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About: A True Conservative On Progressive Prosperity
Thinking About "Assets" and Ownership
October 20th, 2015 Asymptosis	Comments off
My gentle readers will know that I often struggle with economic terminology, both because I find usages are so vague, various, and poorly defined, and because I'm trying to understand fundamental terms' fundamental meanings. Today I'd like to home in on one of the most fundamental — "assets" — and something even more fundamental that underpins it: "ownership."
I'll start with what I think is a usefully precise, technical, term-of-art definition:
Asset. n. A labeled numeric entry on the lefthand side of a balance sheet, designating the value of a claim (necessarily, designated in a unit of account).
This thing called an "asset" only exists, only can exist, on a balance sheet. It's purely an accounting term, and the entity only exists within an accounting construct. There's no other meaning for the term. (Making it a usefully precise definition.)
This is contrary to the vernacular, where a house or a drill press is called an asset. (In this technical context these are more usefully called "goods" or "real goods" or "capital goods.") Because really: how can both a house and the labeled tally of a claim on that house both be called "assets"?
"Financial assets" are distinguished in that they have related, offsetting liabilities on the righthand side of other balance sheets. That's what defines the term. They're claims on claims — claims against that other balance sheet's assets/claims. That's why there's a liability entry over there. It's the right side making a claim against the left side, on behalf of that other balance sheet that holds the asset. As such, financial assets only represent indirect (and variously contingent) claims on real goods, one or more claim-steps removed from claims on the goods themselves.
Purely "real" or nonfinancial assets have no such offsetting claims on other balance sheets. In theory, they represent direct claims on real goods.
That seemingly simple distinction, though, is far from simple when you start exploring it carefully.
To that end, consider the fundamental nature of "claims," hence the nature and import of "ownership" and "property rights." Full credit here to Matt Bruenig, who delivered the Aha! understandings for me on these topics — clear and (mutually) coherent definitions and explanations for concepts I'd been worrying at for years.
Mostly simply, ownership is an exclusionary legal claim. Ownership says you may have a picnic on your front lawn — which seems inclusionary, but that's only meaningful because you may exclude anyone else from doing so. And you may invoke violence (farmed out to the police) to enforce that right of exclusion. As Matt has said so well, a modern ownership claim is best viewed as a violence voucher issued by government.
This imparts a decidedly sinister aspect to the lefthand side of balance sheets — a tally sheet of violence vouchers?
So now to return, with that understanding, to the notion of real vs financial assets. In large, in aggregate, in the big national or global picture, both types of assets ultimately constitute claims on real goods. Someone holding zero real/nonfinancial assets but significant financial assets can make an immediate and successful claim on a new Maserati — a very "real" good. Everyone else is excluded from claiming that Maserati.
If this exclusionary notion is safe, in a very real sense your "real," "nonfinancial" asset claim is actually offset by a liability — on the (EverybodyElseIn)TheWorld balance sheet. Call the entry "Stuff that we're excluded from touching." If all those exclusionary claims wall off AllTheGoodStuff with violence, we're talking a very real liability indeed — even though this imaginary World Balance Sheet doesn't, and practically probably can't, exist.
This notional balance sheet may seem crazy and outlandish to us. But our ownership, property-rights, and "asset" structures do and have seemed equally outlandish to other cultures:
…fee-simple ownership is not the only basis for ownership and possession of land. Many eastern cultures and tribal cultures throughout the world follow the "communal property system" in which ownership of land belongs to the entire social/political unit, like the tribe, families, bands, and nations.
From the inside, ideologies always look like common sense.
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Thinking about Value, and the National Accounts
October 18th, 2015 Asymptosis	6 comments
The remarkable discussion on "national wealth" and the national accounts that is running over at Interfluidity (373 comments and counting…) in response to my last post prompts me to recount an anecdote that I think is germane.
I took exactly one accounting class in my life, at the NYU MBA school — essentially Accounting for Non-Accountants, teaching us to deconstruct corporate statements into cash flow.
There were two profs. (I don't remember their names.) The lead was an old hand, a long-time member of the Financial Accounting Standards Board (FASB), and a real comedian. The young guy was the straight man and enforcer — assignments, testing, and nuts-and-bolts lectures.
The beginning of the very first lecture, given by the old guy, has stuck with me ever since. He started with an anecdote. (Here recounted from distant memory.)
When I was an undergrad (he said), I hung out with these economics types. I was thinking of buying a new car. They told me, "don't do that! As soon as you drive it off the lot it'll lose a third of its value!"
But anyway, I went ahead and did it. I went through all the paperwork with the salesman, signed on the dotted line, and he handed me the keys. "Here you go," he said. "Drive it away."
I looked at him like he was crazy. "I'm not gonna drive it away," I said. "It'll lose a third of its value!"
Ba dum ba.
Then he explained why he used that anecdote right up front, framing the whole (rather grueling) semester-long exercise to come: Accounting, he said, is an exercise in assigning value to things that are often (mostly?) deucedly difficult to e-value-ate. Whether it's the value of that car (before and after it leaves the lot), or the "wealth of nations," accounting is inherently a problematic exercise in estimation. We just do the best we can.
Based on a decade or so of wrestling with the national accounts, I'd extend that thinking further. Sure, estimating value can be very iffy, but that estimation is also, always, a function of the accounting constructs and architecture used to do that estimation. Simply put, the national accounts are an economic model of the national economy. The map is not the territory. The presentation is inevitably stylized, like a Mercatus or Peters projection — and the choice of presentation has similarly important rhetorical and political implications.
The implication: as with any economic model, to understand what you're seeing, you need to look not only at the results presented within the model, but at the model itself. You need to (at least) consider not just potential errors within a model, but model error itself. To get very philosophical: National account structures are, ultimately, epistemological structures — systems for trying to "know" things.
The national accounts, by their very status and position, discourage examination of their model. The notion that they're "just accounting," adding and subtracting straightforward measures, reifies them, and the model they present. The assumptions underlying that model are rendered invisible, apotheosized as god-given truths.
National-accounting sages are very much aware of this reality. Check out Jorgenson, Hulten, Hall, etc. on the "zero-rent" economic model that lies (hidden) at the core of the national accounts as constructed. (They mostly argue: appropriately so.) Or spend some time in that Interfluidity comments thread. If you haven't thought critically and carefully about the national accounts' economic model, you don't understand the national accounts. (I'm not, by the way, claiming that I do. Despite lengthy exertions. Necessary versus sufficient and all that.)
That old-hand FASBer imparted, I think, a profoundly important truth. I've been struggling with its implications ever since.
To put across exactly how important and profound that truth is, I'll end by passing the baton to John Maynard Keynes in his essay on "National Self-Sufficiency":
Once we allow ourselves to be disobedient to the test of an accountant's profit, we have begun to change our civilization.
I only got a B+ in the course, by the way.
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Where MMT Gets Its Accounting Wrong — And Right
October 2nd, 2015 Asymptosis	78 comments
Modern Monetary Theory has been revolutionary in economics, and its influence is — beneficially — ever-more pervasive. It has opened the eyes of a generation to a clear-eyed, accounting-based methodology that trumps dimensionless theory, and has brought a deep, nuts-and-bolts understanding of money, debt, and financial institutions to a discipline where that understanding has been inexcusably absent. Witness: a whole raft of papers from central-bank economists worldwide embracing MMT principles (though often not MMT by name), and eviscerating decades or centuries of facile and false explanations of monetary mechanisms.
