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Unfair Dismissal
Unfair Dismissal
Call (0330 400 4495) now or complete form for a call back.
When an employer ends the employment of work they should have a valid reason for that or else it could be perceived as unfair dismissal.
Even with a valid reason, the employer still needs to show that they have followed procedures by investigating the circumstances in full before dismissing an employee and that they are consistent in their judgment. The employer cannot dismiss a worker for doing something that some other worker did and got away with.
When is it fair to dismiss an employee?
Before the employer dismisses an employee they have to ensure that they fall under one or more of these categories:
- Job capability: if the employee is no longer able to carry out their duties on the job, either for poor performance or because of prolonged sickness. Also if the employee has difficulty keeping up with changes to the job or can't get along with their colleagues.
- Misconduct: an employee who commits gross misconduct such as being violent against a co-worker, customer or property can be dismissed without having to go through the normal disciplinary procedure.
- Legal reasons: if an employee is sent to prison, lost the right to live or work in the UK, or if they can no longer carry out their duties without breaking the law, like a driver who loses their driving licence, are all grounds for fair dismissal.
- Redundancy: in cases of redundancy, the employer has a valid reason to dismiss the employee especially when their role becomes redundant, and everyone carrying that role has been treated fairly.
When is dismissal unfair
Automatic unfair dismissal is related to dismissal cases where the employee was dismissed for exercising their rights. Such as:
- A pregnant employee or someone on maternity leave.
- Paternal leave including adoption and taking time off to care for dependants.
- Employees who ask for their legal rights at work or take action about safety work issues.
- When an employee acts as an employee representative.
- Being part of a trade union and taking part in trade union activities.
- The employee was part of the business for two years or more, and the business was transferred to a new employer.
It is worth noting that any employee who falls under any of the above categories can still be dismissed. However, the main reason for dismissal should not be any one of them.
When dismissing an employee, the employer should make sure they have sufficient grounds for the dismissal, and they should follow disciplinary procedures. In cases of gross misconduct, the employer can execute a summary dismissal after a full investigation.
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Silly, semi-humourous poem written in the morning. About morning. Fun, eh?
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As a private midwife, I have the honour of providing support at the time of birth to women in a wide range of situations. Most people only associate private midwives with home births, but I support both home birth and hospital birth. My specialist skills enable me to support those whose pregnancies end too soon (through miscarriage or premature labour) and women who make the ultimate sacrifice of compassionate induction (termination for fetal abnormality). I work with surrogates and intended parents to provide support at the time of birth to manage the situation sensitively and in accordance with their shared wishes. I work with parents who know that their baby has major health issues and will need extensive specialist care commencing immediately after birth.
Birth plans
Whatever the circumstances, one-to-one support at the time of birth from a midwife who you have chosen to work can be very powerful. This is well recognised by the NHS, but funding and staff shortages make true continuity with your choice of midwife a very rare experience. If you are able to consider buying additional care, this can be a game changer. One of the greatest joys of private midwifery for me is that I have time for you. We build a relationship, I get to know what is important for you, your hopes and fears, and can then I support and guide you. As an NHS midwife, discussion of birth preferences or birth plans was rarely something I could spend enough time on to discuss the issues in any detail. I have often heard women say that they were asked to write a birth plan but had no idea even what the options were or how to choose. As a private midwife, I can spend time (ideally gradually, as the pregnancy progresses) providing you with information which is relevant to your situation. We can discuss the circumstances under which, for example a caesarean section can be the safest option for mum and baby. We can discuss possible labour experience and for example whether hypnobirthing or an epidural are most in line with your beliefs and preferences. We can also talk about the options you don't expect to want, so that you have a clear understanding and if things don't go to plan you are armed with knowledge.
If you or your baby face usual issues or concerns, I can help facilitate planning meetings with relevant specialists so that you know that plans have been made to address these. Often the plans are complex, and are flexible according to the way events unfold. As your advocate and guide I will work to enable the very best care for you and your baby, whatever issues there are. In my experience, knowing that I will manage the technical and professional issues often enables women to focus on the physical process of labour and birth.
Hospital birth and caesarean section
Home birth is not right for everyone. If you prefer or need to birth in hospital, the role of a private midwife is slightly different to the role at a homebirth, but you can combine NHS hospital care with private midwifery support to get great care. In most UK hospitals, insurance restrictions mean that a private midwife is required to hand over primary clinical responsibility to a midwife employed by the hospital. I can still be there with you, providing support, information and advocacy. This can be seem as similar to the role of a doula, but with the major difference that I am a qualified and experienced midwife so can observe and interpret events accurately for you and often provide a valuable second opinion. In many hospital births the midwife responsible for your care will also be caring for other women, and will be subject to the hospital shift pattern, meaning that you can experience rather fragmented care. Working independently, I stay with you. I work with women who have other involved birth partners (eg their husband/ mum/ friend) as well as women who are without family support for whatever reason.
If the reason for a hospital birth is that you or your baby face medical issues, it is often very reassuring to know that I am there, knowing your story and able to ensure that the issues are remembered and managed appropriately.
Having shared the birth experience with you, I can review events with you later, celebrating positive experiences and helping you to make sense of what can be rather muddled memories if things became more complicated.
Urgent call out
Sometimes I do not have the opportunity to meet a family in advance, because they call me when an unexpected issue arises. I am experienced at entering emotionally and physically complex situations to provide advice, care and support at the time of birth. If you. or someone you love, needs urgent support in a complicated labour, or if you are given the devastating news that your baby has an unexpected major problem or has died please call me, any time, day or night.


