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ISA Review ISA BOARD ! Introduction of new members

DIABETES ! ! !

Personal story: Being diagnosed Pathological facts Sugar - Why is it so toxic?

ISA EVENTS ! Teddy Bear Hospital ! Diya 2013 ! ISA Handover weekend

FROM STUDENTS FOR STUDENTS ! ! ! !

Life á la Riga Rica meets... Maxi Vidovic & Gurjoat S. Kareer EDSA & EMSA Reports Visualising Riga

Vol. 2 / December 2013

© International Students' Association


Introduction Can you believe that the red books (or green books for some of you) will soon become history? No running around and chasing professors for signatures. Or that no student will ever go to their 2nd chance for colloquium with a feeling that if they fail, they have to repeat a semester? Or that getting academic issues to the Dean is now easier because of the semester leader program? Or that senior students help junior students by holding lectures and seminars? All that and much more is because of your support and cooperation with the International Students’ Association. We have managed to make the impossible possible, together. And we work hard every day to make a difference and to make all the international students feel that they belong here by listening and reacting. Our mission is to represent, serve, and help to improve the lives of International students at RSU. Not only that, we are now working more towards medical science, trying to put RSU on the map of scientific work performed by the international students as well. Wouldn’t it be awesome that next time someone Googles RSU, scientific work projects done by international and Latvian students come up on the screen? I believe that a diploma from a good and well-known university will give you great job opportunities in the future!

Next to all the academic work it is important to have some fun as well. If you are tired of Madhouse, Cuba bar, Pulkvedis, Piens, La Rocca, The Club etc. you can always join ISA´s social events, free entry with high quality entertainment and an evening to remember with other international and Latvian students. Like us on Facebook and keep an eye on our successful events such as The Welcoming Party, Pub-quiz and lots of amazing cultural events. You are always welcome. We now have an Instagram and a Twitter account to keep you updated on all ongoing ISA projects. We are always available for a chat if you have any worries, complaints or suggestions about academic or social affairs. We also welcome any ideas for social events so just drop us a line if you have anything in mind! Last, but not least, I would personally like to thank The Dean, The International Department and The Student Council for all the support throughout these years. I wish you all success in your session time and a great forthcoming semester. With best regards, Wasifa Javed Butt President of The International Students´ Association


INDEX Self-introduction of the newly elected ISA board members

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Wasifa - President Lukas - Vice President Mohsen - Human Resources Officer Sohini - Head of Social & Integration Affairs Yrjö - Head of Academic A!airs Philip - Medical Science Director Stephanie - Public Relations Officer Laavanja - Liaison Officer Aman - Treasurer Mustapha - Secretary Tobias - Unspecified Officer Robert - Unspecified Officer

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Medical Section: Diabetes

! Sugar, Sugar

! Pathological Facts ! La Dolce Vita

17 20 24

From Students For Students

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Rica meets... Maxi Vidovic and Gurjoat S. Kareer Forget about L'Auberge Espagnol, latviskas m"jas it is Home European Dentistry Student Association European Medical Student Association Visualising Riga

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ISA Events

! ISA Handover Weekend ! Diya 2013 ! Teddy Bear Hospital

Cover: © NR-Photography Model: Carina Jäger Scene: Stephanie Strauven

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Self-introduction of the newly elected ISA board members Wasifa - President Hello there! My name is Wasifa and I am the newly elected President of The International Students' Association. I moved to Riga from the land of mountains and fjords: Norway, as a 20 year old girl with high ambitions and even higher hopes, and looking back after 5 years makes me realize that I had no clue that life can give so many surprises, ups and downs. Being a student in Riga has not only taught me the academical part of being a medical student, but also the appreciation of different cultures, flowers, a good professor and friends, I have made friends for life here and they are the ones I spend real quality time with and of course also ISA´s Human Resources Officer, Mohsen my husband.

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Whenever I go back to Oslo I somehow take a part of Riga with me, I stand up in the bus a long time before my stop comes without realizing it, and I put the money on the desk when buying something because I have been conditioned to do so by all the Rimi cashiers denying to take the money in their hands. But on the other hand I make sure that I still hold on to some old habits when I am in Riga, like smiling to old ladies in the bus no matter how crazy they think I am.

Besides medicine, cooking is my passion. I love the great soccer mom Youtube videos on how to make this and that. And of course with so much food around me I need to hit the gym, dancing Zumba and Power Yoga is something I really enjoy. A cup of green tea and a good novel are some items that I highly appreciate (whenever I have a break from Toronto notes). Organizational work has always inspired me, I am intrigued by how several voices put together somehow get through (even when fighting against the odds), and as a result change is made. I heard about ISA from some of my friends, who were already involved, and gave it a shot. I was first elected in as a board member and later became Vicepresident, giving me the opportunity to participate in organizational work, and helping to make the university a better place to study.


Introduction of board members My aims and goals have been, and will continue to be to share my experience with other students in the form of study process seminars and tutoring. And also helping in arranging both social and academic events with my ISA colleagues, and to increase student participation in the ISA for a more practical and fun study experience. The new ISA board is absolutely fabulous and hard working; I am really looking forward to working with them this year towards a better RSU for all of us.

Lukas - Vice President In the first semester, I was fascinated by all the different extracurricular activities we could do besides the regular studies. The ISA helped to provide organizational framework to do some of them. Getting the chance to meet many fun and inspiring people and discussing new ideas or existing problems, made each and every meeting a fun experience. During the last year I got involved in issues such as the Syllabus and the third attempt rule or the “red book system�, which proved that students have an impact and many problems are solved in a very constructive manner. For the upcoming year my vision for

the ISA includes: 1) Support the application for a permanent membership with the European Medical Students Association (EMSA), which includes continuous communication as well as two permanent RSU representatives who travel to the annual General Assembly. (For more info emsaeurope.eu) 2) Tutoring: Support the implementation of student guided Tutoring. 3) ISA Paul Stradins Review: Continuation and support for the release of an international journal. 4) Teddy Bear Hospital: Support and co-organization of one TBH per semester. There is still a lot of work ahead of us but I believe we as students have the chance and ability to make a change, not only for our fellow colleagues, but also for our university. I cannot imagine this year's Team could let you down... We will make RSU a better place! Together.

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Introduction of board members Mohsen - Human resources officer Hey everyone! My name is Mohsen, and I am a 25-year-old medical student from Oslo, Norway. Currently, I am in the process of finishing my 5th year, 2nd semester here at RSU. I am the newly appointed officer of internal affairs in the ISA board, and even though I know you are thinking : “Wow, that has to be the coolest name of a position ever! Does he solve crimes, and go on great action adventures like in the movie The Departed?” I can assure you, it’s even cooler than that. I started studying medicine because I wanted to help people, but I continued studying medicine because I feel like there is no great mystery than the human body, and I want to be part of the movement figuring it out.

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I like living in Riga, and feel very much at home here. Studying

abroad has been a great chance to broaden my horizons – The fact that we can touch and feel other cultures and to interact with so many different kinds of people on every level is amazing, and it has really given me an edge in life that I would have never gotten if I did the same studies back home. And it’s nice to see national pride displayed in such an extravagant fashion here, something, which I can only compare to my home country of Norway! As the officer of internal affairs, I want to work against potential conflicts within the board, by creating an environment where the members of the board feel both comfortable and safe during their activities within ISA. The results of the ISA’s work are quite amazing, and I will do my best to help the new board streamline their activities, so we will be able to make your lives as students in Riga as good as they can get. I want to help promote our organization as much as possible, so the international student body gets the opportunity to take advantage of our events and give ideas for changes in their academic life. As a 10th semester student, I feel privileged to be in a position where


Introduction of board members I can help change the environment of the students of my university in a positive manner, so I can leave RSU knowing that it is better than it was when I came here.

Sohini – Head of Social and Integration Affairs My name is Sohini Mukhopadhyay, a student of the Medical faculty, and I am the Head of Social and Integration Affairs at the ISA. My love for organizing events started while I was studying for my previous degree. I founded the University of Dundee Indian Society, in Scotland, and was President of that society for three years. One of my personal hobbies is to dance, and when I first came to RSU, I sought the help of the ISA to start up a dance class. That was the first time that I got to know about the ISA activities and the, then President and founder of the ISA, Izem Massensen Ayati, introduced me to the roles of different positions and encouraged me to join the board. When I was offered a nomination for this position in 2012, I was initially a little hesitant as I had just started at the University, and knew medical

school meant a lot of hard work. I really wasn’t sure if I would have the time to dedicate it to extra-curricular work. However, I eventually decided to go for the opportunity and, trust me, I haven’t looked back since! I had already worked in this post for a year but I felt like there was so much I could still develop throughout the following year so I decided to run for it again. My work at the ISA involves creating new events for all of the students and also to promote integration between the home students and the international students to create a harmonious blend. It is sometimes quite busy and hard work, but after each event I get a great sense of satisfaction that reminds me why I still love it! I would definitely recommend my job

to anyone who wants to take it on next year. It actually teaches you the values of good time management and a work-play balance,while being able to do something for your colleagues!

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Introduction of board members We’ve already decided on some events to keep you all going. We kicked off with an Asian Cultural event on the 30th of November 2013, and will be following in the new semester by a Pub Quiz in association with the newly formed RSU British Society. For Christmas, we are trying out something new in collaboration with some Swedish students, the festival of St. Lucia. It should be a completely unique experience for all of us who haven’t celebrated it before. I know I’m really looking forward to learning some new traditions and culture! In the new semester, we’ll also be organizing the Welcome Party for the new students and I’d like to request you all to come along to show the newbies how our RSU students can party! I’m really looking forward to creating more fun events for all of the students at RSU to make them feel more at home. Other than that, I’m also very much open to your ideas. If you have any ideas for new events, just drop me a line at our Facebook page or our email address: rsu.international.students@gmail.com I promise you all that I’ll do my very best to provide you the maximum support for whatever you come up

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with! I look forward to hearing your suggestions and to be working with you all for the upcoming year.

Yrjö – Head of Academic Affairs Hi colleagues, my name is Yrjö Lähteenlahti and I am a 29 years old 3rd semester medical student from Finland. I have a variety of hobbies but mainly I like to ease my stress with piano playing and practicing Bikram yoga with my friends. During the year I train for triathlon competition, which includes running, bicycling and swimming. I think that it is a good alternative way to keep up mild stress levels during the summer period when we don’t have to worry about school. My responsibility in the International Students’ Association (ISA) is being the head of academic affairs. During my first year of studies I noticed that there where good things in our university and things that would need to be fixed. Finding out the problems that we have in


Introduction of board members our studies and trying to fix them is my main goal in the ISA. I see the ISA as a good friend to whom students can talk to, share the problems and realize that someone is listening them when they have problems concerning studies. This is my dream about how the ISA would be understood after this year or maybe even sooner. It is also an organization that presents different cultures and educates us students through its events to be introduced to different cultures. The ISA is also an organization that arranges parties and hopefully the one that can truly help students when they need advice, either in personal or school life. This is the dream for me what the ISA should become during these years that we are improving it. The main reason to be part in the ISA is to make a difference and provide better student facilities and study environment for students that are now studying at the Riga Stradins University and also for the future students as well. Other reason for being a part of the ISA is to meet new people who are coming from different cultures, and learn how your own culture differs from the others in normal situations and also in the ones where you need to negotiate matters at hand.

