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Technology is growing exponentially. Industries are merging, and new ones are being born.
It's becoming clearer that there is no longer such a thing as a digital strategy – just strategy in a digital world.
According to author, innovation expert and strategic advisor Stefan Lindegaard, leadership, innovation and new technologies are fully connected today – and people are the key driver for all of them. If we're going to keep pace with change, we need to strategize differently – which means thinking differently about industries, organizational structures, and leadership.
So how do we actually do this?
We sat down with Stefan ahead of his #IntraCnf Singapore Trending Topic Talk to find out how to balance the old and the new when it comes to strategy, how to know if our strategy is working, and why the C-Suite needs to look very different if we want to succeed.
Your view is that we need a new approach to leadership, organization, structures and in how we think of industries and competition. Why, and what does that look like?
The first step is to address the people working with innovation, the innovation professionals within Innovation Management. They need to realize and acknowledge that we cannot separate innovation from digital and new technologies. It all comes together now.
This technological growth, and the changes it causes, is very much a result of the exponential growth in the development of these things here in Singapore, and more importantly how these technologies are merging. However, as technologies are merging we also need to know what that means for the industrial landscape, the competitive landscape.
Singapore is a good example. Companies are not in trouble, but they need to be a bit careful about what they do for the next 20 years. They realized this and have set up some initiatives in Singapore, and also identified about 25 industries that were important for Singapore. But when you look at these industries, they are very traditional. I'm arguing that because of merging technologies, we're starting to see merging industries, even new industries.
A good example is automotive. We don't really call it the auto industry anymore. We don't really have a name for it. Is it Smart Cars? Is it Mobility?
What is it now, and how does it all come together? A state or country like Singapore will have to address not only their traditional industries, but also those that are merging and coming together as new ones, because that's where the real opportunities are going to be.
It sounds like you're saying it's not that old is an obstacle and new is the solution, but that old and new have to work together. Can you elaborate on that a little bit?
Well, 10 or 15 years ago I would have argued that we should just throw out all the old and bring in the new; but, as we get older and a bit wiser we realize that in order to be successful we need to respect what's already in place.
There's a legacy. There's a history. There's a set of systems. There's a way things are working. There's a way to make money. We need to respect that.
We also need to respect that it's not possible to just change everything and, more importantly, we cannot just change the skills and the abilities of our employees, or even our leaders. This will be more of a gradual change, although it's going to have to happen quite fast for those that want to prosper and survive.
So the trick is: how can we best use what's already in place? How can we leverage the current situation of the company, and then bring it together with the new things, the new skills, the new capabilities, the new opportunities? That is the big challenge right now.
As an innovator you have to comply with the old – governance, financial structures, etc – but at the same time, you also want to improve it, change it into the new. How do you do that on a daily basis?
I'm a big proponent of hybrid solutions. The work we do with innovation, with innovation management professionals, is often around finding the right balance between old and new. It's also around organizational structures. When we examine how organizations work today, we realize they aren't really setup for the future we're headed towards, which is going to be much more open, much more transparent, much more networked. We'll have to adapt our organizations.
But again, going back to the old and the new, it's about finding the right balance. How much old should you keep? How much new should you bring in? More importantly: how fast you can do this? There's no doubt in my mind that we need to do things much faster. Many companies will go down if they don't make some significant changes in the next 12-24 months.
On the other hand, if you push too hard, if you push too fast, the organization simply breaks and then you don't get anywhere. So again, we need to find the right balance between old and new, but also find the right balance of speed, how fast you should move.
How do you know you're getting this balance right?
That's a very good question! And really, it's not an innovation question. To be honest, innovation leaders and managers have very little impact in their organizations. The only people that can really make things happen are C-Suite, and they need to find ways in which they can cope with this uncertainty; and coping with uncertainty also means that they will have to acknowledge that they won't really be able to know when they're imbalanced. They're going to be in a state where they need to get things done, they need to change their organizations, but they aren't sure whether or not they're doing the right things.
Of course this will be more obvious in some industries than others, but it's going be very, very challenging to be an executive in the coming years. It's also going to be very stimulating.
I interact with many executives, and what I sense in them is that they're confused, and some of them are even outright scared of what's going on right now.
The organizations led by leaders who have come to terms with this new reality are going have some very interesting opportunities; those who do not get it will have to get out of those jobs and leave them for a new generation of executives.
Is there any best practice around creating a more agile strategy process?
Look at a company like Facebook: they have a vision of where they want to be 20 years from now. Some Chinese companies are looking forward 100 years, and I think that's where we need to go. We need a vision of where we want to be, a strong 'why' for our company.
How we approach strategy, and how leaders approach it, that will take a fundamental mind shift change. You can no longer strategize for one, three, or five years. For strategy development, you need to get down to months, three to six month cycles, in which you sit down and address and evaluate how well your strategy serves your vision, your 'why'. In an industry where you're talking about years, maybe really heavy industries, then you're going to be in trouble pretty soon.
With such rapid time frames, how do you assess whether or not your strategy is working?
We need to focus on what I call human factors in leadership as well as innovation management. We need to acknowledge that people are very much analog beings. The knowledge we have, the experience we have, the relationships we have, every thought inside our heads: it's not something that's easily available, if at all, to others.
We also have emotional intelligence; we are very much driven by emotions and feelings. So we've got some issues with the human factors. There are positive aspects, but there are also negative aspects. We need to get to a point where we can work with these human factors plus digital capabilities.
I have a couple of focus areas here. One of them is not business intelligence, but decision intelligence. How can we make better decisions by combining our human factors and our digital capabilities for innovation? We're finally starting to see an infrastructure that allows us to go in and work with open innovation in a way where we can work virtually, but more importantly also co-create IPR. Through machine learning we can get better knowledge there, and through lecture technologies we'll be able to actually see who contributes what.
I imagine five to seven years from now, we'll have systems in place that will allow us to create simulations of our innovation projects: you don't have to bring it to market, you can instead run simulations. That's a very exciting topic here right now.
2017, in my view, is the cut-off point where we look from the old companies to the new companies in terms of who is using that sort of technology, and definitely in terms of companies providing the service and platforms.
You mentioned a new generation of executives. How are they different from today's generation of executives, and where do we find them?
Here's what's playing out right now, and is going to be very prevalent in the next three to five years. A company will get in trouble, either losing their top line or bottom line, their profits. The Board of Directors is going to look at the executives and say, "What happened?" And the executives will look back and say, "You know what? We don't really know…" because they didn't understand it. They didn't see the changes coming, the disruption it brought along.
So The Board of Directors is going look at these guys, these executives, and say, "You're out. We need someone else." The challenge is the guys who are in charge now are usually in their late forties and fifties. They're white and, most often, men. We need to start asking Boards, "Should we hire someone similar, with a very good chance of being in the same situation a few years from now?"
It's important to note it's not really about age, it's more about mindset. And there are exceptions: The new CEO of Ford, Jim Hackett, he's actually in his sixties but he has a pretty good understanding of all the things happening in the digital automotive industry. But, if you look at the age group and demographic we work with here, they have some difficulties understanding what's happening in the digital and new technology areas.
So the Board of Directors will have to say, "Okay, we don't want another fifty-year-old white CEO or Senior VP. We need someone who really understands these things. Maybe we need to look at someone in their early thirties." The challenge, however, is that to get someone who fully understands this, who lives and breathes digital? They generally have very limited leadership experience.
That is exactly the gamble they'll have to take; but, I would rather take that gamble than go with someone who does not understand digitalization and the opportunities and challenges it brings.
So is it better, then, to look outside the walls of the current organization to find the next, best leaders?
No. I would put in a lot of effort to identify and develop these talents today, and groom them for higher leadership positions in the next three to five years. I worked with a company of nine thousand people, two thousand of them blue collar, and the CEO said that he could probably only name ten to twelve people fitting the profile we were discussing. So it's a very, very limited number of people inside the organization; but again, it's just as limited outside and more importantly, the competition with these people is going to be ridiculous.
I mean, there's going to be so much demand for young leaders who really understand this, just as there's going to be crazy competition for data scientists.
So the best course of action is to find these people inside your organization, people with the right mindset and understanding, and nurture them. Develop them.
Really, we need to start moving away from traditional hierarchies and functions, from traditional structures – but we still need leaders, leaders who are comfortable operating faster and more openly, more collaboratively.
If you're committed to this sort of shift in your organization generally, natural leaders will emerge.


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Patina Indoor/Outdoor Pendant
Earn $25 back in rewards* for every $250 spent with your Pottery Barn Credit Card.Learn More
- Overview
The bronze-patina finish on the frame of this pendant gives each piece an exceptional color depth. Place this lighting in an entry or dining area, or in a covered porch or patio, to add a warm glow to your indoor or outdoor space.
- Crafted of iron with a water based painted green patina finish.
- Features glass panes.
- Hardwire; professional installation recommended.
- Damp UL-listed.
- Imported.
- Dimensions & Care
- Overall: 15.25" diameter, 30.75" high
- Maximum height: 102.75"
- Canopy: 5" diameter
- Cord: 6' long
- Chain: 6' long
- Bulbs : 25 watts, type B candelabra (not included); also accommodates a 5 W CFL bulb or a 5 W LED bulb.
- Weight: 15 pounds.
- Using Damp Rated Products Outdoor: Outdoor damp rated fixtures can only be used in covered, fully protected locations that are not directly exposed to water, even during storms. Outdoor Damp Locations include covered patios and covered porches that are fully protected from water, even during storms.
- Wipe clean using a soft, dry cloth.
- Avoid using harsh chemicals and abrasives as they may damage the finish.
- Do not exceed specified wattage.
- Shipping & Returns
UPS can deliver most in-stock items within 3-5 business days.
Next Day Delivery and Processing
We can arrange for next day delivery to most destinations within the contiguous 48 states, for an extra charge of $26.00 per address. If we receive your order by 6pm PT Monday through Friday, you'll receive your order the next business day; orders placed on Friday after 6pm PT through Sunday will arrive on Tuesday. Note: Next Day Delivery service is not available for some oversized items, White Glove Delivery, out of stock items, personalized items or for items shipped directly from the manufacturer.
View the complete Shipping and Delivery Information page.
You can return eligible item(s) within 30 days of receiving an order or 7 days for Quick Ship upholstery items for a refund of the merchandise value. An original receipt or gift receipt is required. Monogrammed items and Made to Order furniture or rugs are not eligible for returns. Review the full list of ineligible items and our refund policy below before starting the process.
Easy Ways to Return:
- Stores - You can return most non-furniture items to your local Pottery Barn store for free.
- Bring to UPS Location (under 70 lbs) – See our full Easy Returns Policy to start the process.
Ineligible Items
Items non-eligible for returns or exchanges:
- Monogrammed items
- Mattresses
- Gift cards
- Made to Order items, including custom rugs and furniture
- Final sale items (with prices ending in $.X7 or $.X9)
- Items damaged through normal wear and tear
Questions? See our full Easy Returns Policy.

subset: commoncrawl


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Europe and the Middle East – eastwest4us
Welcome – Ahlan wa sahlan!
This is the premier newsletter of eastwest4us!
I am very busy preparing the crowdfunding campaign starting on Monday June 4th. Yesterday, we finished the video and I am very excited about it! The result is more likeable and nice than professional film making but we tried our best and hope you will like it too!
Here are my 5 good reasons and I would love you to share yours with us.
See you soon!


