Obama asks Senate to DELAY Syria vote after Putin outfoxed him just hours ahead of his major national address
- During a lunch with Democratic senators, Obama seconded Senate Majority Leader Harry Reid's decision to hold off until diplomacy plays out
- Sec. of State John Kerry will travel to Geneva, Switzerland for a THursday meeting with Russia's foreign minister
- Russia brokered a tentative Syrian chemical-weapons deal after Kerry suggested a framework by accident on Monday
- Obama will deliver a 9:00 p.m. EDT speech, originally planned as an apologia for military action, but now likely to be a push for diplomacy
- A French diplomat said the episode was 'extremely well played' by Russia
- The fallout from Vladimir Putin outfoxing Obama will have a ripple effect, clouding future U.S.-Russian relations and ensuring Russia an upper hand
- 79 per cent of Americans say Obama hasn't explained his Syria strategy well, and 56 per cent disapprove of his job performance
President Barack Obama has told a group of U.S. Senators that he wants them to delay a vote on authorizing military force against the Bashar al-Assad regime in Syria until a result of diplomatic efforts with that nation and Russia is clear.
Part of that diplomatic negotiation will take the form of a meeting between Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov in Geneva, Switzerland.
The two will meet Thursday to discuss Syrian crisis, according to news reports.
Obama lunched with Democratic senators Tuesday, seeming to back a Monday afternoon decision by Senate Majority Leader Harry Reid to put off launching the formal Senate process that would result in a test vote on Wednesday.
According to a White House pool reporter, the president met with the Republican Senate caucus after laying out a revised strategy with his fellow Democrats.
A GOP Senate source told MailOnline that Obama redoubled his efforts to woo Republicans to vote for a use-of-force resolution, explaining that it had shifted from a primary strategy to a backup solution, and one that would keep Syria at the bargaining table.
'He's playing both sides of the street,' the source said, 'which isn't all that surprising.'
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President Obama had lunch at the U.S. Capitol with the Senate Democratic Caucus on Tuesday, asking them to delay a vote on military action against Syria despite Assad's alleged use of sarin gas on August 21
Senate Majority Leader Harry Reid said Monday that he would push back his timetable, after an accidental quip by the secretary of state started a mad diplomatic dash in Russia and Syria
Obama has been shoehorned into a diplomatic posture even as he makes a case for military force against Assad
Reid told NBC News Monday evening that he had consulted with the Obama, his fellow Democrats and the Republican leadership before making his decision to delay a vote, making the president's announcement an anticlimactic move.
The Majority Leader, a Nevada Democrat, added after the lunch meeting with Obama that the possibility of U.S. military force would remain in place while the multilateral chess game played out.
'We're going to continue to work moving forward on this but keeping pronounced – and I pronounce it now – that the credible threat of our doing something about this attack is going to remain,” he told reporters.
Senate Majority Whip Dick Durbin added that the revised timetable would push back Senate action at least into next week, according to Politico.
No vote on the president's proposed use-of-force resolution has been scheduled in the House of Representatives, where a majority of members have already said publicly that they oppose the war-powers resolution.
Obama's move came after the Syrian government embraced a Russian proposal to place its chemical weapons under international control so they can be destroyed.
It's likely that the United Nations will be one vehicle the countries leverage to neutralize Assad's chemical weapons stockpiles, whose existence his regime has never acknowledged.
The latest diplomatic flurry has left the Obama administration reeling after Russia outwitted the White House to strike a deal with Syria just hours before the president makes a landmark national address.
The Russia-Syria deal followed Secretary of State John Kerry's unintentional suggestion of a route to avoid U.S. strikes against Assad, which the Russians leaped on in a dramatic 24 hours of diplomatic horse trading.
As a result, Vladimir Putin – not Barack Obama – has emerged as the power broker in Syria.
The winners: Russian Foreign Minister Sergei Lavrov (R) and his Syrian counterpart Walid al-Moualem leaped on John Kerry's gaffe, forcing the White House into a posture of acceptance
The loser: Secretary of State John Kerry opened the door for Assad to save face, in a move that a White House aide later called a 'major goof'
Syrian Foreign Minister Walid al-Moualem met with Russia's parliament speaker on Tuesday, saying afterward that his government had 'agreed to the Russian initiative.' Moualem said the Assad regime had made the pact with Russia in order to 'uproot U.S. aggression.'
The stunning turnaround from a regime that had never admitted it possessed any chemical weapons comes as an enormous embarrassment to the Obama administration.
White House Press Secretary Jay Carney attempted to put a positive spin on the turn of events on Tuesday.
He said on the MSNBC 'Morning Joe' program Tuesday that the White House now sees Assad's apparent commitment 'as a clear result of the pressure that's been put on Syria by the fact that the president has been moving forward.'
'The vote – the authorization – continues to put pressure on Assad, and is the only reason' a negotiation could succeed, Carney said, referring to the pending resolution in Congress.
The White House's increasingly confusing Syria policy has led 79 per cent of Americans to tell CBS pollsters that the president has failed to adequately explain it.
'It was extremely well played by the Russians,' a French diplomatic source told MailOnline.
So well played that President Obama agreed today to engage with the United Nations to 'explore seriously the viability' of Russia's proposal.
No eye contact: Russian President Vladimir Putin and U.S. President Barack Obama have been in a staring match over Syria since the G-20 summit in St. Petersburg, and John Kerry appears to have blinked
A White House aide who requested anonymity told MailOnline on Tuesday that the president had originally planned to use a series of Monday evening television interviews to bolster his case for military action.
Earlier in the day Obama had sent Susan Rice, his National Security Adviser, to give a lunchtime speech in which she argued passionately that the threat of military action should be maintained. She did not mention the hours-old Kerry proposal.
In the wake of Kerry's gaffe, Obama ended up pushing a message of acceptance on six television networks Monday night, saying that the U.S. 'will pursue this diplomatic track,' and that he would 'absolutely' call of military strike plans if Assad gave up his chemical weapons.
The developments have also thrust into limbo the plans for Obama's Tuesday-evening speech to the nation, which a Pentagon aide told MailOnline was 'clearly originally conceived as a plan to get Americans to muscle their congressmen to push for a war resolution.'
But as with Monday's televised interviews, that draft of the speech is likely already in the trash can.
A White House official told Politico that Obama and the French and British heads of state 'agreed to work closely together, and in consultation with Russia and China' on a deal that would guarantee the 'verifiable and enforceable destruction' of Assad's chemical weapons.
With the Russians emerging as the power brokers with Syria, and Assad's government agreeing to relinquish its chemical weapons, the continued threat of a U.S. attack may ring hollow and the White House may be relegated to leading from behind.
Kerry's quip forced Obama to change tack, saying during a series of TV interviews Monday that he was willing to try a 'diplomatic track,' despite rattling the war sabers for weeks
Secretary of State John Kerry made what the State Department later called a 'rhetorical' argument on Monday in London, saying that Assad could avoid U.S. military action by turning over 'every single bit of his chemical weapons to the international community in the next week.'
Then he added: 'But he isn’t about to do it, and it can't be done, obviously.'
A White House aide told CNN that his comments were a 'major goof' diplomatically, since the president had not authorized Kerry to offer Assad a way out.
But Syrian Foreign Minister Walid al-Moualem and his Russian counterpart Sergei Lavrov both expressed interest within hours, as did UN Secretary General Ban Ki-moon.
PUBLIC OPINION SOUR ON STRIKES
Poll numbers continue to show a majority of Americans are opposed to U.S. military action in Syria, despite urging from the president, the secretary of state, and the national security adviser.
An Associated Press poll released Tuesday showed that only 1 in 5 Americans believe the White House's line that failing to respond to Assad's chemical weapons attack will embolden other rogue regimes. Fully 61 per cent said they wanted Congress to vote against military strikes.
Even a majority of Democrats – 53 per cent – now oppose military action in Syria, according to a Pew Research Center/USA Today poll released Monday.
Fifty-five per cent of Americans told CNN pollsters over the weekend that even if Congress authorizes a strike, they would still oppose it. And 69 per cent said it is not in America's national interest to get involved militarily.
A CBS poll released late Tuesday morning found that 56 per cent of Americans disapprove of President Obama's handling of the Syrian crisis, compared with just 33 per cent who approve. And 79 per cent say the president has failed to fully explain what his goals are in the civil war-torn country.
On Monday a Fox News poll showed that Obama's presidential approval rating is at an all-time low, just 40 per cent. Fifty-six per cent of Americans disapprove of the job he is doing in the Oval Office.
Ultimately, a U.S. official told The Daily Beast of Monday's developments, 'most of Washington woke up and read another gaffe by Kerry and thought it was just that. By the end of the day, it seems like it is a new policy under serious consideration.'
France's foreign minister said Tuesday that his country will lodge a proposal in the United Nations Security Council that would force Syria to make its chemical weapons program public and place it under international control so it can be dismantled.
Russia, as one of the security council's permanent members, has the power to veto any such proposal, but as a party to the Syrian agreement it would likely go along with a UN resolution aimed at keeping Syria on course.
'The onus is now very much on the Russian government and the Assad regime,' a spokesman for UK Prime Minister David Cameron said Tuesday, 'to follow up in a way that shows that this initiative is a serious and genuine offer.'
'We have to make sure that this is not just a distraction tactic,' added British Foreign Secretary William Hague.
'How do you tell the difference between breakthroughs and delay tactics?' Hauge mused. 'That's exactly what we have to think about here.'
It was during a press conference with Hague on Monday that Kerry executed what a White House official later called an 'off script' maneuver, responding to a reporter's question by quipping that if Assad turned over his chemical weapons, the U.S. would not attack.
That message undercut the Obama administration's continuing efforts to force a resolution through Congress giving the president the power to launch military attacks against targets in Syria.
Meanwhile, in Syria: Heavy artillery shelling brought plumes of smoke over Barzeh, a district of Damascus, on Tuesday as hostilities with conventional arms continue
Dismantling Syria's stockpiles of sarin, VX and mustard gas will prove to be a years-long process, U.S. officials warn.
'This is a nice idea but tough to achieve,' one official told the Jerusalem Post.
'You're in the middle of a brutal civil war where the Syrian regime is massacring its own people. Does anyone think they're going to suddenly stop the killing to allow inspectors to secure and destroy all the chemical weapons?'
The New York Times reported Tuesday that chemical weapons experts said it would be 'next to impossible' to determine for sure where all of Assad’s 'sprawling, constantly moving arsenal' is kept and who controls it.
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|Home | Bookmark | Tell||Active petitions in over 75 countries||Follow GoPetition|
Petition Tag - sonny
1. Veto SB-157
Payday lending in the state of Ga.
Dear Honorable Sonny Perdue,
We, the undersigned, urge you to veto SB-157. Passing this bill will:
Take away the jobs of thousands of people in the state of Georgia. Take away the help that people sometimes need to make it till payday, to cover a bill,to keep a check fron bouncing or even for food. And for everone in the state great state of Georgia our right to choose.
Remember the freindship of Sonny and Luke? Remember how they watched each others back?
Both Maurice Benard and Anthony Geary have expressed their intrest in working together again.So lets ban together and support their friendship..

