text: Affordable Care Organizations: Implications on Wellness Aug 2, 2014 Lori Heim, M.D. FAAFP Past President & Board Chair American Academy of Family Physicians Objectives 1 Describe impact of ACO on Family Medicine 2) Elaborate on the role of AAFP members in the payment & delivery models pertinent to Family Medicine 3) Evaluate the ACO in the context of health care reform, Patient Centered Medical Home and impact on Family Medicine. Abbreviations • Accountable Care Organizations (ACO) • Feds – Center for Medicare & Medicaid Services (CMS) – Health & Human Services (HHS) • Patient Centered Medical Home (PCMH) • Per-member-per-month payment (PMPM) or per-patient-per-month • Fee-for-Service (FFS) 3 President Obama signs Affordable Care Act (ACA) 3/2010 4 Push for ACA • Control health care costs – This was #1 priority for many – Question has been how best to do this • Expand health insurance coverage • Improve health Incentives from ACA • Community-based care funds grants • Programs to keep patients at home • Initiates payment reforms and pilots for PCMH, • ACO's and bundled payment models 6 Budget-Based Payment • Attempts to shift delivery from volume to value – Away from FFS • Capitation • Shared savings • Bundled 7 Capitation • Prospective global payment • Risk falls to provider – FFS risk is with payer • Payment for patient includes: – Complications – Utilization extremes • Managed Care is example 8 Episode-Based • Bundled payment synonym (sometimes) • Payment is bundled= single payment • Specific condition • All setting • Provider has all the risk but less exposure due to limited time 9 What is an ACO? • Takes concept of PCMH "neighborhood" • PCMH are foundational to success • Assume responsibility for defined population • Financial risk and savings issues – Must understand risk adjustment 10 Why the push for ACO? • Attempt to move to new model • Away from traditional fee-forservice • Control costs • Achieve quality markers PCMH Neighborhood • PCMH primary care based • Expanded with: – Subspecialists – Mental Health – Support services – +/- hospital ACO Payment Structures • Medicare contracts • Medicaid (dual eligible) • Private insurance contracts • Degree of provider integration predictor of ACO formation – Integrated hospital systems and larger PC groups increased ACOs. Health Affairs. Oct 1013 Types of Payment Structures • Shared savings – FFS is basis • Capitation • Bundled/ DRG • Pay for Performance – Bonus or increased differential on top of FFS Shared Savings Options • Upside or both upside & downside – Retrospective adjustments to payments based on cost and quality – 2 sided= provider repays if cost overruns but gets share of savings if costs are less than predicted – 1 sided= shares in savings if any, but less $$ than 2 sided formulas since there is less risk Payment Issues • Risk of penalties if miss savings targets • Acuity of patients • 3 year baseline formula for spending target • Have to calculate the start-up cost – Staff support, IT Quality measures- CMS • 33 NQF measures in 4 areas: 1. Care coordination and patient safety 2. Preventive care 3. Patient experience 4. Care for at risk populations Quality Markers • HEDIS measures • Inpatient hospitalization & readmissions – Usually ambulatory care-sensitive (CV, DM) • Patient satisfaction – May not be indicative of either quality of care or predictive of cost expenditures or savings Fenton JJ, Jerant AF, Bertakis KD, et al. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med 2012;172:405–11. Medicare Program • 366 ACOs after 4 rounds of Medicare Shared Saving Programs (MSSP) contracts • 606 including public & private ACOs • Minimum of 5,000 beneficiaries • 3 year commitment • Adhere to same basic coverage as set in ACA rules ACO Penetration ACO in NM • Accountable Care Coalition of New Mexico, LLC • GPIPA ACO • Presbyterian Healthcare Services ACO Structure Options • • • • Physician led/owned- predominant Hospital system Non-profit community organization Practice management companies Physician Leadership in ACOs • 51% physician led, 33% physician + hospital • 78% majority on governing boards • 40% physician owned First National Survey Of ACOs Finds That Physicians Are Playing Strong Leadership And Ownership Roles Health Affairs June 2014 Physician Led ACO Examples • Wilmington Health, NC – Medicare Shared Savings – BCBS ACO impact for FM • Opportunity for income but also for financial risk depending on structure • Need to determine how savings are shared- Who gets what cut of the pie • Very difficult (impossible) for solo without other integration but doesn't require hospital centric platform, just more common ACO Implications for Patients • Attempts to balance cost savings with quality & patient outcomes – Reaction to prior managed care & incentive to withhold care to control costs • Emphasis on integration of care, communication, prevention – Most realize cornerstone is adequate network of primary care Vulnerable Populations • High- risk clinical populations – CHF, DM, mental health issues, etc • High-risk social populations – Poverty, illiteracy, etc • Opportunity to target interventions with greatest reward either in cost savings (decreased ER/hospital $) or increased quality Cautions & Challenges • Defined patient population"attribution" • Management of "drift" outside network – Penalties to pts for this? • Data is mandatory "big data" but also actionable patient level • Support to act on this data Data • Attribution of patients – Prospective vs performance year methods • Track by population and by individual and their provider group • Requires current claims dataMedicare, Medicaid, private insurance Patient Engagement • Critical component for ACO and any intervention • Yet this is elusive Summary • ACO likely to propagate further • Resources available to evaluate plan to determine if wise move: – cms.gov/Medicare/Medicare-Fee-for-ServicePayment/sharedsavingsprogram/index.html – AMA, AAFP, Most state medical societies – Health Affairs, Commonwealth Fund, Kaiser Permanente Foundation Resources


