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The contested history of the left and Zionism
Posted on 10th October 2014 by ISJ
Miriam Scharf
Philip Mendes, Jews and the Left: the Rise and Fall of a Political Alliance (Palgrave Macmillan, 2014), £65, and Paul Kelemen, The British Left and Zionism: History of a Divorce (Manchester University Press, 2012), £15.99
These two books, one concentrating on Jews and the left internationally and the other on Zionism and the British left, show some convergence in their pre Second World War coverage of left support for Zionism. But the different political perspectives of the authors—Mendes is pro-Zionist and Kelemen is not—lead to very different references, analyses and commentary for the period after the establishment of the state of Israel.
Mendes's premise is that Jews form a community and as such have particular "objective Jewish interests". Mendes's focus is on Jewish involvement in the left and he provides detail of the shift in different countries and political parties from universalist, ie supporting changes that would benefit all exploited classes or groups, to particularist views of Jews. Jews who retain universalist, more socialist, attitudes after 1948—and Mendes acknowledges many of them—are suspect.
Kelemen, by contrast, begins by pointing out the ethnic exclusiveness of Zionism as a problem. Given that Israel is an ethnically defined state founded on the dispossession of the Palestinians, what he aims to explain to us is not so much the divorce of the left from Zionism but why there was a marriage in the first place.
Kelemen details pre-1939 policies, speeches and documents from the Labour Party, Communist Party and Anglo-Jewry to provide this explanation. He then evidences British government attitudes, especially among Labour MPs, to the post-war situation. Noted throughout is the lack of concern for, or sometimes any reference whatever to the Palestinians. Tracing the shape of Zionist ideology, Kelemen notes the principle of national self-determination as adopted by the Labour Party in 1917. He contrasts Lenin's endorsement of self-determination as a way to undermine imperialism with Harold Wilson's vision of an evolutionary process for non-European peoples under Western tutelage. He shows how the latter view prevailed among Labourites whose Social Darwinist tendencies led them to contend that European Jews would develop Palestine for the "greater good" in a way that Muslim Arabs could not. Providing evidence that the nonconformist heritage of the British labour movement—in which "Israelites" were venerated—fed this view, he shows how the kind of anti-Semitism that characterises the Jews as a different and special people also helped the Zionist project and provided an unchallenged racism against Arabs and Palestinians.
The identification of Zionism with social progress was the political line of the labour Zionist party Poale Zion, which Mendes characterises as "Left Zionist", a party linked to the Zionist labour organisations in Palestine. Both authors document the importance of Poale Zion in promulgating and winning Labour Party support for the idea that Jews settling in Palestine conformed to a new socialist ideal. Mendes cites Kelemen on the British Labour Party from 1936-45, when "successive annual party conferences supported the establishment of a Jewish state". Quotes from Labour leaders, like Herbert Morrison and Richard Crossman, exhibit the exceptionalism with regard to Israel that, for Mendes, is welcomed as understanding the Jewish interest. Similar quotations used by Kelemen demonstrate why and how those with social democratic ideas supported Zionism.
Kelemen shows the case for a Jewish nation as an imperialist ally is crucial to understanding the Realpolitik favouring Zionism. For example, he quotes Ramsay MacDonald in 1929: "It is of greatest importance to us that we should keep American oil interests in good relations with us." For Mendes, there is only "alleged collaboration with Western imperialism", even post-Suez.
Both books look at pre-war Jewish support for left parties, clearly showing that the still largely working class Jewish population were far less interested in going to Palestine than in improving their material conditions where they were. Jews were disproportionately active in the Communist Party, Labour Party and trade unions in the UK; and Mendes shows this was also the case worldwide. Here Mendes's contribution on Bundism, the majority working class and socialist response to anti-Semitism and oppression in Eastern Europe, is useful: "The Bund accused the Zionist movement of legitimitising Polish anti-Semitism and also attacked its negation of the national rights of the Arab inhabitants of Palestine." The Bund opposed the creation of Israel in 1948, claiming, "It was designed to serve the imperialistic interests of the Western powers, and would only perpetuate the conflict between Jews and Arabs."
Kelemen and Mendes provide detailed research on the Communist Party, in the former case solely the Communist Party of Great Britain: the CP's anti-colonialist opposition to Zionism, its support for the Union of Arab and Jewish Workers in Palestine against the Jewish only Histadrut, and its support of Arab demands to cease Jewish immigration. They also show that during the rise of fascism support for Zionism rose in the Jewish working class. Both report the most important change for all national CPs was when the line from Moscow reversed into support for the Zionists against British imperialism in 1947. Kelemen quotes telling coverage from the CPGB's daily newspaper, indicating their confusion and then submission, so that by August 1948, "the only force the Daily Worker was prepared to exonerate from causing Palestinians to abandon their homes was the Israeli army". He shows how other left papers including the Daily Herald and the Tribune told the same story.
Mendes records the attitude of Communist Parties showing acceptance of the Moscow line that Israel was part of the struggle against British and Anglo-American imperialism. American, French and Canadian CPs write of "a just war of independence against British and US-sponsored imperialism". Though much harder to swallow for the Arab CPs the joint statement issued by the CPs of the Middle East in October 1948 condemns the "Arab invasion of Palestine", dutifully tailing Stalin's line.
In regard to the CP, Mendes's description of Jews' disproportionate prominence in leadership roles in post-war Eastern European governments provides interesting reading, but is more pertinent to how Stalinism used anti-Semitism than to a discussion about Zionism.
Perhaps more relevant to readers now is the discussion by both writers of the left in relation to Israel following the Second World War. After the Holocaust they concur in showing how the idea common across the political spectrum was that Europe's surviving Jews should have a nation. Kelemen shows that, in the Labour Party, the fact that Israel provided an important strategic ally to the US, and therefore the UK, served to counter Soviet influence and Arab nationalism. This made Zionism popular on the right, while the left continued its support for Israel's "social democratic values". He sees this convergence as enabling the popularising of "an image of Israel as a beacon of progress in the Middle East". Mendes notes that the response of the 1944 Labour Party Conference to the Holocaust was to vote for admission of Jews to Palestine "in such numbers as to become a majority" to urge "the 'transfer' of the Arab population to neighbouring countries". He quotes approvingly leftists, among them Harold Laski, Michael Foot and Aneurin Bevan, arguing for the party's traditional Zionist perspectives and praising both the Histadrut and "socialist" Zionist parties and culture.
Then comes the break, described by Kelemen in terms of how some of the left changed their understanding of the nature of the Israeli state to that of an illegal occupier and imperialist ally, and so began the left's divorce from Zionism. Both writers see Israel's 1967 victory and subsequent occupation of the West Bank and Gaza as a watershed. Both identify the rise of the "new left" in the 1960s, their analysis of Israel being influenced by the emergence of the Palestine Liberation Organisation and the wider world recognition of Palestinians as a national group with national rights.
Kelemen, aware of the accusation of anti-Semitism waiting in the wings, shows objectively how the left was able to break with Zionism and to stand up for Palestinian rights. He relates this to developments among the Palestinian political parties and does good service to the radical left outside the Labour Party mainstream. Kelemen traces the conflict between a pro-Zionist Labour leadership and grassroots activists. This includes the launch of the Palestine Solidarity Campaign in 1969 alongside Harold Wilson's backing of Israel. It also includes the Blair/Brown governments' support for Israel parallel to the proliferation of pro-Palestinian groups during their tenure with dropping levels of support for the Labour Friends of Israel and the Trade Union Friends of Israel. In contrast, Mendes's desire to de-legitimise anti-Zionism leads him to include insignificant esoteric groups and to misrepresent more influential Marxists and Trotskyists.
