text:
The politics of Norway take place in the framework of a parliamentary, representative democratic constitutional monarchy. Executive power is exercised by the Council of State, the cabinet, led by the prime minister of Norway. Legislative power is vested in both the government and the legislature, the Storting, elected within a multi-party system. The judiciary is independent of the executive branch and the legislature.

 Reporters Without Borders ranked Norway 1st in the world in the 2019 Press Freedom Index. Freedom House's 2020 Freedom in the World report classified Norway as "free," scoring maximum points in the categories of "political rights" and "civil liberties".

Constitutional development
The Norwegian constitution, signed by the Eidsvoll assembly on 17 May 1814, transformed Norway from being an absolute monarchy into a constitutional monarchy. The 1814 constitution granted rights such as freedom of speech (§100) and rule of law (§§ 96, 97, 99). Important amendments include:

4 November 1814: Constitution reenacted in order to form a personal union with the king of Sweden
1851: Constitutional prohibition against admission of Jews lifted (see Jew clause)
1884: Parliamentarism has evolved since 1884 and entails that the cabinet must not have the parliament against it (an absence of mistrust, but an express of support is not necessary), and that the appointment by the King is a formality when there is a clear parliamentary majority. This parliamentary rule has the status of constitutional custom. All new laws are passed and all new governments are therefore formed de jure by the King, although not de facto. After elections resulting in no clear majority, the King appoints the new government de facto
1887: Prohibition against monastic orders lifted
1898: Universal male suffrage established
1905: Union with Sweden dissolved
1913: Universal suffrage established
1956: Religious freedom formalised and prohibition against Jesuits lifted (see Jesuit clause)
2004: New provision on freedom of expression, replacing the old § 100
 2007: Removed the old system of division of Stortinget into the Odelsting and Lagting (took effect after the 2009 general election). Changes to the Court of Impeachment. Parliamentary system now part of the Constitution (previously this was only a constitutional custom) (new § 15)

Executive branch

|King
|Harald V
|
|17 January 1991
|-
|Prime Minister
|Jonas Gahr Støre
|Labour Party
|14 October 2021
|}

Norway is a constitutional monarchy, where the king has a mainly symbolic power. The royal house is a branch of the princely family of Schleswig-Holstein-Sonderburg-Glücksburg, and the House of Saxe-Coburg and Gotha in Germany. The functions of the king, Harald V, are mainly ceremonial, but he has influence as the symbol of national unity. Although the constitution of 1814 grants important executive powers to the king, these are always exercised by the Council of State in the name of the king (King's Council, or cabinet). The king is also High Protector of the Church of Norway (the state church), Grand Master of the Royal Norwegian Order of St. Olav, and symbolically Supreme Commander of the Norwegian armed forces.

The Council of State is formally convened by the reigning monarch. The Council of State consists of the prime minister and his or her council, formally appointed by the king. Parliamentarism has evolved since 1884 and entails that the cabinet must not have the parliament against it, and that the appointment by the king is a formality. The council must have the confidence of the Norwegian legislative body, known as the Storting. In practice, the monarch will ask the leader of a parliamentary block that has a majority in the Storting to form a government. After elections resulting in no clear majority to any party or coalition, the leader of the party most likely to be able to form a government is appointed prime minister. Since World War II, most non-socialist governments have been coalitions, and Labour Party governments have often relied on the support of other parties to retain the necessary parliamentary votes.

The executive branch is divided into the following ministries:

 Office of the Prime Minister ()
 Ministry of Agriculture and Food ()
 Ministry of Children and Equality ()
 Ministry of Culture ()
 Ministry of Defence ()
 Ministry of Education and Research ()
 Ministry of the Environment ()
 Ministry of Finance ()
 Ministry of Fisheries and Coastal Affairs ()
 Ministry of Foreign Affairs ()
 Ministry of Government Administration and Reform ()
 Ministry of Health and Care Services ()
 Ministry of Justice and the Police ()
 Ministry of Labour and Social Inclusion ()
 Ministry of Local Government and Regional Development ()
 Ministry of Petroleum and Energy ()
 Ministry of Trade and Industry ()
 Ministry of Transport and Communications ()

Governments 1935–1981

The Labour Party has been the largest party in Parliament ever since the election of 1927 up to the recent 2017 election. Labour formed their first brief minority government in 1928 which lasted for 18 days only. After the 1936 election the Labour Party formed a new minority government, which had to go into exile 1940–1945 because of the German occupation of Norway. After a brief trans-party government following the German capitulation in 1945, Labour gained a majority of the seats in parliament in the first post-war election of 1945.

Norway was ruled by Labour governments from 1945 to 1981, except for three periods (1963, 1965–1971, and 1972–1973). The Labour Party had a single party majority in the Storting from 1945 to 1961. Since then no party has single-handedly formed a majority government, hence minority and coalition governments have been the rule. After the centre-right Willoch government lost its parliamentary majority in the election of 1985, there were no majority governments in Norway until the second Stoltenberg government was formed after the 2005 election.

Governments 1981–2005

From 1981 to 1997, governments alternated between minority Labour governments and Conservative-led centre-right governments. The centre-right governments gained power in three out of four elections during this period (1981, 1985, 1989), whereas Labour toppled those governments twice between elections (1986, 1990) and stayed in power after one election (1993). Elections take place in September and governments change in October of election years.

Conservative leader Kåre Willoch formed a minority government after the election of 1981. In 1983, midway between elections, this government was expanded to a majority three-party coalition of the Conservatives, the Centre Party and the Christian Democrats. In the election of 1985 the coalition lost its majority but stayed in office until 1986, when it stepped down after losing a parliamentary vote on petrol taxes.

Labour leader Gro Harlem Brundtland served three periods as Prime Minister. First briefly from February 1981 until the election the same year, then from May 1986 to the election of 1989, and last from November 1990 until October 1996 when she decided to step out of domestic politics. Brundtland strongly influenced Norwegian politics and society during this period and was nicknamed the "national mother".

After the election of 1989 a centre-right coalition was formed with the same three parties as in 1983–1986, this time headed by Conservative leader Jan P. Syse. This coalition governed from 1989 to November 1990 when it collapsed from inside over the issue of Norwegian membership in the European Economic Area.

When Brundtland resigned in 1996, Labour leader Thorbjørn Jagland formed a new Labour government that stayed in office until October 1997 when he, after the September 1997 election, declared that his government would step down because the Labour Party failed to win at least 36.9% of the national vote – the percentage Labour had won in the 1993 election.

A three-party minority coalition of the Centre, Christian Democratic, and Liberal parties, headed by Christian Democrat Prime Minister Kjell Magne Bondevik, moved into office in October 1997. That government fell in March 2000 over the issue of proposed natural gas plants, opposed by Bondevik due to their impact on climate change.

The Labour Party's Jens Stoltenberg, a Brundtland protégé, took over in a minority Labour government but lost power in the September 2001 election when Labour posted its worst performance since World War I.

Bondevik once again became Prime Minister in 2001, this time as head of a minority coalition of the Conservatives, Christian Democrats and Liberals, a coalition dependent on support from the Progress Party. This coalition government was the first to stay in office for a complete four-year election period since Per Borten's coalition government of 1965–1969.

