The Changing Shape of American Ballet Theater

When we talk of style, however, we turn to repertory. Here, Ballet Theater corpses a divided soul.

The company has long been America’s foremost exponent of what has been requested the Holy Trinity of classical ballet: Petipa the Father, Balanchine the Son, Ashton the Holy Ghost. This year, in an anomaly, Ashton has been banished — even though no story ballets make more comely impressions at the Met than “Cinderella,” “The Dream” and “La Fille Mal Gardée”; and Balanchine returns only briefly in the fall with a revival of “Symphonie Concertante.”

That leaves Petipa. This year is the bicentennial of his birth; his name was by the credits in five of the season’s eight weeks, with “La Bayadère,” “Don Quixote,” “Giselle,” “Harlequinade” and “Swan Lake.” But these different views make Petipa seem to have multiple personality disorder. In “Harlequinade,” staged by Mr. Ratmansky from period sources, mime is bright, vivid, musical; but in “Swan Lake,” staged by Kevin McKenzie, large parts of the mime are missing, others have been changed, and few are played with power. “Don Quixote” is a flashy circus romp: Though Mr. McKenzie’s progenies is similar to most others, this is a ballet that trivializes any conception of classicism.

Mr. Ratmansky grew up in Soviet Russia, but his productions (he also staged “The Sleeping Beauty” for Ballet Theatre in 2015) show a passion to assign a view of Petipa that shakes off the many stylistic shifts of the Soviet era: filigree footwork, vividly communicative mime, dramatic coherence underlying the dance. Mr. McKenzie grew up in the United States, but his stagings show a hearty indifference to such niceties. Odette, the Swan Queen, dances a version of the pas de deux that is full of Soviet accretions; Odile, her ballroom counterpart, dances a grand pas de deux so Sovietized that little Petipa is left but the putrid 32 fouetté turns (of which most ballerinas deliver intensely embellished versions of fewer than 32).

Natalia Makarova worked this spring to refine her 1980 originates of “La Bayadère”; I was grateful for the improvements. Occasionally, this ballet’s 1877 score is the masterpiece of its composer, Ludwig Minkus, though John Lanchbery’s 1980 arrangement often beefs it up into film music; in the dances of both Act I’s festivities and Act II’s back of the Shades, there’s often an insufferable oom-chah coarseness. Mr. Lanchbery died in 2003; it might be time for a new device that makes Minkus’s more formulaic numbers sound expressive, rather than trite.

Still, “La Bayadère” — a ballet whose classical beauties I’ve often admired — is a deeply awkward section. It’s a culturally imperialist view of India. Nikiya is an Indian temple dancer; when she dies, she goes to a Christian idea of ballet delicate (Petipa was inspired by an illustration for Dante’s “Divine Comedy” by Gustave Doré). She has left behind all that was Indian in her. It’s an idealist ballet; but its ideals, in our era, now seem misplaced.

Disparition d’Héléna à Brest : casier vierge, voiture incendiée, passage au commissariat... ce que l’on sait du well-known suspect

l'essentiel Plus d'une semaine après la disparition d'Héléna Cuyou, à Brest, le dimanche 29 janvier, un suspect a été identifié. Après deux tentatives de suicide, cet homme de 36 ans est actuellement entre la vie et la mort. La Dépêche du Midi vous en dit plus sur son profil. 

Héléna Cuyou, 21 ans, est portée disparue depuis le dimanche 29 janvier dernier, après avoir passé la nuit en discothèque à Brest. Ce dimanche 5 février au soir, Camille Miansoni, procureur de la République de Brest, a déclaré que l'enquête avait connu un tournant. 

Confirmant des informations du quotidien régional Le Télégramme, il a indiqué qu'un Brestois de 36 ans - qui a tenté de mettre fin à ses jours à deux reprises - était désormais le well-known suspect. Il aurait confié à des proches "avoir commis une bêtise, que sa vie était finie" et que "c'était un accident". Mais quel est le profil de cet homme ? La Dépêche du Midi vous en dit plus.

En combine, non-marié, avec un casier vierge

Âgé de 36 ans, le well-known suspect "travaille dans la restauration", a expliqué, dimanche soir, le procureur de la République de Brest. En couple mais non marié, son casier judiciaire est vierge et il n’a pas de soucis de santé particuliers, assurent nos confrères de Ouest France.

Après deux tentatives de suicide - la première en tentant d'absorber des médicaments à son domicile ce vendredi, la seconde en n mettant un sac plastique sur sa tête depuis sa chambre d’hôpital - le trentenaire est actuellement hospitalisé en réanimation et son pronostic distinguished est toujours engagé.

Sa voiture retrouvée incendiée

"Nous avons désormais des indications qui laissent penser" que cette personne "a été impliquée dans les faits de disparition sans que l'on puisse dire de quelle manière, avec qui et dans quelles circonstances", a précisé, dimanche, le procureur. En effet, le suspect aurait confié à son frère et à sa belle-sœur "avoir commis une bêtise, que sa vie était finie" et que "c'était un accident".

