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Lady Rhondda
Find out about the life of Lady Rhondda (Margaret Mackworth) and her role as one of the leading women's rights campaigners of the twentieth century.
We have a range of downloadable worksheets, lesson plans, videos and more on our resources page.
Our newsroom is where you'll find our tweets, 3rd party tweets, our blogs, videos and photographs. Also you can download our Electronic Press Kit.
Welcome to a bird in a cage project website
Margaret Mackworth, otherwise known as Lady Rhondda, was an important women's rights campaigner throughout the first half of the 20th century. She was instrumental in the establishment of the Newport Women's Social and Political Union (WSPU), founded one of the most influential political magazines of her day, and was imprisoned for attempting to blow up a postbox in Newport for the cause of women's suffrage. Her work made a significant contribution to the women's rights movement, and had a lasting impact on the democratic landscape of South Wales.
This site supports Winding Snake Productions' Heritage Lottery funded 'A Bird in a Cage' project. Over a nine month period young people from schools in Caerphilly and Newport are creatively exploring the life and work of Lady Rhondda, culminating in the creation of an animated film. The Resources page will be useful to those who want to engage with what we have done. It contains workshop plans, a recording of the project lecture from Professor Angela V John, links to other relevant sites and organisations, and many other visual and learning materials. More information about Lady Rhondda.
Many thanks to our sponsors who have made this project possible:
The Early Years of Lady Rhondda
Activism, Campaigning & the WPSU
Imprisoned For Bombing Postbox
Near death experience:
Businesswoman and Entrepreneur
No Seat in the Lords
The Early Years of Margaret Mackworth
Margaret (née Margaret Haig Thomas) was born in 1883, the only child of Sybil and David Alfred ('D.A') Thomas, in Bayswater, London. Her parents returned to their native Wales in 1887, taking up residence at Llanwern House on the eastern outskirts of Newport, near the village of Magor. Margaret's childhood was mostly spent there, but age thirteen she went to school in London for three years, before becoming a boarder at St Leonard's school in St Andrews, Scotland. Clearly not satisfied with being defined as a society debutante, in 1904 Margaret took up a place to read History at Somerville College, Oxford. However, despite good reports from her tutors, after two terms at Somerville she decided to leave her studies and returned to live at Llanwern.
An Influential Family
Lady Rhondda's title was passed down from her father, Lord Rhondda of Llanwern. D.A Thomas was the son of the grocer- entrepreneur Samuel Thomas, and grew up at Ysguborwen House, Aberdare. Following Samuel's death in 1879, D.A. inherited a major share in his father's business interests, including a number of mines in the South Wales coalfields. He subsequently worked in stockbroking in London, and in 1888 was elected Liberal MP for Merthyr Boroughs. He held his parliamentary position until 1910, regarded as a successful and popular MP. Perhaps surprisingly for a man of that era, DA described his relationship with his daughter as being 'not like father and daughter, we are butties' (John, 2013:33). They spent much time together walking in the countryside, debating political and social matters. As Margaret got older, D.A increasingly discussed the world of business with her, mentoring his daughter to become a businesswoman in her own right.
If D.A had a strong influence on his daughter's cultural and political development, then so did Margaret's mother Sybil, who was also politically active. Sybil Haig was daughter of the Irish wine merchant George Augustus Haig, and his wife Lady Charlotte Guest. Chair of the Aberdare and Abergavenny branches of the Women's Liberal Association, she was also a member of the Central National Society for Women's Suffrage. Margaret writes in her autobiography that her mother 'had prayed passionately that her baby-daughter might become a feminist' (1933:133), with Sybil supporting her daughter's involvement in the spheres of business and politics. The women of the wider Haig family were also highly committed to the suffrage movement. Aunts Lottie and Janetta (sisters of Sybil) were both dedicated members of the militant Women's Social and Political Union (WSPU) as were her second cousins, Florence, Eva and Cecilia Haig.
Activism, Campaigning & The WSPU
Over her lifetime, Margaret worked extensively to further the cause of equal rights between women and men. She campaigned for women's right to vote, as well as for equality in employment and health legislation, and latterly, women's right to enter the House of Lords as peeresses.
Newport WSPU:
In 1909, a Newport branch of the WSPU was convened at a meeting chaired by Sybil Haig Thomas. Margaret subsequently took on the role of branch secretary, only a year after joining the organisation. The Newport branch, or 'suffragette shop' was firstly situated at 4 Clarence Place before being moved to number 46 (Crawford, 2006). In 2014 there is a supermarket at number 4, while number 46, across the road and close to the cenotaph, can be found between a takeaway outlet and a nail bar. Margaret became fully immersed in the suffragette cause, and soon began to write reports on the Newport branch activity to send back to the WSPU headquarters in London. She travelled across Wales and South West England promoting women's suffrage, with her commitment to the cause eventually resulting in imprisonment in Usk gaol.
This photograph shows Margaret campaigning in the streets of Newport alongside her Aunt Lottie, and another local woman, Miss Lawton.
Equal rights beyond the ballot box:
Margaret undertook political work that reached beyond the cause for universal suffrage with the objective of creating a more equal social world for women and men. During WW1 she established a women's panel at the Ministry of Munitions, then as the war drew to a close, she was also selected as a member of the Women's Advisory Committee created by the Ministry of Reconstruction. In both these positions she further explored the labour rights of women working for the war effort, and the consequences for women's employment in the post-war years (John, 2013). In 1923 Margaret created the Women's (Political and) Industrial League with a remit of furthering women's chances of taking up skilled and well-paid employment. This was preceded by her 1921 founding of the 'Six Point Group' with the manifesto of equal rights for women within the workplace, and for mothers and children.
These six points were:
Satisfactory legislation on Child Assault
Satisfactory legislation for the Widowed Mother
Satisfactory legislation for the Unmarried Mother and her Child
Equal rights for Guardianship for Married Parents
Equal pay for Teachers
Equal Opportunities for men and women in the Civil Service
In the 1930s the Group also began to lobby parliament for the rights of married women to take up employment (Moynagh, 2012). Much of this political work had a platform in the journal Time and Tide that Margaret created in 1920. The journal became a significant cultural and political reference point of its time, publishing literary reviews as well as articles promoting progressive, feminist perspectives on the development of equal rights in British society, and examining political issues on an international level (John, 2013).
Despite promising her husband that she would never be sent to prison, in 1913 Margaret was charged with unlawfully placing an explosive substance in a post office letter box. In the preceding years, the WSPU had increased their acts of militancy to include the 'bombing' of postboxes and window breaking of shops and businesses. Writing about this period in her life, Lady Rhondda describes reaching a point when her conscience would no longer allow her to avoid taking direct action when other WSPU members were regularly taking the risk of imprisonment to further the suffrage cause. After bombing a postbox on Risca Road, Newport she was arrested and charged.
In accordance with WSPU policy, she pleaded 'not guilty', but was charged with the offence. Given the option to pay a fine or be sent to nearby Usk gaol for a month, Margaret took the option of imprisonment. She was released after three days of hunger strike under the 1913 Prisoners (Temporary Discharge for Ill-Health) Act. Commonly known as the 'Cat and Mouse' Act, this allowed for the release of suffragettes on hunger-strike and their subsequent re-arrest once they were deemed physically strong enough to continue their sentence. However, when Margaret returned home, she discovered that her fine had been paid anonymously, and therefore did not return to prison. She documents the loneliness and isolation of prison in her autobiography, and after observing sparrows freely moving around the prison patio, she made the resolution to 'never… keep a bird in a cage' (1933:158).
Near death experience: the Lusitania
In May 1915 the First World War was fully underway, and it was then that Margaret and D.A had a close brush with death. On a voyage to the UK from New York, the ocean liner 'Lusitania' sank off the south-west coast of Ireland. Over 1,000 people lost their lives as the result of a torpedo attack from a German submarine. Margaret and D.A, returning from a business trip to New York, were two of the 764 survivors. Shortly after the torpedo hit, father and daughter were separated. As the boat sank, D.A escaped via a life-raft. Meanwhile, Margaret, who had gone to find their lifebelts, narrowly survived drowning. As the deck became submerged, she was trapped under the waves. She lost consciousness, but eventually was rescued, presumed dead, before being reunited with her father in Queenstown, Ireland.
In the early decades of the twentieth century, Lady Rhondda had a powerful and important place in the sphere of British commerce. When D.A sought an associate to become his 'right hand man', his wife suggested that their daughter take on that role (John, 2013). Margaret did so, despite being recently married, and worked with her father from his offices at Cardiff Docks until his death in 1918. By that year, she was in the remarkable position as a woman of sitting on a total of thirty one boards of commerce while chairing seven. The majority of her business interest were based in the coal and steel industries, but she also sat on the boards of national and international shipping companies, as well as a range of other businesses. Passionate about the need for women to be represented in the field of commerce, Margaret was involved in creating and chairing the Efficiency Club (John, 2013), that was essentially a networking organisation for British businesswomen. In 1920 she made the move to further develop her career in cultural and political affairs, establishing what was to become the highly influential journal Time and Tide.
When Lady Rhondda died in 1958, the House of Lords still did not permit women with hereditary peerages to legitimately take up their place there. Although that year saw women being granted peerages on an equal basis to men (and entry to the House of Lords), hereditary peeresses had to wait until the Peerages Act of 1963 was passed. Margaret campaigned for decades for peeresses to have access to the House of Lords, with an early bill in favour of this being informally known as 'Lady Rhondda's bill'. Biographer Angela. V. John points out that while this work was related to an issue distant from the daily lives of the majority of British women, it was nonetheless crucial in increasing the range of influence that women could exert at the very highest level of public office.
Lady Rhondda married Humphrey Mackworth in 1908, living first at Llansoar House, Caerleon until 1911, before moving to Oaklands House in Ponthir. They divorced in 1923. Margaret did not remarry but did have significant relationships over the course of the rest of her life. In the late 1920s she shared a home in Kent with Time and Tide editor Helen Archdale, then lived for twenty five years in Surrey with the writer and editor Theodora Bosanquet.
Crawford, E. (2006) The Women's Suffrage Movement in Britain and Ireland: A regional survey. Abingdon: Routledge.
John, A.V. (2013) Turning the Tide: The life of Lady Rhondda. Cardigan, Parthian.
Moynagh, M. ed with Forestall, N. (2012) Documenting First Wave Feminisms Vol 1: Transnational Collaborations and Crosscurrents. Toronto: University of Toronto Press.
Rhondda, Viscountess. (1933) This was my World. London: Macmillan.
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Banner Making Workshop (Ysgol Gymraeg Casnewydd)
Creative Writing Workshop
Banner Making Workshop
Please click on the links below to download.
Introduction: Exploring history through artefacts. Delivered by: St Fagans Museum
History: Lady Rhondda and the womens' suffrage movement. (KS3 Plan) Delivered by: Professor Angela John
Creative Writing: Suffrage verse. Delivered by: Mab Jones
Music: Choral workshops. Delivered by: Tic Ashfield (Junior Workshop)
Music: Choral workshops. Delivered by: Tic Ashfield (Senior Workshop)
Music: Oh Beautiful Spring score
Music: Senior Workshop graphic scores
The Story of a Lady Bomber
Lecture: The Many Lives of Mrs Mackworth - 17th February 2014 - Download Transcript
BIRD IN A CAGE BLOG
3RD PARTY TWEETS
#Spain raises minimum age for marriage from 14 to 16 http://t.co/EBNLHUfJlQ via @BBCnews
Four incredible women athletes are daring to row 3000 miles across the Atlantic Ocean: http://t.co/N1BGrOSJm5 via @bournemouthecho
Our new study explores the impact of gender equality programming on humanitarian outcomes: http://t.co/6Y1WHVDYrI http://t.co/aHmZWAUcjf
BIRD IN A CAGE TWEETS
@intofilm_edu teaching animation at a summer school in Wales courtesy of the iPad project. Great stuff! http://t.co/gnvOZvTDvh
RT @chaptertweets: Next week's abuzz with kids activities, from film activity days to sewing. We've got the summer holidays covered: http:/…
Great workshops happening again this summer at the USW Film School. The young filmmakers are producing a real corker! Online soon.
Amy Morris: Project Manager
As project manager, Amy is responsible for all aspects of the programme; fundraising, recruitment, scheduling, marketing and promotion, event management, film production and project evaluation. She is also one of the workshop leaders and will produce and facilitate the Agored Cymru accredited History qualification for students at Lewis Girls School. A history graduate and keen amateur historian, Amy is the Managing Director of Winding Snake
Productions and has delivered several award winning projects during her career. She is looking forward to sharing the remarkable life of Lady Rhondda and hopes that the project will inspire people to explore their political heritage.
Email Amy
Lauren Orme: Filmmaking and project assistance
Lauren is leading the production of the animated film that will be created during the A Bird in a Cage project. She is also responsible for coordinating the project program for Ysgol Gymraeg Casnewydd junior school, and is one of the project's workshop leaders. Lauren has been making films for Winding Snake for a year and a half; she has been with the project since its conception during a
tea break from a workshop at Lewis Girls school. She is looking forward to sharing A Bird in a Cage with all the different young people the team will meet along the way, and to helping them to make a film together.
Louise Bowen: Research and evaluation
Louise is responsible for producing and managing content for A Bird in a Cage website as well as developing the project evaluation framework. Over the last 15 years Louise has worked on a variety of projects within adult education and community development, and joins the team fresh from completing her PhD on refugee student experience in UK higher education. She is looking forward to seeing how the young people participating in A Bird in a Cage workshops explore their ideas about democracy using creative methods.
Email Louise
We'd love to hear from you, so please send us a message using the form below, and we'll get back to you as soon as possible.


