There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age.
We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference.
15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent.
Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.
An increasing number of middle-aged women from highly industrialized countries are practicing disordered eating behaviors . Eating disorders often show a chronic course, functional impairment, and seem to increase the risk of several health problems such as future obesity, depressive disorders, suicide attempts, anxiety disorders, and substance abuse . Besides clinically diagnosed eating disorders such as anorexia nervosa and bulimia nervosa , disordered eating includes a wide range of eating-related problems . Such behavior occurs relatively frequently but does not meet full criteria for the diagnosis of an eating disorder ,. In general, disordered eating is a well-researched phenomenon, which is mainly assessed in adolescent and young adult women . So far, few studies have investigated disordered eating in women between the ages of 40 and around 65 years , although health professionals have recently begun to focus their attention on disordered eating among this age group . Admissions of middle-aged women to eating disorder inpatient treatment has increased over the last ten years ,.
Although in several studies, restrained eating has been identified as a main risk factor for young women to develop an eating disorder , as yet, specific trajectories of eating disorders in middle-aged women remain unknown. In general, restrained eating is defined as an intentional restriction of energy intake with the aim of losing or controlling weight . Despite this definition, several studies indicate that restrained eating predicts weight gain and might be a risk factor for future onset of obesity ,.
Several studies found biological (e.g. body mass index), psychological (e.g. self-esteem), and sociocultural influences (e.g. weight-related teasing)  to predict disordered eating patterns - and these seem to be independent of age. However, a specific factor associated with eating behavior in middle-aged women might be menopause status. Menopause is defined as the permanent cessation of the primary functions of the human ovaries . Menopause can be determined retrospectively, once 12 months have elapsed with no menstrual cycle, and this time frame distinguishes menopause from other related terms such as premenopause, perimenopause and postmenopause . Premenopause describes a period of time with regular menstrual cycles. Perimenopause is a period of time when menstrual cycles begin to become irregular. Finally, postmenopause starts after the final menstrual period. After 12 months of amenorrhea, it can be determined that a woman has entered postmenopause .
Menopausal transition is a complex psychophysiological process . During the menopausal transition, women could gain an average of 2 to 2.5 kg in weight over 3 years, which is often regarded as the major contributing factor to midlife body weight gain in women . Besides this, it has been shown that a shift to an abdominal fat redistribution occurs . Since slimness is an important criterion of female attractiveness in many societies ,, it can be assumed that middle-aged women may experience a loss of attractiveness due to the age-related naturally occurring weight gain . However, the data regarding body image in this age group are contradictory. Although researchers found that the perception of attractiveness is not influenced by age or menopausal status , postmenopausal women reported less positive attitudes about their appearance than premenopausal women .
Overall, body weight and female self-experienced attractiveness are closely connected, as are self-rated attractiveness and self-esteem . Additionally, as supported by meta-analyses, self-esteem seems to be associated with disordered eating . Lower self-esteem, which means a reduced sense of contentment, self-acceptance, and a reduced appraisal of one's own worth, predicts higher rates of eating disorders in young women - and body dissatisfaction or symptoms of bulimia nervosa in middle-aged women ,,.
Our study was designed with two aims: first, to examine the association between menopausal status and disordered eating, with a particular focus on restrained eating in middle-aged women. Our hypothesis was that postmenopausal women will show increased scores in disordered eating than premenopausal women. Our second aim was to examine the role of self-esteem in disordered eating in this age group. We hypothesized that low self-esteem will be positively associated with disordered eating in postmenopausal women.
Potential participants were contacted by email using mailing lists and websites from women's organizations (e.g. www.frauenlandsgemeinde.ch) in Switzerland. The information of the advertisement in the internet in order to inform and recruit the women contained a brief explanation about the study: We introduced the background of the study with the fact that little has been known about eating behavior and related factors in middle-aged women. After this short introduction we informed potential study participants that the online questionnaire would contain questions about demographics, their eating behavior, psychological variables, and menstrual cycle status. Email recipients were also informed that the online survey would take about 15 minutes. The inclusion criteria was age over 40 and female gender. At the end of our information letter, we referred to the link, which had to be opened in order to get to the questionnaire. The survey was programmed using the software Unipark (http://www.unipark.info/1-0-online-befragungssoftware-fuer-studenten-und-universitaeten-unipark-home.htm). Overall, we sent about 5'000 Email invitations and 1101 potential participants started to fill out our questionnaire. The drop-out rate (participants who did not fill out the questionnaire completely) in our study was 40.2%.
Participation in the study was voluntary and all women gave their informed consent. Only participants who agreed with the informed consent were able to fill out the questionnaire. Upon completion of the questionnaire, the participants were thanked for their filling in the questionnaire and informed that their anonymity would be guaranteed. Participants who were interested in a follow-up study or who wished to receive further information on the study results could leave their e-mail addresses. Additionally, contact information was provided for the unlikely event that responding to stress or symptom-related questions caused acute psychological problems. This study was conducted in accordance with rules and regulations of the appropriate ethics committee (The Faculty of Arts and Humanities of the University of Zurich, Switzerland).
We excluded participants with the following criteria: age under 40 or over 66, pregnancy, self-reported Affective Disorder, Eating Disorder or Anxiety Disorder, last menstruation more than 15 years ago and participants who did not complete all questions. After the completion of the study, menopausal status was defined as follows: premenopausal women (N = 318) reported to have a regular or irregular menstrual cycle in the past 12 months, which means that participants with a possible perimenopausal status were in the group premenopausal women included, too. Postmenopausal women (N = 250) had not had a menstrual cycle during the past 12 months. The women were asked to provide the date (day, month, year) of their last menstruation. The detailed process of recruitment and the selection of the two groups from a large sample are shown in Figure 1.
The online survey consisted of 58 items. The first section of questions comprised items addressing socio-demographic, general health-related, and menstrual cycle-related variables. The second section of the survey consisted of questions about eating behavior and self-esteem, presented in a randomized order.
Participants were asked to indicate their weight and height, and BMI was calculated as weight divided by the square of height in cm. Besides this, participants were asked to measure their waist (at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest) and hip circumference (widest portion of the buttocks) . Waist-to-hip ratio (WHR) was calculated by dividing the waist by the hip circumference . In addition, we illustrated the definition of the WHR measurement with a picture. WHO norms  define obesity for females as a WHR above 0.85, or a BMI above 30). BMI and WHR were used as control variables in this study.
Eating behavior was assessed with the German version of the Eating Disorder Examination-Questionnaire (EDE-Q) ,. The EDE-Q is a self-report instrument with 36 items covering the previous 28 days. It contains four subscales measuring restrained eating, shape concern, weight concern, and eating concern, to be summarized with a global score. The items can be answered on a 7-point scale, with higher scores reflecting greater eating-related pathology. Frequencies of disordered eating behaviors including binge eating and various compensatory behaviors are also assessed. Based on this questionnaire, "extreme dietary restraint" was defined with reference to the EDE-Q "food avoidance" item, namely "going without food for a period of eight or more waking hours on average three or more times per week in order to influence weight or shape" ,. For the EDE-Q, norms for anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified are available for young women ,,. The scores of the subscale "restrained eating" range from 0.1 to 2.6 among women without diagnosed eating disorders, while means of restrained eating between 2.7 and 6 are found in women with eating disorders. Women with clinically meaningful scores show values ranging between 3.7 and 6.0 for "shape concern", between 3.09 and 6.0 for "weight concern", and between 1.85 and 6 for "eating concern" .
Additional six items measure diagnostically relevant information, e.g. symptoms of binge eating. In our study, we analyzed the item 13 "Over the past 28 days, how many times have you eaten what other people would regard as an unusually large amount of food (given the circumstances)?" and item 14 "On how many of these times did you have a sense of having lost control over your eating (at the time you were eating)?". These key behavioral items were dichotomized for any occurrence (≥1 episode versus 0 episodes over the past 28 days) and regular occurrence (≥4 or < 4 episodes in the last 28 days) .
In this study, the Cronbach's alpha for each subscale was acceptable (restrained eating = .78; shape concern = .89; weight concern = .77; eating concern = .82).
Self-esteem was assessed with the German version  of the self-esteem scale (RSE) , which is a widely used self-esteem inventory in social science research. The scale contains 10 items to be scored from 1 = "totally disagree" to 4 = "totally agree". Negatively coded items were recoded in order to calculate the sum score. In the present study, the Cronbach's alpha for SES was .74, which is acceptable.
Following overall descriptive data analysis and the analysis of frequencies and intensities of disordered eating behavior, and the key behavioral factors for binge eating, premenopausal women and postmenopausal women were compared with regard to eating behavior, such as restrained eating, shape concern, eating concern and weight concern, using multivariate ANOVAs. Furthermore, BMI, age and WHR were included as covariates, and univariate ANOVAs with menopause status as factor and restrained eating or self-esteem as dependent variables were conducted. An additional univariate ANOVA was performed with menopause status as factor and "extreme dietary restraint" as dependent variable including the control variables BMI, age and WHR.
Table 1 provides descriptive data of the total study sample (N = 568 women, aged from 40 to 66 years).
Note: EDE-Q restrained = subscale restrained eating of the EDE-Q; EDE-Q eating = subscale eating concern of the EDE-Q; EDE-Q weight = subscale weight concern of EDE-Q; EDE-Q shape = subscale shape concern of the EDE-Q; BMI = body mass index; RSE = Rosenberg Self-Esteem Scale.
80.8% (N = 459) of all participants show a score higher than 0 on restrained eating. 15.7% (N = 116) of the participants show clinically relevant scores on restrained eating. 10.7% (N = 61) participants reported "Extreme dietary restraint", defined as going without food for a period of eight or more waking hours on average three or more times per week. Of these 61 participants, one participant reported a BMI < 18.5, 42 a BMI between 18.5 and 25, and 18 women reported a BMI over 25.
Comparable scores were found in the subscales eating concern, weight concern and shape concern, with 56.9% to 82% of all participants reporting low to moderate manifestations of disordered eating. 6% to 12.5% reported clinically meaningful scores on these subscales. Figure 2 displays the distributions of eating patterns.
Manifestations of disordered eating behavior.
In addition, results of the key behavioral features showed the following results: 69.7% (N = 396) showed no occurrence of eating large amounts of food (EDE-Q item 13), whereas 30.3% (N = 172) scored higher than 1. 86.7% (N = 493) reported no regular occurrence of this behavior whereas 13.3% (N = 75) showed scores higher than 4. 77.5% (N = 440) showed no occurrence of lost control during eating (EDE-Q item 14), whereas 22.5% (N = 128) scored higher than 1. 89.2% (N = 507) reported no regular occurrence of this behavior whereas 10.8% (N = 61) showed a score over 4.
Most correlations were significant at the .001 level, except for WHR and menstrual status, where the associations with the other variables were mostly insignificant (see Table 2).
Note: Unless otherwise noted, all coefficients were significant at the p = .001 level; a: significant at p < .05; b: non-significant; m.status = menopausal status; RSE = Rosenberg Self-Esteem Scale; EDE-Q restraint = subscale restrained eating of the EDE-Q; EDE-Q eating = subscale eating concern of the EDE-Q; EDE-Q weight = subscale weight concern of EDE-Q; EDE-Q shape = subscale shape concern of the EDE-Q; BMI = body mass index; WHR = Waist-to-Hip Ratio.
The overall multivariate analyses (Hoteling-Spur) with menopause status as factor and the subscales of EDE-Q and RSE as dependent variables revealed a main effect of menopause status change [F(5, 562) = 2.584, p = .025, partial η2 = .022]. Results obtained by multivariate ANOVAs indicate that restrained eating in postmenopausal women is increased compared to premenopausal women (F[1, 566] = 3.931, p = 0.048, partial η2 = .007), and self-esteem is decreased in postmenopausal women (F[1, 566] = 5.234, p = 0.023, partial η2 = .009). No significant differences in other eating behavior variables, such as eating concern (F[1, 566] = 0.087, p = 0.768, partial η2 = .000), weight concern (F[1, 566] = 0.006, p = 0.936, partial η2 = .000), and shape concern (F[1, 566] = 0.093, p = 0.761, partial η2 = .000), were observed between pre- and postmenopausal women (see Table 1). No covariates were included in this multivariate analysis.
Results obtained by univariate ANOVAs with menopause status as factor and BMI as dependent variable indicate that Body mass index (BMI) did not differ between the groups (F[1, 566] = 1.284, p = 0.258, partial η2 = .002). Additionally, WHR did not differ between the groups (F[1, 330] = 3.091, p = 0.080, partial η2 = .009).
Results obtained by univariate ANOVAs with menopause status as factor and restrained eating as dependent variable show that when controlling for BMI, WHR and age, BMI was a significant covariate (F[1, 327] = 18.038, p = 0.000, partial η2 = .052).
The results with the subgroup of women who reported "Extreme dietary restraint" showed a different pattern of findings: The univariate ANOVAs with menopause status as factor and restrained eating as dependent variable show that when controlling for BMI, WHR and age, menopause status (F, = 4.615, p = 0.042, partial η2 = .161) and WHR (F, = 5.406, p = 0.029, partial η2 = .184) were significant predictors of restrained eating.
Results obtained by univariate ANOVAs with menopause status as factor and self-esteem as dependent variable show that when controlling for BMI, WHR and age, menopause status (F[1, 327] = 5.789, p = 0.017, partial η2 = .017) is a significant predictor of self-esteem.
Results from the multiple regression analysis with self-esteem and self-esteem squared as independent variables and restrained eating as dependent variable are shown in Table 3 and suggest a U-shaped relationship (see Figure 3). Overall, self-esteem explained 6.1% of the variance in restrained eating.
Note: RSE = Rosenberg Self-Esteem Scale.
U-shaped relationship between self-esteem and restrained eating.
A mediation analysis with menopause status as an independent, restrained eating as a dependent variable and self-esteem as potential mediator based on the Baron & Kenny  and Sobel method  suggested that self-esteem mediated the relationship between menopause status and restrained eating. However, the bootstrapping approach by Preacher and Hayes (, and as available as an SPSS-syntax on their homepage, http://www.afhayes.com/spss-sas-and-mplus-macros-and-code.html) did not provide significant results. We, thus, do not further interpret the results from the aforementioned mediation analyses.
This study focused on the role of menopausal status and self-esteem in terms of their relationship with eating behavior in normal-weight middle-aged women. Overall, the results suggest that restrained eating is a relavitely frequent behavior among middle-aged women: 15.7% of all participants report restrained eating scores in a clinically meaningful range. In addition, 10.8% - 13.3% of all participants showed a regularly occurrence of binge eating symptoms. Compared to premenopausal women, postmenopausal women report a decreased self-esteem and higher levels of restrained eating, whereas this effect disappears when BMI and age are controlled for. However, even when controlling for BMI, WHR and age, both menopause status and WHR seem to be in a relationship with extreme dietary restraint. Self-esteem was associated with restrained eating, showing a U-shaped curve. Based on these data, it might be followed that self-esteem mediates the relationship between menopausal status and restrained eating, however the results of the additional mediation analyses were inconsistent.
The assessed mean scores of the subscales of the EDE-Q indicate that middle-aged women's eating concerns are comparable with those of young adult women . However, to date, no normative data for this older age group are available. In the present study, a subsample of 6–15.7% women showed subscale scores in a clinically meaningful range, thus suggesting that negative body image and eating disorders may appear in older women ,.
Even tough a recent study examined overweight middle-aged participants and showed increased restrained eating in postmenopausal women, our finding that normal-weight postmenopausal women show increased restrained eating when not controlling for BMI could be seen in a similar line ; we have also found an associtation between menopausal status and restrained eating.
The authors described that postmenopausal women (M = 51.7 years) reported higher levels of dietary restraint than premenopausal women (M = 35.7 years). However, in that study, postmenopausal women still had a significantly higher BMI than premenopausal women. To the best of our knowledge, this is the first study in this field, examining participants with normal weight. Although restrained eating and BMI are modestly positively correlated, it is highly surprising that restrained eating differs between the average normal-weighted pre- and postmenopausal women. This finding might have interesting implications for further studies.
Furthermore, menopause-related changes in body fat distribution or increasing BMI in middle-aged women are seen as having a negative impact on appearance -,. Beyond this, the physiological changes after menopause could be associated with increased feelings of body dissatisfaction and lower psychological well-being than in the years before menopause ,. When internalized ideals of appearance no longer seem achievable , this may affect body image and eating behaviors. This effect seems to be even greater the more physical appearance is seen as an integral part of the self-concept .
It is difficult to distinguish the association between menopause and restrained eating or BMI from age or age-related factors, such as sedentary lifestyle, slowed metabolism, or less sleep. All of these factors have independently been associated with weight gain . Indeed, our data suggest that postmenopausal women showed higher restrained eating and, when controlling for BMI, WHR and age, only BMI seems to be in a modest positive relationship with restrained eating in middle-aged women. Previous research suggests positive , negative , or no relationships between BMI and restrained eating. However, in normal-weight groups, restrained eating and BMI seem to be positively associated ,,. It might therefore follow that in normal-weight populations, restrained eating may serve as a marker for the tendency to overeat - which could then call for constant counter-regulation.
In younger women, several studies have shown that decreased self-esteem is a risk factor for developing disordered eating behavior . However, results regarding this relationship in middle-aged women have been inconsistent, with some suggesting a positive and some a negative relationship ,. The U-shaped relationship found in the present study now suggests that low as well as high self-esteem might be associated with restrained eating, although the findings are more robust for the former. This finding seems to integrate the previous and seemingly contradictory results. Many women seem to link their self-esteem to their appearance. The realization that one is no longer able to fulfill societal ideals of appearance was found to have a negative impact on self-esteem . Given that restrained eating is intended to maintain or decrease a particular weight , and weight loss was found to improve self-esteem , increased restrained eating could be regarded as a measure to raise self-esteem .
However, the results should also be interpreted in light of the study's strengths and limitations. Online-based data collection allows access to a broad sample of participants as well as the assessment of data in a short period of time . Nevertheless, this is a cross-sectional study and the results should be interpreted with caution because our results show only associations without causal meanings; only longitudinal study might provide more conclusive answers to the question of whether menopausal status and self-esteem might cause disordered eating in middle-aged women. Furthermore, potential problems with online recruitment may occur. Online studies are based on self-reported data, which leads to the inability to verify the inclusion and exclusion criteria. In addition, individuals with high BMI or circumferences might not want to share this information, even if it is anonymous. For example, even tough we tried to provide a clear definition of the WHR measurement, it might be subjective what the "widest portion of the buttocks" is, and therefore cause biased results. Overall, the recruited participants might be a biased selective population. It could also explain why the BMI is in a normal weight range. In addition, mixing potential perimenopausal and postmenopausal women may have biased the results – a limitation which is due to our online assessment lacking an endocrine validation of menopausal status. We acknowledge that future and methodological more rigorous studies in this field might use endocrine assessments. However, with this initial investigation in this relatively large sample, endocrine analyses would not have been feasible.
Moreover, participants in this online study may have reported specific eating behaviors as a consequence of their educational and professional background.
In conclusion, this study focused on menopausal status, self-esteem and eating patterns in middle-aged women, and in so doing, might shed light on this relatively understudied topic. It shows that not only women with diagnosed eating disorders may show eating-related changes, but also non-diagnosed, healthy, middle-aged and normal-weighted women may have increased scores, especially in restrained eating. It remains to be analyzed whether it is specifically menopausal status or other age-related factors, which influence self-esteem in middle-aged women. As described in a recent study, it can be hypothesized that menopausal transition could represent a window of vulnerability to eating-related changes . In Western societies, menopausal transition is often perceived as a time of emotional and physical health impairment . Independently, disordered eating is influenced by a multitude of bio-psycho-social factors ,. Thus, while not every woman is necessarily predisposed to developing restrained eating patterns during her menopausal transition, her experienced self-esteem might influence this relationship. According to recent data, over 70% of women aged over 50 years report dissatisfaction with their current weight and shape, being compared to when they have younger , likely, being vulnerable to develop disordered eating. This suggests that women in midlife might be particularly vulnerable to developing disordered eating behavior. Further studies could help identify specific risk groups for disordered eating in this age group, in order to develop prevention and treatment options for the most vulnerable. With increased ageing in our societies and stable youth-related norms of attractiveness, the demand for such interventions might well increase over the coming years.
SD designed the study, recruited the participants, analyzed the data and wrote the manuscirpt. SA helped to recruite the participants and analyze the data. BD supervized the data analysis and edited the manuscript. BTC was involved in the discussion of the data analysis and its implications. UE designed the study with SD, supervised it and edited the manuscript. She was the chief supervisor of the study and manuscript. All authors read and approved the final manuscript.
The authors would like to thank all the women who participated in this study. There were no funding sources for this project.


