It"s good to hear cycling to work reduces your risk of dying. But that"s not why I do it | Laura Laker

It may not be a surprise to see another study suggesting that cycling to work can drastically reduce your chances of getting cancer and heart disease – those who ride bikes for transport already know how good it makes them feel. However, it’s perhaps yet another motivation for those who don’t, to dust off their bikes – and remember some other reasons cycling to work is so great.

In a five-year study of 263,450 UK commuters, published in the BMJ, researchers at Glasgow University found regular cycling cut the risk of death from any cause by 41%, and the incidence of cancer and heart disease by 45% and 46% respectively.

The cyclists in the study were riding an average of 30 miles per week; that’s three miles each way, five days per week. Cycling at a leisurely 10mph, that would take about 20 minutes each way – a manageable distance for most people.

At present only 3% of the UK population commute by bike, while 36% use a car. If we increased cycling in this country to German levels by 2025, we would save £1.8bn in health benefits and £284m thanks to less congestion.

Ask anyone who cycles to work why they do it, and they’ll have a story to tell, whether it’s about how good it makes them feel, how they saved money, lost weight, or won a battle with depression. Most people will tell you how enjoyable it is.

My commuting story began at university. I remember being astonished one morning when I realised my friend Szilvia had cycled from Finsbury Park in the rain. Getting on a bike and riding five miles in such conditions sounded miserable, but she looked happy and bright, and told me how great it was.

We lived fairly close to one another and she offered to ride with me one day. As I pedalled frantically to keep up with her through Regent’s Park, and Camden, it was like I’d grown wings. Before long, like her, nothing short of a gale force wind with pigeon-sized hailstones was going to stop me from experiencing this feeling every day.

For the first time in my life I started getting fit. I arrived at university feeling awake, alert, and generally in a good mood. I continued to cycle to various temp jobs around London after graduation, carrying my work clothes in a pannier and getting changed in the loos.

On crisp, sunny mornings, I’d cycle through the city feeling like it had rolled out the red carpet just for me. I’d levelled up on urban living: I’d whizz past the stationary traffic and queues for buses and try not to look too smug.

I’d chat to others at the traffic lights. Often I’d get to places quicker than public transport could carry me. Often it was the best part of the day.

Fitting exercise into your daily routine is infinitely easier than trying to carve out a slice of it to go to the gym. Without even trying, you get fitter if you cycle. It is no surprise that levels of physical activity are declining as fewer people cycle or walk to work.

In the cities of cycle friendly countries, such as the Netherlands and Denmark, up to 41% of people commute by bike because it’s easy to do and it feels safe. Decades of investment in cycling infrastructure have made it that way. These countries have learned that most people prefer protected, direct routes on main roads, and low-traffic neighbourhood streets. This means people of any age can cycle, from the very young to the elderly. In the Netherlands, for example, 20% of 80-84 year olds regularly cycle.

Imagine if the UK was like the Netherlands, where 20% of 80-84 year olds regularly cycle. Photograph: Rory Buckland L/Alamy Stock Photo

In the UK, meanwhile, we’ve had decades of car-centric planning, and minuscule levels of funding for cycling. Even though cycling is statistically safe, it doesn’t always feel it, and this fear of sharing road space with motor traffic is the key reason people don’t cycle or stop after trying it.

The government knows that every £1 spent on cycling brings £5.50 of benefits, but at present it spends just 72p per person per year on cycling, compared with £86 per person per year for roads. There is huge potential for more journeys to be cycled if that were to change.

Increased levels of cycling can bring benefits for everyone, whether they cycle or not. Bicycles take up far less road space than cars and emit no toxic fumes. They’re good for our high streets: on New York streets where cycle lanes were introduced average trade rose by a quarter. What’s more, bicycles are great social levellers – according to research, mass cycling could increase mobility of the nation’s poorest families by 25%.

If a magic pill were invented that could generate all of these benefits, we would be falling over ourselves to buy it. As it is, no magic is required, just steady, long-term planning and investment, and a commitment to the humble bicycle, so that more of us can enjoy the simple, life-giving joy of cycling from A to B.

It"s good to hear cycling to work reduces your risk of dying. But that"s not why I do it | Laura Laker

Republicans call kicking millions off their healthcare "freedom"? That"s perverse | Adam Gaffney

Paul Ryan is promoting Trumpcare as if it were some sort of medical Magna Carta – a brave declaration of healthcare freedom. “We’re not going to make an American do what they don’t want to do. You get it [healthcare] if you want it. That’s freedom” he recently said on Face the Nation. Freedom to die uninsured, that is.

It’s not that House Republicans are proposing some libertarian healthcare promised land wherein open heart surgeries and rounds of chemo are bartered and traded like tubes of toothpaste – far from it. Instead, the bill largely relies on Obamacare’s blueprint, although it mangles its details for the benefit of the rich while stripping coverage from a staggering 24 million people by 2026 (according to Monday’s estimates from the Congressional Budget Office).

Ryan’s healthcare bill would, like the Obamacare, provide subsidies (or tax credits) for the purchase of private insurance policies. Yet these tax credits would be comparatively more regressive and less generous than those in the Affordable Care Act (ACA); many Americans would thus be freed from having affordable premiums.

The Republican bill also discards Obamacare’s cost sharing subsidies for low-income individuals, who would henceforth have the freedom to pay higher copayments and deductibles. Additionally, it prevents tax credits from being used for the purchase of plans that cover abortion, freeing more women from control over their own reproductive systems.

The bill would also punish those with low incomes by squeezing federal funding of Medicaid beginning in 2020, effectively emancipating millions of poor people from the ranks of the insured.

