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cnroth · 6 years ago

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On Better Help, Mobile/Teletherapy Services, and Barriers to Traditional Treatment

So apparently there’s been a controversy this past week regarding Better Help and YouTube sponsorships. It centers around YouTuber Philip DeFranco, who gives a summary of what happened and his response to the situation here.

What compelled me to write this post was a video by YouTuber and clinical psychologist Dr. Allison, who gave her own thoughts regarding the recent controversy. It’s a good video and worth your time to watch (or you can read the text version on her website). I’ve never used Better Help or any other mobile/telehealth system for psychotherapy, so I can’t speak to this personally, but I found Dr. Allison’s video informative and full of food for thought.

That being said, I want to give some pushback regarding the use of mobile/telehealth applications and whether it is as effective as in-person psychotherapy.

There is peer reviewed research out there supporting the efficacy of telehealth as a mental health treatment modality. The VA (Veterans Affairs) has been doing some excellent research over the past few years on their telehealth programs in the US, and I’ve also seen research out of Australia regarding their state-sponsored mental health initiative to use telehealth to improve access for rural residents seeking mental health services. While many practitioners have expressed concern about using home-based care to treat conditions in which reducing avoidance and/or leaving the home is part of the treatment, there are also studies that address this question and show that home-based treatment can be just as effective at treating PTSD (Acierno et. al., 2017), Social Anxiety Disorder (Gershkovich et. al., 2016), other anxiety & related disorders (Rees & Maclaine, 2015), and depression (Durl et. al., 2014).

While much of the research about telehealth for mental health concerns has focused on telephone and videoconferencing as alternative means for delivering therapy, there are also studies examining the use of mobile technology for treatment of multiple mental health diagnoses, including depression, bipolar disorder, PTSD, schizophrenia and schizoaffective disorders, and substance use disorders (Lui et. al., 2017). There are certainly limitations to these studies, and the results need to be replicated through more and better studies. Given that the technology is relatively new, however, this is to be expected.

More than that, I think it’s incredibly important for conversations about this topic to be sensitive to the many barriers and other special situations that impact access and treatment-seeking behaviors. For example, a project I’m working on focuses on individuals with mental health concerns who live in a specific rural community where there are no qualified mental health professionals. In that community, getting treatment requires a significant burden of travel, time, and money that is beyond what urban and suburban populations might experience. Sure, campaigning for better access to the telehealth services offered by the local mental health authority (whose nearest clinic is still 40 miles away) might be warranted, but I can’t help wondering if mobile apps like Better Help may be a useful resource for some of them.

Distance is far from the only barrier that might incline someone to seek out alternative means of treatment. What about people who travel or move often and want to have one consistent therapist they can interact with no matter where they are? What about people who are struggling with symptoms of depression, anxiety, or avoidance that demotivate them from physically going to therapy, but who might be more comfortable getting to know someone online? What about individuals who are afraid of being seen at a professional’s office, or whose family/community wouldn’t support their desire to seek treatment? What about people who need specialized care that isn’t available where they are? What about symptoms that pop up in between sessions, or people who struggle to communicate their experiences to the therapist in hindsight?

Don’t get me wrong, I’m not trying to argue that mobile/teletherapy is definitely always as good as in-person psychotherapy. There isn’t enough research yet to say, and a lot of work is going to need to be done in a lot of areas to integrate these options into the system and protect the interests of everyone involved. However, I also don’t think this has to be an all-or-nothing debate. It’s not a competition. There are very legitimate reasons why teletherapy might be more viable for some people than traditional in-person psychotherapy, and there is precedent to think that it could be just as effective as in-person therapy. There may also be advantages to combining both delivery systems when possible.

I do hope, however, that we can avoid conflating one platform’s questionable legalese with the entirety of mobile health, telehealth, and home-based healthcare services. There are major gaps and disparities in getting mental health services to people who need them, and these types of services could make a significant impact on filling those gaps. I, for one, am excited to see how these technologies will change mental healthcare in the future.

Other helpful videos to watch:

“Is Online Therapy Right For You?” by Undefined Therapy. Rashawnda Carey is a Licensed Clinical Social Worker and has worked as a therapist for Better Help. This video predates the recent controversy, but I think her perspective is an important one to hear.

“Why is it so hard to get good therapy?” by The Psych Show. Dr. Ali Mattu, a clinical psychologist, discusses reasons why getting quality psychotherapy isn’t always possible, and he brings up a few ideas for alternative strategies.

Sources

Acierno, R., Knapp, R., Tuerk, P., Gilmore, A. K., Lejuez, C., Ruggiero, K., Muzzy, W., Egede, L., Hernandez-Tejada, M. A., & Foa, E. B. (2017). A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth. Behaviour Research and Therapy, 89, 57–65. https://doi.org/10.1016/j.brat.2016.11.009

Lui, J., Marcus, D., & Barry, C. (2017). Evidence-based apps? A review of mental health mobile applications in a psychotherapy context. Professional Psychology: Research and Practice, 48(3), 199. https://doi.org/10.1037/pro0000122

Durl, L, Interian A, Pretzer-Aboff I, & Dobkin RD. (2014). Effect of telehealth-to-home interventions on quality of life for individuals with depressive and anxiety disorders. Smart Homecare Technology and TeleHealth, 2014, 105–119. Retrieved from https://doaj.org/article/466a10b08a8b4363a1aa4d8fed594dbb

Gershkovich, M., Herbert, J., Forman, E., & Glassman, L. (2016). Guided internet-based self-help intervention for social anxiety disorder with videoconferenced therapist support. Cognitive and Behavioral Practice, 23(2), 239–255. https://doi.org/10.1016/j.cbpra.2015.08.005

Rees, C., & Maclaine, E. (2015). A systematic review of videoconference‐delivered psychological treatment for anxiety disorders. Australian Psychologist, 50(4), 259–264. https://doi.org/10.1111/ap.12122

#not star trek #mental health #telehealth #better help #mental health access

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blouseparcel29-blog · 4 years ago

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Lawyers in Amsterdam

Content

The Keys To Making Online Law College Effective.

Advocaten In Nederland, Alkmaar.

Law Institution Professors.

Lawyers Office Appelman Alkmaar

Top Law Schools In The Us & Canada.

What are the big four law firms?

Lawyers working for KPMG, Ernst & Young (EY), PricewaterhouseCoopers (PwC), and Deloitte—the Big Four—is not a new phenomenon. The big accounting firms, which now describe themselves as professional services firms, have been recruiting lawyers for years.

The Barris household also has a website that notes all lawyers in the location as well as provides you their call details and details regarding all types of law. In the meanwhile, don't forget to contact your local bar organization and also inquire concerning the very best lawyers in the North West. After that you require to get in touch with the Divorce Lawyers Association, if you need a separation lawyer in Alkmaar. They are in charge of offering the needed details and also sources around. This is a remarkable organization and you can find out a lot from them.

The Keys To Making Online Law Institution Successful.

In Alkmasr arbeit (lawsuits), you will certainly need to fill in a type inquiring regarding all papers and evidence on behalf of your insurance claim. The filing lawyer will assess your file, which has all documentation that they can discover to reveal your case, and then provide you a written opinion as to whether your case is weak or solid. To come to be a great lawyer, you will wish to do some research online. Find out about the numerous sorts of solutions that are offered by lawyer Alkmasr, along with what you can get out of your lawyer. This will guarantee that you obtain the most effective service available.

This kind of lawyer focuses on dealing with issues such as separation, youngster wardship fights, separation or rekindling connections that have damaged down. A great Alkmaar household lawyer is going to be experienced and also will certainly have the ability to take care of a variety of various issues. Many lawyers in Alkmaar are very educated as well as have law degrees from a variety of colleges. There are a lot of points that an Alkmaar lawyer is able to do when it comes to taking care of a variety of various issues. These types of lawyers are able to assist you get off a charge if you were arrested for a criminal activity.

This is a huge area that incorporates issues like preparing to pass on residential property, retirement and also even more. An estate organizer can be instrumental in helping individuals survive tough financial scenarios. A lawyer in Alkmaar can also be made use of along with another legal rep such as a medical practitioner. For example, if you have a severe health problem as well as you want to have the courts decide your situation then you may want to talk with your attorney.

Another location that Alkmaars can be really successful in is divorce. Due to the fact that there are so numerous separated pairs in this location, there are many lawyers who specialize in managing this kind of lawful issue. It is very simple for an individual to locate lawyers in Alkmaars for nearly any kind of lawful issue. You are mosting likely to discover a huge quantity of lawyer Alkmaars in Amsterdam in this city. These sorts of lawyers are well known for their capability to deal with a variety of different cases as well as are well valued.

Who is the highest paid lawyer in the world?

There are plenty of other “lawyers” with a considerably higher net worth, but they simply have a law degree and no longer use it.Thomas Mesereau: $25 million. Mark Geragos: $25 million. Alan Dershowitz: $25 million. David Boies: $20 million. Lynn Toler: $15 million. Vernon E. Jose Baez: $8 million. Harish Salve: $6 million. More items•

This is a great area to fulfill individuals, obtain referrals and also even have a visit with a few lawyers. A lawyer in Alkmaar can additionally help you if you are experiencing a divorce and also desire some kind of custody or child guardianship.

The sort of lawyer you select will certainly depend upon what the situation will involve as well as what sort of result you want. An additional reason why you might choose to hire a lawyer Alkmaar is that this sort of lawyer is usually mosting likely to have several years of experience handling the specific type of situation that you are encountering. Because you will certainly understand that you can count on this kind of lawyer to have experience with all of the various elements of the law, this is an important consideration. It is important that you take a while to select a lawyer Alkmaar that has some experience because the even more experience that they have, the more likely they will certainly be able to defend your legal rights. When selecting a lawyer is that you desire to make certain that the individual you are going to work with has dealt with similar cases before, a really essential consideration.

They will certainly pay attention carefully to what you need to claim as well as will certainly put in the time to actually comprehend everything that is entailed. They will likewise maintain you notified regarding your case, along with the development in your situation. You ought to be kept educated of any type of adjustments in the event, including any type of court dates, when required. While you must chat with your lawyer regarding things that relate to your situation, you should never ever speak directly to the financial institution. You ought to never request for recommendations concerning the settlement in your case from your lawyer.