But MMT's terminology and associated accounting constructs remain problematic and contentious, even among some MMT supporters like the splinter group, the Modern Monetary Realists. Some of this contention results from the usual resistance to new ideas and ways of thinking. But some arises, in my opinion, because MMT terms and accounting constructs are indeed problematic. (The terminological confusion even causes some to object correctly, but for the wrong reasons — and vice versa!)
These difficulties are apparent when you consider one of MMT's central and oft-repeated mantras and accounting identities, here in its simplified form for a closed economy ignoring Rest of World, courtesy of the redoubtable Stephanie Kelton:
Domestic Private Surplus = Government Deficit
This suggests an important truth, as far as it goes: public (monetarily sovereign federal government) deficit spending creates private assets out of thin air. The government spends new money, created ab nihilo, into private accounts. +Private Assets. No change to private liabilities. So: +Private Sector Net Worth.
But it doesn't actually go very far. That "private surplus" (a term that is absent from the national accounts, and from MMT's ur-text, Monetary Economics by Godley and Lavoie) is not defined in accounting terms, except circularly and tautologically: it's the amount that private assets increase as a result of government deficit spending. That makes the identity true by definitional tautology.
But contrary to what's at least implied by the equal sign, deficit spending is not the only way that private assets increase, or even the primary way. It's not the only source of private-sector "surplus" or "saving," as is often suggested in MMT discourse. Not even close.
Start by thinking in terms of Household Net Worth. This measure has the virtue of encapsulating and telescoping all private-sector net worth, because households ultimately own firms, at zero or more removes, but firms don't own households (yet…). Citibank may own some GE shares, but Citibank is ultimately owned by households. Because: firms issue equity shares; households don't. It's an asymmetric, one-way ownership relationship.
Then take a look at this paragraph from MMTers extraordinaire Eric Tymoigne and Randall Wray:
MMT does differentiate between saving (in the flow of funds it is the change in net worth: ΔNW) and net saving (saving less investment). Net saving shows how the accumulation of net worth occurs beyond the accumulation of real assets. For the domestic private sector, this comes from a net accumulation of financial claims against the government and foreign sectors.
Some of the problems with this paragraph:
• Pace T&W, there is no "saving" measure in the Fed's flow of funds accounts (FOFAs) that equals ΔNW — whether you're talking net or gross saving (with or without consumption of fixed capital), including or excluding capital transfers.
• The "net saving (saving less investment)" bruited in that paragraph is confusingly at odds with the existing definition of the term as used in the national accounts — gross saving minus consumption of fixed capital.
• "Net accumulation of financial claims" does not appear anywhere in the national accounts, and has an uncertain relationship with a measure that the FOFAs do provide: "Net acquisition of financial assets." Are these the same measures? If not, what is their accounting relationship?
I find here a set of terms that I'm unable to resolve into a coherent set of accounting statements — despite years of diligent and highly motivated efforts to do so. (I'm an ardent MMT supporter; I wouldn't be thinking these thoughts if it weren't for the MMT cabal.)
The core problem is these measures' opaque relationship to net worth, and change in net worth. The problem exists because they don't incorporate the primary way that net worth (wealth) is accrued: market revaluation of existing assets, a.k.a. capital gains. Market runups increase private-sector assets, without increasing liabilities. Voila: higher private-sector net worth. "Money" created, ab nihilo.
MMTers seem to have these conceptual, terminological problems for the same reason as more traditional economists (and due to MMTer's efforts at speaking in those economists' language): they're still "thinking inside the NIPAs" — despite MMTers well-founded devotion to the FOFAs.
The BEA's National Income and Product Accounts, pioneered by Simon Kuznets in the 1930s, are essentially income statements. They are one of the primary data sources for the FOFAs. But the NIPAs have a key failing: they don't include balance sheets (the essential second component of a coherent accounting, which the FOFAs add). And the NIPAs completely ignore (with good reason) existing-asset exchanges and revaluations.
Absent balance sheets, and accounting for existing-asset revaluation, it's impossible for balance sheets — and net worth, period to period — to…balance. Economists who don't deeply understand that — and I will assert that few economists do, because they're conceptually trapped inside the NIPA's balance-sheet-free definitions of income and saving — cannot form a coherent understanding of an economy's workings.
In Monetary Economics, Godley and Lavoie (G&L) do show a deep understanding of revaluation's importance — they give extensive coverage to the Haig-Simons accrual-based mark-to-market accounting approach that I also favor. But you'll be hard-pressed to search Google for top MMT names (Wray, Tymoigne, Kelton, Fullwiler) and find asset revaluation, capital gains, or Haig-Simons accounting incorporated into their discussions of income or saving.
This even though the FOFAs (presented in the Fed's Z.1 reports) provide exactly that: balance sheets and income statements based on Haig-Simons accounting — using accrual-based, marked-to-market revaluation of existing assets — wherein the sum of accounted flows totals to balance sheets' period-to-period net worth changes. See for instance the Household tables B.101 (bottom line: net worth) and R.101 (top line: change in net worth).
Those FOFA tables are the source of the Integrated Macroeconomic Accounts for the United States (IMAs), which unlike the NIPAs, conform (mostly) to the international System of National Accounts (SNAs). See for instance Household table S.3.a, which includes the income statement and balance sheet on a single page (bottom line: net worth).
You will find a similar Haig-Simons approach in Armour, Burkhauser, and Larrimore 2013, an analysis that merits significantly more attention, and replication. (The authors, inexcusably, have not made their data set available.) The FOFAs and IMAs provide the necessary revaluation estimates for such a replication, estimates which Armour et. al. achieve by their own methods (somewhat different from the Fed's, but using similar indices).
This is all important because the widespread MMT statement (at least implied, and frequently explicit) — that government deficits are the source of private saving (or "surplus") — is at least a poor explanation of economic workings, and at worst just wrong. Government deficits are a source of private saving.
The two primary sources of private assets (hence saving) are:
Surplus from production (how "surplus" is commonly used in the national accounts), monetized by the markets for newly produced goods and services.
Revaluation of existing assets — assets produced in previous periods — realized in the existing-asset markets.
I would even go so far as to say that these are the primary mechanisms whereby "money" is created. Deficit spending is small beer compared to cap gains. Asset markets go up, and there's more money. This eschews the widespread confution of money with "currency-like things," suggesting rather that all assets — which since they exist on balance sheets are necessarily designated in a unit of account — embody "money."
As an aid to untangling the confusion that I still find inherent in MMT discourse, I offer up the following taxonomy of sources for household income. It's explained in detail here.
Household Income Sources
Comprehensive Income (gross contributions to net worth, before netting out expenditures) Non-Property Income (compensation for labor) Other Labor Income Social benefits and other transfers received (including employers' social contributions)
Primary Income Primary Labor Income: Wages and salaries
Comprehensive Property Income (compensation for ownership) Primary Property Income: Dividends, interest, proprietors' income, rental income, and operating surplus
Other Property Income Market asset revaluation (capital gains)
Other changes in asset volume
Here's what that looks like in an accounting statement, here using IMA data:
Before you raise objections, I point you again to further explanation of this construct, here.