Philip – Medical Science Director Hey guys! My name is Philip Hilz, and in October I was elected to be Medical Science Director at the board of the International Student Association here at RSU. As for you, to get to know me a little better, here is who I am: I am a regular 22 year-old student, originally from the beautiful city of Dresden, Germany. As I was always interested in cultural horizon expansion, I took a gap year after my last year of high school, to travel Oceania and Japan. The experience I got and people I met on that trip, were decisive for my personal development, and contributed to the decision to study abroad. Time fly´s at hyper speed it seems, that now I am in the 4th year of my studies at RSU already, in a country that at the beginning seemed too small, too harsh and of course too dark and cold. But soon after the first weeks had passed, my opinion about Latvia changed a lot. I found nice Latvian friends, with whom I still hang around on the weekends. Furthermore I found awesome hobbies you can do all around the beautiful nature here in Latvia. Kisezers is perfect for windsurfing, the fun park at Sigulda´s small hills,

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Introduction of board members is awesome to train some jumps with the snowboard, preventing future embarrassment in the Alps ;) The close by Baltic Sea and its pine trees are just wonderful to walk around, pick mushrooms and to throw out that fishing rod to catch ones manly dinner. See, things turned out to be super nice here in Riga, even the winter seems to calm down to human temperatures these days! Okay, now you know me a little bit better, so how about I tell you a little bit more about my plans and motivations for the upcoming year of work at the ISA.

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To me it seemed odd that for the time of my studies, none of my colleagues from the upper semesters talked a lot about scientific works or research projects. So I decided to approach my professors to ask about the possibility of some little research work. It was only then in 2011, when for the first time an international student was to be participating and presenting a topic in the morphologic conference at the anatomical

The story continued with no further research projects available in the semesters three, four and five. Between students and authorities this is more than fair enough, as those semesters are usually containing the longest study nights and nobody would want to bother about scientific projects anyway. BUT, even after the fifth semester there was no hint in sight, of how to get some additional, extracurricular science work to hand, without approaching each professor individually. To cut a long story short, I took the job as Medical Science director mainly because I see a possibility of change in this field. RSU is in change, and we want to help making the change a profit for students. Student life will be more interesting, when one has the possibility of going deeper into topics one is really interested in. More challenging, when we will have the chance to present our work at scientific conferences and competitions, not only in RSU, but also abroad, to win prices and honors for their CV. But also scientific research work creates a selfchallenge; to free speaking and presentation making, while under


Introduction of board members constant academic observation and evaluation. Last but not least, I am willing to work on the improvement of study diversity, ensuring the best possible education you can get. One current project aiming for better understanding is the ISA organized interactive review group seminars; held by senior students, aimed at questions asked for specific topics from students in need. I am looking forward to cooperate with the doctors, researchers, the university, and most importantly with us – the students. So please feel free to approach me privately, whenever you have concerns, ideas or critics towards the topic of Medical Science. Cheerio, Philip

Stephanie - Public Relations Officer My name is Stephanie and I’m a 5th semester medical student. I have always been in favour of going abroad especially since I lived for one year in New Zealand. My time overseas, let me discover many adventurous things like sky diving, getting stuck with a small bus of 10 people in the middle of nowhere

with no reception whatsoever, kayaking, white-water rafting and many other things. Already when getting taught the Haka by native inhabitants of New Zealand, the Maoris, I fell in love with this country. It was the first time for me to discover how fascinating other cultures can be, especially when you get to know them in great surroundings like a rugby game of the national team the All Blacks, or a traditional Christmas dinner with friends and their families. Therefore for me the decision to go abroad to Latvia for my studies was an easy and fortunate choice. Living and studying together with international students has always been a pleasure and gave me a new sight on the world, as well as many great friendships. In the atmosphere of the Latvian culture, I have experienced how many possibilities you have in Riga to spend your free time, if you have any for spare along with your studies.

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Introduction of board members As I like to play volleyball, the beach of Jurmala gave some of my friends and me the perfect spots for playing beach volleyball. On the other hand, the quiet parks of Riga are great in the summer for spending some relaxing time on the grass while reading a book or having a picnic with your friends. Trips to Vilnius and Tallinn can also satisfy the travel bug that every now and then is bothering me. I got to know about ISA just about a year ago when I entered 3rd semester. Back then life was all about “How will I ever remember all of this?”, “How will I survive the next massive wave of colloquia?” and “When will I have time to sleep and rest?”. So there was little time for anything else. Now, having arrived in 5th semester, and with more time able to spend on private things, I’m happy to have been elected into the ISA board as the Public Relations officer. My job, to promote the ISA and to bring it closer to us, the students, is something I feel very connected to, as I get to hear every now and then “ISA? I know they exist, but what do they actually do and how does it work?”. Therefore my aims for the upcoming year are first of all the spreading of the word about ISA and motivating many students, also the Latvians, to get more involved with the ISA.

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There is so much to discover and as ISA is a very young organization with being found just 3 years ago, there is space for anyone, who feels like it, to jump in and present ideas regarding a new project, bring up issues you’ve noticed or just make improvement suggestions. One of the projects, I have my head in now, is the ISA’s magazine the “ISA Review”. This magazine is a student journal where every student can contribute articles, photos, cartoons, ideas to, so they get published and can be read by all students. This time, we are printing the ISA Review for the first time additionally to online publishing. This is a big step in the right direction and we hope to get more support with every edition published. Therefore, I hope you all enjoy reading it and if you think “Hey, I could contribute something to this!”, I would be more than happy to talk to you!

Laavanja – Liaison Officer Hello guys, my name is Laavanja Thaventhirarasa. I am 21 years old and a second semester medical student. I am from Krefeld, a small city in Germany.


Introduction of board members My parents are originally from the northern part of Sri Lanka. Now I am elected as the liaison officer in ISA. My duty is to connect the different international societies, so they get the chance to know each other, to collaborate with the different societies and to solve different problems with all together. I´ll try as well to organize social events together with all international societies and to promote them. Another important goal of my new position is to establish collaboration with EMSA (European Medical Students´ Association): “A volunteer- based organization advocating and representing the voice of all medical students of geographical Europe” I hope that I am capable of getting a good cooperation with this organization. This would be helpful for us in different categories, for example syllabus, conferences, technical progress, university life, research projects etc. Actually I want to tighten the bonds between Latvian and international students as well, because nowadays we know from each other

that they exist, but we don´t have any connections to them. This has to change. I think to get to each other could be really helpful during studies and as well for everyday life. Since I have been working in the student council in my school and as well at my last university, I think that I am able to manage my tasks and reach my goals till the end of my period as the liaison officer. As I would like to tighten the relationship of students and ISA, please feel free to talk to me and ask me for help. If I can, I will solve your problems. I am not able to help you, I ´ll send you to someone, who is able to find a solution for your problem. I am looking forward to meet all these new people, share opinions and to work together. My big aim is to make RSU a better place to study and feeling home since we are all from different countries and culture and we all miss our families and friends back home. The most important is that nobody should be left alone in this new and different country. Besides studying medicine, I go swimming in Kipsala, read a lot of non-medical books, cook Sri Lankan/ Indian food and of course German food as well. I love playing in dramas. I used to play in the theater in my hometown but

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Introduction of board members there is unfortunately no time for these kinds of cultural stuff. And I love music. This is actually one good abstraction in between anatomy, histology and genetics. So dear fellow students relax a bit from your studying and do something healthy for mental state and join some of the events, organized by the ISA. You will enjoy it and meet new friends. I hope I´ll reach my goals to make this university a better place study. Yours, Laavanja Thaventhirarasa

Aman – Treasurer Working as part of the Executive Committee for the International Students’ Association has been a privilege and a huge honor. I began my journey with the ISA in 2012, having nominated myself at the 2012 General Assembly for the position of “Unspecified Officer”. During my first year on the Executive Committee, I saw how much a role the ISA played in improving the environment for students at RSU, and I experienced first-hand how willing the University is to adapt to change. However I did experience some disappointment, I was dissatisfied with the level of participation of Dental students in the social and academic events organized by the ISA.

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I have made it my mission to increase the participation of dental student in ISA activities and to use my connections in Cavum Oris – The Dental Students’ Fraternity, of which I am also a Board Member, to help influence changes that will benefit the dental students at RSU. The position I currently hold in the ISA, is the position of “Treasurer”, in this role my primary objective it to organize and compute the ISA expenditure while promoting “Smart Spending”, thus allowing the ISA to host thrilling and engaging activities and projects in a physically responsible manner. When not participating in various student organisations, I enjoy reading, working out, and cooking. Since moving to Riga, I have become quite a specialist in Italian and Indian cuisine. Amanpreet Singh Grewal Board Member / Semester Representative – Cavum Oris Vice President & Co-founder – RSU British Students’ Society Semester Leader – 3rd Semester (Dentistry)


Introduction of board members Mustapha – Secretary So to introduce myself, my name is Mustapha Samy, British Muslim from England and I’m here for the long haul. I have a more of relaxed and calm character. I like to think of myself as a good listener and team player. For those who have known me a little better, they have witnessed my witty/dry humour. My hobbies and interests include DIY, photography, technology and sports. In my free time I like to get out and explore new areas. As for sports I’m into football, badminton, squash and more recently (in Latvia) Körbe werfen (German for shooting hoops). Getting the time or people to play is a different story so mainly now gym and basketball. Having been through the university system in the UK, I now realise that I had taken many things for granted, such as access to facilities and library opening times. Studying at RSU now almost three semesters, I have already witnessed some great changes made by the ISA. Some of the

life only just 5 years ago is unbelievable. For example old newspapers in the Anatomicum as toilet paper, sometimes it’s the little things that make a big difference. Really the university has come a great way with its facilities and its ongoing renovations and I hope these improvements continue. It is very important to know who is representing you and who can help you solve your problems at RSU especially as an international student in an unfamiliar system. The ISA is there as our voice, our guide and a helping hand for any problems during our time at RSU. My motivations to work with the ISA is to try and get a better standard and experience out of university here for myself and for those to come. The current and future projects are set on course to achieving a better experience and international standards for RSU. My visions for the upcoming year(s) include larger/better studying areas/ times and better integration between internationals and locals. Being an international student so far has been a great experience but it is unusual to be sharing the same facilities with Latvians and have such a big distance.

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Introduction of board members The progress made by the ISA so far have been great and motivational, it really is a “watch this space” space. I look forward to the year ahead and hearing from you all.

Tobias – Unspecified Officer Hi everybody, I am Tobi and I would like to introduce myself as a new board member of the ISA (unspecified officer). I am an international student from Germany, currently in my 1st year, 2nd semester of the Medicine program and I am 23 years old. My hometown is the beautiful city GarmischPartenkirchen, right in the south of the Bavarian Alps, next to the highest mountain of Germany, the Zugspitze. Basically, everybody there is put on skies before even being born, so I grow up on skies and love the mountains and outdoor sports. That´s why, before coming to Riga, I studied Politics and Chemistry in Innsbruck, Austria. There I was able to do a lot of skiing, mountain biking, climbing and hiking. Besides sports and medicine, I am into some TV series, acting/theatre and good music. Recently, I became interested in American Football, so if you need somebody to watch some games, the Super Bowl or just throw the football a bit, I am your guy (not that I am any good or played in a team before).

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I wanted to join the ISA to improve our study environment, facilitating our study process and ensure a productive communication channel between the University and us students. After being through an inappropriat e handled conflict with the University last semester, which the ISA actually fixed, we were able to change the study process fast and, in my opinion - in a great way. Now the red grade books are (almost) gone, we have three tries for taking a colloquium and the group leader/semester leader system has been established. These are all things the ISA has been working for quite hard, and this showed me how important the ISA is and how serious our University takes our concerns. But remembering the first contact with the ISA in our first semester, I have to say I did not realize that for various reasons and I did not realize how much the ISA can help


Introduction of board members us. There, I see a key problem for the ISA, the University and for us as students when facing problems, big or small. The voice of the ISA is loudly heard and acknowledged by the Dean and the Departments, but the ISA is not that well known among students. Therefore, I want to make sure that this communication channel keeps working and we can improve our study process constantly. Personally, I think the ISA can be a very productive organization, collaborating with a lot of national associations and the SP. But still, we need YOUR help on this matter. The ISA has gained its strong voice because of YOU. The ISA wants to improve the study environment according to YOUR plans and wishes, solving problems for YOU. So if you have any concerns or feedback, positive or negative, you can always contact and ISA and all ISA board members, to start a communication with the University and trying to solve the situation. If WE, students and ISA, are acting together, WE can make changes faster, easier and more productive. So my goals for my time as ISA board member is to get this idea stuck in your head and make the ISA more popular and known. Only if we receive feedback from you and only if a lot of people express there opinions, the ISA can work properly.

