text:
/** @flow */
import React, { Component } from 'react'
import { ContentBox, ContentBoxHeader, ContentBoxParagraph } from '../demo/ContentBox'
import AutoSizer from '../AutoSizer'
import Grid from '../Grid'
import ScrollSync from './ScrollSync'
import shallowCompare from 'react-addons-shallow-compare'
import cn from 'classnames'
import styles from './ScrollSync.example.css'
import scrollbarSize from 'dom-helpers/util/scrollbarSize'

const LEFT_COLOR_FROM = hexToRgb('#471061')
const LEFT_COLOR_TO = hexToRgb('#BC3959')
const TOP_COLOR_FROM = hexToRgb('#000000')
const TOP_COLOR_TO = hexToRgb('#333333')

export default class GridExample extends Component {
  constructor (props, context) {
    super(props, context)

    this.state = {
      columnWidth: 75,
      columnCount: 50,
      height: 300,
      overscanColumnCount: 0,
      overscanRowCount: 5,
      rowHeight: 40,
      rowCount: 100
    }

    this._renderBodyCell = this._renderBodyCell.bind(this)
    this._renderHeaderCell = this._renderHeaderCell.bind(this)
    this._renderLeftSideCell = this._renderLeftSideCell.bind(this)
  }

  render () {
    const {
      columnCount,
      columnWidth,
      height,
      overscanColumnCount,
      overscanRowCount,
      rowHeight,
      rowCount
    } = this.state

    return (
      <ContentBox>
        <ContentBoxHeader
          text='ScrollSync'
          sourceLink='https://github.com/bvaughn/react-virtualized/blob/master/source/ScrollSync/ScrollSync.example.js'
          docsLink='https://github.com/bvaughn/react-virtualized/blob/master/docs/ScrollSync.md'
        />

        <ContentBoxParagraph>
          High order component that simplifies the process of synchronizing scrolling between two or more virtualized components.
        </ContentBoxParagraph>

        <ContentBoxParagraph>
          This example shows two Grids and one List configured to mimic a spreadsheet with a fixed header and first column.
          It also shows how a scroll callback can be used to control UI properties such as background color.
        </ContentBoxParagraph>

        <ScrollSync>
          {({ clientHeight, clientWidth, onScroll, scrollHeight, scrollLeft, scrollTop, scrollWidth }) => {
            const x = scrollLeft / (scrollWidth - clientWidth)
            const y = scrollTop / (scrollHeight - clientHeight)

            const leftBackgroundColor = mixColors(LEFT_COLOR_FROM, LEFT_COLOR_TO, y)
            const leftColor = '#ffffff'
            const topBackgroundColor = mixColors(TOP_COLOR_FROM, TOP_COLOR_TO, x)
            const topColor = '#ffffff'
            const middleBackgroundColor = mixColors(leftBackgroundColor, topBackgroundColor, 0.5)
            const middleColor = '#ffffff'

            return (

                <div
                  className={styles.LeftSideGridContainer}
                  style={{
                    position: 'absolute',
                    left: 0,
                    top: 0,
                    color: leftColor,
                    backgroundColor: `rgb(${topBackgroundColor.r},${topBackgroundColor.g},${topBackgroundColor.b})`
                  }}
                >
                  <Grid
                    cellRenderer={this._renderLeftHeaderCell}
                    className={styles.HeaderGrid}
                    width={columnWidth}
                    height={rowHeight}
                    rowHeight={rowHeight}
                    columnWidth={columnWidth}
                    rowCount={1}
                    columnCount={1}
                  />

                <div
                  className={styles.LeftSideGridContainer}
                  style={{
                    position: 'absolute',
                    left: 0,
                    top: rowHeight,
                    color: leftColor,
                    backgroundColor: `rgb(${leftBackgroundColor.r},${leftBackgroundColor.g},${leftBackgroundColor.b})`
                  }}
                >
                  <Grid
                    overscanColumnCount={overscanColumnCount}
                    overscanRowCount={overscanRowCount}
                    cellRenderer={this._renderLeftSideCell}
                    columnWidth={columnWidth}
                    columnCount={1}
                    className={styles.LeftSideGrid}
                    height={height - scrollbarSize()}
                    rowHeight={rowHeight}
                    rowCount={rowCount}
                    scrollTop={scrollTop}
                    width={columnWidth}
                  />

                  <AutoSizer disableHeight>
                    {({ width }) => (

                        <div style={{
                          backgroundColor: `rgb(${topBackgroundColor.r},${topBackgroundColor.g},${topBackgroundColor.b})`,
                          color: topColor,
                          height: rowHeight,
                          width: width - scrollbarSize()
                        }}>
                          <Grid
                            className={styles.HeaderGrid}
                            columnWidth={columnWidth}
                            columnCount={columnCount}
                            height={rowHeight}
                            overscanColumnCount={overscanColumnCount}
                            cellRenderer={this._renderHeaderCell}
                            rowHeight={rowHeight}
                            rowCount={1}
                            scrollLeft={scrollLeft}
                            width={width - scrollbarSize()}
                          />

                        <div
                          style={{
                            backgroundColor: `rgb(${middleBackgroundColor.r},${middleBackgroundColor.g},${middleBackgroundColor.b})`,
                            color: middleColor,
                            height,
                            width
                          }}
                        >
                          <Grid
                            className={styles.BodyGrid}
                            columnWidth={columnWidth}
                            columnCount={columnCount}
                            height={height}
                            onScroll={onScroll}
                            overscanColumnCount={overscanColumnCount}
                            overscanRowCount={overscanRowCount}
                            cellRenderer={this._renderBodyCell}
                            rowHeight={rowHeight}
                            rowCount={rowCount}
                            width={width}
                          />

                    )}
                  </AutoSizer>

            )
          }}
        </ScrollSync>
      </ContentBox>
    )
  }

  shouldComponentUpdate (nextProps, nextState) {
    return shallowCompare(this, nextProps, nextState)
  }

  _renderBodyCell ({ columnIndex, key, rowIndex, style }) {
    if (columnIndex < 1) {
      return
    }

    return this._renderLeftSideCell({ columnIndex, key, rowIndex, style })
  }

  _renderHeaderCell ({ columnIndex, key, rowIndex, style }) {
    if (columnIndex < 1) {
      return
    }

    return this._renderLeftHeaderCell({ columnIndex, key, rowIndex, style })
  }

  _renderLeftHeaderCell ({ columnIndex, key, rowIndex, style }) {
    return (

        {`C${columnIndex}`}

    )
  }

  _renderLeftSideCell ({ columnIndex, key, rowIndex, style }) {
    const rowClass = rowIndex % 2 === 0
      ? columnIndex % 2 === 0 ? styles.evenRow : styles.oddRow
      : columnIndex % 2 !== 0 ? styles.evenRow : styles.oddRow
    const classNames = cn(rowClass, styles.cell)

    return (

        {`R${rowIndex}, C${columnIndex}`}

    )
  }
}

function hexToRgb (hex) {
  const result = /^#?([a-f\d]{2})([a-f\d]{2})([a-f\d]{2})$/i.exec(hex)
  return result ? {
    r: parseInt(result[1], 16),
    g: parseInt(result[2], 16),
    b: parseInt(result[3], 16)
  } : null
}

/**
 * Ported from sass implementation in C
 * https://github.com/sass/libsass/blob/0e6b4a2850092356aa3ece07c6b249f0221caced/functions.cpp#L209
 */
function mixColors (color1, color2, amount) {
  const weight1 = amount
  const weight2 = 1 - amount

  const r = Math.round(weight1 * color1.r + weight2 * color2.r)
  const g = Math.round(weight1 * color1.g + weight2 * color2.g)
  const b = Math.round(weight1 * color1.b + weight2 * color2.b)

