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Aleksandra Warska / Anna Maliszewska / Anna Wnuk / Beata Szyszka / Włodzimierz Sawicki / Krzysztof Cendrowski
Citation Information : Journal of Ultrasonography. Volume 18, Issue 72, Pages 50-55, DOI: https://doi.org/10.15557/JoU.2018.0008
License : (OPEN-ACCESS)
Received Date : 17-October-2017 / Accepted: 16-February-2018 / Published Online: 30-March-2018
Ultrasonography, with its detailed imaging of the fetus, is very widely used in obstetrics. The primary aim of ultrasound scanning in pregnancy is to limit the risk of obstetric complications by early detection of abnormalities, such as intrauterine growth restriction and macrosomia. Currently, morphometric formulae are used for estimating fetal weight. They utilize basic biometric parameters. However, Hadlock formula, used for fetal weight estimation, has an error rate of 20%. For this reason, researchers all over the world have been looking for other sonographic parameters correlating with fetal weight, with a higher predictive value. The current scientific reports indicate that new sonographic parameters, such as soft tissue thickness values, are useful for fetal weight assessment. The measurements can be conducted in various parts of the fetus’s body, e.g. thigh, upper arm, abdomen or the subscapular area. Different types of measurements are characterized by different levels of correlation with other sonographic and anthropometric parameters as well as body mass and gestational age. Based on the reports, numerous studies proposing new fetal weight calculation formulae have been produced. Apart from soft tissue, some more advanced and detailed measurements are taken, such as those involving adipose and lean tissue or using three-dimensional ultrasound (3D), for determining fetal weight. Ultrasound measurement of subcutaneous tissue thickness in various parts of the body may prove to be a strong predictor of fetal weight, which is useful for sonographic assessment of pregnancy.
Ultrasound is very widely used in obstetrics. It enables detailed imaging of the fetus, among other possibilities. However, it is different at every stage of pregnancy. The use of diagnostic ultrasound begins already at 4–5 weeks of gestation when it is possible to visualize the gestational sac in the uterine cavity. From approximately 5–6 weeks of gestation the embryo’s echo is visible(1). As the pregnancy develops, the number of assessed parameters and the level of difficulty of the ultrasound procedure increase. The information acquired using this method concerning the developing embryo allow for the prediction, diagnosis and therapy of certain fetal pathologies. The advantages of diagnostic ultrasound primarily include non-invasiveness and ease of the procedure(1). According to the latest reports, ultrasound scans performed during pregnancy are safe and do not affect fetal weight, premature labor risk, the child’s condition at birth or perinatal mortality(2). Sonography is also associated with certain limitations, especially when the visualization of the fetus is difficult due to unfavorable technical conditions, the mother’s obesity, anterior placenta or oligohydramnios(3). The primary aim of ultrasound scanning in pregnancy is to limit the risk of obstetric complications by early detection of abnormalities(1). These include fetal growth abnormalities such as both intrauterine growth restriction (IUGR) and macrosomia, which are more common in pregnancies complicated by diabetes, obesity, hypertension, nicotine addiction or fetal genetic defects, among other conditions(1).
Over the last few years a larger proportion of neonates with high birth weight for gestational age has been observed. This phenomenon is called macrosomia, which can be defined as fetal weight exceeding 4500 g regardless of the fetal age or exceeding the 90th percentile for a given gestational age and population(1,4). In pregnancies complicated by diabetes the estimated fetal weight exceeds 4200 g(4). The prevalence of macrosomia in the general population is 6–14.5% and in women with diabetes 25–42%(5). The risk factors for macrosomia, alongside maternal diabetes, include maternal obesity, post-term labor, a history of giving birth to macrosomic children, multiparity, advanced maternal age, male fetuses and hyperinsulinemia(4). Macrosomia is associated with multiple complications, both for the mother and the fetus. For fetuses and neonates these are increased mortality, shoulder dystocia, perinatal trauma (including humerus and clavicle fracture and damage to the brachial plexus), low Apgar score, postpartum hypoglycemia, prolonged jaundice, systemic defects, respiratory problems, calcium deficiency and infections, among other conditions(1,4,5). For mothers, macrosomia is associated with an increased risk of perinatal trauma such as pelvic diaphragm and anal sphincter damage as well as an increased risk of the delivery by cesarean section and of postpartum hemorrhage(1,4,5). Early detection of macrosomia allows to avoid the above complications.
Another type of intrauterine growth abnormalities is intrauterine growth restriction. This term is assumed to refer to fetuses whose estimated body weight or abdominal circumference value is below the 10th percentile(6). The possible cause of intrauterine growth restriction is considered to be impaired circulation of the fetoplacental unit, i.e. placental insufficiency(1,6). The etiopathogenesis of this condition is still unknown, while the mechanisms responsible for intrauterine growth restriction can be classified as fetal, maternal, placental and environmental factors(1). The most common factors include maternal age of > 40 years, the mother’s short stature, low body mass, arterial hypertension, diabetes with vascular complications, nicotine addiction, obesity, kidney diseases, autoimmune diseases, anemia and cholestasis disease of pregnancy(1,6). Fetuses with suspected growth deficiency include those with constitutional or genetically-related low body weight as well as those with pathological conditions such as intrauterine growth restriction. Low birth weight represents an important problem in obstetrics since it is responsible for 69.6% of neonatal deaths and 66.4% of intrauterine deaths(7). The best diagnostic method for this pathology is regular estimation of fetal weight or measurement of fetal abdominal circumference in high-risk pregnancies(6).
Currently, morphometric formulae are used for estimating fetal weight. They utilize basic biometric parameters such as biparietal diameter, head circumference, abdominal circumference and femur length(8). Hadlock and Shepard formulae are most commonly used; however, they have certain limitations. The sensitivity and specificity of Hadlock formula in the detection of fetal macrosomia are 62% and 93%, respectively, and for Shepard formula they are 21% and 99%, respectively(9). For this reason, researchers all over the world have been looking for other sonographic parameters correlating with fetal weight, with a higher predictive value. The examined fetal parameters include liver dimensions, cerebellar diameter, kidney length, upper arm soft tissue thickness, femur volume and cheek-to-cheek diameter(9–12).
The current scientific reports indicate that new sonographic parameters such as soft tissue thickness values are useful for fetal weight assessment(4,9,11–14). The measurements can be conducted in various parts of the fetus’s body. For example, subcutaneous tissue thickness can be measured in the thigh, upper arm, abdomen or the subscapular area. Different types of measurements are characterized by different levels of correlation with other sonographic and anthropometric parameters as well as body mass and gestational age. Forouzumer et al. demonstrated a strong positive correlation between fetal abdominal soft tissue thickness (FASTT) in the third trimester of pregnancy and fetal weight (r = 0.86, p < 0.001)(13). The study included 300 patients between 32 and 42 weeks of pregnancy. The study method involved ultrasound measurement of subcutaneous tissue at the anterior one third of the abdominal circumference between the outer and inner margin of echogenic subcutaneous tissue. The thickness of adipose tissue ranged between 3 mm and 14 mm with a mean of 6.7 mm ± 1.9(13). Chen et al. conducted a more extensive study on 744 patients with physiological pregnancy(14). They demonstrated that adipose tissue thickness measured in the second and third trimester of pregnancy at the fetus’s abdomen (r² = 0.792, p < 0.0001) and subscapular area (r² = 0.302, p < 0.0001) strongly correlates with fetal age. The method of abdominal adipose tissue measurement was similar to the method described earlier. Fetal subscapular soft tissue thickness (FSSTT) measurement was performed after the whole visualization of the scapula with the caliper positioned between the skin and the subcutaneous tissue margin, perpendicular to the lowest end of the scapula. A study by Rigano et al., who compared three groups of patients: with physiological pregnancy, pregnancy complicated with class 1 gestational diabetes treated with diet and with class 2 gestational diabetes treated with diet and insulin, was even more informative(15). They observed that birth weight was not significantly different for pregnancies of patients with a normal glucose-tolerance test and patients with gestational diabetes treated with diet and insulin, while for pregnancies complicated with diabetes treated with diet alone birth weight was much higher. Subcutaneous tissue thickness values were significantly different between patients with diabetes and patients with physiological pregnancy between 24 and 35 weeks of gestation, whereas between 36 and 40 weeks of gestation there were no statistically significant differences. In the conclusion to their study, the authors underline that subcutaneous tissue measurement can be another useful parameter for the assessment of diabetes management in pregnant patients(15).
Fetal humeral soft tissue thickness (FHSTT) can also be measured. Al-Hilli demonstrated in her study that humeral soft tissue thickness is a more sensitive parameter, but less specific than Hadlock formula(3). It also has a higher negative predictive value than the standard formula. FHSTT measurement involved the visualization of the humerus in the longitudinal section and then the rotation of the transducer by 90 degrees and itis movement towards the head of the humerus in order to measure soft tissues located just below it.