So if you have any problems, come to us, ask us in person, and we will be working together to improve OUR study environment. I know it´s old, I know it´s not originally any more, I know it was said way to often, but I still say it because I really think so: yes, we can. Let´s make the RSU a better place to study, we all are going to profit from this. Thank you, good luck with your studies & stay healthy, Tobi

Robert – Unspecified Officer Hi! My name is Robert Eblenkamp, I am 21 years old, come from Germany and study medicine, currently in the 4th semester. I am a general board member of the ISA. Combining my interest in music with ISA work I organized the first Jam Session at the RSU and I hope more will follow! In addition to that I created colorful posters for ISA Events like the ISA Pub Quiz, the RSU Music Jam and more.

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Introduction of board members For the upcoming year within ISA I wish that more Latvians will join our events to have a stronger Student Community with International and Latvian Students together! As we all know, music is a language of its own which brings people together with no boundaries. The jam was a success with several people turning up with their instruments and some people who came to participate as an audience. There were some amazing tunes and everyone had an opportunity to participate in some way. I hope to continue the Music Jam in the future and to keep it running for everyone to share their interests in music.

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Medical Section Sugar, sugar Pathological facts La Dolce Vita

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Diabetes


Sugar, Sugar Sugar, Sugar How I Got First Time Diagnosed with Type I Diabetes Mellitus in Latvia Giant snowflakes were silently floating from the gloomy firmament embracing Latvia’s capital during the winter months. Each one perfectly unique in its own intricate shape and size. Those hitting the ground showcased the end of a strenuous voyage through earth’s atmosphere. Collections of millions of snowflakes formed white covers, hiding the rooftops, and streets. It had become extremely chilly in Riga. To all the existing woes, I had managed to catch a bad cold. Now, on this particular snowy afternoon, I was standing in line in the local cafeteria, behind a display of a vast array of foods and desserts. It wasn’t my turn yet, but I kept impatiently eyeballing

the food. I felt my heart pounding defiantly against my ribcage. Hot blood was throbbing up my neck. Waiting in a cold sweat, this crowded place wasn’t exactly where I wanted to be just now. However, my stomach had been grumbling in discontentedness, and I was desperately craving a meal. Just a few feet away from me was a

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group of heavily gesticulating school kids, and although I clearly saw their lips moving, their voices seemed muffled as if form a great distance. My vision became blurry and twisted. I felt the urge to breathe heavily, literally grasping the oxygen into my lungs. That’s when I started to black out, only able to differentiate rough contours of the furniture lining the room. I remember, slapping down 60 Santims, then grabbing a can of Coca-Cola from the counter, and trotting to the nearest free table to sink into the chair. It may well have been the most momentous purchase of a soda in my life. The neatsounding hissing of a soda releasing its excess gas upon opening, was music to my ears. I gulped the entire content of the fizzy drink down my throat. To my surprise, shortly after drinking the sugary brew, I felt a little better, so I went on to order a meal. As soon as I got home, I dropped into bed, and instantly fell asleep. I don’t know how much time had passed, but


Sugar, Sugar it was already pitch dark outside, when I awoke to loud hammering against my apartment door. A quick glance on the display of my mobile phone, confirmed that I had missed several calls, and received a bunch of text messages. I struggled to get to the door. The inquiring eyes of a friend of mine were flat out staring at me, when I opened it. I must have looked quite bad, because she grabbed me and we were already on our way to Riga Stradi!a Hospital, which was luckily just around the corner. Even though I had previously been drawing blood from patients, I dreaded the idea of a needle entering my body. Wednesday, February 20th 2013 –at about 10pm, I was admitted into the ER of Latvia’s largest hospital. It had taken us a while to find the right entrance. Although my friend was supporting me with her arm while we were staggering through the snow, we had to stop several times for me to sit down, and catch my breath. They didn’t allow my friend to accompany me, so I was there by myself. I was examined by a middle aged, female doctor, who was accompanied by a young medical student that eagerly took notes on a clipboard. The doctor was magnificent. She appeared very

professional. A chest x-ray was performed, but didn’t reveal any pathologies. Midst of the bustling emergency department, the needle had long ago been peeled from its sterile wrapping like a larvae from its cocoon, penetrated my skin, dipped headfirst and disappeared into my vein. The blood sampling confirmed a blood glucose level of 56 mmol/l (1008 mg/ dl), therefore I immediately received insulin through a pump. For comparison, the mean normal blood glucose level in humans is about 5.5 mmol/L (100 mg/dL) however, this level fluctuates throughout the day. Unfortunately, the staff at the ER spoke little English, whereas I had no clue about the Latvian. Thus, I neither found out about the blood test results, nor did I know what exactly I was receiving through the pump. I was placed in a wheelchair, as an employee transported me across the clinic’s premises heading for the endocrinology department. The

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Sugar, Sugar nurse at the department was my age, and spoke good English. She told me that she was a nursing student at RSU, thereby instantly creating common ground.

head en masse. My aunt had fled her home in Prussia as a child, when the Red Army invaded on the Eastern front in early 1945. She is the sole member of my family that had type 1 diabetes. As a result of her illness, and mainly due to insufficient medical treatment at the time, she had to have both of her legs amputated, lost her vision at 25, and suffered multiple organ failure. She succumbed in 1988 at the age of 48.

I thought that she was both personable, and an outstanding healthcare worker. When she gently informed me that I had type 1 diabetes, it was a turning point in my life that contained both fear and mystery. I instantly lost my adolescent perception of invincibility. Disbelief numbed me as I lay in bed. Maybe you are familiar with the feeling of utter perplexion, that makes your brain shut down immediately, because you just learned of something, that is simply too incomprehensible to grasp. Well, so far I’ve experienced utter perplexion only two times, and the time the nurse told me I had diabetes was one of them.

Today, it has been almost a year since I was first diagnosed with type I diabetes. There are bothersome sites about diabetes. For instance, people asking whether you got diabetes, because you “ate too much candy”, or remarking that “you don’t look sick”. I’m monitoring my blood sugar levels at least 4-5 times/day to prevent major fluctuations. Before each meal, short acting insulin injections are mandatory. On top of that, I’m required to inject long acting insulin preparations once a day. I’ve worked very hard, and caught up on the study delay, finishing the semester on time, and on top of my class. In some ways, I’ve come full circle, to the constitution I was in, before being diagnosed with a chronic disease.

Thoughts of my paternal aunt occupied my mind - anxious thoughts I had suppressed all my life, and that now poured into my

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I believe I am a better medical student, a better individual, with a richer appreciation for the present


Sugar, Sugar because of my past. But I wouldn’t be where I’m now, if it wasn’t for my supportive friends, the warm-hearted nurses, and my excellent Latvian physician, who, by the way, was fluent in the German language. I’m aspiring to work as a physician-scientist after graduation, improving diabetes care, and restoring normoglycemia permanently. Affecting 374 million people worldwide, the long-feared diabetes epidemic has long arrived. It strikes at people at all ages, and in all walks of life. And in the blink on an eye, it may well strike at you, too. Therefore, it is time to raise awareness for diabetes, and promote its care, prevention and a cure worldwide. By Franziska Thimm

Pathological Facts Diabetes mellitus – The background information Diabetes mellitus is a term used about a group of metabolic diseases, which are characterized by hyperglycemia (increased glucose levels in blood serum) which itself results from defects in insulin action, insulin secretion or both. Chronic hyperglycemia seen in diabetic patients is associated with long term dysfunction and damage of kidneys, eyes, blood vessels and nerves. Diabetes mellitus is classified by the American Diabetes Association like this : 1) Diabetes mellitus type 1 Chronic illness characterized by the body’s inability to produce insulin due to destruction of pancreatic beta cells due to autoimmune processes 2) Diabetes mellitus type 2 Consists of a cluster of dysfunctions characterized by hyperglycemia and results from a combination of insulin resistance, excessive glucagon secretion and inadequate insulin secretion Other types of diabetes include : • Maturity Onset Diabetes of the Young(MODY) – Inherited in an

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Pathological Facts autosomal dominant (AD) pattern and is characterized by impaired insulin secretion with minimal or no defects in insulin action • Genetic defects in insulin action Metabolic abnormalities due to genetic defect of insulin receptor • Diseases of the exocrine pancreas – Any trauma, inflammation(pancreatitis), infection, surgical procedure and cancer of the pancreas can lead to secondary diabetes. • Endocrinopathies – Excess amounts of some hormones (glucagon, cortisol, epinephrine, growth hormone) can antagonize insulin action . This can occur with endocrine tumours causing diseases such as acromegaly, Cushing’s, pheochromocytoma, glucagonoma) • Drug and chemical induced • Diabetes of gestation – During pregnancy Diabetes mellitus type 1 and 2 are the ones that are most encountered on an everyday basis, and this is why this article will focus more on these diseases. Diabetes mellitus type 1 : DM I is mostly connected with autoimmune destruction of beta cells in the islets of Langerhans due

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to genetic susceptibility - involving HLA-DR3,DQB1*0201 and HLADR4,DQB1*0302,present in over 90% of those with DM I. Several viruses (e.g Coxsackie virus, rubella, cytomegalovirus, Epstein-Barr virus, retroviruses) have also been known to infect and destroy beta cells. The patients diet may also be a factor, where exposure to milk products and gluten can increase autoantibody production Clinically, it most commonly occurs before the age of 30, and is not associated with obesity. The 3 P’s – Polyuria (increased urination), Polydipsia (Increased thirst) and Polyphagia (Increased appetite) are seen quite often in these patients, together with weight loss, weakness, fatigue, vision disturbances and irritability. The diagnostic criteria are : Fasting plasma glucose of 7.0 mmol/L or over or 2-hour plasma glucose level of 11.1 mmol/L or over or A random plasma glucose level of 11.1 mmol/L or over Clinical signs The treatment principles of Diabetes mellitus type 1 are multifaceted, but 4 goals are recognized.


Pathological Facts The first is glycemic control, meaning that there should be established goals for glucose levels for certain periods of the day (on an empty stomach, after eating, before bedtime and so on). Then we have self-monitoring, requiring that glucose levels be measured several times a day, and both diet/activity and insulin doses should be changed thereafter. Another hallmark is insulin therapy – patients with DM type I require lifelong insulin therapy, and most patients will need 2 or more injections a day. There are different types of insulins, which are classified according to how quick they act and the time period of their activity. They are usually divided into short-acting (e.g Insulin lispro, insulin aspart), intermediate acting(NPH) and long-acting (e.g Detemir, Glargine) Lastly, lifestyle changes must occur where daily caloric allowance should be set, recommendations about fat, protein and carbohydrate intake should be discussed with a dietician, and instructions on how to control blood sugar levels with food intake must be given to the patient Diabetes mellitus type 2 : The cause(s) of DM type 2 is a complex process where interactions between genetic and environmental

factors are involved. Being overweight (several sources cite a BMI >27.9 as a definite risk factor), being 45 years or older, hypertension (>140/90 mmHg) or dyslipidemia (HDL <40 mg/dL or triglyceride level >150 mg/dL) and having a family history of Diabetes mellitus in a parent or sibling (firstdegree relative) are all solid risk factors for Type 2 Diabetes mellitus. Other risk factors include having a history of Diabetes mellitus during pregnancy, or having given birth to a child with Diabetes, having Polycystic Ovarian Syndrome (PCOS) â&#x20AC;&#x201C; A gynecologic disease resulting in e.g infertility and insulin resistance, and being either depressed or schizophrenic (have been linked to DM type 2). Some of the clinical signs of DM type 2 are similar to DM type 1, such as the 3 Pâ&#x20AC;&#x2122;s - Polyphagia, Polydipsia, and Polyuria. Also, weight loss, blurred vision, lower extremity paresthesia (loss of sensation in legs), infections, obesity, acanthosis nigricans (dark pigmentation of skin folds) and hirsutism (increased hair growth in females) are all common signs of this disease.

