A comprehensive and effective substance use disorder treatment program uses many different therapeutic approaches, both traditional and complementary. Qigong for addiction treatment is a complementary holistic therapy that has been shown to positively contribute to a person's ability to achieve and maintain sobriety.
Qigong is an evidence-based therapeutic approach that improves a person's health and subsequent quality of life. Qigong is also effective for treating a range of physical and mental health conditions.
Qigong—sometimes written as chi kung or chi gung—is a traditional Chinese medical practice that originated in ancient China and has developed over thousands of years.1 Qigong is a mind and body practice that involves specific postures and sequences of gentle movements, coupled with changes in mental focus, breathing, coordination and relaxation.
According to a 2007 National Health Interview Survey, about 600,000 Americans practiced qigong in the previous year.2 People practice qigong because of the many benefits it can bring, including psychological benefits such as reducing anxiety, stress and depression. Tai chi is a closely related traditional Chinese medicine practice and it also involves combining specific movements or postures, coordinated breathing and mental focus.
Since many people who are experiencing addiction also have the accompanying symptoms of anxiety, stress or depression, qigong for addiction treatment is a good addition as a complementary therapy for helping participants to decrease symptoms.
One major benefit of qigong is that it helps people who have experienced a loss of coordination to regain some muscle control in a gentle, low-impact manner.3 This is especially helpful for adults who are midlife or older who find it difficult to perform strenuous exercises.
Another major benefit of qigong is that its low-impact, moderate-intensity aerobic exercises help participants relax. This decreases anxiety, depression and blood pressure and benefits recovery.
Chronic sleep problems are associated with a decrease in health and an increase in depressive symptoms. Qigong may also be able to improve sleep quality, which can have a positive impact on a person's mental health.
Research supports qigong for addiction treatment as a promising therapeutic approach for substance use disorder treatment. Qigong can help those experiencing withdrawal during detox. One study showed that people who practiced qigong during withdrawal experienced comparatively fewer withdrawal symptoms than those who did not.
In addition, research studies show that qigong participants had a higher rate of completing treatment and a greater reduction in cravings. Qigong has also been shown to lower relapse rates and improve anxiety scores.
Qigong requires patience, practice and concentration, and it emphasizes control and focus. Some people who are working to overcome a substance use disorder may initially find this difficult to accomplish. By starting out with less complicated forms, and then moving on to the more difficult and intricate forms, many find qigong for addiction treatment an effective way to handle withdrawal and improve both their physical and mental health.
When you or a loved one are evaluating treatment programs, those that have qigong for addiction treatment can help a person recover more easily and effectively. Also, qigong is a tool that can be practiced long past the completion of a treatment program, resulting in lasting improvements to mental and physical health.


Gold prices headed for third consecutive weekly decline, on expectations of Federal Reserve rate hike and as dollar rose to an eight-month high against yen as U.S. bond yields resumed their rise in Asia after the Thanks giving break shut markets in the United States. Base metals were mostly higher. Oil prices fell due to a strong dollar, rising Saudi supplies to Asian clients and fall in Chinese imports. Oil may trade lower today.
Zinc prices touching its highest in almost nine years on bets that demand was picking up faster than supply amid a broad-based rally across base metals. Global supply pool of zinc has been contracting as reserves are exhausted at huge mines in Australia, Canada and Ireland.
Gold showed sideways movement and found the important support level of 28400. Now if it will close below the important support level of 28400 then 28200 will act as next support level. On higher side 29000 will act as vital resistance level.
Silver showed bullish movement and found the important resistance level of 40600. Now if it will close above the important resistance level of 40600 then 41000 will act as next resistance level. On lower side 39900 will act as vital support level.
Crude showed bearish movement and found the important support of 3170. Now if it breaks 3170 then next support level is seen around 3100. On the other hand 3270 will act as a major resistance level; if it breaks the prices could visit 3350 level.
Copper showed sideways to bullish movement and found the important resistance level of 404. Now if it will break the resistance level of 404 then 408 will act as next resistance level. On the other hand 395 will act as a major support level.


