Electroconvulsive therapy on the rise again in England

The use of electroconvulsive therapy to treat serious mental health problems, a procedure long thought to be in steep decline, is on the rise again in England, a Guardian analysis indicates.

Exclusive data covering four-fifths of NHS mental health trusts in England shows that more than 22,600 individual ECT treatments were carried out in 2015-16, a rise of 11% from four years ago, when about 20,400 were carried out.

The number of patients treated also rose, albeit more modestly, to more than 2,200, suggesting that on average individuals undergo more ECT procedures than before.

The figures, obtained through freedom of information requests, show that despite being a crude, controversial treatment, which fell sharply out of favour around the turn of the millennium, ECT is enjoying a revival.

The procedure involves anaesthetising the patient and passing electricity through the brain to induce seizure. Despite ghoulish depictions in popular culture and a marked lack of science explaining how and why it works, treatments can prove effective. Patient stories range from life-changing benefits to tales of lives being ruined.

The data collected by the Guardian covers 44 NHS trusts that provided comparable data. Figures for private clinics are not included.

After considerable fluctuation over the last four years, a comparison of figures from 2012-13 and 2015-16 reveals an 11% rise when it comes to the number of ECT treatments. Almost two-thirds of NHS trusts reported a rise in the number of ECT treatments carried out over the four-year period. The average number of ECT treatments per patient also rose, from 9.6 in 2012-13 to 10.1 four years later.

The changes in ECT were more striking in some parts of the country than others. While the number of treatments carried out by Mersey Care NHS trust, for example, has remained fairly constant over the last four years, the figures for Lincolnshire Partnership NHS foundation trust show a 75% increase in treatments.

Experts and practitioners say a slew of factors could be responsible for the revival. Some say it is down to improved patient access, lack of credible alternatives for serious cases of mental illness and the fact that in many cases ECT does seem to make a difference.

“I think [ECT] should be on the increase because it has been underused for a number of years,” said Tim Oakley, chair of the ECT Accreditation Service (ECTAS) accreditation committee and a clinical director at the Northumberland, Tyne and Wear NHS foundation trust.

“There are some patients who would respond very well to ECT who perhaps don’t get it as quickly as they should or don’t get it at all for various reasons,” he said. “In terms of getting people better, particularly for depression where everything else fails, it is still the best treatment.”

Others point to the patchwork nature of provision – popular in some parts of the country, not in others – as a sign that it is down to local medical preferences.

“The decision about whether ECT is to be used or not is based on the quirks of the local psychiatrist,” said Richard Bentall, professor of clinical psychology at Liverpool University. “There are some places where psychiatrists think it works, and they just do it lots of times, and there are some places where people think: ‘Bloody hell, I don’t think the evidence for this is very good,’ so will only do it in absolutely desperate circumstances.”

He added: “My view is that ECT is a classic failure of evidence-based medicine. I don’t believe that there are adequate clinical trials of ECT to establish its effectiveness.”

While some, including Oakley, have argued that historical ECT trials do show a benefit from the treatment, Bentall believes their design was not up to scratch, and said the data obtained by the Guardian highlighted the need for large randomised placebo-controlled clinical trials – a proposal some proponents of ECT have argued would be unethical.

But Bentall said: “It is clearly unethical to pass electric shocks across people’s brains unless it is effective [and] helpful to do so and therefore there is an ethical requirement to show that treatment is effective.”

Others have suggested the increase in number of ECT treatments could be down to a change from bilateral to unilateral therapy, where the electrodes are applied to one side of the head, rather than at both temples.

“That has slightly fewer side-effects and is less likely to cause memory impairment,” said Andrew Molodynski, consultant psychiatrist at Oxford Health NHS foundation trust and national mental health lead of the British Medical Association’s consultant committee. “It is also slightly less powerful, so it might be that if more people are having that then they are needing slightly more treatments.”

“It is by far the most powerful treatment for depression,” he added. “As a treatment it is certainly not bad as long as it is done properly and for the right people, which is people with genuinely treatment-resistant depression.” While Molodynski added that he did not believe it would be ethical to carry out new clinical trials of the effectiveness of ECT, he thought studies into outcomes over prolonged periods would be valuable.

But Molodynski pointed out that the Guardian figures suggested either that the procedure was being used more freely, or that more people appeared to be falling into the category of those with treatment-resistant depression.

He said the increase should be viewed negatively if it was a result of people with less severe forms of depression not getting the care they needed. “Equally, if people are resorting to ECT for inpatients more quickly, because it works more quickly than antidepressants, in order to get them out of hospital because of our perpetual bed crisis, that would be a major concern.”

One ECT service manager from a London-based mental health trust, who asked not to be named, said the Guardian findings tallied with his own experience of a recent rise in ECT use, adding that the trend was likely to be linked to changes in practice and better regulations, with people becoming more accepting of the procedure. “Our trust treated more patients last year than they have ever treated before,” he said.

A 2014-15 survey which included clinical outcomes for 2,148 people, published by ECTAS and covering England, Wales, Northern Ireland and the Republic of Ireland, reported that 91.5% of patients had improved after the treatment, compared with 1.7% who had become worse.

The mental health charity Mind, however, warned of side-effects, pointing to a 2003 survey it carried out with patients who had undergone ECT who reported memory loss, difficulty concentrating and dizziness.

While the idea of inducing a seizure for therapeutic reasons was first recorded in 1785, ECT was not developed until the 1930s. It was subsequently introduced to England and was commonly used well into the 1960s and 1970s.

But its use waned towards the end of the 20th century. According to the Royal College of Psychiatrists: “Between 1985 and 2002, its use in England more than halved, possibly because of better psychological and drug treatments for depression.”

Dr Rob Chaplin, from the Royal College of Psychiatrists, said: “Previous data collection has shown a decline in ECT, but this appears to have plateaued, perhaps suggesting a change in attitude towards a therapy that has historically been poorly administered and badly misunderstood.

“Since the launch of our accreditation service for ECT in 2003, safety standards have doubled, making ECT in the UK one of the best in the world.

“There is unmistakable evidence that electroconvulsive therapy is an effective treatment for many depressive illnesses, and can act much faster than drugs.”

At present, the National Institute for Health and Care Excellence (Nice) advises that ECT be used only as a last resort for those with prolonged or severe manic episodes, who are in a catatonic state, or who have severe depression or moderate depression when other treatments have not worked.

