Undocumented immigrants avoid vital nutrition services for fear of deportation

The phone calls began in February: “I’m not coming back.” “It’s not worth the risk.” “Erase my name from your records.” One person brought in a sheaf of vouchers and insisted on returning them.

All over the US, undocumented immigrants were calling the offices of the Special Supplemental Nutrition Program for Women, Infants and Children (Wic) and begging to drop out.

Since Donald Trump assumed office with promises of a fierce crackdown on unauthorized immigrants, the fearful response has spawned a hundred stories like these, of people withdrawing into the shadows to avoid unwanted detection.

But the defections away from Wic, a federal program that helps more than 8 million low-income children and mothers purchase formula and nutritious foods, offer some of the first concrete evidence of the far-reaching and potentially devastating consequences for the welfare of people at risk from Trump’s deportation promises.

Of the 90 local agencies that manage Wic, about a quarter have told the national association that undocumented clients are skipping appointments and foregoing benefits.

Many offices have recorded a sharp drop in caseloads. And in areas with a high proportion of immigrants, some clinics stand nearly empty.

“This is happening across the United States,” said Elisabet Eppes, a senior public policy associate at the National WIC Association. “We are extremely concerned.”

The benefits at stake are very modest; most participants receive roughly $ 45 in vouchers a month. But decades of research have linked the program to declines in early childhood obesity, low birth weights, premature births and infant deaths, and an increase in childhood immunizations.

The children and mothers who qualify for Wic are at risk of not only poverty but also malnutrition, because of a poor diet or a health condition.

Lanie Smith, a Wic dietitian in Kansas, recently treated a young boy with epilepsy, a condition that is made worse by a poor diet. As Smith sat with the boy, his mother, who has undocumented family members, debated with Smith whether to withdraw her son from the program.

“We’ve heard a lot of stories about people who either wouldn’t show up for appointments, or who wanted to withdraw from the program, cancel their benefits and be scrubbed from the record,” said Douglas Greenaway, the president and CEO of the National Wic Association. “We’ve had people offer to pay back any benefits they might have utilized: ‘Hang in there, I’ll find money to pay you back.’”

Wic agencies and employees first started having conversations like these in February, after rumors spread that the Trump administration would focus on deporting immigrants who accept public assistance.

The rumors were untrue. But the White House is considering executive action to make them a reality. In February, a draft leaked of an executive order that would encourage the removal of immigrants, including those with legal residency, who received public welfare.

That was enough for thousands of undocumented immigrants to question if Wic was worth the risk.

As fears have mounted, Wic agencies have desperately tried to convince undocumented participants to keep using the program. It is not against the law for undocumented immigrants to participate in Wic, they remind clients, and Wic doesn’t ask about or track its participants’ immigration status.

But panic can outpace policy. When fear of deportation runs high, research has found, unauthorized immigrants become less likely to use the public health benefits for which they’re eligible. Even immigrants with legal status will avoid entitlements if members of their family are undocumented.

Public health advocates worry that Wic may not be an outlier, but a bellwether for the potential consequences of driving undocumented immigrants into the shadows.

Other health and safety advocates are starting to measure similar trends. On Monday, the National Domestic Violence Hotline, the country’s most prominent resource for victims of intimate partner abuse, reported that it fielded more than 7,000 calls related to immigration status in 2016 – a 30% increase from 2015.

The hotline, which was established by Congress in the 1990s with federal funding, responded to 323,660 calls last year.

Supporters of Trump’s crackdown argue that undocumented immigrants shouldn’t be entitled to use public benefits provided on taxpayers’ dollars.

US law already bars immigrants from using many welfare programs designed to benefit the poor. The leaked executive order argues it is necessary to expand and enforce these exclusions because immigrants are more likely to rely on public assistance than legal residents.

But that claim is not backed up by the evidence, which suggests that immigrants are less likely than people born in the US to use welfare programs. The order also ignores the fact that many immigrants – undocumented or otherwise – have children who are US citizens but cannot access public benefits on their own.

If undocumented families continue to flee Wic, most of the consequences will probably fall on very young children, including an untold number who were born to undocumented parents but have US citizenship.

“As pediatricians, we should be trying to encourage families to access all the programs that they’re eligible for, regardless of their immigration status,” said Dr Lanre Falusi, the president of the Washington DC chapter of the American Academy of Pediatrics. “It’s heartbreaking to hear a patient say that even if their child is entitled to use this vital program, even if their child was born here, is an American citizen … they are too scared.”

What would a city look like without undocumented immigrants?

Smith, from the Wic agency in Kansas, said more than 100 people have stopped coming to her clinic in Kansas City – or, as many people as her clinic sees in a single day. Many of those clients called the clinic to say they were simply too scared.

The fears were even more pronounced in California, where numerous local agencies have received pleas from clients who want to be purged from Wic’s record-keeping system. At least one parent called an agency to ask if children on Wic would have to pay the government back someday.

“There are citizen children who aren’t going to receive benefits that they are entitled to because their mothers are too afraid to come in,” said Karen Farley, executive director of the California Wic Association. “Never mind that their parents contribute to the local economy – these are children and babies we’re talking about.”

Undocumented immigrants avoid vital nutrition services for fear of deportation

Reasons to fear the next UK heatwave

It is 14 years since the heatwave of 2003 killed 2,000 people in southern England and the alarm was raised about hot weather being as dangerous for vulnerable people as winter cold.

