text:
UHC : Adolescents must be kept healthy–CSOs
General news5 months ago
A coalition of Civil Society Organisations (CSOs), says progress toward Universal Health Coverage (UHC) requires keeping adolescents healthy as they represent critical window of opportunity in the country.
Mr Muhammad Usman, Chairman, National Advocates for Health, who spoke on behalf of the CSOs said this in Abuja on Sunday at the two-day strategic retreat organised by the African Health Budget Network (AHBN).
The News Agency of Nigeria , reports that the retreat reviewed the country's Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition- (RMNCAH+N), Recovery Plan Scorecard & Validate the Family Planning (FP), 2030 Accountability Motion Tracker Template.
Usman said that investment in adolescents delivered "multiple dividends," improved health and enhancement throughout the life course and contributing to the health of future generations.
"Healthy adolescents also fuel economic growth by contributing to increased productivity, reduced health expenditure, and the interruption of inter-generational transmission of poor health, poverty and discrimination.
"For every Naira invested in adolescent health, there is an estimated ten-fold health, social and economic return," he said.
The Coordinator, AHBN, Dr Aminu Magashi urged that National health strategies and investment plans for UHC must include adolescents.
This, according to him, is with emphasis on the most vulnerable and marginalized adolescents and their families to ensure equity.
Magashi said that investment in vertical or single-issue programmes was rarely efficient.
"Programmes should be designed to address multiple risk factors and vulnerabilities and all adolescents should be covered by mandatory, prepaid and pooled funding with user fees reduced or eliminated," he said.
Magashi said that adolescents should be empowered to initiate action and influence decisions that affected their health and development through mechanisms that allowed for meaningful participation.
"This should be bolstered with disaggregated and regular data to know the magnitude of disease burden, health needs and barriers to services for this age group," he said.
The coordinator said that the RMNCAEH+N recovery plan during the COVID-19 accountability scorecard was developed through rigorous analysis of the 2022 Federal Government-approved budget, ''Others included review and validation meetings and independent monitoring of the activities of the RMNCAEH+N National Multi-Stakeholder Partnership Coordination Platform.
''The scorecard which had three categories was to serve as an evidence tool to be used by all stakeholders including CSOs, media, advocates, young people and development partners.
''This was to strategically influence actions that would promote performance, transparency and accountability in the implementation of country's RMNCAEH+N continuity response plan (2020-2022) during COVID-19,'' he said.
Magashi said that the scorecard reported three categories including Governance and Leadership, Budgetary Allocation and Disbursement, Accountability and Transparency.
He added: "The stakeholders further urged the RMNCAEH+N platform to formalize the participation of CSOs and youth constituencies with clear roles and modalities of engagement.
"They also recommended that CSOs and youth representatives on the RMNCAEH+N platform strengthen meaningful engagement with their constituencies through formal channels for inputs and feedback.
"Other recommendations put forward by the stakeholders include the provision of a dedicated page to be created on the website of the Federal Ministry of Health and other relevant agencies.
"Information about budget releases and expenditure could be posted and sighted there "The CSOs, youth and media to engage the Federal Ministry of Health, Federal Ministry of Finance and donor community to galvanise collaborative efforts.
" Magashi said that this is to strengthen the RMNCAEH+N platform and support implementation of the recovery plan.
"The NGOs, advocates and other critical stakeholders must find a way of talking to the government and the Ministry of Finance in particular and the office of the Accountant General of the Federation (AGF) for the release of approved budgets," he said.
Magashi said that investments in family planning were aimed at saving the lives of women and children, which would lead to prosperity for all.
"Family planning, therefore, is critical to achieving Sustainable Development Goals (SDGs), which are aimed at ending poverty and improving wellness and health.
"It is also key to end hunger as well as promoting gender equality.
"That's why a country as populous as Nigeria needs to promptly release the budget for the procurement of FP commodities," he said.
Also speaking on behalf of health journalists, the President of the Association of Nigeria Health Journalists (ANHEJ), Mr Hassan Zaggi, said that in most countries, health systems and services were mainly designed for either young children or adults.
"Given their specific health and development needs, adolescents require responsive anticipatory models of service delivery.
"Due to biological and gender-based differences that result in varied health risks and disease incidence, these health services must always apply an appropriate gender lens.
''Government need to reach adolescents with high quality, well-coordinated and well-integrated programmes in their everyday context," Zaggi said.
Meanwhile, Mr Olympus Ade-banjo, Chairman, Africa Health Budget Network Meaningful Adolescent and Youth Engagement Working Group, said that inadequate allocation of resources was a major challenge for implementing the good plan Nigeria had for family planning.
Ade-banjo said that expanding the narrative of family planning from being a core health issue to a development issue would provide the opportunity to prioritize family planning as human capital and socio-economic development issue and for the achievement of the SDGs. He said that the nation as a pre-transition country had a high fertility rate of 5.2 per women and a very youthful population bulge.
NAN recalls that Nigeria formally launched the 2030 FP commitment in March 2022. The FP 2030 Commitment which has 8 focus areas states that by the end of 2030, Nigeria envisions a country where everyone including adolescents, young people and populations affected by crisis and other vulnerable populations can make informed choices.
NAN also recalls that they should have equitable and affordable access to quality family planning and participate equally in society's development.
NewsSourceCredit: NAN
NGOs engage Kaduna lawmakers toward attainment of universal health coverage
Save the Children International (SCI) and the Legislative Advocacy Initiative for Sustainable Development (LISDEL) have enlisted the support of Kaduna State Assembly for increased investment in the health sector toward achieving Universal Health Coverage (UHC).
Mr Farouk Abdulkadir, Advocacy and Campaign Coordinator, SCI, said on Saturday, at a capacity building of the lawmakers in kano, that the support of the lawmakers was key to achieving UHC in Kaduna State.
Abdulkadir explained that the capacity building was to enhance their capacities and deepen their understanding on health financing and UHC in line with the goals of Primary Health Care and health policies.
He added that the engagement would enable the lawmakers to develop a Legislative Health Agenda for the remaining part of 2022 and 2023, that would guide legislative interventions in the state's health sector.
"The workshop will also enhance the understanding of the lawmakers' roles in increasing healthcare financial and protection of the poor and vulnerable against health risks," he said.
Mr Usman Mohammed, Vice President, LISDEL, commended the leadership of the state Assembly for the commitment to contribute their quota in improving access to quality basic healthcare service in the state.
Mohammed said lawmakers were expected to support the needed legislation that would improve the efficiency and effectiveness health insurance scheme being implemented by the Kaduna State Contributory Health Management Authority (KADCHMA).
The Director-General, KADCHMA, Mr Abubakar Hassan, also commended the leadership of the state Assembly for their support to improving the health and wellbeing of the people of the state.
Hassan acknowledged the contribution of the lawmakers to the achievements being recorded in the state's health insurance scheme.
He pointed out that the poor and vulnerable population, including women, children and persons with disabilities were accessing free basic health care services in health facilities , courtesy of the law passed by the Assembly.
He commended LISDEL, SCI and the state Ministry of Health for supporting the authority to deliver its mandate the best way possible.
On her part, the Commissioner for Health, Dr Amina Mohammed-Baloni, equally expressed joy with the level of attention the lawmakers accord to the health sector.
Mohammed-Baloni, who was represented by the Director of Planning, Research and Statistics, Dr Joseph Sunday, particularly thanked the state assembly for its support during the budgeting process.
The Speaker of the Assembly, Yusuf Zailani, said that the capacity building would improve their knowledge on the workings of the health sector and enable the lawmakers to improve their oversight function.
Zailani, who was represented by the Deputy Speaker, Dr Isaac Auta, reiterated the state Assembly's continued support to ensure the sector gets the needed financial resources to implement its programmes and projects.
One of the facilitators, Dr Olanrewaju Olayemi, said that the attainment of the UHC largely depends on the availability of financial resources to implement planned programmes and projects.
ng )
Associations enroll 200 FCT residents into health insurance scheme
YouthHubAfrica in collaboration with Christian Aid on Friday enrolled 200 vulnerable persons in Gwagwalada, Bwari and Waru communities into the Federal Capital Territory (FCT) Health Insurance Scheme.
Mr Rotimi Olawale ,Executive Director ,YouthHubAfrica, made this known at the handing-over ceremony of cards to beneficiaries in Waru ,Abuja .
Olawale said that the project was implemented to promote Universal Health Coverage (UHC) in FCT to enable them access quality health care for a period of 12 months for free.
"Health insurance coverage is low in Nigeria and people who are covered are mostly covered by the organisations they work for .
" However , people who work in the informal sector do not have such privilege, many of them do not believe that health can be free or could have their insurance covered.
"Most of them pay out of pocket and when they cannot pay they simply do not go to the hospitals and that is where the marginalisation comes to play ," he said.
Olawale said the idea was to partner with the FCT Health Insurance Authority (NHIA) to assist indigent people access quality health care.
" Our team went to the field with a pre-designed survey, the idea was to identify people who are below a certain level of earnings or marginalised persons would benefit the most from this health insurance scheme .
" We paid on their behalf and register them under the FCT Health Insurance Scheme .
"So today's event is to present the registration card to the beneficiaries we hope that when they get registered in this service, they will be able to access services at the different hospitals, "he said.
Prof. Mohammed Sambo, Chief Executive Officer, FCT National Health Insurance Authority (NHIA) , represented by Mr Greg Azubuke ,NHIA, FCT Coordinator ,commended YouthHubAfrica for the initiative.
Sambo said that the agency attached great importance to the gesture .
He said, "Health insurance is a situation whereby you can just walk into a facility of your choice and access the best possible medical attention without paying a dime .
"That is what we are here to do by the good will of YouthHubAfrica, they have been able to register 200 people from three communities in the FCT .
"By virtue of this registration, these 200 lucky people can easily walk into a hospital of their choice and be treated for whatever ailments ailments they may and walk out without paying a kobo.
" Sambo called on other citizens of goodwill to emulate the example set by YouthHubAfrica by visiting communities and picking certain numbers of people and make them access quality and affordable healthcare in hospital of their choice.
He said the burden should not be left to government alone because it takes collaborative efforts to tackle issues and urged the beneficiaries to make good use of the opportunity.
Mr Temitope Fashola, Country Director ,Christian Aid ,represented by Dorcas Asaolu, Health and Human Development Intern, said achieving universal health coverage meant that everybody has access to needed good quality healthcare without suffering financial hardship .
Fashola said that the LGA UHC Initiative project was born in 2020 to achieve healthcare coverage for all .
"Christian Aid Nigeria has over the course of two years taken the initiative from Nasarawa to Benue and the FCT .
" This handing over of the FCT Health Insurance Scheme cards to participants is in line with the UHC goal and built on adoption model to stimulate trust.
"This is a strong affirmation that with our joint efforts, we can push our cooperation in improving access to quality ,timely and affordable health care for all.
" The District Head of Waru ,Ibrahim Sarki ,thanked YouthHubAfrica for the gesture.
He said he had been a beneficiary of health insurance scheme in the past so he understood how much the organisation would have spent to grant his community members health insurance.
" I want to show my appreciation to YouthHubAfrica that on behalf of my people we are happy ,"he said
FG expresses support for traditional medicine practitioners
The Federal Ministry of Health (FMOH) has expressed commitment to support traditional medicine practitioners in the country.
The Minister of State for Health, Mr Joseph Ekumankama, said this at the commemoration of the 2022 African Traditional Medicine day on Wednesday in Abuja.
Ekumankama said that traditional medicine played a major role in people's life and national development but its innovation was still low or remained on individuals.
The News Agency of Nigeria reports that the theme of this year's celebration is "Two decades of African traditional medicine day: Progress towards achieving universal health coverage in Africa".
Ekumankama said the theme called for taking stock of achievements in the sector since the inception of the annual remembrance of ATM Day from 2001-2020 and the impact on the healthcare delivery system.
"Indeed, Nigeria and other African countries have delivered on key policies and programmes, aimed at promoting and developing various forms of TCAM practices and products within the region," he said.
The minister said that the progress recorded so far was critical to achieving Universal Health Coverage (UHC).
According to him, about 80 per cent of the population, especially those residing in rural communities, patronise TCAM services as their main source of health care.
He said that the availability, accessibility, affordability and acceptability of TCAM made it popular among communities.
"Achieving UHC requires multiple approaches which include the primary health care approach, life course approach, and both are critical.
"A primary health care approach focuses on organising and strengthening the health system so that people can access services based on their needs and preferences, at the earliest, and in their everyday environments," he said.
The World Health Organization (WHO) Representative, Dr Francis Ukwuije, Health Economist, said that Nigeria was one of the African countries that reported improvement in the availability, affordability, accessibility and safety of traditional nedicine practices.
Ukwuije said that the country produced and was involved in the large-scale cultivation of medicinal plants and producing traditional medicine locally.
He said this was according to the progress report on the implementation of traditional medicine strategy in Africa.
"There were submissions from Nigeria to the regional expert committee for products developed as therapeutics for COVID-19, the submissions are still under review," he said.
He called on governments to continue to strengthen collaboration between science, technology and innovation institutions such as NIPRD, NIMR; traditional health practitioners and the private sector.
He said that such collaboration would fast-track research and development, and local manufacturing of traditional medicine-based therapeutics for the health and well-being of Africa's people.