Selena Gomez and The Weeknd finally made their red carpet debut as a couple at this year's Met Gala, but like everything, it wasn't without its awkward moments.
Neither star has run into their ex, though many are speculating that the couple will eventually encounter Bella Hadid and Justin Bieber at some point tonight. However, according to E! News, sources say that the duo was trailing behind Bella's family, including her brother Anwar and mom Yolanda.
Unfortunately, when it comes to Hollywood, there's no avoiding these things. Everything seemed to be in order on the carpet though. That said, Selena and The Weeknd appear to be taking it all in stride, as E! also reports that they heard Selena whispering "I love you" into Abel's ear.
The two certainly seem to be at their happiest and we thought things couldn't get better after that Instagram Selena posted from Coachella. We can hardly wait to see where they end up next.


Monday, September 25, 2017 — In next week's Catalyst (screening Tuesday 3 October, 8.30pm on ABC & ABC iview) join Professor Emma Johnston as she asks the question –Can We Save the Reef?
Off Australia's northeast coast lies a wonder of the world; a living structure so big it can be seen from space. It's more intricate and complex than any city, and so diverse it hosts a third of all fish species' in Australia.
This is the Great Barrier Reef; 2,600km of coral reefs, lagoons, islands, and deep channels - a living fortress that meets the relentless power of the sea head-on, and protects Australia's coast. A name recognized by most, but understood by only a handful of intrepid people. The Great Barrier Reef as we know it - 8,000 years old and home to over 2,000 marine species – is dying in our lifetime.
Can We Save the Reef? is the epic story of Australian and international scientists who are racing to understand our greatest natural wonder, and employing bold new science in an attempt to save it. Professor Emma Johnston is a passionate diver, leading marine biologist, and board member of the Great Barrier Reef Marine Park Authority. It's part of her mission as a scientist, and an Australian, to protect our Reef. Both hard-hitting and hopeful, Professor Johnston shows us how no two are the same and how other reef systems, like the one in Hawaii, are proving to be valuable testing grounds for what can be done at home in Australian waters to help ours survive.
Working with Australian scientist Dr Madeleine van Oppen, Dr Ruth Gates in Hawaii is identifying and testing coral species with the greatest resilience. Part of their joint work is to breed coral under warmer, more acidic, future-ocean conditions. Here in Australia, at the Australian Institute of Marine Science (AIMS), Dr Madeleine van Oppen is pioneering ways to breed hardier Great Barrier Reef corals and, to breed more resilient algae (their symbionts and food source) to co-exist with and keep more coral alive.
Host Professor Johnston explores when and how science should intervene to put hardy new coral species on the Reef, and whether the pitfalls of new genetics could do more harm than good. But this is not a story about coral alone. To understand how to save a reef, one must understand the Great Barrier Reef itself. How and why did it form and thrive? What actually is the Great Barrier Reef? What other threats are affecting it, and how do we best safeguard it? Professor Johnston reveals a phenomenally complex ecosystem, and how the solutions to save ours, may also help save reefs worldwide.
Biography: Professor Emma Johnston is an award-winning marine ecologist and Dean of Science at UNSW Sydney. She is a leading authority in marine ecology and a former Pro Vice-Chancellor (Research) at UNSW. Emma has previously appeared on a science special of Q&A and ABC's One Plus One.
Director/Writer: Adam Geiger, Producer: Colette Beaudry. Can We Save the Reef? is a Sealight Pictures Production, produced in association with the Australian Broadcasting Corporation, with principal funding from Screen Australia.


