You can cut an avocado safely, now learn to help someone with epilepsy | Letters

Last week amateur chefs everywhere were absorbing instructions on how to cut an avocado, after a post-brunch A&E influx of injuries sustained while trying to prepare the fruit (Pass notes No 3,853: Avocado hand, G2, 11 May). Now I hope the nation might broaden their knowledge further by learning how to help someone having an epileptic seizure. It’s National Epilepsy Week, and our new YouGov poll shows that two-thirds of UK adults with no experience of epilepsy would not know how to help. This is worrying when London Ambulance Service alone attends 40 epileptic seizures a day. Taking two minutes to read our seizure first aid steps – www.epilepsysociety.org.uk/10-first-aid-steps-for-convulsive-seizures – could make all the difference in a crisis.
Clare Pelham
Chief executive, Epilepsy Society

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You can cut an avocado safely, now learn to help someone with epilepsy | Letters

I’m childless and lonely. I feel moving would help, but my husband isn’t keen

I’m coming to terms with a life that I wasn’t expecting after 20 years of marriage and am struggling to find a route to a new life. My wish is to live by the coast, about 70 miles from our current home.

My husband and I have come through infertility and eight rounds of IVF without children (adoptions and alternatives have been explored). He is nearly 20 years older than me; I am in my mid-40s, and scared of the menopause robbing me of more of my identity. I don’t necessarily consider myself to be over our loss, but I try to be accepting. Yet it has changed our lives in an unbalanced way. He says that children would have been a bonus, which does relieve the pressure but makes me feel lonely in my recovery. To me, it meant more: the validation of being female, and a space in my heart is missing.

I feel that I’m living a life haunted by what might have been. Our house, bought before we started treatment, has many bedrooms, and my job doesn’t have any career prospects although it is in a field I enjoy. I know that it is time to move on and I could work freelance. My husband thinks that I should stay for the security and the benefits, and his worries are contagious, but I don’t know to whom I would leave my worldly goods if I should die after him.

I yearn for peace and quiet, having also been diagnosed with mild autism. When we go on holiday with our dogs, I find the peaceful places so much better for my state of mind. Walking on beaches is accessible and a rare pleasure for me. I struggle at home in mud and frost.

My husband wishes to stay where we are: he enjoys the city, has friends here and goes to sporting events every weekend. I feel resentful often. While my husband has said he will move, it is said grudgingly. I think life is too short and wish I could make him see that we do have more choices than for me to sit at home on antidepressants.

Yet each time we go away, I ruin the holiday with panic attacks about going home to a life in which I feel lost.

I’m sorry about your failed rounds of IVF: in your longer letter, you called it a trauma but you reduced all of it, pretty much, to a single sentence. Yet its impact, not surprisingly, colours the whole of your letter. The other thing that permeated your letter was identity; you talk of it a few times, once directly. I wonder if you feel that, without the children you planned to have, you don’t know who are.

Barbara Levick, a psychoanalytic psychotherapist (bpc.org.uk), feels that you have had “repeated disappointments” and that “perhaps [not surprisingly], you have real difficulty overcoming the loss. How important is the lack of children to you? It seems a major disappointment, but the catastrophic nature of it is not shared by your husband.”

Or perhaps it is, but there didn’t seem to be a sense of you both having really talked about how you feel. Certainly, I felt you hadn’t told your husband about how you feel. I got the impression of two people, living together in this big house, but locked away in their own worlds.

I kept feeling there were little screams of, “What about me, what about me?” all through your letter. What about you? When do you get to do what you want, say how you really feel? I’m a big fan of good therapy, and I would urge you to hunt some out just for yourself (start with your GP). You need a place where you can talk about how you really feel, and discuss what you really want. “People who are mildly autistic,” says Levick, “can really benefit from some one-to-one work.”

Levick also has the feeling that you have difficulty getting what you want, and wonder why that might be. “I think you need to get yourself doing more of what you like,” she says.

Even without what you have been through, what you want doesn’t seem so very much – a move 70 miles away, to live by the sea, to be able to take good walks. You are not asking for something impossible.

Levick explains that sometimes we don’t do things because guilt or fear hold us back in unconscious ways. I would add that we make excuses for what we can’t do and then we can become so used to those excuses that we start to believe them. Levick feels you are “stuck in concrete”.

I wonder if you could rent a little property by the sea? I wonder how close you could come to making things more into what you need/want? And instead of coming up with reasons why not, think “how could I make this happen?”

Your panic attacks are interesting – talking very generally (and not specifically about you), Levick says that “panic attacks are about [suppressed] aggression. We all have to manage our aggression somehow and it’s a positive thing, it keeps us going. But some children growing up maybe aren’t allowed to express their aggression and then, later, if there are circumstances where the person feels very, very angry that can come out as a panic attack.”

I wonder if any of that resonates with you?

Your problems solved

Contact Annalisa Barbieri, The Guardian, Kings Place, 90 York Way, London N1 9GU, or email annalisa.barbieri@mac.com. Annalisa regrets she cannot enter into personal correspondence.

Follow Annalisa on Twitter @AnnalisaB

I’m childless and lonely. I feel moving would help, but my husband isn’t keen

A supportive, loving community can help heal neglected children | Emma Colyer

Our childhood stays with us throughout our lives. We know this intuitively, from the shiver that can accompany memories of an upsetting event from our early years even into adulthood. But it is also true in a much deeper way.

The Adverse Childhood Experience (Ace) study, carried out in the US in the 1990s, found that children exposed to serious neglect, abuse or household dysfunction were at significantly greater risk of a litany of poor health and social outcomes, ranging from heart disease, liver disease and sexually transmitted diseases to depression, suicide attempts and intimate partner violence. Most starkly, people with a high score on the Ace scale died on average nearly 20 years earlier [pdf] than their counterparts who reported no childhood adversity.

This is not just a case of traumatic events leading to unhealthy behaviours leading to poor health outcomes. There is a growing body of evidence that suggests the impact of toxic stress on the developing brain has the potential to transform the way we view health problems.

Toxic stress is the term used to describe the prolonged physiological arousal that occurs when people find themselves in a threatening situation for an extended period of time. When that threatening situation is an abusive or neglectful home, and when the period of time coincides with a person’s formative years, the effects can change how the body’s organs function and drastically alter the course of a life. It has even been suggested that many poor health and social outcomes in adulthood are really developmental disorders with their roots in childhood, not simply the result of poor health choices in adulthood.

If the right questions are not being asked, we cannot expect to find the right answers

This represents a radical shift in the way we see and treat health and social issues. Our healthcare system tends to treat presenting symptoms rather than root causes. Clinicians tend to ask: what is wrong with this person? Now there is an emerging movement that advocates a “trauma-informed” approach, asking instead: what happened to this person?

Take attention deficit hyperactivity disorder (ADHD). The symptoms of ADHD can bear a remarkable similarity to the effects of childhood trauma, which include hypervigilance and an inability to focus, and could be caused by the heightened physiological arousal associated with toxic stress. Yet there is concerning evidence that children who have experienced trauma are more likely to receive a diagnosis of ADHD than post-traumatic stress disorder. If the right questions are not being asked, we cannot expect to find the right answers.

So what is the solution? Resilience has been shown to mitigate the lifetime impact of childhood adversity, but resilience relies on connection with others – nobody can be resilient without support. Early neglect, abuse and family disruption are about lack of connection, broken connection or loss of connection. At Body & Soul we aim to build the resilience of people of all ages by fostering a restorative, healing connection within a supportive and loving community of members, volunteers, staff and professionals.