The data

There is a dearth of information on how widely ECT is used, so the Guardian requested data from every English NHS mental health trust, as listed by the Care Quality Commission, under the Freedom of Information Act for a 10-year period between 2005-06 and 2015-16.

It quickly became clear that many trusts either did not hold or could not access relevant data for the decade covered by the request.

The vast majority could not provide data for the full 10-year period requested. The data presented here begins in 2012 for that reason: a number of trusts were unable to provide figures prior to that year.

Three trusts refused the request outright, saying the staff time required to comply with the request was too great, while seven trusts could not even provide consistent data from 2012-13 onwards. Some trusts admitted they were missing data over periods of months in certain years.

Two trusts provided data that turned out to be completely incorrect, only providing accurate figures after multiple contacts.

The majority of the trusts provided financial year data. However, in those cases where calendar year data was provided, the data was grouped with the closest financial year.

This project may have revealed an increase in ECT use in England but it has also uncovered a lack of properly collected data relating to the procedure.

Electroconvulsive therapy on the rise again in England

Number of NHS managers still growing as GP posts fall again

The number of NHS managers has grown by almost 18% in the four years since the government introduced a “bureaucracy-busting” shakeup of the health service, according to the latest official data.

The rise of about 4,650 in total management posts since April 2013, when the controversial Health and Social Care Act came into force, contrasts with an alarming fall in the number of GPs over recent months at a time of unprecedented demand for health care. The figures have drawn criticism from the British Medical Association (BMA), who say ministers are failing in their central objective of shifting more resources and manpower from back-office posts to the front line.

NHS Digital figures show management posts have risen from 26,051 in April 2013 – the month when the highly controversial act pioneered by then health secretary Andrew Lansley came into force – to 30,724 at the end of last year, the latest date for which data has been released. This is a serious embarrassment to the government, which insisted when pushing through the legislation in the last parliament – in the teeth of huge opposition from the medical profession – that a key benefit would be a freeing of resources to redirect effort to the front line.

The BMA said that it would be distressing for patients to learn that management posts were rising as GP numbers continued to fall. The latest data shows 92 GP practices closing in 2016 as GP numbers fell by 400 between October and December. Dr Richard Vautrey, deputy chair of the BMA’s GP committee, said: “Patients will be bemused that when their care is being undermined by GP and nurse staff shortages, the number of administrative posts has risen again. With the NHS at breaking point, we need ministers to get their priorities right. They need to follow through on their election pledges and invest in recruiting more GPs so that we can offer enough appointments to the public.”

Under David Cameron’s premiership, the coalition government said its health reforms, which handed control over commissioning services to GPs, would “cut the number of health bodies to help meet the government’s commitment to cut NHS administration costs by a third, including by abolishing primary care trusts and strategic health authorities”.

The process now appears to have gone into reverse. Between 2015 and 2016 the number of managers and senior managers in the NHS in England increased by about 3.5% in hospitals, trusts and clinical commissioning groups.

At the 2010 election the Tories put a promise to cut NHS bureaucracy at the heart of their pitch to voters. Before unveiling the Health and Social Care Act, they began cutting management posts, which were reduced by 12,000 between 2010 and early 2013. But as the requirements of the changes became clear, many who had been handed redundancy payoffs were then hastily re-employed only months later, some on six-figure salaries, to help run the new-look service.

The current health secretary Jeremy Hunt announced plans in 2014 to “train and retain” 5,000 more GPs by 2020, a pledge since watered down to also include doctors in training. According to the latest NHS England figures, however, 92 practices closed in 2016, up 114% on GP surgery closures in 2014. While 34 merged with other practices, the remainder shut completely.

Last week a survey carried out by the University of Exeter found that two out of every five GPs in the south-west of England were planning to leave the profession, with many citing workload and low morale as reasons.

There are also fears that an exodus of doctors and nurses from other EU countries will accelerate as the UK prepares to leave the EU. A total of 2,348 doctors from the 27 other EU states left NHS England between July and September 2016 compared with 1,281 in the same period in 2015 – a rise of 83%.

An NHS England spokesperson said: “The OECD says that on a like-for-like basis we spend only 2p in the pound on NHS administration, compared to 5p in Germany and 6p in France, and we have one of the most efficient health services in the world. But over the next three years we’re going to cut at least another quarter of a billion pounds from administrative costs to reinvest in frontline patient care.”

Number of NHS managers still growing as GP posts fall again

How can I ever work again after the trauma of whistleblowing?

Twice a week we publish problems that will feature in a forthcoming Dear Jeremy advice column in the Saturday Guardian so that readers can offer their own advice and suggestions. We then print the best of your comments alongside Jeremy’s own insights.

Six years ago I was a whistleblower at my workplace. I worked there for three years, but from my first day I noticed daily cover-ups, misuse of position and daily cash fraud.

This was my dream job, at a firm I had looked up to. I was shocked to see what was happening and, for a long time, blamed myself for being too sensitive and thought I was just being paranoid.

At one point the fraud became so serious, and the cover-up so intricate, that I was left with no choice but to report it internally.

I was 100% sure they would find out, correct the situation and give out warnings, and we would move on. But my first report was not taken seriously: they checked out the paperwork I mentioned but overlooked the obvious fraud. They simply dismissed any claims, and the case was closed.

Nothing changed and I decided I would quit as soon as I could. When I made that decision I also decided to become a whistleblower. I thought I had nothing more to lose.

I was very wrong. During the whole whistleblowing experience, I was bullied, snubbed by management as a disgruntled employee and accused of being a “disrespectful colleague”.

I have lost all my hope in humanity. I know it sounds severe, but I really feel this way. I am scared to be employed again, and have been working from home and living off my savings.

How will I ever gain any confidence in the world or in any company? The people I looked up to, those whom I had aspired to be like, have let me down beyond belief. I am a traumatised human who had no other choice but become a whistleblower.

Do you need advice on a work issue? For Jeremy’s and readers’ help, send a brief email to dear.jeremy@theguardian.com. Please note that he is unable to answer questions of a legal nature or to reply personally.

How can I ever work again after the trauma of whistleblowing?

