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BOMSS
British Obesity & Metabolic Surgery Society
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NBSR
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The National Bariatric Surgery Registry is the result of a collaboration between ALSGBI (Association of Laparoscopic Surgeons of Great Britain and Ireland), AUGIS (Association of Upper Gastrointestinal Surgery), BOMSS (British Obesity & Metabolic Surgery Society) and Dendrite Clinical Systems. The key objective of the registry is to accumulate sufficient data to allow the publication of a comprehensive report on outcomes following bariatric surgery. This will include reportage on weight loss, co-morbidity and improvement of quality of life.
Visit NBSR website
NBSR Committee members
BOMSS Trustee, Council member, NBSR Chairman
Senior Consultant Surgeon
Sunderland Royal Hospital
Biography Expand
Mr Peter Small is a senior consultant surgeon at Sunderland Royal Hospital with a specialist interest in bariatric and upper GI laparoscopic surgery. He was appointed in 1998 and established a North of England NHS Bariatric Surgery service which is one of the largest NHS units in the UK with 7 consultant Surgeons.
He has been an executive member of BOMSS Council since 2013 and is a founding Trustee of the new BOMSS Charity. The National Bariatric Surgery Registry has been an integral part of BOMSS since its inception in 2009. Peter Small has been a member of the Registry Committee since 2010, taking over as Chairman in 2017.
He is a keen promoter of data collection and analysis to identify good practice, helping to produce the 2nd and 3rd NBSR Reports in 2014 and 2020 respectively.
Professor Rachel Battherham
BOMSS Council member
Clinical Director and Centre for Obesity Research Lead/ Bariatric Centre for Weight Management & Metabolic Surgery Lead and Director
University College London/University College London Hospital
Professor Rachel Batterham is Professor of Obesity, Diabetes and Endocrinology at University College London (UCL). She leads the University College London Hospital (UCLH) Bariatric Centre for Weight Management & Metabolic Surgery and the UCL Centre for Obesity Research within the Department of Medicine. She is the Clinical Director for the Division of Medicine at UCL and the Director for the UCLH/UCL NIHR Biomedical Research Centre Obesity Research Theme. She is the Royal College of Physicians' Special Advisor on Obesity.
She has received several national and international awards for her obesity including the Royal Society of Medicine's Steven's Lecture (2018), the Andre Mayer award from the World Obesity Federation (2016), and the Diabetes UK Rank Fund Nutrition Prize (2015).
Professor Batterham has made significant clinical contributions to defining the management of obese patients through her membership of the NICE Obesity Guideline Development Group. She is Scientific Chair for the International Federation for Surgery for Obesity and Metabolic Diseases (IFSO) European Chapter (since 2015), a Trustee for the Association for the Study of Obesity (since 2016) and Council Member for British Obesity and Metabolic Surgery Society (since 2016). She is passionate about reducing the stigma that people with obesity experience and ensuring that the patient voice is heard and has established a charity for people affected by obesity, Obesity Empowerment Network UK.
Paul Chesworth
NSBR Council member
Bariatric Patient Advocate
Paul is a patient advocate who shares his experiences as a person living with Obesity and feels very passionate about having his patients voice heard.
As a Bariatric Patient Paul advocates for access to all treatments that will assist people living with obesity to live a healthier, happier life.
"We need to focus on health gains not just weight loss"
Paul's goal is to change the narrative around Obesity by highlighting the complexities.
"We need to help society understand the proven scientific evidence regarding obesity.
We need to remove weight stigma and bias which creates barriers and challenges that a person living with obesity faces"
Paul believes Society, TV, Media, Governments and all healthcare professionals need to understand, to eat healthy and be active will help anybody live a healthier life.
However, if you're a person living with Obesity you need help, support, treatments and most of all to be seen as a person first.
"Obesity is not a choice but a multifactorial, complex, chronic disease"
In 2014 Paul received a RNY Gastric Bypass, he is maintaining a 64Kg loss, his T2D and Hypertension are in full remission, with mobility significantly improved.
Pauls advocacy work has provided him a great learning experience and the opportunity to work with numerous well known organisations.
"Working together Patients, Healthcare Professionals, Governments, TV and Media we can educate each other and society to achieve a common goal, for all people to live their best life in a healthy body". T2D
James Hopkins
BOMSS NBSR Council member
UGI & Bariatric Surgeon, Lead for Emergency & Trauma GI Surgery
North Bristol NHS Trust
Mr Hopkins is a specialist UGI & Bariatric Surgeon, and Lead for Emergency & Trauma GI Surgery at North Bristol NHS trust. He completed bariatric sub-specialist training in the Wessex Deanery and bariatric fellowship training in Taunton. He offers the full range of endoscopic and laparoscopic treatments for severe and complex obesity within the Weight Assessment and Management Service (WAMS) of NBT. His other specialist interests are in laparoscopic (keyhole) abdominal surgery, in particular the management of gallstone disease, gastro-oesophageal reflux disease and all types of hernias, with a further specialist interest in Complex Abdominal Wall Reconstruction for complicated or recurrent hernias, including in patients with obesity.
Mr Hopkins has an interest in clinical outcomes research and has been the lead in the in the development of a Core-Outcome Set for Bariatric Surgery (the BARIACT Project) as part of the ByBandSleeve randomised controlled trial. Mr Hopkins is the NBT site Principle Investigator for the ByBandSleeve multicentre RCT and the Sunflower multicentre Gallstone RCT. He is a previous council member of BOMSS, a current member of the National Bariatric Surgery Registry data committee, contributing to the NBSR 3rd report, and was an advisor on the 2012 NCEPOD enquiry into bariatric surgery – Too lean a service?
BOMSS Patient Safety Committee member
Kamal Mahawar
BOMSS Patient Safety Committee Chair, Council member, NBSR Council member
Consultant General/ Bariatric Surgeon & NatSSIP Lead
South Tyneside and Sunderland NHSFT
Kamal Mahawar is a Consultant General/ Bariatric Surgeon & NatSSIP Lead at South Tyneside and Sunderland NHS Foundation Trust, and Visiting Professor at the University of Sunderland. Mr. Mahawar is a member of the BOMSS council and chairs its patient safety committee. He also sits on the scientific committee of IFSO and the National Bariatric Surgery Registry (NBSR) committee. He was one of the editors of the second and the third NBSR reports.
Kamal has authored over 175 peer-reviewed publications, multiple book chapters in prestigious titles, and two books widely appreciated in media ("The Ethical Doctor" published by Harper Collins and "Fight with Fat") He is the Co-Editor of "Journal of Bariatric Surgery" published by Wolters Kluwer and Associate Editor of "Obesity Surgery", "Annals of Royal College of Surgeons England", and "Clinical Obesity". In addition, Kamal is on the editorial board of SOARD and other journals. The journal "Obesity Surgery" published his biography in 2018.
Kamal sits on the council of the ASGBI (and is its Associate Director for conferences). He is the Northern England representative on the council of the British Benign Upper Gastrointestinal Surgical Society (BBUGSS) and is the chief co-ordinator of The Upper Gastrointestinal Surgeons (TUGS).
Chris Pring
BOMSS Patient Safety Committee member, NBSR Committee member
Bariatric surgeon
St Richard's Hospital, Chichester
Chris is a bariatric surgeon at St Richard's Hospital in Chichester and Visiting Professor at the University of Surrey. He supports the BOMSS approach to evidence based practice and quality improvement.
Bruno Sgromo
NBSR Committee member
Consultant Upper GI and Bariatric Surgeon
After graduating in Italy Bruno completed his training in the Netherlands, Scotland and in Oxford where he was then was appointed as Consultant Surgeon.
Over the last 14 years in Oxford Bruno has developed the Bariatric surgery service, the minimally invasive surgery program for cancers of the UpperGI tract (stomach and oesophagus) and more recently the Robotic surgery.
In Oxford, Bruno has performed over 1000 bariatric operations including primary intervention and revisional surgery.
Working in Oxford allowed Bruno to collaborate and lead several interesting research projects on obesity, non-alcoholic liver disease, diabetes and cancer of the stomach and oesophagus.
Alongside the innovation of surgical techniques, Bruno's clinical interest is on enhanced recovery after surgery and the management of complications.
Since 2014 Bruno has been involved with BOMSS. First in the educational and research committee and more recently in the National bariatric surgery registry.
In 2021 Bruno was the local organizer of the BOMSS annual conference and lead of the training day.
Richard Welbourn
Bariatric and upper GI Surgeon
Musgrove Park Hospital, Taunton
Richard Welbourne is part of a 5-surgeon bariatric and upper GI team in Musgrove Park Hospital, Taunton, after setting up the unit in the early 2000s. Musgrove became the SW Level 1 Commissioned bariatric surgery centre and the first International Center of Excellence for Bariatric Surgery of the US Surgical Review Corporation (2009). The unit was awarded an RCS Fellowship in upper GI and bariatric surgery and has trained fellows continuously as part of the National Surgical Fellowship Training Scheme (2009-).
He is lead surgeon on the NIHR-funded By-Band-Sleeve RCT, the largest RCT of different procedures, which is fully recruited (1,341patients) and expects to report in 2023. Previous roles include Past-President of the British Obesity and Metabolic Surgery Society (2013-15), member NICE GDG for Obesity (CG189) 2014, NICE Obesity QSAC (2015-16), member CRG for Specialized and Complex Obesity (2012-16). He led multi-collegiate RCS commissioning guidance for bariatric MDT clinics (2104, 2017). He founded the UK National Bariatric Surgery Registry (2009), Chair (2013-18), member IFSO Global Registry Committee (multiple reports 2014-2021). IFSO World Congress President (London, 2017). Recipient of IFSO Presidential Medal (2017) and Award of Appreciation (2018). Associate Editor Obes Surg (2019-), Section Editor Curr Obes Rep (2016-). TSC Chair SCOTS study (2011-).
