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Foreign Posturing
An essay
Paul Heinbecker
In the current election campaign, the Conservative spin machine is marketing a story of international statesmanship and principled policy, of economic action plans and historic trade agreements, of a rediscovered warrior spirit and newfound hard-nosed diplomacy. Before electoral spin renders campaign hype into enduring "fact," it is worth examining the broad lines of the Harper government's international performance.
To put the claims made for Stephen Harper's foreign policy into context, it is helpful to compare his government's record with that of previous Canadian governments and especially, in the interests of diminishing any partisan biases, with the (Progressive) Conservative government of Brian Mulroney. Mulroney and Harper both came to office after long years of Liberal government and both have served just under a decade in office. Some of the issues are different, of course, and times have changed, but not so much as to invalidate all comparisons.
International Experience Matters
Image by Raz Latif
Conservative attack ads have been reminding Canadians ad nauseam that the office of prime minister is not an entry level job, which is presumably unintentionally ironic because Harper came to office with scant international experience. According to biographer John Ibbitson, Harper "hates travel, just detests it and really didn't do any of it before he became prime minister." There was, in fact, little in Harper's past to suggest a curiosity about international affairs or an aptitude for diplomacy. What is past is prologue, and Harper's performance has contributed to Canada's international isolation, which is now as deep as it has been in 75 years.
With the exception of David Emerson, who served briefly, Harper has appointed foreign ministers as bereft of international experience as he was. Furthermore, the Harper government made clear it neither valued the expertise of Canada's foreign service, aggregated across geography and time, nor trusted it. His government sold off irreplaceable diplomatic real estate abroad—important multipliers of diplomatic access and influence, that had been acquired over generations—and willfully diminished our diplomats' standing, both in the countries in which they served and at home.
Mulroney also came to office suspicious of what John Diefenbaker had referred to as "Pearsonalities." But after initially threatening public servants with "pink slips and running shoes," he used the foreign service extensively, appointing several of its officers to senior positions in his Prime Minister's Office. In an apparent rebuke of the Harper government, he recently remarked that "not tak[ing] full advantage of the brilliance and innovation of the Department of Foreign Affairs and International Trade" is a "mistake." Mulroney has also observed that Canadian foreign service officers "rank with the very best and are regarded with admiration and respect."
Personal Diplomacy
Regular contacts among leaders, especially face-to-face meetings, are essential because they force stock taking by officials and decision making by leaders. Such personal diplomacy matters because it is probably the surest way of getting the attention of foreign leaders, above all in Washington. Competition for the time of the U.S. president is especially intense, because leaders of 192 countries around the world want their issues on the president's desk, not on the desk of some deputy assistant secretary. For that to happen, a foreign leader needs a personal relationship with him (so far only "him").
In a 2012 Time interview, Obama listed the leaders of Germany, Singapore, India, Turkey and the UK as his close contacts. He did not mention Harper. Nor was Harper close to George W. Bush.
Mulroney understood instinctively the importance of personal diplomacy. Deprecated in Canada, he won the respect and friendship of many abroad. In 1991, the United Kingdom, United States, Russia and France urged him to stand for United Nations secretary general, an invitation he declined because of ongoing constitutional negotiations. South Africa gave him the highest award it bestows on its own citizens and foreign nationals for contributing to the advancement of democracy in South Africa. On the death of Ronald Reagan, Nancy Reagan asked him to eulogize her husband at the funeral. Mulroney was as outgoing as Harper is reserved, and was incomparably better connected.
In the decade since Harper assumed office, there have been just three visits of American presidents to Canada. Bush came once for a NAFTA summit, and Obama came for a five-hour bilateral visit to Ottawa and to the G8 and G20 summits in Muskoka and Toronto. In contrast, Mulroney hosted eight visits by American presidents (Jean Chrétien hosted six). Mulroney also stayed in close touch with Margaret Thatcher, François Mitterrand and Helmut Kohl, and earned Kohl's gratitude for helping persuade the others to drop their opposition to German unification. He also maintained frequent contact with Commonwealth leaders, notably Rajiv Gandhi, Nelson Mandela and Bob Hawke, making full use of summits to advance issues, especially the fight against apartheid—which had no significant diaspora payoff in Canada. He used the personal relationships he developed at summits to good effect, for example, persuading Mitterrand to keep France on the sidelines during Canadian constitutional referendums.
In a 2012 Time interview, Obama listed the leaders of Germany, Singapore, India, Turkey and the UK as his close contacts. He did not mention Harper. Nor was Harper close to George W. Bush. When the latter was leaving office, according to Paul Wells in The Longer I'm Prime Minister, his spokesman said the president called 15 world leaders to say goodbye, including six of his seven G8 colleagues. He reportedly did not call Harper.
The imperatives of personal diplomacy extend to the U.S. Congress. Many of Harper's foreign contemporaries have found it essential to present their concerns to Congress, including the leaders of Israel (twice), the United Kingdom, Australia, Germany, France, Mexico, Korea (twice), Ukraine and Jordan. Mulroney addressed a joint session of Congress in June 1988. Harper has never spoken to Congress.
The Harper government got a hard lesson in the importance of personal diplomacy recently when it was revealed that American negotiators in Trans-Pacific Partnership negotiations had concluded a bilateral deal with Japan that would let Japanese automakers ship cars and auto parts into North America duty free using materiel from Japan's low-cost non-TPP partners, handicapping the crucial Canadian car and auto parts industries. Washington apparently did not give Ottawa advance warning, a breach of trust that would have been inconceivable in Mulroney's day.
Spin and Reality
Unlike preceding prime ministers, Harper did not conduct a foreign policy review when he came to office. Had he done so, he could have tested his ideological instincts against reality and saved Canada embarrassment. His acolytes argued at the time that real countries did not review foreign policy; they just did it, a claim belied by, for example, Washington's National Security Strategy review, which has been done at least once a presidential term. A cabinet of neophytes with a surplus of ideology needed to sort out what it thought, beyond just not doing whatever it was the Liberals had done.
Harper made ideological and idiosyncratic policy choices that put him at odds with nearly all his predecessors, and most contemporary allies, and that left Canada on the margins of global relevance.
Harper's PMO saw him as making a major break with past policy. That policy was said to have been too much about helpfully fixing others' problems and too little about advancing Canada's own hard interests and fundamental values. No more. Canada would look after itself first. Soft, co‑optive power was out; hard, coercive power was in. Canada would stand with democratic allies, and fight.
The corpses of strawmen litter this rhetorical PMO battlefield. In reality, the objective of Mulroney and his Liberal counterparts had never been merely to be nice but had always been to be effective. Mulroney believed that Canada's vast, difficult-to-defend territory, comparatively modest-sized population and dependence on international trade and investment meant that cooperation in creating and upholding international rules of the road, from the United Nations to the International Monetary Fund to the North Atlantic Treaty Organization, were in Canada's hard national interests. Nor had Canada ever been neutral, not in the First and Second World Wars, not in the Korean War and not in the Cold War either. The military has always had a significant place in Canadian foreign policy—but so has robust diplomacy, social justice and economic self-interest.
Initially, the Harper government hyped the military, downgraded diplomacy and flatlined development cooperation. It promised ambitious equipment acquisitions for all three branches of the forces, notably F-35 fighter aircraft. The Chrétien Decade of Darkness was over. But before you could say "false dawn," Ottawa was gearing back sharply on expensive and politically contentious equipment procurements that conflicted with the twin political imperatives of appearing competent in the management of Canadians' taxes and delivering a balanced budget for the 2015 election year. As a consequence, the percentage of gross domestic product spent on defence fell back to about one percent (the NATO target is two percent), the lowest level, according to military historian Jack Granatstein, since the 1930s. In the Arctic, the heart of our Canada First defence policy, the Russians are outbuilding us on icebreakers 14 to 1. Canada recently deployed 200 personnel there for an exercise. So did the Russians—only they deployed 38,000 personnel, 50 ships and submarines, and 110 aircraft.
With defence procurement consigned to the too-difficult-and-expensive file, the government's international focus shifted to trade, most notably the free trade agreement with Korea—Canada's first ever with an Asian country—and the much hyped Comprehensive Trade and Economic Agreement with the European Union. The Harper government has touted CETA as "the biggest deal Canada has ever made." In fact, as measured by the number of dollars in trade and investment an agreement covers, NAFTA dwarfs CETA. Nor is CETA in the bag yet. The EU must still decide whether each of its national parliaments must ratify the agreement. If so, the agreement will not come fully into effect for years to come. And even when it is concluded, about 80 percent of Canadian trade will still be with slow-growth countries.
Harper's record on social justice and development cooperation has also been chequered. On the plus side, his government has made defending religious minorities a central objective, has advocated staunchly for gay rights abroad, and has opposed child and forced marriage. At the G8 Muskoka Summit Harper announced a $2.85 billion contribution to UN efforts to promote maternal, newborn and child health. Subsequently he pledged an additional $3.5 billion. This program has attracted significant financial support from other governments, the private sector and foundations despite criticism, including by Hillary Clinton, for skirting the controversial issue of abortion, which is out of bounds for Canadian-origin funds. The maternal and child health program notwithstanding, overall spending on official development assistance declined under Harper to 0.24 percent of Canada's gross national income in 2014 from 0.29 percent when he came to office, for the first time since 1969 falling below the average of members of the Organisation for Economic Co-operation and Development. (During Mulroney's tenure, Canada's development assistance budget was nearly double, at 0.46 percent of GNI.)
Harper made ideological and idiosyncratic policy choices that put him at odds with nearly all his predecessors, and most contemporary allies, and that left Canada on the margins of global relevance. His government's deprecation of the UN, his snubbing of its General Debates, his disposition to sit in stern, often self-serving judgement of others won us few friends and, along with his irresponsibility on climate change, neglect of traditional development partners in Africa, and unquestioning support of the Netanyahu government in Israel and disregard for the Palestinians, lost us the first election to the Security Council after a string of six straight wins over six decades.
Relations with Washington
The primary foreign policy task of every Canadian prime minister is to maintain a productive relationship with the United States, which is easier said than done. Shortly after acceding to office in 2006, Harper declared Canada an energy superpower (a delusion because a real superpower can turn the tap off as well as on). In order to get that oil to market Harper made the Keystone XL pipeline our highest priority and predicted quick U.S. approval, what he infamously called a "no brainer." Ottawa proved incapable, however, of connecting the dots between its own intransigence on climate change and the reluctance of American environmentalists to permit the pumping of Canadian bitumen through their territory. Harper declined to undertake the politically costly work of reforming oil and gas regulation in Canada, or putting a price on carbon emissions. Rather than go to the Americans with clean hands, as Mulroney had done a generation earlier in his successful campaign to get the United States to reduce acid rain–causing emissions, Ottawa resorted to public relations campaigns to pressure the Obama administration. This tactic gave the president no grounds for overriding American anti-Keystone XL sentiment. We are still awaiting the Keystone decision.
The Harper government has had some successes with Washington, concluding an agreement in 2006 regulating Canadian exports of softwood lumber to the United States, collaborating with the U.S. in bailing out General Motors and Chrysler in 2009, easing trade-limiting regulations, strengthening North American perimeter security and persuading the Americans to let us pay for a second Windsor-Detroit bridge complete with the U.S. customs plaza on the American side. Beyond that, Harper has not taken bilateral trade relations much further than he found them on coming to office. His government's inability to negotiate an exemption for Canada from the Western Hemisphere Travel Initiative, which for security reasons requires most Canadians (and Americans) entering the United States from Canada to have a passport, has likely cost Canada billions of dollars. In contrast, Mulroney's government negotiated the Canada-U.S. Free Trade Agreement and the North American Free Trade Agreement, creating major opportunities for Canadian business. He also negotiated the Acid Rain Agreement, saving forests and livelihoods in Eastern Canada, and the Canada-USA Arctic Cooperation Agreement, protecting Canada's sovereignty interests on ship transit through the Northwest passage.
In dealing with Washington, Mulroney understood the virtuous circle that influence in Washington increases credibility abroad and credibility abroad increases influence in Washington. He was also conscious of the Pearson precept that Canada should "exhibit a sympathetic understanding of the heavy burden of responsibility borne by the United States." That sensitivity, which did not prevent Mulroney from declining participation in Reagan's Star Wars program, did allow him to influence the George H.W. Bush administration on key foreign policy issues ranging from the 1991 Iraq war to relations with Mikhail Gorbachev and Boris Yeltsin, all of which reinforced Mulroney's international standing.
The Harper government has offered modest support to American efforts to combat terrorism and fight ISIL, and participated in the UN-sanctioned campaigns in Afghanistan and Libya alongside Americans. But the Harper government has also frequently put itself at cross purposes with Washington. At the G20 summit in Toronto, Harper pressed Obama on fiscal austerity policies before the latter felt the reviving U.S. economy warranted tightening up. Harper also managed to get cross-wired with Obama and others at the G8 summit in Deauville, France, where he alone blocked a presidential initiative to have world leaders confirm the pre-1967 borders of the West Bank as the starting point for two-state solution negotiations. Furthermore, the Harper government has voiced skepticism about the Iran nuclear deal, which plays into Israel's unprecedented, and unsuccessful, interference in American politics. And despite crucial TPP negotiations with the United States, Harper declined Obama's invitation to send a minister to the conference on climate change and the Arctic that Obama personally convened, a snub U.S. Secretary John Kerry publicly criticized.
In 2009, in response to the growth in false refugee claims from Mexico, the Harper government imposed a visa requirement on all Mexicans, with no forewarning to Mexican travellers and no more than a heads-up to the Mexican government, alienating our third biggest trading partner. No adequate provision had been made for Canada's embassies and consulates abroad actually to issue 260,000 individual visas a year.
The consequences of the visa decision have been as harmful to Canada as they have been irritating to Mexico. Virtually overnight, more than 100,000 officials, students, tourists, businesspeople and prospective investors cancelled their travel plans to Canada. In 2008, 257,000 Mexican tourists had spent $364 million in Canada. By 2010, only 116,000 Mexican travellers came to Canada and spent $158 million. Travel from Mexico to Canada has not fully recovered yet and the cumulative cost to the Canadian travel industry exceeds a half a billion dollars. The Canadian Council of Chief Executives reported that "Canada's imposition of a 'temporary' visa … is perceived as an insult to Mexican leaders and has chilled relations with Canada." Mexican president Enrique Peña Nieto himself cancelled a planned visit to Ottawa when Harper reneged on a promise to resolve the visa issue whose roots he himself had said were in Canada's refugee claims system. There has lately been progress in creating workarounds, but the visa bungle remains a major irritant.
The Harper government has evinced little interest in NAFTA and even postponed this year's Three Amigos summit meeting in Canada, the better, presumably, to conceal the major fissures that exist in an election year between Harper and his North American partners.
Electoral considerations and pro-Taiwan sympathies were apparent at the outset of Harper's time in office and have appeared to recur, colouring and delaying decision making. The Harper government was slow to capitalize on the opportunity to develop a "strategic partnership" with China that had been created by Prime Minister Paul Martin and Premier Wen Jiabao. At the urging of the Canadian business community and China watchers, the Harper government came eventually to accept that the sheer size of the Chinese economy and its unparalleled growth rate were crucial to Canadian prosperity, and that doing business with China did not require cutting off Taiwan or condoning Chinese human rights abuses, its aggressive behaviour in the South China Sea or cyber hacking. Agreements were concluded covering, inter alia, tourism, the takeover of Nexen by the Chinese state-owned oil company CNOOC, nuclear cooperation, a banking centre in Canada to clear commercial contracts in Chinese currency, and a foreign investment promotion and protection agreement. Ottawa then inexplicably let the FIPA languish two and a half years before ratifying it. Several times the Chinese signalled a willingness to negotiate a free trade agreement with Canada, overtures that Ottawa ignored, inadvertently leaving the field to Australia, which gained "first mover" advantage. Meanwhile, the Harper government occupied itself with Europe and Korea. In former ambassador David Mulroney's words, "no one seemed to notice that there was a China-sized hole in our trade policy."
The most controversial break with previous Canadian governments has been in the Middle East, where for obscure reasons of political philosophy, neo-con ideology, religious conviction and electoral opportunism the Harper government aligned Canada with the Israeli Likud party. On Israel's 60th anniversary, Harper said that "Canada stands side by side with the State of Israel, our friend and ally in the democratic family of nations." Previous governments' policy had been "based on the recognition of Israel behind secure borders, together with a just solution for the Palestinians," as Mulroney had told visiting Israeli prime minister Shimon Perez in 1986. In embracing Israel, Harper also rejected the Palestinians. Ottawa cut funding to UNRWA, the UN organization mandated to fund Palestinian health care, education and food programs. It also cut off Kairos, a Canadian ecumenical charitable group, and others. In the Gaza wars, Harper refrained from criticizing Israeli military tactics even when an independent UN commission and respected non-governmental organizations including Amnesty International, Human Rights Watch and Israel's B'Tselem documented possible Israeli (and Palestinian) violations of international law. While the Harper government rightly criticized Palestinians for using indiscriminate and inaccurate rockets, it was less vocal about Israel's using "area weapons"—heavy artillery, mortars and high explosive bombs in one of the most densely populated places on Earth, where extensive casualties among penned-in civilians were entirely to be expected. The Harper government actively campaigned against recognition of Palestine as a non-member observer state and against Palestinian accession to the International Criminal Court. Furthermore, while lecturing others at the UN on the superiority of Canadian principles, the Harper government quietly sold weapons to serial human rights abuser Saudi Arabia and soft-pedalled criticism of Arab dictatorships notably Bahrain and Egypt. In the face of the greatest humanitarian crisis since World War Two, the Harper government initially resorted to "truthiness" in trying to show compassion toward Syrian refugees. In fact, we rank 33rd in the world in the number of refugees per capita.
In responding to Russian aggression in Ukraine, the Harper government and its acolytes rode metaphorically into the Valley of Death. The claims to leadership by Canada, the NATO member the furthest away from Ukraine, with the largest number of Ukrainian diaspora voters and the smallest economic stake in Russia, and only modest military capability, went unnoticed by allies. The only way Canada was leading was in bluster. In Washington Canada's tough talk was seen as political grandstanding by a military lightweight.
Bolstering Ukraine is one thing; bombast is another. There is no prospect that any western government, including the Canadian government, will risk a third world war to defend Ukraine from Russia. Nevertheless, Harper proclaimed, "Whatever difficulties may lie ahead, whatever actions are taken by those who threaten Ukraine's freedom, Ukraine will never be alone, because Ukraine can count on Canada." To do what, exactly?
Foreign Policy Outside In
As a consequence of inexperience or opportunism or both, the Harper government has turned foreign policy outside in. Rather than seeing it as the projection abroad of Canadian national purposes distilled from Canadian values and interests, it has treated foreign affairs often as a means to cultivate diaspora communities and constituencies at home. All democratic governments need to maintain the support of their populations to govern. But in its framing of international issues politically, the Harper government has taken pandering far beyond what any of its predecessors have done.
The Harper government has talked a lot and accomplished a little. Stagecraft has trumped statecraft. Relations with Washington rival the dysfunctional Trudeau-Nixon days. With Beijing, our second most important and fastest growing economic partner, the Harper government has been pursuing an on-again, off-again light-switch diplomacy. Its interest in Asia has generally been more transactional than strategic, and we have been excluded from the East Asia Summit. Harper has needlessly, deeply alienated Mexico, our third-largest trading partner. It has subcontracted our Middle East policy out to Israel's Likud. Its vaunted Arctic defence priority is window dressing. Harper and Baird's posturing on Ukraine is not impressing anyone, certainly not the Russians. Of the major trade deals the Harper government has negotiated, only the one with Korea is in the bag, albeit several years late. The Comprehensive Economic and Trade Agreement with Europe is awaiting ratification by EU member states—not a sure thing—and the TPP is held up on two issues vital to Canada—the auto industry and the dairy industry. Stephen Harper's (and John Baird's) lecturing at the UN have made us the world's scold, and lost us a Security Council election. Foreign posture has replaced foreign policy. Oh Canada.
Paul Heinbecker is Director of the Foreign Policy and Communications Program at the Centre for International Governance Innovation and Director of the Centre for Global Relations, Governance and Policy at Wilfrid Laurier University. He served as ambassador to the United Nations from 2000 to 2003. The views expressed here do not necessarily reflect those of the institutions mentioned.
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A review of Brave New Canada: Meeting the Challenge of a Changing World, by Derek H. Burney and Fen Osler Hampson, and Joining Empire: The Political Economy of the New Canadian Foreign Policy, by Jerome Klassen
Madelaine Drohan
The Half-Life of Politicians
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Tom Flanagan


