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A contemporary approach to a young female patient with Loeys-Dietz syndrome and an uncomplicated type B aortic dissection: a case report
Petko Prodanov ORCID: orcid.org/0000-0002-5293-71401,
Hana Linkova2,
Robert Petr2,
Richard Fojt1,
Zuzana Motovska2,
Jiri Knot2,
Filip Rohac2,
Boris Koznar2,
Mariwan Majid1,
Petr Widimsky2 &
Petr Kacer1
Aortic dissection is a relatively uncommon, but often catastrophic disease that requires early and accurate diagnosis. It often presents in patients with congenital connective tissue disorders. The current aortic surgical techniques are related with serious early and late complications. This case report emphasizes the importance of early diagnosis of aortic root dilatation and the risk of dissection, especially in patients with congenital connective tissue disorders. We present an alternative, contemporary and multidisciplinary approach based on the present state of knowledge.
We present a rare case of a young female patient with Loeys-Dietz syndrome who was admitted with an uncomplicated aortic dissection (Stanford type B / DeBakey type III) and a dilated aortic root. After a period of close surveillance and extensive vascular imaging, thoracic endovascular aortic repair was deemed to be technically not possible. Medical treatment was optimized and our patient successfully underwent a personalised external aortic root support procedure (PEARS) as a contemporary alternative to existing aortic root surgical techniques.
This case highlights the importance of interdisciplinary approach, close follow-up and multimodality imaging. The decision to intervene in a chronic type B aortic dissection is still challenging and should be made in experienced centers by an interdisciplinary team. However, if an acute complication occurs, thoracic endovascular aortic repair TEVAR is the method of choice. In all cases optimal medical treatment is important. There is increasing evidence that personalized external aortic root support procedure PEARS is effective in stabilizing the aortic root and preventing its dilatation and dissection not only in patients with Marfan syndrome, but also in other cases of aortic root dilation of other etiologies. Moreover, many publications have reported the additional benefit of reduction or even eradication of aortic regurgitation by improving coaptation of the aortic valve leaflets in dilated aortas.
Connective tissue disorders such as Marfan syndrome, Loeys–Dietz syndrome, Ehler–Danlos syndrome, inflammatory diseases of the aorta, Turner syndrome and bicuspid aortic valves are associated with medial degeneration and early onset of aortic dissection. Younger people are more commonly affected and pregnancy poses a risk of catastrophic complications. Total root replacement, also known as the Bentall operation, and valve sparing root replacement (VSRR) surgery are associated with long recovery periods and severe complications. There is increasing evidence that the personalized external aortic root support (PEARS) procedure is effective in stabilizing the aortic root and preventing its dilatation and dissection not only patients with Marfan syndrome, but also for other causes of aortic root dilation.
a Transesophageal echocardiography showing an intimal flap through the whole length of the descending aorta with a small mobile echogenic structure in the proximal part of the false lumen b Dilated aortic root and tricuspid aortic valve
a A CT angiography reconstruction showing the location of the proximal entry tear located just after the origin of the subclavian artery. The distal re-entry tear was located at the level of the visceral arteries. b Digital subtraction angiography confirming the type B aortic dissection
The custom-made external support is a pliable macroporous textile mesh designed to exactly match the patient's aortic root without disrupting the coronary arteries. The operation can be performed without the use of extracorporeal circulation and heparinization
CT AG before PEARS and at 14 months after PEARS procedure
According to the European Society for Cardiology guidelines of aortic disease from 2014 in the absence of organ malperfusion or signs of early progression of Type B aortic dissection patients can be safely stabilized under medical therapy used to control pain and blood pressure. Beta blockers should be administered to all patients with Marfan syndrome and aortic aneurysms unless contraindicated. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers are reasonable choices for reducing blood pressure to the lowest point patients can tolerate without adverse effects [1]. If an acute complication occurs thoracic endovascular aneurysm repair (TEVAR) is the method of choice. Nowadays surgery is rare in cases of complicated Type B aortic dissection and is related with a much higher risk of complications and in-hospital mortality rate of 25–50% [2]. When there is no proximal landing zone for TEVAR procedure, the "frozen elephant trunk" technique might be considered. The decision to intervene in a chronic type B aortic dissection is still challenging and should be made in experienced centers.
A 39-years-old female, mother of 3 children, with a history of intracerebral hemorrhage at the age of one and with a family history of sudden death in a second degree relative, presented in May 2018 at the emergency department of the University Hospital Královské Vinohrady in Prague after an episode of chest pain and shortness of breath that occurred during a funeral ceremony. At the time of admission, the physical examination revealed no abnormal findings, her blood pressure was 155/80 mmHg, her height was 185 cm and weight was 95 kg. She was on standard antidepressant therapy and flavonoids.
At the time of admission, the electrocardiogram was normal, D-dimers were elevated to 4170 μg/l and high-sensitive troponin T was negative. The CT computed tomography (CT) angiography revealed a dilated aortic root and a Stanford type B aortic dissection. The left vertebral artery originated atypically from the true lumen of aortic arch as a third branch just before the origin of left subclavian artery. The right vertebral artery was hypoplastic. The left renal and accessory renal artery flow originated from the false lumen and the dissection extended to the origin of the left common iliac artery. Transesophageal echocardiography showed an intimal flap extending through the whole length of the descending aorta with a small mobile echogenic structure in the proximal part of the false lumen. The aortic root was dilated to 51 × 54 mm and the aortic valve was tricuspid with an insignificant central regurgitation jet. The left ventricular function was normal, without regional wall motion abnormalities. Mild regurgitation of the mitral and tricuspid valves without signs of mitral valve prolapse was noted (Fig. 1a, b). Digital subtraction angiography was also performed and confirmed the type B aortic dissection. It also revealed that compression of the true lumen is not as significant as the CT angiography showed before. The proximal entry tear was located immediately distal to the origin of left subclavian artery and the distal re-entry was located at the level of the visceral arteries (Fig. 2a, b).
At the time of admission, the approach was conservative. Considering the stable clinical condition of the patient, with no recurrent pain, no signs of malperfusion or rupture, acute intervention was not indicated. Antihypertensive medication was administered and up-titrated until effective control of blood pressure was achieved. The CT angiography was repeated 15 days after admission. The results showed progression of the size of descending aorta from 35 mm to 40 mm with compression of the true lumen in the thoracoabdominal region, but with no clinical or laboratory correlation or symptoms. The hospitalization duration was 32 days and no complications occurred. The patient was discharged on a combination of antihypertensive drugs - carvedilol, perindopril, amlodipine and urapidil. After 3 months CT angiography was performed again. The results showed slight uncomplicated progression of the descending aorta to 44 mm, with no further progression of the aortic root size.
Genetic studies revealed autosomal dominant connective tissue disorder with heterozygous mutations c.605C > T in gene TGFBR1 which is associated with Loeys-Dietz syndrome. According to the current guidelines for aortic diseases from 2014 management should be tailored in reference to extensive vascular imaging at baseline and family history of vascular events [1].
Further therapeutic approach was considered by the Heart team in collaboration with angiologists and vascular surgeons. As a contemporary less invasive alternative to existing ascending aorta procedures, our patient underwent a personalized external aortic root support procedure (PEARS). The procedure was performed successfully without the use of cardiopulmonary bypass. After 8 days of hospitalization the patient was discharged (Fig. 3).
As for the aortic dissection, the Heart team in collaboration with angiologists and vascular surgeons recommended a conservative approach with close surveillance of the patient. Thoracic endovascular aortic repair or open surgery would only be considered if any complication occurred or if the size of descending aorta showed rapid further progression. The CT angiography performed 14 months after the first medical contact demonstrates excellent effect of the PEARS procedure with stability of the ascending aortic dimensions and morphology and does not show further progression of the size of the descending aorta (Fig. 4).