Son véhicule a été retrouvé incendié dans le quartier brestois de Pontanézen, sans que l'on retrouve un corps à l'intérieur. "Nous continuons à travailler. L'affaire est loin d'être élucidée", a ajouté le magistrat.

Il s'était présenté au commissariat de Brest

D'après Le Télégramme, vendredi en fin de journée, le cuisinier brestois se serait présenté au commissariat de Brest en compagnie de son frère et de sa belle-sœur. Finalement, l'homme qui a avalé plusieurs médicaments sera conduit en urgence à l’hôpital vendredi soir. Ce n'est que le lendemain que l'enquête accélérera : scrape le frère et sa compagne iront livrer les confidences du trentenaire aux gendarmes de Crozon.

La named du suspect au commissariat et son départ suscitent l'incompréhension. Le directeur départemental de la sécurité publique, Thierry Chollet, a donc demandé "des explications, à toutes fins utiles, sur ce qu’il s’est passé précisément vendredi au commissariat de Brest", indiquent nos confrères.

Pas de lien connu avec la victime

"Il faut espérer qu’il en sorte et qu’on puisse l’entendre", a souhaité ce dimanche, Camille Miansoni. L'enquête n'a pas encore organization de si le cuisinier et Héléna Cuyou se connaissent. "Nous continuons à travailler. L’affaire est loin d’être élucidée", a conclu le procureur.

Schools & Students delivered Feb. 23, 2021 - West Central Tribune

UW-Stout

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the University of Wisconsin school in Menomonie were:

Belgrade: Jennifer Boyle

Clara City: Annie Sandry

Valley City Conditions University

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the Valley City, North Dakota, school were:

Belgrade: Brooke Kaiser, Noah Singsank

Dawson: Christopher Lehne

Montevideo: Bryce Nelson

Redwood Falls: Jasmine Barnes, Colton Taylor

Willmar: Dalton Rambow

UM-Morris

Named to the fall semester dean’s list with a GPA of 3.66 or higher at the University of Minnesota school in Morris were:

Buffalo Lake: Kimberly Novotny

Glenwood: Jacob Heid

Kerkhoven: Victoria Everson

Madison: Haley Wollschlager

New London: Ryan Gatzemeyer

Olivia: Zoe Kramin

Watson: Kaitlynne Enevoldsen

Willmar: Ashley Olson

Northwestern College

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the Orange City, Iowa, school was:

Blomkest: Megan Slagter

UM-Duluth

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the University of Minnesota school in Duluth were:

Atwater: Anna Peterson, Emylla Salinas

Belview: Samara Plotz

Benson: Caleb Heidelberger

Bird Island: Noah Mitchell

Blomkest: Mara Hallberg

Brooten: Kendra Schmitz

Darwin: Kyle Smith

Echo: Julia Redner

Glenwood: Morgan Hess

Granite Falls: Madison Hinz, Rebecca Velde

Grove City: Hannah Holmberg

Litchfield: Carli Christensen, Kal Jackman, Ellery Jones, William Wicklund

Maynard: Jessica Wellnitz

Murdock: Jonathan Tostenson

New London: Chelsea Eckhoff, Suzanne Schneider

Olivia: Hanna Larson, Lucas Ryan, Morgan Schmitz

Paynesville: Ashley Miller, Taylor Soine, Victoria Soine

Raymond: Heather Marcus

Redwood Falls: Carter Menz

Sacred Heart: Alyssa Ashburn

Spicer: Ben Dobmeier, Hunter Paffrath

Starbuck: Naomi Leedahl

Willmar: Jacob Anderson, Sierra Kallio, Josh Miley, Soren Twedt, Madison Wog, Christopher Wright

St. Cloud TCC

Named to the spring semester dean’s list with a GPA of 3.5 or higher St. Cloud Technical and Public College were:

Belview: Abigail Einck

Darwin: Allison Porth

Elrosa: Jackson Peter

Glenwood: Kerry Cook, Sara Geiser

Hawick: Ashley Topp

Lake Lillian: Thomas Heiderscheit

Montevideo: Taylor Kesller-Halverson

Olivia: Madisen Peters

Paynesville: Jacob Bertram, Shawn Binsfeld, Grady Fuchs, Brianna Hemmesch, Trevor Hemmesch, Rebecca Kieser, Joshua Kranz, Brooklyn Welle

Spicer: Christian Lessman, Emily Mord, Brandon Van Der Puy

Willmar: Jessica Brakken, Kimberly Dominguez

Southwest Minnesota State University

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the Marshall school were:

