FIBROMYALGIA MAGAZINE SUMMER SPECIAL

FIBROMYALGIA MAGAZINE SUMMER SPECIAL

By Jeanne Hambleton Posted August 1st 2014 -

Where  have the months gone? We are heading fast towards  Xmas. Glad winter has not come yet .I have a holiday to fit in before then  but will  let you know when I am away. Hope you will back.

This has been added  earlier articles about diets  so please scroll down for more information.

 

I have just opened my Summer Special copy of the Fibromyalgia Magazine with the cover reminder about Awareness Raising Week. You have a month to prepare for September 6th to the 13th if you want two weekends to do some business.

I could never understand why it was just seven days losing a golden opportunity of two weekends. With children just back at school that week folks and fibromites usually have a lot to do themselves.

Many of you will know I am passionate about finding a cure for our invisible disability. If someone mentions Folly Pogs Fibromyalgia Research I bore the pants off them with what we need, our loose change appeal for a research project and so on. This is not to mention the soon sale of our own fibromyalgia film with celebrity speakers telling how it is. Watch this space.

Although we are promised some rain at the weekend, I am hopeful that more sun is on the way. So the first article ‘How to Weather the Summer with FM’ was interesting, as I am looking forward to some more heat waves with the weatherman’s promise it will last well into August.

Have you looked at your August copy of UK Fibromyalgia Magazine with 20 Fibromyalgia Research news items?

I am as usual impressed with the variation of articles focused on FM and as a former editor myself of another magazine, if I was editing this magazine many of these article would be in my mind.

Time is always my enemy and I have not read it all but I cannot wait to get to some of the articles. The weather and FM is interesting. We tend to dismiss weather albeit they play a part in our symptoms. We know the high and low pressures make a difference to how we fibromites feel.

If you are flying of on holiday abroad an article from the NHS tells you how to beat jet lag so you will not spend time recovering your holiday. Vitamin D, the sunshine vitamin features is an article by Dr.J.G. Moellendorf an American chiropractor and naturopath.

Thing not to say to fibromites – I would think ‘Fibro what?’ That drives me mad when they have no idea what I am talking about. Also there is light at the end of the tunnel if you practice the pain gate theory and think positive. .

The daily pup talk sounds interesting. Our conference speaker Nancy Gordon spoke about Xolos healing dogs. We know that works.

Sorry Helen Watts you have been on sticks for so long and it was certainly interesting to see the other side of the coin of those less fortunate than ourselves. I had a serious accident abroad and was in a wheelchair on holiday – my first adult experience being pushed. I was staggered how many people walk at a wheelchair and make no effort to avoid it. The poor pusher has to manoeuvre the patient.

Sometimes I think folks can really be thoughtless. Eventually I was on stick and it took me five months to get back on my own feet (just a little bit jellied but nor much) so I do have some sympathy. I am also glad it was not permanent for me. You are always so cheerful too, which is wonderful, Keep up the good work Helen. You are a shining star. It is so easy to take handicapped folk for granted and we certainly should not.

Found the flare up article very interesting and you do not realize just how much can upset our symptoms and often do not connect the weather with out pains or discomfort.

The baby article is so helpful for those keen to raise a family. Good luck.

Feel good feelings by that well-known writer Jan Sadler is something we all should read. I am a real fan of hers. I like the ‘Feel good” words leaning towards positive.

Glad to see Karen Lee Richards has written about flare-ups – one of those problems we live with and never really know when it will happen, so it is good to be prepared.

There are more and more articles about water, web search engines, legal questions and as usual a great recipes from the dear Christine Craggs Hinton and regular columns..

One of the best things I like about the magazine is the editor thinks fibromyalgia, which is helpful as he knows what we go through. It is also good to save the magazine as often you have read something and months later something happens and you remember. You read that but can I find it.

UK Fibromyalgia also had a splendid app for FM and at a good price. To get hold a copy which you will not want to miss (Jeanne said), try http://www.ukfibromyalgia.com/awareness-raising.html)   Last month’s copy was good too.

If you are really into doing things on line you can read the monthly magazine on line using Kindle. Look for Fibromyalgia Magazine… dare I say the one and only.

http://www.amazon.com/MagazineCloner-com-Fibromyalgia-Magazine/dp/B009S5KUZS/ref=sr_1_1?s=mobile-apps&ie=UTF8&qid=1355393794&sr=1-1&keywords=fibromyalgia

This should take you straight there to save you looking. As we journalist in the trade would say, it is a great little coggage – well worth a read.  (For coggage see http://phrontistery.info/c.html). This is a great find if you love words and have not been here before, especially if you are a wordsmith.

 

Back tomorrow. Thanks for reading. Jeanne

11 FOODS THAT MAKE YOU HUNGRIER

11 FOODS THAT MAKE YOU HUNGRIER

From the FMS Global News Desk of Jeanne Hambleton 

Posted on July 29, 2014 by Stone Hearth News

Feeling hungry? You should eat. But what if the foods you are eating actually make you hungrier than you were before you dug in? It is a more common conundrum than you might think.