Since then a UK-wide warning system has been put in place that will inform people when the temperature is likely to exceed 30C for a day and a night. Weather forecast warnings of an imminent heatwave ask that vulnerable people take steps to keep cool.

Hospitals and care homes are supposed to provide a “cool room” for those most at risk. The last such warning was given in August 2016.

But scientists are concerned that this is nowhere near enough to protect the public because, even in moderately warm weather, some places can become dangerously hot. Researchers at Loughborough University forecast: “Overheating in UK homes is a public health disaster waiting to happen.”

They say this is partly because the government has concentrated its regulations on insulating homes to keep people warm in winter, thereby making them more likely to overheat in summer. This plus poor design of houses and more high-rise building has made many homes uncomfortably warm even in mild summers. Tests show that hospital wards and homes for the elderly are among the most dangerous places in a heatwave.

Loughborough says new regulations are required to improve design. This means providing easy-to-open windows and shading to keep out the sun. A public education plan is also needed so people know to open windows at night to let in cool air and close them during the day to keep the heat out.

Reasons to fear the next UK heatwave

Don’t dread old age. I’m 94, and I won’t spend my last years in fear of the Tories | Harry Leslie Smith

I have lived a very long time. Tomorrow, it will be exactly 94 years ago that a midwife with a love of harsh gin and rolled cigarettes delivered me into my mother’s tired, working-class arms. Neither the midwife nor my mother would have expected me to live to almost 100 because my ancestors had lived in poverty for as long as there was recorded history in Yorkshire.

Nowadays, when wealth is considered wisdom, too often old age is derided, disrespected or feared, perhaps because it is the last stage in our human journey before death. But in this era of Trump and Brexit, ignoring the assets of knowledge that are acquired over a long life could be as lethal as disregarding a dead canary in a coal mine.

I have been living on borrowed time since my birth in Barnsley all those years ago: I survived both the depression and the second world war. Even in advanced old age, because I walked free of those two events, I feel like a man who beat all the odds in a high-stakes casino. It’s why I’ve embraced each season of my life with both joy and wonderment because I know our time on Earth is a brief interlude between nonexistence.

Still, many people persist in thinking that old age is the end of one’s usefulness or purpose, which could explain why the news that women in South Korea can expect to live into their 90s has been badly received. Some fear the indignity that old age may bring, or the dependence it may cause because of physical or mental impairment. On occasion I too worry that before death sets in on me that it may rob me of the elements that make me who I am. But ultimately, having experienced the profound indignity of extreme poverty during the 1930s and the sheer terror of war in the 1940s, I know that life must be battled until the bitter end.

Eternity is just around the corner for me but I don’t fear my death. I only regret that death will end my dance to the music of time, no matter how slow the waltz has become to allow me keep up. I know that my physical wellbeing and dignity may yet be affected adversely by the government’s self-created social care crisis but I will not spend either my last years or days living in fear of the Tories. I cannot because I have seen their kind before in the 1930s and 1980s and know that the only way we can beat the tyranny of austerity is through our own personal defiance.

People should not look at their approaching golden years with dread or apprehension but as perhaps one of the most significant stages in their development as a human being, even during these turbulent times. For me, old age has been a renaissance despite the tragedies of losing my beloved wife and son. It’s why the greatest error anyone can make is to assume that, because an elderly person is in a wheelchair or speaks with quiet deliberation, they have nothing important to contribute to society. It is equally important to not say to yourself if you are in the bloom of youth: “I’d rather be dead than live like that.” As long as there is sentience and an ability to be loved and show love, there is purpose to existence.

I learned a long ago time ago that there was wisdom and beauty that could be mined from the memories of those in the sunset of life. It is why as a boy I listened in rapt attention to my granddad as he lay dying from cancer and told me about his life both as soldier and miner during the reign of Queen Victoria.

All of you, when young, will make your own history: you will struggle, you will betray some and others will betray you. You will love and lose love. You will feel profound joy and deep sorrow and during all of this you will grow as an individual. That’s why it is your duty when you get old to tell the young about your odyssey across the vast ocean of your life. It is why when death does come for me – even if it mauls me with decrepitude before it takes me – I will not lament either my old age or my faded youth. They were just different times of the day when I stood in the sun and felt the warmth of life.

Don’t dread old age. I’m 94, and I won’t spend my last years in fear of the Tories | Harry Leslie Smith

Doctors see a new condition among immigrant children: fear of Trump

At doctors’ offices across the United States, a new diagnosis has been popping up in the medical files of immigrant children, their friends and their families: fear of Trump.

Since the 8 November election, pediatricians and clinics serving undocumented immigrants and other low-income patients have reported a spike in anxiety and panic attacks, particularly among children who worry that they or their parents might now face deportation.

One little boy in North Carolina has been suffering crippling stomach aches in class because he’s afraid he might return home to find his parents gone. In California, many families are reporting that their children are leaving school in tears because their classmates have told them they are going to be thrown out of the country.

Children are showing up in emergency rooms alone because their parents are afraid of being picked up by Immigration and Customs Enforcement if they show their faces. Even American-born children are suffering – one boy in the south-east asked a doctor for Prozac because he was worried about his undocumented friend.

“It’s as though a volcano erupted. It’s been awful,” said Mimi Lind, director of behavioral health at the Venice Family Clinic, one of the largest providers of healthcare to low-income families in southern California. “People who don’t have a history of anxiety and depression are coming forward with symptoms they’ve never had before. And people who had those symptoms already are getting much worse.”

