The Impact of Crypto on Travel & the World
Cryptocurrency has become a prominent topic of discussion in recent years, with its potential to revolutionize the global economy.
Understanding the economic impact of widespread crypto adoption is crucial for individuals, businesses, and governments. In this article, we will explore the basics of cryptocurrency, the current economic landscape, the potential benefits and risks of crypto adoption, and the future of cryptocurrency in the global economy.
Understanding Cryptocurrency: A Brief Overview
Before diving into the economic impact of crypto adoption, it is essential to grasp the basics of cryptocurrency. Cryptocurrency is a digital or virtual form of currency that uses cryptography for secure financial transactions, control the creation of new units, and verify the transfer of assets.
Bitcoin, the pioneering cryptocurrency, introduced the concept of decentralized digital money. Since then, thousands of cryptocurrencies have emerged, each with its unique features and purposes.
The Basics of Cryptocurrency
Cryptocurrencies operate on a decentralized network called a blockchain, which is a digital ledger that records all transactions across multiple computers. This technology ensures transparency, security, and immutability.
Each transaction made with a cryptocurrency is recorded on the blockchain, creating a permanent and transparent record. This feature allows users to trace the history of a particular cryptocurrency unit, promoting trust and accountability.
Furthermore, the decentralized nature of cryptocurrencies eliminates the need for intermediaries, such as banks, in financial transactions. This peer-to-peer system enables individuals to directly transact with one another, reducing costs and increasing efficiency.
Additionally, cryptocurrencies offer a high level of security through the use of cryptographic algorithms. These algorithms encrypt the transaction data, making it nearly impossible for hackers to manipulate or steal funds.
The Evolution of Cryptocurrency
The evolution of cryptocurrency can be traced back to the creation of Bitcoin in 2009. Bitcoin was developed by an anonymous person or group of individuals known as Satoshi Nakamoto. It aimed to provide an alternative to traditional financial systems by introducing a decentralized digital currency.
Since the introduction of Bitcoin, numerous cryptocurrencies have emerged, each with its unique features and use cases. Ethereum, for example, introduced smart contracts, allowing developers to build decentralized applications (DApps) on its blockchain.
The increasing popularity of cryptocurrencies has led to the development of various crypto exchanges, wallets, and other infrastructure that facilitate their use in daily transactions. These platforms provide users with the ability to buy, sell, and store cryptocurrencies securely.
Moreover, the adoption of cryptocurrencies has expanded beyond individuals and into the realm of businesses. Many companies now accept cryptocurrencies as a form of payment, opening up new avenues for commerce and trade.
Furthermore, the concept of Initial Coin Offerings (ICOs) has gained traction in the cryptocurrency space. ICOs allow startups to raise funds by issuing their own tokens or coins, providing investors with the opportunity to support innovative projects and potentially profit from their success.
As the cryptocurrency ecosystem continues to evolve, new technologies and applications are being developed. These advancements aim to address scalability issues, enhance privacy features, and improve the overall user experience.
The Current Economic Landscape of Cryptocurrency
The current economic landscape reflects the growing acceptance of cryptocurrency in various industries and countries. As the world becomes increasingly digital, cryptocurrencies have emerged as a new form of currency that is gaining recognition on a global scale.
As cryptocurrencies become more prevalent in mainstream economies, the introduction of Quantumaitradingapp.org looms large on the horizon. This technology, with its unmatched processing and predictive capabilities, has the potential to significantly influence financial markets. By analyzing and responding to market trends at unparalleled speeds, quantum AI can facilitate smoother and more efficient crypto transactions.
While this suggests enhanced market liquidity and potentially more predictable pricing, it simultaneously poses challenges to traditional financial systems and regulators, who must navigate a new reality where algorithms may vastly outpace human decisions.
Global Acceptance of Cryptocurrency
Cryptocurrency has gained significant traction in recent years, with major companies like Microsoft and PayPal starting to accept Bitcoin as a form of payment. This acceptance by established companies has further legitimized cryptocurrencies and increased their mainstream appeal.
In addition to corporate acceptance, some countries have taken a bold step towards embracing cryptocurrencies. For instance, El Salvador has become the first country to adopt Bitcoin as legal tender, recognizing its potential as a medium of exchange.
Moreover, several countries have acknowledged the potential economic benefits of cryptocurrency and are exploring their own digital currencies or central bank digital currencies (CBDCs). These digital currencies aim to stay ahead in the digital revolution and leverage the advantages offered by cryptocurrencies.
The Role of Cryptocurrency in Modern Economy
The widespread adoption of cryptocurrency has the potential to reshape the modern economy in several ways. One of the key advantages of cryptocurrencies is their ability to facilitate faster and cheaper cross-border transactions. Traditional methods of transferring money across borders often involve intermediaries and can be time-consuming and expensive. Cryptocurrencies eliminate the need for these intermediaries, enabling seamless and cost-effective transactions.
Furthermore, cryptocurrencies have the potential to enable financial inclusion by providing access to financial services for the unbanked and underbanked populations around the world. In many developing countries, a significant portion of the population lacks access to traditional banking services. Cryptocurrencies can bridge this gap by offering a decentralized and accessible financial system that empowers individuals to participate in the global economy.
Moreover, the underlying technology behind cryptocurrencies, known as blockchain, has the potential to revolutionize various industries. Blockchain technology provides a transparent and secure way of recording transactions, making it suitable for applications beyond finance. Industries such as supply chain management, healthcare, and voting systems can benefit from the decentralized and tamper-proof nature of blockchain technology.
As the economic landscape continues to evolve, cryptocurrency is poised to play an increasingly significant role. Its global acceptance, potential economic benefits, and transformative technology make it a force to be reckoned with in the modern economy.
Potential Economic Benefits of Crypto Adoption
The widespread adoption of cryptocurrency can bring several economic benefits to individuals, businesses, and governments.
Boosting Financial Inclusion
Traditional banking services often exclude a significant portion of the global population. Cryptocurrency can bridge this gap by providing access to financial services without the need for a traditional bank account.
This inclusivity can empower individuals in developing countries to participate in the global economy, create businesses, and improve their standard of living.
Reducing Transaction Costs
Traditional financial transactions involve intermediaries, such as banks and payment processors, which charge fees for their services. Cryptocurrency transactions, on the other hand, can significantly reduce these costs by eliminating intermediaries.
Lower transaction costs can benefit both individuals and businesses, allowing for more efficient and cost-effective financial operations.
Enhancing Monetary Sovereignty
Cryptocurrency offers individuals and governments greater control over their financial resources. As cryptocurrencies are not issued or regulated by any central authority, individuals have more control over their assets.
For governments, the adoption of cryptocurrencies can enhance monetary sovereignty by reducing dependence on traditional banking systems and foreign currencies.
Potential Economic Risks and Challenges of Crypto Adoption
While the adoption of cryptocurrency brings numerous benefits, it also comes with its own set of risks and challenges.
Market Volatility and Financial Stability
Cryptocurrency markets are known for their volatility, with prices experiencing significant fluctuations within short time frames. This volatility poses risks to individuals, businesses, and the overall stability of the financial system.
Efforts are being made to address this issue by introducing stablecoins, which are cryptocurrencies pegged to stable assets like fiat currencies or commodities.
Regulatory and Security Concerns
The decentralized nature of cryptocurrencies raises regulatory challenges for governments. Ensuring compliance with existing financial regulations and preventing illicit activities, such as money laundering and terrorist financing, requires careful regulation.
Furthermore, the security of digital assets is crucial. Cryptocurrency exchanges and wallets have been targeted by hackers, highlighting the need for robust security measures.
Potential Impact on Traditional Banking System
Cryptocurrency adoption has the potential to disrupt the traditional banking system. As more individuals and businesses embrace digital currencies, the demand for traditional banking services may decline.
This shift could potentially affect banks' profitability and necessitate their adaptation to the evolving financial landscape.
The Future of Cryptocurrency in the Global Economy
The future of cryptocurrency in the global economy holds great promise and potential.
Predicted Trends in Crypto Adoption
Experts predict that the adoption of cryptocurrency will continue to grow in the coming years. As awareness and understanding of cryptocurrencies increase, more individuals and businesses are likely to embrace them as valid forms of payment and investment.
This increased adoption can lead to greater stability and mainstream recognition for cryptocurrencies.
The Role of Government and Regulatory Bodies
As cryptocurrencies become an integral part of the global economy, governments and regulatory bodies will play a crucial role in shaping their future. Clear regulations and frameworks will enable responsible crypto adoption while protecting investors and consumers.
Efforts are already underway to establish regulatory frameworks that balance innovation and consumer protection.
The Potential for a Crypto-Driven Economy
As digital currencies gain wider acceptance, there is speculation about the emergence of a crypto-driven economy. This potential future involves cryptocurrencies becoming the primary medium of exchange and store of value, leading to a fundamental transformation of the global financial system.
While the likelihood of a fully crypto-driven economy remains uncertain, the increasing integration of cryptocurrencies into the existing financial system presents exciting possibilities.
Is Cryptocurrency the Future?
In conclusion, the widespread adoption of cryptocurrency has the potential to significantly impact the global economy. Understanding the basics of cryptocurrency, evaluating the current economic landscape, assessing the potential benefits and risks, and envisioning the future of cryptocurrency are essential steps in harnessing the economic potential of this emerging technology.