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Pathological Facts Diagnosis : Fasting plasma glucose of 7.0 mmol/L or over or 2-hour plasma glucose level (75 g of oral glucose is given of 11.1 mmol/L or over or A random plasma glucose level of 11.1 mmol/L or over Glycosylated hemoglobin (HbA1c) of 6.5 % or over Clinical signs, patient history Treatment: The treatment is aimed at reducing the risk for the morbid complications of Diabetes mellitus. This is done by a multidisciplinary approach, where medications, lifestyle modification, blood sugar control and control of concomitant diseases make up the main effort. The more “out-of-hand” the blood sugar control gets, the further the risks increase for complications. The mainstays of treatment are pharmacologic therapy and lifestyle modifications. When we speak about pharmacologic therapy, we need to recognize that there are many classes of antidiabetic agents, that are used to achieve glycemic control, and these include biguanides (e.g metformin), alpha glucosidase inhibitors, sulfonylureas, DPP-IV inhibitors and more. 1 or more of these drugs

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are given to control the blood sugar. Further, hypertension should be controlled with antihypertensive drugs, dyslipidemia should be managed with cholesterol lowering agents. Lifestyle and diet modifications are as mentioned in the section about DM I. Weight loss and increased activity is vital to success, as well as smoking cessation. The complications of Diabetes mellitus type 1 and type 2 are : • Diabetic retinopathy There can be several microaneurysms in the retinal capillaries which can not only impair vision, but in the end lead to blindness if not prevented. Diabetics are recommended to visit the opthalmologists for screening • Diabetic nephropathy As a consequence of hyperglycemia, the basement membrane of the kidney nephrons can start thickening and there can also be glomerular sclerosis, and this can lead to chronic renal failure. • Diabetic neuropathy Is the result of microvascular changes around the nerves due to hyperglycemia, leading to impaired


Pathological Facts nerve function. This is characterized by loss of sensation in the affected part, especially in the lower limbs. • Diabetic ketoacidosis Is an acute and potentially lifethreatening complication of mainly Diabetes type 1, where patient has ketoacidosis, hyperglycemia and ketonuria. It is characterized by a sweet ketone smell from the patients breath. Sources : Medscape.com Merck Manual Professional 19th edition Diabetesjournals.org Written by : Mohsen Javed, 5th year, 2nd semester

La Dolce Vita La Dolce Vita The sweet life, is a good life. A small piece of chocolate sometimes makes a stressful day nicer for a moment. We reward ourselves. And, sure, why not? We deserve a little reward now and then. But there is somebody who disagrees on the mindless sugar-consumption that we're all used to. He has the answer to our “Why not” question. And the answer is more than inconvenient. This man claims that sugar has sideeffects and I am not talking about caries. Moreover, he says that most of the new “civilisation diseases” or “non communicable diseases (NCDs)”, which are known chronic diseases, can be traced back to sugar. Diabetes mellitus type II, Cardiovascular diseases, Metabolic syndrome and obesity, hypertension, gout, even Alzheimer's and cancer – these are only some of the (non-communicable) epidemic diseases, that have skyrocketed in the past decades in western countries and are now even starting to grow in numbers in developing countries. So, who is this man that makes our sweet loved sugar responsible for all of these diseases?

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La Dolce Vita Robert Lustig M.D., Professor of Paediatrics, Division of Endocrinology, at the University of California, is this man. His most famous lecture “sugar – the bitter truth” that has been posted on www.youtube.com by his University has over four million views. His thesis has attracted worldwide attention, not only among diabetologists and other physicians. And his work is the fundament of this article.

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But what is so bad about sugar? And if it really is that noxious, why isn't it forbidden or banned? Well, of course, sugar is known for its good taste. It makes us feel a little happy and satisfied when we eat it. Our brain tells us that we need that source of energy and rewards us every time we eat a little bit of it. That reward-system has been developed thousands of years ago and told the cavemen that if they get their energy, “that's good”. At that time it was all about surviving and being able to pass on our genes to the next generation. It is for that reason that other essential drives such as hunger, sex, anxiety, pleasure, anger etc. have been linked to subjectively strongly felt emotions. ! Robert Lustig M.D. "sugar - the bitter

Therefore, we feel like we do the right thing automatically, and eating sugar is, according to our brain, a good thing. But the world has changed and so did our needs. We have changed the world according to our needs but, within the recent decades, but something else is different now. Something has changed. People eat more. More than any generation before. To be more accurate, 275 kcal more". It does make sense in a way: we eat way more fatty products nowadays than before. But fat accounts for only 5 g (= 45 kcal). While 57 g (= 228 kcal) come from carbohydrates. But we don't eat that much sugar. A bit in the coffee in the morning, maybe here a cake or a dessert after dinner. The real problem is the hidden sugar in our food. It is almost impossible to live life sugar-free nowadays! Sugar is everywhere: not only in sweets, but if you take a closer look next time in the grocery store, you can also find it in ketchup, bread buns, ciabatta, ham, instant soups, ravioli with tomato sauce, frozen pizza, and even frozen fish fillets#. The list is endless. Almost all products that are available, contain a form of sugar, including those which are “free of flavour enhancers”. Sugar doesn't count as one. " Knaur, “Qherdenken 2014”, S128, Z. 20 – S.129 Z. 13


La Dolce Vita “We have an epidemic of six month old obese infants”, says Robert Lustig. Well, that might be true but where is the relation of this to sugar? Sugar was also available during the past decades, even centuries. As we already discussed, there has been a change. And that change happened within and around the 70's. In 1973, when Nixon was in power in the United States of America, he wanted to make food available for all social classes, including the poor. For this, food had to become cheap. In 1966, Japan invented “high fructose corn syrup” (HFCS) and in 1975 this was introduced to the American market and came in handy for this cause. It was cheap. Way cheaper than sugar and even sweeter! Also, during the early 1970's, a new lipoprotein, the LDL (low density lipoprotein) was found. Later on, it was discovered that dietary fat consumption led to an increase in LDL. We all learnt that LDL belongs beside VLDL (very low density lipoprotein), to the so-called group of “bad cholesterol”. Thus, a rise in LDL- levels correlates to several Cardio-vascular disease (CVD) incidents, which was also found out in the late 70's.

The assumption was that dietary fat consumption, leads to CVDs. Based on that finding, the USDA (U.S. Department of Agriculture), AMA (American Medical Association) and AHA (American Heart Association) called for dietary fat reduction. This reduction was also achieved; today we have fulfilled the demand of reduction of fat in dietary products from 40 to 30%. However, the CVD-incident increased reciprocally. So where was the mistake? It was seen that the LDL-count was created grossly. There isn't just one type of LDL. In fact, there are two and only one of them is “the bad guy”. “Pattern A” - LDL is a large, bulky molecule that is actually too big in size to invade the endothelial vascular lining and deposit there in order to cause artherosclerostic plaque formation. The other type, “Pattern B” is a smaller, more densely packed LDL. That's the bad guy, infiltrating the endothelium, getting eventually phagocytosed by macrophages, which become foam cells, later seen in artherosclerotic changes. Actually the HDL (High density lipoprotein; “the good

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La Dolce Vita cholesterol”) to Triglyceride (form of lipids in the blood) ratio is more reliable. The outcome is that Pattern A – LDL has a high HDL, low TG ratio, which is favourable. Meanwhile, Pattern B has the opposite. Scientists have now found that dietary fat elevates “Pattern A” and carbohydrates elevate “Pattern B”LDLs. The impact of the given LDLtypes on health are thus selfexplanatory! Let’s talk about the health care initiatives, that were thought to reduce the dietary intake of fat in the 1970's. Fat is a flavour-carrier. Therefore, “low-fat” food tastes quite poor, to express it in a nice way. Well, we all know they found a way to make it all “yummy yummy” again: High fructose corn syrup. The cheap and even sweeter answer to ordinary sugar. What makes it that sweet?

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Fructose. 55% of HFCS is fructose, 42% glucose. Fructose (sweet rank score: 173) is more than twice as sweet as glucose (sweet rank score: 74). Just to compare, sucrose equals a score of 100 and HFC comes in total to 120.

So since glucose is the natural form of sugar, fructose is the one that makes the difference. And that’s not only on the sweet-scale. Where body metabolism is concerned, sugars are not all the same! They are metabolised differently and therefore cause different outcomes. Glucose: This is the naturally occurring form of sugar and is the one that our body is used to and has use for. 80% is taken up by muscles, brain etc. and consumed as source of energy. The remaining 20% go to the liver and are enter either as Pyruvate within the citric-acid-cycle and, therefore, are converted in the liver to energy, or is stored as energy depot in the form of glucagon. Some of it enters as citrate via a process known as “de novo lipogenesis”, the fat metabolism, and is converted to the VLDL, which we spoke about before. The Triglyceride reaches the some parts of the body and is, e.g. as belly-fat, stored. This is, from the evolutionary point of view, a very desirable process and makes it possible for us to store energy for bad times. This is the reason as to


La Dolce Vita why fat-reduction by physical activity is not that easy. The body doesn't want to let go of its reserves. But what also happens is that the well known hormone insulin is released during signalling in a negative feedback-mechanism to the hypothalamus in the brain. This indicates that we are saturated with food and the pleasant feeling of satiety follows. Ethanol: This is also a form of sugar and one which is especially well-known to students! It's delerious effects are widely known and one shouldn't be surprised that excessive consumption of the shots in the “Shot Café” may lead to what may be known as a “students’ liver”. So, let's take a look on how students screw their body on weekends: 10% of the ethanol is lost in the stomach, due to the acidity. Another 10% is readily taken up by the brain. 80%, which contains four times the amount of glucose, hits the liver. This is also metabolised in the liver, but with slight differences and acid aldehyde is formed. The proteincross-linking aldehyde is

responsible for the development of alcohol induced liver cirrhosis and development of cancer. Activation of other enzymes cause inflammatory processes in the liver. The Acetate enters the TCA. The citrate that will be converted to fat is proportionally more since the fourfold amount is metabolised. This may lead to a “fatty liver” (steatosis). The further dyslipidemia may also lead to insulin resistance in the muscles. Therefore, ethanol and other sugars cannot be stored any more in muscle tissue. However, they can still be stored in the liver. Fructose: This consists of 50% glucose and thus this half is metabolised in the same manner as the glucose mentioned previously. The other half can exclusively be metabolised by the liver. Nothing is lost on the way to other tissues. It is also converted to Pyruvate and enters the TCA, but on the way, a waste product called uric acid is formed. This is responsible for gout (accumulation of uric acid crystals in synovial fluid) and hypertension (by inhibiting the vasodilator

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La Dolce Vita NO). Unfortunately, not only the citrate, but also the fructose-6-P enters the de novo lipidogenesis via Xylulose-5-P leading to an increased production of VLDL and following dyslipidemia, accounting for obesity and non-alcoholinduced-liver-steatosis and insulin resistance in the muscles. Another undesirable adverse effect of fructose, is that insulin is also deactivated in the liver, causing hepatic insulin resistance. What Fructose doesn't do, is just as vicious as what it actively does to the body. It doesn't stimulate insulin or leptin, since we have no receptors for fructose on the betacells in the pancreas. Therefore, our hypothalamus will never get the feedback signal, that we actually ate something and that, as a result, are full. Our brain is still being signalled that the body is starving in the absence of a proper hormonal response. We eat even more if we start with something sugary, supporting obesity in first place. It's a vicious cycle. So, now,if we compare the harmful effects of ethanol and fructose, we come to the conclusion, that