Our approach is designed to mirror the holistic care that, in an ideal world, everyone would receive in childhood. When our members come to the centre, we provide them with a nutritious, home-cooked meal, which they share in a warm, social environment. They have access to one-to-one and group psychotherapy. They can book in for massages, shiatsu and reflexology. They can see a casework team if they are having practical difficulties with things like housing or benefits. They are encouraged to attend workshops on the importance of physical health and nutrition, as well as training courses on employability. They are invited to explore their feelings through music, dance and poetry. Nurturing these connections mitigates some of the physical, emotional and psychological effects of a childhood spent in a state of uncertainty, fear and physiological arousal. Over time, our members develop the resilience they need to withstand life’s challenges.

Screening for adverse childhood experiences in primary care is feasible, but ultimately primary care clinicians can only refer patients to services that exist. If money continues to be channelled into the treatment of symptoms at the expense of investigating root causes, people’s lives will continue to be defined by their childhood experiences.

What we need is for funders, both statutory and independent, to see beyond the symptoms, and recognise the healing power of human connection, particularly when that connection was missing in childhood. Failure to do so risks consigning those who have experienced adversity in childhood to a future of psychological hardship, relentless medication and an early death.

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A supportive, loving community can help heal neglected children | Emma Colyer

Study looks at cannabis ingredient"s ability to help children"s tumours

British scientists are investigating whether a compound found in cannabis could be used to shrink brain tumours in children.

The study of the effects of cannabidiol (CBD), the non-psychoactive ingredient in marijuana, was prompted by a growing number of parents giving it to children with a brain tumour after buying it online. The lead researcher, Prof Richard Grundy of Nottingham University’s children’s brain tumour centre, said in the last six months there had been a surge in parents administering it without medical advice in the belief it might help.

While no research has been done into how CBD can help children’s brain tumours, some work has been done looking at how cannabis-based molecules can help adult cancer patients. Products containing cannabidiol can be bought online, although recent changes mean companies now require a licence to sell them.

“New ways to treat childhood brain tumours are urgently needed to extend and improve the quality of life in malignant brain tumour patients, so we are excited at the prospect of testing the effect of cannabidiol on brain tumour cells,” said Grundy.

Brain tumours kill more children in the UK than any other type of cancer. Around 1,750 under-18s each year are diagnosed with cancer, of which about 400 are cancers of the brain and spinal cord.

The study, thought to be the first of its kind in the world, will seek to establish whether CBD reduces tumours. The researchers will grow cells from different brain tumours in lab conditions, some with the addition of cannabidiol molecules and others without. They will then compare how the presence of tumour cells differs in both samples through a technique called cell staining. This will help them see how many of the cells are dividing and whether any are dying.

Grundy said: “We expect the cells – brain tumour and normal brain – grown in our standard conditions to be healthy and actively dividing. We expect that normal brain cells grown in cannabidiol will remain healthy. However, we expect the brain tumour cells grown in cannabidiol to stop growing and die.”

Katie Sheen, of the Astro Brain Tumour Fund, which is co-funding the study, said if it proved to be successful CBD could be a gentler, less toxic way of treating cancer than chemotherapy or radiotherapy.

Dr Wai Liu, a research fellow at St George’s University of London, said: “We have performed experiments using CBD in leukaemia and it can deactivate signalling pathways, making cells more responsive to chemotherapy.”

He said some drug companies combined CBD with psychoactive component tetrahydrocannabinol (THC) with positive responses, especially when combined with chemotherapy.

Liu added: “All cells need to communicate and these communications get jammed up, and CBD tries to correct this by restoring them. This ultimately results in these cells being able to undergo cell death.”

“People think that children’s cells are more flexible so there is a possibility that CBD may have a slightly different effect. We will only be able to understand the precise mechanism and value of this treatment when studies like this are done.”

Among those supporting the project are the parents of William Frost, a four-year-old who was diagnosed with a ependymoma brain tumour in 2014 and is being treated at the Nottingham centre. William’s father, Steve, said: “We were told halfway through 2016 that nothing more could be done for William. We couldn’t bear to accept the news and decided to look into alternative treatments.

“We started William on a low-carbohydrate (ketogenic) diet and cannabidiol. Six months later William’s tumour had shrunk by two-thirds. He is slowly improving and attending school part-time.”

Study looks at cannabis ingredient"s ability to help children"s tumours

Did walking help Theresa May decide on a snap election? | Daniel Glaser

It was during a walking holiday in Snowdonia, says Theresa May, after ‘long and hard’ reflection that she made the decision to call a June election. So much for walking and creative inspiration. But is there a connection between the two?

Neuroscience would say that depends on the difficulty of the task. Using a mathematical example, you can test this out for yourself. When you start with an easy challenge like counting in fives, fast walking isn’t a problem, but try multiplying 37 and 23 and you’ll find your feet slow down no matter how hard you try and keep up the pace.

We only struggle to walk and problem solve when the task is sufficiently difficult (if deciding on an election was a no-brainer for May, it’s unlikely her walking pace suffered). Various theories have been advanced to explain the finding, but really it’s down to attention being a limited resource in the brain. It’s not as good at multitasking as you’d expect. In May’s case, it could even be that the opposite was happening; the effort required to maintain a steady walking pace distracted her from the everyday preoccupations of running the country, enabling her to hatch a fiendish plot to steal a march on the opposition.

Dr Daniel Glaser is director of Science Gallery at King’s College London

Did walking help Theresa May decide on a snap election? | Daniel Glaser

New website offers US women help to perform their own abortions

Fearful that Donald Trump’s presidency poses a once-in-a-generation threat to US reproductive rights, an international advocacy group this week is unveiling what is sure to be a controversial response: a web portal dedicated to helping US women terminate their own pregnancies with abortion-inducing drugs they have obtained outside of a medical setting.

The project, launched by Women Help Women, is a nod to the fact that many US women may already be taking matters into their own hands as abortion options in this country contract.

“Women in the US have been and are using the pills without good guidance,” said Susan Yanow, the US spokeswoman for the group, Women Help Women. “If a woman is anxious and has the pills in her hand, and doesn’t know what to do … we can help her understand what to do. We can help her understand what signs to look for, and what’s going on.”

Research suggests that there is a small but significant number of US women who attempt to induce their own abortions without any medical supervision.

Several studies have shown that many of these women, particularly those living along the US-Mexico border, are using misoprostol, a miscarriage-causing drug that can be legally purchased over the counter in many Central American pharmacies. In the US, it is illegal to administer the drug outside of certain medical clinics.

Rules for taking misoprostol are easy to find online. What Women Help Women has done differently is connect US women with counselors who can provide step-by-step instructions, and answer questions, in real time.

Their counselors are trained by medical professionals to walk women through the process of using misoprostol for a DIY abortion. Counselors will also strive to connect women with abortion funds if payment is the main obstacle for getting an abortion in a clinic.

But the main goal is to support the unknown numbers of women who are performing their abortions themselves.

Part of the inspiration, Yanow said, came from an article the Guardian US published in November. The story followed a young Texas woman who, unable to afford an abortion in the US, traveled to Mexico to purchase an abortion-inducing drug over the counter.

“There’s just so many questions,” the woman told the Guardian. “I would so much rather have a health professional help me in this and kind of guide me through it versus DIY.”

Those words stuck in Yanow’s mind. And as she grappled for a way to respond to November’s election, it occurred to her that Women Help Women could tailor its services to the needs of women in the US.

The project will be titled Self-managed Abortion, Safe and Supported, or SASS, and use the website abortionpillinfo.org.

Women Help Women is already a longstanding provider of abortion pills and instructions in other countries. Every month, its staff members answer 5,000 emails from women around the globe seeking to end their own pregnancies.

The group will not provide abortion-inducing drugs to women in the US. And it has made other changes to its methods because of the United States’ uniquely hostile, anti-abortion atmosphere.

In the US, at least 18 women have been charged with a crime based on allegations that they attempted to induce their own abortion. A handful of states have made it explicitly illegal for anyone but certain medical professionals to administer abortion-inducing drugs.

