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Rave Cinemas, LLC. announced today that it will be acquiring up to 40 movie theaters, including 35 from National Amusements, and operating them under the Rave Motion Pictures brand name.
The National Amusements sale was reported here back on December 9th, and this announcement confirms that news.
The press release mentions that the sale of 29 theaters has been finalized. The company also acquired the business operations of four theaters from Rave Reviews Cinemas, LLC. (RRC), together with RRC's corporate infrastructure and the Rave Motion Pictures brand. RRC will retain 21 of its existing theaters, which will be managed by Rave under a management services agreement. The day-to-day business and operations of Rave will be managed by RRC's former management team.
The exact list of locations affected by this announcement has not been disclosed.
The venture will operate under the Rave Motion Pictures brand name, and the company anticipates it will own or manage 65 theaters and approximately 1,000 screens located in 20 states across the country. Rave is expected to become the fifth largest domestic circuit by box office gross and number of screens.
Source: Rave Cinemas, LLC Press Release
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Is this attraction a romantic spot to visit?
Is this attraction a good place to visit on a honeymoon?
Is this attraction good for big groups (greater than 5)?
Is there food available at this attraction?
Is this attraction accessible using public transportation?
Does this activity require advanced planning, ticketing or reservations?
Is this activity accessible without advanced planning or reservations?
Is this attraction popular with tourists?
Is this attraction a "must-see" location?
Is this attraction a hidden gem or off-the-beaten path?
Thanks for helping!
The 15 hour journey from Los Mochis to Chihuahua (or the other way) is really a great experience. It is advisable to break the ride halfway as it can get tedious even in first...
read more
The 15 hour journey from Los Mochis to Chihuahua (or the other way) is really a great experience. It is advisable to break the ride halfway as it can get tedious even in first class. This gives you the opportunity to explore the Copper Canyon more up close and personal.
This is an amazing train ride. The seats are comfy and have plenty of leg room. We took Primera Clase because we left Creel for Los Mochis on a Tuesday and that was all that was available that day. This was actually a good choice as the two previous days (with Segunda Clase carriages behind) the train ran 2 hours...
The train had comfortable seating with good leg room. However, I expected to see views of Copper Canyon, and going from Fuerte to San Rafael, that wasn't the case. The views, when possible, were mostly of valley foothills and a couple lakes. They were on the east side of the train, so sit on that side. Also, much of the...
I found reviews on this site that said you could get tickets on board. Well this is still true for second class tickets but they don't run those every day. First class tickets which include dining and club car CANNOT BE PURCHASED ON BOARD as of March 1, 2016. The only way to purchase these is on line 72 hours...
I'm not a train buff, and after sitting and rolling on the Baja ferry for 7 hours yesterday, I really didn't need to be sitting and rocking on a train for 10 hours today. We travelled in first class just to avoid the "take-away" food advertised in economy. The food in the dining car was good; a little overpriced, of...
We've got the economic class.I really recommend it. It's much cheaper and you will have the same view. Differences between classes: in the VIP class you have newer train seats, a restaurant wagon where you can buy food (very expensive and not really good) and beer. In the economic class you can get a coffee, soft drinks and some snacks.If...
I took the Chepe train from El Fuerte to Creel in order to see the copper canyon area of Chihuahua. I was told that I would have to buy my ticket on the train, so I waited for it to arrive at the station in El Fuerte. There are two trains a day, one going from Los Mochis to Chihuahua...
In an effort to not sound negative, I rated this "Very Good". The positives:
- It was nice to leave the driving to someone else
- We rode out of Chihuahua, which was nice, but I was told the scenery from the other end is nicer
- The seats were comfortable and roomy and the cabins were clean
- The...
5 hours to and from copper canyon. Beautiful scenery all along the way. The snack and Bar car offer the bare necessities.
Departure time was very early almost 6:00am. but we enjoyed train trip and good view that was huge nature and mounts.
We saw beautiful sunset from train. The restaurant in the train was very good and recommend you!especially you can take a Mexican style of break fast.
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Is this a daytrip or do we need overnight accomidations?
Hi, thanks for the El Chepe info. I am struggling to see how to book a ticket on-line, do you know if it is possible? I live in the UK and I am finding this a problem. Can I break the journey at places en-route, using a single ticket journey Los Mochis to Chihuahua? Many thanks, Chris
HI to everyone!
I'd like to go from Chihuahua to El Fuerte on April 1st and stop along the way to stay overnight in Creel, Divisdero and Barrancas. Is it possible ?
How do we get to the bottom of the Canyon and from where? How many days/nights should we consider to get to the Canyon's bottom and back to the train?
Do we need to know how to speak Spanish to take a trip on the train? We are planning a round trip with a few overnights along the way. Adding a bi-lingual guide adds a lot of cost. Can we muddle through with a translating app and some patience?
I would like to know if there is a train service between San Jose los cabos to Mexico airport
See all questions


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4415 Loop 322
Lone Star Eye Assoc
4350 Southwest Dr # N Abilene, KS
G & J Doctors Group PC
4150 Southwest Dr # 101 Abilene, KS
Dr. David Riddlespurger and his staff at Pro-Vision of Abilene specialize in caring for all of your vision needs including eye exams, contact lens and the latest in fashion eyeglasses. We take pride in building lasting relationships with our patients and taking time to know your needs.
If you've been to or used
Pro-Vision of Abilene, leave a review.
It's easy, only takes a couple of minutes and you'll help thousands make an informed decision.


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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|Rodney Waldhoff <rwaldh...@apache.org>
|Re: [VOTE][collections] Functors, dependency from collections to lang
|Fri, 13 Dec 2002 15:44:05 GMT
On Fri, 13 Dec 2002, Stephen Colebourne wrote: > I am assuming that this is a majority vote with at least 3 +1s from > [collections] committers (please correct me if this is wrong). I think this proposal would be more accurately considered a product change (it removes public classes from a released component and adds a new dependency to a released component, arguably it changes the scope of two released components) and hence would require [lazy] consensus approval. I.e., this is a veto-able action. <http://jakarta.apache.org/site/decisions.html> I'm also a bit suprised by the contents of this proposal, it seems to contradict my perception of the recent [fucntor] discussion. -- To unsubscribe, e-mail: <mailto:firstname.lastname@example.com> For additional commands, e-mail: <mailto:firstname.lastname@example.com>
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DIY is coming! Customize you exclusive backgrounds! Be creative and never stop! Bored of using a simple picture as your iPhone / iPod.
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Free iPhone 5 themes, iThemeSky provides free iPhone themes, iPhone 5s Developed iSpirit for manage apps, themes, files between computer and iDevices. evad3rs Lock - Free Lockscreen Theme For iPhone 5 & iPod Touch 5G Be creative and never stop! Download our brand new apps. Choose "Save Home Screen", "Save Lock Screen", or "Save Both" into "Photos" in your device. Free mobile downloads: themes. Opening the iTunes Store. You won't be bored anymore with the old theme! Millions of members are platinum hotel las vegas careers the fun and billions of free downloads served.


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Mehron Paradise Brilliant E17d5 Face Paint Palette (8 Colors)
A clever deal seeker from NH snagged this deal before you could.
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- Features
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- Mehron's Paradise Brilliant Palette includes 8 Paradise colors in a sleek compact case, perfect for those always on the go. Paradise face paints are semi-soft, glycerin-based cake makeup created by Mehron. Paradise face paints are water activated, and because of this, the hues of the colors are easy for the artist to control.
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All I have is the proline camaro body
Printable View
All I have is the proline camaro body
Sent from my iPad mini
Traxxas Tuesday LOVE THAT BODY:wub:
I got an ipad so how do I get the images of the gallery cause I tried photobucket
[QUOTE=Rallydykes;5374562]Traxxas Tuesday LOVE THAT BODY:wub:[/QUOTE]
Thanks! It did turn out pretty good. It looks even better in person though. As for the uploading pictures... I use the app Tapatalk. It lets you open your photo stream on the iPad and put pics right into your post.
Sent from my iPad mini
How traxxas Tuesdays
Any other way
[IMG]jpeg[/IMG] still trying to figure it out
[IMG]0221[/IMG] freakin out
Download the app "Tapatalk".
Search for the Traxxas forums and sign in.
When you go to post, there's a little camera in the corner. Click the camera and use your iPads camera to take a picture. It's pretty simple after that. I'm not sure what it does on the 1st gen iPad with no camera though.
Sent from my iPad mini
The five dollar on
Yep. That's the one.
Sent from my iPad mini
How did you do the carbon look?
decal or inlay probably.
In my opinion...hard to beat the "coolness" of Ken Block.lol.
what rims and tires are you running?
It's a cheap set from Integy...but I liked the way they look.
Here you go. Traxxas Boss 302 body.
why is this not showing my pic?
Copy the code from photobucket that has [ IMG ] before and [ / IMG ] after. thats the image code.


