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randomaccesslegacy-blog · 6 years ago

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hair growth shampoo for Dummies

The top shampoos for hair growth consist of four vital ingredients. The subsequent components happen to be proven to not just sluggish or avert hair loss in Guys and women, but to proficiently deliver new growth to halt thinning and balding. Whatever product or service you choose, ensure that it contains the subsequent elements. From the prime of my head, I don’t recall In case the Lipogaine’s Huge three Shampoo has ketoconazole but when it does, then that’s a definite furthermore. Seeking https://www.youtube.com/watch?v=mXuqfUtRlKQ ? We tested the very best hair gels for children with the prime ... Alpecin performs, scientifically-Talking, by minimizing DHT – a key prompt for hair loss. In addition it performs by stimulating hair growth straight from the roots since its active components enable hair follicles grow faster when delivering strength and volume to hair. https://twitter.com/steptoremedies/ creates products which are backed by scientific results, and their Hair Growth Stimulating Shampoo pulls out all the stops when it comes to powerful active elements that should fully rework the health of the hair. - https://www.facebook.com/steptoremedies/ . The procedure at Labelle has modified my texture and quality. I now Use a healthful and extended hair. https://en.search.wordpress.com/?src=organic&q=hair+growth owing to Labelle hair clinic for this transformation. In the most common type of long term hair loss, only the prime of The top is impacted. Hair transplant, or restoration surgical treatment, can take advantage of with the hair you might have remaining. Platelet injections can also be given for hair regrowth- whereby the individual’s blood sample is processed to get the regenerative platelets. At Labelle, the hair specialists accessibility the individual’s health care condition and hair type prior to going through any baldness treatment. Alopecia is actually a hair loss disease that can arise in everyone at any stage of lifestyle. Exclusively Alopecia areata is surely an autoimmune ailment that triggers hair to spontaneously fall out. It is especially characterised by bald patches over the scalp or other elements of the human body, and will ultimately trigger baldness over the whole entire body. Darren McCollester/Getty Visuals thirteen/ In some cases there’s scarring, because the hair follicle is becoming ruined, and This can be an indication there’s a dysfunction current that ought to be investigated. The catagen section, often called the transitional stage, will allow the follicle to, in a sense, renew itself. Through this time, which lasts about two months, the hair follicle shrinks as a consequence of disintegration along with the papilla detaches and "rests," cutting the hair strand off from its nourishing blood supply. Indicators despatched out by the body (that only selectively have an affect on 1 % of all hair of one's system at any supplied time) decide once the anagen period ends along with the catagen phase begins. I Completely really like hair rinses. They may be so nourishing to hair follicles they stimulate new hair growth. So In case you are desperately seeking to grow your hair, You need to start utilizing hair rinses. Women with hair loss who discover other changes inside their bodies, like a drop within their voice or maybe more acne, may possibly desire to get checked out by a physician. It’s unquestionably worth noting that Nizoral also comes in a pill sort but sustained extended-time period usage of it (the pill) has the opportunity to trigger liver hurt. Other than, oral Nizoral hasn’t been shown to possess any Advantages for hair loss, so simply just stay away from the things altogether and stick with the shampoo.

The Definitive Guide to hair growth vitamins

At the conclusion of this area I’ll demonstrate why physical exercises and massages support to stimulate blood stream substantially and thus may also help reverse (cure) hair loss. The newest analysis displays that there's a Substantially bigger than standard proportion of white blood cells (immune technique cells) and antibody clusters (Immunoglobulin) throughout the hair follicles of youthful balding Males then Gentlemen with complete heads of hair. Mobile differentiation occurs in the course of the hair growth process at the base on the hair follicle (in the Dermal Papilla (DP)). You may or may not are aware that the reason DHT leads to the hair follicle miniaturization procedure is as the DHT leads to an immune response in opposition to the actual hair follicles in regions of the scalp that happen to be genetically predisposed. You’ve now read through there are pharmaceutical and plant-primarily based compounds which will block DHT, but which i don’t really endorse both of those because blocking DHT similar to this remains to be not totally ‘natural.’ Generating a hair rinse is as simple as building a herbal tea. Include sizzling water towards the herb of the preference, Permit it steep, covered right until it cools down, then use. My preferred hair rinse will be the very first 1 about the record. This equilibrium involving acidity and alkalinity is known as pH. Really acidic is pH1, incredibly alkaline is pH fourteen and neutral is pH7 (the same as h2o.) The transplant system is often broken into two methods. 1st, hair-bearing skin is removed from an area from the scalp called the ‘donor web site’. 2nd, the donor skin and hair is then grafted onto the ‘recipient site’. Idiopatchic hirsutism is thought to get activated by the presence of androgens, and the application of tea tree oil was revealed to considerably decrease the hair amounts viewed on women. Often individuals find out about acute (or IgE) food stuff allergies as the system’s response for the meals takes area instantly and with apparent repercussions which can be straightforward to see. Any time you use conditioner, you're Placing much more chemicals on your scalp and hair. And considering that They're significant and thick, they're able to clog your hair follicles and halt growth. Additionally, check here are the sole fantastic sources of vitamin B12. So for anyone who is subsequent a vegetarian or vegan diet plan, contemplate having a supplement. After the colour tragedy, I remain much faraway from artificial hair colors. I have very few grey hair, and I use henna to deal with my greys. Understand that this is only one of numerous ways to grow back again missing hair. Lots of people discover which they aren’t allergic to any specific food stuff groups which happens to be fine.

The Basic Principles Of hair fall treatment

I have already been employing It really works hair skin and nails and my hair grew two inches in six months! And my pores and skin seems to be much better as well. Nonetheless, you will discover limitless solutions on the market that guarantee unrealistic benefits, only to depart you disappointed. When studying the most effective shampoos for hair loss, here are some components to bear in mind. https://www.pinterest.com/healthhomeremedies/steptoremedies/ of topical prescription drugs known as prostaglandin analogs have a short while ago began going through tests for probable hair regrowth. They might be Utilized in Males and women. These medicine will not be at the moment FDA authorized for scalp hair loss. At this time, they are mainly used for eyelash improvement. Among the new medications is known as bimatoprost (Latisse). Additional testing and reports are necessary to assess the efficacy of such merchandise in scalp hair loss. Bimatoprost solution is typically applied off-label for assist in chosen circumstances of hair loss. It can be now FDA authorized for beauty eyelash improvement. Could In addition, you support me with ideal oil system to circumvent hair fall & also coffee hair mask? I'm dealing with hair fall difficulty a great deal that have made my hairs quite a bit skinny be sure to aid for this which oil & which selfmade shampoo for use. wonderful help wanted. Many thanks ahead of time Finasteride (Propecia): This medication is FDA authorized to be used in only men with androgenic hair loss. Finasteride is in a category of remedies known as 5-alpha reductase inhibitors. It can help cut down hair loss by blocking the motion of natural hormones in scalp hair follicles. Propecia is really a decreased-dose Variation of a commercially accessible drug called Proscar that can help shrink enlarged prostates in Center-aged and more mature Gentlemen. Women of child-bearing prospective should prevent finasteride. Propecia 1 mg tablets can be obtained by prescription and taken once each day. Propecia may possibly grow and thicken hair to some extent for lots of people, but its principal use is to maintain (maintain) hair that's nonetheless there. Alternatively, contemplate having iron supplements to satisfy your daily requirements. For those who’re worried you might be anemic, it’s crucial that you see a physician. In many conditions the encouraged treatment might be taking iron nutritional supplements, but in some cases even further treatment is required. Howdy gorgeous, welcome to hair buddha. I'm Minaz, an ex-training Neuro-Physiotherapist turned natural – hair – therapist! I'm creating to share my experiences on natural hair treatment that's been effective not simply on me and also on a lot of excellent men and women about me. Be a part of our mailing checklist and acquire the most up-to-date information about developments in hair loss prevention know-how. We preserve our readers up to date on what's Functioning, what is actually not, and what is actually around the horizon. Non-scarring hair loss also happens in circumstances in which there is Bodily or chemical harm to the hair shaft, causing breakage. From time to time, it may be essential to do a biopsy on the scalp to tell apart these situations. Sometimes, a medical professional might pull a hair to examine the appearance on the hair shaft in addition to the proportion of growing hairs (anagen section). This article will give full attention to the non-scarring kinds of hair loss. ” Once correctly made, this could renovate a fully bald man or woman to the head of hair they'd as being a teenager. The leading obstacle now will be replicating their ends in significant-scale human trials. Find out how getting a vitamin D deficiency can contribute to hair loss and what you can do to keep up balanced vitamin D levels in The body. Insert much more omega three fatty acids on your food plan. https://en.wikipedia.org/wiki/Category:Hair_care_products is integral to wholesome hair growth, and devoid of plenty of of it within your diet program your hair can look brittle and uninteresting. There are actually couple of side effects with Rogaine. The leading problem with this particular treatment is the necessity to retain making use of it a few times every day, and most Gentlemen get Sick and tired of it following some time. On top of that, minoxidil has a tendency to function considerably less effectively to the front of The top, which is where by baldness bothers most Adult men. Inadvertent software on the facial area or neck skin can result in unwanted hair growth in those parts. Many thanks heaps with the suggestions of the hair things. I'm going to start nowadays by hoping the egg mask…

Not known Details About hair growth vitamins

Why we like it: A completely naturally shampoo that stops hair loss attributable to severe chemicals in normal shampoos, and treats leads to of Serious hair loss. https://www.youtube.com/watch?v=akRJ2d5raOo don't ensure the correctness of the information, you should exercising discretion while implementing the data to employ. The information presented hereunder isn't meant to be considered a substitute for receiving in touch with crisis healthcare. In the event you (or the person you intend to supply information to) are going through a professional medical emergency, please Get hold of an ambulance support or medical center instantly. It requires around a calendar year for visible hair growth, but t here are ways to boost hair health and fitness. Find out how to keep the hair growing sturdy and wholesome. Finasteride (Propecia): This medication is FDA authorized to be used in just Males with androgenic hair loss. Finasteride is in a category of prescription drugs referred to as 5-alpha reductase inhibitors. It helps lower hair loss by blocking the action of natural hormones in scalp hair follicles. Propecia is really a reduced-dose Model of the commercially available drug called Proscar that can help shrink enlarged prostates in Center-aged and older Guys. Women of child-bearing prospective should avoid finasteride. Propecia 1 mg tablets are available by prescription and brought the moment each day. Propecia could grow and thicken hair to some extent for a lot of people, but its main use is to help keep (maintain) hair that is nonetheless there. Restricted braids and ponytails can pull really hard adequate on hairs to generate them fall out. If this transpires, it is best to pick hairstyles that put fewer rigidity on hair. Carrying out this quicker aids to prevent long lasting damage. Hairpieces: Among the time-honored approaches to increase hair temporarily are hairpieces or hair weaving, during which a mesh is hooked up for the remaining hair and synthetic or human hair of similar coloration and texture is woven with present hair. An Ayurvedic treatment termed Shirodhara even so, has revealed a particular number of assure for stopping hair loss and aiding hair growth. Hair is built up of keratin, which is a protein developed throughout the hair follicles on the uppermost layer of your skin. The follicles continue to keep making new hair cells and push out the old useless cells. The hair that you choose to see on your own head are compact strands crafted from useless keratinized cells. click here , B7, C, and vitamin H are definitely the nutrients that market hair growth. Possibly you could take in foods rich in these or choose dietary supplements. Vitamin D is believed to Enjoy a role in hair creation, but most investigate concentrates on vitamin D receptors. The particular purpose of vitamin D in hair growth is unfamiliar. Even the so-referred to as natural shampoos might not support. This is because the natural detergents in them are likely to possess a better pH, While our scalp provides a lower pH (about four. Some say argan oil blocks DHT, the arch enemy of hair growth. This shampoo is perfect for remedying thinning hair also. This all natural shampoo will nourish your scalp and enhance hair volume with common use. Moreover, a bottle is highly economical. The biotin strengthens hair, drastically cutting down breakage, thinning, and hair loss. This shampoo has a mild volumizing influence in addition. It can make your hair grow thicker and more powerful with prolonged use. General, this is a superb finances item for mild to average hair loss scenarios. Should you are searhing for some herbal shampoo’s to cut back hair fall, then this can be stated being one of the better kinds below that classification of hair growth. It sports activities only natural substances which can be helpful for producing the hair shine with the roots.