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InvestmentsMortgage
Foreign investors go big on U.S. real estate
International buyers want American sand and sun
July 8, 2014, 12:33 pm By Trey Garrison
Favorable exchange rates, affordable home prices and rising affluence abroad continue to drive international buyers, who snapped up $92.2 billion in U.S. real estate properties and investments between April 2013 and March 2014.
That represents a substantial increase in the previous 2012-2013 level of $68.2 billion, according to the National Association of Realtors.
"We live in an international marketplace; so while all real estate is local, that does not mean that all property buyers are," said NAR President Steve Brown, co-owner of Irongate, Inc. Realtors in Dayton, Ohio. "Foreign buyers are being enticed to U.S. real estate because of what they recognize as attractive prices, economic stability, and an incredible opportunity for investment in their future."
International buyers and recent immigrants purchased homes throughout the country, but four states accounted for 55% of the total reported purchases – Florida, California, Arizona, and Texas.
Florida remains the destination of choice, claiming a 23% share of all foreign purchases. California comes in second with 14%, Texas with 12% and Arizona with 6%.
The top five cities searched online by international buyers in 2014 were Los Angeles, Miami, Las Vegas, Orlando and New York City.
Foreign buyers take many factors into consideration when deciding where to purchase abroad, such as proximity to their home country, the presence of relatives and friends, job and educational opportunities, and climate and location.
European buyers are generally attracted to states with warmer climates such as Florida and Arizona, while the West Coast tends to attract Asian purchasers. Indian buyers tend to gravitate toward states that are home to large information technology companies, such as California, New York and North Carolina.
Within markets in an individual state, it is not unusual to find concentrations of people grouped by nationality, possibly indicating that word-of-mouth and shared experiences influence purchases.
Twenty-eight percent of Realtors reported working with international clients this year. International sales tend to be handled by specialists and only 4% of those who reported having an international client saw 11 or more international transactions in a year.
Of those who reported having an international client, approximately 54% reported that international transactions accounted for 1% to 10% of their total transactions, a decrease from 2013 but still in line with past years' levels.
International buyers are more likely to make all-cash purchases when compared to domestic buyers. In 2014, nearly 60% of reported international transactions were all cash, compared to only one-third of domestic purchases.
Mortgage financing tends to be a major problem for international clients due to a lack of a U.S.-based credit history, lack of a Social Security number, difficulties in documenting mortgage requirements and financial profiles that differ from those normally received by financial institutions from domestic residents.
Most homes purchased by foreign buyers, about 42%, are used as a primary residence. Non-resident foreigners are limited to 6-month stays in the U.S., so these buyers largely use the property for vacation or rental purposes or as an investment. Approximately 65% of purchases involved a single-family home. Nearly half of international clients preferred properties in a suburban area, about a quarter preferred a central city or urban area, and about 13% choose to purchase in a resort area.
International buyers come from all over the world, but Canada, China (The People's Republic of China, Hong Kong and Taiwan), Mexico, India and the U.K. accounted for approximately 54% of all reported international transactions. Canada maintained the largest share of purchases, dropping from 23% in 2013 to 19% in 2014; however, China held the lead in dollar volume, purchasing an estimated $22 billion with an average sale cost of $590,826. China was also the fastest growing source of transactions, now accounting for 16% of all purchases, up 4% from last year. Mexico ranked third with 9% of sales and India and the U.K. both accounted for 5%.