Wild sea swimming in my 60s: "it erases problems, it"s being a child again" – video

A workaholic with grown-up children, Julia found herself lonely and facing retirement without a plan. Living in Italy, she visited England to see her daughter living in Plymouth and decided to stay, but her first winter saw her hibernating from the cold and she put on 20kg. But now the 66 year old says the sea has become a symbol for her re-invigorated life, after she took up daily cold water swimming at Porthcurno beach, near Penzance – ‘it’s freedom, joy, pleasure’

Wild swimming in the UK: 10 top spots

Wild sea swimming in my 60s: "it erases problems, it"s being a child again" – video

I’ll say it again: E-cigarettes are still far safer than smoking

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Despite evidence suggesting e-cigarettes are far less harmful than smoking, more people than ever believe them to be just as harmful. Professor Linda Bauld discusses the evidence

January is a time for New Year’s resolutions and if you’re one of the world’s one billion smokers, your resolution may be to stop smoking. For some people, this year’s quit attempt might involve an electronic cigarette, and a recent study in England, published in the BMJ, suggested that these devices helped at least 18,000 smokers to stop in 2015 who would not otherwise have done so. That’s very good news, but will there be as many quit attempts in 2017 as there have been in the past with e-cigarettes? I’m not so sure.

Since I last wrote about e-cigarettes in this column one year ago, headlines about the dangers of these devices have continued to appear and show no sign of abating. The result is clear. More people believe today, compared with a year ago, that e-cigarettes are as harmful as smoking. In fact these incorrect perceptions have risen year on year, from fewer than one in ten adults in Great Britain in 2013 to one in four this past summer. Surveys of smokers show similar patterns, with an increasing proportion believing that e-cigarettes are more or equally harmful than tobacco.

Related: Why can’t scientists agree on e-cigarettes?

Related: Does a tobacco-free world need to be nicotine free?

Continue reading…

I’ll say it again: E-cigarettes are still far safer than smoking

You Will Never Look at Beets The Same Way Again After Reading This

You Will Never Look at Beets The Same Way Again After Reading This

Child obesity rising again, NHS report reveals

A growing number of children are becoming obese as young as four or five years old, NHS figures have shown, sparking renewed concern about the obesity crisis.

Obesity is rising among children both in their first and last years at primary school, according to the latest annual measurements of child body mass index (BMI) in England.

Overall, 9.3% of four and five-year-olds in primary reception class in England in 2015-16 were classed as obese, up from 9.1% the previous year, according to the national child measurement programme (NCMP).

The number of obese ten and 11-year-olds in their last primary school year also rose from 19.1% to 19.8% last year – nearly one in five.

Richmond upon Thames in south-west London has the fewest fat children in England. In the borough, 11% of year six pupils are classed as obese. In contrast, in the east London borough of Barking and Dagenham 28.5% of children that age were found to be obese.

More boys are dangerously overweight than girls. Among reception pupils, 9.6% of boys were obese compared to 9.1% of girls. Similarly, 21.7% of boys in year six were obese compared to 17.9% of girls, according to the latest NCMP results published by NHS Digital.

The figures reveal that child obesity is rising again after falling slightly in 2014-15.

The statistics also underlined the stark class divide. NHS Digital’s report found thatobesity prevalence for children in reception living in the most deprived areas (12.5%) was more than double that of those living in the least deprived areas (5.5%). In year six, 26% of children living in the most deprived areas were obese compared to 11.7% in the least deprived areas.

Nationally, the number of reception children who are either overweight or obese has also risen, from 21.9% to 22.1%. The same picture emerges with year six pupils, the number of whom found to be overweight or obese rose from 33.2% to 34.2%.

The figures come after Theresa May’s government was criticised for watering down the childhood obesity strategy that her predecessor, David Cameron, intended to publish. Health organisations, charities and campaigners such as Jamie Oliver have accused May of putting the interests of big business above those of public health and letting down children and families by publishing a “weak” action plan in August.

Experts voiced deep unease at the figures and upward trend. “It is deeply worrying that more children are leaving primary school overweight or obese than ever before and levels are increasing”, said Professor Kevin Fenton, the national director for health and wellbeing at Public Health England, which advises the government.

The number of obese ten and 11-year-olds is the highest since children began being routinely weighed and measured in 2006-07. In that year 17.5% Year 6 pupils were found to be in that category. Last year it was 19.8%, even higher than the previous record of 19.2% in 2011-12.

Alison Cox, Cancer Research UK’s director of prevention, said: “Our nation has hit a devastating record high for childhood obesity. The trend over the last decade is showing no signs of slowing down, and this worrying news is something that could have been prevented with more government action.

“But the government still has a chance to save lives. It has already recognised the influence of junk food marketing on children by banning junk food advertising during children’s programmes. It’s time now to stop this influential marketing before 9pm.”

The Obesity Health Alliance, a coalition of health charities and medical organisations, said the figures should act as a wake-up call to ministers. “Year upon year, we are faced with sobering figures that reveal an increasingly worrying trend – the number of obese and overweight children in the UK is not falling and is in fact rising,” a spokesperson said.

“Today’s figures provide yet another wake-up call for all those intent on stemming the obesity epidemic – the alarm bells are ringing and there’s simply no time to hit the snooze button. These poor health outcomes mean we are failing our children, and future generations, if this trend continues”, said an alliance spokesman.”

It wants the government to introduce its levy on highly-sugared soft drinks on time as planned in 2017 and “without dilution”, to restrict the marketing of junk food to children, both online and before the 9pm TV viewing watershed, and to push food manufacturers to introduce “ambitious” targets to reduce the amont of sugar i their products.

Child obesity rising again, NHS report reveals

The fetishisation of work is making us miserable. Let’s learn to live again | Anna Coote

Mounting pressures at work are taking a heavy toll on life at home. Employees say their bosses want them to put job before family, and many are expected to be on call around the clock. More than one in four say they work longer hours than they want to, we learn from the latest YouGov poll.

It’s not a pretty picture: an economy where high levels of stress and anxiety are normal, where people get ill because they’ve lost control of their time, where marriages are damaged and children suffer. And yet, it’s a picture we’re invited to applaud. Our political leaders idolise “strivers” and “hard-working people”, not “chilled-out, caring dads”, for example. The longer and harder we work, the more admirable we are supposed to be.

I am old enough to remember lunchtime. When my workmates and I went out to a nearby eaterie for at least an hour, scoffed a proper meal and probably a glass of wine. These days, like most worker bees, I stay at my desk with my fork and Tupperware pot, nose glued to the screen. And I‘ve become so mesmerised by the modern working culture that I’d be quite shocked to find a colleague dining out at lunchtime. No booze, no siestas, no playtime.

It seems a bit odd when we hear so much about automation and “the end of work”. If the robots are coming, why are we rushed off our feet? In fact, it’s all part of the same picture.