domain: politics


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With the greater use of Fitbits and other wearable technology that can measure a person’s health and activity levels, more employers are embracing the trend as part of workplace wellness programs.
Group competitions, for example, might see employees outfitted with fitness trackers so they can monitor their daily activity levels and compare them to other groups, both inside and outside the company.
In the United States, at least, this trend has caught the eye of federal regulators. The Equal Employment Opportunity Commission (EEOC) has issued a proposed rule that would amend the regulations and interpretive guidance implementing part of the Americans with Disabilities Act (ADA) as they relate to employer wellness programs — and data gathered as part of a company-sponsored fitness program could fall under the proposed rule.
The collection and use of this data, even if done by a third party, should be done with care, according to Canadian experts.
“Employers are going to have to use caution, make sure that whatever they’re doing is reasonable, make sure that consent is obtained from employees and is not coerced or obtained under duress, it’s not forced on them, and they’re going to have a role in making sure that employees understand what is being collected and how it will be used,” said Éloïse Gratton, a partner at Borden Ladner Gervais in Montreal.
While there is privacy legislation federally and in some provinces (including British Columbia and Alberta) around the collection of personal information, the general rule is employers can collect what a reasonable person would consider appropriate in the circumstances, said Deborah Cushing, a partner at Lawson Lundell in Vancouver.
“If you’re collecting this information as part of a fitness program, to me, that doesn’t seem as something that a reasonable person would think you need to manage the employment relationship — it’s more an add-on,” she said.
“So if the employer is collecting that information, they should have the consent of the individual to collect this specific information and identify what that information is going to be used for and who it might be disclosed to.”
And employers should be sensitive about implementing the program, recognizing a fitness-tracking competition may not be for everyone, said Cushing, so it’s better to have an opt-in program versus an opt-out one.
“(Opting out) can create some discomfort for people if they have to identify, for whatever reason, ‘I don’t want to participate in this,’” she said.
That also raises potential human rights issues — if someone has a hidden disability, for example, and hasn’t disclosed it at work but other team members are encouraging him to participate, said Cushing.
“It may make it uncomfortable for that person and they don’t have to disclose it because it’s not really necessary for employment, it’s an add-on. So I think employers should be sensitive about how they do this… though it sounds like it’s for a very good purpose, you’d want to be cautious or careful as to how you design it so it has the desired effect.”
These types of issues are going to come up, said Gratton, and it’s always going to come down to: Was the employer transparent when it collected the information and is this information necessary for the employer?
“Many privacy regulators could say, ‘No, you’re providing benefits but it’s not necessary, it’s not necessarily reasonable to collect this kind of information,’” she said. “Employers are going to have to think about these issues first instead of running with this data, saying nothing to employees and making decisions that may have an impact on these employees. They need to be transparent and they need to ensure they comply with human rights and privacy laws — that’s going to be their challenge.”
In the end, data collected through devices such as health-tracking bracelets should be treated the same way as other personal data collected by an employer, said Matthew Pearn, a lawyer at Foster & Company in Fredericton.
“Most privacy legislation that relates to an employer’s gathering of medical information would likely extend to any biometric data that was gathered — for example, from an employee, so if you were keeping track of someone’s blood pressure, heart rate, blood sugar, any of those things — through these activity trackers… that information would, in my mind, be subject to the same kind of restrictions that would be put on an employer if they had private medical information that had been provided to them through other ways.”
People are very excited about this newer technology but the type of information being collected can be quite sensitive and it could be used in the context of litigation, so that’s something employees need to be made aware of, said Gratton.
“I’m not sure everybody understands the implications.”
For example, if an employee is using a Fitbit and the employer has access to the data, it may confront the worker when she claims she was working overtime or she was sick, and the tracking device shows she was doing a physical activity.
“Employers and employees are going to have to have a transparent discussion and make sure that they agree on the framework, the lines that should not be crossed,” she said.
“In the context of litigation, if there’s information sitting there that could be useful, usually lawyers will request from the court authorization to access it and they’ll get it, so it’s something to keep in mind — you’re using a tool that will be tracking you 24-7.”
An employer has an obligation to maintain privacy over the information but if the employee, for example, is engaged in a civil claim of some kind, the fact that there is this documented history of his activity — whether collected by himself or through his employer’s wellness program — is something that can be disclosed as part of a civil claim, said Pearn.
If an employer tells employees this is part of a fitness promotion activity, it really shouldn’t be using it for other purposes, said Cushing.
“I shouldn’t be using it to manage someone’s performance or say, ‘Oh, you didn’t show up for work today but I see on your Fitbit that you were, by the GPS locator, here’s where you were.’ That would be inappropriate,” she said.
“And if you’re in a unionized workplace, I mean, you’re definitely going to cross some lines if you do that because there’s a number of labour arbitrations where employers have collected certain information and tried to use it, say, for performance management and that has not been looked at favourably.”
When it comes to personal information that’s particularly sensitive, such as blood pressure, employers should make sure there are adequate security measures to protect it so people can’t hack into it or use it for purposes that aren’t appropriate or sell to marketers, said Cushing.
“Under privacy legislation, there’s also obligations to destroy information after it’s met its purpose, so if employers are collecting this information, they don’t want to have it around forever. So either you destroy it after it’s fulfilled its use or if you’re using it for a particular decision about an employee or individual.”
Data in aggregate is useful as it can provide a lot of information upon which to make better-informed decisions — but the tricky part is it could potentially be identifiable, said Gratton.
For example, in small groups, certain employees could be identified in the data.
“Using information in aggregate is one thing — making sure it cannot be linked back to a small group or an individual.”
It’s possible employers may collect this amalgamated information as a way to decrease the cost of group insurance by showing the activity levels of employees, said Pearn.
“There are benefits to the insurer — it’s just a matter of making sure that they’ve removed all identifying information so no individual’s personal information becomes disclosed in the process.”
Looking ahead, third parties, such as insurance companies or employers, could require that employees undergo assessments through these fitness trackers, said Gratton.
For instance, insurance companies could offer better premiums to individuals who agree to be tracked.
Organizations could also decide to provide employees with fitness trackers to potentially reduce corporate plan insurance premiums.
“These type of activities would have to comply with Canadian data protection and human rights laws,” she said.
© Copyright Canadian HR Reporter, HAB Press. All rights reserved.

domain: law


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Report: Cloud revenue growth far exceeds on-premises
View all sessions on demand from Smart Security Summit this.
Battery Ventures State of the OpenCloud 2022 report looks at the context of cloud infrastructure and open source software and provides best practices for cloud companies.
The giant in the sky likes Amazon Web Services (AWS), Microsoft Azure and Google Cloud have demonstrated remarkable growth sustainability — and profitability — at scale, despite the current macroeconomic environment. Billion dollar businesses like Databricks (a battery portfolio company) and Snowflakes is built on top of these giant cloud providers and has plenty of room to grow, as digital transformation accelerates across industries and more workloads move to the cloud.
Heavy cloud growth
Across the four major software-infrastructure companies (MongoDB, Confluent, Elastic, and Splunk), the cloud revenue CAGR was at least 72% and at most 200% from 2018 to 2022. By contrast. , the local CAGR ranges from 4% to 55%.
Overall, Battery predicts that cloud spending will now account for about 25% of the $919 billion in enterprise IT spend in 2022, a share that is certain to increase in the coming months and years due to the ability to market disruption. Against the backdrop of growing pressure to improve productivity and efficiency and a high inflation environment, Battery predicts we will see a gradual increase in cloud adoption across every industry and platform. economy.
“Many cloud companies are showing strong growth and even profitability as the broader IT market remains untouched by cloud computing; There’s still a lot of room for growth,” said Danel Dayan, vice president of Battery and one of the report’s authors.
“While it remains to be seen what will happen in the next few months in the tech industry, given the market downturn, we are confident that the cloud and open source software will soon transform industries in the ways that we see it. in a way we’ve never seen before. ‘ added Dayan.
Battery Ventures 2022’s OpenCloud report is based on publicly available data from Gartner, Pitchbook, US Bureau of Labor Statistics, CapIQ, and corporate earnings reports. (Battery investments and exits are listed this.)
Read Full report from Battery Ventures.
VentureBeat’s Mission is to become a digital city square for technical decision-makers to gain knowledge of transformative and transactional enterprise technology. Explore our Briefings.

