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Ethnic minority inequalities in access to treatments for schizophrenia and schizoaffective disorders: findings from a nationally representative cross-sectional study
Jayati Das-Munshi1,3,
Dinesh Bhugra1 &
Mike J. Crawford2
Ethnic minority service users with schizophrenia and schizoaffective disorders may experience inequalities in care. There have been no recent studies assessing access to evidence-based treatments for psychosis amongst the main ethnic minority groups in the UK.
Data from nationally representative surveys from England and Wales, for 10,512 people with a clinical diagnosis of schizophrenia or schizoaffective disorders, were used for analyses. Multi-level multivariable logistic regression analyses were used to assess ethnic minority inequalities in access to pharmacological treatments, psychological interventions, shared decision making and care planning, taking into account a range of potential confounders.
Compared with white service users, black service users were more likely prescribed depot/injectable antipsychotics (odds ratio 1.56 (95% confidence interval 1.33–1.84)). Black service users with treatment resistance were less likely to be prescribed clozapine (odds ratio 0.56 (95% confidence interval 0.39–0.79)). All ethnic minority service users, except those of mixed ethnicity, were less likely to be offered cognitive behavioural therapy, compared to white service users. Black service users were less likely to have been offered family therapy, and Asian service users were less likely to have received copies of care plans (odds ratio 0.50 (95% confidence interval 0.33–0.76)), compared to white service users. There were no clinician-reported differences in shared decision making across each of the ethnic minority groups.
Relative to white service users, ethnic minority service users with psychosis were generally less likely to be offered a range of evidence-based treatments for psychosis, which included pharmacological and psychological interventions as well as involvement in care planning.
There have been longstanding concerns around the care which ethnic minority groups living with severe mental illnesses receive [1,2,3]. In particular, it is well documented that ethnic minority groups, and in particular black people with psychosis, are more likely to experience complex [1] and coercive pathways into care [1, 4]. Concerns around coercive practices have led some to consider the role of prescribing inequalities by ethnicity, as prescribing practices may reflect discriminatory practices. A recent systematic review of studies, mostly from the USA, suggested that ethnic minority groups were more likely to be prescribed typical antipsychotics over atypical antipsychotics [5]. Evidence from the UK has not indicated differences in prescribing quality by ethnicity; however, these studies have been based on in-patient populations, with relatively small numbers and have only assessed differences between black and white patients [6, 7]. It is possible that inequalities in treatments may be a concern for other ethnic minority groups as well.
There is less evidence on access to psychological treatments for schizophrenia in black and minority ethnic groups. People with schizophrenia should be offered cognitive behavioural therapy (CBT) or family therapy [8], and from recent data, how far this quality standard is met within ethnically diverse populations remains unclear. Previous research, from almost a decade ago, suggested that black Caribbean people with psychosis were less likely to receive psychotherapy [9], and Asian and black service users under the care of community mental health teams were also less likely to be referred for psychological treatments [3]. It is possible that there have been changes since the introduction of the recent guidelines for schizophrenia [8], but no up-to-date studies have assessed this.
Alongside the receipt of treatments for schizophrenia, service users with schizophrenia should be at the heart of decision making. To this end, the choice of antipsychotic medication should be determined through discussion between the clinician and the service user [8, 10], information relating to potential side effects alongside benefits should be clear [8, 10] and written information or an equivalent should be given to service users with schizophrenia and schizoaffective disorders [8, 10]. There should be a care plan jointly agreed on by the clinician and service user and, if appropriate, with the involvement of carers [8, 10]. It is not yet clear how far standards relating to these aspects of shared decision making fall short for ethnic minority groups with schizophrenia.
We conducted a secondary analysis of nationally representative data of people living with schizophrenia and schizoaffective disorders, to determine whether there were differences in treatments (antipsychotic prescribing, psychological therapies, shared decision making and receipt of care plans) across ethnic minority groups.
Setting and participants
The National Audit of Schizophrenia (NAS) was a cross-sectional survey of all mental healthcare trusts and health boards within England and Wales that aimed to collect information on randomly selected patients from healthcare providers on the quality of care provided. In the UK, mental health trusts provide mental healthcare to geographically distinct catchment areas and provide both in-patient and out-patient services; they may also occasionally provide tertiary-level services at the national level. Despite being separate mental health providers, trusts are still expected to provide equivalent standards of care nationally. There have been two waves of data collection for the surveys, first in 2011 [11] and then in 2013 [12]. On each occasion, trusts were asked to provide data on a random sample of 100 service users over the age of 18 with a diagnosis of ICD-10 F20.0-F20.9 (schizophrenia) or F25.0-25.9 (schizoaffective disorder) under the care of community-based services (community mental health teams and specialist teams) within the previous 12 months, with the diagnosis made before the age of 60 years. Patients on in-patient caseloads were excluded. Selection of patients for both surveys was based on established random selection techniques, which included an online randomisation tool or randomly generated numbers by the study team, with mental health trusts generating a sampling frame which comprised case lists from teams or selecting cases centrally using online random selection techniques. Once service users were identified using these methods, local staff were contacted and asked to fill out the data collection questionnaire. They were also able to refer to clinical case notes as well as consult with the service users' general practitioners, if required. Service providers submitted the completed questionnaires via a secure online system. All trusts were asked to verify if data were accurate prior to analysis. A priori sample size calculations determined the number of returns needed in order to have adequate power to provide sufficient precision of proportions to make meaningful comparisons between services. All responses were anonymised and kept confidential. Full details of the methods for both surveys, as well as the extensive piloting phase, have been reported elsewhere [11, 12].
Data collection procedures
Prior to conducting the first survey, focus groups were conducted, alongside a development phase for outcome indicators. A pilot study comprising six trusts was conducted and further helped to inform methods of data collection. The resultant questionnaire took less than 20 min to complete. The final tool included specific measures designed to assess quality of care (prescribing, access to psychological treatments and receipt of physical healthcare monitoring and interventions) according to standards set through the National Institute for Health and Care Excellence (NICE) for the management of people with schizophrenia [8]. The findings related to physical health have been published elsewhere [13].
The surveys were designed to assess if standards were being met in the quality of care received by people with schizophrenia and schizoaffective disorders, according to national quality standards [11, 12]. Service users and providers of mental health services formed an expert reference group and were consulted in the development of the questionnaires. Across the two waves of data collection, questionnaires and instruments which had been successfully piloted and used in the first wave were kept similar to those employed in wave two. Except for a question on whether clinicians had provided service users with a care plan (asked only in the second wave of the survey, as this was not a national standard when the first survey was conducted), virtually identical information on all other indicators was collected across the two waves.
Trusts were asked to provide information on currently prescribed antipsychotic medication and to list all currently prescribed antipsychotic medications with dose. Where service users were not currently prescribed antipsychotic medication, trusts were asked to report details relating to most recently prescribed medications. Information relating to current/recent antipsychotic prescribing (excluding pro re nata (PRN) medications), in particular relating to type, dose and method of administration, were collected. Measures for maximum doses reached (as percentage of recommended maximum doses according to British National Formulary guidelines [14]) and evidence of concurrent prescribing of more than one antipsychotic medication at the same time were also noted from the responses given to the question asking about currently prescribed antipsychotic medications. Evidence of concurrent prescribing of more than one antipsychotic medication at the same time was also noted from the responses given to the question asking about currently prescribed antipsychotic medications. Using this information, a variable was created to identify individuals prescribed more than one antipsychotic medication at the same time, excluding clozapine. The name provided for each of the antipsychotic medications was used to determine the type of antipsychotics (first generation, second generation, clozapine). The method of administration (oral, depot) was also noted. Clinicians were asked whether they thought the patient was in remission and, if not, the level of disability evident. Where clinicians reported that a patient was not in remission or had only partial remission with significant symptoms and disability, they were asked if clozapine had been offered. Evidence of prior or current psychological intervention ever being offered was noted (family therapy and CBT). Service providers were also asked to report whether there was documented evidence that service users had been involved in deciding which antipsychotic medication should be prescribed, whether there was documented evidence in the notes that the service user had been provided with written information on medication or an alternative, and whether the benefits and the side effects of the medication had been explained.
Trusts were asked to extract data on ethnicity from clinical records and indicate whether the service user was 'White', 'Asian or Asian British', 'Black or Black British', 'Chinese' or 'Other' ethnic group, 'Mixed' or 'Not stated'. These categories were retained for the analysis.
Information on other socio-demographic indicators, including gender, age and team responsible for care (assertive outreach team, community mental health team, crisis resolution team, early intervention and 'other' teams) and information on diagnoses according to the International Classification of Mental Disorders-10 (ICD-10) [15] was collected, as well as duration of illness.
Simple descriptive analyses were initially conducted on each of the two datasets using one-way analysis of variance (ANOVA) and χ2 tests as appropriate. Multi-level random effects logistic regression models were then used to assess the association of individual-level covariates, nested within mental health trusts, with each of the treatment outcomes. These models specifically modelled the variance between 'clusters' (in this case trusts) as well as within clusters. Each of the individual-level variables (age, sex, ethnicity, ICD-10 diagnosis, duration of illness, team providing care, remission status) were modelled as fixed effects, with ethnicity treated as the main exposure and all other variables as a priori confounders. For each model the likelihood ratio test (LRT) for 'rho' or the intra-cluster correlation coefficient (ICC) assessed clustering within the dataset against a null hypothesis of no clustering. A statistically significant p value from the LRT indicates evidence of within-trust clustering. Using this approach, the crude association of ethnicity with each of the treatment outcomes was derived, followed by the association of ethnicity with each of the treatment outcomes adjusted for a priori confounders. For analyses relating to clozapine prescriptions, models were re-run with the sample restricted to individuals who were not in remission or had only partial remission with significant disability. Prior to combining waves of the NAS, an interaction term survey year*ethnicity was fitted in models for all outcomes. As there was no evidence in support of a statistical interaction, analyses were combined across the 2 years. All analyses were conducted in STATA 13 [16].
At trust level, for the first wave, 60/64 (94%) of mental health trusts provided data, and for the second wave, all 64/64 mental health trusts in England and Wales submitted data. At an individual level, response rates were 85% in the first wave and 88% in the second wave.
Table 1 highlights demographic features of the sample. In general, ethnic minority service users within the sample were younger than white service users, with a similar sex profile. Service users who were in the Chinese, 'Other' or 'Mixed' ethnicity groups were more likely to be diagnosed as having a schizoaffective disorder, whilst duration of illness was longer in the white group. A higher proportion of black/black British service users were under the care of an assertive outreach team.
Table 1 Demographic features by ethnicity
Table 2 displays proportions accessing treatments for psychosis by ethnicity. The majority of service users (96% in full sample) were prescribed an antipsychotic medication. White service users and people of mixed ethnicity were more likely to exceed recommended BNF dose limits, and a larger proportion of black/black British service users were prescribed a depot. For psychological treatments, Asian/Asian British service users were more likely to be referred to family therapies, while service users of Chinese/other ethnicity were less likely to have documented evidence of their being given a copy of their care plan.
Table 2 Receipt of treatments by ethnicity
Table 3 displays adjusted odds ratios for the association of ethnicity with each of the treatment indicators from multi-level multivariable logistic regression models. Of note, LRTs which assessed the null hypothesis of no within-trust clustering vs the alternative hypothesis of some within-trust clustering (i.e. LRT for rho = 0, also known as the ICC) were p < 0.001 for each of the treatment indicators (antipsychotic prescribing, referrals for psychological therapies, shared decision making and whether service users had a care plan) displayed in Table 3. This suggests that high levels of variance remained between National Health Service (NHS) mental health trusts after adjusting for all individual-level covariates, which may indicate that certain NHS mental health trust-level characteristics might account for variability in treatment provision, despite adjustment for each of the individual-level covariates in the models.
In adjusted models, relative to white service users with schizophrenia and schizoaffective disorders, each of the ethnic minority groups, except people who were of mixed ethnicity, were less likely to exceed BNF maximum doses for antipsychotic prescribing, although service users of mixed ethnicity were more likely to experience high-dose prescribing relative to white service users (Table 3). Black/black British service users were more likely to be prescribed depot antipsychotics compared to white service users. When analysis of clozapine was restricted to the sample of people with treatment-resistant schizophrenia, black/black British service users were less likely to be prescribed clozapine relative to white service users, with a trend towards a similar direction in the Asian/Asian British group. In adjusted regression models, there was no evidence of an association between ethnicity and antipsychotic polypharmacy. There were no reported differences by ethnicity with respect to clinicians reporting that they had provided service users with written information on medications, had explained the benefits or side effects of the most recent antipsychotic medication, or had involved patients in decisions around the choice of antipsychotic (Table 3).
