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Don appropriate personal protective equipment (PPE) based on the patient's signs and symptoms and indications for isolation precautions.
Bronchospasm or laryngospasm, as a result of suctioning, can be severe and prolonged, and, in some cases, can be life-threatening without intervention.
Sputum is produced by cells that line the respiratory tract. Although production is minimal in the healthy patient, disease processes can increase the amount or change the character of sputum. Examination of sputum aids in the diagnosis and treatment of many conditions such as bronchitis, bronchiectasis, tuberculosis (TB), pneumonia, and pulmonary abscess, or lung cancer.undefined#ref2">2
In many cases, suctioning is indicated to collect sputum from a patient who cannot spontaneously produce a sample for laboratory analysis. Suctioning may provoke violent coughing, induce vomiting, and result in aspiration of stomach contents. Suctioning may also induce constriction of the pharyngeal, laryngeal, and bronchial muscles. In addition, suctioning may cause hypoxia or vagal overload, causing cardiopulmonary compromise and an increase in intracranial pressure.
Sputum for cytology, culture and sensitivity, and acid-fast bacilli (AFB) are three major types of sputum specimens.2 Cytologic or cellular examination of sputum may identify aberrant cells or cancer. Sputum collected for culture and sensitivity testing can be used to identify specific microorganisms and determine which antibiotics are the most sensitive. The AFB smear is used to support a diagnosis of TB. A definitive diagnosis of TB also requires a sputum culture and sensitivity.2
Regardless of which sputum test is ordered, a sputum specimen should be collected first thing in the morning due to a greater accumulation of bronchial secretions overnight.
See Supplies tab at the top of the page.
Rationale: Suctioning or coughing up secretions can trigger the gag reflex. If a patient has recently eaten, this may also trigger vomiting.
Take airborne precautions when caring for a patient who is suspected of having TB or other airborne transmissible diseases.
Rationale: The high-Fowler or semi-Fowler position promotes full lung expansion and facilitates the ability to cough.
Rationale: Touching the inside of the sterile container may compromise the laboratory test results.
Rationale: Expectorant must come from the lungs. Saliva is not sputum.2
Ensure that the container is tightly closed before wiping to prevent contaminating the specimen.
Rationale: Excessive coughing can alter the patient's respiratory pattern and cause hypoxia.
Rationale: The procedure can be uncomfortable. Anxiety may develop if the patient becomes short of breath.
Take airborne precautions when caring for a patient who is suspected of having TB or other airborne transmissible diseases.2
Rationale: Entering the larynx and trachea triggers the cough reflex.
Rationale: Inserting the tip of the flexible suction catheter without applying suction minimizes hypoxia and trauma to the patient's airway as the catheter is inserted.
Limit the duration of each suction pass to less than 15 seconds and limit the number of passes to a maximum of three to help minimize hypoxia, airway trauma, and cardiac arrhythmias.3
If the patient becomes hypoxic during the suctioning procedure, discontinue suctioning immediately and provide supplemental oxygen.
Rationale: Suction can damage mucosa if applied during withdrawal.
Ensure that the sputum trap is tightly sealed before wiping to prevent contaminating the specimen.
Rationale: The procedure can be uncomfortable. Anxiety may develop if the patient becomes short of breath.
Clinical Reviewer: Kerrie L. Chambers, MSN, RN, CNOR, CNS-CP(E)
Published: December 2023


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What does the Gnostic know and procure?
The know to get up with the Sun and the initiatives, they greet with love every dawn, they are happy, active and optimistic. They speak little and with simplicity, they do not speak wrong on anyone.
They praise, stimulate and serve without malice. They have a good wish for others. They do not speak of themselves.
They know how to forgive, they don't curse, don't deceive, don't exaggerate, don't distort. They procure to be patient and humble. They do something for the happiness of others. They grant the reason and don't argue.
They recognize their mistakes and limitations. They do not believe themselves wise or better than others. They do not humiliate or accuse. They do not harm, don't underestimate, don't banner other's moral. They are sincere, loyal and grateful.
They don't reveal secrets, not the own nor of others. They don't ridicule, don't ill-treat, they know to look and smile like children.
They don't put snares, don't subjugate or threaten.
They know how to use their hands to heal, teach and bless, they appreciate others and what they do, the Gnostics are not greedy or envious. They act with serenity and decency. They do not spread gossip, they know how to be quiet and never get into others' lives.
They love their families and don't have a rival for their spouse. They don't become vain in prosperity, nor the misfortune knocks them down. Then they only know to obey the Father's will.
Do you want to become one of them?
Anonymous letter.

subset: commoncrawl


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Animal Farm
Penguin Book Cover Competition, 2018
Inspiration for this design came from a visit to a local farm for research on this project.
I sat and watched a large pig asleep for half an hour waiting for it to wake and give me a chance to capture some photographs.
The very large pig then proceeded wake from its sleep, stand up and make direct eye contact with me and vomit (I just have that effect apparently).
The photographs I captured became the main focal point for my illustration.
I hadn't seen many traditional styled illustrations make it onto the covers of the fictional story, so I saw this as my opportunity to take a risk. Instead of a digital approach, I began to sketch out that moment a pig stared at me and vomited.
I aimed to capture the pig's intimidating stare which reflected that of the intimidating pig characters in 'Animal Farm', yet make it look as gross as possible.
The process involved drawing, painting, scanning and printing. I would scan my original illustration into Photoshop, print it out, add details such as the facial hairs little by little with a pen, then scan it back into photoshop again. Although this was a lengthy process, I'm happy with the result.
The title used on the cover was hand written in red ink and scanned into photoshop and used the 'multiply' layer effect. This made the text slightly transparent and darkened the colour.
This gave the effect that the pig was 'branded' as many farm animals are.


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Doncaster Online,
your 'one stop shop' for everything Doncaster
All your news, views, businesses, events and much more – at the touch of a button and through your letterbox in the monthly magazine – and best of all, it's FREE!
Your 'one stop shop' for everything Doncaster View online now
Nurses, doctors and other health professionals at Doncaster and Bassetlaw Teaching Hospitals (DBTH) have penned and performed their own Christmas carol, highlighting the strides in patient care made by the Trust in 2019.
Called the '12 Ways of Sharing How We Care', the tuneful take on the xmas classic '12 Days of Christmas' features around 50 Trust colleagues, from executive directors to ward staff, counting down a number of innovative projects introduced at the local hospitals. The performance also features a number of talented students from Hall Cross Academy, the Trust's partner 'Foundation School in Health', musically accompanying the clinicians.
In just four and a half minutes, the ensemble recaps some of the Trust's proudest achievements for the year, including:
Throughout the past 12 month, the Trust has worked extremely hard to improve its processes to improve the quality of care it delivers for patients, as well as enhancing its communications techniques. With many successful projects to look back on underneath the umbrella brand of 'Sharing How We Care', this approach was recently recognised at the latest Patient Safety Learning Awards in London, with the Trust picking up 'Shared Learning' prize.
Cindy Storer, Acting Deputy Director of Nursing, Midwifery and Allied Health Professionals, said: "This Christmas, we decided to bring together some of the Trust's singing superstars and heroes of health care, to celebrate the work we have done, as a team, throughout the past year. Colleagues work incredibly hard every single day of the year to keep our patients safe and well looked after, and we thought it would be the perfect way to celebrate this, saying a big 'thank you' and 'merry Christmas' to every member of Team DBTH."
The festive film can viewed on YouTube, by following this link https://tinyurl.com/DBTH12days and also features on the Trust's social media platforms.