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Being a good lover means knowing the gestures and positions specific to sexual intercourse that allow the partner to live an intense pleasure. This is how to become a better lover.
Tips for Him – Pleasure for her
- Learn how to undress her – You must know that the clothes for women and those for men have many similarities, even if you do not believe that. More important, avoid rushing up with the whole undressing thing, at least in the beginning, if you are nervous. As the time passes, you will gain confidence in yourself. Undress her slowly as it is more intense.
- Women count on the foreplay – You'll be sure you will never be wrong if you're starting with a foreplay. Usually, the women need more time to reach the same level of excitement as the men. That's why the foreplay is meant to stimulate her erogenous zones such as neck, ears, hips, buttocks, inner thighs, ending with breasts and genitals.
- Become an expert in cunnilingus – Most women are able to have more orgasms in this way. A woman will be more excited, anxious and prepared for penetration after a oral sex foreplay.
- Be the dominant one in bed if your partner looks reserved, and try to dominate with affection, refinement and diplomacy, and then take initiative.
- Let her 'run the show' – Other women prefer to dominate their partner (who generally love this) to get pleasure. Such women 'run the show' by giving orders, choosing sex positions, and so on. In reality, most couples work on the basis of the alternation of dominant/dominated, which vary depending on circumstances or the couple's history.
- Take care of yourself – Whether you choose for slip or for boxers (each category has its followers), wearing impeccable underwear, without holes or spots, with the elastic in perfect condition is ideal. As for socks, be careful to take them out systematically before honoring your beloved woman.
Tips for her – Pleasure for him
- Discover and excite his erogenous areas – Genital organs are not the only erogenous areas of a man. The anal region, neck, ear, mouth, chest are also part of the areas whose excitement makes them pleasure. But each partner is different. Learn to know the partner's erogenous areas, taking into account his reactions and the words he pronounces during sexual intercourse.
- Be prepared for anything – Most men are very excited about the rich imagination of their partner. Suggest to make love in unusual places or in positions you do not have the habit of practicing. During sexual intercourse, your partner would love you to be bold, kinky, and horny, but to a certain point!
- Practicing massage – A good, well-done massage allows a man who returns home late from work to fully relax. Muscle tension disappear, and the man is more willing to make love. In addition, massage stimulates sensuality and is especially suitable for men who have problems with erection.
- Do striptease – Seeing his woman gracefully stripping awakens even the most sleepy lover! Slow gestures, hilarious movements of hips, buttocks and thighs, sliding clothes, gestures made with the head, cheekbones and mututites will guarantee for a successful sex.
- Wears sexy lingerie – Drop the cotton blankets and start wearing silk panties and or lace lingerie, plus some fine stockings that you can use as handcuffs. The most appreciated colors are black, but also white and red are erotic. Keep beige, green, purple, and yellow sexy lingerie as reserves. Who knows? Maybe your man loves a more colorful lingerie. On short, a sexy lingerie is a great way to turn on your partner.
Article Name
How to Become a Better Lover
Being a good lover means knowing the gestures and positions specific to sexual intercourse that allow the partner to live an intense pleasure. This is how to become a better lover.
Diane Luke
Publisher Name


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Please feel free to get in touch by completing the form below and I will come back to you as soon as I can. I will very much appreciate getting your comments on my books, my website, and its Travel and Culture articles, or just say hello!
Important Note: Your email and messages are sent directly to the Author's mailbox and are kept strictly private and confidential.


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Mon-Thu 3 to 9 | Fri 12 to 10:30 | Sat 12 to 10:30 | Sun 10 to 6.
Last call is usually 30 minutes before closing time.
DO YOU Serve food?
We sure do! Our menu is here. We serve light snacks that pair well with beer, including New Zealand-style meat pies, warm pretzels, charcuterie and cheeses.
DO you take RESERVATIONS?
Sorry, we don't reserve tables in the taproom on Friday, Saturday or Sunday. We operate on a first come-first served basis.
Unlike a restaurant, taproom turnover is relatively rapid which means tables become free quickly. Most customers are friendly and don't mind sharing a table, or even moving to accommodate larger groups if you ask nicely.
Larger groups can reserve space from Monday to Thursday.
You can also book out the entire taproom. Minimum spends may be required, depending on the time and day of the week. Please email us for details!
We began manufacturing on November 21 2018 and opened our taproom on December 8, 2018. Follow along on Facebook, Twitter or Instagram for updates on new beers and events in the taproom!
Where are you located?
Our brewery, taproom and getaway is located at 505 36 Ave SE in Calgary. It's right in the heart of the north Manchester brewery district (an area known as The Barley Belt) and is a short walk from a handful of other breweries, including Banded Peak Brewing, Paddy's Barbecue and Brewery, Born Colorado Brewing and Annex Ale Project.
What sort of beer DO you make?
All sorts! Our beer is designed to be fresh, flavourful, complex and hop-centric. Our general approach is to take the best of classic styles and elevate them through craftsmanship and an uninhibited drive for innovation into something that is one-of-a-kind. See what we are currently pouring in the taproom here.
We will have new beer on tap as often as we can brew it. We will build and rotate our list of seasonal, one-off and barrel-aged beers so there is always a wide range of styles and new offerings available in the market and in our taproom.
Head Brewer Jonas Hurtig is an amazing brewer; you've probably already tried some of his creations from his time at Wild Rose Brewery. You won't be disappointed with his craftsmanship.
DO you do growler fills?
Does a bear spit in the woods? Growlers are a great way for you to take brewery-fresh beer away to share (or not). We will be set up to have your glassware filled and out the door with our latest beer every time you visit. Ask your server what beer is available for growler fills.
Will I be able to bring my own growler?
Sure! Just make sure it's clean. A dirty growler can ruin a beer almost instantly. You will be able to buy Cabin glassware and stainless growlers in the taproom too.
It's really simple. When you've finished your beer, triple rinse your growler with hot water. Make sure your tap water is nice and hot, then fill, swirl and rinse your growler. Allow your growler to sit upside down and air dry completely. A wet growler will grow bacteria in it - a dry growler will not. Finally, leave the cap off and allow air to circulate to reduce the chances of bacterial growth.
We'll check your growler when you bring it in and make sure it is clean. We will not pour our beer into a dirty growler. If we have time, we'll try and clean it for you, but if it is heavily soiled it may be time to kiss your funky friend goodbye and get a new one.
Our seasonal patio is open whenever the weather cooperates! We have eight picnic tables, shade, all-day sun and room for 40 people.
Can I bring my dog to the taproom?
We're dog owners and dog lovers, but the terms of our lease prohibit all animals - so that means you have to leave your cat, parrot and snake at home with Rover too, sorry. This includes the patio area.
Can I bring my kid to the taproom?
We have five kids between us, so we're used to having little ones around. Well-behaved children are welcome, as long as they are with an adult or guardian (who have to be well-behaved too...). We have Lego, kids snacks, high chairs and a change table to make your visit as easy and relaxed as possible.
what's with the brown rainbow graphics?
Our brand work was done by local design superstars Daughter Creative. The focus is on reinterpreting those nostalgic patterns that show up at every old-school cabin - deckchair weave (guaranteed to leave marks on your legs), the ubiquitous green garden hose, and, of course, that groovy brown rainbow.
I have a question - how can i get an answer?
Please, get in touch! We'd love to hear from you. You can email us at email@example.com, phone 403 244 3331 or connect through our Facebook, Twitter or Instagram accounts. And of course, once the brewery is open, we'd love for you to come in, grab a beer, and ask all the questions you want.
How can I learn more about Cabin?
Apart from exploring our website and following us on Facebook, Twitter or Instagram, you can sign up for our email newsletters. This is the best way to stay current on news, product releases and our opening date.


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Alta Commercial Core
The Commercial Core Plan for the Town of Alta is a study intended to clarify and establish an identifiable town center in this alpine environment. Alta is situated within the Wasatch Mountain Range at an elevation of 9,000 feet and is one of the highest elevations of any town in the United States. The pristine mountain setting is known as a summer hiking destination and internationally renowned as a ski destination, with the town receiving an annual average of over 500 inches of snow. The site for this resort project is located along a portion of the SR-210 Highway that wanders through the center of the town linking the ski resorts, lodges, and residential and commercial areas. Much of this portion of the roadway is undeveloped as the slopes above are subject to high avalanche and rock-fall risk. The architectural form and site layout were developed as a response to this risk. The prime consultant was Landmark Design with architectural design by Sparano + Mooney Architecture and renderings by Sparano + Mooney Architecture and Bowen Studio.


text: If you want to send me a private message, just make a comment below, or on one of the posts. I'll read it, and take note. Please indicate whether you want your message published or deleted. I will respect your confidentiality, if you specifically request it. Otherwise, the publishing of comments will remain at my discretion.