Meanwhile, all three children of our patient underwent a cardiologic examination. In all of them the ascending aorta was dilated and genetic studies confirmed gene mutation related with Loeys-Dietz syndrome. The oldest child underwent aortic root operation; the others are under close surveillance.
There is little data comparing TEVAR with optimal medical therapy in patients with uncomplicated Type B aortic dissection. The Investigation of Stent Grafts in Patients with Type B Aortic Dissection (INSTEAD) trial showed that TEVAR has no clinical benefit over medical therapy [3]. On the other hand an extended follow-up of this study (INSTEAD-XL) and observations from the IRAD registry show that aorta-related mortality and disease progression were significantly lower after 5 years in TEVAR patients compared with those receiving medical therapy only [4, 5].
The Acute Dissection Stent Grafting or Best Medical Treatment (ADSORB) results published in 2017 identified the number of vessels originating from the false lumen as an independent predictor of false lumen growth in uncomplicated type B aortic dissection. The study also described the clear benefit of stent graft placement on aortic remodeling and increased rates of false lumen thrombosis in the intervention group compared to optimal medical treatment [6].
In our case, regarding the location of proximal intimal tear of the AD, obliteration by implantation of a membrane-covered stent-graft seems to be technically impossible because of insufficient proximal zone of anchoring and risk of iatrogenic occlusion of the left subclavian or/and left vertebral artery. However, if an acute complication occurs, TEVAR is the treatment of choice [7]. Despite the surgical results improvement over past decades, they remain suboptimal, with in-hospital mortality ranging from 25 to 50% [2].
As an alternative procedure to the existing ascending aorta surgery practice, there is increasing evidence that PEARS is effective in stabilizing the aortic root and preventing its dilatation, secondary aortic regurgitation and aortic dissection in patients with connective tissue disorder [8]. However, there is further evidence that it is also applicable to aortic root aneurysms of other etiologies. It is the morphology of the aortic root aneurysm and the risk of dissection and rupture that are more important in the present state of knowledge, not the genotype [9]. The custom-made external support is a pliable textile macroporous mesh designed to exactly match the patient's aortic root. It is prefabricated by using 3-D printed plastic former based on a 3-D model of MRI or CT images, which provides the shape. In contrast with aortic wrapping, the microporous mesh of PEARS is intimately in contact with the aorta due to its personalized design and does not show any signs of tissue necrosis. Histological examination shows that the microporous mesh fully incorporates with collagen fibers and allows recovery of the microstructure of the media [10]. However the due to the nature of the PEARS it can only be performed as an elective procedure while wrapping can be undertaken in an emergency setting. The PEARS procedure can be performed without the use of extracorporeal circulation and heparinization. Coronary arteries stay intact and since the vessel and the valve remain native there is no need for the patient to take anticoagulant medication.
According to a project update, published by Golesworthy [11], as of March 2020, 317 patients have been treated with personalized external aortic root support surgery. The most common underlying condition of these patients was Marfan syndrome (n = 177). Other pathologies included bicuspid aortic valve (n = 24), Loeys-Dietz syndrome (n = 18), idiopathic aortic dilation (n = 19), transposition of the great arteries repaired by a switch operation (n = 3), aortic valve disease treated by the Ross procedure (n = 28), ACTA2 mutation (n = 3), tetralogy of Fallot (n = 1) and 38 cases not yet reported. The follow up of patients demonstrates stability of the aortic dimensions and morphology over a significant time period of 5 to 15 years, with perioperative mortality rate of 0.34%. At least four female Marfan patients after PEARS procedure subsequently had 5 uneventful pregnancies and deliveries without evidence of further aortic dilatation.
The decision to intervene in a chronic aortic dissection type B is still challenging and should be made only in experienced centers. However, if an acute complication occurs TEVAR is the method of choice [7].
As an alternative procedure to TEVAR, PEARS is safe and effective in stabilizing the aortic root and preventing its dilatation and dissection in carefully selected patients with connective tissue disorders [8]. The future results from prospective cohort studies comparing PEARS with total root replacement and aortic valve sparing root replacement will be important to understand if patients receiving PEARS have had an unnecessary intervention and with a higher risk of complications. However, according to the NHS Clinical Commissioning Policy the current inclusion criteria for PEARS as surgical management of enlarged aortic root in adults appears to be safe and effective as the results for valve related deaths and complication rates are low.
PEARS:
Personalised external aortic root support procedure
TEVAR:
Thoracic endovascular aortic repair
Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ. ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. the task force for the diagnosis and treatment of aortic diseases of the european society of cardiology (ESC). ESC committee for practice guidelines. Eur Heart J. 2014;35(41):2873–926.
Lansman SL, Hagl C, Fink D, Galla JD, Spielvogel D, Ergin MA, Griep RB. Acute type B aortic dissection: surgical therapy. Ann Thorac Surg. 2002;74:S1833–5 discussion S1857–S1863.
Nienaber CA, Rousseau H, Eggebrecht H, KischeS FR, Rehders TC, Kundt G, Scheinert D, Czerny M, Kleinfeldt T, Zipfel B, Labrousse L, Ince H. Randomized comparison of strategies for type B aortic dissection: the INvestigation of STEnt grafts in aortic dissection (INSTEAD) trial. Circulation. 2009;120:2519–28.
Nienaber CA, Kische S, Rousseau H, et al. Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv. 2013;6(4):407–16.
Fattori R, Montgomery D, Lovato L, Kische S, Di Eusanio M, Ince H, Eagle KA, Isselbacher EM, Nienaber CA. Survival after endovascular therapy in patients with type B aortic dissection: a report from the international registry of acute aortic dissection (IRAD). JACC Cardiovasc Interv. 2013;6:876–82.
Kamman AV, Brunkwall J, Verhoeven EL, et al. Predictors of aortic growth in uncomplicated type B aortic dissection from the acute dissection stent grafting or best medical treatment (ADSORB) database. ADSORB trialists. J Vasc Surg. 2017;65:964–71.e3.
Grabenweger M, Alfonso F, Bachet J, Bonser R, Czerny M, Eggebrecht H, Evangelista A, Fattori R, Jakob H, Lonn L, Nienaber CA, Rocchi G, Rousseau H, Thompson M, Weigang E, Erbel R. Thoracic endovascular aortic repair (TEVAR) for the treatment of aortic diseases: a position statement from the european association for cardio-thoracic surgery (EACTS) and the european society of cardiology (ESC), in collaboration with the european association of percutaneous cardiovascular interventions (EAPCI). Eur Heart J. 2012;33:1558–63.
Izgi C, Newsome S, Alpendurada F, Nyktari E, Boutsikou M, Pepper J, Treasure T, Mohiaddin R. External aortic root support to prevent aortic dilatation in patients with marfan syndrome. J Am Coll Cardiol. 2018;72(10):1095–105.
Treasure T. John Pepper personalised external aortic root support (PEARS) compared with alternatives for people with life-threatening genetically determined aneurysms of the aortic root. Diseases. 2015;3(1):2–14.
Pepper J, Goddard M, Mohiaddin R, Treasure T. Histology of a Marfan aorta 4.5 years after personalized external aortic root support. Eur J Cardiothorac Surg. 2015;48(3):502–5. https://doi.org/10.1093/ejcts/ezu415.
Golesworthy T. ExoVasc Personalised External Aortic Root Support (PEARS) Project Status - 6 April 2020. 2020. Retrieved from https://www.researchgate.net/publication/340629274_ExoVasc_Personalised_External_Aortic_Root_Support_PEARS_Project_Status_-6_April_2020.
The authors thank Adam Whitley for language corrections.
The author received no financial support for the publication of this case report.
Department of Cardiac surgery, Faculty Hospital Královské Vinohrady, Srobarova 50, 10034, Praha, Czech Republic
Petko Prodanov, Richard Fojt, Mariwan Majid & Petr Kacer
3rd Department of Internal Medicine – Cardiology, Faculty Hospital Královské Vinohrady, Srobarova 50, 10034, Praha, Czech Republic
Hana Linkova, Robert Petr, Zuzana Motovska, Jiri Knot, Filip Rohac, Boris Koznar & Petr Widimsky
Petko Prodanov
Hana Linkova
Robert Petr
Richard Fojt
Zuzana Motovska
Jiri Knot
Filip Rohac
Boris Koznar
Mariwan Majid
Petr Widimsky
Petr Kacer
The author (s) read and approved the final manuscript.
Correspondence to Petko Prodanov.
Written informed consent for publication of their clinical details and clinical images was obtained from the patient.
The authors declares that they have no competing interests.
Prodanov, P., Linkova, H., Petr, R. et al. A contemporary approach to a young female patient with Loeys-Dietz syndrome and an uncomplicated type B aortic dissection: a case report. J Cardiothorac Surg 15, 231 (2020). https://doi.org/10.1186/s13019-020-01274-0
Acute aortic syndrome
Connective tissue disorder