text:
Towing in the footsteps of other rebel cricketers, discarded Pakistan opener Imran Farhat has decided to break his ties with the unofficial Indian Cricket League and return to the national fold.
Farhat told PTI today that he had sent his resignation to the ICL organisers asking them to clear his dues and release him from his contract.
"I have decided that it is better to break my ties with the ICL and try to regain my place in the national team where there are slots up for grab for openers," he said.
Farhat, a stylish left-handed batsman, said he would submit his No Objection Certificate (NOC) from the ICL to the Pakistan Cricket Board in the next few days so that he could be considered for the national team for future tournaments.
"I have taken heart from the fact that the board and the national selectors have recalled four of the ICL players back to the national team who resigned recently," he said.
Mohammad Yousuf, Abdul Razzaq, Imran Nazir and Rana Naved were all included in the Pakistan team after they resigned from the ICL within the amnesty date set for players by the ICC to cut off ties with unauthorised tournaments.


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Flexible Flyer Adjustable Helmet (#H2227)
Item #: H2227
Safely enjoy all of your favorite winter activities! This Flexible Flyer helmet is a must-have. It is perfect for kids ages 6-12 years old. The inner padding and chin strap are fully adjustable to get the right fit. It can be adjusted to fit your child year after year! Patented Coolmax material for added comfort. The interior is removable and washable. Also, there are large air vents for maximum ventilation.Assembled Height: 11.5 inches
Assembled Width: 9.5 inches
Assembled Length: 8 inches
Assembled Weight: 1.5 pounds


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GAME OF THRONES Season 4 Blooper Reel
Game of Thrones fans lucky enough to be in Hall H at Comi-Con were treated to a very entertaining blooper reel from the fourth season of the show. HBO has released that video online for the rest of you to enjoy, so check it out!
Joey Paur — Co-Founder / Editor of GeekTyrant.com, and if you haven't noticed I write… a lot. Movies are my passion and I live and breathe all things geek. This site is part of my life's work, it's a part of me. I love what I do, and I enjoy sharing everything I can with you when it comes to movies and geekery. In my spare time I travel to the netherworlds to battle demons. @JoeyPaur | email@example.com
Newest Posts on GeekTyrant


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Grey's Anatomy
— Sezonul 2 Episodul 18 —
Subtitrare Romana
Folosiți butonul CC a playerului pentru a seta subtitrarea sau pentru a o mari.
Derek and Addison are shaken by the arrival of a figure from their past. Meanwhile, Burke learns Cristina's secret, Izzie deals with a very unusual case, Meredith delves into her family's dirty laundry, and George pours his heart out.


text:
01. Executive Summary
02. List of Abbreviations
03. Scope of the Report
03.1 Market Overview
03.2 Product Offerings
04. Market Research Methodology
04.1 Market Research Process
04.2 Research Methodology
05. Introduction
06. Market Landscape
06.1 Market Size and Forecast
06.2 Five Forces Analysis
07. Geographical Segmentation
07.1 Global Voltage Regulator Market by Geographical Segmentation 2013
07.2 Voltage Regulator Market in the APAC Region
07.3 Voltage Regulator Market in the EMEA Region
07.4 Voltage Regulator Market in the Americas
08. Buying Criteria
09. Market Growth Drivers
10. Drivers and their Impact
11. Market Challenges
12. Impact of Drivers and Challenges
13. Market Trends
14. Trends and their Impact
15. Vendor Landscape
15.1 Competitive Scenario
15.2 Market Share Analysis 2013
15.3 Other Prominent Vendors
16. Key Vendor Analysis
16.1 Analog Devices
16.1.1 Business Overview
16.1.2 Business Segmentation
16.1.3 SWOT Analysis
16.2 Infineon Technologies
16.2.1 Business Overview
16.2.2 Infineon Technologies Business Segmentation 2013
16.2.3 SWOT Analysis
16.3 Maxim Integrated Products
16.3.1 Business Overview
16.3.2 Business Segmentation
16.3.3 SWOT Analysis
16.4 STMicroelectronics
16.4.1 Business Overview
16.4.2 Business Segmentation
16.4.3 SWOT Analysis
16.5 Texas Instruments
16.5.1 Business Overview
16.5.2 Business Segmentation
16.5.3 SWOT Analysis
17. Other Reports in this Series
List of Exhibits
Exhibit 1: Market Research Methodology
Exhibit 2: Global Voltage Regulator Market 2013-2018 (US$ million)
Exhibit 3: Analog IC Segmentation
Exhibit 4: Global Analog IC Market 2013-2018 (US$ billion)
Exhibit 5: Voltage Regulator and Analog IC market 2013
Exhibit 6: Global Voltage Regulator Market by Geographical Segmentation 2013
Exhibit 7: Geographical Segmentation of the Market by Growth Rates 2013-2018
Exhibit 8: Voltage Regulator Market in the APAC Region 2013-2018 (US$ million)
Exhibit 9: Voltage Regulator Market in the EMEA Region 2013-2018 (US$ million)
Exhibit 10: Voltage Regulator Market in the Americas 2013-2018 (US$ million)
Exhibit 11: Global Voltage Regulator Market by Vendor 2013
Exhibit 12: Infineon Technologies Business Segmentation by Revenue 2013
Exhibit 13: Infineon Technologies Geographical Segmentation by Revenue 2013
Exhibit 14: Infineon Technologies R&D Expenditure (US$ million)
Exhibit 15: Infineon Technologies R&D Expenditure (US$ million)
Exhibit 16: STMicroelectronics Business Segmentation
Maxim Integrated Products Inc., Texas Instruments Inc., Analog Devices Inc., Infineon Technologies AG, Linear Technology Corp., Qualcomm Inc. and STMicroelectronics NV
Research methodology is based on extensive primary and secondary research. Primary research includes in-depth interviews with industry experts, vendors, resellers and customers. Secondary research includes Technavio Platform, industry publications, company reports, news articles, analyst reports, trade associations and the data published by Government agencies.


