ramsey family, in Louisville, and the Jersey farm of Bill and Debbie Grammer near Sebring.
Many faces of farming. The stops spotlighted the diversity of family farming. The Loras milk around 40 head of registered Holsteins in a tie-stall barn. There's no off-farm income and Jack and Susie handle all the work, helped by their college-age daughter, Katey.
Paradise Valley, on the other hand, supports multiple households within the family, and milks nearly 400 head of Holsteins three times a day. The farm is well-known in Holstein circles for its breeding success: It currently has 15 bulls being sampled by A.I. studs.
Grammer Dairy is home to Bill and Debbie Grammer and their two young sons. The Grammers recently expanded their facilities and are milking 500 head of registered Jerseys.
Three dairies, three families, three different faces of today's well-managed, profitable farms.
I'm often asked about the future of farming. My powers of prediction are no stronger than yours, but I'm buoyed by families like these three – families who recognize their strengths, and build on them.
Tomorrow's farmer. The 2002 U.S. Ag Census was the first census to track who's involved in farm decision-making, the first to identify not only principal farm operators, but additional operators and multiple generations.
For the first time, USDA estimated the number of all farmers, not just an operation's principal farmer.
The average age – 55.3 – of all U.S. principal farm operators increased more than one year since the last ag census in 1997. But the good news is that the average ages of second and third operators were lower, and the percentages of operators under 35 were higher.
Who will take over? To throw just a couple more numbers your way: Only 5.8 percent of principal operators are under 35, but 11.8 percent of second operators and 35.7 percent of third operators are under 35.
You could say on more than a third of U.S. farms, Dad is still the primary operator; Mom is the second operator and their son or daughter is operator No. 3. There are younger producers waiting in the wings of many farms.
The data aren't all rosy. Less than 10 percent of farms reported operators from different generations working on the same farm. There are many more farms where there aren't younger producers waiting in the wings.
I read earlier this month that 70 percent of farmland will be transferred in the next 15 years. The issue of farm ownership transition should be a hot topic for farm groups – and stronger efforts to link older and younger farmers should be made.
We need to know there will be a Lora or Ramsey or Grammer – no matter what the last name – waiting to host that next bus tour of farmers who want to visit some of the best.


How to obtain copies of Northern Mariana Islands vital records, such as Northern Mariana Islands birth certificates, Northern Mariana Islands death records, Northern Mariana Islands marriage licenses & Northern Mariana Islands divorce decrees. See the guidelines for general information on how to order vital records. Check the related links for additional vital records and genealogical information on Northern Mariana Islands.
Make bank cashier's check or money order payable to CNMI Treasurer.


text:
Ksenija Starinac
Iron Deficiency Anemia in Children
By Jelena Roganović and Ksenija Starinac
Iron deficiency and iron deficiency anemia remain a major and global public health problem that affects particularly infants, young children, and women of childbearing age in developing countries. The prevalence of iron deficiency anemia is still common in industrialized countries despite efforts to improve public awareness and strengthen programs for the prevention and control of iron deficiency. The most common risk factors for iron deficiency in early childhood are rapid growth, perinatal risk factors, poor dietary intake, and gastrointestinal blood loss due to excessive consumption of cow's milk. Iron deficiency and iron deficiency anemia cause a wide variety of symptoms and changes in many different tissues. The most concerning consequences of iron deficiency in children are the alterations of cognitive, motor, and behavioral performance. Persistent neurocognitive changes despite iron repletion have increased the importance of prevention and early detection of iron deficiency. The main principles of treatment include investigation and elimination of the underlying cause, iron supplementation, improvement of nutrition, and education of the patient and family. Oral iron supplements are desirable as first-line therapy. Follow-up is very important to confirm the diagnosis and to ensure that anemia is adequately treated.
Part of the book: Current Topics in Anemia
Ana Isabel Lopes
Yuriy Milovanov
Regilda Moreira-Araújo
Universidade Federal do Piauí, Brazil
Ines Banjari I.
Hong Yan
Xi'an Jiaotong University, China
Lingxia Zeng
Leilei Pei
Chao Li
Marina Taranova
Sara Azevedo


text:
John Bidlake (1755 – 17 February 1814) was an English author, artist and educator.

Biography
Bidlake was born in Plymouth, the son of a jeweler, and educated at Christ Church, Oxford, where he received his B.A., M.A., and D.D.

In the last decade of the 18th century until his death Bidlake was the Headmaster of Plymouth Grammar School where he taught both Samuel Prout and Benjamin Haydon. Among his other protégés were artist Charles Lock Eastlake, Philip Hutchins Rogers, a marine and landscape artist who later exhibited
at the Royal Academy; and Nathaniel Howard, a charity boy who became "an elegant classical scholar, ... a translator of Dante into blank verse," and a Persian scholar of note. Bidlake has been described as "a man of strict religious principles, but not intolerant." He was rather different from the average schoolmaster of the period. As well he was "a little deformed man," whose "back was
bent from fever".

