"Risk-averse" NHS 111 sends more callers to A&E than previous service

The NHS 111 telephone advice service is sending growing numbers of people to A&E or calling an ambulance because its staff are too risk-averse when dealing with illness, a study has claimed.

Critics claim the trend is adding to the huge strain on hospitals and ambulances that have left them struggling to keep up with rising demand for care.

NHS 111 now either sends an ambulance or recommends someone goes to A&E in about one in five (20%-22%) cases of the 1.1 million people a month who ring seeking help, according to the Nuffield Trust.

That is up from an average of 18%-19% over the three years since the service was introduced, research by the health thinktank has found.

NHS 111 replaced NHS Direct across England in late 2013 as part of the coalition’s shake-up of the NHS.

Nuffield Trust’s analysis of the health service’s performance statistics shows that during the course of 2016 a total of 1.46 million of the 11.8 million people who rang 111 seeking help were sent a blue light ambulance. Another 1 million were advised to go to A&E. Taken together, that meant that almost 21% of calls overall were disposed of in one of those two ways.

“This report is further evidence that the NHS crisis this winter, and in particular the record A&E attendances, are the result of a catalogue of bad choices by the government,” said shadow health secretary Jonathan Ashworth.

“The decision to scrap NHS Direct and replace it with the NHS 111 was strongly criticised by health professionals, and today we have learned that NHS 111 is sending more callers, and a higher proportion, to A&E than in previous years, with great variations in performance across different regions.”

The thinktank has also uncovered “great variability between different areas in how likely NHS 111 is to send people to A&E or to the ambulance service”. The report says: “This might suggest that some areas are to likely, or not likely enough, to send people to emergency services.”

For example, while 12.4% of callers in east London and the City were sent to an emergency department, the 111 covering Cornwall did that with just 5.7%.

“These numbers are yet another sign of the unbearable pressure our health system is under,” said Norman Lamb, the Liberal Democrat health spokesman. “Whichever part of the system you look at it’s now at breaking point.

“But it also appears the overly cautious algorithm used by 111 call handlers is increasing pressure on already overstretched ambulance services and A&Es.”

The Nuffield Trust points out that “NHS 111 is more likely to despatch an ambulance than to simply send people to A&E, which is the reverse of the usual pattern of NHS use”, adding: “This lends credence to claims that the service is too risk-averse in some cases.”

That echoes concerns raised privately by many of the 10 NHS regional ambulance services that NHS 111 services too often practise “defensive medicine” and order an ambulance to take someone to hospital unnecessarily, which increases the pressure on them.

The 42 regional NHS 111 services are run by NHS ambulance trusts, groups of GPs and private firms such as Care UK, which has recently won more contracts. It uses far fewer nurses and many more call handlers than NHS did until then health secretary Andrew Lansley scrapped it.

However, the study also found that, paradoxically, NHS 111 is also reducing the pressure on A&E and ambulance services and successfully redirecting callers to GP surgeries and other services outside hospitals. While 45% of callers say they would have gone to A&E or dialled 999 if 111 had not been an option, call handlers send only around 20% of patients to them. Likewise, while a third of users said they would have gone to community-based services if 111 had not existed, the service itself sends about 60% to them.

NHS England said that NHS 111 is performing well amid rising demand for its advice. “The increased number of people referred to emergency care is proportionate to the higher number of calls being handled,” a spokesman said. “111 continues to do an important job helping patients to get the right care, at the right place and at the right time, and in protecting both A&E and ambulance services from unnecessary attendances and callouts.”

"Risk-averse" NHS 111 sends more callers to A&E than previous service

Review Provides Tiny Support for an Previous Drug

Digoxin is one of the oldest drugs in the cardiovascular arsenal, derived from the foxglove plant and initial described in the 18th century by William Withering. It is often employed in individuals with heart failure (HF) and with atrial fibrillation (AF). The few trials supporting its use have been performed in HF individuals before newer treatments arrived. There have been no good trials in AF.

A new observational examine published in the Journal of the American College of Cardiology now supplies the most comprehensive perspective on digoxin use in AF. Researchers examined information on a lot more than 122,000 individuals in the Veterans Affairs method who had newly diagnosed AF. During 350,000 patient-years of comply with-up, approximately 1-quarter of the sufferers died. Virtually 29,000 patients who acquired digoxin had been matched with an equal number of controls who did not. The risk for death was larger amid digoxin recipients than controls — a locating that remained significant right after multivariable adjustment (hazard ratio, one.21).

•     Unadjusted hazard ratio for digoxin sufferers: one.37 (CI one.33-1.40, p&lt0.001)


•     Multivariate adjustment: 1.26 (CI 1.23-one.29, p&lt0.001)

The authors acknowledged the limitations of observational studies but explained that their sensitivity analyses recommended that any effect of unmeasured confounders would not likely have resulted in a main modify in the findings.