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|Three-frame honey extractor
The extractor is made of PE tub and inner basket, which is made of stainless-steel. Beneath the tub is metal stand above the tub is metal gear holder and transparent lid.
All metal parts are protected against corrosion. The extractor may be hand- or motor-geared.
We offer hand gear in two varieties:
Motor gear enables turning left and right. Power of the motor: 80 W. Motor is adjusted to alernating current 220 V.
These extractors are suitable for extracting honey from AZ and LR (some other as well) frames. Grid measures: 450 x 280 mm
All materials implemented in construction, which come into contact with honey, are approved in food production.
|Technical data:
tree-frames extractor | four-frames extractor | five-frames extractor
Domov | Vizitka | Pošta | Naročilo | Slovensko | Deutch


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Folk, Rock, Punk
Stephen Kuc - Guitars, Vocals, Keyboard, Bass Guitar, Harmonica & Percussion
Stephen Kuc is a singer-songwriter, who loves the art of collaborating and writing music .
Stephen has be writing music for about a decade as a hobby and is ready to show the world what he's been working on. His influences of classic rock, folk, and punk rock, among others, seep through his tunes. Intricate yet also melodic guitars and piano sometimes play a complimentary role to his vocal melodies and honest lyrics, and, if not, they're taking a lead role. The songs are simple at heart, yet they have all have a complex soul. After spending some time recording a few of his most recently written, he's going to be releasing a few here on Panoptic Sounds. Keep checking in here to see when the next song will be released!
Tom Petty, Bruce Springsteen, The Gaslight Anthem/Brian Fallon, Frank Turner, NOFX, Oasis, Neil Young, Bob Dylan, RHCP, The Killers, Led Zeppelin, The Beatles, The Byrds, The Strokes


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Rating: NNNNN
VIDEO VAUDEVILLE collects a whole welter of short films and tapes for the Bloor Cinema's monthly series. Wednesday night's all-Canadian program was selected by Scott McLaren, the fertile mind behind the On The Fly festival of videos-in-a-hurry. Many of the night's works showed at Winnipeg's Local Heroes festival, so there's a strong dose of Canuck irony. Gary Burns (Kitchen Party, The Suburbanators) contributes Fuck Coke, which offers a way to fight corporate branding with only a shoelace and a healthy appetite. But some of the best pieces in the program find a stronger punch through sincerity. Rick Palidor's Cal marries a reeling celtic song with the changing landscape of a baby's face. And in Mommy, There's A Monster In My Bed, directors Martine Fortin and Guy Bounneau paint an absolutely masterful portrait of a young girl's inner life. It's a picture of desire and disgust in the bosom of one family. NNNN (Bloor, June 28)


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What was the problem?
Antiretroviral therapy (ART) services are often provided in standard, yet inefficient ways, making long-term it difficult for patients to stay on treatment long-term. Differentiated Models of Care (DMOC) reduce the cost for patients to stay on ART, can provide tailored ART support, reduce congestion in ART facilities and provide the foundation for patient-centered chronic disease wellness systems.
Providing ART services in the local community reduces congestion in distant health facilities and improves retention as stable clients do not have to come to health facilities collect their drugs.
What is the solution?
The PEPFAR-supported Centers for Infectious Disease Research in Zambia (CIDRZ) has developed and is implementing Community-based Adherence Groups (CAGs). CAGs provide routine ART management to patients, decongest high-volume facilities, and minimize difficulties in accessing ART sites. Groups are self-forming, and patients are allowed to join the groups they are comfortable with. The groups develop and maintain a feedback system with the health facility through community health workers. Patients must also follow an agreed code of conduct. Members take turns visiting the health facility to collect a three-month supply of medications for all group members. They also complete a routine clinical exam during the visit.
Currently, CIDRZ runs 856 CAGs at 21 facilities across 5 Districts in the Lusaka, Eastern, and Southern Provinces of Zambia.
What was the impact?
CAGs show high linkage to treatment: through CAGs, 4,375 people were tested for HIV through CAG index testing in fiscal year 2016. Of those, 540 (12 percent) tested positive. 100 percent of these clients were linked to treatment. CIDRZ will restart index tracing and partner notification through CAGs in fiscal year 2018. Given the larger scale, CIDRZ will aim to link at least 90 percent of all clients who test positive to treatment. Linkage to care and treatment is easier through CAGs as clients have established relationships with volunteers and it is easier to follow up with HIV-positive clients.
Clients who participate in CAGs are also more likely to stay on treatment. ART retention is 97 percent compared to 76 percent among patients at health facilities. Local medication collection community at a time convenient to the patients has resulted in high patient satisfaction.
Service providers and clients at health facilities also see benefits through reduced waiting times and lower congestion at ART clinics. Providers perceived a lower in burden of care and are advocating for wider use of differentiated care programs, such as CAGs.
How does it work?
Starting a community-based adherence group (CAG)
At health facilities, all patients receive health education as they wait to see clinicians for routine visits. Those willing to join a CAG are screened for eligibility during their appointment. Stable patients who have been on ART for at least 6 months may participate in the program. They should not have any active OIs and should have a CD4 of >200 and viral load of <1000. These should be ≥ 15 years. Clinicians refer eligible patients to community health workers who explain the model in detail. They help patients identify other potential group members to screen for eligibility.
Once an individual group has been formed, the CAG is assigned a community health worker who sets up a meeting at the facility to define group norms, review the Code of Conduct, sign consent forms, and share contact information. CAGs may be formed for specific population groups such as adolescents, couples, or any other demographics which patients may be comfortable with. Those who do not know other potential group members are grouped with patients from the same catchment area.
At one of the original pilot sites, Chilenje First Level Hospital in Lusaka, some CAGs included unstable clients. Stable clients may provide psychosocial support to unstable clients, resulting in improved adherence. Unstable clients also receive support from a dedicated, multidisciplinary clinical team at the facility trained to work with patients with complicated diseases. Viral load tests are given every 3 months to look for improved viral load suppression in unstable clients.
Making treatment more accessible
The Ministry of Health is engaged in selecting sites and is actively involved in the roll out plan of CAGs. Patients participating in CAGs meet routinely in the community to discuss adherence issues and to offer each other psychosocial support.
CIDRZ provides multiple-months drug dispensing for each of the patients participating in the CAGs. Each CAG has six patients who take turns visiting the ART clinic for consultations and ARV drug collection. During the clinic visit, the patient will receive the scheduled clinical consultation and will collect a 3-month supply for each of the CAG members. When they get back, the patient gives the rest of the CAG members their ARVs at a CAG meeting. Each patient has two clinical visits a year and goes to the clinic for the appointment even if it is not their turn to collect medications.
Each CAG is assigned a community health worker who provides basic psychosocial and clinical support to the CAG members. Community health workers interact with patients during routine clinical visits and during each CAG meeting as patients share drugs with each other in the community. If a CAG member is unwell and needs clinical attention, they self-refer or are referred back to the clinic by the community health worker. The CAG members also provide peer support to each other. Due to the psychosocial and peer support, member satisfaction has been very high.
In addition to ARV drug dispensing, adherence and psychosocial support, CAGs are also used as entry points for index testing. Through index testing children of group members, spouses and other sexual partners, through partner notification, are tested for HIV and linked to treatment.
When a group is first formed, group members will receive one month's supply of drugs. Groups must be monitored to ensure each member collects drugs when required and there are no conflicts or any issues between members that will affect participation in the CAG. Once the group is stable, they graduate to multi-month dispensing.
Increasing health systems efficiency
CIDRZ worked closely with the Ministry of Health to ensure the various concepts of the innovation were understood before implementation and scale-up. CIDRZ targeted high-volume sites and oriented facility staff on how to use the model. Ongoing mentorship and support is offered routinely to implementing facilities to ensure success. This innovation must not be seen as an implementing partner initiative, but as a Ministry of Health initiative that will result in better retention among clients and decongestion of health facilities leading to improved quality of care.
Community ART clubs not only reduce the burden placed on clinics but also result in improved retention, medication adherence and reduced drug resistance cases as patients are better able to fit the management of HIV around their home and work lives. The HIV-related stigma and discrimination can be reduced with CAGs, as PLHIV are no longer only considered as ill patients.
The CAG model reduces the workload of the health staff, freeing up more time to attend complicated cases. CAG model also decongests the clinic as more clients are accessing treatment outside the facility. Clinicians have better access to patients' information regarding pill adherence, wellbeing, and treatment outcomes through a direct feedback loop between group members and healthcare workers
Discussions are underway with Ministry of Health for adoption of the model as standard of care. It is hoped that this innovation will be treated as one of the models of care nationally with financial allocation from the Ministry of Health to support the model implementation.
Identifying and working with advocates
CAGs enable patients to be more involved in the management of their health through active participation and access to ART treatment. In rural areas, the initiative has been supported by the traditional leadership. Through Senior Community Advisors, meetings have been held with chiefs and headmen who provide support of the initiative, ensuring members of the community buy in to the intervention and participate fully.
In some rural areas, villages can be up to 60 kilometers from health facilities. CAGs have lessened the number of times participants have to travel to health facilities thereby improving patients' satisfaction and adherence to treatment. CAGs also reduce patients' travel costs to access treatment. In urban areas, this required advocacy from Neighborhood Health Committees, which still have considerable influence in communities on city outskirts, as well as advocacy and support by facility staff and volunteers, as they drive the intervention at facility-level.
The Ministry of Health is critical to establishing support at the national level. A focal point person focusing on differentiated service delivery is now in place at the Ministry of Health and the 2018 National Guidelines have been revised to include differentiated services delivery (DSD) interventions.
What's Next?
In the 2018 Zambia Ministry of Health Consolidated ART Guidelines, differentiated models of care have been included as an approach for service delivery. Successful pilot implementation of DSD has enabled the stakeholders to advocate for scale-up in other facilities focusing especially on high-volume sites. The CAG model is seen as an avenue for reaching out to untested people living with HIV by involving patients in the groups as indexes and role models.
Currently, there is a DSD Task Force, which is led by the Ministry of Health through a DSD Focal Point Person. This Task Force develops policy as well as guidelines on DSD and provides oversight for implementation at the Ministry of Health level.
The pilot phase of the model commenced in April 2016 and approval to implement at scale was granted by the Ministry of Health in March 2017. CIDRZ is scaling up the model in all Lusaka high volume sites in quarter 1 of FY 2018, (October to December 2017), and to high volume sites in Western, Southern and Eastern Provinces in quarter 2 of FY 2018 (January to March 2018).


