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Home / Podcasts / Health Essentials / Reestablishing Routines When Parenting During a Pandemic With Dr. Kate Eshleman
Reestablishing Routines When Parenting During a Pandemic With Dr. Kate Eshleman
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Throughout the pandemic, many of our best parenting routines were disrupted. Screen time increased, bedtime became negotiable and our typical routines were shaken up. Child psychologist Kate Eshleman, PsyD, talks about why routines are important and ways to get them back on track.
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There's so much health advice out there, lots of different voices and opinions but who can you trust? Trust the experts, the world's brightest medical minds, our very own Cleveland Clinic experts.
We ask them tough intimate health questions so you get the answers you need. This is the Health Essentials podcast, brought to you by Cleveland Clinic and Cleveland Clinic Children's. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.
Molly Shroades:
Hi, and thanks for joining us for this episode of Health Essentials podcast. My name is Molly Shroades and I'll be your host today.
Parenting can be hard. It can be difficult to establish routines and stick to them, even on the best of days. But during the pandemic many of our best routines and parenting practices went right out the window. Today we're joined by child psychologist, Dr. Kate Eshleman to talk about how to re-establish routines within our families.
Thank you so much for joining us.
Dr. Kate Eshleman:
Thank you for having me.
Now starting off, can you just tell us a little bit about what types of patients you see and what brings them through your door?
Sure. I primarily see children, adolescents, young adults and their families that have a chronic or acute medical condition. So they could come for lots of reasons, adjusting to new diagnosis or coping with illness, those types of things.
Awesome. Let's dive right into this topic by talking a little bit about how parenting has changed during the pandemic. What kinds of things have you seen? What kinds of shifts?
Sure. I think, as you mentioned, people are having a really hard time creating and maintaining routine. I think at this point we are far into this and people are getting fatigued and it's just hard to stick to some of these things that we've outlined, the expectations that we've set up and planned to follow through with. It's hard to do day after day.
How do we talk to our kids about situations where we're asking them to follow certain rules and routines but others might not?
I think this is always present in parenting. We all have different styles and rules and expectations but certainly in this context, especially as we're hopefully moving through it and there aren't as many broader rules. So kids are going to see this and they're going to ask questions. And I think, depending on the age of the child, it's important to talk to them about what your expectation is and why that is. Why you're asking them to do that, either to keep them safe, to talk about the things you think may happen if we don't follow these rules and expectations.
Again, it's important to know the child because we want it to be a balance of giving them information and not creating undue worry or stress , kind of balancing that to help them understand your rules and to follow those rules while not make them over worried about those rules.
Absolutely. Now during the pandemic I think a lot of people were faced with a new family dynamic. Everyone was home all the time. You were trying to work and also teach and parent all at once. Can you talk to us a little bit about what happens when a family dynamic shifts like that?
Sure. I think any time there's a change there's an adjustment and I think the hard part about the pandemic is that in general it was sudden. It wasn't planned, which makes it difficult to do. It wasn't within our control and things kept changing so repeatedly. Again, any time there's a change there's an adjustment but these were things that were generally perceived to be negative, at least up front.
So as we're changing and adjusting to this new routine and figuring out what those interactions look like, how do we manage those? How do we interact with each other? How do we control our own emotions and manage those emotions in such an unknown and stressful situation? All of those things impact our interactions and in our day to day life.
Yeah, absolutely. It's been a stressful time for sure for many people. Now to get through this big shift a lot of people had to relax the rules. It was a survival instinct I think for many people. Things like screen time and bedtimes weren't regulated the way they had been in the past. How have parents worked to get these routines back or have those relaxed routines hung on?
I think it's different for everybody and I think it's definitely a struggle because I think now we're adjusting to living in a new normal where we're back to life and back to activities and that sort of thing but those can abruptly change at any time. If a child tests positive in school or you have to quarantine. So these things that we've set up are adjusting.
I think what's really helpful is to maintain expectations, even if those expectations look a little bit different than before. For example, if a family previously had a screen time rule about an hour a day or two hours a day maybe that time has increased but it's still an expectation that it's three hours a day, not as much as you want, right. So maintaining some expectations, even if they look a little bit different.
Yeah, screen time's always a tough one, right, because you might think, "Oh, man they're super happy watching Baby Shark for several hours. I will just put Baby Shark on."
Right. The other thing is that screen time really allowed, especially when we were really on shutdown, it allowed people to stay connected. Some of the older kids, maybe not the younger kids. But they played with friends and they socialized through video games. In a way it was maintaining that socialization. And now, even though they're back to school or back to activities, they're still accustomed to that and enjoy it and want it.
Absolutely. Now stepping back for a second, can we talk a little bit about the importance of routines, particularly bed time and meal time routines?
Absolutely. Almost everyone functions best with structure and routine. So again, even if those are modified it's important to have them. This is really helpful for children as well as adults but it makes the day predictable. They know what to expect and they know what ... then in the morning we're going to wake up and eat breakfast and sit down together or whatever that routine looks like in your house. But they know what to expect and especially in a time of such uncertainty, as during the pandemic, some of that predictability is very important and helps us all cope better.
Right. Absolutely. Now being in the house all day can mean snacking and eating out of boredom. How do we start getting the structure back when it comes to having more defined meal times and nutritious eating too?
Sure. I think a lot of times, as hard as this is, and we always recognize that these concepts are simple but not easy. So really the way to do it is just to do it. I mean, the only way out is through and so you just have to start doing it. I think that some helpful tips may be sitting down on a Sunday and planning for meals. Having mostly nutritious snacks in the house. So if somebody's wandering to the kitchen and grabbing something they only have healthy options. Or if you're going to have some of those less healthy options in the house, which is fine, that we put those away or they're not as easily accessible, either for ourselves or for the kids.
Now do you recommend roping kids in on this planning process? Is that a helpful way to get them engaged?
I think it depends on the child. If you have a child that's a picky eater or will only accept or tolerate certain foods and that can be within normal limit. Lots of kids are like that. Maybe asking them if you're going to go grocery shopping, are there things they'd like to have, certain things they'd want to have for dinner, that sort of thing. Looking up recipes together, taking them shopping, those can all be very helpful activities.
I think the thing to be careful with is if you're going to give them a choice, if there's something you'd like to have for dinner on Wednesday, you have to be ready to do what they say, right. So maybe, depending on the child, giving forced choices. "Would you prefer tacos or soup?" That sort of thing because anything we offer, for the most part, we have to be ready to follow through with.
Got you. So giving them an A or B option?
Correct. Yeah. Or at least setting those guidelines before. That yes, you can choose what we have but I have to be able to make it after work or it has to cost less than ... we're not having surf and turf for dinner on Wednesday.
Awesome. That feels a bit like a dangerous game, but yes. Wonderful. Now for school age children there's been so much change. They're in school, out of school, virtual learning, back in person. How do we help them through all of this?
I think we try and talk with them about what we expect but in that conversation acknowledging, "You're going to be back in school this year, however, there might be times that you have to transition home." So talking with them about what we expect while leaving room, especially in this situation, for some things to change.
So to try and promote that flexibility away from those expectations. They're away from the routine. So talking with them, telling them what you think is going to happen, providing them opportunity to ask any questions or express any concerns and be able to talk through it, really opening those lines of communication.
What might you expect to see as kids adjust back? What kinds of challenges could you expect?
Yeah. We could see a lot of different changes in behaviors. So, especially I think for younger kids, seeing changes in things like separation in the morning. After a child's been home or with a caregiver for a long time some of those goodbyes might be a little bit harder. You might see changes in sleep. I think I've mentioned before that a lot of routines were off and so transitioning back to an earlier bedtime or if kids were having slumber parties together in each other's rooms, now sleeping alone.
And just some of those changes and stressors that we're seeing impact kids in different ways. You might see changes in toileting habits. For a child who at home could go to bathroom any time they wanted and now in a structured setting in school they have to wait for a certain time. You could see some changes in toileting habits or accidents, those sorts of things.
I think for older kids, again that sleep piece is very different. They slept in in the morning and then they ate later or whenever they want. If they're missing breakfast because they have to get out the door and then they're hungrier later in the day. Also, with older kids you could see some kind of just changes in mood and attitude.
There was a lot of flexibility and freedom when everyone was on lockdown and now there's a lot more imposed structure and demands around school and that sort of thing. Some kids just don't love that and you might see that through their attitude and their behavior.
I imagine another part of this that we're going to want to be really having open lines of communication with our children about is social interactions. There's been a lot of isolation. I know some children might have anxiety about being in large groups again. Can you talk to us a little bit about that?
Sure. I think when we look back on how last year and a half evolved there was a lot of emphasis on staying apart and staying away, and six feet, and no large crowds and that sort of thing. If you had the news on things were pretty scary. So it is a shift, I think, for adults and for children to move from that mindset to reintegrating back into some more typical activities but doing so safely.
So I think what we want to do is provide a limited amount of reassurance. Talking with the kids if they have concerns, that, "We would not put you in this situation if we didn't think you were going to be safe." And talking through some of the protections in place, "Remember everybody's wearing a mask", having a plan in place if they're not wearing a mask. You can walk away. Making sure that you wash hands, that sort of thing. Giving them the information about the protections that are in place.
We want to talk through that but I said a limited amount of reassurance because we don't want to over focus on it. If a child is worried about it and we continue to talk about it we allow their mind to stay on their worries. So we want to give that limited reassurance and then move on to the next thing with distraction. Talk about what they do want for dinner tonight or are they planning any activities for Halloween, that sort of thing.
What are a few ways you can start that conversation as a parent with a child who's acting anxious but maybe hasn't vocalized it yet?
Sure. I think that a great way to start is asking, "What's on your mind?". I think modeling that labeling of emotions. "You look like you're feeling a little nervous or scared. Is there something you're thinking about? Anything you'd like to talk to me about?" That's helpful, especially for younger kids because they have to learn to identify and label those emotions. I think modeling that starts that conversation.
I think it's also really important to talk about or consider that when there's something so big like a pandemic going on, naturally we think whatever they're thinking or feeling must be related to this. Whereas, also kids are living normal lives. They still have to think about relationships and potentially sports and school work and that sort of thing. So we don't want to misinterpret their thoughts or feelings to be related to something that it's not and we don't know that unless we ask.
Now we've all been very much together for a while now. Everyone's been right on top of each other in a lot of situations, everything blending together. For parents, when should you step in to your child's life if they're dealing with something?
Like many things I think this is a little bit of a fine line. So there is some value to having conflict as children and adults. When that arises in childhood it allows kids the opportunity to be assertive, work through problem solving and try and help navigate those situations.
However, we don't want it to rise to the level of bullying, whether that's physical or emotional. If you see that your child is very distressed, certainly if there's a physical safety issue you should always intervene. But if it's more the verbal or emotional unkindness, talking to your child, "What was said, how did that make you feel?" Maybe asking the child how he or she thinks you should respond also. But I think if it's creating a lot of distress then it probably is worth addressing.
Absolutely. Now one thing I often wonder about is children that were very, very young going into this, that might not remember before, how have they interacted with this change in socialization?
I think for children that are that young, for the most part they have very little control over their environment and they don't know the difference anyway. So if we have a very young child that's starting pre-school for the first time whether that's related to the pandemic or otherwise, they don't know the difference. So as adults making sure, again, that we're treating this as naturally as we can to make that transition as natural as it can be.
Wonderful. Now, back to the adults, for the many people out there that are working from home still or making the shift to maybe permanently work from home, what are some ways that they can cope with this new world, this new reality of having children at home sometimes and working full time?
Yeah, I think we recognize the ideal circumstances and then we recognize that it's very rarely ideal. But ideally, we would set that structure and that routine, depending on the person because everyone is a little bit different. But if you typically start your day with getting up, working out, taking a shower, getting dressed, the things that you would do before you go into the office, ideally we want to do that if you're going to work from home as well.
Setting that structure and that routine, that you only go and eat lunch during the time that you would eat lunch anyway. You're not wandering through the kitchen and snacking. So really trying to set your structure and your routine as it would have been for you before, assuming that before was a successful routine.
Then I think trying to find some time to get out of the house, whether it's to go for a walk, to go for a drive, whatever it may be. But being at home in the same environment all day can be very difficult for people and I think ultimately it feels like you never have any time to yourself. The dishes are always ready to be put away. The laundry is always needing to be washed. So finding a way to separate, even if it's just for a few minutes, to step out of that environment and to change it up a little bit.
That's really great advice. Now one thing I was wondering too, do you have any other words of wisdom that you typically would say to someone if they come in and they're looking really frazzled and describing that kind of situation?
Yeah. I think the goal is really to be kind to yourself. There is a lot of emphasis on self-care, which is very important and it's difficult to do. So being kind to yourself and recognizing that you have these goals that you'd like to achieve and you do as much as you can today but it doesn't always have to be today, this time. The laundry will still be there. Working out is a good goal, or getting some energy out or some physical activity but today might not be the day.
I think it's also really important to think, it's not an all or nothing thing so maybe you'd like to go for a five mile run but it doesn't have to be a five mile run. It could be a five minute run. So just do a little bit of something. Maybe you don't have to do all of the laundry tonight but if you just throw in a load of wash and remember to change it to the dryer. That's a success.
Finding those little wins, huh?
Mm-hmm (affirmative).
Awesome. So just as we wrap up here, anxiety and long term stress have been ever present during this time. How can parents help their children cope with this long term stress?
Sure. I think again trying to talk with them, assess how they're doing. Asking if they have questions or concerns. I think and we know this, parents taking care of themselves. If you're particularly stressed, I mean and most of us are little ... we have less patience when we feel stress.
So if we are stressed that's going to impact the way that we interact with our children and probably create more stress. And so trying our best to take care of ourselves. Those self-care activities that are helpful for us, going for a walk, talking with a friend, that sort of thing, those can be helpful for the kids too. So in spite of these busy schedules or social restrictions trying to promote your children's coping is very helpful also.
Wonderful, thank you so much for joining us today and sharing your insights Dr. Eshelman.
You're welcome. Thank you for having me.
To learn more, please visit clevelandclinicchildren's.org/behavioralhealth.
Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. You can also follow us on Facebook, Twitter and Instagram for the latest health tips, news and information.
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...Then you beat your butter (225g unsalted) and sugar (50g icing) until nice and pale and creamy...then stir in some melted dark chocolate (25g)...I used 30g!!
This was one of my better ones!!!
...these are great as an after dinner biscuit with coffee (instead of a big pud!!) or just as an 11 o'clock snack with your mid-morning tea or coffee!!!


