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GPs vote against increased access in general practice
Introducing weekend and evening opening hours in general practice will be harmful to patients, GPs at the Pulse Live event in Manchester said today.
Following the Big Debate at the conference this morning, headlined 'Access: is it harmful?', the majority of delegates concluded that the funding for extending access could be better spent on other services, while local leaders expressed concern that pilots will not be able to reduce demand on secondary care.
The Government has made moves towards extended access, including providing £50m central funding to GP practices across England.
But this vote follows similar expressions of disapproval from the profession, including a Pulse survey earlier this year - which found that 58% of GPs said it will harm patient care - and the LMCs conference, which voted against extending access, even if it were properly resourced.
Speaking against increased access, Manchester LMC honorary secretary Dr Tracey Vell argued that the Greater Manchester seven-day access scheme - previously reported on by Pulse - was not a good use of resource.
She said: 'In Manchester there is extended access 6pm-8pm every night at a remote practice, it is not held at your own practice and it is with a GP who is not your GP. It also occurs three hours on the weekend on Saturday and Sunday. This costs almost £500,000 for six months.'
'The access is for a pre-booked, routine appointment with a GP. This means they don't have access to any investigation, but they do have access to your notes, which you give consent to merely by arriving there at your pre-booked appointment.'
She said there were already services that are aimed at reducing admissions.
Related stories
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Analysis: PM pushes GP access to its limits
Pulse Live Manchester 2014: Follow Pulse's live Twitter feed from the conference
Dr Vell added: 'If GP access on remote sites away from the hospital could reduce visitors to A&E departments then walk-in centres and out-of-hours services surely would already have achieved it.'
'In Manchester we spend on all three things at the same time: we spend on out of hours, we spend on extended access, and we also nationally spend on NHS 111. A waste of money and resource when we are not looking at the questions of why people are visiting A&E.'
In favour, John Boyington, a lay non-executive director at a GP federation in Bury, which has provided seven-day access under the Greater Manchester scheme, said that there was already 6% fewer attendances with minor illness at the local A&E, according to figures for the first few months of the scheme.
He said that access should not be 'designed to fit one-size-fits-all'.
Mr Boyington added: 'At the moment, people access a range of services when they can't access their GP in what they consider to be a timely manner. There is a debate about need versus want but we should put such a clear delineation because at the end of the day it is always the patient who develops the first view about whether they need a service.'
'All that happens if you [restrict access] is people take their demand elsewhere.'
Meanwhile, Londonwide LMCs chief executive Dr Michelle Drage said she was 'on the fence', but added: 'If you did have the resources and you were able to provide a service where patients have coordinated care as they go through the service, then of course access to that level of service would be great - [but] the reality is we don't have them.'
Readers' comments (7)
I think the word 'demand' should be rephrased as 'false expectation ':
Clearly, we are talking about having 'A GP ' available 7 days a week for that time period. But the false expectation created in the public(facilitated by the media) can be easily ' your GP available for 7 days' .
After all , what is the bl**dy hell difference between this and a modified/improved version of currently existing out of hour service with the appropriate funding.
Don't give me that crap that we need to try different 'model' to meet the local needs!!!
Not for the first time Dr Vell hasn't quite understood the extended hours scheme in Central Manchester, nor portrayed it accurately. It is part of a system wide range of changes to reduce hospital activity and get people to attend for urgent care problems in Primary care rather than go to A&E. It also provides extra capacity to manage long term conditions.
She is right to say that at the moment there isn't access to the full range of Primary Care, including diagnostics, but that will come as the service becomes embedded. Soon A&E will be able to book in, and ultimately the patient themselves.
She also chooses to ignore the evidence that increasingly suggests that quality outcomes are associated with better access (1). Poor outcomes are also associated with less good access including attendance at A&E (2) and acute presentations of cancer (3). She will know from our own experience in Manchester that better pro-active management of long term conditions also reduces unnecessary admissions. This requires better access to expert advice within the practice, both in terms of holistic care and medicines optimisation, but also prompt access to advice and intervention before people become so ill as to need admission.
The system wide changes, including extended hours, in Central Manchester has been associated with a reduction in urgent care demand which bucks the trend elsewhere. Compared to the same time last year we have seen a 27% ↓ in Primary Care stream at weekends; 38% ↓ in Primary care stream Mon-Friday; 50% reduction in people attending 'because they couldn't get an appointment with the GP'. 95% of population is covered by practices agreeing to be measured by the responsiveness standards, 99% of people in those practices receiving care according to clinically assessed need. There has been a >20% reduction in costs and activity for those managed through integrated care teams. Whole population has access to 8-8 during the week and 3hrs on Saturday & Sunday, well except patients at her own practice. It seems to me strange that she would prefer her patients to be seen by a junior doctor in A&E who does not have the benefit of viewing the patient's notes, than be seen locally by a local GP who can view the patient records and enter the consultation within those records.
Now, the extended hours service isn't perfect, and there are many adjustments being made to improve cost effectiveness and better match demand to capacity. It has only been going for 6 months and there has been an uptake phase. I don't believe we will see the full benefit until it has been going for at least a year, and after it begins to provide full Primary care. Meanwhile, has anyone got any better ideas?
1. Raleigh V, Frosini F Improving GP services in England: exploring the association between quality of¬ care and the experience of patients. The Kings Fund, November 2012
2. Cowling TE, Cecil EV, Soljak MA, Lee JT, Millett C, et al. (2013) Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study. PLoS ONE 8(6): e66699. doi:10.1371/journal.pone.0066699
3. Bottle A, Tsang C, Parsons C, Majeed A, Soljak M, Aylin P (2012). 'Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study'. British Journal of Cancer, advance online publication, 24 July. doi:10.1038/bjc.2012.320.
Yes, there is some emergency demand best dealt with in primary care, but no, spending huge sums on prebooked routine appts out of hours is a waste of scarce resources. Access to notes is one thing, but it is NOT relationship continuity and the literature shows that this is the driver of better quality and lower resource use, elective and emergency.
I think it's about getting the balance right and getting the planned and urgent care capacity to fit the demand. The literature is a bit equivocal, actually, on the benefit of relationship continuity, but on balance it is obviously a good thing. However, some trade access for continuity depending on the situation. Timelness is often chosen over continuity for urgent problems, especially for children. Continuity is preferred for the elderly, people with longterm or emotional issues, and women.
Continuity however, risks collusion with the patient e.g. sickness behaviour and other pathological relationships (see Eric Berne 'Games people play')
On the whole I don't think it's a choice between access or relationship continuity, it's having both for the right occasion. Besides, you can't have continuity without access!
Almost all patients seen in OOH settings never needed to be seen or could easily have been dealt with in own practices - in normal working hours.
There needs to be a convenience charge to stop people just popping in after work as they see it as a 24hr market culture.
Banks don't open usually outside 9-5 though online resources and call centres may help - just like OOH advice lines and NHS direct website for guiding those in real need what they should do.
GP surgeries are small businesses as well as care providers, and primary care needs resources if you are going to push boundaries.
However this needs to be costed in a shrinking financial environment and is this really cost effective use of resources and manpower.
Only Accidents and Emergencies should be going to A&E - redirect all else to Primary care in/out hours.
Without funding you just thin out the numbers over more hours. this just makes life more miserable unless there are enough GPs out there to fill in. Build another lane on the M25 traffic congestion eases for a few months, more people use the service and it backs up again. Same in GP land. Extending hours did not lessen in hours demand, just made me increase hours to 50 or so and be exceptionally grumpy when consulting on extended hours days and missing my kids sports on Saturday morning and not getting a lay-in.
All part of recover from a tough working week!
Without funding you just thin out the numbers over more hours. this just makes life more miserable unless there are enough GPs out there to fill in. Build another lane on the M25 traffic congestion eases for a few months, more people use the service and it backs up again. Same in GP land. Extending hours did not lessen in hours demand, just made me increase hours to 50 or so and be exceptionally grumpy when consulting on extended hours days and missing my kids sports on Saturday morning and not getting a lay-in.
All part of recover from a tough working week!