Cabinet 2005–2013
A coalition between the Labour Party, Socialist Left Party, and Centre Party, took over  after the 2005 general election, where this coalition obtained a majority of 87 out of 169 seats in the Storting. Jens Stoltenberg became Prime Minister and formed a cabinet known as Stoltenberg's Second Cabinet.

This was a historical coalition in several aspects. It was the first time the Socialist Left sat in cabinet, the first time the Labour Party sat in a coalition government since the 1945 four-month post-war trans-party government (otherwise in government alone), and the first time the Centre Party sat in government along with socialist parties (otherwise in coalition with conservative and other centre parties).

In the 2009 general election the coalition parties kept the majority in the Storting by winning 86 out of 169 seats. Stoltenberg's second cabinet thus continued. There have been several reshuffles in the cabinet during its existence.

Cabinet 2013–2021
In the 2013 election, the incumbent red–green coalition government obtained 72 seats and lost its majority. The election ended with a victory for the four opposition non-socialist parties, winning a total of 96 seats out of 169 (85 needed for a majority). Following convention, Stoltenberg's government resigned and handed over power in October 2013. The Labour Party, however, remained the largest party in parliament with 30.8% of the popular vote. The Progress Party also lost ground, but nevertheless participates in the new cabinet led by Conservative Prime Minister Erna Solberg. Among the smaller parties, the centrist Liberal Party and Christian Peoples Party hold the balance of power. Both campaigned on a change in government. On 30 September the two smaller parties announced that they would support a minority coalition of the Conservative and Progress parties, but they would not take seats in the cabinet themselves. The new Erna Solberg government was re-elected in 2017. In January 2020, right-wing Progress Party left the government. Prime Minister Erna Solberg continued with a minority government consisting of three coalition partners — her own Conservatives, the centrist Liberal Party and the Christian Democrats.

Current cabinet
In the 2021 election, the incumbent Solberg cabinet lost its majority. Jonas Gahr Støre of the Labour Party formed a minority coalition government with the Centre Party. The government relies on the support of the Socialist Left Party in order to secure a majority.
On 14 October 2021, Jonas Gahr Støre, the leader of Norway's center-left Labor Party, was sworn in as new Prime Minister of Norway. His center-left minority government included ten women and nine men.

See also the category Norwegian politicians and list of Norwegian governments.

Legislative branch

Norway has a unicameral parliament, the Storting ("Great Council"), with members elected by popular vote for a four-year term (during which it may not be dissolved) by proportional representation in multi-member constituencies. Voting rights are granted in the year a person turns 18.

The Storting currently has 169 members (increased from 165, effective from the elections of 12 September 2005). The members are elected from the 19 counties for four-year terms according to a system of proportional representation. Until 2009, the Storting divided itself into two chambers, the Odelsting and the Lagting for the sole purpose of voting on legislation. Laws were proposed by the government through a member of the Council of State or by a member of the Odelsting and decided on by the Odelsting and Lagting, in case of repeated disagreement by the joint Storting. In practice, the Lagting rarely disagreed and mainly just rubber-stamped the Odelsting's decision. In February 2007, the Storting passed a constitutional amendment to repeal the division, which abolished the Lagting for the 2009 general election, thereby establishing a fully unicameral system.

Political parties and elections

Elections are to be held every four years on the second Monday of September.

Judicial branch

The Norwegian legal system is a mixture of customary law, civil law system, and common law traditions; the Supreme Court renders advisory opinions to legislature when asked; accepts compulsory ICJ jurisdiction, with reservations.

The regular courts include the Supreme Court () with 18 permanent judges and a president, courts of appeal (court of second instance in most cases), city and county courts (court of first instance in most cases), and conciliation councils (court of first instance in most civil-code cases). Judges attached to the regular courts are appointed by the King in council after nomination by the Ministry of Justice.

The special High Court of the Realm () hears impeachment cases against members of the government, parliament, or Supreme Court. Following an amendment to the Norwegian constitution in February 2007, impeachment cases are heard by the five highest ranking Supreme Court justices and six lay members in one of the Supreme Court courtrooms The High Court of the Realm had generally lost most of its significance after 1884, and this institution has been passive ever since 1927. The new system is meant to restore the  to its earlier significance.

Impeachment
Impeachment may be brought against Members of the Council of State, or of the Supreme Court or of the Storting, for criminal offenses which they may have committed in their official capacity. Indictments are raised by the Storting and judged by five Supreme Court justices and six lay judges.

Administrative divisions

The mainland of Norway is divided into 11 counties (, singular ): Agder, Innlandet, Møre og Romsdal, Nordland, Oslo, Rogaland, Vestfold og Telemark, Troms og Finnmark, Trøndelag, Vestland, and Viken. This was reduced in 2020 from 18. In addition are the island group Svalbard and the island Jan Mayen.

Counties and municipalities have local autonomy, but this autonomy is circumscribed by national controls. Counties and municipalities are subject to the oversight of a governor () appointed by the King in the Council of State. One governor exercises authority in both Oslo and the adjacent county of Viken. Each county has a directly elected county assembly, led by a mayor, which decides upon matters falling within purview of the counties (upper secondary and vocational education, some culture, transport and social services). There is also a governor () on Svalbard, who is under the Ministry of Foreign Affairs and not the Ministry of Local Government and Regional Development as the other counties.

The counties are divided into 356 municipalities (, singular ) . The municipalities are led by directly elected assemblies, which elect a board of aldermen and a mayor. Some municipalities, most notably Oslo, have a parliamentary system of government, where the city council elects a city government that is responsible for executive functions. Some municipalities are also divided into municipal districts or city districts (again, Oslo is one of these) responsible for certain welfare and culture services. These districts are also headed by political assemblies, in some cases elected directly by the citizens. The municipalities deal with a wide range of planning issues and welfare services, and are mostly free to engage in activities which are not explicitly restricted by law. Lately, the functions of the counties and municipalities have been the subject of debates, and changes may take place in the near future.

Dependent areas

Norway has three dependent areas, all in or near Antarctica: Bouvet Island in the South Atlantic Ocean, Queen Maud Land in Antarctica, and Peter I Island off West Antarctica. The Norwegian Act of 27 February 1930 declares these areas are subject to Norwegian sovereignty as dependencies.

An attempt to annex East Greenland ended in defeat at the Hague Tribunal in 1933.

International organization participation

AfDB, AsDB, Australia Group, BIS, CBSS, CE, CERN, EAPC, EBRD, ECE, EFTA, ESA, FAO, IADB, IAEA, IBRD, ICAO, ICCt, ICC, ICFTU, ICRM, IDA, IEA, IFAD, IFC, International IDEA, IFRCS, IHO, ILO, IMF, International Maritime Organization, Inmarsat, Intelsat, Interpol, IOC, IOM, ISO, ITU, MINURSO, NAM (guest), NATO, NC, NEA, NIB, NSG, OECD, OPCW, OSCE, PCA, UN, UNCTAD, UNESCO, UNHCR, UNIDO, UNMIBH, UNMIK, UNMOP, UNTSO, UPU, WCO, WEU (associate), WHO, WIPO, WMO, WTO, Zangger Committee.

References


This section contains an overview of Economic, Social and Cultural Rights (ESCR) in general. The dedication of a separate page to ESCR should not be viewed as suggesting these are somehow a distinct category of rights, or that they should be dealt with in isolation from all other rights recognized in the Universal Declaration of Human Rights. Rather, it reflects the growing attention to ESCR over the past decade, not least of all efforts to dispel common misconceptions about ESCR such as that they are mere aspirations or policy goals as opposed to rights, are too vague to be enforceable and are not justiciable.