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'Stories Shared'
Multi Media Exhibition by Youthreach and Artists In The Community 2008
From Tuesday 17th February to Sunday 1st March 2009
Signal Arts Centre is delighted to present an exhibition of work produced in collaboration with Youthreach, the Artist in the Community winners; Greg Murray and Denis Dunne and some senior citizens from the community in Bray.
The premise of the project is to engage Youthreach and the senior citizens in a collaborative project. The project is based on the art of storytelling, of conveying events in words, images and sounds. Traditionally old stories were passed from generation to generation and survived solely by memory. This tradition is fading and part of the project's aim is to give the storyteller (Senior Citizens) an opportunity to be heard, the storyteller creates the experience while the audience (Youthreach) perceives this story/memory and creates personal mental images from the words heard and gestures seen. In this collaboration the audience becomes co-creator of the Art, and this in turn begins a new creative process whereby the audience becomes the creator of a visual depiction of the aural Art.
Opening Reception: Friday 20th February 7-9pm

subset: commoncrawl


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Spring is the season of new beginnings and it's a great time to refresh your wardrobe. X-TN's new collection is all about defining your wardrobe around a few statement pieces to anchor your entire style. Their clothes are for someone who is unique and never boring!
*Disclaimer: No monetary compensation was received for this post.
X-TN is headed by Xuan-Thu Nguyen, who opened her first boutique in 2005 in Paris. Her creations are a mixture of modern and geometric shapes with delicate accents like handmade embroideries. I love the beautiful details of her clothes and the strong lines, like in the jacket above.
I also love this beautiful floral dress! It's 100% silk and perfect for the warmer weather that Spring brings. X-TN's collection is full of staple pieces that a woman can build her wardrobe around. They have just enough detail to be interesting on their own, but you can style them in different ways with accessories, too.
This gorgeous necklace is the perfect example of the exquisite detailing that can be found in X-TN's creations. This would look beautiful paired with a blouse or dress from the collection!
Spring collection from X-TN! Good clothing is an investment, and these pieces will be staples in your wardrobe for a long time.


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Surgery Improves Survival in Diabetic Patients with Heart Disease
Among diabetic patients with severe heart disease, coronary artery bypass grafting (CABG) surgery is better than stenting (percutaneous coronary intervention; PCI) at improving long-term survival and reducing the risk of adverse complications, according to an article in the April 2015 issue of The Annals of Thoracic Surgery.
"Adults with diabetes are two to four times more likely to have heart disease than non-diabetics, and at least 65% of these patients will die from their heart disease," said Paul Kurlansky, MD, from Columbia University Medical Center in New York, who led the study. "Diabetic patients who require medical intervention for their heart disease should speak candidly with their physician to determine the best treatment option for them. Our study has shown that this discussion should be informed by the general superiority of bypass surgery over stenting for this population."
Using a community-based registry, Dr. Kurlansky and colleagues examined data on all patients undergoing CABG or PCI for coronary artery disease February 1–July 31, 2004, who also had follow-up data by 2011. Of the 1,082 patients who met the criteria, the researchers were able to compare 240 well-matched patients from each treatment group.
"Unlike a lot of other studies that focus on select groups of patients who receive special therapies, our results reflect a 'real world' picture of contemporary medical practice and are broadly applicable to the general population of diabetic patients with severe coronary artery disease," said Dr. Kurlansky.
Results showed that mortality was more common in patients who received PCI than those who underwent CABG. Patients in the PCI group also had a higher risk of non-fatal heart attack and need for revascularization. Dr. Kurlansky said that CABG may be more effective in this growing segment of the population because diabetes is a systemic rather than a localized disease. "Since PCI addresses localized lesions, CABG addresses the entire downstream circulation, which tends to be a more complete solution for these patients."
The study did not examine the long-term risk of stroke among the two patient groups, and the researchers note that this parameter warrants further investigation.
"Each patient is an individual and needs to be carefully evaluated according to his or her specific circumstances and needs," said Dr. Kurlansky. "The most important advice for the diabetic patient is to control modifiable risk factors for heart disease—stop smoking, lower your blood pressure, control your weight, exercise, and monitor your blood sugar levels."
Importance of Heart Team Approach
In an invited commentary in the same issue of The Annals, Robert F. Tranbaugh, MD, from Mount Sinai Beth Israel in New York, emphasized the importance of the findings noting, "Kurlansky et al are to be commended for their efforts to better define the optimal treatment of diabetic patients with coronary artery disease."
"It is important for these findings to be incorporated into the management of diabetic patients with multivessel heart disease, starting with an emphasis on the heart team approach," said Dr. Tranbaugh. "Cardiac surgeons and cardiologists need to work together in the decision making and need to be advocates for our patients, seeking the safest and most durable treatment option."
Source Newsroom: Society of Thoracic Surgeons
Annals of Thoracic Surgery


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The Intimate Forest
A Celebration of the Beauty of Nature in Oil Paintings by Harlan
Orange Maples
30x40 2005
Because I am nearsighted I enjoy the beauty of Fall by looking at the leaves, not the whole tree bedecked in amazing colors but the leaves and often one leaf at a time. Every one of them is unique! Unlike snowflakes that will dissolve with your attention, you can handle a leaf. You can turn it over and admire it from the back. You can hold it up so the sunlight shines through or hold it down so the sunlight dances across its surface and note how different it looks.


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Convinced that his imperfect, solitary existence is the best it will ever be, Martin unexpectedly finds himself being sent to represent his company in Japan. His colleagues think it's a joke; his bosses are certain he will fail. What does Martin think? He simply does what he's told. That's how he's survived up to now – by hiding his feelings.
Amazingly, in the land of strange rituals, sweet and juicy apples, and too much saké, Martin flourishes and achieves the impossible. But that's only the beginning. Keeping up the momentum for change proves futile. So, too, is a return to what he had before. Is there a way forward, or should he put an end to the search now?
Gradually, as you'll see when Martin looks back from near the end of his journey, life improves. There's even a woman, Fiona, who brings her own baggage to the relationship, but brightens Martin's days. And just when you think there can be no more surprises, another one pops up.
Throughout his life, people have laughed at 'weirdo' Martin; and you, as you read, will have plenty of opportunity to laugh, too. Go ahead, laugh away, but you'll find that there's also a serious side to all this…
Review Cultivating a Fuji by Fany Van Hemelen:
What a thought provoking book about who difficult it can be to show your true self!
Martin is for a lot of people a strange men. He is a fantastic computer programmer, but his social life is a disaster. He is peculiar and even at his work, he has almost no friends. Than, even if nobody has trust in his social abilities, he has to travel to Japan and is the one who has to be the saver of the company.
Back in time, I discover why Martin is so quiet and anxious. In his childhood, at school and as a student he already was different and just survived finally by protecting himself to escape. He decided to not feel anything more, but normally it's impossible to escape reality.
Luckily is Japan the start of a new beginning. After the perfect deal Martin first has to sink even deeper and start over again.
Cultivating a Fuji is a very touching story about how hard it can be to fit in the crowd. Martin his character is well-developed and even the minor personalities have their own past and problems in this wonderful story.
This is a beautiful narration about real delicate matters, that is woven in a poignant story. I truly appreciate it when people stand up and tell about sensitive things. Such books make it easier to understand each other and make life more happily together. I do know now, I am high sensitive, but when I did know this as a kid it could made my life much easier. In the past, I felt myself often so different or alone and just like Martin I had to deal with myself and both we had to find the key to unlock the door. Just to point out people are not perfect, have feelings and not everything is how it looks….
Cultivating a Fuji is a fascinating way of telling about choosing your own path and the courage to show yourself to the world.
It is okay to be a real person with weaknesses and maybe after this book we can look behind the behavior but see the person…
Miriam Drori has decided she's in the fifth and best stage of her life, and she's hoping it'll last for ever. It's the one in which she's happiest and most settled and finally free to do what she wants. Miriam lives in a delightful house and garden in Jerusalem with her lovely husband and one of three children. She enjoys frequent trips around the world. She dances, hikes, reads and listens to music. And she's realised that social anxiety is here to stay, so she might as well make friends with it. On top of that, she has moved away from computer programming and technical writing (although both of those provided interest in previous stages) and now spends her time editing and writing fiction. Neiter here nor there (currently unavailable), a romance with a difference set in Jerusalem, was published in 2014. The women friends, co-written with Emma Rose Millar, is a series of novellas based on the famous painting by Gustav Klimt. Social Anxiety Revealed (non-fiction) provides a comprehensive description of social anxiety from many different viewpoints. Cultivating a takes the social anxiety theme into fiction, using humour to season a poignant story.
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Titel: Cultivating a Fuji | Auteur: Miriam Drori | Uitgeverij: Independently Published | Categorie: Romans | Uitvoering: paperback | 236 pagina's | ISBN13: 9781094806747 | Recensent: Fany van Hemelen | Datum recensie: 16-05-2019 | Prijs: €13,49 | Bestellen