redpajama_set_name: RedPajamaCommonCrawl


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Displaying items by tag: What We Left Behind documentary
What We Left Behind officially set for BD in August, plus Brightburn pre-orders & more
We've got a couple interesting things for you this afternoon before we get to today's release news...
First up, reviews... I've posted my in-depth thoughts on Tim Burton's Batman (1989) in 4K Ultra HD here at The Bits and will have reviews of Batman Returns, Batman Forever, and Batman & Robin in 4K over the next few days. The upshot of this first Batman film in 4K is that Warner's new transfer and Atmos mix are terrific, but the HDR may take a little getting used to and a few of the sound effects have been changed for reasons explained in the review. You can read that here.
Also, Tim has posted a review of Archer: Danger Island – The Complete Season Nine on DVD from Fox and Dennis has looked at Isn't It Romantic on Blu-ray from Warner.
And some of you may know that this past weekend was the 40th anniversary of Ridley Scott's original Alien (1979). So our own Michael Coate has posted a new History, Legacy, and Showmanship retrospective column looking back at the film's theatrical release. It includes a great new roundtable of experts to discuss the film, including authors Chris Barsanti, Paul M. Sammon, and J.W. Rinzler (whose new book The Making of Alien is coming in July). You can read the piece here and if you're a fan of the film, I think you'll really enjoy it. [Read on here...]
Batman (1989) 4K review
Batman Forever 4K
Batman Returns 4K
Isn't It Romantic BD review
Archer: Danger Island DVD review
The Making of Alien
Chris Barsanti
Paul M Sammon
JW Rinzler
Still Screaming in Space: Remembering Alien on its 40th Anniversary
Turbo! A Power Rangers Movie
Heroes Shed No Tears
John Woo
Hello Frisco Hello
Mother Wore Tights
Pin Up Girl
Brightburn 4K
John Wick: Chapter 3 Parabellum 4K
Stand by Me 4K
Kubrick's The Shining coming to 4K, plus Criterion's August, and the new Forrest Gump BD is remastered
All right, we've got a couple things for you today...
First a couple of new Blu-ray reviews... Tim has looked at Cyril Frankel's The Witches, aka The Devil's Own (1966) on disc from Hammer Films by way of Scream Factory. Tim's also reviewed Eddie Adlum's Invasion of the Blood Farmers (1972) from Severin Films.
More reviews are on the way here too; I'm working on Hannibal 4K from Kino, Shout! and GKids' new Princess Mononoke: Collector's Edition, and more. So watch for those in the next few days.
The big announcement news today is that Warner Bros. Home Entertainment will release Stanley Kubrick's The Shining on 4K Ultra HD on 10/1. [Read on here...]
The Shining 4K
A Clockwork Orange 4K
Forrest Gump: 25th Anniversary Edition remastered
Criterion August 2019
Leon Vitali
The Witches BD review
Invasion of the Blood Farmers BD review
The Iron Man Trilogy 4K
The Inland Sea
The Flavor of Green Tea Over Rice
The Koker Trilogy
Where Is the Friend's House?
And Life Goes On
Through the Olive Trees
How to Stuff a Wild Bikini
Captain Marvel official, plus What We Left Behind documentary, Alita, Wong Kar-wai news, and more
All right, today's update is a bit of a catch-all, but I assure you that we've got a little something for everyone this afternoon...
First, I've posted my in-depth review of Ridley Scott's Black Hawk Down in 4K Ultra HD. It's available now from Sony and I have to say, I think it's one of the most significant picture and sound upgrades yet on this format, especially when you consider that the existing Blu-ray was an early title on the format and that the Extended Cut has only been released on DVD previously. The set even carries over most of the previous Deluxe Edition DVD extras. Best of all, it's only $20 on Amazon right now. Definitely check it out – it's a must have UHD title.
Now then, the big news today is that Disney and Marvel have just officially announced the Blu-ray, DVD, and 4K Ultra HD release of Anna Boden and Ryan Fleck's Captain Marvel. Look for the discs to be released on 6/11, just as we've been expecting for a while now, with the Digital release due on 5/28. You can see the official 4K artwork at left and also below. [Read on here...]
Captain Marvel 4K
Captain Marvel 3D
Alita: Battle Angel 4K
Black Hawk Down 4K review
Toy Story 4K
Toy Story 2 4K
Sacrifice of Angels
Bill McClelland Rest in Peace


Sisters win the roll off again!!!!
Sisters - Sisters Engage the reaver with Arco-Flagellants for the WINNNNN!!!!!!!
LOL. I think the RNG hates you. Thanks for the report!
Maybe roll real dice via skype and record the result instead of using that crap one in vassal? It's always been really weird.
Thanks for reading. Dice in real life can be crazy too. Vassal is just a super easier option.


So here we are the final part of our journey to Bulgarian Ski resorts and the last resort that we want to point out in Bulgaria is … Bansko! Bansko is perfect place to go if you are true ski lover. You can find a lot offers from touring sites for Bansko holiday. If you are already schedule your winter holiday to some other winter resort, well next year is still an option, or go on January or February.
The main advantage of Bansko ski resort is the Hotels. Pamporovo is great for the beginners and kids school for ski. Borovets is very compact and you will find out that everything is very close. The SPA is cheap too. Bansko is the major here, he is the boss! This resort is for advanced ski and snowboard lovers, if you are beginner Pamporovo is best place for you to be. But Bansko have Junior Ski club, it is only for kids and they will be looked after for all day and will learn to skiing with great quality ski teachers.
There are a lot of SPA hotels with a lot of outside pools where you can swim in hot water and not worrying getting too cold. There are many, many restaurants and bars there if you are no with the kids, but we will make another reviews for the nightlife of Bansko.
If you have time, you can go in the old town and shop the amazing traditional things and eat some great local specialties made with love.
Another thing we want to point out. There are a lot of hotels with children playroom, where you can leave your children to play all day… (The child age have to be from 3 to 6-7 years old) And you can stay with your soul mate in life for a romantic 2-3 hour dinner… How cool is that?


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The Coma (Limited Edition)
The Coma by Alex Garland is a gripping mystery and stylistic tour de force from the internationally known author of The Beach.
From the internationally-known author of The Beach, a gripping mystery and stylistic tour de force that delves into the subconscious mind, with brilliantly disturbing results.
A young man is brutally assaulted late at night in an Underground train by a gang of thugs. Beaten unconscious, he lies for days in a hospital bed – but appears to make a full recovery. On discharge from hospital, Carl picks up the threads of his daily life, visiting friends, seeing his girlfriend – until he starts to notice strange leaps in his perception of time, distortions in his experience. Is he truly reacting with the outside world, or might he be terribly mistaken? So begins a dark psychological drama that raises profound questions about the boundary between the real and the imagined.
This mysterious and unsettling tale is illustrated by forty woodcuts created by the author's father, the political cartoonist Nicholas Garland.
AlexGarland
Alex Garland is the author of the bestselling novels The Beach ,The Tesseract, and The Coma, which was created with images by his father Nicholas Garland. He is the co-author of the videogame, Enslaved. He has written the screenplays for 28 Days Later, Sunshine and adapted Kuzuo Ishiguro's Never Let MeGo for the screen.
More books by Alex Garland
Following on from the success of his thriller, Ex Machina, Alex Garland returns to cerebral sci-fi with his adaptation of Jeff VanderMeer's cult…
Annihilation (Screenplay)
The screenplay of Alex Garland's adaptaion of Never Let Me Go with an exclusive introduction from Kazuo Ishiguro.
Never Let Me Go (Screenplay)
The first part of the hugely anticipated 'Tokyo Trilogy' crime series by David Peace, author of the bestseller Damned Utd and…
Tokyo Year Zero (Limited Edition)
David Peace
Long Time, No See is Dermot Healy's long-awaited new novel, from one of the greatest of contemporary Irish novelists in a…
Long Time, No See (Limited Edition)
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The stories of Stanley Donwood collected for the first time in this beautiful limited edition
Humor (Limited Edition)
Stanley Donwood
Faber presents Edna O'Brien's masterly novel, Girl, as a beautifully-crafted exclusive limited edition, hand-bound and signed by the author.
Girl (Limited Edition)
Edna O'Brien