It’s too soon to put precise figures on the wave of Trump-related anxiety, but health professionals and immigrant rights groups say it is unmistakable. “People worry their families will be broken up, that parents will be deported and children will end up in foster care, on a scale that we’ve never seen before. The feeling out there is one of great fear,” said Marielena Hincapié of the National Immigration Law Center.

People who don’t have a history of anxiety and depression are coming forward with symptoms they’ve never had before

Mimi Lind, Venice Family Clinic

Some of the Trump-related anxiety was evident even before the election, especially in states where Republican-dominated legislatures have pushed through measures to make it harder for immigrants to access education, healthcare and other basic services. Trump’s election, however, turned the abiding worry into a full-blown crisis – not least because his victory was unexpected.

Julie Linton, a pediatrician from Winston-Salem, North Carolina, who also serves on the American Academy of Pediatrics’ immigrant child health special interest group, started receiving panicked calls from patients at 6.30am on the morning of 9 November, and she has been deluged since.

Many undocumented parents with sick children born in the United States are now making contingency plans in case they are deported, she says, and in so doing have to face an agonizing choice: whether to leave their children behind, or to risk losing access to the care they need in their home countries. She sees Syrian refugees as well as patients from Mexico and Central America, where it may be difficult or impossible, for example, to find devices to enable children with neuromuscular disorders to walk.

“Parents are asking me: ‘What do I do? How do I set up a power of attorney in case I’m deported?’” Linton said. “It’s hard enough to care for a child with special healthcare needs without having to worry about the threat of deportation.”

A group of immigrants and attorneys gather outside Trump Tower on 22 November to draw attention to Donald Trump’s proposed immigration policies. Photograph: Justin Lane/EPA

It is not just families and children that have felt the impact. Many patients who are vulnerable anyway – alcoholics, drug addicts, those with degenerative diseases or mental health struggles – have been knocked backwards. “To them, it feels that another part of their power has been taken away when they’ve just started to build themselves up again,” said Eileen Garcia, a therapist who looks after HIV and Aids patients at the Venice Family Clinic.

One of her patients, a middle-aged undocumented immigrant who wanted to be called Maria (not her real name), said that while she had been shocked when she received her initial HIV diagnosis she took it in stride because she knew help was available. “But this,” she said, “feels like a death sentence.”

As Maria sees it, she may lose access to treatment if the Trump administration scraps President Obama’s Affordable Care Act, and she may lose it, too, if she is deported and cannot find similar services back in her home country (which she did not want to name). “It’s a double worry,” she said.

The fear felt by many patients is reflected in the protective instincts of their caregivers. For this story, doctors and therapists were extremely careful not to give away patients’ names, or more than the most basic details of their medical profiles, or even in some cases the state where they live for fear of providing clues to authorities pursing an anti-immigrant crackdown.

They also struggle to know what to say to address their patients’ concerns, especially at this early stage.

“Many of us feel pretty helpless right now,” Linton, the North Carolina pediatrician, agreed. “We try to remain nonpartisan but we’re unabashedly pro-child and that’s a hard place to sit right now. For me, as a pediatrician and as a mom, it’s heart-breaking to think that a child is worth less based on conversations happening at the local, regional or national level.”

“This waiting time is the most anxiety-provoking,” Lind, the behavioral health specialist said. “No one can say anything. We have no way of allaying people’s anxiety with concrete facts.”

Doctors see a new condition among immigrant children: fear of Trump

Blind guests fear for future of three specialist hotels sold by charity

The futures of the UK’s three remaining specialist hotels for the blind are in doubt, sparking fears that visually impaired people could be left isolated.

Action for Blind People is selling the Cliffden in Teignmouth, Devon; the Lauriston in Weston-super-Mare; and Windermere Manor, in the Lake District, because it can no longer justify the running costs.

The charity is hopeful that the hotels will stay open under new management, but critics of the sale believe that closure is more likely and that blind and partially sighted people will suffer.

David Haynes, 69, from South Milford, Yorkshire, said: “Without this sort of facility, I don’t know what people will do. You can’t imagine what it’s like leaving your house without any sight at all. People go there because all the staff are trained with regard to working with visually impaired people. It’s safe and secure.”

As well as being a regular visitor, Haynes sits on the Action for Blind People customer council. He is angry the council was not consulted over the decision, which was made by senior management and approved by the charity’s trustees, most of whom are blind or partially sighted.

The three hotels have swimming pools, textured surfaces, talking alarm clocks, large button phones, braille menus and facilities for guide dogs. They also provide a pick-up service from nearby stations and run supervised trips.

Action for Blind People said 2,000 visually impaired people used the hotels last year – just under half the total number of guests – although many went more than once. The charity said an increase in sighted guests is one reason it cannot justify the extra expenditure of £950,000 needed to run and maintain the hotels over the next three years.

But Haynes said the hotels provided an invaluable opportunity for the visually impaired to talk to each other and interact with the sighted. “We all learn from each other,” he said.

“It’s an indictment of 21st-century Britain that there’s no provision for the visually impaired to go to a hotel. All hotels have to have access for people in wheelchairs but they don’t all have to have staff trained to work with the visually impaired, to do small things like saying your meat is at eight o’clock [on your plate], your potatoes are at four o’clock.”

Christine Newcombe, vice-chair of Guide Dogs Circle, is another patron angry about the decision. She describes the hotels as a lifeline, particularly for the most vulnerable, who are completely blind, like herself.