Bidlake was curate of Plymouth's Stonehouse Chapel, now St George's Church, from 1785 to 1812. He also held the position of Common Chaplain to the Prince of Wales (later to become George III) and the Duke of Clarence (later to become William IV).

In 1811 Bidlake gave the Bampton Lecture delivered at St Mary's Church, Oxford and titled The Truth And Consistency Of Divine Revelation, With Some Remarks On The Contrary Extremes Of Infidelity And Enthusiasm: In Eight Discourses. Unfortunately, during this lecture he suffered a stroke as a result of which he lost his eyesight. The Lecture was later to be published as a book in an effort to raise funds for his welfare;

"The Rev. Dr. Bidlake, appointed to read the Bampton Lecture, during the delivery of the third discourse was seized with an affliction of the head, which terminated in blindness. He is without any preferment, and has been obliged to give up the Curacy of Stonehouse, Devon, from which the principal part of his income was derived. It has been proposed to print a new edition of his Bampton Lectures, and the book will be ready for delivery in the course of a few months. In the meantime, Dr. Bidlake's health has been much impaired; and it has pleased God to fill up the measure of his distress by an attack of Paralysis, which his recently seized him. Under these circuinstances his demand for immediate assistance and support is become more urgent; and those persons who have expressed an intention of subscribing to the Work, and who have not yet paid their Subscription, are requested, if they think proper, to advance the same., for the benevolent purpose abovementioned. The attention of others is solicited to this distressful case; and those who feel disposed to assist a Clergyman who is the author of many useful Publications, and who is known to his immediate neighbours by a conscientious discharge of his Parochial duties, are requested to make their Donations to Messrs. Rivington, booksellers, St. Paul's Church-yard; Mr. Rees, bookseller, Pall-mall; or to Mr. Hatchard, bookseller, Piccadilly, it is proposed, in the first place, to relieve the immediate pressure occasioned by this uncommon calamity; and then to apply the remainder of the money subscribed, to the purchase of an annuity, to insure to Dr. Bidlake a comfortable maintenance for the rest of his life. A numerous and respectable List of Subscribers may be seen at either of the 'above places' If any Gentleman wishes to obtain farther information of this case, or of the character of Dr. Bidlake, he is referred to Dr. Cole, the Vice-Chancellor of Oxford."

Publications
Bidlake's published works included seven volumes of poetry, a number of sermons and "discourses" a five-act tragedy in verse, a "moral tale," and an introduction to the study of geography.
 1786 Sunday schools, recommended. A sermon, preached at the chapel in Stonehouse. P.F. Maurice; R. Trewman, Exeter.
 1788 Elegy written on the author's revisiting the place of his former residence Law, Foulder & Deighton, London.
 1789 Slave-trade: A sermon Law, Faulder, Lowndes, and Deighton, London; Trewman, Exeter; and Goadby, Sherborne.
 1790 A sermon, preached before the Society of Free and Accepted Masons Haydon, Plymouth
 1794 The poetical works of J. Bidlake Murray & Harding, London
 1795 Sermons, on various subjects Published by T. Chapman (London)
 1796 The Sea, a poem in two books Published by T. Chapman (London)
 1797 The country parson, a poem. Published by T. Cadell Jr. & W. Davies, (London)
 1799 Eugenio, or, The precepts of Prudentius: a moral tale T. Chapman, 151 Fleet St London
 1800 The summer's eve: a poem R. Bliss, Oxford
 1802 A Sermon and An Oration John Murray, Fleet St. London.
 1802 Youth, a poem Messrs. Murray and Highley, London.
 1803 Sermons on Various Subjects John Murray, 32 Fleet St. London.
 1804 Virginia; or the Fall of the Decemvirs: a Tragedy John Murray, Fleet St. London.
 1813 The Truth And Consistency Of Divine Revelation, With Some Remarks On The Contrary Extremes Of Infidelity And Enthusiasm: In Eight Discourses published by Richard Rees of Pall Mall. Republished by Kessinger May 2009.

References

1755 births
1814 deaths
English male poets
Alumni of Christ Church, Oxford

redpajama_set_name: RedPajamaWikipedia


Every now and then a game changes a genre for the better. Well this is one of those situations. Instead of being given emojis to guess a word, you are given words and need to choose the emojis! Fun! It is lots of fun, and is great for all ages. If you get stuck, then find your answers here! We have sorted them by the starting letter of the word!