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I know in various parts of the world true strike anywhere matches can be hard, or near impossible to get hold of. So in this project I wanted to show you how to make the ultimate light anywhere match. As always I put in a lot of groundwork and testing and I hope you like the results, maybe you can contribute if you have good results with a particular brand of matches or ring caps on my facebook page and share the knowledge. The following information tells you how to do this project, it doesn't mean you should though.
How to make a strike anywhere match
To build one of these highly volatile extreme light anywhere matches you only really need two components. A match of your choice, and some simple ring caps, like the ones used in a child's toy gun. I tried a few different build techniques and found this one gave the most reliable results.
- The first step is to carefully remove the paper from the open end of the ring cap and squeeze the powder out onto a tray. For each extreme match you will require enough powder to roughly fill a ¼ of an empty cap. So if your caps do not have this much in them you may need to remove the powder from another ring cap. Squeeze gently. I recommend pliers of some sort in case the cap goes off and burns your fingers. Never ever empty more that one ring caps worth of powder at a time, in case of an explosion – The powder is friction, impact, and flame sensitive, so safety glasses should be worn.
- Dip the very tip of your chosen match into some water twice and deposit both drips of water into the powder and stir until mixed into a slurry. Put this slurry onto the tip of a gloved finger and roll the match in it, then try and create separate lumps on the surface of the match head. I say use gloves because we cannot be 100% sure what is in the matches or the ring cap powder. (I don't on the video because I cannot operate cameras with gloved hands)
- Support the head of the match while it drys, and place it somewhere safe away from heat, possible knocks and anything flammable. When dry it will be volatile.
Best matches for this project
I got all my matches to work, but some were more sensitive than others. I used Diamond Greenlight for the project, and if you live the USA these where amongst the best safety matches (strike on box only) I could find. In the UK 'Cooks matches' were a reasonable substitute, but not as quite as good. If you dont mind cheating slightly and want to use already strike anywhere matches, Swan vesta and Bluebell work quite well. If you find a good match for this project let me know on the facebook page.
Ring caps
For testing I used Super disc, Sure Shot and Ammo King, and all worked well… However Super Disc did seem to ignite easiest, but it didn't have as much powder as the Ammo king brand, which was very hard to source. Never make a large pile of this powder, wear safety glasses, protect your ears.
Flick start trick match
As you have seen in the video above, all it takes at this point is a flick of the fingers or rubbing the match on most rough surfaces for it to burst into flames. Some of the places I have lit these include on wood, the surface of an egg, brick, stone, paper, my thumb, my face (hurt), the bottom of shoes, and a wall, to name but a few. While this may be great fun, it does leave us with a match too dangerous to store or use, apart really from using it as a trick match or curiosity. It needed more work.
Survival or Camping match
It seemed to me that this had the basics of making a fantastic survival or camping match if we could just stabilise the match and make it waterproof. After trying a couple of things, nail varnish was far the best. Not only did this dull the dangerous impact sensitive nature of the match, but rendered the tip waterproof too, bonus. Under normal conditions of dampness I was still able to strike the match on most rough surfaces like brick or rock, but not paper or anything silly.
Waterproof match
The next obvious step was to coat the whole match in varnish, and after a nice thick coat from tip to tip, once dry they performed very well. After placing them fully submerged in a bowl of water and the kitchen sink I could remove a match, shake off excess water and they would still light, often on the first attempt. In fact I found them superior to some expensive specialist waterproof camping matches bought from eBay. This is the sort D.I.Y. survival match I think Bear Grylls would like.
Best matches for camping
I think there is still more I could do with this match to make it even better for the sort of abuse that is required on camping trips, and I have a few ideas under my belt to pimp these simple matches out further still. So while this build may not be 'perfect', and there is room for improvement, if you're looking for the best DIY strike anywhere match this has the basis of a very good start.
The above project is for consenting adults only and is for education or entertainment only.
Matches are by nature dangerous. Strike anywhere matches are even more dangerous. The extreme strike anywhere matches built here are even more dangerous because they are so volatile. That means knocks, bangs, scrapes and sparks set them off much easier than any commercial match, and this makes them dangerous. Ring caps are also an explosive, do not lose sight of that.

subset: commoncrawl


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Jasmine Becket-Griffith Blue Willow Beauty Fairy Collection
A FIRST! Limited-edition handcrafted fairy figurines with dragon companions feature hand-applied Blue Willow-inspired artwork and high-gloss glazes.
Measure approximately 5-1/4" W x 4" H
- Each issue shipped automatically
- Never risk a price increase
- No risk - 100% satisfaction
- No obligation — cancel any time
- Price:
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The timeless romance of the Blue Willow legend has a mystical allure that's simply enchanting. Now it inspires a magical first-ever from acclaimed artist Jasmine Becket-Griffith: the Blue Willow Beauty Figurine Collection, available only from The Hamilton Collection. Your limited-edition collection begins with Issue One, Perfect Romance. Next to arrive will be Issue Two, A Lifelong Journey Together, followed by Issue Three, Peaceful Travels and additional Blue Willow-inspired fairy figurines, each a separate issue to follow.‡
Inspired by Jasmine Becket-Griffith art and the popular Blue Willow fine china pattern, each figurine in this exclusive collection showcases a magical fairy accompanied by her mystical dragon companion. Each is meticulously handcrafted and graced with hand-applied Blue Willow-inspired designs to echo the beauty of this beloved pattern. Finished in a lustrous, high-gloss glaze to mirror the radiance of fine china, every figurine includes a genuine Swarovski® crystal accent for the perfect finishing touch. Strong demand is expected for this extraordinary collection, so don't delay. Order now!
California Residents click here for Proposition 65 notice.
- Celebrate the timeless romance of the Blue Willow legend with the Blue Willow Beauty Figurine Collection, a first-ever from acclaimed artist Jasmine Becket-Griffith, exclusively from The Hamilton Collection
- Inspired by Jasmine Becket-Griffith art and the popular Blue Willow fine china pattern, each figurine in this collection showcases a magical fairy accompanied by her mystical dragon companion
- Meticulously handcrafted and graced with hand-applied Blue Willow-inspired designs
- Each of these fairy figurines is finished with a lustrous, high-gloss glaze mirroring the radiance of fine china
- A genuine Swarovski® crystal accents every figurine for the perfect finishing touch
- Editions limited to 95 casting days, so order now!
- Hand-numbered with matching Certificates of Authenticity
- Measure approximately 5-1/4" W x 4" H; 13.3 cm W x 10.2 cm H
- Reserves the entire collectible Blue Willow Beauty Figurine Collection from The Hamilton Collection in your name so you never risk an increase on the price of other collectibles in this collection, or miss a single issue of this collection
- ‡Each issue will be shipped to you for your review, about one every month or two (pending availability), at the same low issue price and charged to the credit card on which your order was placed. No need to order each one separately
- You may cancel your collection at any time with no obligation
- "Issue One - Perfect Romance," will be followed by "Issue Two - A Lifelong Journey Together," "Issue Three - Peaceful Travels" and additional Blue Willow-inspired fairy figurines as they become available
©2019 The Hamilton Collection. All Rights Reserved.


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Kidney Disorders
Kidney disorders, or renal disorders, refers to any of the group of diseases that affect the kidneys. Acute kidney conditions include kidney infection, kidney inflammation (nephritis), kidney pain, and so on. Chronic types of kidney disease include various types of
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- Diabetes: Diabetes is a metabolic disease where the body loses the ability to properly process sugars (glucose). The full medical name
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- Diabetic Kidney Disorders: Kidney disorders are a common complication of diabetes of any type. Diabetes causes damage to the small blood vessels in
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- Kidney Failure: Kidney failure is inadequate function of the kidneys, also called renal failure. Kidney failure may be acute or chronic.
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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.