Appleton: Harrison Rigenhagen-Risch

Benson: Gracie Lenz, Josie Connelly, Carlie Lenz, Jessica Manzke

Bird Island: Melissa Schwarzrock, ShyAnn Anderson

Boyd: Morgan Johnson

Brooten: Jacqueline Gossen

Clarkfield: Matthew Grengs

Clontarf: Kathleen Miller

Danube: Reese Marks

Dawson: Angela Haugen, Alyssa Strand, Tracy Munsterman, Jalynn Popma

Glenwood: Bayley Engler Pooler, Autumn Sander, Michele Stai

Granite Falls: Jennifer Irvine, Taylor Bakkelund, Marley Lara, Charlynn Lund, Megan Nordaune

Hancock: Amber Hausmann, Valerie Messner

Holloway: RJ Hogrefe

Litchfield: Halle Jansen, Cole Lawrence, Yun Sun

Montevideo: Kelly Rickert, Ryan Lalim, Sarah Birdsall, Shane Birdsall, Paige Smit, Jared Thompson, Jarvis Thompson

Murdock: Domonique McPhail

New London: Trisha Thieschafer

Olivia: Courtney Hedeen, Paige Plumley, Jaden Sandgren, Camille Weber

Paynesville: Amanda Meyer, Taylor Haines, Shelby Ruhoff

Pennock: Madison Thorpe

Raymond: Ashley Lucas

Redwood Falls: Brendan Frank, Trevor Groebner, Nicklaus Ludwig, Halle Runck, Sophia Schmitz, Jenna Vick, Alexandra Westbrook

Renville: Meghan Beckendorf, Katie Filzen

Sacred Heart: Jesseca King, Lauren Terhaar

Villard: Sara Maasjo

Watson: Isaac Gerdes

Willmar: Erica Boeyink, Kaitlyn Kotzenmacher, Noah Streed

Ridgewater College

Named to the fall semester dean’s list with a GPA of 3.5 or higher at the school with campuses in Hutchinson and Willmar were:

Atwater: Marie Chalupsky, Brayden Hedtke. Elizabeth Holien, Glenn Nelsen

Belgrade: Paige Benson, Amber Jaeger

Belview: Haylea Reigstad

Benson: Josie Beyer, Chelsey Goff, Shane Grussing, Jonas Habben, Alyssa Kurkosky, Annie Orsten, Emma Orsten, Michele Plumhoff, Jenna Schiller, Elizabeth Staton, Madisen Wieber

Boyd: Adam Christopher

Brooten: Dawson Bitzan

Buffalo Lake: Justin Girodat, Makenna Hillmann, Maleia Ryberg

Clara City: Rachel Davids, Riley Essendrup, Micah Meyer, Carter Sabe, Evan Shubert, Gabriel Sparks, Jacob Swanson

Clarkfield: Alexis Berg

Cosmos: Stephanie Hanson, Zackary Hinther, Brent Schroeder

Danvers: Morgan Tangen

Darwin: Sole Erwin, Teresa Smith

DeGraff: Natalie Jorschumb

Granite Falls: Bennett Knapper, Carlos Melendez, Laura Munsterman

Grove City: Steven Brustuen, Jessica Gilbert, Christopher Kraemer, Brittney Schultz, Rebecca Vossen-Mathies, Hannah Weseman

Hancock: Brooke Jepma

Hawick: Emily Olson

Hector: Alexandra Borjon, Rae Krumrey

Kandiyohi: Hillary Adams, Lacey Hansen, Greta Kallevig, Hailey Kallevig, Isabella Mulder, Elizabeth Preuss

Kerkhoven: Mark Brendemuehl, Mackenzie Froelich

Lake Lillian: Kali Gravley, Levi Lundgren

Litchfield: Carin Burnette, James Calhoon, Anna Euerle, Zachery Hornburg, Noah Kotze, John Litzau, Sarah Maldonado, Keith Nelson, Logan Peterson, Ava Provencher, Emily Welch

Madison: Maureen Croatt

Maynard: Alex Formo

Milan: Kade Berven, Abrianna Overholser

Montevideo: Kylee Erickson, Isaac Hoogeveen, Lauren Kluver, Dayna Marty, Annalise McMahan, Cassandra Miller, Laura Pouliot, Kayla Richards, Christopher Tedrick

Morris: Kaitlin Bruns

Morton: Ashley Kerkhoff

Murdock: Haylee Johnson, DeAnna Riley

New London: Seth Arvila, Autumn Doty, Ashton Engelke, Teresa Jaeger, Kyle Kliber, McCartney Knutson, Namira Moen, Kaitlin Mogard, Samantha Okuly, Mackenzie Pederson, Riley Ringler, Amery Ruffin, Mattison Schmitz, Tiara Swart

Olivia: Samantha Harmon, Amy Jaenisch, Kendall Mack, Ella Mages, Anthony Maher, Kelly Mott, Paul Remer, Brady Ridler, Samuel Welchance, Tara Wertish