All the main UK political parties insist that the only successful economy is one that grows, preferably faster than other economies. Growth calls for greater productivity: getting more output per unit of input. The system is greedy for more resources, but workers and machines have to do more for less. More efficient processes (including more robots) reduce the amount of human input required. So those who have jobs must work harder – and longer hours – to hang on to what they’ve got and to keep the economy growing.

Meanwhile, since robots can’t do everything yet, there are new flurries of low-end jobs with zero-hours contracts, insulting pay and no security. This class has been called the “precariat” and much of it thrives on the over-busyness of other workers. It ferries people home at night (Uber), delivers fast food (Deliveroo) and fixes things around the house (TaskRabbit). Many precarious workers have to do two or three jobs just to make ends meet. So they are under heavy pressures too, often torn between poverty and an intolerable work-life balance.

What can we do about it? First, take back control of the workplace. This means workers in all settings finding ways to organise and build up bargaining rights. For the casualised precariat, it could mean building new digital platforms to rival the technological giants that have cornered the market so far.

Second, let us never forget that this is a challenge for men as well as women. Much of the stress and unhappiness that women experience at work is because they take on most of the unpaid work at home. Until men really share the housework and childcare, they are unlikely to be powerful advocates for a more humane regime in the workplace.

And third, let’s move to shorter hours of paid work for everyone, not just women. This has long been argued by the New Economics Foundation and there is growing evidence of its many benefits. Nobody should have to work more than four days or 30 hours a week, even in today’s 24-7 economy. As some jobs are automated out of existence, others could be created to cover the hours left unworked by the newly unstressed.

It should be a gradual shift, with minimal impact on pay. For example, suppose all workers over 50 take a one-hour cut in their working week each year. If they start with a 40-hour week, they can be doing 30 hours at 60 and 20 hours at 70. And suppose all young people entering the labour market for the first time start on a 30-hour week – and stay that way, with each new cohort adding to the numbers, until it becomes the new “normal”. What if all workers in organisations where there is an annual round of pay negotiations were to trade a bit more time each year for a smaller pay rise?

All this should go hand in hand with a higher minimum wage, more generous child benefit and a more secure “social income” in terms of high-quality services that are collectively funded and provided (education, health and social care, childcare, housing and so forth). If lousy wages force people to work around the clock, the problem is pay: it’s not a sensible argument against shorter hours.

If 30 hours became the new standard working week, for women and for men, across all kinds of jobs, from doctors to delivery drivers, from teachers to task-rabbits, there would be a lot less stress and anxiety at work and at home. We’d have more control over our lives, more time to look after one another. We could slow down and relax more – and rely less on carbon-intensive fast food and travel. We’d have more time to be active in our communities and in politics. We’d have more time to campaign for a new working culture that respects love, family and friendship instead of fetishising “hard work”. And most importantly of all we could build an economy that enables people to flourish, instead of one that is entirely fixated on growth.

The fetishisation of work is making us miserable. Let’s learn to live again | Anna Coote

Proportion of under-twos receiving first MMR jab falls again

The proportion of children given the measles, mumps and rubella (MMR) jab by their second birthday has fallen for the third consecutive year, figures show.

Last year 91.9% of children received their first dose of the vaccine by age two, down on the 92.3% in 2014-15 and 92.7% the year before.

However, by the age of five, 94.8% of children had had their first dose – a record high. GPs invite children for the first dose of the jab when they are 12-13 months.

The data, from NHS Digital, also shows that 93.6% of children reaching their first birthday had their first dose of the combined jab that protects against diphtheria, tetanus and polio (DTaP/IPV/Hib). This is down slightly on the 94.2% in 2014-15 and 94.3% in 2013/14.

Overall, coverage for most routine childhood vaccinations at one and two years of age fell in 2015-16 for the third consecutive year. Only about one in three children aged two to four were also vaccinated against seasonal flu, despite a huge push for them to receive the immunisation.

Just 30% of four-year-olds were vaccinated in 2015-16, while the proportion was 35.4% for two-year-olds and 37.7% for three-year-olds.

Measles is a highly infectious viral illness. Anyone can contract the disease if they have not been vaccinated or had it before, although it is most common in children between one and four. Initial symptoms include fever, red eyes and sensitivity to light, greyish white spots in the mouth and throat and cold-like symptoms. The measles rash typically appears after two to four days.

Vaccination levels for measles need to be at about 95% to achieve “herd immunity” to prevent outbreaks of the disease. Wherever vaccination rates are lower an outbreak is possible.

After doubts over the safety of the MMR vaccine in a now-discredited scientific paper in 1998, vaccination rates fell as some parents lost confidence in the vaccine.

Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said: “While routine childhood vaccination coverage at one and two years remains high, it is a concern that the rate has fallen slightly for a third consecutive year.

“These figures are a reminder of how important it is for parents to ensure their child is up to date with their vaccinations, including the MMR vaccine, which has also seen a drop in uptake.

“Measles may not be hitting the headlines every day, but councils, which have responsibility for public health, would encourage people to contact their GP to check their family’s medical records and make sure they and their loved ones are protected. It is important they don’t miss out.”

Proportion of under-twos receiving first MMR jab falls again

Think loneliness is about single people looking for love? Think again | Gaby Hinsliff

It’s hard to feel alone inside a long and happy marriage. But it’s easier than it looks, perhaps, to feel lonely. Last week, Italian police officers responding to reports of screaming and crying inside an apartment in Rome found something unexpected behind the door. Jole and Michele were a devoted elderly couple who had ostensibly got themselves worked up over a sad story on the TV news, but some gentle questioning elicited the fact that both were struggling with terrible loneliness. After 70 years of apparently loving marriage they still had each other, and yet that clearly was not enough.

Related: 10 reasons people are lonely? It’s more complicated than that | Sue Bourne

This being Italy, the officers rather charmingly cooked them a meal of spaghetti with butter and parmesan and stayed to chat, before doing the washing up and posting a flowery account on Facebook of how loneliness can suddenly sweep over you “like a summer storm”. The story went viral because it’s so heartwarming, and yet on second reading it’s also rather unsettling. The lonely are not quite the people we think they are.

It will be 20 years ago this summer that the first Bridget Jones novel was published, a timely reminder to ignore the spectacularly awful sequels and remember just how neatly the original skewered some of the myths about lonely singleton life.

