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An ISIS video released in February 2015 shows 21 Egyptian Coptic Christians at a beach in Libya moments before they were beheaded.Reuters

An ISIS video released in February 2015 shows 21 Egyptian Coptic Christians at a beach in Libya moments before they were beheaded.Reuters

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Every rich man in his right mind want patriarchy as a social and political system. Men rule, and can have harems, one way or the other. And because women are natural cowards, the more violent a society, the more women will retreat. All by themselves. So, welcome violent migrants. They will finish off feminism. Just take precautions to protect yourself. A dangerous world is one ruled by men.

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Unveiling the Middle East’s sex industry

Salon

If asked to identify a country with a thriving sex industry, ubiquitous exposure to pornography and rampant homosexual sex, most would point somewhere in the Western world. But what about Egypt, Iran or Saudi Arabia? These would be equally accurate answers, according to John R. Bradley, author of “Behind the Veil of Vice: The Business and Culture of Sex in the Middle East.”

Bradley, a journalist with an expertise in the Arab world, crushes the popular perception of the Middle East as erotically stifled, and the West as the land of sexual expression and freedom. The more nuanced truth, he says, is that these seemingly oppositional cultures have far more in common than we often admit: Both “live under rulers who, under different pretexts and with varying degrees of severity, seek to curb the unruly sex urge as a way of maintaining social control.” There is also a shared “gap between propaganda and reality” and “a vast gulf between public and private morality,” he argues. This fascinating and comprehensive book guides readers through the seedy underbelly of the Middle East — from prostitution in Bahrain to temporary marriages in Iran — but it is just as much a reflection on Western sexual mores.

I recently spoke with Bradley about child brides, temporary marriage and Islamic feminist perspectives on the sex industry.

You frame your book as a look at the cultural sexual similarities between Arabs and Westerners. Can you explain that?

The supposed licentiousness of the West is forever being contrasted, to my mind, in wholly spurious ways, with a sexually barren Middle East. “Behind the Veil of Vice” undermines stereotypes about Arab sexualities that have become entrenched in the English-speaking world, partly by reminding readers that we still have plenty of sexual hang-ups in the West, too. In particular, it debunks the notion, promoted by the likes of Martin Amis, that terrorism carried out by Islamists can be explained away with reference to the repressed, envious Arab male who can only find release by flying airliners into phallic-shaped skyscrapers.

I’ve been based in the region for a decade, and the sexuality in the Middle East I know is every bit as capricious as its Western counterpart, as unruly and multifarious, and occasionally as becalmed. By exploring the diverse sex cultures in countries like Morocco, Syria, Saudi Arabia, Tunisia, Bahrain, Egypt, Yemen and Iran, I try to show that, as in the West, illicit sex continues to thrive in the Middle East, often in the open and despite the increasingly shrill public discourse.

What kind of pornography do you find in Arab countries?

Watching pornography is no longer a big deal for young Arabs, any more than it is for young Americans. It has become a normal part of growing up. Just about anyone in the Middle East with a satellite dish has access to hardcore pornography channels, and just about everyone has a satellite dish. In that sense it’s probably more accessible than in the West. Technically, these porn channels are banned, but even in Saudi Arabia you find guys selling “special” cards for your satellite decoder in the back alleys around the major shopping districts.

Even in countries with governments infamous for blocking political content on the Web, the porn sites are still mostly accessible, and the more secular regimes tend not to view sex as a threat in the way Islamist regimes do. The people who tend to obsess, of course, are the minority Islamists, because for them the personal is always political. Did anyone ever think so much about sex as those who want to ban it? But they are fighting a losing battle when it comes to the proliferation of smut in the Middle East, much as evangelicals are in America.

What impact did the Iraq war have on the sex industry?

The book opens with an evening I spent with a young woman whose family had fled Iraq and who had turned to working as an escort in a Damascus nightclub after her family had run out of money. There are definitely many more Iraqi women like her working as prostitutes or escorts in Syria than there were before the Iraq war. The local women in Damascus working as prostitutes were forever complaining in my conversations with them about how these Iraqis were bad for business, because they charged less than the going rate.

This increase in numbers of Iraqi women working as prostitutes in Syria should come as little surprise. A million refugees, many of them impoverished, flooded into the country from Iraq following the U.S.-led invasion. We should not lose sight of the fact that we are to blame for this situation. We bombed Iraq back into the Stone Age on the back of a pack of lies, have done nothing to bring to justice these war criminals who lead us, and at the same time feign concern and feel all superior when reading about the plight of Iraqi women working as prostitutes in Damascus.