Enterprising prosecutors have found other, creative ways to levy charges, through the use of laws against child endangerment, practicing medicine without a license, or drug possession.

Women Help Women counselors will inform clients of some of the legal risks that come with self-administering misoprostol, as well as some of the limitations.

But the legal implications of the project are far from certain.

“This area of the law is nothing if not complicated,” said Jill Adams, the chief strategist of the the Self-Induced Abortion Legal Team, a project associated with Berkeley Law. Her group has shared legal information about self-induced abortion with Women Help Women, but stopped short of legally vetting the information that counselors will provide to US women.

In general, the act of looking for or giving out information about self-inducing an abortion is protected by law, Adams said. And she knows of no one who has been prosecuted merely for seeking information.

Still, it could compound the risk of prosecution. Purvi Patel, the first US woman to receive a significant prison sentence for inducing her own abortion, was convicted after prosecutors obtained emails that showed her purchasing an abortion-inducing drug from a Chinese pharmacy.

With those facts in mind, Women Help Women designed its portal to delete conversations between clients and counselors after seven days.Its servers are located abroad – out of easy reach for US prosecutors, the thinking goes – as are all 23 of its counselors.

The legal risks are thought to loom larger than the medical risks.

“In general, I would say there’s kind of a growing recognition that from a safety or a medical perspective, we have few few concerns about” women using abortion drugs on their own, said Daniel Grossman, a clinical professor of obstetrics and gynecology at the University of California–San Francisco who researches self-induced abortion.

“Especially if we’re talking about women using misoprostol on their own. It’s a very safe and effective medication,” he continued. “If women have information about how to use it, then women can safely use it on their own.”

When women go to an abortion clinic, they are typically given two drugs: mifepristone, a drug that blocks hormones necessary to sustain a pregnancy administered in person, and misoprostol, which is taken many hours later and causes the uterus to contract and expel its contents. The Food and Drug administration permits women to leave the clinic and take misoprostol at home.

Researchers believe that women who self-administer abortion drugs are most likely taking misoprostol by itself, because it is easy to obtain from foreign pharmacies. Misoprostol used without mifepristone is less likely to cause an abortion but still has a high success rate.

There are certain medical risks in self-administering an abortion drug without the involvement of medical professionals. An ultrasound is often necessary to confirm a pregnancy and assess how many weeks a woman has been pregnant. Misoprostol is less effective and requires a different drug regimen later in the first trimester.

Medical professionals will also inform women about how to recognize complications, like excessive bleeding, that could occur after they leave the clinic and require medical attention. And using the drug improperly – say, at a high dose in the second trimester – can lead to serious medical complications.

Grossman argued that a project like Women Help Women’s could minimize those risks. “I think that it’s worse to just remain silent while we know women are doing this,” he said.

But abortion rights opponents cite these safety concerns as reasons to oppose any project that makes abortion drugs available outside a clinical setting.

In response to a study, first reported by the Guardian, that tests the efficacy of sending women abortion drugs by mail, a spokeswoman for Americans United for Life said, “We have grave concerns about handing out dangerous, life-ending drugs without medical supervision because women face great risks for chemical abortions.”

Carol Tobias, president of the National Right to Life Committee, asked, “Who are they supposed to call if they have a problem?”

Yanow says that’s exactly the point of Women Help Women’s new portal.

“People are not being advised to use the pills,” she said. “They’re being advised if they’ve already decided to use the pills. What drives this project is the knowledge that women have been managing this on their own.”

New website offers US women help to perform their own abortions

Could shared medical appointments help the NHS and patients?

In medicine, the private one-to-one consultation is sacrosanct.

Yet shared medical appointments have been used successfully for years at the Cleveland Clinic in the US. Patients appreciate them. They compare experiences with other patients, learn from their questions, gain more advice than they might otherwise, and improve their understanding of their symptoms.

For the hospital, the gains are seen in improved outcomes, higher patient satisfaction, dramatically reduced waiting times and lower costs.

Here, then, is an innovation that could help the NHS, caught between rising demand and squeezed budgets, which is leading to longer waiting lists and growing discontent. By sharing appointments, more patients could be treated more quickly, reducing waiting times, saving costs, yet raising standards of care.

They have been tried by GPs in Edinburgh, Sheffield and Newcastle, following the lead of doctors in the US and Australia. As a surgeon, I can see the potential benefits in bringing together patients undergoing the same procedure for pre- and post-surgical care.

Shared appointments are not appropriate for all patients or all conditions. They should always be offered, never imposed, and patients would always retain the option of a one-to-one consultation, if that was what they preferred. There might, however, be trade offs. Patients might be offered a one-to-one consultation in four weeks or a shared appointment in 48 hours.

They can yield real benefits in the routine care of chronic illnesses such as asthma, diabetes and heart disease, where patients can learn from and motivate each other. We already know the secret of Weight Watchers’ success lies in creating peer pressure among group members who compete to see who can shed most pounds. Alcoholics Anonymous similarly allows people to share a problem and begin to tackle it together. There are websites such as PatientsLikeMe which connect people to others with similar conditions.

However, shared medical appointments work differently from self-help groups. Each patient is examined by the doctor, diagnosed and prescribed treatment in exactly the same way as they would be in a one-to-one consultation. The benefit for the patients comes from observing how the other patients are managed, or manage themselves. In one example, a patient with heart disease was persuaded to get on an exercise bike by hearing about a teenager with a heart condition who had a passion for basketball.

The doctors are spared having to repeat the same information a dozen times a day, saving time and costs. Whereas a heart patient might require a half-hour appointment for a routine follow-up visit, with a shared appointment six or seven patients could be seen in 90 minutes.

In certain cases, only part of the appointment might be shared. For example, in a typical shared appointment for female patients at the Cleveland Clinic, the doctor performs breast and pelvic examinations and discusses test results in private, while the remainder of the appointment includes the other patients.

Given these benefits, it is surprising that shared appointments have not been taken up more widely. In an article in the New England Journal of Medicine, Professor Kamalini Ramdas of London Business School and I suggest there are four principal reasons: the lack of rigorous scientific evidence of their value, the absence of easy ways to pilot them, missing incentives and lack of awareness among both patients and clinicians.

There is another reason. Innovations in healthcare typically take 17 years to spread, from proof of principle to widespread uptake. And this is an average – some take decades.

We need smart ideas – and disruptive innovators to implement them – if we are to improve the outlook for patients and for the NHS. Shared appointments is an idea worth pursuing.

Lord Darzi is a surgeon and director of the Institute of Global Health Innovation at Imperial College London. He was a Labour health minister from 2007–09.

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Could shared medical appointments help the NHS and patients?

Pets Help Kids Build Immunity Even Before They’re Born, Study Finds

If you’ve been considering adopting a dog or a cat, this new study might help you make up your mind: According to research published in Microbiome, children born into homes with pets have higher levels of gut microbes that protect against allergies and obesity. Researchers say that indirect exposure to furry friends is especially beneficial to babies in their first three months of life, and even while they’re still in the womb.

This period appears to be a “critical window of time when gut immunity and microbes co-develop,” says lead author Anita Kozyrskyj, PhD, a pediatric epidemiologist at the University of Alberta. Disruptions to this development process—for example, the introduction of foreign bacteria—can change immunity and have implications for long-term health, she adds.

Kozyrskyj’s study compared fecal samples from 746 Canadian infants. Some of the infants were from families with pets (70% of which were dogs), some were from families who had pets during their pregnancy but not once the babies were born, and some had no recent pets.

The researchers found that babies from households with pets had twice the amount of two specific bacteria, Ruminococcus and Oscillospira, that have been linked with reduced risk for childhood allergies (such as dermatitis and asthma) and obesity, respectively.

Even when pets had been given up for adoption before the babies were born, this benefit was still seen. This shows that pet exposure affected the babies’ microbiomes indirectly, with influential bacteria transferring from the animal to the mother to the unborn child.