  return { r, g, b }
}


text:
Skip to section navigation
RAND Health Quarterly
2015, Vol. 5, No. 2
>Article 19
Sleep in the Military
Promoting Healthy Sleep Among U.S. Servicemembers
by Wendy M. Troxel, Regina A. Shih, Eric R. Pedersen, Lily Geyer, Michael P. Fisher, Beth Ann Griffin, Ann C. Haas, Jeremy Kurz, Paul S. Steinberg
RAND Health Quarterly, 2015; 5(2):19
Sleep disturbances are a common reaction to stress and are linked to a host of physical and mental health problems. Given the unprecedented demands placed on U.S. military forces since 2001, there has been growing concern about the prevalence and consequences of sleep problems for servicemembers. Sleep problems often follow a chronic course, persisting long after servicemembers return home from combat deployments, with consequences for their reintegration and the readiness and resiliency of the force. Therefore, it is critical to understand the role of sleep problems in servicemembers' health and functioning and the policies and programs available to promote healthy sleep. This study provides the first comprehensive review of sleep-related policies and programs across the U.S. Department of Defense (DoD), along with a set of actionable recommendations for DoD, commanders, researchers, and medical professionals who treat U.S. servicemembers. The two-year multimethod study also examined the rates and correlates of sleep problems among post-deployed servicemembers, finding negative effects on mental health, daytime impairment, and perceived operational readiness. The research reviewed evidence-based interventions to treat sleep disturbances among servicemembers and veterans and exposed several individual- and system-level barriers to achieving healthy sleep. Implementing evidence-based treatments is just one step toward improving sleep across the force; as the research recommendations highlight, it is equally important that policies and programs also focus on preventing sleep problems and their consequences.
For more information, see RAND RR-739-OSD at https://www.rand.org/pubs/research_reports/RR739.html
Depression,
Military Force Deployment,
Military Health and Health Care,
Military Personnel,
Posttraumatic Stress Disorder,
Sleep,
"In peace and war, the lack of sleep works like termites in a house: below the surface, gnawing quietly and unseen to produce gradual weakening which can lead to sudden and unexpected collapse."
—Major General Aubrey Newman (Follow Me, 1981, p. 279)
Sleep disturbances are a common reaction to stress and are reliably and prospectively linked with a host of adverse mental and physical health outcomes, including increased risk of depression, suicide, posttraumatic stress disorder (PTSD), accidents and injuries, cardiometabolic disorders, and mortality (Bramoweth and Germain, 2013). Given the unprecedented demands placed on the U.S. military over the past 13 years of protracted overseas combat operations in Iraq and Afghanistan, increasing attention has focused on the prevalence and consequences of sleep problems among servicemembers returning from deployments in support of Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND). Perhaps not surprisingly, research suggests that sleep problems—particularly insomnia, short sleep duration, and nightmares—are highly prevalent during combat operations (Bray et al., 2009; McLay, Klam, and Volkert, 2010; Mental Health Advisory Team [MHAT] 9, 2013; Young-McCaughan, Peterson, and Bingham, 2011). Importantly, sleep disturbances are also core symptoms of PTSD, depression, anxiety, and traumatic brain injury (TBI), which are considered among the signature wounds of OIF/OEF deployments (Hoge, Castro, et al., 2004). Research further suggests that, for many servicemembers, sleep problems persist long after deployments have ended and can have a substantial impact on their ability to successfully reintegrate and rebuild their lives post-deployment (Pietrzak, Morgan, and Southwick, 2010; Plumb et al., 2014; Seelig et al., 2010; Swinkels et al., 2013). As the United States continues its drawdown from OIF, OEF, and OND and increasing numbers of servicemembers face the challenges of reintegration, the military health system is being tasked with identifying and treating the range of physical and mental health consequences of war, including sleep disturbances, that persist into the post-deployment period, and that impact subsequent force readiness. It is therefore critical to understand the role of sleep problems in servicemembers' health and functioning in the post-deployment period, the types of programs available to promote healthy sleep and treat sleep disorders, and the policy-level factors that may contribute to servicemembers' sleep. To date, however, there have been no comprehensive reviews of existing policies and programs across the U.S. Department of Defense (DoD) that affect sleep in the post-deployment period.
To comprehensively explore these issues and provide a set of actionable recommendations for DoD, researchers, and medical professionals, the RAND National Defense Research Institute (NDRI) conducted a two-year independent study using a multimethod approach. The study examined the prevalence and consequences of post-deployment sleep problems among U.S. servicemembers, current programs and policies related to sleep in the military, barriers to implementing those programs and policies, and evidence-based interventions to treat sleep disturbances in servicemember populations. Our study's conceptual model suggests that there is considerable continuity between sleep problems in the deployed setting and those in the post-deployment period. While research and policies to date have focused primarily on deployed settings (as reviewed in a recent report by Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury [DCoE] titled Overview of Sleep and Fatigue, 2012), we focused our analysis (where possible) on the post-deployed environment, because research suggests that chronic and enduring sleep problems (i.e., those that persist after a deployment has ended) are most likely to affect mental and physical health and may impact subsequent operational readiness.
Guided by the conceptual framework and in collaboration with our sponsor, DCoE, we employed a multimethod approach that included literature reviews and quantitative and qualitative research methods to answer the following five research questions:
What are the correlates and consequences of sleep problems among servicemembers in the post-deployment period?
What are the current programs and policies related to sleep in the military?
What are the evidence-based interventions to treat sleep disorders among servicemembers?
What are the barriers to achieving healthy sleep for servicemembers?
What actions can be taken to promote sleep health among servicemembers?
Specifically, we reviewed the literature pertaining to the prevalence and consequences of sleep disturbances in servicemember populations in the post-deployment period, as well as evidence-based strategies for treating sleep disturbances in servicemember populations. We also sought sources and strategies with a particular focus on veterans of OEF/OIF, a population found to be at heightened risk for stress-related sleep disturbances.
In addition, we conducted a cross-sectional survey to inform an in-depth analysis of the types of sleep problems and behaviors that are characteristic of servicemember populations, identify specific subgroups of servicemembers who may be at greater risk for sleep problems, and determine whether sleep problems are independently associated with mental and physical health and operational readiness. The survey offered a broad assessment of sleep problems and associated consequences in a large and diverse sample of deployable servicemembers across all four branches of the U.S. armed forces (N = 1,957). We focused on the associations between sleep symptoms or behaviors and several important indicators of servicemember health and readiness. We also included a rich assessment of covariates (e.g., depressive symptoms, presence of traumatic brain injury, shift work, and a host of deployment and sociodemographic characteristics) that are known to covary with sleep problems, well-being, and readiness.
Although deployments may be a precipitating factor in the onset of sleep disturbances for many servicemembers (as highlighted in the study's conceptual model), from a policy perspective, it is important to consider more broadly the system-level factors that may contribute to increased vulnerability to sleep problems across the deployment cycle. Therefore, we reviewed existing DoD and Service-level policies and programs related to sleep in training, operational, and clinical contexts, regardless of deployment status.
To supplement our review of codified policies and programs related to sleep and the barriers to implementation, we conducted a series of 40 interviews with line leaders and clinicians from all Service branches and convened an expert panel consisting of 31 clinicians, line leaders, and researchers with expertise in sleep in the military. In the following section, we summarize our findings for each of the five study questions.
Evidence from the reviewed published literature and our survey data suggest that sleep problems are prevalent, debilitating, and persistent in servicemember populations in the post-deployment period. Consistent with the civilian population, the most commonly diagnosed sleep disorders among servicemembers seeking evaluation include insomnia and obstructive sleep apnea (OSA; Capaldi, Guerrero, and Killgore, 2011; Collen et al., 2012; McLay, Klam, and Volkert, 2010; Mysliwiec, Gill, et al., 2013; Mysliwiec, McGraw, et al., 2013). Servicemembers in general, and those who have deployed, specifically, are at high risk for insufficient sleep duration (i.e., sleeping six hours or less on average; Luxton, Greenburg, et al., 2011; Seelig et al., 2010). This is particularly concerning, given the robust evidence linking short sleep duration with compromised mental and physical health and cognitive impairments, all of which can have a direct impact on operational readiness and servicemember resilience (Wesensten and Balkin, 2013). Perhaps as a consequence of insufficient sleep duration and poor sleep quality, servicemembers are also at high risk for daytime sleepiness and fatigue (Hoge et al., 2008; Toblin, Riviere, et al., 2012). The prevalence of sleep disorders and symptoms in the post-deployment period is higher among servicemembers with comorbid deployment-related injuries or mental health problems than it is for those without such conditions (Bramoweth and Germain, 2013). Our conceptual model and prior research with veterans further indicate that, once initiated, sleep disturbances may follow a persistent course, lasting for years after deployment.
Sleep problems and disorders, in turn, have both short-term and lasting negative effects on physical health, cognitive functioning, and operational readiness. For example, physical health problems, such as obesity and high body mass index (BMI), are particularly prevalent among servicemembers with sleep-related breathing disorders (Brundage, Wertheimer, and Clark, 2010; Engel et al., 2000; Mysliwiec, McGraw, et al., 2013; Seelig et al., 2010). In fact, elevated BMI is a significant risk factor for developing sleep-related breathing disorders (e.g., OSA) in civilian populations (Patel and Hu, 2008; Yu and Berger, 2011). PTSD, depression, and TBI are common disorders associated with sleep problems, but longitudinal evidence further shows that sleep problems can presage the onset of these disorders (Gehrman et al., 2013; Hoge, McGurk, et al., 2008; McLay, Klam and Volkert, 2010; Wallace et al., 2011; Wright et al., 2011b; van Liempt et al., 2013). Beyond increasing the risk of developing a subsequent mental health condition, sleep problems are known to be among the most intractable symptoms of other mental health conditions, such as depression. Moreover, even with successful treatment for a co-occurring mental health condition (e.g., depression), sleep problems can predict poor treatment response or relapse (Manber, Edinger, et al., 2008; Troxel, Kupfer, et al., 2012). Findings from the military's research laboratories have demonstrated the significant effects of sleep deprivation and fatigue on cognition, attention, reaction time, and moral reasoning, all of which are critically important for operational effectiveness (Wesensten and Balkin, 2013).
As mentioned, the existing literature provides suggestive evidence that sleep problems are a prevalent and salient issue among servicemembers and that military deployments may be associated with an increased risk of sleep problems. These findings are generally based on studies that included single or few-item assessments of isolated sleep symptoms (e.g., trouble sleeping or sleep duration). However, sleep is a multidimensional state, including both nocturnal characteristics (e.g., quality, duration, nightmares) and associated daytime consequences (e.g., sleepiness, fatigue). No study to date has examined multiple dimensions of sleep and associated daytime impairments in a large sample of servicemembers across all Service branches and components. In addition, only a handful of studies have examined sleep problems according to servicemembers' deployment history or characteristics of the deployment that may increase the risk of stress-related sleep disturbances (e.g., exposure to combat). Moreover, the existing literature has generally focused on a single Service branch, which may limit the generalizability of the findings. Finally, given that sleep problems are known to covary with sociodemographic and military characteristics, as well as overall well-being (Bramoweth and Germain, 2013), questions remain about whether sleep is merely a proxy for these co-occurring factors or an independent correlate of key indicators of mental and physical health and operational readiness.
We also conducted a cross-sectional survey to address these gaps and to inform an in-depth analysis of the types of sleep problems and behaviors that characterize servicemember populations, identify specific subgroups of servicemembers who may be at greater risk for sleep problems, and determine the extent to which sleep problems are independently associated with mental and physical health and operational readiness. The survey offered a broad assessment of sleep problems and associated consequences in a large and diverse sample (N = 1,957) of servicemembers across all four branches of the U.S. armed forces.
The survey results showed a high prevalence of insufficient sleep duration, poor sleep quality, daytime sleepiness, fatigue, and nightmares in our sample. Approximately 18 percent of the sample reported using sleep medications, which is important to consider given the known side effects of these medications, which may compromise operational effectiveness, and the limited evidence of efficacy or safety in military settings.
We also had a unique opportunity to examine whether the prevalence of sleep problems differed according to deployment history or combat exposure; to date, only a handful of studies have done so. Somewhat surprisingly, we found few statistically significant differences in sleep according to deployment history, though we did find differences according to combat exposure. Specifically, we found only one significant difference according to deployment history. In the Navy sample, those with prior deployments had greater sleep-related daytime impairment than those without a prior deployment. In the Army sample—in which we were able to compare soldiers who had never deployed, those who were currently deployed, and those who had previously deployed—we found no significant differences among the three subgroups on any sleep measure. In contrast to these generally non-significant findings for deployment history, and consistent with the prior literature, we found that higher levels of combat exposure were associated with poorer sleep quality and greater frequency of reporting repeated, disturbing dreams among those who experienced a traumatic event (Plumb et al., 2014; Luxton, Greenburg, et al., 2011; Wright et al., 2011b). These results suggest that it may not be deployment, per se, that is associated with an increased risk of sleep problems; however, exposure to combat may increase the risk, perhaps as a result of conditioned vigilance and hyperarousal that stems from sustained high operational tempo (OPTEMPO) environments.