domain: economics


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Big Five wildlife, stunning scenery, colurful cultures and adrenline activities: Africa the beautiful is yours to explore with our group tours and overland safaris.
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From my side as part of the team I can just thank you very much for excellent service. This was one of my best tours due to a number of factors eg reliable truck (thanks for quick replacement at Van Rhynsdorp); professional and friendly crew providing safe driving and excellent meals; itinerary, activities, weather, team and no health issues. All contributed to a most enjoyable safari experience by the German and Dutch students. Kind regards Skip Krige , Go SA Charters read more

domain: geography


text:
Portuguese Validation of the Dissociative Experiences Scale (Des)
Journal of Trauma & Dissociation, 10(1), 69-82. DOI: 10.1080/15299730802485177
Posted: 15 Jul 2017
Date Written: February 8, 2009
The Dissociative Experiences Scale (DES) is a widely used screening tool for dissociative symptoms. The aim of the present study was to evaluate the validity and internal consistency of a Portuguese version and determine if it accurately identified dissociative pathology. The original DES underwent a "forward-backward" translation process. The translated form was used on 570 participants divided into 3 subgroups: 113 patients with dissociative symptoms, 233 psychiatric patients with various psychopathological disorders, and 224 normal individuals. A principal components analysis with all of the participants yielded 4 factors that accounted for 56.3% of the variance. Reliability as measured by Cronbach's alpha was .94. The receiver operating characteristic curve applied to the cutoff analysis revealed a value of 30 comparing the 2 clinical groups and contrasting the dissociative-based group with the nonclinical group. The ability of the DES to correctly classify those with and without the disease was very good. Sensitivity was 65.0% and specificity was 86.0% with the cutoff score of 30 from the comparison between dissociative symptomatic disorders and the other psychopathological disorders. Comparing the dissociative symptomatic group with the nonclinical group, we found that sensitivity was 65.0% and specificity was 100%. The mean DES scores for the 3 subgroups were significantly different. These findings are in some degree analogous to those in other studies and suggest that the DES is a reliable and valid screen for the Portuguese population.
Keywords: Validation, Dissociative Experiences Scale
Suggested Citation: Suggested Citation

domain: medical


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Over the past few days, I have had the opportunity to talk to a cross-section of actors, producers, directors in the Hindi film industry. All their stories had one common thread: Abhishek Banerjee. I learnt that a producer had hired him as a casting director, the actor was cast through his company Casting Bay, and the director was delighted to utilise his acting abilities. Everyone loved to work with him, as well as enjoyed his on-screen performance. It clearly indicates that the man has earned everyone’s respect. He is becoming the proverbial potato that fits into most of the film industry’s cinematic recipes. On hearing this analogy, Banerjee broke into peals of laughter, and said he aspires to be like broccoli. A rare, exclusive, and acquired taste.
Today, Banerjee has won appreciation for Paatal lok, Stree, Mirzapur, but he first dreamt of becoming an actor after watching Amitabh Bachchan’s films, namely Deewar and Agneepath. The moment of realisation occurred when he received public acceptance. He says, “Audience’s reaction is the litmus test for acting. When I mimicked on stage for the first time in school, everyone liked my performance, including my teachers. I thought to myself, I must have some talent to deserve this appreciation. I wasn’t that good at studies, but I was good at acting, so I concluded I should pursue acting.” He was a member of Kirori Mal College’s highly popular theatre society named Players during his College days, where he learnt the acting ropes.
In 2009, he moved to Mumbai from Delhi, and did the usual round of auditions, but only felt confusion. Banerjee auditioned for Dev D, where he befriended casting director Gautam Kishanchandani. He began assisting Kishanchandani, and later started his own casting company, Casting Bay, with a friend. Banerjee didn’t give up on his dream to become an actor, but he had a complicated journey because he faced rejection as an actor even in the films he was casting
Banerjee reveals, “Gautam Sir was the casting director while I was the casting associate on Ghanchakkar. I auditioned for Idris’ role, and I was told point blank that I’m not good enough. I knew the director, Raj Kumar Gupta Sir, and I was casting for the film. I thought that if they don’t cast me, no one else will. Sir told me ‘Kuch soch. Kya karega ab’, and I felt the rug being swept from under my feet. Mentally at that point, I had given up on acting. In retrospect, I feel it’s good that I didn’t land the role, else I wouldn’t have learnt.”
He was more or less convinced that he shouldn’t audition anymore. He didn’t move to Mumbai to do small roles, or play the hero’s best friend. He wanted meaty characters. Life had other plans for him, and it all happened over a couple of beers.
TVF was working on its first original web show, Pitchers. The casting director wanted Banerjee to audition for a five-minute role in the show, and he wasn’t very keen on it. She chased him, and when he gave the audition, he landed the role. His dialogue ‘Tu Beer Hai’ changed the way people communicated thereon. In the show, the dialogue’s context was kahin pahuchne ke liye, kahin se nikalna bahut zaroori hota hai. Banerjee couldn’t relate when he said those lines in the show. A director friend, Devashish Makhija, put things in perspective. Banerjee describes how Devashish explained to him: “Abhishek, Tu Beer Hai. You need to come out of the beer bottle, and let the magic happen. Stop going back into your shell as a casting director. Acting kyun nahi kar raha hai? I was deeply affected by what he said, so I continued acting.” The duo worked on films like Agli Baar in 2015, Ajji in 2017, and Bhonsle in 2020.
From this point forward, it didn’t matter whether the role was big or small, positive or negative, he has acted continuously. His notable characters include Janna from Stree, Compounder from Mirzapur, Bushi from Humorously Yours and Mahinder from Dream Girl. He gained popularity for his fantastic portrayal of Hatoda Tyagi in Paatal Lok. Banerjee says, “I’ve realised that gangster roles gain unprecedented popularity. It doesn’t matter if you have acted well in other roles or not. If you have picked up a gun or a hathoda and stabbed people, the audience loves you and your performance. They enjoy watching dark characters. I feel actors should not be typecast, but should play varied characters to the best of their ability.”
Banerjee doesn’t read all scripts that come to his company for casting, but among the ones which he reads, if he likes a character, he asks the makers if he can audition, like he did for Paatal Lok. He wanted to audition for Ansari’s role, but that didn’t work out for Banerjee, else we wouldn’t have got the scary Hathoda Tyagi. Believe it or not, he had to audition for the role of Vishal/Hathoda Tyagi.
Besides Hathoda Tyagi, one of his recent good performances was as Manish in a segment called Vishanu in Unpaused. Banerjee plays a labourer, but at the core, it is the story of a father and a husband who is trying to take care of his family in the lockdown. Talking about his reasons to choose the segment, he says, “Stories like Vishanu, and genius directors like Avinash Arun Dhaware bring you back to the ground, reminding you that there is still a lot to learn. The idea was to play the role from not the labourer’s perspective, but from a father and a husband’s perspective. I was drawing references from what my father would have done if he faced similar circumstances. I was looking through the lens of a guardian who wanted to protect his family no matter what.”
By the end of our conversation, he admitted that he is becoming a bit of a potato; he confesses, “I did a lot of work last year. This year is also packed with acting work and casting jobs. But from the inside, I know I’m broccoli. (laughs).” I think Abhishek Banerjee is both a beer and broccoli —he can be a hit with the masses, and also an indie darling.

domain: artistic


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People in Saskatoon’s Eastview neighbourhood are planning an anti-hate march on Tuesday night after a recent attack on a Muslim man.
Muhammad Kashif was attacked by two men in the alley behind his house in Eastview last month. He was stabbed, taunted with racial slurs and had part of his beard cut off.
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Michelle Lee-Klaassen is one of the organizers of the march.
“When I found about (the attack) I just felt sick to my stomach,” she said. “We have small children and I know Mr. Kashif does as well, and we just felt terrible as parents and teachers and people in our community and we wanted to do something.”
Lee-Klaassen said the group has printed hundreds of fliers promoting the event and has been dropping them off door-to-door, while taking time to speak with neighbours about what happened.
“Some people didn’t know that the attack had occurred. Others had expressed that they themselves feel fear for their families after that attack happened in our community. We’re really just hoping to bring visibility to the diversity of our neighbourhood and come together and just show support, that hate doesn’t belong in our neighbourhood,” she said.
The event starts with sign-making at James Anderson Park near the paddling pool at 6:30 p.m.
The walk begins at 7 p.m. from James Anderson Park, then heads down Arlington Avenue, around Preston Avenue and back to the starting place.
After that, there will be a couple of speakers and free refreshments.
The Facebook event page notes that while the provincial mask mandate has been dropped, people are welcome to wear masks if that makes them more comfortable in a group.
“I’m a parent and a teacher and a community member and I just feel like as a person when you see something and you feel like change needs to happen it just takes a little bit of courage and stepping up, because chances are there are other people who are feeling the same way,” Lee-Klaassen said.
'I hate Muslims': Attackers stab, taunt, cut beard of Saskatoon man
Sask. Muslim community in 'undeniable shock and horror' after Ontario attack
The news seems to be flying at us faster all the time. From COVID-19 updates to politics and crime and everything in between, it can be hard to keep up. With that in mind, the Saskatoon StarPhoenix has created an Afternoon Headlines newsletter that can be delivered daily to your inbox to help make sure you are up to date with the most vital news of the day. Click here to subscribe.