This bacterial exchange occurred regardless of the type of birth (vaginal versus C-section), regardless of whether the babies were breastfed, and regardless of whether antibiotics were used during birth. This is important, say the authors, as previous research has shown that C-sections, antibiotics, and not breastfeeding can all negatively impact babies’ immunity.

The presence of pets in the house during a woman’s pregnancy was also associated with a reduced likelihood that she would transmit group B strep bacteria—which can colonize in the vagina and cause pneumonia in newborns—to her baby during birth.

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The study builds on decades of research showing that exposure to dirt and bacteria can help children build up immunity, and that kids who grow up with pets have lower rates of asthma and allergies, says Kozyrskyj. (This effect is strongest with dogs but is true with cats, as well.) “Pets have always been our best friends and they appear to be good for our babies too,” she says.

But further studies are needed to provide definitive evidence that a “dog intervention” during pregnancy can actually prevent allergies. “Our next step is to pursue the ‘does it matter’ question, to determine the allergy and obesity outcomes of studied infants at ages 1, 3, and 5,” Kozyrskyj says.

And of course, allergies and obesity aren’t products of the environment alone; genetics also play a role. It also makes sense that kids with pets have natural protection against allergies, since parents with allergies are less likely to have dogs and cats in the first place.

RELATED: 13 Fun Ways to Work Out With Your Dog

But the study’s results were adjusted to account for whether the mothers had asthma or allergies, and still held true. Kozyrskyj says her team’s findings “are independent of these two possible explanations.”

It’s not far-fetched to think that pet exposure during pregnancy could one day be an official recommendation from doctors, Kozyrskyj says. It’s even possible that scientists could develop a “dog in a pill” supplement, she adds, for mothers to take as a preventative measure against allergies and asthma.

More research is needed for these scenarios to actually happen, however. For now, families have have another reason (on top of plenty already!) to snuggle up to their fur babies—and that includes moms-to-be.

Pets Help Kids Build Immunity Even Before They’re Born, Study Finds

My teenage cousin is having a crisis, but her mother won’t get her the help she needs

My cousin is 16, and apparently going through a crisis. She hates college, skips classes and has spoken to my grandmother often of hating her life and not enjoying anything any more. My grandmother is in bits about this and has tried to talk to my cousin’s mother, her daughter, about getting her some help. However, my aunt’s response has been, “She’s not going to turn out mental like the rest of you people.” (Other members of the family, including me and my grandmother, have had mental health problems.)

My cousin enjoys watching videos and playing video games, but her parents have banned them and see them as an example of her laziness. She is not sleeping either, so her constant exhaustion is taken as yet more evidence of laziness.

What terrifies me is that this is what my mother did to me, and I can only see it getting worse. When I began self-harming in my teens, my mum also banned me from my one hobby, screamed at me when I had a panic attack and slapped me when she found out I had self-harmed.

I had problems with substance abuse and dropped out of school. I moved away from home as soon as I could.

I am now in my mid-20s, and not close to anyone in my family apart from my grandmother. I have now moved somewhere else and, although I don’t see my parents, I am in contact with them. I haven’t seen my cousin for a few years and have no contact details for her. Anyway, I am not sure how, “Hi, I know we haven’t spoken in years but you remind me of me” would go down. I am trying to help my grandmother find a way to talk to my aunt in a manner that won’t enrage her, but my grandmother is a very non-confrontational person and, as much as she is trying to help my cousin, having to confront my aunt has only resulted in my grandmother being screamed at and threatened with losing contact with her grandchild.

I don’t know how to help my grandmother or my cousin, but I feel as if I have to do something, or history may repeat itself.

That you have come so far from a very toxic and unsupportive environment is incredible and a real credit to your strength of character.

It is great that you are so caring about your cousin and grandmother, but I think there is a lot of over-identifying going on. Your cousin doesn’t sound as if she is in a great place, but the facts pertaining to her were thin. The rest of your letter was about your experiences within the family and your fears of what might happen. I am not trying to minimise how you feel, or what is happening in the slightest – but the key is to separate the different strands so you can work on the right bits at the right time.

I consulted Stuart Hannah, a child and adolescent psychotherapist (childpsychotherapy.org.uk), who said: “The news about your cousin is filtered through your grandmother, via her daughter [your aunt].”

News filtered through people who have their own agenda or narratives can get distorted and then there is less likelihood of anyone getting the help and support that is right for them.

I disagree that it is not worth contacting your cousin: I think you should get in touch. Sure, if you go in there with “you remind me of me” that may not be conducive to further communication. But if you make a different sort of contact, more of a general “hi”, and see what happens, that may be really helpful to her in time (don’t expect miracles straight away). After all, you are not that much older than her, a mere decade, and you share a grandmother. There should be lots of other things to talk about so she feels she has someone to talk to if she feels like it – so it’s about her agenda, not anyone else’s.

It sounds as if you have a lot of issues you haven’t dealt with yourself and I wonder if you have some support (apart from your grandmother). If you do, you could come at this situation with less of your own baggage and would be better able to support your grandmother.

I don’t know what the conversations with your grandmother are like, but Hannah counsels: “How can you offer [your grandmother] something different? Something that isn’t judgmental or blaming [that she seems to get from her daughter]. You can listen from a neutral place. Don’t go down the slagging-off route [if you do], and suspend judgment of family members. If you can hear your grandmother’s experience, that may in turn help her listen to her daughter.”

Being empathic is great – however, if we over-identify with a situation (and both you and your grandmother might be), then the danger is, when we hear about something similar we can start to overlay our own experiences on to this new situation. This stops us seeing what is really going, and it imbues everything with extra emotion.

I think, given everything you have said, there is an element of trying to save your younger self, and that’s laudable, but there is a limit to how much you can do. You may also find this website helpful:

Youngminds.org.uk

Your problems solved

Contact Annalisa Barbieri, The Guardian, Kings Place, 90 York Way, London N1 9GU, or email annalisa.barbieri@mac.com. Annalisa regrets she cannot enter into personal correspondence.

Follow Annalisa on Twitter @AnnalisaB

My teenage cousin is having a crisis, but her mother won’t get her the help she needs

Anger as tampon tax is used to help fund anti-abortion group

A new row has broken out over the so-called tampon tax after it emerged that a quarter of a million pounds from a controversial levy on women’s sanitary products is to be given to an anti-abortion organisation.

Under pressure from campaigners after failing to honour a pledge to scrap the 5% VAT on sanitary products, former chancellor George Osborne said that more than £10m a year would be redistributed from the tax receipts to women’s charities.

But there was consternation on Saturday night among women’s groups and politicians who had campaigned on the issue after it emerged that £250,000 of that money is going to Life, a charity that campaigns against abortion and has been at the centre of controversy over the information provided by a network of unregulated pregnancy counselling centres.

A spokesperson for the End Violence Against Women Coalition said: “We are surprised to see that Life is the recipient of a very significant tampon tax grant. The government set out clearly that this money would be spent in ways that would address women’s specific needs and inequalities. It is hard to understand how a service offering counselling based on the fundamental premise that abortion is wrong, to vulnerable women, can do that.”

The government announced last Friday that 70 organisations across the country would share £12m from the tampon-tax fund, which it said would improve the lives of disadvantaged women and girls across the country.

Rob Wilson, the minister for civil society, gave details of the funding on a visit to the Suzy Lamplugh Trust, which is to receive £200,000 to help increase its casework support service for women who are being stalked.

Four other charities, ranging from the Women’s Rape and Sexual Abuse Centre Cornwall, which is getting £179,157, to Black Country Women’s Aid (£240,401), were highlighted in a press notice from the Department for Culture, Media & Sport.

No mention was made of Life, but the organisation appears on a separate long list, which says it will receive £250,000 for “housing, practical help, counselling, emotional support and life skills training for young pregnant women who are homeless”. There has been surprise not just at the award, but at its size: it is one of the largest donations on the list.