You will certainly also be able to obtain some understanding on the type of experience that your lawyer has. You will require to be informed on their background, in addition to their experience. Ask to see the cases that they have dealt with, and make sure that you comprehend what you can anticipate from them. You will also wish to talk with them concerning any kind of grandfather clauses that you might have, such as those that associate with your financial obligation, or clinical issues. The a lot more that you are planned for your lawyer, the far better off you will be when managing them.

Several lawyers also have their own websites which offer contact information and other crucial details on their legal case history. There are lawyers who also supply on-line legal aid with email, chat and with different online forums. If you wish to find a terrific lawyer after that it is far better to begin with a lawyer directory site that contains just the best lawyers in a particular area. If you are not able to reach them online, you can contact them on the phone or in individual. An online lawyer directory additionally offers you with some added services like a detailed criminal record check and also history check of the lawyer.

One of the best ways to figure out what type of lawyer you must employ is to take the aid of a lawyer directory site or lawyer website. There are numerous websites on the net that supply info regarding different kinds of lawyers. You can conveniently browse through their profiles, testimonials as well as profiles of other people that have actually already utilized their solutions and so on.

In Alkmaar, the child guardianship procedure is various than in other locations of the Netherlands. As a matter of fact, it can take longer to have your custodianship situation managed with Alkmaar court than it could take elsewhere. You need to explore what steps are associated with obtaining protection in Alkmaar as well as what steps are required. You desire to talk to someone with experience when it comes to separations.

A lawyer can be valuable in offering you assistance as well as details in relation to what laws relate to your scenario. You will certainly find that a lawyer in Alkmaar can likewise deal with various other careers. A law practice in Alkmaar may concentrate on the work environment law, however they can likewise help those who want other locations of the law.

First, you require to be familiar with exactly how the city looks and also what it consists of. One of the most heavily populated district is Schilderswijk, which is where the city's international airport terminal lies. The following area of focus is Deventer-Moorabbin, which is residence to a number of banks. It is the earliest component of Alkmaar, with several of the old structures still standing. Then there is the town hall, which has lots of crucial structures such as St. Stephen's Basilica and also the Alhambra Palace.

You can compare the solutions of a variety of lawyers and pick an ideal lawyer who satisfies your needs. The website will also assist you employ a lawyer for the very best possible cost as they quote competitive rates. which is additionally among the functions that draw in many individuals. Lawyers can be discovered throughout the country as they have branches in different cities. The top lawyers can be located online and also you can check out their web sites and call them straight for their services.

Prior to hiring a lawyer, make sure that you perform a detailed study and check out all the details supplied by the lawyer directory. You will certainly additionally have the ability to discover the reputation and qualifications of the lawyer by requesting for his/her referrals. Tips For Obtaining the Best Lawyer If you remain in a financial situation, you most definitely recognize the advantages of finding the very best lawyer Alkmaar( advocatenkenkantor Alkmanar). These lawful specialists or lawyers can helping you with all the proper documents when it involves applying for bankruptcy. In order to find a lawyer, you may wish to ask your neighborhood bar organization or spend some time as well as research study on the internet.

What are the most prestigious law firms?

List of largest law firms by revenueRankFirmLawyers1Kirkland & Ellis2,0002Latham & Watkins2,4363Baker McKenzie (verein)4,7234DLA Piper (verein)3,60976 more rows

In Alkmaar, an injury lawyer Alkmaar can assist you with criminal law. The legal system in the North West is various to various other areas of the nation due to the different society of North Americans as well as Europeans. Criminal law deals with criminal activities such as assault with a lethal weapon. An additional location that a lawyer in Alkmaar can concentrate on is estate preparation.

It is also possible to ask inquiries about the experience of the lawyer and also regarding the qualifications of the lawyer. The majority of the on-line directory sites can help you locate a lawyer for you with no extra costs.

Despite which sort of lawyer you pick, you will locate plenty of fantastic lawyers throughout the globe. If you have ever been in an instance that you believe could make use of a professional lawyer, then you will certainly be able to discover one near you. When it comes to discovering a lawyer Alkmaar, the internet is your ideal source.

Among these locations is the Law Culture of the Netherlands. This organization stands for the majority of the lawyers in the country and tracks all the lawyers available in the Netherlands.

Reliable as well as experienced lawyers are prepared and satisfied to help you around of law.

If your company is facing some Economic issues, then you want more aid.

The absolute best law practice will mainly be involved as your lawyer to encourage you regarding just how to resolve estates.

You can utilize the solutions of lawyers in Alkmaar to have actually insurance claims collected.

Likewise, if you are dealing with a business that is insolvent, you will certainly need aid.

It is not constantly easy to discover a lawyer, however this organization can offer you all the info you need about neighborhood lawyers. An additional location you can look into is a directory of lawyers in Alkmaar. These directories are made by exclusive organizations and also permit you to explore all the lawyers in the location. They likewise allow you to look for details sorts of lawyers so you can see what lawyers concentrate on particular kinds of instances. Hiring a good lawyer is not hard, and Alkmaar is among the places you must look if you want a great lawyer.

Advocaten In Nederland, Alkmaar.

It is always an excellent suggestion to call the lawyer's workplace prior to calling back to look at the condition of your case. Any telephone call that you make to your lawyer needs to be maintained to a minimum. This makes sure that the lawyer has actually not made any type of contact with the financial institution or the lender. If there is ever before anything that you really feel may be a problem with the negotiation you are seeking, you will intend to ensure that you have all the needed info and also evidence to present in your defense. Numerous law practice are going to be very highly effective and skilled at assisting you make your life much more enjoyable in the future as a result.

You require to really feel that you will certainly obtain honest guidance which you will be treated relatively throughout the entire procedure. There are a lot of lawyers in Alkmaar that focus on a range of different fields of law however the primary area of law that you will certainly be confronted with is criminal law. Ensure that the lawyer you select is extremely experienced when it pertains to this area of the law.

A personal injury lawyer Alkmaar can additionally work with accounting professionals. An estate lawyer Alkmaar may also deal with designers and also lawyers. After that you can ask your local bar association for a checklist of lawyers, if you are looking to hire a specialist law company in Alkmaar to handle your lawful issues. They can refer you to a lawyer that concentrates on your area.

An excellent lawyer will be able to represent you as well as aid you locate the best solutions for your circumstance. In Alkmaar, you can additionally discover several kinds of lawyers: criminal defense attorney, family members law lawyers, and also corporate advise are simply a few of the sorts of law firms available. There are a few areas you ought to take into consideration first when you are looking for law firms.

An excellent Alkmaar criminal defense attorney is going to be really well-informed and have a great deal of experience. They are going to have the ability to give you suggestions on what to get out of your case as well as what can take place if you are condemned. Because advocaat alkmaar are utilized to dealing with criminal cases and have experience dealing with these types of cases, these kinds of lawyers additionally have a benefit. One reason why there are so many Alkmaars operating in this location is that there are a great deal of immigrants in this field.

Lawyers in Alkmaar - Why You Should Get in touch with a Lawyer in Alkmaar Many of us in the North West area know one particular lawyer; the Barris family members. This specialist household is a familiar name in the legal globe and also its presence can be seen all across North America and the United Kingdom. Something you require to keep in mind when thinking about making use of an attorney, relative or lawyer from this city is what kind of law that a certain person specializes in. When thinking about selecting an attorney and their relative in Alkmaar, it can be alluring to assume that they will certainly be professionals in any offered area of the law.

Law Institution Professors.

It might be handy to speak with your partner before taking any type of activity. The lawyer ought to describe to you what you can expect from the procedure and that they are there to make points less complicated for you. These are just a couple of reasons why you would certainly wish to speak with your lawyer in Alkmaar. Speaking to a lawyer in Alkmaar is an exceptional means to discover concerning the legislations in this area if you have an issue with your marriage as well as need aid. Alkmaar - Where You Ought to Try to find an Excellent Lawyer If you are searching for a lawyer, one of the areas you need to look is Alkmaar.

Lots of people that want to arrive to the United States and live below for a variety of years choose to visit Alkmaar in order to settle in. Many people who have been residing in North Holland for years can also boast of their history. This is why numerous lawyers in Alkmaar are so highly knowledgeable and also skilled.

All sorts of lawful problems are taken care of by lots of law firms all over the globe. Several lawyer Alkmaar business are going to be really effective due to the fact that they are focused on a particular type of legal problem.

This city in the Netherlands is renowned for its wide range of law office that supply the most effective legal assistance to its residents. Right here are a couple of things you must consider before employing a lawyer for yourself.

It can also be really valuable to talk with an insolvency attorney concerning your situation. You will certainly also intend to ask your close friends or household regarding the individual they trust most in the area. You will also wish to inquire about the local bar organization. If there are any type of grievances versus your possible lawyer, this is so that you can discover out.

You can start by looking online for a list of attorneys near you or by looking through a directory of lawyers in Amsterdam. You will have the ability to discover a lawyer Alkmaar who is learnt a variety of various areas of the law. This is very important since every crime has various components to it. As an example, a lot of instances that involve youngster molestation will have various components than situations that entail murder or sexual offense.

Is 100k a good salary in Canada?

Considering the average Canadian salary is about $55k, $100K is a great salary. Couple that with living within your means and a holistic financial plan including smart investing and you can really set yourself up for success financially.

Nevertheless, there are numerous aspects of the law that are covered by this household of professionals. An injury lawyer Alkmaar is experts in representing people who have actually suffered injuries as a result of the negligence of one more person. If you were included in an auto crash and your injuries are due to an additional driver's carelessness, an injury lawyer Alkmaar can work to find compensation for you. After that you might want to take into consideration chatting to a personal injury lawyer Alkmaar about locating a claim versus the firm you function for, if you have actually been wounded in a commercial crash.

In Deventer, you will discover the biggest variety of services contrasted to various other areas of the city. This is additionally an older component of the city, and is house to many historic landmarks and galleries. You will certainly additionally find many financial institutions and also a big business area in Vlissingen.