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Thursday, Nov 14 2019 • 12:20 p.m. (ET)
The Life — And Tragic Death — Of Bijan Ghaisar
Bijan Ghaisar's family and friends gather at a protest last February. Ghaisar was killed when park police fired nine gun shots into his Jeep Grand Cherokee. Courtesy of the Ghaisar Family
On November 17, 2017, a police car chase that began on The George Washington Memorial Parkway ended with an unarmed man — 25-year-old Bijan Ghaisar — being shot at nine times by U.S. Park Police as he sat at the wheel of his Jeep Grand Cherokee, in a residential neighborhood of Fairfax County. He died 10 days later.
Since Bijan's killing two years ago, very few details from the FBI investigation into what happened that night have been made public. Bijan's family has since refiled a lawsuit against the federal government and the director of the FBI was questioned about Ghaisar's case in a Senate Judiciary Committee hearing in July.
Kojo sits down with Bijan's mother, father and sister to discuss their quest for answers — and what it means to remember and mourn a loved one in the midst of a fight for justice.
A few hours after this show aired, the Justice Department announced they would not be pursuing criminal charges against the officers who killed Bijan Ghaisar.
Produced by Julie Depenbrock
James Ghaisar Bijan's Father
Kelly Ghaisar Bijan's Mother
Negeen Ghaisar Bijan's Sister
Roy Austin Attorney for the Ghaisar Family
Mark Warner Member, U.S. Senate, D-Va; Former Governor, Virginia
KOJO NNAMDIWelcome back. On November 17th, 2017, a police car chase that began on the George Washington Memorial Parkway ended with an unarmed man, 25-year-old Bijan Ghaisar, being shot at nine times by U.S. Park Police as he sat at the wheel of his Jeep Grand Cherokee in a residential neighborhood of Fairfax County. He died 10 days later. As the second anniversary of Bijan's killing approaches, very few details of the investigation into the events of that night have been made public, and Bijan's family has refiled a lawsuit against the federal government.
KOJO NNAMDISo, what's next in the family's quest for answers, and how are they able to mourn in the midst of a fight for justice? Members of Bijan Ghaisar's family joins us in studio. I will introduce each, individually. Kelly Ghaisar is Bijan's mother. Thank you very much for joining us.
KELLY GHAISARThank you, Kojo.
NNAMDIJames Ghaisar is Bijan's father. Thank you very much for joining us.
JAMES GHAISARThank you, sir.
NNAMDINegeen Ghaisar is Bijan's older sister. Thank you for joining us.
NEGEEN GHAISARThank you.
NNAMDIAnd Roy Austin is one of the Ghaisar's family attorneys and a partner with the law firm of Harris, Wiltshire and Grannis. Roy Austin, thank you for joining us.
ROY AUSTINGood afternoon. Thank you.
NNAMDIAnd U.S. Senator Mark Warner will be joining us from a Capitol Hill radio studio. Mark Warner is a Democratic member of the U.S. Senate representing Virginia. Roy Austin, I'm wondering if we can start with you. What do we know about the details of Bijan Ghaisar's death?
AUSTINSo, we know very little, beyond the fact that Police Chief from Fairfax Rustler decided to provide us with the videotape of the killing. We know that, from the beginning, these officers were completely out of control, completely unprofessional, and conducted an unconstitutional stop. Three different occasions, they approached the car in a manner that violates policy and common sense. And the final time, they repeatedly shot at Bijan from close range, when there was no risk to the officers or anyone else.
NNAMDIWhen you say they approached the car or the Jeep, I think, in a way that violated policy and common sense, it's my understanding that, on each occasion, they approached is with their guns drawn. Is that correct?
AUSTINThat is correct.
NNAMDIAnd that is a violation of policy?
AUSTINWell, the issue was, this was over a minor fender-bender, in which Bijan was the victim. He was the one struck from behind. And, in this situation, officers are trained, if you need to perform a traffic stop at some later time, you pull up behind the vehicle, you approach the vehicle in a calm manner and you get the information you need. That's not what happened here in any way, shape or form. What happened here is they blocked the car from the beginning, jumped out of the car with their weapons drawn, and then proceeded to even strike the car with their guns, a number of things that no police department would ever train its officers to do.
NNAMDIA Fairfax County police officer was following Park Police as the chase unfolded and the dash cam footage from his patrol car shows that Bijan stopped his car twice during the chase, but drove away both times as the two Park Police officers approached his vehicle, you say, unprofessionally. But do you have any insights or possible reasons as to why Bijan did that?
AUSTINWe do not, other than the fact that anybody who is approached by a police officer, or by two police officers in that manner late at night, unprovoked, would very likely be concerned for their life, and would very likely be trying to get to a place where there were more people who could witness what these officers were doing.
NNAMDIAnd, just to confirm, the police report from the Fairfax County officers who were at the scene when Bijan was removed from his car after the shooting, states that no weapons or illicit substances were found. Correct?
AUSTINSo, absolutely no weapons were found. That is what we know, for a fact. There was never a threat to those officers or anyone else.
NNAMDIWhen we reached out to the U.S. Park Police for comment, their public information officer, Sergeant Eduardo Delgado, wrote back, quoting here: "The U.S. Park Police recognize the longstanding need for more information and details surrounding the investigation and the death of Bijan Ghaisar. In the interest of objectivity and impartiality, the United States Park Police transferred the case to the Federal Bureau of Investigation in November of 2017. The FBI is conducting this investigation. As such, we are neither able to speculate on elements of this investigation nor the release procedures of another agency."
NNAMDIWhen we reached out to the FBI for comment, they declined. The law enforcement stonewalling here has brought about rare bipartisan calls for transparency. Here now is Senator Chuck Grassley, a Republican from Iowa, questioning FBI Director Christopher Wray about the case this past July.
CHUCK GRASSLEYI've sent several letters to the FBI regarding the investigation into the shooting of Bijan Ghaisar by the National Park Police. I haven't received a substantive response. When can I expect clear answers to my questions and a conclusion to that investigation, which I think now is 18 months old?
CHRISTOPHER WRAYWell, I'm not intimately familiar with the investigation, but I believe it is still ongoing. So, it would be premature for us to provide any substantive information at this point.
GRASSLEYYou know, you kind of get the feeling, with several of these incidences, that there might be something out there that's going to embarrass the FBI. Are you worried about embarrassing the FBI if some of this stuff's made public?
WRAYI am not having us withhold any information out of fear of embarrassment to the FBI.
GRASSLEYOkay.
WRAYWe take our share of lumps, and I embrace that as part of the process. The FBI's made its share of mistakes over the years, and you've, I think, played an important role, in some cases, in highlighting some of those mistakes. And I think one of the things that distinguishes the FBI from a lot of other organizations is our commitment to learning from those mistakes.
NNAMDIThat's FBI Director Christopher Wray, responding to questioning from U.S. Senator Chuck Grassley, a Republican from Iowa. James Ghaisar, you are Bijan's father. I wonder what your response is when you hear what you just heard from the director of the FBI.
GHAISARI am positive, like them, like everybody we know, that the silence, I mean, on top of the fact that, you know, public need to know, we have a loss that is unbelievably hard on us. I don't know how to describe it, but I'm trying to learn how to live with the grief, that permanent hole in my heart. So, it is a nightmare every day, you know, starting with the denial, and then go through the whole five phases of grief, and just over and over and over again. So, yes, we are anxious to know more about it. And, hopefully, the only thing we can wish here is justice, because unfortunately nothing can bring our son back.
NNAMDISenator Mark Warner is a Democratic member of the U.S. Senate representing Virginia. He and Senator Chuck Grassley, who you just heard from, a Republican representing Iowa, have continued to press the FBI and U.S. Park Police for information about what happened to Bijan. Senator Warner joins us now from studios in the U.S. Senate. Senator Mark Warner, thank you for joining us.
MARK WARNERThank you, Kojo.
NNAMDIYou've been met with refusals from the FBI and the U.S. Park Police to comment on their investigation into Bijan Ghaisar's death. How do you account for this lack of response?
WARNERWell, Kojo, first of all, let me just say I am embarrassed by the response of our government to this tragedy. It's not right. It's not fair. I had the opportunity to meet with Bijan's parents at an event, it wasn't about Bijan, over a year ago. And my impression is they are remarkable people. And you just heard from James, the tragedy, how it still affects him. And I think about -- I've got three daughters in their 20s -- if this had happened to one of them, and to be sitting two years after the fact with no answers, I don't know how they control their rage, frustration, disappointment.
WARNERAnd let me just take a moment or two, I mean, the family contacted -- we got involved -- Senator Tim Kaine got involved, Congressman Don Beyer got involved. I contacted Chuck Grassley, because he's been active on these kind of investigations in the past to make this bipartisan. He's more senior than me. Senator Grassley's been involved. We have had -- our paper of record, the Washington Post, has been very, very active and editorialized on this subject repeatedly. And if four members of Congress, the Washington Post can't get this family the decency of answers, it is so wrong on every level.
WARNERLet me tell you what we have achieved, which, by no means, is enough. Number one, I have repeatedly gone to the previous Park Service director and as recently as two weeks ago with the acting National Park Service Director David Vela to say, this process of what happened -- because these were Park Police, there's not as much -- I don't think as much training, as many incidents of kind of violence. This was the Fairfax Police or the State Police. These are Park Police. You know, they monitor the parkway, the G. W. Parkway, the Baltimore Washington Parkway in our greater Washington area.