Mendes says a consequence of the 1967 war was that "support for Israel became the principal determinant of Jewish identity". The left after this is characterised by those who support a two-state solution. He resorts to judgemental and subjective language for other analyses:
"anti-Zionist fundamentalists today wish to eliminate the actual existing nation state of Israel. Israelis and their Jewish supporters are depicted as inherently evil oppressors… Conversely, Palestinians are depicted as intrinsically innocent victims. In place of the fundamental and objective centrality of the state of Israel to contemporary Jewish identity, anti-Zionist fundamentalists…utilise ethnic stereotyping of all Israelis…[and] construct a subjective fantasy world in which Israel is detached from its specifically Jewish roots, and then miraculously destroyed by remote control" (pp125-126).
In Kelemen's account different proposals are examined, for example the debate between Ralph Miliband and Marcel Liebman, with the latter arguing for a one-state solution and exposing Israel as an ally of Western imperialism.
One of the most demanding aspects in writing such an account is the massive number of events that provide the context for the development of ideas on the left. Kelemen has not only included the left's various responses to different government papers and reports on Palestine but has made an impressive effort to show how major events in 1947-8, Suez, the 1967 war, etc affected the different elements of the left. He has excavated much interesting evidence of these responses. To give an example from during the 1982 invasion of Lebanon: By August 1982 only two resolutions of 500 submitted to Labour Party Conference concerned the Middle East; a month later 46 resolutions critical of Israel had been submitted. At the conference a resolution from Norwood Constituency Labour Party called for support for "the establishment of a democratic secular state in Palestine as the long-term solution to the Palestine problem"—it passed.
The younger generation of the British left is now pro-Palestinian and critical of Israeli occupation and bombing. Palestinians have become an acknowledged symbol of the oppressed and for the fight for freedom and justice. Kelemen's book showing the history of how the British left finally reached this position is meticulously well researched and well written. Mendes, although including interesting material, has a familiarly skewed analysis. This he exemplifies in his concluding contrast between "Western values" and "the culture of the Arab world", pessimistically forecasting that the latter "would be very unlikely to protect the human rights of Israeli Jews".
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Cough, Spit & A Fondle | Enough Talk, More Writing!
Today, I realized a few things. Firstly, I have noticed that I have started to consciously swallow drinks. And, by that, I mean, I no longer just swallow water from a bottle or tea from a cup and get on with whatever I am doing. For some bizarre reason, I believe because I think that I have started to gulp loudly when I swallow, I make an effort to control the swallowing. Which, in turn, leads me to focus on swallowing after the third go, lets just say, and I inevitably gulp louder, get the liquid to go down the wrong tube, and I end up coughing, spluttering, and have to spit the water out. In case I choke. All makes perfect sense. To me. In my head. There is a reason for this nonsense.
Moving on, I have also realized, that the 16 block walk to the gym actually does bring up a few random stories. I had just been too anti-San Fran, probably missing L.A like the temptress that she is, to let myself observe the carry on. Unsurprisingly, for San Fran, there is a lot of homeless people on the gym route. Which provide a few interesting scenarios. Again, I was waiting at the lights to cross the road (a mighty place to observe life it seems) when I saw a couple at the other side of the road having a big fight. Screaming at each other. In Chinese. It was near impossible not to watch, or start to slow down walking wise to see what was going on.
The Chinese woman was freaking out for some reason, although I am only presuming she was, not speaking too much Chinese myself. She did not seem happy, giving me a nice dirty look as I walked up, maybe she was trying to say hello though. Again, the lack of Chinese was a barrier for me. They had a place set-up in the doorway of a bank, with all their stuff there, two shopping trolleys next to the make-shift bed. The Chinese man was backing off, shouting back a bit, but it was plain to see that the woman was kicking him out, of their doorway. They were now taking up the entire path, so she started physically kicking out at him to clear off, threw a blanket at him, then gave one last tirade in Chinese, and the guy gave me. She had kicked him out, he was gone. Across the road he went, to the bank on the other side of the street, and sat in that doorway, with his blanket. Few more words shouted over and back, and it died down. Fight over.
We were all able to go on our way. The path was clear. There were a few of us after building up on the path, waiting for them to finish up, so we could keep walking on. On we went, me drinking back some Red Bull, listening to see if I was gulping loudly for every drink. Few coughs, few splutters, and the can was almost gone. One last drink, and, conveniently, there was a bin to my right. In fairness, I did kind of stop suddenly, but I just noticed the bin, to my immediate right, as I took the last gulp. Stopped suddenly, stuck the can into the bin, but as I did, the person who had been walking right behind me, walked straight into me.
The last big mouthful sprayed out. Not really actually, more it filled up my mouth, caused me to splutter, then half sprayed, half snorted, out my mouth and nose, as I tried in vain to save a bit of dignity and hold it in. Should've let the spray just gracefully happen. Must have been quite a charming sight, if anyone had seen it. The person who had bumped into me was annoyed with me, for stopping. I was too covered in Red Bull to remember if I should've been annoyed with anyone, probably myself, but it all ended then and there. Continued on to the gym. This was getting more eventful, this was more like it.
Into the gym, did my bit, drinking back the water, needed to refill my bottle up at the water fountain, which is in the downstairs part of the gym. This gym is far quieter than the one in L.A, so you can take your time with the machines. And the fountain. I had a bit left in my bottle, might as well finish it off before I fill her up, so took another big gulp. With my iPod earphones on, I started to think that might be the reason why I was hearing stuff louder in my head, the earphones being on! Which, obviously, made me concentrate far too much on the gulp. And I have already described what happens. Cough, splutter, down the wrong pipe, out comes the liquid. Over the water fountain. Didn't really get the spout part, but still nobody wants to see someone dribble back over the water fountain. Thankfully, I don't think the person behind me, waiting for me to finish up, saw any of it. Either way, I gave it a quick rinse. Left it germ and dribble free.
Leaving the gym and walking home threw up one final piece to this tale. Two days ago, next to the gym, in the bright light of the evening, on a main street, I thought I saw a different homeless couple, getting cordial with each other. As in the full wack. Just with clothes on. Not fully sure, but I was 99% certain. Seeing as they were a foot away from me, in a doorway, while I knocked on the door of the gym, not realizing that it was closed early for a holiday here. I was pretty certain. Leaving the gym tonight, the same couple are sitting in the doorway, not on top of each other or positioned like they were last time. Just sitting side by side. With her hand somewhere. Blatant. Like a hammer.
All of this lead, kind of bizarrely, lead to a feeling of empathy for the homeless folk. For the following reason, which I could relate to, a bit. Kind of. Not that this has ever happened to me, obviously. However, do you remember when you lived at home, and a girl wanted to come around for, eh, a cup of tea? But you didn't think the best place to bring the girl for a cup of tea, was to your place, for various reasons. You were left wondering, where should we go? Where could you go? Probably not their place, for the same reason. More than likely at the age where a cup of a tea in a hotel was too expensive, have you seen the prices, or you simply would not have thought of it. What were you to do? Have a tea party outdoors? Dodge. Fun once, perhaps, but after a while, probably get a cold. So, what are those without any home, meant to do? Not fair really. I know it is probably not top of their list of priorities, but still, amongst many other problems, that must annoy them.
I am not making fun of the homeless either, far from it. Just observations. I'll wrap up by saying I got a bit of good news myself today. I now have a marketing company in L.A waiting for my sitcom pitch, to help me with my viral campaign. Plus, I have camera men and lighting crew waiting in the wings to help me out with making a scene or two. Wuu to the huu. Good to have the pressure on. Must get the script finished and get back there. Time is ticking! My Mastercard is running out! Oh Jesus. (That is meant to be a brutal dumb joke. But, now I think about it, it also makes sense. Take it in the dumb joke way. If you get it. Always fun feeling the need to explain a joke). The End.
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Who's that marketing company you have lined up?


The Dentistry professor from CEU-UCH, Salvatore Sauro, published his most recent research in the Journal of Dental Research. He collaborated with other internationally renowned professors from universities in the United Kingdom (Prof. Timothy Watson), Brazil (Prof. Mario Sinhoreti, Fabricio Ogliari, Victor Feitosa), and Belgium (Prof. Bart Van Meerbeek). This international team which was led by the CEU-UCH professor, Salvator Sauro, has discovered that the structural characteristics of the new adhesives, that they use to bond the filling material to the tooth, influences the durability of these fillings or composite dental restorations.