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fructose in the long term is a hepatotoxin. The bad thing is just that acute fructose “intoxication” has no instant effect. Also, the brain doesn't metabolise fructose, unlike ethanol. A chronic “fructose abuse” leads to almost the exact same results as chronic alcoholism: hypertension, cardiomyopathies, dyslipidemia, pancreatitis, obesity, hepatic dysfunction (ASH vs. NASH), congenital problems (fetal alcohol syndrome vs. fetal insulin resistance), and addiction (or at least habituation). Since all this is known, a “ban the HFCS”-campaign is run in the U.S.A. now. Its supporters, like Dr. Hyman, are trying to get attention about the use of HFCS in our all food and raising awareness on the tremendous impact that it has. According to Dr. Hyman, there are five reasons,why you should avoid HFCS in your food: Sugar in any form causes obesity and disease when consumed in high doses HFCS and cane sugar are NOT biochemically identical or processed the same way by the body (see the comparison of the metabolism pathways of the


La Dolce Vita different sugars above) HFCS contains contaminants including mercury that are not regulated or measured by the FDA. Independent medical and nutrition experts DO NOT support the use of HFCS in our diet, despite the assertions of the corn industry HFCS is almost always a marker of poor-quality, nutrient-poor disease-creating industrial food products or “food-like substances”$ The movement that wants to ban the Corn syrup from our food is growing. Several websites as www.cornsugar.com and www.sweetsuprise.com are trying to clarify how dangerous HFCS really is. Robert Lustig M.D even calls fructose a poison, since “it is only metabolised by the liver, causing harmful effects on the body when consumed”. It is, for sure, causing different Metabolic syndromes (DM type II, obesity, hypertension, CVD). So maybe next time, when we see an obese person eating candy excessively we might take him

seriously if he says that “he can't stop eating once he started”. Fructose does not only not activate insulin release, but it also does not suppress ghrelin, the hunger hormone. There is a reason why you get a soda with your happy meal; it makes you eat more. Actually not only eat. Coca Cola contains, beside caffeine, which has not only stimulating but also diuretic properties, also salt. A lot of salt. The salt is just perfectly hidden by the enormous amount of sugar (HFCS) and therefore we just taste sweet. So what happens, if we add salt and a diuretic in our drink? It makes you thirsty. Sodas aren't just already quite a load of calories to your body and in case of HFCS, not the good one, but also it makes you crave for more. More food, more soda. Welcome to the fast food nation. The incidences of the “non communicable diseases” including the above mentioned, are more rapidly developing where westernisation has started or is already established. The beloved U.S.A is not only “bringing peace and democracy” to oil-states, but they also bring their food. Sadly,

!http://drhyman.com/blog/2011/05/13/5-reasons-high-fructose-corn-syrup-will-kill-you/#close

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La Dolce Vita

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fast food is one of their number one export products! Spreading globally, just as obesity, Diabetes, and CVD. Also, the Insulin resistance that is caused by fructose consumption, is now considered the fundamental problem in obesity, the underlying defect in heart disease, type 2 diabetes and some forms of cancer#. Harvard researchers recently reported that women who drank one or more sugarsweetened soft drinks per day were 83% more likely to develop type 2 diabetes than women who drank less than one a month. $ Other addictive substances are usually strictly regulated and we try to keep them from public availability to prevent systemic abuse. In the case of sugar it was quite the reverse, we did not only inhibit the distribution, but in fact, it was even enhanced. Remember the reduction of dietary fats and their replacement by HFCS as a cheap flavour-carrier? Well guess what? The obesity incidences climbed, while the fat consumption decreased. It's always the same reason, why we choose to drink, eat or smoke, even if we know that it harms them and might even cause their death on a long term view. The reason

is money. There is a high profit sugar industry that supplies the world with what is known as “white gold”. It's biggest represent is Coca Cola with a turnover of 47 billion dollar (~ 36 billion %) and therefore, a profit of 9 billion dollars (~ 7 billion %)%. The profit is also due to exploitation of some of the poorest countries in the world by draining their only water resources leaving the local population suffering behind. But that's another story (if you’re interested, look up: www.killercoke.org) Throughout the world, we have a total sugar consumption of 165 tons per year. 30 million tons are consumed only by Europeans. One can imagine that an industry which relies on the consumers, believes that sugar is not bad at all, and is sponsoring its own “studies” to show that there's nothing wrong with our sugar sweet diet. It also minimises the impact on people’s health or tries to minimise the relation of this to its product. It's all about the profit. People's health is a secondary concern, if the income balance can be maximized. An example of change would be by replacing glucose with


La Dolce Vita HFCS. However, HCFS is cheaper and therefore saves expenditures and raises the profit. But the epidemic of noncommunicable diseases throughout the world cannot be neglected. According to Jean Claude Mbanya, Professor of medicine in the University of Cameroon and President of the International Diabetes Federation (IDF), “diabetes kills one every seven seconds”. "We don't want world leaders to forget diabetes, which is a tsunami of the 21st century," said the IDF President. He says that the number of patients will reach nearly 600 million within the next 20 years &. But the profit of big sugar promoting companies such as Coca Cola, is the equally raising costs especially in the health care systems throughout the world. Based on the IDF report, the overall global spending on patient care for diabetes is about 465 billion dollars. And that is for diabetes alone. The WHO sees non-comunicable diseases (NCDs) as leading cause of mortality in the world '. “36 million out of 57 million global deaths in 2008 were due to NCDs”. NCDs lead to a rising number in % Querdenken

2014, “garantiert gesundheitsgefährdent”, Hans Ulrich Grimm, S.127, Z. 25 - 30

premature deaths: 29% of NCD deaths in low- and middle-income countries in 2008 occurred before the age of 60. Of course this cannot solely be reduced to the influence of fructose. Tobacco smoking and a general unhealthy lifestyle are also contributing to these numbers. But as Robert Lustig M.D showed before, sugar is contributing to the majority of the NCDs. Sugar-addiction is a real problem today. Books like “overcome sugar addiction” by Karl Randolph Pitman and many others have been important aides against this and are best-sellers. Mostly people laugh about sugar addiction, not knowing how many actually are involved. Pure, White and Deadly, published in English in 1972 by John Yudkin and meanwhile translated into German (süß, aber gefährich, 1974) and Swedish (Rent, vitt, livsfarligt 1974), predicted the outcome and development of sugar consume precisely and is therefore as foreseen 40 years ago. The problem is the lack of public awareness. The mentioned books are only read by people who are involved into sugar addiction

# http://presstv.com/detail/199117.html $ http://www.who.int/gho/ncd/en/

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La Dolce Vita themselves, have a person close to them who is involved, or those who have scientific interest in this matter. Sugar is promoted not restricted. It has its own lobby and therefore there is a lot of “pro sugar” promotion. But awareness is rising and it is just about time. A “sugar tax” on sweetened beverages such as Soda is currently subject of discussion the States (. Denmark is already one step further. They introduced the world's first tax on foods high in saturated fats. “Higher fees on sugar, fat and tobacco is an important step on the way toward a higher average life expectancy in Denmark,” health minister Jakob Axel Nielsen said when he introduced the idea in 2009, according to The Associated Press, because “saturated fats can cause cardiovascular disease and cancer.” ")

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Now Denmark is also considering to put a tax on sugar. It can be seen that awareness concerns are rising even on political level. But what can I do myself to prevent ending up with a fatty liver or DM type II? http://www.hcs.harvard.edu/hghr/ online/sugar-dilemma/ &

What can we do? Exercise. And why not? Let's “pedal our love handles on the home trainer away”. Well good luck with that, when you continue to eat daily sugar load. The sugar load equals to 72.8 gm/ day (= 12.1% of total caloric intake), which is what the average adolescent eats. The natural consumption of sugar through fruits and vegetables equals 15 gm/day. Of course working out is good! We increase insulin sensitivity, burn calories, reduce stress and therefore, the cortisol release (stimulating gluconeogenesis) It also makes the citric-acid-cycle run faster and therefore helps to detoxify the fructose and also improves the hepatic insulin sensitivity. Before we start to sweat and climb on the home trainer, we first of all have to change our diet. That, first of all, means that we need to start reading the ingredients of our foods more carefully and avoid fructose and High fructose corn syrup (and too much of the other kinds of sugar as well). It you sugar in its natural form, in combination with dietary fibre. Fruits are are not only made of pure glucose, there are also

http://abcnews.go.com/blogs/health/2011/10/02/denmarkintroduces-fat-tax-on-foods-high-in-saturated-fat/ !'


La Dolce Vita other components, such as fibres. They reduce the rate of intestinal carbohydrate absorption, increase the speed of transit of intestinal contents to ileum, raising PYY and inducing satiety. Firbre,s inhibit absorption of FFA to the colon, which are metabolised by colonic bacteria to short chain FFA (SCFA). This directly helps to regulate the blood sugar level by acting on the insulin release from the pancreas. They also influence the number of glucose transporters in the intestinal mucosa and therefore regulate glucose absorption. Avoid sodas and sweetened soft drinks. Also if one day you're gonna be responsible for another persons health, as parent, by taking care of elderly or during your profession as a physician, apply your knowledge and let not suffer others who don't know it better, c,ause you do now! Remember, the epidemic of obese 6 months old, Robert Lustig M.D spoke of? There's no miracle behind it. Maybe the new formulas that provide a convenient alternative for young mums to breastfeeding their babies. Well if we take a closer look into the ingredients of a famous formula product, and Mr. Lustig did that for

us, we can find the hepatotoxin we discussed so far in the nutrition of newborns. All the systemic effects on the body caused by HFCS will be released into a body and occupy a liver of new born baby. “Sugar, the bitter truth” lecture, held by Robert Lustig M.D. available on youtube.com So we see that due to the obvious lack of regulatory measurements regarding the usage of fructose to sweeten almost all of our foods, we certainly cannot avoid these products. But the government can. Decisions on a political level can make a change, as we can see on the example of Denmark. We just have to raise the awareness and increase the pressure on higher institutions. Otherwise they won't even have a reason to face the sugar lobby with their concerns if everybody doesn't care. So go out there spread the word and make people care. By Philipp Nelles For further reading: www.sweetsuprise.com, www.cornsugar.com http:// www.hcs.harvard.edu/hghr/online/sugar-dilemma/, http:// www.upworthy.com/you-wont-believe-the-drugs-kidsare-on-these-days?c=ufb1 www.thebiggerpicture.org John Yudkin's “Pure White and deadly”, 1972 Robert Lustig M.D “fat chance, the bitter truth about sugar” 2013

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From Students For Students • Rica meets... Maxi Vidovic and Gurjoat S. Kareer ! Drummer meets Religion

• Forget about L'Auberge Espagnol, latviskas m!jas it is ! Erasmus experiences in Riga

• Home ! Integration: Yes, No, Maybe?

• European Dentistry Student Association ! Johannes and Noel bring EDSA to Riga

• European Medical Student Association ! Meeting of European medical students in Lisbon

• Visualising Riga ! Colourful impressions

Rica Meets...