Another new sonographic parameter is fetal thigh soft tissue thickness (FTSTT)(11). To date there have been only single reports concerning this parameter; however, the results seem promising. According to Scioscia et al., it strongly correlates with fetal abdominal circumference and birth weight(16). This conclusion was made based on a study conducted in three stages with 290 patients in total (113, 108 and 69)(16). The method of measurement involved visualizing the femur in the longitudinal section and freezing the image, and then measuring the distance between the outer surface of the thigh and the outer surface of the femur, perpendicular to the bone, in its middle part. In the first phase of the study a linear relationship was confirmed between birth weight and head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and FTSTT. The next phase involved determining a new, modified formula for fetal weight estimation using FL and FTSTT measurement. In the last phase fetal weight estimation results obtained using three formulae, two of them well-known: Shepard and Hadlock and the new Scioscia formula were compared. The authors point to the higher accuracy of the new formula (r = 0.79), while stressing that both Hadlock and Scioscia formulae give satisfactory results (Bartlett’s test: 4.53, p > 0.05)(16). The use of fetal soft tissue measurements for the detection of macrosomia is also being investigated. Han et al. demonstrated the utility of FTSTT for the diagnosis of fetal macrosomia, with a sensitivity of 91% and specificity of 94%(17). They also emphasized that FTSTT, which shows positive correlation with gestational age, can be more useful for fetal weight estimation than other sonographic parameters(17). This is corroborated by Rotmensch et al., who noticed that such parameters as fetal abdominal circumference, femur length and thigh subcutaneous tissue thickness were significantly higher in pregnancies with macrosomia(9). The study also investigated a new index, which is the relationship between fetal thigh subcutaneous tissue thickness and femur length; however, no significant differences were demonstrated for macrosomic pregnancies (p = 0.067)(9). In a study by Chauhan et al. FTSTT correlation as a predictor of high birth weight was not confirmed; however, as the authors note themselves, there was a large time discrepancy between the different ultrasound scans and delivery, which could have affected the accuracy of the study(10). The topic of sonographic measurements of FTSTT in uncomplicated pregnancies and high-risk pregnancies was raised in a study by Abdalla et al.(18). They noticed that the higher the FTSTT, the higher birth weight and length are. A statistically significant correlation between FTSTT and body mass of women before pregnancy and before delivery was demonstrated; however, no relationship between FTSTT and body mass increase during pregnancy or BMI of pregnant women was observed. Higher FTSTT values were found in neonates with higher birth weight between 38 and 40 weeks of pregnancy; however, no such relationship was observed for pregnancies at 37 and 41 weeks(18).
Based on the reports above, numerous studies proposing new fetal weight calculation formulae have been produced(16,19,20). Currently, fetal abdominal circumference is the strongest predictor of fetal weight(19). However, it has a large risk of error, particularly when it is not possible to ensure optimal conditions for the measurement during the scan(19). Obtaining a high-quality ultrasound image is not easy, even for an experienced examiner. Measurements obtained from lower-quality visualizations have a larger error rate. For this reason, Scioscia et al. developed a new formula for estimating fetal weight(16). Based on mathematical analysis they obtained a formula utilizing FL and FTSTT. The advantages of this formula include ease of examination and the possibility to perform measurements when the head of the fetus is located low in the pelvis and is inaccessible to the examiner(16). Scioscia and Hadlock formulae were considered satisfactory to a similar extent in terms of the ability to estimate the actual fetal weight, with an absolute mean error rate below 15% in over 90% of cases(16,20). These results are corroborated by a study by Abuelghar et al., who first verified the utility of Scioscia formula and then modified it to compare the results obtained using both formulae(20). According to the authors, both formulae displayed a significant correlation with the neonate’s birth weight; however, the strength of the original Scioscia formula was higher: r² = 0.609 (p < 0.001) for the modified formula, r² = 0.957 (p < 0.001) for the original one(20). However, the results of a study by Barros et al. published in 2016 do not confirm this. They observed a weak correlation for weight estimated using the Scioscia formula, which is based only on FL and FTSTT(21). They also found that using this formula leads to overestimation of larger fetuses and underestimation of smaller ones. The authors believe that the reason for the differences was a low number of macrosomic fetuses included in their study. In this study ultrasound scans were performed by resident physicians with different experience at the admissions department since the aim of the study was to check the use of the formula in such conditions. Kalantari et al. also worked on the development of new formulae for fetal weight estimation(19). The study included various combinations of customarily used sonographic parameters and FTSTT. The formula in which AC, HC and FL were combined with FTSTT displayed the highest predictive strength (r = 0.77).
Apart from soft tissue, some more advanced and detailed measurements are taken such as those involving adipose and lean tissue. The results of such measurements are presented in a study by Bernstein et al. The measurement involved visualizing the longitudinal section of the long bones – the femur and humerus in this case, and rotating the transducer by 90 degrees in order to obtain the transverse section of the fetal bones(22). Adipose tissue thickness was the difference between the total subcutaneous tissue and lean tissue thickness, i.e. muscle and bone thickness. The authors noted that both these parameters display a unique growth profile. Due to the accelerated fetal growth in late pregnancy these measurements can be a more sensitive and specific marker of fetal growth abnormalities. They were also used by Larciprete et al. and Galan et al., among others, as a more precise marker of fetal body structure(23,24).
In comparison with numerous studies on new sonographic measurements in physiological pregnancies and those complicated by macrosomia, only few publications concern FTSTT in pregnancies with IUGR. Balouet et al. conducted ultrasound scans on 232 fetuses, only 39 of which were estimated to be too small for gestational age (SGA) (25). In this group of fetuses the sonographic assessment of thigh soft tissues had a high positive predictive value (74%) in relation to low birth weight with a sensitivity of 74% and specificity of 94%. A study by Larciprete et al. estimated adipose tissue and lean muscle tissue of the humerus and femur in addition to fetal abdominal and subscapular soft tissue measurement(23). The authors of the study noticed significantly lower subscapular, abdominal and humeral subcutaneous tissue values in fetuses with intrauterine growth restriction. It is also one of the few studies which included patients with arterial hypertension (9 out of 14 examined patients had hypertension and 2 out of 14 had preeclampsia). An interesting observation in this regard may be a study by Galan et al., who studied two populations of pregnant women living at different altitudes 1600 m apart in absolute terms(24). The authors noticed that abdominal, thigh and upper arm subcutaneous tissue thickness values were lower in the fetuses of mothers living in the region located higher. However, no differences in muscle tissue values were found between the two populations. A different opinion is presented by Hill et al., who studied 240 patients for fetal thigh, calf and abdominal subcutaneous tissue parameters. In 13 fetuses intrauterine growth retardation was demonstrated and in 38 high body weight was found. The authors concluded that sonographic parameters could not be treated as reliable predictors in either of the groups(26).
Alongside two-dimensional (2D) sonography researchers are trying to find ways of using three-dimensional ultrasound (3D) for determining fetal weight. The authors of one of the first studies on this subject were Chang et al., who created a fetal weight estimation formula based on the analysis of 3D measurements of the thigh. Their formula had a higher accuracy than the methods used to date which utilized 2D measurements. The absolute error rate of the authors’ formula was 5.9%(27). Similarly, Liang et al. performed 3D measurements of the upper arm which they used to estimate fetal weight with a higher accuracy than the standard methods(28). Both studies were preliminary reports and 3D ultrasound measurements constituted the sole variable in the formula used. Schild et al., in contrast, developed a formula based on three-dimensional measurements of the abdominal, thigh and upper arm volume of the fetus as well as a standard BPD 2D measurement(29). The new formula had a much lower mean error rate than the standard formula based on 2D measurements. Even more precise estimation of body mass in small fetuses (below 1600 g) was achieved by combining 3D measurements with other biometric parameters of the fetus such as FL, HC and BPD(30). The authors concluded that the use of 3D measurements for fetal weight estimation is more precise, but at the same time more time-consuming: the measurement of each limb lasted 10–15 minutes on average. In order to increase the utility of 3D ultrasound Lee et al. in their study aimed to reduce the time needed to perform the measurements to 10 seconds by using a commercial program(12). A hybrid transducer was used for the examination, which allowed to obtain AC, FL and BPD from volume measurements. The authors concluded that combining AC and BPD measurements with upper arm or thigh volume is associated with more precision. The mean error of fetal weight measurement in relation to the actual fetal weight was 6.6%. In the case of the standard Hadlock formula it was 8.5%.
The correct determination of fetal weight is an important issue in obstetrics since it has a significant impact on the course and end of labor and delivery. Incorrect estimation of fetal weight can result in multiple, often dangerous complications both for the pregnant mother and the fetus. The currently used Hadlock formula for fetal weight estimation has an error rate of 20%, which may depend on the skills of the examiner, equipment base, conditions of the examination as well as the stage of pregnancy or labor. For this reason, new parameters that can be used to predict fetal weight are being reported. The aim of researchers around the world is to find a diagnostic parameter that has as small an error rate as possible, is quick to use and reproducible by different examiners. Fetal soft tissue thickness measurements, both two- and three-dimensional, may prove to be such a parameter. The current reports on the topic are not consistent; studies were often conducted on small groups of patients, which significantly limits the possible application of these measurements in the future. Ultrasound measurement of subcutaneous tissue thickness in various areas of the body may prove to be a strong predictor of fetal weight essential for sonographic assessment of pregnancy.