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Today's Market / Norwegian Cruise Line (NCLH) Stock Drops 8% on Double Downgrade
Norwegian Cruise Line (NCLH) Stock Drops 8% on Double Downgrade
It's all about relative performance
November 17, 2022 By Josh Enomoto, InvestorPlace Contributor Nov 17, 2022, 1:41 pm EST November 17, 2022
Norwegian Cruise Line (NCLH) stock dropped more than 8% on Thursday due to a sentiment blow.
Credit Suisse issued a double downgrade on NCLH stock, citing premium unsustainability.
The overall cruise ship industry has struggled in a big way this year.
Source: Nazar Skladanyi / Shutterstock
One of the hardest-hit sectors during the pandemic, the cruise industry is suffering yet another setback, this time targeting Norwegian Cruise Line (NYSE:NCLH). Recently, a Credit Suisse analyst said NCLH stock has been trading at a premium relative to its peers, although this circumstance may no longer be sustainable.
Specifically, analyst Benjamin Chaiken downgraded NCLH stock to "underperform" from "outperform." Chaiken also lowered his target price to $14 from $20 per share. This implies a 20% discount to Wednesday's closing price as well as a 15% loss from the share price at the time of this writing. The analyst explained the following in a research note:
"NCLH is a quality organization, and we are constructive long term, however, the stock has outperformed materially YTD and on a relative basis we see risk to estimates and valuation vs peers."
To be clear, no outright winners exist within the publicly traded cruise ship realm. Alongside the double downgrade, NCLH stock is staring at a 25% loss on a year-to-date (YTD) basis. While this performance does beat out peers Royal Caribbean (NYSE:RCL) and Carnival (NYSE:CCL) — down 28% and 55% YTD, respectively — investors have hardly received an encouraging take from the wider industry.
NCLH stock dropped more than 8% earlier today and is now down 6% as of this writing.
Macro Woes Hurt NCLH Stock and Its Peers
Notably, neither NCLH stock or its main rivals got off to an auspicious start this year. At the time, inflation woes began barreling down on consumer sentiment. Shortly thereafter, Russia shockingly invaded Ukraine, initially sending cruise ships and many other sectors tumbling. Although the travel subsegment did bounce back temporarily, the Federal Reserve's sharp response again pressured consumer-dependent enterprises.
Moving forward, NCLH and its peers suffer from a combination of macroeconomic headwinds and consumer behavioral shifts. Regarding the former, with global central banks largely mimicking the Fed's move to hike interest rates to control skyrocketing inflation, a worldwide downturn may materialize. That wouldn't help cruise operators, which struggle deeply to make up for lost time.
For the latter category, the lift in borrowing costs has sparked major changes to how companies operate. As enterprises now eschew growth for sustained profitability, layoffs are starting to roll off the assembly line, particularly for the tech sector. Broadly, the loss of good jobs won't benefit NCLH stock as consumers tighten their belts.
Finally, consumers appear to be trading down their entertainment expenditures, with more demand focused toward at-home alternatives. Obviously, this dynamic puts pressure on NCLH. However, these headwinds apply to the industry as a whole. Thus, any winner in this space comes with the caveat of a relative definition.
On the date of publication, Josh Enomoto did not hold (either directly or indirectly) any positions in the securities mentioned in this article. The opinions expressed in this article are those of the writer, subject to the InvestorPlace.com Publishing Guidelines.
A former senior business analyst for Sony Electronics, Josh Enomoto has helped broker major contracts with Fortune Global 500 companies. Over the past several years, he has delivered unique, critical insights for the investment markets, as well as various other industries including legal, construction management, and healthcare.
Article printed from InvestorPlace Media, https://investorplace.com/2022/11/norwegian-cruise-line-nclh-stock-drops-8-percent-on-double-downgrade/.