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Insights/Opinion/Politics/Top Stories
As Prince Arthur Eze returns to a familiar role as 'Igbo President Personal Actualizer' for Governor Soludo, this is the first of a two-part article. IK Albert Ngene is Prime Business Africa's Public Interest Analyst. He lives in Atlanta.
Fifty-three (53) years ago this week, the Nigerian Civil War ended. Ndigbo whose secessionist state, Biafra, had been defeated sought afterwards to rebuild their sense of community, gather their thoughts, and walk with a raised head into a new dawn. Their affirmation came from many sources – industry, enterprise, and mission to other regions as if to test once again the integrity of the concept of citizenship of the 'stranger'1 in Nigeria.
Figure 1 – Emmanuel Okala – Rangers goalie and crowd favourite
Ndigbo also found upliftment in culture, entertainment, and sports: The music of Oriental Brothers, Prince Nico Mbarga, and Theresa "Egedege" Onuorah; the international renown of Power Mike (wrestling) and Obisia Nwankpa (boxing); the TV theatre of New Masquerade and Icheoku; and the winning ways of Enugu Rangers FC and Vasco da Gama FC. In 1974, just four years after the war, Enugu Rangers FC was the dominant team in Nigeria – winning both the Challenge Cup and the Premier League. They followed that up with a runners-up position in the African Cup of Champions Clubs in 1975.
As they say, 'Time heals all wounds', so with time Ndigbo began to heal.
"Where life had no value, death sometimes had its price. That is why the bounty killers appeared!" – Sergio Leone
Here Comes The Men Who Profit From Misery
Unfortunately, the Igbo community embarked on this healing process without the most fundamental ingredient that was required – a socio-political leadership that would undertake the institutional and infrastructural reconstruction that was required to make a people whole again. While Chika Okpala, Emma Okala, and the rest of the courage-teachers, mentioned above, were hard at work, the home-grown contractors arrived but on a different mission.
READ ALSO: THE KING IS DEAD … LONG LIVE THE LION KING – Part 1
After the American Civil War the counterparts of our homegrown contractors had arrived in the former confederate states in the South, whose secessionist bid had been vanquished, to make super profits from reconstruction as auctioneers, no-bid contractors, and middlemen; there they were known as the carpetbaggers. Also, their types were found in the American frontier towns of the Wild Wild West where they enthroned a fast gun culture that paid per life taken; and there they were known as the bounty hunters.
Prince Arthur Eze, Emeka Offor, and Chris Uba are popularly described as godfathers of Anambra politics, but they have none of the redeeming features of Don Corleone in Mario Puzo's The Godfather. (Puzo actually based his character on two real historical figures – Frank Costello and Carlo Gambino.) But where Don Corleone was benevolent and gracious with his power, our own godfathers practised cruelty for its own sake. They take everything and give nothing in return.
READ ALSO Prince Arthur Eze Returns To Familiar Role As Igbo President Personal Actualizer For Governor Soludo - Part 2
Figure 2 – Prince Arthur Eze (right) and Kano Governor Ganduje
Preparations For The Fourth Republic, or Its Lack Thereof
General Sani Abacha's government carried out the last states' creation exercise in 1996 which left (New) Anambra in its original contours when Awka was announced as capital by General Ibrahim Babaginda in 1991. In the lead up to the return to civilian rule, Group Capt. Rufai Garba was appointed Military Administrator (Milad) of Anambra State with a mission to set up administrative structures and institutions to prepare the citizens for the Fourth Republic. Garba resumed in August 1996 and somewhere in the recesses of his mind was a plan to build a stadium for the sports-loving people of Anambra as part of his mission. So he embarked on a familiarization tour of the state capital and LGAs to see the status of projects his predecessors had initiated.
His lofty thoughts: to complete what he could and then draw up a plan of action for his own initiatives – that stadium was a priority on his mind. After this visual audit his considered opinion was that there was a high number of abandoned or uncompleted projects around the state – the NYSC permanent site for Orientation Camp, Anambra State Government Secretariat, the Governor's Mansion, Zik's Lodge, and headquarters for many LGAs. He was very disappointed with the situation on the ground. So he summoned the contractors.
Perhaps one or two contractors turned up and recommitted themselves to completing their tagged projects.
Prince Machiavelli Was An Anambra Indigene
But Prince Arthur Eze, who had cornered many of those contracts, was a no-call no-show because he had an ace up his sleeve. Before the Milad could ask – "Where's that bloody civilian?" – he was invited to Abuja for consultation. When Garba got to Abuja, he spied Prince Arthur Eze in the corridors of power, relaxed in the company of the red necks and top brass he was saluting sharply with his chest out and averted eyes. To make a short story brief, the powers that were in Abuja advised him to work with the 'big boys' on the ground in Awka.
At that moment he learned to curb his enthusiasm.
He returned to Awka to mark time. His capitulation was total. Even the contract he awarded and mobilized for the construction of a headquarters for Anambra State Education Commission was left unexecuted. A few months before he was reassigned to his home state, Sokoto, after an unsuccessful two-year tenure, a mysterious fire gutted the governor's residence lest it be said that his tenure was also uneventful. The heady days of a vision of pomp and pageantry that would have marked his commissioning of a stadium for Anambra State were by then a blur in his mind.
READ ALSO See Top Five Italian Schools Offering 2023 Scholarships
His predecessor, Col. Mike Attah, had experienced something similar with Chief Chris Uba over a contract for Zik's Place that would have served as the governor's lodge. The project was paid for but was never executed and the Milad never found a point of leverage on Chris Uba. He was an untouchable. This paralysis of governance from the military administrators as a result of state capture by Anambra's godfathers set the stage for the malpractice of governance that would usher in the Fourth Republic.
Figure 3 – Anambra Secondary School Students arrested for cultism
A Prayer Warrior Comes to the State House
Dr. Chinwoke Mbadinuju was the first governor of Anambra State in the Fourth Republic. In his previous life he had worked for Chief Jim Nwobodo and Chief Alex Ekwueme in the Second republic. He had vacated his chair at the State University of New York as an associate professor of politics and African studies to return home to add value to Nigeria's democratic experiment.
Ordinarily Mbadinuju's theoretical knowledge and experience in the inner workings of government should have qualified him for excellence in governance. Nah! When he was tested he resorted to praise worship in the public space. When he resumed in May 1999, there was hope his tenure would deliver dividends of democracy to Ndi Anambra by way of good governance. That hope was quickly dashed when Chief Emeka Offor, who purportedly played a role in his election as governor, turned up at the State House for his pound of flesh. Mbadinuju, channeling his inner Andy Okeke3 in the Living in Bondage home video, thought that there could be a renegotiation of the 'devil's bargain' he had made with Emeka Offor for his ambition.
He was mistaken, as Andy Okeke also found out. Offor demanded such a large share of Anambra's federally allocated revenue that it was only possible to run a minimal government. This started the domino effect of administrative crises that led to non-payment of teachers' salaries for two years, the long strike by teachers, and the extended idle time pupils and students spent away from schools.
The performance of Anambra students in NECO exams under Mbadinuju was woeful and many boys dropped out of school and entered trade apprenticeship without school grade English Language and arithmetic competencies. Some resumed a criminal career. Anambra's human capital development was put on hold because of the moral weakness of one man and the insatiable greed of another. The civil servants were not exempt. They were owed salaries and they responded with wildcat strikes.
READ ALSO Buhari Appoints New CEO For Nigerian Export Promotion Council
It was at this point that Barnabas Igwe, chairman of NBA (Onitsha), called the attention of the national media to the failure of governance in Anambra state. For his attempted intervention, Barnabas Igwe and his pregnant wife, Amaka Blessing, were waylaid on the streets of Onitsha, dragged out of their car, and slashed and hacked to death with machetes by assassins. The assassins waited until the husband and wife were dead, and then ran over them with the Mercedes Benz car the couple were driving.
All these happened in broad daylight to teach him a lesson to mind his own business.
Figure 4 – Dr. Chike Akunyili murdered on the streets of Onitsha in September 28, 2021
Mbadinuju Sowed for his People a Seed of Death and Destruction
That was the gory spectacle that bottomed out the range between expectation and performance of the Mbadinuju administration. But it wouldn't be the last. Anambra became a bounty hunter town under his watch – a killing field. Chidiogo Akunyili described his father's death as "senseless", but we all know it started with Mbadinuju's malpractice of governance and total betrayal of the trust of his people. The salt on Mbadinuju injury to the polity was the public show of his version of 'sin crying to heaven for vengeance'. He led extensive praise worship sessions at the state house and secretariat while Offor was picking up his monthly cheques.
In other words, Mbadinuju was demarketing God while making a public show of prayer.
"Stranger" is a Nigerian colloquialism for a visitor or guest
Chika Okpala was the lead actor of The New Masquerade
Andy Okeke was the lead character in Living in Bondage who traded his beloved wife for wealth
This is the first of a two-part article. IK Albert Ngene is Prime Business Africa's Public Interest Analyst. He lives in Atlanta
READ PART 2 HERE: Prince Arthur Eze Returns To Familiar Role As Igbo President Personal Actualizer For Governor Soludo – Part 2
Prince Arthur Eze Returns To Familiar Role As Igbo President Personal Actualizer For Governor Soludo - Part 2
Arthur Eze and Soludo
Godfathers in Anambra politics
Reginald Okehie says:
Interesting read. Can't wait to read the Part 2.
Ebere Igboko says:
This is so illuminating and well done. When/where is Part 2? I'm ready for it.
Alexius Emejom says:
This is an articulate history of how we got to where we are today. Gradual degradation of morals and governance.
Legal Expert Faults Keyamo's Petition Against Atiku
Ministry Of Youth and Sports Postpones 7th National Youth Games