As for our survey analyses of outcomes associated with poor sleep, we found that poor sleep quality and sleep-related daytime impairment are associated with poor physical health, probable depression, probable PTSD, and lower perceived unit readiness. These findings are consistent with previous military sleep studies documenting the association between sleep problems and mental health problems, such as depression and PTSD; however, we are not aware of any prior study that included an assessment of perceived readiness. Our findings also extend this work to highlight the robust associations between sleep quality and health outcomes. Collectively, these findings attest to the high prevalence of a myriad of sleep problems, including insufficient sleep duration, poor sleep quality, nightmares, daytime fatigue, and the use of sleep medications among servicemembers. They also add further support to the notion that sleep problems are not merely a proxy for other co-occurring symptoms, but they may confer an independent increased risk of adverse mental and physical health outcomes and compromised operational effectiveness.
In our review of DoD-wide and Service-specific policies and programs, we found a range of sleep-related prevention, medical, training, and operational strategies. DoD recognizes sleep as an important contributor to physical and mental health and operational readiness, and it has established several programs and policies to treat and prevent sleep disorders and to promote healthy sleep practices.
DoD medical policies related to sleep include screening for troubled sleep using the Post Deployment Health Assessment (PDHA) and Post Deployment Health Re-Assessment (PDHRA) programs, setting and adhering to medical standards, applying qualifications for initial military service, referring medical conditions to a medical evaluation board, and treating sleep disorders.
We found that service-specific and U.S. Department of Veterans Affairs (VA) medical policies on treating sleep disorders primarily mention sleep as a symptom of other conditions rather than as a primary disorder. Because sleep problems may precede the onset of other psychological and medical conditions, handling sleep as a byproduct of other conditions in medical treatment policies can lead to underdiagnosis and insufficient treatment of sleep problems.
In general, medical policies related to sleep were included in military programs on resiliency and stress management rather than explicitly addressing sleep management. An advantage of this approach is that sleep-related policies and programs are directed at the whole individual from a broader wellness perspective. But a disadvantage is that the lack of a specific focus on sleep in these stress management programs may undermine the importance of sleep, given that many sleep problems present independently of or even precede the development of mental health problems. This lack of emphasis on sleep may lead to inconsistent guidance on how to help servicemembers achieve optimal sleep duration and quality.
One example of a promising prevention program that puts sleep on equal footing with other key indicators of health is the Army Performance Triad. Perhaps the most comprehensive program to date that promotes sleep health from a prevention perspective, the Performance Triad provides systematic messages about the importance of sleep as a health behavior on par with nutrition and physical activity and promotes the use of objective tools to facilitate sleep monitoring (e.g., actigraphy). To date, however, the program's efficacy has not been evaluated, though research efforts are under way. The program may be a useful platform for other Service branches to develop similarly comprehensive sleep health programs.
Overall, we found that training policies were generally consistent in recommending sleep duration of seven to eight hours per night. However, these policies generally focused on the initial phases of military training (i.e., basic training), and codified policies pertaining to sleep did not necessarily extend to subsequent training environments.
Operational policies—the most common type of policies we identified—relate to sleep during combat operations or exercises. These operational policies focus on prescribing shift-work cycles and the duration of rest periods. These policies also mandate sleep plans, which are part of the process of establishing operational plans and associated risk assessments. However, there was a lack of specific guidance on how to implement these plans. We also found inconsistency in the amount of emphasis placed on sleep in each of the occupational areas within each Service.
A review of the peer-reviewed academic literature showed that both pharmacologic and non-pharmacologic (i.e., behavioral or cognitive-behavioral) interventions have demonstrated efficacy in treating insomnia in civilian studies. Specifically, meta-analytic studies have found that pharmacologic and non-pharmacologic interventions have comparable efficacy in treating insomnia, with effect sizes in the moderate to large range for reducing insomnia for both types of interventions (Morin, Culbert, and Schwartz, 1994; Irwin, Cole, and Nicassio, 2006; Mitchell et al., 2012). However, the effects of non-pharmacologic interventions tend to be more durable (National Institutes of Health, 2005; i.e., treatment gains persist after active treatment has terminated). Nevertheless, pharmacologic approaches remain the front-line treatment in military and civilian populations, despite the fact that there is a notable lack of evidence supporting the efficacy or safety of pharmacologic approaches in treating insomnia in military settings (Brown, Berry, and Schmidt, 2013; DCoE, 2012). Key informants and expert panelists noted that this lack of systematic evidence is concerning because the safety issues pertaining to medication side effects may be particularly germane to servicemember populations, given operational demands and occupational hazards (Brown, Berry, and Schmidt, 2013). In contrast, there is a sizable and growing evidence base supporting the efficacy of cognitive-behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for insomnia, specifically within servicemember populations (see, e.g., Talbot et al., 2014; Margolies, 2011; Gellis and Gehrman, 2011; Koffel and Farrell-Carnahan, 2014; Perlman et al., 2008).
The dissemination of efficacious cognitive-behavioral therapies for sleep disturbances has been limited, partly because of a critical shortage of trained providers in behavioral sleep medicine techniques and a lack of provider awareness of the efficacy of these programs in both civilian and military settings (Siebern and Manber, 2011). Training or hiring a greater number of qualified behavioral health specialists and creating more clinical training opportunities could help decrease this shortage, and efforts are underway both through VA and the Center for Deployment Psychology. Further research using robust randomized controlled trials in military contexts is also greatly needed to establish best-practice guidelines for treating servicemembers and veterans, because the nature of sleep problems and the efficacy of specific treatment strategies may differ for servicemember or veteran populations versus civilian populations. There is also a critical need to develop and validate evidence-based identification and prevention programs, including the use of objective sleep- and fatigue-monitoring devices, to promote healthy sleep behaviors and to provide opportunities for intervention before acute sleep disturbances become chronic and debilitating.
Even with evidenced-based practices and programs to prevent and treat sleep problems in servicemembers and codified policies related to sleep in place, we found cultural, operational, knowledge-related, and medical system barriers across the military context that may impede efforts to promote sleep health and treat sleep disorders in servicemember populations.
Expert panel attendees and interviewees highlighted the importance of military culture as a potential barrier to the promotion of healthy sleep practices. Specifically, they suggested that military cultural attitudes have historically tended to undermine the importance of sleep, which serves as an ongoing challenge to the adoption and implementation of effective sleep policies and programs. For instance, stigma associated with expressing a greater need for sleep may deter servicemembers from self-identifying or seeking help before a sleep problem becomes chronic and debilitating. Screening for sleep disturbances within military contexts is also limited, with sleep being perceived as a low institutional priority in military communities or simply "behind other areas" of war-related health issues.
Operational environments themselves are often barriers to healthy sleep, because of noise, crowded conditions, and the need for vigilance in threatening settings. Furthermore, we found that sleep policies are generally interpreted as "guidance" in operational contexts and, thus, secondary to operational demands. Although efforts to promote healthy sleep behaviors are important, such efforts must be carefully balanced against the realities of the dynamic, high-risk, and demanding military environment. Also, even where sleep policies are in place, leaders may not have sufficient manpower to allow for proper sleep—threats that are particularly salient given the high OPTEMPO of recent years. However, recent efforts to promote healthy sleep by optimizing crew shift schedules have shown that such strategies actually promote performance. Thus, perceived "trade-offs" may be balanced by improvements in servicemember performance and overall satisfaction.
Our qualitative research informed by expert panel attendees and interviewees suggested that the lack of knowledge about the importance of sleep behaviors and sleep-related policies was a barrier to recognizing and addressing sleep problems. This lack of knowledge or awareness is partly the result of limited education and training among leadership about the importance of sleep and the lack of a centralized DoD-wide resource on sleep policies. A centralized DoD repository could supplement some Service-specific websites that do provide sleep resources* to include guidance on the identification and management of sleep problems, as well as how to develop and implement at sleep plan.
Finally, medical and treatment system challenges create barriers. There is a lack of adequate screening tools, procedures, and systems for detecting sleep problems in military contexts. In addition, both continuity of care and shortages in the number of sleep providers and clinics were noted as barriers to promoting sleep health in servicemember populations during our interviews and focus groups.
Understanding these barriers is critical to making well-informed and robust policy recommendations related to preventing, identifying, and clinically managing sleep problems and promoting sleep health in both operational and training settings.
Based on the findings above, we provide recommendations for filling gaps and overcoming barriers to achieving healthy sleep in servicemembers. To some extent and in certain contexts (e.g., in the combat environment), it is accepted that the unique role and demands of the military will necessarily restrict the opportunity for sufficient sleep duration and quality. Thus, we put forth a set of actionable recommendations that take into account these exigencies while at the same time identifying opportunities for programs and policies to promote sleep health in multiple contexts, including both operational and medical or clinical settings and across a continuum of care from prevention to identification and intervention.
In terms of preventing sleep problems, our study found no evidence-based practices to prevent sleep disorders in military or civilian populations, with the possible exception of weight loss and management strategies that also reduce the risk of OSA. This dearth of prevention efforts is consistent with the history of sleep medicine and medicine in general, which has tended to focus on physical illnesses or disorders rather than promoting health. Thus, we provide several recommendations to support prevention efforts, with the ultimate goal of promoting sleep health.
As for increasing the identification and diagnosis of sleep problems, our study identified several factors that may facilitate the detection of sleep disturbances, including the family as a key mechanism for detection, primary care as a key setting for detection, and the use of objective assessments to quantify insufficient sleep and associated daytime impairment.
In terms of clinically managing sleep disorders and promoting sleep health, our study also suggests a need to improve the education of health providers on the assessment, diagnosis, and treatment of sleep problems and disorders; to improve education of servicemembers on healthy sleep-related behaviors, including the appropriate use of stimulants and sleep medications; and to systematically evaluate promising programs and intervention approaches, including the use of technology to monitor and treat sleep disturbances. Policies that support provider training and that offer incentives for specialized sleep medicine training are needed to fill gaps in provider capabilities and the shortage of providers able to confidently deliver care to prevent, identify, and treat sleep disorders among military populations. Moreover, to enhance the dissemination of sleep treatments, trained providers are needed in a variety of contexts, including primary care, rather than in specialty sleep clinics only, where fewer patients are likely to present initially. Although several of these efforts to disseminate evidence-based sleep treatments by providing training for providers are under way within both the VA and DoD, there still is a need for systematic evaluation of the efficacy of these programs in terms of increasing provider knowledge and improving patient outcomes.
Finally, in terms of improving sleep in training and operational contexts, our study found that policies related to sleep are generally Service-specific and sometimes inconsistent in the degree of emphasis placed on sleep in each of the occupational areas within each Service. To a certain extent, these observed variations are expected and necessary, given each Service's mission focus (e.g., Air Force air operations) and the associated sleep policy for that military community. Nevertheless, such variation can create challenges for leaders trying to integrate work schedules or manage shift work in a diverse occupational specialty or joint environment. There are clearly unique challenges to achieving quality sleep in the post-deployment setting, and it is in this context that chronic and debilitating sleep disorders are likely to manifest. Thus, efforts are needed—most likely at the DoD level—to communicate overarching guidance to the Services regarding sleep in terms that are consistent with, and coherent within, an operational framework. Our recommendations in this area are geared toward this end.