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This post may contain affiliate links. A small portion of sales will go towards supporting And Hattie Makes Three.
This shop has been compensated by Collective Bias, Inc. and its advertiser. All opinions are mine alone. #SweeterTogether #CollectiveBias
1) Get To Scoopin' EarlyWe all know there will be pie, cake, and more at your events. You can't forget to go ala mode! The last thing you want to do is be up to your elbows in sticky ice cream serving your guests. A couple of hours before the party, set your favorite EDY'S® Ice Cream on the counter to soften, and make individual scoops into cupcake liners. Then toss them back in the freezer until it's time to serve. Then there is no mess to clean up. You could even add one of the frozen scoops to the top of a waffle cone for an easy sweet treat.
Thinking about all the fun flavor choices that EDY'S Ice Cream has to offer, the possibilities are endless. We especially love the Nestlé Butterfinger® Peanut Butter Cups and Baby Ruth® varieties. I love to offer a variety of options to my guests and most of the time they chose both! I feel confident serving EDY'S Ice Cream because it is proudly made with fresh milk & cream with no rBST (milk production hormone) and no artificial colors or flavor.
Ever been to a party where you have to ask where the napkins or extra forks are? Don't be that party. Ahead of time, take 3 glass jars and label them for your cutlery. A chalkboard sticker would be darling for these too. This is a great DIY to keep in your pantry. Pull them out for parties and put them away when you don't need them. I always purchase an industrial box of cutlery so that I can just refill when my containers are looking low during the party. Another easy tip is to use paper plates and napkins. It's not taboo and totally acceptable to use paper! Easy clean up, too! Always plan for 2 plates per person (hello, second helpings) and 3 napkins. I always keep an assortment of these on hand because you never know when a friend is bring over cake, too!
I find all of my favorite party items like EDY'S Ice Cream at Walmart. I love that every thing is a one stop shop that gives me more time to spend with my friends and family celebrating and having fun. You can find EDY'S Ice Cream in the freezer section in your local Walmart. Seriously, so many options! There may be demos in your area during the month of June. Check the list to see if there is one in your area!
Such great tips to making party planning a bit easier this Summer. I love ice cream and the tip to use cupcake holders is genius.
Great tips! The ice cream tip is genius! We've started buying the huge package of plastic utensils too! And while we have loads of napkins I'm horrible and refilling the holder! My husband is always asking where it is. When we eat at the kitchen counter it's in the dining room and vice versa. Maybe it's time to buy a second lol!
Pre-scooping the ice cream is brilliant! Getting those scoop out at a party before the whole thing melts is a major pet peeve of mine. What a simple and perfect solution to that problem!
I like the plastic cutlery in the jars idea- looks so cute and easy. What a great idea!
YUM! I want some ice cream now! But really…I always want ice cream!
I love Edy's! This post is making me want to go to the store to get some right now!!!!
These are great tips! I love using cupcake liners…so cute!
Genius idea on the ice cream scooping! It's usually a mess, a struggle to get scoops fast enough as kids line up. I'm adopting these for the next backyard party!!
These are all really great tips! I especially love the one about putting the ice cream in individual cupcake liners like that…genius!
These are such simple, yet brilliant ideas! I especially like the ice cream idea – I might just use this tip on an average weeknight. My extremely impatient toddler would appreciate his after-dinner dessert being ready immediately! lol
Great tips! My favorite is the one about the cupcake liner! #client
Love this post, so many great tips. Now it's time to throw a party!
Love these tips! They are so great and make life simpler! The cupcake liner idea is the best!
Love this idea for summer. Pinned for future ideas.
Pre-scooping ice cream?? GENIUS!!
I'm hoping to throw a big ice cream party for my niece. The idea of having extra plates and such is perfect. It would be also cool to do a themed ice cream party and see about getting some plastic spoons that match the theme. https://froyogelatosupplies.com/inicio/store/SPOONS


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Ours is a comprehensive practice, offering in-house orthodontic, endodontic, and periodontic care, in addition to general, cosmetic, and family dentistry. This means all of your oral healthcare needs can be met under one roof, provided by people you know and trust.
We have five doctors in our practice: Drs. Jasmeen Singh and Dhaval Shah offer attentive, gentle dental care. Dr. Quingshan Li is our orthodontist, Dr. Fuwad Al-Sabek is our endodontist, and Dr. Logesh Sway is our periodontist. Along with our team, we'll help you achieve a healthy smile you love!
Working Together
We believe in listening to you: we want to know what you want from us, and about your concerns, too, especially if you have dental anxieties. We'll listen without judgment and ask questions while encouraging you to ask your own.
Dental care works best when we're united: you, our doctors, and our team need to be working together toward achieving your goals. We want you to be involved in all aspects of your care. We'll provide plenty of education and support, helping you develop good home care practices and establish healthy habits. Together, we'll help you achieve a lifetime of healthy smiles!
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Everyone at Absolute Dental can't wait to meet you. We'd love to be your partners, working toward the shared goal of your healthiest, best smile!


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HealthCare.gov has already begun showcasing health plans and prices for 2017.
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As customers this week begin shopping for 2017 health insurance on HealthCare.gov and state exchanges, which is a better buy, overall: a bronze plan, or silver? And will the IRS go after taxpayers next year who don't repay the subsidies they got — but didn't ultimately qualify for — in 2016? Here are the answers to some recent questions from readers.
I know that silver plans are the most popular type of coverage on the marketplace, but bronze plans are often a lot cheaper. Are there circumstances when I should consider buying bronze?
Bronze plans may make sense for some people, including those who are healthy and don't expect to use much health care, as well as those who are sick and expect to use a lot of it. While the out-of-pocket spending limit for both bronze and silver plans is often
Article source: http://www.npr.org/sections/health-shots/2016/11/03/500102120/hunting-for-a-health-plan-for-2017-bronze-may-be-your-best-value?utm_medium=RSS&utm_campaign=affordablecareact
Tagged: obamacare news


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List of Schools in Europe
Woodrush Community High School
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Telephone: 844 4771814Fax: 844 4771812
Schools-UK.eu is the largest online school database in the United Kingdom and is becoming more and more popular between the students.
The visitors can find there information about all types of schools – from kindergartens to universities.
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Learning Center
Our growing inventory of resources for learning the importance and impact of the environmental movement, its activities and those who participated in them. We will keep finding more resources to bring to you over time. Keep checking back. Sign up for our newsletter and we will inform you of new Editor's picks!
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Construction of salt water pool, spa, and pavilion. This pool area was carved out of the mountainside and the earth is held back with a massive stone and concrete retaining wall. Features include fiber optic fountains and architectural stonework with custom forged railings.
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Mother Nature finally delivered a nice gift - SPRING! She is finally here (although we are going on three days of rain in New York) and everyone is looking forward to warmer weather on the East Coast. One of my green resolutions for spring is to grow some herbs. I never planted or managed my own garden -- I've only picked vegetables from my parents' garden when I was very young. And of course then, I didn't appreciate it because I wasn't much of a vege lover.
I've done a little bit of investigating to see which herbs would survive New York spring/summer weather. I've tried to find some that are easy to care for so I can avert all possibilities of killing them! First, I was happy to learn that herbs don't need a lot of space. So, I could grow them indoors over the winter if this herb thing spreads like wildfire and I become obsessed.
This spring, I'm going to create a little garden area in the backyard at my parents' house out East. Thyme, Parsley, Sage and Basil are generally the best to start with because they don't require a lot of care or water - only good soil and sun. So, that's where I'm starting. Herbs like lavender, chamomile and lemon balm should be considered once you've toned your green thumb!
Pick a spot that gets a lot of sun several hours a day (about four hours) and if you can try and protect your herbs from wind by planting them near a fence, wall or other shrubbery. If it's easier for you however, start your herb garden in some potted plants near the outside door so you can access them easily when you're cooking. If you want to stick with indoor plants, you can use plastic containers and keep them on a window sill. Plant them in well-drained soil after loosing up the garden bed and only water them when the soil looks naturally dry. Fertilizers are not necessary.
If you have kids, this is such a fun activity to do with them too. Give them their own herbs to grow and care for and then season their favorite foods with them -- french fries, spaghetti and chicken! Kids love to watch things grow! I would love to hear what spirited women around the world are doing in your garden and hope you will send some gardening advice my way.
Happy Planting & Happy Spring!
- Elaine LaPersonerie - www.winkpr.com
Click here for more of Elaine's posts.


text: Bookings have begun in kolkata although it hasnt created any huge excitement here as expected. on road price here is 1Lks, though they havent given the exact cost break-up.Booking amount is 50,000/- and waiting period is around 3 months ie. if you book it now, you wont get the delivery before end of december.If you want to book the bike you can get in tpuch with Amit Motorcycles near Lake Gardens


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Last Updated on
While dairy free yogurt exists in stores nowadays, you not have any on hand when you need some. Or perhaps you cannot tolerate yeast or fermented products. Either way, you'll find that this dairy free substitute yogurt recipe is creamier and richer than most real yogurt. The best part about this substitute is that it contains an ingredient that you most likely wouldn't suspect that helps digestive issues based on scientific research. Check out the texture in the below dairy free yogurt substitute video.