Responding to a question from the editors of CardioExchange, the lead author of the review, Mintu Turakhia, suggested that clinicians use digoxin sparingly:  ”in light of the a lot of other medication that can be employed for charge control, clinicians need to ask whether or not digoxin ought to be the therapy of option for the patient in front of them when there are other, safer options.”

In an accompanying editorial, Matthew Reynolds praises the study but argues that since digoxin for AF is more most likely to be utilised in larger danger HF sufferers the “true” hazard ratio is probably to be reduced than reported. Offered the substantial charge of adverse events brought on by the drug, he suggests that digoxin ought to only be employed “selectively and with care in AF individuals.” But, he concludes, “for now, there are nevertheless clinical conditions (HF, tough fee control, lower blood stress) in which this previous herbal treatment remains useful.”

Harlan Krumholz said that “this review raises considerations about the safety of digoxin in the remedy of patients with AF. Offered the range of medications available, any use of digoxin in this setting need to demand specific justification indicating why the advantages outweigh the possible dangers. It’s time to pause on digoxin till research can assure that it is providing a net benefit to these sufferers.”

J Am Coll Cardiol. 2014 64(7): 660-668.

Review Provides Tiny Support for an Previous Drug

Age-simulation suit displays what it truly is like to be previous

It is effortless to see how, as a result of their frailties, old men and women would be treated differently – not consulted on selections and spoken to in the peremptory tones that exhausted mothers may possibly use on their kids. (“You’re in that gentleman’s way, darling!”). The previous person’s enjoyment or comfort turns into significantly less of a issue than difficulties-avoidance for others: a café is picked not simply because of a wonderful view, but since it’s simple to get to and the doors are wider.

Nevertheless sporting my empathy outfit, I am escorted outdoors, in which kerbs – which have never played any important function in my prior life – now current a danger. As do stairs and ramps. I stumble and start to really feel anxious it’s not long just before I am asking my companions the exact angle of the subsequent incline.

The worst encounter of all, though, is the tremor-gloves interlude. This involves sitting down and attempting to undertake a series of duties (consuming a cup of water, guiding a sandwich towards my mouth, unwrapping a boiled sweet) while a minimal-voltage recent is transmitted to the fingers. It starts off as a tingling, becomes severe pins and needles, and ends up creating extreme jolts and trembles that mirror the signs of Parkinson’s Condition. To get it to end, I have to area my palms together in an imprecatory method, which I resort to after 15 seconds.

“Wearing this suit is part of the education,” says Sandra Walden, practice growth nurse, whom I only met 45 minutes ago, nevertheless whose hand I’m now clutching tightly to go downstairs. “Nurses try it out, as do medical doctors, physios, even our chairman and chief executive. Till you’ve spent time in that suit, you have no true concept of the troubles that older individuals face.”

Except that now I do. What’s far more, I come to feel ashamed of my tutting when I’ve been inconvenienced by a pottering pensioner. I’ve been given a sneak preview of the long term, and I promise to be not just older but wiser.

Age-simulation suit displays what it truly is like to be previous

The Brave Previous World of Genetic Engineering

Even after two decades of spectacular scientific, humanitarian and monetary successes and an admirable record of security, the application of genetic engineering (GE) to agriculture is still beleaguered by activists and over-regulated by bureaucrats.  This opposition and obstruction can be traced back to a basic fallacy – namely, that the terms “genetic engineering” and the common shorthand “GMO” (for “genetically modified organism”) represent a meaningful grouping of issues, a “category.”

Genetically engineered organisms and the food items derived from them do not in any way constitute genuine classes, which makes any decision of what to contain in them wholly arbitrary and misleading.  Nor have they been shown to be much less secure or, provided the pedigree of the foods in our diet, in any way less “natural” than thousands of other typical foods.  As FDA has stated in response to calls for mandatory labeling to identify meals created with present day genetic engineering tactics, such labeling would erroneously imply a meaningful difference exactly where none exists.  (And since it would be misleading, it would render the foods “misbranded,” creating its sale a violation of the Federal Food, Drug and Cosmetic Act.)  Although FDA has regularly rejected calls for both a mandatory security assessment or labeling primarily based on the use of specific methods, legislation just proposed in the Residence of Representatives would demand the former.