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text:
WONCA YOUNG DOCTOR'S MOVEMENT
Family medicine 360°: Global exchanges in family medicine
Ana N Barata1, Sara Rigon2
1 USF Amora Saudável, Amora, Portugal
2 Research Intern Introduction Program, Aarhus University, Center of Global Health, Department of Public Health, Bologna, Italy
Date of Web Publication 23-Jul-2015
Ana N Barata
Rua Dona Branca Saraiva de Carvalho, 9C 2845-452 Amora
Source of Support: The authors, hereby, declare presenting a conflict of interest as both of them have been involved, at some point, in the establishment and management of the Hippokrates Exchange program as well as the FM360º program over the past years., Conflict of Interest: None
Objective: The global world of the 21 st century has created communities and cultures that are interconnected, thanks to the development both in the field of transportation and technology. In this global intercultural community, future physicians, and even more so future general practitioners (GPs)/family physicians (FPs), need to be clinically competent and culturally sensitive and flexible in order to adapt to different social settings while delivering holistic care in multiethnic teams and environments with professionalism. As such, exchange programs are exceptional opportunities for international collaboration and the development of personal and professional competencies of these health care professionals. Materials and Methods: This article presents a review of the literature on the value of exchanges as well as the results of exchange programs with educational content that are aimed at junior GPs/FPs. Results: Exchange programs have been growing in popularity, especially among junior GPs/FPs. Since its launch in 2013, The "Family Medicine 360° (FM360°) program has been receiving up to 163 inquires till date, promoting global cooperation among the World Organization of family Doctors (WONCA)'s Young Doctors' Movementd (YDMs). Conclusions: By participating in an exchange program, future GPs/FPs are given the chance to experience intercultural communication and peer collaboration. They also develop personal and professional skills and thus, actively contribute to the growth and development of primary care all over the world.
Keywords: Continuing, education, exchanges, medical, primary health care, young doctors′ movements (YDMs)
Barata AN, Rigon S. Family medicine 360°: Global exchanges in family medicine. J Family Med Prim Care 2015;4:305-9
Barata AN, Rigon S. Family medicine 360°: Global exchanges in family medicine. J Family Med Prim Care [serial online] 2015 [cited 2019 Jul 18];4:305-9. Available from: http://www.jfmpc.com/text.asp?2015/4/3/305/161302
The developments in the field of information technology (IT) have made it easier for everyone to read about other settings and cultures at a global level. One could question the benefits of experiencing such cultures firsthand; [1],[2],[3],[4],[5] however, interest for international exchanges has increased among students at all levels and in every field of education, especially medicine. Many schools and universities around the world have acknowledged this need [6],[7] and are now promoting exchanges and the internationalization of academic curricula, wishing to prepare students for a more culturally global world as well as work environment.
The value of exchanges
Health education leaders have been increasingly calling for a major rethinking and reform of the medical education in order to meet contemporary and future health challenges. The socioeconomic conditions of the new century, such as the increased mobility and migration of people, make it important to promote intercultural learning and prepare future health care professionals to work in a global, interconnected, and fast-changing setting where solutions can be met, thanks to prior contact with the problem. [1],[8],[9],[10] A prime example is the commission on the education of health professionals for the twenty first century, launched in January 2010, that issued the one-hundred-year anniversary of the Flexner Report, a primary revolutionary reform in medical education. [9] In 1910, the Flexner Report based on a series of studies on the education of health professionals produced a major renovation of medical training around the world. A century after that ambitious reform, the Lancet Commission highlights a call from 20 professionals and academics for an extensive renovation in the education of health professionals in the 21 st century.
It is known that in the global intercultural community, future physicians, and even more so future general practitioners (GPs)/family physicians (FPs), need to be clinically competent as well as culturally sensitive and flexible in order to adapt to different social settings and deliver holistic care in multiethnic teams and environments. [6],[8],[9],[11],[12] Primary care physicians are the gatekeepers in most health care systems. Thus, it is important for these health care professionals to be familiar with different cultural backgrounds in order to be able to offer the best care and support to their patients.
In such a context, the need to harmonize and internationalize medical curricula becomes a global concern and an imperative need. This raises a debate on its implementation, learning methods, and the required educational activities. [9],[13],[14] One strategy for internationalization that is widespread constitutes the exchange programs. Many postgraduate schools and universities around the world have started to broaden up their curricula to include a more global perspective while at the same time, they offer various intercultural programs (although mainly as extracurricular activities) as part of their core curricula. [15],[16] These programs have grown in popularity among students at all academic levels. [10],[17] Consequently, the concept of exchanges shifted from an initial mindset of a "limited, personal, and fun gap year" to an actual opportunity for "learning and development of the professional experience".
In fact over the last decade, the number of scientific papers advocating the internationalization of higher education while exploring the educational value of exchanges has increased considerably. Studies on international educational exchanges suggest that intercultural exposure, in whichever setting or discipline, may have a positive impact on participants, both at the personal and professional levels. [2],[10],[14],[18] Health electives specifically seem to promote a greater understanding of health care systems as well as the different uses of resources. [2],[19] Professionally, students participating in international electives report increased confidence in clinical skills (diagnosis and clinical examination) while stressing the development of their communication skills, both with colleagues and patients. [2],[3],[20]
Moreover, cultural understanding and sensitivity emerge among the major outcomes of international exposure, along with the ability to show a deeper empathy toward patients. [3],[19],[20],[21],[22],[23] Incidentally, some authors have also noted that the exposure to different health care systems and patients, especially regarding global exchanges, has shown an impact on the students' career plans as they promote interest toward public health and general medicine. [2],[3],[18],[19],[20] At a personal level, the most common developments reported by participants are the opportunity to broaden their perspectives, improve language skills, and increase confidence, and personal growth. [23],[24] However, most surprisingly, students often refer to "personal growth" and "attitude change" as unexpected gains of their cross-cultural experiences. [20] It seems that when applying for an international experience, applicants tend to mainly focus on the professional values of the exchange. They ignore the fact that the exchange itself is the cross-cultural contact that stimulates the need for learning, development of intercultural competencies, literacy, and collaboration. [25],[26] Cultural adjustment researchers have presented different development models of intercultural sensitivity and they have concluded that all of them require personal engagement. In fact, it is only by being confronted by a different culture and engaging oneself in a learning process that one can acquire an intercultural identity and develop competencies that include empathy, perspective-taking, tolerance, communication, and promptness to help when required. [25]
Family medicine 360° (FM360°)
Intercultural networking has always been the primary aim of the Vasco da Gama Movement (VdGM) [27] and the network of new and future GPs/FPs, which is part of the European association of the World Organization of Family Doctors (WONCA). [28] Over the past 10 years, this group has been eagerly striving to promote a global mindset of respect and sensitivity to other cultures for young GPs/FPs that range from research and special interest groups [rural FM, domestic violence, IT, and social media in general practice/FM, among others] to exchanges. The exchange group is, in fact, one of the largest and most active groups within VdGM offering different types of exchanges. It all started in 2008 with the establishment of the "Hippokrates" exchange program, [29] which enabled participants to spend 2 weeks in a European general practice/FM practice in an urban or a rural setting. They follow an educational program that is designed by the host according to the learning objectives described by the participant. After the exchange, the participant is asked to reflect on his/her experience by describing the learning outcomes and writing a short report on the experience.
In order to give the "Hippokrates Program" a greater spotlight and promote the value of exchanges, it has been the tradition of VdGM to share prior exchange experiences during the WONCA conferences. It is also the custom to award two prizes to the best exchange participants: the "Hippokrates Prize," for an exchange in a city and the "Claudio Carosino prize" that is awarded to a rural participant. [30]
In recent years the "Hippokrates Program" has grown exponentially, with the impressive figure of 73 completed exchanges in 2014.
Wishing to take this idea even further, the first global exchange meeting was held on June 27, 2013 during the 20 th WONCA World Conference held in Prague. [31]
The seven global Young Doctors' Movements (YDMs) have been working relentlessly to establish a global exchange program since then. The seven YDMs are organized according to the seven WONCA regions, namely, the AfriWon Renaissance (Africa), Al Razi (the Middle East region), Polaris (North America), Rajakumar Movement (the Asia-Pacific region), Spice Route Movement (the South Asia region), VdGM (Europe), and Waynakay (Central and South America). [32] They've worked side by side to create a global exchange scheme for young GPs/FPs based on strong and shared educational values which made way for the establishment of the FM360° program. [31],[33] It has been a steep learning curve to meet the needs and expectations and respect the different contexts of the various countries. However, it is the common goal that has made the development of this project possible.
The aim of the FM360° program is to promote worldwide intercultural exchanges so as to give doctors an opportunity to learn from each other in different cultural and socioeconomic contexts. Besides being an opportunity to broaden one's professional and personal horizons, these exchanges provide young GPs/FPs the possibility to interact with different primary health care settings and health care systems in general.
The FM360° program is organized as a 4-week program (which may be shortened or lengthened). During these 4 weeks, the visitor is expected to observe the activities that take place in the host's practice and to shadow the host in other community-oriented activities. To provide structure to the exchange, the FM360° program is built on a framework inspired by the "Hippokrates Program," based on the learning objectives and outcomes. The visitor is given a template where he/she is required to fill in his/her learning objectives for the exchange. These learning objectives are assessed by the host who then draws an educational program accordingly. At the end of the exchange, the visitor is expected to reflect on the learning outcomes and submit a report on his/her activities.
The exchange program is financially self-supported by participants who are expected to cover their travel and accommodation expenses. However, the hosts are very much welcome to assist participants in providing options for accommodation. All visitors must obtain their own travel insurance and sign a legal waiver to take part in the program.
Besides having been granted the support of WONCA, hosts in both the USA and Canada may self-report teaching continuing medical education credits for this activity.
Since 2013, the program has received 163 inquiries, organized 38 exchanges, and is currently arranging 10 exchanges. [Figure 1] illustrates that there has been a general increase in the number of enquires by year, the average being 7.2 requests per month. All enquires till now have been from residents, 75% being from the female gender. [Figure 2] shows that most inquiries have come from the European region (64%), namely, Spain (54%) and Portugal (28%) followed by the Central and South American regions (27%) where the countries with the most requests are Argentina (29%) and Peru (27%).
Figure 1: Evolution of the number of received inquiries regarding the FM360° program, by year
Figure 2: Distribution of received inquiries for the FM360° program, by region
According to [Figure 3], the most requested FM360° destinations are Central and South America (30%), Europe (29%), and North America (27%). Globally, the top three most popular destinations are Spain (15%), the USA (14%), and Brazil (11%).
Figure 3: Distribution of requested regions for exchanges through the FM360° program
Although IT may act as a facilitator for global communication and networking, the FM360° program seeks to become an international educational framework to promote global networking between young GPs and FPs. The exchange program is only the first step by which the FM360° program wishes to promote and develop quality exchanges with educational content in general practice/FM. As such, it is in the best global interest to collaborate with and help promote this program that will further it.
Furthermore, the richness of exchange programs is promoting a bilateral knowledge exchange. This is felt by both the visitors and the hosts and it catalyzes the inspiration for change. New ideas to create health care provision may be attempted first in the clinic and eventually spread out to the community and may even reach policy makers. Consequently, the quality of care is improved as it integrates a multicultural knowledge.
Compared to hospital specialists it is more frequent to find GPs/FPs working alone, especially when it comes to rural settings. The loneliness they may experience during practice hours may trigger feelings of uncertainty and at the same time can be a barrier toward accepting new points of view. However, opportunities such as the YDMs and the activities they promote may help to tackle that challenge and help in developing one's personal networking while integrating new perspectives and approaches into daily practice.
The benefits at both professional and personal levels as well as for the community, locally, nationally, and globally are unique and work as triggers for the development of primary health care, which is in agreement with the World Health Organization's goal of universal health coverage for all. Also, the establishment of these networks allow participants to be more aware of global developments and thus, more prone to question health inequalities.
With the knowledge and participation of all GPs and FPs globally, we can act locally and develop a better future, based on a strong primary care system, for everyone.
We would like to thank Per Kallestrup and Harris Lygidakis for their inputs on the article as well as for their support in the development of exchange programs for young and future GPs/FPs.
Eaton DM, Redmond A, Bax N. Training healthcare professionals for the future: Internationalism and effective inclusion of global health training. Med Teach 2011;33:562-9.
Thompson MJ, Huntington MK, Hunt DD, Pinsky LE, Brodie JJ. Educational effects of international health electives on US and Canadian medical students and residents: A literature review. Acad Med 2003;78:342-7.
Van Dormael M, Dugas S, Diarra S. North-South exchange and professional development: Experience from Mali and France. Fam Pract 2007;24:102-7.
McCarthy AE, Petrosoniak A, Varpio L. The complex relationships involved in global health: A qualitative description. BMC Med Educ 2013;13:136.
Law K, Muir N, Thompson K. An evaluation of a European teacher exchange programme. Nurse Educ Today 2011;31:76-81.
Jha V, Mclean M, Gibbs TJ, Sandars J. Medical professionalism across cultures: A challenge for medicine and medical education. Med Teach 2015;37:74-80.
Mitchell KB, Tarpley MJ, Tarpley JL, Casey KM. Elective global surgery rotations for residents: A call for cooperation and consortium. World J Surg 2011;35:2617-24.
van Olmen J, Criel B, Devadasan N, Pariyo G, De Vos P, Van Damme W, et al. Primary Health Care in the 21 st century: Primary care providers and people′s empowerment. Trop Med Int Health 2010;15:386-90.
Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010;376:1923-58.
CHE Consult, Brussel Education Services, CHE, Compostela E. The Erasmus Impact Study. Effects of mobility on the skills and employability of students and the internationalisation of higher education institutions. Brussels; 2014. Available from: http://www.ec.europa.eu/education/library/study/2014/erasmus-impact_en.pdf. [Last accessed on 2015 Mar 4].
McKimm J, McLean M. Developing a global health practitioner: Time to act? Med Teach 2011;33:626-31.
van der Horst F, Lemmens P. Medical education and professionalism across different cultures. Med Educ 2012;46:238-9.
Martimianakis MA, Hafferty FW. The world as the new local clinic: A critical analysis of three discourses of global medical competency. Soc Sci Med 2013;87:31-8.
Stutz A, Green W, McAllister L, Eley D. Preparing medical graduates for an interconnected world: Current practices and future possibilities for internationalizing the medical curriculum in different contexts. J Stud Int Educ 2014;19:28-45.
Jeffrey J, Dumont RA, Kim GY, Kuo T. Effects of international health electives on medical student learning and career choice: Results of a systematic literature review. Fam Med 2011;43:21-8.
Redwood-Campbell L, Pakes B, Rouleau K, MacDonald CJ, Arya N, Purkey E, et al. Developing a curriculum framework for global health in family medicine: Emerging principles, competencies, and educational approaches. BMC Med Educ 2011;11:46.
McKinley DW, Williams SR, Norcini JJ, Anderson MB. International exchange programs and U.S. medical schools. Acad Med 2008;83(Suppl):S53-7.
Cherniak WA, Drain PK, Brewer TF. Educational objectives for international medical electives: A literature review. Acad Med 2013;88:1778-81.
Tarpley M, Hansen E, Tarpley JL. Early experience in establishing and evaluating an ACGME-approved international general surgery rotation. J Surg Educ 2013;70:709-14.
Gupta AR, Wells CK, Horwitz RI, Bia FJ, Barry M. The International Health Program: The fifteen-year experience with Yale University′s Internal Medicine Residency Program. Am J Trop Med Hyg 1999;61:1019-23.
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1 The value of European exchange programs for early career family doctors
Bernadeta Bridgwood,Hannah Willoughby,Madeleine Attridge,Eugene Tang
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2 International exchanges in primary care—learning from thy neighbour
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3 Interactions between dietary supplements in hospitalized patients
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A general purpose modulated probe fluorometer for a wide variety of measurements. The GFP-Meter is available with a choice of filter sets to fit a wide variety of fluorescence requirements including popular selections such as Chlorophyll, Rhodamine, Fluorescein, and Green Fluorescent Protein.
This is a hand-held, field portable instrument with on-board data logging capable of non-destructive measurement of Green Fluorescent Protien.