Montevista home with No Mello Roos and low HOA, Welcome to this fabulous Valencia 3 bedroom 3 bath home, walking distance to Valencia High School! Large Master with 2 closets, Kitchen is upgraded with granite counters and stainless appliances. Upstairs laundry room. Open living room with fireplace. This smart home is truly that! Integrated Bluetooth LED recessed lighting, wireless entry at front door and the garage. Set your temp unlock doors even turn off and on lights, this can all be done with the help of Alexa. This open floorplan has much to offer and private backyard. That's just the beginning of the updated and charming home. The garage has epoxy floors, custom cabinets and a work bench. Come see this true gem and call it home.


text:
Prevention Maine
Retailer/Workplace
Tobacco Help
The first step to quitting tobacco is being ready.
The Maine QuitLink can help you get started.
Call: 1-800-QUIT-NOW
Alcohol and Substance Help
211 Maine provides a toll-free statewide information and referral helpline for individuals seeking services.
Call: 211 or 1-866-811-5695
Text: Your zip code to 898-211
Why Prevention?
Implementing Policies
Recreation, Athletics and Schools
Campaigns & Initiatives
Go to section "Why Prevention?" Go to top
Tobacco, alcohol, and drug use are major concerns for the health and safety of Maine teens. Everyday youth are exposed to countless messages and pressures that encourage experimentation with deadly substances. Research proves that prevention messages and programs can counteract these influencers and prevent initiation, as well as the numerous health effects and risks of tobacco, alcohol, and drug use.
Preventing tobacco, alcohol and drug use in children is critical to the long-term health of our youth, as well as to the overall health of our nation.
Tobacco companies spent millions promoting their deadly products to Maine youth. Exposure to tobacco marketing lures kids into smoking, doubling the odds that they will become tobacco users before the age of 18. The good news is that prevention works. Advocating for prevention has led to a 60% reduction in smoking by Maine high school students since 1996 and the percentage of Maine youth who have never tried smoking is on the increase.
Alcohol is the most used substance among Maine youth. Because alcohol is legal, it is more readily available and adults often model drinking as an acceptable social behavior. Additionally, alcohol marketing seen on TV and other venues can influence youth. The increased exposure not only increases the likelihood that youth will begin drinking, but also the amount they consume. Having open conversations about alcohol laws, modeling responsible behaviors, and discussing risks has shown to help prevent problems that can result from underage drinking.
Marijuana use among Maine youth continues to increase. While Maine moves forward with legalization and regulation, access will also increase. It is important for parents, teachers, and others to understand the harmful effects of marijuana on developing brains and help to prevent initiation, which can also lead to experimentation with other non-legal substances.
With the upsurge in illegal drug experimentation, and misuse of prescription medications there is increased exposure and access to these substances among youth. There continues to be a rise in teen experimentation, use, addiction, and overdose deaths that can be prevented with proper education, awareness, and intervention.
Maine law prohibits smoking, alcohol, and drug use in elementary and secondary schools. Schools should also establish and implement comprehensive wellness policies that guide efforts and goals to eliminate tobacco, drug, and alcohol use, as well as create environments that promote health and wellbeing.
A School's Role
Forbid tobacco, alcohol, and drug use by students, staff, and visitors on all school grounds and at all school sponsored events
Provide comprehensive tobacco, alcohol, and drug prevention education programs
Provide program specific training for teachers
Involve parents and families in school efforts to prevent tobacco and substance use
Offer prevention projects and activities for students
Help students and staff who are using tobacco to quit
Adopt a firm school policy of not accepting any funding, curricula, or other materials from tobacco companies
Evaluate the school's prevention programs at regular intervals
Schools are powerful role models for youth with the opportunity to influence their players' habits around health, sportsmanship, and personal responsibility. School athletic policies that send strong, clear, and consistent tobacco and substance-free messages can prevent youth from experimenting with tobacco and alcohol.
Coaches can discuss the health effects of tobacco and substance use, as well as their impact on sports performance:
Reduces lung function and ability to run
Puts added strain on the heart
Increases asthma symptoms
Chewing tobacco is not a safe alternative to smoking
Causes dehydration
Affects muscle growth and development
Vape Free Maine
Times Have Changed
Party Smarter
Positive Influence
You Are The Target
Safe Sleep for ME
Everyday Survival Guide
All Bottled Up
The Sipping Point
Recreational marijuana use is legal in Maine. Good to Know Maine is a campaign that raises awareness and educates Mainers on safely, legally and responsibly navigating Maine's marijuana landscape. The campaign educates on Maine's laws related to public use, driving and youth as well as safe use and safe storage of marijuana.
The long-term effects of vaping are still unknown. Don't be part of an experiment that uses flavors and nicotine to suck you in. Uncover the truth. Don't get sucked in to the flavor trap. Don't get sucked in to nicotine, the addictive chemical in e-cigarettes. It's not a harmless water vapor.
Times have changed! It is a different world. It's a different time. It's a new ERA. Times Have Changed provides facts and info for parents/guardians to help them navigate today's drug and tobacco landscape. Vaping, THC, technology are just a few things that have changed since back in the day. Stay up to date and see how much times have changed.
It can happen here. It is happening. Substance use disorder is affecting our communities, our workplaces, our friends and family. Do what you can to stop it; see something, say something; don't be quiet. Know that there are resources available – for users and for family members. There are things you can do if you're taking a prescription medication and there are actions that prescribers can take. There are places to turn for help.
Eyes open to the crisis, eyes open to the possibilities for change, eyes open to our collective future.
Learn how you can keep your Eyes Open.
If you are 21 or older, you may often enjoy alcohol when socializing with friends and family. Drinking can be harmful, depending on your age, health status, and how much/often you drink.
If you choose to have a drink, here are some simple steps to help you Party Smarter:
Sometimes the amount you drink can be a signal that you may have a problem with alcohol here are some resources to learn more:
A brief quiz to find out, how much is too much? – Alcohol Screening
Are your drinking habits impacting your health? – Rethinking Drinking
Whether you're a parent, teacher, grandparent or mentor, you could Be A Hero in a child's eyes. The campaign, Be A Hero, promotes the importance of building strong relationships with children. Children who have strong bonds with the adults in their lives are less likely to engage in risky behaviors later in life.
Everybody's not doing – and that's a fact. The campaign challenges youth to engage in critical thinking skills, identify positive influences, and stand up to negative pressures around substance use. It allows youth to develop an awareness of how they want themselves to be perceived and how their actions might impact how others see them. The campaign empowers their expression and celebrates the importance of making smart choices around all substances.
The tobacco industry has purposely targeted youth with advertising, promotions, samples, movies, and more. If you begin smoking when you are young, you are more likely to become addicted which creates a long-term customer for their deadly products.
They review data about popular trends in music, fashion, and products that appeal to younger audiences. They know youth are highly influenced online and they intend to lure you into thinking smoking is hip and part of your identity.
Unfortunately, it works. Big Tobacco spends more than $42 million each year on targeting Maine youth and one third of youth who experiment with smoking do so because of effective tobacco industry marketing.
Learn how you can stand up against tobacco.
Sniffing household products may not only cause death, but also harms the nervous system, affecting nerves that control walking, breathing, and smelling. It also impacts the brain and can cause permanent brain damage impacting decision-making, balance, and motor skills.
While "Meth" is perceived to have little to no risk, long-term use can have significant health effects including psychosis, anorexia, violence, and paranoia.
SIDS (Sudden Infant Death Syndrome) is the sudden death of an infant less than one-year-old that cannot be explained after a full investigation. SIDS cannot always be avoided, but there are ways to lower the chances of SIDS by following Safe Sleep practices.
The purpose of the Safe Sleep Maine campaign is to prevent infant deaths by educating the public in ABCD, the four letters associated with the best practices to make sure infants sleep safely. The campaign aims to help inform new and experienced parents, grandparents, and caregivers on the importance of Safe Sleep for babies.
Suicide is the leading cause of violent death in Maine. It doesn't have to be this way. If you, or someone you know, is dealing with feelings so big that you're unsure about how to handle it, the Maine Crisis Line is here to listen.
It can be hard to name big feelings.
Learning more about what you're feeling, how to recognize your own warning signs when you feel them, and how to manage them when they appear can help so that these feelings don't turn into suicidal thoughts. Understanding the warning signs that come with big feelings can help you recognize when you or someone you know may need help. Big feelings look different, and feel different to everyone.
Learn More About The Everyday Survival Guide
Stress. Anxiety. Boredom. Unrealistic expectations. Do you know what your teen is keeping bottled up inside? When the pressures of everyday life meet the availability of prescription stimulants, your teen may be in harm's way.
Medications such as Adderall®, Ritalin®, Concerta®, or Dexedrine®, when prescribed by a doctor, can help manage symptoms of ADHD. But some teens are taking stimulants not prescribed to them. The reasons may vary from using as a study aid to avoiding boredom. The most common source of these drugs is their own friends or family members. Talk to your teen about their bottled up feelings and the serious risks of taking medication that isn't prescribed.
Your guide to drinking alcohol responsibly. Do you know your sipping point? It is the difference between drinking in moderation and drinking to excess. Know the healthy guidelines, legal limit, and your personal habits when it comes to drinking alcohol.
Maine Prevention Store
Know the Risks: E-cigarettes & Young People
E-cigarette Toolkit
Tobacco-Free Kids
Maine Integrated Youth Health Survey Data
Tobacco Strategic Plan
Maine Parents
Student Intervention Reintegration Program
Sweetser Crisis 1-888-568-1112
Inhalant Abuse Prevention Kit
Maine Medication Collection Sites
You Are Prevention
Snuggle ME Guidelines
School Substance Use Policy Development Guide
Maine Marijuana Education Toolkit
Substance Use Prevention Strategic Plan 2021-2024 One Pager
View Resources Page
HomePrevention
Prevention Info
Maine QuitLink
211 Maine
Key Bank Plaza 4th Floor
All rights reserved. ©2022