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Call for Applications for Youth Conference on The 9th Asia Pacific Conference on Reproductive and Sexual Health and Rights (9th APCRSHR)
Posted on June 26, 2017 By Agung Wicaksono No comments
Categories: Volunteer
- Call for Applications for Youth Conference onThe 9thAsia Pacific Conference on Reproductive and Sexual Healthand Rights (9thAPCRSHR)27 November 2017, VienamThere are an estimated one billion young people aged between 10 and 24 years living inAsia and the Pacific, accounting for more than a quarter of the population in this region.1These young people are just entering their sexual and reproductive years, howeverunderstanding of the sexual and reproductive health (SRH) needs of the majority (831million) who are unmarried remains limited[1]. In Asia, young people are heterogeneous,and have come from all walks of life. They recognized that majority of them across theregion are marginalized and that the situation is particularly difficult for young women andgirls, people living with disabilities, indigenous people, ethnic and language minorities,migrants, young people who use and inject drugs, people living in the context of war andhumanitarian crises, young people who sell sex, people living with HIV, out of school youth,and displaced people, regardless of sexual orientation and gender identity and expression(SOGIE)[2]. The gross inequities in sexual and reproductive health outcomes in the regionparticularly affect adolescents and young people, in particular, through poor access tocomprehensive sexuality education, sexual and reproductive health services including fullrange of contraceptives, safe abortion, STI and HIV treatment and mental health services.Including young people in the design and promotion of the rights and program of actions toSRH helps identify the barriers to access and can ensure equity for young people.The 9th APCRSHR will be organized from 27th to 30th November 2017 in Vietnam, and willbe hosted by Vietnam Public Health Association (VPHA). The first day of the conference isYouth conference. The theme of the 9thAPCRHR is: Leave NO ONE Behind! - Justice inSexual and Reproductive Health, Youth Conference plays an important role to gatheryoung people regardless of sexual orientation and gender identity and expression (SOGIE)in not only Asia Pacific but also across the world who are working and interested in field ofReproductive and Sexual Health and Rights to strengthen their voice, exchange theknowledge and take actions for their justice and rights to sexual and reproductive healthissues.. Furthermore, the youth conference becomes an opportunity to promote meaningfulparticipation to address the SRHR challenges and inequity among young people by crosslearning from their peers best practice and practical action in the conference and in theirown countries when they come back.
This conference will cover sub-themes:1. Overcoming social, cultural and religious barriers in sexual and reproductive health2. Towards a just economic order for sexual and reproductive health3. Strengthening justice systems for sexual and reproductive health and rights4. Making good quality sexual and reproductive health education available to all5. Advancing justice and equity in sexual and reproductive health and health careThe Award/ Scholarship: General guidelines- 50 young people will be given scholarships (25 from Vietnam and 25 from Asia andthe Pacific Region) which covers conference registration fees, travel and transportationincluding visa fees, board and lodging, other related expenses and pre-conferenceorientation.Guidelines for the Youth Scholarship selection- Interested young people from Asia and the Pacific region are invited to submit a youthapplication form together with essays.- The application form and essay must be sent to the 9thAPCRSHR Youth ScholarshipCommittee (firstname.lastname@example.com) with the subject "Youth ScholarshipApplication" on or before 30thJune 2017. Late applications will not be considered.- Youth Scholarship Committee reviews all the youth applications and selects 50 youthscholars (25 from Vietnam and 25 from Asia and the Pacific region). Selected youthscholars will be contacted not later than 30thJuly 2017 via email. Final list of scholars willbe announced on 1stof August 2017.Criteria for Selecting the Youth Scholar1. The youth should be between the ages of 15 to 24; and living and/or working in AsiaPacific.2. Has a significant contribution or involvement in youth programmes and relevant SRHactivities in his/her country as reflected in the essay submitted?3. You have a working knowledge of English.
4. You have experience working with issues of sexual and reproductive health in anycapacity and you are passionate about the sexual and reproductive rights of young people.5. You have a good social network of other young people and have leadership potential6. You have good communication skills and know how to use the Internet and smartphones for Facebook, Twitter and blogs.7. You can demonstrate how you will use what you learn at the Conference in your workand how you will continue to participate in follow-up activities.8. First time participation in the APCRSHR is a plus.Youth Scholar ResponsibilitiesThe selected Youth Scholars will commit to participate fully, learn-share, raise their voiceand take action to address SRHR issues facing youth both during conference and in theirhome countries. During the 4 days conference, the youth scholars will be asked toparticipate in a team to support conference outputs. One team will focus on monitoring andevaluation (M&E), including passing out a survey and going around to collect completedforms during the afternoon session of the youth conference. Another will focus on mediaand communications, including an interactive photo opportunity for use on social media.Post-conference, scholars will be asked to update for their involvement in SRHR advocacyor programs in their home countries that they spread or apply the lessons learned duringthe event.[1] Sexual and Reproductive health of unmarried young people in Asia Pacific and the Pacific:review of knowledge, behaviors and outcomes[2] Nay Pyi Taw Youth Recommendation, 2016 – Youth conference on the 8thAsia Pacificconference on reproductive and sexual health and rights