“People are going to be isolated,” she said. “There’s been no consultation. No one has actually asked blind people what they actually want. The hotels offer peace of mind, health and safety.

“I just go with a friend and and leave John [her husband] at home. We have both got guide dogs. We just have a nice time. They do trips during the stays, [and] that would be difficult in an ordinary hotel.”

An Action for Blind People spokeswoman said: “We’re doing everything we can to find suitable buyers for the three Vision hotels to make sure they stay open, but we do understand that a lot of people are upset by the news that Action for Blind People will no longer be running the hotels.

“This has been a very difficult decision to make as we know how much Vision hotels mean to customers, staff and volunteers. To have kept the hotels open, we would have had to divert funds from other services and after careful consideration, we decided that this was not the right thing to do.”

She said the hotels were still taking bookings.

Blind guests fear for future of three specialist hotels sold by charity

I used to fear working NHS night shifts would kill me

A patient came to see me at my GP practice the other day. “I know you from the hospital,” he said. “It was you I saw on the night I went to A&E.” He paused, and then added: “You seemed tired”.

I couldn’t recall the event – it occurred during the A&E rotation of my GP training in 2014. At the time I felt that night work was killing me slowly. Driving home in the mornings I used to fear it might kill me quite suddenly. In that particular job I was obliged to alternate so frequently and jarringly between day and night work that after three months my life had blurred into a homogeneous grey fog in which I took pills to go to sleep and pills to wake up again. Driving was hazardous but working wasn’t straightforward either. On one occasion I fell asleep while phoning a patient’s relative in the middle of the afternoon. After three months I was struggling, my heart was skipping beats and I was so depressed that I started to think that maybe crashing my car wouldn’t be such a bad idea.

A&E was dreadful, but the doctors working there have one important benefit; they are generally guaranteed a break, of some sort. By contrast, the doctors working unsupported on the wards manage their own time and only take breaks if they reach the end of their jobs list. All too often that doesn’t happen, the bleep doesn’t stop bleeping.

The system is presently unsafe for doctors, I’d argue that it is unsafe for patients as well. A doctor who isn’t safe to drive isn’t safe to work. It’s hazardous, it has been for years but it’s a necessary evil and the prevailing attitude appears to be that we have to accept the risk.

There are plenty of factors maintaining the status quo, the availability of resources, both financial and human, and the expectations of other staff members, and patients to name a few. I would suggest there is another important but unspoken element to this that shouldn’t be overlooked. It involves the doctors themselves.

Doctors are a mixed bunch but there are common threads discernable in their psychological makeup. They are generally competitive high-achievers who are sensitive to social pressure. They often strive tirelessly to achieve the best outcomes for their patients, or to invert that subtly, to be the best doctor they can be.

This ideal best doctor character is a tower of strength, indefatigable and endlessly resourceful, no challenge too great, no demands too exhausting. It’s the ideal that society looks up to and praises, it is one that the average doctor is happy to embody. Unfortunately best doctor is indispensible, doesn’t need sleep and doesn’t leave work unfinished for colleagues to sweep up. Best doctor stands nobly in a proud tradition of colleagues who have undergone the same trials, nay, worse ones, as our forebears are ever eager to remind us.

Best doctor doesn’t moan about hardships, they are battle scars, a source of pride, evidence to show that this doctor stands shoulder to shoulder with the best of them.

The flawed diurnal human pulling the levers behind the facade is just going to have to cope. If they are too tired to drive their car and have to drink alcohol to make it all go away, well, that’s just the price that has to be paid.

Making night shifts safer would require substantial system changes to moderate demand, but alongside them an obligatory level of self-care for doctors. Anything less stringent will simply be ignored.

Unfortunately our chances of witnessing such changes are laughably remote. The current political will, with Health Secretary Jeremy Hunt as its hapless mouthpiece, is more geared towards exploiting these convenient character traits than compensating for them. As the system is placed under increasing strain I expect that the situation will only get worse.

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.

Do you work in the NHS? Please take our survey and tell us whether bullying is a problem and how it affects your work

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.

I used to fear working NHS night shifts would kill me

Childhood obesity strategy may be watered down, campaigners fear

Health campaigners fear that the government’s childhood obesity strategy, expected this week, has been watered down under relentless pressure from the food and drinks industry and will prove ineffective in changing the habits of an overweight nation.

The strategy is supposed to be based on recommendations from Public Health England after an investigation into the measures that would work best. A third of children are overweight or obese by the time they leave primary school.

PHE urged curbs on buy-one-get-one-free and multipack price promotions on crisps, sweets and other junk foods in supermarkets, and came out in favour of tackling junk food advertising to children. It supported a tax on sugary drinks, although it said the other measures would work better.

Health groups fear industry lobbying may have prevailed and that the measures have at least been diluted, although the levy on sugary drinks – announced in George Osborne’s last budget in March – is expected to go ahead. Details of the tax are expected to be announced by the Treasury in a consultation document to be published this week alongside the childhood obesity strategy.

Critics are concerned about the timing of the launch. David Cameron made childhood obesity a personal issue and the strategy was being put together inside No 10. However, it is now expected to appear while Theresa May is on holiday in Switzerland, suggesting she will not champion it in the same way.

The Children’s Food Campaign, a member of the Obesity Health Alliance, which includes charities and health organisations such as the royal colleges, is concerned by suggestions that the tough action they wanted on cut-price junk food and TV advertising will not happen.