WARNERAnd, you know, this just isn't right. We have seen the Park Police be willing to change their training procedures after enormous amounts of pressure. We still don't have enough clarity from the Park Police on what are the procedures in terms of use of firearms particularly, as the attorney pointed out, where Bijan showed no evidence of threatening to any law officer. So, we've made incremental progress with the Park Police, not enough. Their response continues to be, you know, well, we've turned it over to the FBI.
WARNEROnly through the actions of the Ghaisar family were we able to obtain the names of the officers involved. You know, we requested, I requested, Grassley requested, you know, others requested. Only through kind of, I believe, a FOIA request were they, the family able to get the names of the officers. That literally five or six months afterwards, was the first time they were even put on any level of administrative (word?).
NNAMDIBut Senator Warner, what's your next move, here?
WARNERNo, let me just finish this, please. It's one more -- so, that took too long. I have been in regular contact with the FBI. And the FBI, you know, gave me -- and I've shared this with the family, I can't share it with the whole listening audience, somewhat of a level of status of numbers of interviews that have taken place which just don't pass the smell test in terms of why it's taking this many interviews and this long for a circumstance that, you know, we kind of know the universe of individuals that were involved. And thank goodness, in many ways, the Fairfax Police were involved to make sure that we had the video that now has given us this level of proof.
WARNERI am going to continue to press on the FBI. There is something wrong in our legal system that this family, two years after the death of their son, that they have no answers, that no one has been brought to justice, and they don't have a full explanation. And I'm going to end with where I started, Kojo, which is I am embarrassed by the performance of the United States Government that they don't have more response, and that four members of congress and the Washington Post have not been able to secure this family the kind of, at least, beginning answers beyond the question of what they ultimately needed, which is justice.
NNAMDIBut, Senator Warner, what kind of leverage does the Congress have with the FBI? Patty called in to ask: Congress has the power of the purse. Why doesn't congress, Senator Grassley, Senator Warner, their counterparts in the House just zero the Park Police and FBI funding until there's acknowledgement?
WARNERThose options, in terms of holding back funds, restricting funds is one of the next steps that we've started some conversations on. What we had presumed and what I had expected, having had a conversation with some of the senior-most level officials at the FBI who, within the chain of command, are overseeing this investigation, I never in my wildest dreams thought that James and Kelly and Negeen would still be, this many months after that conversation, still waiting to get answers in having this investigation come to some level of conclusion. So, it is time for us to move to the next steps.
NNAMDISenator Mark Warner is a Democratic member of the U.S. Senate, representing Virginia. Mark Warner, thank you so much for joining us.
WARNERThank you, Kojo. And to the Ghaisar family, again, we are all committed, but I just can't imagine, two years after Bijan's murder, shooting, that our government is not giving you a better explanation of what happened.
GHAISARThank you, Senator. Thank you so much.
NNAMDIRoy Austin, do you know of any other cases involving the Park Police that have taken this long to make details available to the public?
AUSTINSo, I do not know of any other matters with the Park Police where they have shot and killed someone that have taken this long. Unfortunately, a number of these civil rights cases being investigated by the U.S. Government seem to take years, when the answer is pretty obvious, and that these things should be moving forward toward justice much sooner with prosecutions. So, I don't have an explanation for why it would take this long.
NNAMDIThe family has refilled a lawsuit against the federal government that was previously dismissed on technical grounds. What does that suit say?
AUSTINSo, the suit says that these officers, both individually and -- well, these officers individually violated the 4th Amendment by taking Bijan's life, and that the U.S. Government is responsible. So, it's under what's called a Bivens Action and under the Federal Tort Claims Act is how the lawsuit is proceeding. And we have not been able to get answers through the FBI, and so the family has had no choice but to seek answers through our civil justice system.
NNAMDIWhy did the lawsuit have to be refiled?
AUSTINIt was a matter of exactly who were the representatives of Bijan's estate and making sure that that was noted properly in the original lawsuit. It was truly a technical matter.
NNAMDIHow will you be able to move this case forward?
AUSTINSo, we are in the Federal District Courts in the northern district of Virginia. And we will move it forward as civil cases move forward through our complaints and our pleadings.
NNAMDIAnd I guess this is a frustration that both you and the family feels. Jody emails us: isn't the Fairfax police video obvious enough? Why on earth were these officers pursuing him as if he were a criminal instead of treating him as the victim of an accident? There is no excuse for this delay. I suspect that's a lot of public sentiment, too.
AUSTINShe is absolutely, 1,000 percent correct. Anyone can look at this video and see exactly what happened here, and that what happened here was criminal and wrong and unjust.
NNAMDINegeen Ghaisar, I'd like to talk to you about your brother. Not just about what happened that night two years ago, but about who Bijan was as a person. What can you tell us about him?
GHAISARI think, to start off, Bij was the funniest person I think anyone who knew him had ever met. (laugh) He could make anyone laugh. He was just a huge presence in any room. You could just feel him around. He was super-inclusive. He would make sure anyone who felt left out in the corner of the room not talking to anyone was, you know, incorporated into the conversation, was, you know, comfortable.
GHAISARHe never liked being a burden on anyone, so a lot of the times, we feel bad that, you know, he wouldn't want us to, you know, have to do anything for him, ever. And he was always doing things for everyone else. He was just very giving, all the time. You know, he had like an intuitive sense, so he just would call at the right time. He was there at the right time. And, again, he was hilarious, so he didn't like anyone being sad. So, he would just make sure he could, you know, get a little giggle out of you if, you know, you looked like you might cry or, you know...
NNAMDI(overlapping) Did he get any giggles out of you by mimicking people he'd been listening to on...
GHAISAROh gosh, yes.
NNAMDI...the radio?
GHAISARSo, yes, I'm not sure how you know that, but growing up, on the way to school, my dad -- or anywhere, basically, NPR was the only thing that we would ever listen to. So, we actually had this, like, long-running joke between the two of us. I'm not good with impressions, but he was very good with impressions. He would do you, Kojo, actually, more than anyone. (laugh)
NNAMDI(laugh) I have trouble doing me.
GHAISARIt was you, Diane Rehm and All Things Considered. So, those were the three that was just constantly playing, even when we weren't listening to it (laugh) for ourselves. In the hospital, I actually -- those 10 days, I would try to, like, I guess make him feel better in his coma. So, I would just try to come up with little things from, like, our memories that would maybe make him feel better in the moment. And that was one of the things I, you know, in an awful way, I would try to mimic.
NNAMDI(overlapping) Two years ago that would've been just flattering for me. Now, it's the downright honor. Thank you very much.
GHAISARThank you.
NNAMDIJames, your son was an accountant. You even worked together at the same firm. What are your fondest memories of him?
GHAISARWell, if you allow me, I'm going to read what he wrote on my Facebook on my 60th birthday. And I think that briefly would describe as who he was and what values he'd hold and what our relationship are. So, briefly, I'm going to read. He says, you have been my best friend, my boss and my role model. But most importantly you have been my father. You always told me that there's no need to chase your dream if you live them every day, work hard and then play.
GHAISARWe have been able to go all over the word together, and I thank you for that. You took me to your hometown to show me that humble beginnings put life in perspective. You have always said that a true happiness comes from helping others. You have taught me to be kind, courteous (crying) and humble, but to also own the room.
GHAISARYou have always said, don't overdo it. And if you truly believe it, then you will find a way to succeed. You have always told me that, in life, one can build many things, but there is nothing like building a family. I hope one day I can be as great of a father to my kids (crying) as you have been to Negeen and me. Cheers to 60 years of living, and a dream, and many more to come. I love you, Papa. (crying) I think this would not only tell you who he was and what our relationships -- I mean, he was definitely, now I feel, a very old soul in the body of a 25-year-old kid.
NNAMDISome memories of Bijan Ghaisar. We're going to take a short break now so we can all collect ourselves. I'm Kojo Nnamdi.
NNAMDIWelcome back. We're talking with family members and the attorney of Bijan Ghaisar, who was shot to death by U.S. Park Police officers two years ago. And there has been no information given whatsoever about the FBI investigation that has been taking place for these last two years. Marie emails: I lost my son two months before the Ghaisars lost Bijan. My son died of undiagnosed type I diabetes, and I've dedicated my life to raising awareness of this disease.
NNAMDII know about the hole in the heart that will never go away from the death of a child, as Mr. Ghaisar describes. But to lose a child and now understand why, and to witness the callous disregard of that child's life by the agencies that are supposed to protect us is unfathomable. I'm grateful for the many members of Congress and the Washington Post who have not given up their quest to uncover the reasons behind this terrible act. Kelly Ghaisar, as the mother of Bijan, what do you want people to know about Bijan, the kind of person he was?