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Seismic design code - Part I – Provisions for the design of buildings, code P100-1/2013
Order of the Deputy Prime Minister, Minister for Regional Development and Public Administration approving the technical regulation ‘Seismic design code - Part I – Design provisions for buildings’, code P100-1/2013
The code applies to the seismic design of buildings and similar structures (example: stands, jetties and so on) located in Romania.
The provisions of code P 100-1/2013 are harmonised with the provisions of standard SR EN 1998-1.
The provisions of the code have the following aims, in the event of earthquake activity:
- to protect the lives and physical integrity of persons,
- to ensure that activities and services which are essential for social and economic life continue uninterrupted,
- to prevent explosions or releases of hazardous substances;
- to limit damage to property.
The design of structures with special functions (such as nuclear power stations, maritime platforms, bridges, dams, levees, chimneys, cooling towers, etc.) is not covered by code P 100-1.
The provisions of the code are aimed at investors, designers, contractors, specialists working in the field of construction who are certified/authorised in accordance with the law, as well as checking and monitoring bodies (checking and/or expert assessment of designs, checking, monitoring and/or expert assessment of works).
Key words: design, seismic activity, structural calculation, seismic forces, structure

domain: law


Good morning! It’s time for a Tuesday edition of Bartow’s Morning News, bringing you the best in news, weather, traffic and sports on your award-winning community radio station.
We have two guest segments scheduled for today. State Representative Christian Coomer will call into the studios today at 7:40AM to discuss the start of this year’s legislative session.
Then, at 8:40AM, Barry Loudermilk, former State Senator for district 14 and candidate for US House of Representatives district 11, will call into our studios to talk about the news story seen on Channel 2 news yesterday. We’ll talk to him about the video that was produced in conjunction with Georgia Public Broadcasting and why he chose to copyright it.
Tune in for Fox News at the top of each hour, state-wide headlines from GNN at the bottom of each hour, and local news, weather, traffic and sports in between. It’s all here on your award-winning AM 1450 WBHF.


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Leeds United attacker Ezgjan Alioski has told the Macedonia media he’s confident his country can get a result against Liechtenstein and that he hopes to get on the scoresheet again.
The player scored in last month’s 2-0 victory over Gibraltar.
Speaking to Gol.mk, the Leeds United star was asked about Macedonia’s game this weekend: “If we play so, we will surely win. If play in good shape, I scored two goals in the first two matches, but I do not care who will score a goal, I want to win. Of course, I want to score a goal again, but if I don’t score, I’ll be happy with three points.”
Alioski has been a key member of Marcelo Bielsa’s side this season and has started all of Leeds United’s league games.
The 26 year old has scored three goals and provided three assists in 12 league games for the Championship side, which has helped the Elland Road club to third in the table.
He’ll be hoping to carry this form into his country’s clash with Liechtenstein on Saturday, a game Macedonia will be expected to win.
Macedonia are then set to meet Armenia next week in the UEFA League Nations, which will be a tricky test for Alioski and his teammates.