Trumpcare would at the same time cut the ACA’s taxes on the wealthy, which, as the New York Times recently reported, would redistribute upward some $ 144bn over a decade to millionaires. Now in fairness, this provision would increase freedom for some: freedom, for instance, to buy a second vacation home, or a first yacht.

And finally, what Ryan seems to see as Trumpcare’s greatest emancipatory element – the elimination of the ACA’s unpopular individual mandate – would simply be replaced by a 30% premium penalty, assessed by insurers, for those who spent time uninsured. As Patrick Henry might have put it: give me a continuous coverage premium surcharge as opposed to a tax penalty, or give me death.

Unbelievably, Ryan sees “freedom” in all of this devastation.

For Ryan and those in his ideological camp, freedom in healthcare is basically the freedom of the consumer, who should be free to buy – or not buy – the particular insurance plan that suits his or her needs and tastes. Hence the bewilderment of Representative John Shimkus who recently asked why, exactly, men should be compelled to buy plans that cover maternity care (Trump’s pick to lead the Center for Medicare and Medicaid Services, Seema Verma, has said something similar).

Ryan thus offers a peculiar vision of healthcare freedom. For the medical literature tells us – to no one’s surprise – that the uninsured are more likely to die. And as noted, the CBO has now estimated that Trumpcare will increase the ranks of the uninsured by 24 million in a decade from now.

The bill would thus increase our freedom to die of health conditions that are amenable to modern medical care, and thereby liberate tens of thousands of people a year off of the face of the planet.

The Ryan formulation of healthcare freedom is thus a false freedom. Real healthcare freedom would look vastly different, though it would also go well beyond what the ACA has accomplished.

Healthcare freedom worthy of the name would mean knowing that one will never – and can never – be uninsured. It would provide the liberty to choose the doctor and hospital of one’s choice.

Healthcare freedom would ensure women’s control over their reproductive health. And critically, true healthcare freedom would mean that we can all make healthcare choices based on our medical needs and personal preferences – not our bank balances – which means eliminating today’s increasingly onerous copayments and deductibles.

Trumpcare would take us in the opposite direction on each of these fronts.

This more egalitarian vision of healthcare freedom may sound utopian, but it is entirely achievable: it emerges when societies create social rights to healthcare through the development of universal healthcare systems.

The conservative vision of healthcare freedom offered by Ryan and company, in contrast, is not a form of freedom at all: indeed, by serving the class interests of the rich at the expense of the welfare – and the very lives – of the poor and the sick, it is better seen as a form of oppression.

Republicans call kicking millions off their healthcare "freedom"? That"s perverse | Adam Gaffney

Stop pretending we can’t afford the NHS: that’s the message of our march today | Larry Sanders

We are living in a world in which the politics of the leaders of two of the world’s great nations – America and Britain – is built on broken promises. During Donald Trump’s election campaign he promised to “take on Wall Street”. So when just weeks later the president announced a cabinet full of banker billionaires, my brother, Senator Bernie Sanders, said: “With all due respect, Donald Trump is a fraud.”

Meanwhile, here in the UK Theresa May took up her post as prime minister on the commitment to “work for all, not just the privileged few”. Well, it is just weeks since our NHS descended into a humanitarian crisis, and we are already looking at another round of privatisation and cuts. Which is why at midday today we will be marching on parliament in support of the NHS.

We don’t need reminding of the horrors we saw over the winter, with people dying on trolleys and turned away from hospitals, and the British Medical Association warning our most cherished institution has been pushed to breaking point. The NHS is facing a £22bn funding gap, with the demand for care set to rise 4% a year while the health service’s budget will go up by only 0.2% every year between now and 2020.

This crisis in healthcare has been exacerbated by the current Tory government – but its foundations were laid by New Labour and further strengthened by the coalition with the Health and Social Care Act of 2012. The creeping privatisation of the past quarter of a century has introduced vast fragmentation and inefficiency into our health service, and, combined with chronic underfunding, has left the NHS on the brink. Anyone who has visited a hospital recently knows how hard doctors, nurses and all the staff are working to make sure patients are cared for with dignity and compassion, despite the strain on the system. It is time we listened to their concerns.

Prime minister Theresa May pledges to build a ‘better Britain’

Adding to the pressure facing hospitals across the country is the financial crisis in social care. We’re living longer, and that’s a great thing – last year, aged 81, I stood in the Witney byelection after David Cameron resigned. But while there are currently one-third more over-85s than 10 years ago, adult social care budgets have been cut by one third in the same time. And the care funded by local authorities accounts for just a small proportion of the care elderly people in the UK currently receive. Every year family, friends and neighbours provide £55bn of unpaid care, four in 10 people in care homes pay for themselves, and a staggering 1.2 million people over 65 with care needs receive no help at all.

We are simply not providing enough care and support for people in the community, at home and close to where they live. This means elderly people are more likely to end up in hospital, and when they get there it is more difficult to get them home again. People who are medically well are stuck in hospital because there is nowhere suitable for them to go and too little support for them at home. The system is failing these people who could be living at home or in supported accommodation instead of being isolated from their communities on a hospital ward. But it also fails those who desperately need the hospital beds these elderly people occupy.

The government’s response has been to engage in a cruel con where local councils were told there was “new” funding for social care, only to find much-needed funding cut from elsewhere. It is little wonder the system is on its knees – and the prime minister’s insistence on ending free movement as part of Brexit risks starving the NHS and care services of the staff they so desperately need.