Leaks suggest there will be no ban on multi-buy promotions in supermarkets. “Price promotions were one of the big issues that Public Health England majored on,” said Malcolm Clark, of the campaign. “It looks like the government is failing to listen to its own public health experts.

“Industry likes to paint us as nanny-statists, but PHE is not a campaigning organisation. They have done a very thorough literature review of peer-reviewed evidence and come up with a recommendation on that.”

The Children’s Food Campaign has lobbied hard for a ban on adverts for foods high in salt, fat and sugar during family TV programmes. A ban on such ads on children’s TV is not enough, they say, because of the huge numbers of children who watch family programmes such as Britain’s Got Talent and The X Factor. They have called for a 9pm watershed, at which time viewing figures for under-15s drop.

The food and drink industry has been strongly opposed to a ban on such adverts before 9pm because it would cover programmes watched by millions of viewers.

Tam Fry, patron of the Child Growth Foundation and spokesperson for the National Obesity Forum, said that if the hoped-for measures did not come about, “it will spell disaster for obesity. It will not be the game-changing document promised by [the health secretary] Jeremy Hunt with draconian measures to tackle the epidemic, but a limp repetition of the flawed responsibility deal.

“The government’s own senior health advisers have called obesity a national risk, requiring a Cobra-style crisis management response. Apart from the government appearing to be resolute about a sugar levy, its intentions are light years away from what is needed.”

Childhood obesity strategy may be watered down, campaigners fear

Social care professionals: what is your biggest fear?

It’s no secret that the social care sector is under huge pressure and staff are expected to juggle never-ending caseloads.

When the most vulnerable make the news, from people living with severe mental health problems or children who suffer at the hands of violent parents, they will probably be known to the social care system.

Social care professionals, social workers and carers can’t be with service users all the time, so what measures do you put in place for when you’re not there? What do you worry might happen in your absence?

Perhaps it’s the woman with dementia who you worry will accidentally start a fire at home, or maybe it’s the mother who can’t leave her violent partner, or that child with mental health problems who can’t access the care they need to keep them safe?

We want to hear from foster parents, carers, social workers, occupational therapists and peer support workers about your biggest fears.

Share your worries by filling in the form below. We’ll use a selection in our reporting.

Social care professionals: what is your biggest fear?

Do We Actually Have to Fear About Shower Curtains Creating Fat Obtain?

I’m afraid we can appear forward to a good deal much more of this sort of nonsense.

Numerous days ago an article titled “Is Your Shower Curtain Generating You Unwanted fat?” appeared in the magazine Spry and was then reprinted in the Dodge City Everyday Globe.  The article drew readers’ focus to the dangers of endocrine disrupting chemicals (EDCs), giving 5 examples of chemicals utilised in each day client merchandise (BPA, phthalates, PVC, PFC’s, and PBDFs).

With a quote from a professor of pharmacology and references to a couple of crude, published research, the writer, Catherine Winters, conveyed the message to her readers that they are surrounded by merchandise containing EDCs that can play havoc with hormonal signaling and induce ailment.  The shower curtain reference was primarily based on a examine that located that shower curtains containing PVC, or polyvinyl chloride, “release up to 108 volatile organic compounds (VOC), some of which could be detected in the air 28 days following the curtain had been hung.”

Nowhere in the article is there any mention of the kind of publicity to the chemical compounds needed to cause the adverse health results mentioned.  You would consider that she is speaking about occupational publicity where 1 is breathing in dust and fumes from these chemical compounds 40 hours a week, week-in and week-out.  In truth, exposures encountered in daily existence are likely to be trivial to non-existent.

English: Plastic bottles in the back of a pickup truck, ready for recycling (Photograph credit: Wikipedia)

I refer to this article not simply because of the wide reach of these publications but simply because the story is symptomatic of anything that is really widespread, not to say pervasive.  We read through and see claims and suggestions of this kind, if somewhat significantly less clearly silly, in newspapers, including the New York Instances, the media a lot more generally, and, even in supposedly peer-reviewed scientific journals.

So this is truly a general, society-wide phenomenon.  In portion, the media and the public are encouraged to think these unfounded scares by bad studies that get published in journals, due to the fact scientists and institutions that should know greater give them currency.  The media can then be depended on to pick up the titillating benefits of these sloppy studies.

If, in truth, as I wrote final week, we are far from comprehending the causes of the weight problems epidemic, we can be sure that in the coming many years a excellent deal of interest will be targeted by researchers on achievable variables that have received significantly less focus but that Could play a role in the improve in weight problems above the past 3 decades.

A hint of a new tidal wave of research that will undoubtedly make numerous new linkages between  a variety of exposures and a multitude of overall health effects is contained in a 2009 paper entitled “Ten Putative Contributors to the Obesity Epidemic.”  The paper has 22 authors and is 79 pages extended.  The lead authors are from the Pennington Biomedical Investigation Center at LSU and the University of Alabama at Birmingham.

Along the very same lines as I discussed last week, the authors commence out by calling into question the typical explanations of the weight problems epidemic.  They publish that, “Marketing practices of energy-dense meals and institutionally-driven declines in physical exercise are the alleged perpetrators for the epidemic, regardless of a lack of reliable evidence to demonstrate their causal role.”  They refer to these widely cited factors as the “Big Two.”