We were extremely honoured to welcome Professor Larry Temkin (Rutgers University) to Oxford to deliver the 2017 Annual Uehiro Lectures on 6, 8 and 10 November. The engaging lectures were fully booked well in advance, and were each followed by a lively discussion.
The world is filled with people who are badly off. Each day, many die from hunger or disease, much of which seems easily preventable. Yet the world is also filled with many who are well off, some extraordinarily so. This vast inequality, between the world's well off and the world's worst off, gives rise to an age-old question. What, if anything, ought those who are well off to do on behalf of those who are badly off? In these Uehiro Lectures, I aim to explore the nature and basis of our obligations, if any, to the needy, and some problems that may arise when the better-off attempt to ameliorate the plight of the worse-off. In doing this, I will explore a wide-range of empirical and philosophical issues.
In this first Lecture, I introduce a version of Effective Altruism, which holds, roughly, that insofar as the well-off give to charity, they should identify and contribute to the most effective international relief and development organizations. I then present an alternative, pluralistic approach, arguing that in addition to the sort of consequentialist-based reasons for aiding the needy favored by Effective Altruism, there are virtue-based and deontological-based reasons for doing so. I then present Peter Singer's famous Pond Example, which has had a profound effect on many people's thinking about the needy. I note that Singer's example is compatible with both Effective Altruism and my pluralistic approach. I then offer variations of the Pond Example, together with other considerations, in support of my approach. My discussion shows that despite its far-reaching impact, Singer's Pond Example doesn't actually take us very far in answering the question of what we should do, all things considered, to aid the world's needy. Unfortunately, my discussion isn't much better in that regard, except that it reveals that there are a wide-range of morally relevant factors that have a bearing on the issue, and that we must be fully responsive to all of them in considering what we ought to do in aiding the needy. The "act so as to do the most good" approach of Effective Altruism reflects one very important factor that needs to be considered, but it is not, I argue, the only one.
Peter Singer famously argued that just as we have compelling moral reason to save a drowning child, so we have compelling moral reason to aid the world's needy. In this Lecture, I raise a number of worries about the relevance of Singer's Pond Example to whether we should be donating money to international aid organizations.
I consider a number of possible disanalogies between saving a drowning child and giving to an international relief organization. These include whether those needing help are members of one's own community, whether they are near or far, whether one's aid requires the assistance of many intervening agents, whether one is actually saving lives, whether corruption is a worry, whether those needing assistance are innocent and/or not responsible for their plight, whether the needy are victims of an accident or social injustice, and whether anyone stands to benefit from one's intervention other than the needy themselves. I show that some of these disanalogies may have important normative significance, making the case for contributing to international aid agencies much less clear than the case for saving the drowning child in Singer's famous example.
In addressing these topics, I argue that we must be attuned to the many direct and indirect ways in which international aid efforts may inadvertently benefit the perpetrators of grave social injustices, incentivizing such injustices. Similarly, we must be aware of the possibility that our aid efforts may end up rewarding corrupt leaders whose policies have contributed to hybrid natural/man-made disasters, thus encouraging such disastrous policies. Furthermore, I note that aid organizations have every incentive to emphasize the good that they accomplish, and to not look for, ignore, or even cover up any bad effects that may result from their interventions, and that independent agencies assessing aid effectiveness may lack the means of accurately determining all the negative effects to which international aid efforts may give rise. Thus, however compelling it may be, Singer's Pond Example depicts a simple situation that is a far cry from the complex reality with which international development agencies have to contend. Accordingly, much more needs to be considered before one can pass judgment on the overall merits of funding international aid organizations.
In this third Uehiro Lecture, I consider a number of worries about the possible impact of global efforts to aid the needy. Among the worries I address are possible unintended negative consequences that may occur elsewhere in a society when aid agencies hire highly qualified local people to promote their agendas; the possibility that highly successful local projects may not always be replicable on a much larger regional or national scale; the possibility that foreign interests and priorities may have undue influence on a country's direction and priorities, negatively impacting local authority and autonomy; and the related problem of outside interventions undermining the responsiveness of local and national governments to their citizens.
I also discuss a position that I call the Capped Model of Moral Ideals, which may have a bearing on the intuitively plausible approach of always prioritizing the greatest need when making one's charitable contributions. Another issue I discuss is the possibility that efforts to aid the needy may involve an Each/We Dilemma, in which case conflicts may arise between what is individuallyrational or moral, and what is collectively rational or moral. Unfortunately, it is possible that if each of us does what we have most reason to do, morally, in aiding the needy, we together will bring about an outcome which is worse, morally, in terms of its overall impact on the global needy.
The lecture ends by taking stock of the main claims and arguments of all three Uehiro Lectures, and considering their overall implications for our thinking about the needy. I consider the implications of my discussion for Peter Singer's view, and the implications of my view for the approach and recommendations of Effective Altruism. I also consider where my discussion leaves us given my pluralistic approach to thinking about the needy. I have no doubt that those who are well off are open to serious moral criticism if they ignore the plight of the needy. Unfortunately, however, for a host of both empirical and philosophical reasons, what one should do in light of that truth is much more complex, and murky, than most people have realized.
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redpajama_set_name: RedPajamaGithub


