NHS crisis: 40% of hospitals issue alert in first week of new year

More than 40% of hospitals had to declare an alert in the first week of January because they were experiencing major problems caused by having too many patients and too few spare beds.

Figures released by NHS England on Friday also show that 32 people have died from flu so far this winter and scores of others had to be treated in intensive care last week alone.

The data reveals that hospitals in England came under huge pressure in the first week of the new year. Serious levels of overcrowding worsened to levels generally regarded as dangerously high.

Overall, 95% of hospital beds were full from 2-8 January, up from 91% the week before.

A&E units became so busy they had to divert patients to other emergency departments 39 times, slightly fewer than the 42 a week earlier.

Bed shortages were exacerbated by outbreaks of norovirus, the diarrhoea and vomiting bug, forcing hospital managers to close 933 beds that were occupied and another 164 that were empty, making a total of 1,197 – almost one in 100 of the NHS’s total supply of 130,000 beds.

In that week, 58 of England’s 153 acute hospital trusts had to go on to what NHS England calls an Opel 3 alert and eight on to the highest form of alert, Opel 4. Both mean trusts are struggling to cope with the weight of demand.

Both take their name from NHS England’s Operating Pressures Escalation Levels framework. It sets out what steps trusts should take to manage the large numbers of patients.

The 58 trusts that went on Opel 3 alert did so because, according to guidance form NHS England, they were “experiencing major pressures compromising patient flow” – their ability to get patients in and out quickly enough – and needed to take “urgent actions” to keep functioning.

Eight went on Opel 4, also known as black alert, after becoming so stretched they were “unable to deliver comprehensive care” and there was “increased potential for patient care and safety to be compromised”.

A total of 375,687 people sought help at an A&E unit in the first week of January, up from 371,599 the week before. However, the number of people who needed to be admitted as an emergency fell from 92,480 to 89,712.

The Guardian reported this week that close to 30 trusts had been forced to declare a black alert since Monday, suggesting that already severe pressure on the NHS intensified this week.

NHS England has warned that the current spell of freezing weather could trigger a rise in the number of people falling seriously ill and also interfere with the running of services.

“This weather could increase the health risks to vulnerable patients and disrupt the delivery of services,” it said.

Prof Paul Cosford, Public Health England’s director for health protection and medical director, said people should keep their homes heated to at least 18C (64F), wear lots of thin layers rather than fewer thicker ones, and wear footwear with a good grip to cope with the snow and ice in many part of the country.

NHS crisis: 40% of hospitals issue alert in first week of new year

The obesity epidemic is an economic issue

It is estimated that today’s obesity epidemic costs the global economy about $ 2tn (£1.6tn) or some 3% of GDP. For individuals, deciding what to eat is a jealously guarded privilege, but for economists obesity is not really about people exercising free-market choice. Instead it is a market failure.

The causes of the epidemic are complex, spanning the social sciences to biology and technology. Consider, for example, the shift towards urbanisation and car transport. By reducing many people’s daily physical activity, these are estimated together to reduce individuals’ need for food by 300 calories a day. So how much less food should the car driver eat to compensate? About one biscuit less a day – a trivial change that only goes to illustrate that few of us really understand the energy needs of our bodies.

In market terms, making a rational choice at the dining table requires people to know how much energy they need and how much they are getting – yet neither of these is known. As any one who has ever tried to lose weight knows, in these matters talk is cheap and advice is unreliable. At various times sugar, protein, fat, starch, fast food, home cooking and snacks have all been held to be responsible for the obesity epidemic.

Back in the 1950s, the dominant theory was that eating fat was responsible for making you obese – and by sating appetite, sugar could help to reduce weight gain.

However, food companies prefer to deflect rhetoric about poor diet being the primary cause of obesity, and instead promote messages focused on exercise and other factors – a phenomenon termed “leanwashing”.

Nonetheless, the political spotlight is now on sugar, with “environmental” changes proposed to reduce the appeal of sugary foods, such as warning labels and nutritional information panels. There’s serious talk of taxing them, in the way that tobacco has been. None of this is supported by any real evidence, but certainly new taxes are always popular with governments. (It’s pretty obvious, after all, that there are plenty of thin children who enjoy sugary foods, and plenty of overweight people whose tastes lie elsewhere.)

Prof Kevin Fenton, national director for health and wellbeing at Public Health England, says there are “practical solutions”, by which he means a de-sugaring of foods such as cakes, biscuits and puddings. But these foods are not sugary by accident – they are sugary because that’s what we like about them. It’s like salted crisps having salt removed … but yes, the health industry has pushed that one too.

Solutions based on labelling of foods by calorific content to improve consumer choices belie both human psychology and the complexity of the body’s digestive mechanisms. As a result, it is futile leaving a solution to the food and drink industry, or on relying on “education” to correct consumer behaviour.

However, consumer choices are being skewed by government actions, such as massive programmes of agricultural support that actually favour fast foods over healthy eating. Billions of dollars go towards subsidising junk foods, through farm subsidies for producing ingredients such as soya and high-glucose corn syrup.

Obesity affects poor households far more than their richer neighbours – and the cost of eating healthily is a very practical reason why.

And, as the US economist Richard McKenzie has pointed out, much of the rise of obesity is precisely a consequence of free-market economics. For example, fast food has become cheaper, in part because of mechanisation and in part because the workers producing it are paid less and less. At the same time, the economic forces that propelled 1960s women away from the kitchen and into jobs also propelled families towards processed foodstuffs and eating out … or just snacking.

When markets go wrong, governments need to step in. Agricultural support should be switched away from junk foods and towards producing healthy ones. The low wages and poor training that fast-food outlets rely on should be made a thing of the past, and tax incentives (such as zero VAT) should support the labour-intensive production of “real food” in cafes and restaurants.

Market corrections, rather than punitive moves aimed at individuals, are the only way to tackle what has become, in economic as well as in social terms, a very real crisis.

Martin Cohen is editor of the Philosopher. His recent book, Paradigm Shift (Imprint 2015), discusses ‘how expert opinions keep changing’

The obesity epidemic is an economic issue

Why a porn star is fighting California"s condom law: "It"s a women"s rights issue"

What does a porn star wear when she hits the campaign trail?

A smile.

And a black net brassiere with intricate straps. A very short, peach satin romper open to the waist. A whole lot of deeply tanned skin. And a fist full of “No on Proposition 60” pamphlets.

Not familiar with Proposition 60? Neither were most of the students Tasha Reign (her nom de scène) encountered on a sunny Monday at the University of California, San Diego (UCSD).

The measure, one of 17 on the California ballot in November, would require adult entertainers to wear condoms while filming sex scenes. To the 27-year-old feminist with a fan base she calls her Reigndeers, Proposition 60 is an assault on her human rights, her artistic freedom and the very constitution itself.

Not to mention that it is often anatomically impractical.

“I do acts where I literally could not use condoms, whether that be anal, whether that be double penetration, whether that be multiple guys,” Reign told the Guardian. “I cannot even imagine having a group sex scene like that.”

I hate the idea that some man is going to tell me what I can and can’t do

Tasha Reign

The logistical hurdles are endless. How do you ensure that the same condom doesn’t find itself inside more than one woman? Do you stop filming while an actor swaps latex? What if the condom breaks during a particularly rigorous outing? This isn’t, she notes, regular sex, 20 or so comfy minutes and it’s over.

“It’s extremely difficult for somebody to be able to maintain an erection for 45 minutes, and to be able to pop with a condom, especially,” she said. “The bigger issue for me is that it opens up the gateway to mandate my body. I hate the idea that some man is going to tell me what I can and can’t do.”