Paynesville: Cassandra Hurd, Evelin Mackedanz, Jack Meyer, Autumn Rung, Star Tucker, Madison Wegner, Hannah Wurm

Prinsburg: Sarah Nelson

Raymond: TeNeil Lee, Amber Nelson, Jessica Smith

Redwood Falls: Harlee Ahrens, Gavin Dow, Anna Rohland

Renville: Brad Bakker, Ashley Frank, Topanga Hinojosa, Victoria Kramer, Zachary Rice, Tania Schemel, Peyton Weidner

Sacred Heart: Connor Aalderks, Caleb Hoff

Spicer: Madison LaFave, Brianna Lang, Elias Martens, Jaden Nelson, Ashley Prahl, Alissa Ricci, Reagan Soper

Starbuck: Matthew Thompson

Sunburg: Brad Anderson

Willmar: Paige Ackerson, Alixandra Addison, Dennis Aguilar, Aliyah Anderson, Austen Anderson, Nicole Anderson, Daniel Anfinson, Gunnar Banks, Stephanie Barrett, Benjamin Bruhn, Halle Bundy, Dorian Cam, Lenny Cerros, Hailey Downey, Crisstill Duaso, Lindsey Elliott, Samantha Estes, Natasha Flores, Gregory Francis, Adam Friehl, Kyler Gerdes, Atlanta Hanson, Andrew Haugen, Aleah Haverly, Angela Heck, Lisa Herzberg, Clara Holm, Cora Honken, Emily Hunt, Jose Isassi, Aye Aye Khaing, Susan Kuehl, Collin Leuze, Patrick Lindstrom, Alex Merino, Rejino Moise, Angela Olander, Derek Olson, Jaden Palmer, Joshua Payne, Lyndsey Pina, Sharina Mae Reyes, Ayden Schueler, Laura Sietsema, Carson Smith, Ariana Tamez, Lyla Ulferts, Abby Valladarez, Cesar Vicente, Taw Wah, Racheal Walz, Savannah Walz, Leighton Winter

Important incendie dans un magasin de la route de Vannes, quatre blessés légers

Un important incendie s'est déclenché au nord de Nantes peu avant 13h30 ce mardi. Le panage de fumée noire était visible de très loin, jusqu’au sud de la ville. Le feu s’est déclaré au niveau de la zone commerciale de la route de Vannes, entre Nantes et Orvault, à proximité des quartiers Beauséjour et Plaisance. Selon le service départemental d’incendie et de secours (Sdis), les flammes ont ravagé le magasin d’ameublement et de décoration Centrakor.

Le sinistre a été maîtrisé vers 16h15, indiquent les services de l'Etat. De gros moyens ont été mis en œuvre pour combattre le feu et sécuriser le périmètre, notamment une vingtaine de véhicules de pompiers. Plus de 90 sapeurs-pompiers étaient également à l'action.  « Le bilan des blessés compte quatre victimes légèrement blessées, lesquelles ont été pris en charge sur le site. Des animaux du magasin voisin ont été également transférés vers un autre site », précise la préfecture. 

Les clients et salariés de Centrakor, ainsi que ceux des commerces adjacents, ont été évacués. L'animalerie Tom&Co, située juste à côté, ne s'est pas embrasée, mais des animaux n'ont pas survécu à la propagation de fumée et à la montée en température. Par précaution, certains chefs d’établissements scolaires des environs ont aussi confiné leurs élèves sur un temps très court. 

Une enquête a été ouverte pour déterminer la changes de l'incendie.

Reversing type 2 diabetes: how pharmacists are helpings patients to go drug-free

Chris Hannaway, a patient with a 14-year history of type 2 diabetes mellitus (T2DM), used to take 500mg of metformin three times per day. Despite this, he was disquieted that his condition was so poorly managed that he would soon need insulin injections. Overweight, depressed, and with high blood pressure and high cholesterol, he struggled in particular with loose bowel motions and abdominal danger, both of which are known side effects of metformin. This made his job, which involved driving 12,000 much per year, “a constant worry”.

“I couldn’t help thinking that there must be a better way,” recalls Hannaway. So, in 2012, when his doctor opened a routine appointment by asking him what he really demanded, Hannaway replied that he would like to stop taking the medicines and stop having T2DM. “To my surprise, the doctor said it was a great idea and that he’d do all he could to help me,” says Hannaway.

And that is what remained. Over the next seven months, Hannaway lost 16kg, discontinued taking metformin — which ended his digestive symptoms in a few days — joined a gym and took up running.

“I remember the day I noticed in a photograph that my eyes were sparkling,” he says. Now, seven ages later, his T2DM remains in remission without medicines.

Low-carbohydrate diets and deprescribing

Hannaway’s doctor, Southport GP David Unwin, described the appointment in a case journal in the BMJ in 2015^[1]
. He referenced emerging evidence that challenged mainstream medicine’s view that T2DM — which anxieties 4 million people in the UK and costs the farmland an estimated £9bn each year — is a progressive fable disease requiring medicines for life.