Like Armour et. al., I use a measure labeled "Comprehensive Income" that includes accrued, marked-to-market capital gains. I go a step further, however, and propose another measure based on that, a residual of sources and uses: "Comprehensive Saving." That measure has a singular virtue: it equals change in net worth.
"Primary income" — the vestige of the NIPA's "income" measure that is carried over into the FOFAs and IMAs (but properly labeled as "Balance of primary incomes") — is given as an addendum measure. The measure here varies from the FOFAs/IMAs only in that interest paid is not deducted from income; it's tallied under Uses.
Comprehensive Saving does not, of course, equal government deficit spending. (Nor does Primary Saving.) Such spending contributes to private-sector saving, but it's not even vaguely identical.
Before concluding, I'd like to touch on private-sector bank lending. (Modern Monetary Realists, are you listening?) Its direct effect on net worth is zero. It creates new assets — bank deposits. But unlike government deficit spending, it also creates equal and opposite offsetting liabilities on both the borrower's and the bank's balance sheets. Both balance sheets expand, equally on the left and right sides.
Borrower: +Assets (new bank account deposits) +Liabilities (new loan payable)
Bank: +Assets (loan receivable) +Liabilities (customer deposits withdrawable)
So the act of private lending itself creates new assets, but it doesn't directly, in accounting terms, increase private-sector net worth.
But: borrowers use many of those loans to create real assets — goods, capital — that are then sold at a higher value (or marked to market at a higher value). That markup increases private sector net worth, and private lending is a huge catalyst for that process. But that is an economic effect, not an accounting identity.
So yes: private bank loans create new private-sector assets, and they have the indirect economic effect of increasing net worth, but they don't, directly and in and of themselves, increase private-sector net worth. Government deficit spending does. MMTers are right that it's special in that way.
What they've missed — or caused many of their followers to miss — is that it's not the only thing that's special in that way.
Really, it's not even close:
Runups in stock and real-estate markets create new wealth, net worth, "savings," money, out of thin air — just like deficit spending, but by a different mechanism.
The markets create money too.
Cross-posted at Angry Bear.
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The Real (Real) Wealth Effect: Do Wealth Changes Change Spending and Cause Recessions?
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Wonky: More on Martin Sandbu's "Pseudo" Income and Saving
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Noahpinion: What Causes Recessions? Debt Runups or Wealth Declines?
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Bill Mitchell (Billy Blog)
Capital Gains and Games
Consider the Evidence (Lane Kenworthy)
Economic Opportunity Institute/Washington (State) Policy Watch
Multiplier Effect (Levy Economics Institute)
New Deal 2.0 (Roosevelt Institute)
Off the Charts (Center on Budget and Policy Priorities)
Presimetrics (Mike Kimel)
Promotional Worksite
Real World Economics Review
Retirement Blues (Jazzbumpa)
Rortybomb (Mike Konczal)
Shewing the Fly
Taxvox (Tax Policy Center)
TheMoneyIllusion (Scott Sumner)
Think Progress (Center for American Progress)


Another 'Irish Red' from our summer trip to er, Ireland. Bottled beer in Ireland's supermarkets is not especially cheap but we found this in Tesco's for less than €2.00 which is pretty good.
What they say: …an incredibly smooth malt body complimented by caramel tones and perfectly balanced in bitterness….
Couldn't agree more. We both loved this. Easily the best of the bottled beers we tried. Not too, gassy either but don't over chill. 4.3% A.B.V.
Readers of my blog A Load of Nonsense will know that we work as drivers for a private school and make the most of all the holidays. The summer break saw us in Ireland with our caravan and there was plenty of opportunity for 'research'. Sadly in the seven weeks we were there we found not one single hand pump, so there was no real ale as such. What could be found in virtually every pub however – alongside Guinness of course – was this.
Formerly known as Nut Brown Ale. Historically so called due to the flavour of the beer, whose roasted malt and caramel sugars produce the "nutty" palate of this dark, smooth ale.
What they say: A lush, sweet stout named after the county in which it is brewed.
It was certainly sweet. Thankfully only half a pint – it came in a gift pack for the Portly Partner's 60th Birthday back in march. Yes, I'm that far behind.
There was nothing wrong with it, just not my thing 2.8% A.B.V.


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WA tells you: the cold is a crisis, but also a turn for the better.
The blockchain industry suffered a "cold wave" in this winter, and it was timely and came at the right time. Because many speculators, air coins, blockchain scams will be eliminated in this "cold wave", the survival of the fittest is an everlasting rule of nature. This is the same as the Internet bubble more than 10 years ago. After the phoenix nirvana, the blockchain industry will soon be reborn after the fire.
WA that is "curving overtaking"
When the blockchain industry encounters a "cold wave", we must open up the market bubble, avoid the air currency, and From the perspective of value investment, strive to "treasure hunting".
WA welcomes people from all over the world to join in co-constructing and co-sharing a win-win situation. Let us work together to create a new world of "Life is free, the world is interlinked."


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text:
Early View
Read-and-publish agreements
Impact of fan therapy during exercise on breathlessness and recovery time in patients with COPD: a pilot randomised controlled crossover trial
Alex Long1,2,
Martin Cartwright2 and
Charles C. Reilly1,3⇑
1Dept of Physiotherapy, King's College Hospital NHS Foundation Trust, London, UK
2School of Health Sciences, City, University of London, London, UK
3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
Corresponding author: Charles C. Reilly (charles.c.reilly{at}kcl.ac.uk)
Background Patients with COPD reduce physical activity to avoid the onset of breathlessness. Fan therapy can reduce breathlessness at rest, but the efficacy of fan therapy during exercise remains unknown in this population. The aim of the present study was to investigate 1) the effect of fan therapy on exercise-induced breathlessness and post-exercise recovery time in patients with COPD and 2) the acceptability of fan therapy during exercise; and 3) to assess the reproducibility of any observed improvements in outcome measures.
Methods A pilot single-centre, randomised, controlled, crossover open (nonmasked) trial (clinicaltrials.gov NCT03137524) of fan therapy versus no fan therapy during 6-min walk test (6MWT) in patients with COPD and a modified Medical Research Council (mMRC) dyspnoea score ≥2. Breathlessness intensity was quantified before and on termination of the 6MWT, using the numerical rating scale (NRS) (0–10). Post-exertional recovery time was measured, defined as the time taken to return to baseline NRS breathlessness score. Oxygen saturation and heart rate were measure pre- and post-6MWT.
Results 14 patients with COPD completed the trial per protocol (four male, 10 female; median (interquartile range (IQR)) age 66.50 (60.75 to 73.50) years); mMRC dyspnoea 3 (2 to 3)). Fan therapy resulted in lower exercise-induced breathlessness (ΔNRS; Δ modified Borg scale) (within-individual differences in medians (WIDiM) −1.00, IQR −2.00 to −0.50; p<0.01; WIDiM −0.25, IQR −2.00 to 0.00; p=0.02), greater distance walked (metres) during the 6MWT (WIDiM 21.25, IQR 12.75 to 31.88; p<0.01), and improved post-exertional breathlessness (NRS) recovery time (WIDiM −10.00, IQR −78.75 to 50.00; p<0.01). Fan therapy was deemed to be acceptable by 92% of participants.