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Welcome to my Tuttle View Dine and Decorate event where I have selected some of my favorites to share with you based on what I think you'd like to see. There's a broad range of items featuring Hester & Cook as being one of my absolute favorite artisans. But I don't want to spoil the fun...there's more to learn and see once you click through.
Join my event here. You'll need the password that was provided in the email.
Thanks for shopping with me!


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For the first time since a weekend confrontation with a large group of motorcyclists led to the beating of the driver of a sport utility vehicle, the wife of the driver publicly addressed the episode on Thursday, saying she and her husband were terrified when a crowd surrounded their vehicle after it struck one of the riders.
A "mob of reckless and violent motorcyclists," put the family in peril, the wife, Rosalyn Ng, said in a written statement issued by lawyers representing Ms. Ng and her husband, Alexian Lien, 33.
When the couple tried to flee, their car plowed through the crowd, injuring another motorcyclist far more seriously, and setting off the high-speed chase up the Henry Hudson Parkway.
"Our fear for our lives was confirmed when the incident ended with the ruthless and brutal attack on my husband," Ms. Ng's statement said.
The bikers were among hundreds of motorcyclists who had descended on New York City on Sunday for a planned but unauthorized ride that was disrupted by the police and never came together.
In her statement, she said the family's "sympathies go out to the injured motorcyclist and his family." But she said that she and her husband, with their 2-year-old daughter in the car, acted reasonably.
"We believe that anyone faced with this sort of grave danger would have taken the same course of action in order to protect their family," she said.
The statement broke days of silence by the people at the center of a spectacle that has riveted the city since a video surfaced showing the initial collision and subsequent chase. The couple has stayed out of sight, ignoring requests for interviews and avoiding the clutch of reporters that was camped outside their Lower Manhattan apartment building.
But even as the investigation into the high-speed affray on Sunday has slowed to a more grinding pace, the public relations maneuvering has been heating up. As lawyers for Ms. Ng and Mr. Lien were issuing the statement on Thursday, the family of the seriously injured motorcyclist was reported to have retained the celebrity lawyer Gloria Allred. (Ms. Allred, on a flight to New York from Los Angeles on Thursday, was not immediately available for comment.)
Earlier in the week, the family of the injured motorcyclist, Edwin Mieses, 32, released photos of him in a New York hospital bed. He remained in critical condition on Thursday, a hospital representative said. Both of his legs were broken and he may be left paralyzed, the family said.
After the chase, the video, captured by the helmet-camera of one of the motorcyclists, was posted online. The confrontation became national news, and touched off a debate online and elsewhere over who was at fault. After the chase on the highway, a group of the motorcyclists caught up with the Range Rover in Washington Heights. The police said riders pulled him from his car and assaulted him. That portion of the confrontation was not on the video.
The police arrested two of the motorcyclists, including the one, Christopher Cruz, 28, whose collision with the vehicle escalated the confrontation. But the Manhattan district attorney declined to begin prosecution of a second motorcyclist who was arrested. Prosecutors suggested that with the investigation continuing, the man's arrest had been premature.
Mr. Lien, who sustained cuts to his face and bruising, has not been charged.


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How To Build Your Brand, Grow Your Business, Get More Leads And Get More Sales!
People love watching videos - they watch videos to be entertained, watch tutorials, research, music and share their own video as well. That's why YouTube has become the #2 most used Search Engine on the internet and the #3 most visited website.
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The Kansas Department for Aging and Disability Services (KDADS) has recognized 14 adult care homes in Kansas for their achievements in providing and sustaining person-centered care
Monthly Archives: August 2017
4 Ways to Donate to Charity Without Writing a Check
These ideas can help you de-clutter your home and earn a tax write-off
By Ashley Eneriz for Next AvenueWhen it comes to donating to charity, sometimes our budgets don't allow us to be as generous as we we'd like. But you needn't always open your wallet to help others. Here are four ways to give back that don't involve writing a check or
Breaking Down Walls Between Medicine and Personal Care
Lack of communication results in waste and health risks, but other models show promise
By Howard Gleckman for Next Avenue(Next Avenue invited all our 2016 Influencers in Aging to write essays about the one thing they would like to change about aging in America. This is one of the essays.)
Imagine an 85-year-old woman who suffers from heart failure, arthritis and
Caffeinated or Not, Coffee May Help You Live Longer
New research provides more good news for those who love their java
By Rita Rubin for Next AvenueTwo recent large studies suggest it might have been coffee that bubbled from the fountain of youth.
Both studies, one conducted in the United States, one across 10 European countries, found that people who drank even a single cup of coffee a day
Help for Pets of Dying Owners Brings Peace of Mind
For many ailing people, their pet is their life, experts say
By Kim Painter for Next AvenueRoland Carter, 78, of Stafford, Va., has advanced chronic obstructive pulmonary disease, suffers from dementia and spends most of his time in bed. Missy, one of his four dogs, usually is there with him.
"Missy stays on his bed all the time —
Should You Move to Be Closer to Your Aging Parents?
Long-distance caregiving is tough, but moving to be near parents is a big step
By Deb Hipp for Next AvenueSara Tapscott won't ever forget the day an employee at her aging parents' assisted living center knocked on their apartment door and told them they'd have to move. Their needs had become too great for the staff to accommodate.
The VA Program That Pays for Long-Term Care for Vets
This little-known benefit can be a help, but expect red tape
By Richard Eisenberg for Next Avenue
Here's a frightening statistic from the just-released United States of Aging survey: Only 3 percent of professionals
The Amazing Technology That Could Change How We Age
Experts say it will make life happier, healthier and easier for older adults and caregivers
By Suzanne Gerber for Next AvenuePop quiz: When you think about how technology will personally impact your life over the next 10 to 20 years, which of these things do you envision as being part of that evolution?:
- Holographic technology to communicate with your family
- A car that chauffeurs you around
- 3-D-printed medicine
- Drones to help with household activities
- All of the above
If the tech-prognosticators are to be believed, the correct answer
What's Better for You: Butter or Margarine? Red Wine or White?
Here's the latest research on smart food choices as we age
By Maureen Callahan for Next AvenueIn the world of nutrition, certain debates seem to ping pong back and forth. Like the issue of butter vs. margarine. Or the battle between coffee and tea. It all starts when a new study comes along that seems


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Love this Hanoi cafe! The materiality of the space is brilliant and it has an aquaponics farm in it. This has given me a more solid idea of how more permanent new features built into and around the ruins may be formed, in contrast to the delicate touch where elements navigate the ruins elsewhere.… Continue reading Precedent | Koi Cafe in Hanoi | Farming Architects
Tag: cultural context
Precedent | Sichuan province homes | Rural Urban Framework
Cultivating Participation: Creating a Modern Pairidaeza
C6 Cultural Context - Project Related Report for my Winchester Horticultural City Head Quarters project. Uploaded to issuu. Hopefully the link works... https://issuu.com/timothyphilipgentry/docs/c6_cultural_context_project_related/2
Precedent | Gando School Library by Francis Kéré
Precedent | Brockholes Visitor Centre by Adam Kahn Architects
Extract from the draft of my project-related cultural context report - word count was too large so had to delete it from the final export (images via e-architecture using this link here) Located at Brockholes Nature Reserve just off of the M6 at Junction 31, it is a floating structure built on-top of a deep… Continue reading Precedent | Brockholes Visitor Centre by Adam Kahn Architects
Precedent | Neues Museum by David Chipperfield Architects with Julian Harrap
Extract from my project-related cultural context report (David Chipperfield Architects images seen on their website using this link): The Neues Museum in Berlin illustrates how a variety of conservation processes may be employed harmoniously to complement each other where a variety of different conditions exist on the same site. It has been 'conserved, rehabilitated, reconstructed and… Continue reading Precedent | Neues Museum by David Chipperfield Architects with Julian Harrap
Precedent | Hedmark Museum by Sverre Fehn
Extract from my project-related cultural context report (images from the Architecture Norway website via this link): A couple of parallels can be drawn between the brief and the work of Norwegian architect Sverre Fehn. First and foremost, his general working methodology shares a common thread with the project as he adopts narratives to guide the… Continue reading Precedent | Hedmark Museum by Sverre Fehn