You can likewise request for free quotes from the lawyers and they will educate you regarding the solutions offered by each lawyer. An on-line lawyer directory site will likewise aid you in locating a good lawyer that supplies high quality lawful recommendations. There will be plenty of pertinent information relating to each lawyer along with his/her qualifications, experience and track record.

You will also wish to find out if you will certainly need to pay any kind of retainer fees along with any type of various other expenses that could occur throughout the program of the process of your instance. It is vital that you find a lawyer that has expertise and knowledge in the area that you are dealing with if you require a lawyer in financial difficulties. You want to find somebody that can explain your alternatives to you carefully. Also, it is very important to discover somebody that can function swiftly, effectively, and also affordably with a lawyer that has your best interests at heart. Excellent lawyers will see to it that they recognize your case and also your circumstance.

This is just one of the cities you may intend to go to if you wish to get excellent legal advice. Last but not least, you need to find out about the number of law practice. Alkmaar has greater than 500 law firms, and they represent more than 100 sorts of situations. This suggests that there is almost always somebody that can provide you guidance on your case.

#advocaat alkmaar #advocaten alkmaar #advocatenkantoor alkmaar #advocatenkantoren alkmaar #advocaten in alkmaar #advocatenbureau alkmaar #jurist alkmaar #advocatenkantoren noord holland #alkmaar juristen

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bobjecieds · 5 years ago

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Trauma-Aware Bundle

https://traumainformedcaretraining.com/trauma-aware-bundle/

A comprehensive overview of developmental trauma, its impacts and symptoms, and various approaches to healing.

This bundle is part of the trauma-informed certificate training but is also sold separately for those who want to understand trauma but not necessarily need a practitioner’s certificate.

Approximately 15 hours of study, 100% online. No textbooks or additional purchases required.

Instructors

Barry & Janae Weinhold

Barry and Janae are authors, lifelong teachers, visionaries, authors, developmental psychologists, and licensed mental health professionals. They are also are devoted partners, parents of four children between them, and grandparents of three.

As part of their quest for higher consciousness and their desire to understand evolution at all levels, the Weinholds have traveled extensively, lived abroad twice and studied a broad array of topics and subjects that helped them create their meta-theory Developmental Systems Theory, their clinical approach Heart-Field Therapy and the game-changing concept Developmental Trauma. These frameworks and concepts permeate their thinking, counseling & coaching and their writing.

The post Trauma-Aware Bundle appeared first on Trauma Informed Care Online Training Center

source https://traumainformedcaretraining.tumblr.com/post/611144069096357888

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beeptunds · 5 years ago

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Trauma-Aware Bundle

https://traumainformedcaretraining.com/trauma-aware-bundle/

A comprehensive overview of developmental trauma, its impacts and symptoms, and various approaches to healing.

This bundle is part of the trauma-informed certificate training but is also sold separately for those who want to understand trauma but not necessarily need a practitioner’s certificate.

Approximately 15 hours of study, 100% online. No textbooks or additional purchases required.

Instructors

Barry & Janae Weinhold

The post Trauma-Aware Bundle appeared first on Trauma Informed Care Online Training Center

source https://traumainformedcaretraining.tumblr.com/post/611144069096357888

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kintersblog · 5 years ago

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Trauma-Informed Certificate

https://traumainformedcaretraining.com/trauma-informed-certificate/

Get Certified for 50% Off – For a Limited Time

Enhance your professional knowledge, skills, and career potential with an expanded model of trauma. Drawn from a three-day conference by the Colorado Professional Development Center, who’ve certified over two hundred people, from therapists to soldiers, and everything in between.

Instructors

Barry & Janae Weinhold

The post Trauma-Informed Certificate appeared first on Trauma Informed Care Online Training Center

source https://traumainformedcaretraining.tumblr.com/post/611144069484331008

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footcare1 · 5 years ago

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Where Can I Go for an Orthotist Education in Barrie?

Finding the right place to start or continue your orthotist education is just as important to your future patients as it is to you. If you truly want to help in such an in-demand medical field, then getting the proper schooling and information is critical to having a long and successful career.

We can’t speak for anyone who may be reading this post, but to us, success is properly treating any conditions that you come across and providing relief and comfort to people who are suffering.

As more and more patients begin showing symptoms of various lower limb disorders, the need for caring, empathetic, and qualified health practitioners has never been higher. With that in mind, we wanted to list the main options that students (or those already working in the field) have when it comes to getting that great education:

Online Courses

These are probably the lowest graded and least respected classes that you can take. Many times, the curriculums are put in place by people with little to no experience in the given subject, and are taught by people without actual medical experience.

Traditional Universities

While you can get a fine education in a number of fields (including medicine) in these institutions, all of the electives and mandatory classes which have nothing to do with your particular training can become cumbersome on your overall progress.

Specialized Programs with In-Depth Curriculums

Foot care education is very specific and detailed. It requires a course which was designed especially with its practices and methods in mind. That is why the courses in Barrie are our recommendation.

#orthotist education #foot care education

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whittlebaggett8 · 6 years ago

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10 classic children’s books that haven’t aged well, Defence Online

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Not all publications have aged effectively.

supply

Carlo Allegri/Reuters

Some basic children’s textbooks have not stood the check of time.

While J.M. Barrie’s common “Peter Pan” is beloved by numerous, his depiction of the Native Us citizens in Neverland are problematic for audience currently.

Hugh Lofting’s “Dr. Dolittle,” was revised posthumously to edit out passages with racist product.

Pay a visit to INSIDER’s homepage for additional stories.

More than the years, many when-beloved typical children’s stories have been re-examined for problematic or disturbing tropes and stereotypes as societal mores proceed to development and moms and dads and teachers get additional sensitized to the materials youth are consuming.

For case in point, novels by acclaimed authors like Dr. Seuss, J.M. Barrie, and Laura Ingalls Wilder that ended up the moment an indispensable section of a school’s looking through curriculum are now getting backlash or even becoming altered for containing themes or people exhibiting overt racism or sexism.

It’s not shocking that all vintage literature has not held up with the evolution of the instances, and in some cases, gurus and moms and dads are continue to divided on regardless of whether or not these is effective can nonetheless be used as a educating resource for children to understand about racism and biases.

From “Peter Pan” to “Dr. Dolittle,” here are 10 traditional children’s publications that lots of think have not aged perfectly.

“If I Ran The Zoo” by Theodor Seuss Geisel, aka Dr. Seuss, has been criticized for that contains quite a few offensive visuals.

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It consists of some offensive stereotypes.

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Amazon

The e book drew criticism for such as drawings of, between other points, two African guys putting on grass skirts without the need of shirts or footwear. In addition, the e book also refers to Asian characters as getting “eyes all a slant” along with a drawing of three adult men of Asian descent carrying a caged animal on their heads.

The e book was challenged but retained at the Toronto General public Library for the line about men and women of Asian descent, but will no more time be go through at the library’s story-time, in accordance to The Edmonton Community Library.

“The Cat in the Hat” is seemingly based on people from minstrel reveals.

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Minstrelsy has a prolonged and hurtful background.

source

Amazon

An additional book by Dr. Seuss, “The Cat in the Hat” has also drawn criticism.

NPR pointed out that Seuss was mentioned to have executed a minstrel demonstrate whilst in higher education. Minstrelsy was a form of vaudeville that mocked African-Us citizens utilizing offensive stereotypes and “The Cat in the Hat” is apparently centered on the main figures of such exhibits.

“The Cat’s physical appearance, which include the Cat’s oversized leading hat, floppy bow tie, white gloves, and commonly open up mouth, mirrors real blackface performers as does the part he plays as ‘entertainer’ to the white family members – in whose house he does not belong,” wrote Kat Ishizuka, director of the Mindful Child Social Justice Library in an examination piece tackled to Study Across The us, a US literacy software that usually takes advantage of Suess’s title and operate to market examining for youngsters.

Laura Ingalls Wilder’s “Little Property On The Prairie” collection advised the story of the author’s childhood as a settler and a pioneer.

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It contained one notably offensive line.

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Amazon

This series has lately appear less than hearth for its racial stereotypes of Native Us citizens and African People. In accordance to the Washington Article, the Harpers publishing company resolved to change the phrase “people” to “settlers” in 1953 to edit her initial sentence “…no folks. Only Indians lived there.”

In 2018, Wilder’s name was dropped from the lifetime achievement award provided by the Association for Library Services to Kids. The association reported that the stereotypes observed in the series ended up “inconsistent with ALSC’s main values.”

The Lynne Reid Banks book “The Indian in the Cabinet,” which was followed by a 1995 movie of the very same name, has arrive beneath censure for the colonial undertones of its depiction of Indigenous Individuals.

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The notion of possessing this kind of a figurine is also seen as problematic.

source

Amazon

Audience criticized the author for obtaining Minimal Bear (the toy figurine) talk only damaged English and view factors in a simplistic way.

Quite a few, together with the website American Indians in Children’s Literature, pointed out that even the notion of owning a “plastic Indian” is problematic in and of alone.

Right now, the book is on Random House’s banned ebook checklist.

While J.M. Barrie’s vintage “Peter Pan” is beloved by lots of, his depiction of the Indigenous Us citizens in Neverland are problematic for audience currently.

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Some have attempted to adjust the supply material.

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Amazon

In the textual content, the Indigenous People in america are termed a racial slur and exhibit specified stereotypical features like speaking in grunts and contacting Peter Pan the “great white father.” Peter Pan himself makes use of a racial slur when referring to them.

Movie adaptations of the story have attempted to update the references to Native People in america – or depart the tribe out completely – even though others have ongoing to drop flat and offend.

Astrid Lindgren’s “Pippi in the South Seas” contained a racial slur.

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It also contained some stereotypes that some identified offensive.

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Amazon

The offending terms ended up modified when a 1969 television series about the pink-haired heroine was re-aired in 2014, according to the New York Times. At the time, producers declared that they had been picking out to edit two different scenes that ended up deemed offensive.

The guide has also been criticized for containing colonial undertones. Dr. Eske Wollrad from the Federal Association of Evangelical Women of all ages in Germany was the most-general public critic of the guide.