GHAISARWell, Bijan was one of the nicest, as Negeen said, funniest people that I know. I am so honored that I was given the gift of Bijan for 25 years. He was my best friend, and we always talked about things that usually son and moms don't talk about, like football, and I love football, and movies. And he was, as Negeen said, very inclusive. Bijan was super-caring. He was super-funny.
GHAISARAnd one of the things that I always say about Bijan, that I have never in my life met a young person or an adult that can enter a room and get the reception that Bijan did. It would always leave me in awe that, out of nowhere, wherever we were at family gatherings or school events or sports events at school where he played, as soon as he would walk into a room, everybody was like, Bij, Bij, Bij is here. Hey, Bij, Bij, Bij. And it was all of us there, and so many other people, but there has to be a reason why someone gets that kind of reception.
GHAISARAnd it was simply, I believe, the fact that he was so caring and so humble. And, on his last birthday, I wrote to him, I said: I wish you all the best in the year to come. And that was September of 2017, which was like a few -- yes, before his death. And Bijan wrote back, he says, thank you, mommy, but I only want what I need. I think that says everything that needs to be said about Bijan. And I do know Bijan, or no one, deserves to die the way he did.
NNAMDIThere are a couple of people who know the family, who would like to comment. First, here's Kavon in Tyson's Corner, Virginia. Kavon, you're on the air. Go ahead, please.
KAVONHey, good afternoon. How are you guys? I just wanted to really express my condolences to the family once again. I mean, it's been two years, and just like the family's been saying, the extended family -- which I'd like to include myself a part of -- is also getting frantic. And the frustration of the family is extending upon us as extended family, but also because I was a close friend of Bijan, as well.
KAVONSo, because of the frustration that has come onto me as a citizen of the state, as a citizen of the Commonwealth, I'm ashamed. I'm ashamed that the federal government and the state that we live in, and have lived in for my whole life and their whole lives, has let us down.
NNAMDIThank you very much for sharing those thoughts with us, Kavon. I think you all know Congressman Don Beyer of Virginia. Congressman Don Beyer, thank you for joining us.
CONGRESSMAN DON BEYERThank you, Kojo. Thanks so much for having Kelly and James on the show and bringing attention of this. I just wanted to give you three quick updates. I'm working with Chairman Raul Grijalva of the Natural Resources Committee in the House on a letter to Chief MacLean, who's now the head law enforcement officer at Interior about...
NNAMDIWe're going to get to that shortly.
BEYER...yeah, reviewing the Park Police protocols and regulations. Because it's very clear these officers violated both the chase policy and the weapons policy in the Bijan case. And then with Eleanor Holmes Norton, we passed an amendment requiring that Department of Interior do body cameras for all of its law enforcement. So far, the main agency has done it, but not the sub agencies, and we need to push on that.
BEYERAnd then, in line with what Senator Warner and Senator Grassley have done with the Department of Justice, we have a letter going out this week saying, you know, color of law investigations don't take this long. It's two years. The whole notion which, you know, the Ghaisars have said so eloquently, that justice delayed is justice denied.
BEYERAnd a subset of that is we really want the 911 tape released. You know, the Fairfax County Chief Roessler graciously let the Fairfax County videotape out, but we still don't know what the 911 call said and what that may have provoked. So, we're trying, in a very frustrated way, to help bring justice as quickly as we can.
NNAMDIDon Beyer, thank you so much for joining us.
BEYERYeah, thank you, Kojo.
NNAMDIAnd Don Beyer's a congressman -- a member of the U.S. Congress. He's a Democrat from Virginia. The Chief of Park Police at the time, you just heard his name, Robert MacLean, met with this family to explain the reasons for their silence on Bijan's death. Here's what he told Fox 5 DC's Paul Wagner back in August.
CHIEF ROBERT MACLEANWhat I decided to do was have the FBI investigate it to bring that impartiality and objectivity. I met with the Ghaisar family after the incident to explain the reason why. And that's what you do in law enforcement, is to afford that public to have the transparency for our actions of allowing an objective, outside partner investigate our critical incidences like that.
NNAMDINegeen, were you satisfied with that response?
GHAISARAbsolutely not. I think Chief Robert MacLean should not only not be getting his promotion, but he should be fired and questioned for everything that he's done in this case, from the second my brother was shot, up until now. I think that everything that he said is a complete sham. I think that I personally remember that we weren't allowed to record him when he came in. He didn't come to visit us until the case was turned over to the FBI, after we had multiple bad incidents with the two police officers under his watch who were watching my brother's room, not allowing us to see him, restricting our access to him, not allowing us to touch him, calling him a perp.
GHAISARAnd then, to top it off, within hours before he came and the FBI took over, they actually told a chaplain, a nondenominational chaplain, that we had waited 48 hours to come and visit my brother so that she could touch him on our behalf to read a Rumi poem, because we are nondenominational. They told her that she couldn't touch him, because he was a Muslim. And that is when he actually showed up here and the FBI took over, within hours of that.
GHAISARAnd we had multiple incidents like that in those three days leading up to the FBI taking over. So, no, I don't believe anything that Robert MacLean has to say, and I have no respect for his answer.
NNAMDIKelly, Robert MacLean has since been promoted to the top law enforcement position at the Interior Department. He was praised for his, quoting here, "stellar record." How did you feel when you heard about his promotion?
GHAISARDisgusted. I think Robert MacLean is -- I have never been able to use bad language, but I'm very tempted. I think Robert MacLean, the least, is a coward. He did not serve or protect his community by covering up this murder. And for our government to promote him to Interior Department is another shameful act in this case.
GHAISARAnd I just feel like what happened to Bijan, from the first second up until now, is a tsunami of bad judgments, of bad actions, of just -- I have -- I cannot tell you. After two years of sitting here and not one government official come to us and even acknowledge the fact that our son was murdered by one of their members, it's appalling. It's unbelievable. It's a nightmare. It is a disrespect. I am ashamed that we live in a society that this is permitted. I really am.
NNAMDIHere's Karen in Washington, D.C. Karen, we don't have a great deal of time left but go ahead, please.
KARENI've been a friend of James' end of the family, as well as James for nearly 40 years. This is a man with the soul of a poet. He has, on his office walls, a picture of Mahatma Gandhi and Nelson Mandela. I want to bring up a point that Kelly just touched on. If we remember that, two years ago, there was a kind of a hysteria in this country in the media about the Muslim ban and the eight nations from which we would not accept tourists or immigrants, I think that this is directly related to a kind of reaction of the police.
KARENIf Bijan looked Middle Eastern, and that sort of hysteria I think would have contributed to this. And I think that our leadership ought to be showing us the better way of our natures, and not the worst way of our natures. And the police are meant to be the adults in the room and not do what they did. And my heart breaks for this, but I think it's a point that is probably why the FBI doesn't want to release any information.
NNAMDIThank you very much for your call. Taylor emails: I met Negeen in 6th grade. We were both new to our elementary school at the time. The Ghaisars are the most welcoming, loving, genuine family, and I am heartbroken for them that Bij is no longer physically here with us. I'm so sorry for you that you still do not have justice, that our government can't own their actions, and that you have to live every day of your life. I'm so grateful for you that you have the support system that you have. And I am here from afar. I support you all. We are Bijan.
NNAMDIWe're running out of time very quickly, but, James, you have said that you are not seeking revenge, that you want justice, that nothing can bring Bijan back. But what would justice look like for you?
GHAISARWell, justice for me is that, of course, these two officers, Alejandro Amaya and Lucas Vinyard, have committed a crime, and they deserve to be punished according to the law. I think that would be the right thing to do, not only for us, but for the society, for this country. That there is the rule of law, and if you do something wrong you will be punished. And, of course, the outcome of this we hope there will be changes, so literally, in the future, somebody else's life was not wasted like this. So, we are hoping for that to resolve. And thanks to all the officials that are helping us to achieve this.
NNAMDIJames Ghaisar is Bijan Ghaisar's father. Thank you very much for joining us.
GHAISARThank you, sir.
NNAMDIKelly Ghaisar is Bijan's mother. Thank you for joining us.
GHAISARThank you, Kojo.
NNAMDINegeen is Bijan's older sister. Thank you for joining us.
NNAMDIAnd Roy Austin is one of the Ghaisar family's attorneys and a partner with the law firm of Harris, Wiltshire & Grannis, LLP. Roy Austin, thank you for joining us.
AUSTINThank you so much, Kojo, for having us today.
NNAMDIThis segment about the death of Bijan Ghaisar was produced by Julie Depenbrock. And our update on the incidence of racist graffiti at Salisbury University was produced by Lauren Markoe and Laura Spitalniak. Coming up tomorrow on The Politics Hour, D.C. Councilmember Vincent Gray will be here to talk about his new bit for reelection and about United Medical Center, among other things. Plus, Montgomery County council President Nancy Navarro will share her thoughts on the county's new economic development platform. That's tomorrow, streaming live only at noon on The Politics Hour. Until then, thank you for listening. I'm Kojo Nnamdi.