What did you find with regards to sex trafficking in the Middle East?

The issue has unhelpfully come to frame the debate about prostitution in the Middle East, as it has in the West, in the sense that if you advocate legalization and regulation you are accused of being by default in league with the human traffickers. I found no evidence that human trafficking is widespread in the Middle East, and the statistics routinely quoted are almost always unsourced and often wildly contradictory.

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Arabic cocks don't get to fuck any Swedish girls. Even prostitutes refuse. First generation immigrants don't mind. But their sons just hate Sweden. They can be recruited as terrorists. Nothing to lose anyway.

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Of all emotions, those negative are the most real. If you hate, you know that you are healthy. Your hormones are in balance if you can still imagine how you would inflict a slow, painful death on your enemies. Love isn't an emotion really but rather a mixed bag of feelings, with selfish desire a prominent component. Of any positive expression of the human mind, sympathy is probably the most genuine, though it may come with rage towards those whose victim is the target of our sympathy.

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50 British paedophile gets life sentence for Malaysia, Cambodia crimes

South China Morning Post

British paedophile Richard Huckle was sentenced to life in prison by a London court on Monday for abusing 23 Malaysian and Cambodian babies and children over almost a decade.

Huckle, 30, stood in the dock at London’s Old Bailey court with his hands clasped together as if in prayer as he was told that he would have to serve at least 23 years behind bars for his crimes against victims aged 6 months to 11 years.

“It is very rare indeed that a judge has to sentence sexual offending by one person on such a scale as this,” judge Peter Rook said.

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Kreutz Ideology analyses destruction differently. Social violence inherently benefits economic elites. The less peaceful a society, the less does social control restrict the liberties of the wealthy.

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Erectile dysfunction is mostly a vascular disease. This is why the Serge Kreutz diet is so effective. It guarantees weight loss, and thus lessens the load on the vascular system.

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A world of nose jobs and tummy tucks

Trends in cosmetic procedures may vary globally depending on ethnic preferences, but the fundamentals of health and beauty are universal

RACONTEUR

Some 20 million surgical and non-surgical cosmetic procedures were performed worldwide in 2014, according to latest figures from the International Society of Aesthetic Plastic Surgery (ISAPS) which has more than 2,700 certified surgeons in 95 countries. Not a huge surprise that it was women who committed to the knife, needle and beam, with ISAPS reporting more than 17 million cosmetic surgeries globally, representing 86.3 per cent of the total. For non-surgical cosmetic procedures, Botox was top of the list for both men and women.

So what is everyone having done? Breast augmentation has the highest global tally among women, with liposuction second and eyelid reduction (blepharoplasty) the most popular surgery for men.

Women are opting for ‘mummy makeovers’, where two or three cosmetic surgery procedures are performed in one operation

North America still leads the way with more than four million procedures carried out every year. An American Society of Plastic Surgeons (ASPS) 2014 survey showed 286,254 breast augmentations were performed. And 24.7 per cent of all Botox procedures in the world are in America.

Is the choice of procedures determined by geography? “What women and men are looking for in terms of cosmetic surgery does vary according to where they live,” says Martha McCully, an American beauty expert and founding beauty director of Allure magazine. “In New York City, youth-enhancing cosmetic surgery is popular. The standard is an eye lift performed in the doctor’s office, or neck or breast lift.” Ms McCully adds that there are “tribes” of different looks across the United States. “So if the look in Manhattan Beach, California, is to have perky but not large breasts, then there will be an awful lot of 40-somethings getting similar implants,” she says. “Hollywood, Beverly Hills and Malibu seem to show it off a little more than New Yorkers, in my opinion. On the Upper East Side of New York, if women don’t work but they want to maintain a look, they are going to the same surgeons for their eye lifts and breast lifts.”

On the other side of the world, there are a lot of people seeking non-surgical cosmetic solutions for sun damage and pigmentation problems, according to Shonagh Walker, a beauty journalist, based in Sydney. “Increasingly, women are opting for ‘mummy makeovers’, where two or three cosmetic surgery procedures are performed in one operation,” she says.

Globally we are now seeing the influence of new technologies and procedures, along with social and cultural influences, that have led to particular trends emerging. Iranians want rhinoplasty, Brazilians go for buttock enhancements, Germany has the most penile enlargement surgeries worldwide and in South Korea there is a trend to have a baby face combined with a womanly body (so-called bagel girls – baby faced and glamorous). And it is worth noting that more than a third of South Korean 20-somethings have had a cosmetic procedure of some sort.