redpajama_set_name: RedPajamaCommonCrawl


 The ACT essay prompt is supposed to be "high school specific."
Ah, Chef, it is time to reveal the Secret Ingredient in this writing challenge: the prompt. The ACT essay prompt is supposed to be "high school specific." That's test-speak for "the prompt will give you a debated topic that is typically geared toward, or concerned with, people your age." You will have to pick a side and argue your point thoroughly and with plenty of supporting examples.
On the ACT Writing test, you don't get to choose your own topic. Instead, you'll be responding to a prompt. ACT essay prompts try to give you issues that are relevant to high school students. For example, your prompt for the ACT might be something like: 'Should the driving age be raised to 18?' It'll always be something you can answer just from your life experiences; you won't have to remember any specific facts.


I would also like to thank Ambassadors Apakan and Sajdik for their reports to the Permanent Council, and to reiterate Norway's appreciation for their important work.
Norway notes with regret that we can still not talk of any meaningful implementation of the ceasefire agreement. Rather the security situation in Eastern Ukraine has continued to deteriorate. More ceasefire violations are observed. New mines are laid. Heavy weapons that should have been withdrawn are still there. Civilians still die. Norway yet again recalls the obligations under the Mine Ban Convention, The amended Protocol II of the Convention on Certain Conventional Weapons and other instruments of International Humanitarian Law. The parties all have a responsibility to protect the civilian population from the dangers that arise from military operations.
The monitors face increased impediments, restrictions, threats and intimidation, predominantly in non-government controlled areas. This hampers their work and goes against their freedom of movement. A long range UAV was lost, likely shot down, after it observed a surface-to-air missile system near the border with Russia. Continued jamming of the UAVs reduces the monitors' ability to provide factual information. We recall that the SMM's mandate covers all Ukrainian territory, including the Crimean peninsula. All parties to the conflict should contribute to the SMM being able to fulfil its mandate. Also, the safety of the monitors and their equipment must be protected.
The incident south of the Kerch strait on Sunday 25 November constitutes a further serious escalation of the tension between Ukraine and the Russian Federation. Russia's use of force was disproportionate and unacceptable. We urge Russia to release the vessels and their crews. We also call on Russia to honour its obligations under International Law, including the Law of the Sea, and under international agreements to which it is party.
Following its illegal annexation of Crimea and Sevastopol, the Russian Federation has pursued a policy of gradually imposing unilateral control over the Kerch Strait and the Sea of Azov, leading up to the incident on 25 November. Through this deliberate policy, Russia has created this latest escalation. It can therefore also choose to de-escalate tension by reversing its policy, and we urge it to do so. Due to the gravity of the current situation, we nevertheless call on both sides to show restraint and do their utmost to reduce tension.
Norway reiterates its strong support of Ukraine's sovereignty and territorial integrity, including the Crimean Peninsula and the adjoining territorial waters.
This incident at sea reminds us that the conflict in and around Ukraine is still a clear and present danger to security in the OSCE area. That is why we consider the work of ambassadors Sajdik and Apakan to monitor the conflict and facilitate the diplomatic process to be so important. The OSCE has no more important task than to work towards a lasting, peaceful settlement of this conflict and of the other unresolved conflicts in our region.
In conclusion, I wish to repeat Norway's strong support for the work Ambassadors Sajdik and Apakan and their teams, continue to do under very demanding circumstances.
Statement in Reply to the Briefings given by Ambassadors Sajdik and Apakan (pdf).