text:
Q: Iif statement and select subquery inside update query Access I am working on a database to help me keep track of employee leave and attendance records.  I created an Employees table, with the list of employees and the yearly leave balances that roll forward from the previous year.  I then made a Leave Records table that lists the leave accrued and used for each pay period.  I can use a formula to calculate the leave balance forward automatically once the leave balance forward for that pay period has been entered.  What I'm having trouble with is getting the database to automatically calculate the leave balance that rolls forward.  The balance will change for each pay period, however what the value needs to be is the leave balance total for the same employee in the previous pay period.
I have the following SQL in a select query and it works:
A/L Bal Fwd: IIf([Leave Records].[Pay Period]=1,[Employees].[Yearly A/L Bal Fwd],(SELECT [Leave Records].[A/L Balance to Date]
FROM [Leave Records] AS Dupe
WHERE Dupe.Employee = [Leave Records].Employee
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FROM Employees INNER JOIN [Leave Records] ON Employees.ID = [Leave Records].Employee;

The issue now is that any pay period beyond #1 it will not return a value unless data has been entered into the [Leave Records] table.  My goal is to find a way to have access automatically calculate the value in [Leave Records].[A/L Bal Fwd] to save time from having to calculate that same field every pay period for 56 employees.  I tried running an update query with the Iif statement above, but it only returned blank values.  I'm trying to avoid creating temporary tables and having too many queries to run to have it update each pay period as much as possible.  The fewer steps I have to take for these values to update and be correct each pay period, the better.

redpajama_set_name: RedPajamaStackExchange


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If your employer is not paying you in a timely manner, do not hesitate to contact us online or at (310) 556-9687 to see how we can help. The Hamideh Firm, P.C. pursues class action lawsuits against employers that do not pay their employees in a timely manner, both during employment, and after that employment has terminated.