“Hunger is a result of many complex interactions that occur in the stomach, intestines, brain, pancreas, and bloodstream,” said weight-loss specialist and board-certified internist Dr. Sue Decotiis. Problem is, it is a circuit that is easily hijacked. Here are 11 foods that can make you feel like you’re running on empty—even when your stomach is stuffed.

White bread
   The white flour used to bake white bread has been stripped of its outer shell (the bran), which depletes the grain’s feel-full fiber content. Eating it spikes your insulin levels, Decotiis said.

In a recent Spanish study, researchers tracked the eating habits and weights of more than 9,000 people and found that those who ate two or more servings of white bread a day were 40 percent more likely to become overweight or obese over a five-year period compared to those who ate less of it

Juices
 Juicing is all the rage, but these “healthy” drinks contain all the sugar of your favorite fruit, but none of the fiber-containing pulp or skin. That means drinking a glass of juice can shoot your blood sugar levels up—and then back down again—bringing on hunger, according to Mitzi Dulan, RD, author of The Pinterest Diet: How to Pin Your Way Thin. Your better bet: blend a smoothie using whole fruit instead, and mix in a scoop of protein powder or nut butter to help balance your blood sugar and boost satiety. (Just be sure to steer clear of sugary fro-yo or sherbet.)

Salty snacks
 There is a reason why you crave something sweet after polishing off a bag of potato chips. Chips, pretzels, and salty snack mixes are little more than quick-digesting simple carbs, which can spur insulin highs and subsequent lows, Dulan said. And since your taste buds and brain link fast-acting energy with sweet foods, it is common to have a craving for something sweet once you finish your salty nosh. What is more, thanks to a phenomenon known as sensory specific satiety, you can fill up on chips and feel like only your salty stomach is full. Your sweet one can still feel empty, Dulan said. So get ready to eat two stomachs’ worth of food.

Fast food
 Pretty much every ingredient behind a fast food counter is designed to make you supersize your meal. For instance, trans fat inflames the gut, potentially impairing the body’s ability to produce appetite-controlling neurotransmitters such as dopamine and serotonin, Decotiis said. Meanwhile, the GI tract absorbs high fructose corn syrup (commonly found in buns, condiments, and desserts) quickly, causing insulin spikes and even bigger hunger pangs. Lastly, fast food’s huge helpings of salt can spur dehydration. And with symptoms that closely mimic those of hunger, it’s easy for dehydration to trick you into thinking you need to go back for seconds.

Alcohol
 Alcohol does not just lower your healthy-eating resolve, it downright makes you hungrier: According to research published in Alcohol & Alcoholism, just three servings can slash your body’s levels of leptin—a hormone designed to squash hunger and keep you feeling full—by 30 percent.

“Alcohol can also deplete your body’s carbohydrate stores (called glycogen), causing you to crave carbs in order to replace what was lost,” Decotiis said. And if you find yourself craving salty snacks, dehydration and a loss of electrolytes may be at work.

White pasta 
White pasta packs all of the same problems as white bread, but it does deserve its own mention as a hunger-offender because it is so easy to eat far too much of it. A standard serving size of cooked pasta is just half a cup cooked, but restaurants regularly serve up four cups in a single entrée. When you overload your body with simple carbs, your pancreas goes into overdrive churning out insulin, and soon you have produced so much of the sugar-managing hormone that your blood sugar levels are low and you’re ravenously hungry. And consider this: What are you pouring over your pasta? If it’s a store-bought sauce, then it probably contains even more hunger-spiking sugar

MSG
MSG (aka monosodium glutamate) is a flavor-enhancer best known for being added to Chinese food, and may also be found in other foods including canned veggies, soups, processed meats, and even beer and ice cream. One animal study from Spanish researchers suggests the chemical triggers a 40 percent increase in appetite, and according to research published in the journal Obesity, people who consume the most MSG are nearly three times more likely to be overweight than those who don’t eat it at all.

“The effects of leptin (a “satiety hormone” made by fat cells) may be blunted by the damaging effects of MSG on the hypothalamus,” Decotiis said.

What is more, the effects can compound over time, so the more frequently you eat MSG, the more you’ll eat, period.

Sushi rolls
 You might intend to load up on good-for-you fish, but you’re really eating more rice than anything else, said dietitian Susan M. Kleiner, RD, a scientific consultant with USANA Health Sciences. Case in point: the California roll. Loaded with 30-plus grams of carbohydrates, it’s like eating three slices of white bread.

“If you don’t eat anything else, sushi rolls are fairly rapidly digested and emptied from the stomach without a high level of satiating properties like fiber or protein,” she said.

