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10 Nisan 2017 Pazartesi

Do women’s periods synchronise when they spend time together?

Talk to a woman about her period and she will probably give you an example of the time her cycle aligned with a friend, partner, colleague or family member. Many of us have noticed that the closer we get to another woman the more we seem to get crampy, grumpy, tired, bloated and spotty at the same time. It’s as if our uteruses, in a monthly show of solidarity, are saying hey, why not go with the flow? Let’s do this painful, stigmatised, and bloody expensive thing together, and take advantage of the three-for-two tampon offers in the process.


However, a new scientific study – thought to be the largest of its kind – has found data showing women’s periods do not synchronise when they live together after all. The study – carried out by period tracking and fertility app Clue in partnership with the University of Oxford – received 1500 responses, which were narrowed down to 360 pairs of women. Analysing three consecutive cycles in each pair, the research found the vast majority – 273 pairs – had a greater difference in period start dates at the end of the study than at the beginning. In other words, menstrual syncing is a myth up there with periods being tied to the waxing and waning of the moon. Not only that, women’s menstrual cycles are more likely to diverge than come together over time.


“It’s very unlikely that cycle syncing is a real phenomenon,” says Clue’s data scientist Marija Vlajic. “Menstrual syncing amongst the sample we had did not exist. We’ve also done some statistical tests and found that the difference in cycles actually grows. This doesn’t mean that pairs go out of sync – it means they were never in sync in the first place. It’s the nature of two mathematical series that keep repeating: the series will diverge as the numbers grow.”


This has been my experience. I have been with my female partner for 13 years, living together for 11 years. In that time, our periods have never synced for more than a month or two, because our cycles are different lengths.


“Exactly,” Vlajic says. “So there will be a time every six months, say, when your periods sync but that doesn’t mean the difference is getting smaller.” Has Vlajic ever experienced her period syncing with another woman? “My background is scientific,” she notes. “So when I say to my friends that I have my period and they have theirs too I don’t conclude that we are syncing. I just think it’s information bias; our brains looking for patterns.”


Still, the belief in menstrual synchrony persists, with a study published in 1999 revealing that 80% of women believed in the phenomenon and 70% saying they enjoyed it. The editor who commissioned this piece told me that she syncs with her sister whenever they spend time together and gets her period at the same time as her closest colleague. The idea has been around for centuries, though because menstrual health has long been overlooked by the scientific research community it was not until 1971 that it was first documented in a study.


In a Harvard research paper titled Menstrual Synchrony and Suppression, psychologist Martha McClintock tracked 135 female college students living in the same dorm and found “a significant increase in synchronisation of onset dates”. She concluded: “the evidence for synchronicity is quite strong, indicating that in humans there is some interpersonal physiological process which affects the menstrual cycle.”


The idea that pheromones enable women to become sexually receptive at the same time has been researched in various groups as well as in rats, baboons and chimpanzees. Themain evolutionary explanation is that it permits female species to avoid being monopolised by a single dominant male. But McClintock’s paper has been discredited on methodological grounds and a whole host of other studies, like this new one, continue to prove that menstrual synchrony is a myth.


So why won’t we let this one go? And how does Vlajic explain all the anecdotal evidence of our periods synchronising? “I like the idea myself of this dominant super uterus in a group of women that makes everyone adjust their cycles,” she admits. “I can see how it gives you a special connection with a woman to go through that at the same time. It feeds into a feeling of connection, support, and sisterhood. Even though we do it every month, t Periods are personal and the thought of sharing with someone makes the idea powerful. That’s why we continue to look for patterns even when they don’t exist.”


Chitra Ramaswamy



Do women’s periods synchronise when they spend time together?

21 Mart 2017 Salı

Why do clinicians and managers struggle to work together?

With an army of more than 1.5 million staff, a £116bn budget and millions of patients to look after, it’s crucial that the NHS is well managed. But three years ago the landmark Francis report warned of serious problems. “Clinicians must be engaged to a far greater degree of engagement in leadership and management roles,” it said. “The gulf between clinicians and management needs to be closed.”


Has the relationship between clinical and managerial staff improved since then? Last year, research by the Nuffield Trust suggested financial pressure was compounding the problem, with many staff worried that “relationships are likely to deteriorate over the coming year”. The report concluded: “There is a long way to go.” We asked clinicians and managers to share their personal experiences of this fragile relationship.


Manager: ‘When I first started it was hard to get clinical staff to work with people like me, but things are changing’


I find it quite rare that clinicians and managers don’t get on. There’s not really a big difference. It’s just that they’re being pushed in very different ways.


National targets cause quite a lot of trouble, because you end up having a really tricky middle-management layer. They’re getting shouted at from above, from the senior director level, to meet their key performance indicators (KPIs). They’re also getting shouted at from clinicians, who see the KPIs as dehumanising.


For me, the sort of issue that I come up against is trying to release staff to do improvement work. I end up being the middle man; I want to get clinical staff out of their workplace for a few days, but I can also see from a management perspective that taking people out for that much time is not an option.


You get really weird setups, where consultants are managed by somebody who’s paid maybe half their salary. They think: “I know you’re my manager, but I also know you can’t tell me what to do, and I’ll do whatever the hell I want.” It becomes difficult for managers to change things and implement new ways of working. They’ve got to be skilled in the art of emotional intelligence. It’s almost manipulation – they need to impart ideas into people’s brains without a direct command.


When I first started, it was hard to get clinical staff to work with people like me – and to want to engage with change and improvement. But recently, we’re finding that staff are coming to us and saying: “We’re struggling, can you come and help us?”