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As Australia’s home of live music, and a city with an exciting blend of cultures including many African communities, it is no surprise that Melbourne has become the nationwide centre of the Afrobeats movement.
Whether it’s Afrobeat, Afrobeats, Afro-beats or Afrobeatz, and the exact the origins of the music – is not entirely clear. What is entirely clear, is that this intoxicating fusion of traditional African drumming and tribal sounds, mixed with electro, RnB or hip hop – depending on the artist - has taken off big time in Melbourne.
People from all backgrounds, ages and ethnicity are swapping their heels for their runners and turning up in droves to try a class, attend a club night, event or festival showcasing this emerging music genre, its unifying dance moves promising a healthy dose of serotonin.
From bars that have regular Afrobeats nights to large ticketed basement and boat parties, locals and visitors can dip their toes in, or jump in fully-clothed.
Sounds Of Africa organises a variety of specialist music events celebrating African culture. The up-coming SOA Block Party showcases two of Melbourne’s best Afrobeat artists Lowkey and Kudzai. The DJs will be playing the best of Afrobeats, Reggae, Dancehall (a music style originating from Jamaica with its roots in Reggae) Zouk, RnB and Hip Hop. Strict dress code of cocktail style Black & Gold. Saturday July 20th.
Let’s Vibe / Sriracha is another event promoter with a passion for exposing the sounds of Africa to Melbourne. The guys organise a range of events from open mic at Whitehart to summer boat parties and smoking hot ‘Sriracha’ basement parties in the city – organiser and DJ Jerry C’s mix of Hiphop, Afrobeats and electronic music usually means they sell out quick.
Members only Moja Afrobeats offers a more boutique style of event and champions the rapidly emerging movement in Melbourne. Moja is a Swahili word that means 'one'. The mission, to get everyone together through the Afrobeats movement. The downloadable app has more info on events coming up.
Brunswick music house incubator Bar Oussou offers free nightly live music in an intimate space with an international flavor. Sunday nights are dedicated to the Ausecuma Beats - with combined influences from Africa, Cuba, and Australia and a Senegalese Feast to boot. Think peace and happy vibes with people spilling out to dance in the streets.
City centre bank plc basement bar, Marrakesh, becomes Bendo every Thursday. Early arrivals can join the dance class to learn to the moves, and once the night kicks off in earnest, the whole crowd unites in harmony as it moves together, choreographed by top notch instructors from all around the world. Impossible not to join in.
I love Dancehall is a monthly ticketed music night at Brunswick’s Rubix Warehouse. The events have evolved over ten years from traditional Dancehall to now include Afrobeats. Next event planned for July 6th.
Family-friendly cultural events and festivals featuring the stars of Afrobeats.
The Sounds of Africa Festival is an annual family-friendly celebration of African culture, music, food and vibes at Ceres in East Brunswick. From drumming workshops and dance performances, arts and crafts, amazing food and of course DJ’s playing Afrobeats - the event is simply a wonderful day out and introduction to the many diverse and colourful African cultures. The 2019 event will take place on December 7th.
A PBS event in its fourth year, the next Beasts of No Nation will be held Saturday August 31 at Max Watts and will pay homage to the irrefutable king of Afrobeat, Fela Kuti, who will be in Australia for the first time since 2014. His singer-saxophonist, two-time Grammy nominee son, Femi Kuti will be joining the performance. Event co-founders The Public Opinion Afro Orchestra will also perform. With all previous Beasts of No Nation events having sold out, there’s no doubt the 2019 event will do the same
Melbourne African Traditional Ensemble (MATE) is in the line up for the City of Yarra’s popular Leaps and Bounds Music Festival. The Pan African quartet hail from Ghana, Ethiopia and South Africa. Traditional instruments and influences create a must-move vibe. The event is organised by AfroHub –a platform for African talent in all its diversity - and Abbotsford Convent.
Sunset Safari at Werribee Open Range Zoo will return for the summer months from November 2019 to March 2020. In this exclusive after-hours and small group event, visitors spend an incredible night out with some of the world’s most iconic animals. While they adventure onto the Savannah for a guided sunset tour and feast with friends at an intimate dinner, they also enjoy immersive performances that showcase the rhythms of Africa by some of Melbourne’s best African percussion and dance experts.
A perfect way to fully understand the appeal of the Afrobeats movement. Dancing and drumming classes of different styles are available all around Melbourne for those who want to sign up to a course, or simply turn up and dance.
Classes are on offer on Thursday nights at the Marrakesh club before the Bendo night kicks off with Afro Caribbean dance styles include Kizomba, a genre of dance and a music originating in Angola and meaning "party", and Zouk, a quick tempo musical style originating from the Caribbean islands of Guadeloupe and Martinique. 25 Bank Pl, Melbourne VIC 3000, (03) 9939 1408
Dance Energy Happiness at Jungle City Dance is run by KT or Kwame Tousuma - a well known name in the dancehall scene - and is open to people of any level and fitness. From traditional to modern Afrobeats trends. Jungle City Studios, 7b Level 1, 7-9 Hope Street, Brunswick 3056
Afrikan Soul has a similar offering at Robles Studio in Carlton and proclaims to be 'the home of Kizomba in Melbourne'. Instructors Lam and Kylie have over 25 years of cumulative dance experience between them, in styles diversified across Africa, Cuba and the Dominican. Their first passion and now primary teaching focus is in the related styles of Kizomba, Semba, and African Dance. First floor 171 Lygon Street, Carlton, 0466 635 533
Also, Afro Funk classes with dance and drumming are available at Asanti Dance Theatre on Thursday nights in St Kilda, and African star dance uses some of the top dancers in Melbourne for workshops, dance and drumming classes, they are available for special events and parties and they run regular classes around Melbourne.
Afrobeats music artists around Melbourne
As the city that musos across Australia gravitate to in order to progress their music career, Melbourne has become the home to some of the top and emerging Afrobeats and hip hop artists.
While Sampa the Great's music is more often described as hip hop, she taps into her Zambian roots and works with one of Melbourne's top Afrobeat drumkit players ( Julian Goyma ) on her increasingly popular style of music. Sampa the Great is on a huge global upward trajectory having won many awards and recently played the UK's Glastonbury Festival.
The Senegambian Jazz Band is local outfit that fuses influences from Gambia, Senegal, Ethiopia, Ghana and Australia with jazz and world music beats, they are playing at the Marysville Jazz and Blues Festival October 18 – 20 2019.
Ajak Kwai is one of Melbourne’s top female artists to catch live in concert. Ajak’s music is inspiring and soulful, infused with funky Afrobeats representing the depth and richness of her South Sudanese roots. Her performances are filled with vibrant sounds and her distinctive voice has mesmerised audiences nationally and internationally. Like her contemporary, Lamine Sonko, she is also an important cultural public figure for the Melbourne / African communities.
Lamine has a group called the African Intelligence and is the lead singer in a number of Melbourne’s top Afrobeats ensembles. They play traditional live Afrobeats and afro funk and have performed all around the world.
Digital Afrika is a two piece band with a new EP out that focuses on dance Afrobeats and house and is selling out events and club nights around the city.
Those who are keen to try before they buy, should tune in to renowned international dancer and drummer, Kofi Shabba's Kiss FM 87.6 Sunday show.
So be it a curiosity, a love of dance or a desire to learn more about the eclectic and colouful African communities in Melbourne, visitors and locals alike should jump onboard this movement as its continues its domination of Melbourne, and the world.
This content can be shared and edited for the purpose of promoting Victoria as a visitor destination. Not for use in paid advertising. Please credit Visit Victoria.