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Yellow Hex Flower and Arrow on Blue and Orange Ribbon
Designer: Sue SpargoWidth: 3/8"Price: $2.25 yardUse with Short Darner #11 Needle and Cotton Thread #294
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The Royal College of Physicians and Surgeons of Glasgow (RCPSG), Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Physicians of Edinburgh (RCPE) and other partners were involved in a project aimed at preventing maternal morbidity and mortality based on the latest findings of the MBRRACE-UK Confidential Enquiries.
Preventing maternal mortality: It's ok to ask reminds maternity professionals about the indirect causes of maternal death during pregnancy and in the postnatal period. It includes information about looking out for the physical and psychological symptoms which indicate that a mother may be in need of further medical attention. More information can be found here.
The project has also produced an animated video about the physical, neurological and mental health conditions that can have an effect on pregnancy. View this short video on YouTube.
Identifying these problems may require help from other specialists and RCOG members must work in multidisciplinary teams and speak to clinical colleagues if they are ever doubtful about a woman's state.
View the Three Ps in a Pod poster here (PDF).
If you would like to comment on this briefing, or would like more information about the RCOG's policy and public affairs activities, please contact firstname.lastname@example.com.
Registered charity no. 213280
10 –18 Union Street
Tel +44 20 7772 6200
Fax +44 20 7723 0575


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The NO COMPROMISE styler, also known as the "one stroke wonder" comes in black or white!! This ghd platinum eclipse uses patented trip-zone technology to ensure that the styler delivers ultimate results in both hair health and styling, reducing hair breakage by over 50% and increasing shine by 20%. Apparently, turning up the heat is Continue Reading
Work Wednesday – Floral Jumpsuit
if you were never really convinced about floral jumpsuits, I encourage you to read on. The best thing about a jumpsuit, romper or the like is the fact that you get to skip the matching part for the day; it's already done for you. Most people think jumpsuits are only for holidays, getaways or day-offs, Continue Reading
Work Wednesday – Positive Pants aka White Culottes
always checking for the heat index.. before i melt entirely. Can't get enough of culottes.. xoxomandeeeee a few of my picks.. shop them below:
Work Wednesday – striped summer shirt for work, then play
From To Easy. A sleek transition from work to play, in the same summery, breezy striped shirt by just switching into a 70's vibe denim midi skirt and a pair of comfy birks (MILANO) ! easy, peasy, lemon squeezy ~ It's already Hump day! Have a good one! Can't wait till the weekend.. xoxo mandeeeee Continue Reading
Rainy day tips
There's so much rain in May it's annoying. It's been amber and red rainstorm warning for the second time in one week! That's why it's soooo necessary to have a pair of good rain boots that you would actually want to wear and style on nasty rainy days. But that can't be good for work, Continue Reading
Weekend Ready – sleeveless skater
This is the most comfortable dress I have worn. I'm in love with its elastic waistband and skater dresses or skirts are always my go-to style because they compliment my curves a little better. On weekends, I prefer to throw on a pair of sandals to give my feet some fresh air, but this dress Continue Reading
Utility Chic
Posing with my pear top: aland (old but similar here), pants: denim&supply by Ralph Lauren (old but similar here), shoes and accessories: forever21 (old but similar here, here and here), watch: emporio armani (old but similar here), bag: 3.1 phillip lim These have been my favourite fitted cargo pants for a few years now. I actually Continue Reading
Work Wednesday – stripes and skirts
Smile! It's Work Wednesday with Mandeeeee again! heehee.. This is one of my favourite A-line skirts because – it has the perfect flare – super easy to match colour – very appropriate length for work – very stretchy material that is able to keep the skirt's shape intact at the same time. And today I Continue Reading
Tips to getting the perfect pair of white pants
I started smelling spring, so I craved for the most perfect pair of white pants.. for work or for play. Seeing inspiration on how to wear white pants everywhere over the internet,I was hungry for my own pair to style. That's usually what happens:you get inspired,then you get your own 'equipment'get creativeand create your own Continue Reading


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Squat Stability: Structure vs. Function
Squat Stability: Structure vs. Function
STOP Squatting Wide (If You Can't Pass This Test)
A big problem in fitness is misappropriating strength and stability. We know right away that strength and endurance are different, being strong doesn't make you a great runner automatically. Strength and endurance, completely different adaptations. Its not so clear when it comes down to strength and stability. When preparing for a big lift(squat) we worry about the strength of the muscles that need to be stable. So we look to strengthen the stabilizers, like using a band on your hips or side steps to strengthen the hips or glutes.
So what is the difference between them? When we add force we're building strength, when we resist force we're building stability. To build stability we are going to focus on isolating the stability at the hip and seeing what our baseline is, at our most unstable position in the squat, where most injuries are prone to happen, the hole of the squat.
We are going to go over this assessment of functional stability of the hip which pertains to squatting. When you are at depth in the squat, you are at your most structurally unstable position. So you need to make sure from a stability standpoint, your getting stability from either structure or function. There is a tradeoff as you descend into the squat, your very structurally stable at the top and as you go down you rely less on structure and more on function. We want to now find where we are functionally unstable.
The Test: Hip Airplane: Video Explanation
- Single leg RDL, think about the relative position of the femur and the pelvis.
- Open your hips to a point of 90 degrees.
- Hold for 3-5 seconds and come back down.
- Work up to 5 clean reps per side as a warmup.
This exercise is trying to replicate the relative angle of the bottom of a squat on one leg to put the function on trial. We want to make sure we are buffering that force with function and not structure. Work on these if you find your function to be weak.