domain: news


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Current approaches to dietary counseling for obesity are heavily rooted in the notion of “personal choice” Typically, patients receive education about dietary contributions to energy balance and are then encouraged to make dietary choices (e.g., food selections, portion sizes) consistent with weight loss. Yet even highly motivated and nutritionally-informed patients often struggle to refrain from highly palatable, energy-dense foods available in the modern environment, and ultimately, only a small percentage of individuals achieve sustained weight loss through dietary modification (1–4). Failed attempts at weight control are frustrating to patients and providers alike. Studies show that both parties frequently attribute obesity to poor “personal choices” or insufficient “willpower” on the part of the patient (5,6). For example, a sample of British dietitians ranked “lack of willpower” as more important to the development of obesity than genetic factors (7), even though adult body mass is 55–75% heritable (8,9). The suggestion that individuals become or remain obese due to their unhealthy personal choices, or a lack of willpower to make healthy choices, is stigmatizing to patients and unlikely to motivate patients to lose weight (10). De-emphasizing the role of personal choice in dietary counseling for obesity would reduce stigma, but doing so carries the risk of undermining patients’ perceived control over their weight loss success. The goal of this commentary is to help dietitians negotiate this dilemma by presenting a scientifically-informed framework that views the personal choices relevant to obesity counseling in terms of three neurobehavioral processes. We argue that applying this framework in dietary counseling can both minimize patient stigma and preserve patients’ sense of empowerment.
The term “personal choice” implies that human behavior derives from conscious, volitional decisions, and connotes that humans have “free will” to decide between alternative courses of action - independent of biological and environmental forces. An implication of this definition of “personal choice” is that individuals can be considered causally, financially, and morally responsible for their behavior (11,12), a notion firmly embedded in the folk psychology of many cultures (13–15). The ethical and policy implications of personal choice in health have been discussed at length (11,16,17). In contrast to the notion of personal choice, some argue that human behavior is explained by neurobiological processes and their interaction with environmental stimuli (18). Supporting this deterministic1 model of “personal choice” are studies demonstrating that 1) future actions can be predicted by brain activation patterns up to 10 seconds before individuals become aware of having made a decision (19), 2) behavior is strongly influenced by processes outside of conscious awareness (20), and 3) individuals can be led to believe that they have caused actions outside of their control (21–24). Others dismiss the apparent conflict between free will and neurobiologically-based explanations of behavior (25–27). Whether human behavior is ultimately rooted in free will, neurobiology, or a combination of both will not be settled anytime soon. Yet, there is still considerable value for understanding how neurobehavioral processes interact with the environment to influence eating behavior for the purposes of understanding obesity’s etiology and reducing stigma.
As dietitians cannot control patients’ environments or their genetic vulnerabilities, and effective non-surgical weight loss treatments do not currently exist, it is understandable why many seek to instill responsibility for change in their patients. However, rather than engendering a sense of empowerment, the suggestion that sufficiently motivated patients can choose to engage in a healthier lifestyle can often lead to guilt and stigmatization by implying that individuals are responsible for failing to control their weight. Indeed, obese patients often feel stigmatized in healthcare settings, which can result in avoidance of the health care system, increased eating pathology, and even weight gain (10,28). Adopting a scientifically informed framework that clarifies how personal choice is affected by biological and environmental factors may reduce obesity stigma in healthcare settings (29) and empower patients by drawing attention to the environmental drivers of obesity that are within their control.
Building on emerging research, we propose that “personal choice” in obesity can be understood as a composite of neurobehavioral processes influenced by biological and environmental forces. Though a number of existing neurobiological models are potentially relevant to understanding personal choice in obesity [e.g., (20,30–32)], we focus on three neurobehavioral processes that have been most consistently implicated in obesity and overeating: food reward, inhibitory control, and time discounting.
Obesity has been viewed almost exclusively as a disorder of energy homeostasis in which overeating results from insufficient satiety signaling or amplified hunger signaling (33,34). However, research conducted over the past decade has demonstrated that the sensory experience of palatable food can easily override homeostatic controls of energy balance, leading to overeating in the absence of true physiological hunger (35,36). It is also appreciated that the palatability of our food supply has been greatly enhanced by the food industry through the infusion of increasing amounts of sugar, fat, salt, and flavorings. This food engineering has been implicated as a key contributor to the obesity epidemic (37). Food reward includes both the experience of pleasure one receives from eating and the motivational drive to obtain and consume palatable food (38). Of these two aspects of reward, the motivational component may be more relevant to obesity since obese individuals do not report experiencing greater pleasure from palatable food than normal weight individuals (39,40). Of particular relevance to personal choice in obesity are findings that one’s sensitivity to food reward is grounded in genetics and neurobiology and is strongly linked to obesity (41).
The neural processing of food reward has been traced to the mesolimbic system (Figure 1), the brain’s “reward circuit” which also mediates the motivation to engage in sex, gambling, and substance use (42). The hedonic pleasure associated with eating is linked to opioid neurotransmission in several small “hotspots” in the nucleus accumbens and other regions, whereas the motivational aspect of food reward is primarily mediated by dopamine pathways from the ventral tegmental area to the nucleus accumbens (38,42–46). Interestingly, blunted mesolimbic system neurotransmission (47), and biologic and genetic markers associated with diminished dopamine signaling (48–50) are linked to higher adiposity. The prevailing hypothesis is that this blunted mesolimbic signaling represents a deficiency in neural reward processing for which affected individuals compensate by overconsuming palatable food. In this way, deficient neural reward processing appears to equate with greater reward sensitivity at the level of behavior.
Greater sensitivity to reward is linked to stronger food cravings (51), preferences for sweet and fatty foods (52), greater ad libitum food intake in laboratory studies(53), and higher body weight among adults and children (40,52,54,55). Sensitivity to reward is hypothesized to explain vulnerability to aspects of the “toxic food environment.” For example, living in areas with greater access to fast food outlets has been linked, albeit inconsistently, to an obesity-promoting diet and higher body mass (56,57), but these effects appears to be strongest among those most sensitive to reward (58). Essentially, high reward sensitivity combined with convenient access to highly palatable, energy-dense foods represents a biology-by-environment interaction that makes one extremely vulnerable to overeating and weight gain.
Food reward accounts for the “pull” towards palatable food that can drive overeating even in the absence of true physiological hunger. Beyond the intensity of food cravings, the question remains whether we can ignore or suppress such urges. After all, isn’t the ability to override our hedonic motivations the essence of “choice,” “self-control,” and “willpower”? The fact that we can refrain from eating palatable food (if only occasionally) while still finding food extremely tempting indicates that the capacity to refrain from eating is a distinct process from food reward. In other words, inhibiting our food intake is not simply a matter of reducing the motivation to eat; it involves actively controlling behavior despite a strong motivation to eat. Though exercising inhibitory control over eating has long been considered the central task in weight management, a scientific description of inhibitory control of eating at the behavioral and neurobiological levels is only now emerging.
We (59) and others (60) have proposed that inhibitory control over eating is supported by executive functions mediated by the prefrontal cortex (PFC). The PFC is considered critical for self-control, planning, and goal-directed behavior more generally (61,62), and the inhibition of eating can be considered a special class of behavior under its governance. There is ample evidence linking the functioning of prefrontal regions to performance on tasks measuring inhibitory control (31) and clinical syndromes characterized by impulsivity such as attention-deficit/hyperactivity disorder (ADHD) and drug addiction (63). In particular, the dorsolateral region of the PFC (Figure 1) has been implicated in the “decision” to engage inhibitory processes for the purpose of self-regulation (63–65). Several recent neuroimaging studies link differences in dorsolateral PFC function with the ability to inhibit eating. Hare et al (64) asked dieters to choose between pairs of 50 food items varying in taste and perceived healthiness. Dieters who consistently selected health over taste showed greater dorsolateral PFC activation when choosing the healthier options compared to those who more often selected taste over health. Further, there was evidence of functional connectivity between the dorsolateral PFC and brain areas associated with reward processing, consistent with the notion that the dorsolateral PFC inhibits the influence of reward on behavior. Other studies have shown that the dorsolateral PFC is activated following the ingestion of food (66,67), and that greater postmeal activation is associated with reduced adiposity (68,69), decreased food craving (70), and successful weight loss (71). Taken together, these findings indicate that the dorsolateral PFC supports active suppression of the motivation to eat palatable food. Unfortunately, life stress and other factors can easily disrupt inhibitory control (72) and lead to weight gain (73). Given this, it is not surprising that weight loss interventions, which largely rely upon persistent inhibitory control of eating, have meager long-term success rates (1–4).
A third factor that likely contributes to the low success rates of dietary interventions for obesity is the human tendency to devalue delayed rewards. Most of us would prefer to receive $200 today rather than $300 a year from now. This decision illustrates the fact that the brain discounts the value of money and other rewards over time, resulting in impulsive, short-sighted decision-making. Time discounting provides a framework for understanding why we sometimes knowingly make choices that are not in our best long-term interest [i.e., why the ‘will’ breaks down (74)]. For some individuals and not others, the immediate rewards of smoking, gambling, and drug use have a more potent influence on decision-making than the long-term social, financial, and physical costs of such behavior. Numerous studies have found that individuals who engage in these “addictive behaviors” assign disproportionate weight to the immediate pleasure derived from these activities compared to those who abstain (75–79). The link between time discounting and body weight is reflected neuroanatomically, with time discounting being governed by the same brain regions associated with food reward and inhibitory control. Time discounting is influenced by an impulsive, appetitive system that promotes pursuit of immediate rewards, as well as a reflective, deliberative system that seeks to maximize long-term gain. Neuroimaging studies indicate that these neural systems are composed of the mesolimbic dopamine system and its extensions, and the dorsolateral PFC, respectively (80–82). In fact, the reciprocal activation of these two brain regions predicts performance on time discounting tasks (83). The relevance of time discounting to obesity is substantial. In a very literal sense, weight loss requires consistent selection of delayed rewards [e.g., health benefits of weight loss (84)] over the immediate rewards associated with palatable food (85). In other words, the process of weight loss is directly at odds with the human tendency for time discounting. Consistent with this notion, several studies have linked higher body weight (86–88) and intake of palatable food (89) to greater time discounting on behavioral choice tasks.
Thus far we have highlighted three neurobehavioral processes that promote overeating and obesity: 1) neurobiologically-based behavioral sensitivity to the rewarding properties of food, mediated by the mesolimbic dopamine system, 2) relative weakness in inhibitory control, mediated by the PFC (particularly dorsolateral regions), and 3) steeper discounting of the delayed rewards of weight loss relative to the immediate pleasure associated with eating, reflecting the interaction between the mesolimbic system and the PFC. There are at least three implications of this neurobehavioral model for dietary counseling for obesity.
First, the model explains eating behaviors which promote obesity without invoking character flaws (e.g., lack of willpower). By emphasizing genetically-influenced neurobiological processes that confer vulnerability to overeating in a toxic food environment, the model enables dietitians to more effectively address obesity (as discussed below) without promoting stigma.
Second, the neurobehavioral model preserves a sense of individual control. Though it may seem counter-intuitive, shifting the focus away from “personal choice” and towards the environmental and neurobehavioral processes involved in eating can encourage patients to take an active stance in their approach to weight management. We recommend that dietitians simultaneously convey two messages about weight control to their patients: 1) obesity is heavily influenced by genetic and environmental factors, and an epidemic of obesity is precisely what would be expected given the genetic heritage of our species and the omnipresence of palatable food in the environment; and 2) successful weight management can be achieved by taking active steps (such as those described below) to minimize the impact of the environment on eating behavior. The first message acknowledges that patients are working against potent genetic vulnerabilities and a toxic food environment, and normalizes patients’ (and dietitians’) frustration with failed attempts at weight control. The second message signals that patients can better control their weight through strategies focused on the interaction between the brain and the environment. For the majority of dietitians, this second message constitutes a shift in strategy from urging patients to make the “tough choices” required for weight control to helping patients minimize the number of tough choices they encounter. This differs from the traditional approach to obesity counseling, which by simply encouraging patients to eat fewer calories than they expend, ignores the very processes that make this advice so difficult to follow.
Finally, the framework presented above supports an increased emphasis on several behavioral strategies that have been considered adjuncts to dietary counseling for many years (90) (Table 1). Dietitians should assist patients in manipulating their environments to minimize exposure to palatable food cues, a step that is essential to reducing energy intake by preventing activation of the brain’s reward circuitry that generates the motivation to eat. For example, patients should remove tempting, high-calorie foods from their home and workplace. Of course, the decision to bring high-calorie foods into the home is made at the food store, and shopping from a grocery list or using online grocers (e.g., Peapod) can help reduce one’s susceptibility to the torrent of food cues at the supermarket (91). Another strategy involves learning to minimize exposure to stress and developing more effective stress reduction strategies, as stress promotes overeating and obesity by enhancing food reward processing (92,93) and disrupting inhibitory control (94,95). Dietitians may briefly review stress management techniques, encourage exercise as a stress reduction strategy, and refer patients to appropriate behavioral specialists. Finally, consideration of time discounting would suggest that increasing the delay to food rewards and decreasing the delay to weight loss rewards promotes better adherence to dietary goals. Consistent with this idea, patients should be encouraged to prepare healthy foods in advance to make them immediately accessible, keep tempting snacks out of the home (thus requiring a trip to the food store to obtain them), and focus on achieving short-term behavioral weight control goals (e.g., meeting a daily calorie goal) rather than focusing exclusively on long-term weight loss. The focus on short-term behavioral goals may be especially important considering that the rate of initial short-term weight loss is predictive of long-term weight loss outcomes (96), and that unrealistic long-term weight loss expectations are sometimes associated with poorer outcomes and higher attrition from weight loss treatment (97; also see 98). Focusing on achieving short-term behavioral goals would likely have the dual benefits of promoting early weight loss through behavior change and de-emphasizing any unrealistic weight loss expectations patients may have.
As the neurobehavioral basis of eating behavior advances, so will our understanding of obesity and weight control. However, enough progress has been made to enable dietitians to shift from a model of obesity counseling grounded in personal choice to one rooted in the brain processes that govern eating behavior in an obesity-promoting environment. In addition to providing nutrition education and encouragement, dietitians should more heavily focus on helping patients overcome the brain-based processes that make dietary modification so difficult, largely through strategies that have been considered “behavioral adjuncts” to dietary obesity counseling for many years. Dietary lapses or failures should be conceptualized as the result of brain systems interacting with a toxic food environment, and not as a reflection of poor personal choices or lack of willpower. Even if this approach is no more effective in producing weight loss than current practices, it is much less likely to elicit patient stigmatization.
1Determinism is the view that behavior is caused by previous mechanistic processes.
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Bradley M. Appelhans, Departments of Preventive Medicine and Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60612, USA.
Matthew C. Whited, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Kristin L. Schneider, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Sherry L. Pagoto, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.