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Bitcoin and Ether rose on Friday morning in Asia, along with nearly all other top 10 non-stablecoin cryptocurrencies. The exceptions were Cardano and Tron after Tron’s gains earlier in the week. The U.S. posted stronger-than-expected jobless claims as investors continue to monitor the country’s ongoing debt ceiling negotiations.
Nvidia boost for cryptocurrencies
Bitcoin rose 1.82% over the last 24 hours to US$26,431 at 9:30 a.m. in Hong Kong, according to data from CoinMarketCap. The world’s largest cryptocurrency by market capitalization was, however, down 1.53% over the past seven days.
Ether climbed 1.85% in the past 24 hours to US$1,800. It remained little changed over the past week.
“This week, Bitcoin briefly dipped below its two-week range between US$26,500 and US$27,000, now challenging the critical 200-weekly moving average at $26,275,” said Rachel Lin, chief executive officer of Singapore-based decentralized derivatives exchange Synfutures.
“A close below this weekly range could negatively impact Bitcoin and the broader crypto market, but a bounce from this…


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When shall I start?
Tackling the High Sierra
If you want to remain in the field of hiking and not go into mountaineering territories, you MUST start the Sierra after snowmelt. Typically, it is considered that hikers should leave Kennedy Meadows around June 15, not before. Of course the exact date when you can start hiking the Sierra depends on the actual snow pack, that’s why you’ll need to keep a close eye on weather reports in real-time. On years with heavy snow falls, passing thru the Sierra is impossible even at the heart of summer when it’s the warmest (that was the case in 2017 and again in 2019, where many thru-hikers had to skip that section). On a regular year, if you start at the right time, the only places where you’ll walk through snow will be mountain passes – there are 12 in total in the High Sierra – and you’ll be safe as long as you take your time, take careful steps and pass when the snow is still hard. As a general rule, this means that you’ll be better off tackling passes as early as you can in the morning. As snow gets softer, you’ll start sliding and post-holing and, depending on what lies underneath the snow pack, you might get injured. Sleeping as close as possible to the pass on the previous night and starting the ascent around 4:30 or 5am is a fairly good tactic that has proven efficient for me.
Starting in Campo
The day you leave Kennedy Meadows dictates the day you start in Campo, it’s as simple as that!
Let’s say that winter has seen normal snow falls. You’ll plan to leave Kennedy Meadows for the High Sierra on the morning of June 15. Kennedy Meadows is usually a good place for a break, there’s no need to depart as soon as you’ve arrived. You wanna rest from the desert and gather your strength for the peaks of the High Sierra, you need time to resupply and shove your food into your bear can, maybe buy some specific gear for the mountain, and maybe you’ll also want to take the time to find friends you’ll team up with for the section to come… so let’s say you’re taking 2 full days of rest. That means you’ll plan to arrive at Kennedy Meadows on June 12, any time in the afternoon (be prepared for the applause and cheering as you arrive at the General Store!)
To know your starting date in Campo, all you need to do is make a retro-planning from there. There are 702 miles between Campo and Kennedy Meadows. By approximating your walking pace and daily mileage, you’ll know when you need to start to be in Kennedy Meadows by June 12. Keep in mind that you need to start VERY slow and that you won’t reach your actual cruising pace before the end of week 1 (there’s a full page on this topic, it’s in the process of being translated), and don’t forget to factor in your days of rest (zeros and neros). Of course this method is somewhat approximative, but that’s not an issue. On a long hike such as the PCT, 3-4 days more or 3-4 days less don’t make much difference. Just keep in mind that you’re better off leaving Kennedy Meadows later than sooner.
On the year I hiked the PCT (2018) snowfalls were exceptionally small: about 60% of the seasonal norms.
I started in Campo on May 1st in the morning and arrived at Kennedy Meadows by mid-morning on June 9, that is 40 days after my start, with 2 zeros in Warner Springs (I’m soon translating the page where I explain why I stopped there for 2 days), 1 nero in Idyllwild, 1 zero in Big Bear Lake and 1 nero in Wrightwood (soon translating the page on resting time management for more information on zeros and neros).
A snow storm hit the doors of the Sierra around mid-May but it was short lived and didn’t radically change the snow pack nor the hiking conditions in the mountain.
Hence I was able to leave Kennedy Meadows on June 11 around 1pm, which means I had one full day’s rest plus 2 long half-days. As expected from the weather reports, I only found snow on the mountain passes during my crossing of the High Sierra.
Arriving in Canada
Just as you avoided snow in the Sierra, you’ll want to avoid it in the Cascade Mountains. For that, you need to plan on finishing your thru-hike before the end of September. On some years there is no snow before mid-October, but on other years full-size snow storms hit the Cascades at the beginning of fall. In 2018, there were mild snow falls as early as September 20. Not enough to stop hikers from hiking this time, but there have been years where several inches of snow would fall overnight, covering the land and completely hiding the trail from other landmarks. When this happens there is only one solution: call S&R.

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Special counsel Robert Mueller's team didn't make a traditional prosecutorial judgement on whether President Trump committed obstruction of justice. But bestselling author Michael Wolff insists an indictment of the sitting president was contemplated, with legal arguments discussed at length in a 56-page "memorandum of law" Wolff claims to have in his possession.
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The durian, for those of you who've never seen one, is a Southeast Asian fruit that looks like a fiercely weaponized pineapple. It's prickly. It's pricey. And it's oh so pungent. And you will never forget your first whiff, says Zamzani Abdul Wahab — the Malaysian celebrity chef better known as Chef Zam — who remembers the first time two of his foreign friends got theirs when they visited him in Kuala Lumpur a few years back.
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WellLife Network Program Site Director - STA001 - Mon-Fri 8am-4pm in Flushing, New York
Program Site Director - STA001 - Mon-Fri 8am-4pm
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Actas the leader in the program in all areas related to the operation of Day Habilitation. This includes general supervision of all staff and direct supervision of: Program Coordinator, Secretary, Maintenance workers andclinicalteam.
Ensure that program is in compliance with all agency policy and procedures, as well as all Federal, State and local standards and regulations.
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Masters Degree in Special Education, Rehabilitation Counseling, Social Work or related field preferred and at least three to five yearssupervisory experience.