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Is this attraction good for big groups (greater than 5)?
Is this attraction good for small groups (less than four)?
Is this attraction free to the public?
Is gratuity suggested at this attraction?
Would this be a good rainy day activity?
Is there food available at this attraction?
Is a car required to access this attraction?
Is this attraction accessible using public transportation?
Is this attraction closed during certain parts of the year?
Is this attraction wheelchair accessible?
Thanks for helping!
The last bar on Polk that isn't a never-ending top 40s pop nightmare. Punk rock? Country? Metal? This is your place. Kanye? Go ... well ... pretty much anywhere else in the...
read more
3 Days in San Francisco
Shopping Guide for San Francisco
San Francisco for families
The last bar on Polk that isn't a never-ending top 40s pop nightmare. Punk rock? Country? Metal? This is your place. Kanye? Go ... well ... pretty much anywhere else in the area.
Thanks guys.
I went specifically because my son had put together 3 bands to play on Saturday night. I must say it was all new but I'll be back. The music was awesome, the crowd was friendly and beer was cold.
We saw a podcast recording here called Baby Genius, which was good fun. It only added to the hipster vibe. :) If you didn't know, hipsters are abrassive at first; and you'll be in their natural habitat, so act accordingly. Fun fact; there is an enclosed smoking patio in the bar.
Okay, so, I am over 50 music enthusiast that has barely stepped foot in a bar in the past 20 years, but my heart is still beating the rhythm-blues rock and roll.
Through the dark bar littered with stand up tables and bar stools, past the juke box and the centrally located walk around bar, is a door way that...
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All I have to say is there aren't any. Yet some people sure act like it. I have seen some horrible bashing and a lot of it done anon. If you want to bash someone grow a pair and post your name. Otherwise how about actually trying to help, reassure, or remember what your mama said and if you can't say anything nice don't say anything at all.
Sorry. But not one of us is perfect.
Asked by Shaken1976 at 7:54 AM on Apr. 29, 2011 in About CafeMomLevel 20 (9,288 Credits)
Answer by ItsJustMe1017 at 7:56 AM on Apr. 29, 2011
Answer by dullscissors at 7:56 AM on Apr. 29, 2011
Answer by bloomsr at 7:58 AM on Apr. 29, 2011
Answer by tnm786 at 7:59 AM on Apr. 29, 2011
Answer by Mrs_Harsh at 8:46 AM on Apr. 29, 2011
Next question in About CafeMom
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40322, KY Rent to Own Homes
|16 Listings Found
For sale by owner. $92,000. Frenchburg, KY. Why just rent? With a min credit score of 640
Frenchburg, KYDetails »
For sale by owner. $92,000. Frenchburg, KY. Why just rent? With a min credit score of 640
Frenchburg, KYDetails »
and bathrooms. Leased to Long -Term Renters. Make your mortgage payments with rental earnings. This property
Pine Ridge, KY, 41360Details »
Nationwide DISCOUNTED Owner/SELLER FINANCED Notes wanted: Serious, Seasoned CASH Buyer
Jeffersonville, KYDetails »
This four-plex was remodeled in 2006. It is fully rented at 500.00 per unit. It is located one mile
Jeffersonville, KYDetails »
Live in your own piece of paradise! In need of separate space for a multi-generational family? Want
5093 Furnace Rd, Stanton, KY, 40380Details »
now and start gathering rent! $1325.00 / month currently with room to increase. Likewise, extra 30
114 Council St, Morehead, KY, 40351Details »
For sale by owner. $92,000. Frenchburg, KY. Why just rent? With a min credit score of 640
Morehead, KYDetails »
iam looking to rent with some or just rent from some freferably a women who has stronge christian
Mount Sterling, KYDetails »
Clay City, KY 3 Beds one Bathrooms House. Available for Lease to Own Program. Aluminum Siding
284 12th St Single Family Residenti, Clay City, KY, 40312Details »
Small Office for lease. Includes a reception area, specific big workplace, storage location
White Oak, KYDetails »
are a peaceful responsible couple who will take excellent care of the property we rent. Please let us know if you
Newfoundland, KYDetails »
with storage building All 3 rental properties are currently rented and income earning info is available
Sandy Hook, KY, 41171Details »
will certainly keep you in control, lessening your business threat with ;.-Your own local contact number
Bruin, KY, 41171Details »
Possible Lease with option to purchase!!! 2002 Palm Harbour 32 x 80 Modular Home situated on 2
Bruin, KY, 41171Details »
RentUntilYouOwn.com is the #1 provider of 40322 Frenchburg, Kentucky rent to own homes listings.
Our goal is to offer the highest quality results, along with helpful 40322 Frenchburg resources and support. We understand that finding genuine rent to own homes in 40322 Frenchburg can be very difficult. Even more challenging is trying to search Frenchburg, KY listings for free.
After discovering how difficult it was for 40322 Frenchburg buyers and sellers searching online, RentUntilYouOwn.com has become dedicated to providing users with the most current, accurate, and detailed listings in 40322 Frenchburg, Kentucky.
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text:
Juventus have confirmed that Coach Antonio Conte has signed a new contract with the club until June 2015.
The tactician has been handed an extension after leading the outfit to the Serie A title at the end of his first season in charge.
Conte, a former midfielder in Turin, joined the Bianconeri last summer after leading Siena into the top-flight.
His previous contract was set to expire in 2013. It is rumoured that he will now earn close to €3m a season.
Betting on Serie A? Bet365 are offering a 100% deposit bonus, up to £200 - find out more


text:
1-1/2 Qt. Frozen Yogurt, Ice Cream and Sorbet Maker
Cuisinart Mix-It-In Soft Serve Ice Cream Maker-DISCONTINUED
- Model
- Internet/Catalog:
- 100645364
Professional quality soft ice cream, yogurt, sorbet and sherbet is now available right at home, with the Cuisinart Mix It In Soft Serve Ice Cream Maker. Not only does it make everyone's favorites, but with three built-in condiment dispensers, it makes them extra delicious! Just a pull of a tab sends sprinkles, chips and other mix-ins down the chute to mix right into frozen desserts as cones or bowls are filled. Operation is fully automatic; simply pour in the ingredients and turn the dial.
Info & Guides
- Adds favorite mix-ins into soft serve ice cream as it's dispensed!
- Pull out tabs to add one, two or all three types of mix-ins
- Pull down handle to dispense soft serve ice cream directly into cones or bowls
- Makes 1-1/2 quarts of frozen dessert in as little as 20 minutes
- Fully automatic, just add favorite fresh ingredients and turn the dial
- Cone holder holds a stack of pointed or flat bottom cones
- Double-insulated freezer bowl holds temperature for fast results
- No chemicals, salt or ice required
- Removable parts for easy cleaning
- Instruction book and recipe book included
- Appliance Type :
- Ice Cream Maker
- Built-In Timer :
- No
- Capacity (qt.) :
- 1.5 qt (US)
- Color/Finish :
- White
- Color/Finish Family :
- White
- Dishwasher Safe Parts :
- No
- Housing Material :
- Other
- Locking Lid :
- Yes
- Manual Option :
- No
- Product Depth (in.) :
- 9.75
- Product Height (in.) :
- 18.2
- Product Weight (lb.) :
- 33
- Product Width (in.) :
- 9
- Reconditioned :
- No
- Returnable :
- 90-Day
- Voltage (volts) :
- 110
- Wattage (watts) :
- 80
Ratings & Reviews100% of customers recommend this product
- Kids love it!
September 07, 2011
- Verified Purchase & Recommended Product
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Budget Hotels in Gaurikund
About Gaurikund
On the trek to the holy shrine of Kedarnath, Gaurikund is a village situated almost 2000 mts above sea level. Gaurikund is also popular owing to the natural thermal spring in this village which was destroyed after the recent earthquake in the area but a small stream still flow through the village. Home to a numerous hot water springs in India, the Garhwal region of Uttarakhand has yet another hotspring near the Yamunotri temple.