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Randomised controlled trials provide the best scientific evidence for the efficacy of biological drugs in inflammatory bowel disease (IBD). However, findings obtained from these trials might not be reproducible in clinical practice. This study aimed to estimate the percentage of patients with IBD treated with biologics who would have been eligible for randomised controlled trials, and to compare the theoretical efficacy of biological drugs with their effectiveness in clinical practice.Methods
We performed a retrospective multicentre study in 375 patients with IBD treated with anti-TNF agents and followed-up for 1 year. The eligibility criteria for the trial were taken from the ACCENT, SONIC, ACT, CLASSIC and CHARM trials. Eligible patients were included in a second analysis to compare results in clinical practice versus those hypothetically obtained if the patient had been included in a trial.Results
Only 45.6% of 375 patients would have been eligible for pivotal trials. One-year clinical benefit (remission or response) was similar for eligible and non-eligible cohorts (68.4% vs. 68.6%, p=0.608). The clinical benefit was greater for current clinical practice than for a hypothetical trial situation (68.4% vs. 44.4%, p<0.001) in eligible patients.Conclusion
More than half of patients with IBD treated with biologic drugs would not be represented in pivotal trials. The effectiveness of anti-TNF drugs in clinical practice exceeds their theoretical efficacy.
Los ensayos clínicos aleatorizados proporcionan la mejor evidencia científica de la eficacia de los fármacos biológicos en la enfermedad inflamatoria intestinal (EII). Sin embargo, los resultados pueden no ser reproducibles en la práctica clínica. Los objetivos de este estudio son analizar el porcentaje de pacientes con EII tratados con fármacos biológicos que habrían podido ser elegidos para un ensayo clínico aleatorizado y comparar la eficacia teórica de los fármacos biológicos con su efectividad en la práctica clínica.Métodos
Realizamos un estudio retrospectivo multicéntrico en 375 pacientes con EII tratados con anti-TNF con un seguimiento de un año. Los criterios de elegibilidad para la condición de ensayo clínico fueron extraídos de los estudios pivotales ACCENT, SONIC, ACT, CLASSIC y CHARM. Los pacientes elegibles fueron incluidos en un segundo análisis para comparar los resultados en la práctica clínica con los obtenidos tras realizar una estimación teórica si el paciente hubiese sido incluido en un estudio pivotal.Resultados
Solo el 45,6% de los 375 pacientes cumplían los criterios de selección para un estudio pivotal. El beneficio clínico al año fue similar entre los pacientes elegibles y no elegibles (68,4% vs 68,6%). El beneficio clínico en los pacientes elegibles fue mayor en la práctica clínica que en la condición hipotética de un ensayo clínico (68,4% vs 44,4%, p<0,001).Conclusión
Más de la mitad de los pacientes con EII tratados con fármacos biológicos no estarían representados en los ensayos pivotales. La efectividad de los fármacos anti-TNF en la práctica clínica es superior a su eficacia teórica.
Crohn disease (CD) and ulcerative colitis (UC) are chronic autoimmune inflammatory diseases of the gastrointestinal (GI) tract.1,2 Conventional treatment includes the use of corticosteroids and immunosuppressants. The incorporation in the last decade of anti-tumour necrosis alpha (anti-TNF) antibodies, with their good safety profile, has transformed the treatment and prognosis of these patients.3 Their efficacy is supported in several randomised and placebo-controlled clinical trials,4–6 which has led to the approval of these drugs by regulatory agencies.
It is generally agreed that randomised clinical trials (RCT) are the best scientific approach to study the effect of a drug or therapeutic strategy. RCTs use strict selection criteria and a defined study protocol to maximise their internal validity.7 Furthermore, most of the variables that could affect or interfere in the outcome are removed in order to evaluate the effect attributable to the study drug and remove most potential bias. In this way, RCTs evaluate the efficacy of a drug in a selected population and under controlled conditions. However, patient selection can limit the external validity or representativeness of the outcomes in the entire patient population eligible for treatment, and the findings must be carefully extrapolated to clinical practice (CP).
In contrast, observational studies evaluate the efficacy of a drug in real CP conditions, and variables and biases that affect the final outcome may appear during follow-up. The efficacy rates of observational studies in inflammatory bowel disease (IBD) using biologics are superior to the efficacy demonstrated in RCTs. For example, the sustained response rates at 1 year in primary responders with infliximab and adalimumab were 39% and 43%, respectively, in the ACCENT 14 and CHARM5 studies. These results were lower than those obtained in observational studies, which reported rates of over 60% for both anti-TNF.8,9
This paper (EFIFECT study) is a theoretical exercise aimed at evaluating the degree of representativeness of patients with IBD treated with anti-TNF in CP and RCTs, and to identify potential discrepancies between the effectiveness and theoretical efficacy of these treatments.Materials and methodsStudy population and data collection
We conducted an observational, retrospective study of patients with IBD treated with anti-TNF drugs in CP in 5 Spanish tertiary hospitals. Cases were selected randomly from electronic databases (1 case for every 4 adult patients with IBD treated with anti-TNF drugs) in order to obtain a representative sample over time. All patients selected were followed-up for at least 1 year after commencing anti-TNF therapy.
Demographic data, phenotype, disease location, current or past medication and history of surgery were recorded. The indication for the biologic, activity at the start of treatment and therapeutic response at 1 year were also included. The data were obtained from medical records.
The study was approved by the Balearic Islands Research Ethics Committee in October 2012 (IB 1947/12 EPA).Endpoints
Part 1. To analyse the percentage of patients with IBD treated with a biologic in CP who would have been eligible for a pivotal RCT, and to investigate the reasons for ineligibility.
Part 2. To evaluate the percentage of eligible patients who achieved remission or response in CP after 1 year of treatment, and to compare it with the outcomes under the hypothetical conditions of an RCT (theoretical estimation). To describe the factors that explain the discrepancy between the efficacy and effectiveness.Definitions and criteria used in randomised clinical trials
RCT criteria: we selected the inclusion and exclusion criteria from the published papers of the ACCENT 1,4 ACCENT 210 and SONIC11 studies for infliximab in CD, CLASSIC 112 and CHARM5 for adalimumab in CD, and ACT 1 and ACT 26 for infliximab in UC. Patients who met all the inclusion and none of the exclusion criteria for at least 1 of the 6 pivotal trials were considered eligible for an RCT.
Remission, response and failure were evaluated at the discretion of the clinician responsible, although whenever the data could be extracted from the medical record, clinicians based their decision on the Harvey–Bradshaw score13 for CD and the partial Mayo Clinic score6 for UC. The clinical response was evaluated at week 52 in patients who continued with anti-TNF, or at the last visit if treatment was discontinued.
Eligible patients were re-evaluated under hypothetical RCT conditions. Evaluation criteria for the RCT were extracted from the different studies.4–6,10–12 Any protocol violation, such as a new steroid cycle, initiation of an immunosuppressant or topical therapy, escalation of an anti-TNF, pregnancy or serious infection was considered as a failure.
Escalation of the biologic was defined as a clinically indicated increase in the dose or frequency of administration.Statistical analysis
A descriptive analysis of the results was performed. Qualitative variables were described as frequencies and percentages with their 95% confidence intervals. Continuous variables were described as means or medians with the corresponding standard deviation or interquartile range. The chi-square test and Fisher's test was used to compare categorical variables, while the Student's t and Mann–Whitney tests were used for continuous variables with values that did not follow a normal distribution. A difference was considered statistically significant when the p value was less than 0.05. The sample size was calculated at 350 patients to be able to detect a 15% difference between the clinical outcome at 1 year with anti-TNF treatment in CP conditions and in the hypothetical RCT setting.ResultsPart 1. Eligibility for a randomised clinical trial
The study included 365 patients with IBD (276 CD and 99 UC) who had received clinically indicated treatment with infliximab or adalimumab in real CP, and who had follow-up of at least 1 year.
A total of 171 patients (45.6%) met the selection criteria for at least 1 of the 6 RCTs. The percentage of eligible patients with CD and UC in the RCTs was 47.1% and 41.4%, respectively.
In CD, age, sex, smoking status, duration of disease and use of immunosuppressants were comparable in the eligible and ineligible patient populations (Table 1). However, ileocolonic location, non-obstructive non-fistulising pattern, perianal disease and percentage of biologic-naive patients were more common in the group of eligible patients. In UC, differences were only found in disease extension and use of immunosuppressants (Table 2).
Baseline characteristics of patients with Crohn disease.
|Age (years), mean±SD
|Sex (female), n (%)
|63 (54.8)
|78 (56.5)
|Active smoker, n (%)
|39 (30.7)
|44 (30.1)
|Duration of disease, M (IQR)
|6 (1–29)
|6 (1–37)
|Location of disease, n (%)
|L1 (Ileal)
|29 (22.5)
|59 (41.0)
|L2 (colic)
|22 (17.1)
|22 (15.3)
|L3 (ileocolic)
|78 (60.5)
|60 (41.7)
|L4 (upper gastrointestinal)
|0 (0.0)
|3 (2.1)
|62 (48.1)
|39 (26.9)
|Evolutionary pattern, n (%)
|B1 (inflammatory)
|82 (63.6)
|51 (35.4)
|B2+B3 (stenosing or fistulising)
|47 (36.4)
|93 (64.6)
|Baseline HBI, M (IQR)
|8 (0–16)
|5 (0–24)
|Use of immunosuppressants, n (%)
|122 (93.8)
|132 (90.4)
|Anti-TNF naive, n (%)
|110 (85.9)
|106 (72.6)
|Infliximab/adalimumab (%)
HBI: Harvey–Bradshaw index; IQR: interquartile range; M: median; SD: standard deviation.
Baseline characteristics of patients with ulcerative colitis.
|Age (years), mean±SD
|Sex (female), n (%)
|19 (47.5)
|22 (39.3)
|Active smoker, n (%)
|4 (9.8)
|3 (5.3)
|Duration of disease, M (IQR)
|5 (1–23)
|5 (1–38)
|Extension of the disease, n (%)
|27 (65.9)
|30 (53.6)
|Left-sided colitis
|29 (22.0)
|24 (42.9)
|5 (12.2)
|2 (3.6)
|Partial Mayo score, M (IQR)
|6 (3–9)
|7 (1–9)
|Use of immunosuppressants, n (%)
|41 (100)
|51 (87.9)
|Anti-TNF naive, n (%)
|41 (100)
|54 (94.7)
IQR: interquartile range; M: median; SD: standard deviation.
The most common cause of ineligibility was prescription of the drug for a reason other than a moderate-to-severe flare-up or perianal disease. This group included patients with mild or no clinical activity, in which the biologic was prescribed to prevent recurrence or corticosteroid dependence, among other reasons. Symptomatic stenosis in CD and use of topical drugs in UC were the next most common causes of ineligibility (Tables 3 and 4).
Causes of ineligibility for a randomised clinical trial in Crohn disease.
|Symptomatic stenosis
|High-dose corticosteroids
|Primary failure to anti-TNF
|Recent surgery, stoma or short bowel syndrome
|Tuberculosis infection
|Recent diagnosis
|HIV, HVB or HVC infection
|History of cancer
|Imminent surgery
Anti-TNF: anti-tumour necrosis factor; HBV: hepatitis B virus; HCV: hepatitis C virus; HIV: human immunodeficiency virus.
Causes of ineligibility for a randomised clinical trial in ulcerative colitis.
|Topical treatment
|Treatment indication
|High-dose corticosteroids
|Tuberculosis infection
|Recent diagnosis
|History of cancer
|HIV, HVB or HVC infection
HVB: hepatitis B virus; HCV: hepatitis C virus; HIV: human immunodeficiency virus.
The percentage response after 1 year of treatment in CP was 68.4%. No significant differences in the clinical response (overall, CD and UC) were observed between patients who were eligible and ineligible for an RCT (Fig. 1).
The overall percentage of remission was 55.3%. Remission percentages were higher among ineligible patients than eligible patients (57.5% vs. 50.8% in CD and 63.8% vs. 51.2% in UC), but these differences were not statistically significant.Part 2. Discrepancy between efficacy and effectiveness
A total of 171 patients (130 CD and 41 UC) who met eligibility criteria were included. The clinical benefit at 1 year was higher in CP than in the theoretical RCT evaluation (68.4% vs. 44.4%, p<0.001). Up to 35% of patients with clinical benefit in CP would have been considered as failures had they been included in an RCT.
The percentage of patients with clinical remission after 1 year of follow-up was 50.9% in CP vs. 39.2% using the evaluation criteria from a pivotal trial (p<0.001). Fig. 2 shows the clinical outcomes in patients with CD and UC with both evaluation criteria.
The most common reasons for discrepancy between CP and RCT evaluation were the need for escalation (75.6%) and treatment with a new corticosteroid cycle (12.2%). Other less common causes were a delay in treatment administration, surgery and infusion reaction.Discussion
The use of anti-TNF drugs in patients with IBD was approved by regulatory agents based on data from pivotal RCTs.4–6,10–12 RCTs use strict inclusion and exclusion criteria to select a homogeneous population.14 Patients with more severe forms, older patients, those with comorbidities, suspected poor adherence or receiving treatment with drugs that could interfere with the study drug are systematically excluded. These studies are designed to maximise the internal validity at the expense of the external validity. The results obtained from an RCT can therefore be reproduced in an analogous population under similar conditions. However, it is common (and often erroneous) to assume that these findings are applicable to general CP, including the situations that were excluded from the original study.
In our study, more than half of patients with IBD treated with anti-TNF drugs in routine practice would not meet the inclusion criteria for a pivotal trial. Only 45.6% of our patients met the selection criteria for 1 or more of the 6 RCTs. Ha et al.15 retrospectively reviewed 206 patients with IBD with moderate-severe disease activity followed up in Mount Sinai Medical Center. Only 34% of patients with CD and 25% of patients with UC would have met the eligibility criteria for 1 or more of the pivotal studies on infliximab, adalimumab, certolizumab or natalizumab. The external validity of RCTs has been evaluated in other chronic diseases with similar results. For example, only 42% and 16% of 2 cohorts of patients with early onset rheumatoid arthritis met eligibility criteria for an RCT that compared methotrexate vs. etanercept, while this percentage was only 5% in the ATTRACT study (infliximab plus methotrexate vs. monotherapy with methotrexate). The authors recommended that the inclusion criteria for RCTs on rheumatoid arthritis should be modified in order to improve the applicability of the findings to CP.16 In another study, Herland et al.17 found that only 5.4% of patients with asthma and 17% of patients with chronic obstructive pulmonary disease met the most common criteria for the RCT. The authors questioned whether the study results could be extrapolated to the real patient population. The percentage representativeness was higher in our study because we focused only on patients with IBD treated with anti-TNF drugs, and not on the entire IBD population.
In real CP, biologics are administered by physicians in different healthcare structures (from IBD units with their own day hospital and specialised nursing staff to professionals who work part time with patients with IBD). The patients are heterogeneous and, as we have seen, treatments are given in situations not considered in the pivotal studies. They can present comorbidities, treatment with other drugs that may interact with the anti-TNF and situations that are more serious or complex than those included in the RCTs. Observational studies, case series, post-marketing RCTs for specific situations, and expert recommendations add to and complement the information gleaned from pivotal RCTs. We have evidence of treatment with biologics in the prevention of recurrence in CD18 and severe UC,19,20 pouchitis,21 abdominal phlegmons,22 patients infected with hepatitis B or C virus23 or during pregnancy,24 situations that were excluded from the pivotal RCTs. Moreover, some expert recommendations come from the experience acquired in observational studies in non-selected populations.
We did not find significant differences in age, sex, smoking habits or use of immunosuppressants between eligible and ineligible patients. In contrast with the pivotal studies, more than 90% of our patients had received or were receiving treatment with immunosuppressants. This is in line with the recommendations of the European Crohn's and Colitis Organization (ECCO) for the use of anti-TNF in CP,3 and is similar to the figure of 98% reported in another study.9 There were, however, differences in the location and pattern of CD, with a higher percentage of ileal forms and stenosing and penetrating patterns in ineligible patients. Some of the RCT exclusion criteria, such as the presence of fibrotic stenoses, abscesses or the use of anti-TNF to prevent recurrence—which are more common in ileal CD—could explain these differences.
We did not find any differences in the response rates between eligible and ineligible patients treated with anti-TNF. Ineligible patients add greater heterogeneity to observational studies, and there could be patient groups with different response rates to the same treatment. For example, only 45% of patients with pouchitis treated with anti-TNF presented a response,21 while success in the prevention of clinical recurrence at 1 year was 80% in the Regueiro study.18
The methodological heterogeneity makes it difficult to compare our results with those of other authors. It would be interesting for scientific societies to establish recommendations that would enable this comparison. Some studies evaluate remission and response rates using activity scores, while others evaluate the clinical benefit according to the clinician's opinion. Some include all patients who begin treatment, while others only evaluate induction responders. Finally, the follow-up time varies, and the results are expressed as mean follow-up time or different time intervals. Despite this, the clinical benefit of 68.4% observed in our study is similar to other observational studies. In the Lovaine cohort,8 with 614 patients with CD treated with infliximab, the clinical benefit was 56.5%, with a mean follow-up of 4.6 years. In another English series, 210 patients were evaluated retrospectively: 65.9% presented a response and 40% achieved clinical remission, with a mean follow-up of 24 months.25 A similar Canadian cohort with 133 patients observed a percentage response at 1 year of around 60%.9 There are similar findings with infliximab in UC (80%)26 and adalimumab in CD (63%).27
However, there is a large discrepancy between the results in CP in most observational series and the data from RCTs. The ACCENT 14 study included 573 patients with CD who were given treatment with 5mg/kg of infliximab. Slightly over half (58%) presented a response at week 2 and were randomised to infliximab (5 or 10mg/kg) or placebo at weeks 2 and 6, and every 8 weeks for 1 year. The percentages of remission and response for the primary responders at week 54 were 28% and 39% in the infliximab 5mg/kg group, higher than the placebo group (17% and 22.5%; p=0.007). The CHARM5 study, similar in design to ACCENT 1, evaluated the efficacy of adalimumab in 854 patients with CD. A first induction phase was carried out with 80 and 40mg of adalimumab at weeks 0 and 2, and randomisation at week 4 to 40mg adalimumab weekly, 40mg every 2 weeks or placebo. Remission and response were achieved in 36% and 43% of primary responders (58%) at week 56 in the adalimumab every 2 weeks group, with significant differences with respect to the placebo group. The ACT 16 study included 364 patients with moderate-severe UC on treatment with infliximab (5 or 10mg/kg) or placebo. Both remission and response at week 54 were significantly higher in the 5mg/kg treatment group (34.7% and 45.5%, respectively) than in the placebo group (19.8%).
In addition to the rigorous selection criteria, RCT investigators establish a strict follow-up protocol, with more frequent, controlled visits than in CP. Any circumstances that could interfere with the study variables are removed. If any protocol violations occur, the subject is withdrawn from the study and considered as failure. For example, in the ACCENT 1 study, the protocol considered as failure any patient who required treatment escalation, received prohibited medication or underwent surgery, regardless of the activity score.4
In the second part of the study, we only considered patients who would be eligible for RCTs, and compared the response to anti-TNF treatment in our CP with the theoretical results under the hypothetical conditions of an RCT. Less clinical benefit was observed under RCT criteria than in CP (44.4% vs. 68.4%). One-third of patients would be considered as failures if they had been included in an RCT. These findings confirm the previous results of a pilot study with 74 patients with IBD presented at the ECCO conference in 2011.28
The main causes of discrepancy between the CP results and those of the theoretical RCT study were the need for escalation (75.6%) and having started a new corticosteroid cycle (12.2%). Dose escalation was necessary in 23% of patients in our series to maintain the response during the first year of treatment. This percentage is similar to the 21% observed in an English cohort at 2 years of follow-up.25 These interventions are common routine practice in patients with loss of response or partial response. In fact, escalation is backed by scientific evidence, and is recommended in IBD clinical guidelines. However, in the pivotal RCTs, any modification of the drug dose or administration interval was considered as a protocol violation, as it interferes with the primary endpoint, which is assessment of the drug efficacy.
The study has some limitations that may lead to bias. Data were extracted from medical records, so there could have been reasons for exclusion or protocol violations for an RCT that were not considered. For example, considering symptomatic stenosis as an exclusion criterion could be controversial, depending on the inflammatory or fibrotic component. There could have been modifications in the concomitant treatments that were not evaluated. Moreover, only 1 reason for ineligibility was recorded, and in cases in which there were more than 1, the investigator selected the most relevant reason. The 1-year results were based on the clinician's opinion in cases where no clinical scores were available, as in other similar studies, and the same criteria were also applied in the theoretical RCT evaluation.
It is important to highlight that RCTs and observational studies have different purposes.29 RCTs are the best approach for studying the efficacy of a treatment in very controlled conditions. However, RCTs do not reflect the way in which the drug is used in CP, and their results do not represent the entire patient population.30 Observational studies offer realistic information on therapeutic response in a heterogeneous population, and better reflect the likelihood of response to a drug administered under CP conditions. Both studies are essential and the health outcomes obtained complement each other in medical decision-making. David Mant31 notes that: "The paradox of the clinical trial is that it is the best way to assess whether an intervention works, but is arguably the worst way to assess who will benefit from it".
In conclusion, half of patients with IBD treated with anti-TNF in real CP are not represented in pivotal trials. Furthermore, RCTs underestimate the likelihood of response to anti-TNF drugs in IBD.Funding
Luis Ibáñez-Samaniego has received a grant from ISCIII (RÍO-HORTEGA CM14/00023).Authorship
Daniel Ginard and Sam Khorrami have contributed equally to the authorship of this manuscript.Conflict of interests
The authors declare that they have no conflict of interests.
Please cite this article as: Ginard D, Khorrami S, Pérez-Carazo L, Tavío-Hernández E, López-Sanromán A, García-Alvarado M, et al. Eficacia y efectividad de la terapia biológica en la Enfermedad Inflamatoria Intestinal. Estudio EFIFECT. Gastroenterol Hepatol. 2016;39:369–376.