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The flashcards below were created by user
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Classification Of Dysphagia
- Dysphagia can be classified as oropharyngeal or esophageal.
- Oropharyngeal dysphagia presents with difficulty swallowing due to inability to properly transfer food from the mouth to the pharynx.
- Underlying etiologies for oropharyngeal dysphagia can Include stroke,advanced dementia, oropharyngeal malignancy, or neuromuscular disorders (eg. myasthenia gravis).
- Patients with oropharyngeal dysphagia can also have associated coughing, choking, or nasal regurgitation on swallowing.
- Other complications can include aspiration pneumonia and weight loss.
- This patient's history of stroke with coughing and choking on swallowing suggests oropharyngeal dysphagia.
- Recurrent right lower lobe pneumonia suggests likely aspiration pneumonia.
- Videofluoroscopic modified barium swallow study : is preferred initially in these patients to evaluate swallowing mechanics, degree of dysfunction, and severity of aspiration.
- Carcinoids are well differentiated neuroendocrine tumors found most commonly in the distal small intestine, proximal colon, and lung, with a strong propensity for metastasis to liver.
- These tumors can secrete several products Including histamine, serotonin, and vasoactive intestinal peptide that are metabolized In the liver.
- In patients with liver metastasis, these hormones are released directly Into the systemic circulation, leading to carcinoid syndrome.
Hallmark of Carcinoid Syndrome
- Episodic flushing is the hallmark of carcinoid syndrome and occurs in almost 85% of patients. Severe flushing may be associated with hypotension and tachycardia.
- Secretory diarrhea may be accompanied by abdominal cramping.
- Other common features Include cutaneous telangiectasias, bronchospasm, and tricuspid regurgitation.
- Pathognomonic plaque-like deposits of fibrous tissue occur most commonly on the endocardium on the right side of the heart, leading to tricuspid regurgitation and right-sided heart failure.
- Elevated 24-hour urinary 5- hydroxyindoleacetlc acid can confirm the diagnosis in most patients.
Features of carcinoid syndrome
- Clinical manifestations :
- • Skin: flushing, telangiectasias, cyanosis
- • Gastrointestinal: diarrhea, cramping
- • Cardiac: valvular lesions (right > left side)
- • Pulmonary: bronchospasm
- • Miscellaneous: Niacin deficiency (dermatitis, diarrhea & dementia)
- Elevated 24"hour urinary excretion of 5-HIAA
- • CT/MRI of abdomen & pelvis to localize tumor
- • OctreoScan to detect metastases
- • Echocardiogram (if symptoms of carcinoid heart disease are present)
- Treatment :
- • Octreotide for symptomatic patients & prior to surgery/anesthesia
- • Surgery for liver metastases
- D-xylose is a monosaccharide that can be absorbed in the proximal small intestine without degradation by pancreatic or brush border enzymes. It is subsequently excreted in the urine.
- In the D-xylose test: the patient is given an oral dose of D-xylose, with subsequent assay of urine and venous blood.
- Patients with proximal small Intestinal mucosal disease (eg, celiac disease) cannot absorb the D xylose in the intestine, and urinary and venous D xylose levels will be low. By contrast, patients with malabsorption due to enzyme deficiencies (eg, chronic pancreatitis) will have normal absorption of D-xylose.
- A false-positive D-xylose test (ie, decreased urinary excretion of D-xylose despite normal mucosal absorption) can be seen in patients with delayed gastric emptying or impaired glomerular filtration.
Features of malabsorption in celiac disease
- General : Bulky, foul-smelling, floating stools
- Fat & protein : Loss of muscle mass, loss of subcutaneous fat, fallgue
- Iron : Pallor (anemia), fatigue
- Calcium & vitamin D: Bone pain (osteomalacia), fracture (osteoporosis)
- Vitamin K : Easy bruising
- Vitamin A : Hyperkeratosis
Diagnosis Of Celiac Disease
- The diagnosis of celiac disease Is highly correlated with positive results on serological studies, primarily lgA anti-tissue transglutaminase and lgA anti endomysial antibodies.
- However, many patients with biopsy-confirmed celiac disease will have negative results on lgA antibody testing due to an associated selective lgA deficiency, which is common in celiac disease.
- If lgA serology is negative but the suspicion for celiac disease Is high, total lgA should be measured (or lgG-based serologic testing should be done).
- Clinical presentation :
- • Fever, jaundice, right upper quadrant pain (Charcot triad)
- • Mental status , hypotension (Reynolds pentad)
- • Liver failure
- • Acute kidney injury
- • Biliary dilation on ultrasound or CT scan
- • Increase Alkaline phosphatase, gamma-glutamyl transpeptidase, direct bilirubin
- • Leukocytosis, increase C-reactive protein
- Treatment :
- • Biliary drainage: Endoscopic retrograde cholangiopancreatography with sphincterotomy or percutaneous transhepatic cholangiography
- • Broad-spectrum antibiotics: Beta-lactam/beta lactamase inhibitor, third-generation cephalosporin + metronidazole
- Risk factors:
- • Severe trauma, extensive bums, recent surgery (eg, cardiopulmonary, aortic, abdominal)
- • Prolonged fasting or TPN
- • Critical illness (sepsis, ICU, mechanical ventilation)
- Clinical presentation:
- • Unexplained fever, vague/RUQ abdominal discomfort, leukocytosis
- • Possible jaundice, RUQ mass, abnormal LFTs
- •• Abdominal ultrasound (preferred) Cholescintigraphy (HIDA scan) or abdominal CT scan if ultrasound not diagnostic
Management of gallstones
- Gallstones without symptoms: No treatment necessary in most patients
- Gallstones with typical biliary colic symptoms:
- • Elective laparoscopic cholecystectomy
- • Possible ursodeoxycholic acid in poor surgical candidates
- Complicated gallstone disease:
- (acute cholecystitis, choledocholithiasis, gallstone pancreatitis)
- • Cholecystectomy within 72 hours
Postcholecystectomy syndrome (PCS)
- PCS refers to persistent abdominal pain or dyspepsia (eg, nausea) that occurs either postoperatively (early) or months to years (late) after a cholecystectomy.
- PCS can be due to biliary (eg, retained common bile duct or cystic duct stone, biliary dyskinesia) or extra-biliary (eg, pancreatitis. peptic ulcer disease, coronary artery disease) causes.
- Patients usually notice the same pain they had prior to surgery, new pain just after surgery, or the same pain that never went away.
- Laboratory findings can Include elevated alkaline phosphatase, mildly abnormal serum aminotransferases. and dilated common bile duct on abdominal ultrasound.
- These findings usually suggest common bile duct stones or biliary sphincter of Oddi dysfunction.
- The next step involves endoscopic ultrasound, endoscopic retrograde cholangio pancreatography (ERCP) or magnetic resonance cholangiopancreatography for final diagnosis and guiding therapy.
- Treatment for PCS is directed at the causative factor.
- The pain is in the right upper quadrant or epigastric region, often constant (rather than colicky), and accompanied by nausea, vomiting, and right-sided shoulder or subscapular discomfort (referred pain).
- Patients may have recurrent symptoms that resolve between episodes
Bilairy Colic Vs Cholecystitis
Features that distinguish biliary colic from cholecystitis are pain resolution within 4-6 hours and absence of abdominal tenderness, fever, and leukocytosis.
Mechanism of billiary colic
- biliary colic is usually secondary to gallstones. Ingestion of a large (usually fatty) meal stimulates gallbladder contraction.
- The intra-gallbladder pressure increases on gallbladder contraction against an obstructed cystic duct and causes pain.
- Subsequent gallbladder relaxation allows the stone to fall back from the duct with subsequent pain resolution.
Mechanism of gallstone formation in pts on TPN
- The presence of proteins and fatty acids in the duodenum acts as a stimulus for release of cholecystokinin (CCK), which In turn stimulates the contraction of the gallbladder.
- In patients on total parenteral nutrition or prolonged fasting, the normal stimulus for CCK release and gallbladder contraction is absent.
- This leads to biliary stasis and promotes the formation of bile sludge and gallstones.
- Small bowel (ileal) resection also contributes to the formation of gallstones. Decreased entero hepatic circulation of bile acids results in altered hepatic bile composition, which becomes supersaturated with cholesterol and promotes gallstone formation.
Mechanism of stone formation in pregnancy and pts taking OCPs
- Estrogen-induced Increase in cholesterol secretion is the underlying mechanism for the development of cholesterol gallstones during pregnancy and in women taking oral contraceptives.
- During pregnancy, estrogen causes an increase in cholesterol secretion and progesterone causes a reduction in bile acid secretion, causing increased cholesterol saturation of bile.
- Progesterone also slows gallbladder emptying and thus facilitates the formation of cholesterol gallstones during pregnancy.
Chronic mesenteric ischemia
- Etiology : • Atherosclerosis (smoking, dyslipidemia)
- Clinical features:
- • Crampy, postprandial, epigastric pain (intestinal angina),
- • Food aversion & weight loss, nausea, early satiety and diarrhea
- • Signs of malnutrition, abdominal bruit
- • CT angiography (preferred), Doppler ultrasonography
- • Risk reduclion (eg, tobacco reduction), nutritional support
- • Endovascular or open surgical revascularization
Mechanism of bowel angina in Chronic mesenteric ischemia
- The anginal pain frequently starts within the first hour of eating and slowly resolves over the next 2 hours.
- The pathophysiology of the pain is most likely related to shunting of blood away from the small intestine to meet the increased demand of the stomach.
- In patients with atherosclerosis, the celiac or the superior mesenteric arteries may be narrowed and unable to dilate appropriately to maintain adequate blood flow to the intestines
- Risk factors:
- • Smoking
- • Hereditary pancreatitis
- • Nonhereditary chronic pancreatitis
- • Obesity & lack of physical activity
- Clinical presentation:
- • Systemic symptoms (eg, weight loss, anorexia (>85%)
- • Abdominal pain/back pain (80%): Insidious onset of gnawing abdominal pain (usually epigastric and radiating to the back), which is worse at night, with eating, or when lying supine.
- • Jaundice (56%)
- • Recent-onset atypical diabetes mellitus
- • Unexplained migratory superficial thrombophlebitis
- • Hepatomegaly & ascites with metastasis
- Laboratory studies:
- • Cholestasis ( Increased alkaline phosphatase & direct bilirubin)
- • increased Cancer-associated antigen 19-9 (not as a screening test)
- • Abdominal ultrasound (if jaundiced) or CT scan (if no jaundice)
Cancers in the head of the pancreas (60%-70%)
- typically present with jaundice (common bile duct obstruction, elevated alkaline phosphatase and bilirubin) and steatorrhea (pancreatic exocrine insufficiency or pancreatic duct blockage).
- In patients with these findings, abdominal ultrasound is preferred for detecting pancreatic head tumors and excluding other potential causes of biliary obstruction (eg, choledocholithiasis).
- • Cancers in the body and tall usually do not present with obstructive jaundice. Abdominal CT scan is preferred (more sensitive and specific) and helps exclude other conditions.
- Ultrasound Is less sensitive for visualizing the pancreatic body and tail (due to overlying bowel gas) and for detecting smaller (<3 cm) tumors.
Overview of chronic pancreatitis
- • Alcohol use
- • Cystic fibrosis (common in children)
- • Ductal obstruction (eg, malignancy, stones)
- • Autoimmune
- Clinical presentation:
- • Chronic epigastric pain with intermittent pain-free intervals
- • Malabsorption-steatorrhea, weight loss
- • Diabetes mellitus
- Laboratory results/Imaging:
- • Amylase/lipase can be normal & nondiagnostic
- • CT scan or MRCP can show calcifications, dilated ducts & enlarged pancreas
- • Pain management
- • Alcohol & smoking cessation
- • Frequent, small meals
- • Pancreatic enzyme supplements
Common causes of steatorrhea
- Pancreatic insufficiency:
- • Chronic pancreatitis due to alcohol abuse, cystic fibrosis, or autoimmune/hereditary pancreatitis
- • Pancreatic cancer
- Bile salt-related:
- • Small-bowel Crohn disease
- • Bacterial overgrowth
- • Primary biliary cirrhosis
- • Primary sclerosing cholangitis
- • Surgical resection of ileum (at least 60-100 cm)
- Impaired Intestinal surface epithelium:
- • Celiac disease
- • AIDS enteropathy
- • Giardiasis
- Other rare causes:
- • Whipple disease
- • Zollinger-Ellison syndrome
- • Medication-induced
Hyperestrinism in Cirrhosis of liver
- spider angioma and palmar erythema both arise from hyperestrinism due to Impaired hepatic metabolism of circulating estrogens, a process that begins in the cytochrome P450 system.Circulating estrogens affect vascular wall dilation.
- Spider angioma: consists of a central, dilated arteriole surrounded by smaller radiating vessels.
- Palmar erythema: Is a result of increased normal speckling of the palm due to increased vasodilation, especially at the thenar and hypothenar eminences.
- Conditions due to hyperestrinism:
- Spider angiomata
- Loss of sexual hair
- Testicular atrophy
- Palmar erythema
- esophageal varices
- caput medusae
- anorectal varices
- arise from the dilation of superficial veins on the abdominal wall due to portal hypertension (PH).
- PH results from increased resistance to portal now at the sinusolds and leads to increased pressure at the portosystemlc collateral veins in the anterior abdomen, rectum, and distal esophagus.
- This then predisposes to esophageal varices, rectal varices, and caput medusae.
- Similarly, PH causes enlargement of the spleen (which drains into the portal vein via the splenic vein) due to vascular congestion of the red pulp.
- occurs when the palmar fascia thickens and shortens, deforming the hand.
- It Is usually most notable initially in the fourth and fifth digits and occurs due to fibroblast proliferation and collagen deposition, which are likely worsened by oxidative stress from increased free radical production.
common causes of cirrhosis In the United States :
include viral hepatitis (C more than B), chronic alcoholism, nonalcoholic fatty liver disease (NAFLD), and hemochromatosis
- pleural effusion not due to underlying cardiac or pulmonary abnormalities.
- Hepatic hydrothorax generally results in transudative pleural effusions and is thought to occur due to small defects in the diaphragm.
- These defects permit peritoneal fluid to pass into the pleural space, which occurs much more commonly on the right side due to the less muscular hemidiaphragm.
- Patients have dyspnea, cough, pleuritic chest pain, and hypoxemia.
- Diagnosis involves documentation of the effusion (eg, chest x ray) and testing to exclude other causes (eg, thoracentesis, echocardiogram).
- Treatment involves salt restriction and diuretic administration. Therapeutic thoracentesis could be attempted in patients with prominent symptoms. Chest tube placement should be avoided as it can result in large-volume protein, fluid, and electrolyte losses as well as other severe complications (eg, renal failure).
- The definitive option for treatment is liver transplantation, although this may not be appropriate for all patients depending on other factors.
- results from intrapulmonary vascular dilations in the setting of chronic liver disease.
- Patients frequently have evidence of platypnea (increased dyspnea while upright) or orthodeoxia (oxygen desaturation while upright).
cirrhosis due to Chronic alcohol use
macrocytic anemia, aspartate aminotransferase [AST] to alanine aminotransferase [Al T] ratio ~2: 1, parotid gland enlargement likely from fatty Infiltration due to chronic alcohol use rather than to cirrhosis itself
Management Of compensated Cirhosis
- Ultrasound surveillance for HCC with or without AFP every 6 monthly
- endoscopy surveillance for varices
Management of Variceal hemorrhage
- Primary prophylaxis can be achieved either with endoscopic variceal ligation (EVL) or administration of a nonselective beta blocker such as propranolol or nadolol.
- Nonselective beta blockers reduce portal venous pressure by blocking the adrenergic vasodllatory response of the mesenteric arterioles, which results In unopposed alpha-adrenergic tone, vasoconstriction, and reduced portal blood flow.
- The choice of beta blocker or EVL depends on patient preference and the size of the varices (EVL is preferred for larger varices).
Management Of ascitis
- Dietary Sodium restriction
- Diuretics (Frusemide and Spironolactone)
- Abstinence from alcohol
Management of Hepatic encephalopathy
- Identify cause : Infections, GI Bleeding
Hepatorenal syndrome (HRS)
- is one of the most dangerous complications of end stage liver disease, occurring in up to 10% of patients with cirrhosis.
- HRS is characterized by decreased glomerular filtration in the absence of shock, proteinuria, or other clear cause of renal dysfunction, and a failure to respond to a 1.5 L normal saline bolus.
- It is thought to result from renal vasoconstriction In response to decreased total renal blood flow and vasodilatory substance synthesis.
- There are 2 subtypes of HRS.
- Type 1 is rapidly progressive: most patients die within 10 weeks without treatment.
- Type 2 progresses more slowly, with an average survival of 3-6 months.
- The most common causes of death are infection and hemorrhage.
- Unfortunately, no medication has consistently proven beneficial in HRS and the mortality for these patients placed on dialysis is very high.
- Liver transplantation is the only intervention with established benefit.
Clostridium difficile colitis
- patient's recent antibiotic use, watery bowel movements, and mild abdominal tenderness suggest possible C. difficile.
- Risk factors for C difficile include: recent hospitalization, advanced age, or antibiotic use (most commonly fluoroquinolones, penicillins, cephalosporins, and clindamycin).
- Unexplained leukocytosis in hospitalized patients should raise suspicion for C. difficile, even without diarrhea.
- C. difficle colitis can range from mild watery diarrhea to fulminant colitis with toxic megacolon.
- Diagnosis: is usually confirmed with stool studies for C difficile toxin (eg, polymerase chain reaction).
- Patients with mild to moderate (WBC<15 ,000/mL) C difficile colitis should receive empiric oral metronidazole while awaiting stool studies.
- Patients with negative studies may require sigmoidoscopy or colonoscopy with biopsy to document pseudomembranous colitis.
- Severe colitis usually requires oral vancomycin with or without IV metronidazole or a possible switch to intra colonic vancomycin.
- Fidaxomicin is a bactericidal antibiotic usually reserved for recurrent colitis or as initial therapy for patients with severe colitis who cannot tolerate oral vancomycin.
Clostridium dlfficile colitis
- • WBC <15,000/mm,
- • Creatinine < 1.5x baseline
- Treatment is: Oral metronidazole
Severe Clostridium Colitis
- WBC more than 15,000/mml
- Creatinine more than 1.5x baseline
- Serum albumin <2.5 g/dl
- Treatment is : oral Vancomycin. But, if ileus is present add IV Metronidazole and Switch to rectal vancomycin
- If following features present:
- • WBC more than 20 ,000/mm3
- • Lactate more than 2.2 mg/dl
- • Toxic megacolon
- • Severe ileus
- Subtotal colectomy
- Diverting loop ileostomy with colonic lavage
Pathogenesis of Clostridium difficile
- Clostridium difficile is a gram-positive, anaerobic bacterium that causes infectious diarrhea in the nosocomial and outpatient setting.
- Hardy antibiotic-resistant spores are ingested and convert to fully functional bacilli in the colon.
- Although the organism is noninvasive, pathogenic strains produce exotoxins ("enterotoxin" A and "cytotoxin" B) that penetrate colonic epithelial cells, resulting in apoptosis and the loss of tight junctions.
- Carriage of toxigenic C. difficile is common, but extensive proliferation is usually required to reach exotoxin levels that are pathogenic.
- The single greatest risk factor for clinical illness is recent antibiotic use (eg, fluoroquinolones, clindamycin, cephalosporins, penicillins), which disrupts the normal colonic flora (eg, Bacteroides), freeing nutrients and eliminating a crucial epithelial barrier.
- Other common risk factors include advanced age (>65) and gastric acid suppression (eg, proton pump inhibitor).
Diagnosis and Management of Clostridium difficile
- C difficile colitis usually manifests with watery diarrhea (~3 stools/day), abdominal cramping, vomiting, low-grade fever, and leukocytosis (- 15,000/mm').
- Overt melena and bright red blood per rectum are rare.
- Diagnosis is typically made with stool assay for C difficile exotoxin genes via polymerase chain reaction.
- Treatment involves the cessation of the inciting antibiotic (If possible), Infection control (contact precautions), and antimicrobial therapy with oral metronidazole or vancomycin.
- A polyp is a grossly visible protrusion from the flat mucosal surface of the intestine. Most polyps are benign. Polyps can be classified as follows:
- 1. Hyperplastic polyps: These are the most common non-neoplastic polyps in the colon. These arise from hyperplastic mucosal proliferation. No further workup is needed.
- 2. Hamartomatous polyps: These include juvenile polyp (a non-malignant lesion, generally removed due to the risk of bleeding) and Peutz Jeghers polyp (generally non-malignant).
- 3. Adenoma: This is the most common type of polyp found in the colon. It is present in approximately 30-50% of elderly people. These polyps are potentially premalignant; however, <1% of such polyps become malignant. Most polyps are asymptomatic; less than 5% of patients have positive occult stool tests.
Probability of adenomatous polyp turning into malignancy
- The probability of an adenomatous polyp progressing into cancer can be judged clinically by the lesion's gross appearance, histology, and size.
- 1. Adenoma can be sessile or stalked (pedunculated). Cancer is seen more commonly in sessile polyps.
- 2. Histologically, adenoma is divided into tubular, tubulovillous, and the villous variety. Villous adenomas, which are most commonly sessile, are most likely (three times more likely than tubular adenoma for malignant transformation) to become malignant among all three varieties. Second on the list is tubulovillous, followed by tubular adenoma with the least risk of malignant transformation. Therefore, as the villus component increases the risk of malignancy increases.
- 3. The likelihood of an adenomatous lesion containing invasive cancer also depends on the size of the polyp. The risk is negligible (<2%) with< 1.5 cm polyp. intermediate(2-10%) with 1.5-2.5 cm size polyp, and substantial (10%) with polyps >2.5 cm In size.
Screening of colon cancer
- Patients at average risk of developing colon cancer should begin screening at age 50 with high-sensitivity fecal occult blood testing (FOBT) annually, flexible sigmoidoscopy every 5 years combined with FOBT every 3 years, or colonoscopy every 10 years.
- Patients with an affected first-degree relative should begin screening at age 40 or 10 years before the age of the relative's diagnosis.
Lung Cancer Screening
- Low-dose chest CT is recommended yearly for lung cancer screening in patients who are age 55-80, have a more than 30-pack-year smoking history, and are currently smoking or quit within the past 15 years.
- Recommended test: • Low-dose chest CT
- Recommended interval: • Yearly
- Age for screening : 55-80
- Eligibility for screening based on smoking history:
- • Patient has >30-pack-year smoking history
- • Patient is a current smoker or quit smoking within the last 15 years
- Termination of screening:
- • Age >80
- • Patient successfully quit smoking for more than 15 years
- • Patient has other medical problems that significantly limit life expectancy or ability/willingness to undergo lung cancer surgery
- Diarrhea can be divided into 3 main categories: watery, fatty, and inflammatory.
- Watery diarrhea can be further broken down into osmotic, secretory, and functional.
- Hallmarks of secretory diarrhea: include larger daily stool volumes (>1L/day) and diarrhea that occurs even during fasting or sleep.
- Secretory diarrhea most commonly occurs when luminal ion channels are disrupted in the gastrointestinal tract, resulting in a state of active secretion.
- A helpful tool in distinguishing osmotic from secretory diarrhea is the stool osmotic gap (SOG): , which calculates the difference between plasma osmolality (considered equivalent to measured stool osmolarity) and double the sum of sodium and potassium ions in stool (corresponding to calculated stool osmolality) SOG = plasma osmolality - 2 x (stool sodium + stool potassium):
- Secretory diarrhea is due to increased secretions of ions; therefore, the difference between plasma osmolality and measured fecal sodium and potassium is significantly reduced (SOG <50 mOsm/kg).
Common causes of secretory diarrhea :
- Include bacterial infections (eg, Vibrio cholera), viral infections (eg, rotavirus). congenital disorders of ion transport (eg, cystic fibrosis), early ileocolitis, and postsurgical changes.
- Secretory diarrhea can occur after bowel resection or cholecystectomy when unabsorbed bile acids reach the colon and result in the direct stimulation of luminal ion channels.
- In addition, resection of the ileocecal area reduces the ability of the Intestines to actively absorb sodium ions against the electrochemical gradient.
In osmotic diarrhea, nonabsorbed and unmeasured osmotically active agents are present in the gastrointestinal tract. These ions result in an elevated osmotic gap (SOG >125 mOsm/kg).
Diffuse Esophageal Spasm
- patient's symptoms (ie, spontaneous pain, odynophagia for cold and hot food) are suggestive of diffuse esophageal spasm.
- Resolution of her chest pain after taking nitroglycerin Is also consistent wlth the diagnosis.
- Nitrates (and calcium channel blockers) relax not only myocytes in coronary vessels, but also those in the esophagus. thereby alleviating the pain.
- Esophagography may or may not show other anomalies (eg, corkscrew shape).
- Esophageal manometry should show repetitive, non-peristaltic, high-amplitude contractions, either spontaneously or after ergonovine stimulation.
Diffuse esophageal spasm
- • Uncoordinated, simultaneous contractions of esophageal body likely related to impaired inhibitory innervation in the esophagus
- • Intermittent chest pain
- • Dysphagia for solids & liquids
- • Esophagram: "Corkscrew" pattern d/t nonperistaltic contractions
- • Manometry: Intermittent peristalsis, multiple simultaneous contractions of the middle and lower esophagus. The lower esophageal sphincter usually shows normal relaxation
- D/D: achalasia (Impaired esophageal motility with incomplete relaxation at the lower esophageal sphincter) and nutcracker esophagus (excessive tone at the lower esophageal sphincter).
- • Calcium channel blockers (Diltiazam)
- • Alternate: Nitrates, tricyclics
- Definition: inflammation due to microperforation of a diverticulum.
- Etiology: Chronic constipation and a low-fiber, high fat diet are risk factors for diverticular disease.
- Clinical Features: Patients with diverticulitis present with abdominal pain (usually lower left quadrant), fever, nausea/vomiting, and leukocytosis. Some have urinary urgency, frequency, or dysuria due to bladder irritation from an inflamed sigmoid colon.
- Investigation: Abdominal CT scan (oral and intravenous contrast) is the best diagnostic test for diverticulitis, differentiating it from other diseases (eg. colon cancer. kidney infection).
- Findings suggestive of diverticulitis include increased Inflammation in pericolic fat, presence of diverticula, bowel wall thickening, soft tissue masses (eg. phlegmons), and pericolic fluid collections suggesting abscess.
- • Bowel rest
- • Antibiotics (eg, ciprofloxacin, metronidazole)
- • Abscess, obstruction, fistula, perforation