text:
Home > Persons > Mateusz Kijowski charged with fraud
Mateusz Kijowski charged with fraud
Poland's prosecutors said Wednesday they have charged the former leader of a massive anti-government movement with misappropriation of the movement's funds and false statements in its financial documents, according to the ABC News report.
Mateusz Kijowski, the former head of the Committee for the Defense of Democracy, or KOD, and the movement's former treasurer were questioned by prosecutors in Swidnica, in the southwest.
The movement, which accuses the government of anti-democratic policies, has led massive street protests across Poland but its power seems to be waning, partly due to the investigation into payments for Kijowski.
Spokesman for the prosecutors, Tomasz Orepuk, said the charges against Kijowski include wrongly invoicing KOD in 2016 and being paid some 121,000 zlotys (29,000 euros, $33,000) for IT services he did not provide. Payment of another 15,000 zlotys was blocked by other KOD board members. Moreover, the money came from the movement's public collection "For democracy" and the payment to Kijowski was in violation of the collection's goal, Orepuk said.
Conviction on the charges, which were also lodged against the former treasurer, identified only at Piotr C., carries a maximum penalty of eight years in prison.
After being questioned, Kijowski told reporters he did not confess to any wrongdoing and insisted that all of the movement's financial decisions were taken collectively, in line with its rules.
"I have committed no crime," Kijowski said.
Last month, the movement voted in a new leader to replace Kijowski, who did not seek re-election.


Isaac and Morgan Schaefer of Magnet welcomed home a son, Carter Ray, born 10:49 a.m. on Dec. 28, 2017, at Perry County Memorial Hospital. Carter weighed 5 pounds, 6 ounces, and was 19 inches long.
Maternal grandparents are Brad and Sandra Hammack of Tell City. Paternal grandparents are Cathy and the late Raymond Schaefer of Tell City.
Great-grandparents are the late Luke and Vivian Kellems; the late Ferd and Francis Hammack; the late Janette and Carroll Hearst; and the late Genevieve and Raymond Schaefer.
John was welcomed home by his brothers: James, 8, Finn, 7, and Liam, 5, and sisters, Keeley, 3, and Grace, 1.
Maternal grandparents are Jackie and Will Henrickson of New London, Conn. Paternal grandparents are Bill and Jennifer Pagragan of Richland.
Maternal grandparents are Marvin and Carol (Ubelhor) Troesch of St. Meinrad. Paternal grandparents are Tom and Danielle (Bosjolie) George of Santa Claus.
Joshua and Alessandra Graham of Manhattan, Kan., welcomed home a daughter, Ilse Viktoria Graham, born at 4:29 p.m. Nov. 10, 2017, at Via Christi Hospital in Manhattan. Ilse weighed 6 pounds 7 ounces and was 19 inches long.
Maternal Grandparents are Rick and Rita Aders of Bristow. Paternal grandparents are Robert Graham of Spring Creek, Pa. Great-grandmother is Beverly Hubert.
The mother is the former Alessandra Aders.
Lindsey and Kurt Rottet of Ferdinand announce the birth of a son, Marshall James Rottet, on Nov. 29, 2017. He weighed 7 pounds, 11 ounces, and was 19 inches long.
Marshall was welcomed home by a brother, Abraham Rottet.
Grandparents are John and Stacey LaGrange of Santa Claus and Terry and Patty Rottet of West Baden.
Great-grandparents are Brenda and Carroll Ray Goffinet of Tell City, Ann LaGrange of Mariah Hill and Shirley Rottet of Jasper.
Kevin and Lauren (Smith) Foley announce the arrival of a daughter, Abigail Paige Foley, born Sept. 3, 2017, at Indiana University Health North in Carmel. She weighed 7 pounds, 15 ounces and was 21 inches long.
Abigail was welcomed home by siblings, Elizabeth Grace, 3, and Gabriel Patrick, 2. The family resides in Whitestown.
Grandparents are Dean and Theresa Smith of Jasper and Rick and Theresa Foley of Chandler. Great-grandparents are Joe and Judy Hagedorn of Tell City, Charlotte Smith of Bristow and Ellie Foley of Newburgh.
Landon and Megan (Culbertson) Hoppes of Evansville welcomed home a daughter, Emery Marie Hoppes, born on at 1:08 a.m. Dec. 5, 2017, at Deaconess Women's Hospital. She weighed 7 pounds, 6 ounces and was 20 inches long.
Emery has a big brother, Griffin Orlando Hoppes.
Grandparents are Keith and Cindy Culbertson of Bristow and Roger and Michelle Hoppes of Anderson. Great-grandparents are Shirley Van Winkle of Bristow and Jack and Connie Juday of Anderson.
Great-great grandmother Betty Hudson of Bristow.
Erin and Zach Toothman of Plainfield welcome the addition of their first child, a daughter, Jane Evelyn Toothman. She was born at 1:16 a.m. Nov. 4, 2017, at Indiana University Health North Hospital in Carmel.
Jane weighed 6 pounds, 12 ounces and was 20 1/2 inches long.
Maternal grandparents are Mark and Mary Jo Vickery of Plainfield. Paternal grandparents are Beth Foutz of Owensboro, Ky., and Jim Toothman of Tell City.
Morgan and Natalie Labhart of Newburgh welcome home a son, Clark Wayne Labhart, who was born Oct. 1, 2017, at Deaconess Women's Hospital. He weighed 8 pounds 10 ounces and was 21 1/4 inches long.
Maternal grandparents are the late Kathleen and Paul Clark of Newburgh. Paternal grandparents are Kenneth and Betty Labhart of Rono.
The mother is the former Natalie Clark.
Jack and Tara Briggeman of Columbus, Ohio, announce the birth of a son, Carson Wayne Briggeman, on June 5, 2017. He was born at Ohio State University Hospital, weighing 7 pounds 10 ounces and was 19 1/2 inches long.
Grandparents are Bill and Vicki Gebhard and Harry and Kim Hawkins, all of Tell City. Great grandparents are Charles "Junie" and Geraldine "Gerry" George of Tell City and the late Chester and Helen Gebhard, the late Glenward "Jack" and Maureen Briggeman and the late James and Delores Hawkins.