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ESL One LA and Birmingham To Be Played Online
ESL has officially announced that both it's events - ESL one LA and ESL one Birmingham will both be played online with changes to the format.
With the recent events of Covid-19 affecting the world ESL made the announcement to postpone The ESLOne Los Angeles Major. This came after United States President, Donald Trump, put in to place a travel suspension. This then impacts the team's ability to get into the country and move around whilst there. Some teams were already in LA for a bootcamp but many of the teams had yet to arrive. Currently, the total number of cases sits at 441,000 with 55,000 of those being in the US.
Just two weeks later ESL announced that the event and it's other event ESL Birmingham, due later in the year, would both be going ahead but in a majorly (excuse the pun) different way.
The event will no longer be a LAN and instead will be played in five online regional leagues. Each of the regions will endure a round-robin group stage which will be followed by playoffs. This, of course, raises a few questions such as DPC points and what teams are participating.
The teams participating can be found here:
Fans can enjoy watching the teams that qualified plus we will see other teams who fell just short of qualifying for the event. Such as North American 'business associates' who missed out on the event after failing to Chaos EC in a bo3. Or Team Nigma who recently beat Team Secret in the 'WePlay! Dota 2 Tug of War: Mad Moon' event 3-2. Team Secret went through the qualifiers of ESL One LA without dropping a single map. The EU/CIS regional is sure to be a blood bath with 16 teams participating
In the wake of this decision, ESL have teamed up with Maincast to organize the regions. As a result, the prize pool has increased to $375k for ESL One LA and $335k. This is up from the normal $300k that non-DPC events get.
Fans who had bought tickets should be receiving emails about refunds. ESL One Birmingham will be happening again in the Arena of Birmingham, 2021. If you had a ticket for this event then it will remain valid for next year's event.
ESL One Los Angeles starts on the 28th March and will go until the 19th of April
ESL One Birmingham will be May-June with exact dates to be confirmed.