Reign is a practitioner of gonzo porn – none of the cuddly couples stuff for her. Her Twitter feed is filled with political activism and waxed genitalia. As she campaigns in front of UCSD’s Geisel Library, she attracts attention, if not always votes.

Ten minutes before every hour, as one class ends and another is set to begin, the tree-lined walkway fills with students. Young women weighed down with heavy backpacks slide their eyes Reign’s way before hurrying off. A young man on a skate board does a double take fast enough to cause whiplash.

Tasha Reign talks to UC San Diego students about Proposition 60, which would require adult entertainers to wear condoms during sex scenes. Photograph: Ariana Drehsler for the Guardian

She walks up to student after student, leading with a smile, campaign literature in her outstretched hand. More often than not on this day, her targets scurry by. The young men at the fraternity table across the path rebuff her.

“It’s like a lot of rejection,” Reign says with a pout. “When they say no, I’m not used to it, actually.”

But she is not deterred. “Are you going to vote on Prop 60?” she begins, over and over. “Let me tell you about it. I’m an adult film star.”

The day after her UCSD foray, she arrives at California State University, Long Beach. In her first hour, she gives her pitch 18 times – 19 if you count the guy who said he wasn’t voting but hung around to talk to her anyway – and posed for a selfie with a young man in full Dodgers regalia.

I want to be able to say: I’m a sex worker. I have a choice in the way that I protect my genitals

Tasha Reign

“This would take away the choice we have to use condoms or not,” Reign tells them. The measure, she says, “incentivizes people to sue adult film stars, giving them access to their personal names, their personal home address, taking your tax dollars and putting it toward regulating an industry that does a really good job at self-regulating itself.”

“It’s a women’s rights issue,” she says. And “it’s also a freedom of speech issue.” And “it’s something the performers, the majority of us, don’t want passed.” And “we just want you guys to vote no.” And “tell your friends.”

Michael Weinstein, president of the Aids Healthcare Foundation, is the measure’s major backer. Neither he nor his organization responded to repeated requests for comment.

The Vote Yes on Prop 60 website says “condoms in porn is about protecting California employees at work.” Although Reign and other adult film actors undergo regular screening for HIV and other sexually transmitted diseases, such testing is voluntary.

The state’s Republican, Democratic and Libertarian parties have officially come out against the measure, along with Aids Project LA, Equality California, the Transgender Law Center and the San Francisco Aids Foundation.

Most major newspapers in the state recommend a no vote. The Los Angeles Times’ editorial against the measure points out that “any resident who spots a violation in a pornographic film shot in the state could sue and collect cash from the producers and purveyors if they prevail in court.”

Reign is a registered Democrat who supports Hillary Clinton for president. She had planned to vote for Bernie Sanders in the primary, but her mother persuaded her otherwise. She lives in the hills above Los Angeles with her Chihuahua mixes, Cinderella and Bambi, and her pot-bellied piglets, Harley and Quinn.

She graduated from UCLA with a degree in women’s studies. And she did not get into adult entertainment, she said, so she could be pushed around by a man like Weinstein “who has never been a sex worker” and doesn’t respect the choices she and her fellow performers make.

She doesn’t believe that such a person “should come in and tell me, on my own adult film set that I’m producing in my own home that I need to use a condom”.

“I want to be able to say: I’m a sex worker. I have a choice in the way that I protect my genitals. This is a huge issue for me.”

Why a porn star is fighting California"s condom law: "It"s a women"s rights issue"

British Vogue ditches models in favour of "real" women – for one issue

The new issue of British Vogue is to be a “model-free zone” after editors decided to use only “real” women to showcase the designer clothes featured in the magazine.

Among the women included in the issue are the architectural historian Shumi Bose, the charity director Brita Fernandez Schmidt, Hello Love Studio creative director and Hello Beautiful founder Jane Hutchison, and ice-cream brand creator Kitty Travers, as well as some of the women behind London’s Crossrail project.

Alexandra Shulman, the editor of British Vogue, said she commissioned the project because she felt strongly that professional women, or women in positions of authority or power, should be able to indulge their interest in fashion without it seeming frivolous. “In this country, there is still a stigma attached to clearly enjoying how you look and experimenting with it if you are a woman in the public eye and not in the fashion or entertainment business,” she told the Telegraph.

Shulman has edited British Vogue since 1992 and is venerated for her egalitarian attitude to body image. She does not publish stories about diets or cosmetic surgery, and in 2009 wrote a letter to all major designers arguing that the tiny sample sizes they offered for shoots encouraged models to be unhealthily thin. “I was also frustrated by a few designers’ PRs choosing only to lend their clothes if they approved of the appearance of the subject to be photographed rather than what they did,” she said.

The cover of the new Vogue issue, out on 6 October, may been seen to contradict Shulman’s previous claims that readers do not want a “real person” on the front of the magazine. In an interview for BBC Radio 2 in 2014, the editor told guest presenter Lily Allen: “People always say, ‘Why do you have thin models? That’s not what real people look like,’ but nobody really wants to see a real person looking like a real person on the cover of Vogue.

“I think Vogue is a magazine that’s about fantasy to some extent, and dreams, and an escape from real life. People don’t want to buy a magazine like Vogue to see what they see when they look in a mirror. They can do that for free.”

Shulman defended the choice of the actor Emily Blunt as the cover star of the “real” issue by pointing out that she plays an everyday woman in her new film, The Girl on the Train. According to Vogue, Blunt joked about appearing on her first cover: “It took three hours of hair and makeup to get me looking this real!”

The issue comes after H&M used the 60-year-old Scottish stylist Gillean McLeod as the face of its swimwear range and US brand J Crew used staff members and their friends instead of models to showcase its clothes at New York fashion week.

Women’s Equality party leader Sophie Walker has spoken out against ‘systematic malnutrition’ in the fashion industry. Photograph: Suki Dhanda for the Observer

The Women’s Equality party, meanwhile, is campaigning to change the fashion industry’s approach to body image by calling for designers showing in London to display at least two sample sizes, one of which must be more than a UK size 12.

Sophie Walker, the party’s leader, told the Guardian last month that these “tiny, tiny little clothes are such that normal-sized women have to starve themselves to fit into them. And we’re not talking a three-day soup diet here, which would be bad enough; we’re talking weeks and weeks of systematic malnutrition, for which young women are paid to fit into these tiny little sizes.”

Last week, four US Vogue editors were branded “jealous and hypocritical” after complaining about the presence of “pathetic” and “desperate” fashion bloggers at Milan fashion week.

Shulman distanced herself from the row, tweeting:

Alexandra Shulman (@AShulman2)

Can I just be CLEAR. The current Bloggersgate furore is via American Vogue not @BritishVogue.

October 3, 2016

British Vogue ditches models in favour of "real" women – for one issue

Bishop campaigns to highlight issue of body image among children

Rachel Treweek, the bishop of Gloucester, has said she is highlighting the issue of body image among children to challenge perceptions that physical appearance determines self-worth.

On Monday, Treweek – the first female bishop to sit in the House of Lords – will visit All Saints Academy in Cheltenham to talk to a group of 13- to 16-year-olds in the first of a series of school visits in her constituency to discuss the issue.

It follows a report from the Children’s Society last month that found one out of three girls aged 10 to 15 was unhappy with her appearance and felt ugly or worthless.

The study highlighted the growing pressure of social media with regard to body image. The proportion of girls with negative feelings about their bodies increased from 30% to 34% over five years; among boys it remained unchanged at 20%.