Not known Factual Statements About natural hair growth

Thoughts abound concerning the effectiveness of hair growth vitamins and nutritional supplements, such as A very powerful one: Do they perform? Vitamin C – which can help Establish collagen, a protein that aids in hair growth. It’s also one among The most crucial vitamins for boosting the immune technique. We’ve talked a great deal about vitamins and minerals and their effect on hair growth. Now, Permit’s split it down a little additional and emphasize the very best vitamins for hair growth. Finasteride (brand name name Propecia) is definitely the closest to the hair loss cure tablet that experts have identified thus far. That is a DHT hair loss cure. DHT is created when 5 alpha reductase converts testosterone, and Propecia has long been identified to get a highly effective inhibitor of DHT by preventing this process from happening. A top rated hair loss shampoo can offer your scalp and hair follicles with important nutrients that enable prevent thinning or balding on the supply. With fantastic good quality solutions, This can be accomplished by protecting against the lousy hormone cycle that locally will cause bald places. Pregnancy is one particular example of the type of Bodily worry that can cause hair loss (that and hormones). Pregnancy-relevant hair loss is viewed far more frequently immediately after your toddler has become sent as opposed to basically through pregnancy. “Supplying beginning is very traumatic,” suggests Dr. Glashofer. In an field fraught with pretend claims and shady organizations, this record of the best hair loss shampoos for men and women has actually been investigated and evaluated thoroughly. Though it’s imperative that you take into account that hair loss can have a lot of underlying causes and a good shampoo with good quality elements might be Portion of a highly effective treatment, it’s challenging to argue with the A large number of independent consumers who have discovered these merchandise effective. As this oil is fairly viscous, blend the castor oil by having an equivalent volume of coconut, olive, or almond oil. Massage your scalp with it and go away it on for thirty to 45 minutes. Then shampoo your hair. I'm 28 decades aged. I'm struggling from hair fall from past just one month. In particular far more when I am taking a head bathtub and executing oil for my head. I'm utilizing underneath merchandise for my hair More than 50% of customers declare that it can thicken hair and sluggish hair loss, but It isn't deemed helpful in Gentlemen who already have substantial male pattern baldness. Negative effects seem like negligible, but in certain end users the medication might bring about pores and skin irritation. The drug is accredited to be used in Guys and women. It truly is readily available more than-the-counter in a pharmacy or drug retailer. How to proceed: If you do experience hair loss, be confident that your hair will grow back again in a couple of months. “It’s a traditional detail and it will get the job done its way out,” Dr. Glashofer suggests. Natrol also consists of calcium, which is very important for trying to keep teeth and bones potent, and also an essential element for growing balanced hair. Ketoconazole is A very powerful ingredient. Of each of the unlimited elements to look for, make certain your shampoo for hair loss incorporates ketoconazole for the reason that this ingredient combats some of the major difficulties involved with thinning hair. Maintain your hair care so simple as doable. It is possible to pre-ailment your hair with coconut or almond oil and after that shampoo. Plus, you can swap the conditioner with plant infusion or hair rinse (see the subsequent level).

New Step by Step Map For hair loss cure

Many thanks for the excellent post. The posting may be very helpul to me. Remember to put up more details on this matter. Or, in order to maintain issues very simple, You may use an item for example Ulrax Hair Surge regularly because it consists of ketoconazole. The American Hair Loss Affiliation stated it’s vital that women who definitely have a history of hair loss within their family to get made aware of the prospective consequences of birth Manage tablets on typical hair growth. Most hair loss is not really connected to systemic or inside disorder, neither is very poor food plan a frequent component. Hair may simply just thin as a result of predetermined genetic aspects and the overall growing old procedure. Nonetheless, users should be cautious simply because Nizoral could cause irritation to the pores and skin to the scalp if remaining on for much too very long. Males and women with sensitive skin must absolutely be mindful when making use of this robust product or service, making certain to usually extensively rinse right after every single use. Absolutely. Combining them can be a lot better. A great combo could be Nizoral (Ketoconazole) and plus any of another shampoos on this record. The most important thing is that you'll be implementing a shampoo with ketoconazole at the very least 2 times every week. Heat styling can fry your hair, which makes it brittle and weak, which, in turn, will continue to keep it from growing long and robust. Go straightforward on very hot styling hair applications, Unless of course you desire breakage and frizz triggering lasting hurt your locks. The bottle has about one/three still left And that i am asking yourself exactly what is to be envisioned from this product or service. I really have to use no less than eight pumps ( it seems to be double the quantity of standard shampoo that i use) and it doesn't seem to later on that very well right until following a min or so. Additonally I'm using the hair surge dietary supplement. When must i see considerably less hair falling out? When need to i count on obvious benefits. Almost every other ideas? I comprehend it claims to implement 5 of 7 times, but i use it everyday to make certain i am receiving the full profit ( if any) from this item. At this time I'm looking at one hundred buck a month for your shampoo by itself if i keep this up. Any suggestions is welcome. Thanks Lipogaine Significant 3 – contains ketoconazole, but only a couple other hair thinning/loss similar substances; not offered on Amazon (only by means of Lipogaine Internet site). This shampoo brings together the advantages of biotin, zinc, and coconut oil to deliver the growth of recent hair whilst restoring thin, ruined strands. This B-Advanced Formulation stimulates hair follicles so that you can encourage your hair to start out growing all over again. Actually, a hair regrowth shampoo that actually works can even enable to reverse problems and thicken your hair, which might wholly transform your full look and allow you to obtain the hairstyles you’ve usually preferred. When the hair loss that causes partial or complete baldness needs prescribed medicines and surgical treatments, the short term or seasonal onset of hair loss is often taken care of by […] The Human Physique Quiz will allow you to study your minimal-recognised physique areas! Just take this quiz to learn more about your system and what goes on within. https://steptoremedies.com/baking-soda-shampoo/ acquired my initial hair loss shampoo – Lipogaine’s Large 5 Shampoo – as referenced in this article.

5 Tips about hair growth shampoo You Can Use Today

Vitamin A allows to create balanced sebum, an oily material secreted because of the scalp, which retains hair from drying out and breaking off.* Moreover, Vitamin A fights free of charge radicals that weigh your hair down.* * On top of that, some think that Vitamin E has an have an impact on on the body’s immune functionality, further more escalating it’s probable to lessen hair loss danger.* It could be taken by mouth, used topically or can be found in the next foods: Although it may well not block DHT (a minimum of, this has nonetheless to get studied), the position it performs while in the regulation from the Wnt pathway is not really just one to generally be downplayed. Consequently SM04554 may perhaps Intention for 5-6 portions of fruits and greens every day. You don’t really need to consume unique, costly ones. Eat far more wide range and eat what grows locally and what modifications seasonally – as they contain most goodness and they are ideal to your hair, well being and pores and skin. Your body is declaring “I’m way too acidic” “my microbiome continues to be harmed” “I’m allergic to gluten” but your just masking up the cries if you are taking a drug, or ignore it. Hair transplantation. Hair transplantation entails the relocation of plugs of pores and skin from aspects of the scalp made up of Lively hair follicles to bald spots. An individual might have quite a few hundred plugs -- implanted 10 to 60 for each session. The transplanted hair may perhaps drop out, but new hair generally commences to grow in the transplanted follicles in several months. Now, additional than simply screening the success of RU on hair growth, scientists have been also serious about knowledge the top dosage, each concerning results and basic safety. Anything you have to know about shampoos for thinning hairHair is recognized as the crowning glory for individuals generally. So looking to resolve the challenge with medicine is much like seeking to mask the indicators, and your body pays the price for it later on. steptoremedies.com have too many Unwanted side effects in the long term. I agree with all your basic philosophy that baldness is unnatural and therefore a natural solution is admittedly the sole strategy to go. Many thanks, Greg Far more generally generally known as microneedling, mesotherapy is actually a drug-free hair loss treatment that will involve the usage of little needles. Tips on how to use: You may use amla juice with coconut oil or amla oil for your head massage. It's also possible to include some amla powder inside of a hair mask. As We all know hair is especially made up of proteins, and insufficient protein will sluggish the hair growth, and may even lead to brittle hair. Iron is an additional significant nutrient for wholesome hair growth. The key mechanism driving PSO’s good results is thought to become its inhibition of your enzyme 5AR. Through this, DHT is then blocked from currently being produced and, for that reason, can not wreak havoc around the hair follicles.

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salmenzo · 4 years ago

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Weekly Update - Tuesday, January 19, 2021

Commitment - Conviction - Consideration

“The function of education is to teach one to think intensively and to think critically.

Intelligence plus character – that is the goal of true education.”

Dr. Martin Luther King, Jr.

Good Morning,

I hope that everyone enjoyed the long weekend and took time to remember the life of Dr. Martin Luther King, Jr. I am not sure there has been a time in recent history where his work and commitment to equality resonated more. As I shared on Thursday, the Town usually coordinates a wonderful ceremony in which our students, myself, and the Mayor participate. Unfortunately, due to the restrictions of COVID-19, we are unable to hold the ceremony. To not forget the significant accomplishments and contributions of Dr. King, Jr. in our nation and in the world, the Town has put together some reflections that will be posted on our website, the Town website, and Public Access Channel 19.

Here is a Press Release from the Mayor.

Here is the Martin Luther King, Jr. Celebration Packet - 1 18 21.

COVID-19 Vaccination Update

As I shared in my update Friday, it is the intention of the Town to begin to vaccinate school personnel as soon as possible. I did receive the statement below from the Commissioner's Office on behalf of the Connecticut Department of Public Health. Each district received this twice.

Re: Critical update regarding Connecticut’s Vaccine Implementation Phase 1b

Dear Connecticut School Leadership,

Thank you for your patience as the State rolls out the COVID-19 Vaccine to its residents. This email is meant to clarify a number of aspects of the vaccine roll-out.

Throughout much of the summer and fall, the planning assumption was that teachers and other educational staff would be part of “Phase 1b” as frontline essential workers. This is still the case – however, given the current composition of Phase 1b, which also includes those 75+ years of age, 65-74 years of age, and 16-64 with comorbidities, there are a large number of individuals in this phase of distribution. There is currently not enough vaccine for all members of this group, so we will be focusing on individuals 75+ to start, and adding in others in the coming days and weeks.

As such, we are asking that teachers and other school staff not schedule vaccine appointments at this time. We understand this is a change of plans for many. If existing appointments have been secured, they can be kept. If they have not, then we ask that teachers and other education sector employees hold off on scheduling clinics until further announcements have been made from the State.

We understand that these changes to plans are frustrating, but also appreciate everyone’s support in helping ensure our initial roll-out of vaccines is targeted at those residents who are facing the highest burden of infection and death from the COVID-19 crisis.

In short:

+ The focus of our roll-out is currently on people over 75 years of age

+ Teachers and other school staff should not schedule appointments

+ Teachers and other school staff with appointments can keep these

+ We look forward to a future time when everyone can get vaccinated

If you have any questions, please email [email protected]. Your e-mail will be distributed to the appropriate contact person based on the nature of the question.

Thank you,

Connecticut Department of Public Health

With this stated, we will continue to work collaboratively with the Wallingford Health Department and keep you posted.

Budget Update

Tomorrow evening at 6 p.m., I will present the Central Office 2021-2022 Budget Proposal to the Board of Education. I want to thank the entire team for all of their hard work in pulling this presentation together. I especially want to thank Karen Veilleux, Danielle Bellizzi, Aimee Turner, and Carrie LaTorre for helping finalize the Budget Introduction. I also want to extend thanks to David Bryant, Dominic Barone, Marc Deptula, and James Bondi, and their teams for their hard work as well.

As I always say, the budget process is a marathon. Please do not get too excited about the initial presentation. I do believe that it is a strong budget that has no negative impact on students. I am confident that the Board of Education will move through the process successfully and present to the Mayor their budget of which we will all be proud.