Today thousands of people will march in support of the NHS, unwilling to stand by and watch while this government dismantles public healthcare – and I’m proud to be among their number. The government tells us there isn’t enough money but this isn’t true. We are the fifth richest country in the world – we have the money to stop our health service turning into a humanitarian crisis, and to care for people when they grow old: in hospitals, the community and homes. We have the money for a fully funded public health service. If Theresa May is to keep her promise to “work for all, not just the privileged few”, she must not let the NHS and social care crumble on her watch.

Stop pretending we can’t afford the NHS: that’s the message of our march today | Larry Sanders

Don"t loose your snooze: the technology that"s promising a better night"s sleep

A bed that adjusts itself in the night to stop people from snoring. A princess and the pea-style gadget that fits under a mattress and monitors sleep. A “water-based, app-controlled mattress topper”, which will encourage deep slumber.

Sleep technology is one of the biggest trends at CES, the world’s premier electronics show, which opened to the public on Thursday.

The range of products on show reflect the growing interest in solutions to insomnia and other sleep problems – as well as the predictions that the global sleep market will be worth $ 80bn by 2020.

The “Sleep Number 360 smart bed”, made by bed company Sleep Number, is among the most eye-catching products. The mattress can detect a change of body position during the night and uses air chambers in the mattress to contour to the sleeper’s frame.

Sampling the bed on Thursday morning, a Guardian reporter was promised “the most comfortable, effortless sleep” of his life.

The reporter did not actually fall asleep during the three minutes he spent on the bed, but could feel the bed adjusting to support his lower back and shoulders. Invited – by a video demonstration screened above the bed – to turn to his side, the bed adjusted again.

The Sleep Number 360 smart bed at CES in Las Vegas, Nevada. Photograph: Alex Wong/Getty Images

A video presentation explained that the Sleep Number 360 bed is “even smart enough to sense snoring before you do”.

Should it detect a snorer, the bed will raise the top of the mattress by 7%, which Sleep Number claims will stop the snoring. “It’s the only bed that goes to work when you go to sleep,” said Kelley Parker, senior product brand manager at Sleep Number.

The bed is able to detect the sleeper’s heart rate, breath rate and motion, to provide an excellent premium sleep experience, Parker said. It can adapt to two different sleepers’ positions. But this kind of sleep, it seems, does not come cheap.

Parker said that “pricing is not finalized” but that it would be similar to existing Sleep Number pricing. (The manufacturer’s top-of-the-range bed retails at $ 7,099.99 – although it is currently on sale for $ 5,899.99.)

A recurring theme at CES is connectivity. Almost every device on show – including some washing machines and ovens – will connect to cell phones and even smart home devices like the Amazon Echo or Google Home.

The Sleep Number 360 bed, and most of the other sleep devices on show at CES, connect to an app on a smartphone to give the user information on how they slept, and even remind a person when they should go to bed. The Sleep Number 360 will also connect to your thermostat to control room temperature during the night. (If you can afford a wireless thermostat after buying the bed.)

A few stalls along from the magic bed, Sleep Ace was demonstrating its own line of sleep-friendly products. The Sleep Dot attaches to the sleeper’s pillow and feeds information back to a cell phone on movement and sleep cycles.

Some wearable devices already to this, but the attraction of the Sleep Dot, which costs $ 49.99, is that you don’t need anything strapped to your wrist.

The National Institutes of Health estimates that 50 to 70 million Americans suffer from some kind of sleep disorder. Nearly one in five adults are said to suffer from chronic insomnia, while in February 2016 the Centers for Disease Control and Prevention said more than a third of people in the US do not get enough sleep.

Another product at CES, 2breathe Sleep Inducer, is a device that helps people sleep using guiding tones composed from the user’s breathing. Photograph: Alex Wong/Getty Images

Sleeping less than seven hours a day can lead to increased risk of obesity, diabetes, heart disease and “frequent mental distress”, the CDC said.

One product that may be appreciated by fans of the Hans Christian Andersen, author of the The Princess and the Pea tale, is the Emfit QS. It’s a sensor that can be installed under a mattress to monitor sleep. It connects to a smartphone to provide “comprehensive reports” about “physical recovery, stress levels, and sleep quality”.

The company says it will be of particular interest to athletes seeking to track physical recovery. Like the Sleep Number the Emfit QS will also send alerts telling a userwhen to go to bed, which could potentially be helpful (or annoying).

Another sleep device generating interest at CES is the “Kryo Sleep Performance System”: a mattress topper that cools down to 60F(16C), which the company claims is optimum for deep sleep.

The Kryo connects to a smart phone – of course – and within ten nights of collecting data it will understand a sleeper’s habits enough to optimize its temperature. The mattress topper has been financed by an Indiegogo campaign, and Kryo estimates it will ship out some of the Kryo sleep performance systems in 2017. It is expected to cost $ 299.

Don"t loose your snooze: the technology that"s promising a better night"s sleep

The mental health college that"s a lifeline in "a sea of being alone"

The students gathered on a three-hour “five ways to improve your wellbeing” course in south London are about to have a powerful realisation.

One of the group is asked to think about how many hours a week she spends seeing healthcare professionals, such as health visitors or psychiatrists, about her mental health condition.

She tots up the amount of hours each week and multiplies it by 52. It comes to just under two full days. Stella Williams, the course’s peer trainer, points out that for 363 days she has managed her condition all by herself.

For the group of students, who are all either current or former patients at the South West London and St George’s mental health NHS trust and now taking courses at the onsite Recovery College, this realisation that they look after themselves for such a large part of the year, makes them smile with pride.