redpajama_set_name: RedPajamaCommonCrawl


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Chef cooks up big BBQ idea
Matt Brown 30 June, 2020, 12:25 pm 10 July, 2020 256
Gramado's owner Saulo Camillo is organising a huge community picnic and BBQ. Photo: Matt Brown.
A group of big-hearted restauranteurs are banding together to give people a boost – with a huge community barbecue.
Some of Marlborough's finest chefs have joined forces to organise a community picnic and BBQ to help bring people back together after lockdown.
The brainchild of Gramado's owner Saulo Camillo, the idea has been inspired by his father who died at just 38 years old.
"He was the inspiration for my whole life, he was a big-hearted man.
"During lockdown I knew that it was going to be tough, so I had to find something to do that I love.
"For me, that's Brazilian BBQ; It reminds me of my family.
"Our idea is in these desperate times to bring to families that have been having financial problems, that haven't been able to take the kids out in a while," he says.
The Gramado's team dishing up BBQ at their first event following the lockdown. Photo: Supplied.
Straight after lockdown, Saulo donated food to 38 families who had been nominated for a culinary treat.
Nominations flooded in and Saulo was encouraged to organise a larger event for 500 people.
It grew so large he reached out to fellow foodies to help. Karaka Cuisine, Arbor and Feast Merchants are all on board.
"I couldn't cater 500 people by myself, so I asked for help," he says.
Suppliers jumped on board too, Saulo says.
Westmeat, Te Mana, Bidfood and Meaters are providing ingredients.
"I had to ask for help, and it's ok to ask for help; That's why we have a community.
"We have a region that looks after each other."
He says the event is for families and individuals that could have had it rough during these "desperate" times.
"It could be people that are lonely or couldn't see their family during quarantine.
"Our idea is to have fun.
"We're going to have fun with whoever is coming."
He says he understands some families don't want to show that they are in need, and so plans to have a central pick up area in town for takeaways.
"A lot of families probably won't come, they don't want to seem in need," Saulo says.
"But it's better to be together with someone who can lift you up."
He says he hopes the event will continue and get bigger.
"In the last three weeks I've had more emails from people wanting to help than to join.
"If you can give a little – not even money, but time, you're going to inspire more people to help.
"Together we can make Marlborough better."
To nominate, email family name, contact number, address and the reason why they're deserving to [email protected]
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    base* base::GetInstance()
        {
            if(m_selfInstance == NULL)
            {
    /*Throws error here and it's natural, because it's violates C++ standard*/
                    m_selfInstance = new base();
                }
                return m_selfInstance;
            }
            int main()
            {
                base *b = base::GetInstance();
                //b->abc();
            system("pause");
            return 0;
            }

In this case how to deal with singleton and pure virtual function together.
If I'll make like m_selfInstance = new der(); things works fine.
But the real problem will occur if there are more derived classes like der_1 and der_2 at that time the istance will be m_selfInstance = new der(); instead of new der_1() or new der_2() .
Please guide me how to go ahead with this.

redpajama_set_name: RedPajamaStackExchange


text:
Remembering Francine
Tags: 1970s, City College of New York, Joseph Heller, Vanity Fair, William Burroughs, Francine du Plessix Gray
Francine du Plessix Gray, shot by Irving Penn, on the cover of Vanity Fair, November 1983.
It was a long time ago, and the memories are starting to fade, but when I heard last week that Francine du Plessix Gray had died, at the age of 88, it reminded me, once again, of the best piece of writing advice I ever got. It's advice that I've adhered to since that autumn afternoon in 1975, in her office in the English department, at the City College of New York, when she showed me a spiral-bound notebook, the latest volume of the journal she'd been keeping since the summer of 1951, and said, "Keep a journal; write in it every day."
It was, she explained, how a writer finds his (or her) voice—by making writing as natural as breathing.
There were other bits of useful advice that Francine—we called her "Francine," not "Professor Gray"—shared with her students, advice of the sort you wouldn't normally get in a CCNY writing workshop. Like (and I forget her exact words, but the message was clear): Edit your own work when you're stoned on marijuana. You'll have no tolerance for bullshit and unnecessary verbiage.
Francine arrived at CCNY for the Spring 1975 semester, slated to teach one graduate and one undergraduate nonfiction writing workshop (what would now be called "creative nonfiction"). I met her my first day back at school—I'd gotten my BA in creative writing and then taken off a few months to travel. Now I was about to embark on a course of study in the graduate literature program after having been rejected from the creative writing program, which, at the time, I saw as the key to my future. I was 21 years old and crushed. The writing program at City College, in those magical days of free tuition, was a promised land where, for little more than the cost of books, one could study under the tutelage of Kurt Vonnegut, William Burroughs, and Joseph Heller, the department chairman, who had personally rejected me.
I thought studying literature might be a constructive way to kill time while I figured out what to do with my life.
I was wandering through the English department—a quonset hut on South Campus—attempting to put together a not-too-demanding schedule of classes, when a woman, fashion-model tall with blonde hair and wearing a Viva magazine T-shirt, asked me, with the slightest hint of what I took for an indeterminate European accent, if I knew where the administration building was.
"New here?" I inquired after giving her directions. I thought she might be a night-school student.
Yes, she replied, she'd just been hired to teach a creative writing workshop.
She asked me other questions about the college, and in the course of our conversation, I told her that I used to edit one of the student newspapers and that I'd been rejected from the creative writing program.
What happened next still seems miraculous. Francine asked me to bring her some of my stories that had been published in the newspaper. I brought her a half-dozen samples of my work, and when I returned to her office later that afternoon, she looked up from my articles, spread out on her desk, and declared, "This is gonzo!"
She invited me to take her graduate writing workshop and asked if I'd be her graduate assistant.
I was in!
Because Francine never talked about it in any detail, all I knew about her history was what I read in the short excerpts about her European childhood—governesses, a Russian mother, Paris—that she showed the class from the autobiographical novel she was writing at the time, Lovers and Tyrants. Had I heard that her stepfather, Alexander Liberman, was the editorial director of Condé Nast, it would have meant nothing to me. I'm not sure I knew that Condé Nast was a magazine-publishing company.
But what was really important to me about Francine was that she taught creative writing in a way that none of my other teachers had. Where Heller, for example, said that there was only one way to write a story—well-plotted with a beginning, middle, climax, and end… no deviations and no sci-fi, supernatural, or detective stories—Francine believed the best way to write was in fragments. Don't think about plot or form. Just get something good down on paper. Trust your unconscious and eventually the fragments will congeal into a coherent whole.
Rather than stories, she assigned fragments. Start from the inside and work your way out: first describe an emotional experience, then a small space, then a person, then a larger space, and keep going until you finally work your way up to describing a historical event.
This made sense to me and I flourished.
Once a week, after she taught her undergraduate class, we'd sit together in her little office in the English Hut, as it was called, critiquing stories, with me, on occasion, alerting her to an unexpected gem.
It went on like this for two terms, during which she guided me though my first attempt to get a full-length book off the ground, reading and editing my rough drafts. After I'd badly missed the mark on one of her assignments, she made a prediction: "You're going to write darkly humorous books and travel around the world."
And our bond became stronger because we were both plagued by a stutter that came and went depending on how stressed we were. Writing was a way to express ourselves fluently.
Francine left City College in 1976, returning to Connecticut and a life of writing books (At Home with the Marquis de Sade, World Without End, October Blood, and Them, among others) and magazine articles, including covering the trial of Gestapo chief Klaus Barbi for Vanity Fair, which won a National Magazine Award for best reporting.
I somehow muddled through my final term of grad school without her.
Over the years, we'd exchange an occasional postcard, but by the mid-1980s we'd fallen out of touch. I now wonder if she was aware that her prediction had come to pass.
Yes, Francine, there have been a handful of "darkly humorous" books and there has been much travel to distant lands to talk about them. And I often think of you when I write in my notebook—which I still do every day.
I invite you to join me on Facebook or follow me on Twitter.
I very much enjoyed reading this. Fascinating information about your history.
- Gary Hoopengardner Sr.


