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Scaling up Refugee Resettlement in Europe: The Role of Institutional Peer Support

With pressure mounting on EU Member States to create and scale up refugee resettlement programs, many have turned to peers in other countries for information, advice, and operational support. This report maps the many forms resettlement-focused peer-support initiatives take and discusses common stumbling blocks and strategies for policymakers and program designers looking to make the most of these critical exchanges.




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Social Innovation for Refugee Inclusion Conference Report: Maintaining Momentum and Creating Lasting Change

Fostering the social and economic inclusion of refugees has long been the domain of governments and NGOs. In the wake of the 2015–16 European migration and refugee crisis, however, new actors have emerged and taken on important roles in integrating newcomers. This report describes key discussions and takeaways from an MPI Europe conference on these developments.




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Money Wise: Improving How EU Funds Support Migration and Integration Policy Objectives

European policymakers are negotiating the blueprint for the next EU funding cycle—a plan that will determine how much money is available for migration and integration aims, what it can be used for, and who can access it. This policy brief explores some of the limitations of EU funds, as well as strategies that could help them more effectively serve migration and integration policy goals.




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Preparing for the Unknown: Designing Effective Predeparture Orientation for Resettling Refugees

Refugees encounter a range of challenges after resettlement—from adjusting to a new culture and language, to finding a job. Many resettlement countries invest in predeparture orientation to help refugees develop the knowledge, skills, and attitudes to face these challenges. This report explores the many forms these programs take, highlighting important design questions and key elements that effective programs share.




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Investing in the Neighborhood: Changing Mexico-U.S. Migration Patterns and Opportunities for Sustainable Cooperation

Migration between Mexico and the United States has changed dramatically in recent years, but policies and political rhetoric in both countries have not always kept up. This report, which draws from discussions of a high-level Mexico-U.S. study group convened by MPI and El Colegio de México, explores this new migration reality and how the two governments could work more closely together to address shared policy challenges.




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Invertir en el vecindario: Cambios en los patrones de migración entre México y Estados Unidos y oportunidades para una cooperación sostenible

La migración entre México y Estados Unidos ha cambiado dramáticamente en los últimos años, pero las políticas y la retórica política en ambos países no se han actualizado a este contexto a la misma velocidad. Este reporte explora esta nueva realidad migratoria y cómo los dos gobiernos podrían trabajar juntos para abordar los desafíos de políticas públicas que tienen en común.




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Immigrant Workers: Vital to the U.S. COVID-19 Response, Disproportionately Vulnerable

Six million immigrant workers are at the frontlines of keeping U.S. residents healthy and fed during the COVID-19 pandemic, representing disproportionate shares of physicians, home health aides, and retail-store pharmacists, for example. They also are over-represented in sectors most immediately devastated by mass layoffs, yet many will have limited access to safety-net systems and to federal relief, as this fact sheet details.




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Responding to Early Childhood Education and Care Needs of Children of Asylum Seekers and Refugees in Europe and North America

Marking the release of an MPI report, this webinar examines the challenges and successes major host countries in Europe and North America are experiencing in providing high-quality early childhood education and care (ECEC) services for children from refugee and asylum seeker families.




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Supporting DLLs in Superdiverse PreK-3 Programs: Findings from Two Studies

Marking the release of two research reports that highlight promising, effective approaches to teaching and learning for Dual Language Learners in multilingual, multicultural classrooms, report authors present their findings on this webinar and discuss key implications for policy and practice.




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State Sociodemographic Portraits of Immigrant and U.S.-Born Parents of Young Children

These fact sheets provide a sociodemographic sketch of parents with children ages 0 to 8 in the 30 states with the largest number of immigrant families, offering data and analysis of some of the key parental characteristics to help stakeholders identify populations that could be targets for early childhood and parent-focused programs working to improve child and parent outcomes.