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Editorial Note: This post by Johanna Ryan looks at an element of the defense offered by Neal Ryan and others, namely that by the standards of the time the authors of 329 weren't doing much wrong.
The controversy over "Study 329" on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. What looked like a study conducted by leading psychiatrists from top medical schools turned out to have been controlled by the company. Individual patient data was hidden or distorted, statistical tests were massaged, and a company ghostwriter spun a narrative that turned an ineffective, risky drug into a safe and effective treatment.
Study 329 was performed in the 1990's, and the resulting journal article was published in 2001. To this day no one has retracted that article. Top medical journals continue to publish drug-company directed research. When you search "the literature" for the best way to treat depressed teens, you will still find that 2001 paper and others like it (about which we know even less).
Study 329 was done at 12 research sites: two in Canada and ten in the U.S. For each site, there was a named author from a major university or teaching hospital actually involved in the research. However, while each of them knew more-or-less what went on at their own site, only the drugmaker knew the whole picture. SK had paid for the study. It ran the analysis, and it produced the draft paper that made the drug look much better than it really was.
The record shows the named authors worried that the results were being distorted, and that SK might leave them to take the blame if the facts came out. In the end, they signed on for whatever reason.
The paper mentions "treating clinicians" made the decisions about raising or lowering doses of paroxetine. Today GSK reassures us that the subjects' treating doctors were responsible for following up on any problems they had during the study. The investigators apparently decided that none of the truly serious problems were due to paroxetine. Which means that they couldn't explain to the Paxil Kids what had happened to them, or how to stay safe in the future. Neither, of course, could their colleagues – your doctor and mine.
The picture painted by Study 329 is scary, but what if there were fifty study sites instead of twelve, or 150 in several different countries? What if the academic "authors" of an article hadn't laid eyes on any of those sites, much less been a Site Investigator?
What if the real Site Investigators were professional researchers-for-hire? What if they'd taken part in a hundred studies, but seldom if ever been named as authors? They wouldn't have to worry if the study design was seen as biased, or the results too good to be true. Their reputations would not be on the line; they'd made their money, and the official "authors" could deal with the fallout.
What if the subjects had no doctors of their own, and were signing up for the study simply to get some medical care? What if their doctor was a professional researcher-for-hire? Either way, the subjects would be dependent on care from a doctor with an economic stake in the success of the study. This could affect their personal welfare, and the reliability of the study results as well.
What happens when a doctor under pressure to recruit subjects with "bipolar depression" is the same one diagnosing you with "bipolar depression"? What if you need, for your health's sake, to drop out of the study, but "your" doctor needs to maximize the number of subjects who finish? What if you're a patient with, say, a thyroid disorder or a drinking problem, who figures this will likely disqualify you from the study but you really need the free medical care, and the travel money will come in handy too. Will you be tempted to say Yes, when the integrity of the depends on your saying No?
I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar. I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials. Three were still in process, and seventeen were completed. Not one had shared its results on the government website, a supposedly mandatory step.
I found at least a half-dozen published papers directly based on these studies, although only two were posted on CT.gov. The average number of authors? Six to eight. The typical paper had a lone academic as "lead" author, the rest being drug company employees. Some had only employee-authors.
The average number of trial sites per study? Fifty-one. The "median" Vraylar study would involve 403 subjects at 65 different study sites in four countries! Together, the twenty studies spanned twenty countries, from Colombia to Bulgaria and from India to Finland. Unlike those U.S. academics on Study 329, I doubted these people would ever get together, in person or via e-mail, to compare notes and debate what the finished paper should say.
Unlike some sponsors, Forest did not share the site names with CT.gov – only locations and ZIP codes. However, a few of the papers thanked various "investigators" by name. With some patient searching of PubMed, CT.gov and Google, it was possible to identify many of the U.S. sites.
Overwhelmingly they were contract researchers. Some were freestanding clinical trial businesses. Others were busy medical practices with a thriving research business "on the side." The first recruited subjects largely by TV, newspaper and online advertising which emphasized free treatment. The second combined some advertising with recruitment among their own patients.
I picked one study to focus on: "Cariprazine in the treatment of acute mania in bipolar I disorder: a double-blind, placebo-controlled, Phase III trial." It was published, available for free online, and it had a manageable number of study sites.
The lead author, Gary Sachs, is from Massachusetts General Hospital. His seven co-authors include four employees of Forest Pharmaceuticals in New Jersey and one medical writer from a Chicago agency hired by Forest. The last two, Istvan Laszlovszky and Gyorgy Nemeth, work for the drug's original developer, Gedeon Richter in Hungary. They also hold patents on Vraylar, and are co-authors on most of the published studies.
The paper confirmed the study was carried out at ten sites in the US and 18 in India between February 2010 and July 2011. The authors acknowledged just 14 clinical investigators by name: six Americans and eight Indians. I was able to match all six named Americans with their research sites, whose numbers are listed in bold on the table below, and to figure out the identities of three of the four unnamed investigators using CT.gov.
None of the sites were anywhere near Mass General, or Forest's Jersey City headquarters either; the closest was in Cleveland, Ohio, some 800 miles from Boston. It appears safe to conclude that Dr. Sachs did not give Vraylar to manic patients or observe the results himself.
001 Flowood, MS 39232 Joseph Kwentus, M.D.
Advanced Geriatric Mgt Millennium P.A.
The funding figures are posted online thanks to the Sunshine Act. The first number is the amount of research funding each doctor received in 2014, while the second tallies "personal" payments for consulting, speaking, and traveling or dining at company expense.
Two physicians had no figures for 2014. Dr. Rajadhyaksha surrendered his medical license in 2012, a year after our study ended, having been found guilty of sexually molesting two women patients. Clinical Innovations, Inc. is still in business but has lost its Riverside "campus" for now. Dr. Reinstein lost his license in August 2014, and is headed for federal prison. But more about him later.
Our lead author, Dr. Gary Sachs, reported no drug-company research funding in 2014, and a mere $4,713.20 in personal payments! With over 100 published articles and a seat on the Harvard Med School faculty, he's clearly a bigger name in his field than Joseph Kwentus or Kashinath Yadalam. I'm sure there are rewards for such eminence. However, they don't come from clinical trials these days, at least not directly.
At Precise Research Centers, just outside Jackson, Mississippi, they don't make picky distinctions between research and treatment. "Precise is one of the top depression clinics in Mississippi. Dr. Joseph Kwentus is one of the nation's leading bipolar doctors," their website declares. Their ads on local TV help you figure out if you are depressed, and tell you where to go for free help.
Dr. Holloway takes another approach. His Oklahoma clinic is actually three facilities in one: Cutting Edge Clinical Trials; Holloway & Associates, his own psychiatry practice; and Optimal Health Weight & Wellness, which treats obesity, chronic fatigue and sexual dysfunction. (If you wonder why a psychiatrist is running a weight-loss clinic, consider the number of new drugs recently tested in this area.) Dr. Herrera at the Heights Doctors' Clinic also combines a busy internal medicine practice with a clinical-trials business.
Sponsors: Click here for our metrics!
These doctors do have reputations to protect. The sponsors, mainly drug companies, want volume, reliability and speed. While experience and efficiency count, often the first one to recruit ten patients with Condition X wins the contract. Apostle Clinical Trials, like many sites, posts its recruitment statistics online to impress sponsors.
These centers are located outside the major cities, or in low-income areas. Black and Latino Americans may be more likely than whites to find one in their neighborhoods. Some patients, especially immigrants, may be uninsured. Many are on disability, with low-paying public medical plans that aren't accepted by many doctors. Others have insurance that requires large out-of-pocket payments. For ambitious trialists, a "patient base" like this can be an asset. They get access to lots of people with serious conditions like schizophrenia or multiple sclerosis. Rates of hypertension and diabetes are well above average. And as one of my local trial sites explains, "managing retention" can be easier with a "diverse" population and a clinician-trialist who knows how to talk to them.
Clinical research: An offer you can't refuse?
Most of this was nothing new. What I didn't expect was that eight of our ten sites would have close links to (mostly for-profit) inpatient psych units or nursing homes. Dr. Volk is on the staff of Del Amo Hospital, part of the huge Universal Health Services (UHC) chain. Dr. Kwentus is medical director at Brentwood Behavioral Health, the UHC hospital down the road, and his trials are promoted on Brentwood's website. Lake Charles Memorial does the same for Dr. Yadalam, its former chief of psychiatry and still on its medical staff.
When you hear "private psych hospital" you may think wealth and privilege. Think again. Today's successful player in the U.S. market is usually investor-owned, often part of a national chain, and may qualify for federal aid due to its "disproportionate share" of poor patients. It also has a keen interest in "non-voluntary" patient groups: troubled teens, people with psychotic disorders, elderly folks with dementia. UHS has opened special units for active-duty soldiers as the military hospitals overflow, and a few companies have won state contracts to treat prison inmates.
In most U.S. states, you can be held involuntarily for brief but renewable periods if you are judged an immediate threat to self or others. Online patient reviews for these hospitals are striking, not for their general negativity (expected), but for the number of people claiming they or their loved ones were kept against their will. Many allege that "suicidal statements" were coaxed from them or fabricated outright. In California, they talk of "5150's", while in Florida it's the "Baker Act." In Illinois, the good old 72-hour hold seems to have magically grown to five days at Chicago Lakeshore. In all cases, padding the bill seems the obvious motive. Could research be another?