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Over 25 Palestinians were killed and over 1,500 injured in a massive round of Israeli attacks on Gaza that began on Friday. In response, Palestinian resistance forces fired rockets into Israel. Media reports indicated that a ceasefire agreement, brokered by Egypt and Qatar, had been reached between Israel and Hamas early on Monday morning. The previous ceasefire after last month's Israeli aggression had broken down after Israel refused to ease the brutal blockade on Gaza.
The latest escalation in the conflict began on Friday when Israeli snipers killed two Palestinian civilians at the weekly Great March for Return protests. The Israeli air force also conducted a raid at a Hamas facility, killing two people. Hamas responded with rockets, after which Israel intensified its offensive.
Palestinian health authorities said that among those killed in the Israeli bombardment were two pregnant women, a 12 year-old boy and an infant. Israel also assassinated a Hamas commander, Hamed Hamdan al-Khodari, in an airstrike.
According to reports, Israeli warplanes, gunboats and artillery targeted more than 200 sites, including seven large residential and commercial buildings and at least 14 homes. Israel also closed all border crossings with the Gaza Strip, as well as the fishing zone off the coast of the besieged enclave.
On Sunday, Israeli prime minister Benjamin Netanyahu called for a serious escalation of the Israeli offensive. Netanyahu was recently re-elected after having promised a more hardline stance against Palestinians.
#شاهد.. طائرات الاحتلال عمارة "أبو قمر" في غزة مساء اليوم. pic.twitter.com/YVU2JSZhaZ
— المركز الفلسطيني للإعلام (@PalinfoAr) May 5, 2019
In response, resistance forces in Gaza launched more than 600 rockets at Israeli settlements, leading to the death of four Israelis. According to Hamas, the response from the Palestine resistance groups was calculated and not disproportionate.
"Need for a united struggle"
In a statement calling for a united struggle against Israeli aggression, the West Bank-based Palestinian People's Party (PPP) noted the need for strengthening the internal front to confront the criminal occupation in the Gaza strip.
The PPP said that the aggression was aimed at maximizing the suffering of the people of Gaza and West Bank, and destroying their livelihood. It further noted that the United States administration was complicit in Israeli crimes in Palestine.
PPP, the Democratic Front for Liberation of Palestine and the Popular Front for Liberation of Palestine, in a joint statement, called on the countries and people of the world to unite with the Palestinians in their struggle against Israeli war crimes.
Gaza Siege and Great Return March
Gaza's two million people live under a brutal land, air and sea siege imposed by Israel and supported by Egypt since 2007. The Israeli aggressions of 2009, 2012 and 2014, the countless military attacks and the inhuman restrictions on the people of Gaza have led to a catastrophic humanitarian situation in the coastal strip. Crucial infrastructure, including hospitals, electricity, water and sanitation facilities are under severe crisis.
In March 2018, the people of Gaza began a massive resistance movement, the Great March of Return, asserting their right to return, and demanding an end to Israeli occupation. Since then, every Friday, tens of thousands of civilians have gathered at protest sites near the illegal fence erected by Israel in Gaza.
Israel's response to the protests has been brutal. Over 200 Palestinian civilians were killed and thousands injured in one year. On May 14, 2018, when the US shifted it embassy in Israel to Jerusalem, Israeli forces massacred 60 Palestinian civilians.
Eurovision as a distraction
The renewed Israeli aggression comes ahead of Tel Aviv hosting the Eurovision song competition on May 15. The event is being held on the anniversary of the Nakba (the catastrophe), when Palestinians were thrown out of their homeland in 1948. The hosting of this event by Israel is seen as an attempt to whitewash its crimes against Palestinians.
"Israel is shamelessly using Eurovision as part of its official Brand Israel strategy, which presents "Israel's prettier face" to whitewash and distract attention from its war crimes against Palestinians," said the Boycott, Divestment, Sanctions (BDS) movement in a statement.


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Experience at-home dining in a way you never thought possible.
Schedule a tour today to find out more about Waterstone of Lexington – luxury living for seniors 62 and over, ideally located adjacent to the Belmont Country Club. We're happy to answer your questions and show you our premier apartments and convenient on-site amenities.


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Preferential customs treatment in the goods trade between the EU and the United Kingdom as of 1 January 2021 (updated on 7 January 2021)
On 24 December 2020, the EU and the United Kingdom reached a conclusion on a trade agreement which is to be applied temporarily until a final agreement can be ratified at a later date. This temporary trade agreement contains regulation on reciprocal preferential treatment of goods originating from the EU and the United Kingdom. According to the regulations, customs duty is not levied when goods are considered to be originating products covered by the agreement.
Originating products under the agreement
In order for goods to qualify for preferential customs treatment upon importation to the European Union or the United Kingdom, they must be originating products from one of the agreement parties and comply with the rules of origin laid down in the agreement. You must always check the product-specific rules of origin for making sure that your products qualify for preferential treatment before a certificate of origin is drafted on them. Product-specific rules of origin lay down the prerequisites for considering a product to meet the standards of an originating product. Product-specific rules of origin are included in Annex ORIG-1 (pages 415-477) containing the rules of origin of the trade agreement.
Proofs of origin
The qualification of products for preferential treatment must be proved in the country of importation with a certificate of origin to be presented in connection with the customs declaration. As per the agreement between the EU and the United Kingdom, acceptable certificates of origin are a statement on origin by the exporter or importer's knowledge.
The format of a fixed-form statement on origin by the exporter is defined in Annex ORIG-4 (pages 482-483) of the rules of origin of the trade agreement. A statement on origin can concern only a single consignment or several consignments of similar products of origin. Statements on origin can be issued by all EU exporters for consignments that contain products of origin for a maximum value of 6 000 euros. Only companies registered in the REX system can submit statements on origin for consignments exceeding that value. In such cases, a company must include its individual REX identification number in the statement on origin. Customs gives the ID number to companies when they register in the REX system. If an exporter has already registered with Customs, for example, as an exporter of EU-originating products to Japan, Canada or to a GSP beneficiary country, then the same FIREX number is used also in statements on origin concerning EU-originating products exported to the United Kingdom. Exporters to the United Kingdom are to enter their EORI numbers under the ID number regardless of the value of the consignment.
A statement on origin can also be issued as a long-term insurance for several consignments of similar products of origin where the exporter delivers identical products to a customer on a regular basis. A long-term statement on origin can cover a maximum period of 12 months, and the period of validity must be indicated separately in the certificate.
Statement on origin template:
(Period: from…………… to …………(1) )
The exporter of the products covered by this document (Exporter Reference No ……... (2)) declares that, except where otherwise clearly indicated, these products are of (3)...………preferential origin.
(Place and date)
(Name of the exporter)
Under section 2 of the statement on origin, EU exporters enter the REX number. UK exporters enter the EORI number. Under section 3, you enter either "the United Kingdom" or "the Union" as the origin depending on the preferential treatment origin. Under section 4, you do not need to enter the location and date if that information is already included in the document. If the statement on origin concerns several consignments of similar products of origin, you must enter also enter the validity period of the statement under section 1. The validity period cannot exceed 12 months.
An importer can request preferential treatment also based on importer's knowledge. Any fixed-form statement on origin text is not required in a request for preferential treatment based on importer's knowledge. However, the request must be based on information and documentary proof from the exporter that can be presented to Customs, when necessary, for proving that the item in question is a product of origin that meets the requirements of the rules of origin. Unlike exporters, importers do not have to be registered in the REX system of the EU.
Customs clearance of products qualified for preferential treatment
When an importer requests preferential treatment for products of origin from the United Kingdom, they must enter the document code for the type of origin clearance based on which they request preferential treatment. In preferential treatment based on a statement on origin, the document code for a single consignment is U116. For a statement on origin concerning several consignments, the code is U118. In a request for preferential treatment based on importer's knowledge, the document code is U117.
Retrospective request for preferential treatment
According to the trade agreement between the EU and the UK, preferential treatment can be requested within three years from the date of importation.
Cumulation in trade between the EU and the United Kingdom
Article 4 of the agreement on cumulation of origin provides for mutual full cumulation. This means that, in addition to materials of origin originating in the EU or the United Kingdom that qualify for preferential treatment, processing of non-origin materials carried out by an agreement party can be taken into consideration in determining the origin of the end-product. However, the production measures carried out in the territory of the other agreement party must exceed the measures referred to in Article 7 of the rules of origin.
An EU exporter who wishes to make use of processing procedures done on non-origin materials in the UK must receive a supplier's declaration referred to in Annex ORIG-3 to the rules of origin. A supplier's declaration can be issued for a single consignment with an invoice or any other document that describes the products accurately enough for identifying them. The template for a supplier's declaration on a single consignment is presented in Annex ORIG-3, Appendix 1 to the rules of origin in the agreement. A supplier's declaration can be submitted as a long-term declaration when a supplier regularly delivers such products to the exporter that have the same unaltered essential qualities in terms of determining their origin that qualifies them for preferential treatment. The format for a long-term declaration is defined in Annex ORIG-3 Annex 2 to the rules of origin in the agreement.
A supplier who drafts a long-term declaration must be prepared to deliver all appropriate documents requested by the customs authority for proving that the information in the supplier's declaration is correct.
PLEASE NOTE! Obtaining supplier's declarations is allowed retrospectively from 1 January 2021 to 31 December 2021.
The Commission has released preliminary information about an implementing regulation to be issued on 31 December 2020 based on which operators engaging in trade between the EU and the UK can apply the transition period in obtaining supplier's declarations. Between 1 January and 31 December 2021, businesses can draft statements on origin qualifying their goods for preferential treatment in the framework of the EU-UK trade agreement without supplier's declarations provided for by the agreement. However, exporters must always have information on the qualification of goods for preferential treatment when they draft statements on origin qualifying goods for preferential treatment. Exporters should have the supplier's declarations on which statements on origin are based on no later than 1 January 2022. If an exporter does is not able to retrospectively obtain supplier's declarations, they should inform the importer in the country of destination.
See also general instructions on the application of preferential treatment in import and export, and instructions on how to enter the REX system:
Preferential treatment of goods based on origin - Customs
Preferential treatment in export for originating products - Customs
Registered exporter (REX) - Customs
Trade and cooperation agreement between the EU and the United Kingdom:
The draft EU-UK Trade and Cooperation Agreement | European Commission (europa.eu)
Commission website on the relations between the European Union and the United Kingdom:
The European Union and the United Kingdom – forging a new partnership | European Commission (europa.eu)
Commission website on Brexit in Finnish:
BREXIT – MITEN VALMISTAUTUA SIIRTYMÄKAUDEN PÄÄTTYMISEEN? | Taxation and Customs Union (europa.eu)
Subscribe to customs clearance and Intrastat newsletter here
Customer support for businesses
The Brexit support line serves customers from Monday to Friday, 9 a.m. to 11 a.m., at +358 295 521 008, and by email at yritysneuvonta.lupa-asiakkaat(at)tulli.fi.
Brexit information
on the Finnish Customs website: Brexit for businesses
on the Finnish Customs website: Brexit for private persons
Prime Minister's Office website: Impact of Brexit on citizens and businesses