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Working with XHTMLJunkies has been a great experience. Their level of service is of stellar class. At first, I had my doubts about doing business overseas due to various reasons however, I decided to give it a chance. I had a particular project to do on my website and i was looking for it to be done at a reasonable price. The first time I spoke with them over the phone call they put my mind at ease because not only did they take the time to understand my needs but they also gave me sound advice.
The project that I requested to be done was completed exceptionally well. There were a few challenges though,however they got the job done. I will be definitely giving them more projects from now on.These guys a offer a really good service.


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Spacious 1 bedroom apartment Fontvielle with parkinghttp://c.com.mc/52054
18, quai Jean-Charles Rey
98000 Monaco
Monthly rent : 4 500 €
Ref: MANTEGNA1
City: Monaco
Type: Apartment
Room(s): 2 rooms
District: Fontvieille
Building: Mantegna
Total area: 61 m²
Living area: 53 m²
Terrace: 8 m²
View: garden
Exposition: south
Floor: 1
Parking: 1
Cellars: 1
Service charges: 650 €
Nice 1 bedroom apartment with high-end finishes, located on the 1st floor of a good residence in "Fontvieille". It is composed as followed:
Entrance hall, living room opening onto a terrace, bedroom, equipped kitchen, laundry room. 1 cellar and 1 parking space.
Available now.
Contact the agency
Icon Property
Le Botticelli, 9 av. des Papalins
98000 Monaco www.icon-property.com
Le Botticelli, 9 av. des Papalins
98000 Monaco www.icon-property.com
+377 97 97 09 40
+377 97 70 27 66
This document does not form part of any offer or contract. All measurements, areas and distances are approximate. The information and plans contained herein are believed to be correct, however, their accuracy is not guaranteed. The photographs show only certain parts of the property at the time they were taken. This offer is subject to change of price or other conditions, without prior notice.


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Continuing our series of stories about precious metals from our dear customers, we have an inspiring account from Bob W. He shares his experience of accumulating precious metals over more than two decades:
My story in no way rivals the wonderful story in your original email, but here it is. [you can find my original story here]
Once I had a back surgery which did not go as planned. I was left at home on the mend and had much time on my hands. I had always enjoyed reading financial stuff and started reading articles about precious metals versus government issued fiat currency.
I learned the difference between the two. I understood the issues of debasement and inflation and what they could do to devalue government issued currency.
At the time (1996), I was out of work and also had a growing family with three children in either private universities or high schools. In spite our financial worries, I made the leap and purchased a combination of silver, gold, and platinum.
I was back at work after a little over a year and continued to purchase small batches of primarily silver whenever I could. The dealer I used for my original purchase eventually suggested I swap out my platinum coins (which had appreciated significantly) for silver eagles, which I did.
Over the years, I've continued to increase my metals holdings, except in 2011 and 2012 at which time I liquidated several hundred eagles.
I also opened up a precious metals IRA when I rolled over a 401(k) from a previous employer in 2006.
I've periodically taken redemptions in kind from this IRA, especially when I felt the market was depressed. I have kept my metal or gifted it to my children at different points in time.
The largest portion of my holdings is still held securely in a storage facility out of state.
Over the years I've tried to encourage family members to view real money as I do.
I have so many comments about Bob's story.
For starters, it's a perfect example of sustainable, long-term investing. Bob has been a patient and steady investor who has systematically invested for decades. He played a long game and didn't give in to speculation and mania, which has paid off for him big time.
For the record, in 1996, an ounce of silver and gold traded at around $5 and $375 respectively. As I write this, gold sits at around $1,295 while silver sells at $16.51.
Removing Emotions and Speculation from Investment Decisions
Another aspect of Bob's story that stuck with me was his resilience and emotion-free investment decisions.
Bob was wise enough to recognize bubbles in the precious metals market and re-balance his portfolio accordingly. In retrospect, it looks straightforward. But in the midst of mania, it takes discipline and courage to sell.
He sold part of his stash of precious metals in 2011. Back then, precious metals were in a big uptrend with gold nearing $1,900/oz and silver $50/oz. The rally was the direct result of Bernanke's aggressive quantitative easing in response to the 2008 financial crisis.
As QE tapered, Bob temporarily reduced his exposure to precious metals to capture some gains at highs.
High metals prices induced excess optimism and speculation among investors. Caught up in the mania, they forgot that all asset classes go through bull and bear cycles. A crash followed.
The reverse is happening now.
With today's relatively low prices, precious metals are falling out of favor. Everyone is obsessed with tech stocks instead, which closely resembles the period leading up to the dot-com crash.
As history shows, following the herd is the fastest way to lose your shirt.
A Better Alternative to a Traditional Precious Metals IRA
I'd like to wrap up this article with one piece of advice for Bob and any of you who have a precious metals IRA. Instead of taking redemptions from an IRA, I suggest transferring your IRA assets to a Roth IRA.
In doing so, you'd still realize gains on the assets being rolled over and pay taxes. Also, you'll enjoy the following benefits in the future:
- Future gains would never be taxable again as long as the assets stay in the Roth IRA.
- Roth IRA distributions are non-taxable for the beneficiary.
- Roth IRAs do not require forced distributions once the owner reaches age 70 ½. Your gains will continue to compound tax-free as long as the assets are in the fund.
- Your heirs will hold all the benefits of a Roth IRA if you don't take redemptions before death.
A Roth IRA is one of the most important parts of your estate plan. Of course, you must consult your tax accountant or estate attorney to see how a Roth IRA conversion would work based on your personal circumstances.
For most investors, however, Roth IRAs are one of the most powerful tax shelters. They are 100% legal and yet very few advisors recognize their value.
Bob, thank you for being a member of the Hard Assets Alliance and for sharing your stories with us!