Life describes itself as unique, combining “pro-life advocacy and education work with nationwide services providing positive alternatives to abortion”. It served notice last year of plans to increase its online presence to compete with established service providers such as Marie Stopes and the British Pregnancy Advisory Service (BPAS).

Among others who criticised the grant was Labour MP Paula Sherriff, whose successful amendment to last year’s budget led to the government pledging to abolish the tax.

“It will seem bitterly ironic to many women if we are taxed for our biology, only for the government to hand over that money to organisations that don’t even believe we should have control over our own bodies, especially when so many are left without basic sanitary protection,” she said.

“Just this Thursday, I led a Commons debate on period poverty and discussed terrible cases like the homeless women who can’t afford tampons and whose health is at risk, the girls in Leeds who play truant during their periods and a charity that provides free sanitary products to Africa now getting requests from schools in Britain because so many female pupils cannot afford them.

“Tackling these issues would surely be a better use of the tampon tax fund. The minister agreed on Thursday to look at funding for sanitary protection in schools and homeless shelters, and I will be asking the government to review their allocation of the tampon tax fund urgently.”

There was also criticism from the Women’s Equality Party. Its leader, Sophie Walker, said: “We consider any restriction on women’s reproductive rights as violence against us and thus it was a shock to learn the government has used the tampon tax fund to support a charity whose mission is anti-choice and aims to ‘make abortion a thing of the past’.

“While we appreciate the work Life does to support homeless pregnant women and care for children with life-limiting or terminal illnesses, we are very disappointed to see the allocation of such significant funds to this one charity while many others struggle, particularly those supporting black and minority ethnic women and disabled women who experience some of the highest rates of violence against them and yet are consistently at the bottom of the list for funding.

The government had originally faced a potential rebellion over the issue, after an amendment tabled by Sherriff won the backing of Eurosceptics keen to assert Britain’s power to set its own tax rates. Osborne had originally pledged to remove the tampon tax in November 2015, but was unable to do so due to regulations applied by the European Commission that prevented member states from doing so.

The government said on Friday that it is committed to continuing the fund until EU rules allow a zero rate of VAT to be applied to women’s sanitary products and that a decision will be made on the future of the Fund once this has been achieved.

Wilson said at the launch of the fund: “From Cornwall to Dundee, the tampon tax fund continues to benefit organisations in every corner of the UK working to improve the lives of disadvantaged women and girls, including those who’ve been affected by violence.

“This fund is helping to improve lives, supporting our ambition to create a fairer, shared society for everyone. I’m glad that so many worthwhile organisations will benefit from this money.”

A spokesperson for Life said: “We believe that our support services for women are not a luxury but are essential for them to have the space to look at options for continuing their pregnancies with support.”

Anger as tampon tax is used to help fund anti-abortion group

Talking about mental illness is no substitute for offering real help | Rachel Kelly

Last week, the Duke and Duchess of Cambridge and Prince Harry joined other notable names, including the rapper Professor Green and the former Labour spin doctor Alastair Campbell, to record short films about modern approaches to mental illness. They all stressed that it was good to talk, or, in the terminology beloved of the mental health world, to “start the conversation”.

I agree – and salute their efforts. Talking and being listened to are therapeutic and are known to be what doctors call a “protective factor” when it comes to good mental health. They make us better able to deal with stress; talking also helps reduce stigma, which otherwise leads to discrimination and social isolation.

I know from first-hand experience the power of stigma. When I had my first major depressive episode nearly 20 years ago, I was a reporter at the Times. I was briefly hospitalised and ill for six months. But when I went back to work, I told no one in the newsroom that I had suffered depression. I didn’t just fear what my colleagues would think – I didn’t want to acknowledge the illness to myself.

Several years later, I suffered a second serious episode. Depression is experienced in different ways, but my illness was born of being an anxious striver who became overwhelmed by the stress of trying to do too much. Chronic insomnia, nausea, a palpitating heart and a terrifying sense that I was falling and had to hold on to something all featured as symptoms. I felt suicidal, not because I didn’t like my life but because of the physical pain of the illness.

It was only after this second episode, which lasted for 18 months or so, that I decided to talk openly about being unwell. I also resolved to discover the evidence-based strategies that would make a third episode less likely.

Fast forward 20 years, and, while we may have “started the conversation”, in many professional worlds stigma is still thriving. In workshops I run – alongside mental health charities – I often start by asking the audience to stand up. Invited to stay standing if they or their family have suffered any kind of mental illness, most stay standing. But when they are invited to stay standing if they’ve been able to talk openly about their experience of mental illness, most sit down.

This is common when I talk to groups at professional service firms: lawyers, accountants and bankers. Despite valiant initiatives such as the City Mental Health Alliance and the Bank of England’s mental health network, many workers feel it may damage their careers to admit mental ill health. They stay stumm, however much royals tell them it’s good to talk.

Part of the reason, I think, is to do with our assumption that a privileged life must entail privileged health. Depression, however, has no respect for background or profession.

For all the great work of celebrities, there’s also a sense in the room that the life of a famous person does not reflect the life of someone working long hours in an office. It’s almost as if the gods of screen or sport are expected to be a bit mentally unstable, given the vicissitudes of their professional life, even if such thinking is misguided. But someone with a steady, well-paid job? Why should they be depressed? Equally, we may think it more likely for those suffering from real social deprivation to experience mental illness. But someone who has his own business? Or a successful doctor or plumber?

So what’s to be done to destigmatise mental health issues?

First, employers need to do more to make it acceptable to be mentally unwell in the workplace. When the royals released the largest ever survey of attitudes towards mental illness last week, just 2% of the 5,000 surveyed said they had spoken to human resources at work. And all this despite almost 12m working days being lost to work-related stress, anxiety and depression in 2015-16.

Probably the most powerful change will be when more senior staff take the initiative and talk about their own struggles. A junior employee is never going to admit to problems if they feel their boss wouldn’t do the same. Meanwhile, employees need safe, non-judgmental platforms to discuss their feelings on a regular basis. Often, people with mental health problems find it harder to stay in work and progress in their career.

Freddie Flintoff (left) and Stephen Manderson (aka Professor Green) are among the stars talking about their mental health battles in the Heads Together films. Photograph: Heads Together/PA

The second key change must be in the NHS. Last Friday, its chief executive, Simon Stevens, said that mental health will now be a priority. Talking therapies for anxiety and depression will be given to 200,000 more patients each year by 2020, and NHS England is committing £1.4bn in funding to expand treatment.

Welcome news, though we’ve heard promising announcements before. But we have decades of neglect and underinvestment to rectify. Last November, an analysis by the King’s Fund thinktank showed that 40% of mental health trusts had a fall in income in 2015-16. This was despite the government’s commitment to parity of esteem for mental health now enshrined in the NHS constitution, and despite assurances from NHS England that almost 90% of plans submitted by clinical commissioning groups last year included mental health funding increases.

I routinely talk to people who have had to wait months for cognitive behavioural therapy, the therapy of choice in the NHS, or an appointment with a psychiatrist. And Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, warned last week that a lack of specialists means that mental health patients are not being treated by people trained to deal with their condition.

Another problem is representation. There are still precious few mental health experts on the boards that run the health service, including the boards of NHS England and Monitor (the health service regulator), or the Wellcome Trust.

I would also love to see the NHS adopt a more holistic approach to good mental health. My own experience is that we all need a toolbox of strategies, nutrition being one of them. Yet NHS doctors have almost no nutritional training.

As the royals said, simple conversations can change the direction of an entire life. But even more important is having access to proper services and getting proper care. And many don’t. So let us see the extent to which words translate into action.

Given the scale of change we need, I worry that too much talk may be seen as an excuse for not enough action. In fact, in a strange way, it will only be when the prime minister and the heir to the throne no longer need to publicise the problem that we will have defeated the stigma.