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Environment, NGO & Charities, SDG Series
Baboon Sanctuary: Women in Conservation and Gender Equality in Belize
by Jessie M. Young - Founder & President of the Community Baboon Sanctuary
It all started in the tiny village of Bermudian Landing, Belize District when a group of women decided to step out of their shells to face the challenges that were affecting their families, communities, and society. Women whose parents could not afford secondary education back in the 50's, were the most vulnerable with few opportunities. A choice had to be made whether to stay home forever, or marry early to a man who was supposed to take care of all their needs. As a result, rural women referred to as 'village gals' were known to make great wives, excellent housewives/maids, cooks, or stay-at-home moms, and often left to raise their children alone as the dads were gone most of the day, coming home exhausted after a hard day's work at the farm.
The good side of this lifestyle was that we used to eat healthy with all organically grown food. Although many could not afford the city lights and all the camouflage foods on the shelves, we were never hungry. As the years went by and farms were being damaged by hurricanes winds and floods, the residents started to migrate to the urban areas looking for work. Parents increasingly saw the need to educate their children so they could have a better life. Males were more privileged than females when it came to permission to migrate, or to go to high school in the city. Back then some parents refused higher education to girls in fear of them becoming too civilized and getting pregnant. They didn't want to waste their money.
When religious institutions started to build schools in the communities back in the 50's, women started going into teaching, which at the time did not require a secondary education if you had completed 8 years of primary school/grade school and were a member of the church. The principal would train them as helpers and eventually they were allowed to sit exams to move on to a teaching career.
Photo Credit: Community Baboon Sanctuary
Though it was not until the 60's that women increasingly began to get exposed to work, the majority of females in the Belize River Valley are teachers. Nevertheless, the teachers and other women who were now working outside their home still suffered from physical, mental and psychological abuse. Birth control was and remains seen as a sin by the church, and frequently households have up to 14 children or more. We work long hours and must come home to do the chores such as making dinner, assisting kids with homework, getting them ready for bed, then getting everything ready for the next day while many of the husbands are out socializing with friends. If they come home drunk, they expect the food to be ready waiting for them.
These chores are still seen as women's responsibility by majority of men in our communities. Boys are raised not to do it for fear of being too feminine. Yet when the girls are doing the boys' chores, they are not seen as too masculine, thus the gender discrimination continues. Migration into the urban areas came with its own problems as drugs and alcohol use became more prevalent. Life didn't get better: poverty became more prominent as income was spent on alcohol and entertainment. Notably, women and children suffered the most.
When Dr. Robert Horwich, a primatologist from Gays Mills, Wisconsin, visited Belize and the community of Bermudian Landing to conduct research on the black howler monkeys in 1981, I knew this was going to be a way for me to inspire other women. Working with him for four years answered many questions I had about the forest and wildlife.
On February 1985 the Community Baboon Sanctuary (CBS) was established to protect habitats of the black howler monkeys locally called 'baboons'. The need for the Sanctuary arose when it became clear that that these species were under tremendous pressure due to extensive habitat loss throughout its limited geographic range of Belize, Mexico and Guatemala. As a result, they were considered endangered.
Dr. Robert Horwich, while studying the monkeys in Mexico, saw a film called Amate the Great Fig Tree by Richard and Carol Foster, filmed in Bermudian Landing community in Belize in which the monkeys lived in peaceful co-existence with the villagers. Intrigued about this co-existence, Dr. Horwich visited Bermudian Landing in 1981 where he met Fallet Young (now deceased), and his future wife Jessie Young. Fallet was the Chairman of the Village council – the highest authority in the community. Together they conducted research on the monkeys from 1981 up to 1984 which ultimately culminated with the formal establishment of the Community Baboon Sanctuary in February 1985.
The Community Baboon Sanctuary, a model grassroots initiative was the first of its kind in the world: private landowners were asked to sign voluntarily pledge to protect monkeys' habitats.
The CBS has stood for 28 years as an example of community-based conservation and helped define a whole new category of protected area both in Belize and globally. Given its historical importance, CBS has received much local, national and international attention.
More importantly, the CBS has had a catalytic effect on rural communities in Belize, Belizean NGOs and the Government of Belize. This catalytic impact led to a wave of community-based conservation and ecotourism projects across Belize and spawned the development of co-management agreements around Belize.
Today, CBS still remains an important conservation presence in Belize, those associated with it have amassed up to 28 years of experience in working through the complicated dynamics involved in managing such a complex ecological and socioeconomic landscape. Thus, the Community Baboon Sanctuary Women's Conservation Group (CBSWCG) and the CBS both play an important part in the conservation and sustainable development community in Belize and have earned a strong voice in the national conservation discussion.
During this time, the main economic activities in the village included small-scale slash and burn agriculture, timber extraction (logging), mining, hunting and poaching (game species) and fishing. Harvesting non-timber forest products and livestock rearing was also practiced, which increased the need for clearing forest to be used for pasture and clear-cutting Riparian forest for easy river access for drinking water. Women and men from the area would commute daily to Belize City to find work in the textiles and merchant businesses. Tourism was non-existent.
The establishment of CBS spurred a new vision for landowners who were asked to sign a model voluntary pledge and leave strips of forest between property boundaries when clearing for milpa slash and burn plantations.
Members were asked to avoid cutting the trees the monkeys ate from, clearing the river to protect against erosion and washing away nutrients from the soil and farms resulting in poor crop yields. The question was, what was in it for me? At the inception of the CBS, the benefits were conservation education and awareness and reliance on the conservation practices mainly to farmers and ranchers. Very little income was derived from tourism.
After about 2 years, tourism started increasing and more people were able to benefit economically from conducting monkey tours on their properties.
Several years later, in 1997, challenges such as finance, management, and other internal issues started to emerge and eventually resulted in the closure of the Sanctuary office for a little less than a year. For me, having been on the back burner for years, it was time to take charge as I could not let such a great initiative where human and wildlife co-existed be lost forever.
In 1998, I immediately moved into action, inviting active women leaders from the eight communities who I thought had leadership qualities, to attend a meeting with the possibility of forming a women's group. It later became the Community Baboon Sanctuary Women's Conservation Group (CBSWCG), made up of a female representative from each of the eight communities involved.
In August 1998, our group was legally registered as a not-for-profit Community-Based Organization and later became an NGO in 2006. Our first financial donation came from the owners of the then Jungle Drift Lodge who paid the legal fees for the registration of the group.
Following the registration, we then petitioned the members/landowners of the CBS to give us permission to take over the management of the Sanctuary. We received full support from the members. Nineteen years later, the CBSWCG is still at the management helm.
We have expanded the Sanctuary membership from 70 to 240 and are able to maintain a healthy population of howler monkeys that have grown from 800 in 1985 to over 4,000 in 2003 (last recorded census). The CBSWCG operates within the Belize River Valley which is at the heart of the Kriol culture, and manages the Community Baboon Sanctuary, a private voluntary protected area.
As local members of the CBSWCG, we know how it feels not to be empowered, not to be able to be self-sufficient or independent. We know what it's like not being able to go to high school, to be marginalized and abused. Yet, we are excellent managers of our homes, our farms, doing our job in silence while the men get recognition. For this reason, members of the CBSWCG are more inspired to take charge in improving livelihoods and to empowering women.
The Community Baboon Sanctuary Women's Conservation Group has five main Goals with alternative livelihood opportunity becoming a major focus. We are aware that without provision of alternative livelihood sources to forest users, all conservation work is meaningless. There will be no clean water, no food security, increases in diseases, and poverty.
As a result, CBSWCG has embarked on projects that stay-at-home women and our members could engage in to increase their household income while providing food for their families. Some of the projects include livestock farming, backyard organic vegetable farming backyard fish farming, agroforestry, training in capacity building and advocacy, as well as micro- finances for existing or new businesses. We have also provided four secondary tuition scholarships each year for deserving students.
These projects provide families with an alternative source of income, capacity building and skills that, when put to practice, reduce reliance on the forests, while simultaneously securing the habitat of the black howler monkeys, benefiting the wildlife.
Yet all was not as good as it seemed. In 2013, questions came from the project recipients since they were producing in excess of family consumption. The questions were then asked: What are we going to do with all these products and produces? The market in Belize City was overflowing and distance and transportation became issues for farmers and entrepreneurs.
The CBSWCG then decided to hold community-wide consultations. The idea of Eco-tourism and Commerce Expo were identified and implemented in February 2014, to market the products of the beneficiaries of the CBS alternative livelihood programs to Belizeans to be followed by weekly market days.
The CBS operates on a budget of $50,000.00 per annum that is collected from tours and other services provided to visitors, as well as small donations from friends. We have four full-time members of staff are and three freelance tour guides. The CBSWCG membership and the Advisory board are both volunteer-based. Thus, we rely on donor funding to implement projects and programmes.
The exposure that the CBSWCG received through the Equator Initiative prize in 2017 will hopefully increase our reach to the world that will lead to a better-equipped office with adequate human resources in the near future. However, we will continue to impact lives with the little we have, that is what matters most to us. If people are happy, wildlife will increase, the forest will regenerate on its own and the effects of climate conditions will lessen.
As women, we need all the support we can get to make our effort successful and sustainable. More women are now becoming involved in conservation, New women's group are emerging in other communities with a similar vision as the CBSWCG. We believe that women are agents of change and must not be underestimated.
The CBSWCG has proven that if given equal opportunities our impacts will be seen and felt worldwide in our households, our environment, our children, our schools, our workplace, on the street corners, in the areas once branded forbidden because of poverty, rape, crimes, gangs and drugs.
We have been implementing most of the SDGs, without realizing it: We promote gender equality, poverty reduction, life on land, and life under water, we form partnerships and social networks, we call for decent work for economic development, we fight climate change. Together with our community, with local and global support, we can make the changes to achieve sustainable communities, "it's no one but ourselves".
EDITOR'S NOTE: THE OPINIONS EXPRESSED HERE BY IMPAKTER.COM COLUMNISTS ARE THEIR OWN, NOT THOSE OF IMPAKTER.COM.
Belize, Climate Change, Conservation, Education, Environment, Gender equality, Habitat, Jessie Young, nature, SDGs, Sustainability, sustainable development goals, women
About the Author / Jessie M. Young
I am the 7th of 13 children. My love for nature started at age 9, my comfort zone being under the forest canopy with every living thing around. I am a project coordinator with the Belize Red Cross; Member of the Gender-Based Violence committee; Founder and President of the Community Baboon Sanctuary and Women's Conservation Group; Founder and Manager of the Harmony Pre-School; Domestic Violence Counsellor; Treasurer Board of Management Belize Rural High School; Street Mediation/Conflict Management Facilitator; Justice of the Peace, meritorious Award for community service; Woman of the year award for community development services and recent recipient of the Equator Prize.
Equal Rights, Impact, Society
Is Gender Equality a Numbers Game?
When I was younger, my mother would not allow my siblings and me to sit at the