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Zeoli Show Log 10.07.16Rich discussed the latest with Hurricane Matthew in relation to the Presidential election, Donald Trump claiming he isn't prepping for the debate and the latest regarding Hillary Clinton's emails. He also discussed Ben and Jerry supporting Black Lives Matter, Donald Trump's 'vulgar' language and more. Rich spoke with Wheely Wheely Good Food Truck co-owner Alanna Li at 3:30pm. He also spoke with Chief Gregory C. Masi during Barebera Backs the Badge at 4pm.
Zeoli Show Log 10.06.16Rich discussed the controversy surrounding the Wheely Wheely Good Food truck, Hurricane Matthew and Clowns Lives Matter. He also discussed running political ads during a natural disaster, Hillary Clinton helping out Chelsea's friend and censorship of Talk Radio. Rich spoke with Dr. Mazz during Ask the Doctor at 4pm.
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The Brain and Tick-Borne Diseases
Robert C Bransfield, MD, DLFAPA President New Jersey Psychiatric Association President ILADEF Immediate Past President ILADS Board of Trustees Medical Society of NJ Clinical Assoc Professor RWJ-UMDNJ Med School Assoc Director Psychiatry Riverview Medical Center Holmdel High School Auditorium Thursday April 26, 2012 10:30-11:15 AM
Outline Overview Tick-borne diseases causing chronic illness
Symptoms & Evaluation Treatment
A Typical Patient: BC (Before Controversial Disease)
A lover of life Healthy, active, proactive and enjoying outdoor activities Not psychosomatic Not malingering
A Typical Patient: AD (After the Disease)
An onset of a worsening and fluctuating multitude of symptoms that are difficult to understand and impair many facets of life The validity of symptoms is questioned by family, friends, employer, physician and insurance companies The "unexplained symptoms" are considered of psychiatric origin—psychosomatic, malingering, etc, etc, etc.
Possible Disease Progression Over Time
Tick bite, flu Musculoskeletal aches and pains Brain fog, sleepiness, fatigue, sleep disorder Increasing multisystemic symptoms Increasing subtle neurological symptoms Depression, anxiety, cognitive impairments Increasing pain, impairment, disability Increasing neuropsych symptoms, dementia
Lyme/TBD: Two Medical Views
Rare, reliable immune testing; easily diagnosed and treated; never or very rarely chronic; never causing psychiatric symptoms, autism, etc; symptoms comparable to "the aches and pains of daily living" Common, unreliable immune testing, difficult to diagnose and treat; chronic; causing psychiatric symptoms, autism, etc [ILADS]; pain comparable to post surgical pain, fatigue comparable to MS, physical disability comparable to congestive heart failure [NIH]
As a psychiatrist I see the failures of our healthcare system
If a patient's symptoms are "medically unexplained" by current beliefs, the patient is considered to need a psychiatrist. Many patients are frustrated with the current system and need psychiatric assistance. In regard to Lyme disease, the late stage symptoms are mostly neuropsychiatric. I have seen thousands of patients with a broad spectrum of neurological, cognitive and psychiatric symptoms, including cases of suicide, violence, homicide, autism, developmental disabilities and dementia.
Mentally Ill Until Proven Otherwise
Complex, poorly understood diseases are often considered to predominately have a psychological basis until proven otherwise. Tuberculosis, hypertension, and stomach ulcers were once considered to be psychosomatic. A failure to make a diagnosis based upon various so-called "objective tests" is not a basis for a psychiatric diagnosis. Many patients are given a psychiatric diagnosis as a result of an inadequate medical exam. Mental illness is always caused by something.
What obstructs forward progress?
Dr Willie Burgdorfer, who discovered Borrelia burgdorferi, the spirochete causing Lyme, stated—"The controversy in the Lyme disease research is a shameful affair and I say this because the whole thing is politically tainted. Money goes to the same people who have for the last 30 years produced the same thing—nothing."* *Under Our Skin
This raises critical questions
Has NIH and CDC Lyme disease research helped patients in the past 30 years? Could this disease have been improperly defined by a group of researchers to maintain the flow of research grant money to themselves, their institutions and their collaborators?
How Is Lyme Disease Defined?
Restrictive research definition: A rigid and very narrow list of symptoms and a reliance upon poor quality immune testing Broad clinical definition: A broad group of symptoms, pattern recognition, PCR (DNA testing) antigen testing, culturing the organism, complex clinical interpretation The CDC states their restrictive epidemiological criteria is not to be used for diagnosis
Sensitivity/Specificity of Commercial Two-Tier Testing for Lyme Disease 46%*
Stricker & Johnson, Minerva Med. 2010;101:41925.
Total allocation of funding for tick-borne disease studies by agency/organization, 2006-2010
Total allocation of funding for tick-borne disease studies by study type, 2006-2010
Dr Fallon equates having Lyme disease to the Story of Job
The History of Mental Illness
You're possessed by demons & need punishment… Your mother caused it & you need psychoanalysis… Your serotonin is low & you need Prozac… Your genes are bad, you can't change them… Your immune system & chronic infections contribute & you need antibiotics & immune treatments… Regardless patients with "medically unexplained symptoms" & doctors who treat them are possessed by demons & need punishment…
Tick-Borne Diseases Causing Chronic Illnesses
Categories of Disease Causation
genetic (inherited alleles) noninfectious environmental (diet, lifestyle, chemicals, radiation) parasitic Paul W. Ewald
Disease Models Bransfield RC. Pediatric Health. April 2009, Vol. 3, No. 2, Pages
Pathophysiology: Time & Space
Evolutionary concepts The patient: disease progression over years and decades Space A systems approach that considers multi-systemic contributors and deterrents to disease
Time Predisposing & precipitating factors Infections
immune & other reactions Pathophysiological processes Dysfunction Symptoms & Syndromes Ineffective Treatment Disease Progression
Space Disease Progression Disease Recovery
NIH Human Microbiome Project
A study researching all of the various microbes that live in people. The project has already established that the bacteria in the human microbiome collectively possess at least 100 times as many genes as the 20,000 or so in the human genome. Bacterial cells outnumber human cells by 10 to 1. Humans depend on their microbiome for essential functions, including digestion, leading microbiologists to conclude that a person should really be considered a superorganism. Six Tribes of Bacteria Live in Your Inner Elbow The crook of your elbow is a special ecosystem that provides a bountiful home to six tribes of bacteria. Even after you wash, there are still 1 million bacteria living on every square centimeter. These bacteria are what biologists call commensals, helpful rather than harmful organisms. They moisturize your skin by processing the raw fats that it produces. The bacteria were discovered as part of the human microbiome project, a study researching all of the various microbes that live in people. The project is in its early stages, but has already established that the bacteria in the human microbiome collectively possess at least 100 times as many genes as the 20,000 or so in the human genome. The bacterial cells also outnumber human cells by 10 to 1. Humans depend on their microbiome for essential functions, including digestion, leading microbiologists to conclude that a person should really be considered a superorganism. Sources: New York Times May 23, 2008 Genome Research May 23, 2008 Science May 22, 2008
PubMed Citations Tick borne diseases: 20,000 Lyme disease: 8,200
Borrelia burgdorferi: 6,250 Mycoplasma: 18,000 Babesia: 2,900 Bartonella: 1,900 Ehrlichia: 1,900 Anaplasma: 1,500 Masters Disease or Stari: 700
Research & Clinical Observation: Microbes & TBD Cause Mental Illness
Thousands of peer-reviewed journal articles demonstrate the causal association between infections and mental illness. 250 peer reviewed scientific articles demonstrate the causal association between Lyme/tick-borne disease and mental illness. Clinical observation by front line physicians also supports this view.
Go round up the usual suspects…
Some microbes associated with mental symptoms & mental illness I
Spirochetes: Borrelia afzelii (Lyme disease in UK, Europe) Borrelia burgdorferi sensu stricto (Lyme disease in USA,UK,Europe) Borrelia garinii (Lyme disease in UK, Europe) Borrelia hermsii (Relapsing Fever) Borrelia turicatae (Relapsing Fever) Leptospira (Leptospirosis) Treponema pallidum pallidum (Syphilis) Bacteria: Anaplasmas phagocytophilum (Human Granulocytic Ehrlichiosis) Bartonella henselae (cat scratch fever) Bartonella quintana (trench fever) Bartonella rochalimae (Bartonellosis) Brucella (Brucellosis) Chlamydophilia pneumoniae (Chlamydia) Chlamydophila psittaci (Chlamydia) Coxiella burnetti (Q-Fever and "Post-Q Fever Fatigue Syndrome") Ehrlichia chaffeensis (Human Monocytic Ehrlichiosis) Francisella tularensis (Rabit Fever or Tularemia) Haemophilus influenzae (Haemophilus) Helicobacter pylori Listeria Meningococcus (Meningococcal Meningitis) Mycoplasma fermentans Mycoplasma pneumoniae Mycobacterium tuberculosis (Tuberculosis) Rickettsia. akari (Rickettsialpox) Rickettsia rickettsii (Rocky Mountain Spotted Fever) Rickettsia species (Eastern tick-borne Rickettsiosis) Shigella (Shigellosis) Streptococcus pneumoniae or Pneumococcus (Pneumonia) Streptococcus (PANDAS, Sydenham's Chorea, St Vitus Dance) Bransfield RC. Pediatric Health. April 2009, Vol. 3, No. 2, Pages
Some microbes associated with mental symptoms & mental illness II
Rubella Toga virus Varicella zoster virus(Chicken Pox) Viral meningitis West Nile virus Protozoa: Plasmodium (Malaria) Babesia microti (Babesiosis) Babesia duncani (Babesiosis) Other Babesia species (Babesiosis) Leishmania (Leishmmaniasis) Toxoplasma gondii (Toxoplasmosis) Parasites: Blastocystis (Blastocystosis) Strongyloides stercoralis (Strongyloidiasis) Taenia solium (Neurocysticercosis or Cysticercosis) Fungal: Cryptocococcus Coccidiomycosis Histomycosis Yeast: Candida albicans (Candidiasis) Candida dubliniensis Prion Variant Creutzfeldt-Jakob Viruses: Borna virus Chikungunya virus Coltiviruse (Colorado Tick Fever) Coronaviruses Coxsackie virus Cytomegalovirus Enterovirus Flaviviridae virus (Japanese B encephalitis & Tick-borne encephalitis virus) Hepatitis C virus Herpes virus family Human endogenous retroviruses Human herpesvirus 4 or Epstein-Barr virus Human immunodeficiency virus Human T-Cell Lymphotropic Virus Type 1 Influenza A virus subtype H3N2 (Hong Kong Flu) Influenza virus Pandemic Influenza of 1918 Papopavirus Paramyxovirus (Measles virus) Parvo B19 Poliovirus Rabies virus Bransfield RC. Pediatric Health. April 2009, Vol. 3, No. 2, Pages
Infections Present in Tick-Borne Disease Patients
Bacteria: Lyme disease, Ehrlichiosis, Bartonella, Mycoplasma, Chlamydia, RMSF, Typhus, Tularemia, Q-Fever, Parasites: Babesiosis and other piroplasms, filiariasis, amebiasis, giardiasis… Viruses: EBV, HHV-6, HHV-8, CMV, St Louis Encephalitis, W Nile, Powassan encephalitis and other viral encephalopathies Candida and other fungi Horowitz R
Cousins: Lyme Disease & Syphilis
•Chromosome + 21 plasmids •132 genes •More genetic material •90% genes unrelated to any other know bacteria •Perhaps the most complex bacteria known •Only 22 genes You may remember hearing or learning about another dangerous spirochetal bacteria….syphilis. Without treatment, syphilis remains in the body even though there may be no signs or symptoms. It may damage the internal organs, brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. Doctors like myself who treat Lyme disease often call Syphilis the Dumb Cousin of Lyme. Why? Because as destructive as syphilis can be, it can't hold a candle to the destructiveness of Lyme disease. Syphilis has only 22 genes that can wreak havoc in the body. Lyme has 132 genes. Syphilis is the dumb cousin Jemsek J
Direct or Immune Effects Causing Pathophysiology?
Infection or Complex Interactive Infections Pathophysiology Causing Symptoms Immune Effects Th1 & Th2
Hepatitis C & Interferon Treatment
A good model for inflammation mediated mental symptoms Symptoms include depression, anxiety, mania, irritability, impulsiveness, hostility, relapse of substance abuse & lassitude.[1] Cognitive impairments Irritability, aggression, anger, emotional lability, anxiety attacks, panic attacks, and insomnia. [2] Psychosis in Patients with Comorbid Hepatitis C and HIV [3] 1 Henry, Castera, Demotes-Mainard 2 Chantel, et. al. Current Psychiatry: Vol.5, No.8, 2006 3 Rosalind et. al. Psychosomatics 44:5, September-October 2003
Cytokine Activation Causes Psychiatric Symptoms
Interleukin-6 Is Elevated in the Cerebrospinal Fluid of Suicide Attempters and Related to Symptom Severity (1) Interluken-1Beta & Self-Inflicted Aggressive Behavior (2) IL-1Beta Causes Fatigue (3) (1) Lindqvist D, Janelidze S, Hagell P, Erhardt S, Samuelsson M, Minthon L, Hansson O, Björkqvist M, Träskman-Bendz L, Brundin L. Biol Psychiatry Mar 6. [Epub] Lindqvist D. 10th Psychoimmunology Expert's Meeting, Gunzburg, 2009. (2) Westling S et al. 10th Psychoimmunology Expert's Meeting, Gunzburg 2009. (3) Corwin et al. Ann Behav Med 2003;25:41-47.
(Mediated by Proinflammatory Cytokines IL-1, IL-6, and TNF)
Sickness Syndrome (Mediated by Proinflammatory Cytokines IL-1, IL-6, and TNF) Anhedonia Malaise Weakness Cytokines Induce Sickness Behavior Hypersomnia Poor Concentration Anorexia Social Withdrawal Musselman DL, et al. N Engl J Med 2001;344:
Body Infections: Brain Symptoms
Infections in the body can have immune effects upon the brain that cause mental symptoms. Cognitive and psychiatric symptoms can be present in tick-borne diseases when there is no infection in the brain.
A Sequence of Brain Symptoms
Early symptoms are mediated by proinflammatory cytokines and include brain fog and fatigue Another wave of symptoms are mediated by autoimmune processes and may include obsessive symptoms, tics, irritability and other symptoms The next group of symptoms are associated with altered tryptophan metabolism, decreased serotonin, increased quinolinic acid and are associated with depression Late stage symptoms are associated with brain inflammation and neurodegenerative changes
Progressive Infection & Inflammation is Associated with Increasing Encephalopathy & Increasing Mental Symptoms Mild Moderate Severe Executive dysfunction Increasing cognitive deficits Dementia Reduced frustration tolerance, irritability, dysthymia Anxiety disorders, depression, impulsivity, personality disorders Major psychiatric disorders, psychosis, suicide, homicide Increasing Neurological, Multisystemic Symptoms & Fatigue
Lyme Disease and Autism
Nicolson GL, Gan R, Nicolson NL, Haier J. Evidence for Mycoplasma, Chlamydia pneunomiae and HHV-6 Co-infections in the blood of patients with Autism Spectrum Disorders. J Neuroscience Res 2007;85: Bransfield RC, Wulfman JS, Harvey WT, Usman AI. The association between tick-borne infections, Lyme borreliosis and autism spectrum disorders Medical Hypotheses. 70( 5), p (2008) Nicholson G. Chronic Bacterial and Viral Infections in Neurodegenerative and Neurobehavioral Diseases Laboratory Medicine (2008) Bransfield RC. Preventable cases of autism: relationship between chronic infectious diseases and neurological outcome Pediatric Health. 70(3), No. 2, p (2009) Bransfield RC. The Psychoimmunology of Lyme/Tick-Borne Diseases and its Association with Neuropsychiatric Symptoms. The Open Neurology Journal. In print. Kuhn M, Grave S, Bransfield R, Harris S. Long Term Antibiotic Therapy May Be An Effective Treatment For Children Co-Morbid With Lyme Disease and an Autism Spectrum Disorder. Medical Hypotheses May;78(5):606-15
Geographical Patterns
Of the twenty states that reported the highest occurrence of Autistic Disorder per 10,000 people; fifteen reported a higher than average number of Lyme disease cases. Conversely, of the twenty states that reported the lowest incidence of Autistic Disorder per 10,000 people; zero reported a higher than average number of Lyme disease cases. Kuhn M, Grave S, Bransfield R, Harris S..
Top twenty five states for prevalence of Autism Disorder and prevalence of Lyme disease in those states in 2009 (Kuhn et al.)
Bottom twenty five states for prevalence of Autism Disorder and prevalence of Lyme disease in those states in 2009 (Kuhn et al.) Centers for Disease Control and Prevention. (2010c). Reported Lyme disease cases by state, Retrieved January 25, 2011 from [39] Thoughtful House For Children (2010). Autism State Ranking Prevalence. Retrieved from
Lyme and Dementia I MacDonald AB, Miranda JM. Hum Pathol Jul;18(7): Concurrent neocortical borreliosis and Alzheimer's disease. Miklossy J. Neuroreport Jul;4(7): Alzheimer's disease--a spirochetosis? Miklossy J, Kasas S, Janzer RC, Ardizzoni F, Van der Loos H. Further ultrastructural evidence that spirochaetes may play a role in the aetiology of Alzheimer's disease. Neuroreport Jun 2;5(10): Waniek C, Prohovnik I, Kaufman MA, Dwork AJ. Rapidly progressive frontal-type dementia associated with Lyme disease. J Neuropsychiatry Clin Neurosci. 1995;7(3):345-7. Miklossy J, Kis A, Radenovic A, Miller L, Forro L, Martins R, Reiss K, Darbinian N, Darekar P, Mihaly L, Khalili K. Beta-amyloid deposition and Alzheimer's type changes induced by Borrelia spirochetes. Neurobiol Aging. May 12, Osvaldo P. Almeida and Nicola T. Lautenschlager. Dementia associated with infectious diseases. International Psychogeriatrics (2005), 17:Supp., S65–S77 C _ 2005. MacDonald AB. Plaques of Alzheimer's disease originate from cysts of Borrelia burgdorferi, the Lyme disease spirochete. Med Hypotheses. 2006;67(3):