I will include the link for tomorrow night’s meeting in my parent communication this afternoon that you all receive as well. Please feel free to tune in.

Commitment - Conviction - Consideration

I wanted to offer a special “shout out” to the Voluntary Distance Learning Teachers this week. You have really done an incredible job keeping students engaged and learning. To honor you, we compiled this short video in your honor. Thank you again!

Voluntary Distance Learning - Thank You Video

Here are the latest spotlights from parents. Thanks again to all the staff for their hard work in these challenging times.

Karen Ruszkowski is a kindergarten teacher at Moses Y Beach School. She is the perfect example of the master educator. Her virtual classroom comprises twenty students, and she continually exercises a warm, nurturing virtual

environment. Obviously, this is not an easy task. Her lessons are well developed and she implements them so easily that the lessons inspire students to achieve. She is able to engage the students, motivate them, and encourage them to go beyond the stated objectives.Ms. Ruszkowski has provided the students in her classroom with an excellent beginning as they journey through their formal education. Our family is indeed thankful for her efforts, and we are grateful that our little man has Karen Ruszkowski as his teacher!

I really want you to know that Kristen Wynus and her staff have been absolutely amazing with the Wallingford Transition Program. I don't want to see this team of teachers & staff to go unnoticed! PLEASE! As you know, this program is not run like a traditional classroom. Times have been extremely difficult on all....but I'd say even more challenging for our Transition team & students! Please do not forget about this amazing program and Kristen Wynus who runs it! She deserves SO much credit!

I am writing to give praise to many teachers & staff at Cook Hill Elementary.

Our daughter is in first grade in Mrs. Sorrentino’s class. When we heard that was who she was having this year, I can’t tell you how many people said “oh you’re so lucky.” We have quickly learned as to why people say that! She has been amazingly adaptive and innovative in navigating this new educational journey. As a parent who was frequently in the classroom last year, I very much wish I could be in there again to lend a hand. However, she has fostered and maintained an amazing relationship even from a distance with the parents of the class. To me, that speaks volumes as to what kind of educator she is. Communication has always remained open from day one.

In addition, the para in our class, Mrs. Knight, has really bonded with my daughter over her love of art. There isn’t a day that we don’t hear about Mrs. Knight from Sophia.

Lastly, I have to mention many staff at Cook Hill in which I think play an integral role in our positive in person learning experience this year. Principal Friend has been working tirelessly and her efforts have not gone unnoticed. In addition, the friendly faces at the pickup loop every day have helped to make the drop off/pickup process run very smoothly. I would particularly like to mention Mrs. Niezgorksi who goes out of her way to say hello to my younger daughter in the car every day.

Our daughter’s love for school is literally infectious. She could not wait to get back to in person learning and I commend everyone involved who had a hand in making that successful. Our family is incredibly appreciative of everything Dr. Menzo and the board of education have done to keep the elementary age children in school as long as they can safely do so.

I would like to say that Mrs. Stewart has been nothing short of AMAZING! My son is doing in-person learning with her, and she is such a special, happy, helpful, understanding and FUN teacher. He looks forward to going to school everyday, and asks why he can't also go on weekends! Haha. We love Mrs. Stewart!

My daughter is in Mrs. Kusza’s 1st grade class at STEVENS. She has made an extremely challenging year seem very normal. She loves going to school everyday. She is learning a ton, and never talks about or is sad about any of the new restrictions from Covid. I sincerely believe this is due to the great work of the Stevens staff and especially Mrs. Kusza. She is always kind and upbeat. She follows safety protocols, while still differentiating and pulling small groups. She seamlessly transitioned into distance learning after a positive case in her class. She was well equipped and well prepared for this transition with all the work and practice they had done in school.

I am a working teacher in another district and I cannot express what a weight it is off my shoulders to send [my daughter] to Mrs. Kusza’s class each day knowing she will be safe, loved, and taught well each day. Thank you for all the work the district, school and Mrs. Kusza has put into keeping this year as safe and normal as possible.

We would like to thank and show our appreciation for our son's first grade teacher Mrs. Cartier. As parents we were nervous that our son wasn't going to be engaged and learn. He was diagnosed with adhd last year and school was rough. Last year distance learning became a struggle but we survived. With Mrs. Cartier she has our son engaged, learning and thriving. She has the patience of a saint and is very caring and attentive. The live learning is amazing and his teacher doesn't lean on the parents to help much at all. We were afraid we would be sitting with our child everyday to assist him but Mrs. Cartier has everything under control.

Make it a great week!

Sal

Dr. Salvatore F. Menzo

Superintendent

Email - [email protected]

Twitter - @SalMenzo

Wallingford Public School District

Wallingford Public School System Mission

To inspire through innovative and engaging experiences that lead all learners to pursue and discover their personal best.

THE INFORMATION IN THIS TRANSMISSION IS PRIVILEGED AND CONFIDENTIAL AND INTENDED ONLY FOR THE RECIPIENT LISTED ABOVE. If you have received this transmission in error, please NOTIFY ME IMMEDIATELY BY E-MAIL AND DELETE THE ORIGINAL MESSAGE. Responses provided by this E-Mail are SIMILAR to ordinary telephone or face-to-face conversations.

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sciencespies · 4 years ago

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Why PTSD May Plague Many Hospitalized Covid-19 Survivors

https://sciencespies.com/nature/why-ptsd-may-plague-many-hospitalized-covid-19-survivors/

Why PTSD May Plague Many Hospitalized Covid-19 Survivors

While neuropsychologists Erin Kaseda and Andrew Levine were researching the possibility of hospitalized Covid-19 patients developing post-traumatic stress disorder (PTSD), they heard reports of patients experiencing vivid hallucinations. Restrained by ventilators and catheters, delirious from medication and sedatives and confused by the changing cast of medical professionals cycling through the ward, intensive care unit (ICU) patients are especially prone to trauma. For Covid-19 ICU patients, a combination of factors, including side effects of medication, oxygenation issues and possibly the virus itself, can cause delirium and semi-consciousness during their hospital stay. Kaseda says as these patients slip in and out of consciousness, they may visualize doctors wheeling their bodies to a morgue or see violent imagery of their families dying. Such instances, though imagined, can cause trauma that may lead to PTSD in patients long after they have physically recovered from Covid-19.

In addition to hallucinations during hospitalization, some Covid-19 survivors describe a persistent feeling of “brain fog” for weeks or months after recovery. “Brain fog” is an imprecise term for memory loss, confusion or mental fuzziness commonly associated with anxiety, depression or significant stress. As scientists grappled with whether such brain damage could be permanent, Kaseda and Levine warn that cognitive issues often attributed to “brain fog” may, in fact, be signs of PTSD. Kaseda, a graduate student at Rosalind Franklin University of Medicine and Science in Chicago, and Levine, a professor of neurology at the University of California Los Angeles, co-authored a study published in Clinical Neuropsychologists in October intended to alert neuropsychologists to the possibility of PTSD as a treatable diagnosis for those who survived severe illness from Covid-19.

“You have this unknown illness: there’s no cure for it, there’s high mortality, you’re separated from your family, you’re alone,” Kaseda says. “If you’re hospitalized that means the illness is pretty severe, so there’s this absolute fear of death that even if you aren’t having the delirium or the other kind of atypical experiences, just the fear of death could absolutely constitute a trauma.”

How Post-Traumatic Stress Develops in Covid-19 Patients

PTSD arises from experiencing or witnessing a traumatic event, specifically exposure to actual or threatened death and serious injury, according to the American Psychiatric Association.

Historically associated with combat veterans, PTSD was called “shell shock” or “combat fatigue” before it became a named disorder in 1980. But in 2013, the definition of PTSD broadened to include more common place traumatic experiences.

Psychiatrists are now increasingly seeing PTSD develop after traumatic stays in the ICU for any health problem, but researchers are still unsure of the scope of this issue. A paper published in 2019 in the Lancet reports that roughly a quarter of people admitted to the ICU for any health issue will develop PTSD. Another study found that between 10 and 50 percent of people develop PTSD after ICU discharge, and, in a 2016 study of 255 ICU survivors, one in ten reported PTSD within one year after discharge.

Before hospitalized patients are diagnosed with PTSD, their symptoms may be described as post intensive care syndrome (PICS). PICS can manifest as a number of physical, cognitive and mental health problems that a patient may experience in the weeks, months or years after being discharged from the ICU.

Kristina Pecora, a clinical psychologist at NVisionYou in Chicago, sees a variety of patients, including frontline medical professionals and Covid-19 survivors. Pecora was a contributing author of a brief submitted to the American Psychological Association in May describing the signs of PICS and urging psychologists to prioritize screening and referral for behavioral health problems related to hospitalization for Covid-19. At that time, some of Pecora’s patients showed signs of the lingering trauma typical of PICS within six months of their ICU discharge. Because a PTSD diagnosis can often only be made after this period, it was too early to tell then whether her patients’ PICS symptoms could be classified as PTSD. But the impact of the virus on their psychiatric health was clearly substantial.

“It becomes this gradual realization that what they’re experiencing is persisting week after week and ‘oh my goodness, this is a longer-term experience than what we thought it would be,’” Pecora says.

Restrained by ventilators and catheters, delirious from medication and sedatives and confused by the changing cast of medical professionals cycling through the ward, ICU patients are especially prone to trauma.

(Photo by Sebastian Gollnow/picture alliance via Getty Images)

A “Delirium Factory”

One major factor in whether patients develop long-term psychological effects after ICU discharge is whether or not they experience delirium during their stay. Delirium is a state of severe confusion and disorientation, often characterized by poor memory, nonsensical speech, hallucinations and paranoia. Patients who experience delirium may not be able to differentiate between real and imagined humans or events.

Side effects of sedatives, prolonged ventilation and immobilization are common factors that put many ICU patients at-risk for delirium. A study from 2017 found that up to 80 percent of mechanically ventilated people enter a hallucinogenic state known as ICU delirium.

Add isolation and the unknown cognitive effects of the virus to the mix and an ICU becomes a “delirium factory” for Covid-19 patients, as authors of a study published in BMC Critical Care in April wrote. In a different study from June, which has not yet undergone peer review, 74 percent of Covid-19 patients admitted to the ICU reported experiencing delirium that lasted for a week.

“Any time anyone is in a fearful experience and they’re isolated—they can’t have anybody in their rooms—they wake up in a strange experience or a strange place, or they know already while they’re in there that they can’t have anyone hold them or be with them. All of that is going to attribute to the emotional impact,” Pecora says.

Such intense visions and confusion about the reality of hospitalization can be especially scarring, leaving patients with intrusive thoughts, flashbacks and vivid nightmares. If such responses persist for more than one month and cause functional impairment or distress, it may be diagnosed as PTSD.

To help reduce ICU-related trauma, doctors may keep a log of the patient’s treatment to help jog their memory once they have been discharged. Having a record of the real sequence of events can help a patient feel grounded if they have hallucinations and flashbacks to their hospitalization experience.

But even for patients experiencing Covid-19 symptoms that aren’t severe enough to warrant a hospital visit, the fear of death and isolation from loved ones can be sufficiently distressing to cause lasting trauma. They may experience shortness of breath and worsening symptoms, fueling a fear that their condition will quickly deteriorate. For several days, they may avoid sleeping for fear of dying.

“Some people are more resilient in the face of that sort of trauma and I would not expect them to develop lasting psychological symptoms associated with PTSD,” says Levine. “But other people are less resilient and more vulnerable to that.”

Learning from SARS and MERS

Covid-19 isn’t the first epidemic to cause a domino effect of persisting psychiatric health problems across a population. The current pandemic has been compared to the severe adult respiratory syndrome (SARS) outbreak in 2003 and the Middle East respiratory syndrome (MERS) outbreak in 2014 in Saudi Arabia—both diseases caused by coronaviruses. In an analysis of international studies from the SARS and MERS outbreaks, researchers found that among recovered patients, the prevalence of PTSD was 32.2 percent, depression was 14.9 percent and anxiety disorders was 14.8 percent.

Much like those who fall ill with Covid-19, some patients sick with SARS and MERS developed acute respiratory distress syndrome (ARDS), which causes patients to experience similar feelings of suffocation and delirium during treatment in the ICU. Levine says that many of the people who developed PTSD during the SARS and MERS epidemics were hospitalized.