Artificial sweeteners
 Whether they are in your diet soda or sprinkled in your coffee, artificial sweeteners (aspartame, sucralose, saccharin, and others) excite your brain cells, making them think they are about to get a sweet serving of energy (aka calories), and then let them down—hard, Decotiis said. The upshot: You may crave—and eat—more sweets throughout the day, trying to make up for the letdown. Over time, this process can actually affect the hunger control centers of the brain, she said. And get this: It has been proposed that artificial sweeteners cause insulin spikes just like real, calorie-packed sugar.

Kids’ cereals
 White flour with a generous dusting of table sugar, these morning starters may cause blood sugar and insulin swings.

“Eating such a high carbohydrate load in the morning when cortisol levels are at their highest is a double assault to your metabolism,” Decotiis said.

During the night and into the morning, your body pumps out huge amounts of cortisol, which is believed to be a natural part of your body readying itself for the stresses of the day ahead.

“Higher cortisol levels mean a lower ability to metabolize ingested sugars. Therefore blood sugar may be high, but still not reach the tissues where it is needed, leading to fatigue and hunger,” she said.

Cereal can be a smart way to start your day—look for whole grain or bran cereals that contain at least 5 grams of fiber and less than 5 grams of sugar per serving.

Pizza 
You know you cannot eat just one slice—no matter how big it is. That’s because your favorite pizza joint’s combination of white flour dough, hydrogenated oils, processed cheeses, and preservatives can throw off your blood sugar levels, production of satiety hormones, and hunger-regulating regions of the brain, according to Decotiis. That said, if you make pizza at home with whole-wheat dough and top it with lean meat, lots of veggies, and just a sprinkling of cheese, then you’ll have a fiber- and protein-packed meal that’s less likely to have you reaching for more food in an hour.

This article originally appeared on Health.com.

 

DIET AFFECTS MEN’S AND WOMEN’S GUT MICROBES DIFFERENTLY

From the FMS Global News Desk of Jeanne Hambleton  Posted on July 29, 2014  

By Steve Franklin   EUREKA ALERT Stone Hearth News UNIVERSITY OF TEXAS AUSTIN

The microbes living in the guts of males and females react differently to diet, even when the diets are identical, according to a study by scientists from The University of Texas at Austin and six other institutions published this week in the journal Nature Communications. These results suggest that therapies designed to improve human health and treat diseases through nutrition might need to be tailored for each sex.

The researchers studied the gut microbes in two species of fish and in mice, and also conducted an in-depth analysis of data that other researchers collected on humans. They found that in fish and humans diet affected the microbiota of males and females differently. In some cases, different species of microbes would dominate, while in others, the diversity of bacteria would be higher in one sex than the other.

These results suggest that any therapies designed to improve human health through diet should take into account whether the patient is male or female.

Only in recent years has science begun to completely appreciate the importance of the human microbiome, which consists of all the bacteria that live in and on people’s bodies. There are hundreds or even thousands of species of microbes in the human digestive system alone, each varying in abundance.

Genetics and diet can affect the variety and number of these microbes in the human gut, which can in turn have a profound influence on human health. Obesity, diabetes, and inflammatory bowel disease have all been linked to low diversity of bacteria in the human gut.

One concept for treating such diseases is to manipulate the microbes within a person’s gut through diet. The idea is gaining in popularity because dietary changes would make for a relatively cheap and simple treatment.

Much has to be learned about which species, or combination of microbial species, is best for human health. In order to accomplish this, research has to illuminate how these microbes react to various combinations of diet, genetics and environment. Unfortunately, to date most such studies only examine one factor at a time and do not take into account how these variables interact.

“Our study asks not just how diet influences the microbiome, but it splits the hosts into males and females and asks, do males show the same diet effects as females?” said Daniel Bolnick, professor in The University of Texas at Austin’s College of Natural Sciences and lead author of the study.

While Bolnick’s results identify that there is a significant difference in the gut microbiota for males and females, the dietary data used in the analysis are organized in complex clusters of disparate factors and do not easily translate into specific diet tips, such as eating more vegetables or less meat.

“To guide people’s behavior, we need to know what microbes are desirable for people,” said Bolnick. “Diet and sex do interact to influence the microbes, but we don’t yet know what a desirable target for microbes is. Now we can go in with eyes open when we work on therapies for gut microbe problems, as many involve dietary changes. We can walk into those studies looking for something we weren’t aware of before. All along we treated diet as if it works the same for men and women. Now we’ll be approaching studies of therapies in a different way.”

Why men and women would react differently to changes in diet is unclear, but there are a couple of possibilities. The hormones associated with each sex could potentially influence gut microbes, favoring one strain over another. Also, the sexes often differ in how their immune systems function, which could affect which microbes live and die in the microbiome.

One notable exception in Bolnick’s results was in the mice. Although there was a tiny difference between male and female mice, for the most part the microbiota of each sex reacted to diet in the same manner. Because most dietary studies are conducted on mice, this result could have a huge effect on such research, and it raises questions about how well studies of gut microbes in lab mice can be generalized to other species, particularly humans.

