#pct class of 2021

[whatsy0urdream]

Pacific Crest Trail, Days 141 - 144

Pacific Crest Trail, Days 141 – 144

September 14, Day 141, Miles 27.3, Mile Marker 2605.1  Back story time! When I lived in West Valley City, Salt Lake City area, for a while I worked in Park City and would drive up the mountain pass every day for work. I was going through an especially hard time as I had just lost my dream job and I wasn’t handling it well. But then I started seeing moose every day on the way to work, and I mean…

[morimess]

So, I don't know how many of you remember how *angry* I was with the world during 2020 into 2021. But that was the time where I was working at that nursing home with absolutely abysmal staffing and we lost over a quarter of residents either to the pandemic or to natural causes and we just *weren't* getting people back.

And when I say that I mean both the census was continuously low, and that the staffing never got better before I left.

But while all that was happening, I was trying to get my Bachelor's of Science of Nursing (for those who don't know how ranking works in medical world it goes (from order of bottom to top of the hierarchy) CNA/PCT/Extern -> LPN/LVN -> RN-> BSN-> PA/NP -> MD). I was a CNA at the time. I was 20/21 working in literal back-breaking conditions where the beds wouldn't lift high enough for me to work- if they lifted at all.

You can read all those old posts and see how shitty the work conditions were.

I ended up failing the BSN program. Flunking so bad they practically said I could never come back.

I flunked so bad, that even after completing entrance testing that placed me well above where I needed to be for a RN program- I could still just barely make it into an LPN one.

I have my LPN now, but goddammit- I could have been more right now.

I'm still going to get my BSN. But I started that program with a graduation date that set me to have it by December of 2022. Instead, I am now 2 degrees below that, making a worse wage because of a shitty combination of anger, depression, paranoia and fear that was only exacerbated by the only human interaction I received was while being at the nursing home.

Online schooling only made it worse because I didn't have to DO anything to go to class. I could just wake up, attend class, then fall back asleep. I lost 20 lbs because I didn't have incentive to eat. I would just scroll this site or TT endlessly for entertainment when I knew I had classwork to do.

I know that if I had just been more disciplined with my work, I could have made it. I know that. But, that's a bit hard to do when the world you knew collapses around you.

being a student during peak pandemic was so fucking surreal like. "it's not an excuse to fall behind" I cannot stress enough to you how much A Worldwide Plague Upending Life As We Know It is literally one of The Top Three Reasons to fall behind

[pcttrailsidereader]

How Do We Change the Faces On the PCT?

Halfway Anywhere has calculated his latest survey of the class of 2021 PCT hikers. We have featured a lot of the data from this survey in previous posts. If you saw those prior posts you know the survey is quite extensive. These survey results were derived from 654 completed surveys. Compared to 2020 this was a 41% increase over last year. We have to take our buffs, sun hats, sweatbands off in appreciation for the dedicated effort that goes into compiling this survey. A few of the highlights that caught my attention included hiker gender, age, and race.

56.8% Male 42.6% Female 0.5% Non-binary

Age breakdowns looked like this:

0.7% < 20

12.98% 20-24

25.79% 25-29

20.7% 30-34

7.54% 35-39

9.12% 40-49

12.11% 50-59

10.35% 60-69

0.7% >70

Average age: 37 Median age: 31

PCT Hiker Race looked like this:

86.5% White

3.7% Two or More Races

3.2% Hispanic or Latino

2.8% Asian

0.4% Black or African American

0.4% American Indian or Alaska Native

3% Decline to answer

A quick glance at these three categories paints a not too surprising picture. If you got dropped anywhere along the PCT and observed for an hour or a day you would likely notice that the average PCT hiker is a male in his mid-thirties and caucasian. Of course you would see good number of women mostly in their mid-thirties and also likely caucasian.

These features alone point toward the promotion of more diversity along the PCT. It is taking place ever so slowly. Will 'Akuna' Robinson is one person who is illustrating that fact as he navigates his way on numerous notable trails beginning with the PCT. 'Akuna' is a black man who is promoting diversity through direct action. His story is in the upcoming 'Crossing Paths', a compilation of PCT stories from the last decade, is due to be released in May of 2022. This book will be a companion to the earlier editions of the 'Pacific Crest Trailside Readers (California, Oregon-Washington) that were published in 2011.

These trends are not new or unique to 2021. Anyone who has walked any part of the PCT knows that these demographics are consistent and have been for a long time. The PCTA has been working hard to promote a more diverse PCT hiker population. In the wake of the Black Lives Matter movement, periodicals such as Backpacker magazine are attempting to address the diversity issue in their publication. The people in the pictures and identified in various articles are not all white mid-thirty somethings.

Bumping in to a Will 'Akuna' Robinson or anyone else of color does grabs my attention. It has left me wondering how do we promote a more diverse community of hikers? What can the collective 'we' do make persons of color feel safe and welcome on the trail? Obviously, based on Halfway Anywhere's data, 30% of the responses were from people aged 40 to 70 years old. Clearly those people feel safe enough and welcome enough. Likely a very small percentage of this group are people of color.

To more fully understand and come to terms with the challenges associated with BIPOC people accessing the out of doors and the PCT in particular we need to remember a key point or two. First there is history. Prior to the Civil Rights Act of 1964 access by people of color was not encouraged. If anything between 1865 and the 1950's some very heinous events like lynchings occurred in 'natural spaces' and forests. Historically with that in mind a chance to go to the woods might not be appealing and frankly could sound potentially scary.

Until the Civil Rights Act of 1964 people of color including indigenous people were discouraged and/or prevented from accessing National Parks and other public spaces. Many of these lands were taken from the same people not allowed access in the past. So what can we do having todays perspective and willingness to bring change?

We have to begin somewhere. Programs like Every Kid Outdoors strive to make the outdoors more inclusive by offering free or low-cost outdoor programs to children from low-income families. Another such program, Community Nature Connection addresses outdoor equity through access and exploration programs. Their Transit to Trails program offers free buses from low-income urban areas to natural spaces like beaches, national parks and mountains. Such programs plant seeds of interest in embracing outdoor activities. Additionally, a growing social media movement with several social media accounts dedicated to championing the #DiversifyOutdoors movement are emerging. Some recognized brands are also pledging to support representation for BIPOC communities across the outdoor industry.