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Koretrak Watch Reviews – Is KoreTrak Smartwatch Scam or Does it Work?
iCrowdNewswire Dec 1, 2020 2:40 PM ET
Smart watches are all the rage which has left many people wondering if they really are a worthy consideration or just another fad. With many new developments and additions to the arsenal of options available, it is now possible to see which ones truly stand out as the top picks. Among such options is the Koretrak Smartwatch. This recent release has managed to attract the attention of many fitness experts who feel like it aids them in getting a proper record of their efforts. This review will look into the many qualities and features of this smart watch.
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Koretrak Watch Reviews
The Koretrak is a brand that many people may not know, but in fact, it has been available all the way since 2007. The watch back then was very different from the final stage that it is in now. Over the period of time, it has developed and received a wide array of features and highlights. Some may consider its creators to be among the first pioneers of the concept of a smart watch.
That said, the Koretrak smart watch offers users a number of core features that can help them in adding easiness and convenience to their lifestyle. It allows for easier tracking and monitoring of many aspects of one's health, while still remaining a stylish and fashionable statement to simply adorn on one's hand.
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What Are the Main Features of this Watch?
With the thought of a "smart" watch, there are some inherent expectations that users have for the product. That said, Koretrak has managed to not only meet but exceed those expectations. The device comes with a lot of tracking features that make it a worthwhile companion for any exercise enthusiast or gymnast. This includes a wide array of helpful monitoring techniques for exercising, running and other such works.
To specify, the watch is able to provide users with ultra-fast measuring for many health statistics. This includes details up to 10 seconds of accuracy. Furthermore, the real-time data also covers aspects like one's health and heart readings. Users are also able to count their sleep and make sure that they are receiving the ample amount of daily sleep as required.
The watch also aids users who enjoy calorie counting. By providing a rough estimate of the calories a person has burned daily, based on their movement and exercise, the watch is able to ensure that one is on top of their daily calorie intake and burning routine.
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Koretrak Watch Specifications
Users who are interested in this product should consider reading the following specifications about it:
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Users are able to order their own watch online. The developers offer a lenient money back guarantee too. This lasts for about 30 days from the time the watch was purchased.
The product is currently offering a wide array of recording facilities that make it ahead of the curve in terms of comprehensiveness.
Final Verdict on Koretrak Watch Reviews
Overall, this is a worthwhile companion to any person's lifestyle. It keeps them ton top of their workout routines and aids in tracking vital health data. People who may be wishing to learn about the details of their heart beats or calorie burning can do so through this watch. That said, it is a worthy consideration and is available at an affordable cost too. For more information, visit their official website. It has pricing details and more. Visit Koretrak Watch Official Website Here
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Mark Wahlberg to open Ohio Chevy dealership
Sean Szymkowski July 20, 2018 Comment Now!
From music to modeling to burger joints and now to car dealerships, Mark Wahlberg is on the move. The 47-year-old celebrity announced Friday he will open a Chevrolet dealership in Columbus, Ohio. The dealership will be a partnership with his current business partner Jay Feldman, who owns a handful of dealerships in Michigan.
The dealer, formerly called Bobby Layman Chevrolet, will wear the actor's name: Mark Wahlberg Chevrolet.
"I am continuously looking for ways to innovate my brand and engage in businesses I am passionate about," Wahlberg said in a statement. "I love cars and the chance to work with an experienced, proven dealer-operator like Jay and represent an iconic brand like Chevrolet inspired me to get involved."
The dealership expands Wahlberg's brand across numerous industries. He operates the Wahlburgers restaurant with franchises in 14 states and Canada; and owns a movie-production company, a health and wellness company, and a water line with music artist Diddy.
Wahlberg first surged onto the scene as a member of New Kids on the Block and Marky Mark and the Funky Bunch. His early success landed him a Calvin Klein modeling endorsement as he transitioned to film.
It's unclear when the dealership will officially open its doors, but it likely won't be the last time we see Wahlberg's name grace a dealer franchise. The entrepreneur added in his announcement that he and Feldman plan to open additional dealerships in the future.
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Boeing scraps 2019 financial forecast, halts share buybacks in wake of 737 MAX disaster
April 24, 2019 by Forimmediaterelease
World's biggest aerospace corporation was forced to pull its full financial forecast for the current year due to unresolved issues surrounding Boeing's once best-selling 737 MAX aircraft.
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Boeing also announced plans to pause share buybacks, citing "a challenging time for our customers, stakeholders and the company."
"Across the company, we are focused on safety, returning the 737 MAX to service, and earning and re-earning the trust and confidence of customers, regulators and the flying public," Boeing Chairman and CEO Dennis Muilenburg said in a statement.
The manufacturer had previously posted a report on the first-quarter earnings that managed to fall in line with analysts' expectations, while its revenue was slightly less than projected. Boeing's earning per share totaled the expected $3.16 from January through March, while the revenue amounted to $22.92 billion against $22.98 billion forecasted by London-based provider of financial markets data Refinitiv.
Boeing stressed that the previous guidance didn't reflect the impact of two crashes of the company's flagship planes, leading to the grounding of all 737 MAX 8 jets by global regulators, lawsuits from some air carriers and a decline in market value.
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According to the producer, more than 135 test and production flights of updated software for the 737 MAX have been carried out so far.
Boeing's bestseller crashed on March 10 not far from the Ethiopian capital of Addis Ababa six minutes after takeoff on the way to Nairobi, Kenya. The tragedy, which killed 157 people, marked the second crash involving the same jet model in less than six months. In October, the same type of aircraft, operated by Indonesia's Lion Air, crashed in the Java Sea shortly after takeoff, claiming the lives of 189 people.
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Soap bars around the world get a new life from Red Lion Hotels
Based on US market statistics, the combined hospitality segment produces close to 440 billion pounds of solid waste per year. A great amount of this waste is made up of discarded soap and bottled amenities. However, through Clean the World's Hospitality Recycling Program, these life-saving hygiene products can skip the landfill and, instead, be sent to one of Clean the World's five Recycling Operations Centers where the products are sanitized, fully recycled, and given a second-life to help those in need. It's a win-win for the hospitality industry, helping to reduce waste and transform lives around the world.
In celebration of Earth Day, Clean the World, dedicated to WASH (WAter, Sanitation and Hygiene) and global sustainability, is joining forces with RLH Corporation to collect and recycle gently-used bars of soap and bottled amenities at Hotel RL locations nationwide to help fight the spread of preventable diseases while preserving our planet.
"We are excited to collaborate with Clean the World," said RLH Corporation SVP of Brand Strategy Amanda Marcello. "At Hotel RL, we are focused on the modern-day traveler, with core hotel elements that allow guests to immerse themselves in local culture while maintaining their connection to the world. We are always searching for opportunities to better our planet, the communities we live in and those around the world. With Clean the World, we will now be able to make a significant improvement in reducing the amount of waste our hotels produce while benefiting communities worldwide by recycling our bath amenities."
Together, this Earth Day, Clean the World and RLH Corporation are bringing awareness to sustainable practices within the travel and hospitality industry. Eight Hotel RL locations adopting the Hospitality Recycling Program this week will begin recycling all soap and bottled amenities from over 1,600 guestrooms. In just one year, the Hotel RL portfolio of hotels is projected to provide over 6,700 pounds of soap and bottled amenities to Clean the World, resulting in the creation of an estimated 23,000 bars of newly-recycled soap to be distributed to those in need locally and globally.
"We are thrilled to join forces with RLH Corporation this Earth Day to share the importance of implementing new, eco-friendly approaches to daily operations that benefit and help to preserve our planet," said Shawn Seipler, founder and CEO of Clean the World. "By diverting leftover soap and bottled amenities from landfills, RLH Corporation will not only help Clean the World provide health and hygiene programs to children and families around the world, but also set a great example of CSR and sustainability throughout the hospitality industry, encouraging others to help make a difference."
Through this joint venture, newly-recycled bars of Clean the World soap will make their way to shelters, food banks and disaster relief initiatives in the United States, in addition to supporting hygiene education internationally through Clean the World Foundation's WASH Education programming. Our global programming, in places like India, Kenya and Tanzania, has contributed to a 60 percent decrease in the rate of hygiene-related deaths in children under 5, helping to keep children healthy and in school.
Filed Under: Press Releases Tagged With: addition, American Travel News, and, around the world, Awareness, banks, bars, based, begin, benefit, better, billion, brand, Breaking Travel News, bringing, celebration, Centers, CEO, children, clean up, close, collect, communities, connection, Corporation, creation, CSR, culture, daily, day, deaths, decrease, Disaster, disaster relief, diseases, Earth, earth day, eco-friendly, Education, eight, elements, families, fight, food, Forces, foundation, founder, friendly, Global, global sustainability, globally, guestrooms, guests, HEALTH, healthy, help, Helping, hospitality, hospitality industry, Hospitality News, hotel, Hotel Travel News, Hotels, hygiene, importance, improvement, in, India, Industry, initiatives, Instead, internationally, IT, join, joining, joint, joint venture, just, keep, Kenya, life, like, lion, live, local, locally, locations, Make, Market, modern, Nationwide, nbsp, need, New, newly, News articles, one year, only, operations, opportunities, over, percent, places, planet, portfolio, practices, preserve, products, program, programs, projected, rate, recycle, recycling, Red, red lion, Red Lion Hotels, reduce, related, relief, Responsible Tourism News, s, said, sanitation, school, searching, second, Segment, Set, Share, significant, spread, states, statistics, strategy, supporting, Sustainability, sustainable, sustainable practices, SVP, Tanzania, the United States, The World, through, to, TO BE, transform, Travel, Travel & Tourism Organizations News, travel and hospitality industry, Traveler, Travelwire News, United, United States, up, US, US market, used, venture, waste, water, way, We, week, win, World, worldwide, year
Allegiant Air to offer scheduled service to Mexico
Allegiant Air today filed an application with the U.S. Department of Transportation to offer scheduled service between the United States and Mexico.
Allegiant Air currently serves more than 450 domestic routes. This will be the company's initial venture into scheduled international service.
"Unlike other U.S. carriers, Allegiant has always been laser-focused on leisure travel and providing access to affordable, non-stop flights for those who wouldn't otherwise be able to go on vacation," said Maury Gallagher, Allegiant chairman and chief executive officer. "Offering service to Mexico will provide a whole new array of options for travelers to discover world-class destinations that may have been previously out of reach."
"We believe that providing scheduled service to Mexico will also be of great economic benefit, by stimulating traffic and providing additional competition in the international leisure market," he continued. "It will not only bring exceptional value to travelers, but will also enhance both tourism and business impact in the communities we serve."
The DOT application is the first step in the process for Allegiant to begin scheduled service to Mexico. Projected dates and locations for commencement of service will be announced at later dates as the process moves forward.