I can’t talk to my son or husband because they don’t know what I’m talking about but people here do

Clara Jones

Launched in 2010, there are now over 50 courses in the shiny prospectus belonging to the Recovery College situated in the grounds of Springfield University hospital that are attended by around 150 people a week. They range from providing information about specific diagnoses (for example, understanding personality disorder), to teaching coping tools such as journaling or mindfulness. There are also courses specifically for carers, families and friends.

Clara Jones, a mother of one, has severe anxiety and depression and admits that being at the college is the very last place she really wants to be. “If I had my way, I’d be at home in my bedroom with the curtains drawn and the door closed. But I make myself come because it gives me the feeling of not being alone and that helps. It took a lot of courage for me to come to the first class,” she says.

Each course is co-produced and co-facilitated by a peer trainer who is someone with lived experience of a mental health issue, and a practitioner trainer, who is a mental health professional.

For Jones, who is one of the 2,700 people to have attended since the Recovery College opened, one of the best things about coming to the college, is knowing she isn’t alone. “People say wise things without even knowing and no one cares if I’m not saying anything. I can’t talk to my son or husband because they don’t know what I’m talking about, but people here do.”

Last week the students learned about how staying active can improve their mental health. One student, Steph Bates, an artist who has obsessive compulsive disorder, tells the group about how she had braved going swimming for the first time in years and how much it had lifted her mood.

Peer trainer Peter Wilson says watching his students build confidence like this is the best thing about his job. “We were running a course about being assertive and in the second week a girl had had a conversation with her partner that she’d wanted to have for years but hadn’t been able to. It’s the nature of the college.”

Wilson has been a peer trainer for a year. “I was sitting on the other side of the table just two years ago, that’s how recent it is. I had my own business but I was diagnosed with bipolar disorder and I lost it all. I then went through the learning curve and it took a while to get to where I am now.

“In class, I draw on my raw experiences of bipolar and how I manage it. I bring that to the room so hopefully students will be inspired.”

One of his colleagues is Kevin Howell, a practitioner trainer, whose background is in psychiatric nursing. Working so closely with peer trainers is one of the most unique things about his role. “I’ll be honest, I was nervous about what experience they’d have in a classroom environment,” he says. “It was quite daunting being involved in a new concept and realising that I couldn’t make any assumptions about my co-trainer’s experience.”

“We had some teething problems at first, one of which was realising we needed a formal process to bring peer trainers on board so that we had confidence in their training and ability.”

A trainee peer trainer programme was developed. Now, Howell says he knows that his co-trainers have both the training and the experience to be a true partner in the classroom. “What’s wonderful about working with a peer trainer is that student can relate directly to them, and this brings out information in the class that I would never hear otherwise.”

Howell believes the college is so successful because they put participants at the centre of what they do. He says: “Students don’t feel they’re on a conveyor belt and are valued for the whole person they are. When the focus is on the individual as a whole rather than their diagnosis you see a much fuller picture.”

For Bates, who enrolled just two weeks ago, the course is already helping her manage her OCD while she waits for a bed in a residential unit. She says: “It’s helpful in so many ways. For me it’s like a float in the sea of being alone.”

* Some names have been changed.

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

The mental health college that"s a lifeline in "a sea of being alone"

Neoliberalism is creating loneliness. That’s what’s wrenching society apart | George Monbiot

What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.

There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart. Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.

In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.

Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.

As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against themselves.

Social media brings us together and drives us apart, allowing us precisely to quantify our social standing

Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? A recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.

If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammals, social contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.

It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.

It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.

Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?

Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?

There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.

This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.

Neoliberalism is creating loneliness. That’s what’s wrenching society apart | George Monbiot

A World Without Down’s Syndrome? review – straight from the heart, and that’s the problem

‘This is Olly, my son,” says actor and writer Sally Phillips, over footage of her grinning 11-year-old cracking jokes to his siblings at the dinner table. Aside from being an amateur standup, paint-flinger and epic hugger, Olly has Down’s syndrome, a condition he was diagnosed with at 10 days old. Phillips wants to talk about a new test offered on the NHS that will give expectant mothers a non-invasive, 99% indication of the Down’s status of their unborn baby. Other countries using the test have had an increase in the rate of post-positive-result terminations. As it stands, nine out of 10 British women choose abortion if their baby is diagnosed in utero.

In her documentary, A World Without Down’s Syndrome? (BBC2), Phillips hopes to kick off a debate on the wisdom of introducing the test, which she fears will cause the number of terminations to go up here, too.

She goes to considerable lengths to take in all aspects of the subject, meeting parents, experts, educators and scientists in places as far apart as Iceland and California. But she is both the perfect person to give an account of Down’s syndrome and the worst possible person to present this documentary about the pros and cons of screening.

How could anyone look at Phillips’s son and say they wouldn’t want their child to be like him? This is the nub of programme, the undeniable foundation on which her argument is built. Now take that out into the world, this image of Phillips metaphorically clutching a picture of lovely, funny, warm, wonderful Olly in her hands and try to get a sensible conversation going about the pros and cons of screening. It isn’t possible for the other side of the debate to flow freely under these circumstances.

What I get instead of an even-handed discussion is at least a light shined on something that has only ever been in my peripheral vision. Phillips is right that the subject needs raising because the way a pregnant woman is spoken to about a Down’s diagnosis undeniably needs to change. “I expected tragedy and got comedy,” is how she puts it. A long list of potential health problems, as currently provided in NHS leaflets, isn’t enough to go on when you’re deciding whether or not to bring a life into the world. She has so much insight and intelligence to bring to this, but her interactions with experts and parents on the other side of this debate often leave her tearful and frustrated.