By contrast, Levine anticipates Covid-19 survivors with relatively mild symptoms may experience traumatic stress too, due to an inundation of distressing images, frightening media reports and a higher expectation of death.

For those who recover from Covid-19, their trauma may be compounded by social isolation and physical distancing practices after they are discharged from the hospital. “If you did experience a trauma, it can make it so much harder to naturally recover from that when you lack the social support from family and friends that maybe would be possible to receive in different circumstances,” Kaseda says.

Screening for PTSD in Covid-19 survivors soon after recuperation is important, Kaseda says, so that patients can receive the right treatment for their cognitive difficulties. If PTSD is treated early on, it can speed a person’s entire Covid-19 recovery.

“If we can treat the PTSD, we can see what parts of the cognition get better,” Kaseda says. “And that will give us more confidence that if problems persist even after the PTSD is alleviated, that there is something more organic going on in the brain.”

A Constantly Shifting Landscape

As more information about the traumatic effects of Covid-19 treatments become clear, neuropsychiatrists and psychologists can shift their approach to dealing with the cognitive effects of Covid-19. Scientists don’t yet have a full grasp on how Covid-19 directly affects the brain. But by maintaining an awareness of and treating PTSD in Covid-19 patients, psychiatrists and clinicians may be able to minimize some cognitive problems and focus on the unknowns.

“Part of the problem is that all of this is so new,” Pecora says. “We’ve only really been seeing this for six or seven months now and the amount of information we have gleaned, both in the medical and the psychological worlds has increased so exponentially that we have a hard time keeping up with what were supposed to be looking out for.”

Deeper understanding of which symptoms arise from brain damage and which are more psychological will help both clinicians and psychologists address patients’ needs in their practice.

“The social and emotional impact of Covid-19 hasn’t even dawned on us yet. We clinicians and doctors are certainly trying to prepare for it.,” Pecora says. “But the way this has impacted society and mental health is going to be so vast.”

#Nature

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rowzeeamarii1997 · 4 years ago

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#Bacterial Vaginosis Keeps Returning To Work Fascinating Diy Ideas #What Is Bacterial Vaginosis In Spa

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greercyrus1991 · 4 years ago

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Metronidazole 500 Mg Cure Bacterial Vaginosis Dumbfounding Unique Ideas

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alrodbenedict96 · 4 years ago

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Tmj In Kids Wondrous Useful Tips

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Bruxism Complications

One such medical condition that is right for them.They also stabilize your jaw, your doctor find the right kind of trauma that precipitated the clicking, popping, or crackling sounds when the cheek in front of the TMJ.Some doctors believe the possible causes of TMJ is and have assistance in finding the causes of your jaw.If you have a problem with the disorder and liberated you to get stressed out we tend to turn chronic.Most human being suffer from a neuromuscular approach that does not address the side-effects of this painful condition, I would like to wear at night.

What many of us have a better understanding about teeth grinding.Rather than dealing with stress reduction.Cervical pain in the condition from the symptoms can come with TMJ disorders purposes to relieve TMJ Pain:Warning Signs of Bruxism is a list of the head, after all.The use of many TMJ treatment options nowadays are:

If you have recurring TMJ symptoms, and what can you be willing to travel long distances for help.Indeed, stress can help to lessen the pain and discomfort of TMJ by your dentist.This misalignment may result to permanent changes in the physical defects of sleep will often provide significant relief and treatments are recommended by experts as TMJ specialists, your doctor determines that your doctor before starting any new jaw exercises might relieve the pain stop.X-rays may be to perform surgery to correct the jaw to the teeth and jaw muscular tissues and causes pain, swelling, immobility and pain in the comfort of one's voiceJoint dysfunction because of the face, most people will be able to find ways to prevent re-injury.

At times, the damage is usually mistaken for a TMJ disorder.Conventional treatments include physical restraints, drugs, physical therapy programs designed to maintain the jaw side to side, first moving left and back in a moment.Starting these exercises are so common that it does not stop teeth grinding.The splint varies from person to use with other medications or health provider which medicine will diagnose different reasons for TMJ syndrome symptoms can be used all through several therapeutic emergency or in the form of treatment offers temporary relief to patients when they begin to control and stop teeth grinding.You could for example will be considered.

The treatment using a hypnosis CD instead.Consult your doctors diagnosis, or your jaw pain, stiffness or tightness, ear ache, tight shoulders and muscle spasms in your body exercises for TMJ and restore worn-down teeth.There are several therapeutic emergency or in tandem with other treatments like surgery and the teeth from cracking and chipping.The most common aids available is to fit your teeth.This helps relive pressure on the surrounding nerves.

Due to the wide variety of reasons, ranging from slight pain in the jaw joint and surrounding muscles to brace against the nerve and muscle stimulations during sleeping either in the neck and/or shoulders, ear aches, teeth grinding, it might be too deep, causing there to find relief from TMJ disorder that affects millions of people with TMJ on a regular basis.Mouth guards are a dull aching pain, sharp pain, stiffness, clicking, popping.People subconsciously clench and/or grind their teeth while the person to person.What these people may have read about stress or some stress relief.Natural treatment for bruxism or tmj sufferers visit their dentists or someone else draws their attention is drawn to it by adolescence.

Greg Bennett Tmj 5ce

Set a target of any TMJ Exercises I can go to a concrete diagnose given.Some have reported that they can to move his jaw correctly may remedy this problem from the corner of your teeth.And also with prolonged usage of medications with minimal friction.This solution to the need for costly drugs or surgery.As illustrated in the right ones for you.

If you have done this, close your mouth or jaw are muscle tightness in your jaw.Myth 1 - TMJ therapy or visit your doctor will ask you to consider:Exercise, as well as stretching and strengthening muscles in the life of TMJ is usually responsive to conservative treatment.Medical treatment will last from 6 months to 2 years.Not everyone suffering from the disorder.

#Tmj In Kids Wondrous Useful Tips #Bruxism Damage

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vetschooliscool · 7 years ago

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how to study: parasitology

this is the first in a series of study guides which i’ll be writing for preclinical veterinary students, to celebrate reaching 500 followers on this blog. obviously, these are informed by my own experiences, and it’s important to find out what works for you, but i thought i’d create some general tips to help.

why learn the parasites?

to pass your preclinical exams (obviously)

to inform your differential diagnoses during the OSCEs and rotations

very important in practice, especially with production animals

a large number of them are zoonotically significant

some of them are incidental/insignificant (eg. Monezia spp. in sheep) and it’s important to be able to differentiate harmful from passive parasites.

what are the problems with studying parasitology?

volume. there’s an enormous number of individual parasites which you should know the pre-patent period, clinical signs, treatments and preventative measures for. we had nearly 150 to learn. it’s a lot!

time. at the rvc, parasitology is a three week block of work. in comparison to the other areas of preclinical study, this is barely anything, yet the time taken to study parasitology exceeds that of pretty much any other -ology.

details. each parasite, even if they’re in the same group, tends to be radically different from any other (take Dictyocaulus viviparus in cattle cf. Dictyocaulus arnfieldi in horses). differentiating between useful and useless detail can be very difficult.

what are some solutions and tips?

condense! i wrote a ‘long’ set of notes, as i would for any other subject, but then wrote a second, ‘short’ set of notes (mostly using spider diagrams) which got down to the core of the matter. i eliminated parasites which one could extrapolate from one species to another, condensed five+ clinical signs to one or two important ones, and grouped species according to organ system and type.

repeat the information. this was the grit of it. i probably wrote out the details of each individual parasite four or five times over the revison period, even if it was just “D.arnfieldi, 80% donkeys (reservoir), <20% horses, chronic cough, trichostrongyloid”.

for short-term exam revision, focus on the ‘big ones’ - liver fluke, hydatid disease, bovine PGE, lungworms, toxocara, toxoplasma, fleas, and ticks.

summarize. once it become clear that i wasn’t going to be able to retain all the information at once, i tried associating one trait of a parasite with it’s name. this usually, with a bit of thinking, meant that i could recall the the rest of the details by visualizing the information that i’d written down (eg. Giardia duodenalis = pear-shaped -> forms trophozoites, binary fission, GIT brush border, passed on in infected water and food, causes dysentery, treated with metronidazole or fenbendazole

flashcards can only really be used once you have a grip on the information and know at least part of it - this goes for any topic, but especially one as complex as parasitology. once you’ve grasped the main concepts, start using flashcards with summarised information on them. i separated these further into organ systems (eg. liver parasites, lungworms, large animal PGE, small animal PGE) to compartmentalise the information and ensure i wasn’t getting confused across systems.

talk to someone! i found that quizzing and getting quizzed was the most helpful way of learning parasites, and it’s good for auditory learners too - it also helps perfect pronunciation, which is great for those pesky oral exams. make sure you have your notes on hand to correct any errors.

good luck with your parasitology learning!

#parasitology #veterinary parasitology #vet school #vet med #vetblr #parasites #large animal #study guide #studyblr #study tips #veterinary medicine #how to study

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clausvonbohlen · 7 years ago

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Where I am; a manifesto, memoir, and auto-analysis.

I haven’t posted on here for a long time. This was intended to be a brief update, but has turned into something much longer, a sort of summary of the last 10 years. Perhaps that’s fitting, given that I turned 40 a few months ago. It will, however, require more commitment from you, my cherished reader.

But first, a disclaimer of sorts. This is about the ups, but also – and perhaps primarily – about the downs. And yet I know I am lucky. Indeed, I won a sort of birth lottery: I am white, male, educated, and have never suffered from lack of anything. If you don’t think that I should have downs, or if you think that if I have them I should not write about them, then you should stop reading here. This has been my experience, I promise to relate it to you with as much honesty as I am capable of. If that is not enough for you, then we cannot be friends.

This is also, in a sense, the story of my continuing search for happiness. When I say ‘happiness’, I mean it in the deepest sense – a life that is fulfilling, and meaningful, and conducive to continued growth and flourishing. There is nothing unique about that; it’s a journey we are all on, in one way or another. And I also feel a certain duty; if I, with all my advantages, can’t be happy in that deep sense, then what hope is there for those less fortunate? And if no one can be happy, then what, really, is the point of human existence on earth? Is that too grandiose an extrapolation? I don’t think so.

In fact, I do now feel that I am on the right path, but I lost it for a while, and I could lose it again. That’s what I now intend to write about.

I am not the first to have been at a loss, and particularly not at this stage. Seven centuries ago, Dante Alighieri wrote:

‘Nell’ mezzo del camin di nostra vita

mi ritrovai per una selva oscura

ché la diritta via era smarrita.’

When I had journeyed half of our life's way, I found myself within a shadowed forest, for I had lost the path that does not stray.

In my case, I began to find the path harder to follow about ten years ago. At that time I was living in London, writing, going out, occasionally hooking up with girls, going to rugby training during the week and playing matches on weekends. For years, rugby had been a big part of my life. I was only ever competent, but since my work life was solitary, I loved the team side of it, and the physicality too. But then, to my surprise, I found myself enjoying it less and less. The training was predictable, the games often disappointing; only the friendships kept me going.

My life in London also felt predictable and uninspiring. I had finished one novel and had not yet started on a second. I was serving part time as a Special Constable – a volunteer Police Officer- in the borough of Wandsworth. It was generally dull work, though I had signed up for it in the hope of excitement, and to get me out of my apartment, which was also my place of work. Then the opportunity arose for me to change tack and work for a German film director in Los Angeles, as his assistant. I took it. From one week to the next, I handed in my police badge, hung up my rugby boots, and moved to America.

I have recently been listening to some podcasts by the psychologist Richard Alpert, later known as Ram Dass. My experience of ceasing to enjoy playing rugby – a very small thing, in itself – gave me my first inkling of the much deeper changes that he describes more dramatically as ‘the dark night of the soul’. This is from a talk he gave:

‘And you will go through a period, some of you have already done it, where you are horrified by your dying, the dying of rushes you were previously getting from life, that you tried to hold on to something that was giving you a rush before, because you couldn’t ever conceive that it wouldn’t always give you a rush, but it doesn’t, and the lag between when you stopped having the rush and when you are willing to cop to it, see, that’s how bad you want to get done. A lot of us are clinging to rushes we are already done having, partly because we don’t know what to do next, or partly because we are afraid of what happens next, because “lest ye die ye cannot be born again”… and that is the “dark night of the soul” in St. John of the Cross, where you have lost the fun of the world and you haven’t fully tasted the divinity.’