Conclusion Fan therapy was acceptable and provided symptomatic relief to patients with COPD during exercise. These data will inform larger pilot studies and efficacy studies of fan therapy during exercise.
Fan therapy was acceptable and provided symptomatic relief to patients with COPD during exercise; these positive preliminary findings suggest that fan therapy merits further investigation in larger and more methodologically rigorous studies https://bit.ly/3xR2GDW
COPD is defined as "a common and treatable disease characterised by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gas" [1]. COPD is progressive, associated with frequent exacerbation of symptoms including increased breathlessness, leading to increased disability and reduced quality of life [1].
COPD is the fourth leading cause of death worldwide [2]. Over a million individuals in the United Kingdom (UK) have COPD, resulting in >25 000 deaths each year due to COPD [3]. COPD mortality in the UK is third in Europe [3].
The burden of chronic breathlessness is significant for patients with COPD, negatively impacting upon health-related quality of life and physical function, as patients frequently avoid activities that evoke breathlessness. This fear-avoidance results in disuse atrophy, which perpetuates a cycle of increasing breathlessness and disability [4, 5].
Exercise interventions such as pulmonary rehabilitation for patients with COPD improve breathlessness and physical function and reduce exacerbation frequency and hospital admission [6]. However, pulmonary rehabilitation is a brief intervention and maintaining these benefits requires patients to continue to exercise independently. Breathlessness is the main limiting factor to exercise in COPD [7]; therefore, any interventions to help patients to self-manage their exercise-induced breathlessness are sought.
Evidence suggests that cool facial airflow from either medical air (room air delivered under pressure via a concentrator or canister) or a fan can reduce breathlessness at rest [8, 9]. The burden of chronic breathlessness is significant for patients with COPD, and their families [10, 11]. Holistic breathlessness support services have been shown to improve breathlessness mastery and reduce distress due to breathlessness, where fan therapy is an integral part of these self-management interventions [12, 13]. Moreover, qualitative data from patients with chronic breathlessness describe improvements in their ability to control their breathlessness at rest (self-mastery) with the use of fan therapy [12]. The efficacy and acceptability of fan therapy during exercise remains unknown in patients with COPD.
The aim of this study was 1) to investigate the effect of fan therapy on exercise-induced breathlessness and post-exercise recovery time in patients with COPD; 2) to investigate the acceptability of fan therapy during exercise; and 3) to assess the reproducibility of any observed improvements in outcome measures.
We hypothesised that fan therapy would reduce exercise-induced breathlessness and improve post-exercise recovery time in patients with COPD. (Null hypothesis: there would be no difference in exercise-induced breathlessness, physiological variables, e.g. heart rate, oxygen saturation or recovery time when assessed in the fan therapy and no fan therapy conditions for a 6-min walk test (6MWT).)
A pilot single-centre randomised controlled crossover, open (nonmasked) trial (NCT03137524) of fan therapy versus no fan therapy during 6MWT in patients with COPD and modified Medical Research Council (mMRC) dyspnoea score ≥2. There was a 30-min washout period between 6MWTs (figure 1).
Study design and flow of patient through the study protocol: a pilot single-centre randomised controlled crossover open (nonmasked) trial of hand-held fan therapy (HHFT) versus no HHFT during 6-min walk test (6MWT) in patients with COPD and modified Medical Research Council dyspnoea score ≥2.
Inclusion criteria: adults with a diagnosis of COPD by a respiratory physician (characterised by forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio ≤70%), with exertional breathlessness (mMRC dyspnoea score ≥2) and a stable smoking status were eligible.
Exclusion criteria: significant cardiovascular or peripheral disease that could influence exercise tolerance, recent change in medication or exacerbation of COPD symptoms requiring admission during the preceding 4 weeks; unable to hold a handheld fan; unable to speak English; or not capable of providing informed consent.
Patients were recruited from specialist COPD outpatient clinics and Pulmonary Rehabilitation at King's College Hospital NHS Foundation Trust (KCH) (Denmark Hill site, London, UK). Participants fulfilling eligibility criteria were recruited by convenience sampling. Potential participants were identified by members of the clinical teams, who gained consent for their contact details to be passed on to the researcher. Thereafter, participants were sent by post an invitation to participate and an information letter from the researcher, given ≥1 week to read thoroughly, then re-contacted by the researcher to discuss any concerns. Interest in the study led to an assessment date being organised, at which consent forms were signed.
Randomisation and masking
Block randomisation was implemented using an online tool (www.sealedenvelope.com/simple-randomiser/v1/) to allocate participants to their initial experimental conditions (i.e. walking with a hand-held fan versus walking without a fan) and ensure the conditions were numerically balanced. Simple four-block randomisation was applied. On completion of the initial walking test and outcome assessments, participants were given 30 min to recover physiologically and then they repeated the walking test in the alternative experimental condition. Due to the nature of the intervention (fan therapy), it was not possible to blind the researcher or patients to the allocations.
No formal sample size calculation was performed, due to the lack of data regarding the potential impact fan therapy may have on exercise-induced breathlessness in COPD. Therefore, this pilot study aimed to recruit 14–16 participants. The pilot data will inform subsequent efficacy studies of fan therapy during exercise.
Ethical approval
Ethical and local research and development approval (KCH17–062) was obtained prior to commencing this research (LREC protocol number: REC 17/NE/0063). The study was registered on www.clinicaltrials.gov (NCT03137524). All participants provided written informed consent.
Intervention: fan therapy
The handheld fans used were commercially available and battery-operated, with three soft propeller blades and an on/off switch usable by participants (Marks and Spencer's Pocket-Sized Travel Fan, cost per fan GBP 6.00). Patients were provided with standardised instructions as how to use the handheld fan: to hold the fan to their face throughout both the walking test and during the recovery period until they reported that breathlessness returned to baseline.
Primary outcome measure
Breathlessness change: the magnitude of exercise-induced breathlessness during a 6MWT, defined as the change (Δ) in breathlessness scores from rest (immediately pre-exercise) to immediately post-exercise, quantified using the numerical rating scale (NRS). The NRS breathlessness is a validated, self-reported, unidimensional scale to rate chronic breathlessness intensity. It is simple to use across a variety of everyday activities, and adjustable to specific time points [14]. NRS anchors were 0=not breathless at all, 10=worst possible breathlessness.
Secondary outcome measures
Breathlessness intensity
Self-reported level or intensity of breathlessness as indicated on the NRS.
Perceived breathing difficulty/effort
Perceived breathing difficulty/effort was quantified using the modified Borg breathlessness (mBorg) scale at rest and at end exercise. The mBorg is quantifies perceived breathing difficulty/effort on a 0–10 scale, with descriptors, e.g. 0=none at all, 5=severe, 10=maximal. It was developed for use during exertion [15]. It has a minimal clinically important difference (MCID) of 1 point, with larger changes more likely at the higher end of the scale due to larger numerical intervals between descriptive markers [16]. Reliability and validity of mBorg breathlessness measurement during 6MWT is accepted (intraclass correlation coefficient from 0.59 to 0.92; mean difference of <1 point) [17].