Treweek told the Guardian the issue urgently needed addressing. “When I talk to girls, it strikes me how much of how they view themselves and their self-worth is caught up with appearance and the way that society sees them,” she said. “Issues of health and mental health are more and more linked with how people are viewed by others, and much of that begins with external appearance.”

The bishop plans to listen to the concerns of teenagers over the coming months before considering what action can be taken.

“I want to challenge the subconscious messages we’re giving,” she said. “We need to look at the language we use as adults and how it shapes our culture. For example, when adults engage with girls, nearly always the first thing we say is a comment on appearance. We need to find out who they are, what they enjoy, what they’re good at, what makes their souls sing.”

She added: “I don’t want to say to girls: ‘Don’t worry about hair or nails or fashion’ – I want them to enjoy those things. But I want these things to be an expression of who they are, not their starting place.”

Treweek acknowledged that as one of a handful of female bishops she had a different perspective on society than her male colleagues. “The church doesn’t always appear in touch with people’s everyday lives. This faith stuff has got to connect with people’s lives – and if this is shown to be an issue affecting girls’ mental health and happiness, then we have to be listening to that, the church needs to engage with it.”

The Children’s Society report found that 14% of girls aged 10 to 15 were unhappy with their lives as a whole. Another study last month by the Department for Education found an increase in psychological distress among 14-year-olds in 2014 compared with similar research in 2005.

Bishop campaigns to highlight issue of body image among children

The NHS: well-off pensioners should pay a social care insurance | the big issue

In searching for a new tax to save the NHS and social care from collapse consideration should be given to a section of the populace that has so far been “featherbedded” by recent governments – retired pensioners who are comfortably well off (“UK needs new tax to save NHS and social care from collapse – top Tory”, News).

This group will probably have occupational and state pensions and possibly other income – state pensions have been increased by 2.5% each year for most of the last few years. Like most other pensioners they will also probably receive fuel allowances, free TV licences, bus passes, free medical prescriptions and eye tests and of course once retired they no longer pay national insurance. But they are becoming a greater burden on NHS and social care resources and I think it could certainly be fully justified if they were to pay a small percentage of national insurance tax, gradually increasing for higher incomes.

I am in my late 80s and would willingly pay a small percentage amount of national insurance, as long as I knew it would definitely be going into a separate NHS fund, not into general revenue. In fact, many other taxpayers would probably be willing to pay an extra amount of tax as long as they knew it was going into a separate NHS and social care fund.
John Hartley
Kirkby Lonsdale

Your front page story further reinforces the politically convenient narrative that the only problem facing the NHS is the increasing number of elderly people. As a late baby boomer I am fed up being regarded as a likely drain on the healthcare system.

Abysmal lifestyle habits, including excessive alcohol consumption and sugar- and fat-rich diets, contribute more to the cost of the NHS than geriatrics.

It’s a lazy and shabby argument to frame the NHS budget crisis principally around a demographic trend that is essentially a positive.

We can improve our personal health by taking responsibility for our lifestyle and we can stop clogging up A&E departments by being more sensible about what constitutes an emergency: we can’t actually stop getting old.
John Wilson
Magheralin
Craigavon

Twenty years ago, I spent a fortnight in the small German town of Weinheim, near Heidelberg, shadowing a German social worker. As a social worker myself I was keen to see how another EU country endeavoured to finance the needs of the frail elderly.

Dr Dan Poulter maintains that the British government needs to introduce a health and care tax as a matter of urgency. When I spent those two weeks in Germany, a new, strictly ringfenced tax had already been operating for a couple of years.

Known as the Pflegekasse (care insurance ), into which all age groups have to pay, it involves three levels of need, ranging from those who are still partly independent, but who need some assistance with personal care, to those who require several daily visits from care assistants, and also to those frail elderly or disabled of any age whose needs can only be met by admission to a care home.

This system, and the way it is paid for, speeds up discharge from hospital and helps to prevent many from being admitted to hospital in the first place. Twenty years on, the system is functioning well.

Why has a similar arrangement never been established in this country? I fear that now we have opted to leave the EU there is even less chance of a British government emulating a good, workable idea that has taken root in an EU country. After all, Britain always knows best, doesn’t it?
Alison Thompson
Thursby
Cumbria

The NHS: well-off pensioners should pay a social care insurance | the big issue

Male circumcision: the issue that ended my marriage

I was in my kitchen getting my children ready for the school run when my phone pinged. I glanced at my friend’s message: “Maybe of interest…!” I paused on seeing the news report she’d sent – a High Court ruling against a Muslim father’s wish that his two young sons be circumcised. The children in the case were to decide for themselves when they were old enough to do so. I felt stunned. Like the mother in the case, I’m from the UK, with a background in which male circumcision is no longer routine. Like the father, my ex-partner is Muslim and wished to have our sons circumcised according to his cultural and religious beliefs. The boys in the High Court case were a similar age to our sons, too – mine are now seven and five. The court’s decision felt extremely close to home.

I took the children to school. On returning home, I sat down to re-read the all-too-brief news report. I cried tears of sadness, relief and remaining fears. While our family has managed to avoid taking our conflict over circumcision to court, the issue has been a major factor in the break-up of our marriage. It also remains alive for us as we negotiate the upbringing of our children. It is something I never imagined would affect me – I’m not Jewish or Muslim and think most parents in the UK don’t for a moment consider circumcising their sons. When you know it is not medically necessary, that it is painful and that there is no other reason to, why would you?

The idea of being cut had stuck in my son’s mind

I was living in Istanbul when my husband and I learned I was pregnant with a boy. I had already become aware of male circumcision being routine in Turkey, grounded both in religious tradition and the widespread belief that it is more hygienic and protects against sexually transmitted diseases. And I knew that my husband believed circumcision to be healthy and the “right thing to do”. On holiday back in the UK and in conversation with my husband, he was adamant our son should be circumcised. I disagreed, arguing it would hurt our child. I asked whether washing was not better than cutting off part of the body to be clean and whether it could be dangerous to believe oneself safer from STDs. As the argument became more polarised, I played for time. I knew my husband to be open-minded, and while his religious belief was strong, he did not follow all the basic Islamic prescripts. I believed he would rethink, and I wanted to trust that both of our opinions and the rights of our child would be important in the decision. I wanted our family to stay intact, as well as my son’s body. We finally agreed on a compromise that our son would, at an age when he could be aware of all the issues, decide for himself.

For my husband this was a compromise of timing on one level – sünnet is usually performed at around six or seven years of age in Turkey. It was also about him losing the role to choose this for his son, and in consequence facing the reactions of his immediate and extended family, his home community, work colleagues and many of his friends. We shared with each other our mutual thought that no one would be likely to freely decide to be circumcised. But he insisted he was glad about our decision. Respecting my husband’s beliefs and intention – that he wanted what was best for our son – meant a huge compromise for me because in the future I would have to discuss circumcision as an option with our son. But I believed that in this compromise our child had at least been given his right to choose.

Our lives continued. Work dominated my husband’s waking hours, as our son’s needs filled mine, and our home was close to his work to make our lives together more practical. During his breaks from work, we would meet and walk around the centre of Istanbul. We learned each other’s languages, met friends, tried out street foods and local cafés. The old city is beautiful, containing the vast structures of the sixth-century Hagia Sophia, the Blue Mosque and Topkapi Palace. It has the open space and green parks lacking in many other areas of the sprawling yet condensed and concreted megacity.