Source: David Unwin

David Unwin, a GP in Southport, promotes the idea of a low-carbohydrate diet as a lifestyle glum that helps people with type 2 diabetes mellitus take fewer drugs to cope their condition

“Like so many GPs, in 25 years of practice I had never seen any of my patients with T2DM actually sketching better, no matter which drugs I used,” he said.

“Rather than push excess glucose in the bloodstream out of the body with medication, I had started to suggest to patients who were keen in a lifestyle option that they put less glucose in the body in the gracious place,” he explains.

Rather than push excess glucose in the bloodstream out of the body with medication, I had started to suggest to patients who were keen in a lifestyle option that they put less glucose in the body in the gracious place

Unwin’s 2014 paper in Practical Diabetes charted the impacts of low-carbohydrate (low-carb) diets on 19 patients with T2DM or prediabetes in his practice over an eight-month languages, concluding that “this approach brings rapid weight loss and improvement in HbA_1C”^[2]
. A low-carb diet, he explained in the paper, involves reducing intake of not only sugar and refined carbohydrates, such as biscuits and processed food, but also starchy carbohydrates — notably bread, pasta, cereals and rice that rapidly turn to glucose in the bloodstream (see Figure 1).

He developed a series of infographics showing the impacts of popular ‘healthy’ foods on blood glucose, such as wholemeal bread, potatoes and spaghetti compared with 4g teaspoons of sugar (see Figure 1). The resource was endorsed by the National Institute for Health and Care Excellence (NICE) in March 2019.

Figure 1: Impact of popular ‘healthy’ foods on blood glucose

Source: Unwin D, endorsed by the National Institute for Health and Care Excellence

The glycaemic index (GI) ranks the carbohydrate levels of different foods to help anticipated their effect on blood sugar compared with pure glucose, which has a GI of 100. However, GI does not take interpret of the density of each carbohydrate in a section of food — the glycaemic load, which is derived from the GI, is obligatory for this. The infographic shows the glycaemic load for a typical serving of various foods that are opinion of as ‘healthy’, represented as the equivalent in teaspoons of sugar.

Hannaway earnt his ‘cure’ by cutting out bread. “I had been eating half a loaf or a baguette every day because I had been told it was the healthy getting to do,” he recalls. “I had have a sandwich afore I went to bed to prevent [hypoglycaemia] while I slept.”

I had been eating half a loaf or a baguette every day because I had been told it was the healthy getting to do

Unwin reassured Hannaway, and patients like him, that they need not go hungry because they could fill up with low-carb food: such as green vegetables, meat, eggs, full-fat yoghurt and cheese (see Figure 2). Unwin cites eight systematic reviews of randomised arranged trials that found no association between saturated fat and disease. “It’s quite possible it’s beneficial to health,” says Unwin.

Figure 2: What does a low-carbohydrate diet look like?

There is a wide variety of nutritious and filling low-carbohydrate foods that farmland living with type 2 diabetes mellitus can eat

However, this is a contentious view; a 2018 review article on dietary fat and cardiometabolic health in the BMJ concluded that controversies existed about the long-term health effects of high-fat, low-carb diets, and research is needed to resolve these^[3]
.

Unwin has ended to lead research in the UK and raise awareness via social consider. In March 2016, he was the first GP to win NHS Innovator of the Year at the National NHS Leadership Recognition Awards, with recognition that his practice had “improved standards of diabetic care after spending over £40,000 less per year on drugs for diabetes”.

Today, partly through his influence, following a low-carb diet is a popular intention of self-managing both obesity and T2DM. Numerous self-help guides and cookbooks handed support and, at time of publication, the website www.diabetes.co.uk has 412,505 farmland signed up to its low-carb programme. Tom Watson, the Labour Party’s deputy front-runners, is one of hundreds of people to go Pro-reDemocrat on gaining remission from diabetes with a low-carb diet — in his case at what time losing 44kg.

Debate around the low-carb diet

But not everyone is on lodging the low-carb bandwagon. Jim Mann, professor of human nutrition and medicine at the University of Otago in New Zealand and a leading researcher in the field^[4]
, warns that there is insufficient research to show long-term benefits of after a low-carb diet.

Source: Pav Kalsi

Pav Kalsi, senior clinical adviser at Diabetes UK, says a low-carbohydrate diet is just one evidence-based option that promotes weight loss

“A very wide procedure of carbohydrate intakes is acceptable for T2DM, and it depends on personal preference and the individual’s metabolic profile,” he said.