With respect to psychological therapies, in adjusted models, each of the ethnic minority groups except for the mixed ethnicity group were less likely to have been offered CBT relative to the white group. The Asian/Asian British users were more likely to have been offered family therapy, whereas black/black British service users were less likely to have been offered family therapy, compared to white service users. Asian/Asian British service users were less likely to have been given a copy of their care plans compared to white service users.
The findings from this nationally representative survey of schizophrenia and schizoaffective disorders suggest large variations in the provision and offer of high quality treatments to ethnic minority service users compared to white service users. Differences were observed across the provision of antipsychotic medications, psychological therapies and care plans. Our findings also indicated that variability in estimates remained at trust level even after adjusting for individual-level attributes. This may indicate a need to consider systemic/institutional factors, and could also include an assessment of area-level deprivation or own ethnic density, alongside individual-level factors in accounting for observed ethnic differences, in future work. We did not have trust-level information to inform our analyses, and as such, residual confounding by trust-level factors may be a concern. Future waves of the surveys and subsequent analyses could include trust-level information (such as ethnic diversity, trust size, trust-level policies focusing on ethnic minority disparities) which may inform future work in this area.
The data for this study were collected prior to the introduction of the updated (2014) UK NICE guidelines for the management of schizophrenia [8] and were based on the standards set out in the earlier guidelines (2009). It is possible that since the introduction of the updated guidance, disparities may have improved; future planned sweeps of the NAS will be well placed to monitor this.
Strengths and limitations
This analysis derives from randomly selected records of service users with schizophrenia and schizoaffective disorders from all mental health trusts in England and Wales. Across mental health trusts, response rates were good. Therefore, the findings are highly generalisable to individuals with these diagnoses, within these countries. Combining two waves of survey meant that more than 10,000 service users provided data for the analysis. This would have improved the statistical power to detect differences. It was possible to survey a variety of treatments for schizophrenia and schizoaffective disorders, and the analyses were not just restricted to prescribing. The findings provide some indication of quality of care received by ethnic minorities with schizophrenia and schizoaffective disorders under the care of community outpatient teams.
One of the limitations of the study is that data were extracted from clinical records. It is possible that in some instances these records did not provide a complete picture of the care that people received. For instance, some patients may have been offered a psychological therapy or a copy of a care plan without this being documented in their notes.
Race/ethnicity is a complex multi-faceted construct, with the two terms frequently used interchangeably across the international literature [17, 18]. Typically 'race' has been taken to refer to differences based on biological attributes, and 'ethnicity' reflects the way in which individuals place themselves with respect to shared identity, cultural/religious affiliations and positions of marginality [17]. As such, ethnicity may be assessed through self-report, but even here may be subject to change over time, and is not a static construct. Arguably both race and ethnicity are social constructs, subject to change, and potentially capturing systems of oppression [18]. In this study we have preferred to use the terminology 'ethnicity' to reflect the complexities of categorisation [19]. A limitation of this study was that we do not know how each of the trusts collected this information on service users. It is possible that for at least some of the service users within the survey, ethnicity was not self-ascribed and was instead recorded by administrators or clinicians using visual attributes. In addition we only had relatively crude indicators for ethnicity, and it is likely that differences between groups were masked. The 'White' group would have potentially included individuals of Irish ethnicity as well as other white ethnic groups. It is a limitation that we were unable to explore this further, given concerns around known mental health inequalities affecting these groups [20, 21], as well as a well-established association between migration in general and schizophrenia [22]. In addition, the other ethnic groups ('Black', 'Asian', 'Chinese', 'Other', 'Mixed') would have contained individuals with differing countries of birth, language, migration and settlement histories, and we were unable to assess these potential indicators of acculturation and migration further.
Although we adjusted for a number of important variables in models, we did not have information on socio-economic position. Information on other clinical factors was also unavailable, including the presence of other co-morbid conditions. It is possible that some of the estimates were confounded by these factors. We were able to assess the role of clustering at the trust level in accounting for variance, but we did not have any trust-level attributes which could be added to the analyses. The role which systemic factors may play in accounting for the differences (such as trust-level commitment to delivering race equality, the financial status of mental health trusts and associated availability of treatments and interpreters) may play a role in patterning differences in outcomes and could be investigated in future work [23].
Prescribing differences
Previous research has indicated that black people may be more likely to be subjected to community treatment orders (CTOs) (supervised treatment orders with stipulated conditions), for whom depot/injectable prescriptions are also more likely [24]. In addition, in another study, participants prescribed depot formulations experienced and reported the depot to be more coercive and less empowering than people prescribed oral medications [25]. These findings do raise a potential concern around differing experiences of coercion across ethnic minority groups, but should also be considered against the potential harm/benefits of depot. For example, in a recent systematic review and meta-analysis, the authors highlighted that depot preparations were more likely to reduce the risk of relapse compared to oral preparations [26]. It is also possible that preferences for injectable medications follow differing cultural expectations for allopathic treatments [27]. It is possible that the frequency of depot prescriptions by ethnicity observed in the present study reflected these and other factors, although we were unable to assess this further. Future research, potentially utilising qualitative methods, could explore this topic.
Observed differences in antipsychotic dosing may have reflected differing sensitivities (e.g. to extrapyramidal side effects) to antipsychotic medications as well as differences in response to relatively lower doses of antipsychotics by ethnicity, within the sample [28, 29], alongside possible prescriber concerns regarding pharmacokinetic interactions. Differences in dose of antipsychotics may have been mediated through a number of factors including but not limited to tobacco use, dietary factors, illness behaviours, patient expectation/adherence, age, gender and weight [28,29,30], alongside enzyme-mediated differences in metabolism [29]. We were only able to adjust for some of these factors in our models. Research within this area is still relatively scant [28], specifically with respect to the role of cultural factors in shaping expectation and response to treatments [27, 28]. More could be done to understand this better.
Clozapine is recommended for treatment-resistant schizophrenia, where two or more previous antipsychotic medications have failed to control symptoms [8]. Clozapine has also been associated with a reduction in mortality from natural causes [31] and is associated with a lower all-cause and suicide mortality risk, relative to other antipsychotic medications [32]. The benefits of clozapine on mortality risk are not just due to frequent contacts with health services [31]. A previous study from the UK did not find an association between ethnicity and theoretical delay in initiating clozapine [33], although studies from the USA have indicated that black and Hispanic Americans with treatment-resistant psychosis were less likely to be commenced on clozapine than white Americans [34]. The findings from our analyses suggest that, despite similar proportions of individuals by ethnicity experiencing significant disability or only partial remission from symptoms, the black/black British group and to an extent the Asian/Asian British group were less likely to be prescribed clozapine. The larger sample size and national representativeness of our sample may account for the differences between this and previous UK studies [33, 35]. Ethnic minority disparities in clozapine use may be due to clinician concerns around potential side effects, including agranulocytosis, weight gain and type 2 diabetes mellitus [34]. The reasons for differences in clozapine prescriptions by ethnicity for treatment-resistant psychosis will require further exploration in future work.
Healthcare providers fell short of recommended guidelines for the management of schizophrenia [8] in ethnic minority groups. Although there are concerns that the wholesale imposition/application of psychological therapies insensitive to cultural context may be Eurocentric, culturally adapted therapies have a role to play in the treatment of psychosis across cultures. Psychological therapies may help to improve therapeutic alliance, adherence to medication and insight, and may help to provide knowledge about a condition and therefore potentially address stigma [36].
Although previous work has indicated increased dropout rates from clinical trials of insight-focused CBT in psychosis in African Caribbean and black African service users [37], the question within the present study assessed whether CBT or family therapies had ever been offered, potentially indicating a belief by service providers that some of the ethnic groups, except for the mixed group, were less suitable for CBT than white service users with schizophrenia. CBT when culturally adapted is beneficial for the treatment of psychosis across cultures [37]. Of those studies which have included ethnic minorities in trials of CBT for psychosis, no differences in response have been found for treatment-resistant schizophrenia by ethnicity [38] or in satisfaction with therapy [39]. In a recent clinical trial assessing culturally adapted CBT for psychosis in black British, African Caribbean/black African and South Asian Muslim individuals, the investigators noted that CBT was beneficial for the reduction of positive symptoms and depressed mood [37].
Whereas Asian/Asian British people (and to an extent Chinese/'Other' groups) were more likely than white service users to have been offered family therapy, this was less the case for black/black British individuals within the survey. Family therapy may be more acceptable to people from collectivistic cultures [40] and easier to deliver if individuals are in close contact with their families. A randomised controlled trial for family therapy in black, Hispanic and white Americans indicated that culturally adapted family interventions were beneficial for psychotic symptoms compared to a psychoeducational control [41]. It was not possible to assess reasons for the variability in referral practices to family therapy by ethnicity within the study, although the lower rates of referral for the black/black British group will require further exploration.
Care plans form the core of high quality care and should be developed jointly between the service user and clinician, with a copy of the care plan given to the service user [42]. The care plan should include a psychiatric and psychological formulation and also detail aspects of physical health [42]. An important aspect of the care plan is to help promote socially inclusive opportunities (such as employment). Although, in general, high proportions across the sample (> 91%) had a copy of their care plan relative to white service users, Asian/Asian British service users were less likely to have received a copy of their care plan. This finding is consistent with a previous national patient satisfaction survey conducted more than a decade ago in the UK which also indicated low levels of satisfaction amongst Asian service users, for example with respect to being well informed/having information on mental health services [3]. The findings in the current study highlight a need to ensure that basic standards of care are accessible in an equitable manner across all ethnic minority groups.
Trust-level variation
Finally, it is possible that trust-level factors play an important role in determining variations in the treatment of psychosis by ethnicity [23]. Although our analyses hinted at this, we were unable to assess this further. Future research could explore potential systemic/institutional factors alongside individual factors which may impact on access to high quality treatments for psychosis in ethnic minority groups.
In conclusion, the findings of this analysis of data from a nationally representative survey of service users with schizophrenia and schizoaffective disorders indicate ethnic minority disparities in psychotropic medication use and access to psychological treatments and care plans, in England and Wales. Greater efforts need to be made to ensure that people with psychosis receive interventions and treatments in an equitable manner. Further rounds of the audit planned for the coming years will provide evidence of progress being made, to ensure this at both local and national levels.
BNF:
CBT:
CTO:
Community treatment order
ICC:
Intra-cluster correlation coefficient
ICD-10:
LRT:
Likelihood ratio test
NHS:
PRN:
Pro re nata
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The National Audit of Schizophrenia (NAS) is managed by the Royal College of Psychiatrists' College Centre for Quality Improvement. It is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. JD is a Clinician Scientist Fellow funded by the Health Foundation working together with the Academy of Medical Sciences.
Access to the data is available is subject to approvals and data sharing agreements from the HQIP.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Jayati Das-Munshi & Dinesh Bhugra
Centre for Psychiatry, Imperial College London, London, UK
Mike J. Crawford
South London & Maudsley NHS Foundation Trust, London, UK
Jayati Das-Munshi
Dinesh Bhugra
MC was responsible for/ oversaw collection of the data, data cleaning and production of datasets for analyses. JD conceived and finalised the study design in discussion with MC and DB. JD led and undertook all analyses in discussion with DB and MC. All authors were involved in the interpretation of analyses. JD led the drafting of the manuscript, with input from DB and MC. All authors contributed to the drafting of the final manuscript and all approved it for publication. JD and MC had full access to the data. MC takes responsibility for the integrity of the data. JD takes responsibility for the accuracy of the data analysis.
Correspondence to Jayati Das-Munshi.
Approvals to access the data for analysis were obtained from the HQIP. The study was also approved by the King's College London ethics committee (LRS-15/16-3228).
Not required.
Das-Munshi, J., Bhugra, D. & Crawford, M.J. Ethnic minority inequalities in access to treatments for schizophrenia and schizoaffective disorders: findings from a nationally representative cross-sectional study. BMC Med 16, 55 (2018). https://doi.org/10.1186/s12916-018-1035-5
Schizoaffective disorders