My manager was about to risk my patient’s life for the sake of a government-inflicted target




A&E nurse: ‘One manager risked a patient’s life for the sake of a target’


We have managers who you rarely see in person. They are simply a barking voice on the other end of the phone. They harass you endlessly when a patient is coming close to breaching the four-hour target in A&E. I get relentless phone calls; if they actually let me get off the phone and do my job I could focus on managing and preventing breaches.


It’s rare that they ever come down as a supporting presence in the department. Some of them have a clinical background, but you rarely see them rolling their sleeves up and digging in to help us out. I feel alienated from managers.


Once, I was working with critically unwell people and a patient was coming up to a four-hour breach. We’re fined for each breach. Someone in a suit approached, took the brakes off the patient’s trolley, and started to push them out. He said: “This patient is about to breach, we need to get him to the ward.” The response was: “This man’s blood pressure is dangerously high. You won’t make it to the ward.” This manager was about to risk the patient’s life for the sake of a government-inflicted target.


Clinical manager: I’ve got a very responsive senior management team


I’m fairly lucky, I don’t have a heavy-handed senior management team and they’re very responsive. If I go along and say I have an issue, they listen. I didn’t set out to be a clinical manager, but managerial responsibilities come with the grade. The advantage is I know what the job is; I’ve had to do it.


I work in a small health board so it’s reasonably easy to communicate with each other. People are around and we’ve got good face-to-face relationships. I think when you’ve got a much bigger organisation, it’s harder to do that.


NHS manager: ‘The health service runs because managers and clinicians get on’


Running the NHS is an incredibly complicated operation, so I guess it’s not surprising if there’s a lack of understanding about what managers are doing all day. But most of the time, the NHS runs because managers and clinicians get on – not despite the fact that they don’t.


Sometimes it’s the managers who are seen as making the tough decisions and implementing the policies no one likes. But actually, in the parts of the NHS that are really succeeding, those decisions will always be made in partnership with clinical colleagues and leaders. And they’ll always have what’s right for patients and their families at the heart of it.


Managers share an awful lot of the same motivations as doctors, nurses, therapists and scientists. They have a lot more in common with clinical staff than we’re given credit for.


Junior doctor: ‘I don’t know who my manager is’


I’ve worked with some managers who are diabolically awful, and it makes it really hard to get your work done. As a junior doctor, it’s difficult to interact with senior management. We’re not invited to any of their meetings; we’re not consulted on anything.


Recently, I worked in a hospital where they sacked all the phlebotomists because they needed to save money, and said: “Well, the junior doctors can take those bloods anyway.” We can, but there’s only so many things you can do at a time. So they get done sporadically through the day, when you’ve got two minutes to spare. It means that if your results don’t get back until 8pm, then a lot of older people won’t be able to get home afterwards, so they’re stuck in hospital for another night, wasting money. If any junior doctor had been invited to the meeting where they decided that, we could have warned them. But there’s no relationship with management, and there’s no consequences if they get things wrong.


Consultant: ‘Managers see things from a very different angle: it’s all numbers and targets’


At the moment, it’s very much: “Here’s your list of patients, get on with it.” People start to resent that after a while. The fundamental change that needs to happen is that managers have more exposure to patients, and doctors have more exposure to management.


Managers see things from a very different angle: it’s all numbers and targets. Operations might get cancelled because somebody in the booking office has put together an operating list without knowing the details of the case, the complexities of it, and how fast or slow that particular surgeon is. It would make sense if doctors had a lot more input into how every day is run, what equipment is procured, and so on. People do try to engage, but it’s incredibly difficult to make those changes.


Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.



Why do clinicians and managers struggle to work together?

10 Şubat 2017 Cuma

How To Get Your Friends and Escape Stress & Anxiety Together?

Life is a highly complex and challenging concept. People deal with life in different ways, and they end up in very different places for that. In reverse, you can be sure that there are also a lot of people that find themselves in the same situation, because we’re all different, but not very different at the same time, if that makes sense.


One aspect of life is how it tends to make us prone to stress accumulation. Depending on how well you’ve made things for yourself in life, you can still be subject to stress and anxiety, and other similar symptoms that no one wants to have to deal with. If you are living a very successful life, there might be less frequent and less intense cases of stress accumulation, but that doesn’t mean you are experiencing continuous bliss.  Maybe you’ve experienced a tragedy or have been witness to one, or maybe you are just having a really hard time lately when it comes to work.


Like we’ve said, you’re never alone and despite how you might feel, there are a lot of people going through the same thing. Speaking of other people, one particular group of people you should focus on are your friends. You talk to them on a regular basis and do things together, but did you know you could actually do stuff with your friends that will help you overcome your not so cool mood or state of spirit?


Join us for the rest of this article, as we explore some of the things you can do with friends, and how you can make the most out of them to overcome the blues or rough period you’re facing.


Agriculture


Have you ever considered gardening? A cool way to spend more time with your friends is by opening a garden together. It’s up to you how big or small it would be, and what would grow inside. Gardening is a known form of reducing anxiety. Seeing things grow out of your own work and dedication can be very satisfying and rewarding for the mind and spirit. And vegetables don’t grow instantly, so you can spend the time with friends while you’re all tending to the garden. Bring a good book or some games and make the most of it.


Traveling


One influential factor in stress and anxiety increase is spending too much time in one place. You need to get out of the house, get some fresh air, or maybe just change the scenery for a while. Get a car, pack some clothes, food and some clothes, and head to a location where you can all relax in each other’s company. Somewhere with a lot of sunlight, maybe, and a beach. Or maybe a snowy mountain with some skiing if that’s more your thing.