Part of this now published study was entered in the Paffenbarguer Awards, that are awarded by the Academy of Dental Materials (ADM), this year. This is one of the most prestigious international awards for research into new materials in the dentistry field. Among the hundreds of studies from universities across the world, the study led by Professor Sauro was deemed to be the fourth best research work out of those entered for this prestigious international award. The delivery of the Paffenbarguer awards took place from the 9 to the 12 October in Vancouver, where the headquarters of ADM are located.


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What Are The Types of Synthetic Marijuana?
12 Keys - JourneyPure » Blog » What Are The Types of Synthetic Marijuana?
Synthetic marijuana is a dangerous and addictive drug that has been pretty quietly sweeping the nation to become of the leading sources of overdoses in the past few years. As of right now, the drug stands as mostly unregulated, legal, and sold at a majority of bodegas and gas stations.
According to news articles, police reports, and hospital records, synthetic marijuana is quickly becoming the favored drug of choice for the homeless population, and for underprivileged or disadvantaged Americans because it is so cheap, so accessible and completely legal.
Where Did Synthetic Marijuana Come From?
In 1984, John W. Huffman, a Clemson University researcher started investigating synthetic alternatives to over 500 different cannabinoids on a government grant. These cannabinoids were meant to be replicas of the active ingredient that was found in marijuana. One of the researchers on the team came up with the chemical compound later called JWH -018, named after Huffman, and in a short time, the chemical started to show up on the shelves of head shops around Europe being sold as incense.
Not long after, it started to pick up steam, and people began to smoke the chemicals. Of course, people experienced negative side effects such as hallucinations, voices, and suicidal thoughts. One young man in Iowa actually committed suicide with a shotgun after smoking the drug, stating to his father beforehand that he "felt like he was in hell."
It didn't take long for the DEA to ban five specific and most popular strains of synthetic marijuana in 2011. That doesn't mean that more and more strains and variations of chemicals haven't continued to be produced, sold, and branded as synthetic marijuana or "cannabinoids."
So, what are some of the different types of synthetic marijuana and why are they so dangerous?
What has largely deemed the most popular type of synthetic marijuana, K2 has been raking in thousands of overdoses daily across the country. For some users, smoking the drug CAN create the effect that real marijuana creates, but for a majority of others, it creates anxiety, hallucinations, panic, confusion, and overdose.
The chemical was originally sold as incense in 2006
K2 is often called, Yucatan fire, green giant, skunk, moon rocks, genie, zohai, and spice
June 27th, 2015 – over 40 overdoses from K2 in a single day, in one hospital
Syracuse, New York, saw 19 overdoses in one day
According to a Brooklyn EMT working at the Kings County Hospital, "It creates a deep central nervous system disconnect the same way PCP or ketamine does, you're outside of your head. You don't have to feel emotions or pain and all those kinds of things… If I picked up a drunk who had a bottle of vodka, I'd pour it out, but when a hospital worker finds a packet of K2 in someone's pocket, they give it back to them in their wallet."
This EMT is referencing the fact that K2 overdoses happen hundreds of time daily around the entire country, yet it is still legal in many states and sold like cigarettes. Since it is not illegal to buy or sell sn hospital workers and first responders cannot confiscate the synthetic marijuana, K2, from people who had just overdosed on it, which means that many of these people return back to the hospital within a few hours of release, because they are smoking the same drug that was just handed back to them.
Often sold under the label of being a "mix of herbs" – Spice is one of the other most common forms of synthetic marijuana that is available on the market. While yes, it is actually a blend of herbs, it and K2 are sprayed with the synthetic marijuana coating, which enables them to have these psychoactive effects.
Many users will note that this variety, as well as the rest of them, have "Not for Human Consumption" written on the bright colored, eye-catching packaging. It is sold, once again, as a natural mix of herbs to be used as incense.
Joker, quite obviously, comes in a bright colored, eye-catching bag with the comic book character, The Joker, on the front. It is actually quite an ominous image, that many people would find pretty creepy to think about smoking something that would make you feel that way, but, alas.
Again, named after the famous comic book character, this blend has the image of the Hulk on the front, with the description of being a "fragrant potpourri" and Kush written above that. Kush is a swipe from the long-time favorite strain of real marijuana, leading users to assume that smoking this blend will create a similar feeling.
In total, there are over 500 known variations of synthetic marijuana compositions available on the market. There is a massive manufacturing market in China that distributes these new variations worldwide, constantly changing compounds in order to stay ahead of new laws around old versions.
The DEA has now started to make many of these chemicals illegal to buy, sell, and consume, over the past few years, but again, new strains are coming out every month in order to keep up with the demand. Some of the other brands you might come in contact with are:
Smoking Santa
Happy Joker
Purple Diesel
Killer Buzz
Scooby Snacks
Mr. Happy
Mad Monkey
Smacked
Spice is so dangerous because the new versions that are coming out are completely unregulated, and users will have absolutely no idea how it will affect them until after they have smoked it.
Getting Professional Help For Synthetic Marijuana Addiction
Addiction is a serious disease, if you or someone you know struggle with Synthetic Marijuana, do not hesitate, reach out for help today and begin taking the proper steps necessary to treat addiction.

redpajama_set_name: RedPajamaCommonCrawl


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Nustay
Nustay/
Nustay files for bankruptcy following serious challenges of the COVID-19 crisis
Sun, Oct 04, 2020 16:30 CET Report this content
Nustay A/S ("Nustay") has today announced that as a result of the COVID-19 crisis, it will be filing for bankruptcy. The company has experienced a very significant drop in sales volume due to the continuing global travel restrictions - with sales at 5% of the volume of January and February 2020. This continued industry-wide uncertainty has also made meant that the company has been unable to secure sufficient funding to continue operations.
COVID-19 crisis has continued to present difficult challenges
As a result of the continuing global travel restrictions, Nustay's Board of Directors have announced that the company will be filing for bankruptcy. Despite introducing a sequence of measures to face the challenges, including cutting overhead spend by 80% and readjusting the marketing strategy to ensure ROI positive sales across all bookings, Nustay has been unable to compensate for the global drop in travel demand. The company has seen its sales drop to around 5% of the volume at the start of the year and without clear indications on when the travel industry might recover again, the company has been unable to secure the necessary financing to continue operations.
Global uncertainty has impacted securing sufficient funding
Over the last few months, Nustay's management has been working intensely to secure the necessary funding to continue operations until the market recovers. A number of refunding structures have been explored and discussed with shareholders, investors and other stakeholders. However, because of the significant uncertainty over when the travel and hotel market will see some recovery, the Board of Directors has been unable to secure the sufficient funding security for continued operations at the present level.
Bankruptcy: the next steps
The bankruptcy process is expected to be as follows. On Monday 5th October, Nustay will file an application for bankruptcy through 'Skifteretten' (the Danish court handling bankruptcies and liquidations). Skifteretten will then examine the application - which the company expects will be approved within a short time period. Upon doing so, Skifteretten will appoint a liquidator to handle the liquidation process.
For further information about Nustay, please contact:
Investor Relations, Nustay A/S
E-mail: investor@nustay.com
Website: www.nustay.com
This information is information that Nustay A/S is obliged to publish following the EU Market Abuse Regulation. The information was provided by the contact person above for publication on October 4th, 2020.