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LBTT guidance on tax relief where, in certain situations, the land transaction involves friendly societies.
This relief is provided by the provisions of schedule 13A to the LBTT(S)A 2013 which is inserted by regulation 2(2)(a) of The Land and Buildings Transaction Tax (Addition and Modification of Reliefs) (Scotland) Order 2015.
In certain situations (see further below), full relief can be claimed for a land transaction involving friendly societies. 'Friendly society' in this context takes the meaning given under section 116 of the Friendly Societies Act 1992: 'an incorporated friendly society or a registered friendly society'.
The general concept of a friendly society is that the society's members contribute to a fund to be used for the welfare of the members or for their assistance when in need or distress.
an amalgamation of two or more registered societies under section 82 of the Friendly Societies Act 1974;
an amalgamation of two or more friendly societies under section 85 of the Friendly Societies Act 1992;
a transfer of engagements between registered societies under section 82 of the Friendly Societies Act 1974;
a transfer of engagements between friendly societies under section 86 of the Friendly Societies Act 1992 (transfer of engagements by or to friendly society); or
a transfer of the engagements of a friendly society pursuant to a direction given by the appropriate authority under section 90 of the Friendly Societies Act 1992.
'The appropriate authority' has the meaning given by section 119(1) of the Friendly Societies Act 1992.
'Registered', in relation to a friendly society, has the meaning given by section 111 of the Friendly Societies Act 1974.