Under the knife: a boy being circumcised in Istanbul. Photograph: Bradley Secker

One day we were walking by the seafront of the Bosphorus, with the edge of Asia and the Princes Islands in sight over the bright blue water. Holding our son’s hands to support him as he began standing on his feet, my husband brought up the topic of circumcision, and his eyes flashed in anger. He claimed my stand against it was because I was dissatisfied with him. I wanted to keep the decision about our son separate, not argue in front of our child, and not complicate the issue. I said it was a decision about our son’s body, health and autonomy, not his. As our argument over the possible effects of the operation deepened, he finally thrust our son into my arms saying: “There. Go. Take your baby.”

My head was spinning. I thought about leaving for the UK. I could pick up our passports and take a plane and be out of the situation for good. I didn’t want the fighting or the insecurities, but I also didn’t want to leave so suddenly in such a sad way. I wanted to believe that, in time, our relationship could heal. Again, the difficulty of the moment seemed to pass. I visited family and friends in the UK a few months later, taking our son for his first birthday. I returned to Turkey and not long after became pregnant with our second son.

In the sweltering heat of Istanbul, our son would often toddle naked around our home. I overheard my husband joking with him one day about his future circumcision. “Let’s cut it, won’t that be fun!” Disturbed, and seeing our son disturbed, too, I immediately objected. I also realised children must be psychologically prepared by their adult carers to undergo circumcision. I would often see sünnet celebration parties on the streets of Istanbul. Boys may be nervous, but they also become objects of pride. They are fêted by their families, dressed up in shiny white, fur-trimmed costumes and given gifts of money and gold. Circumcision is seen as a rite of passage towards becoming a man.

Through tears my husband said how important it was

Attempting to prepare our son for circumcision felt like a betrayal of our compromise that our son would be free to choose for himself. When he started to wake up crying, talking of nightmares of being cut, I objected more strongly to any discussion of the matter until he was older. I told my husband of our son’s nightmares and obvious confusion and fear. I sought to reassure my child that no one would hurt him, that his baba had only been joking and would stop.

The idea of being cut, however, had stuck in my son’s mind. He asked questions and my husband wanted to answer. When my husband asked me to research male circumcision to understand the benefits, I agreed. At one level, wishing the tensions within our family might be resolved, I was open to finding out whether the claims of benefits might be true. But turning to the internet, what I found was an overwhelming amount of information supporting remaining intact.

That was when I knew I had to try to persuade him we couldn’t circumcise our son. I began by bringing up the most obvious negative argument of resulting harm. My husband maintained it was far safer in medical clinics than the rural homestead in which he had been circumcised. (I had seen a sepia-faded photograph, a large crowd of men surrounding him on what looked like a hot and dusty day to witness his circumcision as a young child.) I suggested he read a Muslim site which contained some of the most extensive and detailed medical research I had found together with Islamic religious argument against circumcision. He flatly refused. After some time, I tried to share more of the information I’d found. But I felt I was talking to a wall – he simply did not want to discuss it further. And circumcision, he said, was going to happen.

Our marriage suffered increasingly and circumcision seemed to have cracked its foundations. I told my husband that I wanted us to move as a family to the UK, believing we could all be happier there. I wanted our sons to start school there, and my father was in growing need of home care. The nearing threat of circumcision had become a pushing factor, too, though one I felt I could no longer safely voice.

It was late summer 2011. We had been walking through the Egyptian bazaar and had picked up some spiced salad wraps to eat in Gülhane Park. Our eldest son was sleeping in his pushchair, while I carried my youngest, just a couple of months old, in a sling. We were discussing a trip to my husband’s village to visit his family. Through rarely seen tears he began to explain how important circumcision was, that it was about belonging, and that, in effect, if his sons were not circumcised, they simply would not be his. I replied there was so much more to being a father that created a sense of belonging. And that in a way he was right – our children’s bodies and lives were not “his” to make such a decision over.

I was disturbed by his emotions and the extremity of his statement, recalling the time he told me to take the baby and go. I refused to accept responsibility for his feelings about whether he felt his children were his or not. It seemed his family’s views and his social status in connection with them were more important than our relationship or our children.

It sounds perhaps obvious that I should have left earlier. On the other hand many people, I know, would think I should have stayed and consented to my sons’ circumcision for the sake of my marriage, the vows I took, social harmony, community and family belonging. But I never agreed to it, and never expressed a wish to become Muslim. Even if I had, I would argue that I had the right to change my mind, and that Islam has space for pro-intact arguments on health and religious grounds. I wanted to create a good relationship with my husband, I wanted our children to have both of us bringing them up. But with each argument and the intensity of them stacking up, together with refusal on his part to read the evidence against circumcision and for staying intact, I found it increasingly impossible to trust him. I began to worry he might just take them and have the operation done. I had to balance my growing fears with a mix of reasoning that he hadn’t yet done this, he wouldn’t want to damage our relationship further, that he would want the ceremony around the occasion were it to happen, that it was too early, that I did 99.9% of the physical caring for our children, that there was little practical opportunity for him to take them.

The aftermath: a check-up before the party starts. Photograph: Bradley Secker

Our lives grew more separate on an everyday basis. He stayed overnight at work, and we met to do food shopping, or I would take the children to meet him for breakfast or lunch. I had my date set for leaving Turkey for the UK and was open about keeping to it. We arranged a visa to the UK for my husband. I hoped he might join us after we had settled there – once he had visited a few times and could see opportunity for work or creating a business. In private, I counted down the days, growing desperate to leave and be safely back home.

In the end, my husband remained in Istanbul. We’ve since separated and though we work to keep our relationship positive for our sons’ sake it has been hard to do.

I began to fear I might not see my boys again

As soon as we were in the UK, my husband tried repeatedly and angrily to persuade me to visit. Without him expressing a wish to join us to live in the UK and with his angry outbursts over circumcision, I saw this as threatening. I needed to retreat from direct contact and continued to let the children talk with him on Skype, supervising from a distance. He visited and, as it became more difficult, with his demands that I take them to Istanbul or put them on a plane or take them to London so that he could take them, I made it clear this would not happen until they were older. It wasn’t only about circumcision by that point, though that was enough reason. I also began to fear that were they to go to Turkey I might never see them again.

The mirror situation was not lost on me – it is difficult and expensive for many Turks to travel to the UK and his family is large. They are missing seeing our sons grow up.

Time passed and anger again cooled. Now my sons’ father visits the UK two to three times a year to spend time with them. In between visits they talk and laugh on Skype, exchange voice, emoticon and text messages. We each value their happiness and wellbeing, and want them to grow aware of their Turkish heritage and family. But I do not feel free to build trust on behalf of my children that they would not be circumcised given some opportunity for it to be done, in the UK or elsewhere.

In Turkey, I would not have a legal say either way. Over the phone, I also explained I felt unsafe going to Istanbul, where my consent or presence was not required for our sons to be circumcised. He said “of course mothers attend the operation and you would be there”. As much as I could not accept it would happen, he still seemed to think it unimaginable it would not, that I simply needed reassuring that I would be there to care for my children. My husband agreed to read some of the research on circumcision that explained its negative impacts and why staying intact was healthier. He re-agreed on our original compromise, saying he did not want to hurt us. But trust is hard and slow to rebuild.

The High Court ruling, upholding the rights of two children to choose upon maturity, and the rights of both parents to be heard, offers some reassurance. It also throws up a lot of questions. Were the dissenting parent also Muslim it is not at all clear which way the law would fall. The UK also allows pretty much anyone to circumcise boys pretty much anywhere – it’s almost completely unregulated despite well-known medical risks. How could the law be effective in preventing someone determined to have their child circumcised? And how can I ever feel that my sons will be safe?