Producer/director Clare Richards does try to keep a careful hand on the tiller, often framing setups with Phillips’s own disclaimers about being a novice film-maker, and occasional questions about whether she is getting it right. Phillips herself said in an interview (on ITV’s This Morning) that she wanted someone else to make this film, someone with documentary experience. Presumably, her celebrity status made her a more appealing prospect for the broadcaster than a scientist or journalist with that degree of distance.

As she treads on ever more tricky territory, you can see why she was reluctant. The most difficult scene is her interview with Kate, an expectant mum who terminated a pregnancy after a positive Down’s diagnosis. As she describes aborting her 25-week-old foetus, Phillips tears up and bows her head. She acknowledges Kate’s bravery in talking about such a hard choice, but then she takes out an iPad and shows Kate a video clip of a young American gymnast called Chelsea, who also has the condition. Phillips’s smile seems to be urging Kate to see what she can plainly see: that their lives are no less valid. That people with Down’s can go on to great things.

“Do you mind if I ask you the really difficult question?” Phillips says, in the most direct confrontation of the programme. “So, you think her life would have been better not happening?” she asks tentatively. Kate takes a moment, then says that she thinks it should be up to each mother to decide.

“Kate didn’t want a child like mine,” says Phillips in voiceover after their interview. That wholly emotional summary of what we’ve just seen is why this doesn’t work as a documentary. When a subject is so close to the presenter’s heart that it is indivisible from it, the result is impassioned but not impartial.

As Phillips herself says, this is “a film that asks the question – what kind of society do we want to live in?” The answer here is unequivocal from minute one: a society that cares about everyone, no matter what their chromosomal makeup. Who could disagree?

A World Without Down’s Syndrome? review – straight from the heart, and that’s the problem

Thinner, smoother, better: in the era of retouching, that’s what girls have to be | Rhiannon Lucy Cosslett

There was a time when changing the appearance of a woman in a photograph would take hours and hours of expert, painstaking work by hand. Techniques in the darkroom allowed 20th-century photo editors to “dodge” or “burn”: over- or under-expose images in order to remove “flaws”, such as fine lines or rippling pockets of fat. Retouching required specialist equipment – paints, gelatine, brushes.

Towards the end of the century, Photoshop transformed the way image manipulation was conducted, but nonetheless it still required time and skill from trained professionals, and the software was expensive.

Now, anyone can retouch a photograph of themselves in a matter of seconds. At a recent barbecue, a friend showed me how you can doctor your Instagram photos using an app. At the touch of a button, she smoothed skin and slimmed limbs, adjusted contrast and lighting, airbrushed out “imperfections”.

This girl, by the way, is sensationally beautiful: the kind of girl men follow around rooms like cartoon dogs drooling over a dangled pork chop. And yet she airbrushes herself.

The debate surrounding the west’s skewed, stereotyped female body ideals trundles on, as it always has. In this country the Women’s Equality party, in collaboration with the models Rosie Nelson and Jada Sezer, is taking the fashion industry to task over its continuing fetishisation of underweight, prepubescent figures. Their work is to be applauded. But this is about so much more than the fashion industry now.

Retouching and airbrushing are rife not just among the glossy pages of magazines but also on social media platforms such as Instagram – platforms that make claims of veracity and authenticity despite attempts by teenagers such as Essena O’Neill to reveal the truth behind the images.

Mel Wells’s Samsung phone automatically doctored her selfies. Photograph: Instagram

Some phones now even do the work for you. In June, Instagram user Mel Wells blasted Samsung for automatically doctoring her selfies using its “beauty” setting. Forget the glamorous magazine offices of New York, Paris and London for a moment. Images of female perfection are being created by teenagers in the front room.

Last year the psychiatrist Dr Pippa Hugo warned that photo retouching by teenage girls was becoming the new normal. As many as nine out of 10 teenage girls in some schools would doctor themselves to appear thinner, she claimed – with disturbing psychological consequences.

Isabelle Whiteley, a photographer and researcher, has been travelling up and down the country interviewing girls between the ages of 13 and 18 for her project That’s What She Said. This is an endeavour that uses the girls’ own experiences to try to counteract damaging media narratives. It confirmed the prevalence of photo editing and doctoring among teenage girls.

“It would be more unusual for them to upload a completely undoctored picture to Instagram”, she told me, describing the practice as an “open secret”. Everyone does it, in other words, but no one admits to it.

The result is huge damage to the confidence of young women. Because now, not only are they comparing themselves with the models and actresses in magazines and on their screens, but with their peers – and, perhaps most distressingly, with themselves.

You create an online alter ego for yourself, and she is gorgeous and sexy and perfect, and what you think boys want. She adheres to whatever archetype is popular among your friendship group, school, class demographic – whether it’s the skinny supermodels of high fashion or the pneumatic, waist-trained hourglasses of the Kardashian clan. But then you see yourself in the mirror, and it’s just not good enough.

‘‘It would be more unusual for them to upload a completely undoctored picture to Instagram,’ Whitely told me. Photograph: Isabelle Whiteley / That’s What She Said Project

Whiteley tells me the competitiveness, jealousy and bullying among girls interacting with one another online are out of control. Study after study shows that social media is harming the mental health of teenagers.

Some who grew up in a different time will dismiss this issue as pure and simple narcissism, but such an analysis fails to grasp the psychological complexities of the problem. Those of us who know what it is like to grow up in a culture with a value system that places your body above all else will know just how much energy this preoccupation expends – how it bleeds away at your ability to act in the real world, to achieve things.

And now it is worse than ever. These girls sit on their devices, entranced by a universe in which they feel as though they matter, and they are increasingly unreachable. There’s a meme going around called Me at 14, which highlights the widening gulf between even my generation – the first to live out our teens online, but still victims of the traditional photographic evidence of gawky awkwardness and poor fashion choices – and theirs, with their pouting, pornified poses, contouring and poreless skin.