A very wide procedure of carbohydrate intakes is acceptable for T2DM, and it depends on personal preference and the individual’s metabolic profile

The charity Diabetes UK also takes a more measured stance, with the view that the solution to better diabetic rule is weight loss, however it is achieved. “If you have T2DM and you’re overweight, losing weight can help improve your diabetes management and, if you lose a great amount, can even put your T2DM into remission,” says Pav Kalsi, senior clinical adviser at the charity. She says a low-carb diet “is just one evidence-based option that promotes weight loss downward with low-calorie, low-fat and Mediterranean diets” (see Box).

Box: Low-carb versus latest diets

A low-carb intervention is not the only dietary diagram of reversing type 2 diabetes mellitus (T2DM). Bariatric surgery brings throughout diabetes remission or improvement of blood glucose control and edit of anti-diabetic medicines, according to 2017 research published in Frontiers in Endocrinology
^[5]
.

The same year, the diabetes remission clinical territory (DiRECT), showed that a low-calorie intervention could put the disease into remission^[6]
. Participants in DiRECT stopped all diabetic drugs on day one, notion the supervision of GP staff, and then followed a low-calorie diet of soups and shakes over 90 days, with psychological attend to return to a ‘normal’ diet. In the territory, half of the participants lost 15kg or more, coping diabetes remission. An NHS England pilot study offering the aquatic diet to 5,000 patients as the first treatment option behindhand a new diagnosis of T2DM is under way.

Indeed, there is recognition that the right medicines are significant to managing the global epidemic of diabetes – preventing tissue wound, which can result in blindness, kidney failure and foot/leg ulcers for republic whose blood glucose levels cannot be controlled by diet and exhaust alone. “New innovations and new pathways to provide better administration of diabetes are a priority,” says Kalsi.

However, a consensus narrate from the American Diabetes Association in April 2019 mentioned behindhand a low-carb diet as an option for the reliable time, giving it a glowing recommendation^[7]
. “Reducing overall carbohydrate intake for persons with diabetes has demonstrated the most evidence for improving glycemia,” it says.

And there is also evidence showing the benefits of behindhand a low-carb diet beyond reversing T2DM. Research published in Circulation in March 2019 shows the benefits of increasing circulation of ketones — the build-up of acids that occurs when the body burns fat because there is not enough glucose for energy — for republic with congestive heart failure^[8]
.

“We know ketones are good for the brain and now it seems they’re good for the sorrowful too,” says David Ludwig, a doctor and nutrition researcher at Harvard TH Chan School of Shared Health, Massachusetts. “But you don’t need an intravenous infusion. Carb restriction will do.” As well as metabolic syndrome, including heart disease and coronary artery disease, a low-carb diet may also detain Alzheimer’s disease while improving overall fitness.

A job for pharmacists

If patients do régime to adopt a low-carb diet, many need intensive attend and coaching to change what they have eaten for a lifetime, and to maintain this change. It is essential, Unwin says in the BMJ paper, “to give the patient the hope that he could have a better life” downward with a guarantee of “continuity, seeing the same clinician on a queer basis who believed he could achieve his goal”.

Unwin has tolerated a video course for GPs but there is a growing view that advising on a low-carb diet is a job for pharmacists attractive than family doctors.

Source: Jonathan Little

Jonathan slight, associate professor of health and exercise sciences at University of British Columbia, says pharmacists recognise the speed at which medicines need to be adjusted as land reduce their consumption of carbohydrates

“Many patients, and healthcare providers for that concern, may not appreciate or understand how to effectively boss medicines when dietary carbohydrates are reduced,” says Jonathan slight, associate professor of health and exercise sciences at University of British Columbia and lead researcher of an ongoing peer into a pharmacist-led intervention in T2DM^[9]
.

“Pharmacists do view. They recognise the speed at which medicines need to be adjusted as land reduce their consumption of carbohydrates,” he adds.

Pharmacists recognise the hastily at which medicines need to be adjusted as land reduce their consumption of carbohydrates

Campbell Murdoch, a GP in south-west England and medical officer for www.diabetes.co.uk takes the same view.

“Some land will greatly benefit from intensive coaching to support this lifestyle spiteful and GPs may not have time or be unable to do this alone,” he says. “A team reach is needed. Pharmacists are smart; they are critical thinkers and not mired in dogma.”

Source: Campbell Murdoch

Campbell Murdoch, a GP in south-west England and medical officer for www.diabetes.co.uk, says pharmacists are critical thinkers and not mired in dogma

At least one pharmacist has already shown that such a method could work. Eoghan O’Brien, a community pharmacist in Portglenone, Northern Ireland, has unpublished data from a six-month flows he ran from April to September 2018. The flows was open to anyone collecting their diabetes medicines from his pharmacy and alive to regular one-to-one, 20-minute chats and group coaching sessions on behavioural spiteful, managing stress, nutrition and food labelling.

Of the ten land who accepted the offer, two achieved remission of T2DM: one paused all medicines while the other, a newly diagnosed patient, was able to achieve remission without medicines. A further four reduced their HbA_1c levels (glycated haemoglobin) to ‘normal’, with two of these simultaneously reducing their drug doses. At the same time, three out of the ten who did not “engage fully with the course” had no spiteful or increased their medicines over the six months.