Male circumcision: the issue that ended my marriage

AIDS: The Issue Is The Pope

Those of you who shell out interest to the journal Science most likely already know that they put an picture — just a body shot — of transgender ladies on the cover, to highlight a special part on AIDS.

Here’s the offending image:

There is a good summary of the controversy right here. Separately from the problems of the male gaze and transgender rights, I want to level out one thing else: most of the difficulties in combating AIDS have been due to guys in power: Ronald Reagan, the last 3 Popes, and different other people. If you want to highlight the true challenges in defeating AIDS, they are your cover image they are the ones who made policies that made it tougher for vulnerable populations to get the one particular issue we know protects against AIDS: condoms. A cover shot of headless transgender women is titillation that doesn’t strike at the actual dilemma: policy.

With out creating condoms available, with out educating people about their protective choices, we exacerbate a dilemma in which we previously have a remedy in hand. In that sense, the most significant obstacle to AIDS is none other than the Catholic Church.

In Could 2005, one particular of the first items that Pope Benedict XVI deigned to inform us was that the traditional teaching of the Church is the only way to shield against HIV. This is madness we know condoms safeguard men and women. It is not anti-science — it is anti-fact. And before you level out that we have a new Pope now, let me just display you that we’ve acquired far more of the same coming from celibate guys who really do not truly fret about feasible sexual assaults, dumb teenage sexuality, or kid marriages. Kissing the feet of AIDS individuals is not the very same as protecting the vulnerable, anything Francis has abjectly failed at.

It’s also well worth reminding the globe about Ronald Reagan’s toxic legacy: I wouldn’t mind generating him the poster-boy for the epidemic, offered how small he did to end it. Thousands, if not hundreds of thousands, of deaths can be laid immediately at his feet.

If you want to modify AIDS policy, make the face of AIDS issues the policy-makers. Transgender prostitutes are usually not in the same positions of power to make decisions that will impact hundreds of thousands of people. Target the real sinners: the ones who make the decisions that harm the vulnerable.

*Full disclosure: I am Catholic. Even though if the Pope decides to excommunicate me, I do not consider I’ll mind it also significantly often that’s the price you shell out for morality and compassion.

AIDS: The Issue Is The Pope

AIDS: The Issue Is The Pope

Those of you who spend attention to the journal Science possibly currently know that they put an picture — just a body shot — of transgender ladies on the cover, to highlight a unique section on AIDS.

Here’s the offending picture:

There’s a good summary of the controversy here. Individually from the concerns of the male gaze and transgender rights, I want to stage out anything else: most of the troubles in combating AIDS have been due to men in electrical power: Ronald Reagan, the last three Popes, and a variety of other individuals. If you want to highlight the genuine challenges in defeating AIDS, they’re your cover picture they’re the ones who made policies that created it more difficult for vulnerable populations to get the 1 point we know protects against AIDS: condoms. A cover shot of headless transgender females is titillation that does not strike at the genuine dilemma: policy.

With no generating condoms obtainable, with out educating folks about their protective options, we exacerbate a dilemma the place we previously have a answer in hand. In that sense, the biggest obstacle to AIDS is none other than the Catholic Church.

In Could 2005, one particular of the very first items that Pope Benedict XVI deigned to tell us was that the traditional teaching of the Church is the only way to defend against HIV. This is madness we know condoms protect folks. It is not anti-science — it is anti-reality. And prior to you point out that we have a new Pope now, let me just present you that we’ve acquired far more of the identical coming from celibate males who don’t truly worry about feasible sexual assaults, dumb teenage sexuality, or youngster marriages. Kissing the feet of AIDS patients is not the very same as protecting the vulnerable, anything Francis has abjectly failed at.

It is also well worth reminding the planet about Ronald Reagan’s toxic legacy: I wouldn’t mind generating him the poster-boy for the epidemic, provided how small he did to cease it. Thousands, if not millions, of deaths can be laid right at his feet.

If you want to modify AIDS policy, make the face of AIDS troubles the policy-makers. Transgender prostitutes are frequently not in the exact same positions of energy to make selections that will result millions of folks. Target the real sinners: the ones who make the selections that harm the vulnerable.

*Full disclosure: I am Catholic. Although if the Pope decides to excommunicate me, I do not think I’ll thoughts it as well a lot occasionally that is the value you spend for morality and compassion.

AIDS: The Issue Is The Pope

Poor hospital foods is not just a issue for sufferers it has an effect on NHS employees also

An audit of NHS trusts in London discovered only 19% reported obtaining healthful consuming policies, writes Na’eem Ahmed. Photograph: Rui Vieira/PA

In his very first media interview Simon Stevens, the chief executive of NHS England, stated that employers must get an lively interest in personnel wellness and wellbeing. Stevens’ earlier organisation UnitedHealth offered all workers economic incentives for well being improvement, which includes reductions in body mass index for individuals with a higher-than-excellent BMI. As the purveyor of overall health and wellbeing, how is the NHS carrying out in marketing a healthier life-style between its own?

In 2009, the Division of Wellness estimated that of the one.two million personnel in the NHS, about 300,000 would be classified as obese and a more 400,000 as obese. Obesity, even though induced by many aspects, is greatly influenced by our choice of diet. Individuals functioning inside of the NHS would agree that food in hospitals is limited in selection, reasonably pricey and primarily unhealthy.

The issue of the quality of meals in hospitals is not a new one particular. In 1963, a report from the Nuffield Believe in discovered that hospital meals were overcooked and cold, with minor assortment and bad dietary material. Far more latest press coverage reiterates some of these concerns. The campaign for far better hospital food has centred on patients, with significantly less interest offered to bettering provision for NHS staff. Despite the looming burden of weight problems amid workers, an audit of NHS trusts in London found that only 19% reported getting wholesome consuming policies and 8% particular policies for bodily activity for workers.

Failure to tackle the problem of personnel wellbeing might translate into poorer outcomes for patients. For the duration of the latest Keogh evaluation, Sir Bruce said: “All NHS organisations will realize the constructive affect that content and engaged personnel have on patient outcomes, which includes mortality prices, and will be producing this a essential component of their high quality improvement technique.”

In an ambiance of fiscal constraint, there is a powerful monetary case for bettering NHS employees wellbeing too it is estimated that if current prices of sickness have been diminished by a third, it could translate into an yearly direct cost conserving of £555m.

So what can be completed? The Royal University of Physicians’ Action on Obesity report outlines suggestions for minimizing weight problems between employees including implementation of Good recommendations for weight problems in the workplace and better labeling of meals in hospitals. However diktats from policymakers on hospital catering reform appear to have acquired tiny or no traction.

Locally led initiatives are starting to challenge the standing quo. The pioneering Hitchingbrooke hospital lately won the prize for meals excellence from the Soil Association. Their site claims that patient satisfaction jumped to 92% just two months right after new menus have been introduced. The new menus, set by a Michelin-trained head chef, included changing frozen vegetables with fresh, locally sourced veggies and sourcing all meat from regional farms.

Hospital trusts and commissioners can play a top role in reform firstly by reviewing present provision and setting much more stringent nutritional criteria within contracts. They need to encourage more healthy options and increase competitors amongst suppliers to drive up high quality. Atriums and foyers within hospitals could be transformed by social enterprises to provide healthful food in the type of versatile pop-up retailers, which are getting to be more and more well-known within purchasing centres and on high streets.

Patient and staff wellbeing are our most powerful drivers for alter. As Dr Dan Poulter prepares to announce his suggestions for hospital catering companies it is evident that urgent reform is essential each to avert NHS colleagues inadvertently including to the chronic ailment burden on the well being service and to make certain that we accomplish and sustain large-good quality care for our patients.