Table 1 summarizes the recommendations in the four areas.
Table 1. Recommendations to Promote Sleep Health
Prevent Sleep Problems
1. Increase servicemember and line leader education about healthy sleep behaviors to increase self-awareness and knowledge about the factors that inhibit or promote adequate, restful sleep.
2. Fund or conduct research to perform longitudinal studies on sleep and effects on operational readiness and resilience.
Increase Identification and Diagnosis of Sleep Problems
3. Educate families on signs and symptoms of sleep disturbances as a way to bolster sleep detection efforts.
4. Improve screening for sleep disturbances in primary care settings, including the routine use of validated screening tools to identify those at high risk for the broad range of sleep disorders.
Clinically Manage Sleep Disorders and Promote Sleep Health
5. Develop provider education programs on preventing, identifying, and treating sleep disorders, with a focus on giving providers the latest findings in the field of sleep science to effectively advise patients on sleep issues and a focus on prevention as well as treatment.
6. Develop a clinical practice guideline for sleep disorders that specifically addresses sleep and discusses prevention, identification, and treatment of sleep disorders.
7. Increase the use of mobile technology for assessing and clinically managing sleep disorders, in particular to monitor sleep and alertness and to identify and manage sleep disorders before they become chronic or debilitating.
8. Continue to research evidenced-based practices for aadvancing healthy sleep in military populations (e.g., mindfulness, teletherapy) and establish guidelines for treating servicemembers and veterans.
9. Enhance dissemination of evidence-based sleep treatments (e.g., CBT-I, IRT) by training providers in primary care settings as well as behavioral health clinics.
10. Improve continuity of care of sleep disorder treatments, such as through the use of electronic medical records that link records across the deployment cycle.
Improve Sleep in Training and Operational Contexts
11. Make appropriate revisions to existing training and operational policies to minimize inconsistencies and align with current clinical guidelines about optimal sleep duration that recommend that the amount of sleep required among civilians is eight hours.
12. Educate line leaders on creating sleep plans that align with current research on circadian rhythms, consider the physical sleeping environment, and factor in shift schedules of roommates or tentmates when assigning duty.
13. Create standardized operational and training policies across DoD to increase sleep duration and quality and reduce fatigue-related impairment.
14. Link sleep-related surveillance data on mishaps to evaluate the role of sleep and fatigue.
15. Prioritize sleep in reintegration policies to offer servicemembers a period of recuperation during which they might be able to begin to return to normal sleep habits and potentially prevent the onset of chronic sleep problems that develop well after the initial reintegration period.
16. Disseminate positive messaging about sleep as an operational imperative (a vital sign, such as blood pressure) to increase awareness and reduce cultural barriers.
Given the recent drawdown from combat operations in Iraq and Afghanistan, increasing attention has focused on the factors that promote or hinder servicemembers' ability to reintegrate and rebuild their lives post-deployment. This study offers 16 policy recommendations to promote sleep health in the domains of prevention, identification, treatment, and training/operations. These recommendations should be addressed collectively by individual servicemembers, unit leaders, the military health system, training and operational commands, military health researchers, and DoD at large. Implementing these recommendations must go hand in hand with better messaging about the biological and operational necessity of sleep to overcome cultural, environmental, medical, and operational barriers to achieving healthy sleep among servicemembers. Carrying out such an integrated approach is critical for improving sleep, which is an important contributor to resilience and operational readiness in the U.S. military.
Bramoweth, Adam D., and Anne Germain, "Deployment-Related Insomnia in Military Personnel and Veterans," Current Psychiatry Reports, Vol. 15, No. 10, October 2013, p. 401.
Bray, Robert. M., Michael R. Pemberton, Laurel L. Hourani, Michael Witt, Kristine L. Rae Olmsted, Janice M. Brown, BeLinda Weimer, Marian E. Lane, Mary Ellen Marsden, Scott Scheffler, Russ Vandermaas-Peeler, Kimberly R. Aspinwall, Erin Anderson, Kathryn Spagnola, Kelly Close, Jennifer L. Gratton, Sara Calvin, and Michael Bradshaw, 2008 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, Research Triangle Park, N.C.: RTI International, Report No. RTI/10940-FR, 2009. As of July 10, 2014:
http://www.tricare.mil/tma/studiesEval.aspx
Brown, Cary A., Robyn Berry, and Ashley Schmidt, "Sleep and Military Members: Emerging Issues and Nonpharmacological Intervention," Sleep Disorders, 2013.
Brundage, John F., Ellen Wertheimer, and Leslie Clark, "Obstructive Sleep Apnea, Active Component, U.S. Armed Forces, January 2000–December 2009," Medical Surveillance Monthly Report, Vol. 17, No. 5, 2010, pp. 8–11.
Capaldi, Vincent F. II, Melanie L. Guerrero, and William D. Killgore, "Sleep Disruptions Among Returning Combat Veterans from Iraq and Afghanistan," Military Medicine, Vol. 176, No. 8, August 2011, pp. 879–888.
Collen, Jacob, Nicholas Orr, Christopher J. Lettieri, Kevin Carter, and Aaron B. Holley, "Sleep Disturbances Among Soldiers with Combat-Related Traumatic Brain Injury," Chest, Vol. 142, No. 3, 2012, pp. 622–630.
DCoE—See Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Overview of Sleep and Fatigue, 2012.
Engel, Charles C., Jr. , Xian Liu, Brian D. McCarthy, Ronald F. Miller, and Robert J. Ursano, "Relationship of Physical Symptoms to Posttraumatic Stress Disorder Among Veterans Seeking Care for Gulf War–Related Health Concerns," Psychosomatic Medicine, Vol. 62, No. 6, November–December 2000, pp. 739–745.
Gehrman, Philip, Amber D. Seelig, Isabel G. Jacobson, Edward J. Boyko, Tomoko I. Hooper, Gary D. Gackstetter, Christi S. Ulmer, and Tyler C. Smith, "Predeployment Sleep Duration and Insomnia Symptoms as Risk Factors for New-Onset Mental Health Disorders Following Military Deployment," Sleep, Vol. 36, No. 7, July 2013, pp. 1009–1018.
Gellis, Les A., and Philip R. Gehrman, "Cognitive Behavioral Treatment for Insomnia in Veterans with Long-Standing Posttraumatic Stress Disorder: A Pilot Study," Journal of Aggression, Maltreatment and Trauma, Vol. 20, No. 8, 2011, pp. 904–916.
Hoge, Charles W., Carl A. Castro, Stephen C. Messer, Dennis McGurk, Dave I. Cotting, and Robert L. Koffman, "Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care," New England Journal of Medicine, Vol. 351, No. 1, 2004, pp. 13–22.
Hoge, Charles W., Dennis McGurk, Jeffrey L. Thomas, Anthony L. Cox, Charles C. Engel, and Carl A. Castro, "Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq," New England Journal of Medicine, Vol. 358, No. 5, 2008, pp. 453–463.
Irwin, Michael R., Jason C. Cole, and Perry M. Nicassio, "Comparative Meta-Analysis of Behavioral Interventions for Insomnia and Their Efficacy in Middle-Aged Adults and in Older Adults 55+ Years of Age," Health Psychology, Vol. 25, No. 1, 2006, pp. 3–14.
Koffel, Erin, and Leah Farrell-Carnahan, "Feasibility and Preliminary Real-World Promise of a Manualized Group-Based Cognitive Behavioral Therapy for Insomnia Protocol for Veterans," Military Medicine, Vol. 179, No. 5, 2014, p. 8.
Luxton, David D., David Greenburg, Jenny Ryan, Alexander Niven, Gary Wheeler, and Vincent Mysliwiec, "Prevalence and Impact of Short Sleep Duration in Redeployed OIF Soldiers," Sleep, Vol. 34, No. 9, 2011, pp. 1189–1195.
Manber, Rachel, Jack D. Edinger, Jenna L. Gress, Melanie G. San Pedro-Salcedo, Tracy F. Kuo, and Tasha Kalista, "Cognitive Behavioral Therapy for Insomnia Enhances Depression Outcome in Patients with Comorbid Major Depressive Disorder and Insomnia," Sleep, Vol. 31, No. 4, 2008, pp. 489–495.
Margolies, Skye Ochsner, Efficacy of a Cognitive-Behavioral Treatment for Insomnia Among Afghanistan and Iraq (OEF/OIF) Veterans with PTSD, thesis, Richmond, Va.: Virginia Commonwealth University, 2011.
McLay, Robert N., Warren P. Klam, and Stacy L. Volkert, "Insomnia Is the Most Commonly Reported Symptom and Predicts Other Symptoms of Posttraumatic Stress Disorder in U.S. Service Members Returning from Military Deployments," Military Medicine, Vol. 175, No. 10, October 2010, pp. 759–762.
Mental Health Advisory Team 9, Operation Enduring Freedom (OEF) 2013 Afghanistan, Washington, D.C.: Office of the Surgeon General, U.S. Army Medical Command; Office of the Command Surgeon, Headquarters, U.S. Central Command; and Office of the Command Surgeon, U.S. Forces Afghanistan, October 10, 2013. As of July 10, 2014:
http://armymedicine.mil/Documents/MHAT_9_OEF_Report.pdf
MHAT 9—See Mental Health Advisory Team 9.
Mitchell, Matthew D., Philip R. Gehrman, Michael L. Perlis, and Craig A. Umscheid, "Comparative Effectiveness of Cognitive Behavioral Therapy for Insomnia: A Systematic Review," BMC Family Practice, Vol. 13, No. 40, 2012, p. 11.
Morin, Charles M., J. P. Culbert, and S. M. Schwartz, "Nonpharmacological Interventions for Insomnia: A Meta-Analysis of Treatment Efficacy," American Journal of Psychiatry, Vol. 151, No. 8, 1994, pp. 1172–1180.
Mysliwiec, Vincent, Jessica Gill, Hyunhwa Lee, Tristin Baxter, Roslyn Pierce, Taura L. Barr, Barry Krakow, and Bernard J. Roth, "Sleep Disorders in US Military Personnel: A High Rate of Comorbid Insomnia and Obstructive Sleep Apnea," Chest, Vol. 144, No. 2, 2013, pp. 549–557.
Mysliwiec, Vincent, Leigh McGraw, Roslyn Pierce, Patrick Smith, Brandon Trapp, and Bernard Roth, "Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel," Sleep, Vol. 36, No. 2, 2013, pp. 167–174.
National Institutes of Health, "State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults," Sleep, Vol. 28, 2005, pp. 1049–1057.
Navy and Marine Corps Public Health Center, "Sleep: Resources," web page, undated. As of July 10, 2014:
http://www.med.navy.mil/sites/nmcphc/wounded-ill-and-injured/Pages/sleep.aspx
Patel, Sanjay R., and Frank B. Hu, "Short Sleep Duration and Weight Gain: A Systematic Review," Obesity (Silver Spring), Vol. 16, No. 3, March 2008, pp. 643–653.
Perlman, Lawrence M., J. Todd Arnedt, Kristie L. Earnheart, Ashley A. Gorman, and Katherine G. Shirley, "Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic," Cognitive and Behavioral Practice, Vol. 15, No. 4, 2008, pp. 426–434.
Pietrzak, Robert H., Charles A. Morgan, and Steven M. Southwick, "Sleep Quality in Treatment-Seeking Veterans of Operations Enduring Freedom and Iraqi Freedom: The Role of Cognitive Coping Strategies and Unit Cohesion," Journal of Psychosomatic Research, Vol. 69, No. 5, 2010, pp. 441–448.
Plumb, Taylor R., John T. Peachey, and Diane C. Zelman, "Sleep Disturbance Is Common Among Servicemembers and Veterans of Operations Enduring Freedom and Iraqi Freedom," Psychological Services, Vol. 11, No. 2, 2014, pp. 209–219.
Seelig, Amber D., Isabel G. Jacobson, Besa Smith, Tomoko I. Hooper, Edward J. Boyko, Gary D. Gackstetter, Philip Gehrman, Carol A. Macera, and Tyler C. Smith, "Sleep Patterns Before, During, and After Deployment to Iraq and Afghanistan," Sleep, Vol. 33, No. 12, 2010, pp. 1615–1622.
Siebern, Allison T., and Rachel Manber, "New Developments in Cognitive Behavioral Therapy as the First-Line Treatment of Insomnia," Psychology Research and Behavior Management, Vol. 4, 2011, pp. 21–28.
Swinkels, Cindy M., Christi S. Ulmer, Jean C. Beckham, Natalie Buse, and Patrick S. Calhoun, "The Association of Sleep Duration, Mental Health, and Health Risk Behaviors Among U.S. Afghanistan/Iraq Era Veterans," Sleep, Vol. 36, No. 7, 2013, pp. 1019–1025.
Talbot, Lisa S., Shira Maguen, Thomas J. Metzler, Martha Schmitz, Shannon E. McCaslin, Anne Richards, Michael L. Perlis, Donn A. Posner, Brandon Weiss, Leslie Ruoff, Jonathan Varbel, and Thomas C. Neylan, "Cognitive Behavioral Therapy for Insomnia in Posttraumatic Stress Disorder: A Randomized Controlled Trial," Sleep, Vol. 37, No. 2, 2014, pp. 327–341.
Toblin, Robin L., Lyndon A. Riviere, Jeffrey L. Thomas, Amy B. Adler, Brian C. Kok, and Charles W. Hoge, "Grief and Physical Health Outcomes in U.S. Soldiers Returning from Combat," Journal of Affective Disorders, Vol. 136, No. 3, 2012, pp. 469–475.
Troxel, Wendy M., David J. Kupfer, Charles F. Reynolds, Ellen Frank, Michael Thase, Jean Miewald, and Daniel J. Buysse, "Insomnia and Objectively Measured Sleep Disturbances Predict Treatment Outcome in Depressed Patients Treated with Psychotherapy or Psychotherapy-Pharmacotherapy Combinations," Journal of Clinical Psychiatry, Vol. 73, No. 4, 2012, pp. 478–485.
van Liempt, Saskia, Mirjam van Zuiden, Herman Westenberg, Arvika Super, and Eric Vermetten, "Impact of Impaired Sleep on the Development of PTSD Symptoms in Combat Veterans: A Prospective Longitudinal Cohort Study," Depression and Anxiety, Vol. 20, No. 5, 2013, pp. 469–474.
Wallace, D. M., S. Shafazand, A. R. Ramos, D. Z. Carvalho, H. Gardener, D. Lorenzo, and W. K. Wohlgemuth, "Insomnia Characteristics and Clinical Correlates in Operation Enduring Freedom/Operation Iraqi Freedom Veterans with Posttraumatic Stress Disorder and Mild Traumatic Brain Injury: An Exploratory Study," Sleep Medicine, Vol. 12, No. 9, 2011, pp. 850–859.
Wesensten, Nancy J., and Thomas J. Balkin, "The Challenge of Sleep Management in Military Operations," U.S. Army Medical Department Journal, October–December 2013, pp. 109–118.
Wright, Kathleen M., Thomas W. Britt, Paul D. Bliese, Amy B. Adler, Dante Picchioni, and DeWayne Moore, "Insomnia Severity, Combat Exposure and Mental Health Outcomes," Stress and Health, Vol. 27, No. 4, 2011b, pp. 325–333.
Young-McCaughan, Stacey, Alan L. Peterson, and Mona O. Bingham, Role of Sleep in the Health and Resiliency of Military Personnel, Brussels: NATO Research and Technology Organization, 2011.
Yu, John C., and Paul Berger III, "Sleep Apnea and Obesity," South Dakota Medicine, 2011, pp. 28–34.
* For example, see Navy and Marine Corps Public Health Center (undated).
This research was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.
Wendy M. Troxel @wendytroxel, Regina A. Shih @ReginaShih, et al.
RAND Health Quarterly is produced by the RAND Corporation. ISSN 2162-8254.
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Adults Newly Exposed to "Know the Signs" Campaign Report Greater Gains in Confidence to Intervene with Those Who Might Be at Risk for Suicide Than Those Unexposed to the Campaign
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Methodology of the RAND Health Reform Opinion Study
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text:
NHL professional silk choice to the rookie of the month
A good two weeks after his debut for Detroit Red Wings, the 20-year-old defender from Zell at the Moselle continued in a point rating in front of any other Jung professionals of the league, the NHL announced on Tuesday. With eight templates at an average operating time of 22:26 minutes, silks led the October ranking. The young German had been chosen at the draft 2019 in sixth place and had collected in the preseason, among other things in Sweden game practice. It was not until October 14th had celebrated his NHL debut in the jersey of Red Wings.
Skydance New Media Amy Hennig s team is working with Marvel in a triple game to
TFT Set 6 Student Composition Guide Protectors