Bridget was famously terrified of dying alone and forgotten, but ironically the one thing she wasn’t was lonely: she was riotously surrounded by friends and family, even if they did all keep harping on about her getting a proper boyfriend. It’s smug marrieds who can all too easily collapse in on themselves, severing old friendships they will come to regret in the process. (Anyone who thinks that having a baby means you’ll never feel alone again, meanwhile, has yet to find out how it feels to be home with a howling infant, desperately trying to engage the postman in conversation because he’s the only sentient adult you’ll see for hours.)

It’s all too easy to become consumed by family life and then wake up in middle age, ostensibly at the centre of a rich and busy life, struggling to remember your last meaningful conversation. That feeling may not be loneliness yet, but it’s a first step on the road.

The blunt truth is that not all lonely people are lovable old grannies who tug at your heartstrings

For while the cavernously empty feeling endured by the bereaved or unwillingly single can indeed be a terrible thing, and life-shortening to boot, it’s not the only kind of loneliness. A recent University of California study found that while almost half of its elderly subjects confessed to feeling lonely at times, only 18% of them actually lived alone.

Unhappy marriages, atrophying into long silences and separate lives, might have something to do with that, but the story of Jole and Michele suggests something else: a distinct kind of loneliness stemming not from the absence of significant others but from a feeling of disconnection with the wider world, a sense that you’re no longer part of something shared and human. Is it just a coincidence that the Italian couple’s crisis seems to have been provoked by a run of news stories – violent attacks, abuse at a kindergarten – revealing human nature at its coldest?

Fleeting loneliness comes to all of us occasionally, but it solidifies into something deeper and darker for those who start to perceive the world as a harsh and hostile place, one that wouldn’t welcome efforts to connect even if you try. It’s that nagging feeling of rejection, of not belonging or standing somehow apart from others, that is the true hallmark of feeling lonely in a crowd, and it’s by no means the preserve of the old.

Interestingly, a recent Brunel University study of over-50s found more than half of those identifying themselves as lonely had been that way for over 10 years, suggesting the feeling had become part of the fabric of their lives. (The same study, by the way, found levels of loneliness had barely changed since the second world war; so much for the idea of a modern epidemic, caused by fragmenting and hectic modern family lives.)

Related: The future of loneliness | Olivia Laing

So perhaps it’s not so surprising that this week’s obituaries of the fabulously wealthy Duke of Westminster, a father of four, should describe him as “lonely”. Immense wealth can of course be isolating – although the money clearly didn’t make the duke unhappy enough to get rid of it, or indeed to eschew the family tradition of minimising inheritance tax liabilities – but in Gerald Grosvenor’s case something else seems to be going on. What emerges is a picture of a man struggling all his life with feelings of inadequacy and anxiety, worried that he had done nothing to live up to the reputation of those ancestors who built his unearned fortune. Bullied at school, he reportedly left Harrow without one proper friend.

And if you can’t bring yourself to feel sorry for a billionaire, the blunt truth is that not all lonely people are lovable old grannies who tug at your heartstrings. An unhappy few have pushed others away with their self-destructive behaviour and are now paying a high price for it; some have struggled bitterly all their lives with the art of making friends, never quite mastering social norms. How much of the late-night bile spewed on social media simply reflects the envy and frustration of those who see other people happily connecting all around them and just don’t quite know how to join in? Loneliness has its dark side, one not so easily solved by more visits from the grandchildren or well-meaning volunteer “befrienders” popping in for chats over coffee.

For Jole and Michele, at least, perhaps there will be a happy ending. Now their story has been made public, perhaps surviving relatives or old friends will rally round, and if nothing else the knowledge that strangers worldwide are now asking how they can send letters or visit must do something to restore their faith in human nature.

Yet while a little kindness goes a very long way, it’s too easy to pretend loneliness can all be solved by a few more companionable plates of spaghetti. It makes for a less heartwarming story but the truth is that, like the poor, the lonely may to some degree always be with us – even, perhaps, when they’re ostensibly with someone else.

Police officers serve pasta to Jole and Michele, a lonely older couple, in Rome, August 2016. Photograph: Italian police photo/AP

Think loneliness is about single people looking for love? Think again | Gaby Hinsliff

Cleveland Clinic Once Yet again Tops Heart Hospital Rankings

For the twentieth yr in a row the Cleveland Clinic manufactured the #one spot on the US Information &amp Planet Report‘s yearly ranking of heart hospitals. The Cleveland Clinic was 4th in the total class. For the initial time the Mayo Clinic was the top hospital total, beating long-time rivals Massachusetts Standard and Johns Hopkins.

As I’ve stated prior to, I am not a huge fan of these type of ratings. But irrational as they could be they often have enormous sensible significance.

Here’s the prime twenty:

1. Cleveland Clinic


2. Mayo Clinic


3. New York-Presbyterian University Hospital of Columbia and Cornell


4. Duke University Hospital


5. Brigham and Women’s Hospital


6. Massachusetts Standard Hospital


7. Hospitals of the University of Pennsylvania-Penn Presbyterian


8. Cedars-Sinai Health care Center


9. St. Francis Hospital


10. Mount Sinai Hospital


11. NYU Langone Medical Center


12. UCLA Healthcare Center


13. Northwestern Memorial Hospital


14. Texas Heart Institute at St. Luke’s Episcopal Hospital


15. Barnes-Jewish Hospital/Washington University

Rounding out the top twenty, Emory University Hospital and Johns Hopkins Hospital tied for 16th location. They were followed in 18th spot by a 3-way tie between Houston Methodist Hospital, Scripps La Jolla Hospitals and Clinics, and Stanford Hospital and Clinics.

Cleveland Clinic Once Yet again Tops Heart Hospital Rankings

FDA Once Again Reaches Conclusions At Odds With Its Personal Staff

As soon as again the FDA has reached a conclusion that is straight opposed by some of its very own scientists.  Last month the FDA affirmed the security of olmesartan, a well-liked blood pressure decreasing drug (sold as Benicar and other names). But that reassuring see is not shared by the  FDA scientists who performed the examine that provided the basis for the evaluation. And now outside authorities are also raising concerns about the drug.

Back in 2010 the FDA explained that it was initiating a security review of olmesartan due to troubling findings from 2 clinical trials that raised the chance that patients with kind 2 diabetes taking olmesartan might have an improved danger of cardiovascular death. Four many years later the FDA announced  that it had completed that review. The FDA said that it had “found no clear evidence of increased cardiovascular hazards associated” with olmesartan in diabetic sufferers. The FDA stated that it would not adjust the suggestions for the use of olmesartan but it would consist of new information about the drug in the drug’s label.