redpajama_set_name: RedPajamaCommonCrawl


I love an adventure and when I got the opportunity to visit Newry to tour the food and fashion of the small city, I jumped at the chance. I've only ever been to Newry when on my way to Dublin, it lies about 35 miles outside Belfast and is right on the Belfast-Dublin corridor so usually the only glimpses I get are when my train is whizzing past.
Newry Style City is happening from the 18th-21st of April which comprises style awards, fashion afternoon tea, style secrets talks, fashion shows and independent events.The city is going to show you how to get out of your winter jumpers and into some fabulous fashion pieces for summer. It will be full of the latest hair, fashion, beauty and make up for attendees to look at, try on and get inspired by. Our Fashion and Food Tour let us take in some of the experiences those attending Newry Style City will have.
We started at coffee shop Grounded where we were shown how to get our coffee to 'bloom' in a chemex brewer. Those folk really know their coffee and have a real passion for everything that it represents. We got to taste an absolutely gorgeous Columbian blend, for once not at scorching temperatures. Perhaps you should take along a quiz when you go so you can test their knowledge, ok I'm joking there. If you get a chance check out the size of their traybakes, my goodness!
We moved to Posh a really fabulous occasion wear shop, they do dresses, hats, bags, jewellery and shoes, so pretty much a 'one stop shop' for any wedding or events you have coming up. Very handy.
We then nipped next door to Bogart where we were very entertained and saw some very sharp suits. Also check out the spots and stripes combo, bang on trend! Take the men in your life here and get them looking dapper.
Bows was our next stop, gorgeous dresses and beautiful prints. We were greeted with some champagne and there were so many patterns to lust after, sundaes, flamingoes, lighthouses. I loved the Egyptian style coin drop necklace, really versatile and wearable with everything this summer.
On to Belleza beauty salon to try out Senna brows, oh girls I got mine done, what do you think? I was so surprised as they're so dark but I really like them, it was a real change and took some getting used to. You can see the stencils being applied and then filled in, this was the first time I'd actually seen stencils in action.
We got very well fed when we were in Newry, we popped into Cafe Maya, which has just opened to sample their hibiscus flower drink, it is gorgeous. The best way I heard it described was like cranberry juice but without the tartness.
We then popped across the road to be fed at the busy Art Bar Funkel's where we got to sample their tapas, from Thai green chilli, goat cheese salad, chicken wings, nachos and many more. We all raved about it, I would heartily recommend the Thai green chilli, it was my favourite.
We happily went over the canal to check out some of the gorgeousness from Jack Murphy Jewellers. We were given yummy strawberry daiquiris and out came all the diamonds! Oh my goodness! We got to try on all of the fabulous rings, we saw loose diamonds, uncut diamonds, amazing settings. There's nothing quite like a group of women getting to try on huge diamond rings! Their range is massive, I love Bouton, I have my eye on the Toy Watch in the Strong style for Himself, I think it is gorgeous. If you're in Newry on Thursday 18th April 5.30-8pm they're having a Diamonds and Daiquiri's night you can actually WIN a diamond on the night!
Snaubs has been a feature in Newry for a long time and they've seen a lot of fashions come and go, when we went to have a look we got to see some of their Armani and Versace range. My favourite piece had to be the blue Armani bag!
Azizi lingerie was a great port of call, we got to find out all about their range. The new Panache sports range, Lejaby, my personal favourite Aubade Paris which is a real luxury to spoil yourself with. They also have the Anita Care accreditation, guide and training to fit post surgery women, they are one of very few retailers in Ireland who do so. It was wonderful to hear a retailer who is clearly so passionate about making the lingerie shopping experience for post mastectomy women easy and enjoyable.
We visited Cahill Bros Shoes who have been around since 1914, where Declan entertained us with his wisecracking and we looked at a whole host of shoes, right up my street of course were the Irregular Choice ranges. Many of the girls were also besotted with the bags on display. My favourite piece had to be the Irregular Choice shoes with the starburst buckle detail, just stunning. My fellow blogger and bridesmaid Claire was looking at them too, I think we may have found her shoes for my wedding!
Rounding the corner we popped in to see the award winning Berling, who were absolute darlings and had wonderful mini cupcakes made to greet us! We got to peruse their range and eat cake at the same time, you would not have found happier girls. My pick of the shop was the gorgeous sea toned maxi dress, if I had been there longer I'd have tried it on. I can imagine how gorgeous it would look with sandals in the summer, or even dressed up for a wedding.
The Gallery had some wonderful occasion wear I grabbed a shot of this lovely grey silk dress and coat. I thought my mum would love it for my wedding. I think we will have to come back so I can let her see it.
I've also grabbed a picture of this wonderful retro Warhol inspired Coronation Street shopper, I caught sight of it in the shop beside The Gallery and had to run in and buy it. I of course bought mine of the divine Bette Lynch, Get It, Got It, Good! I think everyone found it hilarious being that I don't watch soaps. Keep your eyes peeled for it on the blog soon.
McEvoy's is a pillar of the Newry community, relied on for school outfitting for dozens and dozens of schools, they are a generational shop where people who once came as children to get fitted now come as adults or take their own children. I was immediately interested in their haberdashery section, full of wool, knitting needles, hooks, sequins, everything you need to completely transform and customise anything!
We raced to the picturesque Canal Court Hotel for afternoon tea, I can tell you they may have the nicest bakewell tarts I've ever had. I should point out if you think your bakewell tart is better, please feel free to send it to me as I will happily test it! The Canal Court is situated beautifully overlooking the canal, I only wish we'd had more time to enjoy the peaceful surroundings but it just means we'll have to all come back. I can highly recommend their bakewell tarts. I've already told my mum I'll take her when we go, so I'm really looking forward to coming back to Newry.
Thank you so much to all of the Newry and Mourne District Council who facilitated our visit, a huge thank you to all of the amazing retailers of Newry who were so kind, enthusiastic and generous to us. Have a wonderfully stylish weekend! We'll be back!


Heavy-Duty Digital Receiving Scales, 150-lbs.
Highly accurate, digital LCD display features a 9-foot extension cord for placement and application versatility. Rugged case and shock-resistant plate meet the needs of busy shipping and receiving departments. Rubberized grid-pattern platform coating helps keep packages in place. Included AC adapter and 9V battery compartment deliver fixed-mount/cart-mount versatility (9V battery sold separately). Auto-off feature preserves battery power. Low-battery indicator. Includes scale, remote display, display cable, AC adapter and documentation.


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Stellar Awards Founder Building National Museum of Gospel Music
Source: Earl Gibson III / Getty
The site of what will become the future home of the National Museum of Gospel Music was blessed Thursday as plans for its construction continue.
Religious leaders gathered at 33rd and Indiana Avenue in Chicago's Bronzeville neighborhood for the ceremony which also honored Dr. Thomas Dorsey, who's considered the father of gospel music. The intersection was once home to the historic Pilgrim Baptist Church. The church was destroyed by an accidental fire in 2006.
The National Museum of Gospel Music is the brainchild of Don Jackson, founder of the Stellar Awards. The proposed 45,000-square-foot facility is expected to cost $50 million to build. Supporters said they've received $20 million in pledges from church memberships, along with local and state officials.
The museum is set to open in 2022.
Source: ABC Chicago
National Museum of Gospel Music	, Stellar Awards


Brazil's deputy Foreign Minister has proposed that the country have the right to share oversight of the Amazon domain name.
The proposal was framed as an "innovative" compromise a seven-year battle with the internet retailer over the rights to the digital domain name.
Brazil and other countries bordering the Amazon rainforest say the name refers to their geographic region and should not be the "the monopoly of one company."