He, however, said that WHO would continue to provide technical assistance to Nigeria to ensure local manufacturing of Pharmaceuticals and traditional medicine-based therapeutics.
On the role of traditional medicine in treatment of COVID-19, Zainab Sharif, Director and Head of Department Traditional, Complementary and Alternative Medicines (TCAM), said COVID-19 called for the need to exploit the African treasures by looking inward for local solutions.
Sharif said the pandemic had harnessed awareness of the values of traditional medicine, investing in research to produce home-grown solutions and well-being of the Continent.
"TMPs submissions of 59 herbal products for the management of COVID-19-related symptoms have led to the listing of some herbal products.
Pharmaceutical companies in Western countries are looking forward to Africa for APIs. "COVID-19 herbal medicines such as Madagascan COVID-19 herbal mixture has been reportedly used in the management of patients with related symptoms and is currently under the third phase of clinical trial.
"Trials in 12 Member States, including South Africa, Nigeria, and Congo are currently ongoing.
TMPs have played a significant role in prevention measures in most communities in Africa," she said.
34,000 vulnerable persons have access to free healthcare in Zamfara, Matawalle
Gov. Bello Matawalle of Zamfara says 34,000 vulnerable persons have access to free healthcare under the state government's Basic Healthcare Provision Fund (BHPF).
Matawalle, represented by his Deputy, Sen. Hassan Nasiha, made this known at the event organised to unveil the BHCPF by State Contributory Health Care Management Agency (ZAMCHEMA) held in Talata Mafara town, Talata Mafara Local Government area of the state "As we all know, access to affordable healthcare continues to be a challenge for most households due to the high level of poverty and the Health Insurance population coverage throughout the country has remained low.
"This challenge forced most states of the federation to domesticate the National Health Insurance Scheme (NHIS) based on religion and traditional value systems and other peculiarities.
"I am happy to say that, the scheme is envisaged as one of the successful reforms in the health sector in the state with over 15,595 prospective enrolles in the Formal Sector Programme and 34,000 vulnerable population to be covered under the BHCPF", Matawalle said.
He said that the scheme is part of his administration's intervention towards achieving Universal Health Coverage (UHC) by ensuring all residents of the state have access to effective, quality and affordable health care services.
"This is also part of our vision to protect families from the financial hardships of huge medical bills and ensure improvement in the healthcare throughout the State.
"Our vision is to achieve UHC for all residents of the state, no one is left behind in accessing healthcare services", the governor added.
He commended the state ministry for health and the agency for their commitment tp the success of the scheme.
"This is a clear indication that both ministry and agency have all it takes to be a point of reference in achieving the UHC in the state", he explained.
The commissioner for health, Alhaji Aliyu Abubakar, called on traditional rulers and Community Based Organisations to monitor the implementation of the program at facility level of their respective domains.
Abubakar said that the state government has bought drugs and other consumables to ensure free treatment of all beneficiaries under the scheme at all facilities in the state.
"There is also provision for referral for patients from Primary Health Care to Secondary up to Tertiary facilities", the commissioner said.
Earlier, the Executive Secretary ZAMCHEMA, Dr Abdulkadir Shinkafi said all the 34,000 beneficiaries of the scheme comprised under five children, pregnant women, the aged and other categories of less privileged and vulnerable groups.
Shinkafi noted that the NHIS has accr
Agency inaugurates committee on contributory healthcare
Kebbi State Contributory Healthcare Management Agency (KECHEMA) has inaugurated gateways forum committee members to provide quality healthcare services to the people of the state.
The Executive Secretary of the agency, Dr Ja'afar Muhammad-Augie, while inaugurating the committee in Binrin Kebbi on Tuesday, said it aimed at addressing some challenges encountered by the agency in the state.
He said," The overall aim of the Basic Health Care Provision Fund (BHCPF) committee is to significantly move the people of the state towards achieving Universal Health Care (UHC).
"They are both based on the current National Strategic Health Development Plan II (2018-2022) in the medium term and the long-term goals for UHC, including the health- related goals.
'' Muhammad-Augie said the committee had been actually operational but informal, adding that Primary Healthcare Development Agency (PHCDA) and KECHEMA inaugurated the committee to address challenges encountered in 2021 by the healthcare provision fund.
"Though, we have not been having regular meetings, I am sure the meetings are going to be regular on important issues that are going to be addressed as the beneficiaries are all and sundry in the state.
"Therefore, the gateways forum is premised upon the objective to promote synergy among the gateways, good collaboration among the implementing gateways and for the gateways to agree on a common goal.
"Others are to foster unity and good working relationship towards achieving the set standard of BHCPF as well as steering a goal to achieve UHC,'' he said.
The News Agency of Nigeria reports that the committee's members were drawn from state PHCDA, KECHEMA and local government areas.
Those in at the inauguration included representatives of USAID, National Health Insurance Scheme (NHIS), National Primary Healthcare Development Agency (NPHCDA).
Imperatives of paradigm shift in policies to achieve Demographic Dividend
Evolving health cum economic emergencies clearly highlight the urgent need for countries like Nigeria to adopt economic policies that are new, unusual, achieveable and effective. These will be aimed at accelerating improved human capital development, productivity and optimal harnessing of Demographic Dividend. Demographic Dividend, according to the UN Population Fund (UNFPA), is the accelerated economic growth that may result from decline in a country's birth and death rates and the subsequent change in the age structure of the population. Understandably, it is an economic boom achieved when there is increase in productivity with increase in the working age of the population structure and lesser dependency ratio. The trajectory of demographic dividend stems from economic boom of the four Asian Tigers namely Hong Kong, Singapore, South Korea and Taiwan whereby the Asian Tigers economies recovered strongly as the world revived from financial crisis. The recovery, according to Dr Eyitayo Oyetunji, Federal Commissioner representing Oyo on National Population Commission (NPC), is highly attributable to government stimulus programmes in each region. Oyetunji explains that the programmes resulted in greater than four per cent growth in the GDP of each country in 2009. To mitigate the socioeconomic among other challenges, Nigeria is expected to rejig her economy. A league of health and economic experts hence call on Nigeria to invest rightly on education and health. Dr Dasogot Dashe of the UN Population Fund (UNFPA) says that for Nigeria to achieve demographic dividend, sufficient investment must be made in education and health sectors of the country. Describing education and health as the rallying point of most sectors of the economy, Dashe says it is unfortunate that the two sectors are being neglected in terms of adequate funding. He says education, especially that of the girl-child, as well as health remain key in economic advancement of every nation. According to him, it is only when a girl-child is educated that she can be knowledgeable about fertility reduction through family planning. Consequently, Dashe emphasises the need for government at all levels and all times to ensure the availability and accessibility of quality healthcare for her populace for human capital development. Dr Olumide Okunola, Senior Health Specialist, World Bank, identifies poor implementation and monitoring of policies as the major challenges impeding the country's achievement of demographic dividend. According to Okunola, global policies as Universal Basic Education (UBE) and Universal Health Coverage (UHC) must be domesticated practically and strictly in Nigeria to transit the country to enjoy demographic dividend. The World Bank health specialist enthuses that the usual complacency on out of school children especially girls must be jettisoned and a policy of mandatory education for all especially girls adopted. He expresses optimism on the impactful outcome of mandatory education for girls as having the potential to not just increase the country's productivity level but reduce fertility rate of Nigeria. "Making sure a girl stays longer in school at least from primary to secondary school will prevent child marriage. "It will also reduce fertility rate as well as reduce maternal mortality by educating the girl on her sexual and reproductive health rights. " Advocacies for right investment are also made by Mr Shubham Chaudhuri, Country Director World Bank at different fora. Chaudhuri faults the subsidy investment on Premium Motor Spirit (PMS) by Nigeria, saying such huge amount of money should be invested in education and health. He opines that government's policies are critical in either achieving demographic dividend or disaster, hence Nigeria should embrace emphasis on beneficial economic roadmaps to attain sustainable development. These policies should be vehemently and indeed practically pursued with uncompromising implementation and monitoring. Also, government should begin to interrogate the efficiency of global goals as UBE and UHC to ascertain its impact. "Nigeria as a matter of urgency should rise above arm chair policy formulation but strict implementation like the Asian Tigers. "Nigeria, as the most populous country in Africa like the Asian Tigers, should strive to achieve economic growth through exports and rapid industrialisation. "Therefore, it is paramount for Nigeria to take advantage of its youthful bulge to drive productivity. " Nevertheless, Nigeria has a favourable demography, says Mr Clement Agba, Minister of Budget and National Planning, at the UN Population Fund's Validation of 9th Country Programme Document (CPD) for the span of 2023 to 2027. Agba asserts that the country, with her youthful bulge, has an active and productive population structure that is highly productive for attendant demographic dividend. On his part, Dr Ejike Oji, Chairman Technical Management Committee Association for the Advancement of Family Planning in Nigeria (AAFP), identifies family planning as key to achieving sustainable development through harnessing of favourable demography. Oji says that until Nigeria's fertility rate of 5.3 per woman is brought down minimally, achieving demographic dividend would remain a mirage. He explains that that access to quality healthcare is inevitable in achieving reduction in fertility rate. According to him, many women tend to have many children as a result of fear of infant mortality which points to the gap in quality healthcare. Understandably, government should take aggressive steps in closing the gap in maternal and infant mortality through vaccinations and antenatal care. This supports that girl and women education is fundamental to attaining human capital development or demographic dividend. Certainly, an educated girl or woman must know when to be pregnant and how many children to have and the facilities for infant vaccination to avert morbidities and mortalities. Indicators at the recent launch of the revised National Population Policy bring to fore the country's quest to address high fertility rate, as President Muhammadu Buhari's demonstrates the government's commitment to addressing fertility rate of the country by launching the Revised National Population Policy on Feb. 3, 2022 . Dr Okai Aku, Executive Director, Planned Parenthood Federation of Nigeria (PPFN), expresses worry over Nigeria's low Contraceptive Prevalence Rate which is 12 per cent. Aku advocates intensive expansion of access to modern contraceptive methods across the country to increase the Contraceptive Prevalence Rate. Also, Ms Margaret Edison, Director, Population Management, National Population Commission (NPC), reiterates the urgency to address Nigeria's sustained high fertility rate, through expanding access to modern family planning, counselling and commodities as well as promote births spacing. Edison, who scores Rwanda high, urges Nigeria to achieve rapid fertility control, improve the health of women, adolescents, new born and children, and other population groups to achieve demographic dividend. She expresses the importance of investing in quality education of young people especially girls, human capital development, advancing holistic effort to achieve significant demographic transition. The Chairman, National Population Commission (NPC), Nasir Kwarra, urges Nigerians to embrace the noble ideals of Planned Parenthood and healthy reproductive behaviours. He highlights the imperatives of "Rights and Choices" as embedded in UNFPA's concept "Bodily Autonomy" which necessitates the urgency to shift the conversation from quantitative population to qualitative population. According to him, it is high time for Nigeria to harness her teeming 216 population from liability to asset by transforming the development landscape of the country. "The call to place emphasis on the people requires looking beyond the numbers to according attention to the profile and characteristics of the population. . " Kwarra opines that such would be better explained by the age structure which shows the ratio of various age groups as a determining factor for the current and prospective fertility or reproductive status of the population. As such, focusing on numbers underplay the importance of "Rights and Choices", he says. Kwarra like Mr Clement Agba, Minister of State for Budget and National Planning, affirms Nigeria's favourable demography. He explains that the country's age structure favours young people, those below the ages 30 years who make up over 70 per cent of Nigeria's population On the other hand, Kwara says the current youthful age structure has the capacity to hold the momentum that would drive and sustain increase of the population growth into the future without immediate interventions. Interventions through provision of quality and sustained investments in healthcare particularly in family planning for women and Adolescents. Furthermore, transformative and relevant education for growing numbers of children and young people that fit in into the present and future jobs requirements, housing and decent employments across successive administrations and governance. That good governance through ingenious and people oriented policies are critical elements in achieving Demographic Dividend is axiomatic. Therefore, introspectively, the federal government, in fact the three tiers of government in Nigeria should vehemently address the emerging population challenges with germane and productive policies to achieve Demographic Dividend. Dr Natalia Kanem, Executive Director, UN Population Fund (UNFPA) has argued that "Societies that invest in their people, in their Rights and Choices, have the proven that such investments create the road to enduring peace and prosperity everyone desires and deserves. " In line with this postulation, Nigeria needs to harness her favourable demography and use as a catalyst for economic growth. Nigeria is expected as matter of urgency to key into the scores of global Development plans to actually achieve their domestic desirable aspirations. This "miracle", like the Asian Tigers, will be tenable when millions who are of working age are engaged productively Therefore, Nigeria at this juncture should vigorously pursue her National Development Plan of 2021 to 2025 to avert demographic disaster. Efforts must be in top gear to achieve reduction in Total Fertility rate of current 5.3 per woman especially Adolescent fertility of 104 children per 1000 women. Essentially, economic and health analysts therefore are urging Nigeria to match their words with action by harnessing the youthful bulge to achieve Demographic Dividend. In conclusion, reduction in high mortality and morbidity rates for children and adolescent mothers with heavy investment in the health and reproductive education remain non negotiable in achieving Demographic Dividend. In addition, importantly, girl child education should be considered national agenda both the at state and community levels in line with the UNFPA's transformative results of ending preventable maternal mortality. Including unmet need for family planning as well as Gender Based Violence (GBV) and harmful practices for desirable healthy lives cum productive and healthy economy. Nigerian political gladiators both at national and sub-national levels should rise to the occasion by way of policy formulation, implementation and monitoring to transition her youthful bulge from liability to asset. NewsSourceCredit: NAN