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The 2014 European Parliament election was held in the European Union, from 22 to 25 May 2014.

It was the 8th parliamentary election since the first direct elections in 1979, and the first in which the European political parties fielded candidates for President of the Commission. The candidates, sometimes referred to by the German term Spitzenkandidaten (English: top candidates), were Jean-Claude Juncker for the European People's Party, Martin Schulz for the Party of European Socialists, Guy Verhofstadt for the Alliance of Liberals and Democrats for Europe Party, Ska Keller and José Bové jointly for the European Green Party and Alexis Tsipras for the Party of the European Left. The Alliance of European Conservatives and Reformists and the European Alliance for Freedom declined to nominate candidates.

While the European People's Party lost ground to the Progressive Alliance of Socialists and Democrats, it remained the largest faction in the new parliament, resulting in the EPP's nomination of Jean-Claude Juncker as Commission President at the European Council. In turn, the European Council accepted the nomination by a simple majority (only David Cameron and Viktor Orban voted against Juncker).

Background
The Council of the European Union decided to hold the 2014 elections in late May instead of early June as had been the case with previous EP elections. The elections were brought forward to provide more time for the election of a president of the European Commission, and because they would otherwise have coincided with the Pentecost weekend which falls during school holidays in many member states.

The ongoing Eurozone crisis, an offshoot of the Great Recession, started several months after the last Parliament election in June 2009. Although it affected most EU member states, the hardest-hit economies were those of southern Europe: Greece, Cyprus, Italy, Spain, and Portugal, along with Ireland. Among other reasons, harsh austerity measures significantly affected the public approval of EU leadership. The percentage of Greeks approving the EU leadership decreased from 32% in 2010 to 19% in 2013, while in Spain, the approval dwindled more than a half from 59% in 2008 to 27% in 2013. Overall, only four of the 27 members countries approved the EU leadership. Peter S. Goodman suggests that "distrust about the treaties and conventions that hold together modern Europe appear at an all-time high." "Europe's establishment parties are widely expected to suffer their worst performance" since 1979, with the three mainstream parties (EPP, PES, ALDE) expected to collectively gain 63% of the vote, a 10% loss since 2009.

The Economist estimated in January 2014 that "anti-EU populists of the left and right could take between 16% and 25% of the parliament's seats, up from 12% today." Euromoney predicted "anti-EU populists and nationalists" winning around 150 seats in the parliament, almost 20% of the total. A Policy Network article from February 2014 suggested that despite the media focus on anti-EU parties, they "will undoubtedly remain modest compared to" other mainstream parties, but "their growth and their intentions to cooperate, signify important changes for the EU and European politics." In several countries, far-right and right-wing populist parties were expected to be in contention to poll the most votes in this election, including parties in Austria (Freedom Party), Denmark (People's Party), France (National Front), the Netherlands (Party for Freedom), and the UK (UKIP). In Greece, the left-wing Coalition of the Radical Left (SYRIZA) consistently led the polling in the leadup to the election. In Italy the populist and anti-establishment Five Star Movement, according to the polls, was expected to be the second most popular party after the Democratic Party, with about 25% of votes.

In January 2014, José Manuel Barroso, President of the European Commission, said, "We are seeing, in fact, a rise of extremism from the extreme right and from the extreme left" and suggested that the election might become "a festival of unfounded reproaches against Europe."

Presidential candidates
The Lisbon Treaty, which entered into force on 1 December 2009, provides that the European Parliament shall endorse or veto the appointment of the president of the European Commission on the basis of a proposal made by the European Council, taking into account the European elections (article 17, paragraph 7 of the Treaty on European Union). This provision applied for the first time for the 2014 elections.

Nevertheless, senior figures such as European Council president Herman Van Rompuy, German Chancellor Angela Merkel, and former Commission president Jacques Delors questioned the aspiration of European political parties to link the presidency of the European Commission with the result of the European elections and insisted that the future Commission president has to suit Member States' expectations first.

Based on these new provisions, the following European political parties designated candidates for Commission president ahead of the 2014 election: the Party of European Socialists (PES), the European People's Party (EPP), the Alliance of Liberals and Democrats for Europe Party (ALDE party), the European Green Party (EGP), the Party of European Left (EL) and the European Democratic Party.

European People's Party
On 6 and 7 March 2014, the congress of the European People's Party in Dublin elected Jean-Claude Juncker as its presidential candidate, who run against Michel Barnier, and adopted an election manifesto. Juncker set out the priorities he would have as president:
Create growth and jobs
Reform and reorganise the European energy policy into a new energy union
Negotiate a reasonable and balanced trade agreement with the United States
Continue with the reform of the Economic and Monetary Union, with the European social dimension in mind
Re-balance the relationship between elected politicians and the European Central Bank in the daily management of the Eurozone
Re-balance the way in which we grant conditional stability support to Eurozone countries in financial difficulties
Strengthen the external projection of our monetary union
give an answer to the British question
Juncker also set out five priorities on the subject of immigration:
Implement the Common European Asylum System
Step up the practical assistance provided by the European Asylum Support Office
Step up cooperation with third countries, particularly North African countries
More political determination when it comes to legal migration
Secure Europe's borders

Finally he set out three foreign policy objectives:
Making the High Representative act like a true European Minister of Foreign Affairs
Permanent structured cooperation in defence matters
A pause for enlargement

Party of European Socialists
The Common Candidate process of the Party of European Socialists was carried out according to the following timetable:
 1–31 October 2013: nominations.
 6 November 2013: PES Presidency meeting to check the candidacies and publish the official list of candidates.
 1 December 2013 – 31 January 2014: internal selection process within each member Party or organisation.
 February 2014: PES Election Congress to ratify the votes on the candidate, adopt the Manifesto, and launch the PES European election campaign.