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Best Restaurants in Bacalar, Mexico | 2023 Foodie Guide
2 January, 2023 by Hannah Lukaszewicz
Most people that visit Quintana Roo will visit places like Tulum and Cancún, and in recent years bigger cities like these have exploded with amazing restaurants and bars to cater to the tourist population. But there are so many other places just begging to be explored, and that offer all the same things you can find in the big tourist cities.
Bacalar is a city located along Laguna Bacalar in the interior of the province, with a mellow beach-town vibe. One of the first questions you might ask is where to eat, and don't worry, there are plenty of options! Whether you're looking for the best tacos the city has to offer or something plant-based and refreshing, you'll find what you're looking for. Check out this list of the best restaurants in Bacalar to satisfy any craving.
1. La Playita
In the heart of downtown Bacalar, right on the banks of the lagoon, is another must-try restaurant called La Playita. With the open-air gazebo in a jungle-like setting but just steps from the sandy beach, you can relax in one of their hammocks while you sip a cocktail and enjoy fresh seafood dishes (or vegan if that's your thing).
La Playita serves a little bit of everything, from juicy hamburgers to classic Mexican and Latin fusion. Think braised octopus, shrimp sandwiches, buffalo cauliflower, and fresh guacamole.
They also make fresh smoothies (try the mango one), or, if you're so inclined, they make house cocktails as well and the strawberry basil daiquiri is quite popular. If you've still got room after all this, make sure to try their chocolate lava cake, one of the most popular desserts on the menu.
Live music features every night, the perfect way to end the day!
Address: 1 765 Costera, C. 26 Esq
View Menu Here
2. Kai Pez
How does an ice-cold beer, a tray of fresh fish tacos, and a warm sea breeze sound…all in the same spot? Pretty good. We're sure you'd agree. That's exactly what Kai Pez has in store.
The food here is simple but flavorful, serving up classics like prawn tacos, grilled octopus, and salmon tartare. You can also get tostadas, empanadas, and ceviche. In fact, their aguachile is one of their most popular dishes. Don't miss out on their cocktail menu for the perfect fruity complement to the seafood dishes.
It's located right on the lagoon with unimpeded views of the crystal blue water. There's also a jetty that extends out to a small thatched gazebo on the water, perfect for dipping your toes or going for a swim. You can book a Bacalar lagoon boat tour right at the restaurant, where a guide will take you out on the water, explain the history of the region, and show you some of the nearby sights.
We had our waiter book our Bacalar boat tour last time, the price was reasonable, and it took the headache out of negotiating and finding a driver that spoke English and had a nice pontoon.
Address: Av 1 S/N, Centro
3. Mango y Chile
If you're looking for a restaurant that serves only plant-based dishes, you can stop searching because Mango y Chile is the gold standard in fresh vegan fare. It is hands down the best vegan restaurant in Bacalar. Even non-vegans love it.
The restaurant is just across the street from the beach, on an elevated patio with views of the blue lagoon through swaying palm trees. The vegan burgers are one of the most popular things to eat here and come with a side of extra-crispy fries. If you want something a little more fresh, they offer a medley of salads and tacos.
You also can't miss their fresh fruit smoothies, coffee frappes, and "milkshakes," which come in so many flavors it's hard to keep track. They also make their own vegan ice cream that you can get in cups with toppings, which will surely be a welcome treat on a hot day.
Address: Av.3 Fuerte San Felipe, entre calle 22 y calle 24, Centro
4. Nixtamal (Cocina a Fuego y Ceniza)
Nixtamal is a little more expensive than many restaurants in Bacalar, but the menu and ambiance make it worth the extra spend. Plus, you can't deny that there's something nice about an occasional splurge, and the menu makes this one of the best restaurants in Bacalar.
Nixtamal specializes in fresh seafood dishes with bold flavors that are expertly cooked. The first notable thing about this beautiful restaurant is the open-concept kitchen and grill, set in a jungle-like atmosphere. When it's all lit up at night with colored lanterns and torches, you'll really feel like you've stepped into another world.
Juicy grilled lobster tails and rib-eye steaks are some of their popular dishes, but the most talked about is their Salmon Xocolatl, a salmon dish made with white chocolate. And, of course, you can't miss their actual desserts, which use house-made chocolate, fresh fruit, and honey to make the most creative sweet treats.
Address: Av 5 Esquina, C. 12
5. Enamora
Small, laid-back, and relaxing: that's what you'll find at Enamora. They are a breakfast café, so this would make a great spot to start your day with a good meal. The spot is charming and rustic, with simple picnic tables under the shade of the trees.
Some of the dishes you can find here include shrimp omelets, goat cheese, prosciutto charcuterie boards, french toast, breakfast tortillas, and even cake. There's even a Swedish egg dish, courtesy of the Swedish owner's homeland. Their coffee is also extremely popular, with many calling it the best in town.
The location is quiet much of the time, but sometimes it's bustling with activity thanks to live music and even artisan markets, which take place right beside the seating area. Overall this is a great spot for breakfast that you shouldn't miss if you're staying in Bacalar.
Address: C. 18, Centro
6. Los de Atlixco
Los de Atlixco is the perfect spot for a relaxed lunchtime or dinner meal with a few friends. They are located in the center of Bacalar, just two blocks from the sandy banks of the Bacalar Lagoon.
The menu is a mix of American dishes, Mexican classics, and Latin fusion-style food. That means just one thing: nothing but the best flavors.
The burgers here are extremely popular, and the restaurant has 12 burger choices on its menu (three of which are vegan or vegetarian). Aside from the classic handhelds, the menu is full of typical Mexican foods like tacos, gringas, burritos, nachos, and more.
Most dishes have a meat or seafood base, and there are meat-free options for vegans or vegetarians. Overall, this is a great restaurant in Bacalar with a fun and mellow vibe and some seriously delicious food.
Address: Adolfo López Mateos 332, Centro
7. El Taco Loco
El Taco Loco was first founded in the nearby city of Chetumal over 30 years ago, where they were one of the first seafood restaurants.
They became so popular that they opened a second location in Bacalar. It's a bit off the beaten track in a quieter area just north of the center, but it's worth the trek. The place is lively without being rowdy, with lots of indoor and outdoor seating amidst lots of lush greenery.
El Taco Loco's service, meals, and ambiance make it one of the best restaurants in Bacalar. They have a very big menu with lots of different choices. Of course, they specialize in tacos with all kinds of unique toppings like octopus and fried snail. But they also do meat and seafood dishes like flank steak, creamy shrimp, and whole fried fish. You can also get the classic shrimp cocktail here, the perfect appetizer before your meal.
Address: C. 19 Libramiento 92, Luis Donaldo Colosio
8. Madre Masa
This is another great little spot in the center of Bacalar that would be perfect for a lighter snack or something in between meals to keep you going. Madre Masa is a bakery-café offering light meals like homemade sandwiches, gorditas, and pastries like croissants and cinnamon buns. Their bread loaves and baguettes are made fresh in-house.
Many of their savory bread and pastries are used for sandwiches, and there are even vegetarian and vegan options. Try the croissant with guacamole and tempura cauliflower or the pork chicharron on ciabatta.
And, of course, no visit is complete without trying some of their homemade black tea kombuchas. But if you don't like kombucha, they also make some delicious iced coffee drinks, like their cold mocha coffee, made with French chocolate.
Address: Av 1 Número 958-Local 2, Mario Villanueva Madrid
9. La Piña
La Piña is one of the best spots in Bacalar, where the setting is almost as good as the food! It's small, with only six tables, but that just gives it an intimate, cozy feel. Tables are set under thatched gazebos and surrounded by jungle and tropical plants, the perfect place to unwind.
The restaurant has a great variety of pizzas, which isn't usually what you'd expect from a restaurant in Mexico, but these are oven-fired and of top-notch quality. You can also get rolled pitas here, jumbo fresh fruit smoothies, and of course the classics like chicken quesadillas and fresh seafood tacos. Their corn tortillas are made-to-order, and you can't beat that kind of freshness.
Address: Av 3 206, Centro
10. Picaflor
A sunny deck shaded by palm trees, a comfy bar with cushioned seating, and some very tasty meals will start your day off right. Picaflor is a breakfast nook just one street away from the lagoon (with views), serving up breakfast and lunch.
There are lots of egg-based dishes here, like the mushroom omelet, egg chilaquiles, or avocado egg toast. They also use tons of fresh fruit, and their smoothies are the most refreshing thing on the menu, but we wouldn't say no to a freshly brewed espresso, their matcha lattes, or a glass of their homemade kombucha.
With so many options, there's something for everyone, and the light but fueling dishes are the best way to start a day of exploring Bacalar.
Address: Avenida Costera, entre calle 26, C. 28 y
11. Finisterre Bacalar
It seems impossible to get sick of Mexican food, but every now and then you might just want something a little different. You'll find it at Finisterre, a restaurant serving Greek and Italian-style cuisine like risotto, homemade pasta from scratch, and fresh seafood dishes using clams, mussels, and more.
But of course, Finisterre's claim to fame is having the best pizza in Bacalar. They do wood-fired pizzas in a huge range of toppings, from the classic 3-ingredient margarita pizza to more elaborate toppings like prosciutto and chorizo.
Pair your dish with one of their many signature cocktails, or ask to take a look at their wine menu for something more refined. There is often live music or singers, the perfect accompaniment to a rich Mediterranean meal.
Address: Av. 3 entre Calle 24 y Calle 26, Lote 16, Centro
12. Navieros Bacalar
Naverios is located just across the street from the lagoon, with views of the blue water. If you love shrimp, this is definitely the place to come since they are known for the quality of their shrimp dishes.
Try the shrimp burger, the coconut shrimp, or the shrimp ceviche. All of these are popular with restaurant visitors, and many have returned more than once to eat their favorites again.
If you want to try something besides shrimp, you still have options. They do tacos, steak filets, soups, salads, and more.
This is a small spot with a quiet atmosphere, which makes it great for a low-key afternoon meal to recharge your batteries before you get back to exploring Bacalar.
Address: calle 16 con, Costera
13. La Cabañita Grill & Cantina
When it comes to choices, La Cabañita is one of the best restaurants in Bacalar. You simply can't beat the variety on the menu and the quality of the dishes. They have recently celebrated 30 years in business, and they are a popular place for locals and tourists alike.
They do a breakfast menu, lunch menu, and an all-day menu. The classics are all there: tacos, empanadas, taquitos, nachos, enchiladas, and more. But they also do lighter meals like soups and salads, all with a Mexican twist. Try coming for breakfast to get their many huevos (egg) dishes. They also have a long drinks menu, with everything from juices to beers on tap and craft cocktails.
The good news for families is that there is a kid's menu with simple dishes, which is perfect for really young kids and picky eaters.
Address: 5 entre 26 y 28
Categories Mexico Tags bacalar, food, laguna bacalar, Mexico, restaurant guide Post navigation
Top 10 Best Breakfast in Lake Geneva – 2023 Foodie Guide
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redpajama_set_name: RedPajamaCommonCrawl


Jeffries Landing - under construction. 14 New, 3 storey homes w/double detached garages. 1/2 blk from new Elementary School. 9 ft. ceilings on main. Very open & spacious floor plans. Estimated finish date July 2007. Glenwood A Plan.
Please send me more information on 7007 201st Street Willoughby Heights, Langley Thank you.