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Ray Ban has prepared a vast battery of novelties for the year 2017. One of the most emblematic is the launch of the new Ray Ban Round Double Bridge glasses.Sunglasses suitable for approaching summer.
Based on the round shape, these Ray Ban glasses feature a double metal bridge and are available in blue, green, pink and gray, with black and gold frames.There are several varied combinations of these glasses.
The year 2017 also saw the birth of Ray Ban glasses with Chromance lenses, special lenses, ideal to make the light vibrate, a little thinking about outdoor activities.These new lenses will be available in summer time in a wide range of colors.
In addition, these Ray Ban glasses aim to provide a comfortable view, even in broad daylight.Chromance lenses only reach the market in July, but promise a glamorous summer .
These new lenses of the glasses have a composition of high contrast pigments, in addition to an antireflective coating and polarized filters.What allows you to adjust to adapt light contrasts, color and the contours of objects.
In addition, these goggles filter the health-damaging UV rays and eliminate all annoying glare, rejecting excess glare.Its colored coating increases the performance of the glasses and makes the vision more comfortable.
To further enhance the user experience, these glasses have simple, functional yet very sophisticated frames , allowing for great lightness, but also great strength and durability. All these features make these Ray Ban sunglasses a great surprise well in time of summer according to financedns.


She had tried everything she could think of, but it made no difference. Extra activities. Added staff. Security cameras . . .
The son came into our community looking into a memory care apartment for his father. He and his brother were having challenges with him, he said. "What kind of challenges?" I asked . . .


We believe that art is limitless, so we don't want to bound you with rules, but before posting photos must remember few basic instruction.
1) Comment on others photo.
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3) Don't post anything that may harass any particular religion, person or community.
4) You are allowed to debate with other members but don't start fighting and posting offensive comments.
Thanks For reading and wasting some time, now go and capture something good and post on the group.


text:
Q: import express from 'express'; SyntaxError: Unexpected identifier I've been making a script via tutorial, but when I'm trying to run index.js via nodemon run index.js, I get syntax error in pointing to import express from 'express'; .
I have nodemon installed, for bd I've also have mongo and mongod running. Tutorial might be outdated or have something installed/running without being told.
My index.js
import express from 'express';
import dbConfig from './config/db';
const app = express();
dbConfig();
const PORT = process.env.PORT || 3000;
app.listen(PORT, err => {
  if (err) {
    console.error(err);
  }{
    console.log('App listen to port: ${PORT}');
  }
});

package.json:
{
  "name": "meetup-backend",
  "version": "0.0.1",
  "main": "index.js",
  "scripts": {
    "dev": "NODE_ENV=development nodemon dist/index.js",
    "build:watch": "babel -w --out-dir=dist ./src",
    "clean": "rimraf dist",
    "lint": "eslint src",
    "lint:fix": "eslint --fix src"
  },
  "repository": {},
  "author": "Emanuel Quimper",
  "license": "MIT",
  "dependencies": {
    "axios": "^0.16.1",
    "babel-polyfill": "^6.26.0",
    "babel-preset-es2015": "^6.24.1",
    "babel-preset-stage-2": "^6.24.1",
    "babel-register": "^6.26.0",
    "body-parser": "^1.18.3",
    "detect-port": "^1.3.0",
    "es6": "0.0.7",
    "express": "^4.16.4",
    "jsonwebtoken": "^7.3.0",
    "mongoose": "4.7.7",
    "morgan": "^1.9.1",
    "passport": "^0.3.2",
    "passport-jwt": "^2.2.1"
  },
  "devDependencies": {
    "babel-cli": "^6.26.0",
    "babel-plugin-transform-object-rest-spread": "^6.23.0",
    "babel-preset-env": "^1.7.0",
    "eslint": "^3.19.0",
    "eslint-config-equimper": "^1.6.2",
    "nodemon": "^1.18.10",
    "rimraf": "^2.6.1"
  }
}

As i run nodemon index.js I get:
 nodemon index.js
[nodemon] 1.18.10
[nodemon] to restart at any time, enter `rs`
[nodemon] watching: *.*
[nodemon] starting `node index.js`
/Users/ari-mikkopenttila/Documents/GitHub/youtubeMeetupAppReactNativeNode/meetup-backend/src/index.js:3
import express from 'express';
       ^^^^^^^

SyntaxError: Unexpected identifier
    at new Script (vm.js:79:7)
    at createScript (vm.js:251:10)
    at Object.runInThisContext (vm.js:303:10)
    at Module._compile (internal/modules/cjs/loader.js:657:28)
    at Object.Module._extensions..js (internal/modules/cjs/loader.js:700:10)
    at Module.load (internal/modules/cjs/loader.js:599:32)
    at tryModuleLoad (internal/modules/cjs/loader.js:538:12)
    at Function.Module._load (internal/modules/cjs/loader.js:530:3)
    at Function.Module.runMain (internal/modules/cjs/loader.js:742:12)
    at startup (internal/bootstrap/node.js:283:19)
[nodemon] app crashed - waiting for file changes before starting...

I just cant seem to find what causes error and how to fix it. Help/advice needed and apologies if problem is easy to fix.


text:
Мо́ддинг (; от  – «модифицировать, изменять») — внесение изменений в конструкцию и дизайн (модифицирование) электронных устройств с целью улучшения их внешнего вида и технических характеристик. Обычно под словом «моддинг» понимают видоизменение компьютеров и периферии. Модификацию мобильных устройств иногда называют словом «моббинг».

Основные понятия

Чаще всего объектом моддинга становится корпус компьютера. Модернизированный корпус называют кейсмодом или просто модом. Если корпус был изготовлен с нуля (или с использованием ограниченного набора серийных деталей), его называют «кастом-кейс» или просто «кастом» (, «изготовленный на заказ»). Модифицированные периферийные устройства (мониторы, клавиатуры, мыши, веб-камеры и т. д.) обычно называют просто модами.

Человек, увлекающийся моддингом, является моддером.

Цели моддинга

Основные цели моддинга — получение эстетического удовлетворения и выражение собственной индивидуальности. Также путём моддинга можно улучшить технические характеристики устройства — организовать эффективное и малошумное охлаждение, добавить новые функциональные возможности, упростить переноску и так далее.

Зачастую моддинг сопровождается разгоном (оверклокингом). Иногда производится и даунклокинг, то есть, уменьшение тактовой частоты, — например, когда нужно создать бесшумный компьютер с малым тепловыделением.

История

Как относительно массовое явление, моддинг сформировался в США и странах западной Европы ориентировочно в конце 1999 — начале 2000 года. В России и странах СНГ моддинг начал зарождаться в конце 2001 — начале 2002 года, а резкий взлёт его популярности пришёлся на 2004 год. Сегодня моддинг насчитывает тысячи последователей по всему миру. Регулярно проводятся конкурсы по моддингу, встречи моддеров, выставки работ.

Во многих крупных городах появляются моддинг-мастерские (моддинг-ателье) — объединения моддеров, работающих на заказ либо совместно создающих сложные моды для последующего участия в конкурсах.

Направления в моддинге

Темы моддинг-проектов могут быть любыми. Простор для моддинг-творчества ограничивается только фантазией моддера и техническими характеристиками используемых устройств.