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Red Bull to the live broadcast the World rally Championship in 2017
Red Bull will broadcast live images of the World rally Championship on its web site and the application from 2017, offering more rally fans the chance to watch next year's series, which takes place free of charge.
Free coverage in great Britain has already been restricted to the highlights of the shows, with live broadcasts only to return a few months ago on Channel 5. However, the shows have been limited to Sunday, of the Power stages.
Red Bull's online broadcasts, which will be available on Redbull.tv or via the Red Bull TV app, it is possible to see live images of the race on Saturday and provide some of the highlights of the shows for the rest of the weekend, giving UK fans access to more live WRC action as this has been available for over a decade.
"It is really exciting that the WRC will be broadcast on Red Bull TV next year," said WRC legend and nine-time world champion, Sébastien Loeb, who is also a Red Bull athlete. "Fans will now have the chance to see the best of the coverage of some of the best motor sport in the world completely free of charge and at a time that suits them."
The new season starts at the Monte Carlo rally in January. The first game of the season will bring a series of new cars to the scene (link below), with less restrictive regulations allowing the car to produce more power and to make use of additional support.
Red Bull first WRC programme will be broadcast at 9 a.m. on Friday, January 20, after the end of the first stage of the Rally of Monte-Carlo. All shows can also be watched on demand on Red Bull TV once they have aired.
Most of the WRC:
2017 Hyundai i20 Coupe WRC revealed
WRC Champion Sébastien Ogier to drive M-Sport Ford Fiesta WRC in 2017
2017 Ford Fiesta WRC M-Sport reveals aspirant to the World rally Championship
Winner of the Dakar, it could lead the Volkswagen Polo WRC in 2017 championship
2017 Citroen C3 WRC Paris concept that will spawn Fiesta ST rival
Co-driver, two-time WRC champion Marcus Grönholm


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By Brendan Rees
A family who were caught up in a Narre Warren South fire on Black Saturday count themselves lucky.
Sue and Geoff Herbert were at a wedding on Saturday 7 February, when a fire tore through their street in Langbourne Drive.
"We were very, very lucky. It came within metre of the actual house," Ms Herbert said.
They praised neighbours, some who stood on roofs, with buckets of water and garden hoses "to save as many houses as they could."
"The good thing was how the community came together…people came from everywhere.
"People were using wheelie bins and everything to try and fight the fires," she said.
At the time, police said the fire, believed to be deliberately lit, started along Coral Drive near Ormond Road at 5pm.
A wind change at 5.42pm, according to a 2009 Victorian Royal Commission Report, caused the fire on Coral Drove to head towards Langbourne Drive.
Houses caught in the blaze on Langbourne Drive were relatively news houses built on suburban-sized blocks positioned very close together.
Ms Herbert says it was "some miracle that the fire apparently swung round in the wind and went back out into the paddocks."
The Herberts lost part of their backyard including their children's cubbyhouse, but others were not so lucky.
"It was very hard, coming home and seeing the devastation of the street, and to know our house was still standing – that took a lot out of us," Ms Herbert said.
"You feel sad in the other sense because others lost theirs."
Allan Appleman was one of the neighbours who fought to save the Herbert's' home.
"We just wanted to thank everyone," Ms Herbert said.
She said her family was still haunted by the devastation of the day 10 years on, adding it was a "big learning curve for us all."
"Every time we have those really strong winds in those really hot days it does bother me a bit.
"We are still living here and we still do get very worried, especially with everything going on at the moment, it gets very scary.
"We're constantly getting onto the council to make sure they keep a fire break which they have been," Ms Herbert said.
"We've educated the kids, we've educated ourselves.
"It's mother-nature, and if it's going to happen, whether there's a fire break or not – it's going to happen."


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$355 3 bed 2 Tia Avenue, High Wycombe WA, 6057
$355 3 bed
2 Tia Avenue, High Wycombe, Perth, 6057
Commute to Downtown Perth
This apartment is in the High Wycombe neighborhood in Perth.
2 Tia Avenue has a Walk Score of 32 out of 100. This location is a Car-Dependent neighborhood so most errands require a car.
This well present 3 bedroom, 1 bathroom corner block home has split system air conditioning in the Open Plan area and a wall air condition in the main bedroom.
Entrance leads you into the Open plan Kitchen/meals/lounge which has polished jarrah floor boards. Modern kitchen with gas benchtop stove and built in electric oven. Loads of cupboard space and a large built in pantry. Glass double doors open up into a games room with tiled floors, venetian blinds and security screens and is of versatile usage.
Main bedroom has wall to wall mirrored built in robe, and ceiling fan. Second bedroom is of good size and also has a ceiling fan. Third bedroom is spacious. Modern style bathroom and toilet combination.
Double roller door garage, shed that needs some tlc and an enclosed side lawn area for the kids to kick the footy.
Pets considered, close to amenities. Time to move in!
Owner/manager tools | Report bad listing | From reiwa.com.au
High Wycombe, Perth, 6057
Most errands require a car.
A few nearby public transportation options.
Explore how far you can travel by car, bus, bike and foot from 2 Tia Avenue.
2 Tia Avenue has some transit which means a few nearby public transportation options.
Bus lines:
0.4 km
0.4 km
0.4 km
0.8 km
0.8 km
View all High Wycombe apartments on a map.
Popular apartment searches include fitness, single family and pool.
2 Tia Avenue is in the High Wycombe neighborhood. High Wycombe is the 198th most walkable neighborhood in Perth with a neighborhood Walk Score of 37.


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A home equity loan or home equity line of credit (HELOC) is often used to make home repairs or remodel a house. They're both a type of second mortgage on a home – with the home as collateral if the borrower defaults – so using a home equity loan on something risky such as starting a business should be done with care.
You can unlock the equity in your home to help finance the purchase of rental property. To do so, you'll need to take out a home equity line of credit (HELOC) or home equity loan on your home.
Fixed-Rate Equity Loans are available for primary residences, second homes and investment properties. Second-home loans and all loans for amounts less than $25,000 require a 1.00% increase in the interest rate and may be subject to other restrictions.
In many cases, homeowners have to borrow the money they need for a project, and most of the time they use a personal loan or a home equity loan. Here's how to decide which option is best for your own.
Getting a home equity line of credit on an investment property isn't easy, but it is possible " if you are in a good financial position and can find a lender willing to issue the loan.. Here's a guide to why you might use this type of equity line, also called a HELOC, on your second home..
Look at a home equity loan as an investment – not as extra cash when making spending decisions. DO: Make home improvements. The safest use of home equity funds is for home improvements that will add to the home's value. If you have a one-time project (e.g., a new roof), then a home equity loan might make sense.
Mortgages and home equity loans are both loans in which you pledge your home as collateral. The bank lends up to 80% of the home's appraised value or the purchase price, whichever is less.
But their traditional financing channel (home equity loans) is increasingly out of reach because fewer. But we also understand that institutional investment is not the right form of capital for.
Type Of Fha Loan No income verification home Loans Does anyone do no income verification mortgages ?? Find answers to this and many other questions on Trulia Voices, a community for you to find and share local information. Get answers, and share your insights and experience.Various Types of FHA Mortgages. If you are interested in acquiring a mortgage loan through the FHA, there are some important facts you should know. The FHA has a wide variety of loans from which you can choose. The FHA allows you to borrow money from a lender, provided your mortgage is insured from default for the first five years.Hud Title 1 Credit Requirements A property owner may apply at any lender (bank, mortgage company, savings and loan association, credit union) that is approved to make Title I loans. Beware of deceptive home improvement contractors. Who To Contact: HUD's Homeownership Centers do not process Title I loans. For more information, please call (800) 767-7468 and request item number.Home Equity Loan On Fha Mortgage The Federal Housing Administration this week released a new version of its reverse mortgage software to account for recent changes to the way it handles loan refinances. version 2.5 of the Home Equity.Where To Get A Fha Loan You can get a home loan with a surprisingly low credit score. fha mortgages have even lower credit standards An "FHA mortgage" refers to a mortgage that is insured by the federal government. In.


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Disclosure : This site contains affiliate links to products. We may receive a commission for purchases made through these links.
14inch to 17inch Circle Y Arkansas Flex2 Trail Gaiter Saddle 1587 ZDSOK
We're proud to be consistently adding to our gaited saddle selection. New from Circle Y_ the Arkansas Trail Gaiter Saddle is designed specifically for your gaited horse. It's proven to fit a wide range of gaited horses. These Gaiter saddles are fashioned to give you horse the freedom of movement and comfort that he needs with his unique gait. Several features provide this: the Flex2 tree_ the shorter_ rounded NeoShock skirts for no gait interference_ and multiple rigging options for freer shoulder movement. The saddle also features Circle Y's impact foam seat_ which absorbs shock and eliminates transference between horse and rider. The Softee leather drastically shortens the inchbreak ininch period for your saddle_ providing a inchready-to-rideinch feel right off the bat. Lastly_ the Ergo-Balance stirrups are designed to place the rider's feet and legs for decreased knee and ankle fatigue and to promote balanced riding. Your gaited horse will prance like never before.
- Color: -1 Walnut_ -4 Regular Oil_ -18 Black
- Seat: – Suede or Grainout
- Tooling: Shell border
- Tree: Trail Gaiter Flex2 Regular or Wide
- Silver: SP Esparagon Edge
- Rigging: 3/4 Dropped
- Swell Width: 13inch
- Cantle Height: 4inch
- Horn Size: 3 1/2inch Neck 2 1/4inch Cap
- Skirt Size: 10inch x 26inch
- Weight: Approximately 23 lbs.
About HorseSaddleShop.com
"Western saddle and boot store. Shipping worldwide and stocking quality saddles, boots, tack and clothing. Friendly expert staff ready to assist you in you purchase of a saddle that fits! Because Quality Still Counts...Horse Saddle Shop, home town experts selling over 23,900 saddles: Click to see our awesomeness" --- HorseSaddleShop.com; More Details


text: Moon 1969: Astronauts Land On Idaho's Craters Of The Moon By Samantha Wright • Jul 17, 2019 Craters of the Moon National Monument Listen Listening... / 11:24 In 1969, sending lunar astronauts to Idaho's Craters of the Moon National Monument seemed like a no brainer. Its barren rock and surreal landscape were good practice for pilots headed to the moon. But it turns out NASA had a bigger goal in mind when it sent astronauts to Idaho. Idaho Matters explores a new documentary about the Gem State's connection to the moon landings. We also take a listen to some of the moon landings — find out more here. On The Wednesday, July 17, 2019 Edition Of Idaho Matters By Samantha Wright • Jul 16, 2019 BLM headquarters moving to Colorado? 1969: Astronauts land on Idaho's Craters of the Moon. Indian Relay at the Fort Hall Reservation. Idaho In Good Position For Super Blue Blood Moon Eclipse By Samantha Wright • Jan 30, 2018 Brian Day / NASA Ames Research Center Idaho is gearing up for a "super blue blood moon" on Wednesday, though the name might be a bit misleading. That's when three celestial events happen all at the same time. Supermoon To Shine Over Idaho Sunday By Samantha Wright • Dec 1, 2017 Bill Ingalls / NASA This Sunday, Idahoans will be treated to a bigger, brighter moon in the evening sky. It's called a supermoon and it only happens once this year. BSU To Hold Lunar Eclipse Watching Party Sunday Night By Samantha Wright • Sep 25, 2015 Elizabeth Haslam / Flickr Sunday night will offer a chance to see the last total lunar eclipse until 2018. This eclipse is special, says Brian Jackson, an astronomer who teaches at Boise State. That's because it will also be what's known as a "Blood Moon."