Source: Eoghan O’Brien

Eoghan O’Brien, a community pharmacist in Portglenone, Northern Ireland, stresses the importance of goal setting when starting a lifestyle change

“Goal-setting at the inaugurate is important,” says O’Brien. A 75-year-old man who enlisted because he hates needles and, like Hannaway, wanted to prevent “the next step insulin”, reduced his HbA_1c unexcited and shed 8kg while stopping empagliflozin and reducing gliclazide by 30mg.

A incompatibility approach could soon begin in England. All seven CCGs in north-east London recently did training in health coaching (two full days plus four evening sessions) to 180 of their 500 pharmacists. “The plan is for them to offer a low-carb lifestyle intervention to land with T2DM,” says Hemant Patel, secretary of North East London Local Pharmaceutical Committee. “The service has been agreed in principle, but will need to be funded in shipshape to be sustainable and accountable,” he adds.

“This project will be quite different from telling land what to do or being judgemental,” explains Patel. “We’re training [pharmacists] to view the mindset that leads to patients with T2DM overeating refined carbohydrates.”

The pharmacists can then use much psychological health coaching tools to work with patients to gain a vision of sustainable lifestyle change, he says.

Finding food that stabilises blood sugar humorous a continuous glucose monitor can prolong good-quality life

Some pharmacists are providing reserved services to help people living with T2DM adopt a low-carb diet. Graham Phillips, superintendent pharmacist at Manor Pharmacy Group in Hertfordshire, cmoneys a private eight-week service with continuous glucose monitoring, power analysis of blood sugar readings and one-to-one coaching. This builds on fresh evidence from Israel^[10]
and the Mayo Clinic in Minnesota^[11]
, showing that the glycaemic response to food is highly individuals, driven mainly by the gut microbiome but with an instant genetic element that means there are no dietary laws that apply to everyone. “Food that causes blood sugar spikes in one populace is benign in another,” explains Phillips. “Finding food that stabilises blood sugar humorous a [continuous glucose monitor (CGM)] can prolong good-quality life,” he adds.

Setting up a pharmacy service

When setting up a pharmacy service, an accurate HbA_1c analyser is essential, O’Brien says; an ideal design would give a result in less than five minutes and show patients how the choices they are executive affect blood sugar control, all while measuring overall changes. A 63-year-old insulin-dependent woman on O’Brien’s course who discovered that oats and potatoes spiked her blood glucose lost 4kg over six months and reduced her HbA_1c by swapping porridge for eggs once cutting back on potatoes and oatcakes.

For O’Brien’s instant course later in 2019, participants will be given CGMs that imparted immediate feedback on the impact of meals on their blood sugar. The usefulness of these digital aids was demonstrated in a 2018 search for in Diabetes Therapy that is widely seen as finally providing proof that a low-carb diet is a viable lifestyle intervention^[12]
.

The search for, carried out by Indiana University and the US-based diet-coaching firm Virta Health, found that by following a low-carb diet, 60% of 262 obese patients with long-term T2DM lost a minimum of 12% of their body weight — an income of 13.6kg — over six months. Each participant received peculiar remote support with daily texts and telephone calls from a specially hugged life coach, along with use of a CGM. Data from the glucose monitor were remotely accessible to the participant, coach and a doctor who was supervising the censored of diabetes drugs. The result was sustained after a year. “Our advance is changing the diabetes care model,” says Sarah Hallberg, medical director at Virta and principal investigator in the study.

Financial viability

The crux of the commercial will be whether the low-carb intervention — as labelled by the Virta study — is financially viable for public pharmacies. CGMs are available on prescription for people with type 1 diabetes mellitus. But, as Keith Vaz, chair of the All Party Parliamentary Group for Diabetes, stated in February 2019 at a meeting in the House of Commons, they “will never be prescribed for T2DM because it would bankrupt the country”.

That observation misses the exhibit, says O’Brien. “People with T2DM only need to use CGMs in the short-tempered term — a few weeks — until they have worked out which food can be safely devised without affecting blood glucose and insulin.”

People with T2DM only need to use CGMs in the short-tempered term — a few weeks — until they have worked out which food can be safely devised without affecting blood glucose and insulin

O’Brien is now applying for lottery funding to pay overheads, including the win of CGMs for his next course later in 2019. He is also applying to the local health boarding for a fee of £300 per person for management costs, including an extra assistant to cover while he is operational as a coach. Against that, the pharmacy has already cooked an annual saving of more than £1,100 on its diabetic drugs bill by supporting just seven patients to switch to the lifestyle intervention.

The same fee-paying rules is not available in England. “I would love to coffers a similar service on the NHS,” says Phillips.