Turkish authorities detained three Russian nationals suspected of links with Islamic State following a suicide bomb attack in Istanbul that killed 10 tourists, media reports said on Wednesday.
A suicide bomber thought to have crossed recently from Syria killed nine German and one Peruvian tourists on Tuesday in Istanbul's historic Sultanahmet Square, a major tourist draw, in an attack Turkey blamed on Islamic State. Fifteen people were also hurt in the attack.
Russia's Consulate General in the Mediterranean city of Antalya said three Russians had been detained over suspected connection to Islamic State, Russian state news agency RIA said.
Police also seized documents and CDs during a search of the premises where the suspects were staying, Turkey's Dogan News Agency said. It was not immediately clear when the detentions occurred.
There was no immediate claim of responsibility for the Istanbul blast but Islamist, leftist and Kurdish militants, who are battling Ankara in southeast Turkey, have all carried out attacks in the past.
Prime Minister Ahmet Davutoglu said he spoke with German Chancellor Angela Merkel to offer condolences and vowed Turkey's fight against Islamic State, at home and as part of the U.S.-led coalition, would continue.


text:
Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy
Brandon Wachal, Matthew Johnson, Alissa Burchell, Harlan Sayles, Katherine Rieke, Robert Lindau, William Lydiatt, Aru Panwar
Importance: Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomesmay help to set realistic expectations about recovery and outcomes and facilitate optimal resource management. Objective: To evaluate the association between the mFI score as a measure of frailty and outcomes following total laryngectomy. Design, Setting, and Participants: Retrospective evaluation using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a risk- and case-mix-adjusted national quality assessment program. The ACS NSQIP database identified 595 patients who underwent total laryngectomy between 2006 and 2012. Patients were assessed for demographics and comorbidity and were stratified on the basis of calculated mFI score. Outcomes, including postoperative complications, length of hospitalization, and discharge destination, were evaluated as a function of increasing frailty using multivariable logistic regression and Cox proportional hazards regression models. Main Outcomes and Measures: Risk of postoperative complications, length of hospitalization, and discharge disposition. Results: After exclusion of patients who experienced significant deviation from standard care protocols and those with missing or incomplete data, 343 individuals were included in the analysis. Of these, 278 (81.0%) were men, and the mean age was 63 years (95%CI, 61.9-64.4 years). Increasing frailty resulted in a nonlinear but progressive rise in incidence of postoperative adverse events. Overall, 96 (28.0%) patients experienced a postoperative complication, and patients with an mFI score of 3 or higher were more likely to develop postoperative complications than were patients with an mFI score of 0 (50.0%vs 16.7%; OR, 3.83; 95%CI, 1.72-8.51). Patients in the highest frailty group experienced a longer mean duration of hospitalization (14.2 vs 9.5 days; difference, 4.7; 95%CI, 1.3-8.1 days) and were more likely to require skilled care after discharge (33.3%vs 3.2%; difference, 30.1%; 95%CI, 7.4%-52.9%). Conclusions and Relevance: An mFI score of 3 or higher is associated with increased risk for postoperative complications, longer hospitalization, and need for postdischarge skilled care following total laryngectomy. The mFI provides a personalized risk assessment to better inform patients, physicians, and payers when planning a total laryngectomy.
JAMA Otolaryngology - Head and Neck Surgery
https://doi.org/10.1001/jamaoto.2017.0412
10.1001/jamaoto.2017.0412
Fingerprint Dive into the research topics of 'Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy'. Together they form a unique fingerprint.
Laryngectomy Medicine & Life Sciences
Frailty Medicine & Life Sciences
Postoperative Complications Medicine & Life Sciences
Quality Improvement Medicine & Life Sciences
Wachal, B., Johnson, M., Burchell, A., Sayles, H., Rieke, K., Lindau, R., Lydiatt, W., & Panwar, A. (2017). Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy. JAMA Otolaryngology - Head and Neck Surgery, 143(8), 818-823. https://doi.org/10.1001/jamaoto.2017.0412
Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy. / Wachal, Brandon; Johnson, Matthew; Burchell, Alissa; Sayles, Harlan; Rieke, Katherine; Lindau, Robert; Lydiatt, William; Panwar, Aru.
In: JAMA Otolaryngology - Head and Neck Surgery, Vol. 143, No. 8, 08.2017, p. 818-823.
Wachal, B, Johnson, M, Burchell, A, Sayles, H, Rieke, K, Lindau, R, Lydiatt, W & Panwar, A 2017, 'Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy', JAMA Otolaryngology - Head and Neck Surgery, vol. 143, no. 8, pp. 818-823. https://doi.org/10.1001/jamaoto.2017.0412
Wachal B, Johnson M, Burchell A, Sayles H, Rieke K, Lindau R et al. Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy. JAMA Otolaryngology - Head and Neck Surgery. 2017 Aug;143(8):818-823. https://doi.org/10.1001/jamaoto.2017.0412
Wachal, Brandon ; Johnson, Matthew ; Burchell, Alissa ; Sayles, Harlan ; Rieke, Katherine ; Lindau, Robert ; Lydiatt, William ; Panwar, Aru. / Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy. In: JAMA Otolaryngology - Head and Neck Surgery. 2017 ; Vol. 143, No. 8. pp. 818-823.
@article{896f05e891ea4c40aa55966e260d6495,
title = "Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy",
abstract = "Importance: Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomesmay help to set realistic expectations about recovery and outcomes and facilitate optimal resource management. Objective: To evaluate the association between the mFI score as a measure of frailty and outcomes following total laryngectomy. Design, Setting, and Participants: Retrospective evaluation using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a risk- and case-mix-adjusted national quality assessment program. The ACS NSQIP database identified 595 patients who underwent total laryngectomy between 2006 and 2012. Patients were assessed for demographics and comorbidity and were stratified on the basis of calculated mFI score. Outcomes, including postoperative complications, length of hospitalization, and discharge destination, were evaluated as a function of increasing frailty using multivariable logistic regression and Cox proportional hazards regression models. Main Outcomes and Measures: Risk of postoperative complications, length of hospitalization, and discharge disposition. Results: After exclusion of patients who experienced significant deviation from standard care protocols and those with missing or incomplete data, 343 individuals were included in the analysis. Of these, 278 (81.0%) were men, and the mean age was 63 years (95%CI, 61.9-64.4 years). Increasing frailty resulted in a nonlinear but progressive rise in incidence of postoperative adverse events. Overall, 96 (28.0%) patients experienced a postoperative complication, and patients with an mFI score of 3 or higher were more likely to develop postoperative complications than were patients with an mFI score of 0 (50.0%vs 16.7%; OR, 3.83; 95%CI, 1.72-8.51). Patients in the highest frailty group experienced a longer mean duration of hospitalization (14.2 vs 9.5 days; difference, 4.7; 95%CI, 1.3-8.1 days) and were more likely to require skilled care after discharge (33.3%vs 3.2%; difference, 30.1%; 95%CI, 7.4%-52.9%). Conclusions and Relevance: An mFI score of 3 or higher is associated with increased risk for postoperative complications, longer hospitalization, and need for postdischarge skilled care following total laryngectomy. The mFI provides a personalized risk assessment to better inform patients, physicians, and payers when planning a total laryngectomy.",
author = "Brandon Wachal and Matthew Johnson and Alissa Burchell and Harlan Sayles and Katherine Rieke and Robert Lindau and William Lydiatt and Aru Panwar",
doi = "10.1001/jamaoto.2017.0412",
T1 - Association of Modified Frailty Index score with perioperative risk for patients undergoing total laryngectomy
AU - Wachal, Brandon
AU - Johnson, Matthew
AU - Burchell, Alissa
AU - Sayles, Harlan
AU - Rieke, Katherine
AU - Lindau, Robert
AU - Lydiatt, William
AU - Panwar, Aru
N2 - Importance: Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomesmay help to set realistic expectations about recovery and outcomes and facilitate optimal resource management. Objective: To evaluate the association between the mFI score as a measure of frailty and outcomes following total laryngectomy. Design, Setting, and Participants: Retrospective evaluation using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a risk- and case-mix-adjusted national quality assessment program. The ACS NSQIP database identified 595 patients who underwent total laryngectomy between 2006 and 2012. Patients were assessed for demographics and comorbidity and were stratified on the basis of calculated mFI score. Outcomes, including postoperative complications, length of hospitalization, and discharge destination, were evaluated as a function of increasing frailty using multivariable logistic regression and Cox proportional hazards regression models. Main Outcomes and Measures: Risk of postoperative complications, length of hospitalization, and discharge disposition. Results: After exclusion of patients who experienced significant deviation from standard care protocols and those with missing or incomplete data, 343 individuals were included in the analysis. Of these, 278 (81.0%) were men, and the mean age was 63 years (95%CI, 61.9-64.4 years). Increasing frailty resulted in a nonlinear but progressive rise in incidence of postoperative adverse events. Overall, 96 (28.0%) patients experienced a postoperative complication, and patients with an mFI score of 3 or higher were more likely to develop postoperative complications than were patients with an mFI score of 0 (50.0%vs 16.7%; OR, 3.83; 95%CI, 1.72-8.51). Patients in the highest frailty group experienced a longer mean duration of hospitalization (14.2 vs 9.5 days; difference, 4.7; 95%CI, 1.3-8.1 days) and were more likely to require skilled care after discharge (33.3%vs 3.2%; difference, 30.1%; 95%CI, 7.4%-52.9%). Conclusions and Relevance: An mFI score of 3 or higher is associated with increased risk for postoperative complications, longer hospitalization, and need for postdischarge skilled care following total laryngectomy. The mFI provides a personalized risk assessment to better inform patients, physicians, and payers when planning a total laryngectomy.
AB - Importance: Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomesmay help to set realistic expectations about recovery and outcomes and facilitate optimal resource management. Objective: To evaluate the association between the mFI score as a measure of frailty and outcomes following total laryngectomy. Design, Setting, and Participants: Retrospective evaluation using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a risk- and case-mix-adjusted national quality assessment program. The ACS NSQIP database identified 595 patients who underwent total laryngectomy between 2006 and 2012. Patients were assessed for demographics and comorbidity and were stratified on the basis of calculated mFI score. Outcomes, including postoperative complications, length of hospitalization, and discharge destination, were evaluated as a function of increasing frailty using multivariable logistic regression and Cox proportional hazards regression models. Main Outcomes and Measures: Risk of postoperative complications, length of hospitalization, and discharge disposition. Results: After exclusion of patients who experienced significant deviation from standard care protocols and those with missing or incomplete data, 343 individuals were included in the analysis. Of these, 278 (81.0%) were men, and the mean age was 63 years (95%CI, 61.9-64.4 years). Increasing frailty resulted in a nonlinear but progressive rise in incidence of postoperative adverse events. Overall, 96 (28.0%) patients experienced a postoperative complication, and patients with an mFI score of 3 or higher were more likely to develop postoperative complications than were patients with an mFI score of 0 (50.0%vs 16.7%; OR, 3.83; 95%CI, 1.72-8.51). Patients in the highest frailty group experienced a longer mean duration of hospitalization (14.2 vs 9.5 days; difference, 4.7; 95%CI, 1.3-8.1 days) and were more likely to require skilled care after discharge (33.3%vs 3.2%; difference, 30.1%; 95%CI, 7.4%-52.9%). Conclusions and Relevance: An mFI score of 3 or higher is associated with increased risk for postoperative complications, longer hospitalization, and need for postdischarge skilled care following total laryngectomy. The mFI provides a personalized risk assessment to better inform patients, physicians, and payers when planning a total laryngectomy.
U2 - 10.1001/jamaoto.2017.0412
DO - 10.1001/jamaoto.2017.0412