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DVD Now Available Worldwide!
August 18, 2009 Filed in: General
I am happy to announce that the RapidWeaver Classroom DVD is now available for shipping worldwide! The DVD is a great option for those who are traveling often, or for those with inconsistent or slow internet access. For everyone else, I would still recommend the subscription, as it gets you unlimited access to all of the tutorials, for as long as you hold an active subscription.


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Ever since left-wing, anti-capitalist, and progressive thinking came into political prominence, it has been the goal of the ruling classes to suppress it. Despite the efforts of 2 Red Scares and COINTELPRO, movements for social justice and liberation have trudged on and have inspired countless generations of activists. We will be focusing on the struggles of activists today and the current methods of political policing used by the ruling classes. The fact of the matter is that radical progressive politics are being undermined today just as they were for the past century, maybe even more so. This is done through police violence, censorship, and leftovers from the era of COINTELPRO. This is an issue that all progressive activists must take seriously in order to prevent the destruction of revolutionary and progressive movements.
The United States likes to claim that it does not have political prisoners or that it does not conduct political policing but, both claims are simply not true. Political policing in the United States is a tradition almost as old as the country itself. It began in the late-1800s with the crushing of unions and strikebreaking and from there evolved into the system we see today. While much of the frankness of the system has somewhat gone away with the decades, the main method still exists. That method is criminalisation. Criminalisation is when the state makes activism or actions illegal. This has been used to crush unions, the Black Panthers, and the Anti-War Movement among others. Criminalisation is how the United States is able to say they have no political prisoners. Criminalisation is often not outright, for that would grab too much attention. They often stretch the definitions of crimes, rewrite laws, plant evidence, or flat out lie in order to jail activists and revolutionaries. Occasionally actions of protest or political expression can be direct crimes, such as striking or union organising in certain states. There are numerous examples of this throughout the history of activism in the United States. To see the worst of it, look at the Black Panthers. For those not in the know, the Black Panthers were a revolutionary group who worked for the self-defence of black communities across the United States. They worked in response to police violence against African Americans across the United States and besides their self-defence programs, they had programs of assistance to the poor and the communities they defended. For all of their history, they experienced the brunt of what COINTELPRO could throw at them. Criminalisation was one of many methods used against them. Most prominently was Fred Hampton. Fred Hampton was the chairman of the Illinois Black Panthers and was a constant target of police harassment. He was murdered in an "arms raid" in 1969. FBI infiltrators had slipped drugs to Hampton during dinner and he was fast asleep when the raid occurred. The police then proceeded to shoot him 2 times in the head. While the police called it an arms raid, that was not the real reasoning. Most of the Black Panthers' arms were legally registered and were not kept at the apartment. There was not even a shootout. Investigations showed that the Panthers had only fired one shot while the Chicago Police had fired around 91 shots. All Panthers in the apartment were indicted on trumped-up charges.
When looking for more modern methods of political policing we need only to look at the ongoing case of Mumia Abu-Jamal or simply Mumia. Mumia is a radical activist, journalist, and former Black Panther from Philadelphia. He was a supporter of the MOVE organisation and other radical elements fighting for liberation in the city. In 1981, Mumia's brother was stopped by a Philadelphia police officer and Mumia had watched the interaction. At the end of it all, the officer ended up with shots in the back and face and Mumia ended up with a shot in the stomach. The prosecution had little to no physical evidence against Mumia and a lot of the evidence they did provide was questionable, to say the least. Even with that Mumia ended up in prison for life without parole. This trial has been questioned by numerous organisations both in the United States and abroad. The call has been for the freeing of Mumia and at least a re-trial. Both are things the City of Philadelphia has been unwilling to do. This is due to the strong levels of embedded racism in the Philadelphia PD and the police advocacy groups and unions pushing back at efforts to give Mumia a fair trial. It is generally believed that the reasons Mumia is being kept in jail are due to the extreme racism of the police and his involvement in radical organising. Philadelphia was one of the cities that cracked down hard on radical movements. Under the direction of Frank Rizzo, the city saw the massive suppression of black liberation movements. This track record does not show much hope for the Mumia case but, hopefully all the outside pressure will cause the city to cave in and free him.
How do these situations relate to today? Well, those actions of the 20th century still occur today. Looking recently we can see the actions of the Trump Administration mirroring the methods used by COINTELPRO. Firstly, the J20 Protestors. J20 is the term given to the protests at Donald Trump's inauguration. The J20 defendants are anti-fascist protestors that were arrested during the protests in January 2017. 214 people were arrested, with most of them having their charges dropped. 58 people are still being prosecuted, each of them is facing at least 60 years in prison each. What makes this case so despicable is that there is no real evidence proving they committed any crime. This action of mass charges against protestors is a scare tactic meant to dissuade political organising. It has been done for many years, most recently during the Occupy Wall Street protests. Political policing is the reality for radical activists on the ground and it is all too often ignored by the majority of Americans. The J20 case is especially worrying given that these were Anti-Fascist protestors and the Trump Administration has been exceptionally hard on anti-fascists but, light on far-right extremists and white supremacists. Think of that what you will. Another very recent example of political policing relating to the White House's leniency towards white supremacists is with the "black identity extremists" debacle. Firstly, the terminology is clearly an attempt to criminalise the Movement for Black Lives, a movement often demonised by scared white people. Despite the absurdity and shallowness of this term, it is no laughing matter and is being used to repress progressive movements in black communities. Most prominently the case of Rakem Balogun and Guerrilla Mainframe. Balogun is the first known person to be prosecuted on the charge of being a "black identity extremist". Balogun was a legal gun owner, activist, and worker who was unjustly detained by the US government. Many point to his organisation to attempt to justify his charge but, Guerrilla Mainframe is not a violent organisation. It does advocate for self-defence for black communities but, it also conducts many community help programs, much like the Black Panthers. These programs include ones providing food, clothes, and housing to the community, much like the Black Panthers. The saying "history repeats itself" is definitely pertinent in this situation.
Criminalisation is no doubt a large problem facing activists and it ties in with another issue: Censorship. Contrary to what conservatives and reactionaries like to say, they are not suppressed at all. Left-wing progressive ideology is far more suppressed by governmental structures and society as a whole looks down on it more than right-wing ideas. This is because left-wing ideas upset the status quo more than right-wing ones. Conservatism does not scare the powers that be. The concept of the leftist boogeyman is merely a ploy to give them more legitimacy and try and appeal to bourgeois notions of free speech. They love to claim that universities are somehow these bastions of "evil Marxism" that is bent on the destruction of Western Civilisation. This is absurd. Right-wing groups are perfectly able to organise on universities, in fact, left-wing organisations have had a harder time organising. This is again due to the fact that left-wing ideas upset the status quo. If you want an example of this look at the University of Virginia around the time of the Charlottesville Protests. The University had penalised anti-fascist students while it continued to allow Nazis and white supremacists to use their facilities without punishment. Look also at the BDS and pro-Palestine movement that has been oftentimes banned at colleges and universities. Right-wing groups are seldom banned unless they are outright racist and even then. That brings up an important point to see when looking at these right-wing arguments. Right-wingers often believe that someone calling out their racism, challenging their beliefs, or merely disagreeing with them is some sort of assault on their freedoms. They whine about safe spaces existing but, will not get out of theirs. They live in an echo chamber and their arguments are absurd and frankly, time should not be wasted on them.
Progressive ideas are censored in a variety of ways. Oftentimes progressive actions will not be reported on or when they are, their meaning and intentions are misrepresented. Take for example, the Anti-Fascist movement. They are often portrayed as violent or people there wanting to censor the speech of others. This is not the case at all. Firstly, the perception of Anti-Fascist protestors as being against free speech is absurd and is a claim that comes mostly from Nazis themselves. Anti-Fascist Action does counter-demonstrations that are not necessarily meant to disrupt the other demonstration, merely protest it happening or provide an alternative narrative. Counter-protesting is key to keeping the marketplace of ideas open and free. As for the issue of violence, this is true. Violence is key to anti-fascism. Fascism is itself violent and can only be combatted through a countering force. It must be stated that Anti-Fascist Action has never been the provocateur of violence, in most cases it is the fascists that provoke incidents to get publicity. Just look at the events of Charlottesville or J20. Another example of media misrepresentation is the Movement for Black Lives. BLM is possibly one of the most misrepresented movements in the modern political landscape. This stems from the embedded racism of American society and the general unwillingness of media outlets to truly try to understand progressive movements. The most misrepresented portion of the movement is their platform. Their platform is often misconstrued as being wholly anti-police or violent, both of which are not necessarily true. BLM mostly calls for police accountability and transparency, although the platform can vary from chapter to chapter. This fact of variance is also not often reported and this can be confusing to the uneducated viewer. Immigrant rights groups, Palestinian rights groups, and a whole slew of organisations suffer the same misrepresentation and censorship. The aforementioned BDS Movement is often censored for its views. anti-Zionism is often conflated with anti-Semitism and this is not a fair or true comparison. Besides the fact that many Jewish people are anti-Zionists. the Israeli government controls much of the narrative on Palestine in the West. The media outlets tend to view things from the Israeli perspective and do not give the Palestinian one. This leads to movements both in Palestine and elsewhere being misrepresented as anti-Semitic. The other method the media uses to discredit activists is to blow up minor events or the views of a minority group. While anyone with critical thinking and basic reasoning could see through these tactics, it often works in fooling people.
Another key method of suppression is the use of infiltration. This is a notable leftover from the days of COINTELPRO that functions in much of the same way. Radical groups are infiltrated by police officers or an existing member is bribed by the police to disrupt the group. These infiltrators are often there not to provide information on criminal activity but, to split and disrupt the group. This can be done by deliberate sabotage of events and meetings. One of the many signs that someone may be in the pocket of the police is when they have severe ideological differences and refuse to put them aside for cooperation. This was a tactic used during COINTELPRO to disrupt New Left and Anti-War groups during the Vietnam War. This being said, this method is probably rarer in its usage today. This is due to a variety of reasons, mainly the shift of priorities for the government and the fact that there are easier and more destructive methods, most of which we have already discussed.
The methods we have discussed are not all of the methods used by the powers that be to suppress radical activism. Discussing each method would take a whole book to do and some of those methods are becoming antiquated as the internet age progresses. The truth is that we live in a time where surveillance in some way should be an accepted reality for activists. Accepting that fact is key to protecting yourself from it. There are a variety of methods one can use to protect oneself but, many are compromised. The best way is to not discuss private organising matters online, discuss them in person. The fact is that there really is not one guaranteed method as a lot of them are built on trust so, activists often have to just take a bet on that. That should not be the world activists live in. This shows the real hypocrisy of the United States as a country. A country that claims to hold free speech as a high ideal has radical activists having to hide their ideas and plans with such secrecy. This is intentional as the state works to maintain the status quo and will do whatever necessary to maintain it. The system wants to break its opposition but, history has shown us that it rarely succeeds. Opposition perseveres. The freedom of ideas must be an important idea for activists, without discourse there is no progress. To quote Mao Zedong:
"Let a hundred flowers bloom and hundred schools of thought contend"