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FDA panel gives nod to Bayer's Gadovist MRI contrast agent
By Wayne Forrest, AuntMinnie.com contributing writer
January 21, 2011 -- An advisory committee of the U.S. Food and Drug Administration (FDA) today voted unanimously to recommend approval for Bayer HealthCare Pharmaceuticals' Gadovist 1.0 (gadobutrol), a gadolinium-based contrast agent for contrast-enhanced MRI of the central nervous system.
The panel also voted 15-1 to allow Gadovist to be labeled without a contraindication for nephrogenic systemic fibrosis (NSF) in the population at risk for the debilitating disease. However, they advised that Gadovist should carry the same black box warning label required of other gadolinium-based contrast agents (GBCAs) sold in the U.S.
On the recommendation for approval, James Tatum, MD, a nuclear medicine physician with the Veterans Administration, echoed the consensus of his panel colleagues. "I feel that safety data and the efficacy data is at least as good as the approved agents and possibly better," he commented after the vote.
Clinical data indicate that Gadovist can be classified as one of the lower-risk gadolinium-based contrast agents in terms of NSF risk, according to panel member Donna Roberts, MD, a neuroradiologist at the Medical University of South Carolina in Charleston and at St. Jude Children's Research Hospital in Memphis, TN.
"Based on the animal studies and postmarketing data, even though we don't have data from clinical use here in the [U.S.], this agent is very similar to other agents already approved," Roberts said. "I would feel comfortable with this agent being labeled as a lower risk."
In a new policy announced in September 2010, the FDA categorized gadolinium-based contrast agents into two categories based on risk of NSF, with agents carrying different warning label language based on risk level. The higher-risk agents were contraindicated for use in patients with acute kidney injury or chronic, severe kidney disease -- these agents include Omniscan (gadodiamide) from GE Healthcare of Chalfont St. Giles, U.K.; Magnevist (gadopentetate dimeglumine) from Bayer of Wayne, NJ; and Optimark (gadoversetamide) from Covidien of Dublin.
Agents in the lower-risk category must still carry warning labels, but they do not require contraindications. These include MultiHance (gadobenate dimeglumine) and ProHance (gadoteridol) by Bracco Diagnostics of Princeton, NJ; Ablavar (gadofosveset) by Lantheus Medical Imaging of North Billerica, MA, and Eovist (gadoxetate) by Bayer. Gadovist will be in this lower-risk category when it receives final approval.
Clinical trial data
In the company's presentation to the FDA advisory panel, Martin Rosenberg, MD, Bayer's senior director of global clinical development, reviewed clinical results from Gadovist's two current phase III trials.
One study compared Gadovist with noncontrast-enhanced MRI, while the second study compared the contrast agent with Bracco's ProHance because of their similar composition.
Evaluations performed by three blinded radiologists concluded that Gadovist's diagnostic accuracy was consistent across both studies for lesion detection, one of four criteria to prove the contrast agent's efficacy. "If we look at the assessment of whether a lesion is malignant or not malignant, what we see versus unenhanced imaging is statistically significant improvements in sensitivity and accuracy without any loss in specificity, an important diagnostic result," Rosenberg said.
In the comparative study with ProHance, Rosenberg offered data indicating that Gadovist matched or exceeded results in all four efficacy categories. "It is also important to note that ProHance met all the primary efficacy criteria as well, which would be expected for a contrast agent approved for [central nervous system] imaging," he added.
NSF association
Part of today's hearing included a discussion on the association between gadolinium-based contrast agents and NSF. Previous research indicates that patients with renal failure are at the greatest risk of contracting the debilitating disease when given gadolinium-based contrast.
Rosenberg told the panel that among the more than 4,500 patients who received Gadovist, 4% of those patients experienced a nonserious adverse event. The nonserious reactions included headache and nausea and were similar in incidence to events with other gadolinium-based contrast agents.
"Most of these events were mild to moderate in intensity and resolved without treatment," Rosenberg said. "We have reported 17 serious events, one of which was considered by the investigator to be related to gadobutrol."
There were two deaths reported in one clinical study. One patient received Gadovist and one patient received ProHance, but Rosenberg said neither fatality was related to the administration of the contrast agents.
To reduce the risk of NSF, Bayer proposed that Gadovist's label include the same box warning and precautions and patient counseling information as other gadolinium-based contrast agents.
To minimize the risk of misadministration, Bayer also recommended that Gadovist's standard dose be administered at 0.1 mmol/kg in the U.S. Doses of as much as 0.3 mmol/kg have been approved outside of the U.S., according to Bayer, and have been well tolerated.
Gadovist's "high stability and nonclinical data suggest a low likelihood of harm with those administrations in the population at risk for NSF," Maria Rivas, MD, Bayer's vice president of U.S. medical affairs for diagnostic imaging and general medicine, told the panel.
By Wayne Forrest
AuntMinnie.com staff writer
FDA takes Bayer's NDA for Gadovist contrast, August 6, 2010
ACR tackles NSF risk in new gadolinium MRI contrast guidance, June 17, 2010
Gadobenate better than gadopentetate contrast in MRA, May 24, 2010
Bayer settles NSF case with Calif. man, January 28, 2010
Bayer initiates phase III trial, December 1, 2009
Last Updated np 1/21/2011 11:52:30 AM
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Information monopolies may be established not only by staking monopoly claims over information content through intellectual property rights (IPR), but also by controlling the hardware infrastructure for manipulating or distributing information. This infrastructure includes computer centers, voice and data switching centers, communication lines, television and radio stations, satellite networks, cable networks, cellular networks, printing presses, moviehouses, etc. Like their software counterparts, the owners of the hardware infrastructure make money through monopoly rents, in the form of subscription fees or per-use charges.
Because they earn their incomes from monopoly rents, the propertied classes of the information sectors are rentier classes. They are the landlords of cyberspace, or cyberlords. The content monopolies are owned by information cyberlords, and the infrastructure monopolies are owned by industrial cyberlords.
Because they earn their incomes from monopoly rents, the propertied classes of the information sectors are rentier classes.
The richest man in the world, as well as several others among the 10 richest, is a cyberlord. The economic powers of cyberlords are immense, and these powers are increasingly being felt in the political and diplomatic arena. Among U.S. negotiators, for instance, IPR-the mechanism which gives software cyberlords their power-is invariably a non-negotiable item in their agenda. It is the partnership between information cyberlords, industrial cyberlords, and finance capitalists which is at the core of the third wave of globalization.
The products of industrial and agricultural economies are material goods; the products of an information economy, however, are non-material goods. The reproduction cost of information goods is very low. This has led to the widespread social practice of freely sharing and exchanging information. On the other hand, it also promises extremely high profit margins, if the seller can monopolize information. Information monopolies have become the main form of ownership in the information sector. The high profit margins that they realize have led to a continuous movement of investment capital towards the information sector, eventually making it the dominant sector of the economy and transforming the economy into an information economy.
The first wave was after slaves, previous metals and lands for raising export crops; the second wave was after new investment acquisitions, sources of raw materials and labor, and industrial markets. The third wave is after sources of mental labor, sources of information raw materials, and markets for information products. This is why the World Trade Organization (WTO) pushed very hard to conclude as soon as possible the agreements on information technology, telecommunications and financial services.
The third wave requires freer movement of information across national boundaries. This has helped erode further the power of the State. Global corporations are now assuming the dominant role in the State-corporate partnership, in close collaboration with supra-national institutions like the International Monetary Fund (IMF), the World Bank (WB) and the WTO.
Because of the huge disparity in costs, trade between information economies and other economies become even more unequal.
In addition to the earlier forms of wealth extraction practised during the first and second waves, new forms emerge or old forms acquire new importance. Monopoly rents become the main form of wealth extraction. Because of the huge disparity in costs, trade between information economies and other economies become even more unequal. Compare, for instance, a CDROM which might sell for $300, but whose production cost is around $3, to a typical Philippine product like sugar, which might sell for 15¢ per pound. Much of the $300in the price of 2,000 pounds of sugar would barely cover the cost of production, while much of the $300in the price of a CDROM would be profit. Royalties from intellectual property rights (IPRs) and other income from information rents assume major significance; technology makes possible high-speed, finely-tuned financial speculation. As the importance of the nation-state recedes, corporations are able to purchase State assets and public properties at bargain prices.
New technologies of exploitation are introduced. Advanced information and communications technologies make possible the convergence of media, entertainment, data, and communications. The application of information technology to genetic engineering and biotechnologies has transformed these fields and made them fertile areas for information monopolies, best illustrated by the patenting of life forms.
As the global information infrastructure now being constructed reach the remotest corners of our countries, we will be further flooded with all kinds of junk culture, easily accessible with a few keystrokes, and the homogenization of our cultures will reach new levels. The reckless experimentation with new life forms in the race to introduce new commercial biotechnology products and services will lead to biological pollution from genetically-modified organisms. Their potential for damage will be infinitely greater than chemical pollutants because these organisms can reproduce by themselves, mutate and evolve. Driven by the logic of profit-making and rent-seeking, biotechnology will pose the greatest threat to human health and survival.
The global information economy will also enable those with vast resources to concentrate wealth further into their hands. To illustrate this capacity for super-exploitation, imagine a corporation which can afford to automate its international financial transactions so that its computers could do a round-the-clock, unattended scan of the global financial markets for opportunities, make decisions automatically, and conclude a financial transaction within three seconds or a buy-then-sell transaction pair within six seconds.
What we face here is really a new personification of greed, one that has freed itself of distracting human feelings like love, compassion, charity, guilt, fear and other emotions, leaving only pure greed, unencumbered and free to pursue singlemindedly the one and only thing that motivates it: profit.
Who but the largest financial conglomerates would have the resources to set up and maintain such automated, round-the-clock facilities with a global reach? We had better think again, those among us who believe that the Third World can leap-frog second wave economies and ride the third wave by surfing the web or by selling our agricultural and manufacturing commodities and our cheaper labor over the Internet. What we face here is really a new personification of greed, one that has freed itself of distracting human feelings like love, compassion, charity, guilt, fear and other emotions, leaving only pure greed, unencumbered and free to pursue singlemindedly the one and only thing that motivates it: profit. It is the search for profit by global corporations that is powering the whole process.
These corporations have even acquired their own rights, which are often more favorably recognized than the rights of real persons. They have learned to nourish themselves and to grow by feeding on nature, people, and information. They have become increasingly aggressive in asserting their freedoms ("liberalization"), overcoming government controls ("deregulation") and in taking over government activities ("privatization").
Corporations had earlier shared global rule with governments. Now, they want to rule it by themselves ("globalization").
The colonization of our countries that began in the 16th century hasn't really stopped. It has just changed forms, coming in waves of globalization that intrude into our communities, impose their unwanted rule, and squeeze the wealth out of our people and environment. With each improvement in technology, with each transformation of capital, a new way of extracting wealth from our shores is employed, continually enriching those who control the technology and our economy while impoverishing us, destroying local livelihoods, ravaging our natural resources, and poisoning our environment.
1. The right to know. It is the government's duty to inform its citizens about matters that directly affect them, their families or their communities. Citizens have the right to access these information. The State may not use 'national security', 'confidentiality of commercial transactions', or 'trade secret' reasons to curtail this right.
6. Universal access. The government will facilitate universal access by its citizens to the world's storehouse of knowledge. Every community will be enabled to have access to books, cassettes, videos, tapes, software, radio and TV programs, etc. The government will set up a wide range of training and educational facilities to enable community members to continually expand their knowhow and knowledge.
8. Public stations. Universal access to information infrastructure is best implemented through public access stations, charging at subsidized rates. These can include well-stocked public libraries; public telephone booths; community facilities for listening to or viewing training videos, documentaries, and the classics; public facilities for telegraph and electronic mail; educational radio and TV programs; and public access stations to computer networks."
9. The best lessons of our era. While all knowledge and culture should be preserved and stored for posterity, we need to distill the best lessons of our era, to be taught-not sold-to the next generations. This should be a conscious, socially-guided selection process, undertaken with the greatest sensitivity and wisdom. It is not something that can be left to a profit-oriented educational system, circulation-driven mass media, or consumption-pushing advertising."
As the Philippine Green program indicates, one of the tasks of such struggles is to develop a non-monopolistic information sector, where intellectual activity is rewarded through non-monopolistic mechanisms which are more consistent with the social nature of information. This will involve a radical rethinking of property concepts in the information sector, reinforcing similar demands for property restructuring in the industrial and agriculture sectors.
How we rise up to this challenge will determine whether our children and grandchildren will live as neo-slaves under a global system as cruel and heartless as the colonial system of old, or as free citizens living in communities where knowledge and culture are again freely-shared social assets, where industrial machinery is appropriately designed to serve and not to enslave human labor, and where ecology is the organizing principle in agriculture.
There is one final lesson, among so many, that our own colonial past teaches us. The first Spanish colony was set up in the Philippines in 1565. Over the next three centuries, colonization would encroach on most of the archipelago, except the Muslims of Mindanao and the upland indigenous tribes. Isolated rebellions would occur but could not shake Spanish rule. In 1864, a public manifesto by a Filipino priest began a Propaganda Movement, which eventually awakened our people's anti-colonial consciousness. In 1896, a full-scale revolution broke out. By 1898, the revolution had for all intents and purposes defeated Spanish colonialism.
It took some 300 years before we Filipinos shook off the colonial mentality that immobilized most of our people and made them vulnerable to Spanish rule. The campaign for the Filipino mind took another 30 years to win. Within three years of anti-colonial armed struggle against Spain, victory was in sight.
The struggle to unmask the colonial monster was 10 to 100 times more difficult than the struggle to bring it down.
Let us keep this lesson in mind today, when we are yet at the early stages of unmasking the monster of globalization. Let not the seeming immensity of this task cloud our vision of the future, when our communities and nations shall at last be free to chart their own destinies guided by the principles of ecology, social justice and self-determination.