Best: Lesser cornstalk borer larvae extensively damaged the leaves of this unprotected peanut plant. (Image Variety K8664-2)-Photo by Herb Pilcher. Bottom: Right after only a couple of bites of peanut leaves of this genetically engineered plant (containing the genes of the Bacillus thuringiensis (Bt) bacteria), this lesser cornstalk borer larva crawled off the leaf and died. (Picture Variety K8664-1)-Photograph by Herb Pilcher. (Photo credit: Wikipedia)

Genetic modification by means of assortment and hybridization has been with us for millennia, and the strategies employed along the way, up to these days, are part of a seamless continuum.  Breeders routinely use radiation or chemical mutagens on seeds to scramble a plant’s DNA to produce new traits, and much more than a half century of “wide cross” hybridizations, which involve the motion of genes from a single species or one genus to yet another, has given rise to plants that do not exist in nature they consist of the varieties of corn, oats, pumpkin, wheat, rice, tomatoes and potatoes we buy routinely.  (Yes, even “heirloom” types and the overpriced natural stuff at Whole Food items.)  On common, we eat dozens of servings of these genetically enhanced types of fruits, greens, and grains each and every day: With the exception of wild berries, wild game, wild mushrooms and fish and shellfish, almost almost everything in North American and European diets has been genetically improved in some way.

The erroneous assumption that “genetic engineering” or “genetic modification” is a meaningful group has led to numerous types of mischief, such as the vandalization of area trials and destruction of laboratories state referendum issues and legislative proposals that would require pointless, costly labeling of some GE food items local bans or restrictions and a spate of spurious lawsuits of numerous varieties.  Probably worst of all, it has also led to a quarter-century of unscientific regulatory approaches at the federal level that inhibit the sorts of agricultural innovations that can provide less influence on the all-natural atmosphere, solutions to the troubles of American farmers, and greater food protection for many of the world’s bad.

Despite the fact that laboratory investigation on plants has been robust because the advent of molecular genetic engineering tactics in the early 1970’s, the commercialization of merchandise has been disappointing, largely since of unscientific, extreme government regulation that discriminates against modern day, molecular GE strategies.  For a quarter century, GE crops have been the most scrutinized in human background, with out any scientific justification for such a burden.  They are far a lot more exactly and predictably crafted than their predecessors, and none has triggered even a single instance of documented harm to people or disruption of an ecosystem.  Yet, they are subjected to disproportionately extensive and high-priced regulation.

Despite the fact that hundreds of scientific studies – both formal danger-assessments as nicely as observations of “real-world use” – have confirmed the security of the technology, not only has there been no reduction or rationalization of the regulatory burden positioned on plants created the newer tactics of genetic engineering, but in a lot of circumstances regulatory stringency and burdens are really increasing.

Last December, the European Food Security Authority published a “Scientific Opinion” which concluded that a range of soybean genetically engineered to have increased than normal ranges of oleic acid (which yields a more healthy cooking oil) “is as risk-free as its typical counterpart with respect to likely results on human and animal well being and the surroundings that “bioinformatic analyses and genetic stability studies did not increase security issues” and that the range “is agronomically equivalent to non-[engineered] reference soybeans.”  Moreover, the EFSA security assessment “identified no issues with regards to likely toxicity and allergenicity” and the dietary evaluation of the soybean variety’s oil and “derived foods products did not recognize issues on human wellness and nutrition.”

This kind of conclusions following the evaluation of new genetically engineered crops are common – and yet the panel advised for higher-oleic acid soybeans a “post-marketplace monitoring prepare, focusing on the assortment of consumption data for the European population, for the marketed meals and feed.”  This recommendation is inconsistent, baseless, wasteful, and just plain asinine.

Pursuing what would seem to be an official policy of wastefulness and cluelessness, on January sixteen EFSA held its seventh meeting with representatives from customer and NGOs to “discuss scientific troubles concerning environmental threat evaluation (ERA) and danger assessment concerns for plants” in the non-group of “new biotechnology-based breeding techniques.” However once more that begs the question that those considerations are by some means distinct from people for older, typical biotechnology-based breeding strategies.  It makes 1 wonder why European regulators really don’t convene meetings to go over new designs for perpetual-movement machines or approaches for estimating the variety of angels that can dance on the head of a pin.

The regulatory obstacles that discriminate against genetic engineering impede the improvement of crops with both commercial and humanitarian prospective, and a lot of of the GE crops foreseen in the early days of the technologies have actually withered on the vine as regulatory costs have created testing and business improvement economically unfeasible.

The degree of regulation ought to be commensurate with the degree of risk.  Given the two theoretical considerations and the huge experience accumulated in the course of the past two decades, none of the regulatory regimes for the discipline trials and commercialization of GE crops around the world are scientifically defensible or justifiable.  USDA’s Animal and Plant Well being Inspection Support is no far better than EFSA.

Legislation launched in April in the U.S. Property of Representatives by Reps. Mike Pompeo (R-Kansas) and G.K. Butterfield (D-NC) would mandate but one more escalation of regulation, with no any justification for it.