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English Plus Integration: Shifting the Instructional Paradigm for Immigrant Adult Learners to Support Integration Success

To successfully integrate, immigrants and refugees need a variety of skills and knowledge—from English proficiency to understanding how school systems and local services work. Yet the adult education programs in place to support them have narrowed in scope. This policy brief proposes a new instructional model, English Plus Integration, to help states more comprehensively meet the diverse needs of their adult immigrant learners.




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Introduction to The Old Ways: A Journey on Foot by Robert Macfarlane

My first exposure to Robert Macfarlane happened a year ago when I picked up a battered copy of The Wild Places in order to shelve it. Instead, I checked it out from my branch and stayed up past midnight to read it. Thanks to Macfarlane, I was exposed to Roger Deakin's Wild Wood and Notes from Walnut Tree Farm. I found photos of Walnut Tree Farm, the late Deakin's house, much visited by Macfarlane, while searching for more information about both of them online.

I am from probably the last generation of American children to be raised on English children's books. I know that there is a generation of Quidditch-playing adults that were weaned on the Harry Potter books of British-born J. K. Rowling. While the Harry Potter books are gripping, they lack an essential British characteristic shared by many successful authors of British children's books:

  • Rudyard Kipling - the two Puck of Pook's Hill books
  • Rosemary Sucliff - all of her books
  • Elizabeth Goudge - Rowling helped get Linnets & Valerians and The Little White Horse republished
  • L. M. Boston - the Greene Knowe series
  • William Mayne
  • Robert Westall
  • Diana Wynne Jones - the British landscape of an alternative Britain
  • J. R. R. Tolkein -The Hobbit
  • Kenneth Graham - The Wind in the Willows
  • T. H. White - The Once and Future King
  • Susan Cooper - The Dark is Rising series
I'm sure that there are many more. What these authors and books have in common is a palpable sense of landscape; the English and Welsh earth itself is as present and influential as any of the characters. In any Harry Potter book I had the sense that the only character connected to the land was Hagrid; the rest of the wizards were interested in nature only insofar as they could exploit it for magical potions or familiars.

Both Macfarlane and his late mentor Deakin possessed the same sense of awareness of the land as these children's authors. Deakin kept his hedgerows alive to shelter birds and let animals wander at will through his house. Macfarlane travels, mostly on foot, as he did while he hiked and climbed in both The Wild Places and The Old Ways.




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Silt Part 1 - land and time under the sea

Warning: The Broomway is unmarked and very hazardous to pedestrians.
 
Warning: Do not approach or touch any object as it may explode and kill you.
 
 
The "Silt" chapter of the book contains some of Macfarlane's most hypnotic writing. It is also the chapter that made me realize that I am not innately the adventurous type of person. Unlike Macfarlane, I'm just not going to walk over unmarked mud paths at low time while running the risk of accidentally being sucked into the undertow and drowned(since he did the walk on a Sunday, he didn't have to worry about being accidentally shot by the Ministry of Defense). But I admire him for doing so.
 
The Broomway is called the deadliest path in Britain. It gets its name from 400 brooms which were used to mark the path to Foulness. When the tide comes in twice a day, other markers are swept away. Until compasses were affordable, people who walked the Broomway carried thread with them. As they passed a broom, they tied the end of the thread to the broom and continued walking. If they felt they had missed the next broom, they could follow the thread back to the previous broom.
 
Macfarlane walked the Broomway with his friend David Quentin, a book dealer turned tax lawyer who prefers to walk barefoot. In the end the mud was bad enough that Macfarlane also walked barefoot to save his sneakers. He left them at their starting point and was able to refind them when they doubled back to the beginning of their path.
 
As Macfarlane walked, he recollected that the land under the Broomway had once been called Doggerland, the home of Megolithic hunter-gatherers. This in turn made him recall the fact that the sea coasts of Norfolk and Suffolk in England are being eroded. Entire towns are being swallowed up by the sea, and houses that were once inland are now being abandoned because they are too close to the shore.
 