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EFL Trophy: What next for English football's most divisive competition?
- From the section Football
Devalued, important for youth development, a theatrical disaster, a success story, terrible for public relations. The Checkatrade Trophy was called many things this season.
But one thing is for certain - the revamped and renamed English Football League Trophy in 2016-17 was controversial, with fans across the country boycotting many games as clubs with Category One academies from the Premier League and Championship were invited to compete.
Lower-league clubs were even fined for selecting "weakened" teams and Bradford changed their goalkeeper after three minutes to comply with the rules for the most irrelevant piece of silverware on offer in the top four tiers of the English game.
While Coventry were crowned champions in front of nearly 75,000 spectators at Wembley Stadium - in what was described as a "fairytale in a bubble" for much maligned Sky Blues fans - the merits and future of the competition continue to be debated after EFL chief executive Shaun Harvey said it "does have a future" in its revamped format.
Before Tuesday's meeting of League One and League Two clubs, where the competition's format will be discussed, BBC Sport spoke to club bosses, managers, coaches, fans and public relations professionals about the divisive competition.
Anger replaced by positive vibes
League Two side and semi-finalists Luton Town were among the most heavily-fined clubs in the tournament, as one of two teams slapped with a £15,000 penalty for failing to field 'full-strength' sides in the group stages.
They were also one of the most vocal critics of the competition - traditionally a knockout tournament for League One and League Two clubs - before going on to earn £130,000 in prize money, all while unapologetically defying competition rules to field youth players.
Hatters chief executive Gary Sweet told BBC Sport: "We took the view, however, that the fines were an investment in our youth system to benefit the club in the long run.
"Purely from a Luton Town perspective, giving so many of our young players a genuine opportunity to showcase their talent in first-team games turned an adverse feeling about the competition into a positive vibe, despite being harshly fined the maximum tariff for breaking Rule 7.3 concerning team selection.
"Our progress to the semi-finals was an obvious bonus and a clear indication that our youngsters deserved their inclusion.
"We showed the competition a tremendous amount of respect from day one, but strongly felt we should be able to use it to give our academy talent a chance to experience senior football, especially given that the initial principle of the revised format was to promote young talent.
"We do not believe that right should be exclusive to Category One clubs and found it perplexing when the EFL promoted its statistical success in this area whilst issuing maximum fines to us and other clubs for following a strategic directive."
Statistics provided by the EFL state that 27% of players who started Checkatrade Trophy matches were English under-21s (up from 23% in 2015-16, and 18% in 2014-15).
On average, 67% of Luton's starting XI - and 78% of their matchday squads - for the group games were under-21 and English. They even fielded the youngest first-team player in their history, with 15-year-old Connor Tomlinson coming off the bench in their win at Gillingham.
Luton say their progress and emphasis on youth "excited and engaged" fans, so much so that half of the fines the club received were paid off by supporter donations.
Elephant in the room
Luton, who were among five clubs to release statements to confirm they voted against the pilot when the revamped competition was confirmed in June 2016, point to bigger issues around the inclusion of second-string Premier League sides as there remains lingering concerns about clubs fielding B teams in lower divisions.
"If Premier League clubs are supportive of extended entry, our position is that we would get behind a restructured proposal as long as team selection restrictions are removed and other measures to promote the competition to fans are included," added Sweet.
- READ: EFL chief says revamped competition has future
- READ: Low crowds and manager cameos
- READ: Record penalties and more small crowds
"Let's put aside the elephant in the room - the issue of B teams. If we ever felt there was ever a possibility of a reformatted Checkatrade Trophy leading to an introduction of B teams into our league structure we would categorically oppose it whatever incentives were on offer.
"Upon receipt of assurances that the inclusion of Category One academy clubs was not the thin end of the wedge, which included a positive change in voting power for clubs, and putting aside the less-than-articulate communication of its introduction, we can't deny that there are some positive footballing advantages to the dynamics of playing academy teams."
EFL must take note of empty 'theatres'
The early stages of the revamped competition were marked by poor, and in some cases miniscule, crowds.
Only 274 watched West Brom Under-21's lose at home to Gillingham on 8 November, the lowest crowd in this season's competition.
Coventry City, who ended up taking more than 43,000 fans to Wembley, attracted their lowest-ever attendance to a first-team game when only 1,338 spectators turned up for the second-round tie against Crawley Town.
Mansfield Town manager Steve Evans, whose team were defeated by Wycombe in the quarter-finals in front of a crowd of 2,047 - the biggest attendance of any match the Stags played in during the competition this term - said the EFL should take heed of the almost universal spectator boycott.
"The format was wrong and you can tell that when you look at football supporters around the country," Evans told BBC Radio Nottingham.
"We should never forget that it is not about teams and clubs - football is about supporters. It is very much like the theatre, you are only as good as your audience. Supporters voted in the early rounds with their feet.
"Yes, it got a little more interesting towards the semi-finals, but that is largely because there were good clubs involved for that level.
"The format has to change. We have to find a new format that delivers what they set out to deliver - a platform for youngsters to play. But no Premier League lads up against experienced players from League One and League Two, that doesn't work."
'Unique and rewarding for young players'
Eight of the 16 invited sides with Category One academies, including Chelsea, failed to qualify from their four-team group, while Swansea went furthest - losing in the quarter-finals.
Inclusion of Premier League clubs saw the prize money increase to £1.95m - a rise of more than 300% on the previous year.
In total, 62 English under-21 players started three or more games for the 16 invited teams - which did not include Arsenal, Liverpool, Manchester City, Manchester United, Newcastle and Tottenham, as they all declined the invitation to play.
Reading's Under-21 side finished second in their group behind League Two side Yeovil, and went on to beat Southampton's academy team before going out in the round of 16 against the Glovers.
Without hesitation, Royals academy director Lee Herron says they would nominate themselves to take part in the competition again as it was a "fantastic" and "unique" experience for the club's emerging talent.
"It was certainly a success story and one that we hope that we can embrace again next year," said Herron. "Not for one minute did we or any of the players get caught up in the national perspective of the tournament being devalued.
"When we played Portsmouth, Yeovil and Bristol Rovers, we didn't feel there was that element going on with their players or those people watching the game. Of course you could see it in the media and elsewhere and understand people opinions, but we didn't feel it personally.
"The experience of playing at that young age against players who are in those leagues week in, week out is a great challenge. Surely that can only improve young British players across the country."
Elsewhere, Wolves gave first-team debuts to four players after their performances in the EFL Trophy.
Wolves Under-21 coach Scott Sellars said: "It is benchmarking to put them up against senior players and it showed our head coach, Paul Lambert, just how far they have progressed.
"He watched the game against Accrington, who included two men with Premier League experience, and he was able to see which of our players were ready. It speaks volumes that we have had four youngsters making their first-team debuts this season."
The fans' view
Playing in front of sizeable crowds, however, was never part of the experience for the invited sides.
David Johnson, a Coventry City fan and spokesman for the Jimmy Hill Way Campaign - the coalition of Sky Blues fan groups - said he, like many supporters he knows, only attended EFL Trophy games once under-age Premier League and Championship clubs where knocked out.
"Why would I have gone to some of the games that were little more then a reserve team game or kick about? Once it got serious and back to what it should be, a competition for League One and League Two clubs, I made the effort," he said.
"While it might be a Mickey Mouse competition, we got to Wembley, the national stadium and there were 40,000+ City supporters there - brilliant.
"But we recognise that, along the way, it was devalued as a trophy."
A win for the sponsors?
Meagre crowds and a controversial new format elevated the competition as a newsworthy item on the football calendar.
Checkatrade, in their first season as naming rights sponsors, found themselves included in the debate - which, according to the vice president of the Chartered Institute of Public Relations Rob Brown, "did the job" when it came to raising brand awareness.
So, does the old adage of 'there is no such thing as bad news' apply?
"For Checkatrade, absolutely," Brown, who runs Manchester-based agency Rule 5, told BBC Sport. "As sponsors they don't, in a sense, suffer from the negative publicity. However, it is bad for the English Football League.
"It is absolutely terrible PR for the EFL. What they are looking to communicate to their stakeholders is that they are creating entertainment and excitement - they have failed on all of those counts. From their point of view it is disastrous.
"Checkatrade have probably done well out of it. And, when you think about it, it is absolutely extraordinary because the story is that an almost-pointless football competition becomes even more pointless. On the face of it that is not a massive story, but it's the degree to which has become a laughing stock within the sport that has brought the awareness.
"While it is good brand awareness for them, everyone wants to be associated with things that are successful, so it is only a short-term gain for Checkatrade."
BBC Sport contacted Checkatrade, but nobody was available for comment.


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'Cash n Carry Me Home' is the debut single from Ghostpoet who according to some is the UK's next big hip-hop breakout. With a lethargic and often enchanting flow, comparisons to Roots Manuva are sometimes inescapable. Couple this with swampy dark beats and you have single 'Cash and Carry Me Home' an ode to Saturday nights on the town. Owing more to Trip-hop and the like or slurry, social commentator Jamie T than anything currently present in the UK Grime scene or (god forbid) UK chart hip-hop – Cash n Carry is a silky ride through a night out in the eyes of Ghostpoet.
You can check out the video below as well as the remix recorded at the Red Bull Studios with Kano.