Radical Proposals as National Cancer Task Force Delivers Report
Africa6 months ago
The National Cancer Task Force is proposing a series of interventions that it says will enable the country to adequately address the challenge posed by cancer.
In a report delivered to Cabinet Secretary for Health Mutahi Kagwe on Wednesday, the task force recommends improving service delivery, the health workforce, health products and technologies, health information and research, coupled with adequate funding and a strong leadership and governance framework.
According to the task force's chair, Dr. Mary Nyangasi, the country needed to implement strategic investments to ensure that Kenyans are protected against the health and economic impacts of the growing burden of cancer.
Speaking while receiving the report, the Health CS said the recommendations should provide a platform for the country to decisively address the burden of cancer, which continues to contribute to the disease burden and financial catastrophe for many households and communities.
This even as she called for the need to bring all stakeholders together, including the council of governors, to ensure concurrence and smooth implementation of the recommendations.
In its report, the task force has identified a number of gaps in the country's cancer care delivery model.
Recommendations include adopting a hub-and-spoke concept in cancer management through the creation of a cancer center of excellence focused on clinical care, research and training as a hub for the country, accelerating development of the oncology workforce through local and international training collaborations.
such as the establishment of innovative financing mechanisms.
The mechanism includes enhancing UHC's benefit package to cover cancer services across the continuum, supporting cancer screening in primary health care through conditional grants to counties, and creating from a cancer fund.
The working group also recommends the introduction of pricing policy regulation on cancer health products and technologies (HPT), as well as framework agreements to reduce the cost of HPT.
The working group has also proposed strengthening the legislative framework on cancer prevention and control by revising existing policies and guidelines on cancer prevention and control, as well as reviewing and amending the Cancer Prevention and Control Act. The amendment is intended to make the national cancer institute fully operational, strengthen the institute's regulatory, research and training role, establish a cancer fund, and regulate and coordinate cancer management services.
The task force also wants to get the National Cancer Institute of Kenya (NCI-K) up and running through the development of relevant regulations and enabling instruments for the employment of competent staff to fulfill its mandate.
Cancer is the leading cause of death in Kenya and one of the main contributors to the impoverishment of affected individuals and their families.
The ministry of health recognized the need to address the growing challenges stemming from cancer and appointed a National Cancer Task Force in May 2021.
The task force was tasked with reviewing the current institutional framework for cancer management, evaluating the capacity of human resources, technologies, medical products and infrastructure for cancer.
The team was also expected to analyze local actors and stakeholders as well as global best practices in cancer care, review the adequacy of existing legal and policy instruments for the cancer response, and recommend strategic interventions to reform care delivery.
of cancer services across the country.
Ministry of Health ensures collaboration with the private sector
The health ministry has committed to partnering with the private sector to accelerate ongoing reforms within the health sector.
Speaking at a Nairobi hotel during a meeting with members of the Kenya National Chamber of Commerce and Industry (KNCCI), CS Mutahi Kagwe of health said that collaborations and partnerships are critical tools for transformation, as they make it possible to implement critical development.
"Mnajua waswahili husema", "Kidole kimoja hakivunji chawa". Through collaboration, we have seen the current government implement mega-projects in different sectors of the economy", Kagwe presented.
He said that the covid-19 pandemic caused the health ministry to work with various private sector actors to combat the pandemic and achieve Universal Health Coverage.
Citing a program implemented by the Ministry of Health in partnership with KNCCI between 2020 and 2021 to support the development and manufacture of 7.5 million PPE as an incentive to promote local fabric manufacturers and producers, Kagwe said the country has achieved spectacular results that are not only an encouragement, but also a stamp of approval for collaboration as a tool for economic transformation.
He noted that the demand for quality health care services has led to the growth of commercial services in the health sector, adding that there are numerous opportunities to scale up innovative approaches and new technologies to rapidly accelerate progress towards UHC. This even as he urged the private sector to explore the opportunities available in the sector.
"I like to encourage people to think globally. As we position ourselves to take advantage of the opportunities available locally, we must also examine the regional and international environment to see how we can take advantage of the global market.
Speaking during the forum, House Speaker Richard Ngatia praised the government for its support during the pandemic, saying it helped reshape local businesses. He said the chamber remains ready to partner with the health ministry in its efforts to improve the country's health outcomes.
Access to Medicare: Experts call for improvement in PHC System
Sone health experts have called for urgent revitalisation of Nigeria's Primary Health Care (PHC) system to enable improved access to adequate medicare.
The experts made the call on Friday at the Nextier Health virtual dialogue on "Revitalising Nigeria's PHC System" in continuation of Nextier Universal Health Coverage (UHC) Series.
The News Agency of Nigeria reports that Nextier UHC Series is one of the flagship programmes of Nextier Health.
The series draw attention to contemporary health issues in Nigeria and globally through the views of health system experts and practitioners.
Akin Abayomi, the Lagos State Commissioner for Health, in his keynote address, highlighted the urgent need to address the challenges in the country's PHC system.
Abayomi, who was represented by Dr Ibrahim Mustapha, Permanent Secretary, Lagos State PHC Board, said the major challenges facing PHC services included inadequate financing and human resources.
He said that other challenges were weak governance and accountability structures, poor data collection and transmission systems, limited access to medicines and essential infrastructure in PHC settings and supply chain.
Abayomi said that PHC system would require significant improvement to achieve UHC.
"All relevant stakeholders across the public and private sectors need to intensify their efforts and build sustainable partnerships to rejuvenate Nigeria's PHC," he said.
Chima Onoka, Head of Operations, Health Policy Research Group, said there was need for a clear delineation of roles and responsibilities of all tiers of government to ensure accountability processes.
Onoka, also a Community Physician, said each tiers of government should have financial autonomy to ensure it had the resources to perform its roles and responsibilities.
He said that local governments had not been able to effectively provide PHC services partly because they did not have direct control over their resources.
Onoka advised stakeholders at Federal and state government levels to focus on programme implementation and also provide financial and technical support for the health system leaders.
He, however, said that such health system leaders should be held accountable for expected responsibilities and resources.
Onoka said that the role of Civil Society Organisations (CSOs) and Development Partners in ensuring accountability emphasised the need for proper incentives to be considered in the design of accountability systems.
He called for a review of the scorecard for assessing performance in the Primary Healthcare System with best practices from other countries as bench mark.
Onoka recommended the need for stakeholders to present performance scorecards to the universities and similar independent institutions, that could assess the performance of PHC programmes and interventions objectively.
He said that for more objective review performance, development partners, stakeholders, CSOs and the public should also be allowed to review the reports and ask the right questions.
"This is in contrast to the current practice in which performance scorecards are presented to the board of the same organisation or public without giving room for effective engagement and unbiased assessment of PHC performance," he said.
Onoka said that health system leaders and stakeholders needed to remove bureaucratic bottlenecks and create platforms that could enable them leverage available resources to achieve health system goals.
He called on state governments to create opportunities for stakeholders, including the private sector, to contribute to their health systems, particularly at the PHC level.
The expert said that the government must bridge the human resource gap by revising the training curriculum of health workers.
He said the government could also save money on capacity-building workshops for fresh graduates by incorporating the training content into the academic programmes curriculums.
Onoka said it was pertinent for government to build trust in the system as that would encourage more access to funds both domestically and externally.
He said there should be increased sustainable investments in the primary healthcare system with a focus on results.
onoka said there was also need to learn from past failures and best practices, and advised stakeholders to provide health system leaders with financial and technical resources they required to perform optimally.
Dr Sam Agbo, Senior Health Advisor, Foreign Commonwealth Development Office, Nigeria, said there was need for a clear definition of roles and responsibilities.
Agbo said National Primary Health Care Development Agency (NPHCDA) should consider acting more as a supervisory agency and focused less on programme implementation.
He said there was also need to improve coordination and synergy between State Ministries of Health and Primary HealthCare Development Agencies.
Agbo said Local Governments financial autonomy would empower them to take responsibility for organising PHC system while Federal and State governments provide the needed oversight and support.
He said professional organisations, Nigerian Medical Association (NMA), National Association of Nigerian Nurses and Midwives (NANAM), Association of Medical Laboratory Scientists of Nigeria (AMLSON) and Pharmaceutical Society of Nigeria PSN) should be encouraged to drive accountability.
He said the people, who were foremost stakeholders in a PHC system, must know their rights, demand them, and hold leaders accountable.
"The people are responsible for applying basic health education principles.
"Countries like China, India, Pakistan, Rwanda, Mali, and Niger with high-performing primary healthcare systems all have a people-centred and driven system.
"NGOs and CSOs should be people-oriented and advocate for interventions that mitigate disparities and protect vulnerable groups," he said.
Agbo said that private sector should be given enabling environment to support the government to deliver on its mandate of ensuring that PHC system was built on the pillars of appropriateness, acceptability, accessibility, availability and affordability.
He said that the activities of development partners must be aligned and harmonised with government plans and people's needs.
Agbo said that aligning programmes of development partners with on-ground priorities, remained a crucial strategy to ensure that donors' catalytic investments made a difference and had far-reaching sustainable impact.
He said that before the Alma Ata declaration on PHC in 1978, Nigeria had a functional village healthcare system that provided services to the people at the community level.
Agbo said that in spite the present challenges being experienced, PHC system could be revitalised if all stakeholders were committed, worked tirelessly, acknowledged health as a human right and made it a political priority.
He described health as a business with a great return-on-investments and should be seen as such.
According to Dr Emmanuel Okpetu, Head, PHC, Kuje Area Council, instead of directly implementing programmes, national and state government agencies should provide technical support and oversight for LGAs. "This will bridge gaps at the PHC level with contextually appropriate solutions as that would help the three tiers of government to collaborate more effectively," he said.
Okpetu said that a clear distinction between implementation and oversight roles of different stakeholders were important.
He said that most oversight functions expected from national and state agencies had been overlooked because they paid more attention to programme implementation at the expense of the oversight functions.
Okpetu said the number, distribution, and quality of human resources in PHC system were suboptimal, adding that task-shifting and sharing were great strategy to bridge human resource gaps.
He said that government should expand the scope of task shifting and sharing beyond maternal health services to include other conditions like non-communicable diseases.
Okpetu called on the government to make necessary policy changes that would make it easier for people to get trained to take up roles in the PHC system.
"The system is in dire need of human resources to provide clinical, laboratory and surveillance services," he said.
Okpetu said that government should go beyond personnel recruitment and redistribution to ensure that appropriate incentives were in place to motivate PHC workforce and encourage personnel retention.
He said that community health extension workers were not motivated with ceilings which limit their career advancement.
"Incentives to be provided include career advancement opportunities and government-sponsored training with signed agreements for trained health workers to work for a specified time frame within the system or repay the cost of training," he said.
Okpetu said there was need to allocate resources to carefully selected and clearly defined priorities.
He said that donors and development partners should avoid duplication of efforts and build trust with local stakeholders and focus on addressing real challenges within the health system based on priorities identified by the government.
Okpetu advised all tiers of government to consider innovative strategies to improve health system efficiency.
He added that governments could contract private sector to run non-performing PHC facilities and institute a pay-for-performance remuneration and financing system.
Dr Uju Onyes, a Health Policy and Financing expert, said there was need to reduce fragmentation in the health governance structure.
Onyes said the challenges of fragmentation was further complicated by absence of clear roles, responsibilities and accountability systems for PHC's stakeholders and institutions.
She said that the deplorable state of PHC system and failed projects were due to poor accountability mechanisms in all tiers of government.
The expert said that stakeholders must work in synergy and deliver on their mandates as their collective action would strengthen the PHC system and make it resilient.
Onyes said although financial resources within national PHC system were inadequate, the inefficiency in resource utilisation was a challenge.
She said that governments and stakeholders should work towards revitalising the system as investments in PHC were cost-effective and would help Nigeria inch closer to UHC.