Although Macfarlane remembers many historical and geographical facts as he walks, he is also sucked in by the queer atmosphere of the The Broomland. Not entirely land, not entirely water, it exists in a liminal state. To Macfarlane:
 
"These borders do not correspond to national boundaries, and papers and documents are unrequired at them.Their traverse is generally unbiddable, and no reliable map exists of their routes and outlines. They exist even in unfamiliar landscapes: there when you cross a certain watershed, treeline or snowline, or enter rain, storm, or mist, or pass from boulder clay onto sand, or chalk onto greenstone. Such moments are rites of passage that reconfigure local geographies, leaving known placed outlandish or quickened, revealing continents within countries." (p. 78)
 
Space, distance, and direction become distorted because of the light over the sands, the movement of the tides, and the constant erosion of the land. A simple walk over the sea shore is a trek that could easily end in disaster where Macfarlane joins the dead of a drowned country.





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Silt Part 2 - Fighting the sea

On October 29th, 2012, Hurricane Sandy hit the tri-state area. I was lucky enough to be unaffected as I live on a hill in a central portion of Queens but I had two family members who lost power for a week. I also had co-workers who live in some of the most hard-hit areas of Brooklyn and Queens. Rereading Macfarlane's "Silt" chapter after Sandy was a sobering experience as I wondered what such a walk in parts of Queens or New Jersey would involve.

In the aftermath of Sandy, I've listened to radio interviews with Dutch engineers who have advocated sea gates and houses on stilts. I've read proposals about sea walls.  In the past week, Governor Cuomo has suggested a buyout of homes in areas likely to flooded again in the future. Once the state buys the land, the homes will be demolished and the land left empty. To quote Governor Cuomo, "there are some parcels that Mother Nature owns...She may only visit once every few years...but she owns the parcel and when she comes to visit, she visits."

However, people who live in flooded and devastated areas such as Freeport, Breezy Point or the Rockaways are reluctant to say goodbye to their communities and shore-based lifestyles. Mr. Cuomo accepts that man cannot ultimately defeat nature, which is why, for example, parts of the English coast are crumbling away without the UK spending billions on sea walls or sea gates (although London is protected by the Thames Barrier). Inhabitants of New York and New Jersey seem more willing to fight nature with man-made barriers, artificially-created natural shorelines, and architectural changes such as in the Netherlands. In the end, residents of NYC will have to decide how much money they wish to spend to protect and maintain their current lifestyles and residences.




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Memory in a House - part 1

Lucy Boston had led an adventurous life for a woman of her time. She had dropped out of Oxford University to become a nurse during WWI and worked in a hospital in Normandy. She had married her cousin, had her son Peter, divorced her husband, and moved to Germany and Italy to paint. When Peter started Cambridge, Lucy also moved to Cambridge and began obsessively painting King's College Chapel. Then in 1939, she bought The Manor, Hemingford Grey.

In Memory in a House, Lucy describes the two years that it took to restore The Manor as "which were by far the happiest of my life, even in spite of the war that broke out as soon as the builders began." (p. 19) In fact, she views her realtionship with the house as a love affair. She was aware that the house, which was built as a Norman manor in 1120 by Payne Osmundsen, was very historic, and she eventually documented everything she found and all the changes she made.

The forced restoration was brought about by the fact that the house was structually unsound due to cheap and unskillful renovations over the years. Faced with unsupported structural beams, walls cracking from top to bottom, and drastically sloping floors, Lucy was had no choice but to fix these problems. She was lucky enough to get honest and competent builders and architects to help her with the delicate job of historical renovation.

It becomes clear while reading the book that restoring the house was as much a creative endeavor for Lucy as painting a picture, or writing fiction. She was extremely sensitive to atmosphere, and accepted the physical imperfections of the house as part of the character that it had developed as it aged. She was also willing to change her mind about the alterations and restoration as she went along; the dining room, which she had thought was hopeless and would be used just as a corridor, became the center of her life, connecting the interior of the house with its equally important exterior garden.