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Senior Member
Posts: 1,626
All Newcomers
To any newcomer,
Don't let people scare you into not taking a lifesaving medication for as long as you need it. Studies are clear, longer treatments are more successful than shorter ones.1,2 Of course, if you can accomplish abstinence with less medication in a shorter time, all the better, or if you can do it without medication assistance, better yet…most people cannot. Most overdose deaths occur during a relapse just after a period of abstinence. Discontinuing an effective treatment for no reason other than rumor and in defiance of the scientific evidence is placing yourself in a life risking situation. Ignoring science and deciding what medications we should take and for how long is how many of us got into trouble in the first place. Please learn about the treatment so the facts will help guide you and find a doctor who cares for your wellbeing that you won't have to second guess.
When prescribed appropriately (to people significantly physically dependent on opioids) buprenorphine has been shown to NOT increase your tolerance, that means you don't need more as time goes on, that means you are NOT becoming more physically dependent on it, that means it is not physically harder to discontinue whether you are on it 3 years or 3 months.
Some people on this board were administered buprenorphine inappropriately; their level of physical dependence did not warrant a full maintenance dose and hence became more dependent than they originally were. Although bupe has shown a milder withdrawal syndrome than other opioids it would appear significant to anyone who has not experienced a true full opioid agonist withdrawal syndrome.
Suboxone maintenance is for people who without it would relapse and put their life at risk. If relapse can be avoided through 12 step, or counseling sub maintenance is not necessary. For those of us who have tried the alternatives and were unsuccessful Sub has become a lifesaver and I for one will welcome any withdrawal I go through when I taper because I know I, like some of my friends, would be dead had I not found Suboxone and a good doctor.
[u]Common misconceptions:
You don't feel any effect from buprenorphine:
Buprenorphine was deigned to give a limited opioid effect. The intensity of this effect varies from person to person, based on genetic makeup of the brain. Bupe was made this way to keep people in treatment. Before Bupe Naltrexone, an opioid blocker, was another treatment. It worked well and blocked virtually all opioids but the cravings were still there and any lingering withdrawal remained. This made for poor compliance and a high relapse rate. Bupe with enough agonist effect to stop cravings and withdrawal helps people stay in treatment long enough develop the tools they need to transition to a permanent addiction free life.
There is no withdrawal from bupe:
I don't know where this one started because ALL of the literature and ALL of the studies show that there is indeed withdrawal. They also show that the withdrawal symptoms observed are mild in comparison to withdrawal from a full agonist. If a person has not experienced withdrawal from a full agonist it would be impossible for them to compare the two. Furthermore milder" is a very subjective term what's mild for one person might be severe to some more sensitive.
Bupe post acute withdrawal lasts longer than other opioids and is more severe:
There are few studies as to long-term post bupe treatment. Partly because there is little reason to study it. All of the science points to a milder withdrawal profile and suggests that any long-term post treatment withdrawal would also be milder. It clearly states in the literature that due to the slow disassociation rate of bupe the acute withdrawal will come on slower and last longer, but be milder". So why then do some people think the science is wrong? Here's why, The brain is changed by addiction to full agonist opioids. It can take many months for the brain to return to a pre-addiction status. During this period symptoms of fatigue, cravings, hypersensitivity to pain will be experienced, and has been experienced long before bupe was invented. If someone with these brain changes took buprenorphine for say 30 days and tapered off they would still feel the effects of the changes to the brain caused by the original addiction, but many blame these symptoms on the bupe. In reality they would have them whether they took the bupe or not. When administered properly people do not become more physically dependent on bupe, they may not be less dependent either. So regardless of how long they are on it the changes to the brain are still there. It is thought that a slow gradual taper will allow the brain to slowly adapt to life without an opioid supplement.
Shorter treatments are better:
Short term treatments are better only if they work. Of course if someone can remain addiction free without ANY medication that's preferable. However many cannot. If they can do it with a 7 day or 30 day medical assisted withdrawal, that's great too. The fact is that most of the people that attempt these methods relapse. For the ones that don't fantastic, for the others a longer term treatment is necessary and preferable to repeat short term failure. The studies are clear longer term, treatments have a much higher success rate than shorter ones. Does mean everyone should do long term treatment? Of course not, it's an individual thing, if short term is unsuccessful then longer term is a wise progression and preferable to relapse.
Finally let's put all of this into context:
The serious condition of opioid addiction should not be underestimated. Treatment is often a life or death decision. If non-medical treatments have been unsuccessful, then medical treatment should be considered. Comfort of post treatment withdrawal should play little role in the decision to administer a lifesaving treatment.
I'll close with this one thought. Please learn as many facts as you can so you can better determine what your unique personal experience will be, and what treatment and treatment duration is best for you. There is plenty of information on this site and links to many more sites to help you learn the truth. Best of luck.
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Thank You (01-25-2009)
Senior Member
Posts: 2,760
Great Idea Suture!!! Hopefully all visitors will see this topic and read it first. It only takes one bad apple to spoil the whole bunch. This is not a place for anti-sub people to post. This wonderful idea by Suter Should be a topic where newbees can recieve the encouragement they need and deserve. Suboxone is a wonderful medication that has saved many lives, including mine.
TIM,,NANCY I hope you will delete any negative posts on this topic.
Again great idea sut. Talk about ticky s
Senior Member
Posts: 4,632
Good idea,
Also if you are new to the site be sure to read this topic if you have not already: http://naabt.org/forum/topic.asp?TOPIC_ID=169
Senior Member
Posts: 624
GREAT topic, Suture.
Bottom line is that the best treatment is whatever works best for the individual. If that involves withdrawal and support groups, that's fine. If that involves a short-term course of suboxone that's fine. If that involves longer-term suboxone with the intent to discontinue use after a certain period of time, that's fine. If that involves life-long suboxone, that's fine too.
The good news is that there ARE options now, whereas not too long ago there weren't. I would encourage any newcomer to read a lot of literature about the different methods of treatment and recovery, ask a lot of questions, and to be an advocate for themselves in ascertaining what they need and not being afraid to ask for it.
Senior Member
Posts: 183
As I have reported elsewhere on this board, my experience with bupe withdrawal is that the acute symptoms were indeed milder than what I experienced in previous withdrawals from "full opiod agonists". However, the post-acute symptoms dragged on for much longer than I experienced with full agonists. It was as if the typical fourth day of hydro withdrawal dragged on for at least a month and a half.
Bupe is a good choice for many people. But you don't do them any favors by misleading them about the implications of that choice.
I find particularly onerous this contention that those of us who complain about how truly crappy it was to withdraw from bupe only think that because we never experienced true withdrawal. That's ludicrous and only serves to discredit you.
-- Guts
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Thank You (11-12-2013)
Senior Member
Posts: 1,626
Don't get sucked into arguments of opinion. Learn the facts yourself so people with selfish needs to validate their experiences don't perpetuate misinformation. A good place to start is the TIP-40. It is a referenced clinical guide and explains very thoroughly the pharmacology and the clinical use of buprenorphine. On page 20:…The preponderance of research evidence and clinical experience, however, indicates that opioid maintenance treatments have a much higher likelihood of long -term success than do any forms of withdrawal treatment…"
"Patients were able to terminate buprenoprhine treatment more comfortably than methadone treatment because of buprenorphine's milder withdrawal effects." Practical Considerations for the Clinical use of Buprenorphine.Science & Practice Perspectives. August 2004. Page 4, column 1 http://www.drugabuse.gov/PDF/Perspec...-Practical.pdf (paragraph 2.)
"…it produces less stimulation and physical dependence than full agonist medications,…" Opening the Door to Mainstream Medical Treatment of Drug Addiction.Glen R. Hanson, Ph.D., D.D.S., NIDA Acting Director, NIDA Research Findings, Column 2, paragraph 3 Volume 17, Number 5. January 2003. http://www.nida.nih.gov/PDF/NNCollections/NNHeroin.pdf
"…the withdrawal syndrome upon discontinuation of buprenorphine is, at worst, mild to moderate and often can be managed without administering narcotics." Advocacy News from ASAM: Buprenorphine Legislation Hailed as Treatment Breakthrough (patient resources.)
"Buprenorphine is considered to have less risk for causing psychological and or physical dependence than the drugs in Schedule II such as morphine, oxycodone, fentanyl, or methadone." Subutex and Suboxone Approved to Treat Opiate Depedence. FDA Talk Paper. October 8, 2002.
http://www.fda.gov/bbs/topics/ANSWER.../ANS01165.html (paragraph 4.)
"This medication is different from methadone in that it offers less risk of addiction and can be dispensed in the privacy of a doctor's office." http://www.oxycontin-help.com/web_li...n%20Treatment/ (Treatment/paragraph 5.)
"…buprenorphine is much easier and better tolerated than the withdrawal experienced with opioid agonists. Although buprenorphine could be tapered in 3-4 days…"Outpatient Buprenorphine Treatment for Opioid Addiction. John E. Franklin, MD, MSc(paragraph 1.)
"However, degree of physical dependence is less than that produced by full agonist opioids. This means withdrawal syndrome should be less severe for buprenorphine."Use of Buprenorphine in the Pharmacologic Management of Opioid Dependence A Curriculum for Physicians. January 2001, by Eric C. Strain, MD, Editor and Jeanne G. Trumble, MSW, Project Director. Development of the curriculum was supported by the: Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration US Department of Health and Human Services. http://www.buprenorphine.samhsa.gov/...Curriculum.pdf (pages 3-44.)
Withdrawal is subjective what is very difficult for one person might be a breeze for another, some people are just more sensitive. Learn the facts and do what's best for you. Wishing you success with your recovery.
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Thank You (01-25-2009)
Senior Member
Posts: 2,425
One thing I've noticed over and over, the people who have been treated appropriately with bupe, like myself, mostly report positive experiences and are happy and grateful that they have their lives back. The people who were treated inappropriately or had unrealistic expectation had bad experiences and are angry. There is another trend, the people who have taken the time to educate themselves before treatment have a much better time with it. None of the Suboxone studies show 100% anything, that means there is always someone happy with the treatment and others unhappy. Why the unhappy people feel the need to augue with the people who were successful is beyond me. OK if it didn't work for you, go to methadone, or rapid detox, or back to your DOC if bupe is so bad.
I have been off bupe for over a year now after being on it for 3 years. I did a long taper and had mild withdrawal at the end. Mild in comparison to a heroin detox which is very subjective. I had trouble sleeping for a couple of weeks, aches and pains, some depression and cravings, everyday got better and after a month I was fine. Never missed a day of work. In comparison when I quit heroin I was curled up in the fetal position puking on myself, crying, cramps, and wishing I was dead…big difference certainly mild in comparison. I really can't compare 30 days out for each because I could never make it that long with H because the long term withdrawal symptoms were so intense.
Guts complained people are misinformed about the intensity of the withdrawal,
Newcomers, please educate yourselves!! You need to determine what is right for YOU! Personal accounts are interesting but they don't tell you what is likely to happen to YOU, there are just too many variables. This will be a better board if we ignore rude people who's only interest is to disrupt.
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Thank You (01-25-2009)
Senior Member
Posts: 1,553
Like any treatment this treatment is not for everyone. To avoid becoming one of the angry people who come to this board to attack the people who have successfully rebuilt their lives with effective buprenorphine treatment and want to spread awareness of this treatment, please learn as much as you can about it. Learn the good and the bad, read the science and listen to the individual experiences, but weigh them accordingly. Then discuss it with a knowledgeable healthcare provider.
Addiction is complicated and although science has come a long way there are still things that are not understood. There are many variables to consider, drug of choice, dose, length of addiction, brain chemistry, triggers, environment, genetic predisposition, coexisting mental illness, coexisting physical problems, and many other factors will all affect your individual treatment.
Here's a great article. It's somewhat technical but explains the processes of addiction and will give you an idea of what science knows and doesn't know about addiction:
Often addiction treatment is a life saving decision, get the facts and don't let anger or rumor influence a decision that could not only save your life, but restore the quality of life that has been missing for so long. I wish all of you the same success with your recovery that I had whatever path you take.
Senior Member
Posts: 1,626
Here's a reprint of something I wrote a while back. It is representative of the type of advice people give here. I hope you will see the non-bias content and the emphasis on education. Had some of the unhappy people who complain about this board took this advice they may not have had such a bad expirience. I hope some of you find it helpful.
Answer to Is Less More"
The correct dose, as stated in the dosing guide, "..is the lowest dose that reduces cravings, eliminates withdrawal and prevents the patients from continuing other opioid drug use..."
That said the correct dose for an individual could be <1mg/day or >32mgs./day. Everyone is different. Not only do they have different brain make up, but two people with exactly the same addiction history may require different doses. There are many unknown factors that contribute to what the correct dose is for an individual.
The dose may change over time, up or down. A patient that needed 16mgs./day for the first month of treatment may only require 10mgs. a month later. Since people do not develop further tolerance to buprenorphine the dose will not continue to go up in response to taking it longer.
Because of the ceiling effect there are diminishing returns on doses above the ceiling which is thought to be 12-16mgs for most people (but could be more or less for others) so doses above 32mgs have little added effect for most. Patients who still have cravings and withdrawal at 32mgs/day may not be appropriate patients for buprenorphine because it cannot deliver enough agonist effect for them. This has been the case in some heavy long term heroin and methadone users.
Besides the typical side effects, constipation, headache, insomnia,loss or gain of energy, there appears to be little consequence to favoring dosing on the high side. Inadequate dosing however, may not suppress cravings and could prompt a relapse, a potentially life risking event.
The progress of the psychosocial treatment accompanying therapy should be considered before changing dose. Patients that need to make many changes and adjustments in their lives may benefit from a stable dose, so they can work on the other aspects of their addiction treatment without the stress and distraction of changing dose.
The correct dose is very individualized. It depends not only on the unique physical characteristics, but on the psychosocial state as well. Fortunately, it's thought that patients do not develop further tolerance to buprenorphine, once stabilized, one will not become more physically dependent as time goes on. Remaining on a higher than necessary dose, will not have a significant down side. (except for the financial cost of the unnecessary portion) Reducing your dose can be stressful and may cause anxiety and fear of the unknown. Be sure to be prepared psychologically before reducing your dose.
Lastly, people with limited dependencies on opioids should be very cautious before starting buprenorphine treatment. Although there is a ceiling effect, and it is a partial agonist, people do become physically dependent on buprenorphine. Normally this level of dependence is below the level of dependence of the original addiction. But for anyone opioid naive or with a very limited dependence 16mgs of buprenorphine could be a higher level of dependence than they originally had. For those people a short low dose detox with bupe might be a wise first step.
…The preponderance of research evidence and clinical experience, however, indicates that opioid maintenance treatments have a much higher likelihood of long-term success than do any forms of withdrawal treatment…."
http://naabt.org/links/TIP_40_PDF.pdf (page 20) pdf page 26
Practical Considerations for the Clinical Use of Buprenorphine
Science & Practice perspectives -- August 2004
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Thank You (01-25-2009)
Senior Member
Posts: 131
HI guys...
I just wanted to say I am a newcomer and am finding you all quite amusing.
The computer is a fabulous way to get a true mix of how people REALLY feel. LMAO.... It's that "NO PLEASE tell me how you TRULY feel." I also belong to a board of parents of children with Down's syndrome and you wouldn't BELIEVE how engaging some posts can be. Fortunately I am able to pick what I can out of each post and see each side of the story. I am trying to get on sub now. It's tough finding a doctor. even here in l.a. Whoulda thunk???? I'm on meth maintenance now only since jan 17th but its just not working out to well for me at the moment. My husband is waiting for a liver and heart valve transplant(his 3rd heart valve) and the meds he has are waaaaaaaay too tempting . The docs are giving him every kind of pain med in town and me???? well they are great but having em in my face is far too tempting. Even knowing thry are in the house is too much for me. Oxys ms contins all of em. I think sub is for me and am going to try really hard to get a doc this week. Wish me luck and don't worry about the controversy it happens evcerywhere hopefully people who come here are smart enough to know to make up their own minds. Thanks for listening Steff
Senior Member
Posts: 2,425
Welcome Steff,
How much meth are you on? You may already know the transition form meth to bupe can be tricky, be sure you are in withdrawal before you take any sub, and once you do be sure your doctor is willing to give you enough to stop the withdrawal.
What is Precipitated withdrawal? http://naabt.org/faq_answers.cfm#70
SAMHSA updates the list of certified docs every Sunday night. So there might be new ones added. http://naabt.org/patient_dr_connection.cfm
Good luck.
Senior Member
Posts: 131
thanks so much....... ((HUGS))) Steff
Senior Member
Posts: 474
Subs PERFECT for people like yourself. If you have a MAJOR habit then Suboxone is probably the BEST option out there. I believe what Elbow is trying to get across is the way some people try to turn Sub into a magical drug thats like Candycanes and Lollipops. When the fact of the matter is that for many people with "nickel and dime" habits the LAST thing they should try is Suboxone. Well next to last, it comes in just behind the drug from Hell namely Methadone. There are no other treatment options available at this point. Someone who has a 6-8 Vicodin a day habit switches to Sub Treatment? Not a wise choice IMO. Much better off just being sick a few days and be free. Once your on Sub, it ain't so easy to say: BYE BYE!!
For people like myself with nasty drug habits its a FANTASTIC option since there were NO OPTIONS prior. But its not something that people should consider lightly. You may be on it till the day you die, so if your NEW think long and hard before jumping in. Do your homework and ask people who have the same kind of drug habit you have. Go to AA/NA and ask them questions.
People get on Suboxone and do less research than if they were buying a toaster. Then they wonder why they can't get off the stuff!
Senior Member
Posts: 131
Slave thanks so much for the advice. I think the reason It's taking me a bit longer to find a doctore is I am trying to weigh the options. And do lotsa research. I've only been on the meth since jan 17th and I hate it yet its my only option now. I can't get up w/o pills and I have to with my kids husband sick etc. I think I have been to hell for a while with the pills and the meth/ My habit got big real big. I mean too big for this girl. I had to have at least 10 lortabs a few oxys maybe some ms contins UGGG scary just think about what I did to myself. I'm trying to figure out if this is the best route for me cause even with the meth I am still using any higher dose on meth I fall asleep so I have a reduced dose and then go and take pills. CRAZY huh. Kinda like financially supporting my habit. EWWW and i hate the meth so bad. really do. I like the idea of going to a meting and finding someone there like myself. Hmmm should be interesting but someohow someway I probably will ..LOL Thanks again Steff
Senior Member
Posts: 285
Welcome Steff,
For what its worth I think you are approaching treatment in the correct way. By researching the good, bad, and ugly of all options. Sub treatment is not for everyone, on the other hand it has saved many lives, so the best you can do is gather all the information and try and make a decision that is right for you.
I know exactly how you feel about the opiates. That's what led me to treatment, the realization I could wind up dead, or lose everthing. I had built such a tolerance that I could have easily overdosed. I have been on Sub since November and have opted to stay on maintenance therapy, for me it has worked well.
I wish you luck and encourage you to post any questions or concerns you may have.
Senior Member
Posts: 2,760
I was on 80mg methodone, my last dose was 3-15-06. If your on a dose comparable to mine, I feel for you. I didnt recieve the instant releif most get from sub. It took 3 days before I could even think about going to work.
I've got some advice for you, Either plan to stay on methohell forever or get away from it ASAP. That sh*t is a hard one to kick. You have been on it long enough for it to get ya! Im not trying to scare you, Im just giving you my experience. What Dose are you taking?? If your at 60mg or more expect a battle. I cant even describe the bone pain associated with coming off meth. Find a Sub Doc soon. Its been 38 days for me, my only problem now is going to sleep. If you can leave the methodone alone for 2or 3 weeks and take oxy you will be much better off. Put as much distance between you and meth as you can.
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In ischemic brain injury, calcium entry into the cytosol triggers mitochondrial calcium accumulation and can cause mitochondrial permeability transition. Despite the importance of this phenomenon, the components of the permeability transition pore and its regulation remain poorly understood. When extensive, permeability transition can result in swelling of mitochondria and the release of pro-apoptotic factors. However, this phenomenon is also involved in a reversible low conductance calcium release mechanism in mitochondria that can be protective in neurons challenged with increases in cytosolic calcium. Preliminary data indicates that treatment of isolated brain mitochondria with estrogen decreases the mitochondrial calcium threshold for permeability transition in a receptor-dependent manner. Estrogen receptor ? has been shown to localize to mitochondria in neurons, yet the role of estrogen and estrogen receptor ? directly in mitochondria is not fully established. My lab has found that ablation of estrogen receptor ? results in decreased brain mitochondrial calcium capacity that is insensitive to estrogen, suggesting that this receptor is directly involved in the modulation of calcium capacity and mitochondrial permeability transition. Inhibition of the well-known modulator of permeability transition, cyclophilin D, normally increases calcium capacity. Strikingly, estrogen receptor ? knockout mitochondria from brain are insensitive to this inhibition. This proposal will test the hypothesis that estrogen modulates brain mitochondrial permeability transition via estrogen receptor ? in mitochondria and that this modulation provides neuroprotection by preventing mitochondrial calcium overload. I will use biochemistry and molecular biology to understand the mechanism of the modulation of mitochondrial calcium capacity by estrogen activation of estrogen receptor ?. I will also investigate the effects of estrogen-estrogen receptor ? modulation of mitochondrial calcium capacity in a cell culture model of ischemia reperfusion injury where mitochondrial permeability transition is involved. I will determine whether estrogen prevents irreversible, detrimental mitochondrial swelling by activating a protective calcium release mechanism. These findings will provide new information about a novel regulator of the mitochondrial permeability pore, as well as reveal a new pathway by which estrogen modulates ischemic brain injury.
The ability of mitochondria to buffer calcium is a critical aspect of neuronal viability, especially in conditions such as ischemic brain injury, in which neurons are challenged with large calcium influxes. I have found that estrogen regulates mitochondrial calcium handling via estrogen receptor ? in brain mitochondria, suggesting a novel role of estrogen receptor ? in mitochondria that may be a therapeutic target in ischemic brain injury. I propose to investigate the mechanisms of this regulation as well as its protective function.
|Burstein, Suzanne R; Kim, Hyun Jeong; Fels, Jasmine A et al. (2018) Estrogen receptor beta modulates permeability transition in brain mitochondria. Biochim Biophys Acta Bioenerg 1859:423-433