domain: medical


text:
Grief is a natural and universal human experience. Grief comes with a lot of other emotions that can be challenging and overwhelming to process alone. it can manifest itself in the form of anger, guilt, intense sadness, anxiety and so many other feelings and emotions. It can sometimes feel like life has stopped for you too, therefore, there’s no point trying, causing insomnia and maybe depression. Seeking support during this time is essential for healing and moving forward. Continue reading to learn why you should join grief organizations like grief support groups, what types are available, and which one is ideal for you based on the type of loss you are experiencing.
Introduction to grief and the importance of seeking support
Grief is a natural and necessary process that allows us to process the pain of loss and adjust to life without our loved one. However, the grieving period can take a toll on you and become overwhelming to deal with alone and getting support from others can really help you get through it. Grief can also be complicated by factors such as guilt, regrets, and unresolved issues, making it challenging to move forward.
Majority of people feel alone and alienated in their grief, and finding the perfect words to articulate their feelings can be a challenge. Seeking support from grief counseling organizations opens you to meeting others who have experienced similar losses and it can be incredibly beneficial. Grief support groups provide a medium that feels safe enough to express your feelings and be vulnerable without feeling like you are being judged.
What is a grief support group?
A grief support group is basically a small group of people who have gone through similar loss such as the death of a child, coming together. These groups are usually facilitated by licensed experts or volunteers, and they also provide a safe environment for people to feel confident enough to express their feelings and experiences. The groups can be open or closed, meaning that new members can join regularly or that a set group of individuals participates. Many groups meet regularly, ranging from weekly to monthly meetings.
As a member of these groups, you are encouraged to speak and share your experience with loss with others, listen when it’s someone else’s torn to speak and also be of assistance to other members that might need it. The groups can be structured or unstructured, with some providing specific topics for discussion, while others allow members to share whatever is on their minds.
Different types of grief support groups
There are many different types of grief support groups available, each with its focus and structure. Some of the most common types of grief support groups include:
General grief support groups
General grief support groups are open to anyone who has experienced a loss. These groups provide a setting or a space that feels safe and okay for members to share their experiences and emotions and feel supported and understood.
Child loss support groups
Losing anyone is hard and can only imagine how losing a child must feel like for a parent. Child loss support groups are facilitated to help parents grieving the loss of a child providing them a safe and supportive environment to be vulnerable and giving them the avenue and opportunity to heal.
Online grief support groups
This kind of grief support groups are conducted online and because of its convenience, it has gained popularity. Anyone with an internet connection and a browsing device, a phone or a laptop can have access to these groups making it easier for people with mobility isuues or those who live in distant areas.
Grief counseling organizations
Grief counseling organizations provide counseling and support services to individuals who are grieving. These organizations can provide one-on-one or group counseling and also make provision for resources and support.
The benefits of joining a grief support group
Joining a grief support group can provide many benefits during the grieving process, including:
Validation and understanding
Grief can lead to isolation because you believe there is no one you can talk to who knows how you feel. In a grief support group, members have all experienced a similar loss and can offer validation and understanding. It might start to feel like a community, which helps you feel like you’re not doing everything alone.
Coping skills and strategies
Coping with loss can be difficult due to the overwhelming emotions and challenges that may precede it. In a grief support group, members can share coping skills and strategies that have worked for them. This can provide individuals with new ways to manage their grief and move forward.
Grief may be a thrill ride of emotions, with many ups and downs. Members of a grief support group can provide emotional support that you need because they too share similar feelings and can empathize with you while encouraging you to stay positive. When dealing with the overwhelming emotions that come with loss, this can be really therapeutic.
Hope and healing
Grief can feel all-consuming, making it challenging to see a way forward. In a grief support group, members who are further along in their grieving process can offer hope and demonstrate that healing is possible. This can give people encouragement and help them see the possibility of getting through it.
How to find a grief support group that fits your needs
Finding the right grief support group for you will require some time, work and patience. Below are some pointers to help you narrow your search.
Ask your healthcare provider
Your healthcare provider may be able to provide you with information about local grief support groups or counseling organizations.
The internet has a lot of tools and information you might need to find a grief support group. Websites such as Psychology Today and GoodTherapy.org have directories of grief support groups and counseling organizations.
Contact local hospices
Local hospices usually provide grieving resources and support like counseling services and support groups to people who have gone through loss.
Ask friends and family
Friends and family members may have information about local grief support groups or counseling organizations.
Grief organizations and resources
There are many organizations and resources available to individuals who are grieving. Here are some examples:
The National Alliance for Grieving Children
The National Alliance for Grieving Children is a nonprofit organization that provides support and resources to children and teens who are grieving.
The Dougy Center
The Dougy Center is a nonprofit organization that provides support and resources to children and families who are grieving.
The American Foundation for Suicide Prevention
The American Foundation for Suicide Prevention provides support and resources to individuals who have lost a loved one to suicide.
Conclusion and encouragement to seek support for grief
Grief is a challenging and complex emotion that can be overwhelming to deal with alone. Joining a grief support group can provide individuals with validation, coping skills, emotional support, and hope. There are many various sorts of grief support groups available, and finding the appropriate one may take some time. Joining a grief support group can be life=changing and I strongly recommend that it is okay to seek support from these groups as it can change your life significantly, you don’t have to do it on your own.