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Maxi Vidovic When I think about musical medical students, the first thing popping into my mind are guys playing the violin or girls playing the harp. Or maybe

someone playing the guitar. At least an instrument which you call a classical instrument with a soft and a contemplative sound. An instrument which is used by his player on Christmas to support the family singing under the Christmas tree. But Riga’s Stradins University’s second semester sports a medical student who breaks ranks with his instrument. Maximilian Vidovic – his friends call him just Maxi – plays the drums in his own alternative rockband called “Verveine”. Simon, a German student, plays the bass and completes the band with Tobi and Felix, both pilots, guitarists and responsible for the lead vocals. This band from Darmstadt has been playing in this constellation since 2010. Two years ago they produced their own album “On visions and colours” which they had worked on for over one year and is now available on iTunes. Influenced by world-wide known rockbands, e.g. The Red Hot


Rica meets... Chili Peppers and Incubus, Verveine created their own alternative indie rock music. I guess you will ask yourself the following questions now: How did Maxi become a drummer? Why is he studying medicine and not a full-term drummer? And while he is studying in Riga how can he fulfill his duty with his band? The first question is easy to answer. Maxi speaks about his family as an unmusical family with the exception of his seven years elder brother Thomas. When Maxi was eight years old, he bought his first own CD: R. Kelley – I believe I can fly. While he was listening to the soft sound of R. Kelley, his brother, already in puberty, chose to play hard and loud punk music in his room. Soon Maxi got that his brother’s taste of music was more sophisticated than his own and he switched from pop music to punk music. That was also the turning point when Maxi wanted to learn playing the drums. He discussed his wish with his parents every day and finally they gave in. But first of all he had to learn the recorder, a musical instrument that you blow into together with holes that you cover with your fingers. With that lesson Maxi studied all about notes. The next step was that his parents suggested as soon as he had played the piano for a certain

time, they would allow him to take classes in drums. Maxi’s desire of becoming a drummer was so enormous that he agreed to this “blackmail” - as he calls it now with a wink - and took piano lessons in the third grade. Finally there came the day Maxi will never forget. He came home from school and his brother got him a full drum kit which used to belong to one of Thomas’ friends. Then Maxi’s drum career started with professional lessons. Even so he achieved his goal, he never gave up using his piano skills although his drums were always top priority. Actually he is very happy about that because right now his electrical piano is the only instrument he could have transported from Germany to Riga. And when Maxi comes home from a long day in the university, he likes

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Rica meets... to play his favorite compositions on the piano to get rid of the stress. Sometimes he is so into playing that he forgets the time and realizes that he has been playing for nearly three hours. This leads to my second question. Besides all his passion and desire for the drums, Maxi’s very top priority was becoming a doctor. Whenever he came into touch with medical topics, even as a little child, Maxi was excited. During his summer holidays in high school he did internships in hospitals which was appreciated a lot by his parents. They supported their son’s wish although they wondered where this deep enthusiasm was coming from. None of his closest family’s professions were being a doctor. But of course you can imagine that there are worse job profiles for a son than becoming a doctor and that is also why Maxi got full support by his parents. After finishing high school, Maxi went to the Berlin Jazz Academy

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for one year because he did not get a place at university in Germany and so he took the opportunity to take lessons in piano and drums from very experienced Jazz musicians. Then he applied for a place at Riga University and got admission. Being able to play the drums or the piano is for Maxi a way of recovering his balance. Moreover, medicine is a natural scientific field which allows only small gaps for real artistic performances. For sure you can invent new methods how to operate on a broken caput fermoris, but there are always certain limits. For imaginative people like Maxi it is important to let his creativity out of his mind without any limits. Maxi thinks it is very important not to have only one thing to rely on – like studying medicine – but also to have other hobbies or fascinations for having the right balance in life. Studying medicine overruled the profession of being a drummer because Maxi’s deepest wish was always to do something very helpful for and with people. In the beginning of November, Maxi played a concert in his hometown Darmstadt with his band and flew home for one weekend, a great experience he told me later. That leads to the main problem of Verveine. With Tobi and Felix being pilots and not having much time and Maxi studying abroad, it is very difficult for the band to find dates on


Rica meets... which every member is free for playing with the band. Nevertheless, with a very good time management all four band members are able to play certain concerts in Germany. According to Maxi’s opinion the only thing missing at Riga’s Stradins University is the musical offer. He would like to participate in a musical project. Building up a Big Band is a difficult task, but Maxi would be very happy if there are more people like him, studying at the RSU who are also looking for the possibility to play their instruments with other students. So if you are interested in playing your instrument here, there might be a way and do not hesitate to talk to Maxi. As an experienced musician he is very open-minded and who knows… Maybe we will soon have an outstanding music project performed by international students from Riga’s Stradins University.

Gurjoat Singh Kareer This is the story of Gurjoat Singh

Kareer, a 21-year-old fifth semester student studying at Riga’s Stradins University from Leicester. His main characteristic is the turban that he wears and I would like to tell you more about this. Gurjoat believes in a special religion called Sikhism which happens to be the youngest religion on earth and is only 600 years old. The three main qualities for this religion are: work hard, share with others and meditation. His turban is more precisely called a ‘distar’and to Gurjoat wearing the distar, which is a six meter long piece of special cloth, is like wearing a crown. Although it seems very uncommon in Latvia, ‘he wears his distar with pride and one hundred percent confidence’ as he told me. This piece of headwear is very important because as a Sikh he is not allowed to cut his hair and the distar also helps him to put his long hair together. You may also have noticed that Gurjoat has different colours for his distar, but there are no special meanings for each colour, he just decides in the morning what colour he feels like. He has more than

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Rica meets... eight different coloured turbans and the next colour he will go for is orange. In general, Sikhism is a monotheistic religion founded during the 15th century in the Punjab region of the Indian subcontinent, by Guru Nanak. World-wide it is the fifth-largest organized religion and has around 25.8 million adherents, which makes up 0.39% of the world's population. The concept of "God" is different in Sikhism than that of other religions. It is known as „one constant” or „Ek Onkar”. In the Sikhism religion God has no gender, he is beyond time and space ("Akaal Purkh") and without form ("Nirankar"). Moreover it is written that there are many worlds on which God has created life. Guru Nanak further states that the understandin g of God is beyond human beings, but at the same time not wholly unknowable. Sikhs

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understand that God is visible everywhere and omnipresent in all creation to the spiritually awakened. Nanak stressed that God must be seen from the "heart" or "the inward eye" of a human being. Therefore devotees must meditate to progress towards enlightenment. Guru Nanak emphasized the revelation through meditation, as its rigorous application permits the existence of communication between God and human beings. There are several religious prohibitions in Sikhism. Besides the prohibition of cutting hair, intoxications are also not allowed. This means consumption of any alcohol, drugs or tobacco. Also material obsession is not encouraged in this religion. Moreover a very significant prohibition is the worthless talk. Lying to others or bragging are totally unacceptable. Actually Gurjoat was not the first Sikh to reside in Latvia, he knew that there was one guy also belonging to the Sikhism religion living here before him. When Gurjoat received his admission to the RSU, he wanted to get in touch with this other person as he had no idea what to expect and was a little worried about what would happen here in Riga. He did not know whether people would


Rica meets... be open-minded or if they might even have prejudices against his religion. But his friend could calm him down and told him that everything was fine here. From then on, Gurjoat was able to look forward to starting his studies in Riga and after two and a half years he too was able to conclude that his friend was totally right and that he had nothing to worry about. As he is now in the clinical part of his studies, I asked him if there would be any problems with the Latvian patients, but Gurjoat did not experience any difficulties. Not even in surgery, where he has already discussed this issue with his professor. And so when Gurjoat will be joining the operation room he will just have to cover his distar with all the appropriate nets and everything should be completely fine. Here in Latvia, Gurjoat lives at the residency of his fatherâ&#x20AC;&#x2122;s life partner Daira. She is Latvian and moved from Leicester back to Latvia due to a change of job. They own a house in Marupe and there they live together with their dogs: Pipa, Stevie and Milly. The three dogs also keep Gurjoat on the go. I asked him if he would miss out on the â&#x20AC;&#x153;normalâ&#x20AC;? student life, but Gurjoat laughed and assured me that he would not be missing anything. In his opinion the place where you live should not interfere with your social

life. He actually has a lot to do during the week, like going out with his group mates, playing badminton, training at the gym, doing stuff around the house like mowing the lawn and taking care of the household together with Daira. But he says that clubbing would not be his cup of tea, because Gurjoat enjoys talking to people and having a conversation more. I would describe Gurjoat as a very relaxed, happy guy who has already found his peace of mind. That is why I asked him about some ideas for other students on how to deal with stress during studying. The first thing he does when he needs to clear his mind is take his biggest dog Milly for a walk. Then, when Gurjoat returns back home again, he can focus on his studies. For him it is also important to listen to meditative music in order to forget about stressful times. Of course not every student has the possibility to walk a dog and not everybody likes his genre of music, but Gurjoat advises you to stay

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Rica meets... active. Try to keep up your hobbies, do your sports, keep on playing your instrument or maybe find new hobbies. Nevertheless, studying should always be your top priority, but it is also important to stay active after a long study day. When you feel like you are no longer able to cope with the stress, Gurjoat also suggests that you shouldn’t build walls, but should talk to your friends about it instead. It is also good advice to not only rely on your group mates, but to also find other people outside of this friend circle because your group mates are likely to be in the same stressful situations. By Ricarda Schaperdot

Forget about L’Auberge Espagnol, latviskas m!jas it is You probably have met us at some point now: maybe at the lecture, your course, your weekend night out, Wednesday night at the Moon Safari, in Old Town – us, the Erasmus students in Latvia. “But why Riga?” This appears to be the first question you get asked as an Erasmus student here. Not only from other Erasmus students, surely also by members of every single group you join during your stay here. I am Martin, a German medical student

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Erasmus Report from Dresden, currently being on a one-year Erasmus vacation, I mean, exchange at the RSU. Clearly, my view is limited to the one of a medical student, hence I cannot account that the experience will be similar for those of Humanities. But just go out and ask them! The answer to the question above should always be “K&p'c n'?” “But couldn’t you just decide for some other place where it’s warmer; like Spain, or France, or Italy?” Yes, of course we most definitely could have done that, but still we decided for Riga. The reasons for this decision are probably as diverse as the characters of every short-term student you will meet here. From my view, the classic destinations in southern Europe are over-visited. Speaking from my German point of view, everybody knows at least five people who have been to either Spain or France, but only a few know someone who has been to one of the new EU countries. Therefore, spirit of adventure, trying something new, may be the first reason. Honestly spoken, the “adventure” part is rather small, because the Erasmus programme makes studying abroad in a foreign country super-easy.


Erasmus Report Secondly, I always found the Baltic countries absolutely likeable. Of course, this is purely subjective and does not really count as a reason to come here. I was eager to meet a new culture, to meet new people, to learn to appreciate the little similarities and differences to my home culture and everyday life. Consequently, some of these experiences were thought to change my perspective on my studies at home, my attitude towards my future profession and my general approach on life. Thirdly, another reason may be of more organisational character. The Erasmus programme has limits: you cannot go wherever you want. What does this mean? For an easy exchange your home faculty needs to have an agreement with other European faculties. Most universities do not offer international study programmes, so if you are neither fluent enough in a third language to study medicine in this particular language nor brave enough to try it anyway, you will decide for an English programme: Voila, welcome to Riga. Once you have been accepted to a place, you think about the need of learning another language. I quickly decided for Latvian, not Russian; maybe the only thing I regret at the moment is not having had a course of

at least basic Russian at home. Nonetheless my decision was followed by taking part in an Erasmus Intensive Learning Course for Latvian that took place two weeks before studies started. These courses are meant to give a small introduction into the â&#x20AC;&#x153;lesser spoken â&#x20AC;? langua ges of the EU and are offered by several institutions in Latvia. But never mind the contents; mind the friends you meet there. Cherish the social group you can establish even before the rest of the Erasmus crowd arrives; get some ECTS in case you need them. Enjoy some party, too. Friends are, at least to me, the most important subject for any Erasmus student. Coming here, not knowing anything, anyone, sometimes not having a place to sleep apart from the hostel you booked back home, I longed for friends to make all of this easier and more fun. And gladly I can say I found them. Although I never thought about it before coming here, but Riga and

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Erasmus Report Latvia are so diverse in opportunities to spend time as my home region is. Who would have thought that I really would go swimming in the Baltic Sea? I thought that it would be too cold for this in August already. Jurmala reminded me of my childhood at the German Baltic Sea coast. I love the countryside, too. The National Parks of (emeri and Gauja are small, yet charmingly beautiful; the coast at Kolkasrags in West is romantic to say the least. I also had the chance to visit C'sis which is a terrific city to see. Riga itself is a perfect city for Erasmus: enough culture, enough party, enough museums and enough space to spend your leisure time. Additionally, it is pretty cool (just ask Lonely Planet or the guys deciding what city becomes the Cultural Capital). So at least that should make clear why coming here is a good thing. Another one: The weather is bad, but not too bad. I mean for sure it is cold and rainy and windy; but all these things we have at home, too. Things that stroke me as totally unexpected but proved to be unimaginably valuable to me is the buddy programme of the RSU. I was sceptical about it at first, but only because we do not really have something similar back at home. All Erasmus students more or less fear they will only meet other Erasmus

