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Diabetes via Shutterstock

Does 'type 2 diabetes' really exist?

A leading researcher believes that because ‘type 2 diabetes’ has various causes and treatments, the term is misleading.

THE TERM ‘TYPE 2 diabetes’ is leading medical researchers astray, and resulting in suboptimal treatment for patients.

That’s according to Professor Edwin Gale, of Southmead Hospital in the UK, who believes applying the term ‘type 2 diabetes’ to the complex and varied set of symptoms that us associated with the disease is wrong.

In a Viewpoint published in The Lancet, Professor Gale said, “If you give something a name, you imply that this thing actually exists. In practice, when somebody like myself talks about type 2 diabetes, I’m saying ‘a form of diabetes for which I can find no other cause’. In other words, it’s a diagnosis of exclusion…There are various conditions, spectrums, and severities of diseases, all wrapped into this one definition.”

Type 2 diabetes is diagnosed when a patient’s body can no longer produce enough insulin, or when the insulin that is produced does not work properly, which leads to problems maintaining a normal blood glucose level.

According to Diabetes UK, type 2 diabetes is estimated to affect around 2.6 million people in the UK.

However, Professor Gale argues that because the symptoms referred to by the term ‘type 2 diabetes’ have such widely varying causes and treatments, the term is misleading both researchers and patients.

Treating type 2 diabetes as a single disease has wasted the times of young investigators says Professor Gale, by the introduction of one-size-fits-all guidelines for disease management.

Although Professor Gale says an interim solution would be to replace ‘type 2 diabetes’ with the term ‘idiopathic hyperglycaemia’, which would encourage clinicians to stop thinking about the condition as a disease in its own right, but rather as an outcome of many interacting processes.

“When a century of scientific endeavour brings us round to the conclusion that we cannot define what we are talking about, it might be time to consider adjusting our minds. It is widely appreciated that type 2 diabetes is not a uniform disease entity with a definable cause, mechanism, and treatment, so why are these terms always used?” asks Professor Gale.

Read: Could your soft drink habit give you diabetes?>
More: “Promising” stem cell treatment for diabetic wounds>

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25 Comments
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    Mute Keith Fealy
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    May 30th 2013, 8:15 AM

    89.8% is a remarkable figure. I remember doing a study a few years back and we discovered that most charities work at around 60%. We’ve always been a very charitable country and it’s great to see that we still are, even in the “current economic climate”.
    God, I hate them three words.

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    Mute bob®
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    May 30th 2013, 7:33 AM

    Chuggers are fine but when they block your path with big open arms and silly lines….aaaargh!!

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    Mute Lucinda Dalton
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    May 30th 2013, 2:49 PM

    I was giving a tenner a month to concern via standing order for 4 or 5 years. But, I would get annoyed at the sheer amount of junk mail sent to me. I emailed them 5 or 6 times over the course of 2 or 3 years asking them to take me off the mailing list. It didn’t happen so I cancelled the standing order and instead set one up with my local, family run animal shelter.

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    Mute Begrudgy
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    May 30th 2013, 7:49 AM

    The amount of communists and bigots on this site is increasing every week. Is no one in ireland now able to earn more then the average wage without criticism. Everyone should be on the same wage should they???. As for this ‘charity begins at home’ comments. Actually look up what it originally meant before you spout bigotted rubbish.

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    Mute Chris
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    May 30th 2013, 8:13 AM

    It’s mostly ordinary decent people that donate to these charities but do they realize that the CEO maybe taking a huge amount in wages from this charity money that most donors could only dream about

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    Mute Niall Noonan
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    May 30th 2013, 8:13 AM

    Agreed. People seem to have this terror/jealousy of anyone who makes money now. Probably an offshoot of feeling powerless over bank bailouts but the anger people turn on charities on here is reaching ridiculous levels.

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    Mute Denise Friary
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    May 30th 2013, 8:28 AM

    Niall, The truth hurts but its still the truth.

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    Mute Niall Noonan
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    May 30th 2013, 8:34 AM

    What truth?

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    Mute Chris
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    May 30th 2013, 7:32 AM

    How much wages does the new CEO receive

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    Mute Killian Donovan
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    May 30th 2013, 8:12 AM

    Surely someone who makes a living helping people should be as entitled (if not more entitled) to a decent salary as anyone else…

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    Mute Keith Fealy
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    May 30th 2013, 8:25 AM

    Not sure about the new CEO, but in 2011 John O’Shea was paid 98k. Concern employ 3,200 people in 25 countries,so I don’t really think It’s excessive. They have also had a pay freeze in place since 2010.