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Medical cannabis market rallies in New Zealand ahead of move to allow patient access
Health & Biotech
Health & Biotech
Special report: Proposed liberalisation of medical cannabis in New Zealand has prompted a flurry of activity among industry players wanting to take advantage of a potentially lucrative new market.
New Zealand has been inching closer towards allowing cannabis use for medical reasons.
This presents the perfect opportunity for a number of ASX-listed companies to prepare for the moment the changes take effect.
While there is a legal pathway for people to obtain cannabis on prescription from a medical practitioner, access to affordable cannabis products remains problematic for New Zealanders.
The New Zealand Government introduced the Misuse of Drugs (Medical Cannabis) Amendment Bill into New Zealand Parliament last year. If the Bill is passed, it could permit people with a terminal illness and in chronic pain to access medical cannabis.
The Bill outlines the fact that most cannabis products produced internationally don't meet the quality and efficacy requirements of therapeutic product regulators such as Medsafe (the NZ Medicines and Medical Devices Safety Authority).
Under the Bill, the ability to set and require minimum quality standards for cannabis products would improve patient safety and give medical practitioners confidence about the available products on the market.
Political and public interest has soared in this evolving industry in New Zealand, and the level of knowledge and awareness around the use of medical cannabis has evolved, making the passing of the Bill a real political possibility.
Broad support in New Zealand for medical cannabis
There is increasing support for expansion of the Bill to include pain relief as a substitute for problematic opioid therapy, a recent poll by the New Zealand Drug Foundation (NZDF) shows.
The poll found 87 per cent of New Zealanders support medical cannabis use for pain relief and 89 per cent support it for terminal pain relief.
Advocates of cannabis reform for the country say the poll results prove that laws are now out of touch with public opinion.
The poll is a sign that people are ready to vote for change in the cannabis referendum due to happen on or before the 2020 election, says NZDF executive director Ross Bell.
"This sends a strong message to MPs considering the government's medical cannabis bill, which currently does not go far enough to improve access for a large group of patients."
"There will be widespread disappointment if Parliament fails to listen," Mr Bell says.
MediCann is a major player in the Kiwi market, with large-scale commercial medical cannabis production under way, and the sale and distribution of approved products in the pipeline, once legislative changes are passed.
The unlisted Kiwi cannabis play has been working with major Kiwi fruit growers to grow medical cannabis after they recognised the potential of cannabis as a new intensive horticulture industry.
MediCann also has recruited a group of influential medical experts across New Zealand, who are both financially and emotionally invested in the company's success.
Changing sentiment
The changing sentiment in New Zealand has given Jayex Healthcare (ASX: JHL) a virtual springboard as it ploughs ahead with plans to commercialise its P2U electronic prescription processing and delivery service technology, and its BluePoint remote dispensing terminals, through licensing those technologies to medical cannabis producers for use in the sale and distribution of medical cannabis on the back of expected legislative changes.
Jayex recently sealed a deal with player MediCann NZ to license its BluePoint and P2U, technologies. The deal sees MediCann NZ granted the exclusive use and application of those technologies in New Zealand in connection with their proposed sale and distribution of medical cannabis products once the New Zealand legislation is passed.
The predicted changes in the New Zealand market comes after Canada legalised recreational cannabis from October 17 this year after final regulatory approvals were passed in June this year.
The use of marijuana to treat medical conditions also got a big boost in the US, with the recognition of 11 new medical conditions for cannabis treatment by the State of Michigan.
Medical cannabis is now permitted in 30 US States after Oklahoma legalised medical marijuana in June this year.
New research also shows that patients in the US will spend more money on legal cannabis than recreational pot smokers within four years.
Frost & Sullivan research predicts that total cannabis revenue in the US will grow at 13 per cent a year from $US5.3 billion today to $US10 billion in 2022.
The shifting regulatory landscape is likely to have a major impact on the plans of ASX-listed cannabis stocks, which is mostly focused on medical cannabis.
This special report is brought to you by Jayex Healthcare Ltd.
This advice has been prepared without taking into account your objectives, financial situation or needs. You should, therefore, consider the appropriateness of the advice, in light of your own objectives, financial situation or needs, before acting on the advice.
If this advice relates to the acquisition, or possible acquisition, of a particular financial product, the recipient should obtain a disclosure document, a Product Disclosure Statement or an offer document (PDS) relating to the product and consider the PDS before making any decision about whether to acquire the product.