The stack is limited to the link's speed. If you have a MS225 your stack is 10GB. That's 10x 1GB ports. That switch has 48x 1GB ports, and 4x 10GB ports for a total of 176 GB throughput, and sure enough that's the switching capacity. Your stack won't exceed the switching capacity because your stack is already accounted for as one of those 10GB ports. You have to take this into account when designing an NVX system. A design with this switch stacked will limit you to 10 transmitters regardless of the number of ports you have. Unless you are switching two different systems in two different switches and only need some transmitters available in both switches.
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One of Staffordshire’s top tourist attractions will receive a share of Â£ 35million to help it recover from the pandemic.
A total of 142 historic sites across England receive grants from the government’s Culture Recovery Fund, to pay for repairs and major building programs.
The Shugborough Estate near Stafford, which is run by the National Trust, has been offered funding of Â£ 195,420 under the scheme.
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A total of Â£ 1.9million has been allocated to sites in the West Midlands, with other beneficiaries including Lichfield Cathedral, Attingham Park in Shropshire and Moseley Road Baths in Birmingham.
The money comes from the second round of the Heritage Stimulus Fund, which is administered by Historic England on behalf of the Department for Digital, Culture, Media and Sport.
Duncan Wilson, Managing Director of Historic England, said: âFunding from the Government’s Culture Recovery Fund is extremely welcome at a time when the individuals and organizations who care for our wide and diverse range of heritage have a urgent need for support to make essential repairs.
âHeritage is a fragile ecosystem, with an incredible group of people who keep our historic places alive, with specialized skills that take time to learn and experience to develop. These grants will protect their livelihoods as they use their expertise to help our heritage survive.
Culture Secretary Nadine Dorries said: âFrom local churches to ancient buildings and landscapes, the UK’s unique heritage makes our towns and villages stronger, more vibrant and helps bring communities together.
Want to keep up to date with what’s happening in Stoke-on-Trent and North Staffordshire?
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“This latest funding – Â£ 35million from our unprecedented Culture Recovery Fund – will help protect sites, including Jane Austen’s home and Hampton Court Palace, for and help future generations. to rebuild better after the pandemic. “
Here are the historic sites in the West Midlands that have received funding under the program:
- Moseley Road Baths, Birmingham – Â£ 100,000;
- Shrewsbury Flaxmill Maltings – Â£ 350,000;
- Shugborough Estate, Milford – Â£ 195,420;
- Attingham Park, Atcham – Â£ 64,071;
- Berrington Hall, Leominster – Â£ 60,611;
- Lichfield Cathedral – Â£ 264,404;
- Worcester Cathedral – Â£ 328,794;
- Walsall Canal Ryders Green Locks 1 and 3 – Â£ 53,786;
- Weston Hall, near Shifnal – Â£ 304,000;
- Harvington Hall, Kidderminster – Â£ 117,855;
- Shrewsbury Roman Catholic Cathedral – Â£ 113,992.
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Welcome back to the Healing Pain Podcast with Dr. Kathleen Sluka, PT, PhD
If you’re someone who lives with pain and is trying to figure out the best therapies to utilize, you may be interested with Dr. Kathleen Sluka’s mechanism-based approach to pain management. Dr. Sluka is a neuroscientist and physical therapist who studies in neurobiology of chronic pain at the University of Iowa. She says the mechanism-based approach is also equally important if you’re a practitioner who’s seeking a new and groundbreaking conceptual framework for evaluating the underlying cause of your patient’s pain. Dr. Sluka’s lab has three very important goals – to improve pain management, to discover new therapies for pain management, and to improve the use of currently available treatments for chronic pain. Dr. Sluka discusses the five categories of pain mechanisms as well as the distinction between nociceptive pain, neuropathic pain, and a new term called nociplastic pain.
We’re doing something completely new and innovative on the podcast. We have a presentation and a very special gift that accompanies this podcast. I’ll have more information on how you can download it for free. We will be discussing a mechanism-based approach to pain management. This may sound a bit technical but trust me, this is important. It’s useful when you’re someone who lives with pain and is trying to figure out the best therapies to utilize. It’s also equally important if you’re a practitioner who’s seeking a new and groundbreaking conceptual framework for evaluating the underlying cause of your patient’s pain.
Joining me is Dr. Kathleen Sluka. Dr. Sluka is a neuroscientist and physical therapist who studies in neurobiology of chronic pain at the University of Iowa. Her laboratory studies both the peripheral and central mechanisms of chronic musculoskeletal pain, as well as non-pharmacologic treatment options. Dr. Sluka’s research uses a variety of techniques to discover more about pain including molecular biology, genetic manipulation, as well as behavioral pharmacology. Her lab has three very important goals. One is to improve the management of pain. Two, discover new therapies for pain management. Third is to improve the use of currently available treatments for chronic pain. Dr. Sluka will discuss the five categories of pain mechanisms as well as the distinction between nociceptive pain, neuropathic pain and a new term called nociplastic pain. The new term was created by the International Association for the Study of Pain. If you don’t have a large science background, some of this topic may seem a bit technical but I have a solution for you to make it approachable and easily to digest.
This interview is recorded on video and Dr. Sluka will be sharing a number of important and descriptive slides to accompany her presentation. The slides are really important. She has also given you permission to use the slides for your personal use. All you have to do to download the slides is go to www.DrJoeTatta.com/93download. Take the time to download the slides and maybe even print them out so you can follow along with us and take some notes. This will definitely help you retain some of the information. If you’re a practitioner, the slides make a really great in-service material. Keep that in mind when you go back to the clinic.
A Mechanism-Based Approach To Pain Management with Dr. Kathleen Sluka, PT, PhD
Kathleen, welcome to the Healing Pain Podcast.
Joe, thank you. It’s great to be here.
I follow your work in professional journals and many of my physical therapy colleagues know you as a university professor and a pain researcher at the University of Iowa in the physical therapy department. You’re also a licensed physical therapist. You do some great work around pain, pain management, and pain science. How did you become from being a licensed physical therapist to becoming interested in studying the really fascinating mechanisms of pain and pain management?
That goes way back to those clinical days. I used to work in the clinic. I saw a lot of orthopedic patients like many of us did. I’ve worked in a private orthopedic patient practice. Most of the patients had chronic pain, a few acute ones, but they almost all had chronic pain. I got interested in studying that in more detail. It turns out at that time there was a really wonderful pain group working not far from where I was working. I was working in Houston. There was this great pain group down in Galveston. I decided to go to graduate school there and I’ve got a degree in anatomy and neuroscience. I joined this great pain group and got some really good training in the basic science mechanisms of pain. After finishing up my PhD and doing a postdoc, I moved to Iowa. From day one, I’ve always been studying the basic mechanisms of pain, but over the years I translated that and started translating a lot of this stuff into people. That’s understanding the mechanisms, taking the mechanisms to people, looking at mechanisms and effectiveness of physical therapy treatments in people, as well as in animals. It has given us a really great insight into what we’re going to talk about.
You started out with your Bachelor’s in physical therapy then went on to a PhD and now in neuroscience. That was approximately how many decades ago?
In the 1980’s, I’ve got my Bachelor’s Degree. I worked for about four or five years in the clinic before I went back and got the PhD. I came to Iowa in 1996. I have been here for over twenty years. I’m running an active research program looking at basic mechanisms in clinical effectiveness for all those years.
When you got your PhD and even when you got your PT degree, pain science really wasn’t a thing. People didn’t really have such an interest in it, right?
No, they didn’t. It was pretty much thought that pain was a symptom and we should just ignore it and deal with the function and get them better. We still deal with the function, but we know now we can’t just ignore pain. We end up with opioid epidemics and epidemics in pain that we have in the United States. There’s been a renewed focus on pain. There was a small group of individuals that’s grown over the years. We keep bringing more and more people into it. Now, there’s a bigger focus on physical therapy on pain as well as the rest of the world.
There was a physical therapy journal that was dedicated to pain mechanisms and what physical therapy has to offer to people with chronic pain and to people who may be using opioid that want to come off it. In that journal, you had a paper called A Mechanism-Based Approach to Physical Therapy Management of Pain. The title is really powerful because it really tells you that if I’m a clinician, especially if I’m a physical therapist, that paper was written to give me a framework around the mechanisms of what we do as professionals. That it helps someone with chronic pain. How did you start to develop your thesis around that paper?
This has been my entire career. I started studying mechanisms when I got my PhD. We started figuring out what was going on in people with muscle and joint pain. In those days, there were few investigators at the basic science level even looking at mechanisms of muscle or joint pain. Even to this day, it’s not the most commonly studied pain despite the fact that is the most common chronic pain condition out there. There are a lot of studies in neuropathic pain. There’s quite a bit done on cutaneous pain, skin pain, but not so much on muscle and joint. it’s been my whole career. I’ve started out trying to understand the mechanisms. Over the years it’s just evolved to having a better understanding of how physical therapy works and having a better understanding of mechanisms. I think we can meld those two together to get to where we are and that’s how we got to the thesis.
Tell us how chronic pain is formed from a mechanism from an injury.
I don’t think we know the full answer but I’ll give you a very general perspective. Let’s say you have an injury. You fall, sprain your back, or sprain your wrist. The initial input you get from that injured area, from your nociceptors, are sent into the central nervous system. It immediately translates to central nociceptive neurons that would produce a central sensitization, and that’s a normal response. There’s nothing abnormal about this. We have increased activity of our nociceptors, increased activity of our central neurons, and together those lead to the pain state when it gets up to the cortex. That’s how we perceive pain. This increased excitability is going on in the periphery, is going on in the central nervous system. In the periphery, there could be changes in ion channels that make your nociceptors more excitable. Those channels could be more of them, they could be what we call phosphorylated, so they just become more excitable at the same number. What that means is we can make our neurons more excitable and you can’t see it or detect it.
You could simultaneously have this increased excitability of your central neurons anywhere in that nociceptive pathway, from the spinal cord through the cortex. Those neurons could be more excitable. There could be more neurotransmitters like glutamate. There could be more receptors in there that respond to the glutamate like your NMDA receptor. There could be more phosphorylation of those receptors that could lead to more excitability of the receptors. There could be increases in gene production of those receptors leading to even more of them. There’s a whole slew of things that are simultaneously going on in the excitatory system within the central nervous system. At some point, there are some people whose peripheral nervous system calms back down and goes back to normal. The central nervous system stays excitable for some reason, and those are people that we often talk about called central sensitization.
The IASP, the International Association for the Study of Pain, has a new term for that. We call it nociplastic. I’ll probably use that throughout here and I’ll try and remind you that that’s what it is. The transition from acute to chronic pain is a whole series of years of work from multiple labs. We’re still trying to figure out how you get from an acute pain state to a chronic pain state. We still think it’s a bunch of stressors. There are a lot of data to support some of these things. It could be multiple insults in low intensities. It could be stress associated with an insult. It could be depression. It could be psychological factors. It could be so many different things. It could be obesity. It could be a sedentary lifestyle. All of those combined with the muscle insult or joint insult or some other stressor together to set the body up to respond in an exaggerated way.
Even if people don’t necessarily understand all of that or only understand pieces of it, I think the take home is that pain is very complex. That may incite fear in certain people, but I think it also starts to open people up and make them aware that there’s more going on here than just my back or there’s more going on here than just my thoughts. It’s a combination of a lot of different things that we’re going to go into more. You mentioned IASP and you started talking about their classifications. One being nociplastic, which is new. Can you talk about nociplastic a little bit as well as the other two that are part of that?
This is part of the mechanism-based approach, is understanding the mechanism terminology. There are three descriptors based on mechanisms that have been developed by the International Association for the Study of Pain. The first is the nociceptive, which is really due to activation of peripheral nociceptors primarily in acute, nociceptive ongoing input. There’s neuropathic, which is directly due to injury of a nerve or the nervous system in some way that can be done in the peripheral nervous system like nerve damage, diabetes, a metabolic disorder of some sort or the direct lesion of the central nervous system.
There’s this new terminology called nociplastic. It’s really meant to be used clinically to replace the term central sensitization. It’s not pain that is not derived due to neuropathic or nociceptive, but due to something else. We don’t know that that central sensitization. It could be due to changes in the central nervous system, but it could also be due to systemic effects or some other unknown mechanisms that we don’t even know yet. We’re keeping that one rather open to talk about that person as having a third descriptor as a nociplastic pain. We think that’s very important on that end.
From those three, do patients always fit into one category?
Certainly not. Referring to our slides. The first slide looks at the three mechanisms. You can see that the three are overlapping, the nociceptive mechanism, the nociplastic mechanism, and the neuropathic mechanism. They overlap because patients don’t have just a single mechanism. They may have one that predominates over another one, but they don’t have one. Since we’re on this slide, I’m going to go ahead and tell you about the other two components that are here. In the middle we have those three components. The nociceptive, nociplastic and neuropathic. I think of those as the bio part of the biopsychosocial model. At the outside, I’ve put motor systems and psychosocial systems outside those three components. Both of those systems, the motor systems or the movement system and psychosocial systems are influenced by those three systems and they simultaneously can influence those three systems. There’s a give and take between them. The negative psychosocial things can make the pain worse. Positive psychosocial things can make the pain better. The same goes for motor. Some motor systems can be directly influenced by those three different mechanisms in the bio, but motor can also influence those as well.
This is the last slide I wanted to show you is that patients really do present with a mixed degree of symptoms. We like using these little pie charts because you can put together the percentage after your evaluation. Let’s say on the top one, nociceptive pain is involved versus nociplastic pain versus motor symptoms. The top one has a lot of nociceptive pain and that would suggest we need to do some more peripherally directed treatments. You look at the bottom two, they have a lot of nociplastic pain, and it would suggest we need some more centrally directed treatments. If you can draw this and think about this in your patient, it doesn’t mean they don’t have all of these things going on to some degree, but it helps you direct your treatment into the area with the biggest issues at the time
I think whether you’re a physical therapist who is using manual therapy and exercise and hopefully possibly some type of pain neuroscience intervention, you may say, “This person may need more of the psychoeducational intervention part of it. Maybe less of manual therapy or maybe less exercise in the beginning.” Conversely, if you’re a psychologist, it may inform you that, “I have a part here in playing in the psychosocial aspects of pain, but eventually this person has to wind up in some moving-based therapy to help them out.” What I love about this model is that it’s so simple because I think most practitioners can look at it and really pick up easily and rapidly. They can apply this to the different types of patients I see in the clinic. How does the biopsychosocial model differ from a mechanism-based approach to pain?
I like to think of the mechanism-based approach as an expansion of the biopsychosocial model. It’s like an expansion for physical therapists in a way because we’ve included the movement system or the motor systems in this. The bio part again is the nociceptive, nociplastic, neuropathic components altogether. The psychosocial was already in there, but we’ve added the motor. We think that that’s super important because that is function. That’s ultimately what we want to do with our patients, is to improve function. That can be done in many ways. You can reduce pain and you can improve function. You don’t actually have to have treatments directed against a motor deficit to improve function. That’s a new concept for physical therapists because we are trained to fix the problem, fix the motor dysfunction, and fixed the biomechanics. In this model, we think that it includes treating the pain and treating the concepts of pain and the mechanisms of pain so that we will then subsequently improve motor and vice versa.
How does motor differ from patient to patient? Does it look the same or do different patients with different types of pain syndromes differ in their motor presentation?
Motor is different between different pain syndromes and between different people within the same pain syndromes. You have to sit in there and evaluate that, which we’re really good at. This is what we do best. There will be some people that will have, say a nonspecific lower back pain with increases in activity and facilitation of the motor system. You might pick that up as a muscle spasm or a tightness in the lower back. There are others who will have an inhibition of the motor system with the same issues. That inhibition will look like muscle weakness to you. Unless you do a very specific evaluation, you won’t pick those up. Sometimes the motor is protective and it should be there. Sometimes it’s not protective and you have to determine when it is protective, when it’s not protective, when it’s excited, when it’s not excited. There’s a whole slew of these and we’ve described a number of them in the paper so you can look in more detail. The motor system, and Paul Hodges has shown this many times, is just quite variable among people. It turns out so are pain is equally variable among people.
