© Hamre et al.; Licensee Bentham Open.
Anthroposophic treatment for migraine is provided by physicians and includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 45 consecutive adult outpatients (89% women) starting anthroposophic treatment for migraine under routine conditions. Main outcomes were Average Migraine Severity (physician and patient ratings 0-10, primary outcome), Symptom Score (patient rating, 0-10), and quality of life (SF-36); main follow-up time point was after six months.
The anthroposophic treatment modalities used were medications (67% of patients), eurythmy therapy (38%), art therapy (18%), and rhythmical massage therapy (13%). Median therapy duration was 105 days. In months 0-6, conventional prophylactic antimigraine medications were used by 14% (n=5/36) of evaluable patients.
From baseline to six-month follow-up, physician-rated Average Migraine Severity improved by 3.14 points (95% confidence interval 2.40-3.87, p<0.001); patient-rated Average Migraine Severity improved by 2.82 points (2.05-3.64, p<0.001); and Symptom Score improved by 2.32 points (1.68-2.95, p<0.001). In addition, three SF-36 scales (Social Functioning, Bodily Pain, Vitality), the SF-36 Physical Component summary measure, and the SF-36 Health Change item improved significantly. All improvements were maintained at last follow-up after 24 months. Patients not using conventional prophylactic antimigraine medications had improvements similar to the whole cohort.
Patients with migraine under anthroposophic treatment had long-term improvement of symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may be useful in the long-term care of patients with migraine.
Keywords: Anthroposophy, combined modality therapy, drug therapy, eurythmy therapy, migraine, prospective studies.
Migraine affects 14% of adults in Europe every year  and is associated with substantial disability, reduced quality of life, reduced work capacity, psychiatric and somatic comorbidity, and increased healthcare use [2-4]. The World Health Organization has ranked severe migraine attacks among the most disabling medical conditions, along with psychosis, dementia, and quadriplegia . Up to three-fourths of patients with acute migraine attacks do not become pain free from 5-HT1 agonists ("triptanes") [6, 7] and half of patients will not respond to prophylactic medications . Many migraine patients use complementary therapies [8-10], sometimes provided by their physicians.
Anthroposophic medicine (AM) is a physician-provided complementary therapy system founded by Rudolf Steiner and Ita Wegman in the 1920s . AM extends the conception of human physiology beyond cellular and molecular mechanisms to holistic interactions of over-riding functional systems (downward causality ). In particular, a complex equilibrium exists between two polar systems: the 'nerve-sense system' (low metabolic rate, mediator of consciousness) and the 'metabolic system' of the abdominal organs (high metabolic rate, minimal consciousness). This equilibrium can be distorted in human disease. In migraine, a predominance of the metabolic system (with symptoms such as nausea, vomiting, diarrhea, abdominal cramps) leads to disturbances in the nerve-sense system (e. g. headache, sensory hypersensitivity, visual disturbances) [13-15]. This imbalance is sought to be regulated by special AM therapies (eurythmy movement exercises, art therapy, rhythmical massage therapy)  and special AM medications [14, 15, 17, 18].
Eurythmy therapy is an artistic exercise therapy involving cognitive, emotional and volitional elements. In eurythmy therapy sessions the patients exercise specific movements with the hands, the feet or the whole body. Eurythmy movements are related to the sounds of vowels and consonants, to music intervals or to soul gestures, e. g. sympathy-antipathy. Between therapy sessions the patients exercise eurythmy movements daily. In AM art therapy the patients engage in painting, drawing, clay modelling, music or speech exercises. Rhythmical massage therapy was developed from Swedish massage; special techniques include lifting movements, rhythmically undulating gliding movements, and complex movement patterns like lemniscates .
AM medications are prepared from plants, minerals, animals and from chemically defined substances and can be prepared in concentrated or potentised form. Potentization implies a successive dilution, each dilution step involving a rhythmic succussion (repeated shaking of liquids) or trituration (grinding of solids into lactose monohydrate). For example, a D6 potency (also called 6X) has been potentized in a 1:10 dilution six times, resulting in a 1:10-6 dilution . Since potencies beyond D23 do not contain any molecules of the original substance, effects cannot readily be explained by molecular mechanisms. However, a systematic review of invitro studies found biological effects of potencies ≥D23 in nearly three-fourths of the studies and in more than two-thirds of the studies with highest quality . All AM medications are manufactured according to Good Manufacturing Practice and national drug regulations; quality standards of raw materials and manufacturing methods are described in the Anthroposophic Pharmaceutical Codex . The available evidence suggests that AM medications and therapies are generally well tolerated with infrequent adverse reactions of mostly mild to moderate severity [19, 22].
AM therapy is practised by physicians (counselling, AM medication) and non-medical therapists (eurythmy, art, rhythmical massage) in 67 countries worldwide . AM therapy providers are certified following structured training programs according to international, standardized curricula. Therapy guidelines exist for AM medical therapy , eurythmy therapy , and AM art therapy . AM is practised in general practice and in specialist fields, including neurology, and is also integrated into intensive care and emergency medicine provided in hospitals, including university teaching hospitals . For patients with migraine, the physician will choose among the available AM therapy modalities in order to tailor the treatment to individual needs of the patient. AM treatments can be administered alone or combined with conventional antimigraine medications .
Several studies have evaluated acute or prophylactic therapy for migraine with Ferrum-Quartz , a mixture of ferrous sulphate, honey and quartz, available as 150 mg capsules and 10 mg tablets ('Kephalodoron' or 'Biodoron' tablets) . Here we present a pre-planned subgroup analysis of migraine patients from a study of a broader range of AM therapy options (eurythmy therapy, art therapy, rhythmical massage therapy, medications) .
For complementary therapy systems in widespread use, regardless of whether evidence from randomized trials exists, it has been argued that the conventional drug research strategy – starting with studies of biological mechanisms and moving through Phase I, II and III clinical trials – is not optimal . Another, more appropriate strategy has been proposed, moving from descriptive studies ('Phase 1') towards comparative studies of the whole system and its parts, and ending with studies of biological mechanisms ('Phase 5') . In the context of this reversed strategy, the present analysis addressed topics in the Phases 1-2 (therapy paradigms, therapy use, clinical outcomes, perceived benefit, safety).
This is a prospective two-year cohort study in a real-world medical setting. The study was initiated by the health insurance company Innungskrankenkasse Hamburg as part of a research project on the effectiveness, costs, and safety of AM therapies in outpatients with chronic disease (Anthroposophic Medicine Outcomes Study, AMOS) [27, 29, 30]. The present pre-planned analysis concerned the subgroup of adult patients with migraine. Since this was the first prospective study of comprehensive AM treatment for this indication, the primary objective was to describe AM therapy for migraine (characteristics of AM therapy users, spectrum of AM therapy modalities used, extent of combination with conventional anti-migraine therapy) as well as clinical outcomes after AM treatment under routine conditions. Further research questions addressed the use of health services, adverse reactions, and therapy satisfaction.
A diagnosis of migraine according to the criteria of the International Headache Society , assessed by the Kieler Kopfschmerzfragebogen, a standardized headache questionnaire in the German language [32;33], documented by the patients (for patients enrolled before April 2001: physician's diagnosis, assisted by a brief written clinical description). In accordance with the clinical practice guidelines of the Drug Commission of the German Medical Association , neuroimaging was not required for routine diagnostics of all patients.
or new referral to AM therapy (art, eurythmy or rhythmical massage).
Patients were excluded if they had previously received the AM therapy in question (see inclusion criteria 3) for migraine. Patients were treated according to the physician's discretion. AM therapy was evaluated as a whole system . Additional costs for AM treatments were 0.1-5.2 Euro per daily dose of an AM medication (51 different price groups, median 0.2 Euro, mean 0.8 Euro); 20-32 Euro per AM therapy session; and 46 Euro and 92 Euro for AM consultations with physicians of 30 min and 60 min duration, respectively. These costs were reimbursed by some but not all German health insurance companies.
Primary outcomes were physician- and patient-rated Average Migraine Severity, documented on numerical rating scales  from 0 ("not present") to 10 ("worst possible"), at six-month follow-up.
Secondary clinical outcomes were Symptom Score and quality of life. Symptom Score, the severity of one to six most relevant symptoms present at baseline, was assessed by patients on numerical rating scales from 0 ("not present") to 10 ("worst possible"). Quality of life was assessed with the SF-36 Health Survey  (Physical and Mental Component summary measures, eight scales, Health Change item).
Physician-rated Average Migraine Severity was documented after 0 and 6 months, while all other clinical outcomes were documented after 0, 3, 6, 12, 18, and 24 months.
Therapy outcome rating (0-10), satisfaction with therapy (0-10) and therapy effectiveness rating ("very effective, "effective", "less effective", "ineffective" or "not evaluable") were documented by the patients after 6 and 12 months.
Adverse reactions to medications or therapies were documented by the patients after 6, 12, 18 and 24 months and by the physicians after 6 months. The documentation included cause, intensity (mild / moderate / severe = no / some / complete impairment of normal daily activities), and therapy withdrawal due to adverse reactions. Serious adverse events were documented by the physicians throughout the study.
All data were documented with questionnaires returned in sealed envelopes to the study office. The physicians documented eligibility criteria; the therapists documented AM therapy administration; all other items were documented by the patients, unless otherwise stated. The patient responses were not made available to the physicians. The physicians were compensated 40 Euro (after March 2001: 60 Euro) per included and fully documented patient, while the patients received no compensation.
The data were entered twice by two different persons into Microsoft® Access 97 (Microsoft Corp., Redmond, WA, USA). The two datasets were compared and discrepancies resolved by checking with the original data. Non-AM medications were coded according to the Anatomical Therapeutic Chemical Classification Index.
The study was approved by the Ethics Committee of the Faculty of Medicine Charité, Humboldt University, Berlin, Germany, and was conducted according to the Declaration of Helsinki and largely following the ICH Guideline for Good Clinical Practice E6. Written informed consent was obtained from all patients before enrolment.
The data analysis was performed for all patients fulfilling the eligibility criteria, using SPSS® 14.0.1 (SPSS Inc., Chicago, Ill, USA) and StatXact® 5.0.3 (Cytel Software Corporation, Cambridge, MA, USA). T-test was used for continuous data with normal distribution; Wilcoxon Signed-Rank test was used for paired continuous data with non-normal distribution; McNemar test and Fisher's exact test were used for dichotomous data. All tests were two-tailed. Significance criterion was p < 0.05. Since this was a descriptive study, no adjustment for multiple comparisons was performed . Pre-post effect sizes were calculated as Standardized Response Mean (= mean change score divided by the standard deviation of the change score) and classified as minimal (< 0.20), small (0.20-0.49), medium (0.50-0.79), and large (≥ 0.80) [39, 40]. Clinical outcomes were analyzed with replacement of missing values by the last value carried forward.
Two pre-planned sensitivity analyses (SA1-SA2) were performed to assess the influence of natural recovery and adjunctive therapy on the 0-6-month outcome of physician- and patient-rated Average Migraine Severity. SA1 concerned natural recovery, which was assumed to be unlikely in patients with disease duration of at least one year . The sample was therefore restricted to patients with disease duration of at least 12 months prior to study enrolment. SA2 concerned the effects of prophylactic antimigraine medications: The sample was restricted to patients not using prophylactic antimigraine medications during the first six study months.
The patients were enrolled by 30 physicians with four different qualifications (27 general practitioners, one neurologist, one internist, and one gynaecologist). Comparing these physicians to AM-certified physicians in Germany with the same four qualifications but without study patients (n = 225), no significant differences were found regarding gender (60.0% vs. 58.5% males), number of years in practice (16.1 ± 6.9 vs. 19.3 ± 8.9), and the proportion of physicians working in primary care (90.0% vs. 92.0%). Mean age was 44.9 ± 5.9 and 48.3 ± 8.0 years in physicians with and without study patients, respectively (mean difference 3.4 years, 95% confidence interval 0.4-6.3 years, p = 0.027).
The patients were treated by 31 different AM therapists (art, eurythmy, rhythmical massage). Comparing these therapists to certified therapists without study patients (n = 1137), no significant differences were found regarding gender (87.1% vs. 80.7% women), age (mean 48.2 ± 9.3 vs. 50.3 ± 9.4 years) or the number of years since therapist qualification (10.5 ± 6.9 vs. 13.2 ± 8.7 years).
A total of 79 patients starting AM therapies for headache were screened for inclusion. Of these patients, 45 fulfilled all eligibility criteria and were included in the analysis. 34 patients were not included; in 27 of these patients the eligibility criteria were not fulfilled (the indication for AM therapy was not migraine but another headache disorder). The remaining seven patients were potentially eligible but not included for the following reasons: patients' baseline questionnaire missing (n = 3), physician's baseline documentation missing (n = 3), patients' and physicians' baseline questionnaire dated > 30 days apart (n = 1).