domain: sociology


text:
Attorney Daniel Ortega was a teenager when he became an advocate for Latino civil rights. His decades-long struggle has changed him more than it has the plight of Arizona’s Latinos.
Ortega said he’s worried about the Latino community’s ability to live and work with other diverse communities. Some argue with him that Latinos have not yet gained equal access to education and jobs and must worry about themselves first, he said.
“And I’m saying that sounds so much like what we’ve been fighting against for so long,” Ortega said. “As I get older and more mature, I realize diversity has to start at home.”
He said he understands why it’s hard for Latino baby boomers to overcome the racism that dominated their upbringing. He calls Arizona’s immigration laws un-American and a revival of that racism. It has taken a more socially acceptable form, he said, because it is tied to a broken immigration system that does not provide a way for Mexicans to work in this country without years of wading through red tape.
“The haters don’t say, ‘We don’t want Mexicans here,’ which we know is all too common,” Ortega said. “They say — justifiably so, in their own minds, as code words — ‘This isn’t about race, it’s about being illegal.’”
Ortega sees hope in young people of all ethnicities who are working hard to fight the hatred within their communities. Younger Latinos have a particularly crucial responsibility because they are the future majority of the United States, he said.
“How we begin to deal with issues of race — issues surrounding hate, inclusion, diversity — is going to be the foundation of how we deal with our own authority when we’re part of the majority,” he said.
Which brings him back to another way he has changed over the years. He now recognizes that the terms “majority” and “minority” have helped to build walls and draw lines between people.
“The word ‘minority’ is not only demeaning, but dehumanizing,” he said. “I am a citizen of the world, and in this country I’m a U.S. citizen. That doesn’t make me a minority in my eyes.”


text:
Heavy rains lashed the National Capital Region on Friday bringing much- needed relief from the hot and humid weather. The MeT department also predicted of more rains in the National capital region.
Heavy rains lashed the National Capital Region on Friday bringing much- needed relief from the hot and humid weather. While the showers brought necessary joy after the gruelling heat, the heavy rainfall also led to water-logging inside the Delhi Secretariat which houses Chief Minister Arvind Kejriwal’s office. According to an ANI report, the incident of waterlogging occurred as water leaks in the premises following incessant rainfall.
Watch waterlogging inside Delhi Secretariat
- Rajya Sabha berth for Priyanka Gandhi Vadra? Clamour grows in Congress to nominate her from Madhya Pradesh
- After meet with Sharad Pawar, NCP minister says Maharashtra to run parallel probe into Elgar Parishad case
- 2012 Delhi gangrape-murder case: Convicts to hang on March 3, Delhi court issues fresh death warrant
— ANI (@ANI) July 13, 2018
Rains lashed several parts of Delhi-NCR following heavy overcast conditions, prompting vehicles to ply with headlights on. According to an India Meteorological Department (IMD) official, several parts of city witnessed rains. The minimum temperature was recorded at 27.8 degrees Celsius while the humidity was recorded at 74 per cent at 8.30 am. The MeT department also predicted of more rains in the National capital region.
The IMD has also issued a warning of heavy to very heavy rainfall at isolated places across several states which includes Goa, Gujarat, Uttarakhand, east Rajasthan, east Madhya Pradesh, Saurashtra, Chhattisgarh, Madhya Maharashtra, Telangana, coastal and south interior Karnataka, Kerala, Andaman and Nicobar Islands, Assam, Meghalaya, Odisha, west Uttar Pradesh, Haryana, Chandigarh, Delhi, Punjab, Himachal Pradesh, west Madhya Pradesh, Vidarbha, coastal Andhra Pradesh, Tamil Nadu and north interior Karnataka


text:
by Beth Hammarlund
Fashion always has a new darling, and half of the young established designers on the scene are still swooned over as wünderkinds. But as much as fashion is, and will always be, obsessed with the new and the young, there are still some old school heavy hitters who are going to knock it out of the park every time.
“Sometimes you have to show a little skin. This reminds boys of being naked, and then they think of sex.” -Cher Horowitz
Although I usually take quotes from Clueless as gospel, Francisco Costa made a pretty solid argument against her skin-baring stance in his collection for Calvin Klein. Exaggerated busts recalled the conical constructions of Jean Paul Gaultier and the signature bustiers of Proenza Schouler, but the collection was anything but derivative.
Peplumed hips and nipped-in waists further enhanced the female form, but the effect barely recalled old-fashioned corsetry. The details and restrained palette, a gentle mix of black, cream and white, exaggerated boobs, peplumed hips, nipped-in waists, something very old-fashioned about the way the clothing worked on the models’ bodies, but the lines and palette were totally futuristic. It’s always impressive to see a designer create pieces that ooze sex, but don’t rely on bare skin to do so. Costa’s collection left much to the imagination, but was anything but conservative.
Oscar de la Renta
Oh, Oscar. We’re having such a weird moment in our relationship. I love your work. Even your worst collections are better than half of the other collections out there. I just wish you wouldn’t give interviews. De la Renta has been pretty pissed at the Obama camp ever since Michelle Obama deigned to wear Alexander McQueen (a British line) instead of an American designer when she went to meet the Chinese president. Most recently he dressed Ann Romney during the Republican National Convention, and one has to wonder how much of that decision was made solely out of spite. But many great artists suffer from severe bouts of immaturity (or megalomania), and de la Renta is a great artist.
His spring collection was a bit all over the place (all of the colors and all of the shapes!), but it came across less “This collection has no cohesion,” and more “There’s something for everyone! All the stuff!!” The man is always going to known as Mr. Upper East Side, but there were plenty of looks and pieces that could be worked into riskier ensembles.
I had plenty of “I want that” moments when I was going through his collection, and my co-worker recently described me as “the blonde, straight Joan Jett.” (Best, and most inaccurate, compliment ever.) So maybe he really does make something for every (rich) one. True, Jett probably won’t step out wearing an Oscar de la Renta evening gown anytime soon, but Kristen Stewart might.
Critics all over are calling the Spring 2013 collection the best of Narcisco Rodriguez’s career. I’m not ready to give it the number one spot quite yet (the man has had a very long, very successful career – I need more time to mull it over), but it was certainly one of the highlights of New York Fashion Week.
It was quite similar to Costa’s collection for Calvin Klein in the sense that the effect was extremely sensual, but Rodriguez upped the ante on the sheer fabric. The looks were absolutely bedroomy. Sensual and classic.
Francisco Costa and Narcisco Rodriguez are champions of minimalism. Ralph Lauren, on the other hand, is unfamiliar with the concept. The first half of his show, a bright assault of turquoise and poppy red, as well as 50 pounds of accessories, was so visually aggressive that by the time the lovely gowns rolled out, I was afraid that they were going to punch me in the face. There were beautiful offerings in black and white , and there was one floral dress in particular that I think may have been lovely, but I couldn’t really tell. I was too distracted by the scarf tied around the neck, the chandelier earrings, the cardigan, the layered bracelets, the over-sized bag, and the fucking beret. His styling almost always bugs me, but it’s kind of his thing. I doubt it will change any time soon.
An art deco white pantsuit was sophisticated with a retro edge, though it did kind of remind me of something the bad guys in one of the Indiana Jones would wear. (Not the fourth movie. We do not speak of the fourth movie.) And crap, there was a simple black cold-shoulder gown that I adored. So that’s great. I have predicted my own future! And now I predict that Trent Reznor will show up at my doorstep with a pizza and a stack of horror movies. Check in with me in a week.
Click HERE for Beth’s Spring 2013 NYFW reviews of Richard Chai Love, Peter Som, Lela Rose, Rebecca Minkoff and Suno.
Click HERE for Beth’s Spring 2013 NYFW reviews of Marc Jacobs, Thakoon, Jason Wu and Altuzarra.
Click HERE for previous installments of String Theory.