Dr Na’eem Ahmed is clinical fellow to Prof Sir Bruce Keogh at NHS England 

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Poor hospital foods is not just a issue for sufferers it has an effect on NHS employees also

Imam Baba Leigh: "FGM is not a private issue. It is a throughout the world issue"

A prominent Muslim activist and cleric, who was thrown into prison in his property country of The Gambia for speaking out against the government, has come out in help of the Guardian-backed campaign to highlight the plight of females and women in the US who are forced to undergo female genital mutilation (FGM).

Imam Baba Leigh advised the Guardian that he supports a campaign by Jaha Dukureh, a 24-yr-old survivor of FGM, to petition the US government to produce a extensive plan to finish FGM and provide companies to folks who have already been subjected to the practice.

“We all want to support her for the straightforward reality that she is a top witness,” said Leigh, adding that even though he can campaign against it, Dukureh skilled the practice first-hand and is aware of far better than most how it affects people.

Leigh, who now lives in Maryland soon after fleeing The Gambia following his release from prison final yr, stated: “FGM is not a individual issue. It is a throughout the world issue.”

The first stage of Dukureh’s national campaign against FGM is a petition to get the Obama administration to commission a report that would update statistics on the prevalence of women subjected to FGM in the US, which had collected far more than 62,200 signatures by Tuesday afternoon.

While some people associate FGM with Islam and declare the religion condones it, individuals of a number of religions engage in the practice, and it is not supported in the Qur’an. “The bodily harm that it leads to to a younger, innocent woman, cannot be supported by Islam,” Leigh mentioned.

Leigh’s human rights advocacy has manufactured him a government target in The Gambia. He was arrested in December 2012 and held for a lot more than 5 months after publicly condemning the execution of 9 prisoners by the Gambian government. Prior to his arrest, the government threatened Leigh for his criticism of the president and advocacy function on problems such as FGM.

“The practice is cultural, it’s classic, it’s deeply rooted culture but it’s not religious,” Leigh explained. This traditional practice is responsible for the death of his older sister, at the age of 29, an additional key cause he does not assistance FGM.

The Guardian along with Congressman Joe Crowley, UN secretary standard Ban Ki Moon and a lot more than 50,000 folks are backing Dukureh’s campaign to get the US government to commission a report on FGM in the US.

Leigh believes the practice will finish at some point. “I consider it is a matter of time that it will quit, in the sense that much more men and women are sensitized now and folks are much more educated about the side effects of it and it has been witnessed also as a violation of child’s rights,” Leigh stated. “It is a violation of women’s rights. At the finish of the day, it is a violation of human rights because girls are human beings as well.”

Imam Baba Leigh: "FGM is not a private issue. It is a throughout the world issue"

Cancer sufferer Stephen Sutton"s issue "deteriorated"

“He is presently comfy and stable, and we will allow you know of any further developments.

“Right now even so, as a household, we wish for a particular quantity of privacy for us to spend what time he has remaining with him.

“We value everyone’s concern, and for all the really like and goodwill sent his way, and indeed ours too, we thank you deeply x.”

Just days ago Mr Sutton admitted feeling angry with the physicians who had initially misdiagnosed his issue as constipation, making it possible for the cancer to advance.

He mentioned: “If it had been caught earlier it could have led to a much better prognosis. It could have altered the scenario.

“But even saying that, I’m not a single to dwell on the previous. It is what it is.”

Mr Sutton played football for Walsall youth crew and competed in cross-nation operating and athletics at county degree just before he started to endure abdomen cramps, excess weight reduction, sickness and reduction of appetite in 2011.

But medical professionals sent him home with laxatives, regardless of a family background of Lynch Syndrome, a genetic condition that increases the danger of bowel cancer and a range of other tumours.

“I lost two stone in excess weight and was very, very unwell,” Mr Sutton mentioned.

“We gave the medical professionals all the data they necessary, informed them about the loved ones background and even showed them a booklet about Lynch Syndrome.

“It explained the widespread symptoms of bowel cancer — I had every single 1. But I just naively listened to them, hoping it was going to get greater.”

He was finally provided an emergency CT scan when he had deteriorated so a lot that he could not maintain down fluids or meals and was unable to rest due to the fact of the ache.

The scan uncovered a blockage in his bowel. The following day, he underwent surgical procedure which uncovered that the development was cancerous.

Considering that then, the 19-year-outdated has collected more than £3.22 million for the Teenage Cancer Trust given that posting a picture of himself in hospital in April with a goodbye message when he believed he was close to death.

Nevertheless, he created what he described as “a miraculous recovery”, coughing up a tumour, and soon after successful surgical treatment was properly enough to be discharged from Birmingham’s Queen Elizabeth Hospital on Could 2.

But commenting on his Facebook webpage final Sunday he advised supporters he was again posting from his hospital bed.

He explained: “Regrettably these days I have ended up back in hospital. I had some breathing issues commencing final night and soon after going to A&ampE have been admitted back to a ward for monitoring.

“I have even now got the cough, then quite swiftly created a wheeze in my breathing and breathlessness on any physical exertion.

“There is no immediate panic and I’m currently really secure – I have been put on nebulisers and other meds which are at the moment assisting my symptoms hugely.”

He added: “The medical professionals consider there may possibly be anything restricting my airway once again, they’re not confident specifically what nevertheless however (tumour regrowth, infection, irritation, are all likely reasons pointed out), but are at the moment discussing the prospects and my scan final results to make a decision what to do subsequent.”

Cancer sufferer Stephen Sutton"s issue "deteriorated"

Usher syndrome: "Don"t define me by a issue I occur to have"

Nick Sturley, who has Usher, writes novels, pantomimes and movies.

Nick Sturley still recalls the train journey home from a hospital check out in London when he was 10 years old. His mother sat opposite him, reassuring him that she was fine, but even at that age he was a master at studying visual cues, and he could inform that something was wrong.

At the hospital, Sturley had been given eye drops and a variety of tests. Afterwards, he sat in an office while his mother talked to the physician. Being deaf, he had no thought what they were saying, and it was only later on, by way of letters among home and his boarding college, that his mom explained that he had “tunnel vision”. He says that when he was “diagnosed as profoundly deaf when I was 10 months outdated [it] was a undesirable ample shock for my mother and father, but to be advised I would also go blind was devastating”.

Sturley had been diagnosed with Usher syndrome, a genetic problem that has an effect on hearing, vision and stability. Generally, the hearing reduction is there from birth. The discovery of a gradual reduction in vision – men and women recognize that they are locating it tougher to see at evening and that their peripheral vision is narrowing – typically comes significantly later on.

There is a debate that most people who are deaf or blind experience at some stage – which is less complicated to deal with? For several who already have one particular issue, it is unthinkable to have the two. Sturley’s sight decreased by means of his 20s, and he says his lowest point was a period of loneliness in the summer season of 1999. He could barely see, and discovered himself alone in his flat although his close friends had been away. “I drank and smoked quite a lot and was extremely depressed.” But the growth of the world wide web helped him out of his “dark hole” and he set up UsherLife, which connects men and women with Ushers, in the virtual and genuine globe.

Despite currently being forced to give up a total-time media occupation at 31, Sturley knew that he “was not the kind who would sit in front of the telly all day”. He makes use of display magnification on his computer: he has written three pantomimes starring deaf actors, two novels, and written and directed two indicator-language films.

He now communicates making use of hands-on British Indicator Language (BSL), feeling the signs individuals are producing with his hands. He says that one of his greatest frustrations is that he are not able to do things spontaneously any a lot more: he demands a communicator manual in purchase to go out socially. But he has a positive mindset, and says he tries “to sweep it aside and get on with it until the subsequent second”.