Filed Under: Press Releases Tagged With: additional, Affordable, Air, Allegiant, Allegiant Air, American Travel News, and, announced, Application, Aviation News, aviation-website, begin, benefit, Breaking Travel News, Business, carriers, Chairman, chief, chief executive, chief executive officer, class, communities, company, competition, continued, Corporate News, currently, dates, department, Department of Transportation, Destinations, domestic, domestic routes, DOT, economic, executive, first, flights, Forward, free, GO!, Government Affairs, impact, in, International, international service, International Travel News, IT, laser, later, Leisure, leisure travel, locations, Market, May, Mexico, Mexico travel news, New, News articles, Non, non-stop, non-stop flights, offer, offering, officer, only, options, out, projected, routes, s, said, scheduled, serve, service, states, stop, the United States, to, today, tourism, traffic, Transportation, Transportation News, Travel, travelers, Travelwire News, U.S. Department of Transportation, United, United States, vacation, value, venture, We, WHO, World, World News, world-class
Saudi tourism sector worth over $70 billion in 2019
Saudi Arabia's travel and tourism sector is expected to contribute $70.9 billion (SAR 263.1 billion) in total to the country's GDP in 2019, according to data from the World Travel and Tourism Council, as exhibitors prepare to showcase what the Kingdom has to offer at this year's Arabian Travel Market (ATM), which is being held at the Dubai World Trade Centre from 28 April – 1 May 2019.
According to data from ATM's research partner Colliers, international arrivals to Saudi Arabia are expected to increase 5.6% per year from 17.7 million in 2018 to 23.3 million in 2023. Religious tourism is expected to remain the bedrock of the sector over the next decade, with a goal of attracting 30 million pilgrims to the Kingdom by 2030, an increase of 11 million from the 19 million Hajj and Umrah pilgrims that visited the country in 2017.
Danielle Curtis, Exhibition Director ME, Arabian Travel Market, said: "At ATM, we are witnessing this growth first hand with the total number of delegates arriving from Saudi Arabia increasing 42% between 2017 and 2018, while 33% of delegates, exhibitors and attendees were interested in doing business with the Kingdom.
"More relaxed access to visas, through online portals such as the 'Sharek' and the growth of the Umrah plus market – combining religious and leisure travel – are expected to be key drivers in the growth of international tourism in the Kingdom."
Vision 2030 has set aside $64 billion to invest in culture, leisure and entertainment projects over the next decade, which will significantly add to the attractiveness of the country as a touristic destination, according to a recent report from real estate firm Savills.
The first phase of the Red Sea project, which is estimated to grow the kingdom's GDP by US$5.86 billion (SAR22 billion) and will consist of an airport, marinas, up to 3,000 hotel rooms and various recreational activities, is expected to complete during 2022.
Additionally, last year Saudi Arabia's Public Investment Fund announced the development of Amaala, a new ultra-luxury tourism megaproject which is earmarked for completion in 2028. The development will add 2,500 hotel rooms – further boosting the accommodation offering for both domestic and international visitors alike.
"Saudi Arabia will see a vast expansion of its hotel and resort inventory during 2019, with over 9,000 keys of three, four and five-star international supply expected to enter the market despite major cities such as Riyadh and Jeddah experiencing an overall drop in ADR during 2018.
"While, this new supply will place additional competitive pressure on hotels performance across the country, the projected growth in visitor numbers in both the domestic and international markets is expected to boost occupancy levels throughout 2019," added Curtis.
Looking ahead to ATM 2019, Saudi exhibitors, who will highlight what the Kingdom has to offer and the exciting developments in the pipeline, include The Red Sea Development Company, Saudia – Saudi Arabian Airlines, Makarem Hotels, AlfaOne Concierge – and of course the Saudi Commission for Tourism and National Heritage who will have a major presence too.
A focused seminar titled 'Why Tourism is Saudi's new 'White Oil' will take place on the Global Stage on Monday 29th April between 14.50 – 15:50. The session will discuss Saudi Arabia's tourism potential as the Kingdom undergoes a period of rapid economic diversification and forges ahead with its Vision 2030 blueprint.
The upbeat tourism forecast is also being driven, by domestic tourism with the number of local tourist trips inside Saudi Arabia exceeding 47 million in 2018. The latest research from Colliers forecasts this figure to increase 8% per year to 70.5 million by 2023.
"Plans are already afoot in Saudi, to achieve the projected increase in domestic visitors, with the Kingdom's Vision 2030 blueprint forecast to double the number of UNESCO heritage sites and increase household spending on cultural and entertainment activities inside the country from 2.9% to 6%.
"Meanwhile, the Quality of Life Vision Realisation Programme (VRP) and the General Entertainment Authority are both working to create new attractions and recreational activities within the country," added Curtis.
ATM, considered by industry professionals as a barometer for the Middle East and North Africa tourism sector, welcomed over 39,000 people to its 2018 event, showcasing the largest exhibition in the history of the show, with hotels comprising 20% of the floor area.
Brand new for this year's show will be the launch of Arabian Travel Week, an umbrella brand comprising four co-located shows including ATM 2019, ILTM Arabia, CONNECT Middle East, India & Africa – a new route development forum and new consumer-led event ATM Holiday Shopper. Arabian Travel Week will take place at Dubai World Trade Centre from 27 April – 1 May 2019.
For more news about ATM, please visit: https://arabiantravelmarket.wtm.com/media-centre/Press-Releases/.
About Arabian Travel Market (ATM)
Arabian Travel Market is the leading, international travel and tourism event in the Middle East for inbound and outbound tourism professionals. ATM 2018 attracted almost 40,000 industry professionals, with representation from 141 countries over the four days. The 25th edition of ATM showcased over 2,500 exhibiting companies across 12 halls at Dubai World Trade Centre. Arabian Travel Market 2019 will take place in Dubai from Sunday, 28th April to Wednesday, 1st May 2019. To find out more, please visit: www.arabiantravelmarket.wtm.com.
MEDIA CONTACT: NATHALIE VISELE, Director, Shamal Communications, Arjaan Office Tower, Dubai Media City, Dubai, United Arab Emirates, Tel: +971 4 365 2711 | Mobile: +971 50 457 6525, E-mail: nathalie.visele@shamalcomms.com , Website: www.shamalcomms.com
Filed Under: Press Releases Tagged With: accommodation, according, added, additional, ADR, Africa, Africa Tourism, airlines, Airport, and, announced, April, arabia, Arabian, Arabian Travel Market, Arabian Travel Week, Arabias, area, arrivals, arriving, ATM, attendees, attracting, attractions, authority, barometer, billion, boost, boosting, brand, Breaking Travel News, Business, Centre, cities, Colliers, commission, company, competitive, complete, Completion, concierge, connect, council, country, course, create, cultural, culture, Data, decade, delegates, Destination, development, developments, director, Discuss, doing, domestic, domestic tourism, double, drivers, drop, Dubai, Dubai World, Dubai World Trade Centre, East, economic, entertainment, estate, event, exceeding, exhibition, exhibitors, expansion, expected, firm, first, five star, floor, Forecast, forecasts, forum, free, fund, GDP, general, Global, Global Stage, goal, grow, Growth, Hajj, hand, held, heritage, highlight, history, holiday, Hospitality News, hotel, hotel rooms, Hotels, ILTM, ILTM Arabia, in, including, increase, increasing, India, Industry, inside, interested, International, international arrivals, international markets, international tourism, International Travel News, international visitors, inventory, invest, Investment, jeddah, key, Keys, Kingdom, largest, last, LATEST, launch, LED, Leisure, leisure travel, life, local, looking, Luxury, major, Market, markets, May, meetings.travel, MICE Industry News, Middle, Middle East, Middle East and North Africa, million, million Hajj, million pilgrims, national, New, new attractions, new route, News articles, North, North Africa, number, numbers, occupancy, offer, offering, Oil, online, over, partner, People, performance, period, pilgrims, pipeline, Place, plans, portals, potential, presence, pressure, professionals, Programme, project, projected, projected growth, projects, public, quality, quality of life, real, Real Estate, recent, recreational, Red, Red Sea, Red Sea Development Company, religious, religious tourism, report, research, resort, Riyadh, rooms, route, route development, s, said, SAR, Saudi, Saudi Arabia travel news, Saudi Arabia. (, Saudi Arabian, Saudi Arabian Airlines, saudi commission, Saudi tourism, saudia, sea, sector, see, seminar, Set, show, showcase, showcasing, shows, significantly, sites, spending, Star, supply, The World, through, to, TO BE, total, tourism, tourism council, tourism forecast, Tourism Investment News, tourism potential, tourism sector, tourist, touristic, Trade, Travel, Travel & Tourism Organizations News, travel and tourism, Travel Destination News, travel market, Travel Week, Travelwire News, trips, UAE travel news, ultra, Umrah, UNESCO, up, upbeat, US, visas, vision, vision 2030, visited, visitor, visitor numbers, visitors, We, week, welcomed, were, white, WHO, Why, working, World, World News, world travel, world travel and tourism, World Travel and Tourism Council, worth, year
Travel Trends Index: International and domestic travel growth projected to dwindle
April 2, 2019 by Forimmediaterelease
Travel to and within the U.S. grew 3.2% year-over-year in February, according to the U.S. Travel Association's latest Travel Trends Index (TTI).
However, the predictive Leading Travel Index (LTI) continues to project a slowdown in both international and domestic travel growth, as both segments could continue to feel the effects of rising trade tensions, volatile financial markets and weakening business and consumer confidence. These factors have the potential to stunt travel growth and dull American competitiveness at a time when the U.S. is seeking to reverse its declining share of the global international travel market.
Though international inbound travel grew for the ninth consecutive month, the segment grew only 1.4% in February. Domestic travel increased 2.8% year-over-year in February, with growth in both the business and leisure travel segments. Domestic business travel outpaced the leisure segment for the first time since October 2018, registering slightly above its six-month moving average with a 3.0% growth. Leisure growth fell slightly below its six-month moving average with a more tepid 2.6% growth rate.
Looking ahead, domestic and international inbound travel are both projected to grow, but at a moderate pace.
Said U.S. Travel Senior Vice President for Research David Huether: "Growth is expected to decelerate in the case of domestic travel while international inbound travel is projected to remain soft. This is consistent with an expectation of stable-yet-moderating economic growth both in the U.S. and globally."
U.S. Travel economists caution that this decelerated growth rate will make it even more difficult for the U.S. to regain its diminishing share of the global international travel market. Acting on certain legislative initiatives—such as Brand USA's long-term reauthorization and the rebranding and expansion of the Visa Waiver Program—can help the U.S. increase competitiveness in the global travel market.
The TTI is prepared for U.S. Travel by the research firm Oxford Economics. The TTI is based on public and private sector source data which are subject to revision by the source agency. The TTI draws from: advance search and bookings data from ADARA and nSight; airline bookings data from the Airlines Reporting Corporation (ARC); IATA, OAG and other tabulations of international inbound travel to the U.S.; and hotel room demand data from STR.
Filed Under: Press Releases Tagged With: according, ADARA, Agency, airline, airlines, American, American Travel News, and, ARC, association, average, based, bookings, brand, Brand USA, Breaking Travel News, Business, business and consumer confidence, business and leisure travel, Business Travel, case, caution, Click, competitiveness, confidence, consumer confidence, continue, continues, Corporation, Data, declining, demand, domestic, domestic travel, economic, economic growth, economics, economists, effects, even, expansion, expected, factors, Feature, financial, financial markets, firm, first, full, Global, global travel, globally, grow, Growth, Growth Rate, help, hotel, hotel room, IATA, in, In February, inbound, increase, increased, index, initiatives, International, international and domestic travel, international travel, IT, LATEST, leading, Leading Travel Index, Leisure, leisure travel, looking, LTI, Make, Market, markets, month, moving, News articles, OAG, October, only, over, Oxford, Oxford Economics, potential, president, private, private sector, program, project, projected, public, rate, rebranding, report, reporting, research, revision, rising, room, s, said, search, sector, seeking, segments, senior, Senior Vice President, Share, slowdown, Source, STR, tensions, term, time, to, Trade, Travel, Travel & Tourism Organizations News, travel association, Travel Destination News, travel growth, travel market, travel trends, Travel Trends Index, Travelwire News, Trends, TTI, U.S, U.S. travel, U.S. Travel Association, USA, vice president, visa, visa waiver, Visa Waiver Program, Waiver, year
Desperate mayday by American climber injured on Mount Himlung in Nepal
UNIGLOBE Travel expands Middle East service with the addition of two Global Partners
Ministers Bartlett and Green to address participants at 5th staging of Christmas in July Tradeshow
Global Rescue: Tourist's Life Saved after Inhaling Mysterious Airborne Bacteria in Namibia
Jamaica's Tourism Workers' Pension Scheme to be a Landmark for Global Tourism Social Legislation – says Bartlett
Seychelles Tourism Board meets Tourism Trade Partners
African Tourism Board giant step into the UK market
Jamaica Tourism Marketing Executive Marie Deeble Walker passed at age 58
Jamaica: Linkages increasing opportunities for Small Tourism Suppliers
FRA sets new single-day record of over 240,000 passengers