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Challenges of Systematic Reviews of Economic Evaluations: A Review of Recent Reviews and an Obesity Case Study
Elisabet Jacobsen ORCID: orcid.org/0000-0002-3211-936X1,
Dwayne Boyers ORCID: orcid.org/0000-0002-9786-81181 &
Alison Avenell ORCID: orcid.org/0000-0003-4813-56282
PharmacoEconomics (2020)Cite this article
Decision makers increasingly require cost-effectiveness evidence to inform resource allocation and the need for systematic reviews of economic evaluations (SREEs) has grown accordingly. The objective of this article is to describe current practice and identify unique challenges in conducting and reporting SREEs. Current guideline documents for SREEs were consulted and summarised. A rapid review of English-language SREEs, using MEDLINE and EMBASE, published in 2017/2018, containing at least 20 studies was undertaken to describe current practice. Information on data extraction methods, quality assessment (QA) tools and reporting methods were narratively summarised. Lessons learned from a recently conducted SREE of weight loss interventions for severely obese adults were discussed. Sixty-three publications were included in the rapid review. Substantial heterogeneity in review methods, reporting standards and QA approaches was evident. Our recently conducted SREE on weight loss interventions identified scope to improve process efficiency, opportunity for more transparent and succinct reporting, and potential to improve consistency of QA. Practical solutions may include (1) using pre-piloted data extraction forms linked explicitly to results tables; (2) consistently reporting on key assumptions and sensitivity analyses that drive results; and (3) using checklists that include topic-specific items where relevant and allow reviewers to distinguish between reporting, justification and QA. The lack of a mutually agreed, standardised set of best practice guidelines has led to substantial heterogeneity in the conduct and reporting of SREEs. Future work is required to standardise the approach to conducting SREEs so that they can generate efficient, timely and relevant evidence to support decision-making. We suggest only data extracting information that will be reported, focusing discussion around the key drivers of cost-effectiveness, and improving consistency in QA by distinguishing between what is reported, justified by authors and deemed appropriate by the reviewer.
FormalPara Key Points for Decision Makers
The need for systematic reviews of economic evaluation evidence has grown recently and is expected to continue to grow into the future as more decision-making bodies explicitly consider the value for money of new healthcare interventions.
A standardised approach on how to best summarise cost-effectiveness evidence is lacking and a set of mutually agreed best practice recommendations is required to improve the efficiency, relevance and transparency of future reviews.
Economic evaluations (EEs) are an increasingly common requirement for evidence-based resource allocation decisions [1,2,3]. Systematic reviews of clinical effectiveness, utilities and costs are often used to populate cost-effectiveness models. However, systematic reviews of EEs (SREEs) are rarely used to provide cost-effectiveness evidence directly to policy makers.
The rationale behind SREEs and clinical-effectiveness reviews are similar. Decision makers are faced with often unmanageable amounts of information, from multiple different sources, often making conflicting value arguments. SREEs can provide an efficient mechanism to synthesise, report and disseminate the available cost-effectiveness evidence to answer a specific value question. By identifying where sufficient research is available to answer a policy question, and by demonstrating where the key research gaps lie, SREEs can help to avoid research waste, allowing funders and researchers to deploy their efforts more efficiently, where the greatest marginal gains of investment can be realised.
Despite their obvious benefit, there are many challenges to conducting a meaningful SREE. Some challenges are also encountered in clinical-effectiveness systematic reviews (e.g. heterogeneity in populations, study designs, methodology and consistency of outcome reporting), but others are unique to SREEs, and may be a limiting factor in their more widespread adoption. There is an extra layer of complexity in synthesising economic evidence due to the substantial variability across, and often within, different country-specific healthcare systems in terms of the payment for and delivery of healthcare. Therefore, different modelling assumptions (care pathways, time horizons, discounting procedures), analysis perspectives (person payer, insurance provider, government payer) or evaluation frameworks (cost-utility, cost-effectiveness, cost-benefit or cost-comparison) are needed to satisfy local decision-making requirements. Generalisability of economic evidence is difficult due to fluctuation of costs (due to inflation, costing practices, changes in payment for healthcare) and variation in society's valuation of health outcomes across countries and over time [4]. The substantial heterogeneity means that quantitative evidence synthesis using meta-analysis is often not possible and so narrative summaries of the evidence are usually required. Anderson [5] discussed the value of conducting SREEs, and how useful they are for answering specific policy questions, and suggest that the conduct of a SREE should be explicitly justified by reviewers, with a clear description of its purpose. Sculpher et al. [6] and Welte et al. [7] suggested 26 and 14 factors, respectively, that need to be transferable to another setting, in order for the EE to be relevant for decision-making. Boulenger et al. [8] pointed out that in order to be fully transferable, the economic model used would have to be tested with the data required for the specific context. The aim of this paper is to complement the existing research. We focus on how to address the challenges of a SREE given that the decision has been made to conduct one.
Large SREEs are resource intensive to complete and can generate large volumes of information, with much scope for inefficiencies in the process. This paper describes the current state of practice, using a rapid review of recently published SREEs, and discusses some of the unique challenges of conducting a SREE using a case study of weight-loss interventions. We envisage that the combination of a narrative review of current SREE practice and insights gained through our own large SREE experience will prove useful for future reviewers of EE evidence.
The objectives of this paper are to describe the current state of practice, identify and discuss the key challenges of conducting SREEs, and suggest methods for improvement based on reflection of our experiences conducting a large SREE for weight loss interventions for severely obese adults (body mass index [BMI] ≥ 35 kg/m2) as part of the REBALANCE (REview of Behaviour And Lifestyle interventions for severe obesity: AN evidenCE synthesis) project [9].
The REBALANCE Case Study
The REBALANCE project included a SREE for weight management (weight-loss and weight maintenance) programmes (WMPs), including diet and lifestyle interventions, behaviour change interventions, drug interventions and bariatric surgery for adults aged ≥ 18 years with severe obesity (BMI ≥ 35 kg/m2).
Full details of the methods, including a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram, and results are reported elsewhere [9]. Briefly, studies conducted alongside trials and decision models that compared costs and outcomes in a single framework were included. A bespoke predefined online data extraction form was used to collect all reported economic data. Studies were assessed against the Drummond and Jefferson [10] and Philips et al. [11] checklists for trial-based and decision modelling studies, respectively.
Forty-six studies were included and narratively synthesised by modality of intervention (bariatric surgery [n = 27], lifestyle WMPs [n = 16] and orlistat [n = 3]) and EE type (within trial and decision modelling studies). Surgery was always deemed cost-effective due to long-term weight loss, but results for non-surgical WMPs were uncertain. The validity of the findings was dependent on the methodological quality of the studies. Common quality concerns were (1) a minority of non-surgical WMPs conducted long-term decision modelling to capture the full impact of obesity-related disease; (2) cost and utility implications from surgery-related complications were rarely included; and (3) weight regain assumptions were rarely described or adequately tested in sensitivity analysis (SA).
Rapid Review of Systematic Reviews of Economic Evaluations (SREEs)
A rapid review of large (≥ 20 studies assessed) SREEs published in 2017 and 2018, recorded in two databases (MEDLINE and EMBASE) was undertaken. As the aim of the rapid review was to describe the most recent practice for conducting large SREEs, only the most recently published studies were included. The purpose of the rapid review was to provide context of current practice and it was not intended to be an exhaustive assessment of the literature. The search strategy, provided in Appendix 1.1 in the Electronic Supplementary Material combined filters for EE studies with a title search for "systematic review". Full-text, freely accessible articles published in the English language were included. Systematic reviews of cost-only studies, methods applications, conference abstracts and letters were all excluded. Abstract and full-text screening was conducted by one health economist using a predefined data extraction form in Microsoft Excel® (Microsoft Corp., Redmond, WA, USA). Information was collected on the number of items stated to be data extracted, actual number of items reported, quality assessment (QA) details, if any, and any visualisation of the results (e.g. graphical representation). A narrative discussion of current practice is provided, supplemented with simple frequency reporting of key information. The SREEs identified were not otherwise quality assessed.