Just because you have fibromyalgia doesn’t mean you have central sensitivity and that’s the only thing driving your pain. Not everybody with chronic pain has psychological dysfunction. I can show you some variability in that. I wanted to point out this because there is a lot of variability in patients. This is just showing the variability in central inhibition, which in people with fibromyalgia is lost on average. I’ve plotted a whole slew of 174 patients with fibromyalgia that we’ve done in our clinical trials. You can see a normal response is above 100 here. You can also see that there are people that are perfectly normal when compared to healthy controls. We also have healthy controls who have no inhibition. While the average is one thing, there’s just so much variability in patients that we need to understand what their variability is so we can better treat it. I would not treat a patient with really good central inhibition by trying to increase their central inhibition because it’s already there. I try and increase their central inhibition if it were lost. That’s what that’s really saying.
The next slide shows the psychosocial variability, which I think is also quite fascinating. Psychological factors are quite variable. These are fibromyalgia patients, and we’ve looked at hundreds of these patients. I just went out and figured out what percentage of them have these different psychological factors. One of the factors is pain catastrophizing, which has been shown over and over to be important in pain, making it worse, and giving us a poor prognosis. In our patients with fibromyalgia, only 26% of them had high pain catastrophizing, which meant 74% of them are normal. Treating them for high pain catastrophizing if they’re normal is not going to be helpful for you. Only half of them have a fear of movement. This helps us understanding these different mechanisms. Evaluating these different mechanisms helps us to really personalize the treatment, use a personalized medicine approach and a person-centered approach instead of giving a cookbook approach to every patient with every diagnosis.
Oftentimes I get questions from other practitioners that email me, they listen to the podcast. These are not physical therapists, they’re other practitioners who say, “Why can’t I just send my patient to the gym or to Yoga?” Of course, we should encourage physical activity in all of our patients. However, as Dr. Sluka was saying, the motor system of the neuromuscular system really is different depending on the patient. You need a licensed professional. In my case, I would argue that a physical therapist is best for this, to figure out what type of specific exercise program they need based on how they present, because everyone’s going to present differently. The pie graphs here with the psychological factors are along the same lines. We can’t just say that every person with chronic pain is a catastrophizer. They may have different variation in them. Should we talk about the different categories of pain mechanisms?
Sure. To do a mechanism-based approach, and this is a very simplistic side, you have to understand how your treatments work. We also have to understand the science of pain. We’ve talked about that a little bit about the different categories. In order to apply it, you have to understand how our treatments work. Years ago, we had no idea how our treatments work. I spent years trying to figure that out. We have a lot better understanding of how many of our treatments work based on some good neuropharmacology. What I’m showing you is that many of our treatments work on different aspects of these different types of mechanisms, either nociceptive, or nociplastic, neuropathic. They also work on all of these different mechanisms. The mechanism-based approach isn’t really that novel and new. This is something that medicine has been doing forever. This is how they applied pharmacological treatments.
If somebody has neuropathic pain, the first line treatment in medicine is a Gabapentinoids Gabapentin and Pregabalin. If they have inflammatory pain, your first line treatments are anti-inflammatories. This isn’t new. This is something they’ve always done. We applied the same approach in physical therapy by understanding our own mechanisms. It turns out that the mechanisms for our treatments’ work are way more complicated than the mechanisms for pharmacological treatments’ work. Exercise has effects across the board. It changes nociceptive processing. If reduces calcium channels in nociceptors, making them less excitable. It changes the nociplastic system by increasing central inhibition and decreasing central excitation. It promotes healing in nerve injury.
It reduces psychosocial constructs like fear, depression and anxiety. We all know it improves the motor system and function. It works across the board, but it works on various different mechanisms. Which type of exercise works on which type of mechanism, we’re not really sure. We do know that aerobic can strengthen the exercises work on almost every one of those mechanisms, and the data pretty much shows that it works on every one of those mechanisms. I’m going to stick with exercise because this is really important. The fact that exercise works across the board and we know that exercise has the strongest evidence to support it in almost every chronic pain condition is probably because it does work on so many different mechanisms. It’s the best multimodal treatment there is for pain because it does that.
It also means that we may not need to use specific exercise programs. It turns out that in exercise alone, that if you compare, say for low back pain or core strengthening program, which we think is the gold standard to aerobic exercise or motor control exercises are a host of other types of exercises, they are equally effective. Not one doesn’t seem to be better than another. It doesn’t matter what exercise program you do, the program that they should do is the one that they will do. It’s part of our job as a coach to figure out what they will do and get them going on something and give them the mechanisms and the treatments to make that happen.
It turns out that TENS works primarily on nociplastic pain. It has a very small nociceptive effect. If you have somebody with a loss of inhibition, a lot of excitation, TENS works really to help them with that. Manipulation, mobilization, and massage work both on nociceptive peripheral mechanisms, but they also have a lot of central neural effects. They have a lot of peripheral neural effects beyond just changing the movement patterns. That’s really important because we can start to jump into using those. Even if someone doesn’t have a restriction in their L4-L5 or whatever it is you want to look for, it can still have a neural effect. You don’t necessarily have to do the quite the same thing. Most of that data has all been done with either grades for high thrust manipulations, there’s not much evidence to suggest that any of those mechanisms worked with a grade II mob, contrary to public belief.
That’s interesting because that really starts to inform a type of manual approach they take in working with the patient. A lot of physical therapists told me when someone is in “a lot of pain,” you should do a grade I mobilization but you’re saying that really supports three and above.
Yes. I’ve hunted for the data. I can’t find the data to support using a grade I or II mobs. All the data that’s been done in pain has been done with threes, fours and high thrust manipulations. I don’t see any reason to even go with that. It turns out that it’s not that much. The other thing that I think is really important when we’re thinking about this is the effects of things like mobilization on pain or TENS for that matter. TENS works best while the unit is on. Mobilization effects are very short lived. They last about 30 minutes. Massage effects lasts as long as you’re doing and when you stop doing them, they go away. They’ll have effects over a ten-week period but they don’t last long.
This isn’t all that unusual because exercise doesn’t either. We know we can’t exercise for two weeks and expect to have long-term benefits. We know it has to be done regularly. That doesn’t seem all that unreasonable, but it’s the same for everything else we do. None of these things are having long-term effects from what we can tell on pain itself. The only thing that probably does is your education. Education is changing beliefs and patterns, changing thoughts, and it can change connections in the brain. We know that it can change how the brain responds to different pain conditions and have long lasting effects because you’re actually just changing belief systems. It only works centrally. It’s not going to have a whole lot of effect in the peripheral nervous system. Thinking about putting all those together, this is why you need that approach.
Manual therapy manipulation only has an effect for about 30 minutes. Maybe some people would say, “If it’s only 30 minutes, then why do it?” We could also argue that if that’s the first intervention I do during a treatment session, then it may allow my patients to move easier during the session or two. I can teach them a self-mobilization they can do at home, which enables them to self-treat and help them cope better. The topic of education is one that’s so interesting to me. Lorimer Moseley probably has the best research on that. Even just the work I do here in my podcast, it’s incredible to me. People reach out to me all the time and say, “I listen to your podcast and I just feel better knowing that I know about pain, knowing that I’m not necessarily hurting myself.” You’re saying it only works centrally. It has no effect peripherally?
Yes, because it’s changing your belief systems. It’s changing your cortical processing of pain. It’s not really having an effect changing how your nociceptor fires. It makes sense if you think about what you’re doing with an educational program. I like to take education to the next level. I think education is beyond education now. I think we should always be putting it into a self-management program. I like your idea of not only doing the manual therapy but giving them a self-manual therapy they can do at home and be part of their home program now. That’s the way I think about a lot of our treatments that we used to say are passive. We shouldn’t be doing these passive treatments to patients. We should get away from that. TENS is the same way. There’s no reason why they shouldn’t be using safe and effective treatments at home to help manage their pain and maybe that would stop them from reaching for an Ibuprofen or an opioid.
We did that to ourselves because we said we don’t want to give these patients passive treatments. We want them to be active participants in managing their pain with safe and effective treatments. If you have a lot of pain one day and it hurts to put your foot on the floor and take that next step and you’re getting a five out of ten every time you take a step, you’re not going to walk that day. You’re going to need to do something else to help manage that pain. As much as we want them to walk every day, they may not. If we could give them other tools, that’s really helpful. Whatever those tools are that work best for them is fantastic. Try to think of these self-management principles that we can add in there to come up with a bigger picture for our patients.
If we dial into the TENS, I’ve been a therapist for 27 years. I think we’ve gone over these waves and hurdles about TENS and ultrasounds and another one. TENS seems to be a little bit back en vogue. Do we know specifically the type of TENS that helps someone?
One of my first projects when I came here on faculty was a group of PT students who wanted to do a project. They chose to do TENS in rats. It started this whole series of studies looking at how it works and then translating how it works into clinical practice. What we’ve come up with is based upon all those years of experience, the most effective TENS methods are is if you could mix the frequencies between low and high frequency, with a high intensity as high as they will tolerate, it doesn’t matter if it’s motor contraction or not, even for high frequency and give it to surround the area of pain. Those are the three probably key components we think to make TENS the most effective. If patients can get their heads around that, it’s pretty easy to do.
You can buy them now over the counter, which is great. They can do that. The instructions aren’t great in over the counter stuff, but we actually have built online instructions that are posted on our university site. We built these instructions complete with videos so that they’re readily available and free to the public so that patients can follow them and use them. We’re using it for another study where we’re trying to implement TENS and exercise into primary care practice. They’re there so that patients can use them. We think then that helps and also for physical therapists to use them for their patients as well.
Years ago, they used to actually educate us in school. You should never turn it too high, it should just be gentle and barely sensory. Over the course of the years, things have changed. Before we start to move onto the last part of the interview, I have a couple other questions for you. Where do you see the pain mechanisms in the future as far as the research goes?
There have been some studies in the pharmaceutical world testing pain mechanisms and seeing if we can match treatments to mechanisms and have shown better effectiveness. Some of our pharmaceutical trials were matched up against mechanisms. I would like to see clinicians and researchers actually test these theories and make sure that we are getting better treatments by matching mechanisms to treatments. We have some data that shows that TENS works for those with Fibromyalgia, for instance, which is matching the loss of inhibition with increased excitability. You see that in fibromyalgia with central nociplastic pain with the treatment of TENS. We need more of those to try and target and see if that approach routinely comes out to be an effective treatment, and if that can be better than just say the standard old treatment that we’ve always done for patients. That needs to be done.
Ultimately, we’d like to see it better implemented. We need some better tools to try to determine how much of a component of their pain might be peripheral, especially in a chronic pain patient. It’s much easier to determine the central mechanisms and the chronic pain patients in the psych mechanisms. The peripheral mechanisms, unless they have a big old information, that can be somewhat difficult to determine in our patients. We need to come up with some good assessment tools for that. We need some better assessment tools to be used clinically for the components of central sensitivity. What’s out there right now is in its early stages and it needs some real validated contesting before we can go further with that. Right now, we do most of it from history and physical to try and figure that out, which is fine. It would be nice to have something a little more solid for the future. I know people are working on validating and testing those.
As healthcare professionals, so let’s take the physical therapy profession, we have a number of different tools we can help people, but what do we need to do as a profession to step up and step forward to help people as we go through this chronic pain epidemic and real change in paradigm?
We need to embrace pain as a disease when it becomes chronic. We need to embrace all the treatments we have. We need to think outside the box a little bit for what those treatments are. We need to really step forward and be active players in self-management strategies. The National Pain Strategy and the Federal Pain Research Strategy both really called out self-management and nonpharmacological principles. Along with the CDC guidelines that suggested that non-pharmacological treatments should be first line treatments. Recent guidelines from the American College of Physicians had published in Internal Medicine, saying first line treatments should be non-pharmacological treatments. This is us and we should be in there with everything we do. We shouldn’t say we don’t do passive therapists, or we only do active therapy. We should do everything.
We should be active players and we should be vocal about it. I think that we may need to give more education to primary care providers to help make those things happen. We may need to provide services and resources to primary care providers so that more patients who are coming in there are being referred to physical therapy. Now, only about 15% of patients with chronic pain that are coming into primary care are referred to physical therapy. Should they all be? Maybe, maybe not. Maybe some of them can manage it on their own with some guidance from their primary care physician, but probably more than 15% should be coming to us. We need education to get those patients to the next level. We need to be more vocal and more active. I think that will be useful for all physical therapists.
When professionals like you and I hop on online and just chat about pain, it’s really beneficial for the public. There are things we can do that are free and low cost that go a long way for helping people with pain as well as helping our profession get elevated to the level that we really deserve. We are the ones who can provide non-pharmacologic therapy, whether it’s a passive mode or a combination of passive and active. I had been talking to Dr. Kathleen Sluka. She is a physical therapist and a pain researcher at the Department of Physical Therapy and Rehabilitation Science at the University of Iowa. She has amazing research. If you want to jump into pub med or look at her research, she’s going to tell you all the ways you can contact her and find out some more information.
Thank you. You can just Google my name and it comes right up. You can email me. You can go to my website at the University of Iowa in the Department of Physical Therapy. You can follow me on Twitter, @ksluka0101. I’ve written a book that goes through all of these mechanisms and all of these in way more detail than you probably want. It’s all on evidence-based approach and an evidence-based book that talks about the mechanisms as well. It’s called Mechanisms and Management of Pain for the Physical Therapist published by the IASP Press.
I want to thank Kathleen for being on the podcast. It’s been great. I love the show. If you’re joining us later, go on and take a look at the slide. She has great, incredible slides that really give you a great framework about a mechanism-based approach to pain management for the physical therapist. Check her out on Twitter. Check her out at the University of Iowa. Share this out with your friends and family on Facebook and Twitter. If you’re new to the podcast, hop onto and sign up for the email list for each week. I will send you the latest podcast that has to do with the healing pain naturally. I’m Dr. Joe Tatta, it’s been a pleasure being here with you.
About Kathleen Sluka
Dr. Sluka is a professor in the Department of Physical Therapy and Rehabilitation Science at the University of Iowa. She received a physical therapy degree from Georgia State University and a PhD in Anatomy from the University of Texas Medical Branch in Galveston. After a postdoctoral fellowship with Dr. William D. Willis, she joined the faculty at the University of Iowa. Dr. Sluka’s research focuses on the neurobiology of musculoskeletal pain as well as the mechanisms and effectiveness of non-pharmacological pain treatments. She has published over 200 peer-reviewed manuscripts, numerous book chapters, and a textbook on Pain Mechanisms and Management for the Physical Therapist. She has received numerous awards including the Marian Williams Award for Research in Physical Therapy and Catherine Worthingham Fellowship from the American Physical Therapy Association and the Frederick W.L. Kerr Basic Science Research Award from the American Pain Society. She is actively involved in the International Association for the Study of Pain, the American Pain Society, and the American Physical Therapy Association serving on committees, task forces and society boards.
The Healing Pain Podcast features expert interviews and serves as:
A community for both practitioners and seekers of health.
A free resource describing the least invasive, non-pharmacologic methods to heal pain.
A resource for safe alternatives to long-term opioid use and addiction.
A catalyst to broaden the conversation around pain emphasizing biopsychosocial treatments.
A platform to discuss pain treatment, research and advocacy.
If you would like to appear in an episode of The Healing Pain Podcast or know someone with an incredible story of overcoming pain contact Dr. Joe Tatta at email@example.com. Experts from the fields of medicine, physical therapy, chiropractic, nutrition, psychology, spirituality, personal development and more are welcome.
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domain: medical