text:
British firms promise to compensate for slavery links
20 June 2020 | 12:38 pm
Two British companies with historical links to the slave trade have pledged to invest in projects supporting black and other minority ethnic communities. Lloyds and Greene King were listed on a slavery legacy database.
British companies
Outrage against Libya slave trade
There has been a global outrage against the slave trade in Libya after a CNN report exposed the evil act a few days back. The International Organization for Migration has confirmed that Africans trying to reach Europe were being sold by their captors in "slave markets" in Libya.
Here's what you probably did not know about Libya slave trade
After a global outcry of the slave trade in Libya, the Federal Government and the organization for migration, funded by the European Union has begun the evacuation of Nigerian migrants from the North African country to Nigeria.
Libya Slave Trade: Charly Boy leads protest to Foreign Affairs ministry in handcuffs
Veteran musician Charles Oputa, aka Charly Boy, on Monday, led a protest against the reported slave trade going on in Libya, where Nigerians are said to be among the thousands of victims.
East Africa's forgotten slave trade
Over several centuries countless East Africans were sold as slaves by Muslim Arabs to the Middle East and other places via the Sahara desert and Indian Ocean. Experts say it is time for this to be discussed more openly.
Benin looks back on its links to the slave trade
DR Congo and Madagascar mark six decades of independence from former colonial powers. The legacy of the damaging years of European colonialism continues to weigh heavily on the development of the African nations. Also, Benin commemorates those in its history who passed through its cities as they were sold into slavery. And Somalia celebrates its 60th year of independence from Italy by reopening long-closed cultural sites like its national theatre in Mogadishu.
Portugal confronts its role in the trans-Atlantic slave trade
As the world marks the International Day of Remembrance of the Victims of Slavery, more and more Portuguese with African roots are calling for a critical reappraisal of this dark chapter in history.


text:
Sen. Cruz Wins Re-election After Strong Challenge From O'Rourke
KUT 90.5 | By Ashley Lopez
Published November 6, 2018 at 2:04 PM CST
Julia Reihs
Sen. Ted Cruz thanks supporters at an election night watch party in Houston after winning re-election.
Republican Sen. Ted Cruz has won re-election in Texas, fending off a tough challenge from Democrat Beto O'Rourke.
"Texas came together behind a common-sense agenda of low taxes, low regulation and lots and lots of jobs," Cruz told supporters at an election night watch party in Houston. "[It was about] securing the border and keeping our communities safe, defending the Constitution and the Bill of Rights."
PHOTOS | Scenes From The Cruz And O'Rourke Election Night Watch Parties
In El Paso, on the other side of the state, O'Rourke told supporters he had called Cruz to congratulate him and offered to work with him to move Texas forward.
LISTEN| An Analysis Of Cruz's Senate Win In Texas
"Tonight's loss does nothing to diminish the way I feel about Texas or this country," he said.
Credit Gabriel C. Pérez / KUT
U.S. Congressman Beto O'Rourke addresses supporters at the Southwest University Park in El Paso after conceding the Senate race to incumbent Ted Cruz.
The U.S. Senate race in Texas was one of the most closely watched and expensive races in the country. In total, Cruz and O'Rourke raised more than $100 million. For the last few months of the campaign, O'Rourke routinely outraised Cruz as momentum for the El Paso congressman grew and the race tightened.
Cruz, who was first elected to the U.S. Senate in 2012, has been a prominent, if not contentious, figure in the Republican Party. Early on in his term, he led the Republican effort to shut down the government in 2013, in a move to defund the Affordable Care Act, also known as Obamacare.
RELATED | It's Election Day. Here's What You Need To Know To Vote Today.
In 2016, Cruz ran for president in a crowded GOP primary. He and President Trump routinely sparred, and Cruz famously did not endorse the president during his nominating convention.
Throughout the campaign, Cruz has assured voters that Texas is and will remain a conservative stronghold, frequently dismissing O'Rourke's media attention as hype.
However, O'Rourke ran his campaign with the assumption that pollsters and political operatives have been wrong about Texas. The state has historically had some of the lowest voter participation in the nation, and his campaign focused on getting a large swath of those non-voters – namely young people of color – to vote. O'Rourke argued that would help a Democrat win statewide.
The last time a Democrat won a statewide election in Texas was 1994. It's been one of the longest of stretches of Democrats being shut out of statewide office in any state in the country.
Austin 2018 ElectionsTed CruzBeto O'Rourke
Ashley Lopez
Ashley Lopez covers politics and health care. Got a tip? Email her at alopez@kut.org. Follow her on Twitter @AshLopezRadio.
See stories by Ashley Lopez
More than 100,000 Austin Energy customers are without power as a winter storm hits Central Texas
Commentary: 'Abolitionist perspective' needed in wake of Tyre Nichols death
Mayor Adler, Gov. Abbott And Sen. Cruz Win Re-election
Turnout was strong across Texas during early voting, far surpassing participation in the 2014 midterms. That momentum continued on Election Day. Nearly…
Follow NPR's Live Coverage Of The 2018 Midterm Elections
NPR reporters will be posting results and offering analysis through Tuesday night.
Know your rights as a voter in Texas
Matt Largey
It's Election Day and if you haven't already voted, make sure you know your rights before you head to the polls.
It's Election Day. Here's What You Need To Know To Vote Today.
Turnout was strong during early voting in Texas — more than 47 percent of registered voters in Travis County have already cast ballots.Those of you who…