text:
YesYesHollywood
YesYesHollywood is your destination for breaking news, the latest stories and all you need to know about celebrities and Hollywood stars.
The team got together to create a unique style of telling stories, providing the latest hot news with more insights about the personalities and behind the scenes, the founder and Head content creator Noubir Loughlimi is the seed planter, his background was more into creating music and editing music videos, then he started blogging about different topics until he decided to create something where he can use his music, editing, and writing skills to bring the latest news to you without you going out looking for entertainment.
Join the family and become a member of the Hollywood world, anything from Fashion to Music, from Movie to Series and Shows, the Entertainment won't stop.
YesYesHolllywood is your place to be for trendy news, entertainment, music, movies, fashion, and everything in between. We provide you with the latest breaking news and videos straight from the entertainment industry.
Contact us: contact@yesyeshollywood.com
© Copyright © 2018, YesYesHollywood

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: Sorting and Querying an Encrypted MySQL Table 2 queries regarding encrypted/decrypted values from a MySQL table.
1) How can I possible sort these, since as the values are encrypted ORDER BY is out, and JavaScript won't sort a) correctly and b) at all. Code below, excuse formatting.
2) How would I query 'between values'
Thanks in advance.

<?php
// Connects to Server, queries all on that table.
$db_connect=mysql_connect("$host", "$username", "$password")or die("Sorry, Poor or No Connection");
$db_found=mysql_select_db("$db_name")or die("Sorry, Cannot Connect to Database");
$result=mysql_query("SELECT * FROM $tbl_name");