  • Children of Green Knowe
  • Lucy Maria Boston
  • Manor at Hemingford Grey
  • Memory in a House

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Visiting Lucy Boston's House, Part 2

Since we were early for our 2 PM house tour, we decided to explore the gardens. Lucy talks about designing and building the gardens in her memoir Memory in a House, which also contains some black and white photos of the gardens back when she published the book. However, I did not realize until her daughter-in-law Diana Boston gave us the tour how much of the gardens Lucy build from scratch. Apparently most of the yard was just meadow until she set to work.

What stunned me, Val, and Dave was how large the gardens were in size. We split up in the gardens, and they saw only the more cultivated side:


 
 
 


until I took them to see the the other side of the house, which has a  moat that surrounds three sides of it, a flowering meadow, and a bamboo thicket:







The bamboo thicket is where the gorilla Hanno lives in A Stranger at Green Knowe. The moat is a a constant presence in the books because when it floods, the house is cut off on an island, the way it was originally designed to be by its Norman builder, Payne Osmundson. The story of the builders of the house is told in The Stones of Green Knowe, which is the last of the series. The River Ouse features in The River at Green Knowe, and can be seen from the yard and the windows of the house.

One of my friends commented that the house and garden must be smaller than I expected since I had read the books first as a child and was now an adult. This is not quite true. Although the house was small - the walls are three feet thick so the exterior is larger than the interior, the gardens were bigger than expected. Boston gardened in the warm weather and wrote and created patchwork in the cold weather. It is amazing to see the variety of garden sections that she created. In my next post, I will discuss the gardens in terms of the books and of my experiences as a child both as her reader and as someone who grew up in a decent-sized yard and in fine public parks.





  • Children of Green Knowe
  • Diana Boston
  • Lucy Maria Boston
  • Manor at Hemingford Grey

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Six Great Ideas, by Mortimer Adler


Dr. Mortimer J. Adler, who was chairman of the Board of Editors of Encyclopedia Britannica, an editor of the Great Books of Western Civilization, and a senior associate at the Aspen Institute for Humanistic Studies, in his thought-provoking discussions of the six philosophical ideas--truth, goodness, beauty, freedom, equality and justice--argues that philosophy is not the exclusive concern of the specialist but “everybody's business," and that a better understanding of these ideas, is essential if human beings are to cope with the political, moral, and social issues that confront them in an increasingly complex, interconnected and interdependent world. To Adler, philosophy is all about ideas, especially the “great ideas.” He urges that a philosopher should begin with these six ideas, and how they relate to each other, because of our shared and common call to be good citizens and thoughtful human beings. Truth, goodness and beauty are ideas we judge by. And freedom, equality and justice are ideas we live by. Noting that these ideas are prominent in some of the foundational documents in American history such as the Declaration of Independence, the Constitution, and the Gettysburg Address, Dr. Adler describes difficult philosophical concepts in non-techincal language, to contemporary audiences who might not have a background in philosophy.




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When Good People Write Bad Sentences, by Robert Harris

All great writing starts with a sentence. But what is it that makes a sentence great?  Could it be grammar, syntax, style, word choice, information, meaning, common sense, passion etc? According to one author, there is only one rule for writing a great sentence. And this is the rule:  "whether you're Christian, Jew, Muslim, or a disciple of the church of Penn Jillette, when you sit down to write, the Reader is thy god." The rule is certainly thought-provoking but one has to wonder if one rule would be enough for writing a great sentence.

Robert Harris, in his book, "When Good People Write Bad Sentences," offers "12 Steps to Verbal Enlightenment" that can cure any eager to learn "bad writing addict." Besides, the 12 steps don’t just provide solutions to well-known problems in the categories of punctuation, syntax, diction, and style but also help bad writers understand the emotional foundations and psychological forces behind those problems. Harris argues, not without humor, that only with this deep understanding can permanent changes take place. He identifies nine types of ineffective sentences that arise from unexamined emotions and self-destructive needs, and offers an integrated approach which could help writers learn to take a broader and healthier perspective on sentence construction.