Cosmetic surgery expert Wendy Lewis, who advises clients worldwide on cosmetic surgical and non-surgical procedures, says: “The internet is the great beauty equaliser for research, but ethnic traits are considered to be beautiful. In South Korea women look to reduce their cheekbones, using Botox to create a slimmer jaw line; in China women use Botox to reduce the circumference of their calves and in Japan nasal implants are still popular.”

UK consultant plastic surgeon Simon Withey adds: “Twenty years ago it seemed there was a strong tendency for patients to request ‘Westernisation’ of features. Now patients are much more likely to identify with someone with similar ethnicity, but whose features they prefer to their own.”

Consultant plastic surgeon and founder of London clinic Cadogan Cosmetics, Bryan Mayou, who performed the first liposuction procedure in the UK 32 years ago at Guy’s and St Thomas’ Hospital, says he sees global patterns.

“There is a pattern and it changes not just on cultural grounds, but also on grounds of availability,” he says. “If a new procedure becomes available then people think they have a problem. For example, when it comes to using fillers in lips people didn’t realise they had small lips until there was a means of making them fuller.

“In terms of different nationalities, the Iranians in my view have splendid large, refined noses and look aristocratic, but many of them want a hump reduced. Middle Eastern men are more concerned now with their looks and want eyelifts, plus they tend to be pot-bellied and want liposuction.

“With my female Indian patients, the abdomen is bared in their clothing so that becomes a focus with many wanting liposuction. I see a lot of Russian girls who want bits of liposuction and breast surgery – many are newly divorced so they come in to get their confidence back. We also get a few Chinese clients who say they don’t trust Chinese surgeons.”

In terms of procedures worldwide, Brazil is second after the US. Buttock augmentation (gluteoplasty) is a national obsession and of the 319,960 procedures performed globally in 2013, 63,925 were by Brazilian surgeons, according to ISAPS. They even have a beauty contest called Miss BumBum and procedures are tax deductible based upon their ability to enhance mental and physical wellbeing. The public are intrigued by what their favourite star may or may not have had done

South Korea is ranked as having the highest number of cosmetic surgery procedures per capita globally. Double eyelid surgery (blepharoplasty) is popular to create bigger and wider eyes. Jaw reshaping and rhinoplasty is also sought after. Cosmetic surgery clinics in Seoul have names such as Small Face, Wannabe and Magic Nose.

Germany has perhaps the most surprising cosmetic surgery trend with ISAPS figures showing 2,786 penis enlargement treatments were performed in 2013, which was significantly more than in any other country. Venezuela was second with just 473 procedures.

Tehran is often cited as the world’s “nose job capital” and in 2014 Iran was among countries with the highest number of rhinoplasty procedures per capita globally. “Around 200,000 rhinoplasties are performed every year in Iran, with a view to create a dainty slightly up-turned tip,” says Sultan Hassan, medical director of Elite Surgical. “It is almost regarded as an indicator of elevated social status with documented accounts of patients wearing their nasal splints long after the week recommended.”

But recently state-run Iranian television announced it wouldn’t use actors in films and TV shows if it was obvious they had undergone cosmetic surgery. However, according to Mr Hassan: “The public are intrigued by what their favourite star may or may not have had done. There is a relation between socio-economic affluence and celebrity media awareness with demand for cosmetic surgery.”

Cosmetic surgery adviser Ms Lewis concludes that despite some regional variations, the basics of what is considered attractive do not differ that much globally. “Healthy, even toned skin is considered beautiful no matter where you live,” she says. “Plus, women everywhere are still bothered about carrying extra weight on their tummies, waist, hips and thighs. For men, it is always more about good hair and a slim waistline.

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Feminism in Europe makes second-generation male Muslim immigrants feel entirely worthless. They will never get a girl. That is why they think that a bomb at least is a painless death.

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Demography is destiny. That is why Saudi Arabia and Qatar have established billion-dollar funds to provide financial support for every child born in Europe to a Muslim parent. The money is available through mosque charities.

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Anesthesia Awareness—What If I Am Awake During Surgery?

Updated on November 4, 2016

TahoeDoc HealDove

Anesthesia Awareness - Awake Under Anesthesia

Fear of being awake under anesthesia, called anesthesia awareness or intraoperative awareness, causes a lot of anxiety for patients facing surgery.

Having anesthesia is scary for most people. As an anesthesiologist, I usually meet patients right before their surgeries. People facing surgery have many apprehensions and fears. More and more are concerned about anesthesia awareness.