“It is not that the figure of Pippi Longstocking is racist, but that all 3 in the trilogy of books have colonial racist stereotypes,” she advised German paper The Local.

Wollrad cited a passage of the e book in which black small children throw by themselves into sand as an additional level in the ebook that she took difficulty with and struggled to read through to her nephew, who is black, according to The Area.

Hugh Lofting’s “Dr. Dolittle,” which was initially printed in 1920, was later on revised posthumously to edit out passages with racist content.

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The book had colonialist overtones.

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Amazon

The ebook came under hearth for portraying unfavorable stereotypes of black people today, colonialist overtones, and for applying racial slurs. For illustration, in 1 part of the original book, the medical doctor agrees to assist an African prince who desires to marry a Caucasian princess by bleaching his pores and skin.

One of the early criticisms of the e book came from Librarian Isabelle Suhl, according to The New York Times, who known as the reserve “chauvinistic” and stated ”the ‘real’ Health practitioner Dolittle is, in essence, the personification of The Terrific White Father Nobly Bearing the White Man’s Burden and that his creator was a white racist and chauvinist, guilty of virtually every single prejudice known to contemporary white Western person.”

The e book ceased printing in the ’70s, in accordance to the Situations, and was altered in the late ’80s to remove significantly of the offensive material.

“Charlie and the Chocolate Factory” initially had a specially offensive plotline, but some nonetheless consider concern with it.

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It was altered, but some even now just take issue with it.

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Puffin Publications

Fans of “Charlie and the Chocolate Factory” may well know the story as a reasonably harmless one particular, but the first tale experienced some aspects that have not fared well in fashionable situations.

The Oompa Loompas, now witnessed as orange individuals from a built-up place, were being originally African pygmies. When the book was launched in 1964, a lot of took situation with the portrayal, and Roald Dahl reported he was ashamed but that he initially did not see the issue.

“You just can’t buck the tide,” he stated, according to The Corporation of American Historians. “It was the past days of the British Empire.”

Dahl revised the guide and it was re-produced in 1973. But even current diversifications of the guide have occur under hearth as viewing the Oompa Loompas as “happy slaves.”

“The Magic formula Garden” has some blatantly racist strains.

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The guide seems to stand as composed.

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Amazon

“The Secret Garden” has been criticized for numerous issues, such as colonizing overtones and outright racism versus black and indigenous people, and stating that they’re not respectable and even “not folks.”

The e book does not seem to have been altered considering the fact that its initial publication.

Not everyone is a fan of “The Offering Tree.”

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Some sense it can have some out-of-date sights on motherhood.

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Amazon.com

The providing tree may be a classic tale of selflessness but many have taken challenge with it in present day instances.

While the “giving tree” is noticed as an allegory for a mother who offers and offers until finally it’s no far more than a stump for its youngster to sit on, not every person agrees that it’s a heartwarming tale of parental selflessness.

“Children’s textbooks teach youngsters, but children’s textbooks also teach mom and dad,” children’s guide creator Laurel Snyder instructed the Chicago Tribune. “When you give a new mom, soon after her 1st newborn, 10 copies of ‘Giving Tree,’ it does deliver a information to the mother that we’re supposed to be this person.”

The post 10 classic children’s books that haven’t aged well, Defence Online appeared first on Defence Online.

from WordPress https://defenceonline.com/2019/05/09/10-classic-childrens-books-that-havent-aged-well-defence-online/

#Books #Features #Freelancer #Literature #News

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marlabs-blog · 6 years ago

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UX Design Impacts the Bottomline. No Question.

Business interactions have moved online, making it critical for companies to offer a friction-less and seamless Digital User Experience. Today, users consider an optimized user experience to be a basic requirement. In turn, companies have begun to treat UX design as a prerequisite implementation strategy across different devices and platforms.

The premise is to understand the reason behind why customers visit a site, and if what they discover benefits both them and the business. This methodology provides brands with the rationale to an optimized digital user experience. Companies can now impact their businesses more effectively with the application of targeted campaigns and strategies throughout its digital ecosystem.

A study by Forrester Research cites a 200% improvement in the conversion rate as a direct result of a well-designed user interface. This number skyrockets further to 400% against better constructed designs. The metrics speak for themselves. There are companies quick to adjust, but for those slower to adapt, a change might require fresh perspective, hard numbers, and a quality review of the digital environment. Here’s how you can go about it:

The Case

UX optimization can improve brand recognition, enhance user retention, and build trust with the audience at a faster than normal pace. At Marlabs, we understand the challenge around driving the importance of UX design to stakeholders that are swayed by numbers alone. But there is a simple way to uncover UX ROI, and that is by comparing before-and-after results post implementation.

In analogy, one may look to the book authored by Robert Pressman, Software Engineering: A Practitioner’s Approach, which highlights that every dollar spent to resolve a problem during design magnifies to $10 during development, and perhaps $100 or more after the product’s release. Likewise, every dollar invested in UX early on is the what’s most cost-effective.

This is interesting because, an eye-tracking study by the Missouri University of Science and Technology states that it merely takes 2.6 seconds for a user’s eyes to land on that area of a website most likely to influence his or her first impression. After studying varying factors such as time taken to focus on important sections of a page, logos, menu, social media icons, and more, researchers concluded a strong correlation between high user engagement and first impressions.

Interestingly, first impressions are often always about design 94% of the time. When British researchers assessed how information and design influence the trust of online health websites, it revealed the latter to stand the primary driver of user-based first impressions. In today’s world, a poor experience design is easily associated with the rejection and mistrust of the brand.

Consider this an important case, because Barry Staw and Ha Haon – two economists – believe that first impressions last for years.

The Approach

It’s important to understand which conversion and UX strategies work for a specific brand or business. Companies might look to competitors for implementation-based ideas, which may or may not be ideal; reason being that UX impacts different target markets differently. An effective digital user experience begins with analysis, a comprehensive look at your own business strategy and how your customers interact with it.

An interesting part about UX design, often overlooked, is responsiveness. Users are known to prefer cross-platform or cross-device compatibility.

There are two scenarios to consider here; for example, a SaaS application could technically run on any internet-capable device with a browser, but regardless of similar core functionalities across devices, the possibility of varying experiences is bound to persist. This is why Google Docs on a desktop feels different than using it on a smartphone. And if your solution is marketed as being accessible from anywhere but is a chore to use on devices other than the desktop itself, you could expect significant churn.

It’s easy to conclude with just this example that user experience design has a significant impact on conversion rates. On the flipside, if an application is seamless across devices and is enjoyable to engage with, users are also less likely to churn. Effectively, a responsive design is simply a means to maintain your brand experience across different platforms.

The Closure

At the end of the day, UX design simplifies complexity – it creates a story that leads a customer from one stage to another, optimizing the chances for a closure or conversion. UX strategies redefines company-customer relationships and interactions beyond the digital ecosystem even. It applies to both internal and external operations, with several companies reporting lowered cost of customer acquisition, improved customer retention, reduced training costs, and increased market share and sales.

Businesses living within the digital ecosystem benefits from the process of user experience. And user acceptance is crucial regardless of whether it’s a service, product, or project; needless to say, positive user experiences lead to a loyal customer base. In turn, these customers transform to become your biggest brand advocates and ambassadors.

Summary of Everything Written:

Digital User Experience, in combination with a solid user interface, can help you win the trust and confidence of your customers.

Your website and online presence represent your brand, and a good UX establishes your brand name in the market. Usability, in addition to an attractive and seamless interface, is bound to help your organization race ahead in the digital world.

The primary aim of working on user experience is to optimize design and present an experience that can satisfy your user base.

Your bottom line can get an enormous boost, skyrocketing future growth, with the right aspects of UX and UI.

In conclusion, UX now possesses the ability to transform business models, thereby becoming a necessary part of our everyday existence and the evolving digital landscape.

Source

#Digital user experience #user experience design #UI #UX #UX design #digital experience

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savetopnow · 7 years ago

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2018-04-02 12 TECH now

TECH

Ars Techica

China’s “Heavenly Palace” returns to Earth and burns up

An actual gaming Easter egg was unlocked on an Atari Jaguar cartridge today

Coal, nuclear plant operator files for bankruptcy, asks Trump for a bailout

Kepler caught strange supernova: Sudden surge, rapid decay

20 years ago, Apple killed the Twentieth Anniversary Mac

Buzzfeed Tech

Chick-Fil-A Will Soon Be Bigger Than Taco Bell, Burger King, And Wendy's

Sen. Ed Markey Says "Congress Must Act" When Facebook Fails To Maintain Safety On Its Platform

Apple Just Released A New iPhone Battery Health Feature

Facebook Must Decide Whether It Will Refurbish Its Facade Or Rebuild Its Service

Julian Assange Just Got His Internet Privileges Revoked

CNet

Crashing Tiangong-1 space station just misses space graveyard - CNET

April Fools' Day 2018: Elon Musk, Google get in on the fun - CNET

Telsa goes bankrupt in Elon Musk April Fools' Day gag - CNET

Facebook is building a tool to fight advertising without consent - CNET

This weird-looking plane isn't a joke - CNET

Clean Technica

Tesla PR Disaster 10 Times As Good As Chevy Bolt Ramp Up

Renault–Nissan Merger — A Good Idea, Collaboration More Important

Do Electric Vehicles Have Better Overall Safety? Part 2

Australian Company Introduces Tri-Turbo Y-9 Engine That Is Cleaner Than An Electric Motor

3 MINI Countryman Panamericana PHEVs To Travel From North America To Tierra Del Fuego

Hacker News

“The street finds its own uses for things”: William Gibson

IIHS: Model S has higher collision claim frequencies than comparable luxury cars

Behind the scenes at YC Demo Day, where hottest new startups pitch companies

Scale API is hiring engineers and ML practitioners

How fast is AMP really?

Mashable

Sara Bareilles slayed 'I Don't Know How To Love Him' in 'Jesus Christ Superstar'

China’s Tiangong-1 space station burns up in Earth’s atmosphere above the Pacific Ocean

The Parkland teens wield real power. Just ask Laura Ingraham and Frank Stallone.