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Low Vision Optometry of Western NY
Tuesdays -Thursdays: 9:00 am - 5:00 pm; Fridays: 9:00 am - 3:00 pm
Macular degeneration is an eyesight disorder that commonly affects people over the age of 50. If acquired, the disease can severely impact all spheres of a person's life by reducing their independence and causing difficulty while driving, reading, and the inability to recognize faces and colors or see objects in detail.
Macular degeneration is of two types:
Stargardt disease is a rare congenital disorder affecting children and teenagers, primarily aged between 6-12. While the condition is usually present at birth, its symptoms develop during childhood, and vision loss increases with age.
Stargardt disease causes impaired central vision and difficulty distinguishing colors, reading comprehension, and seeing clearly in low-light environments. Dr. Kornfeld recommends that people with a family history of Stargardt disease get checked to prevent issues later.
As the disease causes macular degeneration, it does not have a known cure as of yet. Stargardt disease can cause low vision over time as the damaged macula impacts the light reaching a person's brain, leading to impaired vision such as blind spots and light sensitivity. As a low vision optometry specialist, Dr. Kornfeld supervises Stargardt patients, monitors the disease, and prescribes low vision aids that are ideal to allow the patient to lead an everyday life.
The macula is the middle portion of the eye's retina and is responsible for precise central vision and regulating daily activities such as driving, reading, and seeing objects and colors correctly. Macular degeneration can be acquired during any stage of a person's life. However, it is more commonly found in people over 50.
Juvenile Macular Degeneration is usually present in a person during childhood and stays with them through adolescence and adulthood.
Similar to other macular degeneration disorders, juvenile macular degeneration also does not have a known cure. However, Dr. Kornfeld utilizes advanced medical examinations coupled with low vision aid and devises a suitable strategy for each patient for their lifestyle needs.
At Low Vision Optometry of Western New York, we are committed to assisting our patients by implementing modern strategies and thoroughly understanding each patient's condition and stage of the disease. Our progressive approach allows people with juvenile macular degeneration to lead a stable lifestyle without being dependent on their loved ones.
Glaucoma is a set of eye conditions caused by excessive pressure buildup, called intraocular pressure (IOP), damaging the eye's optic nerve. The optic nerve transmits nerve signals from the retina to the brain. If the optic nerve is compromised, the brain loses its ability to form images or discern objects, which causes visual impairment.
Advanced digital devices such as portable digital magnifiers, IrisVision, Orcam, Jordy, eSight, and CCTVs can maximize the vision of a glaucoma patient, allowing them to live everyday life and enjoy the things they love.
At Low Vision Optometry of New York, we schedule regular glaucoma screenings to monitor the progress and manage the condition efficiently.
Diabetic Retinopathy is an eye disorder that can develop as diabetes progresses, and the blood vessels positioned in the back of the eye leak fluid or bleed.
In its initial stages, Diabetic Retinopathy does not cause significant vision loss. However, if the condition is not diagnosed early, it can lead to severe visual impairment and cause blurred vision, dark areas in your vision, and deteriorating color vision.
Dr. Kornfeld can maximize your existing vision as a low vision specialist by employing modern optic techniques and conducting regular screenings. Medications and injections such as Anti-VEGF used by an ophthalmologist can help patients with Diabetic Retinopathy regulate the condition and lead a stable, independent life.
Retinitis Pigmentosa is a congenital disease that causes degeneration of the retina. RP is caused as a result of the inability of rod photoreceptor cells to sense light. The disorder leads to peripheral vision impairment and makes it difficult to see during the night. Once the disease progresses, it can also affect central vision and lead to complete blindness.
At Low Vision Optometry of Western New York, we go out of our way to equip patients with tools and strategies that will allow them to lead an everyday life and continue doing the things they love. RP leads to peripheral vision loss, making it difficult to do routine activities such as driving, reading, or using a phone.
Depending upon the intensity of the condition, we prescribe optical devices such as side vision glasses and custom fit bioptic telescopic lenses, telemicroscope eyeglasses, prismatic reading glasses, or magnifiers to allow RP patients to carry out daily activities normally.
Cataracts is an eye condition that typically develops after the age of 60. The disease is associated with blurry vision and the inability to drive or read as objects are out of focus. A cataract develops when eye lenses become clouded, distorting a person's image.
While surgery is the most common option for cataract patients, we provide various non-invasive options that allow them to enjoy their hobbies and live their lives without visual impairment.
Dr. Kornfeld assesses your condition and stage and accordingly prescribes low vision devices and glasses such as bioptic telescopic glasses, E-scoop glasses, or magnifiers to enhance your vision.
Partial or full vision loss caused by a brain injury or a stroke is called Hemianopsia. Neglect is a condition caused by Hemianopsia that makes a patient unaware of the visual space located towards their left or right side. Neglect causes various problems in a person's life, such as causing them to bump into things often and misreading words or skipping letters on the eye chart.
At Low Vision Optometry of Western New York, we follow a proper treatment protocol for patients diagnosed with Hemianopsia. The treatments include:
Rumble Rehabilitation Protocol
Desktop Scanning
Wall Scanning
After the rehabilitation period is over and the patient can cope with visual scanning in the direction of Hemianopsia, Side Vision Awareness Glasses (SVAG) is an excellent option. The side vision glasses were created by Dr. Rummel and can be prescribed by any local low vision specialist. SVAG's advanced optical technology allows a person to navigate safely and perform daily activities normally.


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All teams arriving in Equatorial Guinea for the African Nations Cup must travel through the capital Malabo and have tests for the Ebola virus, the Confederation of African Football (CAF) said yesterday.
Those who show any signs of the contagious virus, or who refused to be examined, could be quarantined for up to 21 days.
"Everyone arriving at the Nations Cup must respect the medical rules and regulations," CAF said in a statement.
The tough regulations reflect fears of the spread of the deadly haemorrhagic fever that led Morocco to ask for a postponement of the 16-team tournament.
Instead they were stripped of their hosting rights and Equatorial Guinea stepped in at the last moment to take over.
The worst epidemic of the virus on record has killed more than 8,371 people and infected 21,171 in Liberia, Sierra Leone and Guinea, according to World Health Organization figures released on Monday.
Guinea are competing at the Nations Cup but the other two countries not.
The demands for the medical check have led Tunisia to cancel plans to have a warm-up game in neighbouring Gabon.
They said it would be too taxing on team logistics to travel to Gabon for the match and then to Malabo for the health checks.
Tunisia had originally planned to travel straight to the small eastern town of Ebebiyin where they will be based.
The Nations Cup kicks off on Saturday and ends on February 8.
21: Days one has got to be quarantined if he or she refuses to be examined at entry
8,371: The people whose lives have been taken away by the Ebola epidemic thus far
21,171 :The people who have been infected by Ebola in Liberia, Guinea and Sierra Leone


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Exercising is not always easy. You need perseverance and a clear goal because otherwise you will be lost in space. Not knowing what to do, forgetting your routines, and dismissing your workout sessions once and again. That's why many people start the road to weight loss without actually finishing. One of the things they usually say is that they find the gym in Hyderabad repetitive and after a while they start losing their motivation. If that's your case, maybe what you need is another type of exercise or sport that is more engaging and keep your interest.
That's why we are now introducing Muay Thai, a sport that comes from Thailand and is now all around the world. The recent popularity of Muay Thai boxing has many reasons. One of them is that this particular sport is associated with very effective and rapid weight loss. It works out your muscles, toning your body and reducing body weight at the same time.
Muay Thai or Thai boxing is a millenary technique that combines aerobic and anaerobic movements to deliver the ultimate exercise if you're interested in your body and fitness levels. It is not repetitive like cardio machines and gym routines, and you will be always learning something new.
You will not only look better but feel quite good after practicing Muay Thai regularly. It helps you reducing your cardiovascular risk because it lowers your circulating levels of blood lipids, and may also contribute to maintaining your glucose levels at bay if you're diabetic or have been diagnosed with the metabolic syndrome. But there's something else about Muay Thai that makes this sport an excellent exercise for almost anyone.
Muay Thai boxing does not only feature body workout. It also contributes to your mental health and other features such as discipline and self-control. It is not a sport you can use to harm others. Quite the contrary, you are taught to maintain your calm, even in the most adverse situations. Similarly, it encourages perseverance and discipline to small children and any other family member. That's why some families in Thailand decide to enroll children in Muay Thai classes very early in their development, and the majority has had at least some experience with this sport. You can check at Muaythai-Thailand for a good Muay Thai class for your health.
With so many benefits, it is not a surprise that people worldwide is adopting Muay Thai classes in gyms and martial arts academies. But if you really want to experience the real deal and happen to be in Thailand, we invite you to visit one of many Muay Thai training camps in the country. They are devoted to teaching the principles of Muay Thai for foreigners and locals, and will definitely give you a lasting impression about the culture and good habits of Thai people.