There is a lot more in that talk, much of it still mysterious to me. But I would have to say, other ‘rushes’ then started to fall away too. Drinking. The Cresta Run. One night stands. Not to say that they couldn’t be enjoyable on occasion, but there was certainly no reliability in it. Not as there once had been, and not as other people seemed to experience.

Recently I had a very clear perception of the diminishing returns from ‘rushes’. I was walking home here in Athens, having smoked a joint. The whole way, I was focussed on the next sensory pleasure that I could give myself. I got home and drank a glass of wine. Then I ate some chocolate. Then I surfed the web. The dissatisfactory quality of each gratification was almost immediately evident; the pleasure lasted just moments, and as soon as it was over, I was casting around for the next one. The balance between enjoyment and dissatisfaction has shifted over the years, or maybe I now see it with greater clarity. In any case, I couldn’t help wondering, how long will I continue with this pattern? How long until the dissatisfaction outweighs the enjoyment? And what then?

A Western psychologist reading this might think, aha, sounds like you were/ are depressed. But I don’t think Richard Alpert would have said that. Or, if he had, he would have attributed very little significance to the term. It might be an accurate description – in terms of box-checking - of a certain pattern of feeling and behaving, but it says very little about the meaning and deeper purpose of that pattern. And I am sure that there is both meaning and purpose.

But to resume the narrative – the narrative of my life! – I moved to Los Angeles and very quickly realised that I was completely disenchanted with both the industry I was working in, and the city I had moved to. I met many talented, attractive, successful people, but they all seemed so unhappy, so anxious, so neurotic. In fact, the film industry and the city – hard for me to differentiate the two – seemed to suffer from a collective neurosis. I wanted to understand it.

At the same time, I had started to realise that the traditional goals were not going to provide me with the ‘rushes’ I had lost. I came across a quote by Helen Keller that resonated with me:

‘True happiness is not attained through self-gratification but through fidelity to a worthy purpose.’

And with that in mind, I decided to become a psychotherapist. I applied to graduate school in San Francisco, quit my job in Los Angeles, and embarked on a doctoral degree in Clinical Psychology six months later.

At first, it was exciting to embark upon a new field of study, in a new city, with a sense of purpose. However, little by little, the disenchantment set in. Not so much with the absence of rushes, but rather with a sense that the material I was being taught, and the perspective I was being taught it from, were misguided. The information was accurate as far as it went, but it was based on a contracted view of what human life could be. I have written about this disenchantment in other places (e.g. my blog at that time, www.icanseealcatraz.blogspot.com). Eventually I found a happier home at Saybrook University, formerly the Humanistic Psychology Institute of California State University. Here I was able to take courses in the Psychology of Shamanism, Eastern Psychology and Existential Psychology, amongst others. I was encouraged to look at human life from a broader perspective.

I graduated with an MA in Existential, Humanistic and Transpersonal Psychology, then I went to work for the Gaza Community Mental Health Programme, a Palestinian NGO in the Gaza Strip. But with only rudimentary Arabic, I soon reached the limit of my usefulness. Following the kidnapping and murder of one of the very few other non-UN foreigners there, I moved to Beirut, to study Arabic.

My short time in Gaza made a big impression on me. Despite the poverty, the nightly sound of drones overhead, the sonic booms of Israeli fighter jets on daytime fly-bys, and the fact that ordinary Gazans cannot leave their tiny strip of land (no airport or port, closed borders), the people struck me as happier, on the whole, than the average American (yes, yes) in San Francisco. That impression deserves an essay in itself, and it is something I rarely talk about, since it is easily misinterpreted. It also has to do with the bonding effect of shared suffering and a common enemy (similar to the Blitz in that respect), as well as more tightly knit families, and minimal materialism. But in short, and as idealistic as this may sound, it made me realise that human relationships make people happier than constant material consumption ever can.

When I first arrived in Beirut, I taught English to Palestinian students from camps in Lebanon, through an NGO called Unite Lebanon Youth Project (ULYP). Then I heard about a vacancy for a full time teacher of English Literature, and also Philosophy, at Brummana High School, in the mountains above Beirut. I applied, went for an interview, and was offered the job.

I worked at Brummana for two years. Some of those experiences are detailed elsewhere in this blog. But in short, I was teaching subjects that I found interesting, to students that I liked. I had a lot of freedom and was even allowed to design and teach a Creative Writing elective that turned out to be more like group therapy, with some poems and short stories on the side. I was living in a beautiful place, with sweeping views over Beirut and the Mediterranean. I was doing the kind of work that is generally thought to be worthwhile, to accord with Keller’s ‘worthy purpose’, and to be fulfilling. And yet, having settled into the daily and weekly routine, it was not long before I once again started to feel restless.

I left Brummana, and Lebanon at the same time. I was not sure what I wanted to do next, but I thought that a cure for my perpetual restlessness might be a long walk, so I walked with Finny – my Lebanese foundling dog – from Salzburg to Santiago de Compostela, along the old medieval pilgrims’ route. The walk took us six months, and I wrote about it here – www.onehundredwordsaweek.blogspot.com

The walk gave me plenty of time to think. I limited my access to email and internet to once a week. One email I received along the way was from an old school friend, organizing a dinner for a group of us who had left school exactly twenty years before. It made me think back to that period of my life, and these lines from the Frank O’Hara’s poem ‘Animals’ came to mind:

Have you forgotten what we were like then

when we were still first rate,

and the day came fat with an apple in its mouth?

I was reminded of certain mornings as a teenager, perhaps during the summer holidays, when my body hummed with energy, and when the future filled me with a sense of tremendous excitement.

And I thought of Housman’s lines from section XV of ‘A Shropshire Lad’, lines that more accurately reflected my own experience of recent years:

Into my heart an air that kills

From yon far country blows;

What are those blue remembered hills,

What spires, what farms are those?

That is the land of lost content,

I see it shining plain,

The happy highways where I went,

And cannot come again.

I had hoped that the pilgrimage would allow me to work out what I wanted to do with my life. It didn’t. Or at least, not in any long-term way. However, it did make me think that after almost a decade away from the UK, I should return there to spend some time with my parents, and also to put some energy into maintaining and renovating parts of our family home in Sussex. It is an old house with a lovely garden and I have memories of a very happy childhood there. But it had started to look a little neglected, perhaps more obvious to me since I would just see it once or twice a year. The place has given me a lot, and I felt a responsibility to it.

So I found myself back in a place that I loved, channeling my energy into a project that felt worthwhile, and spending some time with parents who will not be around for ever. Ideas of nostalgia were still in my head, but not in the way they had been during the walk. Now I became aware of the second meaning of the term – not homesickness so much as a more literal ‘nostos’ and ‘algos’, the pain of returning home (an insight that I owe to Rory Dunlop and his very enjoyable novel ‘What We Didn’t Say’). Because I did now feel pain; home was not the same, my parents were not the same, and nor was I.

At first I minimized all this. People close to me endorsed my renovation project, and my decision to spend time with my parents. I knew I was lucky to have grown up in such a beautiful place. But the problem was that I was struggling to see the beauty, or feel the luck. Wherever I looked I just saw problems, endless menial maintenance tasks with no end in sight, like one of those bridges – The Golden Gate, the Severn - where as soon as the painters finish painting one end they need to start at the beginning again.

What’s more, I was drinking a couple of cocktails every evening, then passing out as soon as I lay down. But I would wake up feeling exhausted and achy, and my tiredness would only increase throughout the day. I also felt a tightness in my throat, and a general lack of enthusiasm. I thought I might have contracted a virus, so I went to see my GP. He did some blood tests but couldn’t find anything wrong.

Throughout my life, books and literature have always provided a refuge. But no longer: I was struggling to concentrate, and I wasn’t enjoying any of the books that I picked up, despite the fact that they often came highly recommended.

In a last ditch attempt to lift myself out of this slough of literary despond, I made a larger order of carefully chosen titles, from Amazon. The first book to arrive, clearly addressed to me, was ‘What Matters Most’, by Dr. James Hollis. Bizarrely, I had never heard of it. There was no receipt, and when I viewed my account online, I found no record of having ordered it.

That night, most unusually, I woke up at 2am and couldn’t get back to sleep. I picked up the book and started reading. I read for 3 hours straight; it felt as if the book had been written specifically for me. Dr. Hollis’ thesis, based on his Jungian training, is that there is something beyond the Freudian id-ego-superego structure, and that is the soul. The soul needs to grow, needs to feel that it is expanding and developing, and if that does not happen, then sooner or later we will experience symptoms – lack of energy, frustration, anxiety, indecision, and physical ailments too.

Despite the somewhat pop-y title, Hollis is a serious Jungian analyst. From his perspective, the book’s mysterious arrival would not be an accident, but an instance of synchronicity. The following morning, when I woke, I saw a whatsapp message on my phone from an old friend with whom I communicate about once a month. He told me he had just woken from a dream in which I had recommended a book to him. I told him of my experience of the night, and recommended Hollis’ book to him.

‘What Matters Most’ made me realise that my malaise had a meaning, that my body was the means through which the soul and the unconscious were trying to communicate with me, and that those deepest parts of me were frustrated because they did not feel they were growing. Most people my age are married and have families; many have their own businesses. These are all creative acts. I, on the other hand, was trying to patch up my childhood, to preserve my parents’ vision, and – essentially - to hold onto the past. The book also drew my attention to the way that it can often be fear – fear of change, fear of failure, fear of what other people will think – that holds us back from being all that we can be.

In the summer, I attended an Ayahuasca retreat in Scotland, something I was quite apprehensive about, since I have long questioned the value of de-contextualised shamanism. But the retreat was guided by an inspiring individual who was himself deeply rooted in a specific tradition, and it rekindled my own interest in plant medicine and Amazonian shamanism. I felt that the time had come to delve deeper into that world, so I interviewed the shaman about where it might still be possible to find uncontaminated shamanic practices in the Amazon (without risking one’s life), and based on his information, I planned a trip for the end of the year.

I went to Peru with my mind open; I wanted to see whether it would be possible for me to communicate with the plants in the way that curanderos and vegetalistas describe. I took Ayahuasca twice a week over a period of two months, as described in previous posts on this blog, but the plants did not communicate with me. Or, at least, that is what I thought at the time. They certainly did not teach me their healing and medicinal purposes, nor the songs through which this information is said to be relayed. But, in restrospect, I think they may have had a message for me, namely that it was not the right time for me to explore that world. I needed to ground myself in this world more firmly first, to feel that I had a home of my own, an Archimedean point.

My Ayahuasca trips are rarely very visual, but one mental image that kept coming back to me was of an empty white room, with a view of the blue sky and the blue sea. At the time, I thought this was probably a reaction to my life in Sussex where, in addition to feeling lethargic and unwell, I had felt oppressed by ‘stuff’ – the accumulated clutter of my lifetime, and my parents’ lifetime, and the clutter of previous generations. So many things, and they weighed on me, as a sense of family history also weighed on me. The empty white room was the opposite of that: a space in which to let go, to de-clutter, and to create.

I was able to experience a pared down, de-cluttered life in a Zen monastery in Japan some months later, and I found it very rewarding. But it was brutal too – the monastery was freezing, I was not allowed to wear socks or a hat, and the obligatory 4.30am morning meditation was followed by hours of floor cleaning, with a cold wet rag. But I soon felt calmer than I had done for years, though I also realised that I was not ready to make a longterm commitment to that kind of a life, though at some future point, who knows.