In 2016 we’re beyond needing to teach girls about the artifice behind image manipulation. They know very well. But that doesn’t mean that they are immune to its effects, that they don’t desperately feel the need to change themselves as they compare their young bodies to those of supermodels.

Many put Victoria’s Secret models as their phone backgrounds as “thinspiration”. Whiteley tells me one teenage girl described the annual Victoria’s Secret fashion show as “hell every year” because of the impact of the coverage and social media discussion on her self-esteem.

I don’t know what the answer is. But I do know that this is a toxic development in the adolescent experience of young women. It’s unbelievably easy to doctor a photo. I do it to a photo of myself taken in the garden last month, and in under five minutes I am slimmer, browner, better.

I wouldn’t be a product of my environment if I didn’t think the “after” image trumped the “before”. The difference is, I would never post it claiming to truth; lots of younger girls would.

That daughter, sister, friend or niece of yours could be sitting over there in the corner on her phone cutting bits off herself with the precision of a surgeon, ruthlessly assessing her flaws with an eye more critical than the most selective model booker in New York City. And you’d never know.

Thinner, smoother, better: in the era of retouching, that’s what girls have to be | Rhiannon Lucy Cosslett

Vegan Competing Bodybuilders – Yep, That’s Possible

There is a collective opinion among bodybuilders that they must obtain the necessary daily requirements of protein from animal products in order to build more muscle and stay strong. However, reading about enormous benefits from being vegan from their nutrition plans made people more aware of positive benefits from eliminating animal products. The trend of avoiding meat and animal products has risen over the past decade for several reasons. Some are lactose intolerant, others suffer from allergies and skin disorders, such as psoriasis and eczema – people turn to veganism for various purposes. As long as they stay healthy and promote their longevity veganism may be even recommended by doctors who treat patients from rare diseases.

Believe it or not, this new trend has increased among body-builders, too. They understood that being a vegan not only helped them in muscle building but also gave them more energy and shortened their recovery time after workout. Vegan sportspeople can have successful careers without depending on proteins from meat and dairy products.

In order to become a successful body-builder one has to understand how human body gets its necessary proteins.

The key thing one has to know is that protein is made from amino acids. Various amino acids are found in protein, but 22 are most important. Only nine of them must be obtained from the food and this is the reason why they are called essential amino acids. The other 13 amino acids are produced in human body.  Therefore, in order to supply the body with complete protein, individuals need to consume all 9 essential amino acids from food. Animal sources supply the human body with all nine amino acids. However, it is a well known fact that plant-based foods do not have the complete protein amounts.

For example, kidney beans and black beans contain eight essential amino acids while garbanzo beans contain only five, lacking lysine, methionine, leucine and valine. Rice is also another example of a plant based food with high rate of protein amounts, lacking only lysine, while other legumes, in general are rich with this amino acid. Thereupon, as long as people make the right combination, they shoudn’t worry about getting the complete protein amount.

While legumes and rice combination is a good source of protein, nuts and seeds combined together also provide the necessary amino acid supplement for people engaging into sports. Therefore, vegan body-builders do not find it difficult to meet their necessary protein requirements if their nutrition plan is rich with various plant-based foods and they do not limit themselves to only one protein related food. From sunflower seeds, flax seed and sesame to walnuts, chestnuts, hazelnuts, peanuts and almonds, they need to include at least four different nuts and seeds to achieve their goals. Following a five-meal nutrition plan every day including potatoes, grains and legumes a body-builder’s body can develop and be powered by the complete protein amount without cravings for animal related products.
However, a more detailed and careful nutrition plan should be taken into account for body-builders who would like to compete. Well-balanced diet is essential to suffice their daily protein requirements.

Bearing in mind that a three-oz serving of meat contains around 21 grams of protein, which is about one third the amount of necessary protein requirements for an average man, vegans should also take into consideration the amount of food they need to consume to meet these daily requirements. While it is easy for body-builders who eat meat to meet these requirements, those who decided to go vegan should thoroughly examine their nutrition plan following the information below in order to get a general idea of how much they should eat to optimize their results and reach their set goals:

Chia seeds contains all essential amino acids. Same is true for amaranth, quinoa, and hemp. However, the amount of protein in these plant-based foods must be taken into account since chia only has 2.5 grams in one tablespoon. In comparison, hemp seeds contain 3.5 grams in a tablespoon. Half a cup of quinoa has 4 grams of proteins and to compare same amount of amaranth has 4.67 grams, while same amount of buckwheat has 3 grams, peas contain 4 grams and beans contain 10 grams similar like lentils containing 9.5 grams. One cup of cooked spinach contains 5 grams of protein, same amount of guava has 4.2 grams of protein. One oz of raw pumpkin seeds has 9 grams of protein, while same amount of almonds have 8 grams and cashews have 5 grams.

In conclusion, a diet rich with all of these foods can suffice with the daily necessary requirements of protein. However, while following a well-balanced and detailed diet plan, body-builders should also consider taking plant-based protein powders for maximum results.

Reference:

http://yumuniverse.com/plant-based-protein-information-chart/

http://www.prevention.com/eatclean/high-protein-vegetables
http://nutritionstripped.com/10-plant-based-proteins-eating/

Vegan Competing Bodybuilders – Yep, That’s Possible

Everyone tells me the NHS is in crisis – but that"s not what I see

It’s no secret that the NHS is fighting a battle. We see it every day in the arguments to and fro, between the NHS and the government.