Author Cristina Hartmann, from San Francisco, knew she had Usher from a young age, but even though she did not hide it, she “never talked about it both”. Then final year, she “came out” in a website for an on the web local community. She says the response “was massive and unexpected”. She describes it as a bodyweight off her shoulders, but adds: “I did not want men and women to define me by a issue I happen to have.”

Impulsive by nature, Hartmann explains that obtaining Usher has manufactured her “a a lot more cautious and cautious individual than I would be otherwise”. She makes sure she has a friend with her at parties, and memorises public transport schedules. And although obtaining Usher can make her come to feel “uncertain what is taking place around me, which is bewildering and unsettling”, it has also created her “learn how to enjoy what I have when I have it … pals, family, and individuals who show kindness to me”.

For Emma Boswell, the greatest blow after her diagnosis was shedding her driving licence. Twenty years on, she nonetheless misses driving in the countryside, but says that possessing Usher has manufactured her “independent and challenging”. She is married and has two youthful kids. Following getting diagnosed with cancer two years ago, she made a decision to help other deaf men and women with the disease by setting up a support group in London. She is the chair of the Worldwide Usher Network and performs for the charity Sense.

The help every man or woman with Usher requirements is various, she says. Some require help with communication, other people with mobility. People with Usher can discover their diagnosis “traumatic, devastating, upsetting and distressing … but several have a very good lifestyle, some go to university and university, travel, have excellent jobs and have children, adjusting to their demands as their sight deteriorates”.

Even though diagnosis can be deeply distressing, it can also give individuals the opportunity to look for new targets: 36-yr-outdated James Clarke aims to run one hundred races and has carried out 59 so far.

“Accept the way you are. Be accurate,” reads an anonymous poem by a Manchester artist/photographer with Usher. The poem explains how men and women with Usher see the world via a different lens: “My fingers are my eyes, my hands are my ears,” the opening lines say. “I produce my sense of room with my thoughts.”

Usher syndrome: "Don"t define me by a issue I occur to have"

We asthmatics know our issue ideal. So trust us with Ventolin, GPs and chemists | Giles Fraser

‘Generally speaking, people with asthma know how properly their lungs are functioning. We don’t go to the physician for exciting.’ Photograph: Corbis

I have had asthma considering that I was a kid. People long sleepless nights, as well frightened to lie down, breathing as if via cotton wool. In fact, it is the breathing out that is frequently more challenging it’s like pushing against some hidden force that will not allow you expel the air from your lungs. And the wonder of Ventolin is that, most of the time, it can open up your lungs in a few moments.

Oh how I need to have that magical blue puffer. I can’t leave the residence with out it. And when I run out or get rid of it (and, being disorganised, this occurs quite a great deal), I panic. Beg, borrow or steal: I require a single with me at all instances.

But it really is quicker and less complicated to get recreational pharmaceuticals in my element of south London. It normally requires over a week to get a doctor’s appointment and often 3 days to procedure a repeat prescription. You can go into a pharmacy and inquire for an emergency supply but there is absolutely no consistency in whether a pharmacist will permit you to have one. Some do so straight away, other folks give you the third degree and hold you waiting for an hour or so, some just refuse. I now have a pretty comprehensive mental directory of the useful pharmacists and the unhelpful pharmacists in central London. In a quantity of European countries you can buy them in excess of the counter. I generally stock up if I go to France.

Five and a half million men and women in this country have asthma and 1,242 people died of asthma attacks in 2012. Worryingly, a report just published on asthma deaths in the United kingdom concludes that there is a large degree of complacency between health care pros about its treatment.

This corresponds to my very own long, albeit personal, encounter of dealing with medical professionals treating my asthma. The issue is that GPs often will not pay attention effectively to the insight that asthmatics have into their own situation. It is profoundly irritating to sooner or later get an appointment when a single is gasping for air only to be provided a fundamental and patronising tutorial in how to use Ventolin. Normally speaking, folks with asthma know how properly their lungs are functioning. I can normally guess with surprising accuracy what my expiration charge (peak movement reading) is at any provided second. We don’t go to the doctor for fun. They want to pay attention to their sufferers much more.

Yes, we asthmatics can be our very own worst enemies. Numerous of us will not use our preventative inhalers as considerably as we ought. And some of us are foolish adequate to smoke also. But none of this will take away from how hard it frequently is to get the medicines we require.

Personally, I believe Ventolin ought to be offered in excess of the counter in this nation. It is not as if there are people queuing up to use Ventolin at raves. Nor have I ever heard of anybody who has harmed themselves by taking too considerably of their puffer – yes, if you overdose you can get a bit shakey. But you can overdose on water.

Is not it time we started out trusting asthmatics a bit much more in the treatment method of their very own condition?

We asthmatics know our issue ideal. So trust us with Ventolin, GPs and chemists | Giles Fraser

Sleep Issue Linked To Degenerative Brain Disease

A little-acknowledged rest disorder that brings about you to act out your dreams can predict the future onset of Parkinson’s, Alzheimer’s, or an additional brain condition, new analysis shows.

In fact, 80 to 90 % of folks who produce Fast Eye Motion (REM) rest habits disorder will create degenerative brain ailment within the near potential, says researcher John Peever, MD, associate professor at the University of Toronto.

“Rapid-eye-movement sleep behaviour disorder (RBD) is not just a precursor but also a vital warning sign of neurodegeneration that can lead to brain illness,” says Peever, incorporating that the sleep issues must now be considered the “best technique of predicting the onset of brain ailment.”

Peever’s study, published this week in Trends in Neurosciences, suggests the hyperlink happens simply because brain degeneration attacks the brain circuits controlling REM rest just before it attacks individuals areas involved in Parkinson’s, Alzheimer’s, and other neurodegenerative circumstances.

Which can make sense, as investigation hones in on the connection in between sleep and brain wellness. Recent research have identified that lack of rest kills brain cells and that healthy sleep detoxes the brain.

How do you know if you have REM sleep behavior disorder? Oh, you will know. People with REM rest behavior disorder act out their dreams, frequently hitting, kicking, yelling, screaming, or leaping out of bed in the course of the REM phase of sleep.

If you have REMBD, you might locate oneself grabbing or punching your sleeping companion (to the point of hurting them), or falling completely out of bed.

And even though REMBD (also called REM habits disorder, and alternatively abbreviated RBD, REMSBD, and REMBD) is frequently puzzled with sleepwalking, it’s not the same point.

The easiest way to inform the difference: sleepwalkers have a challenging time waking up, and are groggy and puzzled when you wake them up. Those with REMBD, on the other hand, pop awake completely alert and aware of what they were carrying out. Also, when you sleepwalk you generally really don’t bear in mind your dream clearly, while if you have REMBD you generally remember specifically what you had been doing and why.

Rest happens in five distinct phases, the the fifth of which is REM, the sleep stage in which you are most very likely to dream. REM rest is also the most active rest phase, when you may discover by yourself twitching or tossing. However typically for the duration of REM sleep your brain sends a signal temporarily paralyzing your muscle tissues. So even when you dream you’re working away from a criminal, for illustration, your legs don’t move. Nevertheless, in individuals with REM sleep habits disorder, this paralysis ceases to occur.

REMBD is most widespread in older guys – 90 percent of men and women who create it are male, and most are more than the age of 50. Scientists presently knew REMBD was related with certain brain issues, such as Parkinson’s study has shown that about 30 % of people diagnosed with REMBD will build Parkinson’s inside three years.