At current, the FDA operates a voluntary consultation system for genetically engineered food items during which the developer gives the FDA a variety of types of info about the merchandise. Without any recognized exceptions developers have engaged in this voluntary consultation, which is much more than ample to defend American buyers. As mentioned above, there is a broad consensus that there is no scientific explanation to see foods manufactured with modern day molecular techniques as fundamentally different from other meals, so even the “voluntary” consultation – which no food producer dares to flout – is gratuitous and excessive. (Almost identical meals made with older, much less precise and less predictable techniques would not routinely be subject to overview, voluntary or otherwise.)

An additional concern is that a mandatory FDA overview of new genetically engineered foods could constitute a “major federal action” that would trigger FDA procedural obligations below NEPA, the federal National Environmental Policy Act.  In the past, activists acting in poor faith have delayed approvals by bringing several nuisance lawsuits that claimed purely procedural deficiencies below the Act.

Other concerns consist of gratuitous delays and political interference in the assessment of applications.

The Brave Previous World of Genetic Engineering

Two month previous baby "given MMR jab"

Her panicking dad and mom, Christopher Cser, 21, and Bernadett Donka, 27, were forced to consider Chloe from the surgery, London Fields Healthcare Centre – exactly where she must have acquired her two-month vaccinations – to hospital for her to be checked more than.

But hospital workers had been unable to allay the couple’s fears. A series of frantic calls to vaccine companies had been left unanswered, even though there appeared to be no record of earlier, related errors.

Christopher, a retail supervisor, and Bernadett, a hairdresser initially from Hungary, then endured an agonising three weeks – for the duration of which Chloe displayed side-effects including a loss of appetite and sleepiness.

Now the couple say they are suing the nurse for putting them by means of such a “horrible” experience.

They are also angry at the surgical treatment due to the fact they did not take action after discovering the error – leaving the couple to consider their little one to the hospital below their own steam.

Christopher told the ‘Magyar Baba Angol Baby’ site: “When we located out the nurse gave our daughter the vaccination we had been really, really anxious, distressed and we had been actually panicking over what to do up coming.

“The GP did not advise us on anything at all – they essentially neglected us via the whole process.

“We acquired residence and waited. She had a really negative appetite. She wasn’t eating and was falling asleep genuinely easily. We actually had to wake her up to feed her. It was horrible … a actually horrible encounter.”

The couple also have nagging concerns about the long-term results of the error. Now-discredited analysis linking the MMR vaccine to autism stays a worry for the pair.

An spokeswoman for NHS London stated: “We are investigating the issues raised by this loved ones about their child’s vaccination and are currently establishing the information. Whilst it is not regimen or advisable to vaccinate a little one with MMR at two months of age, there is no clinical risk to the baby.”

Two month previous baby "given MMR jab"

Financial approach of Southern Cross residences blamed for previous people"s deaths

Doris Fielding, one particular of 19 residents who died at Orchid View. Her daughter, Judith Charatan, explained: ‘They had been basically filling up beds to make money.’ Photograph: PA

The fiscal troubles of Southern Cross, when Britain’s biggest care-home operator, and the “inadequate emphasis on care” by its managers “put vulnerable men and women at danger” a damning serious situation assessment into neglect at a Sussex care residence, which led to the deaths of five elderly individuals, has concluded.

The financial struggles of the private organization contributed to the poor care obtained by residents at the now-closed Orchid View care home in Copthorne, West Sussex, the report states.

The inquiry was launched after an inquest final 12 months into the deaths of 19 elderly folks at the property identified evidence of “institutionalised abuse” and highlighted a lack of respect for the dignity of residents, bad nutrition and hydration, mismanagement of medication and inadequate personnel numbers.

At its peak, Southern Cross Healthcare was the largest independent care-home organization in the United kingdom, with far more than 700 residences nationally, and virtually forty,000 beds.

“The development and demise of Southern Cross Healthcare indicates rapid development and complicated economic arrangements at the root of the company’s size and profitability,” the critical case assessment (SCR), commissioned by West Sussex Adult Safeguarding Board, notes.

“We are concerned with the implications when such arrangements fail, as in the situation of Southern Cross Healthcare in its management of Orchid See. The effect of this was felt immediately by vulnerable men and women who knowledgeable bad-high quality care and their family members who knowledgeable anxiousness and distress at the way their loved ones had been cared for. There was a significant further expense to the public purse.

“The finish consequence of what occurred with Southern Cross Healthcare was that its fiscal technique and inadequate concentrate on care by its accountable managers put vulnerable people at chance.”

Orchid View was opened in November 2009 and was closed by Southern Cross Healthcare in October 2011. Following an anonymous alert to the police in August 2011, five members of personnel were arrested and questioned, but the Crown Prosecution Services said later there was inadequate proof to pursue criminal charges.

The report lists a catalogue of failings, numerous of them observed by NHS ambulance crew, relatives and pharmacists who visited the house, but whose warnings were not acted on. Ambulance personnel and other site visitors repeatedly noticed that there had been not ample members of employees in the home to search after the residents.