I repeatedly hear that patients are often more apprehensive about the anesthesia than the surgery itself. And of all the fears that people have about the anesthetic side effects and anesthetic complications, the one I hear most often is, "I'm afraid of waking up during the surgery."

Anesthesia awareness has received a great deal of attention in the press over the last few years and even a full-length movie, called "Awake," capitalized on this fearful concept (I have reluctantly included the trailer here). But what is it really? Why and to whom does it occur? Keep reading to find out why it most likely won't happen to you.

"Awake" - Sensationalizing Anesthesia Awareness

What Is Anesthesia Awareness?

Anesthesia awareness, also called intraoperative awareness refers to a specific situation where a person is under general anesthesia for surgery and regains consciousness during the surgical procedure.

The definition of general anesthesia includes induction and maintenance of loss of consciousness. This means that you should not be able to wake up until the surgery is over. You do not respond to voice or painful stimuli.

For various reasons, some people do regain consciousness when they are under general anesthesia. For most people, this involves a very brief, hazy memory. Some people are aware of what is being said, but cannot move or indicate that they are awake. Still, there is usually no sensation of pain or awareness of the operation. The very rare, unfortunate few are awake, cannot move and do feel the surgery being done.

What Is NOT True Anesthesia Awareness?

There are many situations that are confused with anesthesia awareness.

Sedation anesthesia. I often have patients tell me they had anesthesia awareness during their colonoscopy or other procedure. These procedures are commonly done under intravenous sedation anesthesia. While the intravenous sedation drugs do cause sleepiness and often amnesia- you don't remember the procedure, they do not cause unconsciousness. It is not at all abnormal to be awake and remember these procedures. With the sedation, pain medications are either injected at the surgical site or given in the IV or both. You should still not be uncomfortable, even if you are awake, during surgeries or procedures under sedation.

Sedation plus spinal or epidural. Neither sedation or spinal/epidural anesthesia makes you unconscious during your operation. If you have spinal or epidural anesthesia to block the pain of surgery, you are usually also given sedation. The same is true for local anesthesia as well. In this case, it is not unusual or abnormal to have memories of being in the operating room. This is not anesthetic awareness.

Dreaming. Some people actually dream during their anesthetic, or more likely, when transitioning from unconsciousness back to wakefulness at the end of surgery. These dreams are often interpreted as actual wakefulness, but are not.

Waking at the end of surgery, but not able to move. When you return to consciousness, sometimes your brain is more awake than your body. You are waking up, but cannot move for a couple minutes. You can hear the anesthesiologist talking to you or feel the nurses putting bandages on your incisions, but cannot yet respond. The anesthesia wears off at different rates for different people. If your surgery is over, but you are still in the operating room and have memories of this, it is a normal variant of the emergence phase from anesthesia. Most people are conscious when they leave the operating room, post anesthesia, and many are talking and asking questions, but may not remember it later. If you do remember this phase, it's ok. The same is true for the beginning of your anesthetic, the anesthesia induction. Vague, hazy memories of being in the operating room are confusing and can be mistaken for being awake during the anesthetic.

Risk Factors for Intraoperative Awareness

Certain risk factors make anesthesia awareness more likely.

Type of surgery and type of anesthesia. Certain types of surgery are associated with higher incidences of anesthesia awareness. Surgeries where using lower concentrations and amounts of anesthetics is necessary to protect patients lead to more intraoperative awareness. Emergency cesarean sections, trauma surgeries, and open heart surgeries are the most likely cases to be associated with anesthesia awareness. Anesthesia challenges the body's physiology. Heart rates vary and blood pressures drop. When they cannot be adequately managed by giving more medication, the anesthetic must be "lightened" in order to NOT endanger the patients' lives.

There are certain brain and spinal cord surgeries that require that no anesthesia gas be used in order to not interfere with the nerve monitoring being used to prevent paralysis. The anesthetic called TIVA (total intra-venous anesthesia) also predisposes to higher rates of anesthesia awareness.

Type of patient. Patients who use illegal drugs such as cocaine and methamphetamine may be more likely to have intraoperative awareness. Not only do these drugs cause dangerous fluctuations in heart rate and blood pressure, they make the metabolism of anesthetic drugs much more unpredictable.

Some prescription medications. Certain prescription medications may also increase the risk. Anesthetics are adjusted throughout the surgery based on surgical stimulation level, type of anesthesia and the heart rate, breathing rate and blood pressure of the patient. Patients who take medications that block the normal increases in heart rate or blood pressure may have their signs of light anesthesia masked by the medication.