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Do Your Part
Stage a little competition to see how long family members can keep a balloon in the air (without touching the ground). Give each family member a balloon. Blow up and tie each balloon. Time them to see who can keep it in the air longest. Then pair up family members and give each pair one balloon and time them to see which pair can keep their balloon in the air longest.
Which was harder: keeping the balloon in the air by yourself or with a partner? (Probably with a partner.) Why? (Sometimes my partner was supposed to hit the balloon and he failed; I couldn't control what my partner did; etc.)
This reminds me of getting along with people. It is not always easy to get along with others. Even when we try to be kind and helpful, they do not. We say or do things that hurt one another. Sometimes we get mad and don't want to be friends anymore.
What are some things we can do when things get broken with a friend or family member?
Read Ephesians 4:2-3, 28-32. What does it tell us to do? (Be kind, tenderhearted, forgive, say words that build up, put up with one another, etc.)
We can't control what others do, but as much as it depends on us, we must try to get along with people and make things right when we hurt one another.
Together Again
Help kids learn to repair a broken relationship. When kids have a spat with one another, ask them to stand on opposite sides of the room, facing each other. Set the timer for two minutes and ask one to share his side of the story while the other listens without interrupting. Set the timer again and allow the other one to share his side, without interrupting. Then ask, "How can we solve this?" Reach an agreement and decide to forgive.
Then ask each one to take a step toward the other and say one good thing about the other (something good about the other person or something he enjoys doing with the other) until they are face-to-face and can shake hands or embrace.
Relationships are broken when we hurt one another with our words and actions, but we can be reconciled (brought together) when we listen and forgive.
Money Talks
Siblings/families can sometimes get lax in the words said to one another. Call a family meeting and talk about what words are permitted and which aren't.
"I don't like what you are doing" might be permitted; "I hate you" is not.
Make sure that everyone contributes and decides on what is acceptable and what is not.
Give each person a roll of quarters (or dimes or nickels). Announce that every time they say unkind words, they must forfeit a quarter (coin). At the end of the week, the money they have left is theirs to keep or spend.
Latest posts by Splink (see all)
- Splink | God Answers Prayers - October 16, 2019
- Splink | God Pursues the Disobedient - October 9, 2019
- Splink | Reconciled Through Christ - October 2, 2019