A total of 89% (40/45) of patients were enrolled by general practitioners, while 11% were enrolled by specialists. The physicians' settings were primary care practices (89% of evaluable patients, n = 39/44), referral practice (7%, n = 3), and outpatient clinics (5%, n = 2).
The last patient follow-up ensued on 9 May 2007. A total of 96% (n = 43/45) of patients returned at least one follow-up questionnaire. The patients were administered a total of 225 follow-up questionnaires, out of which 157 (70%) were returned. Follow-up rates were 89% (n = 40/45), 76%, 69%, 60%, and 56% after 3, 6, 12, 18, and 24 months, respectively. Respondents (n = 34) and non-respondents (n = 11) of the six-month follow-up questionnaire did not differ significantly regarding age, gender, disease duration or baseline parameters (physician- and patient-rated Average Migraine Severity, Symptom Score). Corresponding dropout analysis for the 24-month follow-up also showed no significant differences between respondents (n = 25) and non-respondents (n = 20). The physician six-month follow-up documentation was available for 82% (n = 37/45) of patients.
The patients were recruited from 12 of 16 German federal states. Mean age was 39.5 ± 11.1 years (range 17-61 years, Table 1). A total of 89% (n = 40/45) of the patients were women. Median duration of the migraine disorder was 12.0 years (interquartile range [IQR] 2.5-20.0, range 4 months to 40 years, mean 13.6 ± 10.1 years). The number of days with headache in the past month was documented in patients enrolled after March 2001 (n = 23) and was 1 day in 4% (n = 1/23), 2-6 days in 61% (n = 14), 7-10 days in 26% (n = 6), 11-15 days in 0% (n = 0), and > 15 days in 9% (n = 2), with a median number of 5.0 days (mean 6.8 ± 6.3 days).
CES-D: Center for Epidemiological Studies Depression Scale, German version.
A current comorbid disease was present in 78% (35/45) of patients. Most common comorbid diseases, classified by the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were F00-F99 Mental and Behavioural Disorders (24%, n = 17 of 70 diagnoses), N00-N99 Diseases of the Genito-urinary System (17%), L00-L99 Diseases of the Skin and Subcutaneous Tissue (13%), and M00-M99 Musculoskeletal Diseases (9%). Further baseline data are presented in Table 1.
At study enrolment, the duration of the consultation with the AM physician was < 30 min in 40% (n = 18/45) of patients, 30-44 min in 40%, 45-59 min in 9%, and ≥ 60 min in 11%. At enrolment 22% (n = 10/45) of patients fulfilled Inclusion Criterion 3a (AM-related consultation of ≥ 30 minutes followed by new prescription of AM medication), 38% (n = 17) fulfilled Inclusion Criterion 3b (referral to AM art, eurythmy or rhythmical massage therapy), and 40% (n = 18) fulfilled Inclusion Criteria 3a and 3b. Of the 35 patients referred to AM art/eurythmy/massage therapy, 89% (n = 31) had the planned AM therapy, 3% (n = 1) did not have AM therapy, and for 9% (n = 3) the AM therapy documentation is incomplete. AM therapies used were eurythmy therapy (n = 17 patients), rhythmical massage therapy (n = 6), and art therapy (n = 8). The AM eurythmy/art/massage therapy started median 9 (IQR 0-35) days after enrolment. Median therapy duration was 105 days (IQR 77-246 days), median number of therapy sessions was 12 (IQR 10-20). AM medications were used by 67% (n = 30/45) of patients. The most frequently used AM medications in months 0-6 were Ferrum-Quartz (n = 14 patients, thereof n = 7 using 150 mg capsules and n = 7 using 10 mg tablets), and Phosphorous dilution (n = 3 patients – contains potentised yellow phosphorus; used by the three patients in a D5, D6, and D20 potency, respectively).
Medications to treat acute migraine attacks were used by 53% (n = 19/36) of evaluable patients; medication groups used were non-opioid analgesics (44%), non-steroid anti-inflammatory agents (6%), and 5-HT1 agonists (14%). The total number of days with use of medication to treat acute migraine attacks in months 0-6 was 1-9 days (n = 9 patients), 10-19 days (n = 3), and 20-90 days (n = 19). Prophylactic antimigraine medications were used by 14% (n = 5/36); medications used were antidepressants (8%), cyclandelate (3%), and flunarazine (3%). The total number of days of use of prophylactic medications was 5 days (n = 1), 60-180 days (n = 3), and unknown (n = 1).
All clinical outcomes were improved from baseline at all subsequent follow-ups (exception: the SF-36 scale Role Emotional in months 0-6) (Table 2, Figs. 1-3). For seven of the 14 outcomes (physician- and patient-rated Average Migraine Severity, Symptom Score, the SF-36 scales Social Functioning, Bodily Pain, and Vitality and the SF-36 Health Change item) all improvements from baseline were significant at all follow-ups. Three further outcomes (SF-36 Physical and Mental Component summary measures, SF-36 scale Mental Health) were significantly improved at three or four out of five follow-ups.
* Positive differences indicate improvement.
** SF-36 Health Change: range from 1 ("much better now than one year ago") to 5 ("much worse now than one year ago"). SRM: Standardized Response Mean effect size (minimal: < 0.20, small: 0.20-0.49, medium: 0.50-0.79, large: ≥0.80).
Fig. (1) Average Migraine Severity.
Range: 0 "not present", 10 "worst possible". Physician and patient ratings.
Range: 0 "not present", 10 "worst possible".
Fig. (3) SF-36 Scales, SF-36 Health Change Item.
SF-36 scales: Range 0-100, higher scores indicate better health. SF-36 Health Change: Range from 1 ("much better now than one year ago") to 5 ("much worse now than one year ago").
At six-month follow-up, an improvement of ≥ 50% of baseline Average Migraine Severity was observed in 52% (n =23/44) of evaluable patients for physician rating and 45% (n = 20/44) for patient rating. Effect sizes for the 0-6-month comparison were large for three outcomes (physician- and patient-rated Average Migraine Severity, Symptom Score), medium for three outcomes (SF-36 Social Function, Bodily Pain, Health Change), small for six outcomes, and minimal for two outcomes (Table 2).
We performed two sensitivity analyses of the 0-6-month outcome of physician- and patient-rated Average Migraine Severity (Table 3: SA1-SA2; see Methods for further description). For physician rating, the individual analyses resulted in a reduction of the average 0-6 month improvement of maximum 6% (3.14→2.95 points). Combining both analyses, the improvement was reduced by 10% (3.14→2.82 points). For patient rating, the individual analyses resulted in a reduction of the improvement of maximum 8% (2.94→2.61 points). Combining both analyses, the improvement was reduced by 2% (2.84→2.78 points).
At six-month follow-up, the patients' average therapy outcome rating (numeric scale from 0 "no help at all" to 10 "helped very well") was 7.33 ±2.42 and patient satisfaction with therapy (from 0 "very dissatisfied" to 10 "very satisfied") was 7.72 ±2.05. The patients' effectiveness rating of eurythmy, art or rhythmical massage therapy was positive ("very effective" or "effective") in 76% (n = 19/25) of evaluable patients who had started therapy, and negative ("less effective", "ineffective" or "not evaluable") in 24%. The ratings of therapy outcome, satisfaction and effectiveness did not change significantly between 6- and 12-month follow-up.
The frequency of reported adverse drug reactions was 3% (n = 1 of 30 users) for AM medications and 9% (n = 3 of 34 users) for non-AM medications (p = 0.616). Adverse drug reactions of severe intensity were reported in three patients using non-AM medications (unspecified psychic symptoms from homoeopathic arsenicum album; nightmares from amitriptyline; skin blisters from estradiol/norethisterone tablets), while medication was stopped due to reported adverse reactions in one patient using AM medication (skin blisters from rosemary ointment). No adverse reactions from non-medication therapies occurred. No serious adverse events occurred.
This is the first prospective evaluation of comprehensive AM treatment for migraine. We aimed to obtain information on AM therapy for this indication under routine outpatient conditions in Germany and studied adults starting AM therapy for migraine. Two-thirds of patients used non-medication AM therapies; two-thirds used AM medications; one in seven patients also used conventional prophylactic medications. Under AM treatment, significant and sustained improvements of migraine severity and quality of life were observed.
Strengths of this study include a detailed assessment of the therapy setting and therapy-related factors, a long follow-up period, and high representativeness: 11% of all AM-certified physicians seeing migraine patients in Germany participated; the participating AM physicians and therapists resembled all eligible physicians and therapists with respect to socio-demographic characteristics; and 87% of screened and eligible patients were enrolled. These features suggest that the study mirrors contemporary AM practice to a high degree.
To assess the routine clinical practice, where the selection of AM therapy options will vary according to individual needs, we analyzed AM as a whole system . The sample size of AM therapy modality subgroups (eurythmy, art, rhythmical massage, medical) did not allow for subgroup analysis. The influence of the AM therapy modality and other therapy variables (e. g. duration of the consultation with the physician at study enrolment, number of AM therapy sessions) on clinical outcomes has been assessed in a multivariate analysis of adult AMOS patients with migraine and other chronic indications .
Another limitation in regard to sample size applies to the number of days with headache. This outcome, widely used in migraine studies, was only documented in a subset of patients, the documentation did not distinguish between migraine and interval headaches, and the number of patients with evaluable data at six-month follow-up (n = 13) did not allow for outcome analysis.
Since the study had a long recruitment period, the study physicians were not able to participate throughout the period and to screen and enrol all eligible patients (criteria: see Methods section). For a different subset of patients from the AMOS project (patients referred to AM therapies for any chronic indication and enrolled before 1 April 2001), it was estimated that physicians enrolled every fourth eligible patient . This selection could bias results if physicians were able to predict therapy response and if they preferentially screened and enrolled such patients for whom they expected a particularly favorable outcome. In this case one would expect the degree of selection (= the proportion of eligible vs. enrolled patients) to correlate positively with clinical outcomes. That was not the case, the correlation was almost zero (Spearman-Rho -0.04, p = 0.496, n = 364 ). Likewise, another analysis of 500 adult patients enrolled into AMOS in the period 1999-2005 showed no correlation between the degree of selection and the 0-6 month difference of Symptom Score . These analyses do not suggest that the participating physicians' expectations of future therapy response led to any selection bias affecting clinical outcomes.
A limitation of the study is the absence of a comparison group receiving conventional treatment or no therapy. Accordingly, one must consider several other causes for the observed improvements apart from the AM treatment. We therefore conducted a sensitivity analysis of physician- and patient-rated Average Migraine Severity, estimating the influence of natural recovery and adjunctive treatment with prophylactic antimigraine medications. These two factors together explained up to 10% of the 0-6 month improvement. Dropout rates increased from 11% after three months to 44% after 24 months. Dropouts and respondents had comparable baseline data, and in a telephone survey of non-respondents from a different subset of the AMOS sample, the proportion of patients with clinical deterioration at 24-month follow-up was comparable in dropouts and respondents . In the outcome analyses, attrition bias was minimised by replacing missing values of clinical outcomes by the last value carried forward. Non-medication therapies such as acupuncture  or biofeedback  were not documented in the study and could therefore not be evaluated. According to a previous analysis from this research program , regression to the mean due to symptom fluctuation with preferential self-selection to therapy and study inclusion at symptom peaks explained up to 0.43 points (11%) of the improvement of an outcome corresponding to physician-rated Average Migraine Severity in this analysis. Other possible confounders are psychological factors and non-specific effects. However, since AM therapy was evaluated as a whole system , the question of specific therapy effects vs. non-specific effects (placebo effects, context effects, physician-patient interactions, patient expectations etc.) was not an issue of the present analysis.
Because 14 clinical outcomes were analysed (Table 2), the issue of multiple hypothesis testing arises . However, eight of the 14 comparisons at six-month follow-up showed significant improvements and six comparisons had p-values ≤ 0.001 – a constellation that would not be expected to occur by chance. (E. g. a Bonferroni adjustment for 14 tests would have indicated p < 0.004 as significance level).
Since AM treatment was to be evaluated under routine conditions, therapy was administered at the discretion of the physicians and therapists and not according to standardized protocols. This raises the question of whether study interventions would be replicable in future studies. However, AM therapy providers worldwide are trained according to highly standardized curricula, specifying e. g. individual eurythmy movements for specific diseases, constitution types, and movement patterns. Therefore, relevant therapy differences across settings would not be expected. Moreover, in this study, any local therapy differences would probably be offset by the large number of participating AM physicians and therapists.
The present analysis was restricted to clinical outcomes and did not assess costs. In an analysis of 487 adult patients from the AMOS study with migraine and other chronic indications, costs of AM medications and therapies in the first study year amounted to 12% of all costs of healthcare and productivity loss . These extra costs of the new AM treatment in AMOS were offset by a reduction of inpatient hospital costs [29, 57]. Other, comparative evaluations indicate similar or lower costs in AM therapy settings, compared to conventional settings [19, 58].