The inquiry helps make 34 suggestions about how this kind of abuse, neglect and inadequate care could be averted in the long term, between them the necessity that private care properties ought to be required to prove to the care watchdog, the Care High quality Commission, that they can recruit and sustain a skilled workforce.

In the course of the care home’s short existence, there had been 6 distinct managers, all but a single of whom did not have the management credentials essential by the CQC.

“Also considerably tolerance offered to Orchid View as they operated with out a registered manager for most of the time they have been open,” the inquiry located.

“There was inadequate growth of a workforce strategy or consideration offered to recruitment, support and improvement of workers competent to deliver the care required,” the report states.

Worries about safeguarding problems need to be raised outside the property if they are not dealt with promptly, according to the inquiry. It also highlights the importance of offering workers added coaching if English is not their very first language.

Nick Georgiou, independent chair of the Orchid See significant situation assessment, stated latest government consultations on making certain greater care inside of the NHS should also be utilized to independent-sector businesses.

“As the role of independent-sector care businesses has grown, the variety, frailty and vulnerability of folks dependent on their care has increased. It is critically essential that these companies show that they can supply the top quality of care required. In this case the support supplier failed,” he writes.

“A amount of the concerns identified in the recent previous with hospital companies in the NHS have been echoed at Orchid See and it is correct that the scrutiny and demands for improvement in the NHS are also expected from the independent sector.”

Peter Catchpole, West Sussex county council’s cabinet member for adult social care and overall health, said: “What occurred at Orchid See was harrowing. There is nothing at all a lot more important than looking after the most vulnerable men and women in our society and in this respect Southern Cross Healthcare has been judged to have failed.

“Statutory companies such as West Sussex county council had no selection but to get action to investigate and eventually move men and women from the property to safeguard them.”

Jean Halfpenny, 77, was one of 5 residents who had been identified by an inquest last 12 months to have died from organic causes “contributed to by neglect”. Linzi Collings, Halfpenny’s daughter, said: “How the corporate failings of Southern Cross could develop these events and how this kind of horrible specifications could go unnoticed by the authorities for so extended has left us baffled.

“We think dramatic modifications are required to the existing care technique, starting up firstly with higher accountability for care-house owners if they are discovered to be making pointless mistakes and supplying substandard services.”

Judith Charatan stated her mom, Doris Fielding, was one particular of the final individuals to be admitted to the residence.

“They knew they have been going to be closed down but they had been still striving to admit individuals into the residence to make income from people currently being in there and I uncover that very unforgivable they were just filling up beds to make money,” she told the BBC.

“If these issues had been addressed when complaints had been raised earlier by other relatives there would have been a good deal significantly less needless struggling and I just can not come to terms with that.”

Financial approach of Southern Cross residences blamed for previous people"s deaths

How Marco Pierre White went from fine dining to a fine previous mess

Marco Pierre White: retired as a chef in 1999 to focus on his company ventures. Photograph: Don Arnold/WireImage

Identify: Marco Pierre White.

Age: 52.

Appearance: Remember that time your dinner lady came to college drunk and wild-haired and clutching a knife? A bit like that.

That is no way to communicate about the enfant horrible of British cuisine. Marco’s eating places are prestigious. They’re influential. They are … in want of a swift clean?

Pardon? Environmental wellness officers visited the Marco Pierre White Steakhouse Bar &amp Grill in Birmingham earlier this yr and awarded it a foods hygiene rating of zero. The specifics of their report appeared in the Instances this week.

And what does the zero rating indicate, exactly? It signifies they identified raw meat and cooked meat stored together and dealt with with the exact same gear, they found the cleanliness, layout and ventilation to be ‘poor’ and they had no self-confidence in the management. Workers say they have acted on the inspectors’ suggestions and subsequent revisits have been constructive, but the zero rating will keep legitimate till the subsequent inspection.

But I was going to go there subsequent week. Conserve your income. There is an Eat4Less sandwich store 10 minutes away. You could get dozens of 99p baguettes for the same cost.

Are there any options that nevertheless involve Marco Pierre White? Oh yes, quite a couple of. White retired as a chef in 1999, which has offered him a lot of time to focus on his other business ventures.

Such as? There is Marco’s Grill, which is inside a football stadium. Or the sports bar he created with a jockey, which is also inside a football stadium …

I’d rather consume someplace that is not within a football stadium. In no way worry! Marco is also the encounter of each Bernard Matthews and condiment makers Knorr, so you could usually go and sit on a park bench someplace, crumble a stock cube above a packet of Hickory BBQ Turkey Chunks and reside out your fantasy of fine dining that way.

Are you suggesting that Marco Pierre White has squandered his talent in favour of an effortless buck? No, I am stating it baldly as truth. I considered that was apparent.