redpajama_set_name: RedPajamaCommonCrawl


text:
Blog | Monday, October 30, 2017
Menopause, hormone replacement, and mortality: a research reality check
Perhaps you are in a hurry. If so, here's the bottom line at the top: it turns out women can use hormone replacement to manage symptoms at menopause with, at worst, no adverse, long-term effect on the risk of mortality or any major chronic disease.
If you have a few more minutes, here's the rest of the story.
To state the obvious, every woman who lives long enough passes through menopause. One might think that medicine would long since have worked out with considerable confidence the health implications, from symptoms to safety, of menopause left to run its native course, versus any particular compensatory "treatment." One would be wrong.
Rather, the medical management of menopause is a precautionary tale about the tribulations of clinical trials; the critical value but inescapable subtleties of science; the frequent trespass of pecuniary motives where purer pursuits of evidence ought (and are thought) to prevail; the requirement for sense in putting science to good use; and a reminder that no single tool is best for every job.
The immediate prompt for this column is a major new report in JAMA, examining the long-term (i.e., 18 years) outcomes in the nearly 30,000 women randomized in the Women's Health Initiative (WHI) Estrogen Plus Progestin and Estrogen-Alone Trials - finding no net harms of HR. By way of reminder, it was the WHI, along with another randomized trial called HERS, that spawned headlines and stark warnings over a decade ago that hormone replacement at menopause was not only not protective in all the ways hoped, but decisively harmful.
The WHI and HERS were both randomized trials, and thus the early results of both, suggesting increased risk associated with hormone replacement at odds with hope and expectations, provoked considerable drama. Neither study ever showed anything much worse than nearly comparable outcomes with and without use of hormone replacement; I am among those who have been writing about the exaggerated responses to these trials since they first issued.
But Newtonian forces prevailed: for every action, an equal and opposite reaction. On the basis of earlier, observational studies, a general and perhaps excessive enthusiasm for every variety of hormone replacement had become the norm. The equal and opposite reaction to the results of the new (as of a decade or so ago) RCTs was to renounce hormone replacement wholesale.
But even randomized, clinical trials only ever answer the questions they pose; and only provide answers insofar as the data are interpreted. Such, then, are the tribulations of even the best of trials, and the fallacy in the currently popular notion that RCTs are always best, necessary, and perfectly reliable. None of that is true.
In brief, summary judgment about the HERS and WHI results, even after laying aside the massive exaggeration of observed harms that populated headlines, obscured many critical subtleties. Among them were these: the kind of hormone replacement used almost certainly matters; the timing of treatment relative to menopause and the age of the women treated almost certainly matters; and the effects of estrogen alone differ markedly from those of estrogen in combination with progesterone.
Even as we pursue "evidence based" medicine, we are perennially at risk of profit-based medicine. The form of hormone replacement studied in both HERS and WHI is one which every colleague expert in women's health tells me they would virtually never choose: Premarin, which is estrogen derived from the urine of pregnant horses (pre-mar-in = pregnant mare's urine); and Provera, or medroxyprogesterone acetate, a synthetic and high-potency progesterone. These were chosen to study because they were most widely used at the time. But they were most widely used never because they were best, but because they were profitable for, and made popular by, the pharmaceutical industry. Even if the worst of news we had ever received about so-called "Prem-Pro" had been true, it would still not clearly have pertained to other forms of hormone replacement deemed far preferable by those best qualified to know.
Then, there was the problem of lumping where the subtleties of splitting were required. The WHI included women who had just gone through menopause, and others who were a decade past that. The responses to hormone replacement in these two groups may not quite be night and day, but they differ fundamentally. Lumping them together into a summary judgment or hyperbolic headline is an archetypal failure to distinguish baby from bathwater.
Even more so the differential effects of combined hormone replacement with those of estrogen alone. Millions of women in the U.S., almost certainly too many, have undergone hysterectomy. These women can use unopposed estrogen as their hormone replacement, since progesterone is only needed to safeguard against uterine cancer, which those who no longer have a uterus cannot get. Colleagues and I conducted an analysis based directly on the WHI data for this group showing a decisive mortality benefit from use of estrogen right around menopause. Our study revealed that a generalized aversion to all forms of hormone replacement, propagated by hyperbolic messaging regarding the risks, had resulted in tens of thousands of premature deaths among women who would have benefited, both in terms of symptoms and safety, from use of replacement estrogen.
We can leave the hormone replacement story there. The current understanding is that hormone replacement is the most effective treatment of symptoms at menopause; that there are better and worse hormone preparations from which to choose; that use right around menopause is safer and more beneficial than delayed use; that unopposed estrogen is likely to confer net benefit; that combination hormone replacement generally does not increase long-term harms; and that the best choice for any given woman should be individualized. We've come a long way, baby, from "it's all good" and "it's all bad," but we spent costly years mired in both before getting here.
The other important message in this tale is not specific to menopause or hormone replacement, but generalizable to how science works- a topic beautifully encapsulated in brief comments by astrophysicist Neil DeGrasse Tyson, addressing the topic of climate change for CNN. What is true of climate science is true of science in general- with particularly urgent implications for menopause and nutrition, among crucial public health topics we seem so adept at muddling.
No single study design is best for answering all questions. Randomized trials, too, are subject to the tribulations of interpretation. No study answers the questions we fail to ask. Evidence is most meaningful when aggregated over time. Absence of evidence is not evidence of absence. Understanding science involves sense. There is more than one way to be wrong. Each new study adds to what was known before; it does not replace it, whatever the headlines may say.
Science is a great tool kit, the best ever devised for answering challenging questions. Everything in a tool kit can be used well or poorly, however. The idea that any one tool is right for every job, or that the character and aptitude of those using the tool don't matter, is as invalid for science as for carpentry. There is much to learn from the muddled history of menopause management by all concerned with the efficient construction of genuine understanding.
Labels: David Katz , guest post , hormone replacement therapy , menopause , women's health