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Sermon - Revd Canon Jonathan Brewster on The First Sunday after Trinity (2019) by St Paul's Cathedral
Sermon by the Reverend Canon Jonathan Brewster, Treasurer, at Sung Eucharist on The First Sunday after Trinity, 23 June 2019.
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Dhaulagiri IV Attempt. A British expedition led by Anthony P. Johnson was composed of nine members. They were trying this very difficult peak from the south via Kangban Khola, the route attempted by the disastrous Austrian expedition of 1969. Various delays kept them from getting to Base Camp before mid-October. The expedition was abandoned on November 20 when Alan Dewison was killed in a fall of 1500 feet when he and Johnson were descending after trying to establish Camp IX. On November 23 Sherpa Kancha was killed by an avalanche between Camp I and Base Camp as the expedition was withdrawing from the mountain.


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Kershaw, Kenneth A. (2006). Plating the More Distinctive Re-Entries In The Half Cent Maple Leaf Stamp II. quantity
SKU: B4h020-0 Category: Canada (Victorian) Tags: 2006, Kershaw
Ken Kershaw's Plating the More Distinctive Re-entries in the Half Cent Maple Leaf Stamp II. Plating Criteria and Detailed Descriptions of the Third and Fourth Printings is the latest BNAPS handbook. Volume I (January 2006) treated the first and second printings. In Volume II, the author describes his very surprising conclusion about the third printing, and then illustrates key findings from both the third and fourth printings using today's technology to the utmost. Both volumes on the Half Cent Maple Leaf stamp follow closely on Ken Kershaw's previous major effort (with Roger Boisclair), the four-book series The Canadian Christmas Map Stamp of 1898, A Definitive Plating Study. Ken Kershaw was born in England and became fascinated by plants at an early age. He graduated from Manchester University with a BSc degree in Botany in 1952. After military service, he went on to a PhD, working on pattern in vegetation, and was appointed lecturer in Plant Ecology at Imperial College London in 1957. He was seconded to Ahmadu Bello University in northern Nigeria for two years. On his return to Imperial College he became involved with lichen ecology, particularly in alpine and arctic areas, in addition to his work on computer modelling and data analysis. He obtained his DSc in 1965 and was appointed Professor at McMaster University, Hamilton, in 1969. His research was then devoted heavily to the ecology of the Canadian low arctic and northern boreal forest areas, and in 1982 he was elected a fellow of the Royal Society of Canada. He is the author of several university texts. Ken's passion for wild plants has been transferred to Canadian philately. He sees his plating work simply as the "taxonomy of bits of paper", and after a lifetime of plant taxonomy finds it a fairly straightforward and fascinating hobby.
Wald, Kimber A. (2006). Canada: The 1927 Historical and Confederation Anniversary Issues.
Kershaw, Kenneth A. and Roger Boisclair (2004). The Canadian Christmas Map Stamp of 1898: A Definitive Plating Study, Vol. 1-4.
Jacobi, Peter (2006). Mining — British Columbia's Heritage.
Spencer, Peter (2006). The Wearing Of The Green: Plates and States of the Canada 1898 One Cent Numeral Issue.
Hillman, Thomas A. and E.R. Toop (2006). The Post Office in Canada: A Chronology of Facts, Feats, and Firsts from the French Regime to 1981, Second edition.
Burgers, Hendrik (Henk) (2006). Canadians in Russia: the Last Contingent of World War I.
George B. Arfken and William S. Pawluk (2006). A Canadian Postal History 1897-1911: The Maple Leaf, Numeral, and King Edward Era.


What does it mean in your home, in your family, to be an American? Have you ever talked about it? With so much in the news about immigration policy, including lots of tearful images of kids and families, why not let Independence Day spark discussion.
Clearly, many people from many countries legally immigrate to the U.S. , and many risk everything to get here by any means available, including illegal. Talk to kids in an age-appropriate way about why that is and what freedom means. Perhaps take a look at this children's book titled What's the Big Deal About Freedom by Ruby Shamir, which includes background on how American came to be called "the land of the free." It might also be an opportune time to discuss that freedom also comes with responsibility. What are our responsibilities as Americans? What is your own family's immigration journey? Where did your ancestors hail from? Did your children's great-grandparents pass by the Statue of Liberty?
To continue the conversation in a way that's understandable to children, some storybooks that address immigration include The Name Jar by Yangsook Choi, Mama's Nightingale: A Story of Immigration and Separation by Edwidge Danticat, and My Diary from Here to There by Amada Irma Pérez.
Last year a National Review article by Grant Addison, reported that some states are considering legislation that would require students to pass the civics portion of the naturalization test before getting their high school diploma. The article also cites a 2012 survey By Xavier University, which found that one in three native born citizens failed it, compared to the 97.5 percent pass rate among foreign-born applicants reported by the United States Citizenship and Immigration Services a couple years earlier.
After the Big and Deep Talks and Tests, toss a little lighter kind of learning into the mix during Fourth of July travel by getting the whole family involved in competing in United States trivia. Use State of Confusion as iOS app, Android app, Mac app, or Windows download. Learn and test key facts about the 50 states, including state capitals, abbreviations, flowers, birds, flags, and nicknames. For both kids and grown-ups, geography, memory, and visual perception skills get a vigorous work-out.
Another great in-the-car or pre-bedtime learning adventure that gets kids "exploring" the world around them are Discover the Zoo Preschool Adventure Tablet, Explore the City Kindergarten Adventure Tablet, Travel the World First Grade Adventure Tablet. Each page "visits" different locations, accompanied by charming characters and fun facts. The tablet format lays flat, making the workbooks easy for right- and left-handed use. Through July 4 they will be 25% off!
Make this Independence Day an adventure in learning about family roots, our country, freedom, and the world around us. Unfurl a flag for the Fourth and have some serious fun!


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HomeGalleriesAudio GalleryAnnouncementsAnnouncementsBroadcaster Derry Brownfield passes away!
Broadcaster Derry Brownfield passes away!
on 13 March 2011 .
CENTERTOWN, Missouri - March 13, 2011 - Derry Brownfield, one of the Midwest's best know farm broadcasters, has died.
Born in 1932, Derry Brownfield died in his home early Saturday from an apparent heart attack. Derry was known for his informative, witty and colorful delivery of the news on his radio show, the Derry Brownfield Show.
Even at the age of 79, Derry could still saddle up and ride a horse.
Derry first entered the world of broadcasting when he and a friend established the Brownfield Network in 1972. In 1994, he established his own radio show, the Derry Brownfield Show. In 1997, Learfield Communications purchased the Brownfield Network but Derry remained on the air until 2008, when a dispute with major advertiser Monsanto resulted in cancellation of his show. Never one to give up, Derry continued broadcasting his show via webcast.
In 1949, at the age of 16, Derry earned his FFA American Farmer degree. He later attended Missouri University, earning both BA and MS degrees. After graduating from MU, he taught Vo Ag for several years before working for the Missouri Department of Agriculture as a marketing specialist. He also served as director of the Kansas City Livestock Foundation.
Over the years, Derry grew his family beef operation to 200 head of purebred Charolais cows on 1,000 acres of Missouri pasture.
Long an advocate for family based agriculture and a harsh critic of its enemies, Derry Brownfield will be missed across Missouri and the entire nation.


From the information we got through JAMB official twitter handle that The Joint Admission Matriculation Board (JAMB) on March 1st, 2017 has announced to the public that the 2017 UTME registration will begin this month, so let us await till the date.
According to the information the registration for UTME will also go hand in hand with the Direct Entry.
Candidates are advised to be patient as registration is not on now, Once the date has been announced you will be duly informed through this page.