The FDA announcement was somewhat perplexing, nevertheless, as I reported last month. The FDA said that despite the fact that it did not locate clear proof of enhanced cardiovascular danger it also did not locate clear proof of security. There was only one research examined by the FDA that  focused on the “subgroup of interest, i.e., diabetic individuals taking high-dose olmesartan,” and it did not supply any reassurance.

Here is the FDA’s description of the review:

A massive (a lot more than 300,000 patient-many years) observational research of Medicare individuals 65 years and older examined the rate of death in patients taking olmesartan in contrast to other ARBs. In a picked group of diabetic patients―patients who obtained only the highest dose of olmesartan (forty mg day-to-day) for longer than 6 months―olmesartan was linked with an enhanced chance of death (HR two., 95% confidence interval: one.one to 3.8) compared to related patients taking other angiotensin receptor blockers. In contrast, the identical examination in non-diabetic patients located that higher-dose olmesartan was associated with a decreased threat of death (HR .46, 95% self-assurance interval: .24 to .86) compared to equivalent sufferers taking other ARBs. The conflicting benefits in diabetics and non-diabetics are tough to reconcile and increase uncertainty about the credibility of the findings in both group. Furthermore, no variations have been identified between the groups getting lower doses of olmesartan and groups acquiring other angiotensin blockers or in those acquiring treatment for less than 6 months.

And right here is the FDA’s conclusion about the examine:

The final results appear to support the finding in ROADMAP however, there are worries regarding the credibility of the outcomes of the Medicare review simply because of the discrepant findings in diabetics and non-diabetics. The observation of a large decrease in survival in individuals with diabetes taking high doses of olmesartan, coupled with a large boost in survival in non-diabetic individuals taking olmesartan—all relative to other drugs of the exact same class—is not a plausible finding.

In my authentic story I offered the following comment:

This FDA communication is very odd, in my view. It does not sound like there is significantly strong evidence either way in this situation. But it looks to me that if the FDA will take 4 years to conduct a security evaluation, and if the only relevant evidence it analyzes appears to assistance the earlier worries, then it shouldn’t just conclude the safety review. If something the safety concern has enhanced, not decreased.

Then last week I obtained a message from a leading hypertension skilled about the published paper of the Medicare review cited by the FDA. He wrote: “The curious factor is that five of the review authors  are personnel of the FDA however the FDA did not accept the conclusion of the study authors suggesting that olmesartan, specifically at substantial doses, need to not be utilised in diabetics.”

Certainly, the conclusion of the paper is strikingly diverse from the FDA communication. At the end of their paper the authors compose:

In conclusion, use of high-dose olmesartan for six months or longer in patients with diabetes was connected with a twofold boost in mortality risk. This supports the mortality discovering from the ROADMAP trial and suggests that olmesartan, specially at higher doses, need to not be utilised in patients with diabetes.

It must be mentioned that this is not the very first time the 1st writer of the paper, David Graham, has publicly opposed FDA positions. He played a prominent position in the Vioxx and Avandia affairs in the previous. Despite the fact that he is occasionally imagined to be a bit of a maverick, in this situation Graham’s position appears to be strengthened by the presence of four co-authors who are FDA scientists.

I asked Sanjay Kaul, a cardiologist and regular FDA advisor, for his point of view. Though he does not dispute the FDA’s decision, his place can not be regarded as an endorsement of olmesartan:

I agree with the FDA’s position that the evidence of harm, while suggestive, is not conclusive adequate to be ‘actionable’. In this kind of conditions, the FDA generally informs the public about the findings. Nevertheless, the FDA’s tone could be interpreted to come across as somewhat reassuring which is not justified by the published report. Offered the uncertainty in proof and other treatment alternatives obtainable, a prudent program of action, in my viewpoint, is being quite selective in prescribing this drug.

Hypertension experts Franz Messerli and Sripal Bangalore also have been reluctant to endorse olmesartan:

The Medicare data does not deliver any clarity about the situation. In fact, figure 2 of the Medicare information would also propose that irbesartan and losartan in individuals without diabetes are killing men and women when compared with olmesartan. The FDA states that this safety review supposedly was prompted by the benefits of the ROADMAP trial. Nonetheless, none of these analyses addresses the query regardless of whether the increased mortality in ROADMAP was possibly a reflection of the J-curve romantic relationship with BP BP. Provided that no pathophysiologic explanation of these findings has been put forward, the FDA obviously decided in dubio pro reo [when in doubt, for the accused], i.e. olmesartan stays protected. This seems surprising because normally the company reacts promptly every time there is even a remote question of harm. In view of the Medicare information the FDA’s verdict might turn out to be wishful thinking far more than anything.

FDA Once Again Reaches Conclusions At Odds With Its Personal Staff

Retina grown from stem cells could permit blind to see once again

The retina is the layer of photo-sensitive cells and neurons at the back of the eye that converts light signals into nerve messages transmitted to the brain.

In the course of the experiment, Dr Canto-Soler’s crew had been capable to motivate initial growth of the retina, which then continued building on its own.

“When we started this work, we didn’t think stem cells would be ready to create up a retina virtually on their own,” Dr Canto-Soler said. “In our technique, somehow the cells knew what to do.”

At a stage equivalent to 28 weeks of foetal growth, the scientists tested the mini-retina by exposing it to pulses of light. They found that the lab-grown photoreceptors responded to light the same way as they do in the human eye.

Dr Canto-Soler, whose analysis is published in Nature Communications, said the method opened up the likelihood of generating hundreds of mini-retinas at a time from a man or woman impacted by blinding diseases.

These could be utilised to examine the triggers of retinal ailments in human tissue, rather than relying on animal versions.

Medicines tailored to personal patients could also be examined on the structures. In the prolonged term, diseased or dead retinal tissue could be replaced by laboratory-grown cells to restore vision, Dr Canto-Soler extra.

Age-relevant macular degeneration, which is induced by a dilemma with the retina, is the major cause of visual impairment in the United kingdom, affecting up to 500,000 men and women, according to NHS figures.

It is most frequent in folks more than 50, with one in ten people in excess of the age of 65 thought to be struggling from the issue to some extent.

Retina grown from stem cells could permit blind to see once again

Jeffrey Archer: "You turn out to be a infant again" following battling cancer

Mr Archer, a former deputy chairman of the Conservative party, extra for a week soon after the operation, which was completed last year, he “became a baby again”.

Explaining in detail the “extremely painful” actuality of residing with a catheter, he said: “The subsequent seven days were the worst.