Even though making it possible for that the Large Two – extreme intake of calorie-dense meals and lack of bodily action – play a position, the authors make the situation that other factors, which have obtained minor  attention, may contribute to fat gain.  For every single of the 10 “putative” elements, they summarize the various varieties of evidence (experimental, ecologic, epidemiologic, and so on.) and examine how every single issue may possibly contribute to the problem.

The ten aspects are:

• Microorganisms


• Epigenetics – that is, variables that affect which genes get expressed


• Growing maternal age


• Greater fecundity amid individuals with greater unwanted fat retailers – that is, the chance that body fat individuals could be a lot more probably to have young children


• Assortative mating – i.e., a unwanted fat particular person may possibly be much more probably to marry a unwanted fat particular person


• Rest deficit


• Endocrine disruptors


• Use of prescribed medicines


• Reduction in the temperature assortment we are exposed to


• and intrauterine and intergenerational effects.

This definitely represents an ambitious study system.  Some of the products signify more centered hypotheses that could be tested (assortative mating rest deficit increasing maternal age), whereas other individuals represent whole new disciplines (i.e., the microbiome endocrine disruptors).

These factors might nicely merit review in relation to weight problems, but it ought to be pointed out that, at current, the evidence for some of them is quite slight.

To the extent that these inquiries are properly-formulated and higher-high quality scientific studies are carried out to handle them, this proposed system is a constructive advancement and is most likely to create new and valuable expertise.

Even so, even though the authors do a credible job of laying out the scientific proof for their 10 elements, there is a disturbing lack of essential viewpoint on some of the data they current.  For example, in their discussion of endocrine disruptors they refer to the truth that most of the population has measurable amounts of these chemical substances in their blood and urine, but they do not query whether these trace quantities are likely to have any biological effect.  They also refer to an association of levels of phthalate breakdown goods in urine with stomach obesity in the NHANES, with out any qualification regarding the uninterpretability of this kind of an association in a cross-sectional study (i.e., in which are the data have been collected at one particular point in time).

It is fine to study these things, and, if carried out right, we are very likely to acquire new and crucial knowledge.  But the final results are unlikely to bear out simplistic suggestions.  They are a lot more probably to flip our interest to things that we didn’t suspect heretofore.

Do We Actually Have to Fear About Shower Curtains Creating Fat Obtain?

Saatchi Bill: physicians ought to embrace innovation, not fear it

Consequently, on Thursday, the new, leaner, cleaner Bill, steeled in the furnace of vociferous public debate, will be presented in the House of Lords. It remains true to its original two concepts: to give medical professionals legal clarity and confidence when they wish to innovate – and to cease the quack experimenting recklessly on vulnerable patients.

At the minute, a physician who makes use of common remedies, in accordance to the proscribed tips, can not be sued – even if the patient dies. A physician who deviates, who tries something new, risks ending up in court.

But some healthcare negligence lawyers have argued that a modify in the law isn’t necessary simply because existing law does enable medical doctors to consider new treatment options presently.

This is only correct up to a level. In a court situation a medical professional can bring in health care specialists to defend the innovative treatment he experimented with. If these specialists say that treatment was sensible, the physician is risk-free. This is identified as the Bolam test. But a physician who wishes to innovate even now faces the threat and fear of a legal case. The reality that the medical professional may possibly have a defence is all but irrelevant – legal proceedings are terrifying, protracted and lifestyle-threateningly nerve-racking. Why chance it?

It is this dread that weighs heavily on the minds of some medical doctors and it is this that adds a dead weight to the desire to innovate.

The Bill basically brings the Bolam defence forward – to the clinic – and cuts out the concern of the long, nerve-racking court case. It lets a medical professional check with with a physique of health-related professionals in advance of the therapy. If the professionals all agree that the new remedy is affordable, the medical professional can proceed, legally and securely.

We also heard that there was a dread by some (not by patients, thoughts you) that vulnerable patients would be exploited and experimented on underneath this Bill. We have acted on this and created it clear and explicit that for a doctor to be covered she or he need to have the agreement of appropriately competent colleagues, such as a multi disciplinary group.

Sir Bruce Keogh, the health care director of the NHS, has been asked by Jeremy Hunt to come up with a way to make this perform in practice. He will report back in a matter of days. The Bill also now states that it are not able to be utilised for the purposes of analysis – only in the ideal interests of the patient.

Finally, we have observed that a lot of medical doctors want the Bill, other folks think it is appropriate in principle but requirements tightening – which we have done – and other individuals say there is no need to have for it.

From this, we draw the following conclusion, that there is a lack of certainty across the health care professions as to what they can and can’t do. Doctors are not attorneys, not all realize the law and consequently fear it. It is not clear to them where they stand and how they are to innovate.

This Bill sets out a simple, clear path to stick to, which will take away at as soon as any uncertainty and replaces it with the self confidence to innovate. At the exact same time, it stands towards the maverick and the quack who would seek out to experiment, alone and unchallenged, on individuals.

Dominic Nutt is the director of communications for the Health care Innovation Bill

To display your assistance for the Saatchi Bill, go to: http://saatchibill.tumblr.com/

Saatchi Bill: physicians ought to embrace innovation, not fear it

Fear of dementia is exacerbating the condition, specialists warn

Nearly one particular quarter of families affected by dementia waited at least two years just before turning to a medical professional – convincing themselves that they would cope ideal without having any outdoors help, the charity discovered. In 4 per cent of instances, it was far more than five years just before aid for suspected dementia was sought.