Whether or not between now and the next Halfway Anywhere PCT survey the data will reflect an uptick in BIPOC representation is hard to say. The trend is not climbing steeply but with each passing season each of us can do our part to promote access, encourage participation, and welcome all people wishing to explore the out of doors and the PCT in particular. Honestly I have never hesitated to go into nature. I have always had the privilege available to go find my way to nature. Sadly this has not been the case for so many who may also share my interest. The loudest and clearest message we can send is 'all are welcome, all are safe, and nature is for everyone, the PCT is for everyone'.

[boggirlsummer]

Oregon Coast Trail

Has anybody heard of the OCT? Before we found a tiny sign like the one below, we weren’t even sure it was a real thing. Zoey has done most of the planning for this trip and claims that a map of the trail in its entirety, with segment mileage, does not exist. And if the OCT Facebook page is to believed, the trail Class of 2021 is just us and some lady named Angela.

Our girl Angela

The primary source for information about the OCT is this woman Bonnie Henderson, who has a book as well as a blog about day hiking the Oregon coast (fellow blogger 😎). She has another book about thru-hiking the OCT coming out which will include critical information about camping spots, impassable beaches, and marine hitchhiking, but it won’t be available until October. @Bonnie, can we get an advance copy? We need this info now!!

So yeah, most of our plan is cobbled together from a few contradictory and possibly outdated sources. Other variables: half of our nights will be spent in first come-first served hiker-biker campgrounds, and we’ll be relying on the local bus system and friendly fisherman for trail bypasses and bay crossings. And of course, my body may fail in new and unexpected ways at any time… I listened to a podcast in December 2020 that suggested I pick a theme word for the upcoming year - I try to play it cool but I secretly love corny shit, so my word for 2021 is “freefall” 😎 So far this has only caused me emotional and financial pain, but I think it may finally pay off on the OCT. Damn…is freefall two words? Cast your vote in the comments.

Again, I’ve contributed near nothing to the planning of this trip and we’re only a few days in, so I may be blissfully unaware of the logistical nightmare that lies ahead. We’re also taking it easy with a modified/low-mileage schedule (riding the bus as needed to avoid hiking more than ten miles a day in areas where camping spots are too spaced out) - partly for my foot but also to have more time to be ~chill~ and spontaneous. It’s been a dream so far! I have no idea why the OCT is so under the radar, this is like the PCT for lazy beach babies on a seafood and beer diet:

The trail takes you through a town almost every day, so there’s no need to carry multiple days worth of food or water. My bag is lighter now than it was on the PCT even with the addition of a leather cowboy hat, a pair of yoga pants, a bathing suit, a WWII-era metal camera, some oil pastels, DEODORANT, mascara and a tie dye tank for townie days 💅🏻 and a third pair of shoes (the solution to my foot problems 🤞🏻). Also, more town stops = more opportunities to eat regular food and stay in hostels/hotels if that’s your thing. Some people don’t camp at all and stay in hotels every night. Also also, if you get tired or hurt or bored, you can just BAIL! You can just get on the bus in the next town and go home. No need to fake a foot injury.

What the fuck is a CLIF bar

Campgrounds with toilets, water, and sometimes showers almost every night!! And, all of our sites so far have allowed campfires. Hiker-biker campgrounds are especially cool - something I had never heard of before this trip! These can be areas within a regular developed campground or more primitive sites along the trail, and they’re only for “people-powered” travelers. They’re super cheap (sometimes free!), no reservations, and seem way less likely to fill up (there may not be a set number of sites in the area, so you can squeeze more people in if needed). Getting a spot at a first-come first-served campgrounds is usually a shit show (at least in CA), but this has been no stress so far. Two of four nights we’ve had the entire camp to ourselves!

Some of the hiker-biker camps have these fancy lockers with USB CHARGING INSIDE!! We’re glamping let’s be real.

Cute! Coastal! Vibes! And sometimes not so cute Jersey Shore-Goes-West dystopian vibes (@Seaside, OR). Seafood, breweries, and ice cream, everywhere. Red Bull, everywhere. Sand, everywhere!

Perfect hiking weather (IMO) - mid 60s, breezy, occasional cloud cover. No waking up at the ass crack of dawn to hike before it hits 100 degrees. No immediate threat of heat dome or wildfire. No drinking 4 liters a water a day and still not needing to pee.

Easyyyyyy hiking…some elevation when going up dunes or forested areas, but mostly walking on the beach (on the packed/wet sand, but I’m considering doing some dry sand intervals to work on my 🍑)

Nobody here! No scraggly longhairs fighting us for a site every night. Nobody hassling us about gear or mileage. No suspicious trail angels. No bugs.

Water water water! I know I’m an Air sign but I gotta be close to the water. I’ve never lived more than an hour from the ocean even after my fam moved to the desert. I was almost born on a fishing boat! So hiking through coastal forests and dunes and along the shore all day is 🤩

Why aren’t you here with us! Get on a plane/train/bus ASAP and meet us at the Tillamook Cheese Factory for lunch tomorrow.

Today is Day 6 on the trail so we’re a little behind on posts, but more coming soon!

XOXOXO

[cirruslizard3]

Sarm's.

Pure Sarms.

Content

Muscular Tissue Gain.

Shipment & Returns.

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Reinforcing Muscle.

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Teacher David Craik offered an interesting discussion on cyclotides - cyclic peptides generated by a selection of plants.

The peptides can additionally be made use of to deliver cytotoxic agents to tumors with profound efficacy.

Incredibly, the peptides demonstrate really rapid tumor infiltration and retention coupled with fast clearance from systemic circulation.

These peptides, making up three disulphide bonds that form a "knot", are both different and durable.

Prof. Craik provided a summary of these peptides and also their energy as a foundation for the shipment of therapeutic peptide epitopes.

The reasoning appears to be that these other representatives can offer the 'fuel' for performance, while a stimulant provides the 'ignition'. Differing only in effectiveness and duration of activity, all these agents produce improved alertness, an increase in high blood pressure, heart price and depth of respiration. The central impacts additionally mean that the customer will be able to partly counter the effects of fatigue. Stimulants may also increase the rival's discomfort threshold, enabling that extra push beyond their generally ultimate effort.