text:
New Delhi: At least 74 drugs -- including life-saving ones used to treat cancer and HIV and haemophilia -- will see a sharp rise in prices as the government has withdrawn customs duty exemption on their imports in a move, some say, that's meant to boost the Make in India programme.
- Govt withdraws duty exemptions to make some foreign drugs more expensive
- Among the 74 drugs are ones used to treat cancer, HIV & haemophilia
- Move reportedly in an effort to boost domestic manufacturing industry
The withdrawal of exemption came last week, following a notice by the Central Board of Excise and Customs. An increase has also been made in the customs duty rates of certain life-saving drugs.
The move will make treatment of a multitude of diseases costlier: Apart from HIV, cancer and haemophilia, the list includes kidney stones, heart rhythm disorders, diabetes, Parkinson's Disease, bone diseases, bacterial infections, anesthetic medication, allergies, arthritis, lupus, menopause, glaucoma, poisoning by a chemical or pesticide, growth failure in children and ulcerative colitis.
Admitting that the government wants to protect the interests of Indian industry, Dr GN Singh, Drug controller of India, however, said efforts are being made to stop the rise of drug prices.
"We are aware of this problem... The health ministry and pharma officials are all taking steps to address this. We won't allow prices to rise," Dr Singh told NDTV.
Talking about the withdrawal of exemptions, he said, "Various people wanted the government to take measures to protect Indian interests".
KPMG India Partner and Head of Indirect Tax Sachin Menon told news agency PTI that the withdrawal of exemption is "is intended to provide protection to the domestic manufacturing industry and enhance the attractiveness of make in India initiative".
The changes signify the intention of the government to promote domestic manufacture of these items as imports would now become more expensive, Mr Mani said.
Calling the government's decision "most unfortunate", Kiran Mazumdar-Shaw, the chairman and managing director of biotechnology firm Biocon Limited, said the removal of exemptions really "impact" patients.
"We understand the make in India concept, but if duty increases on international drugs, it impacts domestic pricing as well," she said. "In principle, we should as a country, save life saving drugs from any kind of duty, especially since its what we claim our national mission to be."