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Using my trusty Thurlow trouser pattern, which I’ve modified again, and a helovalotta patience, I have finally reached the finish line with my version.
I’m not sure what happened to the front leg area. Perhaps they are too tight. Perhaps the fabric distorted after working it so much. Perhaps the bias knee panels have shifted during construction. I don’t know, but it ain’t great – boo! They are also a little too big around the front fly area.
Regardless they are finished and I think still mostly wearable. I’m hoping after a wash or two something may change, but if not, it was a fun experiment in drafting, thinking, cutting, thinking, measuring, thinking, unpicking, thinking, ironing, ironing and ironing and finally finishing!
In hindsight, I also think it might have been better to modify a jeans pattern, rather than a trouser pattern.
The fabric was a remnant from the Remnant Warehouse. It’s some type of stretch ticking and it was great to work with. I have enough left for a skirt, so it may crop up again in summer.
The flat photos here show more of the detail in the pants.
Look at that seam matching! And those faux welts – perfect!!
In this photo you can see the finished edging and bias knee panels.
This is the construction photo, showing how the panels were fixed to the pant fronts. They were not stitched down until the overall fit was checked. Once basting was removed, they were trimmed, ironed to within an inch of their existence and topstitched down – phew!
So there, one more project ticked off my list and for the record another has hit the bin!
This is my Burda Crossover Blazer 06/2012 #121 which made it out of my sewing room long enough to be photographed before hitting the bin. Fabric too drapey, fit a little off and just not sitting right – boo!
More projects to come. I just photographed a few more to share.
Pattern: Sewaholic Thurlow – used before = Free
Fabric: 2.8m Stretch ticking remnant from The Remnant Warehouse = $22.40
Hook, button, interfacing: $2?