“This means that most of the research that’s being done on lab mice — we need to treat that with kid gloves,” said Bolnick.

Bolnick’s co-authors are Lisa Snowberg (UT Austin); Philipp Hirsch (University of Basel and Uppsala University); Christian Lauber and Rob Knight (University of Colorado, Boulder); Elin Org, Brian Parks and Aldons Lusis (University of California, Los Angeles); J. Gregory Caporaso (Northern Arizona University and Argonne National Laboratory); and Richard Svanbäck (Uppsala University).

This research was funded by the Howard Hughes Medical Institute, the David and Lucile Packard Foundation and the Swedish Research Council.

WHEN YOU CLEAN YOUR PLATE, YOU JUST ADD WEIGHT

From the FMS Global News Desk of Jeanne Hambleton Released: 23-Jul-2014 
Source Newsroom: Cornell University  Citations International Journal of Obesity

Newswise — ITHACA, N.Y. – If you are a member of the Clean Plate Club – you eat pretty much everything you put on your plate – you are not alone. A new Cornell University study shows that the average adult eats 92 percent of whatever is on his/her plate.

“If you put it on your plate, it is going into your stomach,” said Brian Wansink, director of the Cornell Food and Brand Lab and the study’s lead researcher.

Wansink and co-author Katherine Abowd Johnson, student at the Johns Hopkins Bloomberg School of Public Health, analyzed 1,179 diners and concluded that the urge to clean our plates is not just an American trait. The results were nearly identical in seven developed countries studied: United States, Canada, France, Taiwan, Korea, Finland, and the Netherlands. If we serve it, we will eat it regardless of gender or nationality.

Wansink says that these findings, published in the International Journal of Obesity, can positively impact an individual’s eating behavior, “Just knowing that you are likely to consume almost all of what you serve yourself can help you be more mindful of appropriate portion size.”

Next time you grab that serving spoon, think to yourself, “How much do I want to eat?” and serve accordingly.

Tape measures at the ready…No do not hide the bathroom scales…see you tomorrow Jeanne 

 

 

LAW BREAKERS AND THE VANILLA PUDDING ROBBERY

 THE VANILLA PUDDING ROBBERY

From the FMS Global News Desk of Jeanne Hambleton  Posted July 31 2014

I have to say I was somewhat mystified when I received an email from Ali and I failed to understand why vanilla pudding should be secured unless it was for some sort of competition.

I read the email diligently and after you have read it I think you will understand why I felt it worth sharing.

Robbery after all that is what it was, is a serious crime and what the robbers stole were really important to some folks. This is a rue story and it happened in Ireland.

Excerpted from an article which appeared in The Dublin Times about a bank robbery.

Once inside the bank shortly after midnight, their efforts at disabling the security system got underway immediately.

The robbers, who expected to find one or two large safes filled with cash & valuables, were surprised to see hundreds of smaller safes throughout the bank.

The robbers cracked the first safe’s combination, and inside they found only a small bowl of vanilla pudding.

As recorded on the bank’s audio tape system, one robber said, ‘At least we’ll have a bit to eat.’

The robbers opened up a second safe, and it also contained nothing but vanilla pudding.

The process continued until all safes were opened. They did not find one pound sterling, a diamond, or an ounce of gold. Instead, all the safes contained covered bowls of pudding.

Disappointed, the robbers made a quiet exit, each leaving with nothing more than a queasy, uncomfortably full stomach. The newspaper headline read:
’ IRELAND ‘S LARGEST SPERM BANK ROBBED EARLY THIS MORNING’…..

I could not contain myself and I laughed out loud.

I would have loved to have seen the look on the robbers’ faces when they read the headlines. The Vanilla Pudding Robbery .This is just too funny not to share and hope you Chuckled Anonymously as I did. Laughter is after all the best medicine.

 

SERIOUSLY, HUMOR IS GOOD MEDICINE

Laughter is the best medicine? The emotional appeal of stand-up comedy

From the FMS Global News Desk of Jeanne Hambleton Posted on July 30, 2014

From Stone Hearth News  Routledge Taylor & Francis Group Oxford UK

Citation Journal – Comic Studies by Dr. Tim Miles

(You might need a cup of coffee – or even glass of wine – to get through this long article – sorry)

Why do we laugh I wonder and hope you did at the first item. It is certainly is an emotional outburst that makes you feel good. 

This article explores the relationship between stand-up comedians and their audiences focussing specifically on the question of emotion. Emotion’s relationship with humour is complicated, and current literature offers a number of contradictory models. Stand-up comedians’ emotional relationship with their audience is also complicated, and current literature does not explore this very thoroughly.