All of this has echoes of a recent, infamous human-research scandal: the death of Dan Markingson in a clinical trial of antipsychotic medication at the University of Minnesota. The hospital made Dan an offer he couldn't refuse: Sign up for the trial, and they'd agree not to have him forcibly committed. How he could be ill enough to warrant commitment, but not too ill to "consent", was never explained. In any event, Dan was kept in that trial, despite evidence that he was getting worse on the new medication, until his death by suicide in 2004. It took another ten years for Dan's mother and a few tireless faculty activists to defeat the University's coverup campaign.
Which brings us back to Uptown Research Institute and its founder Dr. Michael Reinstein. Chicago's Uptown neighborhood was for years a hub for rescue missions, flophouses and large nursing homes where thousands of people with serious mental illnesses were (and still are) warehoused. Reinstein amassed a small fortune there, providing psychiatric "care" to as many as 4,000 patients in 13 nursing homes, and parlaying his clout as a mass prescriber into a second career as a paid Pharma researcher and lecturer. Astra-Zeneca, makers of Seroquel, were his first clients, followed by various makers of clozapine, one of the riskiest drugs in psychiatry.
The results, as reported in a 2009 expose by ProPublica, were horrific: Patients "trembled, hallucinated, lost control of their bladders … Staffers said Reinstein had induced some patients to take powerful psychotropic drugs with the promise of passes to leave the home." Reinstein's role as the "Clozapine King" of Uptown also resulted in at least three wrongful-death lawsuits.
In 2014 Reinstein lost his license and was charged with felony fraud. Following the 2009 expose, however, control of Uptown Research passed to cofounder John Sonnenberg, a psychologist, who disavowed any further connection to Reinstein. However, Sonnenberg was not a physician. An M.D. was needed to give and monitor medications. Reinstein was still practicing out of a storefront next door to the Institute. If he wasn't the physician, who was?
All indications are that Reinstein was active in the research at Uptown through at least 2012 – including the period of our Vraylar trial. We don't know how many Dan Markingson-type tragedies Reinstein was responsible for. But a look at this single study is enough to convince me that other Dr. Reinsteins must be out there – and the system has no way to stop them.
Why was the "Sachs study" of Vraylar for mania limited to three weeks? Why were the subjects offered so many extra medications to relieve side effects, from benzos and chloral hydrate to Ambien? If a 4-7 day "medication washout" period was needed at the beginning, what meds were people taking, and how did stopping affect them?
I can't answer those questions, but I have one of my own: Given what we know about the study's structure and the system it took place in, how will we ever arrive at any reliable answers?
First, in many cases it may do no good to put pressure on medical-school faculty (or their schools) to share the data, when they themselves know so little. Med Schools now have more in common with celebrities lending their names to a new cologne or athletic shoe than with scientists actually testing a new treatment. The drug companies may be the only source of information.
Second, when investigators have an economic stake in both the trial and the patient's treatment, patients' rights and safety are up for grabs. In addition, any diagnoses and treatment records coming out of this system may be valid – or may be fictions created for one billing purpose or another. In other words, the integrity of the research is also up for grabs.
Third, the popular idea of a patient research boycott may simply not work, at least in countries where healthcare is not a right. It's often said that people volunteer for trials for two reasons: Their conditions haven't responded well to standard treatments, and they also want to help others by contributing to medical knowledge. If patients just refused to participate in trials, the reasoning goes, they could force study sponsors to agree to open data sharing.
The assumption is that the boycotters can simply go back to "standard care." In the U.S. and other countries, many don't have that choice. When patients are dependent on the researcher for medical care, how many will just say no? The problems multiply when psych patients are treated against their will – which may be on the rise in national health systems as well as privatized ones.
The focus of reform movements so far, including the landmark expose of Study 329, has been on fighting for open data. Conflicts of interest, and even pharma sponsorship of the research, some say, would not be insurmountable problems if we just had access to the raw data.
In the course of this research, however, I bumped into some emerging trends that might lead to a system where raw data no longer exists, at least as we think of it today. But that's for the next article.
Just so hard to read, so upsetting. We are mere souls to make money from… We are not treated as people, just revenue raising.
Thank you so, so much for Study329.org. Since its release, there is now an Australian lawyer willing to help…. before, there was no help for any of this, no lawyers would even try.
So I thank you all, keep battling that disorder called Pharmaceutical Corruption and Greed Disorder….. so that so many of us, may never ever, have our lives, or our childrens lives, destroyed because of it.
Absolutely horrifying, and brilliantly researched.
Excellent article and yet another example of my reasons for throwing out "evidence-based medicine." It's not only in psychiatry that we have no valid evidence. There seems to be a trend perhaps initiated by such events as 329 etc. to be, at the very least, careless about the demands of research.
What about the studies that produce vital but "negative" results? My own experience with this phenomenon occurred in the late 80s. The teaching hospital in which I worked was one site for a double blind study of an antipsychotic from Sweden that was supposed to be better than Haldol and have fewer adverse effects. We were to obtain 30 elderly patients, currently on Haldol, put them through a washout and then enter them into the drug/placebo study. We had 18 months in which to do this. The study went nowhere because every single patient, washed out from Haldol, improved dramatically. That should have been published.
My experience as a whistleblower, I must confess, made me, for a time, reluctant to say anything about fraudulent research. One's life can be made an utter misery. The need for exposure, thank goodness, eventually overcomes the need for self preservation, at least in some.
Spoken like a geriatrician–a specialty developed from the experience that so many elders are overmedicated with complex regimens that are completely without systematic rationale management. Kudos!
"New unconventional sources of data are changing the way pharmaceutical companies research and market their products, industry insiders reported here at the Health 2.0 Fall Conference 2015.
One year of social media postings yields more information on adverse events than the entire US Food and Drug Administration (FDA) database, said Greg Powell, director of the GlaxoSmithKline global safety program.
That formation overhead is a flight of pigs.
I believe they are watching social media closely, formally and informally.
My blog post about Noven, which makes 5 drugs (all with black box warnings, and none for anything life-threatening, caught on in Orlando and Miami, where Noven has facilities. I don't know what they could do in response other than hang it up, go to confession and devote themselves to good works.
But I don't know that they'll use the data for patient benefit.
This work, as all of the work connected to the "revisions" of Study 329, deserves an international and distinguished award – everyone connected to it so dedicated, honest, ethical.
I remember reading that the "clinical trial" that got Zyprexa approved for children was done on a handful of children in Russia.
Somehow I would suspect this to be the case with research that originates out of america. The finance and handing out funds to researchers who are known beforehand to be "favorable" and "willing" to achieve the obvious goals. That pretty much sums up my preconsieved idea of what modern U.S. commercialism is all about.
But when this is used as a step to have this drug approved all over the World, then I become less understanding of its obvious flaws.
Most of us outside america have bought in to the idea of the "land of hope and Dreams".
I even thought that the american judicial system with Product liability suits kept us safe over here in europe. But thats not the case. And even worse, we trust the americans, "the good guys", in almost all areas of modern society.
But the article above, becomes to me, just an example of how it's "OK" in america to do business with economical motives at the expense of human suffering.
Where is the Jonas Salk-type of doctor, risking almost his own Life to find an anti-depressant, an anti-depressant that actually relieves people from anxiety and depression, and with very few and ACCEPTABLE side-effects?
I'm not naive enough to Think I could find such doctor, but could atleast some of the researcher show some empathic and compassionate sides to their fellow humans?
Thanks Johanna, the research must have taken hours and hours of your time. Can't say I'm happy after reading it but truly appreciate your thoroughness and easy writing style. As for Study 329 not doing very much wrong by the standards of the time – maybe they should look at what is now happening, in the UK, to individuals who thought that their behaviour wasn't very wrong 'by the standards of the time' as far as respecting children is concerned! To me, 'evil' has always been 'evil' irrespective of time; being caught out does not increase the intensity one iota.
Is there a prize that we can nominate you for? Great exposition of the seamy underside of the clinical trials industry!
Great high standards of reporting, Johanna.
By the Standards of the Time is such an appropriate title for your piece/peace..
I thought that was such an interesting voluntary use of words, as, no one had accused him of being a mercenary….if I had said something like that to a psychiatrist, it could have landed me in hot water..
is to push the boundaries of acceptance and for who's good?
I suppose, in the end, it depends on the scale of the fallout and who is counting the bodies?
However, they've refused calls to reveal how many patients have been recruited in this way, or to answer other questions about their psych research. In one case that came to light last year, a man alleged he was told he could get his substantial hospital bill written off if he entered a drug study.
I was flabbergasted at that UM announcement–not that they were stopping, but that they had been doing it at all.
Your article above it what the other commentors say it is, by the way. Excellent and worth prizes.
Yes, absolutely brilliant, Johanna! Wonderful work. Ethical. Keep them coming!
Breggin 1991, Toxic Psychiatry p 382.
Not a lot has changed really. Its the same old same old.
I feel like i have just been given a tour of the inner workings of an organized crime syndicate or terrorist group creating horror stories.
I'm sure Pinel would turn in his grave if he read this.
Here is the most ridiculously, comically, outrageously, unbelievable thing i have heard all year!
Sachs you don't moonlight as a stand-up comedian as well do you?
No Nothing to declare !………..Gary let me remind you … you are not working at the airport!
Yes, let some American journalist dig some in this dr. Sachs's finances.
Perhaps we would find a fancy house, car, boat???
Maybe there are "uncertainties" to "what" have financed them?
Order some prints from IRS, if you could do that in America, we can here..
Any Citizen in Sweden can look at the earnings from any other Swedish Citizen at least 5 years back.
If he is supposed to be without financial ties, then he surely would hand out proof without a hassle?
Great sleuthing, Johanna and timely , too.
Thankyou once again. Mrs K J Powell .
Tie this article together with what 1BOM writes on one of his lates post, how american psychiatry recruits patients to "voluntarily" join pharma-trials, while hospitalized!!!