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YSR Aasara Scheme | YSR Aasara Scheme Payment Status | YSR Aasara Scheme Beneficiary List | YSR Asara Scheme Apply Online | YSR Asara Scheme Application Status
YSR Aasara Scheme :- Navaratanalu is in the manifesto of Mr. YS Jagan Mohan Reddy. Navarathanalu is a combination of 9 schemes, and YSR Asara Scheme is one of them. Today, through this article, we are providing you with all the important details about the YSR Aasara Scheme, like objectives, benefits, eligibility criteria for the schemes, How to check application status, Beneficiary List, etc. To get all types related toYSR Aasara Scheme Stayed with us till the end.
YSR Aasara Scheme 2022
YSR Aasara Scheme is started by the Andhra Pradesh Government. Under this scheme, the government will reimburse SHG loans taken by women belonging to minority groups. Navaratanalu is a combination of 9 social schemes. The schemes are Vidya Deevena, Vasathi Deevena, Amma Vodi, Vidya Kanuka, Nadu-Nadu, YSR Arogyasri, YSR Arogya Aasara, and YSR Pension Kanuka.
Under Vidya Deevena, Vasathi Deevena, Amma Vodi, Vidya Kanuka, Nadu-Nadu schemes free education will be provided to the students who come under the Below Poverty line. Under YSR Arogyasri, YSR Arogya Asara scheme free treatment will be provided. whereas Under YSR Pension Kanuka pension will be provided to the citizens.
YSR Asara Scheme Highlights | |
Article | YSR Aasara Scheme |
Launched By | CM YS Jagan Mohan Reddy |
Beneficiary | Woman of the state |
Objective | To Empower woman |
Launched on | 9th September 2020 |
Implement on | 11th September 2020 |
Official Website | Click Here |
The objective of the YSR Aasara Scheme
The main objective of this scheme is to empower women of SHG and to increase their income. Under this scheme government will provide financial assistance to the women. The government of Andhra Pradesh will reimburse all outstanding loans taken by all women members of SHGs belonging to SC, ST, BC, and minority communities in four installments.
Benefits And Features Of YSR Aasara Scheme
- This scheme will help to empower the women of Andhra Pradesh.
- The government will reimburse SHG loans to women belonging to minority groups through this scheme.
- As a part of the implementation of "Nava Ratnalu", the Hon'ble Chief Minister's commitment to alleviate the poverty in both rural and urban areas and to improve productivity, the YSR Asara scheme is proposed to be launched on 11.09.2020.
- Under the scheme, the Bank loan outstandings of SHGs as of 11.04.2019 will be reimbursed in four installments.
- In urban areas, the estimated beneficiary SHGs covered are 1,54,956.
- Around 900000 beneficiaries will get benefit from this scheme
- Under this scheme, the amount will be paid directly into the bank account of the beneficiary
Click Here :- AP YSR Jala Kala Scheme 2021
Eligibility criteria for YSR Aasara Scheme
To apply for Andhra Pradesh YSR Asara Yojana, the applicant has to fulfill the following eligibility criteria:
- The applicant should be a permanent resident of Andhra Pradesh.
- A member of Self-Help Groups (SHGs) is eligible for this scheme.
- Applicant women must belong to SC/ST/BC/Minority Community.
- The applicant should have taken a loan before 11 April 2019.
Document Required For YSR Asaara Scheme
The following documents are required at the time of applying for the Andhra Pradesh YSR Asara Yojana:
- Aadhar Card.
- Identity Proof.
- Resident Proof.
- Caste Certificate.
- Mobile Number.
- Passport size photo.
Online Application Procedure Of YSR Aasara Scheme
To apply for the YSR Asara Yojana, you have to follow the following procedure:
- First of all, you have to visit the official website of YSR Aasara Yojana.
- Now on the home page, you have to click on Apply Online.
- After clicking on the above link a new form will be open on your screen.
- Now fill in all the details asked in the application form carefully such as name, father/ husband name, date of birth, gender, caste, and other information, etc.
- Also upload the documents asked in the application form.
- Now click on Submit to final submission of the application.
Offline Application Procedure Of YSR Aasara Scheme
- To apply offline for YSR Asara Scheme, you have to visit your nearest bank first.
- Now take the application form of the Asara Scheme from the Bank.
- Now fill in all the information asked in the application form carefully.
- After filling the application form, all important documents have to be attached with the application form.
- Now you have to submit the application to the bank and the bank officer will give you an acknowledgment card.
- Now you have to secure this acknowledgment card as this acknowledgment card will help you to check your status.
Procedure To Check YSR Aasara Scheme Beneficiary List
- To check the YSR Asara Beneficiary list, you have to visit the official website.
- Now on the home page, you have to click on YSR ASARA- LOAN VERIFICATION REPORT option.
- Now a new page will be open.
- Now select your district, choose your municipality, CO, and slum.
- Now details of the beneficiary list will be on your screen.
Procedure To Check Application Status
- First of all, you have to visit the official website.
- Now on the home page click on Application Status.
- Now a form will be open on your screen, enter the Application number and other details asked in the form.
- At last click on Submit.
- Now the Application status will be displayed on your screen.
Procedure To Check Payment Status
- First of all, you have to visit the official website.
- Now on the home page click on payment status.
- Now a form will be open on your screen, enter the Application number and other details asked in the form.
- At last click on Submit.
- Now the Payment status will be displayed on your screen.
Procedure To Lodge Grievance
- First of all, you have to visit the official website.
- Now on the home page click on the grievance.
- Now enter your name, Contact number, Date, and Grievance description, upload the file, and click on Submit.
- By following above given procedure you can lodge a grievance
Contact Details
If you face and have any kind of problem or have a query regarding the Andhra Pradesh YSR Asara Scheme, you can contact on helpline number or write an email to solve your problem.
- Helpline Number- 0863-2347302
- Email Id- [email protected]
Note: How did you like the information provided by us on the AP YSR Asara Scheme, please let us know in the comment section. For more details of any other scheme stay connected with us on YojanaSarkari. Thank you.


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21 January 2009, Dhaka. BRAC's chairperson Fazle Hasan Abed, was recently bestowed with an honourary doctorate in humane letters by Rikkyo University in Japan. The President of Rikkyo University Mr. Hideitsu Ohashi gave a warm welcome to Fazle Abed on January 20th at an award-giving ceremony followed by an insightful lecture delivered by the founder of BRAC titled, "A New Path to Innovate Our Global Society."
In another initiative taken by Rikkyo University, BRAC, and BRAC University, a comprehensive co-operation agreement on both academic and practical grounds has been signed. Focusing on Japan and other Asian countries, this fruitful alliance will lead to a partnership in research and education aiming to cure social problems that counter the advancement of globalisation, such as poverty, governance issues and threats to the environment.


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Oxnard rejects Fisherman's Wharf residential plan
Revitalization project on Channel Islands Harbor could restrict harbor access, council members argued.
OXNARD—A plan to revitalize the Channel Island Harbor waterfront took a huge hit on Nov. 7. Oxnard's City Council, in a 6-1 vote, rejected a massive residential plan central to the Fisherman's Village redevelopment project.
Access to the water and parking were two of the biggest concerns, but the Channel Islands Harbor redevelopment has also been caught in the crosshairs of a power struggle between the city of Oxnard and Ventura County. Oxnard City Hall maintains any new development at Channel Islands Harbor should be consistent with its own policies. Ventura County, on the other side, has maintained Oxnard does not have the sole authority to dictate the future of Channel Islands Harbor.
The Fisherman's Wharf redevelopment project proposes to bring 400 residential units, commercial and retail tenants, an urchin dock and nearly 1,000 parking spaces to Channel Islands Harbor.
Both Oxnard and Ventura County have sought to revitalize the dilapidated Channel Islands Harbor and Fisherman's Wharf area since the mid-2000s, but the Great Recession of 2008 and a political stalemate since then have delayed the project from coming online.
There will likely be an appeal to the California Coastal Commission if Oxnard and Ventura County aren't able to resolve their differences.
A more in-depth report on Oxnard City Council's decision will be in the next issue of The Log.