domain: artistic


text:
With the Street Skateboarding World Championships wrapped up in Rome, along with the controversial Dew Tour stop in Des Moines, World Skate has today settled on the 80 competitors who will compete at the Tokyo Olympics in skateboarding.
20 skateboarders will compete in each discipline: Men's Street, Women's Street, Men's Park, and Women's Park – with five Australians officially in the mix. The final qualifier list is fascinating, to say the least – the biggest names are mostly present, but plenty of left-field candidates have been silently chipping away at a qualifying spot, and we can surely expect some shocks and surprises when Tokyo finally rolls around.
For the Aussies, we've got Hayley Wilson (Women's Street) and Poppy Olsen (Women's Park) locked in, as expected, alongside Keegan Palmer (Men's Park) and Shane O'Neill (Men's Street). Despite being disqualified as a close Covid contact in Des Moines, Kieran Woolley (Men's Park) also did enough to sneak in – and with momentum on his side, there's a pretty solid chance he could snag a surprise medal in Tokyo.
As for dates, the Street events will be held on July 25 & 26, while the Park events take place on August 4 & 5. The full list of competitors for each discipline can be found below. Not long now!
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text:
May 31—They stood on the steps of the state Capitol because they've been fighting for other places.
For Kathy Ferguson, it's been Institute, her historically majority-minority unincorporated community some 10 miles away burdened by environmental hazards from chemical facilities for generations.
"Folks in Institute have been under siege with regard to chemical pollution since the 1940s," Ferguson said, recalling a Union Carbide plant that federal regulators say emitted some of the highest levels of the carcinogen ethylene oxide in recent years was first built during World War II.
For Maury Johnson, it's been the creek waters in Monroe County in the path of the still unfinished Mountain Valley Pipeline, the 303-mile, 42-inch-diameter gas pipeline project that he's opposed throughout its eight years of development.
For Michael Whitten, it's been mine-scarred lands like those around his Boone County home and other fossil fuel projects.
"I'm here today because of the way I feel when I put my granddaughter on the school bus," Whitten, 74, a former miner himself, said at the rally last Wednesday morning. "I look at kids on the school bus and worry about their future."
The Capitol steps were the latest stop that morning in a planned 11-day "Walk for Appalachia's Future" along the path of the Mountain Valley Pipeline, which spans 11 counties in West Virginia from the northwestern part of the state to Virginia.
Wes Holden, a longtime aide to former U.S. Sen. Jay Rockefeller, D-W.Va., lamented what he called the "corporately controlled" state Legislature's weakening of environmental protections. Holden alluded to a legislative rules package approved in the 2022 regular legislative session that weakened water quality standards for suspected cancer-causing chemicals, including some found in coal tar like benzo[k]fluoranthene and chrysene.
"Tell me, are you benefiting from the changes in these new laws and regulations?" Holden asked the dozen fellow activists on the steps of the Capitol. "I don't think so."
On the other side of the Capitol Complex just moments later, West Virginia Coal Association President Chris Hamilton was connecting with an audience well-positioned to help determine the state's environmental and energy future.
Speaking before the West Virginia Public Energy Authority, Hamilton presented PowerPoint slides with nearly two dozen bullet points outlining how his trade association wants the recently reactivated board to promote coal.
Hamilton urged the authority to consider pursuing partial ownership of a Pleasants County coal-fired plant scheduled to deactivate next year and in-state electric utilities given their commitments to move away from fossil fuels.
Authority members complimented Hamilton on his hour-long presentation and reaffirmed their support for keeping coal in the state's energy portfolio afterward.
"Obviously, coal will continue to be there," Kris Warner, a board member by virtue of his position as executive director of the state Economic Development Authority, said after the meeting.
The environmental group Appalachian Voices advertised the Walk for Appalachia's Future in part as a stand for environmental justice before it started Monday.
The U.S. Environmental Protection Agency defines environmental justice as "the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation and enforcement of environmental laws, regulations and policies."
West Virginia environmental advocates say they've been denied that fair treatment in state lawmaking and enforcement processes because they're not getting meaningful involvement. They point to consistent approvals of new and renewed permits for potentially hazardous projects, unaccommodating public hearings and failed attempts to codify greater roles for citizens in the permitting process into law.
Nicolas Zegre, associate forest hydrology professor at West Virginia University, calls the procedural part of environmental justice "who gets to decide who gets to decide."
The White House's Justice40 initiative is a goal of providing 40% of the benefits of federal climate and clean energy investments to disadvantaged communities.
West Virginia environmentalists and concerned citizens have criticized the beta version of the Climate and Economic Justice Screening Tool being used to identify disadvantaged communities for excluding Institute and other communities that have dealt with industrial pollution for decades.
But the tool still depicts West Virginia as a disproportionately disadvantaged state.
More than 839,000 of roughly 1.8 million West Virginians — or 46% of the population — live in communities considered disadvantaged, far more than the national clip of 28%. Just over half of West Virginia's census tracts are considered disadvantaged, outpacing the nationwide clip of 31%.
Census tracts are identified as disadvantaged in one or more categories of criteria if the census tract is above thresholds for one or more environmental or climate indicators and socioeconomic indicators.
Zegre said he believes that West Virginia's high poverty rate (15.8%, well above the national 11.4% clip) and great vulnerability to flooding and pollution should give the state pause.
"We need to rethink how decisions are being made," Zegre said.
Champions of disadvantaged communities say a rigorous rethinking at the state level is needed given the fleeting nature of federal initiatives like Justice40. The initiative isn't a law or rule, and could end instantly under future presidential administrations.
"[W]hen we talk about the potential to end the Justice40 initiative based on a change of administration, I think that's even more important to be working at your state level, because oftentimes our state and local governments are going to have a much bigger impact on our on our actual day-to-day lives, than the federal government," said Ardie Griffin, policy analyst and legislative director for Emerald Cities Collaborative.
Emerald Cities Collaborative is a national nonprofit group focused on promoting low-income communities of color in a green energy economy.
But West Virginia leaders have passed up opportunities to give the state's citizens a greater voice in determining the future of the energy landscape in their neighborhoods. Recurring state statutory snags in limiting environmental hazards have advocates calling for change, but many are skeptical that change will come.
"A good start to addressing environmental injustice in West Virginia would be to begin enforcing existing laws and to acknowledge the reality of science," Vernon Haltom, executive director of the Naoma-based anti-mountaintop coal mining nonprofit Coal River Mountain Watch, said in an email.
The EPA's definition of "meaningful involvement" toward environmental justice includes seeking out the involvement of those potentially impacted and letting the public's contribution influence regulators' decisions.
Morgan King, climate campaign coordinator for the West Virginia Rivers Coalition, identified bills that stalled during the 2022 state regular legislative session that she said would have advanced environmental justice.
House Bill 4640 would have required applicants seeking permits from the state Department of Environmental Protection to disclose the purpose of their planned activity "with sufficient specificity" at the permit location.
The House Energy and Manufacturing Committee never took up the bill, which Democrats introduced in response to the DEP approving an air quality permit for a proposed data processing facility in Morgantown despite little information on the facility's plans.
House Bill 2234 would have required a public hearing for air quality permits for facilities with an investment value of more than $25 million, or size of 25,000 square feet or more, in the county where the facility is to be located.
DEP public meetings on permitting decisions and other environmental proposals have gone virtual during the pandemic, increasing access. The Public Energy Authority recently started livestreaming its meetings while also uploading speaker presentations and meeting video recordings on the board's webpage.
But public hearings on bills advancing through the Legislature during legislative sessions have remained elusive for most West Virginians.
Senate Bill 694 was a sweeping, controversial measure fast-tracked through the Legislature allowing for unitization of gas and oil wells without 100% support from mineral interest owners in a given formation.
The bill drew the ire of some royalty owners and property rights advocates who say the bill is unconstitutional and will result in gas companies taking gas from mineral owner tracts without ever paying for it. Two Brooke County farmland owners sued Gov. Jim Justice in federal court on May 13 renewing those arguments.
The hearing on SB 694 in March didn't come until the bill already had been fast-tracked through the Senate and passed through two committees in the House of Delegates. That hearing required participants to come to the House Chamber, in Charleston, from 9 to 10 a.m. on a Monday on three days' notice.
A House committee hearing to take public input on a hotly debated bill that eventually passed lifting state restrictions on nuclear power plant construction took place at 10 a.m. on a Friday in the House Chamber, also with three days' notice.
Zegre said he wants to see more discussion hubs led by and located in communities affected by pollution and flooding — with state-level decision-makers in attendance.
"It really does need to be a bottom-up approach that meets the top-down approach," Zegre said.
'Shut them down'
But activists against mine and chemical pollution have made their overarching concerns clear over the years.
Coal River Mountain Watch has urged the DEP to stop renewing permits for mines that have emitted coal dust into people's homes, polluted the river watershed and disfigured the valley's landscape.
In April, the DEP renewed a mine permit for the Lexington Coal Company's Twilight III-A Surface Mine, in Boone County, after it found more than 40 violations across four of the company's permits for active mine sites in the watershed since the start of last year.
Just three days prior to the permit renewal, the DEP had issued letters to Lexington Coal notifying the company it was delinquent in paying two $22,500 penalties and was prohibited by a state legislative rule from issuing any permit or permit revision to the company as long as the civil penalties remained delinquent.
The penalties were attached to cessation orders the agency handed down in January after it found that Lexington Coal had failed to backfill and rough-grade mining-affected areas and take other remedial measures at the Twilight III-A and Twilight II surface mines.
The DEP received more than a dozen comments urging rejection of Lexington's permit renewal request.
But the DEP ruled that Lexington Coal's application, submitted in November, met requirements in state code setting environmental protection standards for mining.
DEP chief spokesman Terry Fletcher said in an email that permittees have a "successive right to the renewal of a permit," provided that certain conditions are met, citing state code that grants valid permits "the right of successive renewal upon expiration" unless the terms and conditions of an existing permit are not satisfactorily met.
Haltom said he wants to see permit renewal codified into West Virginia law as something the state can block. He noted previous EPA fines of $20 million and $27.5 million in respective water pollution settlements with Massey Energy and the company that bought it, Alpha Natural Resources, hasn't prevented scores of environmental violations in the valley in recent years.
Studies have linked mountaintop coal mining in West Virginia to elevated cancer, low birth weight and mortality rates.
"These operations are inherently hazardous to the neighboring communities, who pay the price with their health, quality of life, and sometimes their lives themselves," Haltom said. "The best solution is to shut them down."
Zegre cited a 2019 study that found most West Virginia counties ranked in the top third nationally in increasing rates of health-based drinking water violations from 2016 to 2019.
That study, by environmental advocacy nonprofit National Resources Defense Council, chemical industry-focused environmental health nonprofit Coming Clean, and the Environmental Justice Health Alliance, in turn, cited a study by the latter group finding that Charleston residents faced the highest cancer risk — 51 cancers per million people — from toxic air pollutants among nine areas studied nationwide.
The study focused on fenceline zones around highly hazardous facilities across the country.
DEP Environmental Advocate Ed Maguire has characterized the DEP as powerless to statutorily enforce environmental justice, and the EPA as short on guidance in response to questions from concerned citizens about the DEP's environmental justice oversight.
"[A] lot of this stuff becomes subjective," Maguire said in a West Virginia Environmental Council-hosted town hall in December. "If you're in the regulatory business, subjectivity is not helpful."
Other states are being more proactive in defining what environmental justice means and how to achieve it.
Maya Nye, of Morgantown, grew up in St. Albans across the Kanawha River from the Institute plant. Nye later become spokeswoman of People Concerned About Chemical Safety, a Kanawha Valley grassroots group that promoted environmental justice.
Nye now is federal policy director for Coming Clean. She touts the potential of legislation like a law New Jersey adopted in 2020 requiring the state to evaluate cumulative environmental and public health impacts when reviewing permit applications.
The DEP regulates pollution by enforcing standards for individual pollutants from individual facilities, an approach detractors say allows adverse health impacts from high amounts of pollution in an area if no one standard is violated.
"A law similar to the one passed in New Jersey ... could go a long way to address environmental injustice in West Virginia," Nye said in an email.
New York passed a forerunner law to Justice40 in 2019 defining disadvantaged communities and requiring the state to direct at least 35% of clean energy, pollution reduction and economic development assistance spending to those communities.
Zegre praised a bill delivered to Vermont Gov. Phil Scott last week that would create a state environmental justice mapping tool, establish an environmental justice advisory council that includes representatives of a social justice organization, mobile home park residents, municipal government, an organization working on food security issues and other groups.
"I love the layout of what Vermont is proposing, defining environmental justice, developing an [environmental justice] council that does require this bottom-up and top-down to meet in the middle," Zegre said.
Given West Virginians' low incomes and high vulnerabilities to pollution and flooding, meeting in the middle is something state advocates are urging their leaders to do as other states write their own environmental justice policies.
That also means meeting communities where they are.
"West Virginia is several steps behind the times," Holden said.
Mike Tony covers energy and the environment. He can be reached at 304-348-1236 or firstname.lastname@example.org. Follow @Mike__Tony on Twitter.
(c)2022 The Charleston Gazette (Charleston, W.Va.)
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Uploaded on Oct 15, 2011
Nick Carter's performance on WZTV FOX 17 - Tennessee Mornings. Such an amazing song and I think him singing live is better than the version on the album. Enjoy guys! Also thank you Hattie for uploading it for me MP3 form :)