How should psychiatry, as a whole, distance itself from the "abuse" of old? When they to this day exploits fellow humans in the absolute worst imaginary scenario: when your mind is failing you and you seek help for it!
I was never one of the "bullies" at school, but I was a part of the "don't-try-to-mess-with-the-sports-Jocks-types". And at times I was rough/tough towards people.
But there was ONE thing I NEVER was: and that was to be in any way abusive towards any other person who could not fend for themselves!
The psychiatrists 1BOM and Joahanna Ryan talks about here are doing just that. They gamble with that the patients won't get any problem from the untried drug, and that they just fit like a pawn in their own scheme to find subjects to try a chemical onto.
I mean: if a healthy, never had Medical problems type of human, volunteers for a drug trial is one thing. But if you are suffering from schizophrenia, mania, delusion and generally aren't in any good 'contact' with your 'inner self', and seek Medical attention for such issues. Then the Medical authority, doctor, psychiatrist, professor must be absulutely flawless when his decisions almost "rule over" his patients ability to judge for himself.
It is, without a doubt, one of the worst scenarios of ABUSE!
Call it abuse of Power or abuse of "percieved authority" or whatever.
We aren't treating fellow men very good nowadays either.
One take on why the cardiologist's nomination spells good things for your health.
OH fa'Chrissake! Can anybody really be that dumb?
It's not for nothing that Robert Califf has been called the "ultimate industry insider." He spent his years at Duke building up the Duke Clinical Research Institute — a godawful hybrid thing, a Contract Research Organization grafted onto the body of a university. It played host to a huge scandal around fraudulent cancer research of the "personalized medicine" variety during his time too. Califf was not implicated in that scandal, but he sure as hell was not implicated in doing anything about it either.
Johanna….it is difficult to place loyalty to patients…it is difficult to place loyalty to Zen Goalacre…why?
He sits at home playing with his Smart phone….why?
Amazing. @GSK support #AllTrials http://gsk.to/XJgLMI Amazing. Fantastic. Historic.
@bengoldacre @GSK @trishgreenhalgh Well done Ben. As a demonstration & measure of goodwill, will they now retract their Paxil Study no 329?
Thank you for the mention and the link.
Paroxetine: 309 records, 248 trials, 45 countries.
I am truly shocked but not at all surprised. Isn't drug research and development really for the benefit of shareholders who will plough more dosh into the machine to enable more profits to generate more shareholders, dosh etc etc? Client/patient benefit is a mere side effect!


One more day until the I'm Your Neighbor, Portland collection opens at the Portland Public Library's Main Branch.
The bookcase is positioned and waiting thanks to "City of Readers" coordinator Jim Charette, the books have been ordered thanks to Children's Librarian Mary Peverada, and the signage is installed thanks to Banacom Sign.
Thanks to the catalogers for working double time to get the books to the shelves!
Look for the bookcase between circulation and children's after Memorial Day!
I'm Your Neighbor, Portland and the Portland Public Library invite you to the Launch Event of a year-long community-wide read of books set in Maine's "new arrival" communities.
The Featured Books by Maine authors and illustrators tell the stories of people that have come to Portland and to Maine from all over the world in the last several decades and in doing so transformed the city into a vibrantly multiracial and multicultural community.
The May 25th event will introduce the books (for both families and adult readers) with readings, music, and refreshments from local independent groceries.
Attendees will have an opportunity to say "I'm Your Neighbor" in any language they know, share the story of their name with their neighbors, and envision how these books can be used in the community.
The Portland Public Library's I'm Your Neighbor, Portland book collection will open for circulation the day of the event. Books will be for sale by the USM Bookstore and many of the authors will be available for signing.
The project is generously funded by the Maine Humanities Council and hosted by the Portland Public Library. A special thanks to the NAACP's King Fellows for introducing the books.
Please share this event with your friends and colleagues!
SHARE the event with friends on Facebook.
I'm Your Neighbor, Portland is delighted by the arrival of The Portland Public Library's Bookmobile! Over the next year, we will be providing programming for the bookmobile using the Featured Books and hopefully giving these books away as part of the programming.
To help distribute free I'm Your Neighbor, Portland books to Portland readers, please consider Sponsoring Free Book Distribution.


text:
The Grim Trade-Off Of BLM?
Fewer African-Americans killed by cops; many more killed by civilians
101 pairs of shoes and a casket are laid out during a vigil to represent the 101 shooting victims in the 74 incidents that took place during the first week of July 2020 in New York City. (By Angela Weiss / AFP via Getty Images)
Why have murder rates spiked so badly over the last 12 months? No one seems to know, and perhaps it is simply impossible to know at this point. We don't have all the data, since the big uptick is quite recent; and we cannot even agree on what helped bring crime down so sharply in the past three decades. But it does seem to me that the rise is significant, and those who care about black lives might want to figure it out.
Here's the NYT summary of the data, to start with:
Homicide rates in large cities were up more than 30 percent on average last year, and up another 24 percent for the beginning of this year, according to criminologists … Homicides in Portland, Ore., rose to 53 from 29, up more than 82 percent; in Minneapolis, they grew to 79 from 46, up almost 72 percent; and in Los Angeles the number increased to 351 from 258, a 36 percent climb … Homicides in Philadelphia are up almost 28 percent, with 170 through May 9, compared with 133 in the same period last year; in Tucson, Ariz., the number jumped to 30 from 17 through May 13, an increase of 76 percent.
By any measure, that's a huge increase. Yes, we're still in a relatively low crime environment. But the suddenness of the rise and its scale are striking.
So what is causing it? Prime among the explanations is Covid19. But this makes little sense. Lockdowns tend to depress crime, not exacerbate it. And globally, violent crime did indeed collapse, as streets emptied and public interaction declined. Murder rates were stable or fell all over the world. El Salvador, for example, regarded as one of the most violent countries on earth, saw a 20-year low in homicides. Our closest neighbors, Canada and Mexico, effectively trod water — with Canada up a few and Mexico down a few homicides over 2019. The US? A huge spike in murders — unique in the world. And the timing doesn't quite work for Covid as the cause either: homicides surged last summer, long after Covid first hit and lockdown was first imposed.
Maybe poverty, caused by Covid? That doesn't seem plausible either: "Residential burglary, larceny, and drug offense rates dropped by 24%, 24%, and 32% from the same period in 2019." These property crimes would surely rise if people were desperate for money — and they didn't. And 2020, because of an aggressive federal stimulus, actually made many of those struggling to make ends meet slightly less precarious than they were the year before: "[B]etween Dec. 2019 and Dec. 2020, the share of American adults experiencing food insecurity dropped from about 24% to 20.5%, the share having difficulty paying medical bills fell from nearly 19% to less than 15%, and the share experiencing utility shutoffs went down from 3.8% to 2.6%."
One writer suggests that the fentanyl crisis is a big reason. But what's striking about opioids is how little this drug trade is connected to street violence in the same way that, say, crack cocaine was. So much is online, or in someone's medical cabinet, or available with a phone call. Fentanyl puts people to sleep, if they're lucky. It doesn't cause them to act violently and erratically, like meth or crack. And the obvious point: we've had huge increases in opioid supply and overdoses before, and none has been accompanied by a big rise in the murder rate.
Did it have to do with defunding the police? Since very little substantive defunding has yet taken place, and not nearly enough to measure any long-term consequence across various cities, this also seems far too early to tell. Murder rates soared in cities that had fully funded law enforcement; they soared in cities which pledged punitive cuts in funding; and they soared where some cuts were under way. Defunding may well increase homicide rates in the future; it's just too soon to tell right now.
What else have we got? Well, surely the timing of the surge in murders counts. And it can be timed quite precisely, in fact: to the very end of May, before which there was little change and even some decline. The National Commission on Covid19 and Criminal Justice report shows what University of Utah researcher Paul Cassell calls a "structural break" in the data timed exactly to the murder of George Floyd and the subsequent wave of mostly peaceful protests and subsequent looting, rioting and violence that raged across many cities. Before Floyd, no big increase in homicides, aggravated assaults, and shootings. After, a huge spike.
Of course, that is not causation. But it's one hell of a correlation — and no other event seems relevant. It's as if the Floyd murder, and the subsequent urban chaos, sent a signal: the cops are on the defensive. Which means murderers can go on the offensive. And once lawlessness establishes itself, it tends to compound. A few gang murders can soon morph into tit-for-tat urban warfare.
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In Minneapolis, for example, in Cassell's careful analysis, murder jumped after Floyd's murder, but shootings and aggravated assaults also went through the roof. In Chicago, the murder rate was the same on 5/28/2020 as on 5/28/2019: 191 homicides compared with 192. Then the murder rate and shootings took a sharp leap upward, and stayed there. You see nearly the same pattern in Philadelphia. New York City is a less clear-cut case, with surges in murder before and after the Floyd killing, but with shootings increasing 177 percent after the protests and riots. Shootings may be a better indicator of the scale of violence, because not all attempted homicides succeed. Here's a graph of shootings in Minneapolis last year:
Chart excerpted from Paul Cassell's report
As this murder wave took off, we also have to remember, major cities proposed cutting police budgets. New York City did so to the tune of $1 billion. Los Angeles and Minneapolis also saw deep cuts. Seattle, after considering a 50 percent decrease, settled for an 18 percent cut. In Washington DC, the mayor was happy to see "Defund The Police" painted on a street in the heart of the capital in letters so large you could read them from a plane. The message could not have been clearer.