Distance walked (m) during the 6MWT
The 6MWT is a self-paced walking test. It measures walking capacity by measuring total distance covered around a flat 30-m course in 6 min. Standardised instructions are given throughout the test. It is a robust test of functional exercise capacity [17].
Post-exertional recovery time (s)
Post-exertional recovery time was measured, defined as the time taken to return to baseline NRS breathlessness score, peripheral oxygen saturation (SpO2) and heart rate. Participants were asked to report when their NRS breathlessness score had returned to base levels. SpO2 and heart rate were measured using a pulse oximetry (Onyx 9500 Fingertip Pulse Oximeter; Nonin Medical, Plymouth, MN, USA). SpO2 and heart rate were measured at rest, during and post-6MWT.
Acceptability of using the handheld fan
Acceptability was assessed via a Likert scale questionnaire (range 1–5) based on the theoretical framework of acceptability (TFA) [18]. Participants were asked to respond to specific questions reflecting the overall acceptability of fan therapy and five subconstructs from the TFA (affective attitude, burden, perceived effectiveness, intervention coherence and self-efficacy).
The study was conducted at the clinical research facility at KCH. Baseline demographic data included age, sex, spirometry, smoking history, body mass index, mMRC dyspnoea score, COPD Assessment Test (CAT).
Participants performed three 6MWTs: one for practice, to account for potential learning effect, followed by two as per protocol (figure 1). The 6MWT was performed in accordance with technical procedures described by the American Thoracic Society [19]. Participants were given a 30-min period between the practice 6MWT and commencing the crossover trial experimental protocol (figure 1). Outcome measures recorded pre and post all 6MWTs included NRS breathlessness, mBorg, heart rate and SpO2. The distance walked and number of rest periods/stops the patient required was recorded for all 6MWTs completed. Recovery time for NRS and heart rate to return to baseline post-6MWT was timed (in seconds) immediately from the end of the 6MWT. Recovery was recorded in standardised seated position. The self-reported acceptability questionnaire was completed at the end of the crossover trial (figure 1).
To assess the reproducibility/consistency of any observed improvements in outcome measures, patients were invited to complete the experimental protocol again, a week later (trial 2). To reduce the chance of any imbalances between allocation sequence groups (AB versus BA) following the initial randomisation in trial 1 being carried forward to trial 2, participants were re-randomised to allocation sequences for trial 2.
Data analysis and reporting
Inferential statistical analysis of outcomes was completed, with a significance level of p<0.05 using the statistical package SPSS v26 (IBM, Armonk, NY, USA). Normality of the data was determined by skewness and Shapiro–Wilk test. The data was non-normally distributed, hence central tendencies are described using medians and interquartile ranges (IQRs) calculated in Microsoft Excel (version 2016). Within-individual differences in the medians (WIDiMs) and IQRs (fan versus no fan) were calculated by first subtracting a participant's score in the no fan condition from their score in the fan condition, and then calculating the median (IQR) of these within-individual differences. WIDiMs retain the repeated nature of the crossover design at the level of the individual and are used to assess treatment effects [20], in our case using nonparametric tests (Wilcoxon matched-pairs signed-rank tests, with two-sided exact significance). In addition, in tables 2 and 3, group-level medians are reported. For example, for participants allocated to the sequence fan-then-no-fan (n=7), we report the group-level medians for each outcome in the fan condition and in the no-fan condition. These group-level medians do not retain the repeated nature of the crossover design at the level of the individual, so they cannot legitimately be used to estimate treatment effects; however, they are helpful in understanding the likelihood of carryover effects and period (order) effects, as well as the amount of missing data [20]. WIDiMs and group-level medians are not directly related, as they are generated from independent calculations.
Patient characteristics of the 14 patients who completed the randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test
Results observed in the primary randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test (6MWT) in patients with COPD
Results observed in the repeated randomised controlled crossover trial of fan therapy versus no fan therapy during 6-min walk test (6MWT) in patients with COPD
Patient-reported acceptability of hand-held fan (HHF) therapy during exercise
Recruitment and engagement
Recruitment took place over 10 weeks (May to July 2017). 26 patients were screened; three (12%) were ineligible. Of the 23 eligible patients, eight (35%) declined to participate and 14 (61%) agreed to participate and were randomised. 14 participants (100%) completed the trial per protocol (table 1). 13 (92%) out of the 14 patients completed the reproducibility study. One patient declined to participate in the reproducibility study due to unforeseeable personal circumstances.
Patient characteristics
14 patients with COPD completed the trial per protocol (four male, 10 female; median (IQR) age 66.50 (60.75 to 73.50) years and mMRC dyspnoea 3 (2 to 3)), summarised in table 1.
Prior to exercise there were no differences between the experimental conditions for resting NRS breathlessness, mBorg, heart rate or SpO2. Following exercise, change scores for the primary outcome (ΔNRS) showed that low-level physical activity under the fan condition resulted in lower exercise-induced breathlessness, i.e. smaller increases in breathlessness compared to the no-fan condition (WIDiM −1.00, IQR −2.00 to −0.50; p<0.01). For the secondary outcomes, the fan condition resulted in smaller increases in perceived breathing difficulty/effort (ΔmBorg) (WIDiM −0.25, IQR −2.00 to 0.00; p=0.02), greater distance walked during the 6MWT (WIDiM 21.25 m, IQR 12.75 to 31.88 m; p<0.01), and a shorter post-exertional breathlessness recovery time (seconds) (WIDiM −10.00 s, IQR −78.75 to 50.00 s; p<0.01) (table 2). However, there were no overall treatment effects for heart rate, SpO2 or the number of stops taken during the 6MWT.
The reproducibility crossover trial (trial 2) demonstrated consistent findings of benefits for the fan condition: smaller increases in breathlessness (ΔNRS) (WIDiM −1.00, IQR −1.00 to 0.00; p<0.01), smaller increases in perceived breathing difficulty/effort (ΔmBorg) (WIDiM −1.00, IQR −2.00 to 0.00; p<0.01), greater distance walked during the 6MWT (WIDiM 28.00 m, IQR 17.50 to 45.00 m, p<0.01) and a shorter post-exertional breathlessness recovery time (seconds) (WIDiM −65.00 s, IQR −130.00 to −20.00 s; p<0.01) (table 3). Again, there were no overall treatment effects for heart rate, SpO2 or the number of stops taken during the 6MWT.
Fan therapy was acceptable to 92% of participants (table 4), with a median (IQR) acceptability score of 4 (4 to 5) out of 5. 53% reported no additional burden of fan therapy during the 6MWT. Patients reported they liked the handheld fan (median 4, IQR 3 to 5) and that it was of minimal burden (median 1, IQR 1 to 3). Patients were confident to use the handheld fan (median 5, IQR 4 to 5) and understood how it was supposed to help them (median 4, IQR 3 to 5).