text:
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domain: hobby


text:
One night two big shows featuring a tribute to a couple of the worlds favourite bands. Nirvana and the Red Hot Chilli peppers, playing live ON THE GREEN, Riverside Bar open, Tavern and Thai food available.
$25 a ticket, includes 1 house drink – Gates open at 6:30pm show starts 7:30pm – Limited seating.
THE AUSTRALIA RED HOT CHILLI PEPPERS delivers a high energy tribute, reproducing not only the sounds of the Chili Peppers, but the Onstage Antics, images and Costumes.
Performing all the Worldwide hits such as, ‘Under the Bridge’, ‘Give it away’, ‘Aeroplane’, ‘Californication’, ‘ScarTissue’, ‘Around the World’, ‘By the Way’, ‘Dani California, ‘Tell me Baby’ and so much more.
AUSTRALIAN NIRVANA TRIBUTE
A Sydney based Show set up in tribute to the LIVE performances of Nirvana.
The Australian Nirvana Tribute delivers a high energy show, reproducing not only the sounds of Nirvana, but the onstage antics, images and costumes.
Performing all the Worldwide hits such as, ‘Smells like teen spirit’, ‘Come as you are”, ‘Heart Shaped Box’, ‘On a Plain‘, ‘Lithium’, ‘In Bloom’, ‘All Apologies’, ‘Pennyroyal tea’, ‘Sliver’ and so much more.