Across America, many marchers and protestors yelled abuse at any cop they saw, and in some cities, they were given free rein, even to the extent of a no-go police zone. "ACAB" — "All Cops Are Bastards" — was routinely spray-painted. Mayors let the chaos go on — and elite institutions, like the New York Times, fired their own opinion editor for running a piece urging a federal intervention if the violence got even more out of hand. Non-white cops (a significant and rising number in many cities) were put in an incredibly tough spot.
After this relentless assault, regular police officers noticed. Many quit:
In Chicago, 560 officers retired in 2020 in a police department that had about 13,100 sworn officers as of March, records show. That's about 15% more cops retiring than during the previous year, when the number of retirements rose by nearly 30%. In New York City, 2,500 cops retired last year, nearly double the number in 2019, according to the New York Police Department, which has about 34,500 uniformed officers. In Minneapolis, about 40 officers retired last year, and another 120 took leaves of absence. That's nearly 20% of a police department.
But manpower was not the most significant factor. What truly mattered, Cassell argues, is that the police pulled back from the kind of aggressive, pro-active policing that has been shown to be most helpful in reducing fatal civilian shootings — but also most likely to lead to fatal encounters with the police. In Minneapolis, for example, "police stops and officer-initiated calls dropped more than half, use-of-force incidents fell by two-thirds while traffic-related incidents and patrols became far less common." Residents complained that the cops were slow to come, or were in the neighborhoods with their windows up.
In New York City in June of 2020, it was the plainclothes cops proactively tackling street violence who were instantly targeted by the city itself: "about 600 officers in the elite unit, created with the mission of ridding the streets of illegal guns and stopping violent crimes, were 'immediately' reassigned to other duties. The Commissioner called the re-deployment a 'seismic' shift." It sure was. A seismic shift toward vastly higher rates of homicides and shootings. (They did the same thing in Portland, abolishing the pro-active team of uniformed police tasked with preventing shootings. It was only after murder rates doubled in less than one year that the city hurriedly reinstated the unit.)
This kind of decision, along with bail reform, and confusing new regulations on how police should arrest suspects, caused NYPD Chief of Department Terence Monahan to complain that morale had been destroyed: "It's set off a feeling on the streets right now that it's okay to carry a gun, settle old disputes, and start shooting at one another. We're seeing people get sprayed at parties… There's an opinion out there that the cops aren't going to stop them … There's a feeling on the streets right now that if you fight a cop and get it on video, you're going to have a payday."
In Cincinnati, the assistant police chief explained: "There's also the natural pullback by officers based on what we're seeing in mainstream media and social media. For the last couple months, it's almost as if policing in general has been vilified. That's very difficult, the officers are dealing with that, and I think the proactive work has slowed down." It wasn't a policy of pull-back. But it was the reality among cops increasingly skittish toward risking their lives — because they feared getting vilified if something went wrong.
Cops can and perhaps should be blamed for this kind of reticence. They should do their job regardless of the pressures. But if that job has been abolished, it's not their fault. And they are also human. The collective disparagement from so many in authority, the abuse on social media, the PTSD of trying to contain violent rioters day after day, enduring a hail of truly vile verbal abuse during even the peaceful protests: these take their toll. They haven't all gone on strike. They haven't all succumbed to the "Blue Flu." Many have just internalized a new risk assessment.
Which means, it seems to me, that we have a provisional answer to our original question. The homicide wave began with the Floyd murder and has been sustained by the decision of many cops to refrain from the kind of pro-active policing that can lead to exactly the kind of incidents that can become viral — aggressive intervention against armed criminals before they kill. That helps explain why the crime wave is restricted to shootings and homicides — because other more mundane police activities do not carry the same kind of risk to the officer or perpetrator involved.
This is precisely what occurred in what's called "The Ferguson Effect" — but this time, it may be happening on a national scale, as protests have covered the entire country, amid unprecedented pressure on the cops to avoid dangerous interactions.
Another way to test this hypothesis would be to see if fatal police shootings have declined. If cops are not pro-actively tackling potentially armed suspects, you'd expect they'd kill fewer of them, especially innocent bystanders. And, sure enough, there is real evidence for this!
The Washington Post database shows 392 police shootings so far this year, a pace that, if sustained, would amount to around 850 for 2021, down from 1,021 in 2020. That would be much, much lower than anything since 2015. Break the data out racially, and the picture is even clearer. 244 African-Americans were killed by cops in 2020. Only 72 have been killed so far in 2021 — which would suggest an annual toll of 160, an unprecedented decline. In 2020, 18 unarmed African-Americans were killed by cops; in 2021 so far, the number is four. If sustained, that's a real shift for the better.
It's worth reiterating at this point that this is a guess. We don't know for certain why we are enduring a spike in homicides which seems increasingly durable. The full data are not available; key statistics here are provisional. But the best guess we have leaves us with a sobering thought. What if this is the trade-off?
What if we can indeed lower police shootings — but only if police stay out of exactly the proactive policing that makes them more likely? And what if the price of ending proactive policing is, logically, a huge increase in civilian homicides? A look at the comparative numbers of black deaths at the hands of cops (in 2019, for example, 250), and black deaths at the hand of civilians (in 2019, 7,484) is a sobering reality check. Black Lives Matter could be devastating news for actual black lives.
This is not an argument against police reform or even against shifting some core responsibilities — mental health incidents, for example — to other kinds of professionals. It is an argument that pro-active policing has been more important in restraining crime than many have acknowledged; that removing it, before reforming the entire system, is extremely dangerous; and that elite complacency in the face of lawlessness and destruction in the summer of 2020 helped ignite a cycle of murder that is very hard to unwind. When crimes are committed with impunity, more crimes will be committed. And the victims will not be at Yale.
So this scenario prompts a question of supreme irony: what if the final legacy of Black Lives Matter is that it actually succeeds in its core goal, and that in the future, far fewer African-Americans are shot by the cops. And what if the price of this symbolic victory is, in fact, a huge increase in the numbers of innocent black lives lost to civilian murder? That's a trade-off worth discussing, before it becomes a new norm that's very hard to undo.
(Note to readers: This is an excerpt of The Weekly Dish. If you're already a subscriber, click here to read the full version. This week's issue also includes: a contentious pod debate with Bryan Caplan over open borders; reader dissents over my analysis of Orwellian wokeness; more dissents over my defense of liberalism in the face of critical race theory; more dissents and assents over my debate with free-speech hero Jonathan Rauch; seven recommended pieces by other substackers; a classical-music mashup for a Mental Health Break; a Cool Ad with beards because why not; a sparkling view from an SF window and another from night-time Budapest; and, of course, the results of the View From Your Window contest — with a new challenge. Subscribe for the full Dish experience!)
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A subscriber writes:
I'm not writing with a dissent, but with thanks. Reading your weekly newsletter and listening to the podcast is consistently one of the best intellectual parts of my week. I work at a very highly ranked public university and I feel dejected by the intellectual sameness of my coworkers, the students, and even faculty. Reading the news and Twitter and (most) books provides little relief. My biggest complaint is that it's all just so boring. Politicos may squabble at the margins on Twitter, but most of the rest of us just keep our mouths shut to get along. We avoid any topics that may spark a debate. We are so, so careful not to say anything interesting.
But not the Dish! It's great.
Part of my job is to invite speakers to campus for events. But we can't host anyone who students think is unacceptable, for fear of making them unhappy. It's all so f'ing boring. I want to have "unhappiness is interesting" etched into the walls!
I'm a political theorist by training and spent nine wonderful years in undergrad and grad school reading Plato and Augustine and Tocqueville and Nietzsche and digging into what it means to be an imperfect human being in a fallen world. I look at students and faculty and staff and I know that if I asked just one or two good questions and they responded truthfully, I would reveal so much intellectual diversity and heterogeneity! But we can't do that because disagreement about "core principles" (whatever those are) is considered tantamount to assault.
Anyway, enough rambling. I appreciate the Dish tremendously and I admire its intellectual bravery.
New On The Dishcast: Bryan Caplan
Professor Caplan, who teaches economics at George Mason University, is the author of the graphic nonfiction NYT bestseller Open Borders. His views on immigration, nation-states, and democracy are extremely different from my own, so we debate all throughout the episode. Bryan has been the most recommended guest by our readers, who clearly want to see some fireworks on this issue. I had a lot of fun.
To hear three clips of my conversation with Bryan — on whether a country's citizens should have any say over immigration; on whether adding a billion people to the U.S. is wise or feasible; and on whether voting is irrational "poetry", as Bryan puts it — head over to our YouTube page. Listen to the whole episode here.
Follow that link to reader responses to our pod with Jon Rauch, who drew the most email of any guest so far. Several of the responses side with his optimism over liberal democracy; several other readers share my gloom. See where you land.
Dissents Of The Week I: Orwell And The Great Awokening
After I criticized the rhetoric of wokeness, a reader finds that I've gone too far with some of my own rhetoric:
A key thrust of CRT's attack on free speech is not simply to say that only some speakers can possess truth, but rather to say that expressing any offensive idea is tantamount to violence against the offended. This tactic becomes a trump card that shuts down debate. After all, no one wants to be on the side of violence!
I bring this up but because I wonder if CRT's critics are using the same tactic. Look: you referred to "woke authoritarianism" a couple of weeks ago, and just last week David Brooks wrote about "soft totalitarianism," channeling Rod Dreher. These words have quite a chilling effect, for nobody wants to be caught advocating dictatorship! But what you are usually describing — boardroom diversity mandates, campus protests — is a far cry from what "authoritarianism" and "totalitarianism" conventionally mean: they describe political systems where (i) elections are not free and fair; and (ii) the leader is above the law.
So: I wonder if you really contend that the left will use CRT to convert our government into an authoritarian or totalitarian one?
Read my response, and my response to two more dissents, here.