Following the defeat of the Party of European Socialists during the European elections of June 2009, the PES made the decision that PES would designate its candidate for Commission president in December 2009, which rapidly triggered debates about how to select this candidate. The PES Congress gathering in Brussels in November 2011 made the decision that it would select the PES candidate through internal primaries in each of its member parties and organisations. Member parties and organisations are free to determine their own voting process, including by opening it to non-members.
 Possible candidates: José Luis Zapatero, Margot Wallström, Helle Thorning Schmidt, Frans Timmermans, Borut Pahor, Sergei Stanishev, Wouter Bos, José Sócrates, Werner Faymann, Pascal Lamy.
 Declared candidate: Martin Schulz
 Elected candidate: Martin Schulz

Alliance of Liberals and Democrats for Europe Party
The timetable of the Alliance for Liberals and Democrats for Europe Party (ALDE) for designating its candidate for President of the European Commission is:
 28–30 November: Nominations opens & Election Manifesto adopted at London Congress
 19 December: Pre-Summit liberal leaders meeting to discuss nominations received
 20 December: Nominations formally close
 1 February: ALDE Party Candidate to be announced at special Electoral Congress, Brussels

In 2012, the Alliance of Liberals and Democrats for Europe Party (ALDE) members were said to be "struggling" to find a candidate for Commission president ahead of the 2014 European elections. Guy Verhofstadt was considered to be the likely nominee, but a meeting of the then-ELDR party held in Dublin from 8 to 10 November 2012 did not agree to formally nominate him yet; concerns voiced included the fact that it was considered unlikely that Verhofstadt would have a chance of getting elected as President of the European Commission, as Anders Fogh Rasmussen (the incumbent Secretary General of NATO) was expected to be appointed to the post of President of the European Council or High Representative of the Union for Foreign Affairs and Security Policy after the 2014 election, and two liberal politicians in the EU's top ranks were not expected to be considered acceptable. While a compromise position was reached (to nominate a candidate for Commission President "in time for the 2014 European Parliamentary election campaign"), the corresponding resolution was not passed due to disagreements on other points included in the resolution. The ALDE political party finally decided to discuss candidates at the party's pre-summit meeting at the margins of the 19–20 December European Council. Belgian daily De Standaard and EU news website EurActiv reported during the summit that the ALDE party has appointed Mark Rutte and Christian Lindner as 'mediators' between Rehn and Verhofstadt to work out who would be the candidate.
 Possible candidates: Anders Fogh Rasmussen, Guy Verhofstadt, Olli Rehn
 Declared candidates: Guy Verhofstadt, Olli Rehn
 Elected Candidate: Guy Verhofstadt

European Green Party
In July 2013 European Green Party (EGP) announced that it would run an open primary online. Open to all inhabitants in the union over the age of 16 who "support green values", this resulted in Ska Keller and José Bové being elected candidates. Other qualified candidates were Rebecca Harms and Monica Frassoni.

Party of the European Left
Meeting on 19 October 2013 in Madrid, the Council of chairpersons of the Party of the European Left (EL) decided to designate a common candidate for the president of the European Commission to prevent "the forces responsible for the crisis" from keeping the monopoly during the electoral campaign. The Council reaffirmed however that this new measure "will not hide, as European leaders and the troika hope, their authoritarianism".

The Council decided to submit to the decision of the next Congress, 13 to 15 December in Madrid, the candidacy of Alexis Tsipras, who "would be the voice of resistance and hope against the ultra-liberal policies and facing the threat of the extreme right". As Alexis Tsipras will therefore be the only candidate for the job, the Council has mandated the Presidency of the EL to consult all members and observers parties of the EL and the GUE/NGL group in the European parliament about this application. Tsipras's candidature was confirmed on 15 December. Alexis Tsipras was elected.

European Democratic Party
On 2 December 2013 in Rome, the Council of the European Democratic Party decided to designate a candidate on the occasion of the next meeting in February 2014, along with its manifesto. The next president of the Commission will have to "settle a more political Commission". Allied with the Liberals in the ALDE Group but opposed to Olli Rehn, the European Democratic Party welcomed the candidature of Guy Verhofstadt, ALDE Group leader. The party adopted its manifesto on 28 February and named Guy Verhofstadt as its candidate for the Presidency of the European Commission on 12 March. Guy Verhofstadt was elected.

Alliance of European Conservatives and Reformists
The Alliance of European Conservatives and Reformists did not present a candidate for the European Commission presidency. They argued that participating in the process would legitimate a federalist vision of a European super-state and that the lack of a European demos makes the process illegitimate.

European Free Alliance
The European Free Alliance stands for "a Europe of Free Peoples based on the principle of subsidiarity, which believe in solidarity with each other and the peoples of the world."
It consists of various national-level political parties in Europe advocating either full political independence (statehood), or some form of devolution or self-governance for their country or region. The alliance has generally limited its membership to progressive parties, and therefore, not all European regionalist parties are members of EFA.
The EFA stands on the left of the political spectrum, and in the Brussels declaration it emphasises the protection of human rights, sustainable development and social justice. In 2007 the EFA congress in Bilbao added several progressive principles to the declaration: including a commitment to fight against racism, antisemitism, discrimination, xenophobia and islamophobia and a commitment to get full citizenship for migrants, including voting rights.

European Christian Political Movement
The European Christian Political Movement, abbreviated to ECPM, is a political party at European level that unites national parties from across Europe that share Christian democratic politics. The member parties are generally more socially conservative and Eurosceptic than the European People's Party, not only at this election allied with the AECR, without any candidate as well.

European Pirate Party
The newly founded European Pirate Party elected MEP Amelia Andersdotter (who is running for re-election) and The Pirate Bay co-founder Peter Sunde (running for election in Finland) as its candidates for the European Commission presidency. The European Pirate Party is not recognised as a European political party.

Televised debates
The lead candidates designated for nomination to the European Commission presidency participated in various debates, conducted in different countries and variously, in French, German and English. A total of ten debates were held through April and May in the lead up to the election period. Five debates were designed as head-to-head debates between the representatives of the two leading European political parties: Jean-Claude Juncker of the European People's Party and Martin Schulz of the Party of European Socialists. Four others were open to all nominated lead candidates, while one French-language debate was held between José Bové of the European Green Party and Guy Verhofstadt of the Alliance of Liberals and Democrats for Europe Party.

Opinion polls
No pan-European opinion polls are carried out; however, several institutes compiled predictions of the outcome of the elections based on national polls.

Some of the institutes below, such as Pollwatch, applied algorithms to the national poll results before aggregating them, in an attempt to account for the lower than expected results received by governing parties in previous European Parliament elections. However, other institutions did not share the expectation that governing parties would automatically perform worse than the polls suggest.

Note: Percentages indicate proportion of predicted seats and not vote share.

Apportionment of seats

Decisions on the apportionment of seats in the Parliament are governed by article 14 of the Treaty of Lisbon. This article lays down that "The European Parliament shall be composed of representatives of the Union's citizens. They shall not exceed seven hundred and fifty in number, plus the President. Representation of citizens shall be degressively proportional, with a minimum threshold of six members per Member State. No Member State shall be allocated more than ninety-six seats."

It had been the stated desire of the member-state governments to ratify the Treaty of Lisbon before the 2009 election, so that its articles governing the European Parliament could be in force for that election. However, this was blocked by the Irish rejection of the treaty in a referendum. Therefore, in June 2009, the European Parliament was elected under the rules of the Treaty of Nice, which provided for 736 seats, instead of the 751 to be provided in the Treaty of Lisbon.

The Lisbon Treaty was subsequently ratified, and provisional measures were ratified in December 2011 to give the 18 additional seats, to the countries entitled to them, before the 2014 elections, without withdrawing Germany's 3 extra seats. These 18 additional MEPs brought the number of MEPs to 754 temporarily until 2014. These 18 "phantom MEPs" would initially have observer status, before becoming full members of the parliament if an additional protocol is ratified by 2014.

Thus the 2014 election will be the first to apply the apportionment of seats provided by the Lisbon treaty.

Andrew Duff MEP (ALDE, UK) tabled two reports in March 2011 and September 2012 proposing new apportionments of seats (see table opposite). Article 14 provides that "The European Council shall adopt by unanimity, on the initiative of the European Parliament and with its consent, a decision establishing the composition of the European Parliament", respecting the principle of degressive proportionality, the threshold of 6 MEPs for smaller member states and the limit of 96 MEPs for larger member states.

Election dates

Results
The centre-right European People's Party won the most seats, but came up well short of a majority.  In Denmark, France, and United Kingdom rightist groups opposed to the European Union won "unprecedented" victories according to some news organisations such as Reuters.  Elsewhere, populist parties won significant seats.  In total, roughly a quarter of all seats went to parties sceptical of the EU or protest parties.  Thus, the election was seen as anti-establishment. In the wake of the election, several prominent political figures said the EU needed to realign its priorities in a hurry. Dutch Prime Minister Mark Rutte called for "fewer rules and less fuss", while British Prime Minister David Cameron said "Europe should concentrate on what matters, on growth and jobs, and not try to do so much."

Group reshuffling
Between the election and the inaugural session of the 8th European Parliament, scheduled for 1 July, some parties and individual MEPs usually switch allegiances between the political groups of the European Parliament. This process, which sometimes has resulted in the disappearance of whole political groups from the Parliament, or their recomposition in another form, is particularly important for new parties and MEPs.