text:
Tales of the Old Aristocracy and the new
Published March 1, 2019 2:16 am by Claire
Note: After drafting this at home all day, I'm posting it in the cold outside a closed library. I usually do a lot of revisions when blogging something I've written offline. So if it has more than the usual amount of typos, poor editing, or rambling passages, please forgive it. It's been snowing and I'm not staying out here in the car much longer to give it the usual polishing.
Reflections on two recent books and a tragic ancient history whose spirit is rising again
I'm reading two books right now that have absolutely nothing to do with each other. But because of threads running through my own mind (threads certainly not intended by either book author), I'm finding them a provocative pair.
The first (and for this blog, most important) of the two is Marooned: Jamestown, Shipwreck, and a New History of America's Origin by Joseph Kelly. This book came out late last year and Commentariat member Pat immediately gave me a heads-up on it. It took the library several months to get it into my hands, but it was well worth the wait. Kelly takes the position that the common men and women who first settled the disastrous Jamestown colony in Virginia — the people who've gone down in history as idlers, layabouts, traitors, deserters, mutineers, and general all 'round troublemakers — are the real progenitors of American freedom.
The second (and for this blog, lesser) of the two books is Cal Newport's Deep Work: Rules for Focused Success in a Distracted World, which aims to teach a generation of young "knowledge workers" how to appreciate, perform, and profit from the kind of activity that can only be done in long, focused stretches of time uninterrupted by email, Twitter, F*c*b**k, texts, and miscellaneous corporate and personal distractions.
I'll come back to Deep Work later. But I caution you that the two books are really not connected except in my mind. So, as Mark Twain said, "Persons attempting to find a motive in this narrative will be prosecuted; persons attempting to find a moral in it will be banished; persons attempting to find a plot in it will be shot."
Okay, not exactly. But I don't expect anyone else to see the connection I perceive.
I'm betting almost every American reading this (with the exception of some raised in the South) learned that the Pilgrims, who landed in Massachusetts in 1620, were the country's founding colonists. In school, we all cut Pilgrim hats out of construction paper and drew Thanksgiving turkeys around our outstretched hands. We heard stories of how the Indian Squanto (whose name was probably more like Tisquantum) help save the colonists from starvation by teaching them to put fertilizing fish into holes where they planted their crops. We heard thrilling stories about the storm-tossed Mayflower. We learned with hushed breath about the great, important, almost sacred Mayflower Compact — though oddly enough we were probably never told what was in it, why it was written, or what effect it had in governing the nascent Plymouth colony.
Above all, we were taught that the Pilgrims were men and women of one mind and one mission — to plant the shining City on a Hill in the New World, to be a beacon of freedom for all.
Most of us now realize the Puritans who made up the bulk of those Mayflower passengers were as least as interested in preventing freedom of religion for others as they were in practicing it for themselves. Theocrats to the core, those folks. Very unlike us in their love of rigid, authoritarian, conformity-enforcing government. Yet, to this day, even with Calvinism and Calvin's strict god having gone out of fashion, the Pilgrims still bear the proud, noble image of European America's founders. Think of the first English settlers setting foot on the Atlantic shore, and it's an image of those storm-tossed, freezing, but resolute Puritans you likely see.
Oh yes, even back in grade school, our teachers couldn't help but mention that another group of Englishmen had reached the shores of Virginia and established a colony there — 13 years earlier. But … "Oh, Jamestown didn't work out too well; so moving right along …"
You'd think a colony with more than a decade's seniority over the Pilgrims might have been worth more than an embarrassed mention. And perhaps for you Southerners, it was. But aside from romantic tales about John Smith and Pocahontas, not so much for the rest of us. As an inspiring foundational narrative, Jamestown didn't cut it.
For two centuries, Jamestown had held a premier place in U.S. colonial history. But beginning with the War Between the States, several factors pushed the Pilgrims to the fore. The Exodus story of the virtuous, mission-driven Pilgrims cemented itself in the American mind. Kelly goes into how this happened, and it's an intriguing look at how propaganda and changing values replace old truths. But back to Jamestown …
It was a slave-labor camp, says Kelly (making his case in 427 highly readable, though somewhat non-linear, pages). The "common" colonists, who were also shareholders in the venture, boarded ships fully expecting to maintain their traditional English rights and privileges. Instead they found themselves treated as soldiers or medieval serfs. They were not only subject to strict orders — and subject to being sadistically executed for any disobedience — but found themselves ruled by a series of shockingly incompetent commanders. Commanders who ruled solely by virtue of aristocratic connections and/or the military officerships that commonly went non-titled members of aristocratic families in those days.
Although I'm far from being an expert in American history, I've long known that Jamestown was a dumping ground for lesser sons of British aristocracy. You know the old story: send the untitled excess males off to seek their fortunes in a foreign land. What I never knew was that, unlike their adventurous nineteenth century counterparts who headed into the American West, this batch of the Great Entitled expected to be kowtowed to, and certainly not to have to involve themselves in anything as dirty as manual labor. Although they varied in degrees of entitlement and idiocy (and a couple of the colony's leaders were worse than I can describe here), they basically knew and cared nothing about minor matters like growing food. OTOH, they knew a lot about things about pomp and privilege — not to mention the quixotic quest for gold and silver (to be mined, of course, by the "lesser" people for the benefit of their betters).
In the book, John Smith comes across as about the only leader who understood that the colonists had to adapt to entirely unfamiliar frontier conditions — and that they had to start growing their own food to supplement what they got in trade (or extortion) from the natives.
Adapt Smith did. Whatever else he was, Smith (born a commoner and elevated by his early adventures) was a man of personal courage, intelligence, practicality, diplomacy, and good sense. He was, however, as much a dictator as any of the lordlings who constantly sought to depose him. He was just the kind of dictator who kept the colonists from descending into starvation and cannibalism — unlike his successors.
Those "common" colonists rebelled against aristocratic misrule. Some slipped away to join the Indians. Some plotted mutinies. Some refused to work. Some just wanted to go out on their own to fend for themselves. Some were too sick (probably with then-unknown nutritional diseases like pellagra) to perform their assigned functions, which made them look apathetic and rebellious when they were simply ill.
Because every, single eye-witness account of the early Jamestown years was written by someone within the leadership circle, the common colonists have gone into history labeled idlers, layabouts, thieves, traitors, etc. Kelly notes that even most modern historians look sniffily down their noses at those lesser folk, unconsciously crediting the snobbish prejudices of the powerful men who mismanaged the Jamestown venture then blamed those who tried to get out from under their deadly thumbs.
But Kelly identifies these "traitors" with a more accurate description. The rebels were men (mostly men) who, long before Jefferson and Mason and Madison, had strong ideas about living self-determined lives and organizing according to mutual will, without considerations of class. The general name Kelly gives those who chose to "go native" or organize into groups outside Virginia Company control is "maroons" (for which he also provides fascinating history, going back to Sir Francis Drake in Panama). They understood that the company had shattered all its promises to them; and in return they owed it no allegiance. They refused to play their nicely subservient role in a slave colony operated by the uppercrust — even if rebellion was likely to kill them.
Here's Kelly on one of many rebellions — this one among voyagers who got shipwrecked on their way to Jamestown and decided they'd rather stay in Bermuda, where they washed up (another fascinating chapter in the book):
The maroons sketched out a petition. Strachey [chief scribe to an inner circle of colonial despots] said they became outlaws "by mutual consent," a formulaic term that seventeenth-century writers used to denigrate the democratic nature of mutinies, as if "mutual consent" (as opposed to assuming one's subservient place in a hierarchy) were ipso facto outlawry. Formula or not, the concept of mutual consent, typically engaged by mutineers and castaways, is important, and we might presume that this petition itself invoked the concept, that it opened with some language to this effect, though probably without the eloquence of the U.S. Constitution' Preamble. More than likely, the formula would have been something prosaic: By mutual consent, we the undersigned … Some of the fugitives actually signed the document, an effective sort of declaration of their independence, while the illiterates affixed their signs. However pedestrian its wording, the petition demonstrates that those whom Strachey called "outlaws" had formed a community and had devised a means by which that community could make decisions.
Something that sounds absolutely tame to us was an outright assault on the fixed social hierarchy of England. And the various admirals, captains, presidents, and younger brothers of famous earls weren't having that.