Keith Miller's Welcome to Pine Hill is a quiet visual exploration of race, class and daily experience conveyed with an intensity born from lead actor Shannon Harper and writer/director Miller's full understanding of the film medium's true potential.
Welcome To Pine Hill, the film, does indeed start on the stoop, as it did in real life for Brooklyn neighbors Shannon Harper and writer/director/teacher Keith Miller. Keith was out walking his dog one night and local resident Shannon saw the two and recognized his old dog. Shannon confronts Keith and says that he wants his dog back, a stand off that though rarely acted out in current gentrified Brooklyn, plays out in the minds of both sides countless times each day. If not through a dog, through real estate and beyond… "that was our rundown neighborhood bar that you white out-of-towners turned into your cute faux old neighborhood cafe," "that was where we all double parked before you took the space for your bike lane," etc. In the film, this encounter is perfectly played out by Shannon and Keith, and though Keith doesn't appear again in the film, the story that unspools is informed by the race and class perspective of that inciting incident.
Harper plays an amalgam of his actual self and a fictive created role. His character has left behind a life of 'hood thugging and now works in midtown as a claims adjuster. In many of my Uncle Fred's so called "real" movies, the film ends with the hero walking away from the crime life deciding to go straight, oftentimes with a woman by his side. I often wondered what it would be like for Bruce Lee living a straight life. If he was insulted one two many times at the water cooler by his branch manager would he slay him with a quick chop to the solar plexus? We watch Shannon go through his daily life in the office, but when a thug from his past life shows up and asks for a favor, I was ready for a creaky plot contrivance to rise up and draw him back to the streets. But instead the film stays true and real; something else happens to our hero, something that can happen to all of us, and now he has to deal with it just as we mere mortals would. In the process of dealing with this universal problem, Shannon and the audience rediscover the value of the tiny "insignificant" moments that make up our day. In Miller's hands, these small moments become weighted with a rarely felt power and intensity as they become significant story points in a way that we would never experience in a typical movie.
One of the aspects of real—my real, not Uncle Fred's—film that I most appreciate is its ability to compress and expand narrative time as well as its unique ability through acting to meld both amateur and professional techniques to create an experience that is both a familiar yet transformative representation of our own lives. When the theater darkens and a movie begins, our typical time markers should be erased and we should be immersed into an experience of time, character and space, which then becomes its own narrative. Welcome To Pine Hill does have plot points, which I haven't given away here, but they alone are not the explanation for why this film is so transporting. It's the filmmaker's ability to master the passage of narrative and screen time in such a way that we are reminded that there is only one real story that we are all part of: the countdown of our own biological clocks. I believe that if I can drag Uncle Fred off the stoop to see this film, he may finally understand that Welcome To Pine Hill is as "real" of a film as you can ever get.


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It's such a funny feeling when an inanimate object can bring a smile to your face. Recently, Caravelle New York unveiled the latest additions to their arsenal of timepieces in a story called Shades of Grey (not to be confused with the book, of course!). I immediately was smitten with the 45A119 watch upon seeing its bright gold bezel and charcoal exterior – striking the perfect balance of cool modernity and retro sensibility.
I wanted to showcase the watch in a way that is very indicative of Scout Sixteen. Because the watch is quite versatile, I wanted to show it easily adapts to both casual, on-the-fly looks and dressier night-out outfits as well. What do you think of this neutral and trendy look – would you wear it?
No matter your outfit preference, the Caravelle New York Shades of Grey story is one that you'll want to wear again and again. Want to hear the best part? At under $150, you're getting luxury-looking timepieces for a fraction of the big boys!


I have follow issue on subject. Several times per day docking station going unexpectedly to disconnect displayport and power delivery, wherein no power interruption observed in any way. It looks like docking station power is lost, but all of usb ports and ethernet port continue to work normally and doсking station power light is on, wherein laptop is on battary mode and external monitor have no signal. Return to normal mode can only obtained with turn off and on docking station power.
Laptop, docking station, thunderbold firmware and all of drivers renewed and up to date.