That being said, it’s important to know that when dealing with stress or anxiety, there’s always a way out.  And by engaging in these activities with your friends by your side, you can create stronger bonds and free your mind, all in the same experience. It wouldn’t be a bad idea to immortalize the moment either. Pictures tend to last a long time, and having the possibility of revisiting that moment whenever you want is a great thing to have.


Author byline:


John Matthew working as digital marketing expert since 2008, he started his career as social media professional with NTD Telecommunications. John played a vital role in developing following brands freecnaclasses.net and dontpayfull.com and much more. He loves to exercise, yoga, my twin daughters, dailyforex.com, encouraging quotes, sleeping in colder rooms, bunk beds, acne spot treatment, the internet, hiking shoes for women, web hosting and traveling to new places.



How To Get Your Friends and Escape Stress & Anxiety Together?

Drive to bring health and social care together is a well-intentioned mess

As figures leaked to the BBC reveal the worst A&E performance figures in 13 years, a dissection by the National Audit Office of the stalled progress towards health and social integration lays bare government hubris and fictional promises of progress from within the NHS.


Integration takes many forms, including multidisciplinary teams making coordinated assessments of a patient’s care needs, services for a particular condition being brought together, and organisations pooling budgets and jointly commissioning services.


Governments and the NHS have been firing off integration policies since the 1970s. Recent ones include the 2010 announcement that £2.7bn would be transferred from the NHS to local government to promote joined-up working; the 2013 spending review announcement of the Better Care Fund, which resulted in health and local government pooling £5.3bn to integrate services and reduce pressures on hospitals; the launch that year of the Integrated Care and Support Pioneers Programme to make joined-up and coordinated health and care the norm by 2018; and the Five Year Forward View in 2014.




Every time ministers indulge in this sort of nonsense it undermines the credibility of subsequent attempts at reform




The NAO skewers the government on its failure to provide any evidence that integration delivers sustainable cuts in costs or hospital activity. An international study by the University of York in 2014 of 38 integration schemes in eight countries failed to find any robust evidence supporting claims of sustained cuts in admissions, yet ministers persist in creating the impression that integrating services will lead to costs falling out of the system.


The Better Care Fund epitomises the endless cycle of central money being tied to unachievable targets, which encourages local NHS bodies to make promises they have virtually no chance of keeping.


The fund aimed to save £511m in its first year, by cutting demand for hospital services. Everybody in the NHS knows that stabilising emergency admissions would be a huge achievement, let alone cutting them, yet local Better Care Fund plans played along with the fantasy that they could deliver a rapid reversal by promising total reductions of 106,000 admissions between 2014-15 and 2015-16, saving £171m. Admissions went up by 87,000, costing £311m more than planned. Furthermore, delayed transfers were supposed to be cut by 293,000 days; they went up by 185,000.


Every time ministers and NHS leaders indulge in this sort of nonsense it undermines the credibility of every subsequent attempt at reform. Cynicism takes hold, rotting belief that improvements can be made.


There were better outcomes for reducing admissions to care homes, and increasing the proportion of older people still at home 91 days after discharge, but these in no way compensated for the reversals elsewhere.


Damningly, the NAO points out that the three main barriers to integration – misaligned financial incentives, workforce problems and poor information sharing – have been flagged since at least 2003.


The failure to break down these barriers leads to the crazy situation where health and care staff can only succeed in working more closely together if they fight the very system that employs them. In any rational world, processes and structures would be set up to promote the goals you are trying to achieve, not obstruct them.


System bodging should be a compulsory training module for NHS and social care managers, as it is now a core requirement of the job. From STP governance arrangements to competition law to sharing patient records, astonishing amounts of time and money are squandered trying to find ways around the rules.


Overall, the drive to bring health and social care together is a well-intentioned mess. Countless integration cottage industries across the country are working largely in isolation from each other and semi-detached from wider work such as the STPs. Their work is based on poor evidence, effort is duplicated, and time and money is wasted fighting the system.


If integration is to have any chance of happening, government and the NHS central bodies need to focus relentlessly on removing the barriers to change, joining up disparate policy initiatives and gathering and disseminating credible evidence as to what everyone should be doing.


Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.



Drive to bring health and social care together is a well-intentioned mess

1 Ocak 2017 Pazar

London must stand together in 2017 if its golden age is not to end

For three decades, with barely a blip, the UK capital has been going from strength to strength. Nothing has stunted its potency and growth, not the 7/7 bombings or the 2011 riots, not Black Monday or the 2008 global crash, not even the original Millennium Dome. Its economy drives and subsidises the rest of the country, its still-new tier of regional government – the mayoralty and the Greater London Authority (GLA) – has been a success and it has hosted a triumphant Olympic Games. Its population, after shrinking through years of managed decline, is now at an all-time high, and may hit 10 million by 2030. But London enters 2017 with a question mark after its name. Might its golden age be coming to an end?


After the fireworks, the New Year begins amid unaccustomed unease. The heavy, grey cloud above is Brexit, with major employers in an international city whose wealth has been built on financial services pondering their options for the future. Meanwhile, austerity, albeit moderated by Miliband-ish measures from Theresa May, continues to erode from below. It doesn’t lighten the general mood that armed police officers have become a routine feature of everyday London life. In all these circumstances optimism is essential, but staving off its opposite will require fortitude and skill.


The mayor, of course, has a big part to play in all of this. Sadiq Khan’s 2017 will involve the Labour man in unending nagging of and negotiating with the Conservatives in charge of national government, hoping to secure the best possible post-Brexit deal for the capital and, by extension, the country. His panel of Brexit advisors, bankers, accountants, Peter Mandelson and all, doesn’t delight those who think he’s insufficiently left-wing. But pragmatism is an essential mayoral art: if you want a bunch of Tories to take you seriously, you don’t surround yourself with Corbynites.