Snapchat trolls Facebook with a Russian bot filter. It's good.

Watch our IRL dystopia in real time with these Sinclair local news broadcasts

Motherboard

Fitted Sheets Are a Scam

Watch Canon's Mind-Boggling 120 Megapixel Sensor In Action

Watch Pixar’s New, Kinda Freaky Animation Technique

Watching Ultrafine Steel Wool Get Microwaved Is Unexpectedly Beautiful

A Struggling Town Is Reviving Itself With... Geocaching

New York Times Technology

Executive Who Sold Self-Driving Truck Start-Up to Uber Departs

A Quick Online Divorce for $60? Not So Fast, Denmark Says

As Facebook Struggles, Rivals’ Leaders Stay (Mostly) Mum

Tech Thinks It Has a Fix for the Problems It Created: Blockchain

They Tried to Boycott Facebook, Apple and Google. They Failed.

Recode

Snapchat is mocking Facebook and its Russian political ads controversy with a new April Fools’ Day filter

Meet Barry McCarthy, the man behind Spotify’s daring public offering

The Saudi Crown Prince is headed to Silicon Valley. One of its fanciest hotels is closed to the public. Coincidence?

Chicago Mayor Rahm Emanuel says Apple’s technology is a ‘means, not an end’ to help public education in his city

Full transcript: Chris Kirchhoff, formerly of the Pentagon’s Silicon Valley office, on Recode Decode

Reddit Technology

By 2020, China will have completed its nationwide facial recognition and surveillance network, achieving near-total surveillance of urban residents, including in their homes via smart TVs and smartphones.

Cloudflare announces a new DNS (like OpenDNS or Google 8.8.8.8) focused on privacy

More than 100 million LinkedIn users personal data compromised

Giving up Facebook leads to a drop in the stress-related hormone cortisol, study finds

April Fools': Snapchat's latest filter copies Facebook’s layout but text looks like the Russian alphabet

Reuters Technology

U.S. safety agency criticizes Tesla crash data release

Saks, Lord & Taylor hit by payment card data breach

Trump attacks Amazon, again, over U.S. postal rates

U.S. government seeks end to Supreme Court privacy fight with Microsoft

India's electronics ministry moots duties on key smartphone component: sources

Slashdot

Software Bug Behind Biggest Telephony Outage In US History

Linux 4.16 Released

Teenage Subway Aficionados Help With the Upkeep of Every One of New York City's 472 Subway Stations -- At Least on Wikipedia

Trump Says He Wants Skilled Migrants But Creates New Hurdles

Card Data Stolen From 5 Million Saks and Lord & Taylor Customers

TechCrunch

Cloudflare’s new ‘privacy-focused’ DNS service speeds up your web browsing

What Apple’s education announcements mean for accessibility

China’s 9-ton Tiangong-1 space station will burn up tonight, but no one knows quite where

STEAMRole is like Tinder for mentorship

DARPA wants new ideas for autonomous drone swarms

The Next Web

6 reasons why Latin American valuations are lagging behind Silicon Valley

South Africa has an untouched $10M fund for internet accessibility

Get a lifetime of WordPress themes that don’t look like everybody else’s site for over 80% off

Build teams for ‘radical innovation’ to save your company’s creativity

Every blockchain needs a tool for auditing its smart contracts

The Verge

China’s out-of-control space station harmlessly breaks up over the Pacific Ocean

Niantic settles class action lawsuit following last year’s disastrous Pokémon Go Fest in Chicago

The grilles (both real and faux) of the 2018 New York Auto Show

Hyperspektiv is a photo app that produces glitchy, psychedelic images

16 new science fiction and fantasy books to read this April

WSJ Tech

Data Breach at Saks, Lord & Taylor Exposes Millions of Credit Cards

Can Users Have Too Much Privacy?

In Rare Rebuke, NTSB 'Unhappy' With Tesla Over Crash Disclosures

Silicon Valley Rivals Take Shots at Facebook

How Apple, Amazon, Pandora and More Are Trying to Gain on Spotify

Wired

The Politics of ‘Black Panther’ Are What Make It Great

You Know, for Kids

The Life Issue

‘The Sky Is Yours’ Combines Dragons and YouTube

The Uber Crash

#tech

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gabriellakirtonblog · 4 years ago

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[The Best] How to Get Online Personal Training Clients, and More

Want to put great fitness content on our radar? Post on Facebook and include #PTDCBestSubmission.

Best Content of the Week

It’s easy to overcomplicate every part of your job as a personal trainer. The content we highlight this week aims to make it simpler for you: a 12-minute video on how to acquire online clients; a more detailed look at helping clients recover from injuries; a collection of tips showing you how to counter misguided nutrition advice; and a beginner’s guide to the placebo effect, which helps explain why so many people believe those nutrition myths you’re trying to debunk. The collective effect is to strip away the fluff and get to the root of what actually works for you and your clients.

— Esther Avant

Best Article

Five Training Considerations When Returning From an Injury — Tony Bonvechio, Bonvec Strength

Bonvechio begins with an admission that few coaches are willing to put in writing: “Sometimes when people train with me, they get hurt.” It doesn’t happen often, and the injuries are typically minor. His point is that none of us can prevent injuries entirely. To help your clients recover, he recommends training tactics like isometrics, partial ranges of motion, and three others, none of which we’d typically include in our programs.

— Shane McLean

Best Video

How to Get Online Personal Training Clients, Part 1: Why Clients Buy — Jonny Watson, Propane Fitness

youtube

Similar to the Online Trainer Academy, Jonny Watson wants to help online personal trainers get clients in the most straightforward way possible. He shows why the process of convincing someone who’s totally unfamiliar with what you do to become a paying customer is really just four steps: attention, engagement, conversion, and follow-up.

— Esther Avant

GO DEEPER: Four Ways to Keep Your Online Personal Training Clients Engaged

Best Social Media Post

Posted by Mike Doehla on Wednesday, August 19, 2020

Where should you get nutrition information? What’s the difference between accepting responsibility and taking blame? Why do we let the people trying to sell a solution convince us we have a problem? Mike Doehla, CEO of Stronger U Nutrition, has thoughts about these questions, and many more. How many of them apply to your clients?

— Christina Abbey

Best Podcast

The Surprising Truth About the Placebo Effect — Michael Matthews with guest Kurtis Frank

You’ve heard of the placebo effect. In this edition of the Muscle for Life podcast, Mike Matthews and Kurtis Frank discuss how it applies to workouts and other health related areas. They explain when placebos are most powerful, and how alternative health practitioners leverage the placebo effect to their advantage.

— Mike Howard

More Great Fitness Content

[Podcast] Why Having too Many Choices Produces Anxiety — Katy Milkman with guests Barry Schwartz and Jen Glantz

[Video] Safe Return to the Push-Up — Tim Keeley, Physio Rehab

[Article] The Definitive Guide to Knee Pain During Lunges — Tom Biggart, EMB Fitness Solutions

[Article] These 10 Charts Show Why You Don’t Need Fat-Loss Hacks — Brian St. Pierre, Precision Nutrition

[Article] Tracking Data: What Gets Measured Gets Managed — David Rosales, Roman Fitness Systems

Tired of training clients at 5 a.m.?

We all have to pay our dues. For many fitness pros, that means training clients or teaching classes or opening your gym long before the sun comes up.

But if you’ve been paying those dues for years on end, maybe it’s time for a change. Time to try something different. Time to consider another way to make a living while still doing what you love.

That’s why we created the Online Trainer Academy.

Since 2016, we’ve helped thousands of personal trainers, nutrition coaches, and gym owners—serious, passionate fitness professionals like you—launch online training businesses.

Some now do all their coaching online. Others do a combination of in-person and online training. Still others work part-time with online clients to supplement their income from another business.

They all have one thing in common: What they were doing before wasn’t working for them.

They needed a change, and their Online Trainer Academy Level 1 Certification gave them the knowledge and skills to make it happen.

If you love coaching but hate doing it on someone else’s schedule, maybe it’s time to try online training.

Consider this your wake-up call.

The post [The Best] How to Get Online Personal Training Clients, and More appeared first on The PTDC.

[The Best] How to Get Online Personal Training Clients, and More published first on https://onezeroonesarms.tumblr.com/

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cleverwordsandotherstuffilike · 5 years ago

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MacArthur 'Genius' Grant Winners

$625,000 prize (each) - no strings attached prize, recognizing artists, scholars, musicians, writers, and scientists, for the creativity and potential.

Elizabeth Anderson, 59, philosopher

"Employing pragmatist methods to examine the ways that various institutions, policies, and social practices serve to promote or hinder conditions of democratic equality."

Sujatha Baliga, 48, attorney and restorative justice practitioner

"Expanding access to survivor-centered restorative justice strategies that interrupt the criminalization of people of color and break cycles of recidivism and violence."

Lynda Barry, 63, graphic novelist, cartoonist and educator

"Inspiring creative engagement through original graphic works and a teaching practice centered on the role of image making in communication."

Mel Chin, 67, artist

"Harnessing the power of art to raise awareness of social concerns through a practice that defies categorization."

Danielle Citron, 50, legal scholar

"Addressing the scourge of cyber harassment by raising awareness of the toll it takes on victims and proposing reforms to combat the most extreme forms of online abuse."

Lisa Daugaard, 53, criminal justice reformer

"Developing alternative approaches to policing and law enforcement practices to improve outcomes for those struggling with substance use disorder and mental illness."

Annie Dorsen, 45, theater artist

"Pioneering a new genre of theater that dramatizes the ways in which nonhuman intelligence is profoundly changing the nature of work, culture, and social relationships."

Andrea Dutton, 46, geochemist and paleoclimatologist

"Furthering current understanding of sea level dynamics by reconstructing the extent and rate of sea level rise in the ancient past."

Jeffrey Gibson, 47, visual artist

"Melding indigenous North American materials and forms with those of Western contemporary art to create a new hybrid visual vocabulary and prompting a shift in how Native American art is perceived and historicized."

Mary Halvorson, 38, guitarist and composer

"Experimenting at the intersection of jazz and rock with a signature sound on her instrument and an aesthetic that evolves and surprises with each new album and configuration of bandmates."