// Creates Table to be used
echo "
  First Name
  Last Name

";

while($row = mysql_fetch_array($result)) {
  // Decrypts table IDs
  $dec_FName = decrypt($row['FName'],'SECUREKEY');
  $dec_LName = decrypt($row['LName'],'SECUREKEY');

  echo "
";
    <echo>"" . $dec_FName . "	";
    <echo>"" . $dec_LName . "	";
  echo "
";
  }
  echo "
";

  mysql_close();
?>

I Suspect an array needs to be created. I'm happy to use JavaScript, PHP or anything else you can recommend.

A: This works fine for me:
$q3='SELECT users.uid,
users.vr,
users.br,
AES_DECRYPT(users.nm1,"123") AS nm1,
AES_DECRYPT(users.nm2,"123") AS nm2,
AES_DECRYPT(users.nm3,"123") AS nm3,
ussys.ty1,
ussys.ty3
FROM users,ussys WHERE users.uid=ussys.uid
ORDER BY nm1 DESC
';

It sorts nicely on nm1, giving me Zack-Willeke-Victor-Roiwan-Plop-Kwab-Krab-Karel-Johannes-Harry-Gerard-Dirk-Cornelis-Bernard-Anton as a result.

A: I don't think you can do this in the SQL server. If the columns are all encrypted, there's no way it can sort or filter on the columns in a meaningful way.
You'll need to pull the data into your PHP and sort it there. You'll be able to use any of PHP's array handling functions, or your own, once you've decrypted the data.
Obviously with large data sets this becomes unwieldly pretty quick, as you need to retrieve all the data for each use. Perhaps you can store some data unencrypted for this purpose, but clearly that's very specific to your security needs.

A: I know this post is quite old, but I came across the same issue and there isn't really much info out there about this.  This is what I did and it works like magic.
 SELECT AES_DECRYPT(column1, '%key%') AS 'column1' FROM `myTable` WHERE
 1 ORDER BY AES_DECRYPT(column1, '%key%') ASC;

I have a table with 230 rows and 4 columns to decrypt plus the sorting column and it takes 2.5 miliseconds to reutrn the results on a VPS VM with these specs: 2 Xeon E5 CPU Cores, 2 GBs of RAM, 50 GBs SSD.

redpajama_set_name: RedPajamaStackExchange


text:
HUMAN Raises $100 Million In Growth Funding Round Led By WestCap and NightDragon
SQUAREONE – NEW ZEALAND's FIRST MONEY APP FOR KIDS
AC Bridge International Group Publishes Report on Cultural Differences Between China and Australia to Improve Cross-Cultural Understanding Among Companies in Both Countries
Home » AC Bridge International Group Publishes Report on Cultural Differences Between China and Australia to Improve Cross-Cultural Understanding Among Companies in Both Countries
By Nick Wilsion December 24, 2021 Updated: December 27, 2021 No Comments4 Mins Read
AC Bridge International Group ("AC Bridge" )announced the release of "China and Australia Research Report on the Cultural Difference: Its Impact on the Operation of Chinese Enterprises and Countermeasures," which sheds light on some of the key cultural differences between China and Australia. The Report analyses factors giving rise to contrasting values and practices of individuals and organisations in the two countries. In publishing the Report, AC Bridge aims to offer guidance to multinational companies eyeing business opportunities in China and Australia to help bridge misunderstandings arising from cultural and social differences and foster greater cross-cultural communications to facilitate international investment.
Economic globalization deepens cooperation between China and non-Chinese enterprises with diverse cultural backgrounds. Business and cultural partnerships between China and Australia over the past five decades have significantly strengthened the bilateral relationship and paved the way for the prospect of closer economic cooperation. As more companies and organizations from both countries seek to build up a broader consumer base in the two major economies in the Asia-Pacific region, it has become crucial for them to identify cultural and societal factors that lead to differences in systems, behavior, and approaches conducting business.
One of the factors that poses a striking contrast between the two societies is that China is a highly collectivist culture that values group cohesion over individual pursuits. In contrast, in line with other Western nations, Australia attaches greater importance to individualism that stresses autonomy and independence. In contrast, China's tradition to respect structure means that Chinese decision-makers prefer to follow guidance from higher hierarchies. If decisions at the top are right and wise, they will be reflected in efficient and robust execution; if decisions are wrong, they will lead to more significant consequences yet remain uncorrected. Chinese also tend to emphasize morality and personal duty, unlike Australia, where egalitarianism underpins its national identity.
The Report defines China as a society with a high power distance in which employees tend to have great respect for their superiors and those in authority thanks to Confucianism, a dominating social and political philosophy adopted by Chinese rulers for over two thousand years. Consequently, Chinese employees are expected to conform to social norms and hierarchy while maintaining absolute loyalty and obedience to those in authority. In contrast, in Australia, people endorse a lower power distance culture due to the influence of Christian values, which holds that all people are equal in fundamental worth and moral status.
A relatively easy and equal social environment makes Australia a country with a low-context culture, meaning that employees in managerial positions welcome voices from lower-level workers and show adaptability. Communication between employees tends to be clear and direct. However, Chinese employees are exposed to a high-context culture in which straightforwardness is discouraged, are more reserved and tend to ask questions in a non-conflict way in the workplace.
The Report also finds that people in Australia and China have different views on their jobs and companies. Australians, like people in other western countries, are driven by a passion for work and are more willing to make an effort to achieve self-realization, which consequently catalysis corporate reform and transformation. Nonetheless, Australia's traditional and conservative culture means slow adoption of new things and skeptical of change. Different generations in China have developed contrasting altitudes to their career lives. The post-70s and post-80s are still working to 'survive better' — seeking job stability and worrying about changes. But the post-90s and post-00s (Gen-Z) are rarely working for survival needs anymore. They enthusiastically welcome changes. Therefore, different workforce demographics have also resulted in different attitudes towards change within different companies.
The media landscape in China and Australia is different in system, regulations, and guiding principles. China upholds Marxist media theory, with Chinese enterprises following the CPC's publicity guidelines. Journalism in Australia enjoys specific liberty under the News Media Bargaining Code, and the media is more decisive, more independent, and more assertive. Chinese unions are led by the Chinese Government in a top-down effort to improve workers' welfare and working conditions. On the other hand, Australian unions advocate for workers' welfare by organizing strikes, protesting in CBD streets, and negotiating directly with employers.
For more information, please feel free to download the full Report. We hope that it will help Australian and Chinese companies in their brand new but long-standing collaborations.
To read the Report, please visit http://www.business-circle.com.au/en/?p=5895
SOURCE: AC Bridge International Group
Previous ArticleDiamonds for Crypto: Revolution in the traditional Business (KILLED)
Next Article SQUAREONE – NEW ZEALAND's FIRST MONEY APP FOR KIDS
Nick Wilsion
Diamonds for Crypto: Revolution in the traditional Business (KILLED)
Vestas together with Deutsche Bank, Sinosure and Global Power Generation replicate the fourth payment deferral facility during 2021 to finance the 58MW Crookwell 3 Wind Farm
By John Smith January 5, 2022 0
Investment will support faster global expansion across new industry categories to protect enterprises and internet…
Your source for the Today News Journal.
Join The Conversation sign up to receive emails for The Daily special tips general info.
Copyright © 2021-2022 · Today News Journal Privacy Policy