“This is the period when the tube [which is inserted into a patient’s penis] and bag remain in spot, and have to be drained each and every two to 3 hours.

“During the week, you really don’t really feel like consuming but you have to drink tons of water, which only helps to fill up the bag and adds to your discomfort.”

He continued: “You turn out to be a baby again and [later] require to wear a large nappy to make positive that if you cannot get to the loo in time you will not water the carpet and almost everything else on the way.

“And just like a youngster, you have to understand to management by yourself.”

The graphic account comes almost three years soon after his wife, Mary, provided a similarly total account of her battle with bladder cancer.

Speaking about her very own surgical procedure then, the 69-12 months-old explained: “It is a highly sophisticated plumbing job. I had to wait for the joins to heal and they then examined it for leaks.

“It is a formidable operation for the surgeon, allow alone the patient.”

Her husband concluded his account of his 6 week recovery from the operation by advising any man more than the age of 50 to undergo a prostate examination.

He extra: “I have joined Men United and am proud to support Prostate Cancer United kingdom, because if I die ahead of the age of 88, the diagnosis won’t be prostate cancer.”

Jeffrey Archer: "You turn out to be a infant again" following battling cancer

Jeffrey Archer: "You grow to be a little one again" following cancer battle

Mr Archer, a former deputy chairman of the Conservative get together, extra for a week following the operation, which was finished final 12 months, he “became a child again”.

Explaining in detail the “extremely painful” reality of living with a catheter, he mentioned: “The subsequent 7 days had been the worst.

“This is the period when the tube [which is inserted into a patient’s penis] and bag continue to be in location, and have to be drained every two to 3 hrs.

“During the week, you do not come to feel like consuming but you have to drink lots of water, which only aids to fill up the bag and adds to your discomfort.”

He continued: “You turn out to be a child once again and [later] require to put on a big nappy to make certain that if you cannot get to the loo in time you will not water the carpet and every little thing else on the way.

“And just like a youngster, you have to learn to handle by yourself.”

The graphic account comes almost three years following his wife, Mary, offered a similarly full account of her battle with bladder cancer.

Speaking about her personal surgical treatment then, the 69-12 months-outdated stated: “It is a very sophisticated plumbing occupation. I had to wait for the joins to heal and they then tested it for leaks.

“It is a formidable operation for the surgeon, let alone the patient.”

Her husband concluded his account of his 6 week recovery from the operation by advising any man over the age of 50 to undergo a prostate examination.

He extra: “I have joined Men United and am proud to help Prostate Cancer United kingdom, due to the fact if I die just before the age of 88, the diagnosis will not be prostate cancer.”

Jeffrey Archer: "You grow to be a little one again" following cancer battle

Robot skeleton helps wheelchair-end users walk again

Sophie Morgan was 18 when she broke her back in a automobile crash. The accident left her confined to a wheelchair, unable to move or feel from her breastbone to her feet.

Now, with the assist of Rex Individual, a robotic exoskeleton, Sophie is ready to stand and stroll yet again.

Rex is built to help the body in an upright position and can stroll and climb stairs safely without having the help of crutches.

Miss Morgan stated: “I haven’t stood in 10 years. Now that the exoskeleton is right here, I’m possessing to reimagine myself and my daily life in a standing place.”

Among the advantages, Miss Morgan lists being capable to attain items on higher shelves, sleeping better and getting ready to hug folks even though standing near them.

The Rex Individual exoskeleton is offered for £89,073 topic to a healthcare check.

Robot skeleton helps wheelchair-end users walk again

How can Britain deport a child at danger of FGM? Theresa Could must feel once again | Hilary Burrage

Link to video: FGM: Nigerian mother’s fears for two daughters if deportation goes ahead

How considerably can we risk the safety of a modest little one? What if that chance was of female genital mutilation? And what if the little one was born in Britain but is being sent to a country the place FGM is prevalent?

Absolutely the government ought to be concerned. Just weeks ago education secretary Michael Gove, urged on by the Guardian’s anti-FGM campaign, agreed to compose to headteachers reminding them of their duty to protect schoolchildren from cutting. And in February it was unveiled that parents suspected of taking their daughters to Africa for FGM are to be stopped by police at airports.

But instead of concern, the government is really forcing this youngster, against the wishes of her mom, to depart Britain and be sent to Nigeria. The youngster in question is Rashidat, now two, who was born in the Uk after her heavily pregnant mom, Afusat Saliu, fled Nigeria to escape a forced marriage to a considerably older guy – and to evade the imminent threat of FGM on her other daughter, Bassy, now 4.

Afusat’s dread that her daughters will be pinned down and mutilated if they return to her village is genuine. That is what occurred to Afusat herself as a youngster.

I have met Afusat and her pretty daughters. I have assisted support their pleas to stay risk-free in Leeds, the place they came to reside. Her good friend Anj Handa has led a final-ditch e-petition to residence secretary Theresa May towards Afusat’s deportation, now signed by 100,000 men and women. “Her youngsters are at large risk of FGM,” says Handa. “She has no support in Nigeria, no loved ones guarding her from FGM that she can flip to she’s terrified of going back.” Handa says Afusat has constantly complied with immigration rules – and will continue to engage with the immigration services. Her desperate hope is that George Mudie, Afusat’s MP in Leeds East, will be capable to safe a final-minute evaluation.

Mudie is urging House Office minister James Brokenshire to delay the deportation, but supporters cannot verify no matter whether or not she will fly right now. Nigeria has the highest absolute amount of FGM cases anyplace in the planet. About a third of women in the nation have undergone FGM. Some who undergo FGM die most suffer permanent damage. FGM in Nigeria is officially illegal, but kidnappings by traditionalists are a function of its enforcement.

The United Nations and the EU recognise the danger of FGM as grounds for asylum, but the United kingdom Border Agency below May’s manage, apparently know far better.

The hypocrisy is startling. The Uk coalition government declares itself established to lead the eradication of FGM globally within a generation. Britain must be applauding females like Afusat, usually having been harmed themselves, who have had the courage to defy the devastation of FGM.

The UN special envoy, Prof Rashida Manjoo, not too long ago shared her worries about refugee, trafficked and asylum-seeking girls who encounter “insecure immigration standing” in the United kingdom. Sadly, Britain seems determined to demonstrate human-rights-denying callousness in the way it offers with ladies and kids vulnerable to FGM – even ones born in this nation.

Even 1 girl or youngster who has FGM forced on her because she is deported from the Uk is too several. It is certainly unthinkable for that to occur to anybody.