Do say: “I would like to order the beef bourguignon, please.”

Don’t say: “Yes, I’m cancelling my reservation. We’re just going to remain residence and neck some gravy.”

How Marco Pierre White went from fine dining to a fine previous mess

New brain cells could wipe away previous memories, examine finds

“The locating was very surprising to us at first. Most men and women think new neurons indicate better memory,” mentioned Sheena Josselyn, a neuroscientist from the Hospital for Sick Children in Toronto, who led the research.

Right up until now, numerous scientists have imagined long-phrase memories may possibly be tied to language simply because young children normally start off forming lengthy-phrase recollections at about the same time they start off talking.

“But the really weird factor is that most animals display infantile amnesia too,” said Josselyn.

“So the improvement of language can not be the total explanation.”

Inspired by observations of their personal toddler, Josselyn and her husband, examine coauthor Paul Frankland, started to query why young kids could not retain memories of scenarios or occasions.

The recollections involve the hippocampus, the only part of the brain which normally generates new neurons, which scientists feel is vital to make recollections.

But the manufacturing of these new cells tapers off in childhood.

“That’s precisely when we begin to be capable to kind prolonged-term recollections,” Josselyn explained.

Her research of mice, which like people fail to retailer early memories, showed the decline in the production of new neurons as the rodents grew up matched their capability to keep in mind frightening conditions.

Josselyn explained: “More neurons improve the capacity to learn new recollections in the potential

“But memory is based on a circuit, so if you add to this circuit, it helps make sense that it would disrupt it.”

She believes the newly additional neurons could have a beneficial position in clearing old recollections and creating way for new ones.

New brain cells could wipe away previous memories, examine finds

Sorry, Prince William, you know you are acquiring previous when...

_{Prince William in 2014 (Getty Images)}

Now that he has become a father, Prince William’s hair has started to recede faster than a Eurozone economy. Sorry, Your Royal Highness, it seems that you’re getting old.

Here, then, are some more telltale signs that time is taking its toll on us men…

1. Going to bed early is not a punishment, but a blessed relief.

2. You are, very occasionally, more interested by babies than babes.

3. Someone famous dies and your immediate reaction is to subtract your age from theirs and realise, with a start, that the difference is terrifyingly small. Or, even worse, that you’re older.

4. You discover that there is an inverse relationship between the amount of hair on your head and the number of shampoos, conditioners, grooming gels, creams, bottles of Just For Men, restorative foams and anti-baldness pills you possess. Soon, you will have a bathroom cabinet that puts Boots to shame and a scalp like Kojak’s even balder brother.

5. You get the reference to Kojak.

^{Kojak: “who loves ya, baby?” (ALAMY)}

6. All those furious female TV presenters who are always protesting that they’re too old to get decent jobs any more, well, they don’t seem that old to you.

7. You’re clearing out the garage – because that’s the kind of thing you do these days – and you find a pile of old vinyl LPs. You haven’t played any of them in 20 years, maybe more, but every sleeve brings back a memory.

_{Vinyl LP covers: a reminder of happier times (ALAMY)}

8. You see a pretty young thing swishing down the street on a sunny day and your heart still lights up as it always did. But the blood doesn’t pound as hard as a young man’s does. And then you realise that you’re probably older than the pretty young thing’s father. Or, in some parts of the country, her grandad.

9. It’s not just that you’re older – much, much older… – than the footballers on Match of the Day. It’s that the managers have started to seem young, as do the pundits and certainly the referees. Not that you see many of them, because you’ve dropped off less than halfway through the programme. Speaking of which …

10. Afternoon nap – the two finest words in the lexicon.

11. You start to take a perverse pride in wearing old clothes. They’re agreeably familiar, and the tattier they get, the more comfortable they become. It’s a tremendous relief to give up shopping almost entirely. You start thinking they’ll probably see you out if you look after them carefully. And what could provide more satisfaction than being able to get into the jeans you bought when you were 35?

12. Squat on your haunches. Now stand. Just a few twinges, aren’t there? Kneel down for more than 30 seconds. Try to get up. See what I mean?

13. While watching Steve Coogan and Rob Bryden in The Trip to Italy, you hoot with laughter at Coogan’s spot-on impersonation of Neil Kinnock while your unsmiling teenage son asks: “Who’s Neil Kinnock?”

14. Pensions cease to be a subject of no interest whatever and become an overriding obsession. See also the iniquities of annuity rates, the rapacity of fund managers, the dubious ability of financial advisers. And as for George Osborne’s pension reforms in the Budget, oh, be still my beating heart: what excitement!

15. Gardening – there’s another thing that never used to be of any interest whatever. But suddenly you find yourself brooding over slug repellents, leafing through seed, bulb and David Austin rose catalogues and, yes, being genuinely grateful for a really good pair of gardening gloves at Christmas.