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    Mute Denise Friary
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    May 30th 2013, 8:33 AM

    John O Shea was paid 230 thou euro plus expences and got a big pay off when he left Goal.

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    Mute The Green Monkey
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    May 30th 2013, 8:34 AM

    I think John O’Shea is with Goal and that the CEO of Concern gets about €130,000 per annum………..

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    Mute Denise Friary
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    May 30th 2013, 8:38 AM

    Think again.

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    Mute Keith Fealy
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    May 30th 2013, 8:43 AM

    My mistake, I meant to say Tom Arnold. Even still your figures about John o Shea are way off. He founded goal as well btw, saved countless lives all over the world and in 2010 was shortlisted in an rte poll to find Ireland’s greatest person. What have you done lately?

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    Mute Paul Wallace
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    May 30th 2013, 8:47 AM

    @chris I think you’ve been PWNED !

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    Mute Denise Friary
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    May 30th 2013, 9:01 AM

    You forgot to mention that he is also a millionaire.

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    Mute gerbreen
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    May 30th 2013, 9:20 AM

    Always work checking out the background of the CEO and the boards. Mr MacSorley has worked with concern for over 30 years. He is running a large organisation. Any charity thought with an ex banker boss I walk away from

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    Mute Chris
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    May 30th 2013, 9:44 AM

    @killian
    At the expense of the people they are helping

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    Mute Killian Donovan
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    May 30th 2013, 1:48 PM

    Not at all. Charity’s need to be run like businesses. Good salaries will attract the brightest, best and most committed to a sector where they’re badly needed.

    Similar situation on the “overheads” issue. I don’t give a toss what percentage of a charity’s income is spent on overheads, because “overheads” (paying fundraisers and admin staff etc) are investments which make more money in the future. We shouldn’t be asking what percentage of their income goes to charity, but rather how much, in absolute terms goes to charity. What does it matter if 99% of your income goes to charity, if you’ve only raised 10 quid; surely it’s better to raise 10 million quid and have 70% going to charity?

    Sure salaries and “overheads” make the fraction of the income going to charity smaller, but they make the income itself bigger.

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    Mute Neil Burke
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    May 30th 2013, 1:52 PM

    Charities expect volunteers to work for free while the CEO and management earn astronomical salaries. I myself lost all faith in Concern years ago when they renovated their HQ on Camden Street with all that marble cladding (you could run a charity out of a few portacabins, and they don’t need to be in such high rent areas). An outward expression internal excesses.

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    Mute Phil Donohue
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    May 30th 2013, 8:20 AM

    Concern’s work on the ground is streets ahead of other charities. The targeted approach means that they can deliver on crucial programmes that help society as a whole.

    They are an amazing group of dedicated people who place themselves in often hostile environments, simply to help those who need help the most.

    Help if you can. Comment if you want. But criticism should be left to those who have gotten off their behinds and actually helped, no matter how that help is delivered.

    That said, the Chuggers around Dawson St. and Nassau St. are starting to reach saturation point!

    49
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    Mute Martin Morad
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    May 30th 2013, 7:25 AM

    Wake up!!!!!’ Charity begins at Home!!!!

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    Mute Tom Newnewman
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    May 30th 2013, 8:06 AM

    There are even charities at home that will pay your NTL. Ireland has 1st world charity issues not comparable with 3rd world.

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    Mute Bridget
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    May 30th 2013, 8:26 AM

    We have been told that Donegal has least disposable income in Ireland but at the weekend the people in 2 days raised Over €100,000, in Relay for Life.

    People are so generous in Ireland.
    Well done everyone involved and everyone who donated.

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    Mute Virtual Architect
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    May 30th 2013, 8:35 AM

    I presume the desired accounts are on the public record? Chuggers are an unfortunate method of revenue collection. I don’t know why anyone tolerates them.

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    Mute Phil Swan
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    May 30th 2013, 9:01 AM

    Guys I work in accounts, trust me the figure of 89% is the best one they could give you which means they defo buffed it out. Look up their full accounts to see the real story. I do not support them because they have become too big and need too much money for staffing, ads, offices and all sorts so a lot of money is dwindled away before your €10 ever sees a 3rd world country.
    That said they do amazing work all around the world with the money they do eventually spend so hats off for that.