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When you first embark down the road of stock trading, you'll want to investigate the best stock trading platforms available to find out if they have good reputations and reasonable pricing.
The stock trading market has become very competitive so you'll notice that most of the leading platforms have removed the need for a minimum amount to open an account and that many of their trades are commission-free. However, this doesn't mean that the fees aren't hidden elsewhere, so ensure you dig down into pricing structures for your chosen investment products before you commit to anything.
This stock trading platform guide is designed to break down the jargon surrounding the online trading and ease you into the stock market gently.
In this list of the best stock trading platforms, we've spent time playing around with the different features, looking into their pricing structures, researching their reputation with active customers, and examining their product offerings. These are the best on the market right now, many of them having won awards for their technology, services and solutions. Always remember though, investments are a really smart way to manage and improve your financial future, but only if done with the right partner and following solid advice and qualified guidance.
Finally, it's advisable to proceed with caution. It is best to start slow, with low investments until you understand the market and the risks involved.
1. TD Ameritrade: Best for the beginner
TD Ameritrade
A reliable and reputable stock trading platform that's as useful for the beginner as it is for the experienced trader
Account minimum amount: None | Commission fee: None | Account fees: Transfer fee may apply | Investment products: Stocks, bonds, options, exchange-traded funds, mutual funds, Futures, Forex, Margin trading, cryptocurrency trading, managed portfolios, cash management, bonds and fixed income, annuities, IPOs, dividend reinvestment, collateral lending
TD Ameritrade has lots of features, plenty of cool technology and research, and is constantly innovating and creating new tools. This platform is an excellent place to start for beginners as it includes the research, guidance, tutorials, platforms and services that someone starting out would need to ensure they feel confident. The platform has commission-free trading and free extras but does charge for the use of a broker which adds to the price tag. While the platform can happily be enjoyed by traders of any level, beginners and casual traders will appreciate the usability and accessibility of the website and platforms.
- Read the review: TD Ameritrade
2. E*Trade: Best for stability and reliability
A long-standing player in the industry that grows with the investor over time
Account minimum amount: None | Commission fee: None | Account fees: Transfer fees may apply | Investment products: Stocks, Options, ETFs, Mutual Funds, Futures, Bonds and CDs and IRAs, managed portfolios, retirement portfolios, small business, bank and brokerage
E*Trade has great mobile applications and platforms. They are designed to help you get the most from your portfolio and to really expand your skills in investment and trading. This platform is a reliable choice for investors who don't want to take chances and want to work with a company that has been around for a while and has a well-known footprint. As E*Trade has been in the business for several years, it not only has a good reputation, but it has also used its experience to create intelligent and relevant tools and services for its users.
- Read the review: E*Trade
3. Merrill Edge: Best for the personal touch
Merrill Edge
Integrated with Bank of America, Merrill Edge is a trusted and reliable source of investment products and solutions
Account minimum amount: None | Commission fee: None | Account fees: A variety of different fees apply to different options and use cases | Investment products: Stocks, ETFs, Mutual Funds, Fixed Income and Bonds, Options, Margin, BofAML US 1 List, managed portfolios
Merrill Edge's relationship with the Bank of America is a double-edged sword. On one hand, you get the hidden fees and complex pricing structures of a financial institution. On the other hand, you get personal service from any one of the Bank of America outlets around the country. Merrill Edge has a phenomenal research and knowledge center, matched only by E*Trade for scope and depth. It's really excellent and an ideal starting point for someone who wants to learn more about stock trading before they start. The Merrill Edge platform is well suited to beginners and experts alike thanks to its diverse portfolio of investment products and customized accounts and services.
- Read the review: Merrill Edge
4. Fidelity Investments: Best for families and future planning
Fidelity Investments
Fidelity Investments is a nicely rounded stock trading option for investors of all levels and aptitudes
Account minimum amount: None | Commission fee: None | Account fees: Some fees may apply | Investment products: Mutual Funds, Retirement & IRA, trading, stocks, fixed income, bonds & CDs, ETFs, options, sector investing, savings
Fidelity Investments has positioned itself as the family-friendly, future-focused stock trading platform that helps people plan their lives and their financial futures. To this end, it has created some diverse stock options and portfolios that can be used by people of all trading skill level to improve their finances and investments. While the site isn't great to navigate, Fidelity has a wealth of digital offerings, research, tools and services that are designed to make your life easier and your investments more efficient. This is an ideal place to start if you're new to stock trading and want to work with a company that can help you customize your investments in line with your plans for the future.
- Read the review: Fidelity Investments
5. TradeStation: Best for experts
Lots of power and portfolio depth make this a great choice for active and enthusiastic traders
Account minimum amount: $2000 on TS Select account, zero on other accounts | Commission fee: None | Account fees: Some fees may apply dependent on account | Investment products: Stocks, ETFs, Options, Futures, Futures Options, Crypto, IPOs, Mutual Funds, Bonds
TradeStation is another solid and dependable platform that has been on the market for many years. This reflects in its services and offerings and in its sophisticated approach to investments. The website is fiddly to navigate but it has a phenomenal knowledge hub – often considered to be the best on the market – great customer reviews, and an array of investment options and tools. With its advanced tools and services, this is a very good place for the more experienced trader to build a foundation.
- Read the review: TradeStation
6. Zacks Trade: Best for personalization
Zacks Trade
Zacks trade is slick, sexy and beautifully designed but all that comes with a price tag
Account minimum amount: $2500 | Commission fee: Dependent on trade and option | Account fees: Some fees may apply dependent on account, no inactivity or maintenance fees | Investment products: Stocks, ETFs, Options, Mutual Funds, Corporate bonds, Government Bonds
Zacks Trade expects you to pay a minimum account fee and has quite a few little fees added on here and there but the fact that you get free broker assisted trades almost makes this worthwhile. The platform has excellent customer service – you can call during office hours – and you can use their support center to manage your account seamlessly. The research is great, the tools advanced, and the platforms feature-rich, but the broker access is a big plus for this company.
- Read the review: TradeStation
7. Interactive Brokers: Best for investment variety
Interactive Brokers
Interactive Brokers provides advanced trading tools on a highly professional platform that's best suited to expert traders
Account minimum amount: None on both IBKR Pro and Lite | Commission fee: Dependent on account and location | Account fees: Monthly activity fee if you drop below a certain threshold on Pro | Investment products: Stocks, Options, Futures, Forex, Metals, Bonds, ETFs, Mutual Funds, EFPs, Hedge Funds, Robo Portfolios
Interactive Brokers comes across as this old world, traditional banking platform but it has some of the most advanced tools and investment products on the market. It's one of the few to offer fractional shares as an option, plus it has artificial intelligence-powered solutions that have won industry-recognized awards. Traders of all levels will benefit from the technology, tools and investment variety.
- Read the review: Interactive Brokers
What is an online stock trading broker?
Editorial content on this page is not provided, commissioned, reviewed, approved or otherwise endorsed by any service provider. We work hard to keep the content as up to date as possible so you can make the right choice. It is Top Ten Review's, not service provider's, responsibility to ensure accuracy. If the service has changed and you notice something that is no longer accurate then please let us know at firstname.lastname@example.com so we can update the page.
A stock broker is a person or company that has the license to buy and sell stocks through the market exchanges. Stock trading used to be hard for individuals to do due to the long telephone calls to a busy stock broker and the high investment cost. However, online stock broking means it is easier for an individual to manage their own stock portfolio at a lower cost. When choosing a stock broker, there are generally two choices:
A full service stock broker
These are the more traditional stock brokers that have physical offices. They offer a range of services beyond the ability to trade stocks on the exchange, such as retirement planning help, tax tips, and guidance on what stock to buy and sell.
An online stock broker
These online stock broker websites exist to give you a discounted experience of trading stocks on the market exchange. The stock exchange companies do not offer the range of services of a traditional firms, and have a more do it yourself approach to investing in stocks. The best online stock brokers offer a range of extras like research or provide class on how to learn to invest in stocks.
How to buy stock online
Online stock trading companies make trading stock a very simple process. The first step is setting an online brokerage account on the platform or website you are going to use to trade stocks. After your account has been set up, you trade stock by placing the stock's ticker code into the platform. A ticker code is a one to five digits in length and is used to identify stocks.
Most online stock traders will allow you to trade stock in two methods:
Market order
This type of stock order is immediate, and placed at the current market value. If you enter that you want to buy ten shares, you'll exchange shares with someone selling shares in the company. This type of stock exchange is filled quickly, and usually at an extra cost.
Limit order
A limit order will allow you to place a set amount on the trade of shares, so they'll only be exchanged at the price you've set. These are ideal ways to buy stocks that are not often traded. It is also an easy way for a casual investor to manage their profile, you can set the exchange up and just forget it about it until it is filled.
Online stock broker platforms for beginners
When you are first starting to learn how to buy and sell stocks on the market, it is usually best to look for a platform that will support beginners.
A low commission price is essential for people just learning to exchange goods. This means that you can exchange stock with low investment losses. When you are just learning to it is best to do so at a minimal cost.
Also look for a trader with a low minimum investment amount. This way, if you discover exchanging stocks is not the investment method for you, you can stop easily with minimum losses.
The lowest cost way is to use a virtual stock simulator where you can trade stock with fake money. Once you figure out the ins and outs of the market, then start investing with real money.
Another good indication that the stock broker website supports beginners is the wealth of educational material they have to offer. Look for a platform that wants to help you grow as an investor.
How to start online stock trading
A lot of novice stock traders worry they have neither the time or money to start investing. They are also daunted by the stock market and feel they don't have the time or knowledge to immerse themselves into the market. Don't worry, there are many ways to invest that require only very basic knowledge and a relatively small amount of money. If you have $500, here are some ways to invest your money:
Exchange traded funds, or ETFs, are mutual or index funds that are traded like stocks. They have some benefits over direct investing in a mutual or index fund. For example, you only pay capital gains taxes if you trade your ETF shares. ETFs tend to have a solid rate of return, rather than the volatility of an individual stock. Many brokers also offer commission-free ETFs, so you don't pay anything to buy the shares.
Mutual funds
If you feel like taking more risk, buying into an actively managed index fund can give you a chance at higher returns. You can buy into some mutual funds with $500 or less. Keep in mind that you pay commissions and fees, so you may be better off with a more passively managed index fund, which has lower fees.
Robo-advisors are automatic investment programs that use algorithms to trade a portfolio based on your risk tolerance and investment goals. They are a hands-off way to manage your assets when you don't have time or don't want the pressure of doing it yourself. Most robo-advisors don't have minimum investments, but for those that do, $500 is enough to start an account. Most brokers have their own robo-advisor offerings, or you can use robo-advisors like Wealthfront or Betterment.
Online stock trading vs stock brokers
Fees and commissions are a top concern for any investor. Over time, trading expenses can add up, meaning less money in your account. In the last year, the online stock trading brokers we reviewed have reduced their commissions to between $2.95 and $6.95 per trade. A regular broker's commission can range from $19.99 to $44.99 per transaction, and it's easy to see why online trading has become so popular. At 20 trades per year, broker-assisted trading alone can add up to about $400 to $900 per year. So, online stock broking is a lower investment. However, engaging a regular stock broker will give you access to expert advice and years of experience.
What are robo-advisors?
Robo-advisors are automatic investment programs that use algorithms to trade a portfolio based on your risk tolerance and investment goals. They are a hands-off way to manage your assets when you don't have time or don't want the pressure of doing it yourself. Most robo-advisors don't have minimum investments, but for those that do, $500 is enough to start an account. Most brokers have their own robo-advisor offerings, or you can use robo-advisors like Wealthfront or Betterment.
How do robo-advisors work?
A robo advisor will ask you a set of questions about your income, risk tolerance, and investment goals. Based on your answers, the robo-advisor uses an algorithm to suggest investments, create a diversified portfolio and manage it. Some of these automated stock trading platforms also rebalance your portfolio and use tax harvesting to lower your liability to the IRS.
Why use a robo-investor?
The advantages of a robo investor include:
Low Fee Stock Trading:
The automated approach allows for a more competitive cost as all the work is done by software.
Conflict Free:
Human stock brokers sometimes feel pressured to sell a specific product to clients as they have financial deals with companies. A robo-investor will not act in it's own best interest over yours.
Lower Minimum Investment
The minimum investment needed for a robo-investor is as low as $500. This means it is a lower commitment to invest than conventional financial advisors.
Always Available:
Robo-investors are always there when you need them, and you don't have to wait on line listening to hold music to get the help you need.
What to look for in an online stock-trading platform
To ensure you online stock broker is safe and trustworthy there are a number of official and professional regulations and trust that they should belong to. When searching for a stock exchange platform, the professional bodies they belong to should be noted very clearly in an easy to find location. Ensure that they are members of the Securities Investor Protection Corporation (SIPC) and the Financial Industry Regulatory Authority.
If the broker is offering additional services such as a checking or savings accounts they should also be fully covered by the Federal Deposit Insurance Corporation (FDIC).