Comics taking to the stage at the Edinburgh Fringe this week should take note: how much of a hit they are with their audiences won’t be down to just their jokes. As Dr Tim Miles from the University of Surrey has discovered, the link between humour and emotion plays a large part in how well an audience connects with a comedian, and vice versa.

Writing in the journal Comedy Studies, Dr Miles explains: “Clearly there is some relationship between humour and emotion, as the states we associate with laughter are usually emotional ones (joy, pleasure, nervousness, a desire to integrate); but the exact nature of this relationship seems difficult to establish.”

Commenting on his study Dr Miles states, “Comedy has often been seen to be a bit frivolous, but it’s actually something really important. Research shows that we laugh not so much because something is objectively funny, but because we want people to like us, or we want to feel part of a group that’s laughing – it’s all about making connections. My work looking at comedians and comedy audiences has shown how live stand-up comedy fulfils a need for feelings of truth, trust, empathy and intimacy between people, which is really important in a society where many people often complain about feeling isolated.”

As part of his research, Miles analysed dozens of questionnaires and interviews with both audience members and comedians, including Russell Brand and Robin Williams. What he discovered was a strong emphasis on ‘emotional experience’ for both stand-up comedians and audience members. Audiences and comedians were connected by bonds of ‘admiration’ and ‘empathy’ and what he calls ‘the paradox of identification’: identifying with the humour or observations made by a comic, but not being able to identify with them in terms of seeing themselves in their place on the stage.

Miles also observed ‘a complex symbiotic relationship between the stand-up comedian and their audience in relation to the body, and well-being – with a relationship that is, in some ways, similar to a doctor and patient’. Indeed, some comedians felt they offered a ‘therapeutic service, or some sort of drug’; references to medicine, therapy and ‘feeling better’ were made by audience members too.

Miles concludes that stand-up comedy is a ‘performance’ like any other, so emotional experiences like identification, interaction, empathy, mutual therapy, well-being and a need for recognition all play an important part. He also points to recent research that suggests audiences ‘perform’ too: their brains enter ‘laughter mode whenever there is an expectation of laughter’. At least that’s what the performers at this year’s Fringe will be hoping as they try to connect with their audiences.

 THE RESEARCH

The data showed a strong emphasis on emotional experience for both stand-up comedians and audience members.

(The letters after the comments denote the circumstances when the comments were made. See links to reference  and details of comedians – http://www.tandfonline.com/doi/full/10.1080/2040610X.2014.905093#tabModule.)

Comments from stand-up comedians included: ‘When you try a gag out for the first time and you hear the laughter and you think “oh, great” … there’s no feeling like it’ (DFB-KD).

My experience of performance stand-up comedy has been both horrible and enjoyable – at its best, its joyous; at its worst, abysmal’ (TMISU-SMC).

‘Magical when good, excruciating when bad’ (TMISU-AH).

‘It is actually like being able to fly’ (AYI-JC).

Audience members commented along similar lines: ‘It is my favourite pastime. If there was one night left in the world I would go to a comedy club’ (TMQ).

‘When it’s good it’s thrilling, and when it’s bad it’s excruciating’ (TMIA).

And ‘Good stand-up is transcendent; very bad stand-up is at least an experience’ (TMQ).

Specifically, many commented on well-being:

‘Not all comedians are depressed, but I think a very large number of them are… they find making people laugh makes them feel better in the short term’ (DFB-JC).

The corollary of this being a sense of unhappiness or frustration when not performing. Comments included: ‘It’s like an insatiable itch, I get restless if I go too long without a gig… I feel stumped, cut off, listless, uninspired’ (TMISU-MO’S).

Indeed, many stand-up comedians saw themselves as offering a therapeutic service, or some sort of drug. Comments included:

Interviewer: Why do we love people who make us laugh so much?

Stand-up comedian: Because it’s like a drug. I am sure of it. When you laugh you get a good feeling, and we want that feeling. (DFB-RB).

References to medicine, therapy, and feeling better were also common responses among audience members.

Questionnaire answer to the question ‘how would you describe your experience of attending live stand-up comedy?’ included: ‘An essential and rewarding experience. Laughter isn’t available on the NHS, so live comedy is the way to go’ (TMQ).

And ‘Light-heartedness leaves you feeling good and relaxed, like you get your stress out from laughing’ (TMQ).

Similarly, questionnaire responses to the question ‘What do you enjoy most about live stand-up comedy?’ included: ‘I find it therapeutic to go to a stand-up show, not knowing what to expect, and just laugh together with a room of strangers for a couple of hours. It’s a wonderful break from the stresses of life’ (TMQ).

‘There’s the uplifting feeling that laughter gives me. Laughter is like medicine!’ (TMQ).

And ‘Helping someone help me to appreciate and laugh about the otherwise stressful and upsetting things I experience. I once watched a “trans” comic joke about some of the oppressive people and situations I had encountered. I found this healing and de-stressing’ (TMQ).