After removal of duplicates, the search strategy identified 1663 potentially relevant titles. After review of titles and abstracts, 189 studies remained. A further 113 were excluded either because the full text was not retrievable or the article no longer met the inclusion/exclusion criteria (leaving 76 studies). A further 13 reviews failed to report the number of studies in the abstract and were also excluded. Sixty-three full-text papers were retrieved, analysed and data extracted. The median number of studies included in each SREE was 34 (range 21–115). The PRISMA diagram is presented in Appendix 1.2 in the Electronic Supplementary Material.
Review of Current Guidelines
Current guidelines for the conduct of SREEs were narratively summarised to identify current best practice methods. Details of some of the most widely cited current guidelines (e.g. Cochrane guidelines) were obtained from a hand search of reference lists of the identified studies from our rapid review of reviews and the reference lists of other published SREEs. The guidelines focused on were those that provided guidance on the methods of data extraction and reporting.
Description and Summary of the Key Challenges of Completing a SREE
The results that follow describe the experiences of conducting the REBALANCE SREE and the challenges encountered and lessons learned, and make recommendations for future practice across three main areas of the review process: (1) data extraction: what and how much data should be extracted, and how do we extract data efficiently; (2) evidence synthesis: how can we synthesise cost-effectiveness evidence in a meaningful manner, that is informative for decision makers, when meta-analysis is not possible; and (3) QA: how we can better quality assess studies, in a manner that is more consistent with the research question/disease area for review, and are there ways in which the relevance, usability and transparency of commonly used QA and reporting checklists can be improved? The experiences of the REBALANCE study are supplemented with the findings from the rapid review of current practice where appropriate.
Current Guidelines
The Centre for Reviews and Dissemination (CRD) provides broad guidance for undertaking SREEs, including advice to use predefined and piloted data extraction forms [12]. The guidance suggests categories of data (e.g. study results) but provides limited further guidance for reviewers. The Joanna Briggs Institute Reviewers' Manual 2014 includes a pre-specified list of items to extract [13]. Van Mastrigt et al. [14] recommend piloting a data extraction form for thoroughness. Wijnen et al. [15] recommend a list of 35 items for data extraction and illustrative dummy tables for study characteristics and study results; however, they emphasise that the extracted items should reflect the most important items, not just the items in the template provided. There is undoubtedly a trade-off between the efficiency gains of bespoke extraction and the cross-review consistency of a predefined shopping list of data extraction items that must be considered by reviewers. Overall, of the few guidelines mentioned here, current guidance documents provide a range of advice to reviewers, generating marked differences in approaches taken across SREEs.
Findings from the Rapid Review
Table 1 shows the results from the rapid review on data extraction methodology. Studies included in the rapid review are presented in Appendix 1.3 in the Electronic Supplementary Material.
Table 1 Rapid review findings on data extraction methods
Our findings are similar to those of Luhnen et al. [16, 17], who found that 32% and 44% of studies used a standardised data extraction form, respectively. It is concerning that many studies failed to provide any details on the data extraction method [16]. Where detailed information was provided, some studies failed to report on all the data extraction items. Such reviews lack transparency and may be inefficient, as reviewers are extracting more data than necessary.
Lessons Learned from REBALANCE
The majority of data items extracted from the REBALANCE review were not reported. The decision on what data to report was based on text constraints, despite the ability to provide data in online appendices, and striking a balance between reporting relevant informative data and information overload. On reflection, the process was highly inefficient. A helpful and more efficient approach would have been to use a predefined dummy table of results to design the data extraction form. The decision should be based on what is relevant to the research question and what is needed for reporting.
Another challenge from the REBALANCE review was that many studies reported multiple SAs. We extracted all SA results across all studies. However, a more useful and efficient approach may be to predefine the most important SA that might be expected to impact on the incremental cost-effectiveness ratio (ICER). For example, in obesity studies, this might include the rate of weight regain after intervention delivery.
Table 2 provides a suggested template that could be used for data extraction of results information, explicitly linked to result reporting. The suggested template is for cost-effectiveness results only. Study characteristics such as methodological details would also need to be data extracted.
Table 2 Possible template for reporting cost-effectiveness results
To ensure relevance, the form should be piloted on a small number of studies to resolve any remaining issues and ensure data collection items are sensible, complete and relevant.
The REBALANCE study used an online data extraction form, with automated checks to help minimise extraction errors and flag disagreement amongst reviewers. Combining the positive experience of using online forms with the lessons learned, selection of relevant information for extraction could substantially improve the efficiency of the review process.
Reporting and Presentation of Cost-Effectiveness Results
Reporting guidance focuses on providing transparent cost-effectiveness information. This includes reporting study methods such as perspective, population, time horizon, effectiveness source, benefit measurement, study type, model type, SAs (both a list of parameters and range of ICERs), and base-case deterministic and probabilistic results [18].
Table 3 describes the methods used for reporting study results in the rapid review.
Table 3 Method of reporting study results identified in the rapid review
Encouragingly, the majority of studies followed PRISMA recommendations, a key example of how clear guidance can improve standardisation of reporting. Visual presentations of results can help deliver key messages. However, caution is required as there is a risk that the reader may incorrectly compare results across studies without considering the appropriate caveats regarding heterogeneity. Luhnen et al. [17] also found that most studies conducted a narrative synthesis of results and did not use a graphical representation.
Base-case ICERs were reported alongside minimum and maximum ICERs from SA for each study. However, the reporting could have been more informative and transparent if a template such as that suggested in Table 2 was used to derive the proportion of studies that conducted each key SA and the associated impact on the base-case ICER. For example, the REBALANCE de novo model found that results were highly sensitive to weight regain assumptions. However, only a minority of studies in the SREE specified their regain assumptions and fewer still tested them in a SA [9]. It is essential that SREEs identify the most important assumptions, and extract concise information on the impact of these assumptions on results. This would help to describe the true uncertainty in cost-effectiveness results. We did not quantitatively synthesise the ICERs obtained from the REBALANCE review because of the significant heterogeneity across studies in terms of methodology, healthcare systems and definitions of interventions/comparators. Synthesising ICERs would run the risk of misinterpretation of the results, e.g. by comparing all ICERs to the same country-specific cost-effectiveness threshold.
Quality Assessment/Reporting Checklists
Multiple reporting and QA checklists exist and continue to develop over time. Currently, Cochrane recommends the Drummond and Jefferson [10] and Evers et al. [19] checklists for EEs conducted alongside single effectiveness studies and the Philips et al. [11] checklist for decision-analytical models [20].
Table 4 describes the different checklists identified as part of the rapid review, including a description of its general use (decision models or EEs alongside single effectiveness studies) and whether it can be considered a reporting standard or true QA tool.
Table 4 Reporting standards and quality assessment checklists
Similarly to Luhnen et al. [16, 17], we find that the most popular checklist was the Drummond and Jefferson [10] checklist. It is concerning that approximately one-third of SREEs have not conducted any formal QA. Luhnen et al. [16] raised similar concerns, finding that about half of the health technology assessment (HTA) reports and one-third of the rapid reports did not provide a formal QA [16]. It is also concerning that many SREEs claim to have conducted QA, but further reading identifies that in fact reporting standards such as the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) statement were used instead [22]. Furthermore, it was clear from the rapid review that many studies inappropriately used the same QA tool for model-based and trial-based EEs. None of the available QA tools contain sufficiently detailed questions to judge the quality of both study types. Furthermore, none of the checklists in Table 4 allow the reviewer to explicitly distinguish between reporting checks, justifications provided for assumptions and QA based on the reviewer's expertise. Reporting standards and QA tools are often incorrectly used inter-changeably in the assessment of EE studies.
In addition, some checklists include items containing multiple component subquestions. For example, were the assumptions about long-term health effects reported and justified? Or were costs and QALYs discounted appropriately? Such ambiguity can generate inconsistency among reviewers. Walker et al. [27] reviewed ten checklists and found that they performed poorly in terms of inter-rater reliability. Time spent reconciling differences in opinion amongst reviewers could be minimised if questions were clearer.