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I've heard that writing a book is often compared to having a baby. Since I've done both, I can see a couple similarities. For me, writing a book took a lot longer. My first book, Sometimes a Woman Needs a Horse took 30 years from its beginning until I held the finished product in my hands. Beyond the Visible Edge took about five years from the time Bob died until I finished the memoir. I have to admit that the emotions involved in having a baby are a bit similar to writing a book. Each book becomes a part of me, a piece of me that I must then send out into the world to accomplish its purpose.
And now that Beyond the Visible Edge is out there, its time to find the readers who might need its message of hope. If you know someone who has lost a loved one, especially a son, or someone who has a fear of death, please share the link to this website: www.beyondthevisibleedge.com. The book trailer video is on the Home Page. And please take a moment to send me a message or question, or share an experience. I would like to hear from you.
Betsy, I enjoyed your book and I certainly relate with some of your feelings. I would like to share this book with a friend with her grief of losing her husband. Blessings to you with your writing and taking time to write these down.
Arlene, thanks again for posting on my blog page. I am still learning how to use this tool effectively! But I want my book to get into the hands of anyone who might benefit from its message! Let me know if I can help in any way. Thanks.


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Are you planning a weekend with family, friends or some other trip? Bed & Breakfast de Imme may be the perfect place for you. It is exquisitely located in the Weerribben area and surrounded by our impressive nature where the quiet prevails. A comfortable accommodation with various included provisions and a kind atmosphere.
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Our B&B offers an accommodation with a focus on nature and quiet. For that reason we provide no radio and television.