Interviews with audience members elicited further references to health and well-being, including:  At the time I went to see Russell Howard I was having a particularly difficult time, emotionally and mentally, with how I felt, around about the time when I was at the crossroads and I felt: What do I do? Do I go into education, or carry on with jobs that are making me miserable?

What do I do? I came out of that gig, after laughing so hard, and everything felt right with the world – even things such as the economic downturn, the problems with politics, the wars; they felt so irrelevant. I was in my own little bubble. It was like a Nirvana of well-being. It was such a nice feeling, and even if it only lasts for a few hours, it’s just so nice to find that point where you feel balanced, and it’s difficult to explain.

I mean, Christians always say that when they first pray for forgiveness to God they have a feeling of euphoria come over them, and for me it was kind of like that. It was that kind of euphoria where it actually felt like I have a purpose. No medication you can be given will ever give you that feeling. (TMIA).

The data suggest that there is a complex symbiotic relationship between the stand-up comedian and their audience in relation to the body, and well-being – with a relationship that is perhaps, in some ways, similar to a doctor and patient. Stand-up comedians frequently pointed to their emotional need for recognition and attention. Comments from stand-up comedians included: ‘It’s all about validation via the audience. We are trying to fill a hole’ (DFB-GN).

Other comments included:  When I was in a band, I used to think ‘Are they really paying attention?’. People would carry on talking, and you think: ‘Do they really care? Were they actually listening? Did it make any difference to them?’ You get a much clearer sense of the answer to all that in stand-up. (TMISU-DP).

Audience questionnaire responses also frequently commented on the desire for an emotional relationship. One response, for example, to the question ‘What do you like best about live stand-up comedy?’ was: ‘When it caters to the specific audience and location, as it makes it feel more personal. When it feels like we are friends’. In response to the question ‘What do you like best about stand-up comedy?’: ‘The way it makes me feel. Good stand-up will make me cry with laughter, which is a fantastic feeling, evokes memories of good times and stays with me’ (TMQ).

Some stand-up comedians commented on the dangers of their emotional need.

I think it’s quite scary. You have to be careful, that you don’t start replacing real relationships with sort of the love you get from an audience; but, you know, it’s not really a real relationship – but it’s kind of brilliant, lots of strangers telling you you are brilliant, then you don’t really need people close to you to say that to you any more. (DFB-NF).

A number of stand-up comedians commented that they found it emotionally difficult after a gig, when there is an awareness that the relationship with the audience is over.

For example, I really used to find it hard. You think what do you do once you’ve come off, particularly with live stand-up you can have thousands of people laughing at you, loving you, and then you just go home. On, no, I’m on my own, what am I going to do? You need something, you need some punctuation. You cannot just go to bed. (DFB-RB).

The bond that exists between stand-up comedian and audience member operates in terms of admiration, empathy and what I shall refer to as the paradox of identification. Many participants commented on the identification the audience member feels with the stand-up comedian in strongly emotional, experiential and empathetic terms. One audience member commented in interview that: ‘If it is bad I want to die. There is also an incredible level of annoyance. It is different in cinema. There is something about live comedy performance’ (TMIA).

She also commented that ‘I feel they are being themselves and I am judging them as a person. There is a feeling that I know these people’. Typical responses to the questionnaire question were: ‘If the joke is not funny, I’ll feel bad for the comedian’ (TMQ).

Stand-up comedians often commented on their awareness of the audience’s need for empathy. Comments included: ‘You are selling your ideas and your thoughts – they want a human connection with you’ (AYI-SK).

Another commented on his more practical approach: ‘I would go to the back and say to the audience “those are the shitty seats”, and the people in the shitty seats would go “yeah, you’re with us”‘ (DFB-RW).

One audience member commented on ‘the mercy laugh’: ‘If someone is not very good, it is one of the most awkward things and I feel I have to mercy laugh, which is more likely to happen when seeing unknown comedians as they may not be your cup of tea. When someone is “dying” on stage it makes me cringe and I feel like crying for them, so it makes a miserable evening out’ (TMIA).

Many audience members spoke about this sense of seeing themselves as the comedian, but as an impossibly braver incarnation. Comments included: ‘That’s my voice, that’s what I enjoy – the comedian is saying what I’ve always wanted to say but have never been able to find the words to say’ (TMIA).

And ‘That’s the relationship between the comic and their audience – people can imagine them saying such things, and especially with the outrageous comedian, they think “I wish I had the courage to say that”‘.

Stand-up comedy may appear to require no obvious technical skill – unlike, say, ballet dancing. Seemingly anyone can do it; all that is apparently required is the ability to talk into a microphone.

While matters of ‘timing’, and others skills associated with the craft of stand-up comedy, may elicit audience admiration, there is no apparent need for the physical dexterity of an acrobat, or the technical skill of a concert pianist where the training is foregrounded in the performance.