The lack of clarity in QA checklists made it challenging to consistently quality assess a large number of studies, with potential for within- and between-reviewer discrepancies. On reflection, the QA tools [10, 11] used in the REBALANCE study did not always reflect the actual quality of the study. Some studies scored highly, whereas in fact they were judged by the reviewers to be of poor quality. For example, weight regain assumptions were poorly reported and justified by many studies in the REBALANCE SREE, yet they often scored highly using the checklists. One suggestion might be to adapt QA tools to include topic-specific bolt-on items that are pertinent to assessing the quality of EEs in specific topic areas, such as obesity.
Luhnen et al. [16] identified some examples of the use of bolt-on items to standard checklists, including adaptions to the Drummond and Jefferson [10] checklist by using additional QA criteria, e.g. based on a policy brief from the Campbell Collaboration on economic methods [28] or WHO guidance on EEs for immunisation programmes [29]. Checklist adaptability can improve a checklist when it is able to better reflect the quality of the studies. The usefulness of the QA results depends on the quality and applicability of the QA checklists themselves.
SREEs are growing in popularity, but the methodology is still developing. Our rapid review of reviews identifies some concerns regarding the lack of detail on the data extraction method, the potential risk of misinterpretation of the visually represented results and the lack of use of a formal QA. Luhnen et al. [17] have identified many similar concerns in their recently completed review, conducted in parallel with our work. Our study compliments the review of Luhnen et al. [17] by describing the lessons learned from our own recently completed large SREE as part of the REBALANCE study. We identify some solutions to common problems and make some practical recommendations for future practice to streamline and improve the review process.
There is limited consensus around guidelines to standardise practice. Evidence from the rapid review, and reflection on the REBALANCE SREE experience indicate scope to improve review efficiency. One suggestion to improve consistency of reporting and identification of important results is to link the results data extracted to the results reported, focusing on the most important, predefined SAs. Instead of data extracting all potentially relevant data, we recommend data extracting only what will be used for the report. For example, for the results, we recommend extracting only the data demonstrated in Table 2, i.e. not extract all SA, but only focus on predefined key drivers of cost-effectiveness and report those. This leads to time efficiency, while at the same time directing the reader to the most important drivers of cost-effectiveness.
QA checklists appear to lack clarity in their questions, and there appears to be substantial incorrect use of reporting checklists to assess EE quality. A helpful amendment to current instruments may be to simply distinguish between (1) what is reported; (2) whether it was justified by the authors; and (3) whether it was deemed of appropriate quality as judged by the reviewers. In addition, it may be helpful to supplement a core set of QA questions (e.g. discounting, time horizon, etc.) with topic-specific bolt-on items. For example, in obesity SREEs this might include questions about weight regain assumptions, appropriateness and completeness of the modelled obesity related diseases, and incorporation of costs and disutility associated with bariatric surgery complications. These bolt-on items should be SREE specific, agreed in advance of data extraction and linked where possible to the important analyses specified for data extraction (Table 2). To improve consistency in QA, it is important that journals and the health economic community adopt clear consensus guidelines for the conduct of SREE. This should be a priority of future research.
The SREE should aim to provide information on whether an intervention is cost-effective, but should be transparent about the likely significant heterogeneity across the included studies. Reviews should therefore provide ranges of plausible ICERs, alongside appropriate caveats about their generalisability across settings. SREEs should also provide key information from the included studies, including how they differ, in order to make the SREE as transparent and informative as possible. We caution against converting ICERs to a common currency as this might lead to misinterpretation of the results due to heterogeneity across healthcare systems. It is important to acknowledge the differences across studies and to comment on what impacts their generalisability [6, 7]. The process of transparency can be helped using graphical representation of results, but the associated caveats around heterogeneity should be clearly flagged. If applicable, the review should identify a subset of studies that answer the research question for the review. For example, if it is a review commissioned by the National Institute for Health and Care Excellence (NICE), then the review should identify the whole set of evidence, but also narratively (or otherwise) describe the subset of studies that are directly applicable to the research question. A SREE could also be useful in identifying decision models that could be adapted to address a specific research question, as opposed to building the de novo model from scratch. Trial-based EEs might not be able to answer the research questions because they are typically of short duration and based on a single study.
Current process guidelines for SREEs may provide some helpful advice, but further detailed consensus based guidance is needed. Shemilt et al. [30] argued that the Cochrane SREE methodology varies and has inconsistent reporting of the results. To improve transparency, it is good practice to publish the systematic review protocol [14], as was done with the REBALANCE review [31]. Guidelines on the conduct of the search for EE is well-developed (see the Cochrane Handbook for Systematic Reviews of Interventions [20]). Van Mastrigt et al. [14] also provide a step-by-step guide for reviewers developing their search. However, reviewers are faced with many challenges unique to SREEs that are not currently covered by guidance documents, leading to inefficient and inconsistent reviews.
A number of other studies have attempted to address some challenges of conducting SREEs. Pignone et al. [32] suggested ways forward for the SREE-specific challenges such as critically appraising studies and presenting results. For example, they recommend some key features to be critically appraised (including model type, perspective, costs included and others) and they developed a set of guidelines for improving SREE [32], suggesting that ICERs for each comparison should be reported along with the input parameters to better understand the results. Different methods have been suggested on how to present the result in a simplified manner such as the three-by-three dominance ranking matrix (DRM) tool [14, 33], harvest plot [34] and hierarchical method [16, 35]. Others have discussed the use of the QA tools. Ramos et al. [36] highlighted the complexity and impracticality of checklists and suggested a 5-dimension framework on good practice procedure in modelling. Gomersall et al. [33] suggested separating multi-component questions into single items to avoid ambiguity.
There is still no consensus in the health economics community on which guidelines to follow when conducting SREEs. Consistency in SREE methodology would be highly beneficial; however, this is not possible without researchers or journals coming together and agreeing on a standardised approach to SREE.
Whilst we are transparent with regards to our rapid review methodology, it comes with some limitations. Our rapid review was confined to publication years 2017–2018 and only SREEs that included 20 studies or more. The review should therefore be considered as a description of current practice, rather than an exhaustive systematic assessment. The number of items in the predefined data extraction list and the number of reported items are subject to some uncertainty because often when the studies listed items to data extract, items were summarised, not giving a true picture of the predefined listed items versus reported items.
SREEs might prove to be challenging to conduct, with some studies debating its usefulness [5], but a well-conducted SREE is a useful framework for identifying good-quality economic evidence, avoiding research waste and identifying research priorities to support healthcare decision-making. Development of a detailed set of consensus-based guidelines for reviewers of EE evidence is a key priority for future research. We suggest an efficient approach to data extraction be taken and only data extract what will be used for the report, only report the key SAs (drivers of cost-effectiveness) in the results table, and improve consistency in the QA by distinguishing between what was reported, justified and deemed of appropriate standards by the reviewer.
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The authors would like to thank the REBALANCE team for commenting on the REBALANCE systematic review used as a case study. We also wish to thank Karin Gøthe Áslakksdóttir for contributing to the rapid review of reviews.
Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
Elisabet Jacobsen
& Dwayne Boyers
Health Services Research Unit, University of Aberdeen, Aberdeen, UK
Alison Avenell
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All authors have reviewed the manuscript and approved of the final version to be published. Elisabet Jacobsen reviewed the cost-effectiveness evidence in the REBALANCE systematic review, reviewed current practice on conducting systematic reviews of economic evaluations, reviewed the literature on current guidelines for conducting systematic reviews of economic evaluations and wrote the paper. Dwayne Boyers supervised the REBALANCE review of cost-effectiveness evidence, conducted the rapid review of reviews search on current practice of conducting systematic reviews of economic evaluations and wrote the paper. Alison Avenell contributed to the reviews and critically reviewed the paper.
Correspondence to Elisabet Jacobsen.