In keeping with the observed improvements in breathlessness scores and exercise performance, patients perceived the handheld fan to be effective during exercise (median 4, IQR 3 to 4) and to help to resolve breathlessness post-exertion (median 4, IQR 3 to 4). Moreover, these patients who had not used a fan before reported that they would use a handheld fan during everyday life (median 5, IQR 4 to 5), which reinforces the acceptability of this intervention. One person commented that using (holding) the fan negatively affected their walking style. Free-text comments were limited, but supported the use of the handheld fan:
"very useful during exercising" (male, FEV1 0.59 L)
"I think it worked… it helped my breathing" (female, FEV1 1.40 L)
"it acts as a distraction from my breathing, which I find useful" (female, FEV1 1.55 L)
This study aimed to investigate the effect of fan therapy on exercise-induced breathlessness and post-exercise recovery time in patients with COPD, and the acceptability of using fan therapy during exercise in controlled circumstances. Findings across two pilot crossover trials with the same participants suggest that using a hand-held fan during low-level exercise has no impact on physiological measures (heart rate, SpO2), but reduces subjective feelings of exercise-induced breathlessness, increases walking distance and speeds post-exertional recovery time. Fan therapy was deemed to be acceptable by 92% of participants.
This is the first article to report an improvement in recovery time post-exertion due to fan therapy in patients with COPD. The reduction in exercise-induced breathlessness was similar to that described by Marchetti et al. [21], who reported significance between median (range) mBorg at maximal exercise of 6.50 (0 to 10) with fan directed to leg versus 5.00 (0 to 10) with fan directed to face (p=0.03). Our data extend these findings and show that using a handheld fan during exercise was perceived to be acceptable to participants and provided symptomatic relief to patients with COPD during exercise. These data will inform larger efficacy studies of fan therapy during exercise.
Relevance of findings
The UK MRC produced a series of guidelines from 2000 onwards to help researchers develop and evaluate of complex health interventions. These MRC guidelines explicitly recommend that developers assess the acceptability of prototype interventions at an early stage and throughout the development process [22–24]. There is now a growing consensus that developers need to optimise interventions to ensure acceptability to those delivering and receiving them [25]. Evidence shows that the acceptability of interventions impacts on their implementation, uptake, adherence and effectiveness [24, 26–28]. The TFA [18] identifies underlying constructs presumed to contribute to evaluations of intervention acceptability and offers suggestions on how to assess acceptability. The current study used the TFA to guide the assessment of the retrospective acceptability of fan therapy to intervention recipients. The findings provide preliminary support for the acceptability of the fan therapy to patients with COPD, suggesting not only that fan therapy was acceptable overall, but that the intervention required low effort, was liked and participants understood how the fan was supposed to help them during exertion. Participants were confident as how to use the fan as directed. Participants perceived the fan to be effective at reducing breathlessness, helping them return to normal breathing post-exertion, and that it would be useful during everyday tasks (table 4). This is in line with the observation by Bausewein et al. [29] that at 2 months post-completion, 50% of participants continued to use the fan. Findings relating to acceptability were positive for all TFA constructs assessed, suggesting that there is no need adapt the intervention prior to further evaluation. However, acceptability can change with exposure to an intervention; therefore, future studies should assess the acceptability of fan therapy for people with COPD and other respiratory conditions at multiple time points during longer exposures. Furthermore, studies should use the full range of TFA constructs (we did not assess the perceived opportunity costs or ethics of fan therapy) and assess acceptability of fan therapy to intervention deliverers.
In keeping with our observations, Johnson et al. [30] used magnetoencephalography to scan the brains of participants (n=8) with chronic lung disease (50% diagnosed with COPD) during post-exertional recovery following exercise with or without airflow. Time recovery was median 270 s (range 60 to 360 s) with airflow versus 330 s (range 210–390 s), which is longer than in our cohort, indicating that our sample recovered quicker, although our sample did not achieve such a high breathlessness intensity. Preliminary imaging suggested that facial airflow might result in different areas of lobar activity being identified, potentially altering central processing and perception of neural respiratory drive and breathlessness. The insular cortex, anterior cingulate cortex and amygdala contribute towards this [31].
Brain imaging in healthy participants suggest that affective experiences (e.g. distress, anxiety, fear) and the sensory experiences (e.g. pain, difficulty breathing) of breathlessness are processed by different neural pathways [32].
Physiological studies in healthy volunteers propose that cool air stimulates facial receptors connected to the trigeminal nerve, altering input to sensory processing areas of the brain [33], while oral mucosal stimulation can affect afferent information [34], thereby altering and reducing the perception and intensity of breathlessness. Morélot-Panzini [35] describes this as "fooling the brain" into the perception that the respiratory system is more efficient than it is. These physiological observations are supported by qualitative accounts of patients' coping strategies used to manage acute breathlessness e.g. opening windows, letting cold air into the room [36].
Lansing et al. [37] proposed a multidimensional model of dyspnoea based on the pain literature, where unpleasant sensations of breathlessness lead to withdrawal from physical activity, while an emotional component then leads to lifestyle changes to avoid dyspnoea. Avoiding dyspnoea triggers, such as physical activity, results in deconditioning, which lowers the threshold for dyspnoea and causes further decline.
Patients with COPD frequently feel helpless or not in control of their breathlessness, which is distressing for both the patient and their significant others [36, 38]. This can lead to them avoiding activities that make them breathless. An intervention that could reduce the extent of exertion-induced breathlessness and improve the recovery time could be important in breaking the cycle of avoidance behaviours commonly seen in patients with COPD and potentially lead to improvements in health-related quality of life.
Significant differences in favour of fan therapy were observed for two measures of breathlessness (NRS and mBorg) and distance on the 6MWT (tables 2 and 3). Based on the overall treatment effect, NRS scores were 1 unit lower in the fan condition (trial 1 and trial 2); mBorg scores were between 0.25 units (trial 1) and 1 unit (trial 2) lower in the fan condition; and distance walked was between 21 m (trial 1) and 28 m (trials 2) greater in the fan condition. Of these outcomes, only the NRS demonstrated consistent benefits (across both trials) for the fan condition which reached the respective MCID (1 unit for NRS) [39].
Benefits of the fan condition as assessed by mBorg breathlessness and distance on the 6MWT failed to consistently meet the MCIDs of 1 unit and 30 m [17, 19, 39]. Nevertheless, the findings for NRS suggest that the use of a fan during low-level physical activity may lead to clinically meaningful improvements in breathlessness and functional response. However, these improvements need to be contextualised as they were observed in a controlled situation on a flat indoor surface and were transitory. Taken at face value, the findings suggest there could be a role for fan therapy in helping individuals with COPD to cope with physical exertion (e.g. walking upstairs) or participation in patient exercise/rehabilitation programmes.
All outcomes were assessed over a very short period of time, and we cannot comment on the longer-term potential benefits of fan therapy. Future studies need to validate these acute findings and look at the acceptability and feasibility of sustained use of fan therapy and potential long-term benefits. Different roles for fan therapy should also be explored. For example, fans can be used for temporary symptomatic relief during day-to-day activities or in a more therapeutic way as an adjunct to exercise interventions and/or breathlessness self-management interventions; both approaches may be useful. Studies should explore benefits across a wider range of patient-reported outcomes such as breathlessness mastery, health-related quality of life and illness perception, as these are potentially modifiable factors.