Announced membership changes

The following table describes the announced membership changes in the Parliament groupings and the impact on the Parliament makeup:

A group is required to be made up by at least 25 MEPs from seven Member States to be constituted in the new legislature.

A proposed European Alliance for Freedom (EAF) group, said to be composed of the French FN, Dutch PVV, Austrian FPÖ, Belgian VB and Italian LN, was unable to reach the threshold. About a year later, on 16 June 2015, the same parties formed the Europe of Nations and Freedom group together with two MEPs from KNP and a former UKIP MEP.

Make-up following election

Based on the new groupingon the ENF, the Parliament makeup following the election were as follows:

Voter turnout
The final turnout figure for the 2014 European Parliament elections reached an all-time low at 42.54%, and thus marked a continued downward turnout since the first direct election. The result was also lower than the number communicated immediately after the elections. During the election night exit polls suggested a turnout of 43.1% based on preliminary figures. This was then revised down to 43.09% a few days later. There was a small increase in absolute voter numbers, with 163,551,013 valid votes cast in 2014 as compared to 160,687,462 in 2009, though this was outweighed by the increase in eligible voters from 386,711,169 in 2009 to 396,104,240 in 2014.

New European Commission

The leaders of the parliament's seven groups met on Tuesday 27 May to discuss who should become the new president of the European Commission. Citing the Lisbon Treaty's requirement for the result of the elections to be "taken into account", five of the seven groups issued a statement saying that Juncker should be nominated by the European Council to be president. Only the ECR and EFD disagreed. However, when the European Council met that evening, they said that nominations should only be made "after having held the appropriate consultations". They authorised van Rompuy, President of the Council, to consult with the new group leaders in the European Parliament and to report back to their summit on 26 June. The leaders of the UK, Hungary and Sweden were said to have opposed Juncker although the Swedish government then declared that Sweden never had such opposition. Leaders of the European People's Party publicly acknowledged that Juncker may not end up heading the executive European Commission. Friday, 27 June, the European Council eventually proposed to the European Parliament the candidacy of Jean-Claude Juncker to the presidency of the European Commission. The United Kingdom and Hungary opposed Juncker's nomination, while the remaining Council members supported his candidacy. The European Parliament confirmed Juncker's nomination on a vote of 422 in favour to 250 opposed, 47 abstentions and 10 invalid votes. Most EPP, Socialist and Liberal MEPs supported Juncker's nomination.

The appointment of top EU jobs in the new government was expected to be contentious.  Leaders of EU member states agreed to seek a package deal that would give significant posts to the new political parties in an effort to win back public support for the European Parliament. According to German Chancellor Angela Merkel, the new government will focus on making EU economies more competitive in the global economy, seek common energy and environmental policies, and seek a united foreign policy.

The main political groups, including the EPP and the S&D, in the European Parliament on 12 June backed the right of Jean-Claude Juncker to be the next head of the European Commission, after talks with the President of the European Council Herman Van Rompuy.

Juncker has stated that his priorities would be the creation of a digital single market, the development of an EU energy union, the negotiation of the Transatlantic trade agreement, the continued reform of the economic and monetary union, with the social dimension in mind and a 'targeted fiscal capacity' for the Euro area, as well as to negotiate a new deal with Britain, which ultimately failed to be accepted in the Brexit vote.

References

Further reading

External links

 Eurovision debate
 Image-movie of the EU-campaign "Act. React. Impact." (YouTube)

2014 elections in Europe
May 2014 events in Europe

redpajama_set_name: RedPajamaWikipedia


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Michael Cohen: Donald Trump's Fixer
Michael Cohen is big trouble after business dealings are made publice. Image by Iowa Politics.com | Image via Flickr
Michael Cohen went well beyond his depth of knowledge for new customers.
by Jason Boughton
May 11, 2018 at 1:29 AM May 11, 2018 at 1:29 AM
Michael Cohen was the personal attorney for Donald Trump. He was known as the 'fixer.' He was not offered a position with the Trump administration but he still used his influence and the fact that he knew Donald Trump, to make money.
He sold his services to different companies after Trump was elected. A Korean defense contractor, AT&T, and Novartis were some of his new clients. He used a company called Essential Consultants, LLC. He set it up a month before the election. It was around about the same time that Stormy Daniels was paid $130,000.
Michael Cohen's company
The Essential Consultants, LLC was the company that paid Stormy Daniels. He continued the company after the payout to Daniels. He actually recruited companies such as AT&T because they were going to need help understanding Trump's motives.
AT&T was going through a merger with Time-Warner. They would have to go through an antitrust hearing due to this business transaction. They wanted to get insight on how to deal with Donald Trump. They admitted to paying Michael Cohen and that he was not really the help that they needed. They ended their arrangement with Cohen after paying him $200,000.
Another company Michael Cohen recruited was Novartis. They are the world's biggest drug maker.
Due to the nature of their business, they have to interact with the government, especially concerning drug approvals.
Their contract allowed them to exit the arrangement as long as they proved just cause. They opted out of the contract, but still paid Essential Consultants, LLC, 1.2 million dollars. They realized after their initial meeting that he could not give them the required information.
Michael Cohen's business, Essential Consultants, LLC collected an estimated total of $2.2 million from corporate clients. He did really well just by knowing Donald Trump and really not having any knowledge of Trump's presidency. He even bragged to a fellow associate stating, "I'm crushing it," according to My San Antonio website.
Michael Cohen's connection to Trump
Michael Cohen was Donald Trump's personal attorney. He used his company Essential Consultants, LLC to pay Stormy Daniels for an alleged affair that happened many years prior to Trump being elected. He did not have any knowledge of his current situation as President and was not a part of the administration.
He used his past relationship with Trump to garner new business. In a little over a year, he was able to collect $2.2 million because companies thought they could get insight from him. A new president and companies were trying to figure out how to do business with the new president.
One of the companies he did business with was called Squire Patton Boggs.
They are a lobbying firm and they signed Michael Cohen to a $500,000 contract. They did not have any type of relationship with Donald Trump. The company assumed that he could help them understand Trump. They are now trying to minimize contact with him due to his legal problems.
Michael Cohen's ethics
He signed the contract with Squire Patton Briggs a lobbying firm and he did not disclose the company, Essential Consultants, LLC or himself as a lobbyist. The Lobbying Disclosure Act states that everyone involved in lobbying must register as a lobbyist. He failed to disclose his involvement with Squire Patton Briggs.
This is not a foregone conclusion. He did sign the contract as an active attorney so he could claim that he was working as their attorney and not a lobbyist.
The company was using him to gain clients because he was Donald Trump's personal attorney. Squire Patton Briggs did actually sign five clients due to his presence with their firm. As of now, those clients have not been identified.
Another possible violation of the law would be corruption. He gained contracts under false pretenses as he was selling information that he really did not have. He was gaining clients because of his relationship with Trump and no other knowledge.
Michael Cohen made sure that everyone knew he had a relationship with Trump. He ensured that he had multiple pictures taken with him and Trump. This made people believe that he had a close working relationship with Donald Trump.
This would also give the impression he was with Donald Trump a lot more than he actually was. If not corruption, at a minimum this sounds like fraudulent behavior.
His ethics can be called into question but it is not against the law to be unethical. He profited from his relationship with Donald Trump. He was not a member of his administration and was not as close to Trump as he claimed.
Ethics is a gray area. Laws are usually created from ethical violations but they are not considered against law. The question that everyone needs to ask, is how credible is Michael Cohen? Robert Mueller has investigated him plus the companies he has been doing business with. The last few cases Mueller brought before Judges have all ended up being questioned about their ulterior motives.
Robert Mueller is hoping the charges against Michael Cohen might lead to him turning state evidence.
Michael Cohen has most likely broken the law with his business dealings. He sold knowledge that he really did not have, to the highest bidder. The case against him is somewhat circumstantial. A prosecutor could probably get a plea deal from Michael Cohen. The burning question is whether that plea could lead to more problems for Donald Trump and the Russia collusion case that is still under investigation.
Jason Boughton
My name is Jason Boughton and writing is my passion. I spent 4 years in the US Army and 7 years as a National Guardsman. I was stationed overseas in Germany for 2 years and had a 6 month tour in the Middle East during Operation Desert Shield and Desert Storm.
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Jane Flowers
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Prep time: 10 minutes (and freeze for several hours); bake time: 15 minutes (and freeze for 1 hour).
If there's common ground between skateboarding and Halloween (and I suspect that there's plenty), it starts with a healthy appreciation for grotesque imagery. Both Halloween and skateboarding relish in skulls, severed limbs, and satanic paraphernalia, with the primary difference being that skateboarding doesn't need a season to boast its artistic license. If you haven't checked out Seb Carayol's well-researched anthology of subversive skateboarding graphics, Agents Provocateurs, it's well-worth the purchase just to get a delicious history lesson in all the ways skateboarding pays homage to things that will make your skin crawl. For instance, devil horns and a trident are a Halloween staple, whereas skateboarding has the graphic that Jason Lee rejected (and Natas loved); skulls and spider webs are used to decorate lawns across America, whereas skulls were the foundation of Powell's graphics for a decade. Bats, zombies, and gore galore—if it's a staple of Halloween festivities, it's been on a deck.
I'll go ahead and say it: the best candy bar out there is Butterfinger. Sure, Snickers, Kit Kat and Reese's all give it a good run, but (at least by a slim margin) the delectable balance of creamy chocolate and crunchy whatever-the-hell-is-in-a-Butterfinger is unparalleled. While Bart Simpson may be the most obvious commonality that skateboarding and Butterfinger share, skateboarding's affinity for hands and fingers shouldn't be overlooked: from Justin Eldridge and James Craig popping their fingers back into socket, to Toy Machine's knuckles logo, hands and fingers have enjoyed some of the most preferred spots in skateboarding's folklore. Perhaps the most iconic hand/finger graphic of all time, however, is Jim Phillips' Screaming Hand, which celebrated its 30th anniversary last year (bonus info, did you know that the screaming hand was partly inspired by Jim's first-hand (no pun intended) viewing of a dead body? How "Halloween" is that?).