Lyme and Dementia II Macdonald AB.Transfection ''Junk'' DNA – A link to the pathogenesis of Alzheimer's disease? Medical Hypothesis January. Meer-Scherrer L, Chang Loa C, Adelson ME, Mordechai E, Lobrinus JA, Fallon BA, Tilton RC. Lyme Disease Associated with Alzheimer's Disease. Curr Microbiol Mar 9. Miklossy J. Biology and neuropathology of dementia in syphilis and Lyme disease. Handb Clin Neurol. 2008;89: Miklossy J. Chronic inflammation and amyloidogenesis in Alzheimer's disease -- role of Spirochetes. J Alzheimers Dis May;13(4): Aboul-Enein F, Kristoferitsch W. Normal pressure hydrocephalus or neuroborreliosis? Wien Med Wochenschr. 2009;159(1-2):58-61. Miklossy J. Alzheimer's disease - a neurospirochetosis. Analysis of the evidence following Koch's and Hill's criteria. J Neuroinflammation Aug 4;8(1):90.
Lyme/TBD/Infections & Violence
It is hypothesized parasites can alter host behavior by altering aggressiveness and sexual aggressiveness. Infections fostered by poor hygiene and warfare environments can cause impairments that contribute to violence, which can be particularly significant when affecting large groups and powerful and influential individuals. Throughout history, regions of the world with a higher burden of infections and vector borne disease have a higher association with violence. Human history is also a history of violence. Microbes and psychoimmunology are a part of both history and the future. Bransfield RC. Neurology, Psychiatry and Brain Research. Gunzburg, Germany 2012
Symptoms & Evaluation
Assessment In depth history, review of systems
Thorough exam relevant to patient's complaints and findings Are there relapsing progressive multi-systemic symptoms, including cognitive, psychiatric, neurological, and somatic? The greater the comorbidity, the greater the likelihood of Lyme/TBD. Pattern recognition, differential diagnosis Lab: (no test can rule out LYD/TBD) Medical judgment
Consider Neuropsychiatric LYD/TBD with:
An acquired case of attention deficit disorder Regressive autism with childhood bipolar Panic attacks that last more than ½ hour An onset of bipolar illness later in life Progressive white matter cognitive impairments with anxiety and depression Progressively declining mental state Psych symptoms but no musculoskeletal symptoms with prior partial treatment
Comorbidity: Psychosomatic, Somatopsychic or Multi-systemic?
Psychosomatic: Mental distress results in somatic symptoms. Somatopsychic: Somatic distress results in mental symptoms. Or a multi-systemic process adversely affecting the brain and body causing both psychiatric and somatic symptoms.
Multisystemic vs. Psychosomatic
A person is reasonably healthy throughout most of their life, and then there is a point in time where a multitude of symptoms progressively appear. The number and complexity of these symptoms may be overwhelming and illness may be labeled hypochondriasis, somatization disorder, or psychosomatic. However, both hypochondriasis and psychosomatic illnesses begin in childhood and are life long conditions which vary in intensity depending upon life stressors. If a complex illness with both mental and physical components begins in adulthood, the likelihood that this is psychosomatic is very remote.
Psychiatric Assessment www.MentalHealthandIllness.com
Cognitive Emotional Vegetative Behavioral Psychiatric syndromes Neurological Somatic
Risk of Disease vs. Treatment
If Lyme disease is benign, the risk of the disease may not outweigh the risk of treatment. If Lyme disease is serious, the risk of the disease may outweigh the risk of treatment.
Symptom Priority A TBD patent may have over 100 different symptoms.
After completing an assessment, prioritize which symptoms are most sever and contribute the most towards perpetuating chronic illness. Treat the high priority symptoms first and work your way down the list.
What Symptoms Perpetuate TBD Disease?
Sleep disorders Fatigue Cognitive impairments Depression Anxiety Pain Headaches Others
Antibiotics or Psychotropics or Other Treatments?
When a patient has been treated with just antibiotics and has not adequately responded, consider psychotropics. When a patient has been treated with just psychotropics and has not adequately responded, consider antibiotics. When a patient is treatment resistant consider both &/or other treatments.
Symptomatic Treatment
Regardless of whether chronic Lyme disease is active infection or something else, symptomatic treatment is beneficial and can prevent and sometimes reverse progression of illness. Symptomatic treatment improves: Functioning Immune functioning Resistance to infection
Basic Treatment Strategies
Three commonly associated symptoms are non-restorative sleep, fatigue and cognitive impairments Increase deep sleep Normalize circadian rhythm, improve cognitive functioning, stress reduction, pain management as well as traditional psychotropic interventions for depression, anxiety, psychosis, etc.
Delta Sleep and Lyme Disease
Chronic fatigue & sleep disturbances are prevalent in Lyme disease. (1) Sleep restriction increases IL-6 and pain-related symptoms in healthy volunteers (2) Impaired Sleep Correlates with Impaired Immune Functioning (3) Growth hormone is dependent upon delta sleep & modulates immune response (4) Increasing delta sleep is therapeutic Greenberg HE; Ney G; Scharf SM; Ravdin L; Hilton E. Sleep, 18(10): (2) M. Haack, E. Sanchez, J. Broussard, M. Regan, J. Mullington J Pain; April 2004, Supplement 1 • Volume 5 • Number 3 (3) Modolfsy H. Sleep and the immune system. Int J Immunopharmacol 1995;17: (4) Kelley KW. Ann N Y Acad Sci. 1990;594:
Disease Progression Non-Restorative Sleep Pain Immune Fatigue
Cognitive Impairments Emotional Impairments Pain Sensitivity Immune Dysfunction
Psychotropics Antidepressants were developed from TB drugs that had mood lifting side effects All psychotropics may be used when needed Psychotropics effect neurotransmitters &: Are sometimes antimicrobial Can be immune modulators May alter CNS gene expression Can be neuroprotective Can increase neurogenesis and brain derived neurotropic factor
Psychotropics are also Antimicrobial & Immune Modulating
Antidepressants modulate cytokine functioning (1) The immunostimulating and antimicrobial properties of lithium and antidepressants (2) Immunomodulatory effect of SSRIs on human T lymphocyte function and gene expression (3) Antiviral & immunomodulatory effect of lithium (4) 1 Janssen DG, Caniato RN, Verster JC, Baune BT. A psychoneuroimmunological review on cytokines involved in antidepressant treatment response. Hum Psychopharmacol Apr;25(3): 2 Lieb J. J Infect Aug;49(2):88-93 3 Taler, et al. European Neuropsychopharmacology 4 Rybakowski JK. Pharmacopsychiatry Sep;33(5):
Neuropsychiatric Herxheimer Reaction
Treating Lyme/tick-borne disease patients with antibiotics may cause a Jarisch-Herxheimer reaction This reaction may exacerbate any symptom caused by the infection A sudden appearance of depression, suicide attempts, agitation & violence may be a part of this reaction. "You can't bear to live. It is beyond the imagination." Slowly starting the antibiotic, close observation & psychotropics are helpful
Adjusting to Lyme Disease
Individuals who acquire Lyme disease are often more active than the average and invariably have great difficulty adapting to the impairments and limitations caused by this disease. Due to the multi-systemic nature of the disease, it is difficult to do anything that isn't adversely affected by this disease.
Social & Family Dynamics
Patients also have difficulty because Lyme disease, like any other invisible disability, is difficult for family, employers, physicians, insurers, government and others to understand and acknowledge. Often multiple family members have Lyme disease which can result in a further decline in family stability and increased conflicts.
Recovery is a marathon with many twists and turns
Website Mental Health and Illness .com www.mentalhealthandillness.com
International Lyme and Associated Diseases Society
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By Cytonn Research Team, November 20, 2016
On 8th November, 2016, Donald J. Trump emerged the victor in the US presidential elections, winning 290 electoral votes, out of the 270 required to emerge victorious. Further to a Republican winning the presidential seat, Republicans additionally won the House and the Senate, restoring the Party to the pinnacle of the US Government.
As is the case with any change of administration, the US President-elect will try to make good on his campaign promises to the voting public, which are expected to potentially change the way the US relates with the rest of the world. In this weekly, we look at the areas in which Kenya partners with the US, highlight the current state and impact of the partnership, then move to analyse how the landscape will most likely change under the Trump administration, and finally give our outlook on the future relations between Kenya and the US.
Kenya and the US have maintained a mutually beneficial partnership for years. The US began relations with Kenya decades ago, having opened up an Embassy in Nairobi on 12th December 1963. Since then, Kenya has proven a strategic geopolitical location since the Cold War up to date, a key ally in their global campaign against terrorism, as well as Foreign Policy in the East African region.
The unexpected victory of Donald Trump has sparked debate, especially criticism of how the US foreign policy would look like under his administration. During his campaign he highlighted that he is keen on making "America great again" by (i) redirecting focus from the global arena and dwell majorly on the American economy, (ii) being extremely stringent on immigration laws and deporting illegal immigrants, (iii) renegotiating global trade deals he terms as punitive to the US economy, and (iv) wiping out extremism. The US has a major influence on the globe economically, financially and politically; and it is due to his "radical plans" that many believe that global markets should prepare for a bumpy ride.
Below is a table highlighting the current relationship status between Kenya and the US and how it might change under Trump:
Trump's Policy
Trade and Investments
Under the Obama administration trade and investments between Kenya and the US recorded remarkable growth, with net imports increased by 206.4% from the Bush administration, highlighting the improved activity in trade between the 2-nations. Key to note is that imports from the US increased by 90.4%, faster than our exports to the US, which grew by 81.9%, an indication that Kenya depends more on the US; and with over 96 investment projects in Africa worth USD 6.9 bn as at 2015, the US remains to be the single largest investor in Africa. Kenya receives a large proportion of these investments and as at 2015, Kenya recorded a 12.3% share of Africa's FDI
As per Trump's policy, his 7-point plan to rebuild the American economy involves fighting for free trade. His plan involves withdrawal from the Trans African partnership and the renegotiation of trade agreements to better suit the American worker. However, there is no direct mention of any changes to trade between the US and Kenya.
Democracy and Governance
The US emphasises on democracy and proper governance and is known to sever relationships with authoritarian nations. Due to their influence in the global arena, the US has also imposed sanctions on several countries deemed to be undemocratic. With regard to Kenya, the US has always been keen on democracy and as witnessed during the 2013 elections, President Obama allowed for the democratic process to prevail while emphasising that Kenya had to uphold its international obligations and respect international justice. This pressure meant that the newly elected Kenyan President and his deputy had to face the ICC and get cleared before the international community.
Trump once said "Look at African countries like Nigeria or Kenya for instance, those people are stealing from their own government and go to invest the money in foreign countries. From the government to the opposition, they only qualify to be used as a case study whenever bad examples are required". Basing on his statement, in order for the US to fully collaborate with Kenya, we need to address graft. His election can only help confront graft, but we also believe that the Trump administration will largely be inattentive to Africa.
Peace and Security
Kenya offers a strategic geopolitical location to the US ever since the Cold War and currently as the US marshals a global campaign against terrorism. Kenya is also a global leader in terms of humanitarian relief operations, having played a significant role in refugee situations in South Sudan and Somalia. In return, Kenya is one of the largest recipients of US security assistance, having received over USD 80.0 mn to date under the "train and equip" mandate by the US Department of Defence.
Trump cites peace to be the centre of his foreign policy and he plans to achieve this in a more peaceful manner. He also welcomes working with other nations in a bid to eradicate extremism. For Kenya, terrorism has plagued us for a while and a expect US engagement to continue.
Kenya has received almost USD 1.0 bn annually in aid from the US and ranks in the top 10 US aid recipients. Under the Obama administration the USAID formulated the "Country Development Cooperation Strategy" to run from 2014-18; with 3 main goals namely: (i) implement devolution effectively, (ii) strengthen health and human capacity, and (iii) execute an inclusive, market-driven and environmentally sustainable economic growth
Trump during his primaries claimed that his number one priority is to strengthen America and this will involve cutting Aid to countries where they receive no form of "return". This could prove punitive to Kenya as we are one of the top recipients of USAID.
International Organisation
Kenya's economic prosperity and a diverse economy has attracted several international companies that have set up their regional headquarters in Nairobi. Kenya's sustainable relationship with the US has attracted major US firms such as Coca Cola, General Electric, Google, IBM and Intel to name a few. This is a clear sign that Kenya is emerging as a regional hub and with such firms setting up shop, Kenya is set to benefit in terms of job creation and skill transfer.
Attraction of international companies into Kenya is due to Kenya's status as a regional hub and is not politically motivated. Given this, we do not see a Trump presidency as being negative towards this.
Immigration - The Diaspora
The Kenyan born population in the US is fast growing and is now the 2nd highest contributor to diaspora remittances into the country after the United Kingdom. Kenyans have been legally admitted into the US either through (i) family sponsorship (3%), (ii) employment sponsorship (7%), (iii) as a refugee and asylee (26%), (iv) the diversity VISA programme (28%), or (v) being an immediate family member to a US citizen (35%). Diaspora remittances currently the highest foreign exchange earner for the country, with cumulative 12 months' diaspora inflows to June 2016 increasing by 11.0% to USD 1.7 bn from USD 1.5 bn in the year to June 2015.
Trump plans to prioritise job security for all Americans. Under this he is willing to (i) establish new immigration controls, (ii) select immigrants based on their likelihood for success in the US, (iii) end Obama's illegal immigrants amnesties, (iv) force other countries to take back their illegal immigrants, and (v) reform legal immigration to serve America's best interest.
Overall Effect
As per the above, we have 1 positive indicator (democracy & governance), 3 neutral (trade, peace & security and international organisations) and 2 negatives (aid and immigration). It is due to these factors that we believe a Trump presidency is largely neutral towards Kenya's economic growth.
The Kenyan economy is one of the most diversified in the region and has displayed resilience to global shocks, as witnessed by the IMF projecting a 6.0% growth for 2016, despite other African countries being downgraded on account of global turbulence, especially due to commodity prices. As per our topical on "Kenya's Economic Growth" we noted the key hindrances to Kenya's growth being (i) security, (ii) political stability, (iii) corruption, and (iv) weak export growth. As highlighted above, we see the Trump effect to have a positive impact on security and governance, and neutral on trade and investments under which we highlighted export growth being an issue.
Disclaimer: The views expressed in this publication, are those of the writers where particulars are not warranted. This publication, which is in compliance with Section 2 of the Capital Markets Authority Act Cap 485A, is meant for general information only, and is not a warranty, representation, advice or solicitation of any nature. Readers are advised in all circumstances to seek the advice of a registered investment advisor.