When it comes to the malady of writing badly, which he calls "malescribism,"--an uncontrollable urge to write carelessly and unpersuasively--Harris warns that this malady "is no respecter of status, nor does it take into account social, ethnic, or religious orientation." He also notes that malescribes could be black and white, male and female, believer and nonbeliever, liberal and conservative.

Since we all would like to write better sentences consistently, let's look at the advice offered by Robert Harris, and also share some of the great sentences that we have come across in our reading.


 




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Expansion of legal migration opportunities for third-country nationals, particularly in middle- and low-skill sectors, holds potential but should not be oversold as migration management tool, new study cautions

BRUSSELS — While the European Union has called on Member States to expand channels for foreign workers as a way to meet labour market needs and potentially tackle spontaneous migration, they have struggled to deliver on this pledge. To date, policies have focused more on attracting high-skilled workers, but less attention has been paid to admission of low- or middle-skilled nationals. Policymakers would do well not to overestimate the potential of legal channels to reduce irregular migration.




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As Global Refugee Forum approaches, MPI Europe brief offers a road map for smart investment in refugee sponsorship programmes

BRUSSELS — Even as the number of refugees in need of protection has reached an all-time high, the resettlement spots offered by countries in 2018 were less than half the level in 2016—and future commitments may shrink further. With refugee needs high and generosity dimming, there is increasing urgency for humanitarian actors to find new ways to bring refugees to safety as well as to rebuild public interest and consensus around the importance of protection.




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Governments in Europe & North America Need a New Social Contract for the Age of Spontaneous Migration

WASHINGTON — A new age of migration has been ushered in by large-scale spontaneous migration flows on both sides of the Atlantic, which have upended asylum adjudications systems and placed enormous stress on reception, housing and social services, particularly in Europe.




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Las puertas abiertas para los migrantes venezolanos y nicaragüenses en América Latina y el Caribe se cierran un poco a medida que aumenta la escala de los flujos y la presión en los servicios públicos

WASHINGTON – A pesar de que los gobiernos de América Latina y el Caribe han tomado medidas generosas e innovadoras para lidiar con el desplazamiento forzado desde Venezuela y más recientemente desde Nicaragua, la cálida bienvenida se ha enfriado en algunos lugares a medida que el número de entradas, la presión sobre los servicios públicos y la preocupación del público aumenta.




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As European policymakers take stock of seasonal worker programmes, MPI Europe brief outlines principles to improve these schemes for all parties

Findings will be discussed during 25 February MPI Europe – SVR webinar




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Immigrant Workers Are Vital to the U.S. Coronavirus Pandemic Response, But Disproportionately Vulnerable

WASHINGTON — Six million immigrant workers are at the frontlines of keeping U.S. residents healthy, safe and fed during the COVID-19 pandemic, according to a Migration Policy Institute (MPI) analysis of U.S. Census Bureau data issued today. While the foreign born represented 17 percent of the 156 million civilians working in 2018, they account for larger shares in pandemic-response frontline occupations: 29 percent of all physicians in the United States, 38 percent of home health aides and 23 percent of retail-store pharmacists, for example.




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As U.S. Health Care System Sags under Strain of Pandemic, Immigrants and Refugees with Degrees in Health Care Could Serve as an Important Resource

WASHINGTON – Even as 1.5 million immigrants and refugees are already employed in the U.S. health care system as doctors, registered nurses and pharmacists, another 263,000 foreign-born health care graduates are on the sidelines during the COVID-19 pandemic—many of them because of difficulties getting their credentials accepted by employers and licensing bodies.




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Is a U.S. Immigration System Rebuilt after 9/11 Prepared to Tackle Ever-Evolving Security Threats, Including Pandemics? Report Assesses Successes, Gaps

WASHINGTON — The U.S. immigration system was dramatically reshaped by the terrorist attacks of September 11, 2001, which shone a harsh spotlight on weaknesses in visa and immigration screening processes. From the creation of the Department of Homeland Security (DHS) to expanded national security protections in immigration and tourism policies, countless changes in the immigration arena have unfolded over the past 19 years.