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LeVar Burton to be 'Jeopardy!' guest host; petition credited
The 200,000-plus LeVar Burton boosters who signed a petition calling for him to be the new "Jeopardy!"
ByThe Associated Press
FILE - LeVar Burton attends the 70th National Book Awards ceremony in New York on Nov. 20, 2019. Burton will serve as guest host on the game show "Jeopardy!" (Photo by Greg Allen/Invision/AP, File)
LOS ANGELES -- The 200,000-plus LeVar Burton boosters who signed a petition calling for him to be the new "Jeopardy!" host will get to see him try the job on for size.
Burton is among the final group of guest hosts for the quiz show, which lost its longtime host Alex Trebek to cancer last November and has put off announcing his successor.
Burton's supporters seized the opportunity to launch an online petition for the actor, who starred on "Star Trek: The Next Generation" and "Roots," and was the host of "Reading Rainbow," the children's educational program.
In his career, Burton has "inspired and shaped the minds of several generations of trivia-loving nerds," according to the petition that, as of Wednesday, had 246,000 and counting signers.
In an email, a spokeswoman for Burton said he believes the petition drive and his social media interactions with fans were factors in the invitation for him to be a guest host.
There was no immediate reply to a request for comment from producer Sony Pictures Television.
TV anchors and journalists George Stephanopoulos and Robin Roberts of ABC and David Faber of CNBC and sportscaster Joe Buck are the other temp hosts getting one-week stints, Sony said Wednesday. The air dates weren't announced.
https://www.change.org/p/sony-pictures-entertainment-levar-burton-should-be-the-next-host-of-jeopardy


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Indiana Post 341 brings Christmas to foster children
By Andy Proffet
Reba James was "flabbergasted" when she saw all the gifts Dec. 14 at Choices Foster Care Solutions in Indianapolis.
There were toys, games, shoes, even football jerseys wrapped up in festive paper, gifts from American Legion Post 341 in Cicero, Ind., for 33 foster children served by Choices.
"It's just such a generous, wonderful thing to see so much giving — and all the time, it's not just the time here, it's the time that was spent gathering the names, making sure everyone was taken care of, doing all the shopping, doing all the wrapping, and it's not a little five-minute trip from where everyone is coming from to drive down here. It's just a really joyful thing to see," said James, the program director for Choices.
Dave Baughman, the director of Post 341's Legion Riders chapter, said the event stemmed from a social media post he saw in August from a friend who works at Choices asking for school supplies for foster children.
"It was already taken care of, she said get back to me closer to Christmas. I reached out in October because we have to plan this stuff out. We jumped onboard with this and had a lot of fun," Baughman said.
Post 341 Commander Jody Brown said Legion Family members spent over $2,000 on the gifts for the foster children, enough for at least three gifts for each child.
"Our Auxiliary unit, our Legion, our Legion Riders, our whole Legion Family participated in this, and it was just really great," Brown said. "We had individuals handing us $100 bills and $20 bills, it was just fantastic to see the response to this. It says a lot about our post, it says a lot about our American Legion Family in general."
Brown said some 40-50 Legion Family members showed up at the post earlier in the week to wrap all the gifts.
Foster families with children from toddlers to teens filled a room at Choices Saturday morning for the event, which included pizza and desserts. Legion Riders from Post 341 handed out the gifts.
"It just brings a real joy to your heart to see these kids, to see their smiles; it's just amazing," Brown said.
James said, "A lot of times kids, especially the kids that are in foster care, they come from hard places. They've seen a lot of things that most grownups don't see in their lifetimes. It's just a good thing for them to be able to have some laughter and some joy and to really let loose and have fun."
Patriotism, behind bars: Inmates make up Miami County's last American Legion post
Carson Gerber Kokomo Tribune
Photo by Tim Bath
BUNKER HILL – American Legion Post 555 is normal in a lot of ways. Members gather every month for a meeting, where Legionnaires present the colors and vote on important decisions. They organize fundraisers and donate money to a slew of local causes.
Like many Legion posts, there are bars in the meeting hall, but not the kind serving drinks. These bars are prison bars, and they're what make the group one of the most unique in the state.
Post 555 is located inside the Miami Correctional Facility. Its entire membership is made up of inmates housed inside the maximum-security prison.
And those inmates represent the last American Legion post still operating in Miami County.
At one time, both Peru and Amboy had posts, but those closed around five years ago due to dwindling membership. Now, the veterans at the prison are the last ones carrying out the Legion's mission of advocating for patriotism and community service.
Ed Trice, alternate national executive committee member for the American Legion and a past state commander, helped found the post 10 years ago inside Miami Correctional during a major push to get the organization inside all the state's prisons.
Today, there are posts in up to 15 correctional facilities across Indiana, including an all-women's prison in Madison.
But Post 555 at Miami Correctional is still one-of-a-kind, Trice said.
"Miami County is kind of an oddball considering there aren't any posts there outside the prison," he said. "It's really unusual to have only one post in a county, and it's at a prison. I'd say that's the only one like it in the state."
The post may be unusual, but to the 32 inmates who are members of it, the American Legion has been a godsend.
Army Veteran Gawaine Allen Sr. served four years in the 1990s during Desert Storm, but never had time to join the Legion after his service. But that changed when he was incarcerated nine years ago at Miami Correctional.
Allen said he was surprised to find the prison had a post, so he decided to show up for a few meetings to see what it was all about.
"Once I got in here and saw the camaraderie, I felt like it would be a good way to keep myself in line," he said.
And it has. In June, Allen was elected commander of Post 555 – which members have nicknamed the Triple Nickel – and now runs the group that has helped him stay out of trouble and turn his life around.
"With us being part of the Legion, we try to hold ourselves to a higher standard," he said. "We're representing them at the same time we're trying to shine a good light."
Army Veteran Willie Walton, who serves as the post's sergeant at arms, said the biggest way joining the Legion has helped him was giving him a sense of purpose and something bigger than himself to live for while he served out his sentence.
"It can really turn a light on inside you," he said. "You never know, under our circumstances, what can turn that light on. It could be something, a small gesture, to make people realize that we're not just criminals. Some of us are really trying to change our lives."
That sense of purpose comes in part from the annual fundraisers the Legion holds inside the prison. At least twice a year, they bring in outside delicacies such as White Castle, Krispy Kreme donuts or Papa John's pizza to sell to inmates to raise money for local causes.
Just this year, the post was able to donate $3,500 to the new all-inclusive, handicap-accessible playground built in Peru. They also gave money to local nursing homes to buy gifts for veteran residents and donated over $500 to the Indiana School for the Blind and Visually Impaired.
But there are other tasks which give Legion members something to live for, Walton said.
Every morning, a Legionnaire raises the flag at the prison, and every evening, another takes it down. Allen said they try to time the twice-daily ceremony with the one going on just down the road at Grissom Air Reserve Base, which plays "Taps" during its flag ceremony that can be heard at the prison.
There's also a greenhouse at Miami Correctional which is almost exclusively operated by veterans. In the past, they've grown marigolds and other flowers, which they donated to the Miami County Chamber of Commerce to use in a beautification project in downtown Peru. They're currently growing tomatoes, peppers and other vegetables there.
Post 555 1st Vice Commander David Turner said all the outreaches go a long way in helping members stay busy and stay positive during their time in prison.
"Each post has its own, individual uniqueness to it," he said. " ... Here, we can coordinate outreaches to help people out on the outside, and it gives us something to do on the inside."
Commander Allen said inmates can be suspended or barred from being a Legion member if they get written up or have disciplinary issues. And that's an incentive to stay out of trouble and do the right thing.
Andrew White, the prison's veteran service coordinator and a liaison between the facility and the Legion, said that also means post members are some of the most well-behaved inmates at the prison, which has its own veterans housing unit where Legion members stay.
And that good behavior means members have some extra freedoms. During meetings, they are allowed to change out of their prison jumpsuits and wear polo shirts, khakis and Legion-issued caps.
Members are completely in charge of their meetings and determine their own affairs. They even put out an occasional newsletter called the "Triple Nickel."
Walton said it all works to keep post members on the straight-and-narrow path and inspire them to something greater.
"We don't tolerate any foolery, because this is something we want to see succeed," he said. "We hold our members accountable and try to have them follow all our rules of decorum, by the book, to a 'T.'"
But in the end, one of the biggest things the Legion gives to inmates is the camaraderie that comes from working with other veterans.
Stephen Sherwood, the commander of the prison's Sons of the American Legion post, which includes inmates whose fathers or grandfathers were veterans, said it makes it easier to do the right thing when there are others around who understand what they've been through.
"We're more apt here to understanding why someone might need a little more extra help of where they got off the path and found ourselves in prison," he said. "I like it because we're all here together to help each other."
That's why the group meets to talk about any issues members are struggling with, whether its drug addiction or family problems.
Sherwood said with the help from fellow veterans and the sense of purpose that comes with being a Legion member, every inmate has a better shot of staying out of prison once they're released.
And even more importantly, he said, they have a better chance of actually making the world a better place.
"I think once guys realize they can help out and give back, they realize once they're on the outside they don't have to go down that same path," Sherwood said. "They can take a different path and make their communities better."
Pearl Harbor shooting leaves 3 dead, including sailor gunman
By: Navy Times staff
Security stands outside the main gate at Joint Base Pearl Harbor-Hickam on Wednesday in Honolulu. (Caleb Jones/AP)
A Wednesday shooting at Pearl Harbor Naval Shipyard left at least two victims dead and another injured before the gunman took his own life, military and medical officials told Navy Times.
Rear Adm. Robert B. Chadwick II, commander of Navy Region Hawaii, said that the shooting spree occurred near the Los Angeles-class attack submarine Columbia, which was undergoing repairs while in dry dock, and the suspected gunman was a Navy sailor assigned to the boat.
Joint Base Pearl Harbor-Hickam officials previously told Navy Times that he was reported to have gunned down three Department of Defense civilian workers near the shipyard's Dry Dock 2 around 2:30 p.m. local time (7:30 p.m. Eastern Standard Time) before taking his own life.
Navy Times has been unable to independently confirm from area hospitals if all three victims were shot or suffered other injuries connected to the gunfire.
Although one patient reportedly was transported to Tripler Army Medical Center, for example, public affairs officers there said they were not allowed to discuss anything related to the shooting and referred reporters to Navy officials.
The media team at Pali Momi Medical Center confirmed that a patient was transported there but could give no update on his or her condition.
Queens Medical Center spokesman Cedric Yamanaka told Navy Times that one male passenger was transported to the Honolulu hospital. He described the patient as "in guarded condition." Navy officials categorized him as in "stable condition."
The installation was placed on lockdown while Joint Base Pearl Harbor-Hickam security forces responded to the gunfire.
At 4:09 p.m. local time (9:09 p.m. Eastern Standard Time), officials declared the active shooter incident over and the base reopened all gates, which had become clogged with traffic.
Traffic backs up at the main gates after a shooting at Pearl Harbor Naval shipyard, Wednesday, Dec. 4, 2019, near Pearl Harbor in Honolulu. (Caleb Jones/AP)
Officials at Naval Sea Systems Command, which oversees Pearl Harbor Naval Shipyard and Intermediate Maintenance Facility, referred all questions about the incident to Joint Base Pearl Harbor-Hickam authorities.
It's the nation's largest fleet repair and maintenance facility between the west coast of the United States and Japan.
A probe into the shooting is being conducted by Naval Criminal Investigative Services and Joint Base Pearl Harbor-Hickam security forces.
Names of both the apparent shooter and the three victims are being withheld until their next of kin can be notified.
In a prepared statement, Hawaii Gov. David Ige said that the White House reached out to offer assistance from federal agencies.
The governor added that his state authorities also are "standing by to assist where necessary" if Pearl Harbor asks for help.
Base officials will keep the Emergency Family Assistance Center open until further notice. It's located at 4827 Bougainville Drive (same building as the Personnel Support Detachment). The Center's telephone number is 866-525-6676.
Any personnel or family members who wish to meet with a chaplain or obtain counseling services on Wednesday are asked to visit Room 130 at Building 2 or call 808-285-7447.
Those who need support on Thursday morning are asked to visit the Military Family Support Center beginning at 7 a.m. It's located at 4827 Bougainville Drive on the second floor.
If you, a friend or a loved one is in crisis, please connect with a trained counselor now. Confidential, immediate help is available 24/7 at no cost to active duty, Guard and reserve members, their families and friends. Contact the Military Crisis Line at 800-273-8255, then press 1, or access online chat by texting 838255. Your life matters.
The Los Angeles-class fast-attack submarine Jefferson City departs Pearl Harbor Naval Shipyard on Nov. 12. A shooting on Dec. 4 locked down the installation. (Chief Mass Communication Specialist Amanda R. Gray/Navy)