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From LAX, Alaska and United offer direct service (stop, no change of plane) to Anchorage. Alaska, United, America West, Delta and Continental offer connecting service (change of plane). Restricted round-trip fares begin at $410.
Car rentals from most major agencies are available at the airport. The train depot is near Anchorage's downtown.
To make reservations for the ski train, visit the website of the Nordic Ski Assn. of Anchorage at http://www.anchoragenordicski.com . Tickets cost $60. The train will make two trips this winter. The southern trip, to Grandview on Saturday, is sold out. The northern trip, to Curry, is scheduled for March 12.
Other ski options are available in the Anchorage area as well. Alyeska Resort, (800) 880-3880, http://www.alyeskaresort.com , 40 miles south of Anchorage, offers world-class downhill skiing with nine lifts and a 307-room hotel. There are also miles of groomed cross-country trails winding in and around Anchorage.
WHERE TO STAY:
Hotel Captain Cook, 939 W. 5th Ave., Anchorage 99501; (800) 843-1950 or (907) 276-6000, http://www.captaincook.com . Luxury accommodations with an athletic club, business center, 24-hour in-room dining, and shopping inside this downtown hotel. Doubles from $110.
Hilton Anchorage, 500 W. 3rd Ave., Anchorage 99501; (907) 272-7411, http://www.anchorage.hilton.com . Just one block from the depot, this hotel has rooms, suites and executive accommodations. Doubles from $89.
WHERE TO EAT:
Glacier Brewhouse, 737 W. 5th Ave., Anchorage 99501; (907) 274-2739, http://www.glacierbrewhouse.com . Pizzas, burgers, steak and fresh Alaskan seafood. Entrees $9-$37.
Simon & Seafort's Saloon & Grill, 420 L St., Anchorage 99501; (907) 274-3502, http://www.simonandseaforts.com . Specializes in Alaskan seafood, wild game and other Alaskan fare. Entrees $16-$30.
TO LEARN MORE:
Anchorage Convention and Visitors Bureau, 524 W. 4th Ave., Anchorage 99501; (907) 276-4118, , http://www.anchorage.net .

domain: geography


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News and Stories
Veteran Tom Sitter takes up the bugle for the first time in 70 years to play “Taps” over a fallen comrade’s grave. WTMJ’s Rikki Mitchell reports.
My Brothers House, a nonprofit providing housing and counseling services to veterans, will open a residence in Philadelphia exclusively for LGBTQ veterans.
Police in Cedar Springs, Michigan, are asking for the public’s help after parts of a monument dedicated to a fallen soldier were stolen.
Female U.S. war vets are finding help for their post-traumatic stress disorder far from home.
When asked about Donald Trump and about veterans who oppose Trump, Sen. John McCain responded by saying that he wants veterans and their families to renounce Hillary Clinton.
“It was the equipment that we needed in case something happened, to either fix the bikes or help a warrior,” a Wounded Warrior Project official said.
World War II veterans, their families, and many others came together Sunday in Portland, Oregon, to celebrate Spirit of ’45 Day.
On average, 20 veterans a day committed suicide in 2014.
For military veterans with post-traumatic stress disorder, sudden fireworks detonations can be frightening — or even deadly.
A new nonprofit, Honor Everywhere, is helping veterans like never before, allowing them to travel around the country from the comfort of their own home.


With members of Rage Against the Machine, B-Real of Cypress Hill and Chuck D of Public Enemy in their ranks, Prophets of Rage are already a supergroup. At their Toronto concert at the Molson Amphitheatre last night, the group kicked it up another notch by having Dave Grohl join them on stage.
The Foo Fighter joined Prophets of Rage for their performance of MC5's hardcore classic, "Kick Out the Jams," at a show that was already being broadcast on the internet to a global audience from the group's official Facebook page.
Prophets of Rage are currently on their Make America Rage Again tour and will release their debut EP, The Party's Over, later this week.
Watch Dave Grohl perform "Kick Out the Jams" with Prophets of Rage below.
Editor's note: strong language warning.