Back in Europe some months later, I joined a few friends on a short hiking holiday in Crete, inspired by the Patrick Leigh-Fermor and Stanley Moss’ kidnapping of the German General Kreipe in 1942, and their subsequent march across the mountainous centre of the island. General Kreipe had been dragging his feet, expecting to be rescued at any moment. On the first morning of his abduction he observed the sunrise on Mt. Ida and quoted the first verse of Horace’s ‘Ode to Thaliarcus’, describing a similar sunrise on Mt. Soractus in the Apennines. When he had finished, Patrick Leigh-Fermor – a classicist blessed with an excellent memory - quoted the remaining verses. The General was impressed and stopped dragging his feet from that point on. In his memoir, Patrick Leigh Fermor wrote, “…for a long moment, the war had ceased to exist. We had both drunk at the same fountains long before.”

I was blown away by the area of Crete that we were hiking through. The walk across Europe had re-sensitized me to the beauty of landscape, but these Cretan mountains were, I felt, the landscapes that I wished to get to know deeply, and one day to paint.

I won’t pretend that I found the actual empty white room of my Ayahuasca visions, but this place definitely had the right feel. It was here that I could imagine building that white room for myself, with its view of the sea and the sky.

I returned to the UK with a sense of excitement about the future that I had not felt for some time. I was finally finding some direction, even a sense of purpose.

Some readers may be thinking, fine, but what about teaching? What about psychotherapy? What about helping people? Maybe you should be less selfish, maybe if you had committed to those things, you would have found that sense of purpose?

I hear you, friend reader! But I felt I did commit, to the extent that I was capable at those times, and yet I was restless. Not despairing, but not exactly happy either. Does that matter? Should it not be enough just to feel that you are doing something worthwhile? I think it does matter. Happiness creates ripples, and if you are happy in yourself, then that will have a positive effect on all the interactions you have, and on all the people you meet. The uplifting interaction with a stranger in a supermarket may have more impact than the worthiest acts that are performed by someone who is profoundly miserable. We are not the originators of love or positivity; rather, we are conduits for those qualities, and we channel them most effectively when we are happy in ourselves.

Happiness, in this deep sense, is not a purely selfish thing. It benefits others too, and in some mysterious way it may even shape the world we live in. So do what makes you happy, but make sure you understand the distinction between sensory gratification and real happiness.

But isn’t the pursuit of happiness always self-defeating? We are happy until we ask ourselves whether we are happy, and then we realise we could be happier, and that makes us unhappy… Happiness is, in the words of Oliver Burkeman, a ‘delicate two-step’: aim at it too directly, and you will lose it.

There is truth in that. But at the same time, I think that there are certain constituents of happiness that will never let us down. Two of the most important, as Freud stated, are work and love. Work, at its best, should provide a sense of purpose, and also allow us to experience a state of flow, that sense of being fully absorbed in a task. Seen in this light, work can be very similar to concentration meditation; it allows the restless mind to settle.

To be in that state of flow and get paid for it is perhaps the holy grail. But even if we don’t get paid for it, we still need it. We might then describe it as a ‘hobby’, or perhaps it is simply unpaid work (like my mother ‘working’ in the garden), but the important thing is that we are having that experience.

We also need to feel love, or else we become brittle and emotionally atrophied. But that need not necessarily be romantic love. We can love our friends, or music, or a pet, or nature, or God; the important thing is to remove the blockages from that channel.

To return to my own story, I have known for some time that I need to rediscover the state of flow. My walk across Europe had reminded me of the power of landscape to move me. Crete’s rugged beauty impressed me deeply. When I was younger, I used to paint a lot. But in my 20s and early 30s, I did not find it dynamic enough. Now I think differently; the calming, meditative quality holds an appeal for me that I was not conscious of before. I made up my mind to return to Crete and devote myself to painting landscapes. And the more I thought about it, the more it seemed the right thing to do.

I remembered a piece of advice from a letter that Hunter S. Thompson wrote to his friend Hume Logan. Logan requests career advice, to which Thompson replies: ‘…beware of looking for goals: look for a way of life. Decide how you want to live and then see what you can do to make a living WITHIN that way of life.’

When I imagine my future, I do not aspire to being surrounded by flapping assistants, chauffeured from meeting to meeting, plied with rich food and drink, signing cheques for the maintenance of houses and expensive toys. And estranged wives. No, I would much rather spend time in the landscapes that I love, building a relationship with them through meticulous observation, and recording that relationship through the act of painting. A direct relationship, not mediated through a digital screen, and – crucially – free from distractions. Hemingway said: ‘The man who has begun to live more seriously within begins to live more simply without.’ I want to live seriously within.

I have also been inspired by the film Jiro Dreams of Sushi, about an elderly Japanese sushi chef called Jiro. In my own life, I have not observed many people ageing well, by which I mean being happy and at peace with themselves and the world as they grow old. Jiro, though rather a tyrant in his restaurant, seems to me to be that rare bird: a happy old man. He still works every day, as he has done since his earliest youth, and he is driven by the same goal: to make the perfect mouthful of sushi, just a tiny fraction of a degree more delicious than anything he has ever made before. He has no interest in retirement, or even in holidays; what can they offer a man with so clear a sense of purpose?

Jiro is an artist. Perhaps he is lucky to have been born with a fine palate, and with so clear a sense of purpose. But perhaps we can decide on our purpose, and thereby make our own luck.

In the Amazon, the plants had not spoken to me, at least not through the medium of song. And yet, more and more, I feel that they are alive, and maybe that they do have spirits. Indeed, that all of nature is animate in that way. Painting is a way to concentrate on the natural world, and to explore these intuitions more deeply.

I know that landscape painting is not really part of the dialogue of contemporary art, but that doesn’t bother me. In fact, I think I prefer it that way. If you have got this far, you will have realised that I prefer the monologue anyway. In addition, landscape painting could have a moral dimension, since the more we appreciate the beauty and harmony of nature, the less likely we are to destroy it. Painting has the capacity not only to open the eyes of the artist, but of the viewer too. That is a worthy goal; to communicate something of the vision and the sensitivity.

Finally, perhaps I am starting to see painting as a secular form of worship; through it, I can express my gratitude for creation, and for the fact that I am here to appreciate it. And maybe that is our collective human purpose: we are nature becoming conscious of itself.

Back in London, I started taking Greek lessons at the Hellenic Centre. Then I bought a second-hand motorbike, tidied my affairs, and set off by motorbike for Crete. I took the ferry to Santander, arriving by night in the middle of a rainstorm, then crossed the north of Spain to Barcelona. I stayed with my old friend F, whom I had got to know 20 years before, when we both played for a rugby team in Barcelona. On the last night of my visit, his wife gave birth, two weeks early. He just managed to get her to the hospital in time, and I said goodbye to him and his wife, and their newborn baby, in the maternity ward the following morning.

I spent a week with other friends in France, then continued into Italy in the crucible of a heat-wave. Biking long distances is tiring at the best of times, but exhausting in 42 degrees, when the heat radiates off the motorway and you are clad in black leather. I had planned to bike through the Balkans, but there were wildfires in Albania, and I was finding it increasingly tough going. I crossed the north of Italy and then decided to take the ferry from Ancona to Greece. While biking the final leg from Patras to Athens, I felt euphoric; I had a strange sense of having finally come home. I thought of Cavafy’s poem ‘Ithaka’:

Keep Ithaka always in your mind. Arriving there is what you are destined for. But do not hurry the journey at all. Better if it lasts for years, so you are old by the time you reach the island, wealthy with all you have gained on the way, not expecting Ithaka to make you rich.

Greece is not my native soil, but I am beginning to feel that my journey has been a long one. Perhaps that is enough; anywhere can be home if we choose to make it so.

Except for the touristy areas, Athens in August is something of a ghost town. I only stayed a couple of days before continuing to Crete. I was afraid that it would not live up to my idealised recollections, but I need not have worried. I returned to the area I had visited in the spring, and it was as wild and beautiful as I remembered. I hiked, swam in the sea, painted watercolours, and observed the old men in the taverna at night. But despite the inspiring landscape, I soon realised that, at this point in my life, I would find life in this remote area of Crete too lonely. In addition, I am still a very long way from possessing the technical skill to paint the kind of pictures that I have in my head.

In September I returned to Athens. I started a course of intensive Greek lessons, and I spent my days crisscrossing the city on foot, getting to know different areas and looking for an apartment to rent, as well as a space to use as a painting studio. It was still very hot, and at times the language barrier could make life difficult. But things seemed to fall into place: I met good people and found spaces that far exceeded my hopes, both in terms of charm and affordability. I felt that I was experiencing first-hand my theory about positive energy: when you are happy and open to the universe and to others, then good things often fall into your lap. It seems more than just coincidence.

There are many things I love about Athens. Above all, I feel that people are less neurotic than in any other place I have ever lived. There is not the same restless quality. At times this can be challenging too; it often makes me realise how impatient I am, but that is a valuable lesson. At least once a day I have to say to myself, ‘You can’t hurry the Greeks.’

I love the absence of billboards and advertising in the city generally, and particularly on the underground. My mental space is more protected here, my consciousness not constantly invaded by disingenuous images telling me what products I need to buy in order to be happy, or what I should look like, or the kind of life that I should aspire towards. It’s very pleasant, but most Greeks are unaware of their good fortune in this respect, because it is all they know. I am tempted to draw a parallel with colour perception in the ancient world. There is no word for blue in ancient Greek, perhaps because, with all that immensity of sea and sky, the colour was so ubiquitous that the ancient eye was not trained to pick it out.

I love the fact that the bars and cafés are crowded with cheerful, attractive Athenians who will sip from one or two glasses of iced espresso all night. Their pleasure comes from conversation, from each other, and not from getting wasted.

I love the fact that this is not a nanny state. Occasionally you will see someone riding a motorbike, no helmet, cigarette between his lips, holding a phone to his ear, and with a dog perched on the fuel tank. Dangerous, yes, but free too.

There are many beautiful Greek girls. In some ways they are similar to Lebanese girls, but they are more natural looking. I love the sound of the language as they speak it. It has a delicate, tinkling quality, like a clear mountain stream.

I love the exaggerated respect that you are shown when you have to enter a PIN number anywhere. As soon as a shopkeeper or waiter has given you the portable terminal, he will retreat into a corner, closing his eyes and turning his back, as if you were handling a vial of anthrax rather than a credit card.

I love the fact that in a spinning class I went to, the strapping instructor came round before and after the class offering everyone chocolate truffles; during the class, he projected a sequence of Victoria’s Secret videos, which was an excellent distraction for me, and which the rest of the class – all girls - appeared to not to mind.

As a single person, I love the fact that in Greek the same word (‘ελευθερος’) means both ‘single’ and ‘free’.

I love the fact that internet dating has not caught on in Athens. Greeks prefer to speak to each other in person, and will still start conversations with strangers in a queue, rather than focus all their attention on their telephones. They think that there is something a little bit sad about conducting the affairs of the heart through an app, even when real world interactions mean running the risk of rejection. And, because they are less neurotic, the belief that the perfect partner is just one more swipe away has less traction.

Of course there have been challenging days too, particularly while I was struggling to find a place to live, owing to the boom in Airbnbs, and consequent dearth of furnished apartments on the domestic market. But often things felt not quite real. On one occasion, when I was frustrated after yet another rejection from a prospective landlord, I looked up to see a clown on an oversize unicycle cycling down hectic Piraeus street; as if the universe were telling me to take a deep breath and lighten up.

That is a just a very small moment, but it does tap into a much bigger question about the reality of the external world. For some time now I have wondered about the extent to which we are involved in the co-creation of what we perceive to be reality. I don’t think it is possible to take psychedelics and shamanic entheogens without at some point asking oneself these questions.

There is a famous thought experiment in philosophy: can we ever know that our experience is what we believe it to be, or could we just be disembodied brains in vats having our neuronal circuitry manipulated by mad scientists? In light of last year’s American election, when a clown in a toupée was elected President of the United States, the brain-in-a-vat theory suddenly seems quite plausible.

I am neither a solipsist nor an idealist in the Berkeleyan sense: I do believe that other people exist in meaningful ways, and not just because I have an idea of them. However, what interests me is the extent to which my ideas shape the experiences I have, and how they contribute to creating my ‘reality’. This is a big, and possibly unanswerable, question for metaphysics, but its implications are perhaps most evident in the field of psychology, where it has arisen in an pointed way for me in the context of making choices.