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Entries with no category
Originally Posted by Steeli My sweet peppers growing on front windowsill in 9cm square pots: Attachment 29715
Originally Posted by Steeli I've just harvested my garlic, leaves were yellowed and falling over. Grown from supermarket bulb, overwintered outside in a container. First time I've grown garlic. Attachment 29713
Just been to check on me bed having just got in from work.
Me carrots have sprouted!!!! As has about 5 spring onions lol!
Looks like I can sow the next succession of carrots now. Thought I was going to have to either buy more seeds or plant something else.
Wow, how much things can change!
My tom plants have doubled in size since I took the previous photos, basil is triple!
Currently doing some hardening off on the windowsill by, well, opening the windows a crack during the day.
In the raised bed outside my onion & shallot sets are poking through. Still waiting on carrots.
My marigolds have died, didn't harden them off sufficiently. I'll give a go at direct sowing in place of the dead
Here be a peak at what's growing there. Attachment 28431
Tomatoes nearest camera and peppers next to window. Attachment 28432
Mix of Jalapeņo and Cayenne peppers Attachment 28433
Main sill, from left to right, Rosemary cutting, oregano, basil, the Mrs flowers, pot with Thyme and Dill, mix of coriander and mix of all aforementioned peppers.
Grow Your Own Magazine
25 Phoenix Court, Hawkins Road,
Colchester, Essex, CO2 8JY
Copyright © Aceville Publications Ltd

domain: hobby


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GSA has short list of options for new Labor headquarters
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Remarks as Prepared for Delivery by The Honorable Eleanor Holmes Norton
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Plan to expand flights at Reagan National withdrawn
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With Congress playing to block marijuana legalization, what's D.C.'s next move?
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Novum Business Hotel City B Berlin Centrum3.5 Stars
Potsdamer Strasse 129 Berlin DE-10783
Novum Business Hotel is located in the center of Berlin that offers easy access to various splendid attractions like the Berlin wall, Berliner Dom, the Olympia stadium and Berlin Mitte.
Decked with stylish furnishings, all the 85 well-appointed accommodation units are comfortable enough to rest your tiresome body after the busy day out.
Unwind your evening in a party spirit by having a sip of your favourite cocktail at the friendly bar at Novum Business Hotel City B Berlin. Zing your day by savoring the luscious cuisines that are served at the nearby restaurants for your breakfast, lunch and dinner.
Conduct your business meetings at the well maintained meeting rooms that is integrated with the latest technology to ensure the success of your event at Novum Business Hotel City B Berlin Centrum. The well attended reception staff will lend a helping hand to ensure your every need is carefully served in gratification. Pamper your body and soul at the brilliant sauna to feel renewed and refreshed.
|Crowne Plaza Hotel Berlin City Centre||4 Stars|
|Berlin Plaza Hotel Am Kurfuerstendamm||3.5 Stars|
|Berlin Mark Hotel||4 Stars|
|Hotel Berlin, Berlin||4 Stars|
|Wyndham Excelsior Berlin||4 Stars|
|Astoria Hotel am Kurfuerstendamm||3.5 Stars|
|Hotel Sylter Hof Berlin Superior||3.5 Stars|
|Europa City Hotel Berlin||3.5 Stars|
|Hampton By Hilton Berlin City West||3.5 Stars|
|Top Hotel City Gallery Berlin||3 Stars|