After a long period with games away from the National Cycling Centre, the Super League will return after what seems like an eternity, with a classic encounter as Manchester will host Birmingham.
Over the years, these two sides have given us absolute thrillers and Sunday's match promises to be no different as fifth in the table will take on sixth, with only a three-point difference between the two teams.
Manchester will be hungry to turn around the woes of last weekend, after the disappointment of being knocked out of the FA Futsal Cup by Division One South side ProFutsal London. But will be looking to make it three wins in a row in the Super League with a win on Sunday.
Birmingham have been solid this season, but like Manchester, consistency has hampered their progress this season. After a lot of new additions, they still find themselves in a healthy position and have ambitions to finish high up the table.
Despite defeat away to Oxford City Lions in their last game, games against Manchester can always throw up surprises as previous years have suggested. Effectively, the form book will be thrown out the window for this one in what is an exciting prospect for both teams.
Head Coach Sergi Saldana spoke to Manchesterfutsal.com to give his thoughts on the game as he vows to continue to use development players to fill in for missing first-team players.
"We are still in the same dynamic mode compared to the last couple of months. We have players unavailable and again, I will be picking development players to complete the squad.
"This time we will have Ryan Williams, Scott Thompson, Kai Bone and Lewis Spencer-Ogg, apart from Raphe that is not a development player but very young as well.
"I want to only compete for the whole game and give a joy to those who will come to watch us. We are focused on our attack system because lately, we are playing without using our system very well and we hope that we will recover what we lost a few games ago.
Manchester will face Birmingham back at our home, the National Cycling Centre, this Sunday, with kick off at 2:30pm. Tickets can be purchased via the link here.


text:
Sevenoaks is een district in Engeland. Het ligt net ten westen van Londen in het shire-graafschap (non-metropolitan county OF county) Kent. Er liggen hoge heuvels.

Civil parishes in district Sevenoaks

Ash-cum-Ridley, Brasted, Chevening, Chiddingstone, Cowden, Crockenhill, Dunton Green, Edenbridge, Eynsford, Farningham, Fawkham, Halstead, Hartley, Hever, Hextable, Horton Kirby and South Darenth, Kemsing, Knockholt, Leigh, Otford, Penshurst, Riverhead, Seal, Sevenoaks, Sevenoaks Weald, Shoreham, Sundridge with Ide Hill, Swanley, West Kingsdown, Westerham.

Kent
District in Engeland

redpajama_set_name: RedPajamaWikipedia


Brazilian senescent population can grow three times the actual number in the next 20 years , being over 88 million people in 2035. This senescent growing number brings new challenges on quality of life for Brazilian society. How to promote digital inclusion to this profile of user is still a challenge in the literature. We believe that a social network focused on senescent users can enhance the digital inclusion for them. However, it's essential that the social network be designed for senescent users. This study aims to create a project with this characteristics. We analyzed a successful social network (WhatsApp) in order to propose a new one (Florch) for senescent users. We developed a high fidelity prototype of Florch and tested it. Our findings show usability and accessibility problems faced on the project's development. In addition, a Hierarchical Task Analysis of our social network showed that it has less and simpler tasks than the successful social network (WhatsApp).