This study provides the first data on comprehensive AM treatment for migraine in AM settings. The female/male ratio in this predominantly primary care sample (8.0/1.0) was higher than among migraineurs in the population (3.0/1.0)  and also higher than in primary care studies of AM medications for migraine (1.6-3.1/1.0) [60, 61]. The higher proportion of women in this sample might possibly reflect that women are more likely than men to engage in creative therapies such as AM art and eurythmy therapy. The use of non-opioid analgesics (44% of patients), 5-HT1 agonists (14%), and prophylactic antimigraine agents (14%) was similar to the use among migraineurs in Germany [62, 63] or France  during the study.
Baseline migraine disability, assessed by the number of days with headache in the past month (median 5.0 days), was higher than in the German population with migraine (median 2.2 days) , but the proportion of patients with >10 days with headache was similar (9% vs. 12%) . Quality of life at baseline, assessed with the SF-36 Health Survey, was worse than in other migraine studies (median difference for all SF-36 scores in all evaluable studies: 0.42 standard deviations) . The proportion of responders at six-month follow-up (patients with 50% improvement of Average Migraine Severity from baseline: 45-52%) was of the same order of magnitude as in trials of prophylactic antimigraine medications . Notably, in prophylactic trials a response was defined as 50% reduction in number of migraine attacks, which was not documented in the present study; therefore this comparison is necessarily approximate. A systematic comparison of identical quality of life outcomes (SF-36) in migraine cohorts receiving other therapies showed improvements of largely of the same order of magnitude as in this study .
Previous studies have found beneficial effects of single AM medications on migraine . In accordance with these findings, we found improvement of migraine symptoms and quality of life under comprehensive AM treatment. A notable finding was that three-fourths of study patients did not use anti-migraine medications in the first six months after enrolment, apart from non-opioid analgesics. Some migraine patients will not profit from medication; other patients stop taking medications due to adverse reactions or reject them, e. g. because they are passive. Even non-medication therapies for migraine are not suitable for all patients: some therapies are also passive (e. g. acupuncture or chiropractics) and others may be perceived as monotonous (e. g. biofeedback). In this context, the AM approach, with recourse to artistic exercise therapies as well as medication and rhythmical massage therapy, may be a welcome therapy option for some migraineurs.
In this study, adult migraine patients under AM treatment had long-term reduction of symptoms and improvement of quality of life. Improvements were similar in patients not using antimigraine prophylactic medications. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that AM therapies may be useful in the long-term care of patients with migraine.
Not applicable (this is not a clinical trial).
Within the last five years HJH and GSK have received restricted research grants from Wala-Heilmittel GmbH and Weleda AG, manufacturers of AM medications, otherwise all authors declare that they have no potential conflict of interests.
HJH, CMW, GSK, SNW, and HK contributed to study design. HJH, AG, AR, and HK contributed to data collection. HJH, RZ, and HK wrote the analysis plan, HJH and AG analyzed data. HJH was principal author of the paper, had full access to all data, and is a guarantor. All authors contributed to manuscript drafting and revision and approved the final manuscript.
This study was funded by the Software-AG Stiftung and the Innungskrankenkasse Hamburg, with supplementary grants from the Christophorus-Stiftungsfonds in der GLS Treuhand e.V., the Mahle Stiftung, Wala Heilmittel GmbH and Weleda AG. The sponsors had no influence on design and conduct of the study; collection, management, analysis or interpretation of the data; or preparation, review or approval of the manuscript. We thank Wilfried Tröger for helpful discussions. Our special thanks go to the study physicians, therapists, and patients for participating.
 Stovner LJ, Zwart JA, Hagen K, Terwindt GM, Pascual J. Epidemiology of headache in Europe Eur J Neurol 2006; 13(4): 333-45.
 Lipton RB, Bigal ME. Ten lessons on the epidemiology of migraine Headache 2007; 47(Suppl 1): S2-9.
 Brandes JL. The migraine cycle: patient burden of migraine during and between migraine attacks Headache 2008; 48(3 ): 430-1.
 Stovner LJ, Andree C. Impact of headache in Europe: a review for the Eurolight project J Headache Pain 2008; 9(3 ): 139-46.
 Murray CJ, Lopez AD. Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: Global Burden of Disease Study Lancet 1997; 349(9062 ): 1347-52.
 Cady R, Dodick DW. Diagnosis and treatment of migraine Mayo Clin Proc 2002; 77(3 ): 255-61.
 Silberstein SD. Migraine Lancet 2004; 363(9406 ): 381-91.
 von Peter S, Ting W, Scrivani S, et al. Survey on the use of complementary and alternative medicine among patients with headache syndromes Cephalalgia 2002; 22(5 ): 395-400.
 Rossi P, Di LG, Malpezzi MG, et al. Prevalence, pattern and predictors of use of complementary and alternative medicine (CAM) in migraine patients attending a headache clinic in Italy Cephalalgia 2005; 25(7 ): 493-506.
 Upchurch DM, Chyu L, Greendale GA, et al. Complementary and alternative medicine use among American women: findings from The National Health Interview Survey, 2002 J Womens Health (Larchmt ) 2007; 16(1 ): 102-3.
 Steiner R, Wegman I. Extending practical medicine Fundamental principles based on the science of the spirit [GA 27] [First published 1925]. Bristol: Rudolf Steiner Press 2000.
 Campbell DT. Downward causation in hierarchically organized biological systems In: Ayala FJ, Dobzhansky T, Eds. Studies in the philosophy of biology. London: Macmillan 1974; pp. 179-86.
 Schirmer F. Migräne aus schulmedizinischer und anthroposophischer Sicht. [Migraine from the point of view of conventional and anthroposophic medicine] Der Merkurstab 1998; 51(6 ): 348-55.
 Rivoir A. Migräne [Migraine]. Stuttgart: Verlag Freies Geistesleben & Urachhaus 2002.
 Sommer M. Stoffwechsel und Migräne. [Metabilism and migraine] In: Medizinisches Seminarr Bad Boll, Ed. Anthroposophische Medizin in der Praxis, Band 2 [Anthroposophic medicine in clinical practice. Bad Boll: Natur Mensch Medizin Verlags GmbH 2002; 2: pp. 229-46.
 Ritchie J, Wilkinson J, Gantley M, Feder G, Carter Y, Formby J. A model of integrated primary care: anthroposophic medicine. Queen Mary, University of London: London: Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine 2001.
 Wilde K, Leonhardt W. Vademecumskizze zum Thema Migräne und Kopfschmerzen [Therapy manual for migraine and headaches] Beiträge zu einer Erweiterung der Heilkunst 1982; 35(3 ): 126-30.
 Fintelmann V. Intuitive Medizin In: Einführung in eine anthroposophisch ergänzte Medizin [Intuitive medicine Introduction to anthroposophic medicine]. 3rd. Stuttgart: Hippokrates Verlag 1995.
 Kienle GS, Kiene H, Albonico HU. Anthroposophic medicine: effectiveness, utility, costs, safety. New York: Schattauer Verlag 2006.
 Anthroposophic Pharmaceutical Codex APC, Second Edition Dornach: The International Association of Anthroposophic Pharmacists IAAP 2007.
 Witt CM, Bluth M, Albrecht H, Weisshuhn TE, Baumgartner S, Willich SN. The in vitro evidence for an effect of high homeopathic potencies - a systematic review of the literature Complement Ther Med 2007; 15(2): 128-38.
 Hamre HJ, Kiene H, Kienle GS. Clinical research in anthroposophic medicine Altern Ther Health Med 2009; 15(6): 52-.
 Annual Report 2005. Dornach: International Coordination Anthroposophic Medicine / IKAM Medical Section at the Goetheanum 2005.
 Eurythmy Therapy Guideline. Filderstadt: Berufsverband Heileurythmie e.V (Eurythmy Therapy Association) 2004.
 Pütz H. Leitlinie zur Behandlung mit Anthroposophischer Kunsttherapie (BVAKT)® für die Fachbereiche Malerei, Musik, Plastik, Sprachgestaltung [Guideline for treatment with Anthroposophic Art Therapy with the therapy modalities painting, music, clay, speech] Filderstadt: Berufsverband für Anthroposophische Kunsttherapie e V [Association for Anthroposophic Art Therapy in Germany] 2008.
 Hamre HJ, Becker-Witt C, Glockmann A, Ziegler R, Willich SN, Kiene H. Anthroposophic therapies in chronic disease: The Anthroposophic Medicine Outcomes Study (AMOS) Eur J Med Res 2004; 9(7 ): 351-60.
 Fønnebø V, Grimsgaard S, Walach H, et al. Researching complementary and alternative treatments - the gatekeepers are not at home BMC Med Res Methodol 2007; 7: 7.
 Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H. Health costs in anthroposophic therapy users: a two-year prospective cohort study BMC Health Serv Res 2006; 6: 65.
 Hamre HJ, Witt CM, Glockmann A, Tröger W, Willich SN, Kiene H. Use and safety of anthroposophic medications in chronic disease: a 2-year prospective analysis Drug Saf 2006; 29(12 ): 1173-89.
 Headache Classification Commitee of the International Headache Society . Classification and diagnostic criteria for headache disorders, neuralgias, and facial pain Cephalalgia 1988; (8 ): (Suppl 7)1-96.
 Göbel H. Die Klassifikation von Kopfschmerzen: Kriterien und praktische Durchführung. [Classification of headache: criteria and practical implementation] Z aerztl Fortb Qual sich 1993; 87(6): 451-8.
 Göbel H. Die Kopfschmerzen: Ursachen, Mechanismen, Diagnostik und Therapie in der Praxis [Headaches: Causes, mechanisms, diagnostic and therapy in clinical practice]. Berlin, Heidelberg: New York: Springer-Verlag 1997.
 Empfehlungen zur Therapie von chronischen Kopf- und Gesichtsschmerzen. Inhaltlich abgestimmt mit der Deutschen Gesellschaft zum Studium des Schmerzes (DGSS) und der Deutschen Migräneund Kopfschmerzgesellschaft (DMKG) [Guidelines for treatment if chronic headache and facial pain. Consensus with the German Society for the Study of Pain and the German Migraine and Headache Society] Cologne: Drug Commission of the German Medical Association 2001.
 Boon H, MacPherson H, Fleishman S, et al. Evaluating complex healthcare systems: A critique of four approaches Evid Based Complement Alternat Med 2007; 4(3): 279-85.
 Westhoff G. VAS Visuelle Analog-Skalen, auch VAPS Visual Analogue Pain Scales, NRS Numerische Rating-Skalen, Mod. VAPS Visual Analogue Pain Scales, NRS Numerical Rating Scales, Mod. Categorical Scales, Mod.] Handbuch psychosozialer Messinstrumente Göttingen, 1993; 881-5.
 Bullinger M, Kirchberger I. SF-36 Fragebogen zum Gesundheitszustand Handanweisung [SF-36 Health Survey, German Version: Handbook]. Göttingen: Hogrefe-Verlag 1998.
 Feise RJ. Do multiple outcome measures require p-value adjustment? BMC Med Res Methodol 2002; 2: 8.
 Cohen J. Statistical power analysis for the behavioral sciences. 2. Hillsdale: NJ: Lawrence Erlbaum 1988.
 McDowell I. Measuring health In: A guide to rating scales and questionnaires. Oxford:: Oxford University Press 2006.
 Hamre HJ, Glockmann A, Kienle GS, Kiene H. Combined bias suppression in single-arm therapy studies J Eval Clin Pract 2008; 14(5 ): 923-.
 Brauns H, Steinmann H. Educational Reform in France, West-Germany and the United Kingdom: updating the CASMIN educational classification Mannheim: Mannheimer Zentrum für Europäische Sozialforschung 1997.
 Bundesgesundheitssurvey 1998 In: [Federal Health Survey 1998 Public Use File]. Berlin: Robert Koch Institute 2000.
 Federal Statistical Office In: Statistical Yearbook for the Federal Republic of Germany. Stuttgart: Metzler-Poeschel Verlag 2001.
 Hoffmeister H, Schelp FP, Mensink GB, Dietz E, Bohning D. The relationship between alcohol consumption, health indicators and mortality in the German population Int J Epidemiol 1999; 28(6 ): 1066-72.
 Junge B, Nagel M. Das Rauchverhalten in Deutschland [Smoking behavior in Germany] Gesundheitswesen 1999; 61(Sonderheft 2 ): S121-5.
 Breckenkamp J, Laaser U, Danell T. Freizeitinteressen und subjektive Gesundheit [Hobbies and Subjective Health] Wiesbaden: Federal Institute for Population research at the Federal Statistical Office 2001.
 VDR Statistik Rentenbestand am 31 [VDR-Statistics of Pensioners on December 31, 2000] 2005.
 Bergmann E, Ellert U. Sehhilfen, Hörhilfen und Schwerbehinderung. [Seeing aids, hearing aids, and disabilities] Bundesgesundheitsblatt 2000; 43(6): 432.
 Ministry of Health and Social Welfare. Arbeitsunfähigkeits-, Krankengeld-und Krankenhausfälle und -tage nach der GKV-Statistik KG2 1996 bis 2002 [Number of cases and days with sick leave and with inpatient hospitalisation, according to the statistics of the Statutory Health Insurance KG2, 1996 to 2002] Bonn 2003.
 Hautzinger M, Bailer M. ADS, Allgemeine Depressions Skala Manual In: [Center for Epidemiological Studies Depression Scale, German Version Manual]. Weinheim: Beltz Test 1993.
 Hamre HJ, Witt CM, Kienle GS, et al. Long-term outcomes of anthroposophic therapy for chronic low back pain: A two-year follow-up analysis J Pain Res 2009; 2: 75-85.
 Endres HG, Diener HC, Molsberger A. Role of acupuncture in the treatment of migraine Expert Rev Neurother 2007; 7(9 ): 1121-34.
 Nestoriuc Y, Martin A, Rief W, Andrasik F. Biofeedback treatment for headache disorders: a comprehensive efficacy review Appl Psychophysiol Biofeedback 2008; 33(3 ): 125-40.
 Hamre HJ, Witt CM, Glockmann A, et al. Health costs in patients treated for depression, in patients with depressive symptoms treated for another chronic disorder, and in non-depressed patients: a two-year prospective cohort study in anthroposophic outpatient settings Eur J Health Econ 2010; 11(1 ): 77-94.
 Studer HP, Busato A. Ist ärztliche Komplementärmedizin wirtschaftlich? Eine Gesamtbeurteilung von Ergebnissen des Programms Evaluation Komplementärmedizin PEK [Is physician-provided complementary medicine cost-effective?. An overall assessment of results of the Swiss programme for the evaluation of complementary medicine PEK] Schweizerische Ärztezeitung 2010; 91(18): 707-11.
 Lipton RB, Bigal ME. The epidemiology of migraine Am J Med 2005; 118(Suppl 1 ): 3S-10S.
 Kienle GS, Kiene H, Albonico HU. Halblützel 1980 [Experiences with "Biodoron" in an open study] In: Anthroposophic medicine: effectiveness, utility, costs, safety. Stuttgart, New York: SchattauerVerlag 2006; p. 137.
 Kienle GS, Kiene H, Albonico HU. Brachmann 1983 [Further experiences with "Biodoron" in clinical practice] In: Anthroposophic medicine: effectiveness, utility, costs, safety. Stuttgart, New York: SchattauerVerlag 2006; pp. 127-8.
 Haag G. Migräne und Lebensqualität - Ergebnisse der MELT-Studie [Migraine and quality of life - results of the MELT survey] Nervenheilkunde 2004; 23(5 ): 297-9.
 Radtke A, Neuhauser H. Prevalence and burden of headache and migraine in Germany Headache 2009; 49(1 ): 79-89.
 Lucas C, Chaffaut C, Artaz MA, Lanteri-Minet M. FRAMIG 2000: medical and therapeutic management of migraine in France Cephalalgia 2005; 25(4 ): 267-79.
 Göbel H, Petersen-Braun M, Soyka D. The epidemiology of headache in Germany: a nationwide survey of a representative sample on the basis of the headache classification of the International Headache Society Cephalalgia 1994; 14(2 ): 97-106.