Policy delivery will begin with Khan hailing a freeze on those public transport fares that Transport for London (TfL) sets, but not the universal one some of his election campaign statements and a line in his manifesto claimed. Political opponents will attack him (again) for that, and for the demands he is making on TfL’s finances as a whole as his first mayoral budget, covering all GLA functions, comes under closer public scrutiny.


Khan’s new “hopper” fare, which enables bus passengers to catch two buses for the price of one during a 60 minute period, has given him – not to mention a lot of Londoners on low incomes – a quick early win. But this initiative, though welcome, needs to be seen in the context of falling bus ridership, something TfL can ill afford given its increasing dependence on fares revenue.


This, in turn, is a consequence of worsening road traffic congestion, which London’s economy could do without. Congestion also harms air quality, another issue the mayor has sought to make a fast start on. He is set to kick-off implementing his anti-pollution policies by introducing an emissions surcharge (the so-called “T-charge” on toxicity) on high-pollution vehicles entering the congestion charge zone early in 2017, but will be urged by critical friends to go further with his policies as a whole.


Holding down public transport fares is one part of a broader attempt to address London’s high cost of living, which leaves too many of its households, including around 40% of its children, struggling to make ends meet on unacceptably low pay and excluded from many of the city’s many riches. Housing costs are, famously, a huge factor in this and also hugely difficult to control. The mayor’s housing team has assembled a purposeful strategy for getting more homes built for sale, rent or a combination of both at prices ordinary Londoners can afford. Khan will hope to be able to boast of initial successes as he embarks on the vast task of trying to better match housing delivery to the city’s social and economic need. The backdrop to all this is the ongoing three-year monster mission of writing a new London Plan.


There are going to be tensions. Hammered by successive grant cuts and hampered by limits on their freedom to borrow to build, some of the capital’s boroughs, often Labour-run, are becoming ever more adroit at finding ways to meet at least some local “affordable” housing demand, but these can mean private sector partnerships involving publicly owned land that don’t always work as well as planned. The available alternatives – largely, small variations on doing nothing – aren’t all that attractive either.


Squeezed between the same rock and hard place we find shortages of school places and health and social care provision also having their impact at borough, and indeed neighbourhood level. Dynamic boroughs and the mayor alike are trying to get more more purchase on low-cost childcare and improving post-school skills training, as the city strives for greater autonomy in the running of its affairs.


A striking thing about the politics of London is the high degree of consensus about the benefits of devolving power over such things as welfare programmes, property taxes and infrastructure investment from Whitehall. Agreement crosses party lines and unifies business interests, social sector campaigners and more. There is strength in that solidarity. London will need every ounce of it to keep on prospering in 2017 and beyond.



London must stand together in 2017 if its golden age is not to end

15 Aralık 2016 Perşembe

The only way to beat the Tories is for opposition parties to work together | Shirley Williams

Theresa May’s Conservative government is less united and less powerful than it may seem. It has a small and vulnerable majority, remains divided on what kind of relationship it wants with the European Union, and disagrees on some key political issues like the role, if any, that grammar schools should play in secondary education.


Even the current urgent crisis on care for elderly and disabled adults is a source of argument. Should local councils, starved of resources after years of heavy cuts, be held to their statutory responsibilities, or is the crisis so extensive that only government responses will suffice – higher national taxes or an increase in national insurance contributions to meet the evident suffering of the old, the sick and the poor?


Proposing a precept of a few percent more on council taxes will lead to greater burdens on local businesses: some will be bankrupted, shops and offices will close, and more areas of our towns and cities will become derelict.


Yet the government has faced little effective opposition, not because of its majority but because the opposition parties fail to work together, even though on many issues there is no difference of principle or conviction between them, and there is a clear opposition to the Conservatives. On the survival of the NHS, the need to tackle care for the sick and elderly at a national level, the commitment to comprehensive education, greater fairness in taxation and on tackling poverty, there is little if any reason why cross-party opposition campaigns could not be forged.


The Brexit negotiations will involve a review of all the laws and rules the UK accepted as part of agreed European legislation. Once the negotiations begin in earnest, the best part of the European Union’s welfare and employment rights heritage will be at great risk. For parties of the centre and centre left, it is vital to fight to retain employment rights, such as provision for parental leave, rest time and holiday entitlement. If these are abolished, thousands of people will be worse off. But the opposition work required will demand time and effort from all the progressive parties, working together.


Sadly, despite the urgency, the opposition parties are not working together. Tribalism, not least in the Labour party, dominates, and provides the government with a green light for its more extreme policies. What we have to do is sit down, take each one of the issues on which we are broadly in agreement, and work out how best, in parliament and elsewhere, we can support a common policy. For instance, in the case of the NHS we could strongly argue for a continued immigration policy that allows men and women from other countries who are prepared to work in the health service to come to the UK. In the case of the council precept, we need to put together the outline of a national policy for care. And on civil liberties issues such as detention without trial, we could agree on the position that there should be a limit on how long anyone can be detained.


The parties of the centre and left are highly unlikely to merge or become one party. But they could surely forge progressive alliances on issues and surely agree to protect and defend the common ground based on values we already share, above all to protect the poor and those in need. The price of tribalism is conceding to the government so much that we value in our society.



The only way to beat the Tories is for opposition parties to work together | Shirley Williams

How can health and social care work together effectively?

As the dust settles on the chancellor’s autumn statement, the future of social care remains one of the hottest topics of discussion among MPs, political pundits and practitioners alike.


Adding to the debate is the issue of how we deliver a more joined up health and social care service in a world where demand for both is increasing.