text:
Top 10 in Our First 100 Days
July 09, 2015 / Amplified Soccer
With our first 100 days of Amplified Soccer Athlete now behind us and more than 1,000 downloads of the app under our belt, we wanted to recap the top 10 viewed articles from the website to showcase some of our partners and writers.
Thanks to everyone that has made this possible (see full list at the end of the article), for our great audience and for the motivation to keep providing this resource!
1) Developing Decision Making Speed in Soccer from Performance Conditioning Soccer
Speed of foot, speed of movement, speed of thought and speed of skill execution all contribute in determining a soccer player's ability to "play at speed". Weineck (1992) listed seven characteristics of speed and their significance as they relate to soccer performance. These elements include 1) perceptual speed, 2) anticipation speed, 3) decision making speed, 4) reaction speed, 5) speed without the ball, 6) action speed with the ball, and 7) game action speed. My previous article dealing with the development of soccer- specific speed, discussed how players can improve their "movement speed without the ball." This can be a critical factor affecting a player's overall level of performance since the bulk of player movement - sprints, stops, starts body fakes, jumps, turns and sudden changes of direction - are often performed without the ball!
This article discusses an equally important element affecting soccer performance - decision making speed. A player's ability to make correct split- second decisions is particularly critical at higher levels of competition where time and space are limited. The individual who can consistently choose the best course of action from a variety of possible options under conditions of limited time, restricted space, physical fatigue and challenging opponents will have a decided edge on players who lack that ability.
2) Civana Kuhlmann, a new 99er
That team along with all current and former players have set a very high benchmark for the current youth players. Kuhlmann from Littleton, Colorado is definitely one of those players. First kicking around a ball when she was only 3 or 4 years old, she states that there is nothing else she would rather do than play soccer. When she started realizing that playing soccer was her calling, she was willing to put hours of practice into being the very best. She soon would take her talents to playing for her hometown club, Colorado Rush Soccer Club, and the United States Youth National Team program.
3) Appalachian State's Mountaineers Superwoman: Freshman Kelly Flanders
When you think of college soccer, you think of big-time universities such as: The Florida State University or UCLA, but the SunBelt Conference holds an upcoming college soccer star rising through the ranks who can change that mold all-together. Appalachian State University Freshman Kelly Flanders is poised to make an impact after an outstanding freshman year for years to come.
"Kelly is an inspiration through her work rate, her achievement, and her leadership," states Appalachian State Women's Soccer Coach Sarah Strickland. This is only one of a few great things that current and former teammates, coaches, and community leaders had to say about Kelly Flanders.
4) Beast Mode Soccer is Changing Individual Soccer Training and Everyone is Taking Notice
David Copeland-Smith is part of a new generation of skills specialists, alongside others like Scott Moody/AthleteFIT and Chris "Trainer" Gorres that are becoming their own training brand while changing the way that individual athletes take their game to the next level outside of the standard team and individual training.
For those aspirational athletes looking to get ahead, they have to work harder and smarter than ever before and this is where David and Beast Mode Soccer get involved. It's rare that someone embodies their brand as much as David Copeland-Smith does with his training program/philosophy, Beast Mode Soccer. However, David is one of the hardest working people you will ever meet and athletes wanting to work with him need to be ready to match him.
5) "Greatness is..." - Michelle Akers Horse Rescue
"Greatness is intentional" - Meaning it's something you do every day..."on purpose"... to be great. Michelle Akers did that as a soccer player, and now she's doing it with her horse rescue. She tries to make their lives "great" every day.
Michelle does an awesome job taking care of her horses. But she desperately needs our help. When it rains her pastures flood and her barn floods. Her horses have no where to go. Many times their hay even gets soaked. The barn needs to be relocated or even rebuilt on higher ground. Her land needs to be fixed so that when it rains the water has somewhere else to go. To fix these things will cost a lot of money. Money she does not have.
6) Player Profile: Andy Alvarez
Andy Alvarez is a Gulliver Preparatory High School (Miami, FL) soccer stand out and 2015 Army University incoming freshmen. In 2015 Alvarez was voted team MVP, Gulliver Prep Athlete of the Year, and All-Dade County Athlete of the Year, while also adding his second Florida High School Athletic Association Class 2A State Championship. He finished his senior season as the No. 5 ranked recruit in the country with 21 goals and 21 assists.
For 17 year old Andy Alvarez, soccer as well as life has never been about the recognition, high school awards, or state championships that he's been apart of. It has only been about one thing, serving others. A true class act, Alvarez has focused more on making those around him successful and less on himself through his high school career. In that process however, he quietly wrote his own success story.
7) Becoming the Complete Player: Training Advice from the Pros
Yael Averbuch, David Copeland-Smith (Beast Mode Soccer), and Chris Gorres (Trainer Gorres) spent some time with Amplified Soccer Athlete discussing how to "Become the Complete Player."
Topics of Discussion:
• The difference between good and great players
• Common mistakes players make
• How to train without a fancy facility
• Soccer-specific strength and conditioning
• ACL prevention
• Common themes among successful athletes
• More!
8) From the Magazine: 7 Technical Tests of the U.S. Youth National Team
U.S. Soccer's Youth National Team Director April Heinrichs and her staff have identified and refined the following protocols which can be used as tests, homework and training exercises. These tests were designed with U-12 to U-20 players in mind, are geared towards motivating players to spend time on their own improving their ball control, short range passing, speed and agility with the ball, and, the use of their instep for driven balls and shooting. A player that controls the ball is a player that helps control the tempo of the game, advance the ball and contribute to the team's tactical abilities. We hope you find these technical tests fun, challenging and rewarding as you see the daily improvement in your game!
"The primary vision of the U.S. Women's Youth National Teams program is, to deliver more technically skilled and tactically sophisticated players to the full Women's National Team in an effort to sustain performance success over the next 20 years. As part of the goal to develop players, we have identified the need to establish nation-wide technical testing and benchmarking. We hope to inspire players to spend more time with the ball through this cultural and behavioral revolution."
— U.S. Soccer Youth National Team
9) The "Gauntlet" KU Women's Soccer Fitness Test
The University of Kansas Women's Soccer team finished third in 2014 in the Big 12, which is one of the best conferences in Division 1 women's soccer. KU competed with soccer powerhouses such as Texas, Texas Tech, West Virginia, Oklahoma State, Oklahoma, and Baylor, managing to end with a successful record of 15-6, be ranked as high as ninth in the nation during the season, and receive their first NCAA bid since 2011.
KU's success in 2014 can be attributed to numerous things, but one major change that occurred was the required and grueling preseason fitness tests. For more than ten years the team would have to run two fitness tests, the Beep Test and a shuttle test. The players would only have to pass at least one test to play and receive gear, but if they passed both tests, they did not have to participate in extra running during preseason.
10) Movement Training and Early Specialization from AthleteFIT
To be a confident, competitive, skillful athlete we first need to establish a very strong foundation in dynamic balance, rhythmic footwork and an understanding of how to quickly reposition the body to gain a competitive advantage. Coordination is key to mastering any skill, and many young players are lacking this foundational component of sports mastery.
Movement based training is becoming a lost art as young athletes get pushed into technical and tactical sport skills (early specialization) during critical periods of development. Training has dramatically changed in the past decade, and although the research and sports science field has helped top end athletes achieve great things, we are losing the battle in the trenches.
Bonus: An Athlete's Self Talk
It's not just your feet. It's not just your ability to control or strike a ball. It's not just your eyes. It's not just your ability to see space or see a move ahead. Your words are important too. Not just to direct others, but also to direct yourself, To motivate yourself, To focus and to play with confidence. Your language, your words are important too!
Athletes need to talk their way through the game. Their words can lead to excellence, to high performance and to the kind of consistency that typifies a champion.
Their self-talk can be action based – their inner voice can keep them physically driving forward, physically strong, physically tough, physically working hard.
Bonus: Why Yael Averbuch is the image of Amplified Soccer Athlete
One of our favorite early posts before we had grown to where we are today.
Energy, Passion, Determination and Hard Work! These adjectives describe Yael Averbuch and are feelings evoked in the image that adorns the main page of our website and the cover of the first issue of Amplified Soccer Athlete magazine.
"I pursue my goals with every ounce of my being, but above all, I love the journey." – Yael Averbuch
Athletes like Yael - achievers, strivers and in general those athletes that have the passion to work hard to become better and more complete - are the reason that we launched Amplified Soccer Athlete. We love the game and want to provide resources and a digital magazine for those athletes who want to put in that extra work and prepare physically and mentally for the journey. When we were connected with Yael, the image and her involvement became perfect fits and we are greatly appreciative of the ability to use that image and for her continued support.
Thank you to all of our regular contributors, Scott Moody from AthleteFIT, David Copeland-Smith from Beast Mode Soccer, Chris "Trainer" Gorres, Dan Abrahams, Ken Kontor from Performance Conditioning Soccer, Yael Averbuch, John DeWitt, Olivia Nadon and Jon Denham.
Thank you to our current team of Brian Peters, Eric Dodd, Chris Clements, Marykate Halm, Alyne Moore and Jamie Fletcher.
Thank you to Clint Hall from Facebook.
Thank you to all of the contributors from our Indiegogo campaign: Cliff and Kathy Burt, Jeff and Carrie Moore, Steve and Kathy Knickerbocker, Tammy Romanisko, Tyler and Shala Burt, Derek Dolezal, AJ and Alix Orrick, Joyce Markley and Diane Hansen.
Thank you to our families!
Special thanks to Rhae "soon to be Burt" Moore and Randi Simmons.
Without all of you this dream doesn't happen!
July 09, 2015 / Amplified Soccer/ 1 Comment
Features, Mental Game, Performance Conditioning, Psychology, Skills & Drills, Strength & Fitness
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New York Yankees second baseman Gleyber Torres has been voted American League Rookie of the Month for May, and Pittsburgh Pirates outfielder Austin Meadows has been voted National League Rookie of the Month for the second month of the 2018 season.
Starting pitcher/designated hitter Shohei Ohtani (2-0, 2.16 ERA, 31 SO; 8 XBH, 9 R) of the Los Angeles Angels also received votes for AL Rookie of the Month after his strong period of May.
Starting pitcher Walker Buehler (2-1, 2.32 ERA, 31.0 IP, 37 SO) of the Los Angeles Dodgers also posted a deserving month. On May 4th against the San Diego Padres at Estadio de Béisbol Monterrey in Mexico, Buehler led a quartet of pitchers, including Tony Cingrani, Yimi García and Adam Liberatore to throw the first combined no-hitter in Dodgers franchise history, and the 12th in Major League history. In addition, Buehler became the first hurler age 23-or-younger in Dodgers history, and the 11th overall since 1908, to register at least 31.0 innings pitched and 37 strikeouts with five-or-fewer walks in a single calendar month. New York Mets starting pitcher Noah Syndergaard was the last to accomplish the feat, doing so in May during his All-Star 2016 campaign. Others receiving votes for NL Rookie of the Month included Seranthony Dominguez (1-0, 0.00 ERA, 15 SO, 0 BB) of the Philadelphia Phillies; outfielder Harrison Bader (.310, 12 R, 4 HR, 7 RBI) and shortstop Yairo Muñoz (.424, 14 H, 2 HR, 9 RBI) of the St. Louis Cardinals; third baseman Brian Anderson (.308, 17 R, 33 H, 7 2B) and starting pitcher Caleb Smith (3-2, 2.60 ERA, 27.2 IP, 28 SO) of the Miami Marlins; and relief pitcher Dan Winkler (1-0, 0.00 ERA, 10.1 IP, 15 SO) of the Atlanta Braves.
In recognition of their Rookie of the Month Awards, Gleyber Torres and Austin Meadows will each receive a specially designed trophy, suitably engraved, for their accomplishments.
In 24 games as the Yankees second baseman, Torres posted a slash line of .317/.374/.659 with 13 runs scored, 26 hits, a double, nine home runs, 24 RBI and six walks to claim his first monthly honor. With a minimum of 30 at-bats, Gleyber finished his strong month among AL rookies first in home runs, RBI and slugging percentage; tied for first in extra-base hits (10); second in hits and batting average; third in on-base percentage; and tied for third in runs scored. The right-handed-hitting slugger is the first Yankee to take home monthly rookie honors since his All-Star teammate Aaron Judge last season for the month of September.
Torres began his award-winning month of May with a nine-game hitting streak from May 2nd-11th. Over the course of his hot stretch at the plate, the young middle infielder hit .400 (12-for-30) with six runs scored, three home runs and 10 RBI. Torres became the youngest player in Yankees lore to record a nine-game hitting streak since Hall of Famer Mickey Mantle, who notched a 10-game hitting streak from June 24-July 3, 1952 at 20 years and 257 days old. On May 25th against the Los Angeles Angels at Yankee Stadium, Torres, who earned AL Player of the Week honors for the period ending May 27th, went 2-for-3 with his ninth home run on the season. The Venezuelan native homered in his fourth consecutive game, becoming the youngest player in AL history to accomplish the feat. According to the Elias Sports Bureau, at 21 years and 163 days old, Torres became the fourth-youngest player since 1900 to homer in four straight games, older than just Miguel Cabrera in 2004 (20 years, 262 days), Andruw Jones in 1998 (21, 139) and Albert Pujols in 2001 (21, 147). The four-game streak began in grand fashion on May 21st after Gleyber logged the first multi-homer game of his career. At 21 years and 159 days, the right-handed-hitting rookie became the second-youngest player in franchise history to post a multi-homer game, behind Mantle, who clubbed a pair of homers on August 11, 1952 when he was 20 years and 296 days old. Torres, who was acquired by the Yankees in the 2016 trade for Aroldis Chapman, is the youngest Yankee to ever blast nine round-trippers in his first 28 career games.
Meadows batter .409 (18-for-44) with nine runs scored, three doubles, a triple, four home runs, seven RBI and three stolen bases across 13 games played to earn his first monthly award. Among NL rookie hitters with at least 25 at-bats, Meadows finished his awardwinning month first in slugging percentage (.795); tied for first in home runs and extra-base hits (8); second in batting average and onbase percentage (.426); tied for fourth in runs scored; and tied for fifth in hits, doubles and RBI. Austin is the first Pirates player to claim the NL Rookie of the Month Award since Jung Ho Kang in July 2015.
Meadows began his big league career with multi-hit games in five of his first seven contests, including his first game as a Major Leaguer on May 18th against the San Diego Padres. During a three-game stretch from May 23rd-25th, the ninth overall selection in the 2013 MLB Draft hit .500 (7-for-14) with four runs scored, two doubles, a triple, one home run and two RBI. In addition, the contest on May 25th capped off a streak of five consecutive games in which the young outfielder scored a run. On May 29th against the Chicago Cubs at PNC Park, Meadows went 3-for-5 with two runs scored, a double and one home run. With the performance, the Georgia native batted .439 (18-for-41) with three doubles, a triple, four home runs, seven RBI and three stolen bases over the course of his first 11 Major League games. According to the Elias Sports Bureau, the 23-year-old became the fifth player in the Majors since 1961 to bat .400 with at least four round-trippers in his first 40 at-bats, joining Pujols, Jeff Francoeur, Brian Giles and Yasiel Puig.