Mûre guesthouse, floor area: 75 m². Adjoining the « Myrtille » guesthouse with common entrance. 1 room with queen-size bed and direct access to terrace. 1 shower room. 1 independent WC. Bed linen and towelling provided. Cot on request. Fitted open kitchen (Dishwr, Mwave…), dining and lounge area with flat screen TV (British and French channels), DVD player, iPod dock, hifi, WiFi. Oil-fired central heating. Private terrace with garden furniture. Shared with other rentals and owners: 14mx5,5m heated swimming pool (open from May to October), spa for 6 people, French boules playing area, children's play area, covered area with table tennis, billiards, table football, fridge available and gas BBQ shared with the « Myrtille » rental. Parking.


There are so many tips out there on good health, so it may be difficult to identify exactly what you need to do in order to maintain good health. In fact, there are so many articles, journals, and social media posts on healthy living that would really tempt us to go break the bank shopping for all kinds of healthy foods.
First of all, we need to remember to keep everything moderate; even if we have some areas of our lives we would like to change, we need to do that gradually and not all at once. Sudden changes are frightening, stressful, and eventually may have a reverse effect on us, which results in escaping back to the old harmful habits.
Therefore, we thought to give you a few tips on how to bring a positive change in your life and how to tune it up step by step, to becoming healthier.
We all know fresh fruits and veggies are good for us. However, we don't really know that fresh meat, green leafy vegetables, and beans are as good as they can get. In addition to adding fruits and vegetables in your daily meals, also try to eat less processed food as that's the first giant step to a healthier lifestyle. Eating regularly is also an important thing. This does not mean you must eat 3 times a day; instead, eat only two times a day if you please, but try to stick to that, along with the times of consuming your meals.
No, you don't need to run to the closest store and spend huge amounts of money to buy fitness gear, or invest in running shoes which you may not wear ever again. Start simple: start walking more. Walking is a great start. Active cleaning and decluttering is worth a normal fitness exercise too. So, try to forget about your car and public transportation and go walking or hiking more. That's a brilliant start and you won't feel forced to run, lift weights, or frequent gyms.
Try replacing your unhealthy habits with healthier habits. For instance, try vaping instead of smoking, drinking more caffeine free coffee, eating much less fat, and quit binge drinking. We are not your doctor to tell you what you should and what you shouldn't do, but we all know that these things are bad for our general health. If you go step by step and consume less harmful substances, that's already a great achievement.
Always have some "me" time which you only use to be alone to relax, to reflect, and most importantly to be alone and not feel harassed by all the stress that surrounds us in our everyday lives. This is essentially the best way to battle stress.
Always use a sunscreen in the summer and include it in your day crème as well (at least SPF 15). While many products still don't have it, elite brands such as Clinique and Estée Lauder all have their daytime lotions infused with proper sun protection.
Check out this magazine that caters specifically to Women's Health and includes great tips every month!
← Is Moldy Food Dangerous?