We report some positive preliminary findings, along with some null results that suggest fan therapy merits further investigation in larger and more methodologically rigorous studies. The current study raises important practical considerations such as how will people use handheld fans in their day-to-day life (is it just an aid while they try to improve their respiratory fitness on a treadmill, or would they find it useful while walking to the park/shop/friend's house?). There is also a question of whether people will use a fan on an ongoing basis, either as a rehabilitation aid or as a practical day-to-day aid for going to shops, etc. Does the use of a fan translate into quality-of-life benefits? The low cost and scalability of fan therapy could increase the potential impact, although the real-world practicalities of fan therapy should be examined.
A strength of the study was the use of a practice walk with the 6MWT. There is known learning effect with the 6MWT, with the second test usually performing better [17].
Internal validity was enhanced by a randomised crossover study design, which is suitable in chronic disease for evaluating the temporary effect of an intervention [40].
This study achieved a 53.8% recruitment rate from screening, similar to previous breathlessness literature [41]. This suggests that the generalisability of the current findings may be limited to only those people willing to engage with the intervention. Future studies could usefully embed an assessment of the reasons for refusal to participate, as has been done in other challenging clinical areas, e.g. occupational therapy intervention for individuals with dementia [42].
We must acknowledge the potential fatigue impact of undertaking three 6MWTs in a day. We ensured that there was sufficient time between walk tests and that patients remained at their symptomatic baseline prior to each test. However, we did not account for the potential effect of fatigue on the observed outcomes, a point that warrants consideration when planning subsequent trials.
Washout periods aim to reduce the potential of carryover effects of the intervention being studied. There is no consensus on the optimal duration of washout periods. Pharmacological studies often calculate their washout period based on five or more times the half-life of the drug under investigation [43]. For nonpharmacological interventions, deciding the optimal duration of the washout period is challenging. Galbraith et al. [44] reported that a 10-min washout after use of hand-held fan therapy at rest was insufficient. In this study, we choose a 30-min washout period as we believe that this would provide sufficient time for patients to physiologically recover from the 6MWT and for the acute potential effects of the fan therapy to have diminished. It must be acknowledged that a longer washout period of an hour may be more appropriate in subsequent studies, especially if including patients with advanced disease (mMRC >3). Moreover, it is important to factor in the overall time burden of the study design on participants, an important factor when estimating recruitment rates.
Commercially purchased, pocket-sized travel fans were used [41]; however, a limitation of this and most other fan therapy literature is that the that airflow generated by each fan used (either static or hand-held) appears to be generally unknown. Marchetti et al. [21] reported that the peak airflow generated by their static fan was 840 ft·min−1. Airflow studies describe a range of flow rates. What remains to be ascertained is whether there is a minimal or optimum flow rate that should be used in these studies to allow for greater comparison and transparency of results.
Fan therapy using a low-cost, readily available hand-held fan was acceptable and provided symptomatic relief to patients with COPD during a short period of low-level exercise (walking). Our positive preliminary findings suggest that fan therapy merits further investigation in larger and more methodologically rigorous studies. The current study raises important practical considerations such as (how) would people use handheld fans in their day-to-day life
This report is independent research supported by the National Institute for Health Research (NIHR) (MRes studentship at City, University of London, to A. Long). This study represents independent research supported by the NIHR. An NIHR Clinical Lectureship (ICA-CL-2018–04-ST2–001) supports C.C. Reilly. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR or the Dept of Health and Social Care.
Provenance: Submitted article, peer reviewed.
Data availability: Data will not be shared
Author contributions: Conception and design: C.C. Reilly. Data acquisition: A. Long. Statistical analysis and interpretation: M. Cartwright. Drafting the manuscript for important intellectual content: A. Long and C.C. Reilly. Final review of manuscript: all authors.
Conflict of interest: A. Long has nothing to disclose.
Conflict of interest: M. Cartwright has nothing to disclose.
Conflict of interest: C.C. Reilly has nothing to disclose.
Received March 24, 2021.
Copyright ©The authors 2021
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org
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About ERJ Open Research

redpajama_set_name: RedPajamaCommonCrawl


I am an older widow and maybe considered an outsider, but we have owned a cabin near Flatridge for 45 years. I don't have any cell service, as I am behind the mountain from the tower. Therefore, I had to rely on a land line over the years.


text:
A Rosa Filmes é uma empresa produtora, distribuidora e financiadora cinematográfica com sede em Lisboa.

Fundada em 1993 por Joaquim Sapinho, a Rosa Filmes produziu os filmes:
 2013 - A Vida Invisível - Realizado por Vítor Gonçalves.
 2011 - Deste Lado da Ressurreição - Realizado por Joaquim Sapinho.
 2011 - O Que Há De Novo No Amor? - Realizado por Mónica Santana Baptista, Hugo Martins, Rui Santos, Tiago Nunes, Hugo Alves e Patrícia Raposo.
 2009 - Morrer como um Homem - Realizado por João Pedro Rodrigues
 2009 - 4 Copas - Realizado por Manuel Mozos
 2005 - Diários da Bósnia - Realizado por Joaquim Sapinho
 2005 - Odete - Realizado por João Pedro Rodrigues
 2003 - A Mulher Polícia - Realizado por Joaquim Sapinho
 2000 - O Fantasma - Realizado por João Pedro Rodrigues
 1999 - Glória - Realizado por Manuela Viegas
 1999 - Mal - Realizado por Alberto Seixas Santos
 1999 - Jorge Molder - Realizado por José Neves
 1998 - José Cardoso Pires - Diário de Bordo - Realizado por Manuel Mozos
 1998 - Viagem à Expo - Realizado por João Pedro Rodrigues
 1997 - Parabéns! - Realizado por João Pedro Rodrigues
 1997 - Esta é a Minha Casa - Realizado por João Pedro Rodrigues
 1997 - António Lobo Antunes - Realizado por Solveig Nordlund
 1997 - Cinema Português? - Realizado por Manuel Mozos
 1995 - Corte de Cabelo - Realizado por Joaquim Sapinho
 1995 - "Cinéma, de notre temps: Shohei Imamura - Le libre penseur" - Realizado por Paulo Rocha
 1994 - Lisboa no Cinema - Realizado por Manuel Mozos
 1994 - Julião Sarmento - Realizado por Joaquim Sapinho
 1993 - Portugaru San - O Sr. Portugal em Tokushima - Realizado por Paulo Rocha

Ligações externas
 Sítio Oficial da Rosa Filmes
 Rosa Filmes no IMDb

Empresas de produção cinematográfica de Portugal
Empresas fundadas em 1993

redpajama_set_name: RedPajamaWikipedia


The Great Lakes are threatened by invasive species, pollution, and emerging commercial aquaculture proposals, creating a need for state and federal policies that protect the Great Lakes and sustained public funding for Great Lakes restoration efforts. Adding to the challenge, political shifts at state and federal levels have made it more difficult to uphold environmental regulations and maintain public funding for environmental restoration.
To address these challenges, a powerful constituency of recreational anglers needs to be mobilized. Recreational fishing in the Great Lakes is a major economic contributor to local economies, and fishing is an important part of the lives of the 1.6 million anglers who fish in the Great Lakes region and millions more who visit and enjoy the Great Lakes states. By educating and engaging Trout Unlimited members and other anglers, strength will be added to current Great Lakes advocacy efforts and advance our shared goals of protecting and restoring the Great Lakes.