16. It’s not that you spend Saturday evenings in, watching all those Euro-cop shows on BBC Four, laying off the Scandinavian murder mysteries and Belgian conspiracy thrillers just long enough to relish the intrigues of Danish coalition politics; it’s that you actually think you’re rather trendy as you’re doing it.

17. You used to be reasonably hip, but now you have literally no idea at all what the number one single could possibly be. If you happen to hear it, your first reaction is to spot all the songs and artists you remember from the old days from which it (like virtually all contemporary hits) has been ripped off.

18. How can one be both shortsighted and longsighted at the same time? Reach middle-age, that’s how. Suddenly TV dinners become a nightmare as you discover that you can either see the telly, or the food on your plate. But not both, and suddenly…

19. You can hold your own in a discussion about varifocals. “Oh, do they work for you? Really? I couldn’t the hang of them at all, myself. They just made me feel woozy and walking downstairs was a nightmare of vertigo. What? You have different prescription lenses in either eye? Amazing, etc…”

^{One Direction (I think…) (GETTY IMAGES)}

20. The baby that you once held so nervously in your arms goes to school, and you add ‘nativity plays’ to the list of unexpected pleasures. Then you go to cello recitals and cheer at football games; and fight to get your children into the school you wanted; and you suffer through GCSEs and A-Levels, through fights with friends and first romances, through furious rows and slamming doors, through endless evenings spent ferrying them to parties and back. Then suddenly they’re halfway round the world, backpacking anywhere from Bolivia to Bangkok. And they’re graduating, getting jobs and somehow costing even more than they ever did before. And you simply can’t imagine how the time could have gone by so fast.

Oh, and one final thing…

21. You know you left another sign of getting old somewhere safe, just in case you needed it, but you simply can’t remember where…

Sorry, Prince William, you know you are acquiring previous when...

Concern of previous age becomes acute soon after 50, examine finds

The survey was commissioned by social care marketplace supplier cloudBuy.

Prime 20 worries:

one. Well being concerns

2. Severe illness

three. My thoughts failing me

4. Turning out to be forgetful

five. Losing my independence

six. Dropping my sight

7. Becoming a burden to others

eight. My physique failing me, but my mind getting fully fit

9. Income

ten. Obtaining to go into a nursing/care house

11. My partner getting critically ill

12. Dying

13. My partner dying just before me

14. Being lonely

15. Having to move out of my home

16. Not being able to drive

17. Getting bed-ridden

18. Dropping my hearing

19. My appears and visual appeal

twenty. Not being ready to proceed with my hobbies

Concern of previous age becomes acute soon after 50, examine finds

Public lacks believe in more than health-related records because also many lies in previous

He explained the true difficulty for several critics of the scheme was “we really do not believe in the government.”

Mr Lilley, who runs a internet site for healthcare managers, explained: “They lied to us about the Well being and Social Care Act. They could be lying to us about the use of our information. It’s been a balls up. It’s a balls up of the politicians’ creating. We can find out. There is considerably to criticise, but criticise the politicians – and not the NHS.”

He told the Wellness and Care Innovation Expo that data had “revolutionised” attitudes in direction of healthcare, and could vastly boost the top quality of care.

Tim Kelsey, national director for patients and data at NHS England, which is in charge of the scheme, stated efforts to describe the programme to the public so far were “not excellent enough”.

He informed delegates: “For a safe NHS we need to have a information-driven wellness service. My message is we have to make this perform. We are going to make this work. We are going to promise that people’s data is safe. we are going to have a proper public conversation.”

A poll of 2,000 grownups by the Royal School of Standard Practitioners located two thirds of folks do not truly feel the public was properly informed about the programs and their appropriate to opt out.

Previously, Wellness Secretary Jeremy Hunt announced that he was going to introduce new legislation to guarantee that insurance coverage firms could not buy data through the scheme.

Mr Hunt wished to give “rock-solid” assurance to sufferers that confidential data could not be offered for commercial insurance coverage functions, the Division of Wellness mentioned.

The Daily Telegraph disclosed that hospital data of 47 million sufferers have been offered to a society of actuaries for insurance purposes. Yesterday it emerged that similar information had been employed to advise companies on how to target audiences by way of social media.

Public lacks believe in more than health-related records because also many lies in previous

Are college sickies soon to be a issue of the previous? - Skirting the Issue

In my grownup lifestyle, becoming ill is not almost so exciting. Initial, no one’s there to hand you something, not even a tissue. 2nd, you have got total handle of the remote – but who cares – you have that anyway and besides, you have received a bucket load of emails to catch up on. Any time I commence feeling a teeny weeny bit better at residence, I start emailing and catching up from my sick bed, desperate not to miss so a lot that I have got a mountain of work to return to when I’m far better.