A 22 year-old herbalist, Eshaiwu Mohammed, has been granted bail in the sum of GH ¢14,000 by the Tarkwa Circuit Court for defrauding by false pretences.
He pleaded not guilty to the charge, and will re-appear before the court on August 26.
The Prosecutor, Police Detective Chief Inspector Oscar Amponsah told the court, presided over by Mr. Justice Alex Obeng Asante, that in April this year, the complainant, Simon Ayivor and his friend Eric, had information that the accused person was a spiritualist who doubled money.
He said Simon became interested and contacted the accused person with Eric for assistance to enable him get rich and live a comfortable life.
C/Inspector Amponsah said Simon being a native, gave his consent, and the accused person under the pretext of buying some items to begin the process for him to get money, collected various sums of money totaling GH¢12,000 from the complainant.
According to the Prosecutor, after the amount had been given to the accused person, he failed to avail himself to the complainant and all efforts made by him to retrieve his money could not yield any result.
The complainant reported the incident to the police, and on July 6 Mohammed was arrested in his hide-out.
C/Inspector Amponsah said during interrogation the accused person informed the police that he collected an amount of GH¢9,000 from the complainant for what he requested for.


text:
in Pharmacology
Cardiovascular and Smooth Muscle Pharmacology
Drug Metabolism and Transport
ELSI in Science and Genetics
Experimental Pharmacology and Drug Discovery
Gastrointestinal and Hepatic Pharmacology
Inflammation Pharmacology
Integrative and Regenerative Pharmacology
Neuropharmacology
Obstetric and Pediatric Pharmacology
Pharmaceutical Medicine and Outcomes Research
Pharmacogenetics and Pharmacogenomics
Pharmacology of Anti-Cancer Drugs
Pharmacology of Ion Channels and Channelopathies
Renal Pharmacology
Respiratory Pharmacology
Cardiovascular and Smooth Muscle Pharmacology aims to publish research related to the pharmacotherapy of cardiovascular disorders and those of other smooth muscle-rich organs, such as functional disorders of the heart, blood vessels, kidneys and urinary tract, as well as the central nervous system.
It aims to publish significant basic and clinical research findings related to the pharmacotherapy of cardiovascular disorders and those of other smooth muscle-rich organs such as those of the urogenital tract. This includes functional disorders of the heart, blood vessels, kidneys and urinary tract, as well as the central nervous system parts regulating such function. Malignant disorders of these organs will be covered in other sections of Frontiers in Pharmacology. We welcome all manuscripts that shed light on of drug action and the underlying mechanisms. This includes analysis the interaction with receptors and/or other specific biological targets (e.g. enzymes, particularly kinases and phosphatases, transcription factors) and their consequences at the cellular, tissue and organism level. Accordingly, in vivo studies in experimental animals and humans are equally welcome, as are pharmacokinetic studies related to drugs for the treatment of urogenital disorders.
Indexed in: PubMed, PubMed Central, Scopus, Web of Science, Google Scholar, DOAJ, CrossRef, Chemical Abstracts Service (CAS)
PMCID: all published articles receive a PMCID
Cardiovascular and Smooth Muscle Pharmacology welcomes submissions of the following article types: Brief Research Report, Case Report, Correction, Editorial, General Commentary, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Review, Specialty Grand Challenge and Technology and Code.
All manuscripts must be submitted directly to the section Cardiovascular and Smooth Muscle Pharmacology, where they are peer-reviewed by the Associate and Review Editors of the specialty section.
Articles published in the section Cardiovascular and Smooth Muscle Pharmacology will benefit from the Frontiers impact and tiering system after online publication. Authors of published original research with the highest impact, as judged democratically by the readers, will be invited by the Chief Editor to write a Frontiers Focused Review - a tier-climbing article. This is referred to as "democratic tiering". The author selection is based on article impact analytics of original research published in all Frontiers specialty journals and sections. Focused Reviews are centered on the original discovery, place it into a broader context, and aim to address the wider community across all of Pharmacology.
pharmacology.editorial.office@frontiersin.org
For all queries regarding manuscripts in Review and potential conflicts of interest, please contact pharmacology.editorial.office@frontiersin.org
For queries regarding Research Topics, Editorial Board applications, and journal development, please contact pharmacology@frontiersin.org

redpajama_set_name: RedPajamaCommonCrawl


Click the button below to add the Karmen Valance to your wish list.
This simple tailored design is easy to make. The center of the valance has a separate flat, shaped underlay that pulls forward and attaches to the flat sections with buttons. Use the pointed underlay or the straight across version. The jabot is a flat-pointed tab that offers a return. The pointed horn attaches to the jabot separately. There are no pleats in this valance; therefore, bulk is not a problem.


1-9 Lewis Road consist of five separate but attached buildings. Each entryway has 6 units, three floors with two units on each floor. The apartment/homes on Lewis Road are two bedroom, one bath, 1450 square foot flats. Very nicely laid out (see floor plan below). All flats have hardwood floors, nine foot ceilings, nice architectural details, ceramic tile baths, fully applianced eat-in-kitchens, washer/dryers, very good closet space. Additionally, each apartment has a secure, private, storage room in the basement with outside access. These apartments are rented including heat, hot water, basic cable TV service, household trash removal and maintenance of appliances. Our focus is on tenant services!!


Paris 2011 – Citizen series.
Here it is… …best regards to the artists from Paris. Hope to see you soon in Berlin.
September 30th, Life Tapeart-action at the Paris Carshow…the whole afternoon. Watch out for Mercedes-Smart booth…see you folks.