It's getting close to Christmas and it was time for a luxury vacation on Koh Samui, one of the finest beach destinations in Asia. While researching online for a nice hotel with 2BR suites Kirikayan Luxury Pool and Villas caught my eye. It looked great. Luxury in a peaceful mountain setting away from main tourist hassle. It's exactly what I like, no compromise. The booking included free airport transfers to and from Koh Samui airport. There were various free shuttle services to a private strip on Mae Nam Beach and to Chaweng Beach, the island's central tourist strip with shopping, restaurants and entertainment.
Comfortable living room area with LCD TV and a small patio. The apartment contained two bedrooms, one with kingsize bed and another with twin beds, a kitchen and dining area.
Source for Discount Reservation at Kirikayan Villas.
It's a couple of years ago when I stayed at a serviced apartment rather than a hotel while visiting Thailand's capital Bangkok for a stopovers of several weeks. One must admit, serviced apartments offer a more residential feel while providing all the conveniences of a first class hotel. They don't rent out small rooms, but studios, 1 bedroom and even larger apartments for a fraction of the cost of a first class hotel. You can stay there by the day, week or month. Centrepoint Sukhumvit is one of the leading houses in Bangkok. They offer various locations around town including New Petchburi Road across from Panthip Plaza, Thonglor and Langsuan to mention just three of their prime locations. They recently added a new prestigious residence on top of Terminal 21 Mall on Asoke.
Amari is a well established chain of first class business and resort hotels in Thailand. I have stayed at houses of this chain in various Thai cities and always enjoyed it. About a year ago they invested into expansion in Pattaya, First they expanded theit beach resort with a new highrise and afterwards they errected a new lowrise suite hotel in a very quiet location in Central Pattaya: Pattaya Nova Suites. I stayed there 3 times over the past year. The one-bedroom suite was my choice. The house does not give you the feeling of being inside a hotel with people rushing in and out. It's more of a place for an extended stay. Since the pricing of the rooms is on a higher than average level for Pattaya it attracts a rather wealthy crowd. Stylish people who enjoy comfort and peace. It's a perfect place for me as internet connectivity is pretty good for Pattaya where time outs and slow lines are always a problem. The interieur design is simple, stylish and functional. You have everything you need and ample of room to lean back and relax. Each unit has a small kitchen with all cooking utensils you ever need. The maids clean everything so there is no need to wash any dishes by yourself. There is a rooftop pool and a nicely equipped gym on the 11th floor. At night time they have 2 very nice bars in their basement. One is a bed club and the other one a cocktail club that is made out of ice. Yes ... and ice bar in sunny Pattaya to chill you down at night.
I had a quick 2 day trip to Pattaya over the weekend. Pattaya is a well known beach and nightlife destination about 2 hours by car from Thailand's capital Bangkok. Pattaya is primarily known for it's affordable prices on food and accommodations as it attracts a lot of European long term visitors who rather spend the cold season in the comfortable tropical temperatures of the Gulf of Thailand.
The pool area in front of the building. Courtesy of View Talay Place website.


Rachael grew up in a small town in the Midwest where her family taught her to work hard, have fun, and be kind. As a child, if Rachael wasn't putting on a play or singing show tunes, she was helping with the countless fundraisers (or "fun-raisers" as she thought they were called) her mom organized for the Missouri non-profit where she worked. Rachael loved theater, and she also loved giving back to her community, but she never thought she would have a job where those two worlds came together. When Rachael moved to NYC after earning a degree in Theater Performance at the University of Missouri Kansas City, she had the chance to volunteer for Opening Act, and she was inspired to get more involved with this awesome organization. Rachael continued volunteering for Opening Act for several years while working for another local, arts education non-profit. Now, Rachael is thrilled to be Opening Act's Executive Assistant, and she plans to work hard every day to deepen the organization's impact and continue to reach even more students. Rachael lives in Manhattan with her super cool husband and serves on the Young Professionals Committee of Kids Creative.


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Harsh winter weather can work against you in a number of different ways. Firstly, the freezing temperatures are extremely uncomfortable to working outside in, so make sure you wrap up warm and don't end up with a cold for Christmas. Secondly, the icy weather can lead to treacherous and dangerous paths and roads. This can be very dangerous especially in terms of driving as it is extremely common for car crashes to happen on icy roads.
Labelling isn't necessarily as a seasonal tip but is still an essential measure of preparation. If you label your boxes and packages according to their content this will massively help the unpacking at your new home. As a result of this simple organisational tip, your moving process will be much quicker, much less chaotic and much less stressful.
There are two main peak periods in the removal industry, and at AR Removals in Wakefield, we certainly see Christmas and the summer holidays as the busiest. Therefore, it is advised that you book with your professional removal company early to save disappointment. Just like you would for your Christmas lunch, booking in advance not only guarantees you your space it is also one more thing you don't need to worry about.
AR Removals are a domestic and commercial removal company based in Wakefield. All of our staff are trained and experienced in packing and unloading, so you won't need to lift a thing, especially over the icy pavement. For more information about our Christmas service, call us today on 01924 371164.