text:
Chinese women's football team set for Cameroon
Published June 20, 2015 at 6:12 PM
Updated June 24, 2015 at 10:26 AM
The Chinese Women's football team takes to the pitch in about two hours, hoping to reach the quarter-finals of the Women's World Cup. After escaping their difficult group stage, China has returned to the place where the tournament kicked off – Edmonton, Alberta. There, they have a showdown with upstart Cameroon. CCTV's Jonas Gilbart filed this report from Canada.
China qualified second out of a very tough Group A with a win over the Netherlands.
They lost to Canada in the tournament kick-off match.
They tied with New Zealand in their group finale.
Chinese women football team set for Cameroon
The Chinese Women's football team takes to the pitch in about two hours, hoping to reach the quarter-finals of the Women's World Cup. After escaping their difficult group stage, China has returned to the place where the tournament kicked off Edmonton, Alberta. There they have a showdown with upstart Cameroon
Zero Waste with Bea Johnson »


• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist or nurse.
• If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
Solivito® N provides water-soluble vitamins into your bloodstream when you cannot eat normally. Vitamins are chemicals required in small amounts for the body to work normally.
Solivito® N is usually used as part of a balanced intravenous diet, together with proteins, fat, carbohydrates, other salts and other vitamins.
• if you (or your child) are allergic (hypersensitive) to Solivito® N or any of the ingredients of this medicine listed in section 6. If you develop a rash or other allergic reactions (like itching, swollen lips or face or shortness of breath or bronchospasm), please inform your doctor.
Your doctor may want to do regular blood tests to check your condition.
This medicine may affect the result of other tests you may have. It is important to tell any doctor doing tests that you are using Solivito® N.
This medicine contains Methyl-parahydroxybenzoate (E218) which may cause allergic reactions (possibly delayed), and exceptionally bronchospasm.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription.
Solivito® N has no effect on driving or using machines.
The dissolved and diluted Solivito® N will be given to you by infusion (IV drip).
Your doctor will decide on the correct dose for you to receive.
Other solutions containing carbohydrates, lipids, amino acids, electrolytes and trace elements may be added to this product by the doctor.
The usual daily dose for adults and children weighing more than 10 kg is one vial (dissolved to give 10 ml of solution).
For children weighing less than 10 kg, the usual daily dose is one tenth of a vial for each kg of body weight.
It is very unlikely that you will receive more infusion than you should as your doctor or nurse will monitor you during the treatment. However if you think that you have received too much Solivito® N, inform your doctor, pharmacist or nurse as soon as possible.
Allergic reactions may occur in patients hypersensitive to any of the ingredients of Solivito® N, see section 6 for the full list.
No known side effects have been reported with Solivito® N.
Solivito® N also contains glycine (aminoacetic acid), disodium edetate and methyl parahydroxybenzoate (E218).
infusion. Keep the container in the outer carton to protect from light. Do not store above 25°C.
Do not use this medicine after the expiry date shown on the label. The expiry date refers to the last day of that month.
Any solution remaining after treatment should be disposed via approved hospital procedures.
Solivito® N is a yellow powder containing water soluble vitamins.
When the powder is dissolved, each vial contains 10 millilitres of solution.
Solivito® N is supplied in cartons containing 10 glass vials with a rubber stopper.