As part of our pledge to humanity we are striving to be paperless. We now accept online referrals and all you need to do is complete the form below. You also have the option of attaching a referral letter or scan images if you have any and they will all be sent securely to our bookings team.


text:
'Who cares about Detroit?': Durant joins the fray
The Oklahoma City Thunder's Russell Westbrook isn't the only player who took exception to Reggie Jackson's celebration
'Who cares about Detroit?': Durant joins the fray The Oklahoma City Thunder's Russell Westbrook isn't the only player who took exception to Reggie Jackson's celebration Check out this story on detroitnews.com: https://detne.ws/1MWAthy
James Hawkins, The Detroit News Published 2:06 p.m. ET March 31, 2016 | Updated 12:03 a.m. ET April 1, 2016
Reggie Jackson plays to the crowd during the final seconds of the Pistons' win over the Thunder.(Photo: Carlos Osorio, AP)
The Oklahoma City Thunder's Russell Westbrook isn't the only player who took exception to Reggie Jackson's celebration in the final seconds of the Pistons' 88-82 win Tuesday.
Kevin Durant was irked by Jackson's antics and had some harsh words for his former teammate following the Thunder's shoot-around on Thursday, according to ESPN's Royce Young.
"It was bush league, in my opinion," said Durant. "Jumping up and down, running around. I understand you're happy you won the game, but our whole team didn't play. We would've beat the hell out of them if it did."
Neither Durant nor forward Serge Ibaka, who both received a rest day, played against the Pistons
"I wanted to play against Detroit, for sure, but you know, it's Detroit," Durant said. "Who cares about Detroit?"
After Aron Baynes secured a rebound and was fouled with 1.1 seconds left, Jackson began circling the court and motioning to the crowd to make some noise. Jackson then exchanged words with Thunder center Steven Adams while Baynes shot two free throws.
"I know I don't talk like that, but that (ticked) me off," Durant said. "But what can I do about it? Some guys are who they are. They won the game, congrats."
Jackson brushed off the notion that he enjoyed beating his former team more than any other opponent. Rather, he was glad the win helped put the Pistons in seventh place in the Eastern Conference standings.
Entering play Thursday, the Pistons (40-35) lead the eighth-seeded Pacers by a half-game and ninth-place Bulls by 2.5 games.
"I just enjoyed getting the win and controlling our destiny," Jackson said following the team's practice Thursday. "Just continue to position ourselves to ultimately be where we wanted to be at the beginning of the season. We're still trying to make the playoffs, still got a chance to get there and just happy we got the opportunity."
When asked about Westbrook's criticism, which came after the game, and why Jackson hasn't been publicly outspoken about the Thunder organization, Jackson said: "I played there for three and half years, had some good memories, had some ups and downs, had some battles. Not really much going on now. I'm just here trying to find a way to get as many wins as possible and hopefully lead my team to the playoffs."
Pistons coach Stan Van Gundy said Jackson's reaction wasn't out of the norm.
"That kind of stuff happens in every NBA game. I haven't been in an NBA game yet where somebody wasn't talking or doing something. Haven't been in one yet," Van Gundy said. "Do I like it? I don't, but that's a player's thing. I didn't think there was anything over the top or anything else, so there was nothing to address.
"There was nobody cheap-shotting anybody or anything else. The incident in OKC earlier this year with the fan, we talked about that one; that's different. On the court, that's between those guys."
Van Gundy's bold moves position Pistons for playoffs
Home stand blues
While the Pistons have gone 6-2 during their current nine-game home stand, Jackson has hit a rough patch offensively. He's shooting 35.2 percent (43-for-122) from the field and 23.7 percent (9-for-38) from 3-point range while averaging 14.5 points, well below his season marks (43.6 percent, 35.2 percent, 18.5 points).
Van Gundy said Jackson's struggles stem from pressing too much.
"I just think he needs to not put so much pressure on himself and feel like he needs to carry the load," Van Gundy said. "Just play, make the plays that are there in front of him, throw the ball to open people, take good shots and all of that and not worry as much. I think at times he puts a lot of pressure on himself to feel like he has to make every play."
Another reason has been a more concerted effort by opposing teams to trap and blitz Jackson.
"I think guys are trying to get the ball out of my hands early, trying to take Andre (Drummond) out of pick-and-roll situations," Jackson said. "I'm drawing two, Andre is drawing another one or two in the paint, so when we kick it out and make plays, we just hope those (wings) are ready and make the defense pay with the long ball to open up the lane for Andre and myself."
Several Pistons sounded off on the controversial video of the Lakers' Nick Young that recently surfaced online and was apparently taken by teammate D'Angelo Russell.
Van Gundy said while Russell is a rookie, he doesn't think he's "too young to know better on that one."
"It's an unbelievable situation. I mean that. I'm not shocked too often in the NBA, but that one shocked me and that's just something you don't see," Van Gundy said. "Guys usually keep each other's business pretty well under wraps and respect each other's privacy, so that one was surprising."
Jackson said with the NBA being a "fraternity," he doesn't think Russell will be welcomed in other locker rooms anytime soon.
"It's a very tough position but, I'm fortunate on my end I don't have to go through it," Jackson said. "Everybody has their own trials and tribulations, so that's something he's going to have to figure out."
Marcus Morris said Russell's actions were the ultimate breach of trust.
"It's just something that you don't want to see in the NBA. Like a lot of guys say, it's a brotherhood and things that are personal business stay personal," Morris said. "Me personally, I'd probably never say another word to him.
"It's definitely tough to come back from and you trust guys. You're around them all year and I'm pretty sure Nick Young knows some things about him that he'd never say."
jhawkins@detroitnews.com
twitter.com/jamesbhawkins
Does Gerard Gallant's firing open door for return to Red Wings?
Lions great Alex Karras elected to Hall of Fame
15 players who could make sense for Lions in Senior Bowl
Trieu: Michigan gaining traction with many in-state prospects
Donnie Corley gets second chance at football, far from Michigan State
Recruiting trouble: Sex assault scandal throws MSU for a loss


The Grand Final of the seventh edition of the Europe Online Contest begins today, and we have now more than two weeks to send your ranking to know the winner of the seventh edition. Remember, you can also vote through the voting form that has been added in the website: you will see it under all the participants in the official page of the edition, as a subpage of the 07 edition, or here. The 25 finalists will see that they cannot rank 25 countries, only 24; so, please, put the name of your country in the 25th place of the form. You can also vote through your e-mail as you have always done; it is up to you!
Don't forget to leave a comment supporting your country in our recap video or in the chat! It is a very strong final, isn't it?
The running order for the Grand Final has been released already and we already know where will the countries perform. Right after the results of the second Semi-Final, the EOBU (Europe Online Broadcasting Union) started to decide the running order for the final along with randomize.org, who has supported the event.
These countries will complete the Grand Final!
Whilst Belarus and Bulgaria have been disqualified, there has been almost a tie between the 9th and 12th place. As in Semi-Final 1, this edition has become one of the most exciting in terms of voting. Plus, there are no clear favourites at all.
These are the ten qualifiers from the First-Semifinal!
The ten qualifiers from the first semi-final have already been revealed. Did your favourite make the cut?
The head of delegation from Belarus has decided to withdraw as The Netherlands has done even before the edition is over - that means they are both out of contest and they are disqualified in their Semi-Finals. Both countries have felt unmotivated in the competition, although Belarus joined less than a month ago, which serves some polemic as some people state that they have not even tried the competition. This leaves, so far, 17 countries in Semi-Final 1 and 16 countries competing in Semi-Final 2, although the number could increase in the upcoming days.
The dutch head of delegation has announced this morning that the country will not participate in the upcoming edition of the Europe Online Contest due to organization reasons. Even though the country could come back, it is still unknown whether we'll see it again or not.
Despite of that, the country is currently looking for its new head of delegation.
The splits results from EOC 06 are available!
The split results from the sixth edition have been published on this website for you. If you want to see them, click here, or go to the history page, click on the image of EOC 06 and under the table you will see a button of "Split Results", click on there, and there you go!
The second Semi-Final kicks off and we are heading now to the Grand Final. Europe, start voting... now!
The first Semi-Final of the edition has already begun. Europe, start voting... NOW!
As our poll states that Semi-Final will be a "blood bath", the running order for this edition has been revealed. Human will open the show whilst Itinérant will be the last to perform before we know the 25 finalists. As the level in this edition is super high, we can't bet on the winner yet, can we? Leave a comment in the chat to know your opinion!
Which is the strongest Semi-Final? Leave a comment in the chat.
And we think so too. We are lost without music.
Big 5 or Big 6?
Should Australia participate in the competition?
Should we add voices during the voting?
Which is the strongest Semi-Final?