text:
'Lie' by Moussaoui caused 9/11 deaths
By - The Washington Times - Monday, March 6, 2006
Opening its argument that Zacarias Moussaoui be executed, the government asserted yesterday that he "did his part as a loyal al Qaeda soldier" and caused the deaths of nearly 3,000 people by failing to tell what he knew of the September 11, 2001, attacks.
Moussaoui's defense countered that his dreams of being a terrorist were far removed from anything he could do, and that he had no part in the attacks.
"That is Zacarias Moussaoui in a nutshell," said his court-appointed attorney, Edward MacMahon. "Sound and fury signifying nothing."
As Moussaoui stroked his beard in the Alexandria courthouse and families of September 11 victims watched on closed-circuit television in four other states, prosecutor Rob Spencer evoked the horror of that day and laid blame on the only man charged in the attacks.
"He lied so the plot could proceed unimpeded," Mr. Spencer asserted. "With that lie, he caused the deaths of nearly 3,000 people. He rejoiced in the death and destruction."
He went on: "Had Mr. Moussaoui just told the truth, it would all have been different."
A schoolteacher, a veteran of the 1991 Gulf War and an Iranian-born Sunni Muslim woman are among the jurors who will decide whether Moussaoui is put to death or imprisoned for life. The trial is being shown via closed-circuit television at federal courthouses in New York City, Boston, Central Islip, N.Y., Newark, N.J., and Philadelphia.
U.S. District Judge Leonie Brinkema impaneled 18 jurors and alternates in 90 minutes. One who appeared upset at being chosen was excused, meaning the trial will proceed with 12 jurors and five alternates instead of six.
Moussaoui, a 37-year-old French citizen, has acknowledged his loyalty to the al Qaeda terrorist network and his intent to commit acts of terrorism, but denies any prior knowledge of the September 11 plot.
Moussaoui pleaded guilty in April to conspiring with al Qaeda to hijack planes and commit other crimes. The trial will determine his punishment, and only two options are available: death or life in prison.
In his opening statement, Mr. MacMahon appealed to jurors to judge his client fairly, not "as a substitute for Osama bin Laden."
He scoffed at the idea Moussaoui had any part in the plot. "Moussaoui certainly wasn't sent over here to tell a lie, ladies and gentlemen."
Frequently ejected from the courtroom earlier because of his outbursts against his court-appointed attorneys, Moussaoui sat quietly through the opening of his trial, gazing often at the jurors or the gallery.
At the end of the morning hearing, he spoke to one member of his defense team: "Just to let you know, you're not my lawyer, thanks a lot."
His mother, Aicha el-Wafi, spoke up for her son in a CNN interview. "All they can have against him is the things that he said, the words that he has used," she said, "but actual acts that he committed, there aren't any."
D. Hamilton Peterson of Bethesda, who lost his father, Donald, and stepmother, Jean, on hijacked United Airlines Flight 93, which crashed in Pennsylvania, declared, "I want accountability."
"I believe Moussaoui is an excellent candidate for the death penalty," he said outside the courtroom. "He is nothing less than a mass murderer."