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The way out of the dilemma.
We need to agree that the whole universe is evolving. Not only physically but genetically, neurophysiologically, socially and, in the case of human beings, culturally. In terms of joint social and cultural evolution it has been convincingly argued that without the "useful fiction" of supernatural beings human social groups could not have evolved beyond the size of an extended family or clan. There is little doubt that even today there are people whose cerebral hemispheres are not adequately synchronised and who hear voices which are often believed to be supernatural.
*The value complexes embedded in the religious cosmologies of the most powerful agricultural civilisations centred on fertility, righteousness, and land ownership, and were rewarded by forms of deferred immortality after death.
*The powerful mercantile industrial societies that replaced them have done so with an ideology based on materialism, utilitarianism, mechanistic causation, capital investment and money systems. The value complexes became centred on productivity, bureaucratic legalism, economic utility, and material accumulation with credit providing deferred material rewards on earth to money-lending capitalists. Money and debt are as much fictional constructs as immortality. Banks have been authorised by governments holding a monopoly of political power to print money and to make loans of money they haven't even got. As soon as this imaginary money is borrowed it becomes a debt in terms of "real "money. Paper money is essentially a legal contract promising material redemption.
What happens when the global system of indebtedness loses credibility and the bears get loose in the stock markets? Should this happen, and it is certainly within the bounds of possibility, what control will governments and commercial enterprises have if they can no longer reward their electors and employees with material goods? The Boy Scouts, whose training includes bush survival skills, have a motto we should be adopting, "Be Prepared."