Saidiya Hartman, 58, literary scholar and cultural historian

"Tracing the afterlife of slavery in modern American life and rescuing from oblivion stories of sparsely documented lives that have been systematically excluded from historical archives."

Walter Hood, 61, landscape and public artist

"Creating ecologically sustainable urban spaces that resonate with and enrich the lives of current residents while also honoring communal histories."

Stacy Jupiter, 43, marine scientist

"Integrating local cultural practices with field research to design conservation strategies that protect ecosystem biodiversity and the well-being of coastal communities."

Zachary Lippman, 41, plant biologist

"Investigating the genetic mechanisms determining flowering and flower production and developing tools for breeding hardier, higher-yielding crops."

Valeria Luiselli, 36, writer

"Challenging conventional notions of authorship in fiction, essays, and inventive hybrids of the two that pose profound questions about the various ways we piece together stories and document the lives of others."

Kelly Lytle Hernández, 45, historian

"Challenging long-held beliefs about the origins, ideology, and evolution of incarceration and immigrant detention practices in the United States."

Sarah Michelson, 55, choreographer

"Expanding the scope of contemporary dance in works that extend and subvert classical, modern, and postmodern traditions and make evident the physical realities of dancers' performance."

Jeffrey Alan Miller, 35, literary scholar

"Shedding light on how the writing practices of Renaissance scholars shaped foundational texts of modern Christianity, philosophy, and literature."

Jerry X. Mitrovica, 58, theoretical geophysicist

"Revising our understanding of the dynamics and structure of Earth's interior and developing models to better predict the geometry and sources of sea level change in the modern world and the geological past."

Emmanuel Pratt, 42, urban designer

"Integrating agriculture, education, and design in a resident-driven approach to community development and turning neglected urban neighborhoods into places of growth and vitality."

Cameron Rowland, 30, artist

"Using physical objects and contractual relations—such as items seized in civil forfeiture or furniture made by prison labor—to make visible the mechanisms through which systemic racism is perpetuated."

Vanessa Ruta, 45, neuroscientist

"Investigating how stimuli in the physical world shape the function of neural circuits and are translated into innate and learned behaviors."

Joshua Tenenbaum, 47, cognitive scientist

"Combining computational models with behavioral experiments to shed light on human learning, reasoning, and perception, and exploring how to bring artificial intelligence closer to the capabilities of human thinking."

Jenny Tung, 37, evolutionary anthropologist and geneticist

"Revealing links between social environmental factors—such as social status and social integration—and genomic variation and how these connections impact health, well-being, and longevity."

Ocean Vuong, 30, poet and fiction writer

"Marrying folkloric traditions with linguistic experimentation in works that explore the effects of intergenerational trauma, the refugee experience, and the complexities of identity and desire with eloquence and clarity."

Emily Wilson, 47, classicist and translator

"Bringing classical literature to new audiences in works that convey ancient texts' relevance to our time and highlight the assumptions about social relations that underlie translation decisions."

https://www.npr.org/2019/09/25/763748204/macarthur-genius-grant-winners-attest-to-power-of-individual-creativity

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thechasefiles · 5 years ago

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The Chase Files Daily Newscap 9/9/2019

Good Morning #realdreamchasers. Here is your daily news cap for Monday, September 9th, 2019. There is a lot to read and digest so take your time. Remember you can read full articles via Barbados Today (BT), or by purchasing a Weekend Nation Newspaper (WN).

Bajans ‘rise’ – Barbadians managed to dig deep and come up with $440 956.41 for the people of The Bahamas last night. It was all part of the Rise Again Bahamas mediathon staged at the Caribbean Broadcasting Corporation’s Pine, St Michael offices, in an effort to raise funds after Category 5 Hurricane Dorian wreaked havoc in Grand Bahama and Abaco eight days ago.Entertainers across the length and breadth of Barbados gave of their time by performing during the almost eight-hour event, as they too encouraged everyone to donate.At the end of the telethon, Minister of Information, Broadcasting and Public Affairs, Senator Lucille Moe, urged Barbadians to continue donating as the online platform would remain open for another 48 hours, while accounts at FirstCaribbean International Bank would be open until weekend. Here, entertainer Lil Rick (left), Barbados’ Ambassador to CARICOM David Comissiong and Moe proudly showing the amount raised last night.(DN)

NATION VOWS TO GIVE MORE – CHIEF EXECUTIVE OFFICER of the Nation Group of Companies, Anthony Shaw, has vowed to match whatever his staff donates within the coming week to The Bahamas relief effort. He made the pledge following a $15 000 donation on behalf of the group to the Rise Again Bahamas mediathon at the Caribbean Broadcasting Corporation, The Pine, St Michael, last night.“Marketing and HR have a memo to send to staff starting today to get them to contribute towards this exercise. Additionally, the company will support whatever initiatives come from staff which is very important, because it is all of us and we all need to be a part of the effort,” he said. He urged staff under the Nation umbrella to “bring your cheque books and we will match whatever you contribute”. The NATION currently has multimedia journalist Anmar Goodridge-Boyce stationed in The Bahamas, working alongside sister company The Express newspaper out of Trinidad and Tobago. However, Shaw indicated it was likely that another team would be sent to do additional coverage of the aftermath of Hurricane Dorian and its effect on the people of Grand Bahama and Abaco. (DN)

NEW JUDGES APPOINTED – Attorney General Dale Marshall has announced the appointment of new judges to the Court of Appeal and High Court of Barbados. In the Appeal Court, those judges are: Justice Rejendra Narine, a judge in Trinidad and Tobago; Barbadian, Francis Belle, who serves as a judge of the Court in the Organization of Eastern Caribbean States (OECS); and Jefferson Cumberbatch, a leading academic at the University of the West Indies.Meanwhile, those appointed to the High Court are: Shona Griffith from Belize; Cecil McCarthy, QC, who acted as a judge in the High Court of Barbados over the last three years; leading practitioner of Family Law in Barbados, Cicely Chase-Harding, QC; Barry Carrington, a public servant who also acted as a judge in 2018; and Chief Magistrate, Christopher Birch.“Under the Constitution of Barbados, the Prime Minister, having taken into account the recommendations of the Judicial Appointments Committee, is obligated to consult with the Leader of the Opposition.“The Prime Minister did that consultation over the last week and the Leader of the Opposition has without any reservation supported the recommendations that were first made by the judicial appointments committee and accepted by the Prime Minister,” Marshall said.He also announced that renowned jurist, Justice Carlisle Greaves, will return to act s a temporary judge, along with Laurie-Ann Smith-Bovell, who has also done “outstanding work” in the island’s justice system. These temporary appointments will see the number of criminal courts hearing criminal matters moving from two to five, with the two temporary judges working to clear the backlog. However, the Attorney General explained that the appointment of temporary judges was not advertised. “If the business of the Court is such that urgent appointments need to be made, the Chief Justice will activate the process,” he said. Prime Minister Mia Mottley explained that in changing the way judges were appointed in Barbados, this was the first time the positions were advertised, and a committee established to conduct interviews and make recommendations. Those recommendations, she said, were then accepted, and consultations held with the Leader of the Opposition, before the recommendations were taken to the Governor General. (BT)

BODIES OF TWO WOMEN DISCOVERED –The decomposed bodies of two women were discovered earlier today at a residence in Regency Park, Christ Church. They are believed to be those of an elderly woman and her daughter said to be in her 50s. Police made the discovery around 1:30 p.m. accompanied by a concerned family member who is visiting from Britain.(DN)

INCREASE IN GASOLINE & DEISEL PRICES -The retail prices of gasoline and diesel will increase effective midnight Sunday, September 8. However, the price of kerosene will decrease. Gasoline will be adjusted from $3.78 per litre to $3.81 per litre, while diesel will rise from $2.96 per litre to $3.02 per litre.Kerosene will drop from $1.36 per litre to $1.35 per litre. This represents an increase of 3 cents per litre and 6 cents per litre for gasoline and diesel, respectively, while kerosene decreases by 1 cent per litre.These price adjustments are in keeping with Government’s policy of allowing retail prices to be reflective of those on the international market. (BGIS)

Fogging schedule for September 9 to 13 – The Vector Control Unit of the Ministry of Health and Wellness will resume its weekly fogging programme on Monday, September 9, in St George. Areas to be treated are Charles Rowe Bridge, Lower Estate, Lower Estate Tenantry, Price Road, Parish Land, Airy Hill with Avenues, Flat Rock Development and environs.On Tuesday, September 10, the team returns to St George to fog Flat Rock Tenantry, Mayfield Road, Rowans Park North with Avenues, Rowans Park East with Avenues, Rowans Park South with Avenues, Exchange, Glebe, Valley Land, Glebe Land and neighbouring districts.On Wednesday, September 11, the unit will head to St Peter to treat the Speightstown Bypass, Queen Street, Bovell Road, Mango Lane, Chapel Street, Gooding Alley, Major Walk, Sand Street, Church Street, Golden Mile with Avenues and surrounding areas.On Thursday, September 12, the team will treat St Peter and St James fogging Gills Road, Around the Town, Farm Road, Niles Road, Farm Tenantry Road, Burma Road, Battaleys, 1st and 2nd Street Holetown, Trents, Trents Tenantry, Jamestown Park and environs.The Regional Police Training School in Christ Church will be sprayed on Friday, September 13.The fogging will be conducted between 4:30 and 7:30 p.m. each day.Householders are reminded to open their windows and doors to allow the spray to enter. (BGIS)

TRIDENTS LOSE OPENER - BARBADOS TRIDENTS might have a different line-up but the result is still very much the same. Fielding a team that included seven first-timers, the Tridents started their 2019 Caribbean Premier League campaign with a disappointing defeat by 47 runs at the hands of the Guyana Amazon Warriors last night.After a depressing tournament last year when they lost eight of ten matches, the Tridents, under new ownership, made sweeping changes this season including the acquisition of former West Indies coach Phil Simmons but those made no difference to the outcome of a vastly one-sided match at the Guyana National Stadium.Facing a barrage of left-handers after winning the toss, the Tridents conceded 180 for four and most of the mayhem came in the last four overs when Nicholas Pooran and Sherfane Rutherford, two of the four lefties in the hosts’ top six, combined to smash 72 runs. The Tridents were then undermined by a quartet of spinners that reduced them to 53 for five in the eighth over, leaving the result a forgone conclusion despite Ashley Nurse’s counter-attacking 40 off 25 balls that gave them only a semblance of hope. (DN)