Чаще всего работы выполняются в одном из следующих стилей:

 постапокалиптика — создание компьютеров, будто бы переживших ядерную войну или иную глобальную катастрофу. Очень распространены стилизации под игровые вселенные S.T.A.L.K.E.R. и Fallout;
 хайтек — создание ультрасовременных, футуристичных корпусов. В последние годы завоевали популярность моды, выполненные по мотивам фильмов Трон и Трон: Наследие;
 стимпанк — стилизация электронных устройств под эпоху пара и викторианскую Англию. Выполняется с использованием деревянных, кожаных и латунных элементов; также для этого стиля характерны многочисленные шестерёнки и медные трубки, изображающие детали паровых машин и двигателей Стирлинга;
 тематический моддинг — изготовление корпуса по мотивам творчества музыкальной группы, компьютерной игры, книги и т. д.;
 реклама — создание мода с использованием комплектующих конкретной фирмы, которая, как правило, выступает спонсором. При этом обычно обыгрывается логотип компании и её фирменные цвета;
 встраивание — установка компьютерных комплектующих в необычный корпус (бытовой прибор, предмет мебели, игрушку или даже чучело животного);
 HTPC (Home Theatre Personal Computer) — создание практически бесшумного компьютера для использования в составе домашнего кинотеатра. При этом нередко используется пассивное охлаждение;
 гетто — намеренно «неаккуратное» изготовление мода с использованием различного «хлама». Впрочем, иногда так называют просто грубо сработанный и некрасивый кейсмод, даже если его создатель не планировал именно стиль «гетто-моддинга». Но в случае намеренного «гетто-моддинга» используется именно «хлам», а не непригодные к использованию детали, и собранный в таком стиле компьютер лишь только внешне выглядит кустарно собранным.
 технический — самый распространённый вид т.н. «шопмода», направленный на увеличение производительности охлаждения при снижения его шумности и, как правило, проектируемый на этапе выбора компонентов (корпус, блок питания, вентиляторы, кулеры, системы управления скоростью оборотов). Ставит целью не эстетический эффект — а избыточность охлаждения при приемлемой для пользователя шумности, при этом не всегда сопровождается оверклокингом.

Приёмы моддинга

 выпиливание окон
 перекраска
 аэрография
 гравировка
 оклеивание плёнкой
 установка системы водяного охлаждения (СВО)
 добавление вентиляционных отверстий («блоухолов», )
 оплётка («раундинг») кабелей блока питания
 подсветка
 установка ручек для переноски
 добавление индикаторов и регуляторов
 искусственное состаривание
 изменение формы панелей корпуса

Материалы для моддинга
Моддерами широко используются алюминий, сталь, оргстекло (акрил), дерево, карбоновая плёнка, стеклоткань. Также продаются специальные товары для моддинга — фигурные вентиляционные решётки, декоративные винты и гайки, лампы подсветки, светодиодные ленты, специальные кнопки и тумблеры, многофункциональные панели для установки в отсеки системного блока, наклейки и т. д.

Инструменты и технологии
Моддинг можно осуществлять с использованием любых имеющихся средств. Даже при помощи ручной дрели и напильника можно проделывать ровные отверстия в металле. Но для облегчения и ускорения работы рекомендуется иметь следующие инструменты:
 электродрель
 гравер (дремель) (прямошлифовальная машинка)
 электролобзик
 заклёпочник

Если позволяют возможности, моддеры используют такие высокотехнологичные операции, как лазерная резка и фрезеровка на станке с ЧПУ.

Для покраски в домашних условиях чаще всего используется краска в баллончиках, но лучший результат даёт использование порошковой краски. Для создания рисунков начинающие моддеры применяют кисти и трафареты, более опытные — аэрограф.

Моддинг-жаргон
 «водянка» — система водяного охлаждения компьютера
 «гриль» — декоративная защитная решётка на вентилятор
 «ёлка» — мод с излишне яркой и многоцветной иллюминацией
 «раундинг» — упаковка кабелей блока питания в жгуты либо индивидуальная дополнительная оплётка каждого провода
 «реобас» — панель, позволяющая управлять скоростью вращения вентиляторов
 «шопмод» — корпус, напичканный готовыми аксессуарами для моддинга при отсутствии какой-либо «ручной работы» и творческой изюминки

См. также
 Модификация (компьютерные игры)
 Разгон
 Тюнинг
 Ретротроника

Примечания

Ссылки
 modding.ru - Крупнейший российский сайт о моддинге
 Популярный сайт о моддинге
 Один из старейших русскоязычных моддинг-сайтов
 Новый сайт о моддинге
 Украинская моддинг-мастерская
 «Азбука моддинга»
 Галерея качественных модов
 Моддинг - тоже искусство
 Галерея моддинга от i2HARD - лучшие моддинги со всего мира
 Моддинга ПК от HYPERPC - Моддинг для апгрейда

Хобби
Компьютерная культура

redpajama_set_name: RedPajamaWikipedia


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There were roaring dinosaurs on one side and children's blocks on the other.
And, in the middle, a couple dozen employees of Dondlinger Construction learned better teamwork and communication.
They worked in a corner of Exploration Place in the first session of an unusual new business training program created by the museum and Wichita Area Technical College.
The museum has had blocks for children to build castles and towers in its KEVA exhibit area, and that's still available.
But now, businesses can also book the exhibit along with a trainer during weekday afternoons.
The four-hour seminar starts with employees in teams building towers silently, then doing it again but allowed to speak to each other. On a final go round, they plan as well as communicate. As their interaction grows, so does their effectiveness in building a structure.
The exercise drives home the merits of good teamwork and communication, said Dan Hemmen, who teaches the course for WATC and is also vice president for quality at the Atlas Group.
Tom Dondlinger, president of Dondlinger Construction, who observed the first session, said he sponsored the children's exhibit a year ago and now is happy to also see it used for a business purpose.
The program costs $60 per person for sessions booked by Nov. 26 and $75 per person afterward. Call Exploration Place at 316-660-0620 for more information.