text:
https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAxNzYwLW92ZXJ2aWV3
Drugs & Diseases > Pulmonology
Restrictive Lung Disease
Author: Jonathan Robert Caronia, DO; Chief Editor: John J Oppenheimer, MD more...
Sections Restrictive Lung Disease
Cytotoxic agents
Pulmonary, Tyrosine Kinase Inhibitors
Restrictive lung diseases are characterized by reduced lung volumes, either because of an alteration in lung parenchyma or because of a disease of the pleura, chest wall, or neuromuscular apparatus. Unlike obstructive lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD), which show a normal or increased total lung capacity (TLC), restrictive disease are associated with a decreased TLC. Measures of expiratory airflow are preserved and airway resistance is normal and the forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio is increased. If caused by parenchymal lung disease, restrictive lung disorders are accompanied by reduced gas transfer, which may be marked clinically by desaturation after exercise. [1, 2]
The many disorders that cause reduction or restriction of lung volumes may be divided into two groups based on anatomical structures.
The first is intrinsic lung diseases or diseases of the lung parenchyma. The diseases cause inflammation or scarring of the lung tissue (interstitial lung disease) or result in filling of the air spaces with exudate and debris (pneumonitis). These diseases can be characterized according to etiological factors. They include idiopathic fibrotic diseases, connective-tissue diseases, drug-induced lung disease, environmental exposures (inorganic and organic dusts), and primary diseases of the lungs (including sarcoidosis).
The second is extrinsic disorders or extrapulmonary diseases. The chest wall, pleura, and respiratory muscles are the components of the respiratory pump, and they need to function normally for effective ventilation. Diseases of these structures result in lung restriction, impaired ventilatory function, and respiratory failure (eg, nonmuscular diseases of the chest wall, neuromuscular disorders).
The mnemonic "PAINT" has been used to divide the causes of restrictive lung disease into pleural, alveolar, interstitial, neuromuscular, and thoracic cage abnormalities.
Table 1. Causes of Restrictive Lung Disease (Open Table in a new window)
PFT Findings
Pleural
Trapped lung, pleural scarring, large pleural effusions, chronic empyema, asbestosis
Radiography, CT scanning, pleural manometry, pleural biopsy
Low RVa, low TLC, low FVC
Edema, hemorrhage
Radiography, CT scanning, physical examination
Increased DLCOb in hemorrhage (Intrapulmonary hemoglobin absorbs the carbon monoxide, thus increasing the DLCO reading.)
Interstitial lung disease including IPFc, NSIPd, COPe
Radiography, CT scanning, physical examination, echo often shows pulmonary hypertension
Low RV, low FVC, low TLC, decreased DLCO, poor lung compliance
Myasthenia gravis, ALSf, myopathy
Physical examination, EMGsg, serology
Low RV, low TLC, low NIFh, low MMVi
Thoracic/extrathoracic
Obesity, kyphoscoliosis, ascites
Low ERVj and FRC in obesity, low VCk, TLC, FRCl in kyphoscoliosis
aResidual volume.
bDiffusion capacity of the lungs for carbon monoxide.
cIdiopathic pulmonary fibrosis.
dNonspecific interstitial pneumonitis.
eCryptogenic organizing pneumonia.
fAmyotrophic lateral sclerosis.
gElectromyography.
hNegative inspiratory force.
iMaximal voluntary ventilation.
jExpiratory reserve volume.
kVital capacity.
lFunctional residual capacity.
Air flows to and from the alveoli as lungs inflate and deflate during each respiratory cycle. Lung inflation is accomplished by a contraction of respiratory, diaphragmatic, and external intercostal muscles, whereas deflation is passive at rest. Functional reserve capacity (FRC) is the volume of air in the lungs when the respiratory muscles are fully relaxed and no airflow is present. The volume of FRC is determined by the balance of the inward elastic recoil of the lungs and the outward elastic recoil of the chest wall. Restrictive lung diseases are characterized by a reduction in FRC and other lung volumes because of pathology in the lungs, pleura, or structures of the thoracic cage.
The distensibility of the respiratory system is called compliance. Compliance is the volume change produced by a change in the distending pressure. Lung compliance is independent of the thoracic cage, which is a semirigid container. The compliance of an intact respiratory system is an algebraic sum of the compliances of both of these structures. Therefore, it is influenced by any disease of the lungs, pleura, or chest wall.
In cases of intrinsic lung disease, the physiological effects of diffuse parenchymal disorders reduce all lung volumes by the excessive elastic recoil of the lungs, relative to the outward recoil forces of the chest wall. Expiratory airflow is reduced in proportion to lung volume.