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text:
This postcard dates to the time before people had a sense of how to create a visually attractive postcard.
It features four Caucasian individuals, some of whom might have been awoken recently from a nap, standing in from a building that's boldly labeled DICKSON MOUNDS, so that there is no doubt about the matter.
The men are not identified and the postcard was never written on or mailed. The only things we can learn from back are that it was published by L.L. Cook Co. of Milwaukee and that the design of Kodak Paper stamp box indicates the card was produced in 1950 or thereafter.
I'm assuming that these men have something to do with DICKSON MOUNDS and didn't just happen to be standing in the field when the photographer took the photo for the postcard.
So what is Dickson Mounds? Well, that's the cool part. It's a Native American (Mississippian culture) settlement site and burial mound complex that was in active use from about 800 A.D. to 1250 A.D. and is located near what is now Lewistown, Illinois. In 1927, a chiropractor named Don Dickson (possibly one of the men in the postcard) discovered the burial mounds on his family farm. He left the remains and artifacts intact and covered the excavation with a tent. Later, he opened a private museum on the site. The state of Illinois has owned the site since 1945 and opened the Dickson Mounds Museum in 1972. In 1992, after much debate, the portion of the museum that displayed Native American remains was closed and the remains were reburied.
The Dickson Mounds are about 140 miles north of another notable Native American location, Cahokia Mounds State Historic Site.
Here are some links for further information and exploration of Dickson Mounds.
Dickson Mounds on Wikipedia
Dickson Mounds Museum official website
History of Dickson Mounds Museum
"Dickson Mounds area draws more than just history buffs," Journal Star of Peoria, Illinois, June 10, 2016
"Controversy Laid To Rest As Dickson Mounds Closes," The Chicago Tribune, April 4, 1992
"The Worst Mistake in the History of the Human Race," by Jared Diamond, Discover magazine, May 1987
Labels: History, Postcards


text:
Q: Windows USB cleaning Ubuntu equivalent commands I like to test out a lot of linux distros, so I have a USB that I load live images onto frequently. Sometimes, though, I need it for something else, and I need to erase all the partitions on it and restore it to normal. To do this, I generally use these commands on a Windows PC:
diskpart
list disk
select disk <mydisk>
clean
create partition primary
format fs=fat32 quick

That works like a charm most days, but I don't really use Windows anymore, so I was hoping to find an Ubuntu alternative set of commands that I could use. Does anyone know what the Linux terminal equivalent of these commands are?

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Few other art forms, or businesses, depend on a seasonal spike in trade as heavily as books do.
Many publishers will expect to earn almost half their annual revenues in the couple of months before Christmas. How odd, then, that the technical changes that obsess this sector should still prove so inimical to the pleasures, and rituals, of buying a book as a present. E-readers may bulk out millions of stockings this season.
Yet the works you read on them remain ghostly intangible files, hard to transfer easily as gifts or loans between readers or (most) devices, thanks to the fences erected around them by "digital rights management". So, however much you adore your iPad or Kindle, why not renew your aquaintance with the joy of the printed volume as a source of festive delight this year? From food to fiction, art to science, sport to history, many of the titles selected by our experts showcase the skills of the designer, the illustrator, the typographer, the printer, as well as of the author whose words they enhance.
Does digital publishing menace the future of these arts? If so: all the more reason to go out, or stay in, and buy these treasures while you can. We will lead you to the year's best in every genre, each book a valuable object to have – and to hold.
Take 5 this summer and be in to win!
THE DROP - reviewed on Radio New Zealand today.
Can eBooks Meet Changing Social Demand?
The New Yorker on the future bookstore??
Best ski-writing of 2011 ?


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Lady Gaga Wasn't Supposed To Be In A Star Is Born
Another massive celeb was supposed to play Ally.
A Star Is Born is the movie of the year. Yes, we know it came out in 2018 but it's still very important.
Don't lie to us, we know you're still listening to 'Shallow' on repeat.
Correction: A Star Is Born is the movie of the century. Basically, it's a great movie.
Bradley Cooper and Lady Gaga play the roles of Jackson and Ally perfectly and it's hard to imagine the movie without them. But what if we told you Gaga was never supposed to be in the film?
Yep, Gaga was the SECOND choice to play Ally.
According to IMDB, Beyoncé was originally in talks to play the leading role.
"Talks of a fourth A Star Is Born remake began in 2011 with Clint Eastwood attached to direct and Beyoncé set to star," it reads.
"However, the project was delayed due to Beyoncé's pregnancy."
Yeah, having a baby will do that.
That's not all though, because Bradley wasn't meant to be in the movie either!
IMDB says that Christian Bale, Leonardo DiCaprio, Tom Cruise, Johnny Depp, and Will Smith were all in talks to play the male lead.
They're all great picks but they're no Bradley.
A movie with Beyoncé and Leonardo DiCaprio would have been drastically different… it probably would have included a lot more sequins and maybe an iceberg.
Images: A Star Is Born / Warner Bros. Pictures, Giphy / Giphy.
ENOUGH WORDS! RELAX YOUR EYEBALLS WITH THIS VIDEO:
Kate tries to use 'Shades On' as a legitimate answer in Quick Draw with Morgan Evans… It doesn't cut it.
Written By Krisinda Merhi
Gotta Tell You - Samantha Mumba


The day after she delivered a powerful speech honoring the victims of the Orlando shooting, Lady Gaga shared a moving story about lifting each other up in the wake of tragedy.
Gaga recounts how Pacheco's (pictured above) attitude — coupled with Ellie Goulding's empowering song "Army" — motivated them as the class proceeded.
"As the music rose to the lyrics 'when I'm with you, I'm standing with an army' and we all climbed together, sweating out our stress and our thoughts, he yelled, 'Today get stronger! And then stronger! And when you're finished here go out there and spread that strength to the world,'" Gaga wrote.
After the class, Pacheco approached Gaga and teared up as he told her he was at the rally the night before, where she recited the names of the victims. The first name she read, he told her, was his friend, Edward Sotomayor Jr.
"In this moment I was reminded why it's so important that we protect all people and never doubt the absolute human heart that can always surprise you with its strength and love," Gaga wrote. "Loui, a member of the LGBT community, who just lost his friend in the largest isolated shooting our country has ever seen, still showed up for work early in the morning to make ME feel strong. To empower me and all the other men and women in the class to keep going and get stronger so we could help each other.


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The Fairphone is an Openly-Designed Conflict-Free Smartphone
under Green Products, Green Technology, Greener Gadgets, Innovation, News
by Inhabitat Staff
Buying a mobile device these days can feel like signing a pact with the devil – and to make matters worse, it's difficult to determine where the parts were sourced and assembled and whether they were ethically produced. Fairphone aims to take the guilt out of gadgetry by producing the world's first openly-designed, conflict-free smartphone. The company launched a successful crowdfunding campaign to reach their minimum goal of 5,000 pre-orders and now the Fairphone is on its way towards mass production.
The dual SIM, Android phone comes equipped with a Mediatek 6589 chipset and 16 GB internal memory. Running on Jellybean 4.2, the mobile device contains two 8 megapixel cameras, a 4.3 qHD touch display, and scratch-resistant Dragontrail glass. The materials are sourced from conflict-free areas, and the company has partnered with initiatives in the Democratic Republic of Congo as well as the Solutions for Hope Project to ensure that the tin and coltan required for their phones do not fund illegal forces, improve working and mining standards, and help stabilize the region.
They team is close to being able to use Fairtrade gold, and they are currently in talks with Rwanda to find conflict-free tungsten. Tin will eventually come from Banka, Indonesia. Their ultimate goal is to make the phones completely from recycled materials. Customers receive a bill of materials with the purchase of every €325 phone that allows them to track a transparent supply chain. In addition to being environmentally and socially conscious in its production, the Fairphone can be easily taken apart for recycling and the company is hoping for programming insight from those who develop for Firefox and Ubuntu.
Fairphone has made their first 20,000 units, and almost half have already been purchased. They are currently only available in Europe, but with enough demand, we hope to see an expansion into North America!
+ Fairphone
Via Treehugger
2 thoughts on "The Fairphone is an Openly-Designed Conflict-Free Smartphone"
Dee Coombes September 10, 2013 at 3:04 pm
Brilliant!!!
That's nice. I wish they didn't forget Mer (Sailfish) as well. Ubuntu is moving away from the GNU/Linux community, and while Firefox OS is nice, it's still not quite as Free-Software-friendly as Mer.
Buying a mobile device these days can feel like signing a pact with the devil - and to make matters worse, it's difficult to determine where the parts were sourced and assembled and whether they were ethically produced. Fairphone aims to take the guilt out of gadgetry by producing the world's first openly-designed, conflict-free smartphone. The company launched a successful crowdfunding campaign to reach their minimum goal of 5,000 pre-orders and now the Fairphone is on its way towards mass production.