Muscular Tissue Gain.

Bicyclists now seem to favour this method of enhancing performance over nearly any other. Professional athletes may illegally use hGH in combination with AAS in an attempt to enhance muscle mass bulk and also stamina. On the other hand, hGH is a hormonal agent created by the pituitary gland, which is crucial for typical development in kids as well as assists the body in structure muscular tissue and also bone. Bicyclists will take energizers both alone or as a mixed drink of several related drugs. There appear to be no guidelines below, although energizers might often be taken along with longer-term 'therapies', such as steroids, EPO and growth hormonal agent.

However there is additionally the trouble of the less active lifestyles as well as inadequate diet plans which lots of people with schizophrenia take on and also it is below that an excellent personal workout regimen can make a genuine difference. Nonetheless, you need to run PCT with Tren, which must be 20mg each day of Nolva for 5 weeks, cardarine gw outcomes.

Shipment & Returns.

Throughout the initial day, my mind was constantly telling me I was hungry. The 2nd day my stomach was informing me I was hungry by regularly grumbling. My power levels stayed surprisingly high throughout the quick as well as I educated everyday. I even completed two exercises on the last day, both at a fairly high strength as well as without a visible dip in performance. When fasting our bodies damage down kept fat and generate ketones for energy. Ketones burn a whole lot extra efficiently than sugar and also, although there's little scientific evidence, people claim this helps with psychological clarity.

This can just be a 10 min stroll around the block or a stroll to the stores once daily. Attempt to make the walk fairly brisk to obtain the optimum advantage and also do not simply amble along.

It was commonly observed by team that several person's signs were much alleviated when they were working in the farm. If you do not feel up to some press ups as well as rise in your room then possibly a bit of walking would be good.

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To be effective the stroll must be quickly enough to enhance your breathing price but not so quick that it would make it tough to talk to somebody at the same time. Recent proof indicate the NHS not being excellent at aiding individuals with schizophrenia to manage their physical health problems. After that there is the issue of the side effects of the antipsychotic drug utilized to treat the favorable signs of schizophrenia such as hallucinations.

Enhancing Muscular Tissue.

As a result you have to make sure that the medicine degrees in your blood are adequate as well as steady throughout these hours. You can solve this concern by taking 50% of the overall daily needs in the early morning and the continuing to be 50% at night. The recommended consumption of this supplement for novices is from 10mg to 20mg milligrams on a daily basis. Be really mindful not to surpass the advised dosage as these can significantly impact the hormonal agent equilibrium in your system.

Well, for tablets, all they do is increase blood circulation, and also all a rise of blood circulation does is makes your erection stronger. To find out why most of us males are currently exercising our member as well as why you should to, take some time out of your day and read on to learn more. Tai Shikun asked Ximen Qing Xiao Qingzi Ah, in your daddies crude medication shop, exists anything that is anemic as well as unappetizing, eaten that makes people feel warm as well as sweaty? After purchasing top steroid, you just need to follow to steroid best techniques and also you will certainly achieve success. Remember to enhance the use of leading steroids with various other measures. You also require to work out diligently as well as to always consume a well balanced diet regimen.

Sarms Vs Peptides, Sarms Vs Steroids Body Building.

Genes affect things such as your skin color, your height as well as also your voice but they have little bearing on how muscle you will certainly be. In a globe, where people are flexing their genes to grow taller and absolutely alter their skin shade it should not be hard to change something that is not coded in your genes such as your body shape or weight. Customers of SARMs GW have found that using this drug in minimum dosage gives the optimum outcomes. It is valid for people who have very little or minimal experience concerning Cardarine, particularly when a person has a minimum or no understanding about this medication. Its dosage is additionally dependent depends on its half-life period of 12 to 24-hour.

The benefits of feeding bioactive peptides to swine - National Hog Farmer

The benefits of feeding bioactive peptides to swine.

Posted: Fri, 06 Nov 2020 08:00:00 GMT [source]

They do not mean to disrupt the receptors of prostate, liver, kidneys or mind that makes them a possibly much safer choice to steroids. SARMS job like hormonal agents, which are chemical conciliators in your body. They connect to particular receptors in the body as well as exert their effects depending on the intensity as well as period of the binding. The initial idea behind the development of SARMs was to produce a drug with anabolic impacts on skeletal muscle and bone, whilst preventing unfavorable results in other tissues. In essence, they are a modified kind of testosterone used in hormone replacement therapy and also steroids. These are a class of androgen receptor ligands that bind to androgen receptors in the body and trigger androgenic signaling paths. By recognizing its advantages, you can establish the amount of it according to body requirements due to the fact that if we eat it in more amount, then it is damaging to human body organs.

Dosing appears to be in the 4mg to 12mg array, with ideal cycle length being 4 to 6 weeks. Given its much shorter half-life, RAD requires to be dosed at least twice daily. Dosing is in the 7mg to 21mg array, with 14mg being the "wonderful spot". Nevertheless, it does function well in a SARMs stack to additional rise weight loss as well as endurance. When SARMs bind to the receptor they demonstrate anabolic and hypertrophic task in both muscle mass and also bone. This makes them optimal candidates for TRT, weakening of bones treatment and muscular tissue wasting therapy.

AmbioPharm Inc. Announces New Shanghai Campus Opening and European Executive Team Members - Business Wire

AmbioPharm Inc. Announces New Shanghai Campus Opening and European Executive Team Members.

Posted: Thu, 07 Jan 2021 08:00:00 GMT [source]

Men are recognized to develop womanly characteristics such as busts and a high pitched voice. They experience accelerated male pattern baldness because of the boost of testosterone in their body. Females that use it exceedingly can create masculine top qualities such as hair growth in locations where there were little to none like the top of the lips and also the chest.