Insightec said today it is partnering with the Virginia Tech Carilion Research Institute looking to develop treatments for brain disorders utilizing the company's Exablate Neuro focused ultrasound device.
The treatments will also utilize Siemens (NYSE:SI) magnetic resonance imaging devices, with potential applications in treating cancer, brain tumors, targeted disruptions of the blood-brain barrier for therapeutic delivery and neuromodulation to treat psychiatric disorders.
"There is considerable basic research to be done in order to develop safe and efficacious protocols for these treatments and we are excited to be one of the research sites to carry this breakthrough technology forward," research lead Stephen LaConte said in a prepared statement.
"We share a common vision, a culture of discovery and openness, and a commitment to study and develop scientifically validated technological innovations to treat patients with otherwise untreatable brain disorders," Virginia Tech health sciences & tech VP Michael Friedlander said in prepared remarks.
Collaborative research efforts are being facilitated by the Focused Ultrasound Foundation, which aims to develop new applications for focused ultrasound.
"Collaboration with academic centers of excellence, such as VTCRI, is a key component of Insightec's heritage of innovation. Collaboration fuels the scientific breakthroughs that ultimately improve patient lives," Insightec chair & CEO Dr. Maurice Ferré said in a press release.
Last month, Insightec said it raised $150 million in a Series E round of financing led by Koch Industries' Koch Disruptive Technologies to support its MRI-guided focused ultrasound technologies.


It's more explicitly focused on just hooking up than most dating apps, though it has the option to "get date" or "get down." Download Down (i OS, Android) Tinder was the app that set off the dating app craze.Its iconic interface lets you swipe yes/no on a series of potential dates.Applause found that, in general, the most popular US dating apps trailed other apps in quality by 23 points (out of 100).That's a big difference, and perhaps indicates that people take out their dating woes on the apps they use.But its innovation is that women have to be the ones to message first.
This non-smoking hotel is located in Hochheim am Main, just 15 km from Frankfurt Airport.


text:
The 50 top earning Premier League players in 2022/23 - in pictures
Haaland, Salah, Casemiro, De Bruyne and Ronaldo all battling for top spot - but who is the winner?
1) Manchester United's Cristiano Ronaldo is the Premier League's highest paid player, earning £515,000 a week at Old Trafford, according to sporting website capology.com. Reuters
Dominic Hart
It's a football season split in half by the 2022 World Cup and the game's top stars have more trophies than ever to play for.
The Qatar tournament will showcase most of the world's best in a festival of football.
World Cup 2022: Complete match schedule, kick-off times and venues
Many of those players earn their living in England, and you can see the 50 highest-paid players in the Premier League and their weekly salaries for the 2022/23 season, according to capology.com, an online football salaries and finance website, in the photo gallery above.
To move on to the next image, click on the arrows, or if you're using a mobile device, simply swipe.
Who is the Premier League's highest paid player?
Yes, he's still out in front. Cristiano Ronaldo is the best-paid player in the Premier League, with the Manchester United forward earning a weekly salary of £515,385 a week, according to capology.com.
The top 10 highest paid Premier League players in 2022/23
1. Cristiano Ronaldo – Manchester United, £515,000 per week
2. Kevin de Bruyne – Manchester City, £400,000 per week
3= Erling Haaland - Manchester City, £375,000 a week
3= David de Gea – Manchester United, £375,000 per week
5= Jadon Sancho - Manchester United, £350,000 per week
5= Mohamed Salah - Liverpool, £350,000 per week
7. Raphael Varane - Manchester United, £340,000 per week
8. Raheem Sterling – Chelsea, £325,000 per week
9= Jack Grealish – Manchester City, £300,000 per week
9= Casemiro - Manchester United, £300,000 a week
Updated: October 31, 2022, 6:24 AM


The Mastering Aboriginal Inclusion workshops delivers you with collected intelligence, researched from practices that have been tried and perfected by some of Canada's top diversity companies.
This one-day workshop, with accompanying five module self-study CD, will open your organization to the opportunities to embrace inclusion as a business paradigm. The material represents cutting-edge research and knowledge to help you build partnerships with the Indigenous community and advance your business case for inclusion.
The learning material comes to life through the interactive facilitation of our inclusion experts; giving you and your colleagues the knowledge and confidence to introduce and advance proven inclusion strategies that transform organizational behaviour and practices that help you climb our seven-stage Inclusion Continuum.
We deliver customized Mastering Aboriginal Inclusion training at a location of your choice. Contact us today to for a quote to customize a workshop to meet your needs.
Support the business case for creating a workforce that is inclusive of Indigenous people.
Locate and communicate effectively with urban and rural Indigenous talent throughout Canada.
Develop strategies to successfully recruit, train, mentor and advance Indigenous employees.
Position your organization as an employer-of-choice for Indigenous people, and company-of-choice for Indigenous businesses and communities.
Adapt practices to fit your workplace.
The original Peoples of this land now called Canada have been here for hundreds of years prior to contact and maintain a unique relationship with the land. This learning unit is a summary of key flash points of Aboriginal (Indigenous people: First Nations, Metis, Inuit) history in Canada. It is designed to provide you with a brief introduction on the subject and to take you and your colleagues on a journey from exclusion to inclusion.
The information, resources and promising practices included in this learning resource were gathered from companies that also have been on the journey to climb the Inclusion Continuum and become employers-of-choice for Indigenous people. Learn about the four critical Aboriginal demographics; labour and skills demand, diversity and corporate social responsibility.
This learning unit has been designed to provide you with introductory information about the challenges and successes of retention strategies that support Indigenous inclusion in the workplace. Explore the challenges by hearing, first hand, from Indigenous workers in Canada, and then weave this information to offset hurdles to better retain Indigenous talent. A sample of promising practices from companies across Canada will also be shared.
This topic has been specifically designed to provide you with basic information on the recruitment process to source candidates, provide insight into the challenges faced by Indigenous candidates and also provide a sample of promising practices from companies across Canada.
Learn about the six key elements that support an effective Indigenous workforce development approach; leadership and commitment, communication and marketing, relationship building, recruitment, retention and advancement as well as implementation and measurement. This webinar will help you journey towards creating a workplace that supports Indigenous recruitment, retention and advancement.
Effective cross cultural communication will further your efforts to better support Indigenous workforce development strategies. Communicating in the workplace with an awareness of diversity issues and respectful workplace strategies will help your inclusion efforts to recruit, retain and advance Indigenous Peoples.
Partnerships may take many forms, have few or multiple partners or simply be warranted because of resource development or a formal impact benefit agreement. No matter what the reason for joining together, partnerships mean growth and new opportunities. This learning unit provides information on six key areas in developing a partnership strategy.
Companies or organizations that want to build positive relationships/partnerships with Indigenous people, businesses and communities.
Company leaders and directors/managers in human resources, communications/marketing, procurement, corporate social responsibility.


McNevins group of motels provides quality accommodation and dining for discerning travellers in South East Queensland and in New South Wales, at Maryborough, Loganholme, Warwick and Tamworth.
McNevins Maryborough Motel and Sails Restaurant and Function Centre are located adjacent to the central business district of the heritage city of Maryborough, the gateway to Australia's whale watching capital Hervey Bay and Fraser Island. Call (07) 4122 2888 today or book your accommodation online.
McNevins Loganholme Motel and Ferrymans Restaurant are located on the Pacific Highway halfway between Brisbane and the Gold Coast, just 10 minutes from Dreamworld and the major theme park attractions. Call (07) 3209 8830 or book your accommodation online.
McNevins Warwick Motel and superb Gunyah Restaurant are located on the New England Highway, 2 minutes south of the Warwick central business district. Call (07) 4661 5588 today or book your accommodation online.
McNevins Tamworth Motel and Restaurant 999 are located on the New England Highway, 10 minutes north of Tamworth, Australia's country music capital. Call (02) 6760 9200 or book your accommodation online.
McNevins don't just offer great accommodation for our visitors – we host a variety of excellent facilities that allow guests huge flexibility when they stay with us.
The brand-new conference facility at McNevins Tamworth Motel is one such example of this, where groups of up to 70 people can use our spacious and well-equipped space for private functions, special events, meetings, and conferences.
Our restaurants are also well equipped to provide high quality food for our guests at prices that are always affordable, meaning you'll never have to look anywhere else for a quality meal.
You'll always enjoy your stay at McNevins...the discerning traveller's choice. For general information about McNevins motels, you can email us at info@mcnevins.com.au.
Proudly supporting the 1200kms for Kids: Charity Bike Ride each year.
Mcnevin's Tamworth Motel Winners of the 2013 Tamworth Business Chamber Quality Business Awards for "Excellence in Accommodation"
McNevins Maryborough 2012 Winners of the Fraser Coast Tourism Award for Excellence in Deluxe Accommodation.
Winners of the Fraser Coast Tourism Awards for Excellence in Deluxe Accommodation 2012 and 2013 and 2014 winner for our Sails Restaurant.
What's happening in Tamworth from September – November at the Australian Equine and Livestock Events Centre? Heaps!
Your feedback is important to us, please share with us any comments you may have about our website, your stay at a McNevins Motel or simply a comment you would like to make about our company.


got trained from him [Andrew Cremer].
[City of London School for Boys].
"Z. has been offered a place into City!
Thank you for all your support during this process."
"S. has been offered 30% scholarship in Chigwell and 50% in Forest.
Fantastic results, thanks to you again!
All this would not have been possible without your teaching and guidance. "
and we have accepted it.
We would recommend you to all friends and their children attempting 11+."
City of London School for Girls.
Thank you very much for everything."
who has a calm, friendly manner.
He has raised our daughter's understanding of the subject, and I would recommend him with no reservations whatsoever."
Pupil M.R. from Ilford, whom Andrew coached in English from 2015-2017, came first out of 1,007 applicants in the 11+ exam for Woodford County High School for Girls, where her C.E.M. Redbridge Score was 130.09.
 She was also awarded a place at the Henrietta Barnett School in Hampstead Garden Suburb, which her parents accepted. Her C.E.M. Score for Chelmsford County High School for Girls was 128.90.
In the CSSE exam, her standardised score was 396.636.
NEW RESULTS JUST IN (Feb. 2019)!