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Obama to Give Wind Farms 30-Year Pass on Eagle Deaths
Is this more evidence that Obama hates America?
Check it out:
The Obama administration is about to approve a rule that will ensure the death of golden and bald eagles for the next 30 more years.
Hundreds of thousands of birds die each year flying into the deadly turbine blades atop the soaring towers that compose wind farms. The rule will give wind farms thirty year permits for the "non purposeful take of eagles-that is where the take is associated with but not the purpose of, the activity.'' The take of eagles is also a euphemism for the slaughter of them.
The wind farms fulfill Obama's ambitious pursuit of developing renewable energy sources. Unfortunately, some bird species being destroyed by the turbines are not renewable. As a result, Obama finds himself wedged between the ire of opposing green groups. In July, wildlife groups met with administration officials and lobbied against the granting of 30 year permits for energy companies that own the wind farms.
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Labrada Nutrition Natural Fat Burning Stack
-1 Bottle Labrada Nutrition Raspberry Ketones
-1 Bottle Labrada Nutrition Pure Green Coffee
-2 Bottles Labrada Nutrition Ursolic Acid
Want to shed thos pesky pounds and lean up so that you can see all that hard work you have put in at the gym? This Natural Fat Burning Stack will get you lean in no time with its adavanced fat burning formula that includes the popular GREEN COFFEE BEAN EXTRACT!
When it comes to shopping, there are times when more is definitely better. For the woman who lives and dies by her shoes, seeing a wall-to-wall display of heels in every size, shape, and color is as good as it gets.
Why Should I Stack these Products?
"Stacking" refers to using more than one supplement at a time to maximize your results. These stackable products are all designed with the same goal in mind (in this case, fat burning), but help you reach it in different ways.
For example, one product might help keep your energy levels up while dieting so you can continue to exercise with the same intensity as you when you were eating more carbs. Another might help keep your food cravings in check so you don't overeat. Still another might help you hang onto lean muscle while losing stubborn fat. All of these products are helping you get a leaner, tighter body – just in different ways.
The same approach is used with Labrada's new Natural Fat-Burning Stack, which contains three distinct products
- Ursolic Acid,
- Green Coffee Bean Extract
- Raspberry Ketones
Though the combined effect is noticeable weight loss, each product supports this weight loss via different mechanisms. This way, no matter what your struggle or weakness is when trying to lose weight, all your bases are covered and you have better odds for success. Let's take a closer look at the powerful Natural Fat-Burning Stack line-up here …
Labrada Pure Raspberry Ketones (100mg Per Pill)
TV Doctor Customers: Labrada Raspberry Ketones contain 100mg of the popular ingredient Raspberry Ketone per capule. This is Dr. Oz's exact recommendation. For best results, Dr. Oz said to start by taking 100 mg at breakfast. Go to 200 mg at lunch if that doesn't work. This bottle will then last you 30-60 days.
Raspberry Ketones for Fat Loss
Studies have shown that raspberry ketones hold promise for fat loss. In one study mice were fed a calorie rich high-fat diet supplemented with raspberry ketones. After 10 weeks it was shown that the raspberry ketone supplementation prevented both subcutaneous and abdominal (visceral) fat gain, and also protected against development of fatty liver.
These anti-obesity effects are beneficial, since abdominal fat (the type of fat that causes protruding bellies even in otherwise "skinny" people) is strongly associated with obesity-related complications like the metabolic syndrome, Type 2 diabetes and coronary artery disease, even in the absence of classical risk factors.
The association between abdominal adiposity and accelerated atherosclerosis has been shown to be independent of age, overall obesity or the amount of subcutaneous fat. Thus, raspberry ketones can help you get in better shape and improve your health.
Labrada Nutrition Green Coffee Bean Extract 525mg 60 Caps
Fat Loss just got so much easier!
Labrada Nuitrition Green Coffee Bean Extract promotes healthy weight loss by regulating your metabolism and burning more fat.
TV Doctor Customers: This Pure Green Coffee Bean Extract supplement supplies 525mg per capsule. Dr. Oz's recommendation is 800mg 2x per day before a big meal. There are no additives.
Fat loss optimizer. Supports fat loss. Natural Anti-oxidant. Green coffee bean extract is a natural powder extract from unroasted coffee beans.
- Slows down the absorption of glucose from the small intestine and lowers after meal blood glucose levels.
- Inhibits carbohydrate digesting enzymes and the actual absorption process itself.
- Has chlorogenic acid, which significantly inhibits fat synthesizing enzymes, while increasing the activity of fat burning enzymes.
- Increases blood levels of adiponectin, a hormone that is secreted from fat cells.
- Adiponectin enhances fat burning and also increases insulin sensitivity, lowers blood glucose (blood sugar) and reduces triglyceride levels.
Green coffee bean extract is rich in natural compounds, such as chlorogenic acids, that are known to have health benefits and to influence glucose and fat metabolism. Recent peer-reviewed, published studies have found that Green coffee extract: helps support significant fat loss. Contains natural anti-oxidant properties.
Labrada Nutrition Ursolic Acid Supplement 120 Caps
Ursolic acid is a naturally occurring ingredient found in food such as apple peels. Ursolic acid provides healthful benefits for dieters and athletes.
Ursolic Benefits:
Lean Muscle Optimizer
Supports Fat Loss / Weight Loss
Supports Lean Muscle
Supports Cardiovascular Health
This supplement promotes weight loss and well as promoting gains in muscle growth. Ursolic acid has been shown to affect molecular pathways that could actually prevent muscle loss and weakness.In studies involving both humans and mice, ursolic acid was proven to help counteract the catabolic effects of fasting/dieting.
helpful to fat loss review by Lane on 10/24/2016
Labrada Nutrition is one of the best supplement companies on the market today. One thing that I like about the brand is that they do not put any ingredients in their products that they themselves would not want to take. Therefore, everything is natural in this stack. I really like this stack because the ingredients are scientifically based. I never even have to worry if the stack is working, because studies have shown that these ingredients actually work.*DISCLAIMER. Individual results may vary.
Note: Note: In the event of a pricing error or fraud alert, we may refuse or cancel any orders placed for that item in accordance with our Terms & Conditions. We will notify you of any cancellation. Also, because manufacturers continually change product specifications without notice. While we try our best to keep product descriptions up to date, they do not necessarily reflect the latest information available from the manufacturer. We are not responsible for incorrect or outdated product descriptions and/or images. It is your responsibility to know what products are legal or illegal in your country. FDA: These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.