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Executive Director, Translational Research
Current Appointments
- Bert N. La Du Professor and Associate Chair of Anesthesiology Research
- Executive Director of the Michigan Institute for Clinical and Health Research
- Associate Dean for Clinical and Translational Research, Medical School
- Director of the Center for Consciousness Science
As executive director of translational research, Mashour works closely with U-M Office of Research (UMOR) leadership, the Office of Technology Transfer, the Business Engagement Center and faculty across campus in advocating for translational research in its many forms across the schools, colleges and campuses of U-M. Mashour chairs the Translational Research Council, which was created and is charged with coordinating translational activities across campus. He helps educate faculty and staff about the value and methods of translational research, while collaborating with members of the UMOR team to exchange knowledge, develop shared vision and strategies, and enhance synergies between UMOR and the Michigan Institute for Clinical & Health Research (MICHR) in community engagement, compliance, education and training. Mashour joined UMOR in April 2016. He also serves as associate dean for clinical and translational research in the Medical School Office of Research, director of MICHR and has various faculty appointments.
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A Clayton home's crawl space can have some serious moisture issues that often lead to a number of problems for the rest of your house. Due to this excess moisture, foundation issues, mold, and mildew growth, as well as termites and other pests can infest and damage your home. These are just a few of the common problems caused by moisture. The best solution is hiring a professional crawl space waterproofing and encapsulation from Crawl Space & Basement Technologies of Clayton.
How can I know if my Clayton home has some crawl space moisture problems?
- High humidity in the first floor
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I have water into my Clayton crawl space, How is it possible?
- High humidity. Climates with high humidity like North Carolina can cause some serious water intrusion in homes with foundation vents. The warm, humid air will pass through the vents and condensation occurs on the HVAC ducts, floors joist, and insulation.
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How can I prevent water from getting back in?
Treating the source of the intrusion is the first step in resolving the moisture issue. However, if your home construction is on flat land or a negatively graded lot, then the water collecting in the crawl space cannot be stopped. This moisture comes from ground saturation. Once over-saturation occurs, water naturally migrates below the French Drain and the footing, allowing for entry to the interior crawl space. A French Drain is rendered INEFFECTIVE at keeping water out.
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1st Step: A drainage trench is dug, usually around the perimeter, in the interior of the crawl space.
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Time Out says
Local DJs in a New York-style rooftop bar
Bangkok's sweltering heat doesn't stop a bunch of expats and tourists from enjoying the last rays of sun over happy hour at multi-level rooftop spot, Octave. Located at Marriott Hotel Sukhumvit, Octave offers light, East-meets-West bites and tapas-style dishes for you to nibble on while enjoying the bar's signature cocktails. What makes this New York-style rooftop even cooler is how it serves moreish finger food in a transparent chest of drawers resembling skyscrapers. We recommend the waruoro platter (fresh oysters, tuna salmon nigiri, California roll and rainbow roll, B1200) and the enothini platter (prawn and bacon sliders, marinated chicken with mango coriander salsa, tuna tartar and sesame wafers, goat cheese with caramelized onions and crab-cake pops, B1200). Meanwhile, local ingredients are used to create cocktails like a Thai-style mojito (Thai rum, lime, mango and basil) and Shining Sun (rum, tamarind, pomelo, lime shrub, mango and pineapple juice). The menu is rotated every four months and promotional menus crop up every month. A local DJ takes over the decks from 8pm until late.


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Alwarea Khaled
- Male
- country
- Syria
- disciplines
- architecture, design, Photography, photography, production, scenography, sculptor, sculpture, video
- languages
- Arabic, English, French
- 21.08.1988
- at Damascus, Syria
- life at Paris, France
contact information
Born in 1988 in Damascus, Syria, Khaled Alwarea is an architect and multidisciplinary artist. His work varies between installation, visual art, photography, sculpture, filmmaking, scenography and interior design. In 2014, he founded the design studio "UV LAB" and carries out projects for the Middle East and Europe. In Lebanon, he is dedicated to the refugee crisis and equitable access to educational facilities for disadvantaged youth. He has been in France since 2016 and is a member of the agency of artists in exile.


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During the summer holidays kids can be kept entertained with a full
week of acting singing and dancing, culminating in a costumed performance
for family and friends.
SUMMER SCHOOL 2019 Inverness
The Nutcracker Prince
a play with music adapted from the ballet and the film the four realms
To reserve your place £20.00 (none returnable deposit required)
Summer school details...
Inverness....22nd -25thJuly. Monday to Thursday 11am-3pm. Thursday evening performance at 7.30pm
course held at Merkinch Community Centre
Summer School Elgin
Peter Pan
5th-9th August Monday-Thursday 12-4pm Friday evening performance7pm
New Elgin Hall
A packed lunch is required everyday. Pupils are not allowed to leave the rehearsal room so make sure they have everything they require especially drinks..dancing can be thirsty work!
We visit key towns in the highlands and bring our productions for them to play all the parts, have a wonderful week of theatrical fun, learn new skills, make new friends and take away many happy memories which will last a life time. The chosen musical will include dance singing and acting all children are given the opportunity to audition for parts or take a part in the chorus. This is also an excellent theme for their essay what I did in my summer break when they return to school!
Monday to Thursday from 11.00am until 3.00pm (unless hall unavailable at these times) Four full days of rehearsal. With a full dress rehearsal on the day prior to the performance. A packed lunch is required each day. Children at no time are allowed to leave the rehearsal room so please ensure they have all they require in their lunch box. Fees are payable in advance and no refunds are given as booking a place denies another person of that place. (Refunds are only offered If a child is ill and a doctors certificate provided a booking fee will be deducted) A chorus part is just as important to the shows success as a leading part. To be part of the whole concept and form a team for the good of the show is our aim. No one individual is going to make or break a performance it is a team effort! Fees payable are £75.00 per child. A none returnable deposit of £25 required at time of booking.
WHAT CAMPBELL THINKS P5. Shayne is really nice. It is an extremely good experience to go on stage. Every good actor starts like this I want to be a professional actor.