Dissents Of The Week II: Liberalism vs. CRT
A reader dissents over my column on critical race theory:
I too champion liberalism as you envision it. But in asserting, "The debate is about whether, in your deepest heart and soul, you are a liberal or an anti-liberal. And of those two options, I have no doubt where I stand. Do you?" — aren't you imitating the anti-pluralistic, with-us-or-against us rhetoric that you are criticizing? Aren't you being illiberal?
Read my response, along with two other dissents, here. And as always, keep the dissents coming (and please try to keep them concise, since we only have so much space): dish@andrewsullivan.com.
The View From Your Window Contest
Where do you think it's located? (It was taken about a decade ago, so bonus points if you get close to the right date.) Email your guess to contest@andrewsullivan.com. Please put the location — city and/or state first, then country — in the subject line. Proximity counts if no one gets the exact spot. Bonus points for fun facts and stories. The winner gets the choice of a VFYW book or two annual Dish subscriptions. If you are not a subscriber, please indicate that status in your entry and we will give you a three-month sub if we select your entry for the contest results (example here if you're new to the contest). Happy sleuthing!
The results for the last week's window are coming in a separate email to subscribers later today.
See you next Friday.

redpajama_set_name: RedPajamaCommonCrawl


A TOTAL of 28,947 people visited Clare Museum in Ennis during 2013, making the year the busiest since 2008. More than 3,000 extra visitors came to the museum during the year representing 12.5% increase on 2012 and continued an upward trend that began in 2011. While both the The Gathering and increased traffic into Shannon, particularly from the United States, were important factors in this increase, a number of museum initiatives were hugely successful during the year also. Among these initiatives were public talks on the Hidden History of Clare that attracted great interest locally during the winter and spring. Another was the Festival of Poland, a project designed to build a bridge between the museum and the largest ethnic minority in the county.


If your like me, you love your berries, but HATE it when you spend an arm and a leg on the fresh stuff only to find they've gone moldy in a day or two. Here is a tip on how to prevent berries from getting mushy and moldy.
Rinse fresh berries in one part vinegar/ten parts water to preserve freshness.
Dump the berries into the mixture and swirl around. Drain, rinse and place them on a paper towel to dry for a few minutes, then put them back in the fridge. The vinegar kills any mold spores and other bacteria that might be on the surface of the fruit.
This entry was posted in Food, Healthy Food, Uncategorized and tagged Fruit.


Since we are all, ahem, novice players here is a compilation of good stuff from the web.
Not releasing a decent hand when beat, thus losing the whole stack on one hand.
Calling with weak holdings when facing a bet.
Playing too many starting hands.
Not raising pre-flop with premium hands (putting pressure on limpers holding drawing hands) and then going too far with them after the flop.
Over/under betting the pot (risking a lot to win small/not protecting hand).
Most of the time you should raise/re-raise with top-pairs (AA-QQ) and top connectors (AK, AQs) in order to make low-pairs and various connectors pay to see flops against you. Remember, they will often have the opportunity to double up on you if they hit (although many beginners do not realize this and fold too often pre-flop).
Stick to the premium hands. You will pay dearly to "chase" with second-best hands in NL.
Keep most raises down to between 70% and 100% (making it 3 times the big blind to go typically equals an 80% pot bet) in order to save money when you get re-raised or called by stronger holdings. If there are limpers in front of you, raise to about 4-6 times the big blind.
Have respect for strong tight players (for example, you should drop AQ if a strong player raises under the gun).
When very weak players have entered the pot, be inclined to call and take flops with them.
BIG POCKET PAIRS, A-A through J-J. You're probably going to play these hands no matter what, even though there are times when you should throw them away, especially pocket jacks, but I don't expect a saint's patience from you, so there you go. But here's the thing about your big pocket pairs in poker: they play best against few opponents. That's because their high card strength is their primary asset. If your pocket kings encounters a flop like 9-8-7, it's probably still the best hand, but the more foes it faces, the higher the chance that someone is sitting on a straight draw and getting the right odds to go for it. So if you have big pocket pairs, would you please do me one little favor and raise? Raise! Drive out the ribbon clerks. This is imperative.
Don't get cute and try to trap. You're not that cute, and the baby rabbit with his foot in the trap is most likely to be you.
MEDIUM POCKET PAIRS lose a lot of potential to win without help because they're so easily dominated by the flop. Your dogballs (8-8) look like happy warriors preflop, but when the flop comes A-K-T, you have to figure you're beat. What, then, to do with middle pairs? Fold before the flop? Oh, I wish you would, just for the discipline you'd demonstrate. Failing that, treat your medium pocket pairs as the drawing hands they are. They're really not going anywhere for you unless you hit a set on the flop, and that proposition, in Texas Hold'em, is 7.5-1 against. So try to sneak in late in an unraised pot with lots of callers, recognizing that your post-flop strategy is fit or fold: Either you'll get help from the flop or you'll get gone.
Yes, there are times when you'll raise with middle pairs in an attempt to isolate against the A-Ks and A-Js of this world. Just don't try to force the issue by overplaying your middle pairs in early or middle position. You're inviting too much loving attention from all the overcards (or, zounds, overpairs!) behind you.
LITTLE POCKET PAIRS are a great, chip-sucking vacuum. We look at them and our eyes go glassy. We do some rudimentary math and realize that we're better than even money against any unpaired hand. Against any single unpaired hand, yes, but not against even one more than one. (You want math? Oh, I got math. Against Ad-Kc and Qh-Jc , your frisky 4h-4c will lose 70% of the time! Sobering, ain't it, Bunky?) Little pairs, even more than medium pairs, then, demand large, soft fields and unraised pots. Don't even think about playing them in early position, because you won't know if you're going to get the soft field and unraised pot you need. Limp late into large fields or chuck 'em in the muck.
Sure, sure, sure, every now and then you'll flop a set - and confirmation bias will tell you that it happens much more often than not. But the bottom line is that little pairs are little poison, a disastrous leak in most people's play. If you're paying any attention at all to the notion of starting requirements, pay attention to this: Most players can't get away from any little pair. If you can, you'll be so far ahead of them they'll never catch up.
· With BIG PAIRS, raise to isolate.
· With MEDIUM PAIRS, limp late into large fields.
· With SMALL PAIRS, look for an excuse to fold.
GOOD ACES. Good aces are position dependent. An A-T is not a good ace in early position. You probably need to hit the flop twice (with two aces, two tens, or an ace and a ten) to feel confident, and you just can't count on that. The same A-T may be considered a good ace in late position. Thus, give yourself a sliding scale. A-K is always a good ace, A-Q likes a little position, A-J likes a little more position and so on. A-T is a bad "good ace." I wouldn't get all that worked up about it.
If you wouldn't play an unsuited ace in a certain situation, don't play a suited one either.
MEDIOCRE ACES. I call them mediocre aces on purpose because I want you to think of these cards (A-9, A-8, A-7) with abiding disdain. They're not good hands, and you shouldn't treat them as such, even if everyone else at the poker table has other ideas. In fact, the more excited your foes are about aces, the less enthusiastic you should get about your middling ones. If everyone plays any ace (in a game that's said to be below the anyace line) then there's no way someone makes a sensible laydown with an out-of-position A-T or A-J. Your promiscuously played A-9 or A-8 will end up being dominated and crushed.
Sure, you'll hold dominance over the nitwits playing baby aces, but you'll only be able to exploit that dominance if you know your opponents very well and can put them on worse aces than your own. And look at the bind that gets you into! If the flop comes A-big-big, you're heading for a split pot situation, but if it comes A-little-little, you could be staring down the barrel of a flopped two-pair.
Again I would repeat: The hand you don't play is the hand you can't lose. With your mediocre aces, you should either be staying out of trouble or raising with intent to clear the field and capture the blinds either before or after the flop. At this point, you're playing the naked strength of your ace. You're looking either for folds all around or for calls from hands like K-J or 7-8, followed by a ragged flop you can bet. But that's running a bluff, not betting a strong ace.
BAD ACES. Like any other hand containing a little card, bad aces are contaminated by little poison. I can see no rational reason for playing A-6, A-5, A-4, A-3 or A-2, even suited, except in unraised blinds. Especially in the aforementioned anyace games (the kind you're likely to encounter at the low limits you now play) any little ace you play is likely to be dominated and crushed by the slightly less cheesy aces your opponents opt to play. They can't stay out of trouble. Can you?
· Good aces are position-dependent. The later the ace, the better it is.
· Mediocre aces are trouble hands. Only play them if you're in late position with excellent reads.
· Bad aces are bad hands. For your profit and your peace of mind, learn to muck bad aces.
WHEELHOUSE HANDS. In my nomenclature, wheelhouse cards are cards between ten and ace-in most players' wheelhouse, so to speak. A wheelhouse hand, then, is one containing two unpaired, unaced cards: K-Q, K-J, K-T, Q-J, and Q-T. Those are some pretty hands, right? Erk. Well, maybe.
K-Q probably gets more players into more trouble than any other hand in the history of Texas Hold'em. It flops a top pair, good kicker, only to get crushed by top pair, ace kicker. Remember, most people will play K-Q, but virtually everyone plays A-K and A-Q, so if you get heat in this situation, it's probably from a better hand.
This whole class of hands, though, represents a slippery poker slope. If you can convince yourself that K-Q is playable, how much argument could K-J require? And if K-J is good, what could possibly be wrong with Q-J? Q-T? Before you know it, you're considering any wheelhouse hand to be playable, even for raises.
· If there are raises in front of you, don't call, not ever. Respect the declared strength of those hands, and recognize that they're likely to bet again after the flop.
· If you're in late position with many callers, just call. You want to play this holding like the drawing hand it is.
· If you're in middle to late position and no one has entered the pot... raise! Yes, it's a substandard hand, but you're raising for deception here, and if you hit your hand, you'll get paid off well.