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Jess O'Callaghan
#1513 Things and Stuff
Apr 4, 2015
Podcast: Play in new windowDo you have too much stuff? Clutter, collections, clothes, books, toys, old stuff, new stuff? This week on All the Best we look at the complicated relationship humans have with the things they own. We meet a woman who left behind all her...
#1444 What Is Cool?
Jan 3, 2015
Podcast: Play in new windowWhat defines "cool"? Is pop music cool? Or vintage vinyl? Is wearing grandma's doily as a reworked cardigan cool? Or is that daggy? What makes something cool, and who decides when its time is over? When you were little, the answers to these...
#1435 In the End
Oct 11, 2014
Podcast: Play in new windowFrank Herbert was an American Science Fiction writer who died in 1986 and he famously said 'There is no real ending. It's just the place where you stop the story.' But that place can be frustrating. You know that feeling of...
#1430 Everyday
Sep 6, 2014
Podcast: Play in new windowThere are some things we do day after day after day. This episode of All the Best is all about those things. We have stories about waking up, going to work, singing quietly on the commute. Stories about the every day things that can make...
#1426 How Are You Still Alive?
Aug 9, 2014
Podcast: Play in new windowToday we're asking: How Are You Still Alive? You'll hear stories of near misses, close shaves and fortunate lives. People who were unlucky, and then lucky. People who throw themselves from high places, and kids who get lost in the...
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Peanut Butter-Loaded Butterfinger Cupcakes
Jillian Hatsumi
Recipe Type:
12 to 14 cupcakes
1 and ½ cups all-purpose flour
¾ teaspoon baking soda
⅛ teaspoon salt
¼ cup unsalted butter, softened
½ cup creamy peanut butter
½ cup granulated sugar
¼ cup brown sugar
1 whole egg
1 egg yolk
1 teaspoon vanilla
1 cup Greek yogurt
¼ cup milk
Click the link above for the recipe.
Make the Cupcakes:
Preheat oven to 350°F. Line a muffin tin with 12 cupcake liners.
In a medium-sized mixing bowl, whisk together the flour, baking soda, and salt; set aside.
In a stand mixer fitted with the paddle attachment, beat the butter, peanut butter, and both sugars together until light and fluffy, about 2 minutes. Add in the egg, egg yolk, and vanilla, mixing until combined. Add the Greek yogurt and milk, and continue beating until fully incorporated. Add the dry ingredients, and mix until just combined.
Evenly distribute batter among cupcake liners, then bake for 20-23* minutes, or until you gently press on the top and it springs back instantly instead of leaving a dent. Allow cupcakes to cool for 15 minutes before transferring to a wire rack to cool completely.
Make the Frosting:
Click the link above for the recipe.
Recipe by
Honest Cooking by Mercato Fabbrica
at https://honestcooking.com/peanut-butter-loaded-butterfinger-cupcakes/


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The Risk Factory is currently closed as per government advice. We will be reviewing the situation in the coming weeks and will update accordingly in due course.
Suggested learning resources for teachers and parents whilst we are closed are available on our Resources page.
The Risk Factory is an interactive safety centre. We manufacture everyday risks in a safe environment and aim to teach people how to deal with or avoid risks altogether. Our aim is to provide high quality, interactive community safety education, which will help to develop pro-active citizenship.
The centre is part funded City of Edinburgh and Midlothian councils. We also have a number of sponsors and partners that support the centre. In 2020/21 we are very grateful for the generous support of SP Energy Networks and the Gas Safe Charity.
The centre has a number of meeting rooms available. We can cater for meetings, conferences and our scenario area provides a unique setting for training. All the profits from our room hires go directly into supporting our education programmes.


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Thais. Age: 26. Treat yourself with a touch of class and make your night an unforgettable pleasure. I would like to be your companion to official engagements, cultural events as well as personal intimate friend for pleasurable and hedonistic hours in private atmosphere.
Камасутра – искусство секса
Камасутра видео, камасутра смотреть бесплатно, камасутра онлайн, Эротические фильмы без цензуры
Maria. Age: 30. Hello dear one! My name is Masha. I am an elegant and sensual, the perfect company to share the best moments of pleasure. I like to seduce my guest and to see it enjoying....Do not doubt it and allow you to surprise.


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Humanizing The Search Index – Becoming An Algorithm
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Trainings, Projects, & Gaming – Fall 2015 Updates & Reflections
Hello internet, it has been a while. I have wanted to do more blogging recently. Yet, I keep running into the issue of starting a post with an awesome idea, but keeping the post in draft form indefinitely because it is not high enough quality or I feel there are pieces missing. I need to interrupt this pattern. … Continue reading Trainings, Projects, & Gaming – Fall 2015 Updates & Reflections
Teaching Digital Scholarship with WordPress on Mobile Devices
Yesterday concluded the first section of my Mobile Blogging & Scholarship Training. This is a professional development workshop series for instructors at the University of Oklahoma, which I created in my role as Educational Technologist at the Center for Teaching Excellence. The Course Over the course of nine hours, six sessions, and two weeks, professors … Continue reading Teaching Digital Scholarship with WordPress on Mobile Devices


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|5 Star Reviews
|4 Star Reviews
|3 Star Reviews
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|1 Star Reviews
|All Reviews
Although they look silver in the picture they are white. A lovely surprise on arrival!
tink | 26/02/19 | Collected by Trustpilot
25 more characters Please write 7 more characters
Charles | 06/01/19 | Collected by Trustpilot
I Purchased this item as a Gift For My Great Nephews Engagement , He Was Really Pleased with it , As I Was with the service/ Delivery .I Would Certainly Use the Company Again .
david chapman | 04/08/17 | Collected by Find Me A Gift
I bought these as an engagement present which I am to attend soon... I was really pleased with the item. To be honest they arrived a lot quicker than I thought too..
Christina Godly | 14/07/17 | Collected by Find Me A Gift
Bought cushions for a couple I know but had no idea what to get them. They were actually better looking than I expected (the cushions, not the couple!) and were packaged nicely. Delivery was fabulously fast as well -brilliant as it was all very last minute!
Jacqueline Gorman | 29/10/15 | Collected by Find Me A Gift


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Rand Paul," the Republican candidate in the US elections in 2016 said that his country should not have been arming the terrorist groups (Al Qaeda – Daash – Al-Nusra Front) in Syria, in response to a question about what America should do if it is proven that group of "Daash " is Behind crash of Russian " Matroyjat" plane in Sinai.
This came in an interview with the station of (CNN) where he continued saying about the US response: "I do not think that there is one way to deal, I said long period ago that we should not arm "extreme jihadist movements" in the world so we should not arm" Al-Qaeda "or" Daash "or" Al-Nusra Front "in Syria. " Daash "in Syria owns US military cars worth of billion dollars and they also have billion dollars pay them for the fighters, so we have made real mistakes in that region."
He added saying: "I'm not an expert with explosives, and I do not have enough details .. but I already said that the real threat to our country comes from abroad and we have to beware of the internal air traffic, but more important thing is that I do not think that the international airports have a degree of security and safety that we have and we must beware of international flights, some of these risks are in the staff who are responsible for bags and luggages, we had some violations earlier in this side compared to those staff in the international airports that do not enjoy degrees of safety that we have them .
Source (( Alalam Channel )).


text: Portable generators have become quite popular among outdoor enthusiasts these days. These machines are great as backup power sources when you have to spend several days outdoors. But there are also many homeowners these days that buy portable generators. In this article, we enumerate the different benefits of using portable generators at home. Portable generators are great... Continue Reading →