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    Mute Theresa Ward
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    May 30th 2013, 10:22 PM

    Like you, I do respect that they do great work, no quibble with that.
    Recently got accosted/ambushed TWICE during my lunch hour by one of the lovely chuggers. Politely declined and was chased down the street with an agressive “What’s your problem with Concern?” to which I answered (honestly) that I don’t give money to charities who spend such a high percentage on advertising/administration. My relentless friend continued to harrass me, insisting he knew better than me, although I had politely reiterated that I do give to charity, just ensure that in doing so, every cent of every euro goes to where it’s needed.
    Clearly, I’m not on Concern’s mailing list and I have learned that the only way to deal with chuggers, however well meaning they are, is to hiss and snarl. They don’t get more subtle social cues. Sad but true :(

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    Mute Denise Friary
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    May 30th 2013, 8:04 AM

    I wonder how much of the money thats collected goes to the needy when the head of the charities get massive wages and expences.

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    Mute Weddingcar Ie Wexford Limo
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    May 30th 2013, 8:12 AM

    Eh 89% id say !!

    96
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    Mute Denise Friary
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    May 30th 2013, 8:21 AM

    Fergus Finlay is paid 119 thousand euro per year plus expences. 89% my hat.

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    Mute Niall Noonan
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    May 30th 2013, 8:31 AM

    So the guy who runs an organisation that helps millions of people every year, probably saves countless lives too, gets paid the same amount in a year as a dentist and approx. half of what Wayne Rooney is paid in a week. And people think he’s getting too much??

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    Mute Denise Friary
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    May 30th 2013, 8:37 AM

    Niall,yes because he is just a spokesman and has 2 other well paid jobs as well.

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    Mute Niall Noonan
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    May 30th 2013, 8:41 AM

    And Wayne Rooney kicks a bag of air around a patch of grass, what’s the point?

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    Mute Keith Fealy
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    May 30th 2013, 8:55 AM

    What’s Fergus Finlay got to do with it?

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    Mute Denise Friary
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    May 30th 2013, 9:05 AM

    Do you not know that our nice Fergus is the spokesman for Barnardos.Wakey Wakey

    15
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    Mute Keith Fealy
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    May 30th 2013, 9:13 AM

    This article is about concern. Wakey wakey !!!

    33
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    Mute Dermot Lane
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    May 30th 2013, 10:19 AM

    Denise are you for real? Could anyone really be as dumb and ill informed as you continually appear to be? Fergus Finlay works for Bernardos. The figures quoted above refer to Concern. Whether you agree with them or not, they have nothing to do with Fergus Finlay, I can’t understand why you would even mention him.

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    Mute Denise Friary
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    May 30th 2013, 10:47 AM

    Fergus Finlay is relevant to this debate because he is head of a charity.

    9
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    Mute Keith Fealy
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    May 30th 2013, 11:37 AM

    He’s the head of a completely different charity, it has no relevance here. The article tells us how much of the money concern receives is spent on charity. How is the salary of an employee of a different charity relevant?

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    Mute Daithi G.
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    May 30th 2013, 8:18 AM

    89.8% of €147m spent on charitable causes, leaves about €15m spent on what? Is that’s how much it costs to run Concern? If so, that’s €1.4m per month!!!

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    Mute Kevin Whyte
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    May 30th 2013, 8:26 AM

    So?

    19
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    Mute Keith Fealy
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    May 30th 2013, 8:28 AM

    They employ 3,200 people.

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    Mute Denise Friary
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    May 30th 2013, 8:40 AM

    So,the man is correct.

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    Mute Chris
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    May 30th 2013, 8:44 AM

    Do the 3,200 people get paid I bet the majority of these people do this work of their own free will and fair dues to them they do wonderful work its not these people that are the problem. It’s the people at the top of the chain who make it a business for themselves. How can anyone justify taking 100,000 plus Euros from a charity when the money being collected is supposed to help the poor of the world do these people have any morals

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    Mute Trevor Nolan
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    May 30th 2013, 9:16 AM

    I assume they do. The 3,200 are employees. If you’re a volunteer you are not an employee. After costs they still provided appx. €132 million for charitable purposes. That’s still a serious amount of wedge!

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    Mute Daithi G.
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    May 30th 2013, 9:34 AM

    My point was the fact that their “employees” are volunteers (or at least that’s what I thought) so I was wondering what kind of expenses could they have that cost them over €1m per month? How much more good could they do with another €15m in the pot?

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    Mute Katie O'Brien
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    May 30th 2013, 12:43 PM

    Chuggers in 2011 got paid over 10 euro an hour…..