Numerous people take sporting activities supplements hoping for a variety of wellness benefits, from weight-loss to muscle building. Yet 99% Purity CJC-1295 NO DAC are being offered unlawfully and can be extremely harmful. Nonetheless, what is appealing is that also in cancer clients experiencing durations of severe muscular tissue squandering, the introduction of SARMs has actually demonstrated considerable boosts in lean body mass and far better total physical functioning. This is defined as being "tissue-selective", indicating they are only implied to receptors that are needed to create the preferred effect of the drug.

Is collagen peptides good for hair growth?

Collagen may promote healthy hair in a variety of ways. For one, your body may be able to use the amino acids in collagen to build hair proteins and strengthen the skin that contains your hair roots. It may also prevent hair follicle damage and graying.

Nutrition isn't nearly weight management, either-- it influences everything from recuperation time to the ability to break negative routines, power levels to mood, high quality of sleep to cognitive capability. We are devices made of flesh and also food is the fuel that makes each of our major systems function. Irritatingly, every person operates differently, so it's my work-- and your task-- to exercise each individual's partnership with food. I have actually remained in the health and fitness sector for over 12 years and also during that time my expertise of-- and passion in-- nourishment has actually greatly created. When I was beginning as a Personal Instructor, all I really knew was exactly how to lead a workout; I cringe thinking about a few of the techniques I used to make use of. Years of experience have actually instructed me that nourishment is one of the most important thing, regardless of what your health and fitness objectives. Many individuals have observed this type of work to be very restorative and there is significant unscientific material around the advantages of horticultural job as treatment.

So to understand about Buy Peptides , read this article, and follow the direction. According to fitness professionals, LGD could be efficient building muscles yet may not work contrasted to SARMS.

[whatsy0urdream]

Pacific Crest Trail, Days 134 - 140

Pacific Crest Trail, Days 134 – 140

[pcttrailsidereader]

Our Top 5 Stories of 2020

By Rees Hughes

This review of the year has become a trailsidereader.com tradition.  However, instead of our usual Top Ten, we are going with just five because of #1.

1) Well . . . the Covid-19 has to take top billing. The PCTA took the lead in the efforts to discourage thru-hiking the PCT in 2020.  Rural communities, with minimal capacity for health services, adjacent to the trail certainly did not want thousands of hikers passing through.  And emergency services, potentially preoccupied with Covid-19, did not want the unnecessary broken leg or mountain rescue to deal with. As a result, many a trip was delayed, deferred, or cancelled in 2020.  The PCTA took additional actions to suppress social media (e.g., de-activating Facebook pages for the Class of 2020).  Although there were those who did not heed the warnings, activity on the PCT was definitely diminished.

The nasty virus that changed 2020

2) Fires.  So we thought that the fires of 2018 re-set the fire season bar to an amazingly high level until 2020 exploded in mid-summer and raged through the autumn.  Fires were more intense, more massive, more destructive, and more widespread.  In California, nearly 4.2 million acres burned, more than double the previous record of 1.67 million acres in 2018. Five out six of California’s largest fires on record occurred in 2020, including the largest in state history – the 1.03-milllion acre August Complex fire.

California’s August Complex fire on September 8

The PCT was impacted in a number of areas by closures, intense smoke, and fire damage . . . from the Transverse Range in Southern California to the Bucks Lake/Quincy area to the Central Oregon Cascades.  It is worth noting that fire in 2020 was a global phenomenon with record fire seasons in Australia, Brazil, and even the Arctic.

At the root of the extreme fire season on the West Coast was climate change.  Unless the record high temperatures accompanied by drought conditions change -- and there is no reason to think that they will -- the experience of 2020 is likely to become the new normal for the PCT.

3) Photos to Inspire You to Walk the PCT.  We ran a series through much of March and April that featured several dozen hiker responses to this prompt.  Here are a couple of images contributed by Mala Cuffo.  If you missed them, it is worth going back to those early months of spring.

4) Farewell to Angels. Eric Smith wrote a thank you to some of the long-time trail angels whose kindness and generosity has helped define trail culture.  The Saufleys (Hiker Heaven), Barney and Sandy Mann (Scout and Frodo), the Andersons at Casa de Luna, and Carmen in Julian (Carmen’s Restaurant) all have either closed or have announced their intent to close ��angeling’ operations.  You can read Eric’s post here:

https://pcttrailsidereader.com/post/190683149223/farewell-to-angels

Terry Anderson at Casa de Luna

As numbers have grown along the PCT starting earlier and earlier in the season (lasting longer), the commitment can become overwhelming. I am one of the many who benefited from the gracious, open arms of each of these angels.

5) Getting Out.  Although not PCT-specific, the pandemic reinforced the importance of getting outside, spending time in nature, and celebrating trails, parks, forests, and wilderness.  As we learned more about how the coronavirus spreads, it became clear that some of the safest places we could be were outdoors where the wind dissipates any concentration of the virus.  I know that for me and many in our community that there was a reawakening regarding the importance of resources like public beaches and parks, trails for walking and cycling and equestrians, etc.  Indicative of this reawakening, our local community passed a ‘parks and open space’ tax in November with 80% approval . . .

Epilogue

It is unclear what 2021 will bring.  The roll out of the vaccine gives me hope that there will be a return to a more normal PCT experience.  However, it seems unlikely that distribution will be sufficiently widespread by March and April to permit thru-hikers to make their normal early start.  This, combined with California’s escalating drought conditions, would suggest that by late July fires will be impacting trail users.  I’m thinking that it will be a great year for some section-hiking . . . there are so many reasons to get out there (see Joris Bouchard’s image below from the ‘Photos that Inspire You to Walk the PCT’ series).

[halfwayanywhere]

Pacific Crest Trail Horror Stories (Class of 2021)

Pacific Crest Trail Horror Stories (Class of 2021)

In the yearly Pacific Crest Trail Hiker Survey, hikers share both their lowest moments on the trail (physically, mentally, emotionally – the literal lowest point of the trail is Cascade Locks, Oregon), as well as when, if ever, they found themselves in a situation where they felt they were in danger or where they were legitimately afraid. Hiking the PCT means more than blindly wandering down a…

[shytiff]

 August 2021

1 - morning walk with ness mendel to palm hills. my dumb ass decided to do a bit of run. my heart was screaming by the time we hiked lol. continued with some youtube dance work out at mess. had kanayam as always. the fish and chicken somehow tasted even better than usual. afternoon nap. had muesli and simba again. 