redpajama_set_name: RedPajamaCommonCrawl


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Étiquette : booking
Stampeders hoping 3rd time's a charm after booking ticket to Grey Cup
The Calgary Stampeders have been here before.
The last two seasons have gone according to plan for the mighty Stamps until the championship game.
They were the heavy favourites two years ago against Ottawa only to lose to Henry Burris and the Redblacks in overtime.
They were heavy favourites last year against Toronto only to lose to Ricky Ray and the Argos in a nail-biter — who can forget that goal line fumble by the Stamps?
To say it has been repeat disappointments for the Stampeders is an understatement as they were just a few plays away from being back-to-back Grey Cup champions.
How is it, then, that a team could find the composure to get back to the Grey Cup, after devastation the last two years?
Perhaps the motivation to right the wrongs of the past was enough to spur these Stamps onto Edmonton for another shot at glory.
Now quarterback Bo Levi Mitchell and the Stamps are heading back to the Grey Cup in a rematch of the 2016 game Calgary lost to the Redblacks. It's a chance at ultimate redemption.
Bo Levi Mitchell seals the victory
The 22-14 win on Sunday over the Winnipeg Blue Bombers was somewhat underwhelming. At times it slowed to a defensive halt.
But with about six minutes left in the game and Calgary leading 14-11, Mitchell orchestrated a drive to put the game out of reach.
Mitchell wasn't spectacular throughout the game, going 17 for 31 passing for 214 yards and three touchdowns. But with the game on the line he marched Calgary down the field with a seven-play 74-yard touchdown drive capped by a brilliant pass and catch to Eric Rogers in the end zone.
Calgary Stampeders quarterback Bo Levi Mitchell lifts the trophy after defeating the Winnipeg Blue Bombers in the CFL West final on Sunday night. (Jeff McIntosh/The Canadian Press)
That put Calgary up by 10 points with just a little more than three minutes left in the game, a deficit the Bombers could never overcome.
Many have speculated this could be Mitchell's last game at McMahon Stadium as he may head south with NFL aspirations. If it was, it was vintage Mitchell — finding a way to win.
This now marks the fourth time Mitchell will enter the Grey Cup game as a starter. He won his first start, only to lose the last two. Now he'll hope to lead Calgary to another championship.
'Tired of seeing the Stampeders'
This is now the fourth time in the last five years the Stampeders are heading to the Grey Cup.
They won it all against Hamilton in 2014. But their last two meltdowns in the title game have been well-documented.
The West trophy presentation celebrations in the south end zone of McMahon Stadium after the game Sunday couldn't have been more subdued and reserved — it was as if the Stampeders wanted no part of what seems to have become somewhat routine to them all. They want the big prize.
Calgary's head coach Dave Dickenson could barely look at the trophy.
He quickly shuffled it along to his players before being asked to share a few words over the loud speakers inside the stadium.
« A lot of Canada is tired of seeing the Stampeders in the Grey Cup but tough luck, we're bringing our team to Edmonton, » Dickenson said. « We have great fans and a great city. The city is looking for something like this. »
Publié le novembre 19, 2018 Auteur adminCatégories AnglaisÉtiquettes 3rd, booking, charm, Cup, Grey, hoping, Stampeders, ticket, TimesLaisser un commentaire sur Stampeders hoping 3rd time's a charm after booking ticket to Grey Cup