^{Being ill when you’re older ain’t so fun}

Nope, becoming sick with a undesirable cold or ‘flu when you had been younger definitely had a silver lining.

But all which is about to change. Well, it could do, anyway.

Teachers’ unions are currently fighting for all schools in the Uk to adopt a laptop program that allows sick kids to get element in lessons from their properties.

What? Come again? Enabling sick young children to participate in school lessons from property, above the net? Urgh, I cannot feel of anything at all worse – in reality I truly feel rather sick at the considered of it.

I need to level out that this technique, named Elluminate, is intended for these little ones on prolonged-term sick depart, this kind of as young children who can not attend school because they are struggling from a bodily illness. For some youngsters who have daily life-threatening conditions like cancer, the technique could support to try out and integrate them into mainstream society and lead as typical a existence as possible. This is a good issue.

All colleges have had the gear for Elluminate since 2011, in accordance to the BBC, but a lot of do not use it to its complete prospective (a lot of dad and mom have not received accessibility to it, for illustration) and numerous youngsters who have to take lengthy intervals out of college for illness are falling behind as a end result.

^{Catch up on the web!}

I can see why the unions are campaigning for its wider use. But I fear that in the approach, some vivid spark will realise that every single kid should get advantage of the technique. Right after all, they’ll likely be on their iPads or laptops for the duration of the day at some level, so why not log in to the school’s classrooms getting broadcast above the world wide web and catch up?

The extremely sick culture plaguing British workers – that even when you’re sick, you should even now actually be at perform otherwise, you’re not a really good employee, are you? – is slowly infiltrating into our secondary colleges.

Teenage girls in particular currently suffer from ample tension (on a par with middle-aged males, apparently) because of exams and other pressures: can’t we permit them this little luxury of getting a complete day to themselves, when they are ill? In addition to, if someone’s sick, they are sick – they cannot be anticipated to focus on something. Which is why daytime Television is the ideal treatment.

Are college sickies soon to be a issue of the previous? - Skirting the Issue

Juicing: Previous and Potential

If you are like me or hundreds of thousands of other Americans, then you have possibly noticed a increasing trend between our newly health conscience peers. Juicing, an old thought, that has taken America by storm and touted as a remedy all for all of life’s ailments. Just in the past number of weeks my close friends have been parading their kale and spinach concoctions over Instagram and Twitter, and I’ve determined to do some investigatory blogging to see what all the buzz is about.

I remember back in the early 90s when Jay Kordich, the originator and father of juicing, introduced the first Juiceman Juicer. His claim that he beat bladder cancer by drinking 13 glasses of carrot and apple juice catapulted him into infomercial stardom. He enthralled the nation with his energetic design and winning mindset, and droves of Americans proceeded to purchase Juiceman Juicers to by some means capture Jay’s endurance and youthfulness. Quickly soon after, Jay’s and his Juicers hit its peak of reputation and juicing as soon as once again disappeared into obscurity.

Historical past looks to like to repeat itself simply because juicing is after once more atop our overall health and fitness crazed society, but recent studies and posts have place some of its claims to rest. Yes, it is real. People do not eat adequate fruits and vegetables, but juicing may not be the only answer. According to the huffingtonpost.com, juicers can depart behind critical vitamins and nutrients identified in the skin and peels of specified fruits.

Also, there is no trustworthy scientific evidence that juicing vegetables is the greatest way to eat foods. The claim that breaking down the fibers of fruits increases absorption has no scientific backing. In actuality, considering that juicing destroys natural fibers in the fruits and veggies, the body absorbs fructose sugar far more effortlessly, this side result can significantly improve blood-sugar ranges. This is a potential difficulty for men and women suffering from diabetes and undergoing chemotherapy.

By replacing meals with juices it deprives the physique of essential proteins and nutrients that can only be identified in meat and other non-juiceable meals. I personally locate it significantly more rewarding and productive by complementing a well-balanced meal with a dose of liquid nutritional vitamins. Liquid vitamin products essentially take the very best attributes of juicing and converts it to a convenient concentrated form. LiquidHealthInc.com provides liquid nutritional vitamins produced from entire meals. They get whole fruits and vegetables and break them down to their essence, which make them really absorbable and nutritious. Their cold press strategy of extraction preserves the purity and the nutritional worth of the whole fruits and greens. This approach is completely diverse from traditional centrifugal type juicers that destroy the normal fibers in fruits and greens. This technique crushes and grinds the nutrients that leaves natural fibers intact.
Guest Post: Luis Quinanola, LiquidHealthInc.com is a material blogger and nutritionist. When he is not glued to his laptop display, he spends his cost-free time enjoying basketball, writing music, and playing with his dog.

Juicing: Previous and Potential