text:
JME Commentaries
The burden of normality: from 'chronically ill' to 'symptom free'. New ethical challenges for deep brain stimulation postoperative treatment
Frederic Gilbert
Correspondence to Dr Frederic Gilbert, University of Tasmania, 41 Private Bag, Hobart, TAS 7001, Australia; fredericgilbertt{at}gmail.com
Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson's disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, behavioural, affective and social. In many cases, patients express difficulty adjusting from being chronically ill to their new status as 'treated' or 'seizure free'. This postoperative response adjustment has been described in the literature on epilepsy as the 'Burden of Normality' (BoN) syndrome. Most of the discussion about DBS postoperative changes to self is focused on abnormal side effects caused by the intervention (ie, hypersexuality, hypomania, etc). By contrast, relatively little attention is paid to the idea that successfully 'treated' individuals might experience difficulties in adjusting to becoming 'normal'. The purpose of this paper is (1) to articulate the postoperative DBS psychosocial adjustment process in terms of the BoN syndrome, (2) to address whether the BoN syndrome illustrates that DBS treatment poses a threat to the patient's identity, and (3) to examine whether the current framework for rehabilitation after DBS procedures should be updated and take into account the BoN syndrome as a postoperative self-change response.
Behaviour modification
healthcare for specific disease
psychosurgery
http://dx.doi.org/10.1136/medethics-2011-100044
Although more than 80 000 people worldwide have been treated using Deep Brain Stimulation (DBS) since 1995,1 there are relatively few studies into postoperative psychosocial adjustment correlated with a sudden relief of the chronic symptoms of Parkinson's disease.2–4 These postoperative psychosocial adjustment outcomes are characterised by Parkinson's patients who experience difficulties adapting despite improvement in motor disability function. Available publications report cases of successfully 'treated' Parkinson's patients who experience difficulty adjusting to a new concept of themselves,3 or cases of DBS patients with clear motor improvement who report a feeling of strangeness about their postoperative self.4 There are ethical rationales for increasing research into the study of the postoperative process in Parkinson's patients treated with DBS.5
What motivates these ethical rationales is that similar postoperative psychosocial adjustment outcomes have been documented in clinical studies of epileptic populations. Epileptic patients who have received an anterior temporal lobectomy (ATL) identified a range of postoperative complications in a number of domains: psychological, behavioural, affective, and social (see table 1).6–12 This postoperative psychosocial adjustment was first characterised by Bladin as the 'Burden of Normality' (BoN),12 then described further by Wilson et al as a syndrome.6–11 The BoN syndrome describes the adjustment response process following efficacious psychosurgery, when patients suddenly change from 'chronically ill' to 'well' or 'seizure free'. The BoN syndrome is a described phenomenon in the epilepsy ATL postoperative literature,13 but this description of postoperative adjustment is limited and has not yet been applied to Parkinson's patients who have undergone a DBS intervention and who have difficulty coping with the expectations associated with becoming 'normal'.
BoN's features observed within epilepsy patient treated by an ATL6–12
Given that a reduction in debilitating symptoms might not necessarily result in well-being, as suggested by the BoN syndrome, DBS procedures raise ethical issues related to harmful risks (such as a threat to a patient's identity) and also highlight challenges with respect to ethical obligations (such as providing access to information, preoperative psychometric self-image measurements, postoperative follow-up, etc). The first section of this paper articulates the BoN syndrome in terms of postoperative DBS treatment; the second explores ethical concerns regarding to what extent the BoN syndrome is evidence that DBS treatment may pose a threat to identity; and the third focuses on ethical obligations related to clinical issues of DBS.
BoN in DBS postoperative adjustment process
Being an invasive treatment, DBS is often considered as the last option in cases where patients with severe, debilitating and treatment-refractory illness cannot be treated with pharmaceutical drugs. The current generation of DBS treatments have, in the main, been approved to treat Parkinson's disease, essential tremor and dystonia. DBS has also been used in many trials to treat psychiatric conditions such as severe depression, obsessive-compulsive disorder, Tourette's syndrome, obesity, epilepsy, Alzheimer's disease, impulsive and aggressive behaviour, and addiction.14 In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery.15
As seen in the introduction, clinical studies of epileptic populations who have received ATL identified a range of side effects and complications known as the BoN syndrome. In many cases, patients express difficulty adjusting to their new status as seizure free. A fundamental characteristic of the BoN syndrome is that self-changes are not directly related to clinical side effects of mood disturbance, but rather are independent and associated with the psychological experience of becoming seizure free.9
There is growing evidence of postoperative adjustment issues within populations of patients treated with DBS.2–4 ,16 Although significant in number,2–4 ,16 challenges associated with postoperative DBS outcomes have not been articulated in terms of a syndrome. It is important to consider the difference in treatment of ATL for epileptic patients and DBS for Parkinson's patients (ATL is irreversible, while with DBS the stimulation can be switched on and off) and recognise that epilepsy and Parkinson's patient populations differ significantly in the nature of their disease. However, when comparing the types of change within both populations, many similarities appear. In terms of the BoN syndrome (table 2), the four types of change in patients with epilepsy who have received an ATL align with the major types of change within DBS Parkinson's patients who find it difficult to 'reintegrate into a normal familial and social life' despite improvement in motor disability function.3
Case reports of postoperative adjustment process
Table 2 is presented only as a sampling of evidence of adjustment responses within epilepsy and Parkinson's patients; it provides a set of examples and is not meant as an extensive representation of all possible postoperative responses. Table 2 illustrates that postoperative psychosocial adjustments are not unique or specific to epileptic patients; it also captures the difficulties experienced by Parkinson's patients who have undergone a successful DBS treatment; the BoN syndrome is a postoperative response shared by these two different types of patient treated by distinct kinds of psychosurgery. As such, the 'type of change' appears mostly independent of the kind of treatment received by patients. Given the similarities in the 'types of change', articulating postoperative DBS adjustment responses in terms of the BoN syndrome helps us to see that the changes experienced by different patient populations are compatible.
However, the mere fact that the phenomenon occurs in two types of effective brain surgery treatments for chronic neurological disorders does not at all imply that it is relevant to all types of effective surgical treatment. In other words, it is not only the change from 'chronically ill' to 'symptom free' that guarantees the BoN phenomenon to occur; otherwise after knee- or hip-surgery the BoN could be observable in a high percentage of patients. In general, the BoN seems to be statistically observable within postoperative intervention related to brain surgery. One way to understand the statistical correlation between brain surgery for neurological disorders and the phenomenon of BoN is to understand that direct interventions in the brain increased probabilities to affect neuronal regions associated with personality and self.2–4 ,16 In contrast, for example, with surgery to the knee or hip, which are mostly motor-articulation parts of the body, the sense of what a patient makes of himself is inseparable from his brain. This connection between the brain and the sense of the self illustrates that psychosurgery, like DBS or ATL, raised higher probabilities of resulting in a phenomenon such as BoN compared to other medical interventions which involve motor-articulation parts of the body, such as such knee or hip surgery.
In terms of DBS, the BoN syndrome does not rule out that brain surgery, electric stimulation, drug reduction or neurodegeneration due to pathology, might influence a patient's perception of himself. Given that epileptic and Parkinson's patients share BoN syndrome features, it seems that 'type of change' in table 2 is not strictly a side effect of the DBS or ATL, but rather a response to effective treatment. In other words, it is the reduction of pathological symptoms related to brain surgery in different patient populations—they share the experience of becoming well, which causes similar postoperative responses. The BoN syndrome seems to take its origin in postoperative response improvements of neurological disorders, rather than in the type of brain surgery treatment. The BoN syndrome suggests that postoperative self-changes are a response of being symptom-free of neurological disorders.
Ethical concerns: is the BoN syndrome evidence that DBS poses a threat to patient's identity?
It has been argued that DBS postoperative change in a patient's identity 'is alarming' and 'is one of the most urgent conceptual and ethical problems'.17 As the above table 2 indicates, some patients declare: "I don't feel myself anymore", "I haven't found myself again after the operation".4 However, should it be concluded that the BoN syndrome illustrates that DBS may pose a threat to a patient's identity? Following a successful intervention, the reduction in symptoms does not just affect the person's functioning—the ability of the brain to achieve or approximately accomplish what we take to be normal human capacities; it also affects the phenomenology of experience, that is, the individual's subjective conscious experience of himself, his body and the world around him. Radical life change from the instability of being ill to the stability of being better, due to an efficacious treatment, does not necessarily introduce continuity in identity. Self-image narrative extends across time, pre- and -operation. For some, DBS may generate a biographical disruption,18 ,19 or a break in psychological unity which may problematise patient responsibility for action and decision-making competence.20 But to what extent is the BoN syndrome evidence that DBS is a menace to a patient's identity?
The current DBS postoperative adjustment literature represents an eclectic photograph: some patients seem to suffer from BoN syndrome when they experience a loss of their 'ill-image' narratives after stimulation, whereas others describe that being symptom free after stimulation helped them to find their 'true selves'.2–4 ,16 ,21 What is more, some patients experience continuity between themselves after stimulation and the persons they had been before Parkinson's disease.2–4 ,16 ,21 Within these eclectic reports, the BoN syndrome does not illustrate a threat to the identity per se, but rather suggests that chronic symptoms can be integrated components of patient self-image. What is at stake in cases of the BoN syndrome is that the postoperative self-narrative might simply not cope with the psychosocial consequence of emerging from the absence of symptoms.
In reported cases of DBS treatment associated with personality changes, the BoN syndrome might be explained by an abrupt transition in a patient's self-image which is concurrent with the reduction of the symptoms.9 Although the symptoms are fundamental parts of a patient's self-narrative, the relatively sudden alleviation of chronic symptoms in some patients may result in difficulty in discarding the pathology from their self-image. Patient psychosocial difficulties associated with learning to live as free may be correlated with key identity development periods. Wilson et al9 observed that the greater changes in self-image were associated with seizure onset during, or before, adolescence, and lesser changes in self-image were linked with adulthood onset, and that this might reflect an already established sense of self during adulthood.9 In terms of DBS treatment and the potential threat to a patient's identity, this suggests that change in self-image would therefore be proportional to the early onset of the pathology.