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Masters programs in France
Being a part of French LMD system – Licence, Master, Doctorate programs; one following the other, the Masters programs in France is generally, 2 years in duration which is of great advantage to students only from India and Norway as recognition of 1-year Masters program is difficult and is of two types viz. Research masters, typically for doctoral studies and Masters for students preferring to enter job market after graduation.
A number of fees are completely dependent upon the kind of university he chooses and the type of course in the university. If one pursues an education in a public university the burden reduces to a great level as the government bears a major part of the expenditure, about €10,000 per student per year. With the cost being as low as €183 for Bachelor programs, €254 for Masters programs and €388 for Doctoral programs, it draws the attention of thousands of students in India to study higher education courses in France and achieve valuable and prestigious degrees. In case of private universities, the cost is a bit higher but still affordable in cases where scholarships are awarded to the student. The major advantage and element of attraction for Indian as well as International students is that France is the first non-English speaking country to recruit students from all over the world and more than 700 Masters courses in France are taught in English, thus assuring necessity in the fluency of French language,
Higher Education Courses in France
From philosophers, Voltaire and Montesquieu, mathematicians Descartes and Laplace, writers Zola and Dumas, artists Cézanne and Renoir to film-makers Godard and Besson, France have been producing intellects and the skeleton for this has been the continuous efforts to promote high standards education to students studying higher education courses in France.
Highly effective, useful and supportive scholarships are given for students studying in Masters which are provided by various administrations, organizations, programs like the CROUS bursaries provide funding for accommodation and living costs which are need-based and are around €750, Eiffel scholarship program awards prestigious award based on excellence and with an aim to attract international students it awards the selected students a monthly allowance of €1,180, Francophone University Association offers scholarships to selected students. Regional scholarships, which also offer scholarships to assist students in their Higher education courses in France and to attract international students, offer about 200 scholarships annually new to France through various subprograms like French Government scholarships, Industrial sector scholarships, Joint Masters, Erasmus Mundus and many others. All these scholarships contribute to funding in France for Masters and encourage students from all over the world to pursue Higher education courses in France.
To pursue Higher education courses in France, where two France's leading universities, Ecole Normale Supérieure and Ecole Polytechnique feature in the top institutions in the world, where learning is done thoroughly with continuous tests, lab-based practical and essays throughout the year, where 2,78,000 students from all over world, a remarkable number being from India, travel all the way to gain and experience world-class knowledge and skills and if you believe France is the fourth most popular destination for study abroad and pursuing higher education courses in France, in such a magnificent place would be a wish come true, then without a thought, join us and give yourself the best of the world.


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The pledge is to direct those against the Stand Your Ground laws to boycott those 20+ states in the US. On the 13th of every month people in those states will boycott and not make any purchases for those 24 hrs. If you're not in a Stand Your Ground State feel free to participate as well. After all the self defense laws that allowed George Zimmerman to walk free apply in all 50 states.
The other days of the month we will zone in on a different state, boycotting their main attractions and the products that they make the most money. No need to financially support a government who refuses to protect them! Guess which states goes first? ;)
The NAACP has written Trayvon's Law along with the help of the Dream Defenders. We ask that you take the pledge and join our event and group page on Facebook to spread the word! You can also follow on twitter @boycottsyg


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The Fridge
During the past 20 years, Jan accomplished a solid knowledge both in terms of technology (workflow, etc.) and on the creative processes of audiovisual and transmedia projects.