NCF AWARDS CROP OVER TOP PERFORMERS–Competitors in the various competitions during the recently-concluded Crop Over festival were recognised for their hard work and dedication last night. Just over 100 prizes were given out by the National Cultural Foundation (NCF) to the top performers and contributors to this year’s Crop Over Festival. That number does not account for those who were placed second or third in the various categories. Band leaders, masqueraders, calypsonians senior and junior, visual artists and volunteers were all recognised for the roles they played in staging a successful festival. Awardees along with specially invited guests were treated to an evening reminiscent of the major moments of the season. Minister of Creative Economy, Culture and Sport John King congratulated the awardees and thanked corporate Barbados for their continued support of the festival. The awards ceremony was held at the Daphne Jospeh Hackett Theatre, Queen’s Park.(BT)

SHANELL IFILL MISS UNIVERSE BARBADOS 2019 –A beaming Shanel Ifill was crowned Miss Universe Barbados 2019 at 10:33 p.m. Saturday night The 20-year-old University of the West Indies student, won the hearts of both the judges and the crowd at Hilton Barbados, to beat a field of eight other delegates. First runner up went to Beviny Payne while second runner up was Hilary Williams. The top three were chosen from a field of a top five, which was named earlier in the night after a question and answer segment. The other two contestants in the top five were: Alexandra Ortiz and Jeunessa Banfield. Others in winners’ row: People’s Choice Award: Hillary Williams - Miss Photogenic: Kristen Asha, Miss Congeniality: Jeunessa Banfield. (BT)

That’s all for today folks there are 113 days left in the year Shalom! Follow us on Twitter, Facebook & Instagram for your daily news. #thechasefiles #dailynewscaps #bajannewscaps #newsinanutshell

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biofunmy · 5 years ago

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Surging prescriptions, deaths: Australia faces opioid crisis

The coroner’s sense of futility was clear, as he investigated the death of yet another Australian killed by prescription opioids.

Coroners nationwide have long urged officials to address Australia’s ballooning opioid addiction, and to create a tracking system to stop people from collecting multiple prescriptions from multiple doctors. Yet even as thousands died, the coroners’ pleas were met largely with silence.

“For what it is worth, I add my voice to the chorus pleading for urgency,” Western Australia coroner Barry King wrote in his report, delivered in May.

Half a world away, Australia has failed to heed the lessons of the United States, and is now facing skyrocketing rates of opioid prescriptions and related deaths. Drug companies facing scrutiny for their aggressive marketing of opioids in America have turned their focus abroad, working around marketing regulations to push the painkillers in other countries. And as with the U.S., Australia’s government has also been slow to respond to years of warnings from worried health experts.

In dozens of interviews, doctors, researchers and Australians whose lives have been upended by opioids described a plight that now stretches from coast to coast. Australia’s death rate from opioids has more than doubled in just over a decade. And health experts worry that without urgent action, Australia is on track for an even steeper spike in deaths like those seen in America, where the epidemic has left 400,000 dead.

“If only Australia could understand how quickly this can get out of hand. We’re not immune to it,” says Jasmin Raggam, whose brother Jon died in 2014 of an opioid overdose and whose brother-in-law is now addicted to the opioid OxyContin. “I was screaming from the mountaintops after Jon died and I’d started doing my research. And it was like I’m screaming and nobody wants to hear me.”

On an island off the coast of Tasmania, Dr. Bastian Seidel and his colleagues are immersed in what he calls a “nightmare scenario.” Two years ago, when he was president of the Royal Australian College of General Practitioners, Seidel dubbed Australia’s opioid problem a “national emergency.” Today, he wonders if anyone was listening.

“It’s depressing at times to see how we, as practitioners, literally messed up our communities,” he says. “It’s our signature on the scripts. … But the pressure being put on by the drug companies, by certain health sectors — that’s the situation that we are facing now.”

Australia knows the extent of the problem, he says. The country knows addiction is devastating its communities. And yet, he says, nobody is doing anything.

“Unfortunately, in Australia, we’ve followed the bad example of the U.S.,” he says. “And now we have the same problem.”

———

AUSTRALIA’S OPIOID ADDICTION

Opioids were once reserved for treating pain that was short-term, terminal or related to cancer. But in the 1990s, pharmaceutical companies began aggressively marketing them for chronic pain.

Starting in 2000, Australia began approving and subsidizing certain opioids for use in chronic, non-cancer pain. Those approvals coincided with a spike in opioid consumption, which nearly quadrupled between 1990 and 2014, says Sydney University researcher Emily Karanges.

Dr. Jennifer Stevens, a pain specialist, saw the surge with startling clarity while working at St. Vincent’s Hospital in Sydney.

A few years ago, a pharmacist at the hospital told her they needed to hire an extra person just to handle all the prescriptions they were handing out for Endone, a brand of oxycodone. Stevens discovered that the hospital’s Endone prescriptions had increased 500 percent in 8 years, with no decrease in other opioids dispensed. Further study revealed that 10 percent of patients were still taking opioids three months after surgery, even though the drugs are generally only recommended for short-term use.

“We were just pumping this stuff out into our local community, thinking that that had no consequences,” says Stevens, a vocal advocate for changing opioid prescribing practices. “And now, of course, we realize that it does have huge consequences.”

Just like in the U.S., as opioid prescriptions rose, so did fatal overdoses. Opioid-related deaths jumped from 439 in 2006 to 1,119 in 2016 — a rise of 2.2 to 4.7 deaths per 100,000 people, according to the Australian Institute of Health and Welfare. Most of those deaths were related to prescription opioids, rather than illegal opioids such as heroin.

More than 3 million Australians – an eighth of the country’s population – are getting at least one opioid prescription a year, according to the latest data.

The numbers and the warnings may have been glossed over partly because of Australia’s piecemeal system of data collection and reporting, says Dr. Christian Rowan, an addiction specialist in the state of Queensland. Data is reported by various states, coroners and agencies, and often includes only prescriptions filled through the government-subsidized drug system and not private prescriptions.

“Because it’s fragmented, people haven’t had a line of sight as to what’s happening,” he says.

Australia’s government insists it is now taking the problem seriously. The opioid codeine, which used to be available over the counter, was restricted to prescription-only in 2018. And last month, the country’s drug regulator, the Therapeutic Goods Administration, announced tougher opioid regulations, including restricting the use of fentanyl patches to patients with cancer, in palliative care, or under “exceptional circumstances.”

“I can’t speak for the past,” says Greg Hunt, who became the federal Health Minister in 2017. “I can speak for my watch and my time where this has been one of my absolute priorities, which is why we’ve taken such strong steps. … My focus has been to make sure that we don’t have an American-style crisis.”

But for Sue Fisher, whose 21-year-old son Matthew died in 2010 of an overdose, it’s too little, too late. The crisis is here, along with what she calls a “crisis of ignorance.”

“We’re living in a country that is oblivious to what’s going on,” she says. “Why aren’t we learning from America’s mistakes? Why don’t we learn?”

———

THE DRUG COMPANIES

When Rustie Lassam thinks of the drug companies that pumped opioids into Australia’s market, she thinks of her infant son’s agonized wails as he went through withdrawal.

For years, doctors had told her that opioids would help her back pain, which led to an all-consuming addiction. During her pregnancy, she swallowed nine high-dose OxyContin tablets every day. So when she thinks about the way pharmaceutical companies have marketed those drugs to doctors, she weeps with rage and grief.

“If only they knew what addiction did to people, how really it affects us to the very core of who we are,” she says. “And there they are, making all this money off the back of my broken life.”

In the U.S., drug companies such as OxyContin maker Purdue Pharma are facing more than 2,000 lawsuits accusing them of overstating the benefits of opioids, downplaying their addictiveness and encouraging doctors to prescribe the drugs to more patients in higher amounts.

In Australia, pharmaceutical companies by law cannot directly advertise to consumers, but are free to market the drugs to medical professionals. And they have done so, aggressively and effectively, by sponsoring swanky conferences, running doctors’ training seminars, funding research papers, giving money to pain advocacy groups and meeting with doctors to push the drugs for chronic pain.

“If the relevant governing bodies had ensured that the way the product was being marketed to doctors especially was different, I don’t necessarily think we would see what we’re seeing now,” says Bee Mohamed, who until recently was the CEO of ScriptWise, a group devoted to reducing prescription drug deaths in Australia. “We’re trying to undo ten years of what marketing has unfortunately done.”

Mundipharma, the international arm of Purdue, has received particular criticism for its marketing tactics in Australia. In 2018, addiction specialist Dr. Simon Holliday filed a complaint against the company over a marketing pamphlet for its drug Targin, a painkiller designed to prevent the constipation that is common with other opioids.

The brochure cited 2009 guidance from the Royal Australian College of General Practitioners that says weak opioids are less effective than strong ones. But in a statement, the doctors’ group said the ad was misleading and that Mundipharma appeared to have deliberately ignored its updated clinical guidelines.

Holliday filed a complaint with Medicines Australia, the pharmaceutical industry’s regulator. But membership to Medicines Australia is not mandatory, and Mundipharma declined to participate in the complaints process because it had dropped out as a member.

Holliday then went to the Therapeutic Goods Administration. He got nowhere. So he wrote to Hunt, the health minister, and other lawmakers. He received no response.

In a statement to The Associated Press, Mundipharma said that the guidelines it referenced were current at the time the pamphlet was in circulation. “The material was balanced, accurate, fully supported by the product information, consistent with the approved indication, and contained adequate safety information,” the company said.

This year, Mundipharma has faced scrutiny over a promotional campaign that critics say violates the spirit of Australia’s law banning drug marketing to consumers.