Arterial hypoxemia in disorders of pulmonary parenchyma is primarily caused by ventilation-perfusion mismatching, with further contribution from an intrapulmonary shunt. Decreased diffusion of oxygen rarely contributes to hypoxemia because sufficient time still exists for full equilibration of oxygen or carbon dioxide. However, if transit time is significantly shortened, as with exercise, this can highlight the pathology with significant exercise-induced desaturation.
Intrinsic lung diseases
Collagen-vascular diseases, including scleroderma, polymyositis, dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis, are potential causes of restrictive lung disease.
Other causes may include drugs and other treatments (eg, nitrofurantoin, amiodarone, gold, phenytoin, thiazides, hydralazine, bleomycin, bischloroethylnitrosourea [BCNU or carmustine], cyclophosphamide, methotrexate, radiation). Also see Drug-Induced Pulmonary Toxicity.
Causes related to primary or unclassified diseases may include sarcoidosis, pulmonary Langerhans cell histiocytosis, lymphangioleiomyomatosis (LAM), pulmonary vasculitis, alveolar proteinosis, eosinophilic pneumonia, and cryptogenic organizing pneumonia (COP).
Inorganic dust exposure (eg, silicosis, asbestosis, talc, pneumoconiosis, berylliosis, hard metal fibrosis, coal worker's pneumoconiosis, chemical worker's lung) may cause restrictive lung disease.
Organic dust exposure can lead to hypersensitivity pneumonitis (eg, farmer's lung, bird fancier's lung, bagassosis, and mushroom worker's lung, humidifier lung, hot tub pneumonitis).
Idiopathic fibrotic disorders
These may include acute interstitial pneumonia, IPF (usually interstitial pneumonitis), lymphocytic interstitial pneumonitis, desquamative interstitial pneumonitis, and nonspecific interstitial pneumonitis.
Extrinsic disorders
Nonmuscular diseases of the chest wall, in which kyphosis can be idiopathic or secondary, may cause restrictive lung disease. The most common cause of secondary kyphoscoliosis is neuromuscular disease (eg, polio, muscular dystrophy). Fibrothorax, massive pleural effusion, morbid obesity, ankylosing spondylitis, and thoracoplasty are other causes.
Neuromuscular diseases manifest as respiratory muscle weakness and are due to myopathy or myositis, quadriplegia, or phrenic neuropathy from infectious or metabolic causes.
Pleural diseases, including trapped lung or asbestos-related pleural plaques, are an underrecognized, and potentially treatable, cause of restrictive lung disease.
For intrinsic lung diseases, studies cite an overall prevalence of 3-6 cases per 100,000 persons. The prevalence of idiopathic pulmonary fibrosis (IPF) is 27-29 cases per 100,000 persons. [3, 4] The prevalence for adults aged 35-44 years is 2.7 cases per 100,000 persons. Prevalence exceeded 175 cases per 100,000 persons among patients older than 75 years. Exposure to dust, metals, organic solvents, and agricultural employment is associated with increased risk.
In North America, the prevalence of sarcoidosis is 10-40 cases per 100,000 persons. [5]
The incidence of chronic interstitial lung diseases in persons with collagen-vascular diseases is variable, but it is increasing for most diseases. [6]
Kyphoscoliosis is a common extrinsic disorder. It is associated with an incidence of mild deformities amounting to 1 case per 1000 persons, with severe deformity occurring in 1 case per 10,000 persons. [7]
Other nonmuscular and neuromuscular disorders are rare, but their incidence and prevalence are not well known.
According to the US Centers for Disease Control and Prevention (CDC), 35.9% of Americans older than 20 years are obese, and 69% of Americans are at least overweight (body mass index [BMI] 25-30). [8]
In Sweden, the prevalence rate for sarcoidosis is 64 cases per 100,000 persons. In Japan, the prevalence rate of sarcoidosis is 10-40 cases per 100,000 persons. [9] The prevalence of sarcoidosis is difficult to determine.
Pediatric data from England have demonstrated the prevalence of idiopathic scoliosis to be 1 case per 200 patients aged 6-14 years. [10]
The worldwide prevalence of fibrotic lung diseases is difficult to determine because studies have not been performed.
Although a familial variant of IPF exists, a genetic predisposition has not yet been elucidated. [11]
The incidence among black Americans is 35.5 cases per 100,000 persons. In contrast, the incidence among white Americans is 10.9 cases per 100,000 persons. [5]
LAM and lung involvement in tuberous sclerosis occur primarily in premenopausal women, although a handful of cases of LAM have been reported in men. Sporadic LAM has a prevalence of approximately 4.9 cases per 1,000,000 women. Men are more likely to have pneumoconiosis because of occupational exposure, IPF, and collagen-vascular diseases (eg, rheumatoid lung). Worldwide, sarcoidosis is slightly more common in women. [9]