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Global Demand for Medical Professionals Drives Indians Abroad Despite Acute Domestic Health-Care Worker Shortages

India is the world's largest source for immigrant physicians, and for Indian-trained doctors and nurses the allure of working abroad is strong despite an acute domestic shortage of health-care workers. Against this pull, the Indian government has enacted a number of policies to limit and regulate the emigration of health-care professionals, though these have been more ad hoc in nature and not part of a fully realized strategy.




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Which English Learners Count When? Understanding State EL Subgroup Definitions in ESSA Reporting

States publish a wealth of data about their English Learner students’ academic achievement and other outcomes such as graduation rates. But the answer to the question “Who is an EL?” is not always the same. This brief explains how the EL subgroup varies across states and types of data, and why it is important to understand these differences when making decisions about how ELs and schools are faring.





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Beetroot, yoghurt, date and za'atar dip

500g cooked and peeled beetroot (about 900g fresh) 2 garlic cloves, crushed 1 red chilli, deseeded and finely chopped 1 cup of Greek yoghurt 5 fresh Medjool dates 3 tbsps. olive oil 1 tbsp. Za'atar Good pinch of Himalayan salt 2 shallots, finely sliced on the diagonal Handful of toasted and crushed hazelnuts 50g goat's cheese, crumbled





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Lamb kofte with lemon yogurt flatbread

700g minced lamb 30g pine nuts, roughly chopped 1/4 cup flat-leaf parsley, finely chopped 1/2 onion, diced 1 garlic clove, finely chopped 1 tsp cumin 1 tsp ground coriander 1/2 tsp dried chilli flakes (optional) zest of 1/2 lemon pinch of salt and pepper 3 tbsp. oil Lemon Flatbread 1 cup plain flour 1 1/2 tsp baking powder pinch of salt 3/4 cup plain yoghurt zest of 1/2 lemon





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Greek syrup drenched semolina, yoghurt and almond cake somali

1 1/2 cups fine semolina 1 1/2 cups sugar 1/2 cups Greek yogurt 2 tsps. baking soda 1/2 tsp ground mastic resin, we are substituting ground fennel 3-4 tbsps. butter, melted slivered almonds For the syrup: 2 1/2 cups sugar 1 1/2 cups water 1 lemon, cut in half 1/2 tsp. rose water Dash of vanilla extract 1 cinnamon stick




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Arroz de Marisco (Portugeuse rice dish)

The Portuguese have a double gene for flavours. They keep it simple, they rely on extremely good produce. This dish has such a unique flavour. It's ideal with all wines. A good Lisbon paste is the trick!




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Lemony myrtle delicious pudding

Sometimes these old desserts are just the ticket on a winter's night. We have used a little lemon myrtle powder to add that native home growing touch to this gorgeous pudding.




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Jerusalem artichokes cooked overnight with hazelnut praline

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, shared by Dan Hunter, chef and owner of Otways' restaurant Brae.




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CAULIFLOWER PAKORAS WITH MINTED YOGURT

These tasty little Indian Fritters will convert a body who has a dislike of cauliflower. Served simply with a minty yogurt they are simply delicious.





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Malibu strawberry tart with coconut thickened custard

I love the texture of a cool tasting coconut custard with market fragrant strawberries macerated in well more coconut liqueur.




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Roast Christmas Duck with Port and Cherry sauce

Getting in early with my Christmas recipe to inspire you to move away from the traditional Turkey . Not one for sweet tasting sauces with meat however his works extremely well against the rich sometimes games flavour and the sweet sour notes from the cherry sauce.




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Chocolate and almond torte with amaretto cream and fresh market raspberries

This is the biscuit base to sprinkle in top of the cake Make enough to accomodate 22 cm round tin 50 g Unsalted Butter 50 g Raw Sugar 50 g Almond Meal 8 g of Coco Powder Pinch of Salt 40 g plain Flour Beat all ingredients together in machine with k beater Roll into oblong wrap in glad and freeze Cake mix 250 g eggs or 5 x large eggs 75 g of local honey 125 g castor sugar beat all ingredients together 75 g Almond Meal 120 g plain Flour 25 g coco powder 8 g Baking powder sieve ingredients Add to egg mix then add 120 ml of double Cream Melt together 70 g 70% best quality chocolate 75 g unsalted butter




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Phillippa's Ginger Almond Shortbread

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive at 3.30PM. It was shared by Phillippa Grogan, adapted from Phillippa's Home Baking written with Richard Cornish.