Rachel Kelly’s books include Black Rainbow, her account of her struggle with clinical depression. She is an ambassador for Sane and Rethink Mental Illness

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Talking about mental illness is no substitute for offering real help | Rachel Kelly

Prescription changes will help the NHS | Letters

The news that the NHS is to remove certain medications from its list of prescribed items (Report, 28 March) may come as a shock to some, but for anyone working in healthcare the step is an obvious one, which may act as a much-needed pressure release valve.

According to government data, each 11.7 minute trip to the GP costs the NHS £45; add to that the cost of prescribing (£3.83 per item) and we are nearing £50. Now compare that with the price of purchasing one of the items listed, directly from a pharmacy, eg Omega 3 capsules (you can get 30 for £6.65). It doesn’t take a genius to see why the NHS is struggling to cope.

The NHS will review 10 items, in the first instance including travel vaccines (these should arguably be self-funded as they fall into the lifestyle category), and erectile dysfunction medication (affordable non-branded options are available from your pharmacy). Access to gluten-free food was once restrictive, but it’s now in all major supermarkets. As a pharmacist, I welcome this move: it saves money, puts the onus back onto the patient to take responsibility for their own health and reiterates that pharmacies should be the first port of call for minor ailments. But we mustn’t forget that, while the price of these items may be affordable for some, for others, paying for their medication is just not an option – one size does not fit all, so exceptions will need to be made.
Stuart Gale
Frosts Pharmacy, Banbury

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Prescription changes will help the NHS | Letters

What are your experiences of getting help for gynaecological problems? | Sarah Marsh

GPs are failing to treat women with common gynecological complaints, according to MPs. A report by the all-party parliamentary group on women’s health (WHAPPG) said female issues are not being treated with dignity or respect. They discovered that many women were left feeling they were “going mad” after being turned away by doctors despite painful symptoms.

A survey of 2,600 women found that 40% of those with endometriosis, when the womb tissue grows outside the uterus, had to visit their GP 10 or more times before getting treatment. This is a condition that affects about 2 million women, with symptoms including stomach aches and painful bleeding.

As a result, women were left doing their own research to understand the illness. The WHAPPG recommended more training for GPs, calling for more information for women in surgeries.

What are your experiences with your GP? Were you turned away or did you get really good care? Did you eventually get the help you need? Share your stories with us in the form below.

What are your experiences of getting help for gynaecological problems? | Sarah Marsh

Stem cells help some men with erectile dysfunction after prostate surgery

Men unable to have an erection after prostate surgery enjoyed normal intercourse thanks to stem cell therapy, scientists are to report on Saturday at a medical conference in London.

In first-phase clinical trials, eight out of 15 continent men suffering from erectile dysfunction had sex six months after the one-time treatment, without recourse to drugs or penile implants.

The positive result showed no signs of flagging during a subsequent year-long monitoring period. “As far as we know, this is the first time that a human study with a 12-month follow up shows that the treatment is lasting and safe,” said Lars Lund, a professor at Odense University hospital in Denmark, who took part in the trials.

“That is much better than taking a pill every time you want to have intercourse,” he said.

The results were promising enough to convince Danish health authorities to authorise so-called phase III “double-blind” randomised trials in which one group of men is given stem cell therapy and another placebos.

Only men recovering from prostate cancer and able to control their bladders will be enrolled in the new experiments, Lund explained.

To perform the procedure, doctors remove fat cells from a patient’s abdomen via liposuction. The cells undergo a brief treatment and emerge as all-purpose stem cells, meaning they can mutate into almost any specialised cell in the body.

“We do not cultivate the cells or change them in any way,” said Lund’s colleague Martha Haahr, head researcher and lead author of a study detailing preliminary results, published last year in EBioMedicine.

The stem cells are then injected with a syringe into the penis, where they spontaneously begin to change in to nerve and muscle cells, as well as the endothelial cells that line blood vessels. Men are under general anaesthesia while all of this happens, and are discharged from hospital the same day.

Prostate surgery is responsible for about 13% of erectile dysfunction cases. Up to 80% of men experience difficulty having sex immediately after an operation, previous research has shown.

Diabetes accounts for 40% of erectile dysfunction cases, and vascular disease another 30%. Men with diabetes would be the next target group for clinical trials, Lund said.

The results reported at the European Association of Urology conference could be an effective “therapeutic option for patients suffering erectile dysfunction from other causes,” Haahr said.

It is estimated that nearly half of men between the ages of 40 and 70 experience erectile dysfunction to some degree.

The global market for drugs treating the disorder is expected to top $ 3.4 billion by 2019.

Failure to perform sexually can also, in some men, result from relationship problems, performance anxiety or repressed homosexuality, Haahr said.

Stem cells help some men with erectile dysfunction after prostate surgery

Drug which cuts "bad" cholesterol can help prevent heart attacks and strokes

A new drug can prevent heart attacks and strokes by cutting bad cholesterol levels, scientists have found.

An international trial of 27,000 patients found that those who took the drug evolocumab saw their bad cholesterol levels fall by around 60% on average.

The patients in the trial were already taking statins, which are used to reduce low-density lipoprotein (LDL) cholesterol. Despite this, the patients who took evolocumab saw their bad cholesterol levels fall even further. They were also less likely to suffer from a heart attack or stroke than those who took the placebo.

The study found that for every 74 people who took the drug for two years, one heart attack or stroke would be prevented.

However, the findings, published in the New England Journal of Medicine, found that the drug had no impact on the rate of cardiovascular mortality.

Prof Peter Sever, from Imperial College London – which led the UK branch of the study, said: “This is one of the most important trials of cholesterol-lowering since the first statin trial, published 20 years ago. Our results suggest this new, extremely potent class of drug can cut cholesterol dramatically, which could provide great benefit for a lot of people at risk of heart disease and stroke.”

There are approximately 2.3 million people living with coronary heart disease in the UK, according to the NHS. It is responsible for more than 73,000 deaths a year in the UK, and occurs when fatty substances build up in the arteries, making it harder for blood to get to the heart.

Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said: “Coronary heart disease is the single biggest killer in the UK and worldwide and ‘bad’ LDL-cholesterol is a major cause.

“While statins have had a significant impact in reducing the risk of heart disease for millions of people, they are not tolerated by everyone and only reduce cholesterol by a certain amount.

“A promising new approach is blocking the action of PCSK9, a molecule which reduces the breakdown of LDL-cholesterol in the liver. Creating new treatments which use this approach could prove life-saving for patients with high cholesterol and those who can’t tolerate statins.”

Drug which cuts "bad" cholesterol can help prevent heart attacks and strokes

Parenthood can help you live longer in older age, research suggests

Parenthood could boost your chances of living longer in your later years, according researchers who believe the effect could be down to children helping with care and support.

While previous research has shown that adults with children live longer than those without, the new study unpicks how the effect plays out in older age.

“We started first at the age of 60 and we looked all the way up to the age of 100,” said Karin Modig, a co-author of the research from Sweden’s Karolinska Institute.

Modig and colleagues used national registry data to follow almost 1.5 million Swedes born between 1911 and 1925 as they aged. The team found that while the risk of death increased with age for all adults, having children was linked to greater longevity. The results are published in the Journal of Epidemiology and Community Health.

At the age of 60, men who had children had almost two years more on their remaining life expectancy than those without, at 20.2 and 18.4 years respectively. A similar trend was seen for women aged 60, with life expectancies of 23.1 years for those without children and 24.6 years for mothers.

By contrast at the age of 80, parents had a life expectancy of 7.7 years for men and 9.5 years for women, compared to 7 years for men without children and 8.9 years for women without children.

The team also looked at the risk of dying within a year for each age, taking into account factors such as education and marital status.