(≡) Ginkgo biloba f. biloba L.
(=) Ginkgo biloba f. pendula (Van Geert) Beissn.
(=) Ginkgo biloba f. variegata (Carrière) Beissn.
Del Tredici, P. 2007. The phenology of sexual reproduction in Ginkgo biloba: ecological and evolutionary implications Bot. Rev. (Lancaster) 73:267-278.
Gong, W. et al. 2008. Phylogeography of a living fossil: Pleistocene glaciations forced Ginkgo biloba L. (Ginkgoaceae) into two refuge areas in China with limited subsequent postglacial expansion Molec. Phylogenet. Evol. 48:1094-1105.
Mun-Chan, B. et al. 1986. A checklist of the Korean cultivated plants (Kulturpflanze) 34:101.
Tang, C. Q. et al. 2012. Evidence for the persistence of wild Ginkgo biloba (Ginkgoaceae) populations in the Dalou Mountains, southwestern China Amer. J. Bot. 99:1408-1414.
National Germplasm Resources Laboratory, Beltsville, Maryland. URL: https://npgsweb.ars-grin.gov/gringlobal/taxonomydetail.aspx?id=17540. Accessed 20 April 2019.


The complex is located on the seafront, on the paradisiacal beaches of white sand and turquoise water of Bávaro, 35 minutes from the Punta Cana International Airport, steps from the White Sands Golf Course. The Ocean Blue & Sand hotel has a complete structure integrated into its environment. The hotel has a 24-hour All-Inclusive service, Spa Center of the Despacio, Dive Dive Center! and water sports and a program with unique activities that will make your stay a unique experience.
With the grace of the dancing palm trees to the rhythm of the breeze and the elegance of the waves caressing the white beach, Ocean Blue Golf & Beach Resort, with all five star suites, emerges, and is specially designed to make the dream of a dream come true Lush Caribbean vacations.
Ocean Blue & Sand Resort has a wonderful gastronomic offer, with thematic restaurants and buffet with exquisite dishes.
Oriental restaurant with night show to entertain your evening. Savor the Japanese specialties of this cuisine while living with the oriental culture in a Caribbean environment.
The show is guaranteed in this restaurant: while you taste your aperitif you can entertain yourself watching the Chef in cooking live.
Buffet restaurant with a variety of specialties and international cuisine.
Buffet restaurant on the beach with cold, hot dishes and show cooking.
French gourmet cuisine restaurant with Caribbean touches.
Elegant Italian restaurant inspired by the atmosphere of the Carnival of Venice, with a curious decoration.
American restaurant with American cuisine, à la carte, with authentic 1930s decor.
The chef of this restaurant offers special and light dishes in a quiet, characteristic and pleasant place. Overlooking the hotel plaza and its tropical gardens, it is the perfect restaurant for tasting light dishes.
Specialties of tea, coffee and homemade pastry.
With national and international drinks included and midnight snack.
With national and international drinks included.
Located in the hotel lobby. All kinds of drinks and cocktails are served.
Spacious and modern stay completely renovated with bedroom area, living room and balcony overlooking the gardens. It can accommodate up to 5 people (maximum of 4 adults).
Spacious and modern stay completely renovated with bedroom area, living room and patio or balcony overlooking the pool. It can accommodate up to 5 people (maximum of 4 adults).
Close your eyes and let yourself be carried away by the soft singing of the warm breeze and the Caribbean waves and the aromas of tropical fruits and typical delicacies … Open your eyes and find yourself at Ocean Sand Golf & Beach Resort, with all five-star suites , and specially designed for a wonderful luxury stay.