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Male-Pattern Baldness Found Rooted in Stem Cells
By Amanda Chan
An inability of stem cells in the scalp to develop into the type of cells that make hair follicles may be an underlying cause of male-pattern baldness, according to a new study.
The discovery gives hope that people who are bald could regrow their hair with a future treatment, said study researcher Dr. George Cotsarelis, a professor of dermatology at the University of Pennsylvania.
In people who are bald, hair follicles have shrunken and become microscopic, Cotsarelis said. And scientists long thought that bald people also had a depletion of hair follicle stem cells, which are necessary to grow hair.
But the new study shows that bald people have the same number of stem cells as those with hair. So if scientists could coax the stem cells into producing more hair follicle progenitor cells, then it would be possible to generate bigger hair follicles that could grow hair, he said.
If the hair follicle stem cells were "gone or markedly depleted, it would be much more daunting, but because they're there, it tells us there should be a way" to re-grow hair, Cotsarelis told MyHealthNewsDaily. "It's not impossible. It gives you hope."
The study was published today (Jan. 4) in the Journal of Clinical Investigation.
Counting cells
Cotsarelis and his colleagues analyzed skin cells from the bald and non-bald parts of the scalp of people with androgenetic alopecia, the technical name for male-pattern baldness.
They ran the scalp cells through a machine that tagged each cell with a marker. By using different markers to distinguish between stem cells and hair follicle progenitor cells, scientists were able to count the number of each type.
They found there were the same number of stem cells in the skin from bald scalps as there were in the skin from the non-bald scalps. However, there were fewer hair follicle progenitor cells in the skin from the bald scalps than the skin from the non-bald scalps.
In other words, the scientists found that baldness was occurring because the stem cells were unable to complete their normal development and become hair follicle progenitor cells.
Currently, Rogaine and Propecia are the only two treatments for baldness approved by the Food and Drug Administration, Cotsarelis said. They are effective for maintaining hair already on the scalp, but aren't that effective in re-growing hair, he said.
Propecia, for example, blocks testosterone's effect on hair follicles — the hormone can reduce big hair follicles to small ones. But the drug doesn't actually bring back the big follicles, Cotsarelis said.
To regrow hair that has been lost, you'd need a drug that "can make a small follicle into a big follicle," he said.
"If we figure out what the signals are, and the factors that are necessary to activate the stem cells to make progenitor cells, there should be a way to reverse those small follicles to make them large," he said.
Pass it on: Bald people have hair follicle stem cells, and researchers say finding this means there is hope for a treatment that could regrow hair.
Hair Loss and Balding: Causes, Symptoms & Treatments
10 Medical Myths That Just Won't Go Away
7 Health Woes Brought On By Winter
Follow MyHealthNewsDaily staff writer Amanda Chan on Twitter @AmandaLChan.
Amanda Chan
Amanda Chan was a staff writer for Live Science Health. She holds a bachelor's degree in journalism and mass communication from the Walter Cronkite School of Journalism and Mass Communication at Arizona State University, and a master's degree in journalism from Columbia University.