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The ongoing saga over inappropriate emails has now reached the highest court in the commonwealth.
Steve Esack of Morning Call identified PA Supreme Court Associate Justice Seamus McCaffery as the recipient or sender of 54 pornographic emails received and forwarded throughout 2008 and 2009.
The emails have between 20 and 54 forwarded recipients from the justice's personal email account. The long email chain contained not only videos and images of sexual acts, but also sexually explicit jokes.
Several of the recipients still work in the attorney general's office, or other forms of state and local government. However, further names are being protected for liability reasons.
McCaffery briskly asked a Morning Call reporter to leave his property late on Wednesday night after stating "Not only do I not have any comment, since when does the news media pry into personal emails."
Attorney General Kathleen Kane declared she'd only be releasing the names and email chains of eight former public employees snared in the scandal. Her spokeswoman Renee Martin cited an ongoing grand jury probe as the reason she couldn't share further information.
Martin further stated that it is not illegal for adults to send or recieve porngraphy depicting adults.
Just last week, PA Supreme Court Chief Justice Ron Castille, warned that any judge connected to this scandal will have to "pay the piper." The two men are known to have a contentious relationship.


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Trenython Manor Goldene and Richard
- Photographer: Cornwall Parties Photography
- Wedding Dress: Bridal Gossip
Shall we get married Abroad or in Cornwall? Cornwall!
Goldene and Richard chose to get married in Cornwall because they wanted everyone they loved to celebrate their day with them.
"Our first idea was to go abroad but didn't want to make everyone pay so much! So we chose to have our wedding in the Cornish countryside"
Trenython Manor
"Trenython Manor is a beautiful place to get married you have use of all the amazing rooms and it just feels so relaxed, we fell in love with everything about the house and the scenery from the terrace sold it."
A wedding feast
at Trenython Manor
Food is important and the in-house chef takes great care to produce the perfect wedding feast for your day. On the menu, for Goldene and Richards day the couple chose belly of pork or melon for starters, roast beef or veggie for main for dessert creme brulé or sticky toffee pudding.
"All the food was delicious and absolutely amazing!"
A Sweet treat and bunting
Trenython Manor supplied a sweet cart for the reception along with sweet jars and bunting with the couples wedding colours flowing through the house.
"We had a few children on the day and everyone loves sweets!"
Cornwall Parties Wedding Photography and more...
Cornwall Parties Photography, Ami was their photographer and her husband Ben was their videographer but there's more he also did their reception disco too!
"Cornwall Parties Photography were brilliant! We got a bargain going for one company to do all of it and the pics and video are amazing"
A Country theme
The theme for the wedding was country, tree trunks for centrepieces and old milk jugs with baby breathe flowers and candles and all their guests received an old fashioned key for wedding favours.
"Our colours, blush pink and baby blue we wanted a soft kind of summer vibe no dark colours and everyone wore either blue or pink. It all looked so beautiful."
"My dress picked me...
You know what I mean! Caroline from Bridal Gossip is absolutely amazing at what she does and she helped me so much made me feel confident and perfect!
I fell in love with it straight away and knew it was "the one" the moment I put it on, I felt like the lady of the manner wearing it all day and night."
Two dresses?!
The dress that picked Goldene was actually her second dress - after a very bad experience with her first dress (it can happen ladies!!) Luckily Goldene found Bridal Gossip and with Caroline's help Goldene felt like she had nothing to worry about and she just knew she was going to find "the one".
Goldene wore pearls for accessories and baby breath in her hair her two daughters wore blush pink dresses with baby breath and rose halos.
"They looked adorable".
favourite part of the day
"My favourite part of the day and also the scariest was walking down the aisle and saying my vows after I stood there for a couple of mins I felt like no one else was in the room and just looked into my husband's eyes and meant every word we said to each other!
The rest of the day after that went so fast and I would do it again in a heartbeat!
My advice to other brides is to enjoy every second of planning your special day and even though you get stressed and feel like you are going to blow! But when it all comes together you will know how much you have put into your day and it's quite overwhelming.
Just enjoy every single second planning your special day it all falls into place and it's the most magical experience.
Richard said his favourite part of the day was watching me walk down the aisle!! I didn't think he would pay attention to the decorative part of the wedding cause blokes don't really have a clue but Richard was overwhelmed with how it all looked and was very proud of it."
Makeup Jenna Jazz, Hair and Makeup
- Photographer: Cornwall Parties Photography
- Wedding Dress: Bridal Gossip


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About This File
The barrier between reality and dreams has fallen. And you have volunteered to venture into the fray, wary of the unintended consequences of such a frightful marriage. Fight your way through a decaying military industrial complex that has merged all too seamlessly with the nightmarescapes of Hell itself. And hope against hope that the dream doesn't suck you in for good... You'll need freelook and jumps activated to beat the odds.


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New satellite images appear to show a new pontoon bridge over a potentially strategic waterway near Ukraine.Russia has built up forces in Belarus, and such a bridge could be useful in an assault on Kyiv.Russia has said its presence in Belarus is for training, but many in the West are unconvinced.As the possibility of a Russian invasion of Ukraine looms large, new satellite images taken this week show the construction of new roads and an apparent pontoon bridge over the Pripyat River at a position in Belarus just a few miles from the Ukrainian border.
The bridge appeared overnight Tuesday in an area close to 4 miles from the Belarus-Ukraine border, CNN reported .
It is unclear if the bridge seen in the high-resolution satellite imagery taken by Maxar Technologies on Tuesday is still there.
Sky News reported that in recent days, the bridge has been constructed and deconstructed, prompting a Western official to note that "this activity is highly unusual [and] inconsistent with any past exercise we have seen."
A new military pontoon bridge has been established over the Pripyat River, less than four miles from the Belarus-Ukraine border.Satellite image ©2022 Maxar Technologies It is unclear who constructed the apparent pontoon bridge, Russia or Belarus, but both countries have forces training together in Belarus.
Building and then disassembling a pontoon bridge — a floating bridge designed for the movement of troops, as well as tracked and wheeled vehicles across a strategic waterway — could be a kind of practice for expeditionary bridging in a conflict.
There are a lot of unknowns surrounding the bridge and its purpose, but by bridging the Pripyat in a fight with Ukraine, forces in Belarus could cross the river and advance toward the Ukrainian capital of Kyiv, CNN reported .The photos of the bridge, however, did not show any armor assets nearby.
Troops train to rapidly erect expeditionary bridges like these by connecting floating modules that span a river's width, allowing forces to readily maneuver and be less dependent on existing bridges that may be damaged or destroyed in a conflict.Kyiv, which sits on the banks of the Dneiper river, could be assaulted from its northwest if Russian forces were to ford the Pripyat river.
Russia has said that its increased military presence in Belarus is for joint "exercises," according to CNN , but Western observers are unconvinced, especially as other Russian claims of de-escalation appear to be falling apart.
On Tuesday, Russia claimed that it was taking steps to reduce its troop presence along the border of Ukraine.
That same day, President Joe Biden said the total number of Russian troops along the Ukraine border had swelled to 150,000.
The following day, a senior US official revealed that Russia had deployed close to 7,000 additional troops, possibly part of Biden's stated figure, to positions along the border with Ukraine.
The White House, State Department, and the Pentagon did not immediately respond to Insider's request for comment on developments near along the Pripyat.
A source familiar with the latest activities told CNN though that Russia is constructing "bridges, field hospitals, all kinds of support infrastructure," adding that this "is why we aren't really taking seriously their claims of de-escalation."
As Insider reported Tuesday , another Maxar satellite image appeared to show a field hospital in Zyabrovka, Belarus, which is about 15 miles from Ukraine's border.
Jeffrey Edmonds, a former CIA military analyst and current CNA Russia expert, t old Insider that such structures are unusual because "you don't conduct a training exercise where you expect large numbers of casualties."
"You deploy large medical assets when you expect heavy casualties from actual war, not from a training exercise," he said.
Biden said on Thursday that he anticipates that a Russian attack on Ukraine could come in a matter of days.