FRIDAY, DECEMBER 7, 2018 | newseum | wASHINGTON, d.c.
Please join the Center for Democracy & Technology, in partnership with the Freedom Forum Institute, Charles Koch Institute and WAMU's 1A, for a one-day symposium on the future of speech online.
Online communities are a central part of the lives of many. At their best, these communities create new connections, break down barriers, and lift up their members. But some online communities also drive polarization, spread false news, or coordinate harassment. How do these different communities develop and evolve—and how do they fit into the larger landscape of online speech?
The Future of Speech Online is an event of the Center for Democracy & Technology.
If you have any questions, please contact us via email at events@cdt.org.


text:
Home » Harold Pinter , The Caretaker » In what sense does Davies represent Everyman
Davies represent Everyman
Davies in The Caretaker is a prominent character whose life and problems can be seen as representing certain basic features that are shared by every human being.
The problems faced by Davies are the problems of normal human existence. He tries pathetically to cling to his dignity when society wants to deprive him of his rights. Davies is frightened of loneliness and anything he does not understand such as taxation, house purchase, and 'papers'. His fear of down payments, back payments, family allowances, bonus schemes is common enough to make it a standard human reaction. It may be that in Davies Pinter shows his audience an even more basic human instinct, that of territorial advantage, or the desire to gain dominance in any given situation. Davies certainly shows this in his dealings with Aston and Mick. His belief that he will 'sort himself out' when he gets down to Sidcup can be seen as representing all the things that people dream of doing, but never achieve. Davies represents all people who try to evade reality by dreams and fantasies.We can find other aspects in which Davies can be said to represent more than just his own self. He uses the language of the common man. Like any other human being, he is a wanderer who faces trials and tribulations during the journeys he makes. As a religious figure, he is poor, unmarried, and is rejected by his fellow men, and in this respect at least he can be compared to Jesus Christ.But if we are to see Davies as representative of mankind, we are to ignore many of his most obvious features. He is an outcast before he is rescued by Aston,an unprincipled vagrant, and a filthy, ill-clothed wreck of a man. Certainly there are many people like Davies in the world, but he is nevertheless an extreme case, a total loss of society, and hardly typical of all humanity. If he were Everyman, society would have ceased to exist thousands of years ago.
The problems of Davies are common enough for an audience to feel a degree of sympathy for him, and they are clearly drawn from the real world. Davies shows the dark said of life, in the form of loneliness, rejection, inadequacy, loss of personal identity, and failure, but however compelling the portrait might be, it is only one side of life. Therefore Davies is not unusual, but equally is not a representative of all humanity.
To sum up, Davies should not regarded as a symbol. He is a representative figure, no doubt, but his vision is limited to one side of human experience. So Davies should be seen not as Everyman but simply a part of man.
By Green Land - March 25, 2019
Labels: Harold Pinter, The Caretaker


text:
WATCH! The Emerging Economy of Freelancers; and the Difference of the "ME" & "WE" Generations
#SuccessStrategies, Business Mountain, VFNtv Programs, WATCH FULL PROGRAM
FREELANCING/SIDE GIGS, FUTURE EMERGING JOB MARKET
As we watch the economy of America take an impressive swing upwards, jobs reports are continually being shared and analyzed in hopes of getting a better understanding of what is happening. Sometimes these reports are clear-cut. But, what about the workforce that isn't so easily identifiable? About the workforce of freelancers? As Fox News reports, this portion of the workforce is contributing more than $1.4 Trillion annually into the American economy.
While 'freelancers' may not show up everyday for a "9-5", they have their own unique skillsets that they market to those who need their talents and abilities. As Andy Challenger, with Gray & Christmas states, "the workforce has become really flexible. More and more employees out there want to be working freelance. Right now, estimates are about 53 million Americans are working freelance right now. That's 34% of the American workforce". Challenger continues to say, "projections are that half of all Americans could be working freelance by the end of the decade."
So, the question is, is there an office for these 'freelancers'? While some can choose to work from home, others have the option of using the resources provided by private companies like wework.. "The third largest startup in the U.S. has an evaluation of $20 Billion. It rents office space on demand." Companies such as wework provide not only office space, but also shared communities for people to be able to have an environment of creativity needed to carry out their projects.
Business is no longer about the four-year college degree; getting a job and having it for the next 45 years. With our changing and developing economy, what a college student learns in their first year may be entirely outdated by the end of their second year. We must shift our mindsets and understanding of how things need to be. Some may express that the negative perspective of freelancing, or "gigging", is that it does not provide health care or benefits. It is important that we take the responsibility of what is needed.
CEO and Co-Founder of we work, Adam Neumann, shares about the pinnacle high of starting a business, as well as the sobering realities of practical needs that have gone unanswered. "The first day of building a business is a big day, because that is the day when the full dream comes into play." Neumann continues, "But then the second day kicks in: where is my office? Where is my internet provider? How am I gonna pay for electricity? Where am I going to get sales from?" These are all legitimate questions that every entrepreneur faces. This is where We Work seeks to fill those gaps. Neumann explains. "At We Work, we really strive to help you as much as we can. Focus on doing what you love. Create your life's work and let us take care of the rest." Neumann sums up how they have positioned themselves to respond to today's developing economy. "We work is the office space of tomorrow."
What is additionally intriguing about freelancers is that this form of working reportedly earns more than twice the annual salary in America. The beauty of this is its flexibility to adapt and change to whatever your changing business or idea may be. You aren't tied to an office building or other contracts holding you to a specific region or location.
Are you in freelance? Are you looking for a shared community of creativity to carry out what God has called you to do? We want to hear from you. Share how creative environments help you to be more productive. See the full conversation on today's changing workforce, and so much more. Also shared in this segment: workforce, unemployment, Fox News, health insurance, shared office spaces, community workforce, creativity, freelance, gigging, community company, multiple streams of income, and mindsets. Greg and John shared in this segment.
PENDULUM THEORY, ME VS. WE GENERATIONS, WE ARE IN A "WE" – BUSINESS RELATIONS
When we look back throughout history, there are many cycles of change that can be seen. According to Roy Williams and his extensive research of more than 3,000 years, the American economy has been carrying out the same cycle every 80 years. He calls it the "Pendulum", and its details are written out in his book: Pendulum: How Past Generations Shape Our Present and Predict Our Future.
When sharing his research to Glenn Beck, Williams describes the extremes on each side of the Pendulum are the "WE" on the left and the "ME", on the right. On the left side are ideas such as "I'm O.K. You're not O.K.", which results in a 'witch hunt'. The right side carries with it ideas of "You're O.K. I'm not O.K.", which results in Hero Worship.
During extremes of the Me Generations arise individuals, whether it be Adolf Hitler or Ronald Reagan. This lasts for 20 years, and then it comes back down, which takes another 20 years. At the end of this 40-year turn, then a We Generation begins causing the entire process to take 80 years. When looking at this cycle, the tragedy of the matter is that we always take a good thing too far. It is this realization that causes the "pendulum" to come back down.
Moving into the We Generation greatly contradicts the values of the Me Generation". The "We" says, "the group, the team, the collective". Williams begins to share where we are today. "That's where we've been since 2003. We've been in the upswing of a "We" cycle." Continuing his point, he shares, "It's your planet too. It's my planet. We're all in this together. Do you recycle?" In a "We" cycle, the demonstration of your actions speaks louder than the simple proclamation of what your dreams are.
Williams shares an insightful understanding of what takes place during the transition between the two cycles. "There is always some confusion in which way the wind is blowing right at the tipping point between a "We" and a "Me" or a "Me" and a "We". And, we will carry forward some of the old behaviors and some of the old way of thinking, not realizing that the Earth has shifted beneath our feet; and people's heads and hearts are in a different place now."
Understanding these principles greatly impacts how we market our businesses. Consider the business model of Starbucks. They have completely capitalized on the concept that people care more about community than a cup of coffee. With this understanding in mind, what is your sitting area like? Can people sit around and talk? Right now, we are in a "We" Generation. Don't simply connect to just anything, know that those that you are connecting to share the same values and ideals that you have.
How does this encourage you? Are you looking for a sense of belonging? Are you wanting to know how to better position and market your company in this We Generation? Connect with us and share. See the full conversation about the shifts of our generation, how to connect with what is happening, and so much more. Also shared in this segment: Roy Williams, Glenn Beck, Adolf Hitler, Ronald Reagan, Me Zenith, Me Generation, We Generation, We Zenith, upswing, downswing, pendulum, pendulum theory, seasons, times, Starbucks, VFNTribe, VFN tribe, tribe, where do I belong?, and a sense of community. Greg and John shared in this segment.
VFNKB #SuccessSecrets OWN YOUR HAPPINESS; T.D. JAKES
In this culture of ever-changing attitudes, likes, dislikes, shares, apps, forwards, and everything else imaginable, many people find themselves affected by what other people are saying, or not saying. When it comes down to it, no one else is more in control of your happiness than yourself. This has a great impact on how we live our lives. When Bishop T.D. Jakes spoke with Steve Harvey, he shared about the importance of this revelation.
"You have to own your own happiness. Take it away from other people demanding that they make you happy." Bishop Jakes continues to point out, "your kids are not going to make you happy; your spouse is not going to make you happy; a big house is not gonna make you happy. Own your own happiness and be responsible for doing those things that bring joy into your heart…"
Our life takes a dramatic turn when we take back the happiness of our own lives, and put it on ourselves, and stop expecting others to do what only we can do. How does this effect you? Have you had trouble enjoying your daily routine because of what others have said or not said? Share with us your comments. See the full conversation from Bishop T.D. Jakes, and so much more. Also shared in this segment: joy, happiness, Steve Harvey, life coaching, life principles, and your life story. Greg and John shared in this segment.
Bishop T.D. Jakes, happiness, We Generation
"In God, We Trust" Motto BACK IN SCHOOLS LAW, FL State Rep. Kim Daniels
Controversy and Progress Happen Simultaneously; Bishop T. D. Jakes