· If you miss the flop, you're done with it. Don't chase.
This last point is crucial. If you can't get away from suited connectors (or any hand) on the flop, you shouldn't play them in the first place. We are our own worst enemy sometimes, and never is this more evident than when we chase, chase, chase with little or no piece of the flop.
Okay, other Texas Hold'em hands.
LITTLE SUITED CONNECTORS. Little poison. Don't play.
UP-DOWNS. An up-down is something like K-6 or Q-5 or J-7. Don't play 'em.
UP-DOWN SUITEDS. Don't play 'em either.
GAPPED HANDS. T-8, 9-7, 8-6, etc. These forlorn ragamuffins are looking to hit the flop twice for two pair, trips or an open-ended straight draw. It's delusional madness. Don't play.
UGGOS. An uggo is an ugly hand with absolutely nothing going for it. 8-3, T-2, 9-4. Don't play. Not ever. I mean, seriously, get real.
Here's the deal with starting requirements: Either you have them or you don't, and either you respect them or you don't. There are plenty of players out there content to play any hand they hold. "Any two will do," they believe, and God love them for their cherished beliefs. Over time, they'll give you all their money... so long as you don't sink to their level.
Every poker hand is a horse race, you know. If every race were equal, everyone would win the same amount over time. But the races aren't equal - not when you have the choice of racing or not racing. When you enter the pot with good cards, it's like starting with a big head start. When you go in with bad cards, it's like starting with a big, fat handicap.
Having - and sticking to - a starting requirements strategy, ensures that you usually start with the lead. Either a big lead, as with big pocket pairs, or a small lead, as with A-big. Start with a hand like 7-6, though, and you're back, back, back in the pack. Yeah, you might win, but you inevitably have some catching up to do, and most of the time you'll finish exactly where you start: behind.
How about skipping that part? If you're not the favorite, scratch yourself from the race! There'll be another one along in a minute.
Position, Patience and Power are the key to winning in Texas Hold'em. The most important decision you will make is choosing to play a starting hand. The biggest mistake a player makes is playing too many hands. Being aware of your Position in relationhip to the dealer is important in Texas Hold'em. You need a stronger hand to act from early position because you have more players acting after you who may raise or re-raise the pot. It is important that you are Patient and wait for Powerful starting hands to play from the correct position.
The player to the left of the big blind acts first before the flop. He along with the other two players to his left are in early position. The next three players are middle position and the ones after that are in late position. The blinds act last before the flop and first after it. Here are some guidelines for stating hands that I recommend you play when you are starting out. They are fairly tight but will give you a good foundation to work with until you learn a little more about the game.
Raise with A-A, K-K and A-Ks from any position. (s denotes suited cards) Call with A-K, A-Qs, K-Qs and Q-Q J-J, T-T and fold everything else.
Call with A-Xs, K-Ts, Q-Ts, J-Ts, A-J, A-T and small pairs. (note x denotes any card) It takes a stronger hand to call a raise than it does to make with one, If there is a raise before it is your turn to act you should fold. Why put in two bets with marginal hands?
Many players will play any two suited cards from any position and they will play an Ace with any small kicker. These hands are losers in the long run and you should avoid getting into the habit of playing them. They are traps that will cost you money.
Once you post your blind the money no longer belongs to you. Many players feel they must defend their blinds by calling all raises even with marginal hands. Don't waste additional money on marginal hands. Also, don't automatically call with the small blind if you have nothing. Saving a half bet will pay for your next small blind.
Deciding whether to continue playing after seeing the flop will be your second biggest decision. It can also be one of the most costly decisions if you continue after the flop with an inferior hand. It is said that the flop defines your hand. That is because after the flop your hand will be 71 percent complete. Where does this figure come from? Assuming you play your hand out to the end, it will consist of seven cards. After the flop you have seen five cards or 5/7 of the final hand, which is equal to 71 percent. With this much of your hand completed you should have enough information to determine whether to continue. Poker Author Shane Smith coined the phrase "Fit or Fold. If the flop does not fit your hand by giving you top pair, or better or a straight or flush draw, then you should fold if there is a bet in front of you. If you played a small pair from late position and you do not flop a third one to make a set you should throw the pair away if there is a bet.
If you think you have the best hand after seeing the Turn card and are first to act, then go ahead and bet. Many players will try to get fancy and attempt to check raise in this position. If the other players also check, you have lost a bet or two. In low limit games the straight forward approach is usually the best as there are plenty of players who will call you. Make them pay. Why give them a free card if you don't have to.
If another player raises on the turn and you hold only one pair you are more than likely beaten and should fold.
If you get to the Turn and you hold only two unsuited overcards (two cards higher that any cards on the board) with no flush or straight draws, then you should fold if there is a bet in front of you. Too much money is lost by players who hope to catch a miracle card on the river. The best hand you can make with two unsuited overcards is a pair which will probably lose anyways.
If you have been playing properly you will not see the river card unless you have a strong hand that is a favorite to win or you have a draw to a winning hand. Once the river card is turned over, you know exactly what you have. If you were drawing to a hand, you know whether you were successful or not. Obviously if you do not make your hand you will fold.
As with the Turn you should bet your hand if you are first to act. If you bet and the other player folds then they more than likely would have just checked if you had checked in an attempt to check raise.
When you get to the river there are two mistakes that you can make. One is to call a losing bet, which will cost you the price of a bet. The other is to fold your hand, which will cost you all the money in the pot. Obviously folding your hand will be a far more costly mistake then merely calling a bet. If there is a slight chance you may have the winning hand you should call. I'm not advocating calling with nothing but you should call if there is a chance to win.
Your ability to read the board will help make you a winning player and it is not hard to learn. Since Texas Hold'em is played with community cards turned up for all to see, you can easily determine the best possible hand that can be made from the board cards and two unseen cards. It is extremely important that you learn determine how your hand stacks up against the other possible hands that your opponents may hold. Two situations should send up a red flag when you see them.
If there are three suited cards on the board someone can make a flush. If a player raises when the third suited card is turned over you should be wary of continuing. If there is a pair on the board a player can make four of a kind or a full house.
When you are not involved in a hand you should still pay attention to the game. You can gain valuable information about your opponents simply by observing what hands they play. It's easy to determine the players who plays and suited cards, or single aces by watching the hands they turn over at the end. That brings me to one final tip.
NEVER SHOW YOUR HAND if you don't have to. If you win the pot because everyone else folded you are under no obligation to show your cards. You don't want to give away any information about yourself if you don't have to And player who turn over their cards when they don't have to are doing just that.


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I am a female entrepreneur, living in Scotland with a Scottish registered business, buying supplies from Europe, and with Simpsons Tea, selling British branded products. So you could say that I cover all the bases when it comes to experiencing business life. And we are in trouble. Big trouble.
Under the SNP, we have entrenched patriarchy in Scotland and it is killing the country. Our economy is on it's knees. The SNP, with their obsession with independence, have driven the country into systemic poverty. Scratch below the New Town surface and you will find dire levels of poverty, which I believe is due to hardened patriarchy. Open up the economy to equal pay and extra support for female entrepreneurs and watch what will happen. In fact, it has been proven that if a country encourages it's female entrepreneurs it improves its economy. This is NOT a female issue. It is an economic issue.
However Scotland has done very little to encourage its female entrepreneurs, indeed with the hardened patriarchy at every level, I would go so far as to say it is actually actively discouraging them.
I have had a tea business now for nearly 10 years and during that time, we have won contracts, exhibited at international food exhibitions all over the world and won many awards. However I also have been cheated by the banks (RBS's mis-selling loan swindle of 2010) and experienced an absolute lack of support from both the Scottish and British government agencies.
I turned around my business by export, yet, I have not had one bit of support from the Scottish Government under the SNP or any support from the British Government. This is outrageous.
SUPPLIER DIVERSITY – The US has supplier diversity legislation in order to try to support female entrepreneurs and the UK has nothing. This needs to change.
MICRO-CREDIT – We need micro-credit schemes to boost female owned business rather than crippling bank loans that are mis-sold and fraudulent.
VC FUNDING FOR WOMEN-OWNED BUSINESSES – We need proper VC funding for women-owned businesses that understands the many different obstacles that female-owned businesses face.
It is with great delight that I hear today that Jeremy Corbyn is bringing in policies for the equality of women. In a society dominated by widespread banking corruption at the heart of the city and dominated by patriarchy, Corbyn recognises that if you empower women you empower a nation.
I suspect that Corbyn will bring in massive change in the banking system and will attempt to dismantle the "old boys network". It would be ideal if part of this reform takes into account the fact that lack of access to finance and punitive banking loans are currently strangling female entrepreneurship.
As part of this reform, it would be amazing if it is recognized that the access to finance is currently one of the main barriers to female entrepreneurship. It is already widely accepted that female entrepreneurship is an economic issue but no-one is really was doing anything to enable it.
The combination of free childcare and micro-credit would revolutionise the lives of women. For the first time, women would be enabled to become financially independent. This is a huge change and at it's heart, it is an economic change. Corbyn realises that if you empower women, you empower a nation. Microcredit banking through a new National Investment Bank would release microcredit loans to SME's owned by women to encourage business start-ups and growth.
We have business accelerator programs that are no more than glorified car salesmen acting solely as salesmen for the banks. Obviously, this is corrupt and useless. I hope that Corbyn flushes these out by his measures for reform for the equality for women.
Another issue that is very important is VC funding. We have dreadful statistics, as shown above. Why can't some of these measures include match funding to help women start up their own VC firms to invest in women? We need more VC's that are NOT part of the Old Boys Network. I would like to see a vision of the future where I set up my own venture capital firm to invest in women. Maybe under Corbyn's reforms, this might be possible.