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- This topic has 26 replies, 11 voices, and was last updated 4 years ago by Stoner.
- PSA: Samsung 12.1" Chromebook, £106
Morgan computers flyer just hit the inbox. Grade A refurb (I've had 3x refurbs from Morgan computers and all have been perfect). This one even has a 3G SIM slot in it which may be of interest, although I usually tether with 3G/4G phone. £106 delivered (£83 ex VAT)
Mine's ordered an on it's way.
I have 2x samsung series 3, that have been outstanding and taken hideous abuse. This is a sniff bigger.
Posted 4 years ago
I approve of this message.Posted 4 years ago
Seeing as MrsSB has now abandoned the iPad and uses [frustratingly] much presfers to use MY chromebook – I shall probably be snapping up one of these 🙂Posted 4 years ago
Well done Stoner.
PS these are £200 (Brand new though) on Amazon.Posted 4 years ago
OT what is that phone you use/recomend as I need a new one
TaPosted 4 years ago
Jiayu S3 Advanced.
As it happens Ive just placed an order for 2x of those too, from Gearbest (China) for Mrs S and my Bro. £108 each delivered, with risk of additional £30-40 for Duty if it gets intercepted.
Unfortunately they dont have any in stock at the EU warehouse.
There are however other phones at the EU warehouse (Which then dont run the risk of additional duty costs) if you want something delivered faster and with less risks. They have a sale on at the moment for some lower spec android 4.4 handsets which are v good VFM
e.g. http://www.gearbest.com/cell-phones-c_11293/c6_16gb/?odr=low2high&odr_value=1&page_size=36&display=g&24h_ship=f&is_clearance=n&wid=3
these are all in EU, with free shipping.Posted 4 years ago
ta how big can you make the text messages go as i sometimes struggle with the small writingPosted 4 years ago
Ive just switched "Large text" on in the accessibility menu, and all the text has gone Fisher Price sized. You wont have any problems unless you are Mr Magoo 🙂Posted 4 years ago
Much appreciated sir.Posted 4 years ago
Intel Atom and 2GB? Does Chrome work well on that low a spec? I'm curious, but it doesn't seem such good value when you can get an i3 with 4GB and Windows for not much more.Posted 4 years ago
chromeOS is pretty much a base linux kernel.
It works fine on lower spec. 1Gb of RAM is a drag, but two is plenty now theyve sorted out the RAM leaks in chromebrowser.
lower spec = low heat, low power. Ive never had a problem with it.
Anything running windows needs RAM & cpu cycles to carry the massive OS overhead.
And not to mention, you dont have to hang around for 30mins of updates every week either 🙂
aracer – let me lend you a chromebook and try it for yourself.Posted 4 years ago
Hmmmm. I won't be able to put printer drivers onto this would I?
My parents are currently without a laptop and any replacement would need to be able to hook up to their non-wireless printer.
Is there any Android solution for plumbing an 'old' printer up to on of these Chromebooks??Posted 4 years ago
Chromebooks can not serve printing. They use the google servers as print servers if you have a google print ready printer, OR you can use another computer with a Windows or iOS running to act as a print server connected to the printer. But you cant directly connect an old dumb printer to a chromebook.
I changed my printer to a google print ready canon for £30 on ebay.
It means I can print to it, from any of my devices from anywhere.Posted 4 years ago
Cheers Stoner. That's what I thought.
Probably easier to stick to another laptop as they are already relatively familiar with how to use one.
Giving them another 'new fangled device' might make them explode….
I thought the Hudl 2 would be simple enough, but every phone conversation with them ends with 'ooooh, just got a quick question about XYZ on the tablet….'Posted 4 years agoStoner wrote:
chromeOS is pretty much a base linux kernel.
It works fine on lower spec. 1Gb of RAM is a drag, but two is plenty now theyve sorted out the RAM leaks in chromebrowser.
Interesting – though I reckon most of the reason I need more RAM on my Windows machine is Chrome eating it (I'm a bit of a tab monster – current count is 17, though that's probably low for me! – but it clearly still leaks as it works fine for a while). Though I'm also successfully using W7 with only 512MB on a very carefully tuned system. Would be interested to try one sometime, though to be honest I do need a Windows machine for some of the things I regularly use.Posted 4 years ago
my bro has a W10 VM for me on his server that I can get to through Chrome Remote for any weird Windoze stuff I might (very rarely) need to do. I really cant remember the last time I had to use it in anger though.Posted 4 years ago
anyway, PM me, and if you are coming past the Kingdom of W any time soon, drop in and pick up one as a loaner.
IJT and Morgan Computers are one and the same.Posted 4 years ago
i think i bought my 486 dx50 from morgan!Posted 4 years ago
IJT and Morgan Computers are one and the same.
Really? IJT are in Jersey (just a registered office I guess) and Morgan aren't – does that matter?Posted 4 years ago
yes. Zomerzet sister companies.Posted 4 years ago
Stoner, as ever, you are the voice of reason. We should all buy you a pint sometime. I'm amazed at your IT knowledge.Posted 4 years ago
thanks?Posted 4 years ago
I got the Morgan flyer in my inbox too. Tempted to buy my daughter one. I'm a big fan of my chromebook (Toshiba).Posted 4 years ago
Hi Stoner, sorry to jump into your post with a slightly ot question.
Do you think a Chromebook would be a suitable alternative to a laptop for a 12 year old to do homework on, she does not need to print out as all work is saved on a usb stick and she is using google docs anyway?
How safe are they?Posted 4 years ago
Stoner Jr has one of my older chromebooks. You can create a supervised user and review what sites they visit and manage them by whitelist or blacklists. The only annoyances is that supervised users are blocked from installing extensions and can not be permitted to install approved ones. however it won't limit access to Google docs/drive
I have also set the default browser to the kids safe Rex search engine.
YouTube is blocked and I put shortcuts to interesting and appropriate stuff in his bookmarks bar.
I review what sites he visits regularly and if I don't like one I just add to the blacklist.
It's not foolproof and I have put the computer where I can easily see what he's doing. He also knows that if he comes across a site that he doesn't understand or freaks him out, he's not in trouble, just has to tell me.Posted 4 years ago
Mine's arrived, so I'm in from work and an unpack.
Let's start with the negatives.
Bit slow from Morgan Computers there – 7 days since the order was placed.
This unit has the US (English) keyboard. It does say so in the listing, but do be aware that it means that the key layout is very slightly different:
1) 3 has a # on it not a £
2) 2 has a @ on it not a " and
3) there's no € on the 3
you can set the keyboard to UK and Shift+2 gives ", Shift+3 gives £, RightAlt+4 gives € (as opposed to Alt Gr+3) and Shift+' gives @ anyway.
Or leave the OS setting in US, and hunt'n'pick for those few weird ones.
The enter key is one row deep, not two so a little more precision required when mashing the keys for carriage returns.
Have a good rummage in the box, as you'll need to find the UK 3pin lead to replace the weird 2-pin that's in the OEM package.
Now, a major booboo was on launching, I got the "Chrome OS is missing or damaged" error screen. That's a new one on me.
However, the recovery process is painless, but does require another computer running Chrome Browser and a USB stick to create the recovery media. This is a stage either missing from the factory refurb process (poss overlooked and accidental) or was done as a matter of course and not informed of. It's really a simple process to recover the OS so dont freak out if yours comes without the OS installed, but it's naughty of Morgan computers to let these go out like that. However, as I say, maybe mine was a mistake. It didnt faze me though. I'd be interested to see if others have the same event.
(go here if you need to do the recovery and follow instructions https://support.google.com/chromebook/answer/1080595?hl=en-GB&source=genius-rts )
So on to the good.
Wow, perfect condition. It really is box fresh. Obviously had a quick wipe over with a cleaner probably as a matter of course, but not a single scratch, speck of dust or mark suggesting previous use.
2x USB ports, one open, the other with a dust guard and micro HDMI output. An SD slot at the front, and of course the SIM slot. Looks like a fullsize. An IMEI sticker on the bottom, next to which I see a s/n sticker with a Jun-2011 manufacturing date on it, so a reminder again that these are relatively old stock.
However, the OS updated straight away to a stable channel 47 version which is a Jan-2016 release.
Once the OS had sync'd all my stuff, it's unexpectedly slick. It certainly seems to tick over better than my HP11, and no noticeable difference when compared to my 2013 Series 3 Samsung.
Oddly though, it produces a very low Octane benchmark score (a javascript benchmark suite) when compared to my other chromebooks/box. I have no idea why, as it really runs very slickly indeed – and I dont think it's just a confirmation bias by me.
Asus 4GB Celeron 1.4Ghz Chromebox: 13,526
My sooperdooper chrome desktop, with extra RAM
Samsung Series 3 2Gb 1.7Ghz Chrombook: 6,043
HP11 2Gb 1.7Ghz Chromebook: 7,360
Samsung Series 5 2Gb 1.66Ghz Chromebook: 3,850 😯
The new one
I havent tried any heavy lifting on it yet, like watching HD, but since it's not really what I use it for, I doubt I'll ever find out what the low benchmark means day-to-day.
In summary, a few niggles from the supplier side, and the keyboard will take all of 5mins getting used, but I'm happy that this is destined to have an abusive relationship with me/my rucksack/the kitchen over hopefully at least the 3yrs that it's £120 predecessor has suffered. At a very reasonable 11 pence per day of computing, and falling.Posted 4 years ago
The topic 'PSA: Samsung 12.1" Chromebook, £106' is closed to new replies.


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De Smet City Parks
Monday, October 17, 2016
You don't have to be a medical doctor to know that there are countless physical benefits involved with getting outdoor activity. What is less known is that that outdoor activity can have positive effects on mental health as well. According to an article in the Harvard Health Letter, the physical and mental benefits of outdoor activity include disease prevention, improved mood, improved concentration and faster healing.
There's no shortage of places in De Smet to get some outdoor activity. There are three city parks, each with slightly different offerings. Here's a look at what they have to offer:
Washington Park
This park is the largest of the three. It offers picnic shelters, sand volleyball and horseshoe pits. There's also RV and tent camping available in this park with electricity, water and a bathhouse with warm water showers!
Rose Vincent Memorial Park
This park has a slightly different focus. Here you'll find a basketball court, playground equipment and peaceful areas for picnicking. For those who've caught the "disc golf bug", there's also a disc golf course.
4-H Park & County Fairgrounds
Located near the Kingsbury County Fairgrounds and starting point of the Laura Ingalls Wilder tour, this smaller city park has playground equipment and a picnic shelter. There's also a building on the grounds for social get-togethers.
There are a lot of options for outdoor activities in De Smet. All you have to do is choose the one that suits your needs! For camping rates and additional information on De Smet city parks, call 605-854-3731 or click on this link.
Category: (none)