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Adult Acting Classes with Acclaimed Director Michael Beh, 10th and 30th November, Black Box Theatre
Black Box, Classes, Past
ACCLAIMED THEATRE DIRECTOR, designer, producer, scholar and acting teacher Michael Beh will conduct two masterclass workshops at the Black Box Theatre on 10th and 30th of November.
MASTERCLASS 1: PRESENCE, PERSONAL POWER AND THE ACTOR'S CHOICE
When: Sunday 10 November from 10.30am to 4.30pm
In this workshop:
Become the best actor that you can be. Apply these skills to other elements of your daily life.
Explore breath, rhythm, movement and voicing to create multi-dimensional, mythologised character.
Be introduced to the concept of 'isness' as you enhance your personal presence as an actor and the presence of your character.
Introduction to neutral mask work. Perform to the power of the angel.
Explore monologue, audition preparation and scene work in this workshop designed to empower the actor and magnify the character in performance.
Please bring a known monologue to this workshop with 2 paper copies for use.
MASTERCLASS 2: THE ACTOR AND THE AESTHETICS OF ACTION
When: Saturday 30 November from 10.30am to 4.30pm
Develop skills that will empower your craftsmanship as a professional artist. Learn how to interpret script to empower the manifestation of real truth in performance.
Explore how to activate playing psycho-physical actions.
Both highly practical masterclasses draw on the performance theories of the great Russian artists - Konstantin Stanislavsky, Evgheny Vakhtangov and Michael Chekhov.
WHO SHOULD PARTICIPATE IN THESE MASTERCLASSES?
Masterclasses are designed for actors 18+.
Emerging artists are very welcome to attend.
No prior knowledge of their work is required to participate.
The work explored in this Masterclass Series is suitable for acting for stage, television or film.
GETTING THE BEST OUT OF THE MASTERCLASSES
Each Masterclass runs from 10.30 am – 4.30 pm.
Wear comfortable clothes that you can easily move in. Also bring water to maintain hydration plus a pencil, eraser and notebook.
There will be a lunch break of approximately 45 minutes.
TO BOOK THE MASTERCLASSES
Book at http://www.curators.com.au/arc
Or contact Michael at arc@curators.com.au or 0430 246 353
ABOUT MICHAEL BEH
Michael is the company founder and Producing Director of The Curators, Brisbane's bold, new, independent theatre where he recently directed the critically acclaimed adaptation of Ibsen's GHOSTS.
He also is the principal teacher of the ARC Actor Training Program in Brisbane which has just announced the commencement of its vibrant, new ARC Professional Training Ensemble Program.
This year, Michael was the adjudicator of the Sunshine Coast Theatre Festival and Norfolk Island Play Festival.
He is a Fulbright Fellow who trained with Adolf Shapiro from the Moscow Arts Theatre School at Carnegie Melon University, USA. He has studied with an array of the finest acting teachers in the world including Mladen Kiselov, Mike Alfreds, Augusto Boal, Diane Cilento, Anne Bogart, Frank Theatre and Larry Moss.
Michael has previously worked with Queensland Theatre, La Boite Theatre, Brisbane Festival, Anywhere Theatre Festival, heartBeast Theatre, City Theatre and Gyre Theatre and has directed over 55 plays.
He has also taught in the Drama Departments at Carnegie Melon University and QUT.
Michael has dedicated his professional career to the development of emerging actors with many of his students gaining entry to the conservatoire acting programs at NIDA,VCA, WAAPA, QUT, NYU, Cal Tech, Rose Bruford, RADA and Central School (London).


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Home > Articles > News
Science Notes – Parsing the properties of Egyptian purple pigments
Between 30 BC and the 3rd century AD, during which period Egypt was a province of the Roman Empire, a practice developed of attaching a portrait of a mummified individual to their mummy wrappings. Approximately 1,100 of these paintings have been collected over the centuries, the majority during the 19th and early 20th century – but, as many were bought and sold as works of art instead of archaeological artefacts, information about their context and provenance has disappeared.
Contextualising Bronze Age burials on the Isle of Man
Recent assessment of a unique burial assemblage from the Isle of Man has helped illuminate a rare type of funerary practice also found in parts of Wales and northern England. This new work provides a blueprint for moving away from traditional single-object typologies towards a more holistic approach that takes into consideration multiple forms of evidence in order to get a clearer picture of varying cultural practices across different regions.
Around 8,150 years ago, a sudden shift in the seabed created the Storegga tsunami in the North Sea. With all known evidence pointing towards this event greatly affecting, but not completely inundating, Doggerland (the strip of land that once connected Britain to continental Europe – see CA 367), the search is now on for evidence of human occupation. While it is thought that there must have been significant Mesolithic groups living here during the period, without knowing just how populated the area was likely to be it cannot be determined how catastrophic the tsunami may have been.
Roman villa revealed near Wrexham
The remains of a Roman villa have been revealed near Rossett, Wrexham. It is the first site of its kind to be found in north-east Wales, adding to our knowledge of the region during this period.
Updates to the definition of Treasure
The definition of what is considered 'Treasure' is to be revised by the Government, to broaden its parameters and provide increased protection for archaeological finds made in England and Wales. It will be the first change made to the Treasure Act since it came into effect nearly 25 years ago.
A new chronology for Glastonbury Lake Village
A new robust set of radiocarbon dates from the Glastonbury Lake Village in Somerset has allowed researchers to establish a more-precise chronology for how the site was used during the Iron Age. As the settlement contains so many well-preserved finds from this period, it is hoped that this new information will help to provide a better timeline for similar artefacts found across Britain and Ireland.
Britain's first 5th-century mosaic identified?
New dating evidence from Chedworth Roman Villa in Gloucestershire may have identified Britain's first-known 5th-century mosaic, researchers have announced.
Science Notes – A new approach to wood preservation
Wood can be a difficult, and costly, archaeological material to preserve. This is nowhere better highlighted than by the enormous efforts put into place to help conserve the Mary Rose. When the remains of Henry VIII's warship were lifted out of the Solent in 1981 (see CA 218 and 272), little was known about how best to preserve the wreck once it had been removed from the protective anoxic conditions under the seabed. But over the past three decades, multiple techniques have been developed to keep the ship, and other wooden artefacts recovered from archaeological contexts, from degrading before our eyes. In this month's 'Science Notes', we explore the latest of these preservation techniques.
Migration and disease in the Iron Age
Scientific analysis of a human skeleton discovered at Tarrant Hinton in Dorset has shed new light on life – and the transmission of infectious disease – in Iron Age Britain. The remains were originally found during excavations at a small Iron Age/Romano-British settlement between 1967 and 1985. Examination and radiocarbon dating of the skeleton indicated that it was that of a man, aged between 30 and 40, who had died between 400 BC and 230 BC.
Hadrian's Wall revealed at Walltown Crags
Many miles of Hadrian's Wall survive beneath turf and rubble, unexplored and often under threat from erosion, people, and animals. A recent excavation at Walltown Crags in Northumberland, undertaken in advance of fixing some of this damage, revealed sections of the Wall that had not been seen for centuries.