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    Mute Ciarán O'Sullivan
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    May 30th 2013, 1:11 PM

    It’s mad that you get a negative score for questioning the questionable slant on the concern advert.

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    Mute Peter Connolly
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    May 30th 2013, 2:13 PM

    3,200 salaries, building rental, building maintenance, electricity bills, various insurances, various travel expenses, advertising, etc, etc… Do I need to go on? For god’s sake 11% on running costs is fantastic, stop looking for excuses to moan.

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    Mute 1 Human Being
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    May 30th 2013, 7:28 AM

    I taught concern was a charity?

    17
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    Mute Leigh Power
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    May 30th 2013, 7:46 AM

    It is, so keeping on teaching that.

    87
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    Mute Andrew Telford
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    May 30th 2013, 8:11 AM

    Sorry but I don’t believe that… I have been told for a fact by several individuals who have worked signing people up for donations that the first year of any subscriptions paid goes to the outsourced sales/collection firm. I also suspect the average life of a donor to be somewhere between 3 and 5 years max.

    I assume you’re quoting that income as net of the collection firm which as they are outsourced can cover their costs themselves before reporting what’s left as net donations to the concern parent company.

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    Mute Kevin Carroll
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    May 30th 2013, 8:53 AM

    Thats true of other charitys bot concern or Amnesty as they are in house and dont work for a private agency

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    Mute Kevin Carroll
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    May 30th 2013, 8:55 AM

    Bot = not. Damn autocorrect switching to Italian!

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    Mute Gearóid Ó Murchadha
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    May 30th 2013, 9:05 AM

    You have been told for a fact? I’ve been told many things “for a fact” but that doesn’t make them true. I’m sorry but hearsay and your suspicions aren’t really much to go on!

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    Mute ieoinu
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    May 30th 2013, 10:27 AM

    All the chuggers have turned me off supporting concern. They seem to be unable to hear the words ‘no thanks’ and plague elderly people who can’t walk away fast enough. I am beginning to put them in the same bracket as those vile ‘pro-lifers’ as another reason to stay away from town.

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    Mute Janet Coyle
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    May 30th 2013, 12:09 PM

    Not sure about the percent there what I would like to know is why they need such a huge office in Camden St ?

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    Mute Lisa O'Reilly
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    May 31st 2013, 5:49 AM

    They are a WORLD WIDE NGO, working in 26 countries including the DRC, Afganistan, Burundi and Haiti which are some of the worst places in Earth for living -and they are there, representing YOU. Here in the US, I work with refugees from Congo, Tanzania, Kenya, Sudan, Guinea and they all say the same: the Irish are the best, most trustworthy, intelligent and caring of all they have met in their struggles as refugees. I am ver proud of that and what our NGOs do on behalf of the Irish people. We are everywhere and it takes a huge skill, time, talent and tact to navigate the cutthroat and ruthless world of non-partisan, diplomatic aid in some of these countries that are being run by thugs and gangs. We’re there cos we are trusted to have no allegiance except to the People in Need. So, in order to maintain that reputation and gave the organization at its best it meeds not only to attract the best, but pay what the reputation of that group has developed. I know it’s hard to understand that when you’ve got something stuck up the proverbial but try!

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    Mute michael kenrick
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    May 30th 2013, 2:01 PM

    So it cost 16 milliion euro to run Concern that year, I asked on of there chuggers in Cork recently and he very reluctantly told me he is paid €13 per hour, In my opinion all charities should be run by volunteers and collections done by volunteers, Concern is a money making machine for those at the top and i will never give to a charity that takes 16 million a year for so caled “Running costs” and constantly bombards us looking for money

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    Mute Keith Fealy
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    May 30th 2013, 4:33 PM

    Will you take a full time volunteer position with them micheal?

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    Mute Ciarán O'Sullivan
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    May 30th 2013, 1:09 PM

    Where did the other €16,000,000 go?

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    Mute michael kenrick
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    May 30th 2013, 2:04 PM

    The heads of charities in this country is a very lucrative earner , Amazingly they are very coy about how much they pay there execs whilest constantly asking for more donations,

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    Mute Jack Bowden
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    May 30th 2013, 7:53 PM

    The more I think about charity the more I think it can do more bad than good sometimes. It distorts the markets, props up failed regimes and puts people in long term poverty traps.
    Fair play for people for giving to charity and for people who work for charities their hearts are on the right place.

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