2 - a hectic BP slash usila slash mtbs day with dr arief. Tried sop bebek h syafei and sate bandeng. Worked out w renata to a 20 mins pilates vid and 2 madfit songs and one 5 min stretch. Dinner was tofu soun seaweed and egg soup courtesy of renata. And baked banana with ovomaltine lolll im so grateful friends give me food.

3 - in usila today but turns out theres still one more day of vaccine in kantor kecamatan, so nessa and i went. We screened together w dr arief. Finished at about 2 pm. Can finaly eat at like 3ish after getting to the mess. Felt a bit of headache and my nose starts to go runny. So i slept. But my nose was so blocked. So i asked renata for her boiled noodle. Felt a bit better. Cleared my nose. Slept.

4 - it did feel better, finally. The soreness i felt in my abs yesterday gets worse today lmao. BP w nessa. orientation w dr harnis. talked ngalor ngidul about love life et cetera at our room lol

5 - fasted today. sahur was rice, crispy mushroom and abon since i felt sick of eating egg. it seems that love life talk continued today    at BP w dr anggi. printed stuff at kubang wates. bought kepak bandeng at RM tajuk and some snacks in indomaret. turns out Prof gave me one more ppt to do, for PIT. and the manuscript deadline is on the 8th :) immediately started doing something about it since now i know ppt and word making rly takes time

6 - muesli and pizza from alfia for bfast. vaccine today w dr lutfi. talked with kang ade and turns out he lived in kalideres before lol. bought don’s burger for dinner and ate it with fried egg. 

7 - MTBS today. got a lot of free food. read stranger than friends. went to transmart w nessa to buy stuff. did the word for Prof’s PIT topic acompanied with lofi study on the tv accompanied with nescafe latte. taste kinda.. weird. 

8 - ran a bit today, alone. bought nasi uduk for 5000 and i added scrambled egg. continued the word and finished it at like 11 am. sent it. relaxed for a bit. read black mirror. lunch was from labbaik but things went shit and i ended up paying 72k lol. printed document stuff w nessa and went to palm hills in the golden hour. ate together w the gals. played scrabble and talked a bit with fianti until almost 11 pm.

9 - had left over chicken and pizza for bfast. usila today and the patients came back to back. bought kanayam while waiting for 2 pm. slept. did (so little) work of ECMOCARD SAP. im so research dumb. 

10 - had steak and rice and renata’s veggie soup for bfast. vaccine today at vivo near intermedia with teh dian. waited for a mother with 9cm dilatation in ugd with nessa, but it took so long so i went back first. met up with atikah at o seven lmao. she arrived at like 12 and waited at palm wates. tried carbonara sphagetti (yum! but not fulfilling enough) and fried tofu. slept early and i probably passed out at like 930 pm. atikah was talking w ratnaa and we’re talking about the day’s randomness of atikah’s customer that somehow lives in cilegon

11 - woke up late. drove motorbike around palmhills to sightsee a bit. bfast at nasi uduk place around the corner. did some ngambi-together in green wates, accompanied by atikah’s 2 songs, repeated many times. went to mess. ate seafood in merak (a place near billiard cafe). got fish and shrimp. went to pulau kecil with pak asep’s help. walked around the tiny island. saw a monkey. the waters surprisingly clear. and then after maghrib Prof asked me about the ppt lol. so i hurriedly made it and emailed it, with zoom sesh 2mrw

12 - muesli for bfast. a hectic day today at bp x usila with dr lutfi (she went up for a bit for promkes). leftover kangkung and fish for lunch. hurriedly added some stuff to Prof’s ppt before the zoom sesh at 3. did 1 pamela reif vid and “attempted” her 10 min ab workout. dinner was soun and egg and renata’s veggie. 

13 - vaccine day for ODGJ and special needs children ft. dr Arief. finished at like 10:15. bought discounted wingstop (86k for 20 piece). was about to send Prof’s ppt but turns out there’s a ppt from the sponsor. in english. so i had to mold the 2 ppt and do some translation. finally sent it, and the literature. the sponsor used a lot of old literature lol. 

14 - wingstop and rice for bfast. mtbs today. no patient lmao. bu ningrum gave me cimol again! and a snack called selondok. waited out 2 pm with nessa. there’s a mom that came with upper abdominal pain. it did not improve after ranitidine, so she was referred. mom dad etc came to cilegon. i vacuumed. bujing lia had itches within like 15 mins of entering my room :(( lol. since the bed was put out, renata and i slept in yoga mat lol. nessa went to damkar. but i dreamed of something that night.

15 - mom’s spaghetti for bfast. off to pulau besar at 7 am. walked around the island a bit. swam in pulau kecil. ate at saung bonang (<50k per person!). tidied up the hydrovacuumed bed. a 20 ish minute ab and glutes workout with renata. love life talk. accidentally turned on live video in cld lmao. talked with aisyah due to said live vid. gave some brownies and spaghetti to mendel lol. dinner was mom’s chicken, kentang balado and capcay. 

16 - usila today. lots of patients with dizziness. ate mom’s chicken and spicy potato for lunch. 

17 - free day today. picked up my towel from sodaqo laundry. nasi uduk for breakfast. lazed. washed my undies. lunch was meat soup made by renata. watched run bts while eating indomie. watched extreme job (quite hilarious). filled my logbook. slept at like 12 am

18 - spaghetti for bfast. no patient at kia. promkes about hypertension. some patients at igd today. my mistake today was not realizing the pneumonia on a 8months patient with severely dehydrated diarrhea :( there’s also a 4 yo child whose fever did not improve after like 3 hrs and pct and compress. i have to be better :(. lunch was kanayam. bought chatime together with ness tri. tried lychee milk tea and the taste did not combine well at all. imagined better productivity with nessa even though its less likely to happen lmaooo

19 - fasted and had nongshim carbonara dry ramen for sahur. BP today. Almost bought martabak but its just keBMan on my part.