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Julia's River Camp is situated 8kms from Talek Gate, within the Masai Mara Nature Reserve. You can follow signposts from Talek Gate. The nearest airstrip to Julia's River Camp is Ol Kiombo at 8 km distance.


Daughter of screenwriters Nicholas Kazan and Robin Swicord, and granddaughter of prominent director Elia Kazan, actress Zoe Kazan joined the family business after graduating from Yale University in 2005. Beginning with acclaimed productions of off-Broadway plays like The Prime of Miss Jean Brody and The Things We Want, Kazan soon made her Broadway debut, starring alongside S. Epatha Merkerson in a revival of Come Back, Little Sheba. Kazan would continue to find success on Broadway, but eventually branched into on-screen acting, as well, appearing in films like Fracture, In the Valley of Ellah, and Me and Orson Welles. In 2009, the actress became a professional playwright when her play Absalom was presented at the Kazan Humana Festival of New American Plays. Kazan next joined the cast of the quirky ensemble movie happythankyoumoreplease.
Basel Well, you seem to be, but you never know with the two of you.
Dylan This going to be so weird.
Ruby I miss you already, Ruby!
Ruby I 'm not your child!
Ruby You don't get to decide what I do.
Mary-Catherine I always thought of that as the moment you came into focus... like "Oh, there you are".
Mary-Catherine I always thought of that as the moment you came into focus... like 'oh, there you are'.
Mary-Catherine You can't just keep him. He's not a goldfish!


Bishop Dwenger junior offensive lineman Joe Tippmann announced his commitment to Wisconsin on Twitter on Saturday.
"I was beyond blessed to go around the country, visiting different schools and meeting great coaches and great people," he wrote. "This has been such an amazing process and appreciate everyone that has been with me throughout it.
"I would like to thank all my friends and my family that have supported me, coach (Chris) Svarczkopf for doing so much for me in his last year before retirement and coach (Jason) Fabini for getting me the exposure."
Tippmann was an All-State selection this year as he helped the Saints to a regional championship. He also had offers from Iowa, Indiana and Purdue, plus interest from Notre Dame and Northwestern.
SOUTH SIDE 97, INDIANAPOLIS NORTHWEST 49: At South Side, Asher Blum, Trejean Didier and Cortney Shorter each scored 13 points, Mikale Stevenson added 12 and Demarque Perkins 10 for the Archers.
BLUFFTON 46, GARRETT 42: Johnathan Irwin scored 22 and Max Corle added 16 for the Tigers.
Kobe Lucarelli led the Railroaders with 17 and Micah Malcolm scored 13.
HOMESTEAD 55, NOTRE DAME ACADEMY (OH) 53: At Notre Dame Academy, the Eagles had the ball trailing by two with nine seconds left but the Spartan defense secured the stop and the win.
Sylare Starks led Homestead with 17 points, Sydney Graber scored 13 and Lauren Selking had 10.
BISHOP LUERS 63, BOWMAN ACADEMY 28: At Bishop Luers, Lydia Reimbold led the Knights with 21 points, while Christian Haggard scored 13 and Daryan Bryant 11 for the Eagles.
SOUTH SIDE 66, ANGOLA 42: At Angola, Shamari Tyson scored 22 points, Taniece Chapman added 13 and Alaya Chapman 12.
Sarah Brandt led the Hornets with 13.
NORTHROP 70, BLACKHAWK CHRISTIAN 19: At Northrop, Niomi Dube scored 21, Arielle Thatcher added 17 and Breanna Douglas 12 for the Bruins. Hallie Vander Dussen scored seven for the Braves.
WOODLAN 43, HERITAGE 39: At Heritage, Addison Bayman scored 22 and Gabby Joyce added 15 for the Warriors.
Alivia Beard and Taylor Zelt each scored 11 for the Patriots.
HENRY WILK CLASSIC: At Penn, Huntington North and Columbia City each went 1-4. The Vikings defeated Warren Central 46-27 in Round 4 and fell 56-6 to Penn, 45-36 to Culver Academies, 51-18 to Niles (Michigan) and 65-9 to Detroit Catholic Central (Michigan).
The Eagles defeated Valparaiso 48-27 in round two and lost 39-30 to Warren Central, 68-11 to Niles and 43-36 to Edwardsburg (Michigan). Individually, Ryan Sheets went undefeated in the 113-pound weight class and Hunter Reed at 160.


SINGAPORE - Singapore has condemned the vicious gun attack in Strasbourg, France, on Tuesday (Dec 11) that left several people dead and many injured.
"We extend our deepest condolences to the bereaved families and wish the injured a swift recovery," a Ministry of Foreign Affairs (MFA) spokesman said in a press statement issued on Wednesday.
The MFA noted that at this juncture, the French authorities are carrying out security operations in the area and the situation is developing.
It added that the Singapore embassy in Paris is in contact with the French authorities and there have been no reports of Singaporean casualties or injuries so far.
The MFA advised Singaporeans in Strasbourg to monitor the news and heed the advice of the local authorities. The ministry also asked Singaporeans to contact their family and friends to let them know they are safe.


If you want to go green, one of the ways is to make an eco-friendly interior design that will be absolutely recyclable and also unharmful. When you get tired of polluted environment the home is your ultimate getaway so why not create an eco-friendly interior design that will not harm your health in any way and won't harm environment when some of its contents get discarded?
In order to create an eco-friendly interior design the natural and organic materials must be used. Ditch particleboard, chromed metal, and plastic. You might spend more money on creating an eco-friednly interior design but the natural materials are also very durable and always good.
Eco-friendly wall coverings and paint as well as river rocks used as wall covering will help you decorate the walls. The walls can also be covered with wood panels, ceramic tile or cork. For ceiling opt for wood panels or beams combined with whitewashed or suspended ceiling. As for the flooring, it can be done in stone or wooden parquet made from European woods, bamboo or cork. The combination of lighter and darker woods can give an opportunity to play with the shades and make patterns.
Naturally your furniture should be made of natural woods. The chairs and tables made of wood blocks and stone table tops from natural stone or marble can also add a touch of wilderness to your home. Pure nature around is almost impossible unless you are ready to give up all of the technology but even choosing among the hi-tech items look for less harmful like bioethanol fireplaces as well as use these tips on how to go green.
Interior accessories should also be eco-friendly especially because they get discarded more often than the wall or floor coverings and furniture. Glass or clay vases, rocks, wicker baskets, old chests and dry leaves and tree branches from your yard can be a great addition to your home decor. Recycling old furniture made of natural materials is also a good budget-saving idea.
Well, it's obvious that plants are the part of nature so surrounding yourself with ones will also add up to your eco-friendly interior design. Be sure, though, you have enough time to look after them and if not then buy low-maintenance plants.
Great lounge. It definitely looks like the outdoors has come inside!
Keep up the good posts- great work.
Very cool article and great ideas about eco-friendly design.