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Pattern Party Card
Hello and welcome back.
The 4th of 10 cards made at my Birthday Stamp-a-stack (SAS) I held this past weekend at my house.
This Pattern Party (stamp set) card was fun and very colorful. The girls had fun with this one and its one of my favorites. Also an easy card to make too.
Enjoy you day.


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Episode 1 thread
Episode 1 recap
Episode 2 thread
Episode 2 recap
Episode 3 thread
Episode 3 recap
Well, tonight's going to be rough.
You've got the run up to the Los Angeles Rams' third preseason game of 2016, their first road contest in the Rockies against the Denver Broncos. You've got the host of injuries they came out of that game with and the impact it's going to have on the install this week for the preseason finale against the Minnesota Vikings (now without QB Teddy Bridgewater due to a reportedly horrific knee injury). And, the annual tug of the Hard Knocks dramatic drawstring, the first cuts with the Rams forced to get to a 75-man cap as of today.
We're hitting the hard wall of the preseason. It's where Hard Knocks usually shines brightest. The fan favorites begin straddling that fence between unemployment and earning a spot with the team for meaningful football. The stories endearing us to the players we know won't make it with the horrible anticipation of having to watch them be cast out (Austin Hill...).
Tonight's the penultimate episode setting up the dramatic finale which tees up the first season of Rams football in more than 20 years. I might not blink.


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- Home
- Kentucky Trivia
- Kentucky Facts and Trivia
Kentucky Facts and Trivia
Want to know how the Kentucky fried chicken became so famous? Simply indulge in our Kentucky facts and trivia to know the reason behind the popularity of this retail chain restaurant. Many such interesting titbits are detailed in our Kentucky state facts and trivia. Here's one more fun fact for you! The famous 'Happy Birthday' song is said to have been penned down in the state. Explore our site for other funny facts about Kentucky.


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It's Monday, and we're fresh from some great racing at Ironman New Zealand. It was really great to be down watching some racing again (and yes, I did miss racing myself!).
While down at the event, Prof Grant Schofield and I were invited to present on the low carbohydrate healthy fat (LCHF) performance for Ironman.
The link to the presentation can be found in this closed Facebook group here (anyone can join), and we think it was quite well received with 50+ people attending.
However, as always around racing, one of the main questions we always receive is "how do I fuel my races with LCHF?". Luckily, along with two of my endurance physiology colleagues at AUT, we discussed this very topic in a paper that used theoretical energy fuel requirements of Ironman triathletes at different performance levels (~8 h, ~9 h, and ~13 h).
This paper was published in the Journal of Sports Medicine, and I've tried to summarise below. The science is quite heavy so I will split this blog into two parts. This one with the background and the next one with more practical theory.
In the Sports Medicine paper, we tried to determine what the likely carbohydrate and fat requirements would be for Ironman triathletes completing the distance at an elite level (~8 h), at a very high-performing amateur level (~9 h), and at a lower-performing amateur level (~13 h). To do this, we first estimated the overall energy requirement of completing each of the three disciplines, assuming efficiency values typical for the three levels of athlete. As the elite model performance was swimming, cycling, and running faster than the amateurs, the rate of energy expenditure in each discipline was much higher. This is a characteristic feature of better athletes from a metabolic perspective – the ability to sustain higher rates of energy expenditure for long periods.
Next, we identified a low and high estimate for the rate at which each of the three athletes might have been using fat as an energy source, in each of the three disciplines. This varies substantially between different people, so we gave quite large ranges (0.6-1.2 grams per minute for the elite model, 0.5-1.1 grams per minute for the high-performing amateur model, and 0.3-0.9 grams per minute for the low-performing amateur model). Lastly, we used the estimated rate of energy expenditure to calculate the theoretical requirement for the use of carbohydrate as an energy source at both the low and high estimate for fat oxidation.
That's the complicated part! What was most interesting was that, in all of our models, i.e. low and high rates of fat oxidation and across the performance spectrum, the estimated requirement for energy from carbohydrate sources was higher than what we have stored in our bodies as glycogen (anything from 788-1999 grams depending on the model). This confirms what anyone who has ever finished an Ironman already knew; we need to preserve our limited carbohydrate stores.
In short, what our paper showed, was that for the very elite and top-level age-group athletes, even with very high levels of fat oxidation, it's almost impossible to complete an Ironman distance race without taking in some form of carbohydrate. I have modelled this below (Figure 1 and 2) and showed at my fat oxidation rate (1.2 g/min, a consistently realistic "maximal" number is ~1.6 g/min). I wouldn't have made it out of the Energy Lab had I not consumed some carbohydrates (I took 50 g per hour on the bike and 110 g for the entire marathon)
However, at the same time, had my fat oxidation not been high and substantially lower (<0.5 g.min, which is very typical for age-grouper and even pros) I would not have made it to the finish, no matter how much carbohydrate I consumed. Take Figure 3 and 4 below. This athlete who we tested in the lab had maximal fat oxidation of 0.3 g/min (exact same body weight and VO2max as me). Figure 3 shows him hitting the wall in the last 50 km of the bike at 60 g of carbohydrate per hour including the run), and Figure 4 shows him hitting the walls at the start of the marathon with 90 g of carbohydrate per hour. Bottom line is, unless he increases his fat oxidation, he will never make it! Moreover, consuming that much carbohydrate (60 plus grams per hour) can leave you with severe gastrointestinal distress. I have also done a video regarding the perils of very high carbohydrate consumption and fasted blood glucose levels and subsequent health here.
What was unfortunate is that when our paper was published, it seems that this was the main message that was received; "Ironman triathletes at high-performance levels must ingest carbohydrate to meet their energy requirements, or risk bonking". Indeed, the paper showed that some carbohydrates are essential for the top age-grouper and elite athlete. However, throwing more carbohydrate into the mix isn't the answer; increasing your fat oxidation is! For a whole variety of reasons.
In the next blog, I will talk more about why increasing fat oxidation is both sensible and achievable.
Endure IQ's weekly Brew Up newsletter brings you Dr. Dan Plews' weekly top 5. Everything from the latest science and tech, to must read books/podcasts, and weekly workouts.
Get the latest Brew Up newsletter from Endure IQ's founder, Dr. Dan Plews.


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Young Boy Drowns in Elk River
A six year-old boy drowned Friday afternoon in the Elk River in McDonald County, according to the Missouri State Highway Patrol.
The boy, who lived in Kansas City, waded out into the water about a mile and a half north of Noel (extreme southwest Missouri) around 2 p.m. and could not return to shore.
He was later recovered and taken to Freeman Neosho. Where he was pronounced dead at 3:45 p.m. by Dr. Pace.
This was Troop D's 14th drowning for 2021.
25 True Crime Locations: What Do They Look Like Today?
Below, find out where 25 of the most infamous crimes in history took place — and what the locations are used for today. (If they've been left standing.)