20 - vaccine day today. Filled logbook. went to mess and went back again to cibeber through the rain when i was called by the teteh. Helped the delivery (the mcroberts, to be exact), and got some hecting. The midwives were rly kind :) ness ren were sleeping so i got some silence for myself. It was nice. Tidied some stuff and slept

21 - mtbs. Whatsapp class for pregnant woman abt c19 vaccine. Bought martabak hokky medium (50k,green tea, chocolate, ceres and cheese). Turns out alfia also bought martabak assen. Fried mom's chicken and ate it with renata's porridge. Movie night, watched under the gods 1 along with popcorn

22 - woke up kinda late if i wanted to run, but the weather was cloudy and nice, so i went out at 7:15ish. ran a bit towards KS complex behind mess. walked through a jogging track, empty houses, krakatau bike park. played badminton with tri. washed undies. ate mom’s food for bfast slash lunch. napped a bit. off to o seven, bringing mom’s brownies. ordered green tea latte (25k), it tasted sweet and i had to remind myself that its not matcha lol. did some logbook and literature search for prof’s ppt. ate renata’s broccoli. folded clothes. tried nessa’s scarlett scrub. put on some lotion. mask. turned on fianti’s candle (smells rly nice and calming!). vcall with fi, scrabble and some talks. and suddenly its 11pm

23 - usila today. quite a lot of patients, so much that i was thirsty. dr yanti called since she needs some preskas docx. lol so sudden. bought mizone and dimsum kuy (10.5k with gofood pickup promo). the dimsum was good and fulfilling. didnt do anything else much in the mess. read a painter behind the curtain. it was rly rly good. all the characters made sense and had great insight. some are assholes (im looking at u, Raymond). ate the keripik mom bought from sidimpuan. first time actually trying it. its actually not that spicy lmao i used to think its the spiciest thing in the world. banana, brownies and protein shake for din din.

24 - empty KIA today. no promkes. or UGD patients. some mentoring on preeclampsia by dr Arif. went to BNI but turns out our card havent been activated yet.  cooked mom’s sphagetti sauce (thats not enough amount) along with egg and cheese. yum. had banana brownies and protein for dinner. started trial to blinkist

25 - BP today. reasonable amount of patients, accompanied by blinkist. tried ngikan by gofood pickup (17.5k). i still prefer kanayam’s fish and nasi liwet. a pregnant woman came to UGD. so i went back at like 7 pm, but turns out the mom went back home lmao. mas apit said i shouldve contacted him. point taken. so a nicely lit cafe along the way to pkm called Serada, so i tried it. It has industrial vibes. Got latte (25k). did some logbook. Read some blinks in bed

26 - vaccine today. Both screening and getting moderna lol. My arm hurts. So far no fever. bought roti O croissant and the usual coffee bread for 12k using gofood. Watched weathering with you. Turned on the candle. Read blinks

27 - arm hurts. but thankfully its mtbs. slept while waiting until 2. kanayam sambal matah for lunchie. finally took PCT that solved my headache and incoming fever and arm pain bcs i dont want to stumble while on the motorbike. watched harry potter #1. washed clothes and filled some logbook, powered by left over serada latte. need to sleep so i wont wake up late 2mrw

28 - mass vaccination in SMP RJ with mendel kak esa. 800ish patients. Lots of food and snacks and coffee. Picked up by mom and dad. Slept on the way. And like magic, when i open my eyes im at the airport. Basking in the silence of my room

29 - relaxed. Moms nasgor for bfast. Met up with atikah puy in kopi sedjenak. Tried their croffle with nutella. Went to racheels since its her online grad day. There were also sil and dev. Lotsss of food was eaten that day. Doughnuts, moms brownies, fruits, phd bigbox. Atikah and puy also came along to racils. Had lots of fun talk.

30 - sahur. Off to cilegon. A bit of road fixture was going on. Stopped in the rest area since i wanted to pee. KIA/ugd today. There was a patient who had an accident with a truck. Her nails were falling off. I panicked when Prof asked for his ppt so i hurriedly finished it. Had moms chicken for iftar. Fell asleep after maghrib

31 - usila. Renata fried bakwan and tofu and fish and chicken. Lotsss of fries yum. We played with makeup and ness set up her ling light. I imitated jks tattoo using eyeliner lol. Did the word for Prof. Jk went live for his bday!! I listened until i fell asleep (lol hes still going)

[ohsemblog]

SHAREHOLDER ALERT: CLAIMSFILER REMINDS ARRY, CCXI, PCT, WISH INVESTORS of Lead Plaintiff Deadline in Class Action Lawsuits

SHAREHOLDER ALERT: CLAIMSFILER REMINDS ARRY, CCXI, PCT, WISH INVESTORS of Lead Plaintiff Deadline in Class Action Lawsuits

NEW ORLEANS, June 18, 2021 (GLOBE NEWSWIRE) — ClaimsFiler, a FREE shareholder information service, reminds investors of pending deadlines in the following securities class action lawsuits: ChemoCentryx, Inc. (CCXI)Class Period: 11/26/2019 – 5/6/2021Lead Plaintiff Motion Deadline: July 6, 2021SECURITIES…

[whatsy0urdream]

Pacific Crest Trail, Days 127 - 133

Pacific Crest Trail, Days 127 – 133

August 31, Day 127, Miles 25.6, Mile Marker 2250.5  Town day! Sort of, Bill Nye and I hit the trail by 6:00 AM this morning in order to do the last 5 miles to FSR 23 to catch the 8:30 AM shuttle into Trout Lake. The trail felt like it was straight up this morning, what a way to get the blood pumping. We arrived at the pickup location with 30 minutes to spare, so I foraged some blueberries and…

[pharmaphorumuk]

Biosimilars in the UK: where are we now and where does the NHS want to go?

The UK health service has well over a decade’s experience of dealing with biosimilars, but the NHS acknowledges that it has yet to make the most of these drugs.

That was certainly one of the messages from a ‘state of the biosimilar nation’ event I attended over the summer in London, and it’s not a surprising one.

The first European biosimilar approval in 2006 for a version of a human growth hormone was, to some extent, a false dawn for the sector, in as much as it didn’t pique widespread financial interest from healthcare stakeholders.