On Monday Mr Hunt addressed the World Overall health Assembly in Geneva about the problem of dementia in ageing societies.

He warned that global estimates propose that the globally expense of dementia care – £600bn – mean it now takes up about one per cent of the world’s gross domestic solution, equivalent to the 18th greatest economy.

At the G8 summit on dementia in London final year, ministers pledged to double investment in analysis, in the hunt for a cure.

But ministers will say on Tuesday that the challenge for society is even greater, calling on communities to do more to ensure that the most vulnerable are not left in isolation.

The Health Secretary will announce the winners of new awards, supported by The Telegraph, to celebrate efforts by people, groups and firms to generate much more dementia-pleasant communities.

On Monday night Mr Hunt said: “Dementia is a growing, worldwide challenge and one particular of the most substantial healthcare concerns we encounter in this country. The Government is established to tackle this head-on – but we also need to have as a total society to respond to the disease. That’s why these awards are so critical – because they recognise men and women who are making a massive distinction to bettering dementia sufferers’ quality of lifestyle in their nearby communities.”

It follows a pledge by the Prime Minister to recruit one particular million “dementia friends” to undergo coaching in the situation and make certain these residing with dementia are provided far more assist in their communities and neighborhood retailers.

Most current figures propose that significantly less than half of the 800,000 people presently residing with dementia in the United kingdom have been formally diagnosed by GPs.

Ministers suspect that in several circumstances physicians are declining to make a formal diagnosis of dementia since they believe that carrying out so will result in undue distress to sufferers and relations.

But charities explained the new findings display that a lot of of people who suspect they or loved ones are suffering from condition are reluctant to come forward, with numerous fearing confronting their condition, even though other folks believed small aid was accessible.

Jeremy Hughes, Alzheimer’s Society chief executive, explained: “It’s worrying that so a lot of men and women are not looking for help. Receiving a diagnosis can aid individuals recognize what’s taking place to them and open the door to therapies and help that they otherwise wouldn’t have accessibility to. It also allows the two the man or woman with dementia and their carer to take manage of their lives and plan for the long term.”

He urged individuals who feared they have been struggling from dementia to seek out support, rather than “bury their heads in the sand.”

The findings came as a commentary in The Lancet by dozens of specialists warns that Britons need to embrace healthier lifestyles in order to lessen the risk of dementia.

A consensus statement led by public health officials says the public requirements to be persuaded to “think brain, believe heart” due to the fact actions to boost cardiac well being will also decrease the likelihood of dementia.

The group of specialists call for a new nationwide concentrate on dementia chance reduction, with action to tackle smoking, drinking, sedentary behaviour and poor diet plan.

They say a lot more awareness is essential of the hyperlinks between unhealthy lifestyles and dementia, and adjustments in policies to promote healthy living.

Dr Charles Alessi, senior advisor and dementia prevention lead at Public Health England, explained: “We want to start to “feel brain, think heart” as brain wellness is inexorably linked to heart health and we can add healthful years to our lives by minimizing hazards earlier in our lives.

“Public wellness programmes have contributed to a big decline in deaths from heart condition and stroke over the past 50 years – we now need to have to attain the same on dementia, which is one particular of the largest difficulties dealing with our society.”

The Alzheimer’s Society’s poll of one,043 individuals with dementia and their carers showed 54 per cent of instances waited 6 months just before going to their GP. In complete, 23 per cent waited at least two years, although 4 per cent waited at least five years ahead of they sought support.

A separate on the internet survey of 2,358 British adults found dementia is the situation people are most reluctant to seek aid for, in contrast to other wellness issues including critical heart and digestive problems.

Fear of dementia is exacerbating the condition, specialists warn

Dont fear, Im not contagious and other microbiological delusions | Jenny Rohn

It is that strange time of 12 months when, despite springtime breaking out all more than town – tulips, apple blossoms, sunshine, the performs – everyone in the known universe appears to be sick.

I myself have been bouncing back and forth in between gastroenteritis and colds for the previous month. In spite of getting a microbiologist by coaching, I really do not presume any special knowledge about my own illnesses. Or possibly it’s because of my coaching. Lots of folks though, I’m coming to realize, have extremely strong opinions about infectious illnesses. Last week, my teenage relative, who’d stayed house from school with a debilitating cough just the day prior to, bent down to plant a massive juicy kiss on my baby’s encounter ahead of I could quit her.

“Don’t be concerned, I’m no longer contagious,” she told me breezily.

Quite understandably, when our signs have peaked and we’re feeling a bit greater, we could presume that the danger of spreading illness is past. But is it genuinely that easy? It all depends on the particular microbe and strain. Rhinovirus, for illustration, 1 of the agents that brings about the typical cold, loads up your snot with so numerous particles that you can simply be infectious a full two days soon after your symptoms hit, and perhaps longer. Other bugs have different windows of contagion, and even considering the identical agent, strains can exist with a lot more behavioural diversity. As we seldom get a optimistic identification of the microbes that inflict us, producing assumptions about our own amounts of contagiousness is not this kind of a excellent thought.

One more assumption that doesn’t stand up to scrutiny is some people’s practically mystical certainty about the exact source of the offending microbe. How usually do we hear folks claiming confidently, “I caught this cold from my colleague at work,” or, considerably far more vindictively (petulance masked as reassurance), “It’s Ok to be around me –I truly caught this from you”.