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Deer District watch party area expands, allowing up to 65K fans for Game 6
By: Rose Schmidt
Posted: Jul 19, 2021 3:40 PM CST | Updated: Jul 19, 2021 7:07 PM CST
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MILWAUKEE (CBS 58) – The outdoor watch party at the Deer District has been expanded to allow up to 65,000 fans to attend Game 6 of the NBA Finals on Tuesday, July 20.
"We're building the church for Easter Sunday. This is going to be a big event," said Bucks President Peter Feigin. "It gives us an opportunity to win a championship at home. You couldn't ask for anything more."
The Milwaukee Bucks have announced adjustments made to accommodate for more fans. The main stage and screen will now be located on Block 6 of the Deer District, directly north of Fiserv Forum between Vel R. Phillips Avenue and 5th Street. The main stage and screen will be on the north end of block six near the intersection of 5th Street and McKinley Avenue.
The watch party will stretch back across Juneau Ave., which will be closed between 6th Street and Old World Third Street, and continue onto the plaza at Fiserv Forum. Vel R. Phillips Avenue will also be closed between McKinley Avenue and Juneau Avenue. Additional viewing screens will be set up on the plaza.
.@Bucks President Peter Feigin says the team is "expanding their footprint" outside @FiservForum for Game 6. A giant stage is being built in the lot across the street. They're also reconfiguring the area outside the arena. You can see they took down the main stage. pic.twitter.com/HDxGuV2j6S
— Rose Schmidt (@RoseSchmidtTV) July 19, 2021
"I think every event we get better and better, and now we're really planning for something we could have never even fathomed where we have tens of thousands of people watching and if we win, I think we'll have a week full of hundreds of thousands of people celebrating," Feigin said.
Feigin said he does not anticipate having to turn people away. He said if the Bucks win, Milwaukee will celebrate like it's never celebrated before.
"Milwaukee should be the centerpiece of the world. This should be where people want to be -- to see one of the greatest events that will happen," he said.
Aloft Milwaukee Downtown, which is across the street from Fiserv Forum, is booked for Tuesday night.
"We had a lot of reservations in advance -- people anticipating that there might be a game, but those last few rooms that we had really flew off the shelves after the win on Saturday night," said Greta McCue, director of sales for Aloft Milwaukee Downtown.
Local restaurants are calling in reinforcements. Jack Roman is the director of marketing for Cream City Concepts, which owns Oak Barrel, Who's On Third and Third Street Tavern.
"A year ago or more, we were counting on the DNC. We were all looking at that as that's our big statement to the world, and I'm sure it would have been great. That got canceled, and it was really a downtime. It was like, 'What's gonna happen? What are we gonna do?' and it's almost as if the Bucks stepped up to fill that void," Roman said.
Roman said they're staffing up and stocking up on product. He said customers should arrive early and he asked them to be patient with their servers.
"We really haven't dealt with these crowds in years. Things are not as fast as they once were," Roman said.
McCue said having the Bucks in the Finals has given businesses a boost and given people a reason to come to Milwaukee.
"As we get closer to the end of the series, more people are more excited. There's a chance for the Bucks to win at home tomorrow and people want to be here and be a part of that history being made," she said.
Gates to the Deer District watch party will open at 6 p.m. Fans planning to attend the watch party in the Deer District are encouraged to RSVP at www.bucks.com/playoffs to receive the most up-to-date information and guidance.
Gates to Fiserv Forum will open two hours prior to tipoff at 6 p.m. on Tuesday.
Heavy traffic is expected throughout Deer District on Tuesday and fans with tickets to the game are encouraged to arrive early. Fans with tickets to the game will also have their own dedicated express entrance to the plaza located on the north side of Fiserv Forum near the intersection of Juneau Avenue and 5th Street.
Contributions to this story also made by: Mark Stevens


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Владимир Тимофеевич Соколов (1827—1890) — русский  и певец, автор многочисленных романсов, имевших большое распространение в 1850-х и 1860-х годах.

Биография
Родился 14 января 1827 года на Охтенском пороховом заводе, в семье штабс-лекаря Тимофея Михайловича Соколова и его жены Марии Петровны, недалеко от Санкт-Петербурга. Получил образование в Медико-хирургической академии, но жизнь посвятил не медицине, а музыке. Он является автором многочисленных романсов, многие из них выдержали до четырёх изданий. По характеру и мелодичности романсы Соколова могут быть отнесены к разряду романсов Гурилёва, Варламова; в некоторых из них видно направление Даргомыжского, который долгое время руководил его музыкальными заняитями. Особой популярностью пользовался его романс «Море и сердце».

Кроме романсов он писал дуэты, квартеты, трио, хоры. Многие романсы и песни других композиторов Соколов аранжировал на два, три и четыре голоса. Некоторые смешанные хоры из «Жизни за Царя» и «Руслана и Людмилы», а также духовные сочинения Давыдова, Галуппи, Березовского, Бортнянского он перекладывал на одни мужские или на одни женские голоса.

Соколову принадлежит почин переложения популярных фортепианных пьес (напр. «Frühlingslied» Мендельсона) для одного голоса с аккомпанементом. Многие песни без слов Мендельсона переложены им на два, три, четыре голоса.

В 1862—1869 годах преподавал пение в 1-м петербургском реальном училище. В 1872 году был приглашён помощником инспектора в Петербургскую консерваторию, позже был преподавателем пения в Полтавском кадетском корпусе.

Умер в чине коллежского советника  года. Похоронен на Волковском православном кладбище.

В. Т. Соколов был женат на дочери артистки императорских театров Феодосии Александровны Поляковой Надежде Яковлевне Поляковой (1848-?). В этом браке родились дочери: Илария (1871-1949) и Мариамна (1875-?).

Старшая дочь композитора, певица Илария Райская, была второй женой Александра Валентиновича Амфитеатрова.