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Matthew's gospel contains the only reference—inside or outside the Bible—to the massacre of the innocents, Herod's killing of all the baby boys two years and younger in Bethlehem and its environs.
So, was it all a Christian invention to gain sympathy for their founder? Was Herod even capable of such a cruel act? Following is a very lightly edited transcript of an interview of historian Paul Maier (one of whose novels I loved). The interview was conducted by Tony Reinke for one of Desiring God's podcasts, Authors On The Line.
Tony Reinke: Tell us more about the character we find embedded in the Christmas story, this man we know as Herod.
Paul Maier: Well, Tony, you may be surprised to hear this, but believe it or not, if you're ever asked which is the one figure from the ancient world on whom we have more primary evidence from original sources than anyone else in the world, the answer is not Jesus or St Paul or Caesar Augustus or Julius Caesar—none of those… Not Alexander the Great, no, no. It's Herod the Great, believe it or not. Why? Because Josephus gives us two whole book scrolls on the life of Herod the Great, and that's more primary material than anyone else. And I don't think Herod deserved it. [Laughter]
He was a very remarkably successful politician, keeping the peace between Rome which had conquered Judea in 63 BC. And he acted simply as a Roman governor overseas. He was simply known as a 'client king'. Meaning, very often when the Romans conquered a province and they didn't want to send a governor out, and there was a local king doing a good enough job… And so, yes, he may be called 'king' but he was definitely deferent to Rome for his whole administration.
In 40 BC he was awarded the title king. He didn't actually take control of the land until with Roman help he drove some adversaries out of Jerusalem. From about 37 BC on he's in charge until his death in 4 BC.
Actually he was remarkably successful in a lot of ways. He deserves the title 'Herod the Great' if we talk about his accomplishments for much of his life. He was the one who rebuilt the great temple in Jerusalem. He was the one who single-handedly created the city of Caesarea: where there was no good port in the Holy Land, he creates one by sinking some ship hulls and then using them as a base to build a breakwater in an otherwise rectilinear sea coast. He built Caesarea in 12 years, and he built other cities like that too. In Jerusalem he face-lifted the entire city in addition to building a gorgeous palace for himself. He had a hippodrome, a stadium, theatres and this kind of thing. He was kind of a Hellenistic monarch.
And he also built seven great fortresses across the land, strong points at which he could defend his administration. One, the most famous, was Masada, down along the south-west corner of the Dead Sea. Everything he touched diplomatically seemed to turn to gold. He kept peace both with Jerusalem and Rome, and that says he was very successful.
Reinke: There's another side to Herod. Tell us a little bit about the paranoid side of Herod that begins to emerge later in his life.
Maier: Well, basically, he was responsible for many of the problems back home. His home was a can of worms, simply because he married 10 wives and each of those produced princes for him and each of those male princes was scheming to succeed as number one. And there can only be one number one. And so if there weren't two or three collateral plots taking place before they had orange juice in the morning, you knew something was wrong.
Josephus gives a hideous tale of what was going on in the family: attempted poisonings, one brother against another. It so rattled Herod that he actually put to death 3 of his own sons on suspicion of treason. He put to death his favourite wife out of the 10 of them. Mariamne was his favourite, she was a Hasmonean Maccabean princess and he put her to death then he killed his mother-in-law—I should have said one of his many mothers-in-law. He invited the High Priest down to Jericho for a swim. They played a very rough game of water polo and they drowned him. He killed several uncles, a couple of cousins… A fellow said he's a real family man—in that negative respect.
As a matter of fact, Augustus himself, to whom Herod was always very deferent, said, "I would rather be Herod's pig than his son." It's a double pun. In Greek it's suos and huios—a clever turn on words. The other idea is that at least pigs weren't slaughtered for human consumption over there, and they had a better chance of a longer life. And so it's a brilliant pun on the part of Augustus.
Reinke: At one point late in his life, Herod plots to kill a stadium full of Jewish leaders. The plot ultimately failed, it doesn't pan out. But explain that episode from his life and why he did this.
Maier: Well, Josephus says here a very grisly thing to report about Herod in his last months. He was so paranoid that he … Of course, he did have some grasp of reality, for instance he was worried that nobody would mourn his own death in the Holy Land, which shows how deadly accurate he was. [Laughter] They were preparing general celebrations. And nobody likes to die knowing that they're going to dance in their grave. And so he was going to give the people something to cry about.
It's in 4 BC, he's down in his winter palace in Jericho—it's the only place in the Holy Land that doesn't snow or get cold in the winter, it's 1200 feet below sea level. Herod is dying and he tries every remedy in the world to stop the gang of diseases that were creeping up on him. He went to the hot springs at [unclear name] at the north-eastern corner of the Dead Sea—by the way they're still springing hot water 2,000 years later—and that didn't cure him. And so now he goes back to his winter palace and he invites his sister Salome in and he says, "I want you to arrest all the Jewish leaders in the land and imprison them in the hippodrome just below the palace here." And that hippodrome has been discovered archaeologically, by the way. And so she does and then she says, "Brother, why am I doing this?" And Herod says, "Well, I know that when I die the Jews are going to rejoice, so let me give them something to cry about." And so he wants them all executed in that hippodrome so that there will be thousands of households weeping at the time Herod the Great dies.
So is that the kind of a sweet guy who could have killed the babies in Bethlehem? Yeah, I think so.
Reinke: Speaking of Matthew 2, the Bible records a scene from Herod's paranoia late in his life. The wise men, of course, alert him to the birth of the new king in Bethlehem. They don't then return to him and Herod eventually slaughters all the boys that are two years old and under in Bethlehem and in all the region.
For all that Josephus wrote about Herod, he doesn't mention this. In fact there's no extra-biblical evidence that this event even happened. How do you respond to that claim? Is the slaughter of the innocents historically reliable?
Maier: It's interesting. Josephus does not mention it, and therefore a lot of biblical critics will pounce on that aspect of the nativity account and say therefore it didn't happen. Now please understand this is an argument from silence, and that's the weakest form of argumentation you could use. As we say in the profession, "Absence of evidence is not evidence of absence."
And in this case, one or two things could have happened. Josephus may have heard about it and not used it. Because you don't have hundreds of babies killed; you only have about 12, as a matter of fact—12 or 15. The infant mortality in the ancient world was so huge anyway, that this is really not going to impress a reader too much, believe it or not. And I think Josephus is choosing between the two stories about how Herod dies and right before his death. I think I would take the one where he's going to slaughter hundreds of Jewish leaders. Or he may not have heard about it. Again, simply because little Bethlehem didn't amount to much. A little village of 1500 or so. We did an actuarial study of Bethlehem at the time. You wouldn't have more than about 2 dozen babies two years old and under, half of them the wrong sex. And so this is not a big deal, and I think that's why Josephus either never heard about it or didn't feel it important enough to record. So this does not militate against Matthew's version by any means.
In fact I was arguing once, years ago, on the infant massacre with a professor in Wagner College in New York who claimed that this is all fiction, and that surely a massacre of hundreds of Jewish boy babies would have come to the attention… I agree it would have if there had been hundreds. It couldn't possibly be the case.
And 'all the coasts thereof'… Well, look, Jerusalem is 5 miles away. So therefore this would include Jerusalem as well if we're going to take literally 'all the coasts thereof'. We're talking about Bethlehem and probably a half mile around when we're talking about the surroundings of Bethlehem.
Reinke: As a historian, is there any doubt in your mind about the historicity of the slaughter of the innocents?
Maier: I see not one iota of evidence that it could not have happened. And therefore, again, there's no reason to doubt the account as far as I'm concerned. To be sure, Luke hasn't heard about it. Remember, Matthew and Luke don't copy from one another when it comes to the nativity. And that's good, because this way they can hit it from different angles.
I think it really happened, and let's remember again that the first martyr of Christianity was not Stephen, it was Jesus, but not even Jesus… For my money the first martyr in Christian church was the first baby that was killed in Bethlehem, and we always overlook that.


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Congressmen Raise Concern About U.S. Role in Bombing Campaign
Since Saudi Arabia initiated its air campaign began in Yemen last March, the United States has announced $8.3 billion in new, major arms deals between Washington and Riyadh.
On the Hill, however, concerns are growing over the U.S. role in a crisis that has claimed the lives of over 2,100 civilians with no military solution in sight.
On October 14th, Representatives Debbie Dingell (MI), Keith Ellison (MN), Ted Lieu (CA), and 10 additional congressman sent a letter to President Obama urging his administration to "work to the fullest extent possible" to limit civilian casualties in Yemen and to strive towards a diplomatic solution to the conflict.
The utilization of U.S. weaponry and intelligence in an increasingly volatile campaign serves as the impetus for the letter. Citing the recent two deadly strikes on wedding parties that killed over 150 civilians, the representatives echo Amnesty International's claim that the "vast majority" of civilian deaths and injuries in the seven-month-old conflict are attributed to the Saudi-led coalition.
They maintain that U.S. support to the coalition is significant and undeniable, writing, "Secretary of Defense Ash Carter has acknowledged the United States is providing the Saudi-led coalition with intelligence, surveillance, reconnaissance, and logistics information, as well as resupply of equipment and munitions."
The congressmen stress the need to take extra precaution in the campaign to minimize such casualties: "When U.S. weapons and intelligence are utilized, the decision to conduct an airstrike [in Yemen] should correspond to the standards that would apply to any U.S. military operation for limiting civilian casualties and collateral damage." In fact, it is U.S. policy to refrain from providing arms when the United States has knowledge that the weapons will be used in "attacks directed against civilian objects and civilians."
As thousands of refugees flee the country every day, the letter cites the concerns of UN Secretary General Ban Ki Moon and his position that there is no military solution to the conflict. "With reports of the Houthi rebel leaders now open to possible UN negotiations, we urge you to continue all diplomatic efforts," the letter concludes, giving credit to the Obama administration's efforts to engage in negotiations thus far.
While their letter is critical of the Saudi-led campaign, the representatives underscore their support for UN Resolution 2216, which demands all parties in Yemen, in particular the Houthis, immediately and unconditionally end violence.
All of these issues will be discussed in more detail at upcoming Security Assistance Monitor and Forum on the Arms Trade briefing at the Stimson Center on October 20. The event is titled "Crisis in Yemen - Humanitarian and Security Consequences of Military Support to the Region."
Leah Schulz is an intern with Security Assistance Monitor specializing on the Middle East and North Africa.


text: https://www.usatoday.com/story/news...mmigration-green-cards-immigrants/2204107002/ Steven Camarota, the director of research for the Center for Immigration Studies, did his own analysis of the green card population and found that 63 percent of households headed by a noncitizen used at least one welfare program, compared to 35 percent of households headed by a native-born citizen. That's why the center supports the new public charge rule, and other measures to shift the U.S. from a primarily family-based immigration system to a merit-based one. "Either we select future immigrants unlikely to need welfare by emphasizing skills and education, or we accept the welfare burden that comes from our current immigration system," Camarota said. looks like it might be harder for immigrants to get a green card if they are getting public assistance. i think this is a good change.