Let’s consider what an integrated health and social care system might look like. Should the cultural differences between health and social care be preserved within a closer partnership? And what role can technology play in bringing together services that have traditionally worked in parallel?


‘This shouldn’t be a land grab’


For some local authority leaders, there should be a focus on ensuring the distinct strengths, values and characteristics of the sectors are not diminished in any way.


This was one of the topics raised at a roundtable event hosted by the Association of Directors of Adult Social Services, in partnership with Capita One, where seven directors of adult social care contributed to the discussion.


Liz Bruce, director of adult social services for the London tri-borough councils, said: “The strengths and skills you have if you mix up health and social care are tremendous if we get it right. Health is really good at things that we in social care shouldn’t take the lead in. This shouldn’t be a land grab, it should be a partnership.”


Cultural shift


To build a joint working environment that meets the needs of vulnerable citizens and their families, the first step is to get a clear picture of the potential barriers to success so they can be broken down.


A Capita One survey designed to explore whether the challenges around health and social care integration were regarded as cultural or technical found 65% of local authority leaders believed the greatest challenge was the cultural shift for the people involved. Only 35% of respondents said the greatest difficulty would be bringing the systems together.


These figures reflect the wider view that when it comes to helping people adapt to a new way of working, the importance of relationships should not be underestimated. As John Powell, director of adult social services for the London borough of Redbridge, explained during the roundtable discussion: “Where integration and joint working is successful, it is because of long-standing arrangements with relationships between people in the various organisations.”


The need to cement lasting relationships between health and social care is central to Redbridge’s approach to integrating services. “We’ve gone into GP practices, starting dialogues and working together. GPs, district nurses and social workers are all working together,” Powell said. “What we’re now trying to do is build on the existing relationships we have.”


Effective technology


So, what role can technology play in enabling a more people-centric, communications-based approach to health and social care integration?


Bringing different IT systems together may not be regarded as the main barrier to achieving more joined up ways of working. However, the roundtable debate revealed services can face other challenges in this area.


Health and social care professionals may be used to working separately, so technology needs to make it easier for authorised people in each service to share data, without needing to spend additional time or effort in doing so.


David Pearson, director of adult social services at Nottinghamshire county council, said: “No matter how these systems are brought together, it is important that, for social workers and health professionals, it feels as if it is one integrated system rather than multiple systems.”


New software solutions are being developed that can ensure people working in health and social care see the same information on an individual or family they are in contact with, in real time. For local authorities, such tools can free people to work more effectively to meet the often complex needs of vulnerable citizens and their families.


But it’s not just about sharing information more effectively. The role of technology in supporting and managing people’s needs could be significant too. Devices that remotely monitor patients’ wellbeing and allow instant contact with services in an emergency are one example of how people with specific needs could get the support they require to remain in the community.


With the right steps in place, local authorities can achieve a genuine shift in culture that will enable health and social care teams to work together, without losing sight of their distinct identities and responsibilities. Technology also has an essential role to play in paving the way for a future where health and social services have the tools they need to support our most vulnerable citizens in living happier, healthier and more independent lives, for longer.


  • Mark Raeburn is managing director of Capita One. Read the full local authority interviews here.

Join the Social Care Network to read more pieces like this. Follow us on Twitter (@GdnSocialCare) and like us on Facebook to keep up with the latest social care news and views.



How can health and social care work together effectively?

7 Haziran 2014 Cumartesi

Marriage in recovery: Soon after 9 years together, would I alter anything at all?

rehab column family

‘It’s difficult to comprehend why I wanted that intimacy so significantly, why I craved people relationships so deeply.’




We are walking in a different city, tipping our heads proper back to catch a glimpse of the magnificent rooftops skimming the sky, pointing out gorgeous previous-fashioned shop indications, attempting to act like locals by strolling at the right pace, on the right side of the pavement.


“Marry me?” R says, studying out a scrawl of 1-dimensional spray artwork on a wall in front of us. It really is great that the city speaks our language, or we would be misplaced.


“It would be a no from me, if the particular person who wrote that puts as minor energy into marriage as they do into graffiti,” I say.


Was it a live spray-paint proposal, or did he or she go out in the dark of night to spray those phrases, foremost their lover out on to the street the following morning for an response? And if so, how could you say no with anything so indelible, so public?


The after-white words have grown dirty, dusty, so I’m guessing they’ve been there longer than my marriage to R. It has been 9 years nowadays. We are strolling for miles in celebration of our time together. It feels longer, possibly simply because I truly feel so outdated (even though I’m technically not), traipsing all around with knees that are age-inappropriately creaky and that ache in flat sneakers.


“Would you? I indicate, would you marry me nevertheless?”


I often resist answering these sorts of question, due to the fact despite the fact that I am a keen talker, they are pointless. With all we know now, how would we change what we did in the past? I really never feel I would change anything at all, because I’m most cozy and familiar with exactly where I am, and if anything had been altered then how would I be certain that I’d have all the excellent factors I do now? My kids, wholesome dad and mom, friendships, function. And R.


“Yes. Yes, I believe I would,” I reply.


It really is not spoken with the round-mouthed certainty that romance fiction would demand, but it is a definite yes.


I don’t tell R, of program, that I spent 3 many years in my teens making an attempt to drop my virginity, one more two making an attempt to get a boyfriend who lasted longer than a week, and, right after that, another eight many years striving to locate a husband. I almost certainly look like the least feminist man or woman ever. But I will not have to battle my corner. I am a feminist, and individuals wishes are things I still remember as vividly as the pain induced by splitting my nose open as a young youngster. Yes, it is tough to comprehend why I wanted that intimacy so considerably, why I craved those relationships so deeply, but the truth is, I did, and I nonetheless type of do.