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JetLag Eaten Font
by moonmoth design
2 font family styles
Eaten Style
Bold Eaten Style
About JetLag Eaten Font
the pasta font prototypes improperly stored; so it's back to the drawing board. if you want something done right, ask someone you can blackmail. might be some usages for this design. Bleach commercials? Mouse trap packaging? Cloud computing user manuals?
Have managed to get myself incarcerated in Milan. (Nice view of the city from my cell, by the way. Am considering developing a striped font- now that i have some time on my hands.)
It has been said: never try to bribe a castrato with cheese. And I never have. But how was I to know that there's a corrolary to that adage involving carbon credits and tax collectors. Luckily I've got Cardinal Vespucci to vouch for my honor and/or sense of humor. Unfortunately he's in the Seychelles for the weekend and has turned off his cell.
All this because I'm driven to educate pasta eaters. Too bad people don't read the back of a vermicelli package like they would a corn flakes box. Alphabet soup remains my one hope


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Best Mountain Bike Rear Shocks Review Bike Rear Shocks Buying Guide
Our priority is to serve our customers first and foremost. The seller is 365cycles and is located in this country US. Rockshox monarch plus rc3 rear shock debonair 7.875×2.25fits 2015-18 santa cruz sign up for news, special offers & other good stuff! Expert customer service by bike experts!
Archive for the debonair Category


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While most British Columbians are now vaccinated against COVID-19 and a majority of us are also on board with a vaccine passport system to help get us out of this pandemic, more than a thousand anti-vaxx ding dongs gathered this week to protest outside a hospital in Vancouver.
Described by some of those participating as an "anti vaccine passport rally," the gathering was a whole lot more than that, which is why we made the decision to characterize it as an "anti vaccine" protest in our news coverage of it.
Attended by conspiracy-theory-sharing simpletons of all varieties ("Bonnie is a Nazi!", "Media is paid off to prolong PLANDEMIC!"), the mayor of Vancouver and the premier of B.C. have both denounced it, and health-care workers who were affected by it have spoken out.
In its wake, the city and province lit up both Vancouver's city hall and the B.C. legislature buildings in pink as a showing of support for health-care workers keeping us alive, and essentially as a middle finger to those who were moronic enough to participate.
As expected, supporters of this anti-vaxx protest that blocked the streets around Vancouver General Hospital have not been happy with most of the media coverage of this misguided gathering which not only demoralized healthcare workers but physically blocked arteries to and from the hospital on 12th Ave. It endangered lives, making it difficult for people to receive care, and did more damage than the organizers could imagine; however, so far none have publicly expressed regret for the way in which they went about their protest against the government.
Some participants claimed they were there simply to voice their opinion that people should have a right to not be subjected to a vaccine passport, and that reasoning might have elicited some sympathy from the general public if it weren't just so damn stupid.
Protesting the government's widely welcomed vaccine passport outside of a hospital, far from any government decision-makers, is beyond ignorant. It seems an awful lot like the work of a selfish mob advocating for their right to not get vaccinated in the first place.
That's also really, really dumb, considering where we're at right now.
There's no way for us to know if somebody on Parler shared this story with you or if you came across it because you're a regular reader of our news media publication, but let's just assume you're a normal human being reading this.
Let's go through some hypothetical questions with you here and see where you end up.
1. If you were to show up to a protest, how many conspiracy theories on signs would it take before you thought "Hm, maybe this isn't an entirely sane bunch?" and decided to leave?
2. How many actual Q-Anon t-shirts would you need to see before you raised an eyebrow and reconsidered if you'd like to be associated with a crowd, and if they are actually your people?
3. Would you chant "Lock her up!" with a crowd like the one on Wednesday, or would you simply go home after everyone started screaming that phrase in unison?
If these were your people and you participated in that chant and hope to lock up B.C.'s Public Health Officer, there's a place for you in B.C.
It's not the old leper colony on D'arcy Island, but it's close.
It's anywhere on Crown land, hundreds of kilometres from any community, and it's free! If you move there you're entirely within your rights to build what's referred to in legislation as an Emergency Cabin.
Of course you're likely going to be inclined to "dO YOuR oWn REsEaRCh!" on this, and you'll want to watch as many YouTube videos from "experts" as you possibly can before you make your decision, but I assure you I've looked at the legislation and I know this is the right decision for you.
You could bring together the materials to construct an emergency cabin for less than your monthly rent or mortgage payment. You could leave the city and never again be bothered by anyone who thinks it's the right thing to do to work together to make sure our society doesn't completely collapse.
Your new life of freedom awaits. Let me know if there's anything I can do to help get you there.


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Brill, Buckinghamshire | View on map
Carefully restored pub with rewarding food, local ales and interesting furnishings; bedrooms
- Separate restaurant
Bar food times: 12-2.30, 6.30-9 (9.30 Fri, Sat)
Typical main dish: Pointer burger and skinny fries
Typical main dish price: £15.95
Average two course evening meal price: £24.00
- Speciality beers
- Cask ales
Price of cheapest bitter: £4.00
Name of cheapest bitter: XT
- Dogs allowed in bedrooms
Number of bedrooms: 8
Bedrooms cost between £140.00 and £160.00
- Children allowed in the bar
- Children allowed in the restaurant
- Dogs allowed in the bar
- Dogs allowed in bedrooms
The good pub guide review
Unusually, this handsome place is a pub-cum-restaurant-cum-butchery business and all the meat comes from their own livestock herds and neighbouring farms; also, free- range eggs, home-baked bread and home-made pies, sausage rolls and so on (open 2.30-6.30pm Wednesday-Friday, 9am-2.30pm Saturday). The stylish bar has low beams, windsor chairs, elegant armchairs and sofas with brocaded cushions, open fires or woodburners in brick fireplaces and animal-hide stools by the counter. House ales come from XT Brewery, and there's a solid list of artisan spirits and liqueurs, and a thoughtfully curated wine list, all served by friendly, attentive staff. The airy and attractive restaurant has antique Ercol chairs around pale oak tables, cushioned window seats, rafters in a high vaulted ceiling and an open kitchen. French windows open on to the sizeable garden. Opposite this handsome inn is a red brick cottage which houses their eight restful, pretty bedrooms. Tolkien is said to have based the village of Bree in The Lord of the Rings on this pretty village.
The good pub guide food review
Interesting, indulgent dishes include bubble and squeak with crispy bacon, poached eggs and nollandaise sauce, devilled chicken livers on toasted brioche, baked whole camembert to share studded with garlic and rosemary, ale battered fish and triple-cooked chips, basil and pumpkin seed pesto linguine with roasted aubergine and toasted pumpkin seeds, and puddings such as citrus chocolate mousse and tiramisu with Tia Maria, chocolate crumb, coffee ice-cream and chocolate tuille.
2021 Awards
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Contact Details
Pointer, 27 Church Street, Brill, Aylesbury, Buckinghamshire, HP18 9RT
(01844) 238339
Opening Hours
Weekdays: 3-11pm Mon, Tues; 12-11 Wed, Thur; 12-midnight Fri
Saturday: 12-midnight
Sunday: 12-9pm


text:
Cerrudo Services, as prime contractor, won the award of this Comprehensive Tactical Infrastructure Maintenance and Repair (CTIMR) contract in 2012. Cerrudo self-performed 80% of the work. The catagories of work were: Fences and Gates, Roads and Bridges, Drainage and Grates, Lighting and Electrical and Vegetation Control and Debris Removal. For each category the classifications were Routine Work and Urgent Work. Several crews were required to accomplish the routine and urgent tasks under this contract. Cerrudo had three crews responsible for above and below grade fence, gate and grate repairs, roadway maintenance including blading, grading, drainage, structure clearing and silt removal, culvert replacement, electrical service calls, line, pole and transformer replacement and vegetation control and debris removal.
Routine and urgent work required for the maintenance and repair of the fences and gates entailed a wide range of tasks. The amount of repair tasks for a typical 12-week work period included both above and below grade repairs and maintenance for up to 60 urgent and routine tasks. Routine roadway work included surface blading of roadways, ditches and embankments, roadway and pothole repairs, shoulder maintenance, tree removal and ditch cleaning and shaping. The electrical crew responded to service calls and maintenance of the electric systems. There was an average workload of 3-4 tasks per week for the electrical crew for service calls to replace lights, service gate motors and controls, service junction boxes and transformers and to perform line replacement.
Vegetation control consisted of mowing lawns and brush, and subsequent debris removal at the same time as the maintenance and repair activities in the area.