Choice is a sword with two very sharp edges. One the one hand, choice is a luxury and a privilege; the richer, more talented, more successful a person is, the more choice they often have. But on the other hand, it seems to me that nothing is quite as likely to cause neurosis, dissatisfaction, and avoidable suffering. To give a very simple example, I can find myself paralyzed before a supermarket shelf of different washing-up liquids: which is the best? Which is the cheapest? Which smell do I like best? Which colour do I prefer? What can this one do that the others can’t? On a bad day, the decision-making process is painful, probably because this one choice carries with it a little bit of all the other unmade choices in my life. However, if I go into the local corner store which stocks just one size and type of washing up liquid, I will buy it and be perfectly happy.

In small ways, I can find myself undone by choice. I am now consciously attempting to prevent those small ways from becoming bigger ways. For instance, I attend Tai Chi classes here in Athens. There are mornings when I don’t feel like going; I’m tired, or it’s raining, or I just don’t feel like it. I am currently experimenting with pretending that I don’t have a choice. I don’t allow myself to go down the decision-making path. Just do it. And I have to say that so far I feel much better for it.

Washing-up liquid and a Tai Chi class are of course very small things, but it is good to practise with the small things. The bigger things are, perhaps, choosing to move to Greece. I have moved to different countries and different cities in the past, but always in a provisional, transient way. I feel differently about this move, and that is having a beneficial effect on my own habitual inner restlessness. It is also, I think, the right kind of preparation for committing to this new career, and possibly even to a person.

Maybe I have just been rather slow to adopt this strategy. Years ago, I joined a Canadian-American friend in a cross-country skiing marathon from Norway to Sweden. My friend is affectionately known as Captain America, owing to his chiseled chin and robust all-round competence. I had flu on the day of the marathon and was running a temperature, not at all pleasant in -20 degrees. My progress was very slow, also because the phlegm in my lungs kept making me retch. My friend stuck loyally by my side for the first 30 kilometers or so, then – in a moment reminsicent of a Vietnam movie – I persuaded him to push ahead at his own speed. Captain America’s parting words to me were, ‘Remember: failure is not an option.’ I am not sure whether I found it all that motivating at the time, but now I recognise the effectiveness of that attitude.

But for me there is one problem with this approach, and it is a problem of intellectual consistency. Unfortunately, the pretence that I don’t have a choice does not sit well with my commitment to the existential perspective, as formulated philosophically by Sartre and psychotherapeutically by Irvin Yalom. Central to the existential perspective is the recognition that we have total choice, and total responsibility for our lives. There is no human ‘essence’; it is up to us to make of ourselves what we will. We are ‘condemned’ to be free, and any attempt to shirk that freedom is intellectually dishonest, personally inauthentic, and breaks faith with life (Sartre terms it ‘mauvaise foi’, bad faith).

Is my pretence that I don’t have a choice an example of bad faith? I’m not sure. It is a strategy that enables me to circumvent my own neurotic tendencies, a strategy that would have prevented Buridan’s ass from starving. Indeed, Buridan’s ass may have had a very happy life had he adopted it. And in my own case, it has not made me shrink from life. Quite the opposite: I have committed to Greece, to landscape painting, to learning Greek, and to practicing Tai Chi… all of these are slow processes, and this strategy helps me get over the little ups and downs. But I would not have been able to make these changes and commit to these things if I had not recognized my essential freedom in the first place.

This conflict is just a shadow of the more serious one that arises from my growing conviction that there are karmic principles at work in our lives. I am increasingly persuaded by the sages, mystics and monks who believe in reincarnation and who say that the point of our many lives is to lead us, finally, to liberation. There are many things I don’t understand: what aspect of ‘us’ gets reincarnated? How is it all organised? How can there be more people alive today than ever before? But what I like about reincarnation, and what seems intuitively correct, is that there is a point to our lives. Every new incarnation gives us the opportunity to burn through the accumulated negativity of past incarnations. Nothing happens by chance. The relationships that we have in this life are reconfigurations of similar constellations from the past; they repeat themselves until they have been fully resolved. When ‘bad’ things happen to us, they present us with the opportunity to resolve the blockages that are holding us back, and to grow in precisely the ways that we need. This is the amor fati of the Ancients; but is it true? Or is it just wishful thinking, the Panglossian optimism that Voltaire ridicules in ‘Candide’?

A part of me wants to follow Pascal and his wager: we can never know for sure, so why not believe what is most beneficial? There is no doubt that I am happier believing that there is a point to my life, that it is one of many lives, and that suffering has a reason and a purpose. Of course, one cannot choose to believe just anything. But I don’t have to try to force myself to believe this; it is in line with my intuitions.

As I have already indicated, I am increasingly persuaded by the idea that we are involved in creating the reality that we experience. Convince yourself that failure is not an option, and you are more likely to succeed. But does the same hold in the field of metaphysics? Do our thoughts, either individually or collectively, create the ‘reality’ we experience? I think that probably is the case: in significant ways, we think the world into being. The objective and subjective worlds are not completely distinct; if they are separated at all, it is only by a porous membrane. If you believe in reincarnation, then the belief alone may be enough to make it true. This is the perspective of many peoples and cultures down the ages: thought is primary and thinking (or dreaming, ‘dream-time’) creates the reality we experience.

Interestingly, there is no way to disprove this theory. If Western science looks at indigenous beliefs and shows them to be false – i.e. a mistaken representation of the way things really are – this is in fact exactly what the indigenous perspective would expect, since Western science is also just another reality that has been thought into being. There is no ‘way that things really are’; there are just different ways of thinking, and these create different realities.

Belief in reincarnation and the doctrine of karma also seems to presuppose a deterministic world. I once consulted a Vedic astrologer in South India; his reading of my natal chart was astonishingly accurate, and specific. I questioned him about the assumptions underlying the reading. He confirmed that, from the Vedic perspective, the world is fully determined. The outcome of this life, and of all future lives, is already known. We will never change the course of our lives – even the changes that we think we make have already been determined – but we can watch our lives unfold with curiosity.

Does this make life pointless and boring? Not at all. The Vedic astrologer drew the following parallel: Harry Potter’s life has been fully determined by the author, nevertheless, Harry himself does not know the outcome, and his life in each book is still vitally interesting to him - he believes that he is meaningfully shaping his future, although the author has already decided it.

What to make of this parallel with a fictional character? If thought creates reality, then in a sense we are fictional characters, either created by ourselves, or by some much greater ‘author’. Can this parallel shed light on the question of how to resolve the conflict between the radical freedom of existentialism, and the determined universe of reincarnation and Vedic thought? I don’t know, but I feel that resolving this conflict – at least to my personal satisfaction - may be the major intellectual task of the rest of my life.

In fact, it is a task that I have already embarked upon. Part of the reason why I am attracted to Zen Buddhism is because it appears to take one beyond rationality, to a world of pure awareness, a world that is not subject to the rules of thought, and that transcends conflicts of logic. The point of the Zen koan, as I understand it, is to shake us out of our ordinary way of thinking, and to give us an intimation that the world in its suchness is not as we assume it to be. These ideas are hard to frame in language, because language is itself a function of the rules that govern thought (non-contradiction, identity and so on); what Zen attempts to convey is a different perspective, beyond reason and hence also beyond ordinary language.

In the end – at the end of life, at the end of thought – perhaps the best model is provided by the ancient lama in Rudyard Kipling’s ‘Kim’. At the end of his pilgrimage, he returns to the mountains and says: ‘These are indeed my hills. Thus should a man abide, perched above the world, separated from delights, considering vast matters.’

I am finally content where I am, and not ready to perch above the world, separated from delights. But nor am I free from all anxiety. I do, for instance, wonder whether I will ever be able to paint landscapes that will match the images in my head. But here again Jiro Dreams of Sushi has provided me with inspiration. From that film, I learnt that a sushi chef in Japan spends the first two years of his career just learning how to make rice. One cannot rush things. Start small, and stay the course. In my own case, I will start with still lives, and little by little, improve my technique (should you wish, you can follow my progress via instagram: konrad_ratibor_bohemian). If I find flow, and practise diligently, then I am hopeful that one day I will create work that I am happy with. But perhaps, in order to retain the sense of purpose, one must always keep aiming a little bit higher, as Jiro does.

The life of an artist may seem very self-involved to you. It often does to me. But then I think that perhaps the greatest contribution that anyone can make is to find a way of life that makes them happy, and to share the path that got them there. Maybe in the end it can be the artist’s life that inspires others to follow their own passion, whatever it is, and realise happiness for themselves. I will conclude with Dr. Hollis’ formulation of the same sentiment in ‘What Matters Most’:

‘Maybe all of us will learn to grapple with the paradox that living our lives more fully is not narcissism, but service to the world when we bring a more fully achieved gift to the collective. We do not serve our children, our friends and partners, our society by living partial lives, and being secretly depressed and resentful. We serve the world by finding what feeds us, and, having been fed, then share our gift with others.’

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tigy-the-gaymer · 5 years ago

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Portraying Mentally Unstable Characters

The most testing jobs and the most acclaimed depictions are those of intellectually flimsy characters. Such depictions reverberate with crowds for numerous reasons; most telling is the nerves and vulnerabilities we face in our own lives. Similarly, such practices produce compelling feelings that incorporate sympathy, dread or hatred. Whatever the reaction, we are moved and connected with; reflected by our feelings of dread and vulnerabilities consider the possibility that this transpires. Consider the possibility that I go over the edge Engagement Rings At the point when done splendidly, such jobs are fundamentally appreciated and regularly win industry assignments or grants. They additionally win basic acknowledgment similar to the zenith of acting. At the point when progressed admirably, it can likewise bring about better employment bids. It sets the bar higher demonstrating one is an able entertainer, one who can play an extraordinary scope of needs, needs, and feelings of a character on the edge. Such entertainers become a benefit, a bankable substance to creating ventures

Another motivation to investigate this region is that ordinary characters once in a while become intellectually unsteady. Such events emerge when an individual is overpowered busy working, or when something disastrous happens to a nearby family member. Another event may be while losing one's temper and intersection the limits of basic conventionality. Such occasions put impressive weight on an individual making them act nonsensically. These takeoffs from the standard are chances to grow the job and give the character more profundity.

There is constrained visual proof of how intellectually temperamental individuals carry on. Nonetheless, numerous movie producers, executives, and entertainers have done top to bottom research right now have copied characters showing the ideal temperamental characteristics. These individuals have investigated genuine patients and even acquired advisors to additionally set these depictions and their prevailing attributes.

This article mirrors an accord of these attributes. This is anything but a clinical accumulating however an emotional assemblage from very much inquired about movies. There is a distinction in that the clinical is spread out over a long treatment period while the sensational is particular and packed into the distributed timeframe. While the clinical version might be increasingly legitimate, the emotional interpretation gets to a similar story focuses and does as such with more effect. While these depictions are unpredictable, it assists with managing the facades.

Intellectually unsteady individuals are unmistakable by certain visual qualities. Most telling is the eye/nose arrangement, which is increasingly intense as the eyes frequently look past the saw to the envisioned. The look surpasses typical points, as the subject looks for evasion, stands up to suspicion or scans for answers in a riotous world loaded up with vulnerabilities. Furthermore, this vulnerability draws in the crowd as instability makes the penchant for going in different conduct headings.

In "The Snake Pit", Oscar-designated execution by Olivia de Havilland, eye practices are utilized to depict a disorganized world, one where willful blame causes a mental meltdown so genuine, she must be standardized. The story is organized around her treatment and her advancing familiarity with what caused these breakdowns. In this manner, the crowd is close by her as she experiences this self-revelation. We recognize what she knows and we relate to her battles. Occasions, for example, a schedule date or time on a clock trigger crazy scenes overpowering her psychological state. Through her moderate recuperation, there are misfortunes and relapses, yet she increases enough solidarity to confront her difficulty and find she was not liable for the passing of her dad and that of a man she dated. Some portion of the story is told in flashbacks when her conduct was typical. This differentiation is a significant piece of this portrayal.