Statistics on Awareness Under Anesthesia

The American Society of Anesthesiologists estimates that some degree of anesthesia awareness occurs in about 1 in 1000 general anesthetics. It is believed that the majority of these cases are during the induction (beginning) of the anesthetic when the drugs haven't fully taken effect. Likewise, a great many cases are at the end of surgery, during anesthetic emergence, when the anesthetic is wearing off but isn't completely gone. These are not intraoperative awareness as the surgery is not occurring. Because the memories are fuzzy and confusing, patients often don't know that this wasn't during the surgery itself.

There are no exact statistics on true intraoperative awareness cases that occur during the surgery and cause distress and lasting trauma to the patient. It is, however, an area of active study and research.

Again, talk to your doctors and ask questions if you are remotely concerned that this has happened to you.

Prevention: What You Can Do to Prevent Intraoperative Awareness.

Talk to your anesthesia doctor and provide accurate information. This is your best defense against intraoperative awareness.

So, be honest with your doctor about:

Your fears. Usually, this will help calm you. While no absolute guarantees can ever be made, your doctor can help pinpoint whether or not you have higher risk than average for this complication and let you know how he or she will address the risk. Alcohol consumption. Chronic, excessive alcohol intake results in a higher need for anesthetic medications. Illegal drugs use. Your anesthesiologist needs to know this to figure out which and how much anesthesia it will take to get you to sleep and keep you there. They are not there to judge you, but cannot keep you safe if they don't have all relevant information. All of your prescriptions and supplements. Different medications affect the metabolism of anesthesia differently. And just because supplements are "natural" or "alternative" doesn't mean they don't have side-effects or don't interfere with anesthetic medicines. How the Anesthesiologist Monitors During Surgery

The anesthesiologist, using intraoperative monitoring, will be watching your heart rate, blood pressure, and breathing rate (if a ventilator doesn't need to be used). Increases in these seen on the intraop monitors indicates that the anesthesia is too "light." These parameters generally increase before any awareness occurs. The anesthesiologist is constantly adjusting the delivery of the anesthesia gas and giving other medication in the IV to keep the anesthesia level where it needs to be. The anesthesia is increased to ensure adequate depth of anesthesia if it's too light. Likewise, even though you are unconscious, your body will reflexively move to stimulation if the anesthetic depth needs to be increased. This also occurs before awareness.

The various brain monitors on the market have not been shown to reduce anesthesia awareness, despite what the makers of these expensive devices say. They do provide other useful information and may or may not be used if your hospital has them, at the discretion of the anesthesiologist.

BIS Monitor

A study published in the "New England Journal of Medicine" (August 18, 2011) has actually shown that relying on a BIS (brain) monitor can actually increase the incidence of intraoperative awareness vs. using measurement of the anesthetic concentration (the usual technique). This sounds counter-intuitive, but to me is not surprising. Here's why...

The BIS monitor (which I use for other information) gives a number that is indicates the level of consciousness. Other indicators include heart rate, blood pressure and breathing rate/pattern changes (if the patient is breathing on their own). In my experience (disclaimer-based on only my experience, not scientific study), the changes in vital signs happen first. Heart rate goes up before you see a change in the BIS number. That means that providers who rely only on the BIS number and ignore the changes in vital signs may be missing the chance to prevent awareness. The awareness may have already happened before the change in BIS number is seen. There is a lag between the event and the change in BIS.

Personally, I try to use all the data available to me and not rely on the BIS monitor for prevention of awareness. Vital signs to me are more reliable, happen earlier (before awareness can occur in most cases) and should not be ignored to focus on the BIS monitor. The BIS does provide other useful info, but is not as reliable as the manufacturer may claim to prevent awareness.

Treatment for Anesthesia Awareness

If you have had a case of genuine intraoperative awareness, let your doctor, surgeon, or anesthesiologist know right away. Many people do well with just an explanation of why it might have happened. Others suffer short-term or even long-term post-traumatic stress disorder. In those cases, an evaluation by a psychologist or psychiatrist and possible medications may be needed, usually on a short-term basis.

If you aren't sure if you had true anesthesia awareness, speak to your surgeon or contact the anesthesiologist. Most people who aren't sure have had one of the other experiences -- like sedation, dreaming, or waking at the end and being confused about the time -- and feel much better after having their questions answered.

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30 percent of all Chinese men suffer from a certain medical condition which actually is a birth defect, and which is called a micropenis (less than 1 inch). This is why the Chinese are so good in making money. They have to be good for something.

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There is a new solution coming up for ugly old women. Normally they would just become man-hating feminists. But soon they can have their brains transplanted into a sex doll, and feel beautiful again.

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