Literally, what comes across in Marooned is that elitists' contempt for the common people was so overwhelming that they would rather see the entire colony die in anguish than admit that the perks and privileges of the aristocracy weren't serving any useful purpose. Rather than adapt, they'd bring about utter destruction — then blame their victims. And too many historians have agreed.
Marooned is a terrific book, filled with color and insight. It's well worth reading. Thanks, Pat, for turning me on to it.
And not for nothing does Kelly wryly refer to those status-blinded aristocrats as England's "2 percent" — mimicking the infamous "1 percent" of the present day. The parallels are striking.
I think that's why my mind makes a connection between Marooned and Deep Work even when any connection is tenuous and unlikely. In Deep Work, Newport is speaking to the young tech elite. His aim seems innocent enough: to teach them to be more successful and innovative by using intensive, uninterrupted, highly focused time.
It's the kind of deep thought we associate with people who change the world — who make great scientific discoveries or create profound works of art. It's jarring to see Newport recommending it for people who aim to create the next Twitter or build an AI to better detect the thoughtcrimes of We the Peasants (and not incidentally get rich and more powerful by doing so).
Not long ago, techies were out there at the fringes of society (unsurprisingly, a lot of readers of this blog are or were that kind of tech worker). And who could begrudge them any well-earned success?
Now, too often, the younger versions of those formerly ill-regarded tech folk are not only in the 1 percent, economically, but are joining the class of those who, along with politicians and crony capitalists, increasingly feel entitled to rule. They may rule (or empower the rulers) by creating more sophisticated surveillance tech or behavior-prediction systems, or by perverting so-called "free markets" to do their own surveillance or covertly attempt to shape the political opinions of We the Lesser People.
So even though I thought a lot of Newport's advice was very good, I kept thinking he was urging his intended audience of young "knowledge workers" to use excellent technique for ultimately despotic and destructive purposes.
In one way, that's not new. Elitists were ruling long before Jamestown. Even in the days when the U.S. was arguably a free country, men like Hearst and Pulitzer were using the media to manipulate readers' minds.
Their moral and political descendants are just able to do it a lot less obviously now. Somehow, this is once again bringing out the worst in the people holding, or newly gaining, economic, academic, and political control.
The rigid, deadly elitism of seventeenth century England once seemed like ancient history to freewheeling Americans. We had a glorious eighteenth century and left the crumbling, unmourned relics of Divine Right of Kings and aristocracy behind. Or so we believed.
Throughout the nineteenth and twentieth centuries, we cherished the myth of the value of the common man. Never mind that to some extent it was always just that — a myth. It meant that the lowliest farmer, factory worker, or homemaker felt — and in some ways was — valued as a crucial part of the nation's make-up. Even if the illusion wasn't quite true, it made a difference to people when they felt like they were the salt of the earth, the upstanding citizens, the ultimate protectors of a freedom that was their and their childrens' hard-won legacy.
Secretly, politicians and American aristocrats may have looked down their noses at our mothers, fathers, and grandparents. But they had to pay at least a semi-sincere lip service to the millions of working people they supposedly served. And those "little people" rose to their mythic status with honor. One of the things I remember most vividly about my mother and her passion for politics is that she fervently believed her party (the Democrats, of course) was "the party of the working man." She spoke with such fierce pride in that. Her lifelong citizen activism, it was always clear, was her way of paying back the government she perceived valued and supported her. This humble West Virginia hillbilly scorned any would-be elite. She taught her children that, rising out of the working class, we were as good as anyone else on earth. We had every right and reason to stand up for ourselves against anybody who foolishly imagined themselves to be our betters.
Now, once again as in the dreadful seventeenth century, we're seeing an elite class that no longer even bothers to honor We the Peasants with lip service. We are simply The Deplorables. The bitter clingers. The obstinant obstacle in their path to absolute power. Salt of the earth? Forget it. We are now all racists (even when we're not), sexists (even when we're not), homophobic (even when we're not), violent (even when we're not), ignorant (even when we're not), and utterly disposable.
When things go wrong, the aristocracy hastens to blame the peasants — and makes sure to do so in terms that brook no argument. When you've labeled someone an idler or traitor (seventeenth-century style) or a deplorable or a bitter clinger (twenty-first-century style), you've stated nothing that can be reasoned against. You've simply dismissed the humanity of an entire segment of the population. What more is there to say?
We the Peasants can speak out. For now, we're still allowed to exercise that right. But we will never be heard by the "better sort" of people because speaking in our own defense or the defense of individual freedom and self-determination is an act akin to lèse-majesté against the new variety of arrogant fools who imagine themselves to be our betters and our rightful rulers.
Does it matter if they hear us? In one sense, no. We are who we are, and we may be better off going our own way despite their prejudices. In another sense, it does matter. Because by re-asserting our humanity, our sense of justice, and our eternal equality as human beings We the Peasants might — if they could hear — save both the willfully blind New Aristocracy and ourselves from the fatal divide now developing.
Published in Books and Movies, Computers & Technology, Cultural insanity, Free speech, Government, Mind and Spirit, Privacy and self ownership and Religion
Previous Post Just another little check-in and a few links
Next Post Another weekend check-in, with thanks. And spring!
Owl March 1, 2019 6:03 am
The connection is obvious . . . once it is pointed out.
Perhaps more evidence of the cyclical nature of history, how it rhymes?
The epitome of human creativity – different ways of making the same mistakes over and over again.
Pat March 1, 2019 6:31 am
An excellent book review, Claire – one I hope will inspire others to read the book.
The knowledge that "the winner gets to write history" has always been a bugaboo of mine, especially so when I have occasion to know what is the truth about a subject. I have lived in the Jamestown area and know more than a little of this area's history.
Oral history can be very influencial and "Marooned" makes it more understandable where Jefferson might have gotten a few of his ideas early on, then placed them in juxtaposition against what his formal education had taught him.
And yes, "The parallels [to the 1% of the present day] are striking", indeed. I was recognizing names and events as I read the book some months ago, and even more some currently in the news since the elections.
Comrade X March 1, 2019 8:14 am
Thank you Claire (&Pat), I can't wait to read "Marooned".
I was raised in VA, I'll never forget going to Jamestown as a kid where it has been recreated, my visit was on a rainy muddy day that gave it even more realism and seeing those three little ships that they crossed over in makes you really question how they even made it over here. I'm sure today everything being promoted there is as politically correct as what they have done with TJ's "little mountain".
When I was in school we had a VA history book that was 4″ or 5″ thick and an American history book that was about 1″ so you can guess which colonial settlement I knew more about.
larryarnold March 1, 2019 9:03 am
Every generation of elites (usually the sons or grandsons of "deplorables" who worked their butts off to make a better world so their children wouldn't have to live in squalor) thinks they've invented something new and shiny. When they discover it's all been done before, they're like, "But this time we'll get it right."
Stay warm up there.
Ro March 1, 2019 12:30 pm
On a slightly different note one of the biggest points wholly overlooked by many historians is that even experienced farmers struggled with the raw land of the new world. Farmland in Britain had been cleared 100s of years before. There were no big tree roots, large rocks or other such obstructions. Most problem Predators and game animals had been strictly controlled or eliminated. The land had also been regularly fertilised. Growing on such raw land is wholly different and such inexperience meant a failed crop and starvation!
To make things worse the vast majority of the settlers would have been unfamiliar with firearms, unless having served as soldiers, and utterly clueless about hunting. Only the wealthy landowners hunted and most were driven hunts. Tracking, trapping and shooting game would have been an entirely new experience. Quite frankly it's nothing short of a miracle that any survived at all!
Comrade X March 2, 2019 10:37 am
"Quite frankly it's nothing short of a miracle that any survived at all!"
yep;
https://www.history.com/news/what-happened-to-the-lost-colony-of-roanoke
Eric Oppen March 3, 2019 6:57 pm
"Maroon" also referred to communities of escaped slaves who lived out in the back country in the Caribbean and North and South America. Some of these colonies survive to this day in parts of northern South America, and there was a large one in the Dismal Swamp in Virginia and North Carolina. In Jamaica, the Maroons were powerful enough, and well-entrenched enough in rough enough country, to force the British to treat with them as equals, and they were de-facto independent for quite a long time.