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students and never someone â&#x20AC;&#x2DC;nativeâ&#x20AC;&#x2122;. At least I got some wonderful Latvian buddies who I rightfully may call friends now and who try their very best to make me feel at home here. I regard it to be important as well to get some grasp of the original Latvia. It is hard for us to get a connection to any long-term student here. Of course, I could not expect to join year-long established groups of friends out of a sudden, so we Erasmus students tend to stick together in groups like sheep. Maybe it is also the reason we appear a little odd as well from time to time. But we mean no harm! I guess it is just a normal reaction to stay with the people who have a similar background for their stay here. Anyway, my small invitation into the life of an Erasmus student must by limited and biased by default. Certainly, a lot of my fellows may not agree at some points or even dismiss all of my gibberish talk. I enjoy my time here and I am sure I will always remember the experiences I make. I hope I did not bore you too much and was able to give you a small impression of what it is like to be here for only a limited time. By Martin Arndt


Home Home We all experienced it: we left our homecountries to experience an exciting adventure, the studies abroad. Back then, for most of us it wasn't more than a temporary stay in another country – more like an extended ERASMUS-stay. Most of us didn't choose this exact country by purpose, it just had to fulfil it's task: giving us the opportunity to start our studies. Well, from my perspective, this might have been one of the best choices I made so far. After almost two and a half years I must say I certainly feel home in Riga. But what is it, this “home” that we thought does only exist in one place, the place where we grew up. Is it the familiar culture? The people? Family and Friends? Can I feel home somewhere, where I don't speak the native language fluently? Where people have a different culture? I think I am not the only one who feels connected to Latvias capital city as a second home after some years. But what exactly do we feel connected to? The international programme gives us the opportunity to mingle with other nationalities and their cultures, to learn new languages, celebrate traditions that we've never even heard of before.

But the average international student just mingles and integrates within the “bubble” that we build up when we enter the international programme. The bubble is rarely left and therefore integration outside the “international bubble” does only happen in some exceptional cases. Sadly some even don't mingle within the bubble, but rather stick to their own folks. So if the average international doesn't even integrate into the Latvian society, exept for hanging out with some Latvian fellas from time to time, to what exactly do we feel connected? The Bubble? After six years, when the M.D. programme ends, do we automatically loose a home, since we pop that bubble? Is it that point- and meaningless to be in the international programme? No. A home might be a place, where you spend a time – in our case some years – where you found friends, where you can freely express

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Home yourself, your personality in anyway, where people understand you. To quote Christian Morgenstern, “Home is not where you live, but where they understand you” It might be this feeling of serenity, when you lean back and just feel like this is exactly the place where you should be right now. So if we regard the term “home” rather as a feeling, then a place, one can understand why for me a home is not necessarily the place where you are born. It might be of course, but some of us have even been born in a country that they left early in their childhood, and grew up in a country that they nowadays would call their home. We still would agree that the place we grew up the most of our childhood and spend the most of our lifetime is a home for us. So for which one should we decide then? Old or new home? Is a feeling is restricted to only one city or country? A feeling can be felt anywhere at anytime. It is still so astonishing that we can feel home in our homecountry and the place where our studies are located? I know for sure that many of us have already had this weird feeling, when they left Riga to “go home for vaccations”, while leaving “the other home” at the same time.

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I don't see it so disadvantageous. We just enriched our life of an experience most people haven't come in touch with: two homes. We enrich our life in so many ways every day by just getting acquainted with all the different cultures and views that come along with it. Now and then we have these eye-openermoments without even realising it. It gives us new experiences, opens our minds to new views and ideas and therefore on a longterm enriches our personalities. Just once in a while we should bring up the bravery to step out of our little “bubble” and mingle also with the society that hosts us for the whole duration of our studies. I know it takes some courage, but don't worry there's nothing to loose but a lot to win. Just dare integration – it won't hurt. By Philipp Nelles


EDSA EDSA Conference in Birmingham, August 2013 Cavum Oris, the RSU dentistry students fraternity, has been trying to become an official member of the EDSA (European Dental Students Association) for several years now. Due to the persistency and constant efforts of Leon Schneider (former president of Cavum Oris) the issue of membership was fortunately once again raised in the meeting of the course leaders of the dentistry faculty in spring 2013. The only thing that was holding us back up until that point was the fact, that none of the university organizations was willing to pay for the costs of the trip to the next EDSA conference for two RSU students. Since this seemed rather ridiculous, Noel Abdayem (4th year course leader dentistry, President â&#x20AC;&#x201C; Cavum Oris) and me, took matters into our own hands. Since becoming a member of the European Dental Students Association is of big importance to our faculty - and also the university - we quickly decided to cover the costs by putting up private equity and registered for the 52nd EDSA Conference in Birmingham. Now there were some preparations that needed to be done prior to the conference in Birmingham. In order to present our faculty in the best possible

way, Noel and me developed a presentation and a speech which we would then hold in front of all the delegates at the conference in Birmingham. Once we got off our planes in Birmingham we were greeted by students at the airport, who then

guided us to the student dorms on campus of Birmingham University. Every day of the conference started with a nice breakfast at a local pub which was located close to the dorms. This was followed by several lectures which were either held by EDSA general sponsors (e.g. Curaprox, Oral B etc.) or lecturers from different universities. All of these lectures covered the most up to date discoveries, technologies and theories in dentistry; some of them more â&#x20AC;&#x201C; some of them less interesting. On the second day of the conference the countries, which applied for new membership, were introduced to the delegates, this was our time to

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EMSA

EDSA shine. After properly presenting Latvia, Riga and of course the dental faculty of RSU we were guided off the podium with applause by the audience. None of the people in the audience seemed to have expected a modern, wellequipped and up to date dental faculty in an “eastern European” country as Latvia – they were impressed. After all the votes were counted it was official: Cavum Oris of Rigas Stradins University in Latvia, was now an official member of the European Dental Students Association with full consent of all present delegates of their countries. As we are now an official member of EDSA and have two official delegates for Latvia (Noel and me), it is our turn to organize the next summer meeting for the EDSA which is going to be held in Riga during the last week of August in 2014. This means that at the end of August approximately 100 students from all over Europe will be attending the conference in Riga. Preparations are already going full speed and we are looking forward to hosting such a great event in the cultural capital of 2014. Please spread the word and like our Facebook page “EDSA Riga 2014” to make sure you are always up to date! Feel free to contact Noel or me any time if you want to get involved in

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the process and be a part of the greatest dentistry event that RSU has ever seen! With best regards, Johannes Göbel (3rd year course leader dentistry, Vice President – Cavum Oris)

EMSA and its General Assembly A travel report from Lisbon The study field of medicine is huge. At some universities the curriculum may be more sophisticated then at others, but at all medical faculties students themselves organize extracurricular activities. EMSA and its multiply online publications on extracurricular activities provided a great support in organizing Movies & Medicine or the Teddy Bear Hospital. Since the first contact more than a year ago, I was always wondering how it would be to meet these guys in th person. On September 4 , I got the chance. I arrived on a sunny Wednesday morning at the Hotel close to the medical faculty of the University of Lisboa where all of the participants of the General Assembly were supposed to stay. The aefml (Portuguese student organization) equipped us with an arrival package and helped us check


EMSA in our hotel rooms. Afterwards, we walked to the hospital of the University (Maria Santos) where we attended a welcoming session and a pre-GA with information on the agenda. The same night, our colleagues from Lisbon organized a gala dinner, which was a great opportunity to discuss topics on European exchange in a relaxed atmosphere during a delicious dinner. Later, we enjoyed Lisbonâ&#x20AC;&#x2122;s infamous nightlife at a beach with a great view over the Tagus river. The next morning the Dean of the faculty and the first president of Portuguese medical students association welcomed us. During his opening speech, he criticized the application process at medical schools nowadays and furthermore stated that medical students should engage in voluntary work before starting medical school. In his opinion, med school is not only supposed to produce medical healthcare providers or Nobel price winners but human beings with the motivation of helping other people. Niels from the Netherlands asked me if I would want to volunteer for the credential commission. Our team was !http://www.youtube.com/watch?v=jbk SRLYSojo

supposed to take care of the whole voting process. I signed up with the idea of helping the organizing committee and getting to know its members. I thought this was a task I could do parallel to all the other activities of the GA, but I learnt that it was quite the opposite. It was quite an organizational effort to take care of the voting process and we had to keep in mind many details to ensure a smooth and correct voting process. During the first plenary session, we listened to short presentations about the annual activities of the board members. Afterwards we attended a training session on communication skills, during which we could reflect on our personality and communication style and practice different tools to improve them. Now it was the time of the first Pillar session on public health. We discussed issues such as the world distribution of income, matter of politics, and the impact of capitalism on public health. A youtube video by 1 Hans Rosling made a great contribution to our discussion. The next day we started of with a European integration pillar session. We were introduced to the main projects of the pillar: Euro talk and the 2 twinning project . Later, each country had a few

"http://issuu.com/emsaeurope/docs/ha ndbook_-_twinning_project

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EMSA minutes to prepare a short presentation about their country. Since Maggie from Austria and me were the only representatives of our countries, we decided to have our presentation together. It was a funny and easygoing session with the opportunity to learn more about other European faculties and cultures. In the afternoon, we had the chance to listen to a representati ve of the International AIDS society A membership enables several opportunities to get involved in HIV/AIDS related topics. During the annual conference, which will be held in Melbourne in 2014, you have the chance to present and publish your research work in the field of AIDS. A special designed grant program provides financial support and scholarships. Moreover, you can apply for abstract mentoring. Scholarships are open to everyone working or volunteering in the field of HIV and aids.

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How much do you think people pay for a subscription to a medical journal? Would you guess up to 3

http://righttoresearch.org

15000$? Unfortunately, not everyone has access to the scholarly literature, despite advances in communications technology. The high cost of academic journals restricts access to knowledge. The initiative of the Right to Research Coalition aims at working on a better access to scientific research literature. Open Access is an alternative to the traditional closed, subscriptionaccess system of scholarly communication. Open Access makes the results of scholarly research available online for free, immediately upon publication, and removes barriers for scholarly and educationalre-use

(.

In between the plenary session and training, we had lunch at the hospital canteen or a delicious snack which the OC team provided. During the plenary sessions, all of the annual reports of the board members were presented and discussed. Later, the general assembly discussed and edited new motions during the plenary. After a long day of discussions, presentations and training we enjoyed a great party at the faculty canteen. The theme of the party was European Village Party. Each country provided a table with local food and beverages.


EMSA At the last day and the third session of the public health pillar we attended a seminar by our guest speaker Stephan Dessler. We elaborated definitions of stigma and discrimination in context of HIV and split into three groups to each work on a specific case, which we presented and discussed within the group afterwards. Before lunch we listened to a sample of EMSOC (European medical Student orchestra and choir). This is a great project during which medical students with passion for classical music gather for 11 days in one of the faculty member organizations to play two concerts. (One in an open air setting e.g. a shopping mall and the other at a 4 proper orchestra venue) During the last plenary sessions all of the motions, which were not voted upon during previous plenar sessions were discussed again. It was interesting to see the importance of the internal rules and statutes for an organization. Even though the general assembly was slowly coming to an end most participants were still focused to make changes. Now it was time for a short coffee break and the presentation of the new board members. We listened to their plan of action for the upcoming term and we got a good impression on how the future officers will impact and shape the European Medical Students Association. ) http://emsocinfo.org

After hours of voting and counting we finally congratulated Olga Rostkowska as the chairwoman of the European Medical Students Association for the next year. It was finally done and we gathered one last time to have a final party. The organizing committee arranged a nice pub just next to the hospital with student friendly prices for lots and lots of beer. All in all I am extremely grateful for attending this yearâ&#x20AC;&#x2122;s general assembly and to discover, explore and share ideas for an European Medical Students Association. I hope this article may convey some of the spirit, enthusiasm and great encouragement, which I experienced during the last few days. Are you ready to work on an European level? Do you want to share ideas with medical students from all over Europe? Then let's get together and discuss ways how we can think global and act local. Europeanly yours, Lukas Herrmann, 4th semester medical student

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Visualizing Riga Dear

Christmas feeling in Riga! You can find this lovely place on one of the corners of the freedom monument square, in the middle of Riga. Decoration that was put out for" the independence day of Latvia on the 18th of November. This shot was taken on Brivibas iela facing the freedom-monument late in the evening. This photo was taken in the ! middle of a rainstorm. Thats why you can see the illuminated raindrops around the light which gives the picture an interesting look.