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Customers can get a comprehensive hair treatment including a full head of colour with highlights, a cut, blow-dry and conditioning
Customer Reviews
What You'll Get
Choose from Five Options
- AED 89 for a root colour and blow-dry
- AED 89 for a cut, blow-dry and hot oil head spa treatment
- AED 129 for three sessions of wash and blow-dry
- AED 199 for five sessions of wash and blow-dry
- AED 239 for a full head of colour with a full head of highlights, a cut, blow-dry and hair treatment
The Fine Print
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Photo: Pool photo by Morry Gash via AP
Photo: Pool photo by Morry Gash via AP
September 01, 2018 12:16 PM
John McCain's procession has made a stop at the Vietnam Veterans Memorial on the way to his service at Washington National Cathedral, and his wife, Cindy, has placed a wreath on the memorial.
She was accompanied by Defense Secretary Jim Mattis and John Kelly, a retired Marine Corps general who's President Donald Trump's chief of staff.
John McCain was a decorated veteran who was held for more than five years as a prisoner of war in Vietnam. He refused early release.
RELATED: Washington Says Goodbye to John McCain
McCain's casket had remained overnight in the Capitol rotunda, where thousands of mourners had filed past on the day before to say goodbye as McCain lay in state.
It's an interesting list of pallbearers who are set to serve at McCain's memorial service.
It includes actor Warren Beatty and a Russian dissident, Vladimir Kara-Murza. There's also former Vice President Joe Biden, former New York City Mayor Michael Bloomberg, FedEx founder Fred Smith and billionaire investor Ronald Perelman.
RELATED: After Church Service, McCain to Depart Arizona for Last Time
Several current and former senators also are on tap as pallbearers for the Arizona Republican.
At the cathedral, tributes to McCain will come from ex-Presidents Barack Obama, a Democrat who defeated McCain in the 2008 White House race, and George W. Bush, who won the 2000 GOP nomination over McCain.
Also on the speakers' list are former Secretary of State Henry Kissinger, former Connecticut Sen. Joe Lieberman and daughter Meghan McCain.
RELATED: John McCain Memorialized as Hero, Fighter and Wiseacre
McCain died Aug. 25 at age 81.
Saturday's service is the last for McCain in Washington. He'll be buried Sunday at his alma mater, the U.S. Naval Academy in Annapolis, Maryland.
The Associated Press
Updated: September 01, 2018 12:16 PM
Created: September 01, 2018 08:25 AM
(Copyright 2018 by The Associated Press. All Rights Reserved.)