The main objectives for the next year include: preventing the approval of harmful commercial aquaculture proposals in the Great Lakes, increasing funding for the Great Lakes Restoration Initiative (GLRI) which continues to receive at least $300 million in annual appropriations and cultivate stronger, more diverse, and engaged TU chapters.
In order to affect decision-making processes—whether legislative or regulatory—it will be important to build a strong base of support and activate supporters at key points in the process. TU is working to educate chapters on Great Lakes aquaculture proposals and GLRI funding through chapter meetings, email distribution, social media and conference calls. TU will also coordinate and communicate with other angling groups, conservation organizations, and stakeholders to stay abreast of all Great Lakes issues. Other potential allies such as recreation-dependent businesses in port cities and towns will be important partners in these discussions. These allies and other nonprofit partners will be called on to engage at important points such as commenting during regulatory processes, contacting legislators, and submitting op-eds and letters to the editor.
In 2016, Michigan Governor Rick Snyder and his administration released a report which recommended against allowing net-pens in the Great Lakes. The synthesized report can be found here.
The establishment of a Great Lakes Organizer within TU has marked the first step towards providing a single point of contact for issues that affect the Great Lakes Basin. This position will also empower local chapters and state councils to coalesce around important and impactful legislation.
With an extended 2016 federal legislative recess, legislators are being brought to in-district projects to demonstrate the integral part that GLRI funding plays in restoration and protection projects.


With the election just six weeks away and polls showing a neck-and-neck race, much is on the line.
Who's On Stage And Who's Not?
Clinton and Trump will have the debate stage to themselves, even though 76 percent of the country wants another candidate to join them, like Green Jill Stein or Libertarian Gary Johnson.
But neither Stein nor Johnson reached 15 percent in the polls, a requirement put in place by the Commission on Presidential Debates.
While official-sounding, the CPD is actually a private, non-profit corporation created to wrest control of the debates from the independent League of Women Voters.
They're "phony, part of an unconscionable fraud," said CBS news anchor Walter Cronkite.
Moderating tonight's debate is Lester Holt, who anchors the top-rated NBC Nightly News.
Don't expect Holt to say anything as critical as Cronkite or Shaw; or even to ask too many follow up questions.
In fact, he may not be allowed to.
The moderator will not ask follow-up questions or comment on… questions asked by the audience or the answers of the candidates.
Neither the CPD, nor the Clinton or Trump campaigns, responded to earlier questions regarding whether they'd signed an MOU for this year's debates.
NBC's Matt Lauer took a similar approach at a recent forum in which he interviewed Clinton and Trump separately before a live audience. Lauer was widely panned for, among other things, not fact-checking Trump's misstatement that he'd been against the Iraq War from the outset.
Clinton campaign manager Robby Mook, speaking Sunday morning on ABC's This Week, called on Holt to fact-check Trump at tonight's debate. "All that we're asking is that if Donald Trump lies, that it's pointed out," said Mook.
That's the CPD's position as well. "I don't think it's a good idea to get the moderator into essentially serving as the Encyclopedia Britannica," CPD executive director Janet Brown told CNN.
At tonight's debate, Clinton and Trump are even using the audience to throw each other off.
The Clinton campaign offered a front row seat to Mark Cuban, the billionaire owner of the Dallas Mavericks. Cuban then took to Twitter to taunt Trump, with whom he has a long-running feud.
Just got a front row seat to watch @HillaryClinton overwhelm @realDonaldTrump at the "Humbling at Hofstra" on Monday. It Is On !
Trump responded by threatening to invite Gennifer Flowers, who had an affair with Bill Clinton in the 1980s. Flowers accepted, but the Trump campaign now says she wasn't officially asked, and it's unclear if she'll be attending.
This may well happen. Different groups and causes are converging on debate host Hofstra University. After all, Trump and Clinton are the most disliked major party nominees in recent history.
More than 1,500 fast food workers will be protesting outside the debate to call for a $15 an hour minimum wage, a union organizer told the Daily News.
Libertarians will be outside protesting Gary Johnson's exclusion from the stage.
Keeping this dissatisfaction away from the debate auditorium will be cops, who are expected to number more than a thousand.
Protesters will be put in "Free Speech" zones, explained the local police commissioner, who plans to put protesters with opposing views in separate areas.
The debate runs from 9-10:30 p.m. (EST), without commercials. It's being broadcast live on all the major networks, several cable stations, and is widely available online.


text:
Published on May 22nd, 2008 10:13 pm EST
David Benyamine is gearing up for the high stakes cash games in Vegas during the World Series of Poker by crushing his competition on Full Tilt Poker. According to HighStakesDB (link below), David Benyamine is currently up over $1.8 million dollars in Pot Limit Omaha games on FTP, just in May. He apparently had a particularly juicy session this morning where he won over $700k, beating players such as "Durrrr" and "Alstonprice" out of six figures each.
Prior to this session, Benyamine had been up a still-ridiculous $1.15 million in May over 18,302 hands (in the PLO games). This works out to an unbelievable $62.83 in profit for each hand that he has played so far in May. Markus Golser, "Ziigmund" and Cole South have all had spectacular months in the PLO games on Full Tilt Poker, but they are all still lagging seven figures behind Benyamine on the month.
Can anyone argue that David Benyamine isn't one of the top Pot Limit Omaha players in the world?
Barry Greenstein once had this to say about Benyamine: "More than any player I know, David is so talented that it hurts him. On the Internet, he will put himself into situations where no one could succeed: multitabling five or six different forms of limit and no-limit poker against top-flight opponents. If he could be satisfied playing one or two screens of Pot Limit Omaha, I would take him over anyone."
Benyamine seems to have taken this advice, and his profits have swelled because of it. His biggest problem used to be that he would throw millions of dollars away in the high stakes NLHE games on Full Tilt Poker and Pokerstars. If you combine some of the aliases that he used prior to signing his deal with Full Tilt Poker ("ballsrider", "magicpitch1") with his current alias (David Benyamine), you can see that he won millions of dollars playing Pot Limit Omaha, but then threw almost all of that money away playing No Limit Hold'em. You'll still catch him playing Limit or No Limit Hold'em from time to time, but he seems to have mostly plugged that leak. Since the beginning of 2007, according to HighStakesDB, Benyamine's various aliases have dropped $3 million dollars on Full Tilt Poker playing No Limit Hold'em.
On the flip side, since the beginning of 2007, Benyamine has dominated the biggest PLO games on the site like no one else.
If you include his 700k win from earlier today, the "David Benyamine" alias has won around $5.3 million in the PLO games on FTP since the beginning of 2007.
Another one of his old aliases, "ballsrider", generated $1.51 million in total profits over that same time period, before being shut down. Yet another one of his aliases, "magicpitch1", is up over $682k from the beginning of 2007 until now. Add those three aliases up, and Benyamine is up around $7.6 million playing PLO on Full Tilt Poker since the beginning of 2007. That makes him by far the biggest PLO winner on the site during that time.
Now, these stats don't include any H.O.R.S.E. or any other of the mixed games on the sites. But the point is clear - if Benyamine follows the advice of Barry Greenstein and sticks to a couple of PLO tables at a time, he will likely be by far the biggest winner on Full Tilt Poker for years to come.
Photo: GreasieWheels.com
Filed Under: Cash Games
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