I also will not tell R that he was the third particular person along the line that I was set to marry. The initial two never acquired additional than a proposal and a period in which I used the unsightly word “fiancee” with pride. I feel I gave everybody a fright when I presented my very first accurate adore as the one particular I was going to settle down with, have children with. He was beautiful, but I was not even old sufficient to drive.


And the second was a joke. I blame the complete moon on the evening we met, and the fact that I managed to look for out the only guy who was more fixated on marriage than I was. Of course we determined to get hitched 5 days later, and broke up two months soon after that when I realised he was agoraphobic and we couldn’t bear the sight of 1 yet another. If my sister is currently being a cow, she reminds me of this partnership and I physically demonstrate what it would be like to die of shame.


So R was the only actual suitor, even if I did have types on him by the time he’d set foot into my house. I adored his mothers and fathers, he loved mine, and they have been satisfied sufficient with the concept of us, which assisted. 1 morning in bed, R asked if I’d marry him, and I stated yes, and after that I had main reservations and he probably did too. But we continued with the notion of marriage, pondering if it was regular to be denied that elusive something of which everybody speaks, but that we had not actually skilled between us.


But surely we love each other far more than we did back then, and the spark appears every single now and then as some thing far much more enduring – a warming heart-swell that is total of adore – when I least assume it, for illustration when R’s stuffing the children’s damp sneakers with newspaper right after they’ve been in the rain.


With each other nearly eleven years, married for 9, we stride previous more graffiti and stroll into a deli. We order coffee and two cream cheese and lox bagels. In our hands, the bagels appear like huge wedding rings, and we things them into our hungry mouths and toast the long term with a fishy kiss. And they mentioned romance was dead.




Marriage in recovery: Soon after 9 years together, would I alter anything at all?

29 Mayıs 2014 Perşembe

Australian Intercourse get together propositions voters in excess of budget - video

The Australian Sex celebration is refusing to take the government’s price range position lying down. In a crowdfunded video, the small celebration proves size doesn’t matter when it comes to the big concerns: the NBN, the proposed college chaplaincy program, the raising of the retirement age, modifications to university funding and the Medicare co-payment. Its select-up line to voters? “We’re not just about sex we’ll make sure you do not get fucked.”




  • Source: Australian Sex Celebration

  • Length: 1min 16sec

  • theguardian.com

  • Thursday 29 May possibly 2014




Australian Intercourse get together propositions voters in excess of budget - video

9 Mayıs 2014 Cuma

"The healthcare sector need to operate much better together"

Jackie Smith

‘At work I am always learning that I really do not have all the solutions and there is worth, constantly, in listening to others and their tips.’ says Jackie Smith. Photograph: PR




Describe your role in a single sentence: Chief executive and registrar of the Nursing and Midwifery Council (NMC), the regulator of nurses and midwives in the United kingdom.


Why did you want to function in healthcare? I have worked in regulation all my existence healthcare touches everybody and is essential to all of us.


How do you want to see the sector adjust in the subsequent five years? The sector need to function greater together, to control and meet expectations and to provide on promises.


My proudest achievement at work was … to stabilise the NMC at a time of crisis we are now creating actual progress.


The most challenging point I’ve dealt with at function is … bringing the NMC back from the brink – everyone deserved much more from it and it is starting to make a big difference.


I consider the largest challenge the NHS faces is … escalating demand, the bodyweight of public expectation and the escalating price of delivering health which is free of charge at the level of delivery.


The individuals I work with are … committed to what we are trying to obtain. They are a great group of personnel – loyal and supportive of each other.


I do what I do since … I feel in regulation and in producing a big difference.


At times men and women believe that I … require to present a lot more of my human side.


At function I am often understanding that … I will not have all the answers and there is value, always, in listening to others and their concepts.


The one issue often on my mind at operate is … that you are only as great as your final contact with the public – try out usually to give a much better support.


If I could go back 10 many years and meet my former self I would inform them … that life teaches you most of the lessons to find out – pay attention and learn, that is the the advice I would give any person now.


If I could meet my future self I’d anticipate them to be … pleased with what I have – existence is full of opportunities and some of us are fortunate enough to encounter them, get pleasure from!


What is the very best element of your work? Being ready to make a distinction.


What is the worst portion of your occupation? Not becoming able to predict what may well happen subsequent.


What makes you smile? Getting in a position to do one thing constructive, even so large or small.


What keeps you awake at night? If I feel I could do far more – life is short and we have minor time to make an influence.


If you would like to characteristic in our “Five minutes with …” series, or know an individual who would, allow us know by emailing healthcare@theguardian.com


Are you a member of our on the internet local community? Join the Guardian healthcare network to acquire regular emails and unique delivers.




"The healthcare sector need to operate much better together"

20 Nisan 2014 Pazar

Celebrating Earth Day: Science And Engineering Should Join The Get together

A number of years ago seventh graders at a tony personal college near San Francisco have been given an uncommon Earth Day assignment: Make a record of environmental tasks that could be achieved with Bill Gates’ fortune.  This strategy to environmental awareness fits in nicely with the Obama-Pelosi-Reid worldview that the correct to personal house is subsidiary to undertakings that others think are worthwhile – the redistributive theory of society.  And how intriguing that the resources produced “available” for the students’ considered-experiment were not, say, the aggregate net worth of the members of Congress but the wealth of 1 of the nation’s most productive, modern entrepreneurs.