Under this description, it is difficult to see the BoN syndrome as an incarnation of an intrinsic threat to patient's identity. For instance, in some cases, although DBS did not successfully treat the symptoms, patients' postoperative perspective is surprisingly positive.22 In others cases, patients are regarded by their doctors and relatives as ill-adapted after successful stimulation; however patients seem to feel subjectively better.2–4 It appears that the BoN syndrome can occur when the doctor's perspectives differ from the patient's subjective experiences. A distinction between an internal perspective (patient's perspective) and the perspective of external, third- or second-person who judges a patient to beill-adapted (doctors, family members) illuminates heterogeneous narratives. From a patient's perspective, after successful stimulation, the BoN syndrome may reflect how one feels after losing the narrative of being chronically ill (loss of coherence of the self)—and maybe the privileges that go along with being recognised as sick by a third-person perspective. While there is no single understanding of how normality is defined from all perspectives, the BoN syndrome seems to emerge when there is an unexpected outcome from the first-person perspective (there is something wrong with me since the intervention, I did not expect this) and third-person perspectives (doctors and family members say the symptoms are gone, therefore the patient should be well). However, perspectives, built on years of chronic sickness cannot disappear as fast as symptoms, especially when symptoms are abruptly stopped by DBS. Consequently, there is a danger of imposing a 'forced normalisation': requiring patients to incorporate 'a change in self-image which is concurrent to the improvement seen in their illness'.5
From the phenomenal experience of being ill to the subjective perspective of being symptom free, a patient needs to exercise an ongoing narrative. A person's capacity to reinvent her self-image does not take place in a series of disconnected experiences. The heterogeneity of her own narratives extends across time but also across all perspectives (doctors, relatives and patient). Interactions between all perspectives reveal that a conception of identity based on relational components might be more adequate to address the ethical issue of the BoN within postoperative DBS patients.23 The notion of relational identity helps to understand that a successful intervention followed by the BoN syndrome does not necessarily threaten all of the patient's narratives.23 While DBS may result in profound changes in characteristics closely linked to personality, it does not necessary imply a challenge to pre-existing narratives since any sudden event or experience integrated into one's identity-constituting narrative could potentially disturb post-adjustment process.23
Rather than being a threat to identity, the BoN syndrome associated with DBS treatment illustrates the idea that a patient's illness is intimately linked with their relational identity, especially when the initial onset of the disease interfered with early juvenile self-image. as statistically observed within epileptic populations.9 The clinical phenomenology of the BoN syndrome appears to be the process of discovering that a patient's identity and social relationships are deeply tied to illness, at least more than the patients themselves, and/or their relations, had expected prior to psychosurgery.9 Instead of being evidence of a threat toa patient's identity, the BoN syndrome demonstrates that the role of illness in a patient's identity is often underestimated: "I don't seem to recognise myself without the problems I had before".3 Correspondingly, the ability to discard illness from self-image may be overestimated: the BoN syndrome reflects that patients do not necessarily enjoy a life unrestricted by symptoms as demonstrated in cases where patient wanted 'to be recognised as sick' despite successful treatment.4 This suggests that eagerness to abandon illness from self-image might be proportional to a patient's well-being.21
Though it can be argued that the BoN does not threaten a patient's identity per se, it does not imply that there are no important ethical concerns left associated with a patient's postoperative sense of his or her self. Any brain intervention introduces risk to a patient's self in general; especially when it is related to treatment of a psychiatric condition. Indeed, treatment of psychiatric conditions (ie, severe depression, OCD, etc) involves surgery which targets neural substrates other than motor control dysfunction tissues (ie, dystonia, severe tremors, etc); to some extent it could be argued that it aims at fixing precisely the self. In these conditions, brain interventions always carry an ethical risk of negatively affecting patients; probabilities of harming, in particular, patients' postoperative sense of their self remain significant. These ethical risks must not be neglected.
Ethical obligations: does BoN call for pre- and postoperative DBS responses?
Some may object that discussing an ethical strategy for potential BoN is premature, given the current evidence and given that the concept of BoN is mostly limited to epileptic patients. However, seminal DBS clinical follow-up studies have already called for the need to tackle postoperative psychosocial maladjustment within DBS's patients.2–4 Agid et al report "64% of patients who were working before surgery wanted to stop their professional activity and 65% of those who were married (or lived with a partner) experienced a conjugal crisis after operation",3 while Schupbach et al report 70% of patients developed postoperative martial conflicts and only 56% of patients restarted their professional work after surgery.19 Moreover, other clinical follow-up DBS studies have been alarmed by the significant worsened mood in patients—25% of followed patients—and raised the importance of being 'educated about the potential impact' of the postoperative life.24 These numbers may not be absolute evidence, but at least they are significant numbers that help to anticipate further postoperative ethical obligation. Given that there are no unified measures within the postoperative DBS psychosocial adjustment process, articulating these measures in terms of the BoN syndrome model could enhance the framework towards better ethical rehabilitation. This observation follows previous studies which have concluded that it is possible to apply the BoN syndrome model to patient populations other than epilepsy—narcolepsy patients being one example.7
The BoN syndrome raises ethical difficulties because it illustrates that DBS treatment may result in unexpected outcomes for patients, although there has been a diminution of symptoms, even after many years of follow-up.2–4 ,16 As a result, the ethical question of benefits and risks associated with DBS treatment is raised by the BoN syndrome. Unfortunately, the current limited numbers of follow-up studies or data available in the literature do not help in weighing the beneficial and harmful effects on patients. A first ethical obligation, given the state of our current understanding of the BoN in DBS patients, is to encourage further research.5 This research should assess whether the BoN syndrome is a temporary phenomenon or whether it lasts over years, and also whether it can be reversed by turning off the stimulation. Even if the BoN syndrome vanishes progressively after a few years, it raises a moral obligation to inform patients about the transient character of the phenomenon.
The potential psychosocial risk demonstrates that access to information with respect to the BoN syndrome is a moral imperative. It should be an ethical priority to properly inform future patients of treatment responses that might not be appropriate to the therapeutic goals of the DBS intervention. Access to information regarding the BoN syndrome should also highlight the limits of the treatment, and its potential long-term psychosocial effects, despite diminution of the illness. Families, relatives and care-givers should be informed of the BoN postoperative risks.
A lack of preparedness to deal with the BoN outcomes could make patients and their families more vulnerable and lead to distress. Clinical preparation should focus on introducing regulatory preoperative psychometric self-image measurements to identify links between patient self-image and illness. These psychometric self-image measures could prepare patients in anticipating radical self-change due to abrupt improvement. Pre- and postoperative follow-up should frame a rehabilitation programme for patients.
Potential adverse -term psychosocial outcomes require care-givers to act upon rehabilitation, but also on preventing unrealistic expectations and to proactively address improbable hopes while preparing patients and families for potential changes in narrative.8 High expectations for postoperative life are often represented, first, by patients expecting that psychosurgery will solve most of their issues, and second, by families anticipating that familial dynamics will be untouched, and third, by medical teams predicting that psychosocial outcomes will be better following a reduction in pathological symptoms. Patients and families who are poorly prepared before surgery are more likely to show adjustment difficulties after surgery.10 The BoN syndrome stresses the moral obligation for care-givers to accompany patients throughout their entire care trajectory (from early enrolment to many years after intervention) leading to a better social reintegration and adjustment process. Engaging interdisciplinary teams in pre- and postoperative follow-ups would enhance the effectiveness of managing optimal solutions in the face of the BoN syndrome.
This paper has argued that the postoperative DBS psychosocial adjustment process should be understood in terms of the BoN syndrome. Acknowledging the BoN as a possible DBS postoperative outcome has important ethical and clinical implications for tackling the impact of the procedure on patient's identity by developing an optimal framework for rehabilitation.
Neurological disease and treatment can both potentially alter identity. Underestimating the role played by illness in a patient's self-image can lead to distortions in self-narrative after DBS psychosurgeries. While not being evidence of a threat to a patient's identity per se, the potential harms illustrated by the BoN syndrome entail a moral obligation to establish preparedness regulations covering pre- and postoperative follow-up. Postoperative modifications in narrative are not necessarily ethically problematic;25 however, a model which measures adjustment elaborated from pre and post follow-up with patients suffering from epilepsy should inspire researchers to tackle the adjustment phase for the DBS patient population. As a result, it will not only prepare patients and their families for adverse outcomes, but also facilitate postoperative care-givers' work, as it is the case within the epileptic population.26
The reduction in pathological and debilitating symptoms may not necessarily result in amelioration for a patient who undergoes a DBS intervention; this observation shakes the assumption that patients who successfully undergo a DBS treatment should enjoy their new life. The risks that a patient might experience postoperative difficulties are unpredictable so far. Problems associated with anticipated patient future trajectory responses reflect a current lack of measurement in the postoperative studies; this lack raises the danger of the BoN syndrome as an invisible disability. The clinical challenge is to improve patients' well-being, which is not strictly related to neurological motor dysfunction but also related to an invisible 'forced normalisation'.5 It is always the brain which is treated, never directly a patient's social relations and, ultimately, self.
With life expectancy increasing, and the number of patients suffering from neurodegenerative pathologies growing, the risk of an exponential use of DBS treatment is plausible. Thus, lack of ethical indications tackling the BoN syndrome could negatively affect public healthcare systems. Also, considering allocation of healthcare resource ethics, further concerns have to be addressed. On what principles ought the BoN syndrome measures to be based? Should patients' suffering from the BoN syndrome be compensated by companies who make DBS implants? Future work in applied ethics is required in order to suggest what practice-based concept of equity should indeed be used within the practice of DBS procedures linked to the BoN syndrome.
Thanks to Eliza Goddard and Susan Dodds for enlightening discussions which were invaluable in drafting the argument of this paper. Thanks to the anonymous reviewers for their helpful comments and suggestions.
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Funding This research was funded by the Australian Centre of Excellence for Electromaterials Science (ACES). CE0561616
Competing interests None.
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