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Mad Dogs: Series 3 (Import DVD)
Discovery Miles 550
Hassle-Free Exchanges & Returns for 30 Days. Learn more
Product Description
Mad Dogs III picks up where series II ends with the boys desperate attempts to escape the island resulting in them being even further away from home and safety than they were before. Worse, they seem to have infiltrated a drug cartel and are now under the watchful eye of shady government ops. It seems the only possible chance for salvation is a witness protection programme, a new identity and the promise that the friends sever ties with each other. But how long is it before one of them buckles making contact and the past starts catching up with them; all over again? The boys might be out of the Beleriac light, but they're heading straight into the heart of darkness… Will the Mad Dogs ever get home?
- Rating
- Number of Discs
- 1
- Format
- TV System
- Country
- Region
- Barcode
- 5024952963508
- Title
- Mad Dogs: Series 3 (Import DVD)
- Studio
- Delta Home Entertainment
- Year
- 0
- Running Time
- 60
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Region details
Region 2 - Europe (except Russia, Ukraine, and Belarus), Middle East, Egypt, Japan, South Africa, Swaziland, Lesotho, Greenland, French Overseas departments and territories.


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Dr. Kozhuvattasseri Madhusoodanan MD Patient Reviews
- Cardiovascular Disease Minneapolis, MN
Overall Rating
1 Patient Reviews
- Wait Time 5 minutes
- Easy Appointments
- Promptness
- Friendly Staff
- Fair and Accurate Diagnosis
- Bedside Manner
- Spends Time With Patients
- Appropriate Followup
Showing 1 - 1 review
1.0 of 5
June 30th, 2014
Dr. seemed unable to understand even fairly simple sentences. Dr. seemed to lack an even basic understand of logic. I would rate the Dr. as astonishingly inept. My deteriorating health and greatly reduced aerobic capacity he described as "perfectly normal". When I asked if there was anything I could do to restore my ability to climb stairs or mow my lawn without extreme discomfort, he suggested that I "try exercising". He knows I exercise an hour a day(!).
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