The campaign, which encouraged people suffering painkiller-induced constipation to talk to their doctors, never mentions Targin by name, because it legally can’t. But the advertising agency Mundipharma hired described on its website how they worked around that regulation, by using print, radio and online ads to target regions where pain medication use was high. Google search data showed that people looking for information on constipation from painkillers used terms like “blocked up,” so the agency used the phrase “blocked pipes.”

In a statement, Mundipharma said the campaign was a “disease awareness initiative” that did not violate the spirit of any law and did not market any medication.

In an interview, Hunt said he has asked the country’s drug regulator, the TGA, to investigate both marketing campaigns, along with some of Mundipharma’s other activities in Australia. Among those activities: the company’s “Pain Management Master Classes” for doctors. The classes, which have provided training to more than 5,000 doctors in Australia, have been praised by some as helpful for physicians seeking guidance on treating complex pain, and condemned by others as a conflict of interest, given they are run by a company that sells painkillers.

Mundipharma said the classes cover non-opioid treatment options and “strongly emphasize” that opioids are only appropriate after a comprehensive assessment.

Stevens, the Sydney pain specialist, has pushed back against several drug companies over their marketing tactics. A couple years ago, she says, Mundipharma was marketing Targin to surgeons at her hospital, reassuring them that they could prescribe higher doses. Unlike pain specialists, surgeons are generally not well-educated on the intricacies of opioids, she says.

Stevens complained to Mundipharma and they stopped the practice. She says they have become much more cooperative since.

“Marketing, on the whole, is very clever and very successful — otherwise it wouldn’t be done,” she says. “We love a freebie. … We’re no different from other members of the population. It’s just that we are targeted more.”

In a statement, Mundipharma said it strictly adheres to the Medicines Australia code of conduct and has always been transparent about the risks associated with opioids. Still, in a submission last year to the TGA as it considered tougher restrictions on opioids, Mundipharma appeared to minimize the severity of Australia’s problem.

“We acknowledge that there is an issue associated with opioid misuse,” the company wrote. “However to describe the Australian situation as a ‘crisis’ is alarmist and risks stigmatizing patients who have a legitimate need for opioid analgesics to manage their pain.”

———

HOW THE GOVERNMENT FELL SHORT

David Tonkin blames his son’s death on a system that allowed him to see 24 doctors and get 23 different medications from 16 pharmacies — all in the space of six months. Between January and July 2014 alone, Matthew Tonkin got 27 prescriptions just for oxycodone.

The addiction that ultimately ended Matthew’s life began in 2012, after he was injured while serving with the Australian army in Afghanistan. When the 22-year-old arrived on leave at his father’s home in the western Australian city of Perth, he held up a stack of OxyContin pill strips. The drugs had been prescribed to him by American doctors in Afghanistan for his injured hip and ankle.

“Look, Dad,” he said. “The Yanks really know how to look after you.”

Matthew was 14 kilograms (30 pounds) lighter than the last time his father had seen him. He was suffering from post-traumatic stress disorder from the horrors of Afghanistan, including the death of his best friend, a fellow soldier. He was also suffering from a growing addiction to opioids. The addiction escalated after the army sent him to recover in Queensland, where doctors put him on an opioid called tramadol.

Matthew soon discovered how easy it was to get whatever prescriptions he wanted. He forged his doctor’s signature. He told one doctor he’d knocked a bottle of pills into the toilet and needed more.

In August 2013, another doctor prescribed him more oxycodone after Matthew said he was suffering from PTSD and hip pain.

A few weeks later, Matthew had his first oxycodone overdose. A few months after that, he was discharged from the army.

One doctor called a hotline for medical professionals to report Matthew’s apparent misuse of prescription drugs. But when Matthew moved back to Perth to live with David, doctors there had no way of knowing his drug use had been flagged in Queensland.

He hopped around clinics collecting prescriptions for opioids. The doctors were largely oblivious to what he was doing because Australia has no national, real-time prescription tracking system.

David begged Matthew’s doctors and pharmacists to stop giving him OxyContin. Matthew just went to other doctors.

At a solemn gathering to honor military personnel on April 25, 2014, two of Matthew’s friends had to hold him upright.

Back at home after the service, David told Matthew to hand over his pills. Matthew shoved David across the kitchen into the cupboard. Then he pinned his father to the floor and began to choke him.

David thought he was going to die.

Matthew eventually let go and both men went to the hospital for treatment. Two days later, Matthew called his father. “Do you still love me, Dad?” he asked.

And of course, he did. So David kept trying to save him, right up until July 3, 2014, when he returned home from a walk and realized Matthew hadn’t come out of his room all morning.

The night before, Matthew had been sick. David had cleaned the vomit off his son’s bedroom floor and changed his sheets. Matthew took a shower, thanked his father and climbed into bed.

David walked into his son’s room. “Time to get up, mate.”

There was no answer.

David placed a hand on Matthew. His body was warm. But he had no pulse.

David called for an ambulance and started CPR. As he pumped his son’s chest, the dispatcher counted out the beats.

One. Two. Three. Four.

Nothing. Nothing. Nothing. Nothing.

Five. Six. Seven. Eight.

Nothing.

———

WARNINGS IGNORED

The conclusion from King, the coroner, was blunt: Had a prescription tracking system been in place, Matthew would not have been given the oxycodone that killed him.

King’s findings on Matthew’s death were delivered at least a dozen years after the first coroners’ reports began warning of a growing opioid problem. As early as 2007, a coroner had suggested that someone look into why the opioid prescription rate on the island of Tasmania was so high.

Two states — Tasmania and Victoria — developed their own prescription tracking systems, but they only monitor opioid prescriptions within their respective states, and neither is currently mandatory.

The development of a national system has been mired in bureaucratic delays. In 2017, the government committed 16 million Australian dollars (US$11 million) to creating one, and Hunt, the health minister, later said it would be ready by the end of 2018. It has yet to be rolled out.

In an interview, Hunt blamed the delay on the states. The national framework is ready, he said, but the states must connect to it.

In March 2019, New South Wales coroner Harriet Grahame warned that Australia’s opioid deaths could reach many thousands over the next five years.

“We appear to have few coordinated strategies to address this problem,” Grahame wrote in a report. “Lowering the rate of opioid overdose is clearly achievable but it will require a government willing to listen to health experts and to act decisively on their advice.”

After Matthew died, and for years to come, David would suddenly awaken at 10 p.m. — the same time that Matthew used to call from Afghanistan. Now, instead of his son’s voice, there is only silence.

———

THE POOR PAY THE PRICE

From her home in rural northwest Tasmania, 51-year-old Carmall Casey seethes over a system she says pushed her and so many others into addiction. It is a system that has made opioids the cheap and easy alternative for Australians, particularly the poor.

“I became an addict without knowing,” Casey says.

Here in Tasmania, there are echoes of American Appalachia — in the rural towns, the poverty and the cascade of lives torn apart by pills that promised to take away the pain but in the end created more.

This is Australia’s poorest state, and like Appalachia, it is the country’s epicenter for opioids. Tasmania has the nation’s highest rate of opioid packs sold per person — 2.7 each. One region has the highest number of government-subsidized opioid prescriptions in Australia: more than 110,000 for every 100,000 people.

Ten years ago, while working as a dairy farmer, Casey jumped off a truck and felt her knees give way. An operation provided temporary relief, but the pain came back. She was told she had osteoarthritis.

A doctor prescribed her opioids to ease her pain. When she stuck the first patch on her skin, it felt like heaven.

But the agony eventually returned, so the doctor upped the dosage. The side effects were hell — depression, anxiety, panic attacks. And her pain got worse.

Desperate, she saw other doctors. They sent her away with more prescriptions for more opioids: fentanyl, codeine, oxycodone, tramadol, buprenorphine, tapentadol, Targin.

An estimated 20% of Australians suffer chronic pain. But in poor, rural areas, access to pain specialists can be logistically and financially difficult. Wait lists are long, and a few sessions with a physiotherapist can cost hundreds of dollars. Under the government-subsidized prescription benefit plan, a pack of opioids costs as little as AU$6.50 ($4.50.)

Dr. Tim Andrewartha, a general practitioner in northwest Tasmania, says giving a patient with chronic pain a drug for quick comfort can be tempting, when the alternative may be a years-long wait to see a specialist.

“As a medical practice, we’re just falling short in terms of acknowledging the lack of evidence that these drugs have for chronic, long-term use,” he says.

Casey couldn’t afford private health insurance, so finding a surgeon who would treat the cause of her pain was a struggle. She drove ten hours roundtrip to meet a surgeon in the capital, Hobart, only to be told the wait list for the operation was two years.

While taking a truck driving course, she injured her shoulder and began the same carousel of fruitless doctors’ appointments.

She tried to quit the painkillers. She returned them to the pharmacy and dumped them down the sink. She suffered through the nightmares and shakes of withdrawal. But eventually, the pain would grow unbearable, so she’d take the drugs again.

She lost her farm. Even worse, she says, she lost her daughter.

She made bad choices on the drugs, she admits now. She was living with a volatile man who began to bully Sarah, so she sent her daughter, then 14, to live with her father. It’s a decision that tore them apart, and still tears Casey apart today.

One day, she scrawled her anguish on a tattered envelope. “Imagine having a toothache for weeks, months 1 year, 2 years, 3, 4, and it’s still aching now … the pain eats away at you, the drugs send you crazy,” she wrote.

In June, she told herself: Enough. She returned the remaining pills to her pharmacist.

She found a surgeon who took her seriously. And she got an appointment with a physiotherapist who is teaching her exercises to manage her pain.

On a recent afternoon, she rifles through a box of medicine in her kitchen. Suddenly, she freezes. Tucked inside is an old pack of tapentadol that she thought she’d thrown away. She washes the pills down the kitchen sink.

She doesn’t know what she’ll do when the pain returns. But she says she will never return to opioids.

“I’m not going back,” she says and begins to weep. “I’m not.”

———

This story, part of the AP’s reporting on the global opioid crisis, was produced in partnership with the Pulitzer Center on Crisis Reporting. The Global Opioids project can be seen here. http://bit.ly/2zWNwSk

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