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It is said in Malden Musings...
• Unfortunately these things happen from time to time. In my haste to make deadline last week, I omitted the single most important birthday shout out of the year! And yes, I did pay the price for it! The birthday girl whose strawberry perfume grabbed hold of me in the ninth grade at Beebe and never let go. So, without further delay happy belated April Fool's birthday to the ageless beauty that I married a few years back, the lovely Pam.
• The "City of Malden Bar Tenders Hall of Fame" will soon be taking nominations. Kevin Hanley, Paul Gennetti, Ralph Kelly, "Little" Albert Spadafora, Frankie Villa, Greg Lucey, Dave Angelo and Jimmy Palermo are just a few names guaranteed to become charter members. Please send me your names and the bars they tended.
• Congrats to Malden High School's newest head football coach, Mr. Malden Youth Sports himself, Steve Freker. Yes, that Steve Freker, Malden High School 1977 grad, current MHS baseball coach, long-time referee in the Al Locke League, former backbone of the Malden Evening News and a grinder back in the glory days of hoop at the Y. All the best, Freck!
• Here's wishing Rep. Steve Ultrino, D-Malden, the best of luck running for re-election as he seeks his third term. Steve's been fighting the good fight since being elected but still has time to enjoy a good meal at Papa's Bar & Grille on Highland Avenue on occasion — a stone's throw from the house he grew up in. Keep up the great work, Steve!
• Not Malden-related, but I just love the Boston-based band Buffalo Tom. They turn 30 years old this year and will be playing out at the Paradise on Commercial Avenue on April 20. They are the best!
• The Boston Globe article on Feb. 18 chronicling the long, arduous fight Sen. Ed Markey has fought — 50 years and counting — for a freeze on nuclear power is just a small reminder of why we have continued to send him back to Washington these many years. Thank you, senator!
• In case you missed it, international civil rights activist and South African superstar musician Hugh Masekela passed away at 78.
• As I stated in a previous column, I am starting to really love the new face of Malden Square or, as some are calling it these days, Malden Center. A much overdue face-lift has given this ancient city center a vibrancy that, frankly, has been missing for generations. I don't need to recount here again the swift demise the Square experienced when they placed "The Beast That Ate Pleasant Street" in the middle of it. Coincidence? I think not. As I have written in the past, the Square was in such desperate straits in those bad old days that McDonald's could not survive! Long live the Square!
• You can never thank Lester Morovitz, owner of Malden Taxi & Malden Trans and one of the Malden's biggest benefactors, enough for his generosity, compassion and the love he has shown for this community for so long.
• Another Red Sox season is upon us. Just a thought, let's kill the phrase "Curse of the Bambino" once and for all this year. As we all know by now it was not the trade of the Babe, but the inherent racism and cronyism that doomed the Sox the years before John Henry took over. As a wiser man than myself once said "every time that myth is repeated a new generation are ignorant of the Sox very shameful past."
• Happy birthday to the girls of April — the "Fabulous" Judy Cahill, Carol Cioffi, Paula Farrell Underhill and Cathy Connelly — celebrating the big day together 48 years strong now. Congrats and here's hoping the tradition goes many, many more years!
• Have you been to the Italian deli and grocery Barbiero's at 580 Broadway yet? Why the heck not? Love this place! Old school Italian deli back in Malden! Forget about it!
• Belated congratulations to MATV staff members Ronny Cox and James Mudge for their first-place award at the "Alliance for Community Media - NE Region's Media Festival" for their short "It's a Wonderful Life...in Malden." Well-deserved recognition for these two stalwarts of our community. Great job guys and a blast to watch!
• Malden is certainly heading in the right direction with the hiring of police officers such as Noelle Bowie-Pierce. Noelle was sworn in by City Clerk Tom Brennan this past November and has made her moms Kim a very proud Maldonian, Class of MHS 1975, of course. Best of luck, Noelle!
• If you haven't tried "Malden's House of Pizza" in Maplewood Square by now, what the heck are you waiting for? Owners Jean Pierre, Elie and Gerges El Hachem are serving up some of the best pie this side of Pearl Street. "I love Maplewood Square!" said in my best Tommy Heinsohn voice.
• Happy belated birthday to a "Friend of Malden," via Somerville, that dawn to dusker who is always fighting the good fight (at times much to the chagrin of IACC members), Danny Siraco.
• Speaking of Malden Square, I am hearing rumors of a couple of taprooms/breweries as well as a possible comedy club. This ain't your grandfather's Malden Square!
• Dave Surette read from his newest offering "Malden" last week at the Malden Public Library to a good-sized crowd of Maldonians including family and long time friends. His big brother Steve was in the audience looking like the All Scholastic hockey player he was as a senior at Malden High in 1973. Bobby Moulton played hockey with Dave back in the day, he was spotted enjoying the evening with his fellow 1974 alum Rie Lowenstein. I'll have a more detailed account in a later Malden Musings.
• Happy belated birthday wishes to two of my favorite people on Planet Earth, Christian and Lola's parents — Joe and Angela Falzarano! They are an inspiration to watch as they raise their two beautiful children, three dogs and two cats. Insert smiley face.
• "There are 8 millions stories in Malden. These have been a few of them."
What do you get when you mix 6-foot-7-inch former MHS basketball coach and educator Jack Hussey, 5-foot-4-inch MHS hockey phenom and lifelong prankster Jeff Hurley and an astute literary observer such as Dave O'Brien? You have a heck of a "Malden back in the day" story. Dave O'Brien is an accomplished author and MHS Sports Hall of Famer, Class of '77. Dave wrestled and played football in high school, but more importantly had an offbeat personality who marched to nobody's drummer but his own. Much like his dad John, who was none other than MHS educator and the first "free thinker" I ever met, John is the author whose "Musings" I sample from time to time. See below. Dave's been killing it lately on Facebook with his memories of Malden "Back in the day..." I thought I'd share one of his more memorable diatribes from his high school days:
"I'm in (Jack) Hussey's English class. I actually liked him. He assigned quality homework. So, the class is about to watch a movie. If I can remember what movie, I'll die a happy man.
Surprise announcement, everyone! Another class will be joining us. And who walks in but a 'Bandstand Brother.' Jeff sees me and sits in the seat right behind me. But he shows too much enthusiasm. Hussey notices. And he says, 'Jeff, David isn't going to talk to you. David's too smart to talk to you.'
Now. With 40 years hindsight, I should have been the one to say it. Anyway. Jeff says, 'expletive deleted.' Hussey says, 'leave!' Jeff gets up and leaves. On his way out, he passes between Hussey's back and the blackboard. Invisible for a moment. Jeff passes Hussey and comes back into view. Hussey pushes him from behind. Jeff turns. Hussey says, 'you elbowed me in the back.'
Jeff punches Hussey in the jaw. Hussey says, 'why you little expletive deleted.' They crash into each other. Hussey is bigger, so it spills into the hall. And now I'm standing in the door way with Glenn Patterson and Steven Brickman. The rest of the class is on their feet behind us. Hussey and Hurley are right in front of us. Up against the lockers. Hurley has Hussey bent over and is flying fists and feet. But Hussey is big and pissed. And right now he would throw away his retirement to kick the daylights out of this high schooler. But Jeff is younger and faster, and he has the edge. Hussey is weakening and Jeff is winning. Mr. (Dick) Cunningham comes around the corner and sends them both in opposite directions with one bark. Administrators interview the witnesses. Jeff is not suspended. Hussey is advised to put it on cruise control until retirement. Thanks for teaching me to write, Jack."
Thank you, O'B!
Ten more "Musings" from the inimitable pen of the late John "Father of Dave" O'Brien whose wit and wisdom endeared him to generations of MHS students, Maldonians and faculty at Malden High School, as well as the inspiration for the name of this column. Here are 10 witticisms from his iconic "Musings" columns taken from a "Malden Sun-Times," dated Aug. 18, 1977 — generously donated to me by my pal MATV Executive Director Ronny Cox, who promised me last month that he would find a top hat that would fit me for my next inauguration gig as city messenger:
• "And now for the winter of my Ms. content."
• "I never promised you a garden, Rose."
• "It takes a square to pick a dilly."
• "My friends call me the Lone Ranger because I owe silver."
• "I told my gardener to stop beating around the bush, so he threw in the trowel."
• "She wanted to meet me at the Hatch Shell, but I was chicken."
• "I just don't cotton to gin, Eli."
• "If you see Esther at the Fiesta, tell her I am on a siesta."
• "I've always been a fall guy in the spring."
• "You can pickle beets, but you cannot beat pickles."
As Peter Falk's iconic TV character Columbo would say, "Just one more thing sir":
"Jesus Christ Superstar" has been the buzz around watercoolers all over the country since last week's surprisingly good production featuring John Legend and Alice Cooper. "Jesus Christ Superstar" came roaring into town on Jan. 13, 1996, with original Jesus Ted Neely back doing what he was put on earth to do, play Jesus Christ in the Broadway musical. After the show, a group of us went out with Ted to Chinatown in Boston for a plate of beef and onions with black bean sauce. Well, that's what I had anyway. There were about nine of us; we were trying to arrange seating. Ted came up with the most logical suggestion, and I quote, "Boy, girl, boy, girl, Jesus, boy, girl, boy, girl." Long Live, Ted Neely.
—Peter is a longtime Malden resident and contributor to the Malden Observer. He can be reached at email@example.com for comments, compliments, complaints or criticisms.


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We all know that Hockey has some of the most fun fights in sports, given the fact that it's a sport that 'allows' most types of fights. Unfortunately though, this one went a little haywire…
During a game in the Quebec semi-professional league, an incident between two players ended with a referee catching several fists to the face.
It was a playoff game between the Cool FM St-Georges and Eperviers Sorel-Tracy over the weekend when Hubert Poulin (Cool FM St-Georges) and David Lacroix (Eperviers Sorel-Tracy) decided they wanted to bash each others face in.
During the fight, one of the players got taken down and as he got up, you could see either his jersey or his pads were covering his eyes and he continued to swing… which meant knocking the ref out… Here it is:
Hockey player accidentally punches ref and…. KNOCKS HIM OUT ? pic.twitter.com/duilyVUC6w
— Sports ON Tap (@SONTHighlights) April 9, 2019


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At the age of 77, Irene Letcher was released from the devastating grip of dementia, passing away peacefully at the Rocky Mountain Village on Saturday, April 13th.
On June 5, 1941, Irene and her twin sister Vera were born in Natal, BC to Czechoslovakian parents Joseph and Yarmilla (Musil) Kotek. Being one of 8 children, Irene quickly learned the value of hard work, and appreciated the importance of family and friends.
The "life of the party", Irene had a terrific sense of humor; she was always laughing and joking. She was a wonderful cook and enjoyed baking, especially when she was preparing for Christmas – her favorite time of year! Irene thrived on the joy of the season and went all out every year.
Irene loved life and enjoyed keeping active; travelling with friends to play slots at the Casinos, trips to the Dominican and New York, swimming, sewing, crafting, spending time with her "Koffee Klan", and of course, the infamous shopping trips with her daughter and best friend, Cindy.
Irene was an avid reader, a book always close by. The hardest part of her daily life happened a few years ago when she lost her eyesight. Her sister Vera would read to her on the phone every night until Cindy thoughtfully purchased audio books for her to enjoy. Once again, Irene was able to enjoy the books she so loved. Irene was a joy to be around and was loved by all who knew her. She will be forever remembered with love, smiles and laughter. Until we meet again.
Irene is lovingly survived by her children: Cindy (Sean) Petkau and Vance Letcher (Shelly Ann Polovelnikoff); her twin sister Vera Ranson, sister Rosemarie (August) Ebbinghoff and her brother Vladimer "Laddie" Kotek as well as several nieces and nephews. She was predeceased by her parents, her husband Cliff, and siblings Myrtle "Midge", Frances, Lillian and Stanley "Chappy".
To send flowers to the family or plant a tree in memory of Irene LETCHER, please visit our floral store.
Alzheimer's Society of BC
Web: http://alzheimer.ca/en/bc


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The proof dust jacket has the same design on the front, spine and rear flap as the published editions.
The front flap has DR NO (proof) vs DOCTOR NO (published).
The rear panel has the reviews in a different order, for the published version they are in reverse chronological order.
Nov 2015. A copy without the proof dust jacket was sold for $3500 by Heritage Auctions.


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