There are untold numbers of contagious microbes strains on the prowl, each with their personal exceptionally complicated infection processes. Since of the variability of incubation intervals and viral shedding windows (which can variety for days), the most apparent culprit – your partner, your child at nursery, the chap who sneezed all over you on the Victoria Line – may be a red herring. And in a city of eight million, like London, you will be exposed to an astonishing array of men and women. Transport for London estimates that an regular of 24 million journeys get area across its network every single day, which includes travellers from other cities and countries creating connections. On an average commute to operate on London Underground, for instance, you might come also near than you’d ideally like to hundreds folks in the carriages and tunnels and platforms that handrail or escalator rail you are clutching could have been sweated on by thousands before you, many of whom have almost certainly wiped their runny noses with a stray hand. Except if you are confined at home with no standard site visitors, pinpointing the actual second of infection would be not possible identifying if your strain is the exact same as your work colleague’s would require complex sequencing procedures nicely past your pay grade.

The assumption about who contaminated you also prospects to a false sense of protection about possible outcomes. That same teenaged relative informed me a few days later, of my most recent stomach complaint, “You’ve received the exact same issue I had final week. Mine only lasted 24 hrs, so you will feel a lot far better by tomorrow.”

As significantly as I’d like to be comforted by such cheerful adolescent omniscience, even if we could be particular we had the very same lurgy (see above), distinctions in our very own genetic backgrounds, total constitutions and previous publicity-based mostly immunities can make the course of the identical disease fairly different in two diverse individuals. Germs that only cause frank sickness in immunocompromised people are an severe example of this principle. But every of us is exclusive, and even otherwise healthful men and women do not all reply in the very same predicable way to an identical microbial onslaught.

I am sometimes asked whether having an acute information of ailment transmission is a burden. I utilized to think so: when I was taking intensive microbiology courses at university and graduate school, I was so freaked out by germs that I was afraid to get a sip of beer from someone else’s glass, or consume leftovers no matter how robustly refrigerated. Now, I’m significantly much more relaxed. The realization that it is virtually unattainable to pinpoint precisely when and where the up coming nasty microbe will strike brings a sort of liberating release: you cannot know, you can not run – and you definitely can not hide.

Dont fear, Im not contagious and other microbiological delusions | Jenny Rohn

Excellent Mood Food items: Don’t Fear be Satisfied

The previous adage, “You are what you eat” is getting to be more and more real. What we decide on to eat and when we eat it has a huge affect on how we feel. Here’s a enjoyable listing of food items you ought to eat to improve your mood fast!

Peanut Butter with Apple might be just the ticket. If you are feeling crabby your entire body might just be saying “Feed Me Now”. To elevate your mood try out a mixture meals that consists of a carbohydrate with either some protein or some excellent body fat. Carbs alone give you a quick burst and are gone too quickly but incorporating unwanted fat or protein slows digestion and aids vitality ranges remain with you longer. The apple is a wholesome complex carbohydrate and the peanut butter gives the healthier body fat.  Sprinkle it with love by including Chia seeds.

Avocado is the yummy green vegetable that consists of serotonin which takes place to be a feel-excellent neurotransmitter. It is also fantastic for your skin, hair, nails and has been known to reduce inflammation.  So make some guacamole, pull out the all-all-natural gluten cost-free chips and have a margarita (sugar free of course) and you will be happy you did.

Dark Chocolate should be eaten in instances of anxiety and want.  A new review in Switzerland found that eating just an ounce and a half of dark chocolate can reduce the tension hormones cortisol.  This minimizes people emotions of becoming stressed out.  I could have saved them hundreds of thousands of dollars in study to tell them that chocolate usually tends to make me pleased! Chocolate has even been referred to as “the new anti-anxiousness drug.”

Green tea with Passion Flower is made up of theanine and the herb Passionflora, which calms you and aids you maintain clear concentration and focus but with much less caffeine than coffee so you won’t get the jitters. Sample Gift Pack.

Bananas have dopamine, a normal chemical that enhances your mood. You get the extra bonus that bananas are large in B nutritional vitamins, including vitamin B6, which can soothe your nervous method. Plus the magnesium in bananas will contribute to this constructive mood foods.

Berries incorporate anthocyanins that are full of antioxidants.  These in flip help your brain make dopamine, a chemical that improves coordination, memory and your mood. So the very good information here is you will feel content and then you will bear in mind you felt satisfied!

Greek Yogurt is total of protein, aids digestion and is said to give you a flatter abdomen due to the fact of these qualities.  This all adds up to producing you feel considerably happier. Just make confident you are acquiring a brand with no additives, preservatives or additional sugar.

Chia Seeds are small minor gluten cost-free seeds with super powers worthy of donning a cape. Just one particular tablespoon delivers more calcium than a glass of milk, more Omega-3s than you get from Salmon, 42% of your day-to-day fiber, plenty of protein and beats out blueberries in antioxidants. Omega-3’s have the capacity to be mood lifting and to help possibly alleviate depression according to several new research. I adore them on celery sticks with peanut butter. Sprinkle them on any of the over foods for a double dose of happiness. (Read Mama Mia Mighty Chia))

And often we function towards our content foods options by partaking in food items that will always carry us down. The three excellent mood foods busters are sugar, gluten and processed foods. Just Say No!

Healthy Blessings,

Sandy

If you loved the submit on Excellent Mood Meals pass it on!

Excellent Resource: Foods &amp Mood: A Full Guidebook

Wellness Tricks four Lifestyle Website

Excellent Mood Food items: Don’t Fear be Satisfied