The audience identifying with the accessibility of stand-up comedy paradoxically operates in conflict with the sense that they cannot identify with the performer, due to the perception that performing stand-up comedy requires a heightened level of bravery, though this admiration may include a degree of respect for the craft. Nevertheless, the emotional relationship between stand-up comedian and audience member exists in a constant state of tension and peril.

CONCLUSION

To suggest – as Bergson did – that emotion is the enemy of humour, based on this empirical data, is clearly wrong, at least in the context of stand-up comedian–audience relationships.

What we see instead is a paradigm shift, with a focus on identification, interaction, empathy, mutual therapy and well-being; as well as a need for recognition. Put simply, the focus is on performance, if one accepts Goffman’s definition of performance as ‘all the activity of a given participant on a given occasion which serves to influence in any way the other participants’ (1959, 15–16).

Participants in these laughter acts have entered a performance and play mode, a semi-fiction where emotion, and its consequences, no longer operate in the same way as before. When one enters a comedy club, there is an expectation of laughter; and in a UCLTV mini-lecture on ‘The Neuroscience of Laughter’ (http://www.youtube.com/watch?v=M7lE2cl2zFo), neurologist Sophie Scott argues that the brain prepares to enter a laughter mode whenever there is an expectation of laughter. In short, it performs.

What is needed now is a performance-based model of humour – one that places emotion in the experience of human interactions, and draws from a wider range of disciplines, including neuroscience.

From here, an understanding of humour’s relationship with emotion may finally begin to resolve some of the problems and contradictions that exist in current models.

Dr Miles explains: “Clearly there is some relationship between humour and emotion, as the states we associate with laughter are usually emotional ones (joy, pleasure, nervousness, a desire to integrate); but the exact nature of this relationship seems difficult to establish.”

Commenting on his study Dr Miles states, “Comedy has often been seen to be a bit frivolous, but it’s actually something really important. Research shows that we laugh not so much because something is objectively funny, but because we want people to like us, or we want to feel part of a group that’s laughing – it’s all about making connections. My work looking at comedians and comedy audiences has shown how live stand-up comedy fulfils a need for feelings of truth, trust, empathy and intimacy between people, which is really important in a society where many people often complain about feeling isolated.”

As part of his research, Miles analysed dozens of questionnaires and interviews with both audience members and comedians, including Russell Brand and Robin Williams. What he discovered was a strong emphasis on ‘emotional experience’ for both stand-up comedians and audience members. Audiences and comedians were connected by bonds of ‘admiration’ and ‘empathy’ and what he calls ‘the paradox of identification’: identifying with the humour or observations made by a comic, but not being able to identify with them in terms of seeing themselves in their place on the stage.

Miles also observed ‘a complex symbiotic relationship between the stand-up comedian and their audience in relation to the body, and well-being – with a relationship that is, in some ways, similar to a doctor and patient’. Indeed, some comedians felt they offered a ‘therapeutic service, or some sort of drug’; references to medicine, therapy and ‘feeling better’ were made by audience members too.

Miles concludes that stand-up comedy is a ‘performance’ like any other, so emotional experiences like identification, interaction, empathy, mutual therapy, well-being and a need for recognition all play an important part. He also points to recent research that suggests audiences ‘perform’ too: their brains enter ‘laughter mode whenever there is an expectation of laughter’. At least that’s what the performers at this year’s Fringe will be hoping as they try to connect with their audiences.

For full article and references see  http://www.tandfonline.com/doi/full/10.1080/2040610X.2014.905093#tabModule

 

 

AN UNEXPECTED KNOCK AT THE DOOR – UK BENEFITS

AN UNEXPECTED KNOCK AT THE DOOR – BENEFITS

From the FMS Global News Desk of Jeanne Hambleton

Posted 30 July 2014: “Benefits and Work”

Courtesy of <campaign@benefitsandwork.co.uk>

An unexpected knock at the door. Someone standing there with an ID card claiming they have come to check if you are getting the correct benefits and could they please come in?

What do you do?

You do not have to be guilty of anything to find the possibility of such a visit very alarming – especially if you have a mental health condition made worse by stress and anxiety.

Last month there was a lot of concern about just such visits, prompted by a change to a page on the DWP website which stated:

You may get a visit from a Department for Work and Pensions (DWP) officer to check that your benefits payments are correct.

A Performance Measurement review officer may visit you if you are claiming:

Employment and Support Allowance
 Housing Benefit Income Support
 Jobseeker’s Allowance
Pension Credit

Your name is selected at random to be checked. You will not always get a letter in advance telling you about the visit.

The concern was the addition of the sentence:

You will not always get a letter in advance telling you about the visit.

Worries about how to deal with such a visit were posted on various blogs and forums and we received numerous requests from members for guidance on how to deal with these visits.

 So Benefits and Work made a Freedom of Information request.