Corbyn's investment in women can help to create and grow some of the world's most incredible entrepreneurs as well as contributing hugely to social projects internationally. I just hope that he realises that women's equality extends to female entrepreneurship too.
Social media is the great leveller in the world of politics and art. The internet has democratised the politician's spin; visually reducing politicians to a laughing stock. Visual satire is now being produced on a scale never seen before in the digital arena. The combination of platforms such as Twitter and Facebook, along with editing tools such as Photoshop, enables artists to create digital works, with immediate effect. Many artists are now using digital satire as a means of expressing their creativity as well as questioning political and social injustice.
Lesley Riddoch wrote a while ago about this issue and I wanted to add my own thoughts, as I am a female business woman working and growing a business in the UK, based in Scotland.
The issue she discussed in her article was why women are lagging behind in the rush to vote Yes. As a female entrepreneur, the notion articulated by Professor John Curtice that "women lack the hunter-gatherer instinct and tend to be home-makers not risk-takers" is a view that belongs quite firmly in the man-cave that the Professor must occupy. Seriously, are we STILL debating whether women's brains are up to it? Surely, we have evolved beyond that? Well, we have but it seems some of our fellow men have not.
Lesley's view is one that I support wholeheartedly…."I've argued women fear independence might only mean limitless power for the unreconstructed dinosaurs that sadly still abound in Scotland – self-important, puffed up men (and women) who are hostile to minorities, social change and non-hierarchical ways of working".
Having started-up my business over five years ago, survived the recession, grown and then restructured the business for future growth, I have earned my entrepreneur wings. Female entrepreneurship is an economic issue not a "female" issue and is one the other countries like the US have embraced. The US now has supplier diversity laws that require a certain percentage of supply chain purchases to come from female-owned businesses. We need both men and women to support women to start-up AND grow businesses.
Sadly, some of the so called business leaders that I have come across in Scotland belong firmly in the "unreconstructed dinosaurs" camp, with name-calling, belittling, sexist put-downs the norm. And woe betide letting any one know you might be a female entrepreneur that is also a MOTHER!! Then all respect goes right out the window. When I won Mumpreneur of the Year in 2010, the Chairman of a well established business networking group in Scotland congratulated me in a public forum but then went on to suggest that I might also go for the "Dumbpreneur" award next time. What astounding ignorance.
Is it any wonder that I chose to network and grow my business in London/Europe/US rather than look to my own country for that support? And that is a currently devolved country. As for what it would be like as a fully independent country, it makes me shudder.
So, Professor Curtice, it is not that my brain is wired to knit scarves and cook up a storm in the kitchen. It is actually wired to be courageous, brave, creative, intelligent, innovative and most of all entrepreneurial and believe me, if you want to be a female entrepreneur in Scotland, you are going to need all of those attributes.
The Mama is working with social enterprise, Resolve to celebrate women on International Women's Day!
International Women's Day is on Friday 8 March 2013 and thousands of events are being held throughout the world to inspire women and celebrate achievements. One such event is being hosted by the Edinburgh Social Enterprise, resolve.
Speaking about the event, resolve business manager Wendy Bates explained how, for many women, juggling is a fact of life.
As well as being treated to a glass of bubbly and a delicious lunch, women will hear from local 'Mumpreneur' Anna Louise Simpson, as she shares her fascinating journey from Corporate Lawyer to Oil Painter to full time mum and founder of her award winning herbal tea company, Mama Tea Limited." www.mamatea.com. In particular, Anna Louise will discuss how she manages to 'juggle it all', within the wider context of a consideration and celebration of women internationally.
It will be a relaxed atmosphere with plenty of opportunity for proper "me-time", whether it's chatting and sharing experiences with fellow guests, having a pamper at one of the beauty stations or benefiting from the coaching and wellbeing experts who will be on hand running workshops and providing expert advice.
The descriptor for this fabulous event is "Stylish, Sassy and Scottish" – sounds right up my street! This event is taking place on Friday 8th February 2013 in a central Glasgow location and the object is to gather a host of Scotland's high profile female industry leaders, creatives, academics and emerging talent who support a United Kingdom. Now I am not a political creature by any means but I believe in a unified Britain for both personal and business reasons. I also enjoy a good debate and a little glamour into the bargain sounds like my cup of tea.
Organised by the fabulous Tess Hartmann of Hartmann Media, we are all in for a great event.
Is Diversity the key to Innovation?
Last week was a week of exploring diversity. I attended the Women's Business Forum in Harrogate as a guest of RBS. This was a conference exploring diversity in the corporate world and looking at some of the practical solutions to help more women get to the top and get on to boards. Later in the week, I met with the Chief Executive of Corporate Banking, Chris Sullivan and other senior members of RBS, as well as some inspiring Scottish female entrepreneurs to discuss female entrepreneurship in Scotland.
To my mind, the low numbers of females in the board-room and the low numbers of female entrepreneurs are linked. These are two sides of the same coin. Lack of confidence is a recurring theme for both females in business and females in the corporate world. I am a confident woman but I have had my confidence severely knocked both in the corporate world and as the CEO of my own business. That doesn't mean to say there is something wrong with me or that I have to act like one of the boys to get on. No, I think it is linked to a much deeper issue. It is one of CULTURE.
Don't get me wrong. I am not a bra-burning feminist. I am not bemoaning my lot. I am not using this as an excuse because I can't be bothered working hard. Far from it. I need my bra, I have a brain and I work extremely hard. But I am also a mother. Yes, women have the babies. And a lot of women feel that they should put their family before their career and their business. That is exactly natural. But WHY should we have to choose? We have to choose because of CULTURE.
We have a culture in the Western world that does not accommodate diversity. Often it is dominated by white males. Whether that is in our board rooms or on the investment panels of the people I am hoping to impress for an investment. It is not a culture that supports the flexible working/creative working/confidence building building bricks that we need to have a truly diverse culture. We have a diverse society. Women and men, we are all from different backgrounds, straight or gay, white or black. The human race is diverse. It has to be. This is not about bashing white males, we need them! We just need everyone else too!We HAVE a diverse society already – we just need to support it in a DIVERSE CULTURE.
Sylvia Ann Hewlett( President of the Center for Talent Innovation in New York) talked a lot about the link between diversity and innovation last week. She also spoke about the problems caused by no diversity of thought – "group think". She has participated in studies showing that a diverse board affects the bottom line as diversity of thought leads directly to innovation.
Looking at diversity of thought, I think we see a fantastic argument for chipping away at the lack of diversity so prevalent in our culture. Diversity contributes to ideas and there is a real connection between diversity and innovation. Creativity and innovation are key to growing our economy, creating entrepreneurship and growing sustainable profitable companies. If we can only start to see more diversity across the whole of our culture, then what will the future look like? Innovative, creative, expansive and exciting. This isn't a "women's" issue. It is an evolutionary issue.


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bring about reforms in all sectors, including agriculture, health and education, after winning the general election.
farmers could not face financial losses.
struggling for ending poverty, unemployment and illiteracy.
out 800,000 families from poverty in Sindh, he added.


1 When these things were done, the leaders came to me, saying, "The people of Israel and the priests and the Levites have not separated themselves from the peoples of the lands, with respect to the abominations of the Canaanites, the Hittites, the Perizzites, the Jebusites, the Ammonites, the Moabites, the Egyptians, and the Amorites.
Part of worshiping in truth is to be obedient to God's Word. An important, but often, misunderstand facet of this is the concept of "separation." We have spoken of repentance as turning from sin and of holiness as being set apart or separated to God. This, in turn, implies that one is separated from sin. This separation from sin is frequently viewed as being a separation from sinful people. Yet, in His High Priestly prayer recorded in John 17, Jesus makes it clear the believer is not removed from the "world." The prayer is that the believer be protected in the world.
15 I do not pray that You should take them out of the world, but that You should keep them from the evil one. 16 They are not of the world, just as I am not of the world.
Yet, Paul quotes the Old Testament in 1 Corinthians to make it clear the believer is to be "separated" from "the world."
14 And God both raised up the Lord and will also raise us up by His power. 15 Do you not know that your bodies are members of Christ? Shall I then take the members of Christ and make them members of a harlot? Certainly not! 16 Or do you not know that he who is joined to a harlot is one body with her? For "the two," He says, "shall become one flesh." 17 But he who is joined to the Lord is one spirit with Him. 18 Flee sexual immorality. Every sin that a man does is outside the body, but he who commits sexual immorality sins against his own body. 19 Or do you not know that your body is the temple of the Holy Spirit who is in you, whom you have from God, and you are not your own? 20 For you were bought at a price; therefore glorify God in your body and in your spirit, which are God's. 1 Now concerning the things of which you wrote to me: It is good for a man not to touch a woman.
Are these positions in conflict? No, not if they are understood properly.
35 Who shall separate us from the love of Christ? Shall tribulation, or distress, or persecution, or famine, or nakedness, or peril, or sword? 36 As it is written: "For Your sake we are killed all day long; We are accounted as sheep for the slaughter." 37 Yet in all these things we are more than conquerors through Him who loved us. 38 For I am persuaded that neither death nor life, nor angels nor principalities nor powers, nor things present nor things to come, 39 nor height nor depth, nor any other created thing, shall be able to separate us from the love of God which is in Christ Jesus our Lord.
�and the author of Hebrews uses the term to refer to Christ's sinlessness.
26 Her priests have violated My law and profaned My holy things; they have not distinguished between the holy and unholy, nor have they made known the difference between the unclean and the clean; and they have hidden their eyes from My Sabbaths, so that I am profaned among them.
How then does the church be separated, yet still be a witness in the world?
This page printed from http://www.judeministries.org//details.phptableID=366&studyID=37.


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