The findings reveal that the benefits of having children became more pronounced with age – an effect that was greater for men than women. Furthermore, the team found that having children had a stronger impact on the longevity of men who were not married than those with a spouse.

The researchers suggest that could be because unmarried men are more dependant on their children for support than men who are married, adding that previous research has suggested that men benefit more from marriage when it comes to survival than women do, possibly explaining why the effect is not seen for women.

Unlike some previous research, the authors found that the sex of the child had no influence on their parent’s longevity – however the finding was based only on families with one child. “Perhaps being the only child is related to a greater responsibility of parents, reducing the difference in the amount of help given by sons and daughters,” they write.

While it is not clear why having children is linked to a longer life, the researchers suggest it might be down to children helping to look after their ageing parents, be it through physical care, emotional support or even arguing for better treatment.

However there are other explanations, including that adults with children might have healthier lifestyles, or that there are other factors that could decrease an individual’s chances of having children and raise their risk of death.

But while having children might boost the years left on your clock, Modig says it is far from the only factor influencing longevity.

“In terms of all other causes that would affect your death risk in these old ages, having a child is not among the greatest ones,” she said. “But it is still a 1.5% difference [for 90-year-old men] which is still substantial.”

Parenthood can help you live longer in older age, research suggests

Smoking numbers hit new low as Britons turn to vaping to help quit cigarettes

The number of smokers in Britain has reached its lowest point since records began in 1974, according to new data, while more than a million people say they are using e-cigarettes to help them quit smoking.

The latest data from the Office for National Statistics shows that 17.2% of adults in the UK smoked in 2015, down from 20.1% in 2010.

Smoking levels are highest in Scotland, at 19.1%, followed by Northern Ireland, where it is 19%, Wales on 18.1% and England on 16.9%. The numbers have been dropping fastest in recent years in Scotland and Wales. Among local authorities, Blackpool is the only one to feature consistently in the 10 heaviest smoking areas between 2012 and 2015. In 2015, 25.3% of adults in Blackpool smoked.

Smoking by country

The data also shows that 2.3 million people were e-cigarette users in England, Scotland and Wales in 2015, about 4% of the population. Their survey also shows that 4 million more people describe themselves as former e-cigarette users. A further 2.6 million say they have tried them but not gone on to use them regularly.

Half of the 2.3 million who were current users of e-cigarettes at the time of the survey said they were doing it to quit smoking. A further 22% said they were vaping because it was less harmful than smoking. Only 10% said they chose to vape because it was cheaper than buying cigarettes. Others – 9% – said they used e-cigarettes mainly because they were permitted indoors.

The figures will bolster the arguments of those who believe e-cigarettes have a major role to play in ending the tobacco epidemic. The issue has been hugely controversial among public health doctors and campaigners, some of whom consider e-cigarettes to be a stalking horse for the tobacco industry which hopes to make smoking acceptable again and has invested in vaping.

e-cigarette users

The World Health Organisation has expressed concern over e-cigarettes, but Public Health England has said vaping may be 95% safer than smoking tobacco.

Half of current smokers say they have tried e-cigarettes, and 14.4% of current smokers also vape.

Some of the statistics suggest that it is often the heavier smokers who turn to e-cigarettes. Those who also vape smoke marginally more cigarettes per day on average than those who do not – 11.8 versus 11.3. Smokers who have given up on e-cigarettes smoke 12.2 per day versus 10.6 among those who have never used an e-cigarette. Smokers who have children at home are also more inclined to use e-cigarettes.

The ONS vaping data is from the opinions and lifestyle survey 2014-15 and relate just to Great Britain. The ONS figures on general smoking trends include northern Ireland.

smoking graphic

Men are more likely to smoke – 19.3% do, compared with 15.3% of women. Smoking is most common in the 25-34 age group, where 23% smoked in 2015. It is least common in the over-65s, among whom 8.8% smoke. But the biggest decline since 2010 has been among the 18-24 year-olds, where it has dropped five percentage points to 20.7% in five years.

Figures for Great Britain also show that smokers have been cutting back on the numbers of cigarettes they consume. Average consumption is down to 11.3 cigarettes per day, the lowest number since 1974.

Deborah Arnott, chief executive of ASH said: “The decline in smoking is very encouraging and shows that strong tobacco control measures are working. However, the government can’t leave it to individual smokers to try to quit on their own. If the downward trend is to continue we urgently need a new tobacco control plan for England, and proper funding for public health and for mass media campaigns. That’s essential if the prime minister is to live up to her promise to tackle health and social inequality.”

Smoking numbers hit new low as Britons turn to vaping to help quit cigarettes

Smokers trying to quit hit by postcode lottery as GPs ration help

Smokers in England wanting to quit face a postcode lottery as cash-strapped councils and GPs restrict access to services that can help them.

The revelation has alarmed health experts and charities who claim that lives are being put at risk as a result of the fragmented provision.

Evidence obtained under the Freedom of Information Act shows that an increasing number of clinical commissioning groups – the 200 or so organisations that deliver NHS services in England – have been instructing GPs to stop providing the services. Many of the groups argue that it is no longer their responsibility.

In 2012, local authorities were made responsible for improving public health and given £2.8bn of ring-fenced grants to pay for it. But, as the grants have been pared back, councils have pulled their funding for stop smoking services.

This has led to a rationing of treatments – such as nicotine replacement therapies, bupropion (brand name Zyban) or varenicline (Champix) – in many areas. When used in conjunction with counselling, studies suggest the chances of a smoker quitting can be substantial.

Almost a quarter of a million people stopped smoking in the 12 months to April 2015 as a result of using the services, a quit rate of 51%. The services are said to have a high success rate in helping smokers in poorer communities stop.

“We are increasingly concerned that cuts in council spending, NHS cost pressures and a lack of joined-up thinking by central government are combining to block progress on cutting smoking, still the No 1 public health challenge facing the country,” said Deborah Arnott, chief executive of Action on Smoking and Health (Ash).

A briefing last year to clinical commissioning groups in Worcestershire said: “Worcestershire county council will only fund a smoking cessation service for pregnant women. The CCGs have considered the implications of this decision and due to the current financial challenges are unable to commit local funding to smoking cessation services or prescribing of products to support stop smoking attempts.

“GPs are therefore advised that no prescriptions for nicotine replacement therapy, bupropion or varenicline should be written for new patients from 1 April 2016.”

It added: “The CCGs appreciate that GPs will be in the difficult position of having to explain to patients that this service is no longer available.”

For every £1 invested in help to quit smoking, £2.37 is saved in treatment and lost productivity. Photograph: Matt Cardy/Getty Images

Restrictions have also been imposed in East Kent, York and Somerset. Windsor, Ascot and Maidenhead CCG told GPs last May: “The royal borough has commissioned a new smoking cessation service. From April 2016 Solutions4Health are commissioned to support only three groups: pregnant smokers, smokers with mental health issues and young people. The bottom line is that GPs are not commissioned to provide smoking cessation services.”

But local authorities are failing to plug the gap created by GPs discontinuing the service. A survey by Ash and Cancer Research UK has found that smoking cessation budgets have been cut in almost three in five authorities. Health organisations claim this is a false economy.

At least £1.4bn a year is spent on social care because of smoking-related illness, Ash says. Access to services for patients needing surgery – known as “Stop before the Op” – is considered particularly important.

Smokers are 38% more likely to die after surgery than non-smokers due to higher risks associated with lung and heart complications; higher risks of post-operative infection; impaired wound healing and the need for longer hospital stays and higher drug doses.

The National Institute for Health and Care Excellence estimates that for every £1 invested in quit smoking services, £2.37 will be saved on treating smoking-related diseases and lost productivity.

But the service is not considered a priority. A report by the British Thoracic Society, published in December, shows that NHS hospitals are falling “woefully short” of national standards when it comes to helping patients quit.