That only came more recently, as patent expiries for the blockbuster anti-TNF class of arthritis drugs approached. Now that the likes of Remicade (infliximab), Enbrel (etanercept) and, most importantly, Humira (adalimumab) have to compete with biosimilar versions, the NHS is grappling with how to make the most of this opportunity.

Thus, it made sense for Anne Marie Morris MP, who is also chair of the All-Party Parliamentary Group on Access to Medicines and Medical Devices, to outline the “huge opportunity” that biologics present.

“Biosimilars are clearly a new and big issue for us,” she said, introducing Westminster Health Form’s Biosimilars in the NHS – Commissioning, Development and Engagement with Clinicians and Patients event in London.

“We need to ensure that there is access to NHS patients for these biosimilars and we need to be an attractive market so that biosimilars are developed here and not, dare I say, in the USA. But we also need to take patients with us, because these are different medicines,” she said.

“Something like adalimumab requires a whole system approach to drive the change that we require” Suzy Heafield

The place for biosimilars within the NHS

Exactly how the NHS is working to ensure biosimilar access was comprehensively explained by Suzy Heafield, a commissioning pharmacist who works for NHS England and NHS Improvement as head of medicines value and sits within its relatively new Commercial Medicines Directorate.

Prior to that she was a clinical pharmacist in Nottingham and then a commissioning pharmacist working for Clinical Commissioning Groups (CCGs) and the Primary Care Trusts (PCTs) that preceded them.

She noted that, from a commercial point of view, there are two key recent policy documents that drive NHS England and NHS Improvement’s commercial policy, including its approach to biosimilars. One is the NHS Long-Term Plan and the other the Voluntary Scheme for Branded Medicines Pricing and Access.

The Commercial Medicines Directorate’s mission was, she said, commercially-focused, but clinically-led.

“So, our commercial activity is fundamental to supporting patient access. Our priority is to allow access to the latest innovative and most clinically-effective new healthcare treatments and solutions. But at the same time, we want to make sure we secure maximum value for the NHS and taxpayers from its ever-growing spend on medicines and other healthcare solutions.”

And there are big numbers at stake. Last October Humira (adalimumab), still the world’s biggest-selling drug, came off patent in Europe, after which the NHS struck an historic biosimilar deal that represented the biggest saving in its history from a single drug negotiation.

Looking further ahead, NHS England envisages savings as a whole from biosimilars of some £400 – £500 million per year by 2021, if it can increase uptake of ‘best value biologic medicines’.

This would give the health service “headroom to be able to fund new treatments and to improve access to patients”, Heafield said, adding that NHS England is eyeing up being able to use some of the money saved for new investments into improving care pathways.

To do this, the Commercial Medicines Directorate is running the Best Value Biologics Project to enable appropriate use and uptake – whether of the originator product or a biosimilar version.

She explained: “Where a best value biologic isn’t the originator, we’re looking at switching and how we can enable switching. The introduction of biosimilars drives greater competition and releases cost-efficiencies through competition, and it also supports increased access to biological medicines.

“So, we may be looking at access to biologics at an earlier stage in the treatment pathway. Or we may be looking at access to new innovative medicines.”

As examples of some of the newer, expensive treatments coming through that would need to be funded somehow, Heafield cited CAR-T and gene therapies.

NHS biosimilar uptake

The NHS has a steep uptake target for adoption of the best value biologic product, aiming for 80% of patients to be using it within one year of a biosimilar version first becoming available.

It didn’t achieve that with Remicade and Enbrel, which were the first two anti-TNF biologics to face competition. In fact, Remicade took 28 months to reach the 80% target, and after 12 months Enbrel had only reached 50% of eligible patients.

That changed with the next two biosimilars to come online, which were versions of the cancer drugs MabThera (rituximab) and Herceptin (trastuzumab). This time around incentives were put in place under a Commissioning for Quality and Innovation (CQUIN) framework and there was closer working with the Cancer Vanguard and NHS Improvement.

“We saw a massive change in the uptake of rituximab and trastuzumab – with rituximab we achieved 80% uptake at month ten after launch, and trastuzumab at month eight,” Heafield said.

After MabThera and Herceptin it was all eyes on Humira for the NHS and uptake of the ‘best value biologic’ versions of the arthritis drug was heading towards 67% at month seven, but it still faces regional variation in uptake.

“It just shows that something like adalimumab requires a whole system approach to drive the change that we required, and it has been successful. But obviously we won’t be resting on our laurels,” said Heafield.

One of the next priorities for biosimilars in the future is to plan for the next Humira tender, because the initial NHS agreement was only signed for a year so will in theory expire in December. But Heafield and the NHS’ Commercial Medicines Directorate also have plans for a more nuanced approach to the use of biosimilars.

“We need to work with clinicians and patient groups to determine if, and when, we should look at biosimilar-to-biosimilar switching. Up to now all we’ve been saying is originator-to-biosimilar. There’s now evidence emerging around biosimilar-to-biosimilar, but again this can’t be a ‘done to’, it has to be a ‘done with’, and at the appropriate time,” she concluded.

The post Biosimilars in the UK: where are we now and where does the NHS want to go? appeared first on .

from https://pharmaphorum.com/views-analysis-market-access/biosimilars-in-the-uk/

[halfwayanywhere]

The Pacific Crest Trail Gear Guide: Class of 2021 Survey

The Pacific Crest Trail Gear Guide: Class of 2021 Survey

In the second installment of this year’s Pacific Crest Trail Thru-hiker Survey, we dive into PCT hikers’ gear. Pacific Crest Trail gear lists vary wildly between hikers and (spoiler alert) it’s impossible to find a perfect PCT gear list. That said, we can try. I’ve organized this post in a way that I hope will give a comprehensive picture of what gear PCT thru-hikers are using. This post covers…

[opiniaogoias]

Jornal Opinião Goiás - Serviço Florestal Brasileiro pretende inscrever 15 mil famílias de Povos e Comunidades Tradicionais no CAR

Jornal Opinião Goiás – Serviço Florestal Brasileiro pretende inscrever 15 mil famílias de Povos e Comunidades Tradicionais no CAR

Ação é apoiada pelo Projeto FIP-CAR e abrange o bioma Cerrado no estado do Piauí

Amobilização para a inscrição de 15 mil famílias de Povos e Comunidades Tradicionais (PCTs) do Piauí no Cadastro Ambiental Rural (CAR) iniciou em julho, após publicação de decreto estadual permitindo o retorno das atividades não essenciais. A expectativa é atender todas as famílias até março de 2021.