domain: artistic


text:
Want to get your GED in Edmond WV? The General Education Development exam is for adults who have not completed their high school diploma. The certificate that you receive upon completion of the West Virginia GED examination is accepted as an equivalent credential to a high school diploma by employers and colleges throughout the United States.
The GED exam tests basic skills that students learn about in high school. Subjects taught in GED classes include writing, reading, social studies, math, and science. Those are the subject areas that make up the General Education Development examination in West Virginia.
Usually GED programs in Edmond WV are offered at:
- Edmond Literacy Centers
- Edmond Libraries
- Edmond Colleges
- Edmond Workforce Learning Centers

domain: library


Government accused of ‘rowing back’ from conversion therapy ban by Tory MP Caroline Nokes
Caroline Nokes, the Conservative chair of the women and equalities committee, has joined criticism of the government’s inaction on conversion therapy after the resignations of three of its LGBT+ advisers.
The MP expressed her “disappointment” at the government for not yet banning so-called conversion therapy Thursday (11 March).
She spoke after three members of the government’s LGBT+ advisory board quit citing hostilities toward the community, with one, Jayne Ozanne, saying junior minister Kemi Badenoch’s obfuscating on the long-promised conversion therapy ban was the “straw that broke the camel’s back”.
Nokes said that after listening to Jayne Ozanne discuss conversion therapy on Good Morning Britain, she was “so disappointed that government [is] rowing back from legislating to ban it”.
“Last July we were given the impression it would be done,” she added.
Listening to @JayneOzanne on @GMB this morning about her experience of so-called conversion therapy. I am so disappointed that Government rowing back from legislating to ban it, last July we were given the impression it would be done.
— Caroline Nokes MP (@carolinenokes) March 11, 2021
Similar frustrations were aired by the LGBT+ Conservatives, the official LGBT+ wing of the party.
“We are deeply concerned by the comments made by Jayne Ozanne,” it said in a statement to PinkNews.
“It is upsetting to hear of her experience and read the allegations she has made.
“A thorough investigation is needed to ensure this does not happen again. We need to set a standard for others to follow. This is not it.”
Government LGBT+ advisers quit over Boris Johnson’s handling of conversion therapy
Jayne Ozanne, a gay evangelical, left the LGBT+ Advisory Panel and resigned as a member of the Conservative Party on Wednesday (10 March).
Herself a survivor of the horrific treatment, Ozanne’s explosive resignation quickly fanned the flames of outrage being directed at the Conservative government’s handling of LGBT+ rights.
Just days prior, parliament held a debate on conversion therapy, during which under-secretary of state for equalities Kemi Badenoch delivered what critics called a “vague” speech.
No timeline or any specifics about the potential legislative ban were provided, and she suggested that an exemption for faith groups has been floated. She also refused to use the word ban repeatedly, sparking concerns.
The lack of progress on the issue has been especially irritating, activists have said, considering the Conservatives pledged back in 2018 to “eradicate” the abhorrent practice as part of their LGBT+ Action Plan.
Johnson reaffirmed this in an interview with PinkNews in the run up to the 2019 general election. But after much silence and inaction, Badenoch’s speech worried many, including Ozanne.
“For me, the straw that broke the camel’s back was [Badenoch’s] speech on Monday night, at the end of an extraordinary debate on the need to ban conversion therapy,” she told ITV.
“Every MP from across the parties, from across the United Kingdom, had stood and talked about the need for urgent action.”
Badenoch’s suggestion “she’d been engaging with who many of us would say are perpetrators”, Ozanne said, could “enable spiritual abuse, in my mind, to continue”.
Academics, psychiatrists, queer faith leaders, LGBT+ partisan political groups and queer charity executives have all demanded that conversion therapy be banned in Britain.


text:
Cernit offer pure primary mixer colours in the larger 500g blocks only - this is 717 Primary Yellow - a brighter, cooler yellow than their regular shade, more akin to the zinc yellows now discontinued from so many brands.
Primaries are designed specifically with colour mixing in mind and are 50% opacity colours. This means they have a more translucent finish for a porcelain-like depth to the baked clay and the colours will appear darker and more intense accordingly. To lighten colours and maintain this finish, use the Porcelain white. To lighten colours and also make them more opaque, mix with the opaque white.
Cernit polymer clay Number One range has a wide selection of colours and is Phthalate-free. It is easy to use and very strong when baked, even in thin sheets. Bake for half an hour at 110 - 130 degrees C.

domain: chemistry


text:
10 - 16 degrees with scattered cloud and a cool north westerly wind.
Anglers CP: Common Tern 6. Wigeon 1 female. Pink-footed Goose 1. Canada Goose 151. Canada X Greylag Hybrids 4. Common Sandpiper 1. Grey Wagtail 3. A Hobby flew over at 10.27hrs.
Not great news. A female and 3 young MINK! on the shallows.

domain: biology


After being eliminated from Love Island Australia on Monday night, Vanessa Sierra revealed why she chose to put her pursuit for love “in the hands of producers”.
The 24-year-old is no stranger to controversial relationships involving reality stars, and said it’s that past experience that left her “burnt” and made her lose hope of “dating in the real world”.
Vanessa dated Married At First Sight star Dan Webb after his split from MAFS co-star Jessika Power earlier this year. She then went on to date Jess’ brother, Rhyce Power, whom she later accused of assaulting her on a holiday in Thailand – an allegation Rhyce has denied.
“Definitely the level I was burnt by my last relationship put me off dating,” Vanessa told HuffPost Australia on Monday.
“I kind of didn’t trust myself dating in the normal world and so I actually said this to my best friend, ‘Well if I put my dating life in the hands of producers I feel like I’m going to make better choices than if I were in the outside world’.”
During her time in the villa, Vanessa was firmly coupled with male model Matthew Zukowski, but their relationship faced its challenges over the past few days due to trust issues.
“I feel like Matt messed up in the villa. He didn’t have my back,” she said, adding it’s for this reason she wouldn’t rekindle their romance in the outside world.
“He just never gave me the benefit of the doubt so I don’t think I would pursue that outside the villa even though it could have worked. He’s let me down in the villa.”
Recently eliminated contestant Sam Withers also expressed interest in Vanessa earlier in the season, and the model is keen to contact him now that they’re both out of the villa.
“Obviously there was a connection with Sam and I right from the start and I was quite open about it with both Matt and Sam,” she said. “They were both aware, but because my connection was stronger with Matt and Sam hadn’t really stepped up to pursue it, I sort of left that on the sidelines and focused on Matt.
“There’s always a feeling of ‘what if’? Seeing myself fall out with Matt, I don’t regret anything but I do wish I gave Sam a little bit more time.
She said “he’s definitely one of the first people I’m going to call when I get out of the villa” as she wants to “give him that chance, even on a friend level”.


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John Wilsey, Ph.D.
First Liberty Institute Research Fellow, and Associate professor of church history at the Southern Baptist Theological Seminary
John D. Wilsey is associate professor of church history at The Southern Baptist Theological Seminary. He is the author of One Nation Under God? An Evangelical Critique of Christian America (Pickwick, 2011) and American Exceptionalism and Civil Religion: Reassessing the History of an Idea (IVP Academic, 2015).
He recently edited an abridgment of Alexis de Tocqueville's Democracy in America, which was published by Lexham Press in 2016. And he is writing a religious biography of John Foster Dulles, Secretary of State in the Dwight Eisenhower Administration, which will appear in the Eerdmans Library of Religious Biography series in 2020.
Wilsey is an affiliated scholar in history and theology at the Acton Institute and a research fellow with the Ethics and Religious Liberty Commission of the Southern Baptist Convention. He was also the 2017-18 William E. Simon Visiting Fellow in Religion and Public Life with the James Madison Program in American Ideals and Institutions at Princeton University.
Wilsey is married with two daughters, and they live in Louisville, Kentucky.


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“Just under half (47 percent) support strike action versus 34 percent opposed"
Despite the Tories pledging to bring in tougher anti-strike legislation, with Britain already possessing some of the most restrictive anti-union laws in Europe, public support for striking workers continues to hold up.
The government has sought to portray striking workers demanding better pay and conditions as selfish and greedy and accused them of holding the country to ransom in recent weeks, with the Border Force, nurses, paramedics and postal workers now joining the railway strikers in demanding better pay and conditions.
The RMT in particular has faced criticism over recent days over its decision to strike over the Christmas period, with general secretary Mick Lynch hitting back at the BBC yesterday for “pursuing an editorial line that I could read in the Sun or the Daily Mail, or any of the right-wing press in this country”.
The Sun today printed a front-page accusing the RMT boss of ‘losing it’, however, the public it seems are still on the side of railway workers.
Politico reports on the latest polling by Savanta which shows that: “Just under half (47 percent) support strike action versus 34 percent opposed, compared with 50 percent in support of, and 29 percent opposed, at the end of October.
“Forty percent blame the government for the railway strikes, while 37 percent blame the trade unions and only 11 percent blame the workers themselves.”
Rishi Sunak is clearly having a tough time trying to portray the unions as villains as he tries desperately to shift the blame for the strikes onto the workers and unions.
Basit Mahmood is editor of Left Foot Forward

domain: news


text:
With a distinctly modern flavour the Patras Round Concrete Table embraces minimalist design with its strong silhouette and sculptural like shape.
Transform your outdoor dining space with a bullnose edged table top and a single ribbed pillar base.
Crafted in fibre cement in a grey finish.
Dia 150 cm
H 74 cm