It's been more than one month since AEGEE-Izmir was in the spotlight of the AEGEE network: on 6th – 10th of February, the antenna hosted the annual European Planning Meeting (EPM), where new objectives for the organization were set out and relevant topics – "green sustainability" and "EU-Turkey relations" – were heatedly discussed. The AEGEEan talked to the main organizer Batuhan Çarıkçı to find out more about the event – and not only.
Thank you for talking to us, Batuhan! Why did you apply to host European Planning Meeting 2019 in the first place?
Basically, after the big positive development of AEGEE İzmir since 2016, the local needed a "good challenge" to strengthen its status in the network and keep the motivation of its members on top level. And actually, applying to host a statutory event wasn't one of the objectives of the agenda during the previous local Agora, but after seeing a few open calls for the EPM 2019, we didn't want to miss this chance to prepare our members for this challenge!
Are you a big antenna now?
There are currently more than 100 registered members, with around 40 of them actively volunteering.
How many participants and organizers took part?
Marie Claire Graf and Anne-Sophie Klein Gebbink as Content Managers.
You chose a highly relevant and quite controversial main theme for the EPM – green sustainability. Would you say it's a big topic in Turkey?
To be honest, I don't think people take "green sustainability" as a big topic yet, unfortunately. Turkey has currently many other issues to deal with, like corruption, social unrest and economic instability. Apart from that, there is the fact of "having been near the warzones of Iraq and Syria for many years" next to them, so the labyrinth is getting more complicated and year by year we have more military expenses, rather than investing into sustainable solutions for the environment.
What is the government strategy on sustainability in Turkey? They have passed laws to reduce the consumption of plastic pouches like the EU.
They are very rarely doing fine things, but this one was a good move, indeed. There's still long way to go though, especially in recycling. They should cooperate closer with all the municipalities, but of course if they can find some time to cooperate with them, instead of seeing them only as "castles to conquer". Apart from that, we should keep in mind that they are still trying to build fossil fuel plants around the country, as if we are in 20th Century. Fortunately, most of those attempts were precluded by strong cooperation between activists and some NGOs.
Let's now talk a bit about the host city. What is particularly famous about Izmir? What is the historical importance of the city?
Its cuisine for sure! Sorry, I can't continue without talking about food! Izmir has a great variety of seafood and mezes, with the combination of the traditional alcoholic drink "rakı", which includes anis. Next to it, the most famous beer brand of Turkey "Efes" (Ephesus in English) is coming from İzmir. Apart from that, Izmir is a good destination for sun, sea and beach kind of holidays. She also has very rich options for history lovers, there are 15 ancient cities within her metropolitan borders, including the famous ones Ephesus and Pergamon! We can't help mentioning the very special anthem of Izmir. In past, it was symbolizing the liberation of İzmir on 9th of September 1922, but today, after almost hundred years, it's symbolizing the political stand of İzmir, independent from its lyrics.
How was the EPM? Are you satisfied with the outcomes?
It went much more comfortable and stress-free, when I compare to the preparation period. Here once again I want to highlight the perfect job of all our organizers and helpers during the event; their motivation and concentration was always high. Next to that, we had a very good group of participants, which I think did good job with creating an active vibe during the content part and drafting an impactful agenda for next year.
Do you have plans for organizing more events like EPM?
I think, we are done with statutory events in Turkey -for now-. But, of course AEGEE İzmir will keep organizing international events, and hopefully the number will get higher year by year.


text:
Successful laparoscopic treatment of small-bowel obstruction in early pregnancy
Toshihiro Kitai1, Eri Yamabe1, Aki Isobe1, Kanji Masuhara1, Mutsumi Fukunaga2, Toshikatsu Nobunaga1
1 Department of Obstetrics and Gynecology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan
2 Department of Gastrointestinal Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan
Date of Decision 03-Feb-2020
Date of Acceptance 18-Mar-2020
Date of Web Publication 10-Jul-2020
Dr. Toshihiro Kitai
Department of Obstetrics and Gynecology, Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokutanji-Cho, Nishinomiya 662 0918, Hyogo
Small-bowel obstruction (SBO) during pregnancy is uncommon and can be difficult to diagnose. Therefore, the condition is associated with significant maternal and fetal mortality. We report a case of successful laparoscopic treatment of SBO in early pregnancy. A 37-year-old woman presented with diffuse abdominal pain and vomiting at 8 weeks of gestation. She had a history of abdominal surgery. Exploratory laparoscopy was performed by a gastrointestinal surgeon because SBO, and specifically strangulated ileus, was strongly suspected. On entry into the abdomen, dilated small bowel was visible in the pelvis; this was attached to the pelvic wall and twisted near the right adnexa. The small bowel initially appeared dark and congested, but after releasing the adhesions, it regained its normal color, was viable, and peristalsis was observed. Therefore, bowel resection was not required. No recurrence was observed after food ingestion, and the patient was discharged 12 days after surgery.
Keywords: Laparoscopy, pregnancy, small-bowel obstruction
Kitai T, Yamabe E, Isobe A, Masuhara K, Fukunaga M, Nobunaga T. Successful laparoscopic treatment of small-bowel obstruction in early pregnancy. Gynecol Minim Invasive Ther 2020;9:248-50
Kitai T, Yamabe E, Isobe A, Masuhara K, Fukunaga M, Nobunaga T. Successful laparoscopic treatment of small-bowel obstruction in early pregnancy. Gynecol Minim Invasive Ther [serial online] 2020 [cited 2021 Jan 28];9:248-50. Available from: https://www.e-gmit.com/text.asp?2020/9/4/0/289344
Acute abdomen during pregnancy is often encountered and may require surgery. The common nonobstetric abdominal surgical conditions encountered during pregnancy are acute appendicitis (1 in 1000–2000 deliveries), cholecystitis (1 in 1000 deliveries), pancreatitis (1 in 1000–5000 deliveries), and small-bowel obstruction (SBO).[1] SBO in pregnancy is rare (reported incidence 1 in 2,500 deliveries),[2] but it is associated with a significant risk of maternal (6%) and fetal (26%) mortality.[3] Most of the cases are thought to occur during the third trimester and are generally treated using open surgery;[4] few cases of SBO during pregnancy treated using laparoscopic surgery have been reported. This article reports the successful laparoscopic treatment of SBO during early pregnancy.
A 37-year-old woman was hospitalized at 8 weeks of gestation because of diffuse abdominal pain and vomiting. She had a history of laparoscopic total proctocolectomy and ileoanal anastomosis for ulcerative colitis; this surgery had been performed after a previous pregnancy, and there had been no postoperative complications. On this occasion, she became pregnant through artificial insemination. On physical examination, she appeared ill, with vital signs as follows: body temperature – 36.6°C, blood pressure – 100/41 mmHg, and pulse rate – 80 beats/min. She vomited a few times after arriving at the hospital. Her abdomen was distended and displayed intermittent tenderness in the lower portion. Vaginal examination revealed no bleeding or signs of imminent abortion. The results of the laboratory investigations conducted on admission were as follows: white blood cell count – 9.6 × 103/μL, hemoglobin – 11.5 g/dL, and C-reactive protein – 0.05 mg/dL, with the bilirubin, alanine transaminase, alkaline phosphatase, lactate dehydrogenase, creatine phosphokinase, blood urea nitrogen, serum creatinine, and amylase values being within the normal ranges. Arterial blood gas values were as follows: pH – 7.621, partial pressure of arterial carbon dioxide – 13.7 mmHg, base excess – 4.9 mmol/L, sodium ion – 133 mEq/L, chloride ion – 107 mEq/L, hydrogen carbonate ion – 14.3 mEq/L, anion gap – 11.7 mEq/L, and lactic acid concentrations – 4.4 mmol/L. These results suggested metabolic acidosis and respiratory alkalosis. Transabdominal ultrasonography revealed diffuse fluid-filled small-bowel loops with poor peristalsis. However, the uterus and bilateral adnexa were normal, and a fetal heartbeat (FHB) was detected in the uterine cavity. An abdominal X-ray revealed a dilated small bowel with an abnormal gas pattern, suggestive of intestinal obstruction. A preoperative diagnosis of intestinal obstruction during pregnancy was made.
Subsequently, a contrast-enhanced computed tomography (CT) scan was considered to determine the site of the obstruction, but instead, an exploratory laparoscopy was performed by a gastrointestinal surgeon, because the patient had a history of abdominal surgery, and her high lactic acid concentration was suggestive of progression to strangulated ileus, necessitating immediate surgery. Under general anesthesia, a 12-mm port was placed in the umbilical region and three 5-mm ports were placed in the right and left upper quadrants and left lower quadrant of the abdomen. On entry into the abdomen, dilated small bowel was visible in the pelvis. This small bowel was attached to the pelvic wall and twisted near the right adnexa [Figure 1]a. The small bowel appeared dark and congested initially, but after releasing the adhesions, the bowel regained its normal color and was viable [Figure 1]b. Furthermore, bowel peristalsis was observed 20 min later; therefore, small-bowel resection was not required. The FHB was present before and after surgery, and the postoperative recovery of the patient was uneventful. No recurrence of the bowel obstruction was observed after food ingestion, and the patient was discharged from the hospital 12 days after surgery. The pregnancy appeared normal at 12 and 16 weeks of gestation, but intrauterine fetal death occurred at 18 weeks, the cause of which was unknown.
Figure 1: Intraoperative photographs. (a) Loop of small bowel, twisted and attached to the pelvic wall near the right adnexa. The small bowel appeared dark and congested. (b) After releasing the adhesions, the bowel regained its color and was viable
SBO in pregnancy is rare, but late diagnosis may be associated with adverse events in both mother and fetus. Although an accurate diagnosis is required, the diagnosis of SBO is often challenging. A previous history of abdominal surgery may be suggestive of SBO, but instances of SBO developing in the absence of any surgical history have been reported.[5] Other factors that complicate the diagnosis include maternal physiologic changes during pregnancy making physical examination more difficult, the need to differentiate SBO from obstetric complications, such as hyperemesis gravidarum, and the risk to the fetus of radiologic investigations.
Many reports have shown that CT is useful for the diagnosis of SBO, and if necessary, this should be performed without delay.[6] In the case reported here, the diagnosis of SBO was relatively easy, being possible on the basis of the history and imaging findings. Therefore, and because strangulated ileus was strongly suspected, surgery was performed promptly, without CT being performed. As a result of this decision, the need for intestinal resection may have been avoided, and for this reason, exploratory surgery may be indicated without the delay required for CT examination. The safety of anesthesia during pregnancy for both obstetric and nonobstetric conditions has been well established.[7] General anesthesia is not associated with a higher risk in pregnant women. Furthermore, there is no evidence to show that the currently used anesthetic agents are teratogenic in humans at any gestational age when the standard concentrations are used. Therefore, pregnant women should not be denied surgery that is indicated, regardless of their trimester.[4]
Laparoscopy is now widely used as a diagnostic and therapeutic tool for the care of pregnant women with abdominal pain. It is well tolerated by both mother and fetus, with minimal adverse effects having been recorded during all three trimesters.[8] SBO due to adhesions is more common in advanced pregnancy, with 6%, 28%, 45%, and 21% of cases occurring during the first, second, and third trimesters and the puerperal period, respectively.[4] In the late second trimester and beyond, laparoscopy becomes technically difficult, and therefore, open incision may be preferable; indeed, previously reported cases of SBO during pregnancy have usually been treated using open surgery. For laparoscopy, open trochar placement into Palmer's point is recommended, to avoid injury to the uterus during entry,[9] and the surgeon should be careful not to touch the uterus thereafter. Palmer's point is in the left upper quadrant, 3 cm below the costal margin, in the midclavicular line. Immediate preoperative and postoperative fetal monitoring is recommended if the fetus is capable of surviving early delivery.
In the present case, the patient presented in early pregnancy, immediately after the onset of symptoms; therefore, it was possible to release the adhesions and reverse the ileus using laparoscopic surgery. If the gestational age makes laparoscopic surgery difficult, or if intestinal resection is considered necessary, open surgery should be selected instead of laparoscopic surgery. A published series of cases of SBO caused by adhesions during pregnancy showed that the prevalence of fetal mortality resulting from surgery is 0%, 18%, and 13% during 1–12 weeks, 13–28 weeks, and 29–40 weeks of gestation, respectively.[10] Unfortunately, intrauterine fetal death occurred in the present case, but 2 months had passed since the surgery, and this was therefore unlikely to be related to the procedure.
Laparoscopic surgery is a minimally invasive treatment for SBO during pregnancy. When a substantial number of cases have been treated in this way, statistical analysis of the success rate should be performed.
We thank Mark Cleasby, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
The ethics committee of Hyogo Prefectural Nishinomiya Hospital has approved human experimentation. Institutional Review Board Project #31-36 was obtained on October 1st 2019.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
There are no conflicts of interest
Skubic JJ, Salim A. Emergency general surgery in pregnancy. Trauma Surg Acute Care Open 2017;2:e000125.
Sharp HT. The acute abdomen during pregnancy. Clin Obstet Gynecol 2002;45:405-13.
Perdue PW, Johnson HW Jr., Stafford PW. Intestinal obstruction complicating pregnancy. Am J Surg 1992;164:384-8.
Zachariah SK, Fenn MG. Acute intestinal obstruction complicating pregnancy: Diagnosis and surgical management. BMJ Case Rep Mar 2014, 2014bcr2013203235. DOI:10.1136/bcr-2013-203235.
Rauff S, Chang SK, Tan EK. Intestinal obstruction in pregnancy: A case report. Case Rep Obstet Gynecol 2013;2013:564838.
Lazarus E, Mayo-Smith WW, Mainiero MB, Spencer PK. CT in the evaluation of nontraumatic abdominal pain in pregnant women. Radiology 2007;244:784-90.
Kuczkowski KM. Nonobstetric surgery during pregnancy: What are the risks of anesthesia? Obstet Gynecol Surv 2004;59:52-6.
Affleck DG, Handrahan DL, Egger MJ, Price RR. The laparoscopic management of appendicitis and cholelithiasis during pregnancy. Am J Surg 1999;178:523-9.
Thepsuwan J, Huang KG, Wilamarta M, Adlan AS, Manvelyan V, Lee CL, et al. Principles of safe abdominal entry in laparoscopic gynecologic surgery. Gynecol Minim Invasive Ther 2013;2:105-9.
Webster PJ, Bailey MA, Wilson J, Burke DA. Small bowel obstruction in pregnancy is a complex surgical problem with a high risk of fetal loss. Ann R Coll Surg Engl 2015;97:339-44.
Kitai T
Yamabe E
Isobe A
Masuhara K
Fukunaga M
Nobunaga T
small-bowel obstruction