text:
Alice Street: A Memoir by Richard Valeriote
By Richard Valeriote
Alice highway recounts how Valeriote used to be born on the sundown of fine instances and the sunrise of challenging ones. His mother's 15th baby, he grew up in an Italian Catholic kinfolk on a highway filled with proud households with a large number of languages and backgrounds. From being packed into the neighborhood church, to operating and borrowing his approach via scientific university at McGill whereas surviving a number of critical health problems, to his very winning profession as a physician in California, his tale is entwined with these of every body from foundry employees to overseas ambassadors. A hot and informative examine the demanding trip made by means of such a lot of, Alice highway is a testomony to the power and personality had to make it via tumultuous times.
Read Online or Download Alice Street: A Memoir PDF
Best memoirs books
Autobiography: The Story of My Experiments with Truth
The tale of My Experiments with fact is the autobiography of Mohandas okay. Gandhi, masking his existence from early early life via to 1921.
25 Chapters of My Life
Our Billie: Learning to Live with Every Family's Worst Nightmare
'An remarkable paintings' - Joanne Harris. each parent's worst nightmare turned a fact for Ian Clayton. On a quick vacation holiday in Hay-on-Wye, he took his nine-year-old twins canoeing, and in a freak twist of fate his daughter Billie used to be drowned. In a remarkably frank and shiny manner, Clayton describes what occurred on that spring day, his determined makes an attempt to avoid wasting his kids, after which what it felt like years later to come back nose to nose with the boys who employed out the canoe.
In the Dark on the Sunny Side: A Memoir of an Out-of-Sight Mathematician
Misfortune struck one June day in 1944, while a five-year-old boy used to be eternally blinded following an coincidence he suffered with a paring knife. Few humans turn into across the world famous examine mathematicians and famously winning collage professors of that erudite topic, and never strangely a minuscule variety of these few are visually impaired.
A Short Life of Trouble: Forty Years in the New York Art World
The Wink of the Zenith: The Shaping of a Writer's Life
Sun Chief: The Autobiography of a Hopi Indian
Additional info for Alice Street: A Memoir
Mr Ferraro was an old, heavyset man who spoke in a booming voice and sat on his porch fingering his rosary beads, his lips moving in silent prayer. I would wave to him and he always waved back. Mrs Ferraro was short and could barely see over the porch railing. Whenever someone passed, she'd lift herself up on the arms of her chair and crane to see who it was, then sit down again. Mrs Dupuis seldom smiled as she sat on her porch waving her ever-present fan. I imagined that her dourness reflected some painful secret.
His apparent disapproval caught me off guard. " Mike flew out of the chair and stormed out of the house, headed for the store. I tagged along at some distance and hung back as Mike chastised Dominic for steering me away from the college prep program. Dominic was equally vociferous. "Who's going to pay for it? I've suffered enough in this store, having to earn the money for you and Silvio to go to Western. " Mike prevailed by pointing out that, since I would have to start high school over again, this meant the first tuition payment was five years away – the usual four years of high school plus the customary college prep year of our British-influenced school system.
It was improbable because I had to grow up fast, flirted with the Grim Reaper once or twice, went to bed hungry more nights than I care to remember, and survived thanks to a series of small miracles facilitated by family, friends, and strangers alike. If I hadn't lived it, I'd swear it was fiction. It seems fitting now that my life began just a couple of months before the Wall Street Crash of October 1929 that killed off the Roaring Twenties and ushered in the Great Depression. Born 5 August, I was my mother's fifteenth child and her next to last.
Dar El-Salam Book Archive > Memoirs > Alice Street: A Memoir by Richard Valeriote
Category: Memoirs