Every time I log on to Facebook I’m invited to another protest against the junior doctor contracts, or about the NHS student bursaries. At one point every single message in my inbox was a petition, I spent the whole evening signing, sharing and sending them around. I wanted to save the NHS too.

Clearly, the NHS is in crisis, right? This is what the media tells me. My friends bring the topic with them when we go out to dinner, an unwanted guest at the table. Patients express their concerns and opinions. But I do not agree.

Related: Our grassroots campaign is fighting NHS bursary cuts

I’m a second-year student, a year away from being a qualified mental healthcare professional. I don’t feel my NHS is in crisis: when I walk through the doors on a placement, I don’t see the bad, I don’t see a weak NHS shaking at its knees and I most definitely don’t see a crisis.

Instead, yesterday I saw an older woman. Sitting with her and listening to her stories made me wonder what stories I would tell when I was as old and wise as her. I helped to bathe her, feed her and laughed as we watched the TV. After hours of caring for her, she asked: “Who are you?” I won’t deny that it hurt, but I knew that her need for me to care for her was more important than my need for her to remember what I did.

Yesterday I saw a young woman. I became her friend for the day. Her numerous medical requirements meant I had to work much harder to keep her safe. She wouldn’t let me do her physical observations, but I persevered. She wouldn’t come for her medication, so we brought it to her. She didn’t want to eat alone, so I got some dinner and we ate together. Then, at the end of the shift, she didn’t want me to go home.

Related: Neonatal nursing is an amazing job, but it takes an emotional toll

I saw a child. Scared and afraid, she cried out for her parents, but they weren’t there. I sat up with her in the patients’ living room at 2am. I brought her a hot chocolate and sat with her in silence as she didn’t want to speak. She wanted to be free of the pain she felt. “Why am I here?” she asked. “Do my family hate me because they think I’m crazy?” Nothing I could say would reassure her, but I didn’t give up. I stayed with her until she fell asleep at 7am.

Instead of seeing a crisis, I see an NHS that needs more support, more love and more care. The NHS that has cared for all of us is asking us to care for it too. It’s daunting being for students caught up in this crossfire, yet we continue to stay because we want to make a difference.

Next time you are about to say “the NHS is in crisis”, replace it with “the NHS is in need of care, love and support”. Help to build your NHS and don’t contribute to its destruction. Not every baby who cries is in a crisis, it may just require some nurturing before the wails pass.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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

Everyone tells me the NHS is in crisis – but that"s not what I see

Why J Crew is promoting clothes that"s even smaller than dimension zero

Waisting away? No healthful grownup ought to need to have a size 000. Photograph: Alamy

Title: 000.

Age: Brand new.

AKA: XXXS.

Physical appearance: Really modest.

How modest? If it were a particular person, it would have a 58cm (23in) waist.

Is it a particular person? Allegedly.

If it is not a man or woman, then what is it? It really is clothing. Or, far more exclusively, it’s a clothing dimension. Or, even far more particularly, it really is a women’s clothes dimension just lately introduced by US retailer J Crew.

Who the hell is supposed to match it? Officially, J Crew is making 000 clothes to appeal to the “smaller sized-boned” female. But it has been accused of taking “size vanity” to preposterous extremes.

Dimension vanity? It means producing the illusion of thinness in your customer by resorting to quantity deflation. The notorious American “dimension zero”, for example, equates to a United kingdom dimension 4. A minor later, the 00 dimension (United kingdom 2) was introduced, now followed by 000.

Doesn’t that simply help to perpetuate a warped public perception of what constitutes a regular human physique? It undoubtedly does. A 58cm waist is deemed a healthy measurement for a woman aged six to eight.

It really is the two harmful and sickening! Your outrage is mentioned, even though dimension vanity is typically for the advantage of the bigger buyer, ie the size 24s who have been flatteringly downgraded to a twenty.

Is that J Crew’s explanation? Oh no. A spokesman for J Crew stated the 000 innovation was “basically addressing the demand coming from Asia for smaller sizes than what we had carried. Our sizes typically run large and the Asia market place tends to run little.”

Now I do not know what to believe. Or what to wear. Mail Online, alternatively, attributed the demand for the new sizing to a trend on the component of female celebrities of posting skeletal selfies, which are noticed by impressionable young ladies.

I’ve in no way seen any such selfies. Will not fret, Mail On-line reprinted loads of them so you can get the notion.

What next? Zero-zero-hrs contracts? Treble-zero tolerance? Never give anybody any suggestions.

Do say: “It does not even make mathematical sense – zero occasions zero occasions zero is nevertheless zero. Zero to three decimals areas is still zero. YOU Cannot HAVE Smaller sized THAN ZERO.”

Will not say: “Hey, skinny! The children’s division is on the second floor.”

Why J Crew is promoting clothes that"s even smaller than dimension zero

$1.8 Billion For The L.A. Clippers? That"s 3.27 Occasions A lot more Than Any Other NBA Team, And 120 Times The Team"s Working Revenue

Two swift ideas on the rumor that ex-Microsoft CEO Steve Ballmer is ready to pay up to $ one.8 Billion to get the Clippers.

1st, the NBA is a shared monopoly, which permits group crew owners to charge unusually large charges for the sale of their franchises as prolonged as no other crew owner is looking to promote at the exact same time.

Second, no other NBA proprietor is actively seeking to sell his staff correct now, which gives Donald Sterling a true monopoly in excess of the marketplace for buying an NBA franchise.

Based mostly on these variables, the stars purportedly have aligned for Donald Sterling to have obtained an offer you for the Clippers that is too great for even Montgomery Burns to have refused.

Presuming today’s rumors are correct, let’s put these numbers in viewpoint.