The amazing help provided by Series 9 costume designer Ray Holman to costumers on Twitter and at the Doctor Who Festival, along with some detective work I was able to do when I was in London, has necessitated an update to my previous article on the Doctor's coats in series 9.
I was correct when I said that the Doctor's blue coats (and the new red velvet) were made by Chris Kerr of Berwick Street, the same tailor who also made all of Matt Smith's coats. I incorrectly said though that the coats were made of melton wool when in fact they are actually made from a much pricier pure camelhair in navy, purchased from W.Bill. Thanks to Doctor Who Magazine we know that the red velvet is a cotton/modal blend purchased from Holland & Sherry. The lining for all the coats was provided by Chris Kerr, but is also available through W.Bill.
As I mentioned, the costuming area at Doctor Who Festival in November had a wealth of information. Each of the costumes displayed had with it a change form that listed out all of the items that comprised that costume. It was this way that I (and anyone else who saw it) learned that the Doctor's latest waistcoat was black 5 button purchased at TM Lewin. After comparing my own with the photos I took at the Festival I can say that I am 99% certain the waistcoat model name is the Palmer.
Awesome breakdown! It confirmed my suspicion that the navy coat was a blue camel hair.


I'm not sure we always realize the effect we have on the young people around us. Or for that matter, any saint. One thing that God consistently reminds me of, is that I am an example to those who look up to me. I feel that there is blood on my hands, if I lead an example, that would discourage them from living for God. I have seen leaders in the 20 years I have lived for God, be flippant with regards to their example. Even, careless. As I write this, I go back in my mind to my teen years. There have been more than a couple leaders who have even backslid. In fact, the man who was preaching the night I received the Holy Ghost, is not preaching the Truth today. Is that discouraging? Yes! Do I throw in the towel because of their example? A resounding NO! This race is not for the one who started in it. Nor is it for the fastest one. But it is for the one who finishes it.
I wonder how many are turned away. All because someone who should have been an example, wasn't. Maybe that's why Paul said what he did. I believe the example we should emulate is Jesus'. When we seek to follow men, or for that matter, their ways, we will fall so short. I tell the good people who I minister to..."don't follow me... follow the One who I am following". "Oh that I might know Him..."


text:
Larry David in Woody Allen's Next
Posted: February 7th, 2008 by WorstPreviews.com Staff
Larry David, the mind behind "Seinfeld" and "Curb Your Enthusiasm," is set to be the lead in Woody Allen's next feature film, which is scheduled to shoot in New York City in the spring.
Plot details are being kept under wraps, but David will act alongside Evan Rachel Wood (Across the Universe). The movie marks Allen's return home after he made three films in London and one, the upcoming "Vicky Cristina Barcelona," in Spain.
The movie has yet to be titled, but the joining of Larry David and Woody Allen seems like a perfect fit, since the two share a very similar sense of humor.
Source: Entertainment Weekly


text:
Q: Files uploaded via FTP aren't showing changes on Squarespace Developer Mode My squarespace site is in developer mode. I download files, like the .region, .less, and .conf files and edit them locally. I upload these files and expect to see a change on the squarespace site.
Up until yesterday this was working, then I made a mistake in one of the LESS files and got an error about incorrectly parsed JSON in the .conf file where the LESS file was included. I got a whole ton of errors from this, and have since then fixed both the LESS file and the .conf file.
However, the issue is that my squarespace site is now not registering that any changes have been uploaded, despite the fact that my FTP files are successfully being uploaded and downloaded from the FTP server.
I have also not seen any updates to my Git on the developer mode tab since this error was registered.
My question is how to fix this, and how to start seeing edits done locally to region, etc, files again.

A: You can try to turn off the developer mode and then turn it on back.

redpajama_set_name: RedPajamaStackExchange


My friend and fellow Westbrook pastor Caleb Trimble preached this last weekend about the Gospel and lamenting. It was almost prophetic that he should choose to focus on lamenting as he preached through Acts 16. If you have the time, you should go and listen to it.
Turn back; respond to me, O Eternal, my True God!
We need to lament. It seems sacrilegious to many of us to ask "God, where are you?" or "How long until you fix this, God?" You might say, "But of course God is with us and he fixed it with Jesus on the Cross," but that's not why we lament. It is a true confession of our feelings. It is us turning to God recognizing that the world is still broken and that we are waiting on Christ's return. It is the church mourning with those who mourn and asking God to bring justice to this unjust world. The Gospel is presented to a broken world and, as Caleb reminded me this weekend, it's not until we see the brokenness that we can truly offer the good news.
So today we should lament. Let us cry out to God and ask how long. Let us mourn with those who mourn and confess that we have not mourned with those who have been mourning a long time. We lament the loss of life and ask God to bring justice. And, like the Psalmist, we will continue to trust in His faithful love.
 The Voice Bible (Thomas Nelson, 2012), Psalm 13.
Previous Article Is everyone really welcome?


The Schoenwieshütte (private, 2.266m, opening hours 9.00 - 16.00 hrs) is located at the foot of the Hangerer, a walking hour above the fast-paced Obergurgl (1,927m). A wide, continuous road leads up to the hut, which guard the entrance to the beautiful Rotmoostal. The ascent begins at the end of Obergurgel at the valley station of the Hohe Mutbahn 1, past the 400 year old Zirbenwald and the foothills of the Hohe Mut and runs the last stretch parallel to the Rotmoosschlucht, which is finally by bridge at all. There is now nothing left in the way of a refreshing ski water on the sunny Hüttenterrasse. But, just a photo you should perhaps shoot quickly from this prototype of a hut, whose roof spreads like the wings of a bird over the flat stone building. Descent as ascent.


It is important to know that the recovery time after a knee replacement surgery is very vital to the success of the operation. Hence, what is to be taken care of is that your home or the place where you will be after your stay in the hospital is totally readied up to cater to certain things.
1.Try to declutter your living space so that there is enough room for a walker to fit in comfortably. For this purpose, you can remove some of the furniture in the rooms. Or even make sure that big items in the home are pushed to a corner so that there is space to move around in the centrAlso, all electrical and electronic cabling should be placed out of the way so that it does not get stamped upon by the walker.
2.Make sure that the house is in a spick and span shipshape before you go for surgery. For a while after it, you may not have the energy or the inclination to clean up the house properly. Hence, this task should be done beforehand. One can take certain other precautionary measures too like installing hand rails in the shower or the bathtub area.
3.Try to ease up the whole environ by making ramps in the steps leading to the house, if any. One can even get a set of non-slip socks which will help you move around without any footwear with ease and without the fear of slipping. Make sure you get a walking aid so that you are not left putting any undue pressure on your knee while walking around for daily chores and necessary activities.
Make it a point to get some night lights installed in the house at key junctures so that if you wish to reach the kitchen or the washroom at night, you do not face any mishap.
4.Try to plan out a recovery area within your living premises. For some time after surgery, you will need a lot of resting and sitting around without much movement. Get a sitting or a rocking chair which is very comfortable to be in. This chair should certainly have arms and a footrest even, preferably. One can easily go in for a reclining chair as well since one can lift up one's legs too and rest them in this. This recovery area should be well fitted with things which you need regularly and for which you otherwise have to keep getting up.
5.If your room is on another floor in the house, try to shift into one of the rooms downstairs so that this does not become an issue for you. If you are living alone, try to get some help to stay with you for a few days so that someone is there in case any post-operative emergency arises and you need on the spot help for it.


Peter McLaren, Ph.D. is Professor of Education, Graduate School of Education and Information Studies at the University of California, Los Angeles. He is the author, co-author, and editor of approximately forty books. His writings have been translated into twenty languages. Four of his books have received the American Education Studies Association Critics Choice Award for outstanding books in education.
Peter Leonard lives in Birmingham, Michigan with his wife and four children. He is a partner in the ad agency of Leonard, Mayer & Tocco, Inc.


Have a nice talk with him. Or, maybe, he can be bribed by a piece of sirloin.
I don't know what is wrong with him.
he used to be such a good doggy.
Take him out 20 times a day.repeat it for three days then might he remember which is the door for going out.