One more Earth Day assignment for individuals very same students was to read Rachel Carson’s best-selling 1962 book, “Silent Spring,” an emotionally charged but deeply flawed excoriation of the widespread spraying of chemical pesticides for the management of insects.  As described by Roger Meiners and Andy Morriss in their scholarly nevertheless eminently readable 2012 analysis, “Silent Spring at 50: Reflections on an Environmental Traditional,” Carson exploited her reputation as a properly-identified nature writer to advocate and legitimatize “positions linked to a darker tradition in American environmental thinking: neo-Malthusian population management and anti-technologies efforts.”


Carson’s proselytizing and advocacy led to the virtual banning of DDT and to restrictions on other chemical pesticides in spite of the fact that “Silent Spring” was replete with gross misrepresentations and scholarship so atrocious that if Carson were an academic, she would be guilty of egregious academic misconduct.  Carson’s observations about DDT have been meticulously rebutted level by point by Dr. J. Gordon Edwards, Professor of Entomology at San Jose State University, a prolonged-time member of the Sierra Club and the Audubon Society, and a fellow of the California Academy of Sciences.  In his stunning 1992 essay, “The Lies of Rachel Carson,” Edwards demolished her arguments and assertions and named consideration to vital omissions, faulty assumptions, and outright fabrications.


Consider this quote from Edwards: “This implication that DDT is horribly deadly is fully false.  Human volunteers have ingested as a lot as 35 milligrams of it a day for nearly two many years and suffered no adverse results.  Hundreds of thousands of men and women have lived with DDT intimately throughout the mosquito spray programs and nobody even received sick as a consequence.  The Nationwide Academy of Sciences concluded in 1965 that ‘in a little far more than two decades, DDT has prevented 500 million [human] deaths that would otherwise have been inevitable.’ The Planet Well being Organization stated that DDT had ‘killed far more insects and saved much more men and women than any other substance.’”


Meiners and Morriss conclude properly that the influence of “Silent Spring” on present day environmentalism “encourages some of the most destructive strains inside environmentalism: alarmism, technophobia, failure to contemplate the expenses and advantages of options, and the discounting of human effectively-becoming all around the world.”  Sounds like a description of the mindset of the U.S. Environmental Safety Agency.


The 1st Earth Day celebration was conceived by then-U.S. Senator Gaylord Nelson and held in 1970 as a “symbol of environmental duty and stewardship.”  In the spirit of the time, it was a touchy-feely, consciousness-raising, New Age experience, and most routines have been organized at the grass roots degree.  In current many years, Earth Day has offered an possibility for environmental Cassandras to prophesy apocalypse, dish anti-technology filth and proselytize.  Passion and zeal routinely trump science, and provability will take a back seat to plausibility.


One particular of the U.K.’s wonderful thinkers, Dick Taverne, aka Lord Taverne of Pimlico, discusses numerous of the shortcomings of New Age philosophy in his excellent book, “The March of Unreason.”  Taverne deplores the “new type of fundamentalism” that has infiltrated several environmentalist campaigns — an undiscriminating Back-To-Nature motion that views science and technology as the enemy and as a manifestation of an exploitative, rapacious and reductionist perspective towards nature.  It is no coincidence, he believes, that eco-fundamentalists are strongly represented in anti-globalization and anti-capitalism demonstrations around the world.


In this, Taverne echoes the late physician and novelist Michael Crichton, who argued in his considerably-acclaimed novel “State of Fear” that eco-fundamentalists have reinterpreted traditional Judeo-Christian beliefs and myths and produced a religion of environmentalism, a religion with its own Eden and paradise the place mankind lived in a state of grace and unity with nature until finally mankind’s fall — which came not from eating an apple, but after consuming from the forbidden tree of knowledge (that is, science).  This religion also has a judgment day to come for us all in this polluted planet — all of us, that is, except for true environmentalists, who will be saved by attaining sustainability.  One particular of Crichton’s characters argues that given that the end of the Cold War, environmental alarmism in Western nations has filled the void left by the disappearance of the terror of communism and nuclear holocaust, and that social management is now maintained by hugely exaggerated fears about pollution, worldwide warming, chemical compounds, genetic engineering and the like.  With the military-industrial complicated no longer the main driver of society, the politico-legal-media complex has replaced it.


This politico-legal-media complex peddles dread in the guise of advertising safety.  French author and philosopher Pascal Bruckner captured its tone nicely: “You’ll get what you’ve got coming!  That is the death want that our misanthropes handle to us.  These are not wonderful souls who alert us to troubles but tiny minds who wish us suffering if we have the presumption to refuse to pay attention to them.  Catastrophe is not their fear but their joy.”


The small-minded misanthropes have appreciated some dubious “successes.”  They have effectively banished agricultural biotechnology from Europe, have the chemical sector on the run and the pharmaceutical market in their crosshairs.


Lord Taverne believes these are ominous trends that are contrary to the rules of the Enlightenment, returning us to an era in which inherited dogma and superstition took precedence over experimental data.  Not only do the practices of eco-fundamentalism retard technologies and the availability of items which, employed responsibly, could significantly boost and lengthen many lives and shield the environment, but they strangle scientific creativity and technological innovation.


By limiting citizens’ and businesses’ capacity to engage in voluntary transactions, irrational practices born of eco-fundamentalism undermine the overall health of civilized society and of democracy.  Defend science and cause, argues Taverne, and you defend democracy itself.  Nicely said, Milord, and Happy Earth Day to you.


Henry Miller, a doctor and molecular biologist, is the Robert Wesson Fellow in Scientific Philosophy and Public Policy at Stanford University’s Hoover Institution. 



Celebrating Earth Day: Science And Engineering Should Join The Get together

12 Şubat 2014 Çarşamba

How To Greater Put together For Winter Storms, Blackouts, Hurricanes And Zombies




The ice was here, the ice was there,
The ice was all close to:
It cracked and growled, and roared and howled,
Like noises in a swound!
–Samuel Taylor Coleridge



As Winter Storm Pax approaches Washington, D.C., tweets out of Atlanta demonstrate bare Walmart and grocery shop shelves.