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Recent Study: Nigeria's Cards and Payments Industry
From: Fast Market Research, Inc.
Published: Fri May 23 2014
The Nigerian card payments channel recorded strong growth during the review period both in terms of volume and value. The card payments channel grew at a review-period CAGR of 12.89%, rising from 30.5 million cards in circulation in 2009 to 49.5 million in 2013. Over the forecast period, the card payments channel is forecast to register a CAGR of 9.76%, rising from 56.1 million cards in circulation 2014 to 81.4 million in 2018.
The review-period growth was a result of the Nigerian government's efforts to move its cash-based economy towards non-cash payments. Projects such as Cash-Less Lagos have been launched to promote electronic payments and curb issues such as tax evasion and money laundering.
In terms of transaction value, the card payments channel grew at a significant CAGR of 31.69% during the review period, from NGN1.1 trillion (US$7.1 billion) in 2009 to NGN3.2 trillion (US$20.3 billion) in 2013. The channel is expected to post a forecast-period CAGR of 11.09%, from NGN3.6 trillion (US$22.4 billion) in 2014 to NGN5.5 trillion (US$31.1 billion) in 2018.
Mobile payments (m-payments) registered an exponential review-period CAGR of 147.46%, from NGN1.3 billion (US$8.4 million) in 2009 to NGN47.1 billion (US$300.4 million) in 2013. M-payments are anticipated to record a forecast-period CAGR of 23.24%. E-commerce also grew at a healthy review-period CAGR of 24.29%, from NGN38.6 billion (US$259.2 million) in 2009 to NGN92.1 billion (US$586.9 million) in 2013, and is anticipated to record a forecast-period CAGR of 12.63%. Outbound travel spending by retail and corporate consumers increased during the review period at a CAGR of 17.25%, and is anticipated to increase further over the forecast period at a CAGR of 9.31%, fueling the growth of travel cards.
In 2012, the Central Bank of Nigeria (CBN) introduced a new policy stipulating a cash handling charge on daily cash withdrawals or deposits which exceed NGN500,000 (US$3,188.6) for individuals and NGN3,000,000 (US$19,131.5) for corporate bodies, in order to reduce the amount of physical cash in circulation. The policy is initially piloted in Lagos and will be gradually introduced in other Nigerian states. Consumers, financial institutions and the government are all expected to benefit from the policy.
Full Report Details at
- http://www.fastmr.com/prod/813732_nigerias_cards_and_payments_industry_emerging.aspx?afid=303
* The Nigerian card payments channel recorded strong growth during the review period both in terms of volume and value. The card payments channel grew at a review-period CAGR of 12.89%, rising from 30.5 million cards in circulation in 2009 to 49.5 million in 2013. Over the forecast period, the card payments channel is forecast to register a CAGR of 9.76%, rising from 56.1 million cards in circulation 2014 to 81.4 million in 2018.
About Fast Market Research
Fast Market Research is a leading distributor of market research and business information. Representing the world's top research publishers and analysts, we provide quick and easy access to the best competitive intelligence available. Our unbiased, expert staff is always available to help you find the right research to fit your requirements and your budget.
For more information about these or related research reports, please visit our website at http://www.fastmr.com or call us at 1.800.844.8156.
You may also be interested in these related reports:
- Argentina's Cards and Payments Industry: Emerging Opportunities, Trends, Size, Drivers, Strategies, Products and Competitive Landscape
- Emerging Opportunities in Austria's Cards and Payments Industry: Market Size, Trends and Drivers, Strategies, Products and Competitive Landscape
- Poland's Cards and Payments Industry: Emerging Opportunities, Trends, Size, Drivers, Strategies, Products and Competitive Landscape
- The Czech Republic's Cards and Payments Industry: Emerging Opportunities, Trends, Size, Drivers, Strategies, Products and Competitive Landscape
- Spain's Cards and Payments Industry: Emerging Opportunities, Trends, Size, Drivers, Strategies, Products and Competitive Landscape
Company: Fast Market Research, Inc.
Contact Name: Bill Thompson
Contact Email: press@fastmr.com
Contact Phone: 1-413-485-7001


Bastrop scored first and last, but Westlake dominated in-between and won 51-14. Bastrop scored after a short kickoff recovery led to a 45 yard drive for a touchdown. Ray Ross caught a 3-yard pass for the score. Lee McMillan kicked the extra point. Westlake then started their 51 point attack. The first quarter scores came on a 15 yard pass from Walker Kobelan to Brad Dornak; a 39 yard pass from Kobelan to Ryan Swope; and a 54 yard run by Swope. 1st quarter score was 21-7. The 2nd quarter scores came on a 5 yard run by Scope; a 26 yard pass from Kobelan to Mike Walker; and on a 29 yard run by Jeff Ballew. Westlake's lead at the half was 42-7. Scoring started with a safety against Bastrop followed by a 15 yard pass from Tanner Price to Justin Tucker giving Westlake a 51-7 lead. Then came the outstanding play of the game. Bubba Johnson of Bastrop returned the kickoff 109 yards and the final score was 51-14. There was no scoring in the final period. Westlake led in first downs 17-15, rushing yards 273-194, and passing yards 100-52. Bubba Johnson led the Bears runners with 91 yards. Swope led Westlake runners with 131 yards.


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Tag: Lipiodol
UK approves Lipiodol Ultra Fluid for hysterosalpingography in women undergoing infertility...
Guerbet has been granted approval for an indication extension in the UK, where Lipiodol Ultra Fluid is the only oil-based contrast medium indicated for...
Portal vein embolization with NBCA-lipiodol promotes greater liver growth than PVA...
In a comparison of the regenerative capacity of portal vein embolization (PVE) before major hepatectomies with two different embolic materials, N-butyl-cyanoacrylate (NBCA) with lipiodol...
Lipiodol offers an effective therapeutic option for melanoma patients suffering postoperative...
Lymphatic fistulae and/or lymphoceles in the groin following radical lymphadenectomy are frequent, and therapeutic options are needed to avoid severe restrictions for oncologic patients...
Lipidol Ultra-Fluid recevies approval for use in cTACE by China NMPA
Guerbet has announced the approval of an additional indication for Lipiodol Ultra-Fluid by the China NMPA (National Medical Products Administration) for use in transarterial...
Automatic characterisation of Lipiodol deposition after cTACE may make predictions about...
Automatic characterisation of Lipiodol (Guerbet) deposition is feasible, workflow efficient, and improves consistency across patients, argued Sophie Stark (Yale School of Medicine, New Haven,...
New indication approved for Guerbet's Lipiodol Ultra Fluid
A new indication for Lipiodol Ultra Fluid (Guerbet) has been approved in Switzerland and in India for chemoembolization (cTACE) of tumours in adults with...
Artificial intelligence will support clinical decision making in interventional oncology
Aaron Abajian and Julius Chapiro, New Haven, USA, write about results from an early experiment in applying artificial intelligence (AI) and machine learning as a...
German Federal Institute for Drugs and Medical Devices approves new indication...
Guerbet has announced that the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM; The German Federal Institute for Drugs and Medical Devices) has now approved Lipiodol...
Thailand FDA approves new indication for Guerbet's Lipiodol Ultra-Fluide
Guerbet has announced that the Thailand FDA has given approval of a new indication for Lipiodol Ultra-Fluide for selective hepatic intra-arterial injection for visualisation,...
Guerbet expands distribution partnership in Canada with Methapharm
Guerbet has announced that as of 1 February 2017, Methapharm will promote and distribute all Guerbet products in Canada. "As a result of our excellent...


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Inca civilization was aware of the existence of the planet Nibiru!
October 6, 2020, By Cognitio | Leave a reply
Inca civilization was aware of the existence of the planet Nibiru! Original article by Alessandro Brizzi.
In the Coricancha panel there is information comparable to that found on the Akkadian seal VA243 of Sumerian origin: both in fact show the solar system in its complexity, as well as being certain proofs, that both the Sumerian people and that of the Inca civilization, had certainty of the presence of Nibiru, located between Jupiter and Mars. The Incas built several beautiful temples for their gods: the most important is undoubtedly Coricancha, the "gold garden" in the heart of the city of Cuzco, in Peru. It is also called the "Golden Temple" and was built in honor of the Sun God, known as Inti. In the Inca religion, Inti was the god of the Sun, son of Viracocha, the god of civilization.
It is said that in its origins it was a fantastic place with gilded doors, emeralds set in the walls, floors covered with gilded sheets and gardens full of gold statues of emeralds and courtyards full of gold statues and animals of all kinds: birds, jaguars , llamas, monkeys, butterflies etc .. It is thought that the original construction of Coricancha took place by order of Pachacuti Inca Yupanqui, the Inca emperor, while the temple was later enlarged by another emperor, Manco Capac at the beginning of the century. The site wanted to depict the Sun with rays shining in all directions. The Spanish colonizers demolished the temple, and built the Church of Santo Domingo over it, trying to annihilate all beliefs of the Inca people: the gold was melted into ingots which were claimed by the King of Spain. In addition to the Temple of the Sun, Coricancha was composed of five other temples dedicated to Viracocha, the creator god, Quilla, the goddess of the moon, Illapa, the god of thunder, Cuichu, the god of the rainbow and Venus, the goddess of dawn. : in each site there was a statue in honor of the respective god, as well as numerous religious artifacts. In the Viracocha Sun Temple, our attention is drawn to a golden panel featuring a strange "egg" and an elliptical orbit that divides the panel into two zones: one with five planets and one with four. Scholars tell us that the egg represents 'the primordial egg' from which the stars, man and woman, and all the elements present in the panel are born: but they cannot explain why in the ellipse there is … another planet. Other artifacts of Sumerian origin reveal a link between the old and the new world, but the Coricancha panel could indicate much more, and perhaps until now it has been underestimated for its importance.
Author Wayne Herschel developed an interesting theory about the panel, after Zecharia Sitchin also spoke about it in his book "Gods of Golden Tears". According to Herschel, the panel contains two very important pieces of information: confirmation that all the planets of the solar system were known in ancient times, and the existence of Nibiru. On the panel we can clearly see 5 celestial bodies positioned in the shape of a cross. We see the sun, the Moon, but above all we can see the egg (which actually corresponds to an ellipse), at the base of which we can strangely notice another mysterious celestial body isolated from the rest. Below it we find four other celestial bodies, positioned in the shape of a cross, while immediately alongside, we find a large group of celestial bodies. It appears these details represent the celestial structure, so the panel appears to be a perfect star map.
The Coricancha panel seems to contain information comparable to that found on the Akkadian seal VA243 of Sumerian origin: both in fact show the solar system in its complexity, as well as being certain evidence, that both the Sumerian and the Inca people had certainty of a 10 ° planet located between Jupiter and Mars.
Most experts agree that it may be a real star map, for others, the panel indicates the position of the "missing solar disk": the legend tells of the Spanish "conquistadors" who arrived in Peru, and of an Inca priest named Aramu Maru who escaped from the temple stealing the sacred disc for the Inca people. Believed to be a gift from the god Viracocha, the Inca priests in the Temple of the Sun used the golden sun disc to check the spiritual health of their entire empire. The Golden Sun Disk was used to control 41 energy lines emanating from the temple throughout the Inca territory, which were intended to control the welfare of the people: the priests considered the Temple of the Sun as the center of the known universe, and the disk of the Golden Sun was located in the center of the temple.
It is said that the disc was six or seven feet in diameter, composed of a particular "translucent gold" of celestial origin, donated to the Inca by the god Viracocha. The disc possessed the power of healing, but also that of unleashing violent cataclysms or serving as a portal for shamans to travel to other spiritual dimensions. Some time before the conquistadors took possession of the Coricancha Temple, the Disc of the Golden Sun was removed and hidden elsewhere in the Inca Empire: a local tradition tells that shortly before the Spaniards invaded Cuzco the disc was brought "to the sun" by the powerful Inca chief, Manco Inca. So, did the Incas also know Nibiru as the Sumerians?
Click on the image and travel…
Tags: Inca civilization
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