It found that 72% of hospital patients who smoked were not asked if they would like help in stopping.

Since last May, all cigarettes must be sold in plain packs that carry the message “get help to stop smoking at www.nhs.uk/quit”. But the fragmented nature of stop smoking provision means some people are being told to contact services miles out of their local authority area.

For example, the site directs smokers in Worcester to a service in Solihull some 35 miles away – for which they do not qualify.

“It’s alarming that a pre-operative patient advised to stop smoking will only get NHS help if they live in the right place – a postcode lottery that will damage patients’ health and certainly cost the health service money in the long run,” Arnott said.

A Department of Health spokesman said smoking rates in England were the lowest they have ever been as a result of its policies. “The needs of individual communities vary significantly across the country, and local areas are best placed to understand local needs,” the spokesman said.

Smokers trying to quit hit by postcode lottery as GPs ration help

Will Geoengineering be Used to Help Avert an Oroville Dam Disaster?

Oroville Dam in California has a major problem with a possible failure due to an unseasonable amount of rain and damage to it’s emergency spillway. Evacuations have been ordered for effected counties. The potential for major damage and loss of life exists if the area receives more heavy rain. This an emergency that geoengineering can help alleviate in the short term. Pros and cons of this technology set aside to get to the deeper question.

Why isn’t this decades old technology being used to save lives or avert disaster?

The answer may be obvious. This would call public attention to ongoing geoengineering programs by the U.S government. Leading to questions about the nature of the entire drought situation in California as a hole and the real capability and risks of geoengineering.

Geoengineering in it’s many forms has been used for decades by governments and corporations around the world. Pieces of evidence and government documents on weather modification are numerous. Available through private websites and the government itself. Why wouldn’t this technology be used to avert a major disaster? Although it is not fully admitted by the United States. The capability exists to easily help the situation in California if more heavy rain is expected. Other nations openly admit some of their programs and ours.

The Indian government issued a report stating that out of control geoengineering by the U.S. was ruining the planet. According to the India Times.

US DEVELOPED WEAPON SYSTEM MAY CAUSE GLOBAL WARMING: GOVERNMENT

China admittedly has a Weather Modification Office and engineered the weather for the 2008 Olympics games. Firing 1000 rockets with desiccating chemicals to make sure it did not rain for the ceremonies. Easily modifying the weather for national holidays  using only 18 jets and 432 small rockets filled with myriad of different chemicals. Making sure it was a clear blue sky when the natural forecast was for rain.

A Guardian Newspaper environment blogger witnessed this admitted geoengineering first hand in 2009 at the National Day Parade in Beijing. May sound familiar to other people witnessing unadmitted geoengineering. With small fleets of jetliners making passes high in sky releasing miles long plumes of chemicals behind them. Forming or dispersing cloud formations.

But was it? By 5.30am, when I arrived at the media centre for the National Day parade, the skies had cleared sufficiently to be able to see a star. But there were still thick clusters of cloud and some mist. It might rain again, I thought.

We were bussed to the press gallery outside the Forbidden City by about 7.20am. A band of cumulus lingered over the Great Hall of the People. They had darkened when I called a friend an hour later.

Just before I rang off, I described the skies to him. “It might still rain on the parade, but I think the odds are now on their [the organisers’] side,” I said.

Once the march started, I concentrated on that, but I recall being impressed by the unusual vividness of the sky on some of the images on the giant screens.

Other colleagues told me they found it remarkable that the clouds seemed almost to be held back from the square, even though there were still some around the edges.

By the time of the fly-past around 11am, the skies were clear until air force jets left behind lines of coloured smoke-trails. Now, six hours later, Beijing is still enjoying perfect conditions.

What happened? According to Chinese Meterology News, there were four attacks on a bank of clouds that approached Tiananmen from the south-west between 7.30am and 9.05am. In total 432 rockets were fired to achieve the desired result.

Xinhua news agency reports that the authorities also had the capacity to delay rainfall.

“Only a handful countries in the world could organise such large-scale magic-like weather modification,” it quoted Cui Lianqing, a senior air force meteorologist as saying

China could do this with precision back in 2008. Even making it snow in Beijing due to mild drought.

The United States still can’t even muster an effort or even discuss the subject. What is going on?  The public is being lied to at every turn about the current state of technology. Possibly because if the U.S. government admitted it could use geoengineering to help in this situation. Then it may come to the public’s attention that it has been going on for years with all the associated risks.

Sources:

http://economictimes.indiatimes.com/news/defence/us-developed-weapon-system-may-cause-global-warming-government/articleshow/53268090.cms

https://www.theguardian.com/environment/2009/nov/04/controlling-the-weather-china

https://www.theguardian.com/environment/blog/2009/oct/01/china-cloud-seeding-parade

http://news.xinhuanet.com/english/2009-10/01/content_12139802.htm

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5 Surprising Foods That Can Help Diminish Acid Reflux in Children

Acid reflux is an uncomfortable experience a lot of children of all ages frequently struggle with. While it is not a dire or severely distressing health issue at first, it does feel very unpleasant. Also, it can result in further health complications down the road like inflammation of the sinuses and throat pain, especially when ignored. The inflammation and irritation of the esophagus can lead to injury hence the presence of blood in stool.

What a lot of people do not realize is acid reflux can be easily reduced by simply the consumption of certain foods. This would mean that the child does not have to take any special medicine or drug in order to quell symptoms, considering that the intake of chemical medication can sometimes cause damage to internal organs of the child in the long run.

Following some little changes in the child’s diet along with the intake of specific natural food products, acid reflux can become a thing of the past. Listed below are five foods that can help diminish acid reflux in older children.

1. Fennel

Fennel is a great natural combatant against acid reflux. It is an old-age natural remedy Germans swear by when treating acid reflux in children. Fennel has many health benefits, one of which is helping greatly in diminishing both heartburn and acid reflux. Fennel seeds contain in their chemical structure a key component called Anethole, which is capable of suppressing spasm of the stomach and gastrointestinal tract, a culprit for heartburn and acid reflux.

2. Yogurt

Yogurt is a tasty, simple approach to put acid reflux down a notch. Your kid will surely love it. There are a lot of reasons why yogurt is particularly useful in reducing acid reflux. One main reason is being chocked full of probiotics. These are beneficial bacteria that strengthen the digestive tract. The alkalinity level of yogurt also makes it very soothing to the throat. Besides desirable digestive properties, probiotics in yogurt is known to bring many other health benefits.

3. Almond Milk

Almond milk, a healthy substance by itself, is great in reducing the symptoms of acid reflux. Just a glass of almond milk during an episode of heartburn or acid reflux can make all the difference. Almond milk is an alkaline substance rich in vitamins D and E, loaded with much calcium. These components help neutralize stomach acid, soothe the stomach, and reduce heartburn and acid reflux.

4. Ginger Tea

Ginger has always been a well-known natural remedy. To deal with acid reflux, give the child ginger tea for it helps in the absorption of stomach acid which aides in digestion. It also promotes proper regulation in the flow of stomach juices to ensure proper digestion. Ginger is also composed of anti-inflammatory properties beneficial in the reduction of inflammation and irritation.

5. Oatmeal

Oatmeal, a classic example when it comes to healthy, balanced breakfast, but also has benefits in the management of both acid reflux and heartburn. Its key factor in reducing symptoms of acid reflux and heartburn lies in its high fiber content. Fiber helps prevent overeating, which is a common reason for acid reflux episodes in children. Fiber can also reduce the symptoms of acid reflux by helping in absorption and regulation of the stomach’s digestive processes.

Conclusion

Acid reflux and heartburn are both unpleasant and in no way a good experience. Thankfully, its symptoms can be dealt with by simply using natural remedies. The best part about using remedies is the undeniable fact of being affordable, natural, and favorable for the body in many different ways.

5 Surprising Foods That Can Help Diminish Acid Reflux in Children