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Average Rating: 2.0 (1790 Ratings)Filter Results
Compare ZYRTEC with similar:
Type: Over-the-counter Drug
Results are sorted by Date added.
Key to Ratings: 1=LOW (I would not recommend taking this medicine.)
Page: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90
|RATING||REASON||SIDE EFFECTS FOR ZYRTEC||COMMENTS||SEX||AGE||DURATION/|
|1||asthma/allergies (dust, mold, etc.)||uncontrolable behavior, angry outbursts, hitting, biting, extreme mood swings||My son has been taking Zyrtec and Singulair for about a 1 1/2 years and Claritin before that. He was such a good baby, very laid back and happy. We discovered his exstensive allergies after his first birthday. That's about the time we started meds. I never made the connection with his wild behavior until reading these postings. I feel so guilty for thinking he was a bad child when he couldn't control it. We are stopping the Zyrtec and are going to try Allegra. I can't believe none of his doctors ever made the connection!||M||3||1.5 years ||12/2/2009||3||Allergies/Asthma||Cant stay awake more than 3 hours at a time. No matter what I'm doing, watching tv, driving, typing, working, I just cant stay awake. I'm constantly in a fog.||Works great on my allergies though! lol||M||43||2 months ||12/1/2009||2||Nasal Allergies & Sinus Issues||fatigue, sluggishness, systemic body aches, depression, irritable, difficulty concentrating||I was started on Zyrtec some 3 yrs ago to help alleviate constant Sinus pressure and headaches do to allergies. The side effects were noticeable after about 3 months. Fatigue & irritability are the worst. I didn't mind to much at the time as I recognized it and living alone I was able to manage it. Now I have been trying to get off the drug for the last year and seems like every time I quit I go through a stage of feeling fine then I become extremely irritable and just bite every ones head off for the smallest of things.||M||40||3 years ||11/30/2009||3||uticaria / severe itching||severe fatigue, sluggishness, systemic body aches, depression, irritable, loss of interest, anxiety, weight gain, social withdrawl, difficulty concentrating||This drug had worked extremely well to treat my chronic uticaria (dermographism) and on most days completely eradicates the severe itching. However, the side effects that I experienced to this drug are simply not worth taking it. The most significant of these side effects would be fatigue. Since I've been taking cetirizine hcl (zyrtec generic), I have been able to sleep for hours and always wake up more tired than before. Throughout the day I constantly feel weak, unmotivated, and emotionally distraught causing me to have difficulty concentrating and doing well in school. I'm going to try switching to another antihistamine because I want to be able to enjoy life again. I recommend this drug for uticaria for people who don't care about the down side effects.||M||19||5 months ||11/28/2009 ||2||asthma/allergies||Moody, cranky, emotional highs and lows, sleeplessness, aggression||8 months ago the doctor prescribed 1tsp a day for my 4 year old who has asthma that is triggered by common allergies. It wasn't until he transitioned from childcare to school that a red flag was raised concerning his moodiness, behavior issues, sleeplessness, etc. I thought it was a phase, but he really wasn't himself. I spoke to his teachers, counselors, the doctor and everyone said he was just having transition issues. I didn't buy it and at my mother's suggestion, started to research all of the medications he was taking for the asthma. Low and behold, Zyrtec has all of these crazy side effects. Who knew?! Why would you prescribe that for a child?! I took him off of it 2 weeks ago and he's done a 180. He's a happy go lucky kid who's back to being himself.||M||4||8 months ||11/18/2009||1||seasonal allergies||moodiness, unstable balance||my 3 yr old took zyrtec in the spring for allergies and didn't have a problem. now that fall is here he has been very moody and losing his balance easily. he fell off a chair by not doing anything and got a concussion. very scary! read about other children who had similar issues with this.||F||28||1 months ||11/18/2009||1||allergic asthma/hives||My poor baby was on zyrtec AND pulmicort (inhaled steroid) for about 3 years (from 2 1/2 until age 6) and we had such worries about his behavior. He had been a happy, easy baby and, after starting preschool (and having his first allergic/asthmatic problem, resulting in us starting these meds), he CHANGED. We never associated the meds with the problem...went to child therapist even....and we noticed some improvement in behavior as he grew (and we understand now, as his body got bigger and the dosage stayed the same...making the side effects a bit less potent). Finally, the Dr. suggested taking a "summer off" the meds to see what would happen (medically not behaviorally) since he had not had any asthma issues in a while. So, the summer when he was six, we weaned him off. We didn't make the connection yet but, he gradually became such a delight....we attributed it to maturity..and he started first grade like a new boy! THEN, he got a cold and had some mild asthmatic compl||I cried when I put all the pieces together...and had a talk with the Dr. who denied that what I was describing was possible. We consulted with antoher DR. (our pediatrician) who supported our decision to keep him OFF the zyrtec completely (we use low dose of benadryl for the hives...hassle to dose every 4 to 6 hours but, he does not react to 1 t. and it does the job!) and the inhaled steroid only when he is sick (and we know to expect some behavior changes).||M||6||3 years ||11/18/2009 ||1||Asthma and Allergies||I've been taking this for 5 years. At first I thought it was amazing, my asthma didn't bother me anymore, and neither did my allergies. Last year, I've been experiencing drowsiness constantly, ticks (turrets), never clearly awake, head in a fog, couldn't focus, depression, either really happy good behavior, or really low depressed behavior.||Nothing good about this drug overtime you get more and more depressed and moody.||F||16||5 years ||11/18/2009||5||nasal allergies||I've taken Zyrtec for years with great results and have experienced no side effects.||Some of these postings are probably right for some people, but some of them are "out there".||F||52||3 years ||11/12/2009||1||allergies||My children took this. My son turns into another person..no reasoning, hyper, mean, whining, clingy, waking up at night...He took it from the day he turned 2 until around the middle of the summer. I was at my wits end..I stopped zyrtec...new person? My daughter becomes clingy, emotional, has anxiety, emotional mess...no more, no more. Nordic Naturals ProEFA fish oil (369)literally stopped his allergies/eczema in its tracks...maybe another option for some of you out there..Never again..A runny nose for a few days is a whole lot better than this. My children are 2 and 5.||F||5||6 months ||11/10/2009 ||1||Chronic allergies||It took me approximately 4 weeks to recognize that I was suffering from severe depression, anxiety attacks, and paronoia. A freind had recommended it as it is somewhat effective for allergy relief, but the side effects are terrible.||M||61||4 weeks ||11/7/2009||1||year-round allergies||Pounding heart, high blood pressure spikes, racing heart, extreme fatigue, chest pain||Helped allergies but side-effects sent me to ER thinking I was having a heart attack. Doctors said I had too much job stress. GP said I needed something for anxiety. My heart was pounding even when at rest. During the night I would wake up with a rapid fluttering. Thought I had heart trouble. I realized the problems started with the Zyrtec because I keep a blood pressure diary and it all coincides. Asked the pharmacist if Zyrtec could cause any of the symptoms I was having and had an AHA moment. All symptoms stopped after off of it for 4 days. When I get cold, I have an intense itch that I never had before. Hope that goes away. It is only where skin is exposed to cold - like face and hands. Will never use this drug again.||F||59||31 days ||11/7/2009||1||HIVES/ALLERGIES||My son has been taking this for 2 yrs. and yesterday I decided to research the side effects and I came to this website and I was reading all the different reports I was frozen like a turkey. My son is super hyperactive, has leg cramps, nervouseness, is getting white stops in his face many symptoms that other users said they had. Omg! I've gone to bed crying so many nights and wondering what I was doing wrong. Only a few people really now my son and understand me, now I wonder if it's the medicine, he was only 1yr when he started to take it and from dawn to dusk he is a wild child :( My husband & I decided to stop giving him Zyrtex and it's been 1 day so far and hope and pray that it was that but at the same time I hope that the medicine did not do more harm. Now I'm just watching him closely for any changes. I will post at a later time the outcome. I just pray it's for the best and that my little guy gets better and undercontrol. I love Him so much :)||I give it a 5 because since he's been taking it, the Hives have not come back. But I give it a 1 if it's the cause for his abnormal behavior that we had to live with for 2 yrs.||M||3||2 years ||11/6/2009 ||3||Allergies||Drowsiness, slight confusion.||My only real complaint was that it didn't work as well as other allergy medications, but the side effects weren't so bad when compared to other medications.||F||21||4 months ||11/3/2009||1||For children||Well, I am taking it and I am wide awake- so I was looking up to see if it effect others in that matter- When my son was younger 5-6, he could not take zyrtec or clartin. He was mean on both- even his teachers asked what had I put him on. He can take d-allergy or allegra and he doesn't have the side effects. He also has asthma...I guess I need to take in the am....considering I have to be at work in 6.5 hours and I'm WIDE AWAKE!!!||F||32|| ||11/3/2009||1||coughing, allergies||My 3 yr. old son was taking this medicine, prescribed by our Dr., for 5 days. Since he started taking this he has had major breakdowns over the littlest things. I associated this with his age, but wondered why it just happened over night. I was telling a friend of mine about how he had became very angry, was back talking, hateful, and very emotional. He would have temper tantrums like I have never seen him have before, even in public...which never happened. She was telling me about how her Dr. wanted her son to take this too, and so she researched it. She found that many moms were complaining of these same symptoms so she chose not to use it. I decided not to give it to him this morning and I can not believe the difference it has made. We were blessed that he hadn't been on it long so hopefully he will just continue to quickly improve.||F||31||5 days ||11/2/2009||1||allergies/sinus||extreme sluggishness, some tightness in my chest||I felt very clear and lucid at first...then it hit. 15 later and I still can't get it together. This medicine is horrible. Not taking anymore. So gald I found this. Other people were telling me to just hang in there and take it a few more times.||F||44||1 days ||11/2/2009||5||Allergies -Cough, Asthma||Only take in the evening because of drowsiness. Some dry mouth also.||I have been on various medications to find something to stop my allergic post nasal drip which produced a constant dry cough and asthma for the past two years. I tried Nasacort, Depomedrol shots, Claritin, Advair, and numerous other medications which either did nothing or had horrible side effects. Zyrtec finally has me functioning normally again! I have had to figure out the right dosage and that was 5mg every other day. I take it in the evening since it does make me very drowsy but I am fine in the morning. Zyrtec is great.||F||47||1 months ||10/30/2009||5||itchy skin and allergies||No side effects. This drug is a wonder for me.||I love this drug. Nothing else worked for me. My itchy skin depends on it. I have to take it everyday or I am miserable. I have no side effects and am thankful since I see so many negative responses. I'm not anti-social, not depressed, not irritable, no panic attacks, no bad dreams,etc. Looks like I"ll be taking this drug for as long as it helps me. 10 years and couting. I'm very glad it's OTC now.||F||29||10 days ||10/28/2009||2||severe itching||I've had horrible nightmares and freaky dreams, hallucinations, and severe drowsiness. I first time I took it, I took it right before bed and got to sleep about an hour later. I kept waking about every hour from these weird dreams that scared the crap out of me. I keep hearing noises in my room, I feel slightly dillusional and I can't keep myself awake. I would only recomend this if it's a last resort (which is the reason why I'm taking it) because you'd probably be better off without it!||F||19||4 days ||10/27/2009|