IPF is rare in children. Some intrinsic lung diseases present in patients aged 20-40 years. These include sarcoidosis, collagen-vascular–associated diseases, and pulmonary Langerhans cell histiocytosis (formerly referred to as histiocytosis X). Most patients with IPF are older than 50 years. [12]
The natural history of interstitial lung diseases is variable. It depends on the specific diagnosis and the extent and severity of lung involvement based on high-resolution CT scanning and lung biopsy. [12] IPF is typically a relentless progressive disorder, and patients have a mean survival of 3-6 years after diagnosis. [13] Early recognition of IPF is important to help understand the natural history of the disorder, which may be beneficial for directing patient management and predicting (possibly improving) prognosis. [14]
Pulmonary sarcoidosis has a relatively benign self-limiting course, with spontaneous recovery or stabilization in most cases. [15] However, up to 20% of patients develop pulmonary fibrosis and disability. [16]
Prognosis for collagen-vascular diseases, eosinophilic pneumonia, cryptogenic organizing pneumonia (COP), and drug-induced lung disease is generally favorable with treatment. [17, 18, 19]
Patients with chest wall diseases and neuromuscular disorders develop progressive respiratory failure and often succumb during an intercurrent pulmonary infection. [20]
The mortality and morbidity from various causes of restrictive lung disease is dependent on the underlying cause of the disease process.
The median survival time for patients with IPF is less than 3 years after diagnosis (noted 3-6 months earlier). Factors that predict poor outcome include older age, male sex, severe dyspnea, history of cigarette smoking, severe loss of lung function, appearance and severity of fibrosis on radiologic studies, lack of response to therapy, and prominent fibroblastic foci on histopathologic evaluation. [13]
See the image below.
Gross pathology of small and firm lungs due to restrictive lung disease from advanced pulmonary fibrosis.
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Approximately half of the patients with idiopathic pulmonary fibrosis develop clubbing. Clubbing is commonly seen in patients with asbestosis.
Lung volume is plotted against transpulmonary pressure. Compliance is the change in volume for a given change in pressure. A patient with emphysema has a higher lung compliance compared with a patient with no lung disease, while a patient with restrictive lung disease has a reduction in compliance.
Idealized flow volume curves for normal, obstructive, and restrictive lungs.
The expiratory flow volume curves of 2 patients are depicted graphically. A is a patient with restrictive lung disease (idiopathic pulmonary fibrosis), low forced vital capacity (FVC), but an increased ratio of forced expiratory volume in 1 second (FEV1) to FVC because of increased elastic recoil. B is a patient with chronic obstructive lung disease whose FEV1/FVC ratio is low but whose lung volumes are increased.
Pulmonary function test results from a patient with restrictive lung disease.
Intrinsic lung disease may progress to extensive fibrosis, regardless of etiology. This is described as honeycomb lung.
End-stage sarcoidosis.
Usual interstitial pneumonitis (left).
Usual interstitial pneumonitis (right).
Histopathology of a case of idiopathic pulmonary fibrosis. Alveolitis with fibroblast proliferation and collagen deposition is present.
In usual interstitial pneumonitis or idiopathic pulmonary fibrosis, subpleural and paraseptal inflammation is present, with an appearance of temporal heterogeneity. Patchy scarring of the lung parenchyma and normal, or nearly normal, alveoli interspersed between fibrotic areas are the hallmarks of this disease. Additionally, the lung architecture is completely destroyed.
Characteristic features of usual interstitial pneumonitis as described in the image below.
Cryptogenic organizing pneumonia (also called proliferative bronchiolitis) is often patchy and peribronchiolar. The proliferation of granulation tissue within small airways and alveolar ducts is excessive and is associated with chronic inflammation of surrounding alveoli.
Cryptogenic organizing pneumonia, as described in the image below, showing a close-up view of fibrogranulation tissue in terminal airspaces.
Granulomatous lung diseases are marked by granulomas characterized by the accumulation of T lymphocytes, macrophages, and epithelioid cells. These may progress to pulmonary fibrosis. This low-power image shows well-formed granuloma along the airway.
Multiple well-formed noncaseating granulomas secondary to sarcoidosis.
Sarcoid granulomas.
High-power view of sarcoid granuloma shows giant cells.
A patient who developed restrictive lung disease had findings of cryptogenic organizing pneumonia on an open lung biopsy specimen.