The authors received no direct funding for this study and/or preparation of this manuscript. However, the REBALANCE study was funded by the National Institute for Health Research HTA programme, project number 15/09/04. See the HTA Programme website for further project information. The views and opinions expressed related to the REBALANCE project are those of the authors and do not necessarily reflect those of the Department of Health, or the funders that provided institutional support for the authors of that report. The Health Services Research Unit and Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.
Elisabet Jacobsen, Dwayne Boyers and Alison Avenell declare that they have no conflict of interest.
This study did not require any ethical approval.
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Jacobsen, E., Boyers, D. & Avenell, A. Challenges of Systematic Reviews of Economic Evaluations: A Review of Recent Reviews and an Obesity Case Study. PharmacoEconomics (2020) doi:10.1007/s40273-019-00878-2


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Interracial dating in Maxdorf (DE)
Dating A Friend You've Known For Years Can Be The Best (& Most Terrifying Thing) Ever
March 2, 2019 January 5, 2021
How do you make friends during a lockdown? Dating apps
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Moving to a new city can be difficult, and making friends can make part of that whole transition even more tiring. Sometimes, it can even be hard to make friends in a place we have grown up in and known our whole life. However, lucky for us because we live in the digital age, more apps are being developed that bring people closer together. Many of these apps revolve around dating, but new developers have taken the concept of "swiping right" for romantic matches and applied it to making friends. These Apps designed for "friend making" really aim to bring people closer together based on their interests. So whether you're into running and swimming, painting, brunching, or just hanging out at the beach, these seven apps are sure to help you find your perfect match. Meetup is a great place to start when you're looking for a whole new ring of friends, or after you just moved to a new city.
Author contributions: M. We show in this paper that meeting online has displaced friends as the main way heterosexual couples in the United States meet. Traditional ways of meeting partners through family, in church, in the neighborhood have all been declining since World War II. Meeting through friends has been in decline since roughly We present data from a nationally representative survey of American adults.
Dating Your Friends' Former Flings Is Fair Game, IMO. You were never that serious anyway.
We use cookies and other tracking technologies to improve your browsing experience on our site, show personalized content and targeted ads, analyze site traffic, and understand where our audiences come from. To learn more or opt-out, read our Cookie Policy. Match Group and the media brand Betches are partnering to launch an iOS dating app that allows users to help their friends pick out potential dates.
The app is called Ship , and it lets users swipe for their friends and chat about profiles, so even if your best friend is in a relationship, he or she can download the app and look around for you. Your mom could, too. More importantly, it comes from the popular, female-oriented content machine Betches, which produces a website, Instagram account, and podcast, among other things.
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It has a massive following across various platforms. The app, which launches today, allows a single user to create a group of people who are allowed to swipe for them. If a friend sees someone they think would be a good match, they can swipe right on them, bringing their profile into the group chat. The app still requires the single person and the potential match to like each other before they can chat. Another company, called Wingman , offers a similar concept.
More broadly, people have voiced that they want to swipe with friends, so apps like Tinder another Match Group entity responded with things like an Apple TV version for more public swiping. What differentiates this Match launch from any other is that Betches already has a built-in, dedicated audience. The company has more than 6 million Instagram followers, and it says 3 million unique visitors come to the site monthly.
Are Americans ready to trust Facebook with their dating life? Barely more than a month has passed since the U. With its U. By year-end, Facebook Dating users will be able to select which Facebook or Instagram Stories they want to add to their dating profile. Though the U. This is an area where the company is now heavily invested.
We won't suggest current FB friends within Dating or notify them that you joined Dating. · All conversations you have in Dating are separate from your conversations.
Facebook Dating, a matchmaking service the company already offers in Brazil, Canada and 17 other countries, arrives in the U. But after years of privacy missteps by the social network, will people trust it with their love lives? For a company that's also developing its own digital currency and dabbling in e-commerce, love is another step toward reaching into all aspects of human existence.
Although many aspects of Facebook Dating resemble what other matchmaking services offer, Facebook's version promises to be different, just as Tinder did before it with its swipe action and Bumble with its female-first messaging. Your Facebook Dating profile will be separate from your main one, but it will tap existing features such as events and groups, as well as your network of friends to identify "secret crushes. Facebook Dating, while being free to use and free of ads, can still help Facebook make money if it keeps people glued to its other services longer.
Tell that to Seth Carter, 32, an engineer from Terre Haute, Indiana, who tried a host of dating apps ranging from Match to Bumble, Tinder and Christian Mingle prior to his current relationship. But he worries that Facebook's stated commitment to privacy would ultimately buckle under pressure to make money off the service. Facebook says it won't be doing any of that. But users like Carter can hardly be blamed for their apprehension, given the company's multiple stumbles over protecting people's private information.
If you're the kind of person who likes being set up on blind dates, seeks your friends' approval before going out with someone new guilty , or are just really freaking frustrated with the current state of your dating life and want someone else to figure it out for you, the Ship dating app may be for you. It's the dating app that lets your friends swipe right on your behalf — a social twist that sounds both exciting and terrifying at the same time.
Apps like Tinder and Bumble have let users share profiles with friends via link for a while now, but actually giving one of your friends the power to hook you up with a potential partner is something that requires a pretty high level of trust.
There are many reasons why friends may not like someone's choice of partner, such as jealousy, misunderstandings or snobbery.
So why is it that the friends-to-lovers paradigm bears such perennial relevance? And does it work IRL? Naturally, these rates increased hugely over time, explaining how — in numerical terms – a "six" can easily become a "nine" in a matter of weeks. They found that, on average, the couples had known each other four months before dating.
Plus, 40 per cent of them were friends beforehand. So it makes sense that some of us are inclined to fraternise with friendship when both parties are of the same sexual orientation. In fact, some of the best relationships often start out as friendships. Think of Sheryl Sandberg, who was friends with her late husband Dave for six years before they became romantically involved.
Certainly, no relationship can stand the test of time without the foundations of a strong friendship, agrees love and relationships author Daniel Jones.
It is the norm. Little wonder, then, that Facebook is bringing a dating service to the richest denizens of its internet fief. Facebook Dating launched in America on September 5th, having been tested first in smaller markets such as Colombia and Canada.
Bless your married friends' hearts, they mean well. But they have no idea what they're talking about.
Support for children, teens and adults with hemiplegia, hemiparesis, hemiplegic cerebral palsy, childhood stroke, infant stroke, hemiplegia, hemiparesis, neonatal stroke, brain bleed, stroke in utero and pediatric stroke. Plan to go out with friends or have them over at least once a week. Invite someone to do something with you. This is the step where some people get stuck. You may feel shy about asking people to hang out, but unless you take this step, you may find yourself home alone on a Friday night.
Here are some tips on getting started. What can we say? Individuals with hemiplegia date, fall in love, fall out of love, get married, get divorced, and so on — just like other people. So, no special info for you in the dating section of this website. On dating while differently abled. Ways to Enhance Social Inclusion. Kids Have Strokes – Say it. All Rights Reserved.
Coming to the realization that one of your friends is a total babe is actually a pretty common occurrence. Sometimes it happens after three months of friendship, and other times it happens three years! And while personal experience makes me want to rush and scream "Definitely! Of course, there isn't anything inherently wrong with dating someone in your friend group. And while the potential of harming an already existing friendship is often the reason people use for not dating a friend, Ettin suggests not letting fear get in the way of following your heart.
› can-dating-within-your-friend-group-ruin-yo.
Medically Reviewed By: Lauren Guilbeault. It happens without expecting it. You're sitting there, muddling through the deep questions for friends you usually tango with, and you feel it: a spark that goes just a little bit beyond the normal connection you feel with your friends. From that, you might wonder: "Could this actually work? At first, everything seems sublime.
You know you're compatible; you've been friends for years. You know each other's friends and family members, you know each others likes and dislikes, and you know what to expect from one another emotionally, mentally, and physically.