New Circus Dance Program
On Stage Performance is so excited to bring circus training to you! Your dancer can learn from our trained professional intructors on how to safely learn Lyra, German Wheel, Ribbons and Acrobatics. This program is skill based and will not be part of our spring recital. Students will perform a parent deminstration in December and April. Classes will be held in 4 week sessions. You will have the opportunity to take up to 8 sessions this dance season.


text:
Home | Hot spots | Gambia hotel and Lodges | Georgetown baobolong camp
Georgetown baobolong camp (Inland spot)
Georgetown is an island town located on the river Gambia some 325km further into the real and unspoiled countryside of the Gambia. Few tourist camps are dotted on the island and certainly, one of the best known is the Baobolong camp on the centre of the Town. The camp offer clean and comfortable accommodation yet basic with friendly and attentive staff hence makes an excellent base for the exploration of key birding and wildlife sites of this part of the inland that lies within easy reach. The freshwater section of the calm and navigable River Gambia are fringed by lush riparian forest that comes in good diversity of both birds and mammals including Hippos, Chimpanzees, Monkeys, Crocodile, and plenty of Birdlife.

domain: geography


+ Added default mimikatz command to module description
+ Initial v3.0 commit to master, Quick re-cap on the new features:
* Credentials and hosts are now stored in a database, the cme_db.py script can be used to query it
* Module system has been implemented allowing anyone to create payloads
* All underlying powershell code has been ported to a module
* The HTTP/HTTPS server now tracks connections: no more guessing when to CTRL-C
* All around better code quality, error handling and logging
CrackMapExec is your one-stop-shop for pentesting Windows/Active Directory environments!
From enumerating logged on users and spidering SMB shares to executing psexec style attacks, auto-injecting Mimikatz/Shellcode/DLL’s into memory using Powershell, dumping the NTDS.dit and more!
The biggest improvements over the above tools are:
– Pure Python script, no external tools required
– Fully concurrent threading
– Uses ONLY native WinAPI calls for discovering sessions, users, dumping SAM hashes etc…
– Opsec safe (no binaries are uploaded to dump clear-text credentials, inject shellcode etc…)
Intallation on Kali Linux, Ubuntu and all Linux Platform:
git clone https://github.com/byt3bl33d3r/CrackMapExec
pip install --upgrade -r requirements.txt
git pull origin master
git submodule init && git submodule update --recursive
Kali 2.0 Installation problem with v5/drsuapi.py not found?
– Just clone repo/copy from ttps://github.com/CoreSecurity/impacket/blob/master/impacket/dcerpc/v5/ into your folder/usr/lib/python27/…./impacket/dcerpc/v5/


text:
After the very tragic events of Sandy Hook, CT in 2012 and the Boston Marathon bombings in 2013, Open Circle Staff created the following guide and suggestions to assist teachers to help their students deal with traumatic events. Some of this document relates to classroom activities, but the thoughts and suggestions will be helpful to all parents and teachers.
During times of trauma, children may need reassurance that their classroom and school are safe places for them. It is important to recognize the needs of individual children who might have a harder time coping with traumatic events than others. Often children who are prone to anxious feelings or those with their own trauma history can be triggered by another traumatic event, even if it did not directly happen to them. In addition to the positive, supportive classroom climate and the social and emotional learning tools that Open Circle provides, some students may need additional time with a school psychologist or guidance counselor to help them manage their fears.
It is also critical that adults get the support they need to help students with their questions and feelings about this tragic event. Modeling how to stay calm and knowing when to ask for help yourself will help reassure students of their safety and remind them that the adults in school will be there to take care of them.
During difficult times, safety, consistency and predictability are critical to helping children maintain a sense of stability and psychological comfort. Open Circle provides a classroom routine and climate that is safe, consistent and predictable. Continuing to do Open Circle, as usual, is very important. Revisiting and applying the following skills and concepts may be one way to help students and adults as they deal with traumatic events.
Being able to apply calming-down techniques is helpful for both children and adults. It is normal and understandable for adults to feel anxious when upsetting things happen, and yet children take their emotional cues from adults. When adults model ways to calm down, they are reinforcing a critical self-regulation skill. The physiological benefits of calming down are also useful as we try to take care of ourselves during stressful times. Knowing how to calm down contributes to a child’s courage and resiliency. Children are empowered to take charge of their own bodies and emotional reactions. They can use this strategy in and out of the classroom, whenever they feel worried or upset.
In Open Circle, children learn that people have all kinds of feelings – some feelings may be comfortable or uncomfortable, but all feelings are OK. We are encouraging children to share their feelings and expand the range of feeling words that children can identify. Our emotions give us information about our internal state, and they can pass with time. Children can learn to identify many feelings to best communicate their emotional state, and they can also learn that even uncomfortable feelings don’t last forever. We do not need to bring up the tragic event directly to encourage use of feeling words. For example, we can ask, “When you wake in the middle of the night and hear loud thunder, how might you feel? Are there other examples of times when you felt that way?”
Feeling words allow us to let people know in words rather than in actions how we feel and therefore keeps them from misinterpreting, let’s them know what’s wrong, and helps them to pay attention to our experience. Sharing children’s books such as The Way I Feel, by Janan Cain, or Lots of Feelings, by Shelley Rotner, might be one way to help young children expand their feelings vocabulary beyond “sad” and “mad,” so that they can communicate with more accuracy. Some children will have difficulty expressing feelings and say that they are feeling “nothing.” This is at times a self-protective strategy when feelings are experienced as too overwhelming. (At other times, children are simply unaware of their feelings at given moments). We cannot push children to talk about feelings if they do not want to, but rather we can teach the necessary skills and create a safe and caring environment so that when they are ready, they can participate.
Even if children can identify feelings and find feeling words, they are not always comfortable with speaking up and therefore they may not share the feelings they are experiencing. The Open Circle lessons on Speaking Up focus on the importance of speaking up on behalf of oneself and others.
Dealing with Double D Behavior and Telling a Responsible Adult
In Open Circle children are learning to identify at least one adult with whom they can speak if they feel anxious or scared. This lesson also reminds children that when they tell a responsible adult about dangerous or destructive behavior they are keeping themselves and others safe.
In times of crisis and stress, children need the support of adults who will really listen to them. In the Open Circle lesson on listening skills, children learn to identify what listening well looks and sounds like and which people are capable of listening to them when they need to be heard.
Some classes might want to find ways to help victims of a tragedy. The process of giving to others is often empowering, as well as helpful. The problem-solving process can guide students as they choose an appropriate way of helping. If your class uses a problem box, keep this box available and remind students that it is anonymous. If you are not comfortable dealing with what a child writes for the problem box, consult with school counselors, administrators and parents.
The National Association of School Psychologists and the U.S. Substance Abuse and Mental Health Services Administration have excellent resources available in multiple languages for helping children, parents and teachers cope with violence, crisis and traumatic events.

domain: sociology