Sterling’s sale to Steve Ballmer would pay out him 3.27 times more for his franchise than the earlier NBA substantial of $ 550 million — paid for the Milwaukee Bucks back in April.  This is not a slight premium over previous NBA staff income.  It turns all previous valuations on their head.

In addition, the rumored $ 1.8 Billion sale price tag for the Clippers represents a worth of 14.06 times the team’s annual revenues and 120 times the team’s working revenue primarily based on values presented in a most recent FORBES report about NBA teams (the report that listed the Clippers’ revenues at $ 128. million and their operating earnings at $ 15. million).

This kind of ratios are astounding not only for a lot of conventional companies, but also for most sports franchise income.

Steve Ballmer. (Photo credit score: Wikipedia)

While territory rights to the Los Angeles market would on one hand appear to make the Clippers uniquely useful, the fact that the Clippers shares these NBA territory rights with the Lakers as effectively as competes to limited extent towards the NHL’s L.A. Kings would have seemed to have offset some of the market place benefits.

In addition, one would have expected the “goodwill” related with the buy of the Clippers to have been tiny if any.  Shedding methods and purportedly racist speech do not normally increase of business’s brand equity.

Prior to Sterling’s racist rant, 1 could have reasonably expected the Clippers franchise to have fetched Donald Sterling amongst $ 500 and $ 800 Million in an average sellers industry.

$ one.eight Billion?  Perhaps, V. Stiviano actually is the best salesperson of all time.

________________________________

Marc Edelman is an Associate Professor of Law at the City University of New York’s Baruch University, Zicklin School of Enterprise, where he has published a lot more than 25 law overview articles on sports activities law issues.  His latest articles or blog posts include “A Short Treatise on Amateurism and Antitrust Law” and “Are Commissioner Suspensions Actually Any Various from Illegal Group Boycotts.”

Steve Ballmer is rumored to have manufactured $ 1.8 Billion bid to get the L.A. Clippers (Photo credit: Wikipedia)

$1.8 Billion For The L.A. Clippers? That"s 3.27 Occasions A lot more Than Any Other NBA Team, And 120 Times The Team"s Working Revenue

Who runs the NHS in England? That"s a great question

The present reforms have designed new sources of electrical power inside of the NHS, writes Scott Greer. Photograph: Alamy

The Public Accounts Committee discovered this month that neither the Division of Overall health (DH) nor NHS England was able to “articulate” who was responsible for NHS maternity services. Ahead of Christmas, the chair of NHS England berated the secretary of state for well being for obtaining concerned in the day-to-day operating of the NHS. A month later on, the care services minister Norman Lamb attacked NHS England for its “flawed and unacceptable” choice to alter the cost paid to suppliers of mental overall health services, a power the DH had granted to NHS England in the very first location.

So who does run the NHS in England? In a current report for the Centre for Wellness and the Public Curiosity we experimented with to response this question. The 2012 Health and Social Care Act sought to separate off, when and for all, the day-to-day operating of the NHS from political interference and to “restrict the capacity of the secretary of state to micromanage and intervene”. It did this by way of establishing NHS England as a separate entity from the DH, which would have the electrical power to spend most of the NHS spending budget and commission a significant amount of healthcare solutions. It would be controlled by way of a yearly mandate set by the secretary of state and be left to get on with the job.

History displays that this is not the first time that this has been experimented with. Margaret Thatcher’s governments designed the NHS management executive and even moved it to Leeds in an additional try to distance the working of the well being service from politics, a method that ended in failure as the management executive was abolished and electrical power taken back into the DH where New Labour ministers could far better assert their handle. Why? As Jeremy Hunt is locating out, voters and the media will often direct their anger at the politicians rather than the bureaucrats if A&ampE services fail to supply in the middle of winter, no matter what is written down in a mandate. And, as the recent confusion reveals, this current division of roles and responsibilities is unlikely to stay secure for really long.

But what the recent reforms have also completed is to generate new sources of energy inside the technique, partly due to the dispersal of power away from ministers to NHS England and regulators this kind of as Monitor and the CQC, but also simply because of the personalities and backgrounds of individuals in charge. The DH itself has turn out to be much less capable to assert its authority in the running of the NHS as there aren’t as numerous civil servants doing work there now NHS England, Check and the CQC in between them now have above 4 and a half occasions as many senior civil servants as the DH.

And, as we show, even though several of these working NHS England have prolonged histories of operating in the NHS and the DH, the body charged with regulating the new NHS market, Check, is run by an executive group drawn virtually completely from private sector management consultancies – KPMG and McKinsey in distinct. Do these two quangos agree on how competition in the new NHS marketplace should operate? Or how the £20bn of cost savings ought to be produced? Seemingly not – a clash of values maybe reflecting the various schooling of their best teams and signs of a feasible turf war ahead.

The secretary of state is, of course, ready to use his powers of patronage to guarantee that people operating the new NHS quangos are in line with his thinking. But then was not it the lately appointed chair of the CQC, the former deputy chairman of the Conservative party, who attacked his political master’s “crazy” obsession with micromanagement following Jeremy Hunt made personalized cellphone calls to people hospitals struggling to meet A&ampE waiting time targets? There’s obviously some way to go just before Andrew Lansley’s aspirations of “improving transparency and escalating stability” in NHS governance are realised.

Scott Greer is associate professor of health management and policy at the University of Michigan, research associate of the European Observatory on Overall health Methods and Policies and senior going to fellow of LSE Wellness

This article is published by Guardian Specialist. Join the Healthcare Experts Network to acquire normal emails and exclusive delivers.

Who runs the NHS in England? That"s a great question