So here is my challenge to May: show to us that no a single as a result far deported has skilled FGM or other harmful classic practices given that they left our shores. Show that you have secured assurances from authorities in the appropriate countries that they will hold deportees protected. Show that you are not a hypocrite.

And never deport Afusat and her tiny ladies except if you can be 100% certain that this safety net is in area in Nigeria, right now.

I would like to be proud of my country’s record on human rights. At the moment I am deeply ashamed. It can never ever be Ok to send small children away to threat atrocities like FGM.

• The epetition can be signed right here

How can Britain deport a child at danger of FGM? Theresa Could must feel once again | Hilary Burrage

Vitamin Dietary supplements Come Up Brief Once Once again

As soon as again the U.S. Preventive Providers Activity Force (USPSTF) has concluded that there is no good proof to support the program use of multivitamins or most person or blend nutritional vitamins by wholesome grownups to stop cardiovascular ailment or cancer.

The USPSTF also recommended against the use of two distinct vitamins — beta-carotene and vitamin E. Beta-carotene has been linked to a significant enhance in the chance for lung cancer among smokers, although “a large and constant physique of proof has demonstrated that vitamin E supplementation has no effect on cardiovascular disease, cancer, or all-trigger mortality.”

For other vitamins or multivitamins, the process force located handful of considerable harms, however they stated the evidence was insufficient to permit definitive assessments of the risks and positive aspects.

The recommendation statement, published in Annals of Inner Medication, updates the USPSTF’s preceding 2003 suggestions and incorporate new evidence about vitamin D, calcium, selenium and folic acid. An initial draft of the recommendation statement was published final December. The USPSTF statement is broadly consistent with equivalent statements from the National Institutes of Health, the Academy of Nutrition and Dietetics, the American Cancer Society, the American Institute for Cancer Research, the American Heart Association, and the American Academy of Household Doctors, all of which identified no proof that nutritional vitamins could aid prevent cardiovascular ailment or cancer.

The USPSTF states that nutritional vitamins and minerals are important to general well being and notes that “a diet plan wealthy in fruits, greens, entire grains, fat-totally free and lower-body fat dairy items, and seafood has been related with a diminished risk for cardiovascular ailment and cancer.” The group also acknowledges that some people with nicely-defined conditions may possibly advantage from specific nutrients. Folic acid, for instance, when taken by pregnant females can support avoid neural tube defects, and vitamin D  may be advantageous in older folks to stop harm from falling.

Virtually half (forty%) of  U.S. adults take at least one particular dietary supplement, and nearly a third (32%) take a multivitamin supplement. In 2010, people in the U.S. invested a lot more than $ 28 billion on dietary supplements.

Vitamin Dietary supplements Come Up Brief Once Once again

FDA Once Yet again Rejects New Indication For Johnson & Johnson"s Xarelto

The third time wasn’t the charm. The FDA these days turned turned down– for the third time– the supplemental New Drug Application (sNDA) for rivaroxaban (Xarelto, Johnson &amp Johnson Johnson &amp Johnson) for use in acute coronary syndrome individuals to lessen MI, stroke or death. In addition, the FDA– for the second time– turned down the sNDA for rivaroxaban in the same population for the reduction of stent thrombosis.

The complete response letters come as minor shock, considering that an FDA advisory panel final month strongly recommended against approval for the indications. As I’ve reported right here on several occasions, the huge sum of missing data from the pivotal ATLAS ACS 2-TIMI 51 trial has been the source of the company’s inability to acquire the ACS indications. Though J&ampJ has produced significant efforts to fill in the missing data, the FDA reviewers and panel members did not think the information was reliable sufficient to attain firm conclusions about the relative safety and efficacy of rivaroxaban for use in ACS.

“We remain committed to delivering sufferers who have suffered from acute coronary syndrome with additional safety towards stent thrombosis and secondary lifestyle-threatening cardiovascular occasions,” mentioned a J&ampJ executive in a statement. “We are evaluating the contents of the letters and will establish the acceptable up coming actions.”

FDA Rescinds Xarelto REMS

In a separate improvement, the FDA has rescinded the Xarelto REMS (Risk Evalaution and Mitigation Technique). The company had been required to communicate the risks of an increased threat of thrombotic events when the drug was discontinued without having an ample alternative anticoagulant and of decreased efficacy when not taken with the evening meal.

FDA Once Yet again Rejects New Indication For Johnson & Johnson"s Xarelto

Astaxanthin Impresses Once again and Again

Preliminary research conclusions recommend astaxanthin, a carotenoid formed in algae, has sturdy antioxidant properties to aid protect against excessive oxidative injury (too a lot oxidation from excess free of charge radicals).

Oxidation is triggered by normal biological processes. In other words it is a solution of being alive. However, also much oxidation brought on by intense exercising, poor diet, environmental pollutants, and so forth. is difficult for the physique to management. Oxidation and extra free radicals lead to cellular harm, inflammation, premature aging, and slower recovery from workout.

Presently, the main use of astaxanthin supplements is as an antioxidant simply because authentic research demonstrated that due to astaxanthin’s potent antioxidant exercise, it could be advantageous in cardiovascular, immune, inflammatory and neurodegenerative ailments.

Astaxanthin has been just lately exhibiting up in sports activities functionality items considering that supplementation has been shown to improve endurance and minimize muscle injury. In one particular examine, it was demonstrated that astaxanthin may possibly modify muscle metabolism by its antioxidant properties and result in enhanced muscle efficiency and bodyweight reduction advantages.

Another study involving 1200 meter track athletes using astaxanthin demonstrated that a everyday dose for 4 weeks resulted in the accumulation of lower amounts of lactic acid, which theoretically delays fatigue.

Astaxanthin degrades quite swiftly and is ideal taken reside rather of a powder or pill.  The negative fish smell from capsules is the rotting of the really nutrients you need.  Aqua Well being Labs has nurtured a micro-algae referred to as PhytOriginal they sell Reside, boosting large amounts of living astaxanthin in each and every cell.   There are also a number of other companies claiming huge amounts, but testing the ranges is extremely challenging.  Degradation commences instantly after the cell is killed so time is major issue.  The a lot more time it sits on a shelf  – the more spoilage will take more than – significantly minimizing all the rewards.

All in all, astaxanthin looks risk-free and promising as an antioxidant and is be valuable for stressed people consuming significantly less than excellent diet programs.

www.jscimedcentral.com/

Astaxanthin Impresses Once again and Again