text:
Record-breaking family migration overwhelming…
Record-breaking family migration overwhelming border agency
More than 76,000 migrants crossed the U.S.-Mexico border last month.
In this Feb. 26, 2019, photo, U.S. Border Patrol Customs and Border Protection Chief Carla Provost testifies before the House Judiciary Committee on Capitol Hill in Washington, Tuesday, Feb. 26, 2019. Firearms use by U.S. Customs and Border Protection officers and agents has reached a record low. According to data obtained by The Associated Press, there were 15 instances in which officers and agents used firearms during the budget year 2018. (AP Photo/Jose Luis Magana)
By Colleen Long and The Associated Press | The Associated Press
PUBLISHED: March 5, 2019 at 3:47 p.m. | UPDATED: March 5, 2019 at 3:54 p.m.
WASHINGTON — The number of migrant families crossing the southwest border is again breaking records, and the crush is overwhelming border agents and straining facilities, officials said Tuesday.
More than 76,000 migrants crossed the U.S.-Mexico border last month, more than double the number from the same period last year. Most were families coming in ever-increasingly large groups — there were 70 groups of more than 100 people in the past few months, and they cross illegally in extremely rural locations with few agents and staff. There were only 13 large groups during the previous budget year, and only two the year before.
The system "is well beyond capacity, and remains at the breaking point," U.S. Customs and Border Protection Commissioner Kevin McAleenan said a press conference Tuesday.
The new figures reflect the difficulties President Donald Trump has faced as he tries to cut down on illegal immigration, his signature issue. But it could also help him make the case that there truly is a national emergency at the border — albeit one built around humanitarian crises and not necessarily border security. The Senate is expected to vote next week and join the House in rejecting his national emergency declaration aimed at building border walls, but Trump would almost certainly veto the measure and the issue is likely to be settled in the courts.
After the deaths of two migrant children in Border Patrol custody, Customs and Border Protection stepped up medical screenings. They also announced sweeping changes including more rigorous interviews as migrants come into the system.
And McAleenan said a new processing center would be built in El Paso, Texas, that will be better suited to manage families and children and handle medical care concerns — but it's not a permanent solution.
"While our enhanced medical efforts will assist in managing the increased flows, the fact is that these solutions are temporary and this solution is not sustainable," he said.
While fewer people overall are being apprehended crossing the border illegally each year — about 400,000 over the last budget year compared with the high of 1.6 million in 2000, the increasing numbers are alarming, officials said.
Those apprehended used to be mostly single men from Mexico, but are now mostly families from Central America — since October, more than 130,000 families have been apprehended between ports of entry. From October through September 2018, about the same number of families was apprehended at the U.S.-Mexico border. Tens of thousands of children illegally cross the border alone. While single men used to evade capture, the families are seeking out agents.
Customs and Border Protection also reported using firearms less and less. There were 15 instances where officers and agents used firearms during the budget year 2018, down from a high of 55 reported during the 2012 budget year, and down from 17 during 2017's budget year and 25 the year before.
Despite high-profile instances in recent months where agents used tear gas on groups of migrants that included children, use of less-lethal force like tear gas, batons or stun guns are also down, to 898. That's a decrease from the high in 2013 of 1,168, according to the data.
Border officials said the large families groups are creating opportunities for smugglers because attention is diverted to the large groups. Border officials say they worry they're spending too much time on migrant care and not enough on security.
During 2018's fiscal year, border agents and officers seized more than 1.7 pounds of narcotics, including 1.1 million pounds of marijuana, 282,570 pounds of cocaine, 6,552 pounds of heroin and 2,463 pounds of fentanyl, mostly through ports of entry, according to the border security report from budget year 2018, released Tuesday. Fentanyl seizures were up nearly 70 percent from the last budget year.
Complaints of excessive force prompted the border enforcement agency to commission an audit and investigation by the Police Executive Research Forum, a research and policy group. The 2013 audit highlighted problems that included foot-patrol agents without access to less-lethal options, and it recommended law enforcement not be allowed to use deadly force when people throw rocks — a suggestion that was rejected.
Following those reviews, major training and policy changes were made. Border Patrol agents now undergo scenario-based drills at the academy and learn how to de-escalate tense situations. They get 64 hours of on-the-job training on use of force. Agents and officers are authorized to use deadly force when there is reasonable belief in an imminent danger of serious physical injury or death to the officer or another person.
They have discretion on how to deploy less-than-lethal force: It must be both "objectively reasonable and necessary in order to carry out law enforcement duties" — and used when other "empty hand" techniques are not sufficient to control disorderly or violent subjects.
Officials say they deploy the lowest form of force necessary to take control of a situation, but instances a few months ago where tear gas was used on migrants that included children drew strong criticism.
The story corrects month to October, not January, on apprehensions between ports of entry.
governmentandpolitics
U.S. immigration policy


text:
Book ~ "Elizabeth & Margaret: The Intimate World of the Windsor Sisters" (2021) Andrew Morton
From Goodreads ~This biography follows Queen Elizabeth II and her sister, Margaret, as they navigate life in the royal spotlight.
They were the closest of sisters and the best of friends. But when, in a quixotic twist of fate, their uncle Edward Vlll abdicated the throne, the dynamic between Elizabeth and Margaret was dramatically altered. Forever more Margaret would have to curtsey to the sister she called 'Lillibet.' And bow to her wishes.
Margaret's struggle to find a place and position inside the royal system - and her fraught relationship with its expectations - was often a source of tension.. This book explores their relationship over the years.
Elizabeth was four years old when her sister, Margaret was born. Though they were close, the sisters were different ... Elizabeth was quieter and more of a rule follower whereas Margaret was the more attention seeking sister. Things all changed when their uncle Edward VIII abdicated the throne and their father was suddenly and unexpectedly the king ...which meant that Elizabeth would someday become queen. This shifted the dynamics between the sisters because Elizabeth now started being groomed to take over the monarchy someday and Margaret was left out, which she didn't like at all.
The book follows the sisters as they were growing up. Things shifted again when Elizabeth married Phillip and didn't spend as much time with Margaret. The book focuses more on Margaret after Elizabeth's marriage. She became a party girl and started dating a married man (he eventually divorced his wife). That relationship cooled as distance was put between them and Margaret ended up marrying someone else. It was a hot and cold relationship, becoming freezing as the years went by, and they ended up hating each other. There was bad behavior on both sides, including infidelity. They divorced and Margaret moved on to a much younger man. Margaret's smoking and partying behavior caught up with her and in her later years she wasn't in the best of health. She ended up passing away at the age of 70.
I like reading bios/autobios and thought this one was interesting. I liked the writing style. It wasn't overly long as there weren't a lot of details and I was okay with the high level view.
There are lots of pictures at the end of the book from when they were children to Margaret's coffin being carried from the chapel.
Label(s): Andrew Morton, Books, Books - 2021, Published 2021
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Hey, I'm new to this blogsite and hoping our CU will sign on to NAFCU. But in the meantime, I will soon bare my soul and hope for the best. Since I haven't blogged here, I'll see how this shorter message shows up; then launch into the 'real questions/issues' in a subsequent message/post.
so you don't assume too much when you read/reply.
I have some (what to me are) perplexing questions (not necessarily associated with the current Financial Sector/CU crises). This will be what I'll be keen to have input from my more experienced colleagues.
Thanx in advance for your indulgence.


text:
Q: Decorator to register Python methods in PyCLIPS I make use of PyCLIPS to integrate CLIPS into Python. Python methods are registered in CLIPS using clips.RegisterPythonFunction(method, optional-name). Since I have to register several functions and want to keep the code clear, I am looking for a decorator to do the registration.
This is how it is done now:
class CLIPS(object):
...
    def __init__(self, data):
        self.data = data
        clips.RegisterPythonFunction(self.pyprint, "pyprint")
    def pyprint(self, value):
        print self.data, "".join(map(str, value))

and this is how I would like to do it:
class CLIPS(object):
...
    def __init__(self, data):
        self.data = data
        #clips.RegisterPythonFunction(self.pyprint, "pyprint")
    @clips_callable
    def pyprint(self, value):
        print self.data, "".join(map(str, value))

It keeps the coding of the methods and registering them in one place.
NB: I use this in a multiprocessor set-up in which the CLIPS process runs in a separate process like this:
import clips
import multiprocessing

class CLIPS(object):
    def __init__(self, data):
        self.environment = clips.Environment()
        self.data = data
        clips.RegisterPythonFunction(self.pyprint, "pyprint")
        self.environment.Load("test.clp")
    def Run(self, cycles=None):
        self.environment.Reset()
        self.environment.Run()
    def pyprint(self, value):
        print self.data, "".join(map(str, value))

class CLIPSProcess(multiprocessing.Process):
    def run(self):
        p = multiprocessing.current_process()
        self.c = CLIPS("%s %s" % (p.name, p.pid))
        self.c.Run()

if __name__ == "__main__":
    p = multiprocessing.current_process()
    c = CLIPS("%s %s" % (p.name, p.pid))
    c.Run()
    # Now run CLIPS from another process
    cp = CLIPSProcess()
    cp.start()

A: it should be fairly simple to do like this:
# mock clips for testing
class clips:
    @staticmethod
    def RegisterPythonFunction(func, name):
        print "register: ", func, name

def clips_callable(fnc):
    clips.RegisterPythonFunction(fnc, fnc.__name__)
    return fnc

@clips_callable
def test(self):
    print "test"

test()

edit: if used on a class method it will register the unbound method only. So it won't work if the function will be called without an instance of the class as the first argument. Therefore this would be usable to register module level functions, but not class methods. To do that, you'll have to register them in __init__.

A: It seems that the elegant solution proposed by mata wouldn't work because the CLIPS environment should be initialized before registering methods to it.
I'm not a Python expert, but from some searching it seems that combination of inspect.getmembers() and hasattr() will do the trick for you - you could loop all members of your class, and register the ones that have the @clips_callable attribute to CLIPS.

A: Got it working now by using a decorator to set an attribute on the method to be registered in CLIPS and using inspect in init to fetch the methods and register them. Could have used some naming strategy as well, but I prefer using a decorator to make the registering more explicit. Python functions can be registered before initializing a CLIPS environment. This is what I have done.
import inspect

def clips_callable(func):
    from functools import wraps
    @wraps(func)
    def wrapper(*__args,**__kw):
        return func(*__args,**__kw)
    setattr(wrapper, "clips_callable", True)
    return wrapper

class CLIPS(object):
    def __init__(self, data):
        members = inspect.getmembers(self, inspect.ismethod)
        for name, method in members:
            try:
                if method.clips_callable:
                    clips.RegisterPythonFunction(method, name)
            except:
                pass
...
    @clips_callable
    def pyprint(self, value):
        print self.data, "".join(map(str, value))

For completeness, the CLIPS code in test.clp is included below.
(defrule MAIN::start-me-up
    =>
    (python-call pyprint "Hello world")
)

If somebody knows a more elegant approach, please let me know.

redpajama_set_name: RedPajamaStackExchange