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Movie reviews, Sci-Fi Movies
The movie industry can sometimes be incredibly strange. In 1982 the original Blade Runner was released. A movie that many consider to be a groundbreaking piece of science fiction filmmaking. Throughout the years the film has become a cult classic, that has been gathering praise long after it's release. Because when it was released 35 years ago, it did not perform very well, and even some critics did not give the movie very positive reviews. When the news was announced that a sequel was being made for this film, many people including myself, had to raise a few eyebrows. Why do you make sequel to a film that quite frankly doesn't need one, and were there people really waiting for this at this point? When the first trailer was released for it, I became cautiously optimistic. For it really looked….good. With the release of the film now upon us, critics are giving the movie very high marks. With glowing reviews under it's belt and cool trailers, one would think this film would become an overnight box office succes right?
What do you mean this film isn't doing well at the Box-office?
Well, that's where you would be wrong. Just like the original, the movie is currently under performing at the cinemas, so I guess in some cases history does repeat itself. This is going to be a bit of an unusual review for me, as I am not going to tell you much about the plot of the film. To do so, would be to rob of you of a lot of enjoyment as in this case the less you know about it, the more you will be surprised by it. What I can tell you is that this sequel takes place 30 years after the events of the first movie. The mighty Tyrell Corporation has gone bankrupt. Out of it's ashes a new pioneer for the replicant technology, a man named Niander Wallace, arises. He has created a new type of replicant that is obedient and has been integrated into society to work as servants and slaves. The older types are still being hunted and retired by the cops known as Blade Runners. One of them, the Blade Runner known simply as K has stumbled on a secret that could shake the very foundations of society. Powerful forces will stop at nothing to prevent that secret from coming out…
This is my response to that!
It's very hard to describe to you exactly what I thought of this movie. Perhaps it's best to give you my state of mind as I left the theatre yesterday afternoon, after having sat there for almost three hours seeing the movie for the first time in IMAX. And that state of mind was very, very sad. Not because I hated the film, but because of the atmosphere that this movie manages to create. One of the things that I love in films is to escape in a make believe world for a few hours. What we have here however is a very bleak and depressing future, that seems to penetrate itself into the very core of your mind. Together with the brilliant music created by Hans Zimmer, and the incredible visual style, I don't think I have ever seen a more depressing view of the future than what has been created in this film. It's one of the main reasons why this has become a must see movie, but it's not only the visuals that make the film so astounding.
Hello little man.
We also have a script here, that would not surprise me if it got nominated for an Oscar. There are so many layers in it, that it's difficult to tell too much about it without heading into spoiler territory. Suffice it to say that one of the main things that I really liked about it, is something you might be surprised at: and that is the universal theme of love. K has a very unusual relationship, which is both beautiful and incredibly sad at the same time. But just like in the original it's also the age old question of what it exactly means to be human, that makes it's return. And even more than in the original 1982 classic, that question is even harder to answer in this sequel. Even though some of the trailers for the film would like you to believe this is an action movie, it really isn't. It's very slow moving, and while there is some action, the main part of the film is spent with K trying to figure out his place in the uncovering of the secret.
I can see clearly now the rain is gone.
Performance wise there is a lot to enjoy. Ryan Gosling plays K, and he manages to create a character that is both very human and at the same time also isn't. This really is his journey, and for an audience to go along on that journey, you have to be able to create sympathy for your character. And Gosling certainly has excelled at that. The role of Niander Wallace is performed by Jared Leto. Though his character had a chilling aura, it certainly wasn't a very memorable part. In fact it was his replicant enforcer Luv, played by Dutch actress Sylvia Hoeks that made a much more lasting impression. She played a great villain, and pardon my French: a perfectly evil bitch. And of course there is Harrison Ford who reprises his role as Rick Deckard. Even though time might have catched up with him, he can still pull off the part. It was an absolute joy to seem him make an appearance again, and the movie just would not have been the same without him in it.
The first person to make a remark about my age is going to get it!
So, are there any negative points? Yes, there are. The film clocks in at almost three hours, and that was just too long overall. Some scenes felt unnecessary, and could have helped with the pacing of the movie had they been left out. At times the film is just a bit too slow. But then again, this really isn't much different from it's original counterpart. Now on to the hard part: do I recommend this film? I can honestly say that this is an incredible movie, with a fantastic script, a believable and utterly beautifully created world and some high caliber performances. At the same time, this movie also won't be for everyone. If you can't handle slow paced films, and expect an action spectacle you would be wise not to go this movie. For fans of the original though, this almost feels like coming home. It's a sequel that pretty much rivals and at some points is even better than the classic. And that is a very hard thing to accomplish. I won't lie to you though, it's bleak vision of the future will take you a bit of time to let go of. Also be prepared to have the movie spinning around in your head for a while. But that usually is a good sign.
I give Blade Runner 2049 a 9 out of 10 score.
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52 thoughts on "Blade Runner 2049, American/Uk/Canadian movie (2017)"
I thought it was great. I guess sci-fi that isn't Star Wars will always suffer in theaters.
True enough. I also think it has to do with the fact that the original movie, while widely known amongst science fiction fans, is not as well known by the regular audiences. Shame though, as you say, it was an absolutely great film 😀
Actually I found the sequel to be a little better than the original
I was worried about whether this would be any good. As you said, the original was groundbreaking in many ways and didn't really seem like it needed a sequel. Still, it sounds positive thus far.
Yeah, the first time I heard of this, I really thought it could only end up in disaster. But it was an amazing sequel, and highly recommended if you are a fan of the original movie 😀
Greg Leighton says:
Great post. I'm glad you enjoyed the movie!
Thanks a lot 😀 Yeah it was awesome. Just like the first movie I think this is one thst is only going to get better over time 😀
Wolfman's Cult Film Club says:
I could of easily of sat there for another 3 hours, weirdly I found the bleak, doom and dystopia so overwhelmingly achingly beautiful. Taking in every minute nostalgic detail. Absolutely adored it. So much so I just have to see it again this week. Great review btw Raistlin 🙂 All the best… Mike The Wolf
Thanks a lot for the kind words: really appreciate it 😀 You are so right. The bleakness of it all was one of the movies greatest strength (though leaving the theatre it definitely affected my mood as well). This is one of those movies that you will rewatch again and again, and probably will see new things in every time you do a rewatch 😊 I'm definitely going to see it a second time myself as well 😀 Thanks again for your comment 😊
A pleasure, thank you. Roll on Friday and the chance to visit 2049 again. 🙂
Dylan Langes says:
Great Review. It is a shame that the movie isn't doing better at the box office, because it really is fantastic
Yeah it's one of those things that I guess really can't be explained as much as one would want to. It's always a shame when a movie that you really like doesn't perform better. Thanks for the kind words: always appreciate it 😀
I think the run time was the biggest influence. At nearly 3 hours people get turned off by that.
Yeah that is definitely a factor as well. It's a real shame. I wished the movie would have performed better. It would have been nice if a sequel would be made for this one..I really would not have mind to spent a few more hours in this world 😊
I guess we have a problem now and it's called Jared Leto. He penetrates into movies and makes them worse. He had 2 dammit opportunities to play very important characters – The Joker and a big role in Blade Runner 2049. Both performances felt so…unnecessary? Not sure if it's the right word.
Jokes apart, I think it wasn't only his fault this time, but rather of the script.
I totally agree with everything you say, Raistlin! Except maybe the score which was good, but at times felt like typical Hans Zimmer. And the fact that the film has a very open ending, probably following the original….
Great review as always.
Erm….well it looks that problem is going to get even worse than. I just read that Tron 3 is apparently rumored to be going back into development, and guess who is involved in that? Yep…Jared Leto.
In all fairness though, he is a very good actor. His performance in Dallas Buyer's Club was truly amazing and heartbreaking. But you are right, the two roles you are pointing out did seem pretty unnecessary. Especially for an actor of his caliber.
Thanks for the kind words on the review. The score by Hans Zimmer was at times truly breathtaking, but there also so e moments that I did not like as much. As for the open ending…who knows, maybe in 35 years we will get another sequel 😉
Yep, you're right, with a box office like that it may take quite a while…
Leto can be a good actor, it's true (I loved Dallas BC too), but he is good at overacting as well or not feeling the character. Joker was way too "Jokery", and Wallace was just so freaking serious with all that angel stuff…
Tron with Leto? Wow! Well, that's better anyway than Garrett Hedlund.
Haha,I think you have a point there. We will just have to wait and see. This movie has been rumored so many times now, that I really wonder if it will ever get made in the first place 😊
I haven't seen the original yet, but I think it was you who mentioned it was also a very bleak and depressing movie hahaha So, all in all, this sequel managed to accomplish just that as well.
I'm glad the performances were good and the atmosphere, music, etc. so on point. Too bad about being so long… Maybe a better editor next time to cut off the unnecessary scenes?
Either way, excellent review as always! Very happy that you enjoyed this and had it spinning around in your head afterwards hahaha
Haha, thank you as always. I think it was me who pointed that out lol 😂 But in all fairness this really was an amazing film. Even though it was a tad not too long, there were so many positive notes to it, that they far outweighed the negative ones. And yes lol, it's still spinning around in my head 😂😂
Experience Film says:
Beautiful review. I wish I could like this post twice.
I'm so relieved to hear this is not an overt action film, but a rather a slower study of character and humanity. I can handle Slow. I usually like slow movies.
But I'm glad you mentioned its bleak portrayal of the future, and that it made you very sad. I will try to prepare myself for this when I go see it (Can't believe I haven't yet).
Thanks again for these very kind words: I always appreciate them, so thank you. Well no worries about not having seen it yet. There is still plenty of time left 😊 It's definitely good to be prepared for it, I think you will be struck by the emotional bleakness of the film that is both beautiful and sad at the same time. If you do get to see it, I look forward to hearing your thoughts on it 😀
Hoeks is Dutch? Wow. She did an incredible performance.
Yup, she is. And I could not agree more. She was truly a force to be reckoned with 😀
You are totally right. This isn't a film for everyone. It's slow and surprisingly quiet. But it's such a beautiful portrait of a very bleak future that I couldn't take my eyes off it, and I hope everyone does see it, because it is so spectacular! And as you mentioned, there is more to recommend than the visuals alone. It's a worthy sequel to a sci-fi classic.
Absolutely agree. In fact this is one if those films that I definitely want to check it out fir a second time in the theatres. It's really so awesome, despite the sadness it made me feel in the end. This film will probably go doen the same path as the original did, with more people seeing to show appreciation for it later on 😊
haha love that picture of ryan gosling reacting. This sounds like it was done well and I do love the look of those visuals, even if it was a little long. Great review!
Thank you very much 😀 It really was a terrific movie, despite it's length, and one that deserves to be seen in the theatre with as big a screen as is possible 😊
You're welcome! Definitely want to see it then! 😊
Glad you loved it! Yes, the view of the future is unsettling and well done. The emotion/atmosphere/quotable dialogue of the original was what I connected to most and is linked to Vangelis' soundtrack. There was lots of fan service in the sequel, yet I didn't get that special emotional feeling. Still, I quite liked it and rate BR2049 a 7/10. Maybe I need to see it again to appreciate Villeneuve's vision! Or perhaps I'll wait for the inevitable director's cut 🙂
I agree with the fan service, but I also do have to say that it never got really offensive in any part. In fact it was all done very tastefully, except for that one scene with Jared Leto, which I felt was both unsettling and a bit unnecessary as well. I do think this is a film that will only grow more, the more times you watch it. I plan on seeing it a second time in the theatres for sure. Lol, and yes it would not surprise me at all if we get a director's cut for this one 😊
I agree BR2049 is mostly non-offensive. What I meant with unsettling is how locations point to pollution and climate change, with the orange-colored area, wave barriers, and garbage dumps. Of course the 1982 film had its own thing with constant rain a sign of something not right!
Ah okay 😊Sorry I misunderstood. But yeah, that certainly was really unsettling, the garbage dump scene was one of the most impressive ones for me. The total desolation, and people and even children actually living there. A really frightening and terrifying prospect. The rainscenes in Ridley Scott's classic, were only adding to the desolation for that movie, which honestly also had it's own sadness and unsettling feeling 😊
Oh glob, 3 hours sounds a bit on the long side. It does sound really good though. 🙂 Is the original as long as this one?
It seems like the kind of sci-fi, I could enjoy 😀 Which is saying something, because sci-fi is a weird genre for me (I somehow love and hate it, at the same time). 😀
The original is a little under two hours and also still very good. I reviewed that one a couple of weeks bsck. Even though that one has been made a long time ago, it has withstood the test of time amazingly well. It's an absolute classic and also well worth the watch 😀 I highly recommend you watch the first one, and then start on the new one. There are some subtle references to the old movie in this new film 😊 It's great stuff though 😀
I'll watch the first one first 🙂 I'm actually kind of excited, about watching it 🙂
I've heard there's a few blade runner references in Akira 🙂 (I may have become obsessed with Akira)
I really want to see this dear 😊😊 Thank you for sharing. Great review x x
You are welcome and thank you 😀 If you get to see it, I hope you are going to enjoy it. Looking forward to hearing your thoughts on it 😀
Your welcome dear 😊😊 Yes, I'll search for it x x
Sounds like a thought provoking movie. Good to hear that it turned out well, as usually when Hollywood does a sequel to a classic the fan base is resistant to it.
I'll have to watch 2049, after I get round to watching the original. Need to work out which cut I should check out.
Yeah I hear you. There are so many cuts now that it's difficult to decide which one to go for. I would say the director's cut might be the best one to check out. As for this sequel…even though it's length might just have been a tiny bit too long, in some places it was even better than the original movie. Hope you will enjoy both films. Will be interested in hearing your thoughts on them 😀
ghostof82 says:
Saw it three times at the cinema. It was better each time (the pacing seems less of an issue on repeat viewing). Film of the year for me, loved it. Nice balanced review.
Thanks a lot for the kind feedback, appreciate it 😀 For me so far, this has also been the film of the year. Due to unforseen circumstances I unfortunately only been able to see this movie only once in the cinema. But I absolutely loved. I don't think any film is going to beat it this year, with maybe the exception being The Last Jedi. But we will have to wait and see I guess 😀
I've been a Star Wars fan since 1978 when the first film showed here in the UK, and I'm still a fan, yes, but the series seems to be getting like a machine now. I'm sure The Last Jedi will be good, but strangely I'm not crazily hyped for it. I know small-budget dramas are not what Star Wars is about, but with all these anthology films being prepped, wouldn't it be nice to see a few budgeted at around $50 million each without huge space battles etc? There's only so many times you can do these big space battles without them becoming boring, or light-sabre duels too. Star Wars needs to evolve or risk becoming a parody of itself.
At the very least, BR2049 tried to be a little different, expand its 'franchise' somewhat, open it up. But what do I know? BR2049 flopped and The Last Jedi will easily bust a billion dollars.
Yeah, I have exactly the same fear that you have for the future of the franchise. I fear that it really is becoming a money making machine now, especially with the new movie trilogy that has been announced as well as the live action series. I definitely hope I am wrong as I am a big Star Wars fan myself. But I guess we just have to wait and see how this is all going to turn out. It really is quite a shame that BR2049 flopped 😢 I would not have minded to spent some more time in this world with a sequel, but I don't think that is going to happen anymore 😢
You never know, if BR2049 builds an audience over the next few years (these Blade Runner films have a long shelf-life) someone might give it a go in a decade or two. Possibly a mini-series spinoff on HBO might happen; I'd write nothing off- a sequel to Blade Runner seemed impossible until a few years ago. You just never know.
I only hope that the quality is maintained whatever happens.
Hmm, that is certainly true. Hopefully there will be something that continues this, as it really is a world/future I'm interested in seeing more of 😀
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I agree with Krista however is there anyway to change his school, because he no longer feels safe in the environment that he is in and school should be a safe place.
Do you know any of the other parents whose children are being bullied? There is strength in numbers. If they too, have complained, with no results, then it may be time to contact your government's department of education.
If, after two weeks, you have not received any response (or only a form letter), then it is time to go to the media.