A patient who developed restrictive lung disease had findings of cryptogenic organizing pneumonia on an open lung biopsy specimen. The biopsy sample shows intraluminal buds of granulation tissue.
Lymphocytic interstitial pneumonitis, for which the prominent finding is a lymphoid infiltrate that involves both the interstitium and alveolar spaces.
Usual interstitial pneumonitis honeycombing.
Chest radiograph of a 67-year-old man diagnosed with idiopathic pulmonary fibrosis, based on open lung biopsy findings. Extensive bilateral reticulonodular opacities are seen in both lower lobes.
High-resolution CT scan of the same patient in the image below demonstrates peripheral honeycombing and several areas of ground-glass attenuation. Ground-glass opacification may correlate with active alveolitis and a favorable response to therapy.
A CT scan image from a 59-year-old woman shows advanced pulmonary fibrosis. Extensive honeycombing and traction bronchiectasis are present.
Restrictive lung disease may occur in stage II and stage III sarcoidosis. In this image, mediastinal lymphadenopathy is shown secondary to stage II disease.
Sarcoidosis on CT scan shows nodules in midlung zones. These nodules are predominantly along the bronchovascular bundles and in a subpleural location.
Restrictive lung disease secondary to sarcoidosis.
A chest radiograph of stage III sarcoidosis. This stage refers to pulmonary infiltrates without evidence of mediastinal lymphadenopathy.
Chest radiograph from a 39-year-old woman with severe kyphoscoliosis who developed hypercapnic respiratory failure. Spirometry findings showed a severe restrictive lung disease, with a forced expiratory volume in one second of 0.4 L/s and a forced vital capacity of 0.5 L.
The flow volume curve of a patient with lung fibrosis.
Likely case of idiopathic pulmonary fibrosis, which should be treated with prednisone.
Pressure volume curve comparing lungs with emphysema, lungs with restrictive disease, and normal lungs.
Table 1. Causes of Restrictive Lung Disease
Table 2. Contrasting Clinical, Radiologic, and Histologic Features of Acute Interstitial Pneumonia (AIP), Usual Interstitial Pneumonia (UIP), Nonspecific Interstitial Pneumonia (NSIP), [43] and COP [44]
NSIP
Pathologic
Temporal appearance
Heterogeneous
Interstitial inflammation
Usually prominent
Collagen fibrosis
Patchy
Variable, diffuse
Fibroblast proliferation
Diffuse, interstitial
Patchy (fibroblast foci)
Patchy, airspace
COP areas
Honeycomb changes
Hyaline membranes
Yes, often focal
Jonathan Robert Caronia, DO Fellow, Department of Pulmonary and Critical Care Medicine, Lenox Hill Hospital, North Shore LIJ Health System
Chuan Jiang, MD Physician, Lenox Hill Hospital, Northwell Health
Chuan Jiang, MD is a member of the following medical societies: American College of Physicians, Society of Hospital Medicine
Klaus-Dieter Lessnau, MD, FCCP Former Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory, Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital
Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, Society of Critical Care Medicine
Daniel R Ouellette, MD, FCCP Associate Professor of Medicine, Wayne State University School of Medicine; Medical Director, Pulmonary Medicine General Practice Unit (F2), Senior Staff and Attending Physician, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital
Daniel R Ouellette, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine
Disclosure: Received research grant from: Sanofi Pharmaceutical.
John J Oppenheimer, MD Clinical Professor, Department of Medicine, Rutgers New Jersey Medical School; Director of Clinical Research, Pulmonary and Allergy Associates, PA
John J Oppenheimer, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, New Jersey Allergy, Asthma and Immunology Society
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Amgen; GSK; Aquestive; Aimmune<br/>Clinical Adjudication/Data Safety Monitoring Board for AZ, GSK, Abbvie, Sanofi; Executive Editor for Annals of Allergy, Asthma & Immunology; Editor for Medscape; Reviewer for UpToDate; Honoraria from American Board of Allergy and Immunology.
Laurie Robin Grier, MD Medical Director of MICU, Professor of Medicine, Emergency Medicine, Anesthesiology and Obstetrics/Gynecology, Fellowship Director for Critical Care Medicine, Section of Pulmonary and Critical Care Medicine, Louisiana State University Health Science Center at Shreveport
Laurie Robin Grier, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Society for Parenteral and Enteral Nutrition, Society of Critical Care Medicine
Lalit K Kanaparthi, MD Attending Physician, North Florida Lung Associates
Lalit K Kanaparthi, MD is a member of the following medical societies: American College of Chest Physicians, American Medical Association, American Thoracic Society
Sat Sharma, MD, FRCPC Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
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