The current Atlanta traffic fiasco was like a re-run of D.C.’s “Carmaggedon ’11.”


The Division of Homeland Protection demands to be telling us a lot more frequently that we’re on our own rather than implying its got the vital infrastructure below manage and is coming to the rescue.



Federal Emergency Management Agency

Federal Emergency Management Company (Photo credit: Wikipedia)




They sooner or later get to you but it takes time, emergency declarations galore notwithstanding.


Everybody requirements to know how to be self-enough and to avoid roving gangs. The standard final-minute run for milk, eggs and bread is rarely sufficient, and we clog the roads. French toast is not that good anyway.


In fact, rather than assume aid, be pre-ready, and ready to aid others. Shovel your neighbor’s drive push caught automobiles out of the road.


Get a very good shovel at Home Depot Home Depot. I had to dash out yesterday because someone had “borrowed” mine. Thirty-eight bucks for what looks like the arm of Optimus Prime they’d conveniently hidden the cheap shovels. Purchase a manual chain hand noticed.


Pax is a single point, but genuinely it’s the storm we’re not ready for that’s the huge concern, like the paralysis of the 2012 North American Derecho.


Losing electrical power is the large concern this week almost everything relies on the grid, and society grinds down tough following only a couple days.


Cellphone and radio:  Curiously ample, as Hurricane Sandy showed, individuals appear to endure significantly psychologically without their smartphones.


So keep a backup battery always pre-charged, but most importantly, get a solar charger like this that can take care of your phones and even Apple’s Apple’s iPad or Google Google Android tablets and devices (10 watt minimum).


A handcrank radio with LED that also can charge your phone provides double security have a couple of these.


Meals:  Be prepared for at least a week of foods without having electricity More is better. Stay stocked (get advantage of income) on boxed pasta, rice, canned greens, and canned meats like tuna, chicken and Spam. Stock canned noodles little ones like, and soups. Tons and lots of each. Neglect the freezer.


Water:  Retailer plenty and tons of water (I like to use two-liter bottles) and know how to hold it pure (have typical Clorox bleach on hand). In the rare occasion you truly do drop water support for some purpose, have a bulk box of baby wipes on hand for hygiene. There are moveable toilet choices of which every person requirements to be conscious But you really do not want to know that from me, Google it.


Cooking:  Have a little propane stove along with one-lb propane canisters (you can never ever have ample) that energy it (and electrical power an outside lantern).



How To Greater Put together For Winter Storms, Blackouts, Hurricanes And Zombies

Get together drug ketamine to be upgraded to Class B

The announcement came as an inquest heard that Ellie Rowe, 18, died following snorting the drug at the Boomtown Honest festival in Winchester, Hampshire, last summer time.


Speaking at a drug therapy centre in west London, Mr Baker explained: “I’m not positive in the extremely extended phrase that the present system is a best a single for drug manage.”


He went on: “What I do consider is in the brief term there’s a message that wants to be sent on ketamine. In terms of the place we’re going in twenty or thirty many years time, in terms of the optimum strategy of minimising drug use then I am not certain.


“It undoubtedly right after all has not stopped drug use by classification. But what it does do is send a message to individuals who are interested.


“You have to assume some drug customers truly care about their bodies, as a result saying to them this is much more hazardous than that, what they will consider into account and what they will really do.”


He went on: “The classification has a worth in giving a steer to folks at the really least. Even so, individuals even now get medicines and are nonetheless obtaining convicted for having them.”


“It is greater to send a signal than not to send a signal.”


In December final 12 months the Advisory Council on the Misuse of Medication (ACMD) recommended that the drug be reclassified following locating evidence that it was much more hazardous than previously imagined.


Initially developed as an anaesthetic, and frequently utilized on horses during veterinary surgical procedure, ketamine was banned as a recreational drug in 2006


Mr Baker, who was moved to the Residence Office from the Department for Transport in October’s coalition reshuffle, has previously shown sympathies to arguments in favour of legalising or decriminalising cannabis.


But he denied his stance on ketamine gave a “mixed message”.


“I’m led by the evidence, in which the evidence requires you is in which you finish up going,” he said.


“Any individual who says we must legalise every single single drug is naive, and every person who says we must have every thing as a Group A drug is also naive.”


He additional: “That doesn’t automatically suggest the classification and the approach is often appropriate. It does not imply that.”


“I desired to go forward on the evidence base, wherever that takes you. It’s not a type of philosophical view. I’m not taking a libertarian see that everyone must be ready to do what they want and we’ll all have flowers in our hair and allow it all hang out.


“But nor am I taking the see that we need to be locked up and throw away the key.


“What helps is wise evaluation of the place and wherever that takes you,” he mentioned. “That may consider you to an unpleasant place.”


An estimated 120,000 folks misused the drug in England and Wales for the duration of 2012/13, figures recommend.


In March 2012, Property Secretary Theresa Could commissioned the Advisory Council on the Misuse of Medicines to refresh its advice on ketamine, which was last reviewed in 2004.


The announcement comes as a report warned users of legal highs they are “dancing in a minefield” after a huge surge in the quantity of deaths linked to the substances.


The variety of circumstances in which novel psychoactive substances – otherwise recognized as legal highs – were identified as the result in of death rose from ten in 2009 to 68 in 2012, in accordance to data published in the National Programme on Substance Abuse Deaths (NPSAD) report, compiled by specialists at St George’s, University of London.



Get together drug ketamine to be upgraded to Class B