Photos play a huge part in our travel lives. It's fantastic to be able to experience a country, culture, food and people and have those memories in our minds. It's even more fantastic to have great photos of the things we see and do so we can look back on them whenever we choose.
This year took us through China, Mongolia, Russia, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan, Turkmenistan, Iran, England and finally…home to Canada. We've gone through our bazillion or so photos and selected some of our favourites to take you on a journey through our year of travel.
A wonderful woman we met in the Old Town, Yangzhou, China.
We went to Shanghai many times…such an awesome skyline!
We went to the nearby city of Suzhou for a long weekend away. Motorcycles, bicycles and street vendors are found all over China!
Beautiful Yangzhou, China – our home for a year.
Colourful blossoms were found all around China during March & April. We went to Hangzhou for a few days to see these beauties.
A very friendly Chinese man that we met during our trip to Hangzhou.
We ate so many dumplings during our year in China! Not only are they delicious, but they're cheap.
We spent 6 days in the Gobi Desert and loved it. Watching the sun set over these gorgeous dunes was a highlight.
Two lone gers in the middle of the Mongolian steppe.
Man & Man's Best Friend in Mongolia.
We trekked independently in Mongolia for 8 days. This was one of our campsites for the night…with double rainbows as a background!
Spreading around some Canadian cheer on the Mongolian steppe.
A means of drying out cheese for the nomadic people.
Camping along the shores of Lake Baikal: the deepest, oldest and one of the clearest freshwater lakes in the world.
The gorgeous Nur-Astana Mosque at sunset.
Big Almaty Lake in the Alatau – Eliy National Park.
A 3 day horse trek to Lake Song-Kul. Us at the 3,000m high pass.
Looking back down the valley during our 3 day trek from Karakol to Altyn Arashan.
At 3,560m the Ala-Kul Lake was stunning.
Enjoying the picturesque village of Arslanbob.
A Pamiri girl in Ishkashim.
Gorgeous views of the Wakhan Corridor from the ancient Abrashim Qala Fort.
A Wakhi woman during the harvest in the village of Langar.
Views of the Pamir Mountains and Hindu Kush on the Pamir Highway.
An Afghan man looks on during the cross border market with Tajikistan & Afghanistan.
A Wakhi girl in the village of Langar.
Amir Timur Mosque lit up at night in Samarkand.
One of the many white marble buildings in one of the strangest cities we've been in: Ashgabat.
Hiking around the desert village of Garmeh.
Taking an afternoon break in the sun, Tabriz.
Illuminated stained glass at the Nasir al-Mulk Mosque in Shiraz.
A Persian Cat in Persia!
A Qalyan (water pipe) shop in Kerman…these are found all over Iran.
Pomegranates are so delicious and found all around Iran.
The troglodyte village of Kandovan.
At the Kaluts in the desert to watch the sun set.
Our second visit to London was just as good as the first back in 2011.
This was such a fantastic year for the two of us! Since being home in Canada, we've been so "go, go, go" that we haven't really had a chance to reflect on this 5 month trip that we just undertook. Going through all of these photos really helped the reality of it sink in.
We thank everyone for following our journey this year, commenting on our articles and giving us constructive criticism. We really appreciate it. We have lots of plans for 2014, so stick around to see what we get up to!
What did you get up to in 2013? Any plans for 2014? Share with us below!
Those dumplings look delicious. Also, your campsites look great as well as the hike!
Thanks Angela! Trust me, those dumplings were delicious! We always ate them haha.
I'm really jealous of your Iran photos!
Thanks for the comment Doug. Iran was so photogenic!
Impossible to choose a favourite, they are all so awesome! I can't wait to travel the silk route one day, and your photos are so inspiring. We've chatted to quite a few travellers on this trip who have come that way either by cycling or public transport and they have all raved about it.
haha, yep, dumplings are definitely good! We can't wait to come to Central America! Hopefully within the next year.
Love the photos, especially of the camping in Mongolia. Love the Canadian stickers on the kids eh, some Canuck propaganda!
Aren't those kids so adorable with the Canadian flags on their cheeks! Too cute. Thanks for the comment Frank, the one of the campsite is definitely a favourite of ours.
Incredible photos! You really seem to have had an adventurous year! Wishing you a great 2014 as well!
Thanks for the comment. Happy Travels.
Absolutely breathtaking photos guys, particularly of so many off the beaten track places that most of us would never think to venture to! It's quite cool after seeing these photos from Iran and Tajikistan to suddenly see my hometown of London right at the bottom! Look forward to reading about all your adventures in 2014!
these pics are really great. I have been traveled to china 5 years ago and i still want to come back there one more them. china seem to be a small world of many small countries because you can see many kind of people and culture there.