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Hey, Guys! I'm Niels a first semester medical student at RSU and a passionate Photographer. Here I would like to share some of my first visual impressions on Riga with you. Enjoy and if you want to, even let them inspire you for your own photographs. If you would like to see more of my work or want pictures taken of yourself, do not hesitate to have a look at my Facebookpage. (www.facebook.com/NRPhotographyOfficial)


Visualizing Riga

A tradition that can be found in many cities around the world nowadays: Couples place a lock on an handrail of a bridge to secure their love for each other. These locks can be found on a small bridge in one of the parks at the freedom-monument. This cool Piano can be found in one of the open air bars at Livu Laukums in the old town. â&#x17E;Ą

This is a picture of the Blackheads House in Riga. It was shot early in the afternoon right after the rain stopped and the sun came out. This gives us a beautiful sky and soft light in the scene.

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A shot of the small river seperating Vecriga from the Center, displaying the nature right in the heart of Riga. Photos: ŠNR-Photography

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International Students' Association Events • International Students' Association Handover Weekend • Teddy Bear Hospital • DIYA 2013

International Students’ Association Handover Weekend Nice, it’s Saturday! No Uni, no need to get up… ah wait! It’s the morning of 9th of November and ISA’s handover weekend is just about to start. Philip picks some friends and I up in his great old green Lada and we head towards a location 30 minutes away for the handover weekend. When we arrive we find a little house, which has all the comforts you could wish for; besides a cosy design with wooden floors and a sauna inside, there is a volleyball field, a pond and a swing located outside.

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For me, as a Freshy in the ISA board team, the handover weekend is something completely new and I don’t know what to expect. I’m astonished to discover that instead of a dry and boring official sittogether, we actually start with “getto-know-each-other” games. Afterwards the always-motivated Students Council girls Alise and Liva conduct a presentation talking about the 1070 international students represented by ISA nowadays and how the ISA working for the next generation of students to further improve RSU’s reputation. Lots of talking makes us hungry; Lunch is served and we all enjoy yummy food while sitting together, involved in lively discussions. Viesturs L)sis is the one to get us out of our after-lunch lethargy. With teambuilding games, which he practices with his organisation Piedz*vojumu gars, he motivates us to communicate with each other to make life easier when working in a group.


ISA Handover Weekend

DIYA 2013 even the tough people need a snatch of sleep.

The day gets longer and, after dinner discussions about ISA’s aims for the upcoming year, Wasifa, president of ISA, gives us feedback of the ISA projects from last year.

Sunday morning – the bed issue (15 beds for 25 people is just not enough), even though very well solved by creating a “mattress camp”, left its’ marks. Well, maybe also late night activities might have had something to do with the tiredness, but as trained night owls we were ready for a day of discussing ISA projects, roles and duties as well as important issues that came up.

After two great and amazingly well organised days, which I want to thank It’s time to relax and let the eventful especially the SP girls Annija, Alise, day decay. Entering the sauna, I notice that others L*va, Linda, El*na, Milere and Jana for, had the same idea. While enjoying the we returned exhausted but delighted to Riga. heat, Yrjö gives us a lesson in how to properly have a Finnish sauna. Some By Stephanie Strauven guys must have overdone it with the heat as they feel the necessity to jump Diya 2013 in the outsight freezing cold pond and loud laughter is audible. On the 30th of November, 2013, we Topping the evening off is a cosy hosted Diya 2013, an Asian cultural gathering with guitar evening at the RSU main campus. playing and the one or The evening kicked off with a host of other glass stalls in the RSU canteen. Vibi drew of wine or henna designs on people’s hands beer. As while they watched in awe at the the drinks speedily go various designs that she was able to to our create! That girl is truly talented! heads in Laavanja and Vinita taught people to the early create their own Rangoli patterns on mornings,

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DIYA 2013 dark cardboard with chalk. They also taught people to make diyas (yes, like the name of the event!) from clay, a traditional Indian lamp which can be filled with oil and a wick to be lit during festival times. We also had some delicious food from Indian Raja and Dzagannat sweet store. Indian Raja had rice, chicken curry, chickpea curry, and street food in their stall, while Dzagannat provided desserts with eggless cake and other sweets and vegetarian cakes.

On another side of the canteen, was the photo booth where people could dress up in traditional Asian outfits and get their photos taken by our talented photographer Niels. Everyone seemed to love getting all dressed up in the colourful clothes and getting their photos taken with Bollywood poses!

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Finally, came the time for some performances from the RSU Bollywood Dance group. We had a Kandyan classical dance from Sri Lanka, followed by a few Bollywood and folk dance numbers. It was really something to see the crowd joining in by clapping and feeling the rhythm of the beats! After the performances, the floor was given to the audience and several of the audience members got dancing with the latest, rhythmical Bhangra and Bollywood! It was truly a night to remember with some people experiencing aspects of Asian culture once again, while others experienced it for the first time and learnt a new culture and way of life.

Do keep your eyes peeled on our Facebook page where the photos from the event and the photo booth will be up soon!


DIYA 2013

Teddy Bear Hospital Not really. That evening, the premeeting for the Teddy Bear Hospital on the following day took place.

If you have any other ideas for an event that you’d like to bring to RSU with the help of the ISA, please don’t hesitate to drop us a line and let us know what you’d like to plan. We’re always open to suggestions and really want to help you make the best our of your University life. Bring your suggestions to us at any time…and we will try our best to make them come to life! By Sohini Mukhopadhyay

For those who did not hear about it already, I want to explain shortly how the Teddy Bear Hospital (TBH) works: As we all remember from our childhood, visiting the doctor has not always been a fun experience. Some children may even develop fear of doctors and white coats. To show them that white lab coats do not necessarily mean something bad, but that doctors actually are important to prevent/cure some disease or treat injuries, the TBH wants to show children how a visit at the doctors’ works and what they do. This is an international idea, which was brought to the RSU by ISA. So in this case, pupils of the 2nd and 3rd grade of the Riga International

Teddy Bear Hospital November 12th, 6pm, Lecture Hall 1 at the RSU. A group about 30 medical students are discussing how to deal with a broken leg. Normal scenario? No. That leg belongs to bear. And not a wild one. The broken leg belongs to School are bringing their sick or a teddy bear. Has studying made injured teddy bears to the „teddy those students completely insane?

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Teddy Bear Hospital

doctors“, meaning medical students from the 1st semester on. Those teddy doctors - together with the child examine the bear, give a diagnosis and then provide treatment according to the injury/disease. The purpose is to decrease the children’s level of fear of a doctor’s visit. Personally, I participated for the first time, and so I want to share my experiences and thoughts with you. Back to the pre-meeting; besides information about place and time, we were introduced to some techniques

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about how to create a bond with the (maybe a bit shy) children. „Stay calm, (pretend you) know what you

are doing, speak in a gentle voice, never ignore the child and always stay on the same eye level when speaking to the child“. This may sound logical and natural, but if you never heard of it, these are crucial and very helpful informations. For me, working as a ski instructor during winter time, it was a very good reminder. Additionally, we were told about some

special cases. What to do if a child says something about cancer, death or abuse? In these cases, it was really good to know that we can get help from higher semester students and from the teaching staff of the Riga International School. For the actual event, the library of the International School was converted into a “hospital“. First stop was the ER, where the pupils where assigned to a teddy doctor. Other stations were X-ray, microbiology, general medicine, pharmacy, dentistry and surgery. We had two teams of doctors, one was


Teddy Bear Hospital working an early shift and helping to set up the “hospital”, the late shift helped to clean up after the event. When the pupils came into the “hospital”, they where quite excited. Some were hesitating a bit more than others, but the majority was laughing and running towards us, standing their in our white lab coats. No sign of fear of the doctors at this moment.

Most important question then: „I do not have a teddy bear… I brought my shark. Can you treat it anyways?” Of course, teddy doctors are experts in treating sharks and other stuffed animals, too, so no problem there. My first patient was an owl, who could not fly. Apparently, the other day the owl, named „Owl“ just came home and could not fly anymore. Anna, her owner suggested a broken wing. As soon as it came down to the disease/ injury of their favorite stuffed animal, the children became a bit worried and anxious. As it turned out in the X-ray,

Anna was right. „Owl“ had a broken wing, which needed to be fixed in surgery. So Anna dressed up with a coat, gloves, a hair cover and a mouth cover, and she actually explained to me, why this anti-septic clothes are important. After giving Owl a sleeping juice, Anna performed a great surgery on her stuffed animal and we put a bandage around the wing. Then we went to the pharmacy to talk about some medication for Owl, but we agreed, that one day of „no flying“ is the best treatment for her. After another patient, the shift was over for the early shift team. Going back to RSU, we shared our experiences and some other interesting cases. One bear had his left ear, his left leg and his right arm broken and a cat had an actual open back with stuffing coming out. We all

agreed, that working at the TBH and working side by side with

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Teddy Bear Hospital children was a great break from our studies, and hopefully, the children had the same feeling. Almost all of us agreed to participate the next time as well. I hope this article makes you a bit excited about the TBH, other social and academic events of the ISA and may even encourage you to participate at the next TBH. The goal of this TBH was accomplished and the TBH was a success. The feedback of the Riga

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International School was very positive, so we, and the whole ISA are looking forward to the next Teddy Bear Hospital. If you have any questions, you can ask all ISA members. Thanks to the organizing committee! Oh and about Owl: I don´t know for sure, but I strongly believe that she recovered completely. By Tobias Hentschel


Closing Words Enthusiasm and love for what you do, is the greatest, and easiest, path to ultimate success. When working with the great team of writers and photographers, the enthusiasm, fun and motivation has never been missing.

Publishing Information: Articles: Franziska Thimm Mohsen Javed Philipp Nelles Ricarda Schaperdot Martin Arndt Niels Rudnik Johannes Göbel Lukas Herrmann Sohini Mukhopadhyay Stephanie Strauven Tobias Hentschel

Even when time was getting short and the pressure was well and truly on, the last hidden reserves of energy and concentration were uncovered and this has led to this tremendous final result – the ISA Review, a magazine put together Proofreaders: by students for students! I’d like to thank the amazing people by my side, who have constantly been my support throughout the compilation of the journal. Our aim was not only to further develop the ISA Review, but also to find a way to combine medical facts with fun and entertaining reading and this task has been achieved far better than what I could have wished for.

Lukas Herrmann Sohini Mukhopadhyay Stephanie Strauven Layout & Design: Niels Rudnik Stephanie Strauven Published by:

I hope you enjoyed reading what we put together for you and we hope that it has caught your eye. We would love to include new ideas and creative heads from other students, are always welcome to help us to create an informative and yet entertaining magazine, the ISA Review. Yours, Stephanie Strauven Officer for Public Relations Magazine: © International Students' Association Cover & Photos of Cover, Diya 2013 and TBH: © NR-Photography

This magazine is also

Available Online

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http://sp.rsu.lv/isa/ rsu.international.students@gmail.com


Isa Review December 2013