Two weeks walking in some of the most spectacular scenery of the Alps. Breathtaking views in the many clear days and surreal when walking in the clouds. Varied terrain to entertain all...this is a must for any mountains lover. Excellent arrangements from Exodus as always and great leader and camp manager.
About every hour of my walking time every day. The scenery was breathtaking. Cheering UTMB trail runners in Chamonix, swimming in an Alpine lake in a clear sky day, eating lunch by a glacier, the Emerald lake, eating my favourite Swiss chocolate when reaching a col, the outstanding views of mountain peaks above a sea of clouds from Cabane Praflouri, snowball fight in the boulders, introduction to trail running to St Nicklaus, walking in the clouds on the longest suspension bridge in Europe, trek to Zermatt with clouds opening over the Matterhorn.
Two weeks walking in some of the most spectacular scenery of the Alps. Breathtaking views in the many clear days and surreal when walking in the clouds. Varied terrain to entertain all...this is a must for any mountains lover. Excellent arrangements from Exodus as always and great leader and camp manageress.
John and Ags made my holiday!!! Inspirational, brave, kind, funny, passionate, knowledgeable, supportive and a good laugh. I always felt safe and in good hands, the food was absolutely delicious. They tended to all group members and really went the extra mile for me...quite literally 😊. I could have not wished for better leaders. They inspired me so much I have already booked a mountain skill weekend in Snowdonia!
Quite strenuous trek high up in the Alps,beautiful scenery with a excellent group of people.
There were a few moments that stood out.The sunset at Cabane Mont Fort,the high alpine landscapes,walking on snow in August,climbing up the ladders to one of the cols. My favourite days were days days 7 & 8 on the remote stuff.
Our group was led by John Briggs,he's as good as it gets! Excellent leader,some days we had to start earlier to avoid afternoon thunderstorms,he got us all out on the hill & back down safely without any drama's.Due to the nature of the terrain the group would split but he had everyone covered,we also got some winter skills walking on snow lessons from him. Our leader back at camp was Adz from Lithuania,she cooked some great meals was great company & well organised.You couldn't have asked for more from either John or Adz.
If you've done the TMB trek this is definitely harder,but for me it was more rewarding due to the remoteness of the places you were walking through.
It's quite strenuous so make sure you train for it.I'm a cyclist so I was doing my regular cycling,usually 60 miles a weekend plus walking as fast as I can for 10 miles without jogging a few times a week,also I used to rock climb so that came in handy for the easy scrambling that you had to do in places. The descent's are steep in places so bring poles even if you never use them at home,your knees will thank you.
This was a trek that was harder than I expected for the walking, but there are no altitude issues at all. It was professionally led by John Briggs and coked for by a lovely Lithuanian lady we all called Ads. Most days we walked up to a col with fantastic views and then back down to the next camp site or other hut style accommodation. There was a fair bit of walking on snow and ice, but the presence of the snow really added to the scenery and I was not uneasy about it at any time. I lost 7lbs which was slightly disappointing (I lost 21 lb on last year's 3 week trek in Pakistan) but the food was irresistible, and wine and beer were available at modest prices.
Our first view of the Matterhorn was amazing. Utterly majestic.
Very professional says it all. A good leader in control of the group at all times and offering help and advice when needed.
Do some training. Not just in the gym. I visited the Brecon Beacons for four two day stints in the weeks before I went. It really paid dividends, not only being able to take the walking in my stride, but being able to enjoy the trip rather than suffering from tiredness. Be prepared for steep ascents and descents over several hours.
Always accept the guide's judgement. If he decides to turn back or take a detour because he considers a section unsafe, he is probably right. Don't question the decision.
A Memorable Trek This trip had everything, meadows, mountains, snow, rock and the thrill of the great outdoors. However, the trip wasn't just about the wonderful scenery and hiking, a large part of its success was the team spirit that was fostered by our leader John Briggs and camp manager Egle.
There were several highlights, however, I very much liked the steady ascent to Villa and Col Torrent. The panoramic views of the vast mountain range were wonderful.
John Briggs is an outstanding leader, multi-talented. His practical instruction on how to proceed on difficult terrain was most helpful. He was always prepared to go the extra mile to ensure each day was a success. Overall John displayed exceptional leadership skills. I have no hesitation in nominating John for the annual leader awards. John was ably assisted by Egle, together their pleasant manner added greatly to group bonding and the forming of new friendships. On returning from a trek, Egle would have tents set up and coffee and biscuits at the ready. The delicious, wholesome 3 course meals were cooked on a gas stove. in the middle of nowhere, (magic) and all done with a smile.
On our trip in early July we encountered several snow fields. I found it useful to have a light set of walking crampons.
This trip is strenuous and at times challenging. There is a definite need to train and get into good physical condition. This will ensure you are not under pressure on the trek and can enjoy it to the full.
A thiroughly enjoyable, challenging and stunningly beautiful trip across the French and Swiss Alps.
It's hard to distill all the best bits of the trip into one, but the combination of stunning scenery, personal challenge and top quality leadership and support makes the trip a jewel in the Exodus crown.
John Briggs was a top rate leader. Hugely knowledgable, impressively fit, patient and kind and an all round great guy.
The trip is challenging in parts but that should not deter you from experiencing some of the best views in the Alps, and spending time with a great bunch of fellow travellers. It's hugely enjoyable and well worth it.
My second Exodus trek in the Alps, and the Haute Route deserves the challenging grade, definitely tougher than TMB. Very well organised by Exodus, excellent leader and camp manager, and a great bunch of 12 trekkers.
Reaching the summit of the third col of the day between Mont Fort and Prafleuri mountain refuges, the Col de Prafleuri (almost 3000m). This day 5 of the walk stayed over 2500m all day, we were fortunate to have a fine day for it.
John is a natural leader, highly skilled in mountain technique but also very sensitive to the different abilities and interests of group members. He quickly gauged the correct pace, and knows when to give extra support to people who need it, e.g. with tricky parts of a steep descent. He kept our spirits up on the days with poor weather, and on fine days allowed the fastest members of the group to go ahead (but then wait at junctions). He has an excellent knowledge of Alpine geography and trees, which he was ready to share. Having been led by John on TMB in 2014, I was delighted to meet him again on arrival at Geneva.
This trip is not for those who lack fitness and stamina. Several days wth 1000m or more ascent and descent, one after another: there is no rest day until after 6 days walking. Do this trip if ready for a challenge, otherwise consider the Tour du Mont Blanc TMB.
Our camp manager Egle deserves full credit alongside John. She managed to perform wonders on a basic cooking stove, very imaginative menus, and the large portions one needs on such an energetic trek. The whole Exodus camp set up is very well thought out, including the design of tents, mess tent and all the auxiliary equipment like facilities to charge phones etc. I would suggest that the tents used are absolutely fine for one person but I would advise anyone travelling without a partner or very good friend to pay the single supplement. The two mountain refuges were an interesting experience of living close together, unavoidable to complete the route. Most of the campsites very well equipped, Exodus do not hide the fact that two others have very basic facilities.
A great walk with fabulous scenery. The group was very supportive and friendly and this added to the enjoyment of the holiday. The food was amazing, delicious and filling. The camp manager was brilliant - very efficient, and a great cook.
Arriving at the col after climbing up the ladders at the Pas de Chèvre. I've never done anything like that before. Exhilarating!
Our leader really added to my enjoyment of the holiday. He was very knowledgeable about the flora and fauna of the area and pointed out interesting plants that I would have missed otherwise. We even saw an eidelweiss on the mountainside. He also shared his interest in the geology and history of the area which I found interesting and helpful in understanding the mountains. He was a thoughtful leader and took time to help people who needed support over the more difficult terrain. His route finding was impeccable and when bad weather came in the group felt complete confidence in him to get us to the campsite.
Take an inner sheet sleeping bag for the night in the huts.
It's a great holiday- get fit and do it.
This was my first ever trek so I was anxious at first. I quickly settled in to the group and found the trek a great adventure and experience. The guide we had was excellent in terms of gaging the groups abilities and leading us. The support member of staff was also relaible and provided a good service. It was a hard trek at times but very rewarding. I am already looking to plan my next trip with Exodus!
The groups support for each other. I can't name one moment as there were many. Everyone had different strengths and abilities and were able to inspire each other at different times.
Excellent. Very knowledgeable, supportive and friendly. He was a great leader and I had every confidence in him.
None that has'nt alresdy been provided in the trip notes.
No further information to add.
We did this trek in July and had perfect blue sky weather every day, but rain on the last day for the walk into Zermatt. The trek for us was one of the best European treks we have done and was very challenging/tough but extremely rewarding with stunning and changeable scenery every day. We really enjoyed the camping although the mountain huts and auberge were a little close for comfort but manageable once you got use to the idea of sleeping closely with other people!! This trek had it all for us. High col passes, snow walking and bum sliding, steep ascents, steep descents, rough terrain, boulder jumping, chains, forests, gushing rivers, waterfalls and lakes and absolutely stunning snow capped mountains and scenery. However, we were a little disappointed that the itinerary was not followed on the first day of walking and we missed not starting from the teleferique at Plan Praz and also the high level contour walk with ladders and chains.
Arriving at a col each day at just under 3000 metres after a long, hard ascent and the stunning blue sky views that awaited us.
As a result of Simon's background he was a fast paced, no-nonsense leader which, on occasions, was necessary due to the challenging/tough nature of this trek. However, a slightly slower pace to meet the total group needs might have been more appropriate as those who were at the back every day struggled to keep up and we had to keep waiting for them to catch up. Conversely, you really need to be a good and very fit mountain walker to get the best out of this trek.
On your first day off at Les Bossons, Chamonix (the warm-up day), do the ascent and descent from the campsite to the Refuge de Bellachat at altitude 2152 metres. This will give you a good feel for what the daily ascents and descents are like, whilst warming you up nicely for what is in store most days. If you make it, try the delicious omelettes at the Refuge and the views are also very stunning. For the huts and auberge take a head torch with a red light so as not to wake people up with a bright LED and also ear plugs. You only need to take a sleeping bag liner in your day pack and no flip-flops for the huts as croc shoes are provided. You will need to take a towel and soap etc as you can have a shower in the Mountain Huts at a cost of 5 Francs and they are free in the auberge. The long descents can be very arduous on your knees - definitely take and use two poles.
As the trip notes state this is a challenging/tough trek and you need to be more than a fell walker, capable of walking at altitude. You must also be capable of walking at a moderate to fast rate each day sometimes over very uneven rocky ground, otherwise you will probably be the one at the back holding the group up every day and preventing them from achieving the daily challenges e.g. ladders and high routes thus causing the leader to 'water-down' the itinerary. This will affect the dynamics of the group and also put you under pressure and potentially prevent you from enjoying a wonderful trek.