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What's the quality of your statements to the Universe?
Can we go there?
A little beyond the academic realm.
To where your wisdom resides.
Which, I've found,
takes all that they tell us is TRUTH,
you know,
research shows this to be so,
and blows it to hell!
It's no wonder that most Alphas find themselves to be lone wolves.
What we experience through our willingness to question and experiment with,
is so challenging to the collective unconscious,
the collective conscious,
the only way to hold on to the last threads of their sanity,
is to call us crazy.
Bring that white jacket Baby,
I look pretty spectacular in any colour 😉
You've heard me talk about vibration before.
That everything and everyone is vibrating on various levels,
from low as mud,
to high as a kite,
and everything in-between.
As I went through my Pranic training,
I was taught to see and feel energy.
High vibrational energy moves fast,
it shines,
it feels stimulating and exciting.
Low vibrational energy is sluggish,
it's dull,
it feels heavy and thick.
High vibrational energy has me shaking my arse.
Shoulders back,
chest proud,
tummy taught,
face smiling.
Low vibrational energy has me sitting,
shoulders slumped over,
head hanging,
tummy portruding.
Look at your posture right now – which one is reflected back to you?
High vibrational food feels light,
regardless of how much I eat,
and since the nourishment value is so high,
my body desires less as she has received sufficient energy to thrive.
Low vibrational food feels heavy,
you might call it comfort food,
comforting the ache in your heart which you try and fill through your tummy.
It's addictive AF which has you over-eating every meal.
Even though your tummy wants to explode,
there's no nourishment and your body is STARVING.
Look at your last meal – which one is reflected back to you?
High vibrational clothes caress my skin,
like my lover's touch,
it's sensual and sexy.
High vibrational clothes accentuate the beauty of my shape,
and I feel like a rock star strutting into any room.
Low vibrational clothes feels scratchy,
like when that greasy man touches your arm.
It hides my shape as though I have something to be ashamed of.
It normally hangs in all the wrong places,
obscuring who I am so that I can just melt into the background.
Look at what you're wearing right now – which one is reflected back to you?
Including your underwear.
High vibrational thinking is focussed on MORE.
How do I serve more?
How do I create more value?
How do I have more fun?
How do I take this to the next level?
It's solution and expansive in nature.
Low vibrational thinking is fear based.
It's focused on me and my problems.
It sees obstacles to every solution.
It's like a soap-opera.
OMG the DRAMAAAAAAA.
It has me feeling like a victim.
It has me thinking that I'm screwed over.
What are you thinking right now – is it solution or problem focussed?
High vibrational company leaves me stimulated.
It's a coming together of inquisitive minds,
all open to provocative conversation and new ways of thinking.
I feel completely present,
and I love the free exchange of ideas, questions and introspective silence.
Low vibrational conversations is a waste of my fucking time.
They basically have nothing to say.
There's no presence.
People desperately trying to fill the silence born out of loneliness, with mindless chatter that might as well never have taken place as I leave the conversation the same as I came into it.
Think about the last conversation you partook in – which one is reflected back to you?
I'm often accused of being rude and abrupt,
always by those with meaningless words,
not understanding that EVERYTHING matters.
Your choice of vibration is your statement of quality to the Universe.
It says who you are choosing to be every minute of every day.
Your choice of food, clothes, conversations, company, thoughts, everything,
proclaims to all and sundry that you're a person of high vibration or low vibration.
Understanding that you will attract MORE of that,
as that is your choice.
There's no judgement,
Free Will Cupcake.
I'm just wondering if you're proud of who you are choosing to be?
I'm wondering if you're happy with your life choices?
For the longest time I tried to convince myself that it didn't matter.
That since I am a naturally positive, uplifted, high vibe person,
I could afford to surround myself with those who choose to live on a low frequency.
I told myself that I could afford to entertain those who simply wanted a little of my time,
nodding my head amicably whilst being bored out of my mind.
I thought that since my body was athletic, gorgeous, fit and healthy,
it wouldn't matter if I wore granny panties and old track-suites.
I was WRONG!
It wasn't until I became unavailable for low vibrational ANYTHING,
that my life transformed into one of pride, satisfaction and liberated joy.
I threw out those panties and went commando until I could afford satin and lace.
I left the toxic relationships,
I stopped wasting my time with time-wasters,
I became unavailable for anything that brought my energy down,
and I started DANCING WAY MORE!
I started taking fewer actions,
ensuring that every action I take is of high quality,
which not only meant more time availability,
but way better results,
more energy,
more creativity,
more thrive!
This is what matters!
If you're feeling tired,
taking action from dawn to dusk and still only receiving mediocre results,
Read this article again,
from the top,
and pay attention.
Where are you currently saturated with lower vibrational energy?
Is it your food?
Your clothes?
The company you keep?
Your conversations?
Your thoughts?
Sort out that FIRST.
From THERE you ONLY take quality action
and watch what happens.
This is the way of the Alpha Darling.
Only death is inevitable.
Thriving is the choice of those who choose high vibrational living.
Live with honour,
PS: Twice a year I open my calendar for driven achievers to lock in their goals, ensuring they have their best year ever!
This is one of those times.
You will walk away with:
* Your SMART goals to ensure transformation and real life impact
* Aligned values that support your desires thereby ending self-sabotaging behaviour
* Obliterated blocks and BS
* Your success avatar ensuring aligned action for FAST results.
90 minutes with Anel moved me forward on many many levels. She cuts straight to the point and doesn't mince words. It is always a firm but gentle kick in the ass!
She has the ability to get straight to the heart of the issue and ask the right questions to cause you to resolve them quickly and clearly. Far more valuable than the cost!!"
- Traci Johnson, TraciJohnson.com
Limited spaces available at https://anelbester.as.me/goals and ONLY for the month of June.
Book if you're willing to play full out!


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In the historic center of San Juan del Río there is OYO Hotel Posada Laura, a simple and modest lodging near the base and traditional restaurants in the area such as Casa Gabriel.
Its very central location allows you to walk to different parts of the center.
The rooms are simple, clean and have free Wi-Fi, private bathroom and TV.
A 10 minute walk from la parroquia de San Juan Bautista, the Santuario of Nuestra Señora de Guadalupe and Plaza Fundadores. The famous Parque de los Guzmán is 20 minutes by car. The bus station is 20 minutes away by car and Queretaro International Airport is 33.6 km away.


text:
- Alumni Groups
- Interpersonal Skills Development
- Employment Assistance
- Safe & Confidential - Call 24/7
- Most Insurances Accepted
- Get the Facts
Didi Hirsch Via Avanta Residential Center4 (2 reviews) ADD YOUR REVIEW
Paying for Treatment
- Insurance is Accepted
- Financing is not Available
- Medicare is not Accepted
- Medicaid is not Accepted
Treatment Insights
Didi Hirsch's Via Avanta is a residential treatment facility for chemically dependent women and mothers struggling with addiction, psychiatric disorders, domestic violence, and poverty. Clients receive primary medical care, HIV testing, prenatal education, legal assistance, vocational training, employment assistance, and housing placement. Addiction services provided include 12-Step resources, addiction counseling, group support networks, specialized psychiatric care for adults and children, meditation, fitness facilities, and yoga. Parenting classes and family therapy sessions are provided as well.
Didi Hirsch Via Avanta Residential Center Reviews and Ratings Details
The following is based on a combination of Surveys of Alumni, Staff, Loved Ones, and Reviews and Ratings from around the web.
Reviews at a Glance
- 12-Step
The term "12 Step Program" describes a way to recover from addiction that is based on the model developed by Alcoholics Anonymous. Many drug and alcohol treatment centers base their treatment on 12 steps – the first three of which are situational, the next four addressing the practical issues created by the addiction, followed by two steps focused on making amends for hurting others. Steps 10 and 11 involve a deeper examination of the previous steps and the final step is focused on helping others avoid and recover from addiction.
- Family Program
Research shows that the odds of successful, sustained recovery from addiction are far higher when family members and loved ones are involved in treatment. Drug and alcohol addiction often have genetic roots, whether related to substance abuse, mental illness or both. Family dynamics also play a role and, often, family members are the first to realize a loved one has developed an addiction. Also, it's important for family members to understand and embrace the lifestyle changes that are required to sustain recovery.
About the AAC Helpline
American Addiction Centers (AAC) is the leading provider for addiction treatment nationwide, specializing in evidence-based treatment and mental healthcare. With 9 locations across the U.S., AAC has a facility near you that is ready to help you start your journey to sobriety today.
When you call the helpline displayed on Recovery.org, you will be connected with a caring admissions navigator to discuss your options for treatment. Our representatives work solely for AAC and will discuss whether an AAC facility may be an option for you.
Our helpline is offered at no cost to you and with no obligation to enter into treatment. Neither Recovery.org nor AAC receives any commission or other fee that is dependent upon which treatment provider a visitor may ultimately choose.
For more information, visit americanaddictioncenters.org.


text:
Guy Ritchie interviewed at Wembley
More live updates from our friends at Wembley Stadium.
A few minutes ago Guy Ritchie was interviewed by Edith Bowmen and M has arrived at Wembley.
Highlights of the show so far have been Genesis, the Black Eyed Peas who made an extensive use of the stage catwalk, Duran Duran and Red Hot Chili Peppers.
We all can't wait for Madonna!
Thanks to Sharon