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Julie & Julia is fabulous entertainment. I'm reading reviews and I'm sick of many male journalists who dismiss this movie as "chick flick," "one for the over 50's," "for women." I'm so sick of sexist journalism. Gi Joe is not reviewed as a "dick flick," or "strictly for the boys." Male journalist write as if this movie appeals to everyone. Yet whenever a movie is about women, these male journalists classify.
These same journalists would never have the balls to say that, for example, the movie Obsessed -staring Beyonce Knowles and Idris Elba -is strictly for the African American crowd. They wouldn't dare put that in print. Yet despite the fact that women make up 51% of the population, the movies about us are relegated to minority status.
Hollywood and its rag tag of young male journalist ass lickers ignore the global box office success of Mamma Mia. Hollywood is not quick to cash in on producing carbon copies of a feel good movie about the over 50's crowd. Instead we have to suffer from vacuous effects laden and toy-marketing tie-in kids' movies. I've said this before in a recent article, but which demographic has the most disposable income? Is it the teenager who relies on handouts from mum and dad or is it the over thirties, over forties, over fifties crowd who are just dying to spend money on theatre tickets?
Answers on a postcard.
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StreetScout / SEARCH: 1201 E Apache Boulevard Tempe, AZ 85281
- $1,917 price
- 5973340 listing id
- Square Feet: 10,000 sqft
- Year Built: 2019
- Neighborhood: PARK PLACE
- Status: Active
New street retail space located at the base of a new luxury Park Place apartment complex. Conveniently located less than a quarter mile from Arizona State University. Walking distance away from Arizona State University. High residential density and visibilty. Foot and street traffic. Just steps to light rail station.Total of 10,000 contiguous square feet available can be divisible to 1,000 square feet.
Courtesy of: LRA Real Estate Group, LLC
Office Phone: (480) 526-5644
Copyright Arizona Regional Multiple Listing Service, Inc. All rights reserved. Information is deemed reliable but not guaranteed.
Updated: 16th March, 2020 2:38 PM.
1201 E Apache Boulevard Tempe, AZ
Streetscout Powered by Placester


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Whenever I get a new client and they are a few days "in", eating a healthy diet and experiencing what it feels like having a significant dose of protein with every meal, sooner or later I will get this question: "But isn't eating so much protein bad?" I'm not sure where this fear stems from, but I blame the crappy fitness and health industry. No, it isn't bad for you, quite the opposite is the case, it is healthy! Let me explain why. Continue reading "Protein: Myths and Reality"
Tag: meat
Breakfast Pulled Beef
Easy peasy meal prep for even the most stressed cooks.
As temperatures get a little lower (which I am extremely happy about), and autumn peeking around the corner, I am in the mood for something different for breakfast. Something warming, comforting and hearty, keeping me satieted many hours. I like my easy cheesecake, but now I'm not cutting anymore and can afford to eat something different. However, even if you are cutting at the moment, this recipe could be for you: you just have to be smart about the cut of meat to use.Continue reading "Breakfast Pulled Beef"
What You Should Know About Nutrition
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Fitness, health and nutrition media is notoriously full of misinformation, misinterpretation and outright lies. Too many interests collide, forming an asteroid field of poor guidelines, health myths and misunderstood science. With this article I want you to be able to filter out this noise and get a better picture of what really matters.Continue reading "What You Should Know About Nutrition"
Ground Beef Mapo Tofu Style
Szechuan inspired umami bomb.
I love Szechuan cuisine! There is a nice Szechuan restaurant in Vienna (Meister Xiao – go for it if you are in Vienna!) a couple of minutes away from us and they are serving gorgeous dishes. One of my favourites is mapo tofu: ground beef or pork, silky tofu, black beans and abundant spicy oil made from chili, szechuan pepper and broad bean paste. It's served with fluffy, delicious, steamed rice. Guess what? It did not fit in my macros 😉 but we had similar ingredients at home and developed the following cut-friendly recipe adding also some more veggies. Give it a try, if you love spicy flavours as we do!Continue reading "Ground Beef Mapo Tofu Style"
Your Masterpiece: The Perfect Steak
A basic cooking method to honour your steak.
Who doesn't like a good steak? Letting your inner viking take over and sink your teeth into tender, juicy meat … I'm getting hungry only thinking about it! Most people are afraid to cook steak at home, as it is easy to completely ruin your beloved meat if you are not careful. But don't give up, once you have mastered a few basics, you can have the perfect steak at home, anytime and in no time.Continue reading "Your Masterpiece: The Perfect Steak"
Pork Loin Letscho
Easy protein for every day.
Letscho is a popular dish in Austria, originally from Hungary and mainly consists of peppers, tomato and onions. Traditionally it is combined with bacon and served as a main dish, but in Austria it is prepared with even more vegetables and therefore considered a side.We've combined both ways and created a macro-friendly one pot version of this popular dish. Check it out!Continue reading "Pork Loin Letscho"
Sunday Roast: Summer Edition
Solving the dilemma of hot summer days and the need for a perfect roast.
I love my sonday roast! I go to the butcher and let him select a nice cut of meat for me and on my way home I plan how I'm going to cook it. A few simple sides to go with it. Most of the time this will be roasted vegetables, since I am addicted to their simplicity and deliciousness. But in the summer times my enthusiasm for sunday roast comes to a halt: it is hot outside and the last thing I want to do is adding heat by roasting something for hours in the oven. But I have found a solution and you will love it!Continue reading "Sunday Roast: Summer Edition"


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harsh intent-goodbye.
kelly lune
written 7/19/13 for dVerse Mix and Match
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collum lune
written 7/19/13
Tony collected links to two years of dVerse Meeting the Bar and Form For All and suggested that we explore one that we missed. How fucking exciting, y'all! Seriously, if you want to learn about writing poetry, this a one stop shop. The contributors who wrote the original posts are fabulous. Check it out.
I chose Samuel's lesson on lunes and I am so happy that I did. I see more lune tweets, they may even put a dent in some of my cinquains (y'all know I like a short form.)


text:
Explore the back of house areas at Alexandra Palace and learn about the history of this iconic place. Led by our wonderful team of volunteers, these walks are designed to give you access to some areas of the Palace generally unknown to most of our visitors.
Tours are free and are about 45 to 60 minutes long; please note that they are not step- free, if you need to use the lift please do get in touch at email@example.com
Get here early and soak up the atmosphere of our Festival Village – featuring a line-up of the finest names in London street food and an eclectic bill of bands and DJs. Start your gig the right way.
Alexandra Palace
Alexandra Palace Way
Tube: Wood Green
Railway: Alexandra Palace Rail
Bus: W3 or Shuttle Bus