This is the story of my life. I am impatient. God is working with me on that one, for sure. This is for all those who live with chronic pain. A reminder that God is still there, nearer than we sometimes realize. Wait on the Lord. Be encouraged.
Oh God, why do you forget me?
Why do I still live my life in pain?
And tears well up in my eyes.
Why have you not healed me?
Why is your soul so anxious?
I designed you to be?
God is creating a masterpiece.
Why do I ever doubt this?
Why am I ever sad?


text:
Douglas /
MuseumsDouglas
British Lawnmower Museum
The Museum has now become one of the Worlds leading authorities on vintage lawnmowers and is now the largest import & export specialists in antique garden machinery, supplying parts, archive conservation of manuscript materials and valuing machines from all over the world.Included in this Unique National collection are…
Distance: 11.5 miles away
North West Museum of
A unique & extensive collection of vintage buses is the centrepiece of this Regional Transport Museum.The Museum houses the North West Museum of Transport Limited's collection of vehicles. It can trace its roots back forty years, when a group of enthusiasts from the St.Helens area got together to…
The new Prescot Museum sees a contemporary space merge with a traditional museum. Following its relocation from Georgian premises to an indoor shopping centre, the museum has retained and enhanced many of its most popular and historically significant displays, giving them a new lease of life and a…
Wigan Pier
At the heart of The Wigan Pier Experience is The Way We Were, an authentic recreation of life in the 1900s for the people of Wigan and surrounding Lancashire. Witness the Victorian way of life from schooldays through to work and play. You can experience…
World of Glass
Visit The World of Glass for a great day out ‐ so much to see and do You can see live glassblowing demonstrations with Sarah, Charlie & Graeme. or why not try your hand at blowing a glass bauble on one of our glass blowing courses Experience our…
Distance: 7 miles away