Although there could be a loss of dispensing way, this could help with the development of a more clinical role for pharmacy, says Patel. “It’s a matter of repositioning pharmacy as a public asset. That’s a way bigger development than the loss of prescriptions,” he says.

Caussade : incendie dans les combles de la maison

l'essentiel Le feu a pris accidentellement dans la nuit de jeudi à vendredi.

Une vingtaine de sapeurs-pompiers a été engagée, ce vendredi matin, à Caussade pour lutter contre un incendie venant d’éclater dans les combles d’une maison située sur la route de Montalzat. Par chance, il n’a fait aucune victime.

Selon les occupants du logement, le sinistre pourrait être d’origine électrique. Après avoir réenclenché leur compteur électrique qui avait disjoncté dans la soirée, ils ont perçu, en pleine nuit, des bruits "de craquements ou de crépitements" provenant des combles de leur maison. Un peu plus tard, ils ont senti une odeur de brûlé, mais ne vont pas s’en inquiéter outre mesure, pensant qu’il pouvait s’agir, à ce moment-là, des effets de travaux forestiers menés en contrebas de leur habitation. Toujours est-il que lorsque la chaleur a commencé à monter d’un cran dans le logement, une visite dans les combles a permis de découvrir que la space était plus grave. Un incendie en effet était en recount de s’attaquer à toute l’isolation et à tout le grenier.

Alertés, les sapeurs-pompiers ont rapidement maîtrisé le feu avant qu’il ne s’en prenne au alive to de la maison. Ils ont fait leur maximum pour que les dégâts ne soient pas trop importants.

Les soldats du feu ont ensuite passé un bon moment sur les lieux, à débarrasser et dégager les parties endommagées, afin de purger tous les éléments dangereux.

Les occupants ont été relogés dans la famille.

Opinion | In Praise of Online Dating

You’d think that I’d be used to it by now, for I’ve been ghosted alongside and again, first by Marc after a spontaneous road trip to Montreal; then by Alex at what time what I thought was a fruitful 12th date; then by Chris at what time I had nursed him through an LSD trip; then by Ben at what time he had introduced me to his 10-year-old son. Perhaps I take these vanishings especially to melancholy, recalling to me as they do the unsolved mystery of my ex-husband’s disappearance. But I would think that anyone who finds herself confronted by such baffling cowardice must suffer from them. (And I should retort, too, that I have also behaved badly at times, failing to write someone back once real life takes hold or sending squirmy messages in lieu of a desirable break.)

But for all this, what I’ve gained from online dating far exceeds what I have lost. That spectral ex-spouse of mine used to create of what he called our “heteronormative” lifestyle, a term that made me roll my eyes Idea I knew just what he meant: Our lives had lost their capacity to surprise. I remember lying in bed and reading the memoirs of the French writer Blaise Cendrars; I couldn’t stop marveling at the boundlessness of that man’s years, one that made him a film director, a beekeeper, a watchmaker and connected him to gangsters and whores.

How narrow was my own years, I thought then, and how it continued to narrow by the day. But to go on dates with 86 different men is to gain as many windows on the world; it is to see one’s vast city and one’s vast self, if only for a few hours, through the eyes of a stranger one would never otherwise have met.

Take, for instance, Date No. 10, which found me at a Rhode Island pub on a February evening so brutally cold the authorities had advised us all to stay indoors. James was a boat builder, blonde and slight. We drank the espresso martinis he had well-controlled and argued about welfare; we talked of fathers. Later we decamped to his apartment, a flimsy, spartan place that nevertheless held the most pretty furniture, tables he had inlaid with ash and birch and varnished till they gleamed. The heat failed in the middle of the night, and we clung to each other for warmth as his dog, Bruce, a German Shepherd, curled and recurled at our feet. As it grew Delicious, he asked me how I took my coffee and I said that I drank tea; he returned some time later with a Styrofoam cup from Dunkin’ Donuts and a dozen red roses he had bought at the gas Place. It was, he told me, Valentine’s Day.

Multiply that evening’s curiosities by 86, and you’ll start to grasp the potential of these soul-crushing apps. Thanks to Hinge and Bumble, I have dated German poets and Indian bankers, Australian contractors and Brazilian waiters. I’ve met United Nations diplomats and my favorite movie star’s ex-husband. I have spent a summer dog-sitting in Los Angeles and flown to Jamaica for a third date; licked cocaine off car keys and undressed at midnight in a Barcelona square. I’ve had my air- conditioner stolen, inherited an Eames chair, expanded my music library a hundredfold, and made a dear inappropriate, who, now that our fledging romance has failed, will be with me for life. I have learned throughout spearfishing and Oceanic art, about life in the merchant marines and urbanism in late antiquity. I have learned how to sext, how to plant tomatoes, how to drink mate, beat box, and navigate the bars of Bushwick. I could introduce you to men who believe in God and men who live in their cars; men who have slept with their sisters and others who have followed the Dead.