A love story and a twist ending reminds us not everything is as it seems.
Movistar's Love Story captures the sweet tale of boy meets girl, a modern story of young love through social media. But not everything is as it seems.
A leading telecommunications company in Mexico and Latin America, Movistar wanted to send a message as part of its CSR efforts - Movistar Conscience - aimed at promoting secure and responsible use of telecommunications and social networks, particularly for young and vulnerable users. The work was launched during National Children's month to warn against the risks of fake profiles on social media.
Beautifully shot and powerfully delivered, the work received organic coverage from major Mexican and international news networks, publications, and advertising trades. Within just two weeks, the work garnered more than 700,000 views on YouTube and 7 million views on Facebook page. Stunned viewers liked the work 85,000 times and left more than 19,000 comments. But the most important achievement was the conversation generated on an important issue.


text:
"100% Вълк" () е австралийска компютърна анимация от 2020 година на режисьора Алекс Стейдърман. Продуценти са Алексия Гейтс-Фоале и Барбара Стивън. Сценарият е на едноименния роман на Джейн Лайънс от 2009 г.

В България

Филм
В България премиерата на филма на няколко пъти е отложена поради коронавирусната пандемия. Най-новата дата на излизане е на 17 септември 2021 г. от Про Филмс.

Синхронен дублаж

На 1 юни 2022 г. филмът е излъчен за първи път по "Виваком Арена" от 20:00 часа. На 5 юни от 9:15 часа беше излъчен повторно.

Сериал
Сериалът, който е базиран на филма, започва излъчване по Супертуунс на 21 ноември. Ролите са озвучени от Елисавета Господинова, Татяна Захова, Денислав Димитров, Стефан Сърчаджиев – Съра и Христо Узунов. Дублажът е войсоувър в студио Про Филмс. Началната песен е записана на български и изпята от Кръстина Кокорска.

Източници

Външни препратки

Анимационни филми от 2020 година
Австралийски анимационни филми
Компютърни анимационни филми
Филми за кучета

redpajama_set_name: RedPajamaWikipedia


Anita Moorjani, Dying to Be Me: My journey from cancer, to near death, to true healing (2012), Hay House Inc., Carlsbad CA USA.
After four years of cancer, the author's body was shutting down. She was actively dying. In a near-death experience, she learned how precious and perfect she was, and that her illness was rooted in lack of self-love. She had a miraculous recovery and now gives inspirational talks about self-love.