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Upside down local tomato, goats cheese and onion tart

Always a winner taking advantage of the local summer tomatoes . Who doesn't like flaky puff pastry?




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Greek Santorini tomato fritters with yogurt and dill dip

400g ripe roma (plum) or pomodorino (baby plum) tomatoes 1 1/2 tablespoons chopped mint 1 teaspoon dried oregano 90g plain flour 1 teaspoon baking powder 1 teaspoon salt Light olive oil, or sunflower oil for pan-frying 250g Greek-style yogurt 1 tablespoon finely chopped dill Lemon wedges, to serve




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French salted caramel ganache tart

An indulgent French chocolate and salted caramel tart. Decorate with fresh raspberries and pistachio nuts for great colour and a sweet zing.




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Start-Up Visas: A Passport for Innovation and Growth?

Over the last decade, a number of governments have launched start-up visa programs in the hopes of attracting talented immigrant entrepreneurs with innovative business ideas. With the track record for these programs a mixed one, this report explains how embedding start-up visas within a broader innovation strategy could lead to greater success.




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Refugee Sponsorship Programs: A Global State of Play and Opportunities for Investment

From Argentina to New Zealand and points beyond, a growing number of countries have begun exploring refugee sponsorship as a way to expand protection capacity at a time of rising need, involving individuals and communities more directly in resettlement. This brief takes stock of what both new and well-established programs need to succeed, and outlines opportunities for private philanthropic actors to support them.




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¿Se Están Cerrando las Puertas? Respuestas a la Migración Venezolana en América Latina y el Caribe

MPI llevó a cabo un seminario en línea para marcar el lanzamiento de: Un portal sobre Migración en América Latina y el Caribe; y un informe que examina los efectos de las políticas migratorias y de integración en 11 países en América Latina y el Caribe ante el aumento de la migración venezolana y nicaragüense.




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Association of BMI, Fitness, and Mortality in Patients With Diabetes: Evaluating the Obesity Paradox in the Henry Ford Exercise Testing Project (FIT Project) Cohort

OBJECTIVE

To determine the effect of fitness on the association between BMI and mortality among patients with diabetes.

RESEARCH DESIGN AND METHODS

We identified 8,528 patients with diabetes (self-report, medication use, or electronic medical record diagnosis) from the Henry Ford Exercise Testing Project (FIT Project). Patients with a BMI <18.5 kg/m2 or cancer were excluded. Fitness was measured as the METs achieved during a physician-referred treadmill stress test and categorized as low (<6), moderate (6–9.9), or high (≥10). Adjusted hazard ratios for mortality were calculated using standard BMI (kilograms per meter squared) cutoffs of normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Adjusted splines centered at 22.5 kg/m2 were used to examine BMI as a continuous variable.

RESULTS

Patients had a mean age of 58 ± 11 years (49% women) with 1,319 deaths over a mean follow-up of 10.0 ± 4.1 years. Overall, obese patients had a 30% lower mortality hazard (P < 0.001) compared with normal-weight patients. In adjusted spline modeling, higher BMI as a continuous variable was predominantly associated with a lower mortality risk in the lowest fitness group and among patients with moderate fitness and BMI ≥30 kg/m2. Compared with the lowest fitness group, patients with higher fitness had an ~50% (6–9.9 METs) and 70% (≥10 METs) lower mortality hazard regardless of BMI (P < 0.001).

CONCLUSIONS

Among patients with diabetes, the obesity paradox was less pronounced for patients with the highest fitness level, and these patients also had the lowest risk of mortality.