Примечания

Литература

Выпускники Императорской медико-хирургической академии
Преподаватели Первого Санкт-Петербургского реального училища
Преподаватели Полтавского кадетского корпуса
Похороненные на Волковском православном кладбище

redpajama_set_name: RedPajamaWikipedia


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Departments and Medical Units
Endoscopy and Diagnostic Procedures in Children
Common Tests for Diagnosing and Monitoring IBD
Endoscopic Capsule
Pediatric Colonoscopy
Pediatric Gastroscopy
Common Tests for Diagnosing and Monitoring IBD pH-Metry Endoscopic Capsule Pediatric Colonoscopy Pediatric Gastroscopy
A colonoscopy is a test carried out in order to examine the rectum and the entire length of the large intestine (also known as the colon). In most cases, the test examines the last part of the small intestine as well. Similar to other pediatric endoscopic tests, colonoscopies are performed under deep sedation, usually administered by an anesthesiologist. During the test, a doctor inserts a flexible tube (at the end of which is a tiny camera) into the patient's anus in order to identify the location, type and severity of problems such as inflammation, bleeding or polyps. After 8-10 years with colitis, this test should be administered every 1-3 years to identify pre-malignant changes related to the chronic inflammation, if any have developed. The doctor will provide instructions for clearing the intestine prior to the test.
A sigmoidoscopy is a similar but much shorter test, examining only the rectum and the end of the colon, known as the sigmoid. This shorter test suffices when there is a need for a general assessment of the severity of the disease, such as evaluation of a course of treatment or when atypical symptoms occur.
A gastroscopy is a test carried out in order to examine the esophagus, stomach and duodenum (first part of the small intestine). During the test, a doctor inserts a flexible tube (at the end of which is a tiny camera) into the patient's stomach through the mouth. The test can assist in identifying inflammatory involvement of the upper intestine, which in some cases could imply Crohn's disease. In children, gastroscopy serves as a routine examination in assessing IBD. With regard to adults, the test is usually performed when focal symptoms are present.
A regular abdominal X-ray
Abdominal x-rays do not play a significant role in diagnosing IBD though there are some clues to be inferred from an X-ray that could support diagnosis. X-rays are used in assessing acute exacerbations of Crohn's when intestinal blockage or intestinal perforation are suspected, and in severe ulcerative colitis for diagnosing complications such as toxic dilatation of the bowel.
"Passage" - small intestine follow-through examination using contrast solution
This test is carried out in order to visualize the small intestine, the vast majority of which is not covered by colonoscopy and gastroscopy. Before the test, the patient drinks a contrast solution and for the following 2-3 hours a radiologist follows the progression of the solution until it reaches the colon. The test could visualize inflammation typical to Crohn's disease as well as assisting in pinpointing the precise location and nature of the disease (such as a narrowing of the intestine or small intestine fistula resulting from the disease). This information is valuable for diagnosis, planning of treatment and assessing future risks posed by the inflammation. The examination has several disadvantages: it involves radiation, its degree of precision depends on the examiner's skills and it does not visualize the colon. The degree of precision of the test is lower than CTE and MRE (see below).
To complement the Passage test, this examination uses contrast solution inserted into the rectum to visualize the large bowel (colon). The test visualizes the colon well but with the expansion in usage of endoscopic technologies enabling a clearer view of the tissue as well as sampling biopsies when necessary, barium enemas are becoming a much less frequent choice.
Computed Tomography Enterography (CTE)
This test creates a 3-D image of body organs using X-ray technology. This technology has improved significantly in recent years to the point that its current resolution is of such high quality that the lining of the intestine can be visualized better than with a traditional radiography test (Passage). Thus, the entire small intestine can be visualized, facilitating more precise diagnosis and characterization of the disease. Furthermore, the test also provides a very good visualization of all the abdominal organs. This allows for diagnosing fistulas, abscesses, free fluids and other pathologies. The prominent disadvantage of this examination is the large amount of radiation entailed. However, with newer CT machines the amount of radiation is smaller.
Magnetic Resonance Enterography (MRE)
This unique type of MRI can visualize the intestine as well as a CTE test, with one significant advantage: no radiation. The examination is not invasive though it is less readily available. Recent studies point to an additional advantage: MRE usage has been shown to provide not only high quality imaging of the small intestine but also an indication of the disease's activity level at the time of the test, reducing the need for an endoscopic evaluation. This non-invasive evaluation of the degree of tissue inflammation is a true asset in Crohn's disease, when the clinical activity is not always compatible with the severity of intestinal inflammation. Results can help in the decision making process when changes in treatment are being contemplated. MRE can replace both Passage and CTE tests.
This test enables imaging of the small intestine, the vast majority of which cannot be visualized through regular gastroscopy or colonoscopy. Patients (10 years or older) are asked to swallow a small capsule that includes a tiny camera, which then transmits three images per second to an external machine which receives the data as the capsule travels through the intestine. With younger patients incapable of swallowing the capsule, it can be placed in the intestine via gastroscopy. When the test is completed, the progression of images can be viewed as a movie on a computer screen, such that inflamed areas suspected as inflicted by IBD can be identified. The test is more accurate than a Passage and the direct view of the intestine's tissue facilitates precise diagnosis of tissue pathologies. Relative to an MRE or a CTE, this exam has several disadvantages: it cannot "see" beyond the inner intestinal lining; the intestine must be prepared in advance for the exam (the precise preparation protocols, including diet restrictions and substances to be taken, differ across medical centers); a rather large capsule must be swallowed; and there is a risk that the capsule could become engaged in areas of the intestine that have become narrow as a complication of the chronic inflammation. In order to reduce this risk, a placebo soluble capsule can be taken prior to the test, and with the use of a detector or simple stomach X-ray the examiner can verify that the capsule has indeed made its way through the entire intestine successfully.
The capsule's diagnostic value is demonstrated in cases in which Crohn's is suspected in the small intestine yet colonoscopy and gastroscopy results are normal. The capsule has further been instrumental in recent years in diagnosing a growing number of cases of active Crohn's disease limited to the middle small intestine, a much less common form of the disease.
This veteran machine continuously undergoes technological upgrading and various "face lifts", constantly improving its resolution. Skilled hands can measure the thickness of the intestine (a finding which could point to an inflammation of the intestine's lining), identify stomach abscesses, free liquid in the stomach and other rare complications. Ultrasound evaluation is an excellent screening test when there are non-specific suspicions and for monitoring acute situations of known cases of Crohn's. The test is simple, inexpensive and does not involve radiation. Its disadvantage is its relatively low level of accuracy compared to the other imaging technologies mentioned, which is further dependent on the examiner's skills. Recently, more advanced methods applying ultrasound technology to IBD have been developed, such as using duplex technology (which measures the blood flow to the intestine, that intensifies during inflammation) and injection of contrast substances.
Additional Tests
Additional examinations, such as observing white blood cells marked with radioactive markers which tend to concentrate in inflamed areas, exist in the world but are not in routine use in Israel. Additional tests rarely add vital information to the results of the aforementioned baseline tests.
To Pediatric Gastro Institute