A urgência na…

[lindafrancois]

Dialyzing While in a Pandemic

As a health care provider for dialysis patients for twenty-five years, I can only imagine what might be going through the minds of patients during this time. Between watching the news and scrolling through social media, the level of uncertainty within our communities is running high. Dialysis treatments cannot stop and fears may range from possible hospitalizations to potential limited access to food.

All of this may be overwhelming – which is totally understandable and OK. Your dialysis care team is here to provide support and tips to help lower your chances of exposure to COVID-19 and keep you safe.

Patients receiving dialysis need to take necessary precautions to prevent contracting the virus and avoid possible complications and hospitalization.

Managing Emotional Health and Stress

Here are some tips on what you can do to help manage your emotional health and stress.

Remain Calm

Dialysis centers remain open because dialysis is an essential treatment.

Nurses and patient care technicians (PCTs) continue to come to work to make sure schedules at dialysis centers continues as usual and provide safe care to help prevent hospitalizations.

Registered dietitians continue to review your labs and make sure that you are doing everything possible to keep good blood chemistry results, avoid fluid overload, to stay strong, healthy and well nourished. These things may help to prevent hospitalizations.

Social workers continue ensuring that you are able to manage any emotional, financial or lifestyle impacts during this time. They are trained counselors and also have expertise in connecting patients to needed assistance (such as food, medication and/or insurance/employment resources). Again, these things may help with your quality of life and keep you healthy and out of the hospital.

 Facility Administrators and management teams will continue to work with centers so they can remain open and have the staffing and supplies they need, so your health care team can continue to provide timely and safe dialysis.

Be Prepared

Make sure you have the foods you need for at least two weeks. Stocking up means you or your caregivers do not have to go to the store as often. If you do not have transportation to get groceries or medications, reach out to family and neighbors, or go online to order what you need.

Refill your medications before running out and take them as prescribed.

Wear a face mask if you venture out.

Wash your hands when you return home or after touching anything outside. These actions may help prevent hospitalizations

Home Dialysis

If you receive dialysis at home (peritoneal dialysis or home hemodialysis), here are some specific recommendations:

Make sure you have all the supplies you need to do home treatments.

Make an inventory list and be conscious of not wasting resources.

Follow proper infection control practices such as washing your hands often to help prevent infection.

Eat Well

It is a good time to start (if you have not already) eating healthy meals every day, which may help you stay strong.

Ask your dietitian about the foods that are best for your individual needs.

Try to eat/cook all your perishable foods first, such as fresh lean meats and fresh produce.

If you do not know how to cook, this is a good time to learn, visit DaVita.com for recipes and kidney diet tips.

Use a slow cooker if you have to work at home or outside. Your meal will be ready in 6 to 8 hours.

Follow your dietary restrictions, such as low potassium, low phosphorus and low sodium.

Watch fluid intake more closely to avoid fluid overload. Eating less processed or fast food will help reduce sodium intake and may help with thirst and fluid control.

Keep Your Mind and Body Busy

Staying busy may help you improve and manage your emotional health. Here are a few examples of how to do this:

Exercise.

Take walks by yourself, your significant other, child or pet. Remember to wear a mask.

Do stretching and breathing exercises at home, such as yoga, tai-chi or other exercises. There are free online classes.

If you have weights, use them to exercise at home.

If you like dancing play your favorite tunes and dance. That is exercise!

Pick up a new or former hobby.

Read a good book. Ask neighbors or borrow books from nearby relatives as libraries may be closed.

Listen to audio books or podcasts.

Write in a journal – your thoughts, hopes, daily diet, genealogy tree…write anything, use pencil, pen, a typewriter or computer!

Learn a new language.

Learn to sew, knit or crochet.

Paint with anything you have, colored pencils, crayons, paint, etc.

Play cards or learn to play bridge or poker.

Try Sudoku, puzzles, crosswords, etc.

Learn to play chess or other games you already have.

Sing or pick up an old instrument you know how to play, or learn how to play if you have an instrument at home.

Try cooking new dishes. Create new recipes with the ingredients you have at home.

Catch up with old TV shows or watch a whole season in one week.

Spring clean.

Clean your closet and select clothes you have not worn in years to donate.

Pick up a box of pictures and organize them, put in an album if you have one.

Pull weeds outside if it is sunny and nice.

Connect with others.

Talk to your family members or neighbors and old friends, keeping distance or by phone, Talk via Face Time, Skype, or similar apps. Get in touch. You may find that others are feeling lonely, too.

Write and send letters to loved ones who are out of town.

Look to the future.

Make a list of everything you would like to do after this pandemic is over.

Plant herbs, chilies or vegetables. Some home garden stores are still open. Seeds may be ordered online.

I wish you the best! Stay home as much as possible. Do not miss dialysis treatments and do what you can to improve your health. You have the power to live strong. Make plans for what you are going to do when the restriction to stay at home is over. I hope that by 2021 we have learned a great deal about our world and ourselves. Be safe and stay as healthy as possible.

Visit DaVita.com and explore these diet and nutrition resources:

DaVita Diet Helper online meal planner and tracker

DaVita Kidney-Friendly recipes

Today’s Kidney Diet cookbooks

Diet and Nutrition articles

Kidney Smart® Classes taught by kidney experts in your area

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Dialyzing While in a Pandemic published first on https://dietariouspage.tumblr.com/

[larrymccarty]

Toyota Camry 2021 Dimensions, Redesign, Interior

Toyota Camry 2021 Dimensions, Redesign, Interior

Toyota Camry 2021 Dimensions, Redesign, Interior – Having said that, this really is nevertheless an honestly fast auto. And not simply speedy for any Toyota Camry 2021, possibly. Because of further stiffening coming from new shocks as well as an elevated spring season price (a 44-pct rise in tightness in the beginning, and 67-percentage from the back), the Camry remains to be created in the…