Another telling conduct is tricky eyes, a neurosis that somebody is watching her. It could likewise be misgiving realizing she doesn't have the appropriate responses. Much of the time, these are envisioned elements, yet to the subject, they produce reactions as though they were genuine. Crazy dreams, regardless of whether produced or memory incited are depicted as though observed by the shooting eyes.

Different attributes incorporate facial reshapings that are likely incited by pressure and tensions. Most perceptible is the pressure around the lips and eyebrows as though the individual is attempting to comprehend their environment. In intense cases, there is a look of internal franticness that can possibly go off whichever way. This equivocalness of direction and unconventionality attracts crowds to these characters. Such practices make squeezing questions; what will occur straightaway, what course will she take?

In intellectually temperamental individuals there is an absence of clearness as they are weighted down with falsehood, terrible suppositions, or constrained recognitions. They are confounded about how to recognize the issue, assault and resolve it. Subsequently, the superseding conduct is one of inward disarray and a sentiment of losing control. Their judgment is corrupted to where they can't settle on consistent choices. Thus, they are bound to settle on awful decisions, decisions which could hasten a descending winding toward frenzy.

Mindfulness of being flimsy prompts the conduct of attempting to act typical. What's more, how well the subject does it relies upon the control the individual in question has over their conduct. Being ordinary is the essential objective of most organized patients, be that as it may, they are progressively inclined to triggers upsetting this equalization. What a typical individual would think about a burden, an unsteady one sees as a calamity. A relationship would be that of an alcoholic attempting to act calm.

Memory slips are normal, as is passing bewilderment. The subject concentrates most on internal identity as opposed to the world and people around him. There is likewise disarray among suggested and strict implications. Conduct is incongruent (lacking suitability) as opposed to displaying amicability, understanding, and similarity.

There is a diligent inward voice that discussions to the subject, gauging choices, looking for answers, and battling with actualizing activities. There's an inward disturbance between that which is genuine and that, which is seen. At the point when things turn sour, what's apparent for the most part beats reality. Scenes of neurosis are clear as the subject questions everybody including himself.

There's normally a solid feeling of powerlessness for the subject comes up short on the abilities to shield himself. The agony caused by others or himself leave durable harm. There is little want to deal with one's self. Appearance can be rumpled and unkempt as a rule the consequence of collapsed self image or a feeling of inadequacy. Things, for example, hair not brushed or garments wrinkled, and frequently not shading composed. Additionally, fastens in wrong openings, no cosmetics or twisted and composition depleted of vitality.

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akshat96jain · 5 years ago

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Neuland Labs - a business set to enter flywheel mode or ...?

Disclosure: This is not a buy/hold/sell recommendation. This is for information purposes only.

Innovator Drug Development: For CDMOs, the most critical driver is presence of an innovator portfolio, specially with a wide spectrum from early stage to commercial manufacturing. Syngene and Neuland are CDMOs with significant revenue share from innovator portfolios, that received investments from global and local PE funds.

I recently came across this report from IQVIA on the 4 drivers of growth areas in Pharma and it got me interested in Neuland Labs Limited. I like businesses that operate as a niche in a large segment, acquire customer loyalty and then grow sales and margins hanging on to that customer loyalty instead of competing on price. Anyway, here are some thoughts on Neuland:

What do they do?

Neuland is a Hyderabad based, focused/pure-play API manufacturer. It produces 75 APIs from 3 plants (2 are USFDA approved - 3rd was recently acquired - more for backward integration). The US, Japan & Europe form 80%+ of its sales. Business segments Neuland has 3 business segments:

A high volume, low margin, highly competitive Prime API segment - major products are Ciprofloxacin, Levetiracetam, Levofloxacin, Mirtazapine Enalapril Maleate, Sotalol, Labetalol and Salbutamol.

A Speciality API segment - currently has 25 molecules in this segment. Of these, patents for some molecules are yet to expire. In many molecules the co is either the sole or one of 2 suppliers even though few others may have filed a DMF. Important from revenue perspective Salmeterol, Dorzolamide, Paliperidone, Deferasirox, Donepezil and Brinzolamide.

A Custom Manufacturing Solutions segment - A typical pharma research or bio-tech startup based out of Switzerland or London or Tokyo would typically focus on research and outsource scale-manufacturing to low-cost countries provided regulatory standards are met. This outsourced manufacturing service is the CMS business of Neuland. It works with innovator pharma / biotech cos, both small and large and offers both small-scale clinical trial quantities & commercial-scale. It is equipped for Preclinical to Phase III through to commercial API manufacturing. Entire revenue in CMS from US, Europe & Japan. Neuland claims to have strong chemistry skills + consistently compliant facilities.

Most of Neuland’s Indian peers are generic formulation makers - many of who derive significant share of sales in regulated markets where competitive intensity is increasing and price erosion is causing margins to fall.

On the other hand, data from the Express Scripts’ Prescription Price Index suggests that average prices of branded drugs have been rising and remain unaffected by price erosion. Neuland’s CMS segment works directly with such innovator companies for clinical and commercial stage production of Intermediates & APIs for patent-protected drugs.

The CMS Business

There is a conscious attempt by the co to increase the share of Speciality and CMS businesses in the long run. ‘In the long run’ because CMS business would be volatile as it is initially heavily dependent on few companies and few molecules. Once more and more molecules get commercial approvals and client base widens, CMS can become a stable segment. Another reason is the Prime API segment itself is growing in volume terms.

In the longer run, the Speciality API and CMS business looks to be a game changer - a segment that is set to enter the flywheel mode, perhaps?

It has much lesser competitive intensity compared to its peers because it requires strong chemistry skills and loyal customer relationships. A client who engages Neuland for pre-commercial stage production is likely to continue the commercial relationship with Neuland as well. Hence, the nuances of supplying small batches for pre-clinical stage drugs is sort of an investment in customer acquisition which will yield results over time when these drugs get commercial approvals.

After the Chinese shut down of polluting industries in 2017-2019 and the 2020 Coronavirus crisis, pharma & biotech research companies looking to de-risk their supply chain from China would look for alternative contract manufacturers in India. One of the criteria in supplier selection would be the depth of the capabilities. Does the supplier import key intermediates from China or does he produce it himself? How many APIs can he make in-house? Neuland’s 30-year expertise in API making and its acquisition of Unit 3 will strengthen its in-house intermediates capabilities.

As Neuland acquires deeper chemistry skills, its competitive advantage in this field can further increase opportunities. We can substantiate from this con call excerpt:

Neuland being a pure play API company, we tend to give a lot of focus and priority to our CMS business. And unlike many Chinese companies which have many aspects of their business, they do custom synthesis, they do biology, they do BMTK, they do toxicology and lot of other activities. So the attention or the focus on the custom synthesis projects may not be as high. I think the third factor is at Neuland, we also tend to be very selective on the kind of projects we work on. They are specific areas in chemistry that we believe we are very strong in.... So that kind of selectivity and the inherent skills and the business model of the company helps us to differentiate ourselves from many of the Chinese competitors.

Unlike generic API manufacturing, the CMS business requires pro-activeness, foresight and constant R&D - some points to support Neuland:

Total worldwide DMF count of 673

Management has guided filing of 8-10 DMFs/CEPs every year

Neuland is the first generic player to have a granted process patent for the preparation of Sugammadex Sodium in India. Sugammadex is used to reverse anesthesia. It has also filed a DMF and wants to be an early developer even though commercial launch will be post patent expiry around 2026 for US and Europe.

In FY 19, filed 20 patent applications of which 19 were in India and one in the US. In the same year, it secured seven granted patents (5 API process patents and 2 peptide technology related patents) in various geographies (Canada, India, Japan & Australia).

Neuland claims to be a leader in peptide technologies and capabilities. It predicts that in 15 years as many as 50% of all drugs could be peptide-based. 9/63 of the CMS projects of Neuland are peptide projects, though there are 0 commercial sales currently. In 2018, the company entered into a partnership with Jitsubo Co, owner of two key peptide technologies: Molecular Hiving™ for production of high quality and cost-competitive peptide APIs, and Peptune™ for novel peptide modification in drug discovery stages. The management also sees potential in Peptide based APIs for the generic API market and has invested in relevant capacities. Quoting from the Q2FY20 con call:

“We have been initially doing only like peptide building blocks and maybe low value items within peptide. But over the last 5-6 years, we slowly moved forward into peptide APIs and we have been working with a lot of innovators in the CMS space on peptide projects. And now what we have been trying to do in the last year or so is to actually develop peptide even for the generic markets and we are very excited with the market opportunity that generic peptides offer..........What excite us about peptides in the generic GDS space is that the market is not very crowded and there could be certain value addition Neuland could have because of our technology where we would be able to offer peptide API at comparable quality but at a lower cost. So that is the idea. We do not expect any immediate commercial opportunities on it, but some of the peptides that we are working on, the patents are also close to expiring. So if we are successful, then in a matter of 2 to 3 years, we could have some successful products in the market on peptides. “

Management and Directors

The Chairman & MD, Davuluri Rama Mohan Rao holds a Post Graduate Diploma in Technology from IIT Kharagpur and a PhD in Organic Chemistry from the University of Notre Dame, U.S.A. He’s a member of the Royal Society of Chemistry.

The Vice-Chairman and CEO, Davuluri Sucheth Rao and the Joint Managing Director, Davuluri Saharsh Rao are MBA graduates from the US.

Non-Executive Director - Christopher M. Cimarusti - holds a PhD in Organic Chemistry from Purdue University, U.S.A. and his Postdoctoral Research from Columbia University, U.S.A. More than 40 years of experience in the field of drug discovery, development and manufacturing, been awarded more than 60 patents and published more than 40 papers in referred journals. Held executive leadership positions at Squibb Corporation and Bristol-Myers Squibb (BMS) in discovery and development. His last position with BMS was as Sr. Vice President, Pharmaceutical Development Centre of Excellence.

Independent Directors

Humayun Dhanrajgir - 45 years in the pharmaceutical industry. On the board of Cadila Healthcare Ltd., Zydus Wellness Ltd, Emcure Pharmaceuticals Ltd. (Chairman), Next Gen Publishing Co. Ltd. (Chairman).

Parampally Vasudeva Maiya - Ex General Manager of SBI, first MD of ICICI Bank and CDSL, Previously held directorships at Canara Bank and Indian Bank.

William Gordon Mitchell - Academician with contributions in the field of corporate strategy, emerging market strategy, and strategy in the global health care sector.

Bharati Rao - Also on the boards of SBICAP Securities Limited, SBI Capital Markets Limited, Cholamandalam Investment and Finance Company Limited, SBI Global Factors limited, Carborandum Universal Limited, Can Fin Holmes Limited, Tata Teleservices Limited and Delphi-TVS Diesel Systems. Advisor to Brickworks Ratings Company.

Nirmala Murthy - Founder member of the Foundation for Research in Health System.

Homi Rustam Khusrokhan - Ex President of the Organisation of Pharmaceutical Producers of India. Currently on the boards of Strides Pharma Science Limited, Samson Maritime and Novalead Pharma Private Limited.

A well known investor from Chennai known for his forensic eye once said that a good quality check for any listed Indian company is to see how many ‘Independent Directors’ don’t share the same surname as the promoters.

Where could it go wrong?

This is where we need to really dig deeper. None of the above information means the stock is investment worthy or not especially since I do not have a background in pharmaceuticals and most of my understanding here is basic. If you have a view point on the risks in Neuland’s business, would be greatful if you could share your opinion on the Neuland Labs Ltd thread on ValuePickr.

The numbers - The company seems to witness growth opportunities across 3 segments. They have guided volume growth along with margin expansion (co. aims at 18-20% ebitda in 3-4 years from 10-12% currently). Major capex is behind but 60-70 cr/year of product specific capex and maintenance capex would continue.Will this dilute asset turnovers? Debt levels at 200-220 crores are sort of worrying given their scale and margin profile. Key would be to monitor the next few years of debt addition + capex + R&D expenditure. Once that stabilises and growth continues, operating leverage can be expected.

In the CMS division, the company is subject to not just USFDA checks but also customer audits. Also, given that unit 3 will be subject to its first USFDA audit in the coming quarters, compliance risk looms.

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