text:
proDERM Academy
Medical Devices in the EU
The Claims Support Seminar
A Review by Theresa Callaghan
"The combination of benefiting from expert knowledge and the opportunity to network within the cosmetic industry made the seminar especially valuable."
Realities & Practicalities
Following the huge 2018 success of this ever popular seminar sponsored by the proDERM Academy, the 2019 edition held here in Hamburg early December had high expectations, and neither speakers, delegates nor organisers disappointed. Once again, the proDERM Academy Claims Workshop successfully brought together a wide faculty of experts from diverse backgrounds covering all aspects of the claims development process. As with previous years, and following a warm welcome from host Professor Klaus Peter Wilhelm, Day 1 opened with a practical session at the proDERM Clinical Research Centre. Demonstrations and practical knowledge were headed up by Stephan Bielfeldt and his team on how to generate evidence for claims substantiation.
Claims & The Consumer
Clearly energized, the following 2 Days comprised lectures and discussions on bringing claims to fruition from regulation to effective implementation. Day 2 opened with a general keynote presentation from Theresa Callaghan (Callaghan Consulting International, Germany) setting the scene for following lectures. Theresa discussed the essentials of a claim, and described a common sense approach when developing a claim in terms of concepts, product users, expectations of claims, what is to be measured and the weight of evidence required before a claim can be finalised.
This led into a cautionary yet slightly humorous presentation by Erik Schipper (i3 Innovate, Sweden) who delved more deeply into the importance of the consumer when creating claims and gave practical examples of the consequences of getting it wrong. His message was clear – be very aware of consumer insights when developing claims and the importance of how they fit together. Erik's presentation was a cautionary tale to drive home the message – focus, and clearly understand 3 key issues — what consumers say they do, what consumers actually do and why consumers do what they do, and importantly should never be biased toward a marketing whim!
"Delegates and Speakers were in fine Form with some really good debates!"
Old & New Challenges
Consumer trials for claims development presented by Shazia Ginai (Neuro-insight, UK). Shazia showed that the world really is awash with cosmetic claims and as such the bombardment of them by advertising companies give rise to many consumer perceptions which are mis-read by developers if they are not careful. Consumer research is very powerful as it showcases the realistic perspectives and they go hand-in-hand with the technical support provided by laboratory and CRO testing. Consumer language and avoidance of bias and "forcing" in questioning are paramount in consumer studies.
Harald van der Hoeven (CLR Berlin, Germany) provided an outstanding presentation on the importance of the raw material supplier in the claims development process and used the development of actives for the microbiome as an on-trend example. If we do not understand the microbiome how can we make claims? The biggest debate surrounded the concern of experts that the industry knows too little of the impact of influencing the skin's microbiome, and the possible problems that are likely to ensue.
Where to Get the Data
Firstly, Stephan Bielfeldt (proDERM, Germany) opened the session with a concise overview of how information to develop a claim can be provided by clinical setting. Clinical studies can really help bolster and help create strong claims for cosmetics and are one of the best approaches to obtain credible and relevant information for claims and a wide variety of methods and tools are available.
Sylvia Zebrowski (proDERM, Germany), provided us with a guide to watch out for when using statistics in the development of claims, and make sure you use the correct test for your data. Too many studies use the wrong statistical analysis test resulting in invalid data. This is important when presenting data for advertising purposes and for when challenges of claims end up in court, or challenges by ASA's for example.
"Very informative Claims Seminar with a great mix of presentations and tours and perfect conditions for networking!"
Workshop: Building Claims
Delegates were provided with a selection of data covering consumer assessments, market share and technical study performance data for a new product from which they had to create a number of solid claims. Working in teams, were encouraged to interpret the data and compile strong and provocative claims. The results were lively, intense, creative and competitive with some very robust challenges and defences! The take-home message here was clear: "does the consumer understand what you are getting at, and is it actually relevant to them." An added humorous note too, always be careful where you place your commas, asterisks, and Asterix!
The 3 R's – Rules, Regulations & Reviews
We were pleased to welcome Emma Meredith (Director General of the CTPA, UK) who provided us with clarity on the new claims guidelines published in July 2019. Given that each country in the EU has made its won decision on these guidelines, Emma provided some persuasive arguments on why it is important to ensure that any 'free-from' claim for example complies with the 6 claims criteria. Many do not. In addition, Emma also presented the Brexit scenario. In principle the UK will follow suit with the EU legislation when it comes to claims requirements and compliance.
Meera Cush (Delphic, UK) then explained claims compliance from the perspective of the Responsible Person (RP). Whilst major brands and multinational companies have their own internal RP function(s), SME's (small & medium enterprises) contract this service to either independent companies or even their contract manufacturer. The responsible person has a tough task meeting obligations in relation to claims since legislation is not black and white ; the role requires a level of practicality and flexibility; and it is important to keep in mind overarching goals and consequences of non-compliance. Issues with Brexit also arose in line with Emma's presentations
"Excellent organized workshop with a diverse group of participants, interesting lectures as well as intensive and constructive discussions."
Making Impact: Seals, Endorsements, TV Advertising
Klaus-Peter Wilhelm (proDERM, Germany) took us through using seals and endorsements as part of the overall "claims" package, and provided a number of interesting examples on how these can work to improve sales and product credibility. It is important to take into account that seals and endorsements must also comply within the regulations with responsibility falling to the manufacturer and seal provider, especially when challenged either legally or by a competitor. The strength and credibility of a seal will always depend on the integrity and reputation of the seal provider!
Chris Gummer (Cider Solutions, UK) then brought us full circle and the event was closed out with a lively informative presentation on how to prepare claims support evidence for advertising in the UK. With some excellent examples and challenges thrown in, Chris outlined the tough and detailed requirements of UK advertising and Clearcast already gives guidance on the requirements for claim support and advertising in other EU countries.
Judging from the feedback the course delivered as part of proDERM Academy programmes, will become essential for anyone (especially marketing, R&D and legal) involved in claim substantiation or claims regulation in the cosmetics industry. We look forward to welcoming anyone involved in making claims to our next Claims Workshop.
"It is a great getting-together with experts all over the field leading to exciting and fruitful conversations."
Kiebitzweg 2
22869 Schenefeld
Phone: 040-839 358-0
Fax: 040-839 358-39
Web: www.proDERM-academy.com
Mail: info@proderm-academy.com
www.proderm-academy.de | Imprint & Data Protection
We use cookies so that we can offer you the best possible website experience. This includes cookies which are necessary for the operation of the website, as well as other cookies which are used for anonymous statistical purposes. You are free to decide which categories you would like to permit. Please note that depending on the settings you choose, the full functionality of the website may no longer be available. Further information can be found in our Privacy Policy.
More information on cookie use and opting out Imprint
More information on cookie use and opting out
Show cookie informations Close cookie informations
Owner of the website.
Saves the cookie settings according to the selection of the website visitor.
www.proderm-academy.com
Save the browser settings on every page.
https://www.proderm-academy.com/data-protection/
In order to continuously improve our website, we anonymously track data for statistical and analytical purposes. With these cookies we can , for example, track the number of visits or the impact of specific pages of our web presence and therefore optimize our content.
https://policies.google.com/technologies/types?hl=en
_ga,_gat*,_gid
Other Cookies (2)
These cookies can not be classified in the aforementioned categories. These cookies are used i.a. to analyze usage behavior or the success of advertising campaigns or to show you maps or other content.
Serves to protect from so-called spam mails, which are sent via the contact form.
This cookie is used to support Google's advertising services.


text:
Чартер Оук () град је у америчкој савезној држави Ајова. По попису становништва из 2010. у њему је живело 502 становника.

Демографија
Према попису становништва из 2010. у граду је живело 502 становника, што је -28 (-5.3%) становника више него 2000. године.

Референце

Градови у Ајови
Википројект географија/Насеља у САД

redpajama_set_name: RedPajamaWikipedia