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The Kingdom of Thailand is a country in Southeast Asia, bordering Laos and Cambodia to the east, the Gulf of Thailand and Malaysia to the south, and the Andaman Sea and Myanmar to the west. Thailand is also known as Siam, which was the country's official name until May 11, 1949. The word Thai (ไทย) means "free" in the Thai language. It is also the name of the Thai people - leading some inhabitants, particularly the sizeable Chinese minority, to continue to use the name Siam.
ราชอาณาจักรไทย
Raja-anachakra Thai
(Flag) (Coat of Arms)
Motto: none
Anthem: Phleng Chat
Capital Bangkok
Template:Coor dm
Largest city Bangkok
Official languages Thai
Constitutional monarchy
Bhumibol Adulyadej
- Declared
- Recognised
• Water (%)
514,000 km² (49th)
• 2002 est.
• 2000 census
62,354,402 (19th)
121/km² (n/a)
GDP (PPP)
• Per capita 2002 estimate
$388.7 billion (21st)
$6,400 (63rd)
Currency ៛ Baht (THB)
• Summer (DST) (UTC+7)
Internet TLD .th
Calling code +66
3 Provinces
3.1 North
3.2 East
3.3 South
3.4 Northeast
3.5 Central
8 Miscellaneous topics
9.1 Official
Main article: History of Thailand
Thailand's origin is traditionally tied to the short-lived kingdom of Sukhothai founded in 1238, after which the larger kingdom of Ayutthaya was established in the mid-14th century. Thai culture was greatly influenced by both China and India. Contact with various European powers began in the 16th century but, despite continued pressure, Thailand is the only Southeast Asian country never to have been taken over by a European power, though Western influence, including the threat of force, led to many reforms in the 19th century and major concessions to British mercantile interests (as such many historians include Thailand in the "informal British Empire").
A mostly bloodless revolution in 1932 led to a constitutional monarchy. Known previously as Siam, the country first changed its name to Thailand in 1939, and definitively in 1949 after reverting to the old name post-World War II. During that conflict Thailand was in a loose alliance with Japan; following its conclusion Thailand became an ally of the United States. Thailand then saw a series of military coups d'é´¡t, but progressed towards democracy from the 1980s onward.
The official calendar in Thailand is based on the Buddhist Era, which is 543 years ahead of the western calendar. For example, the year AD 2000 is equal to the year 2543 BE.
On 26 December 2004 the west coast of Thailand was devastated by a 10 metre high tsunami following the 2004 Indian Ocean earthquake, claiming more than 5,000 casualties in Thailand, half of them tourists.
Main article: Politics of Thailand
The king has little direct power under the constitution but is the anointed protector of Thai Buddhism and a symbol of national identity and unity. The present monarch enjoys a great deal of popular respect and moral authority, which has on occasion been used to resolve political crises. The head of government is the Prime Minister, who is appointed by the king from among the members of the lower house of parliament, usually the leader of the party that can organise a majority coalition government.
The bicameral Thai parliament is the National Assembly or Rathasapha - รัฐสภา, which consists of a House of Representatives (the Sapha Phuthaen Ratsadon - สภาผู้แทนราษฎร) of 500 seats and a Senate (the Wuthisapha - วุฒิสภา) of 200 seats. Members of both houses are elected by popular vote. Members of House of Representatives serve four-year terms, while Senators serve six-year terms. The highest judicial body is the Supreme Court or Sandika - ศาลฎีกา, whose judges are appointed by the monarch. Thailand is an active member of the regional Association of Southeast Asian Nations.
Main article: Provinces of Thailand
Thailand_map_CIA.png
Map of Thailand
Thailand is divided into 76 provinces (changwat, singular and plural), which are grouped into 5 groups of provinces. Each province is divided into smaller districts - as of 2000 there are 795 districts (Amphoe), 81 sub-districts (King Amphoe) and 50 districts of Bangkok (khet). However, some parts of the provinces bordering Bangkok are referred to as Greater Bangkok (Prari Monthon). These Provinces include Nonthaburi, Pathum Thani, Samut Prakan, Nakhon Pathom, Samut Sakhon. The name of each capital city (mueang) is the same as that of the province: for example, the capital of Chiang Mai province (changwat Chiang Mai) is amphoe mueang Chiang Mai.
Chiang Mai Chiang Rai Kamphaeng Phet Lampang Lamphun Mae Hong Son Nakhon Sawan Nan Phayao Phetchabun Phichit Phitsanulok Phrae Sukhothai Tak Uthai Thani Uttaradit
Chanthaburi Chonburi Rayong Trat
Chumphon Krabi Nakhon Si Thammarat Narathiwat Pattani Phang Nga Phattalung Phuket Ranong Satun Songkhla Surat Thani Trang Yala
Amnat Charoen Buriram Chaiyaphum Kalasin Khon Kaen Loei Maha Sarakham Mukdahan Nakhon Phanom Nakhon Ratchasima Nongbua Lamphu Nong Khai Roi Et Sakon Nakhon Sisaket Surin Ubon Ratchathani Udon Thani Yasothon
Ang Thong Ayutthaya Bangkok Chachoengsao Chainat Kanchanaburi Lopburi Nakhon Nayok Nakhon Pathom Nonthaburi Pathum Thani Phetchaburi Prachinburi Prachuap Khiri Khan Ratchaburi Sa Kaeo Samut Prakan Samut Sakhon Samut Songkhram Saraburi Sing Buri Suphanburi
See also: List of cities in Thailand
Main article: Geography of Thailand
Thailand is home to several distinct geographic regions, partly corresponding to the provincial groups. The north of the country is mountainous, with the highest point being the Doi Inthanon at 2,576 m. The northeast consists of the Khorat Plateau, bordered to the east by the Mekong river. The centre of the country is dominated by the predominantly flat Chao Phraya river valley, which runs into the Gulf of Thailand. The south consists of the narrow Kra Isthmus that widens into the Malay Peninsula.
The local climate is tropical and characterised by monsoons. There is a rainy, warm, and cloudy southwest monsoon from mid-May to September, as well as a dry, cool northeast monsoon from November to mid-March. The southern isthmus is always hot and humid. Major cities beside the capital Bangkok include Nakhon Ratchasima, Nakhon Sawan, Chiang Mai, and Songkhla.
See also: List of islands of Thailand
Main article: Economy of Thailand
After enjoying the world's highest growth rate from 1985 to 1995 - averaging almost 9% annually - increased speculative pressure on Thailand's currency, the baht, in 1997 led to a crisis that uncovered financial sector weaknesses and forced the government to float the currency. Long pegged at 25 to the US dollar, the baht reached its lowest point of 56 to the US dollar in January 1998 and the economy contracted by 10.2% that same year. The crisis spread to the Asian financial crisis.
Thailand entered a recovery stage in 1999, expanding 4.2% and grew 4.4% in 2000, largely due to strong exports - which increased about 20% in 2000. Growth was damped by softening of global economy in 2001, but picking up in the subsequent years due to strong growth in China and various domestic stimulation programs along the Dual-Track Policies promoted by Prime Minister Thaksin Shinawatra. Growth in 2003 is estimated to be around 6.3%, and projected at 8% and 10% in 2004 and 2005.
Tourism contributes significantly to the Thai economy, and the industry has benefited from the Thai baht's depreciation and Thailand's stability. Tourist arrivals in 2002 (10.9 million) reflected a 7.3% increase from the previous year (10.1 million). Thailand is also a major destination for fascinating tourist visiting places in the South-east Asia (http://www.tourismthailand.org), for instance, the beautiful Southern and Eastern seasides and islands, the Northern waterfalls and botanic gardens, as well as, Sukhothai: the UNESCO world heritage site in 1961.
Main article: Demographics of Thailand
Thailand's population is dominated by ethnic Thai and Lao, the latter concentrated in the northeastern Isan region and making up around one third of the population. There is also a large community of Thai Chinese, who have historically played a disproportionately significant role in the economy. Other ethnic groups include Malays in the south, Mon, Khmer and various indigenous hill tribes.
Around 95% of Thais are Buddhists of the Theravada tradition, but in the south of the country there are some Muslim areas, and small minorities of Christians and Hindus also exist. The Thai language is Thailand's national language, written in its own alphabet, but many ethnic and regional dialects exist as well as areas where people speak predominantly Lao or Khmer. Although English is widely taught in schools, proficiency is low.
Main article: Culture of Thailand
Muay Thai, or Thai boxing, is the national sport in Thailand and its native martial art. It reached popularity all over the world in the 1990s. Similar martial art styles exist in other southeast Asian countries.
The standard greeting in Thailand is a prayer-like gesture called the wai. Taboos include touching someone's head or pointing with the feet, as the head is considered the highest and the foot the lowest part of the body.
Thai cuisine blends four fundamental tastes: sweet, spicy, sour and salty.
List of Thailand-related topics
Communications in Thailand
Transportation in Thailand
National parks (Thailand)
Historical parks of Thailand
Music of Thailand
Thai immigration to the United States
Foreign relations of Thailand
Military of Thailand
Education in Thailand
Public holidays in Thailand
Thaigov.go.th (http://www.thaigov.go.th) Royal Government of Thailand
Thai National Assembly (http://www.parliament.go.th/files/mainpage.htm) Official parliamentary website
Tourism Authority of Thailand (http://www.tourismthailand.org) Official tourism website
List of organizations providing assistance and help to the victims of Thailand Tsunamis (http://thailand.united.co.uk/)
Thailand Tourism Guide (http://www.asinah.org/travel-guides/thailand.html)
CIA - The World Factbook - Thailand (http://www.cia.gov/cia/publications/factbook/geos/th.html)
Countries in Southeast Asia
Brunei | Cambodia | East Timor | Indonesia | Laos | Malaysia | Myanmar | Philippines | Singapore | Thailand | Vietnam
Retrieved from "http://aids.academickids.com/encyclopedia/index.php/Thailand"
This page was last modified 18:18, 4 Nov 2013.
This page has been accessed 22797 times.


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text:
Winds cut power, delay flights in Los Angeles
December 1, 2011 / 11:16 AM / AP
LOS ANGELES - Some of the worst Santa Ana winds in years blasted through California, toppling trees and power lines and delaying flights as a low-pressure front threatened bring fierce gusts throughout Southwestern states.
High wind warnings and wind advisories are in effect for parts of California, Utah, Nevada, and Arizona, New Mexico and Wyoming.
Fierce Santa Ana winds cause power outages
In California, winds sweeping down through canyons created gusts of up to 80 mph through the night, with a 97 mph gust recorded Wednesday night at Whitaker Peak in Los Angeles County.
"What's driving this is a large, cold low-pressure system that's currently centered over Needles, Calif. The strong winds are wrapping around it," weather service forecaster Andrew Rorke said.
The system will sit and spin counter-clockwise over the area for the next day, although "it won't be quite as hellacious" as on Wednesday night, Rorke said.
The pressure front will then begin moving cross-country, eventually bringing blustery weather to Oklahoma, Missouri and Indiana, he said.
More than 250,000 customers in Southern California were without electricity Thursday morning and about 26,000 more in the Santa Cruz Mountains of Northern California. San Francisco was spared any blackouts but thousands elsewhere in the Bay area were in the dark.
In Southern California, 23 flights were diverted and several delayed beginning Wednesday at Los Angeles International airport because of severe crosswinds and debris on runways, officials said.
The winds had died down by Thursday morning but some delays were reported in both arriving and departing flights, Federal Aviation Administration spokesman Ian Gregor said.
Northeast of Los Angeles, foothill communities were hard hit as the winds swept down the San Gabriel Mountains.
Trees, some more than 100 feet tall, crashed down in the suburbs Wednesday and landed on homes in Pasadena and near Beverly Hills, but no major injuries were reported. Several dozen people in Pasadena were evacuated from an apartment complex when a tree fell on it and smashed the roof.
A gas station in Pasadena was damaged overnight after a tree crashed onto the gas pumps, but an employee shut off the pumps and no fuel leaked.
"We probably have over 100 trees that are down and arcing wires and transformers that have blown," police Lt. Jari Faulkner told the Los Angeles Times.
The winds were colder but fiercer than the Santa Ana winds that often hit California in late fall, but they carried the same ability to dry out brush and push fires into conflagrations.
First published on December 1, 2011 / 11:16 AM
© 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.


text:
import React from 'react';

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