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Other Sports
Sports briefs: May 15
Lightning score 3 quick goals, cruise past Bruins in Game 1
Sean Bergenheim began a stretch of three Tampa Bay goals in 1:25 in the first period and the Lightning beat the host Boston Bruins 5-2 in the opener of the Eastern Conference finals Saturday night. Bergenheim, who scored just 14 goals in the regular season, got his NHL-high eighth of the playoffs at 11:15. Brett Clark connected at 11:34 and Teddy Purcell wrapped up the onslaught, both with unassisted goals. The two goals in 19 seconds and three in 1:25 are club records.
■ ESPN hockey analyst and former NHL player Matthew Barnaby pleaded not guilty Saturday to charges related to a "domestic incident" at an upstate New York home, police said. The 38-year-old pleaded not guilty to five charges, including criminal mischief, criminal trespass and harassment, and was released on his own recognizance. Police refused to give further details.
Barnaby broke into the league with the Buffalo Sabres and had a reputation as a league tough guy. A native of Ottawa, Canada, he played for seven NHL teams before retiring in 2007 because of a concussion suffered during a fight.
Nadal gets another shot at Djokovic
No. 1 Rafael Nadal and No. 2 Novak Djokovic will resume their rivalry in the Italian Open finals Sunday.
Nadal, who has won this tournament five of the last six years, overcame a tough first set against Richard Gasquet on Saturday before rolling to a 7-5, 6-1 semifinal victory. Djokovic was pushed to the limit in extending his unbeaten streak to 38 matches, defeating fourth-ranked Andy Murray 6-1, 3-6, 7-6 (2).
"I think anyone who saw the match knew that the winner was not decided until the last point," Djokovic said. "It was a fantastic match to be a part of."
In the women's finals, Maria Sharapova will meet Sam Stosur, last year's French Open runner-up. Sharapova outslugged top-ranked Caroline Wozniacki 7-5, 6-3, and Stosur downed fourth-seeded Li Na of China 7-6 (6), 6-0.
Djokovic beat Nadal in title matches in Indian Wells and Miami this year, then also won in Madrid last weekend, his first victory over the Spaniard on clay. This tournament is a warmup for the French Open, which starts next weekend.
"Every aspect of the game will be important," Nadal said. "I know Djokovic is playing at an exceptional level right now, but I just have to fight to the end like I always do. If I don't beat him tomorrow, then the next match."
Auto racing
Carpenter tops chart in Indy practice
Sarah Fisher retired from driving to start a family. Turns out, her replacement can deliver, too. Ed Carpenter turned a fast lap of 224.786 mph in the No. 67 car, putting the expectant mother and team owner atop the speed charts on the opening day of Indianapolis 500 practice. New Zealand's Scott Dixon, the 2008 Indy winner, was second at 224.491 mph.
Rookie JR Hildebrand, of Panther Racing, surprised many by finishing third at 224.433 — just two days after passing his rookie test.
Defending champ and two-time 500 winner Dario Franchitti, Dixon's teammate at Target Chip Ganassi, was fourth at 224.107.
C0llege baseball
Thomas More takes conference title
No. 3-seeded Thomas More defeated 4th-seeded Westminster 9-1 at Struthers, Ohio, for its second straight Presidents' Athletic Conference Tournament championship. Ryle graduate David Etscheid pitched a complete-game two-hitter for the Saints.
Rooney clinches Man U.'s 19th title
Manchester United became the most successful team in English soccer league history with a 19th title triumph that overhauled Liverpool's record. With only a point required at Blackburn to capture the Premier League trophy with a game to spare, Wayne Rooney salvaged a 1-1 draw from the penalty spot in the 73rd minute.
■ Ricardo Lenhart caught three touchdowns and Maurice Douse ran for two as Northern Kentucky (10-2) remained unbeaten at home with the 34-28 victory against Huntington in their Ultimate Indoor Football League matchup. Jared Lorenzen finished 15-for-27 for 183 yards, three touchdowns and no interceptions.
■ Kentucky track and field senior Mary Angell and junior Luis Orta both earned runner-up finishes at the SEC championships in Athens, Ga. Angell was second in discus with a career-best mark of 54.14 meters. Orta was second in the men's 3,000-meter steeplechase with a time of 8:53.00.
■ Abby Wambach scored and assisted on Amy Rodriguez's goal in the first half to lead the United States to a 2-0 win against No. 4 Japan in an exhibition soccer match in Columbus, Ohio. Wambach's 118th career goal came in the 29th minute off a header from 8 yards after a 40-yard free kick by Ali Krieger.
■ Peng Wu overcame Michael Phelps in the final 50 meters for the win in the 200 fly at the Charlotte UltraSwim in North Carolina.
The last word
Eric Torpy — a Larry Bird fan serving a 33-year prison sentence in Holdenvile, Okla., instead of 30 because he told the judge he preferred Bird's No. 33 — said he figures Bird has heard of him by now. Torpy told The Boston Globe:
"I'm pretty sure he thinks I'm an idiot. I mean, truthfully, most people do. My own family does, so I'm pretty sure he does, too."


text: Ken had an amazing life. It would have been so interesting to have lived during that time. Not only did he live through the 60's and the 70's he was extremely influential. The Alternative press helped shape the culture by getting art and poems out to the general public. They did not do it for money or fame. They did it because someone had to share the amazing work that was going on and that someone was Ken and his wife!


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General Information:
Height: 10-16 in
Weight: 10-20 lbs
Life Span: 12-16 yrs
Coloring: White, cream, apricot, gray, blue, black; solid or double colored coats possible
Area of Origin: North America
Similar Breeds: Bichon Frise, Toy Poodle, Lhasa-Poo, Cocka-Poo, Malti-Poo, Shih-Poo
History and Origin:
A designer dog breed, the Bichon-Poo is a cross between a Bichon Frise and a Poodle (typically a Toy Poodle). Also sometimes known as the Poochon or Bich-Poo, this cross-breed aims to pull the best characteristics from both parent breeds. First bred in the late 20th century, the Bichon-Poo was one of many mixes with Poodles to intentionally produce dogs with hypoallergenic coats. A fantastic family dog, the Bichon-Poo typically possesses the admirable qualities of both the Bichon and the Poodle, and is a true companion.
Personality and Temperament:
Social, loving, and intelligent, the Bichon-Poo will make friends wherever it goes. It is eager to meet new people and animals, and is happy to share its home with children, other dogs, and cats. While friendly to strangers, it will nevertheless protect its owners property with an alerting bark. The Bichon-Poo has a comforting, calm, affirming personality, making it suitable for nervous or first-time dog owners.
Exercise & Training:
While a typically calm dog, the Bichon-Poo loves being active. While a strenuous exercise regime is not needed, daily short walks and some play time will help keep it happy and healthy. Intelligent and aiming to please, it is an easy dog to train. Just like both of their parents, they love to perform and learn tricks, often happy to be the center of attention in a crowded room. Ensuring it receives early and consistent socialization is key; the Poodle tends to be slightly more high-strung than the Bichon, and it is possible that this trait may occur in a Bichon-Poo.
The Bichon-Poos coat is typically curly, soft, and frequently fluffy, but it can also take after the Bichon and be straighter and softer. While it is a low-shedding breed, the fur is prone to matting and tangles, and daily brushing is recommended to maintain coat and skin health. Frequency of professional grooming depends on the desired appearance of the coat: A more trimmed looked requires grooming every 6-8 weeks, while a longer look may only require maintenance every 12-16 weeks.
Similar Breeds:
Many other Poodle designer mixes share similar characteristics and personality traits as the Bichon-Poo. Some notable mixes include the Cockapoo (Cocker Spaniel x Poodle), Lhasa-Poo (Lhasa Apso x Poodle), Malti-Poo (Maltese x Poodle), Shih-Poo (Shih Tzu x Poodle).
Interesting Facts about the Bichon-Poo:
1. While not recognized by kennel clubs such as the AKC, CKC, or UKC, the Bichon-Poo can be registered with recently-formed hybrid breed clubs, such as the American Canine Hybrid Club (ACHC).
2. Genetic testing has suggested the Bichon-Poo's dominant color is determined by its Poodle side.
3. Both the Bichon Frise and the Poodle are considered to be hypoallergenic dogs; the Bichon-Poo is recommended for those with dog allergies.
Additional Resources about the Bichon-Poo:
Small Paws Dog Rescue – Including Bichon-Poos
Dogs Discovered – Bichon Poo Information


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"There is in nothing in my history to prepare me for the experiences I have with this work. I think this defies metrics. Everything in my long ago education says it should not work but it damn well does work. Beautifully." -J. Wier
Do you feel frustrated that -when it comes to fear and anxiety- you seemingly don't have resources available besides talk therapy, methods which calm you down for only a short time, or medication? You may be worried you're going to feel this way or struggle with these problems forever. Or that you'll have to limit what you do with your life in order just to survive.
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Ask Kristen Support Phone Calls$200.00
Private Sessions With Kristen$2,400.00


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Libby York & Friends @ Berlin's
City : Key West, Florida
Venue : Berlin's at A& B Lobster House
Address : 700 Front Street
Time : 7-10pm
every Tuesday & Wednesday night throughout the season @beautiful Berlin's at the A & B Lobster House. Tuesdays with Tim McAlpine on guitar, Wednesdays with Bobby Nesbitt on keyboard. 305-294-5880


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The U.S. Open Is Upon Us.
And this means another guy trying to predict the winner, and failing miserably.
I'm going to give you my three picks each with a category. First will be the "Well Duh" pick. Second will be the darkhorse pick. And last pick of mine will be the "Wilfore you are crazy" also known as a hot take.
I will also add why I think they have a realistic chance of conquering the tough track at Erin Hills.
"Well Duh": Dustin Johnson
Everybody and their brother is picking DJ this week. Why? Well he is the Vegas favorite and he hits the ball a country mile. On a course that my play over 8,000 yards from the tips, you got to hit the ball pretty far. DJ hits the ball better than anyone on tour and has been on a rampage this 2017 season. Other than two missed cuts this season, he has three wins, a T2, 3, T3, T6 and a few other solid finishes under his belt. If it weren't for a phantom back injury, he may be chasing his second major this year. Also love the fact he is playing with Spieth and Martin Kaymer the first two days. I am a firm believer in friendly competition and no way DJ will let them beat him, setting him up great for the weekend.
Darkhorse: Alex Noren:
You know, that random guy who is currently ranked 8th in the world. Yeah I like him. Winning the BMW PGA Championship recently Noren is playing great golf. He also finished 10th at the Players where he carded a 68, 71, 72 and 73. He hits about 68% of fairways which will help a lot this week, as the rough at Erin Hills would give a golfer night terrors.
Wilfore… you are crazy: Pat Perez
I like Perez. He is a fired up golfer, not afraid of much. And I think fear may strike some guys this week, Erin Hills is not the most welcoming layout. He hits the ball far enough and does everything else well enough, I think he can limit mistakes and stay in contention until Sunday. I think what puts Perez ahead of the field is his short game. He is 5th in strokes gained around the green this season. This should help him, not being the longest of hitters, he will be able to save himself from 30 yards and in. Watch out for Perez this week in Wisconsin.


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As ice in Norway melts, it is revealing archaeological curiosities of historical significance. The retreating ice is sending archaeologists into overdrive, as they must scramble to find these artifacts before air exposure damages or destroys them.
So far, researchers have stockpiled about two thousand such pieces of history. Most significantly, they have found a great number of iron and bone-tipped arrows that were used by ancient peoples to kill reindeer, as well as walking sticks and shoes used by the hunters. They provide clues that have given us a better idea of what life was like for Norwegians in the distant and not-as-distant past.
Artifacts were being deposited in Norway's mountainous regions all the way through the 14th century, and beyond. The oldest artifacts date to around six thousand years ago, with the most recent dating to around the 1300's.
Norwegian reindeer typically stick to ice-covered ground during the summer. It's a behavior that likely evolved to reduce infections from parasites. Hunters, observing this tendency, focused their hunting on areas with ice patches. The reindeer they killed were used not only for food, but also to make antler tools.
The hunting artifacts start winnowing down around the time the Vikings descended from power. Researchers speculate that this is due to people killing large quantities of reindeer with pitfall traps instead of bow and arrow.
Around the 1400s, hunting artifacts dropped precipitously, as people in the area reeled from the Boubonic Plague. Shortly thereafter, firearms were invented.