Nevertheless prior scientific studies have not identified this kind of an intense correlation as Peever’s investigation 80 to 90 % is a huge percentage.

As soon as you’re diagnosed with REMBD, the normal therapy is a muscle relaxant this kind of as clonazepam (Clomid or Klonopin). Nevertheless this new analysis suggests it is a great notion for anyone diagnosed with REMBD to have a comprehensive workup for Parkinson’s, Alzheimer’s, dementia, and other brain problems.

Prescription drugs are offered for many of these problems that can delay or slow progression of the disease when taken early ample, so REMBD could serve as an alert to do so.

Explains Peever: “It’s important for clinicians to acknowledge RBD as a likely indication of brain illness in purchase to diagnose patients at an earlier stage. This is essential since drugs that lessen neurodegeneration could be used in RBD sufferers to stop (or defend) them from building a lot more extreme degenerative ailments.”

For a lot more well being news, comply with me right here on Forbes.com, on Twitter, @MelanieHaiken, and subscribe to my posts on Facebook.

Sleep Issue Linked To Degenerative Brain Disease

Can military manoeuvres tackle Britain"s sloth issue?

The overall health and attractiveness business is one of the few to have continued booming through the last economic downturn, with a 66 per cent boost in the value of United kingdom fitness clubs, from £2.4bn in 2006 to nearly £4bn final year.

Yet it would seem to be fighting a losing battle – these days an all-get together Parliamentary commission warns that an “epidemic of physical inactivity” has developed the most unfit generation in history, with couch potato lifestyles blamed for 37,000 early deaths a 12 months.

Seventeen females, all professionals, most in their 30s and 40s, have signed up for a week’s bootcamp in Spain. I have brought along my mother – who at 74, has a couple of decades on most of the group.

TrimmerYou Bootcamp was a single of the initial operators to set up in the Uk, founded by former Royal Engineers soldier Ryan Lord.

When it begun the ethos was clear: excessive benefits meant severe measures, adopted wholesale from the military.

All participants on its residential camps had to be “on parade” by 5.55am every day, ready for a full day’s vigorous exercising – with further workout routines thrown in not just for lateness but also for misdemeanours this kind of as sloppy posture.

At very first, says Lord, the emphasis on discipline acted as a novelty.

Nevertheless, suggestions discovered few were prepared to contemplate taking on the challenge once more, with many saying that the relentless discipline and limitless orders had put them off.

As a result, the ethos has altered, along with far more luxurious venues introduced, which includes our 5 star villa.

Lord says: “We found that a good deal of girls who contacted us pondering about doing a bootcamp have been frightened off by the thought of an intense military regime, and getting bullied into carrying out things they didn’t want to.

“We needed to make confident that our bootcamps encouraged a varied range of people we nevertheless want women to perform as tough as they can, but to know that they are working inside their own limits, and that they have the freedom to dip in and out of activities.”

A couple of days in, it is clear that the “softer” bootcamp is nevertheless quite severe, by most requirements.

Each and every day begins at 7am with an hour of cardiovascular exercise routines – typically based close to working, but all paces are covered, which includes power strolling. Most days involve all around 5 sessions, of amongst an hour and 90 minutes, with lots of circuits which mix up cardio-vascular function and excess weight-education as effectively as water aerobics.

There are two diet plan possibilities – a 1,250 calorie a day limit for individuals attempting to get rid of weight, or a 1,800 calorie restrict for these who are purely on a fitness kick.

All 17 girls indicator up for the one,250 calorie selection all hoping to shed the elusive 7 lbs advised by the advertising and marketing blurb.

The record of factors excluded from the diet regime is daunting: no caffeine, no extra sugar, no wheat, no alcohol.

But the cooking, by a chef who previously worked at The Dorchester, is exquisite, and surprisingly plentiful a option of breakfasts – even though most opt for porridge, to sustain them – two modest snacks a day, plus two major meals.

Not surprisingly, soups, salads and lots of veggies function frequently, but fish cakes, chicken, tortillas, guacamole and houmous also make a welcome look.

Even even though we are functioning out for most of the day, most of us don’t get as well hungry, but for some, the gap in between dinner at 6pm and breakfast at 8am proves most difficult.

Activities are varied, and shifted all around to suit the shifting weather. A cooler day indicates a hike up La Concha, a mountain larger than Ben Nevis (even though we are driven half-way up).

As the heat builds, we can be located working out in the pool, or by the breeze of the beach.

It is clear that for a lot of, even though the variety one aim is weightloss, a week of fitness also delivers “time out” from every day stresses and active working lives.

The timetable makes it possible for lots of time for a chat – and a siesta. Most lunchtimes are two hrs extended, and sunbeds round the pool indicate there is time to prime up the tan.

By the finish of the week, most of us have ducked out of at least a single session.

For me it was netball, and a dread of flashbacks to school other folks took an extra siesta when muscle groups began tiring, or when sunbathing merely appeared more attractive than sit-ups.

My mother has place some of the younger crowd to shame, taking tips from instructors for reduced repetitions of workouts if she doesn’t want to push it to the severe.

In truth, most of us have nonetheless stuck to nearly all of the regime in the end, its ourselves we really do not want to allow down.

Workers Paul Giblin, one of the two instructors who puts us by way of our paces, says: “We are here to encourage, not to hand out orders, but I feel on a bootcamp the camaraderie of the group helps make a wonderful big difference every person who commits to this needs to give it their best shot, and the others will spur them on.”

An RAF Bodily Training instructor for 20 many years, based mostly at RAF Cosford, in the Midlands, he says that 1 of his major goals is to inspire clientele to make permanent alterations to improve their fitness levels.

It is a theme which he frequently returns, handing out suggestions about how to develop physical exercise into even the busiest lives – such as a twenty minute severe exercise which leaves the best of us panting.

Giblin says: “I want absolutely everyone to have a excellent week, but a lot more than that what I genuinely want is for them to stroll away from this feeling more assured about exercising, and generating plans to create it into their lives.”

On the last night, weights and measurements are taken, just as they were on day 1.

There’s no obligation to share, but numerous of us have managed the 7 pound bodyweight reduction we hoped for and most have lost at least four lbs.

The instructors insist we ought to care far more about the misplaced inches, given that muscle will be replacing body fat, and most of us have misplaced at least two on the waistline.

In an sudden treat, the group is taken to a nearby restaurant and allowed free rein on the menu (puddings apart) and even a couple of glasses of wine to round the week off.

By morning as we pack and say farewells, the scales are wavering upwards a harsh reminder that it does not take a lot to fall out of military manoeuvres.

But the mood is higher, and talk is swapped of new motivations to embrace a healthful way of life.

Kathryn Willman, 27, a surveyor, from Surrey, has misplaced five and a half pounds, but says that what she has acquired is a greater romantic relationship with food and fitness.

She says: “I came simply because I had received into a bit of a fitness rut and I wished to lose some fat. But I’ve suffered from consuming issues in the past, and I feel the emphasis on healthier foods here, as effectively as on activity is actually crucial its aided me to alter the way I feel about my entire body.”

Wendy Cadman, 58, from the West of Scotland, feels total of power, and prepared to embrace a new occupation as a boarding college matron.

She says: “I came right here to improve my fitness, and I feel I’ve accomplished that but that is not all you get. By stepping out of your everyday life, and switching off from the every day demands, there’s a kind of mental cleansing as well: it feels like a fresh commence.”

Trimmer You has bootcamps in the Uk beginning at £349, whilst the Marbella camp commences at £765 plus flights

www.trimmeryoubootcamp.co.united kingdom

Can military manoeuvres tackle Britain"s sloth issue?