Now Facebook users in the United States can officially use the social network as a dating service—complete with specialized profiles, a matchmaking algorithm, and more. Facebook Dating , which began rolling out in other countries last year and launches in the US today, gives users ages 18 and up access to a suite of features designed to help them find a meaningful relationship.
Plenty of them will be familiar to anyone with experience on other dating apps , but a few options take unique advantage of Facebook's biggest asset—its extensive cache of data on you and all your friends.
Friends may also get together because in some cases, it can feel like a natural progression within the relationship. Two friends might feel.
Subscriber Account active since. Sometimes friendships turn into romantic relationships — and bonding as pals before becoming a couple can come with many perks. You probably already know their hobbies, likes, and dislikes. Masini said there is sometimes less of a risk involved when you become friends with someone before you date them.
She said this is the case because you already know a lot about this person before committing to them including what their life is like on a daily basis, their job, their family, and their interests. You know what this person's life is like.
FWB always feels a little bit like a relationship, and a little bit like how fun. And then someone or other starts getting feelings, and things get confusing quickly. But do you? It just kind of seems that way. Do you plan on continuing this? Hello, guys.
Coming to the realization that one of your friends is a total babe is actually a pretty common occurrence. Sometimes it happens after three.
The first kiss my boyfriend and I shared as friends-who-now-know-they-like-each-other was nothing short of terrifying. I pulled him into what I thought would be a sweeping, spark-filled smooch and he just stood there, hardly moving. The rest of the date was even more catastrophic. We nervously drank too much and watched Sweet Home Alabama on his bed without looking at each other.
I was convinced we had no chemistry and that I ruined a perfectly-great friendship. All to say: I have been there.
I can actually count how many friends I text back in a timely fashion on one hand, and I know all my coworkers on a personal level. I surround myself with like-minded people: creatives, writers, directors, and fashion enthusiasts. Most of my activities take place in Brooklyn, where I and most of my peers live, and my dating radius is less than five miles.
Your friends are going to know about your fights, your sex life and just about any problem you have in your relationship. 2. You can't avoid him if you break up. You.
We live on different continents, but inevitably, a few times a year, we find each other somewhere in the world, have a few days of romance, and then go our separate ways. It was while planning this vacation that it hit me: The two longest relationships of my life have both been with men who I was never officially dating. Boyfriends and girlfriends have come and gone, but my friends with benefits have stood the test of time.
I mean, eight years. And he actually knows me better than a lot of my partners ever did. So what is it about the friends with benefits dynamic that is more sustainable, and often more transparent, than an actual relationship? People are skeptical of fuck buddies. Or at least, without getting super-jealous and Fatal Attraction —esque? But why do things have to be so black and white? Why destroy it with a relationship?
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Hitchhiker's guide to Serbia is a result of joint effort of a number of the Serbia Travel Club members, from diverse experience and useful information that slowly but surely accumulated on the forum. The guide is intended for those who still believe that possession of money is not a necessary precondition for moving around, the adventurous spirits who are ready to bring a touch of uncertainty into their travels, those fond of all sorts of conversations with those who accept us into their vehicles, to share a couple of hours and kilometres with us.... and of course to the enthusiasts who won't miss the opportunity to fill their lungs with the clean highway air and get to know the enchanted world of fragrant gas stations, freezing winds and questioning one's own sanity at cursed, deserted crossroads in the small hours of night.
An opportunity to contribute to this idea by sharing your experience and information with other hitchhikers.


In 1984, Tawfiq al-Hakim (1898-1987) – a major literary and intellectual figure in Egypt and the Arab world who contributed to the development of Arabic literature, – wrote "Thawrat al-Shabab" ("The Revolt of the Young"). The 20 chapters swing easily between al-Hakim's past and present: recalling incidents from his past, discussing their relevance to his present, and examining the concerns of the younger generation. Mona Radwan translated the book into English for a 2015 publication date, four years after the January 25 Egyptian revolution. In the translator's introduction, Radwan explains the importance of the timing of this publication, shedding light on this pioneering figure who predominantly contributed to Arabic literature through his novels, short stories, and plays. More importantly, Radwan discusses the gap between generations which ultimately leads to the young people lighting the spark in most revolutions around the globe. The 20 essays included in the book, most of them relatively short, have proven extraordinary harbingers of issues raised by events that occurred in Egypt over a decade after the author's death.
In his "Introduction," al-Hakim attempts to define the nature of revolutions ("thawra" in Arabic), distancing them from upheavals (a term chosen by Radwan to describe "alhoga" in Arabic). Young people lead every revolution as the representatives of youthful vigour, and although a revolution ultimately resorts to violence, it should retain that which proves useful, becoming a step in the natural evolution of rising nations. The revolt of the young, however, cannot be easily defined, for it is not based on specific demands, but rather is "the cry of the whole age . . . the awakening of an alarming future." Even though al-Hakim's book concerns the 1952 Revolution led by young army officers, it has equal relevance to other revolutions, such as the popular 1968 French revolt against De Gaulle's regime, and the young Americans' rejection of the Vietnam War. Al-Hakim's uncanny abilities even extend to the foretelling of future youth-driven insurrections, such as the 2011 Revolution against the Mubarak regime, and the June 30, 2013 revolt against the Muslim Brotherhood regime.
In the final chapter, provocatively entitled "The Case of the Twenty-First Century," al-Hakim reflects upon the nature of young people's revolutions, which traditionally begin with the youth's "refusal of guardianship over their new lifestyle." He believes that the young need to shoulder "their huge responsibilities to change the face of the world" and to disfigure the bad and ugly features of it. Although Radwan's translation of "The Revolt of the Young" might look like a resurrection of days gone by, this voice from the past really offers counsel to today's generation living in an age of political and social turmoil.


Description 17 printed below image on lower right side ; Engraving by Carl Mayer based on chalk drawing by August Kloeber ; Half-length, full face, portrait of Beethoven.
Internal Note Laid in mat: 12 x 9 1/2 in.; Available on slide S13.; Digital access sponsored by Louis Vargo (8-2013).
Citation Field Digital Beethoven-Haus HCB BBi 17/34.


The DutchTub team have created a version of their "tea cup" hot tub that is encircled by wood, which might look better for Silver Spray.
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Home » Diversity Matters
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Benchmark's Van Johnson works to dispel myths about clinical trials and vaccines to protect the Black community… read more.
Minorities Advancing Clinical Research Operation or M.A.C.R.O. serves to increase awareness on racial disparities in clinical research and advance the goals of diverse representation of participants in clinical trials. These trials bring people the lifesaving treatments and everyday medicine that is essential to us, it is important that they accurately reflect the entire population. Underrepresented minority groups have historically been denied or given less healthcare, this has led to mistrust and underrepresentation, lack of education in some areas and more. We work to acknowledge this history and understand the concerns of minority populations, educate communities about the important of participation and the safety measures in clinical research, and partner with other organizations to make a greater difference for our participants alongside Doctors and others medical professional, educators, and more. We are hopeful that through our efforts with M.A.C.R.O., we can drive change to provide a safe space for all and ensure there is equal representation in clinical research.
To support these efforts, Benchmark Research is a proud partner of the Healthcare Diversity Council with two members of our leadership team serving as Board of Directors including Benchmark CEO Mark Lacy and CBO Cynthia Dukes, as well as two serving on the local advisory boards in Texas and California. Through this partnership, we work to bring awareness to our cause to other healthcare sectors, patients that would not normally be exposed to this education and connect with fellow advocates. We are continuously working with other organizations to voice our mission.
In addition to our pursuit to increase diversity in clinical trials, we at Benchmark truly reflect our values and efforts for diversity, equity, and inclusion through our employees. We believe our participants should be represented in the team that cares for them.
Contact info: If your organization would like to learn more, please contact VanJohnson@BenchmarkResearch.net or MadelynRascoe@BenchmarkResearch.net.
Benchmark Research has a track record of safety and expertise, having conducted more than 1,000 trials since 1997 at clinics located in California, Louisiana and Texas.
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