As a result of that request we can now reveal that, in reality, the vast majority of people who get a visit do not get a letter in advance – surprise visits are the rule, not the exception. There is more on this below.

However, we can also reassure our readers that:

  • you do not have to let them in; and
  • you can insist on being given proper notice;
  • you can insist on having the interview at a DWP office instead of in your home.

And doing so will not affect your benefits, though refusing to take part in an interview at all,  may leave you open to a fraud investigation.

In the members’ area we  have published the letter we got in response to our request and 62 pages of the guidance document issued to officers carrying out these visits – though there are a large number of redactions to the guidance. You will find the documents in the DWP Guides section of the ESA download page in the members’ area.

Only a tiny percentage of claimants receive one of these visits. But the majority who do get one are not given any warning.

In fact, far from ‘You will not always get a letter’ , DWP staff are actually told:

‘You must make an un-notified visit to each customer, apart from the exceptions detailed in the subsequent paragraphs. If this is ineffective a second un-notified visit must be made.’

If two un-notified visits are made on the same day then another un-notified visit must be made on another day.

After that a letter has to be sent giving you at least 48 hours’ notice of a visit or 24 hours where the letter is hand delivered.

There are also certain classes of claimant who should never receive an unannounced visit, including:

“customers suffering from depression or a medically defined mental illness
customers with an alcohol or drug-related dependency
disabled customers where there is evidence from the preview information that they may be distressed if an MRO calls unannounced. “

However, where the visiting officer suspects, on the basis of your files, that you may be committing fraud they can still carry out an un-notified visit even if you are in one of the categories above.

And it is important to be aware that one of the things visiting officers will do is look out for any difference between the details given in your work capability assessment medical report and your behaviour at home. The rather bizarre example given is that of a claimant who is up a ladder washing windows when visited, but their incapacity is listed as vertigo.

So, if your condition is a variable one and you are having a better day, make that very clear – even if you are not asked.

If you are not already a member, join the Benefits and Work community before midnight on Friday and you can get 20% off the cost of your annual subscription. Just type the following code into the coupon box when you pay: 5854

Claimants and carers get an annual subscription for £15.96, down from £19.95. Professionals get an annual subscription for £77.60, down from £97.00.

ESA NEWS
The flaws in the Employment and Support Allowance (ESA) system are so grave that simply “rebranding” the work capability assessment by appointing a new contractor will not solve the problems, the Work and Pensions Committee has said in a new report.

Employment and Support Allowance needs fundamental redesign, say MPs

Category: Latest news  Created: Wednesday, 23 July 2014 09:43

The Committee calls on the Government to undertake a fundamental redesign of the ESA end-to-end process to ensure that the main purpose of the benefit – helping claimants with health conditions and disabilities to move into employment where this is possible for them – is achieved. This will take some time, but the redesign should be completed before the new multi-provider contract is tendered, which is expected to be in 2018.

In the meantime, the Committee recommends that DWP implements a number of other changes in the shorter-term to ensure better outcomes and an improved service for claimants. These include:

  • DWP taking overall responsibility for the end-to-end ESA claims process, including taking decisions on whether claimants need a face-to-face assessment, rather than this decision being made by the assessment provider.
  • DWP proactively seeking “supporting evidence” on the impact of a claimant’s condition or disability on their functional capacity, rather than leaving this primarily to claimants, who often have to pay for it. DWP should seek this evidence from the most appropriate health and other professionals, including social workers and occupational therapists, rather than relying so heavily on GPs.
  • The “descriptors” used to assess functional capability in the WCA being applied more sensitively.
  • Placing claimants with a prognosis of being unlikely to experience a change in their functional abilities in the longer-term, particularly those with progressive conditions, in the Support Group and not the WRAG.

Dame Anne Begg MP, Committee Chair, said

“Many people going through the ESA claims process are unhappy with the way they are treated and the decisions which are made about their fitness for work. The current provider of the WCA, Atos, has become a lightning rod for all the negativity around the ESA process and DWP and Atos have recently agreed to terminate the contract early.

“But it is DWP that makes the decision about a claimant’s eligibility for ESA – the face-to-face assessment is only one part of the process. Just putting a new private provider in place will not address the problems with ESA and the WCA on its own.

“We are therefore calling for a number of changes which can be made to improve ESA in the short-term, while also recommending a longer-term, fundamental redesign of the whole process.

“We hope that the new Minister for Disabled People, who was appointed last week, will respond positively to our constructive recommendations for improving the ESA process.”

One of the key issues which the Report identifies is that ESA is not achieving its purpose of helping people who could work in the short to medium term to move back into employment.

Read the full report on the Parliament website http://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/news/esa-wca-report-substantive/

Meanwhile a report commissioned by the DWP into benefits sanctions, which saw a fourfold increase for ESA claimants in 2013, has found that the way in which the DWP communicate with claimants is legalistic, unclear and confusing. The most vulnerable claimants are often left at a loss as to why their benefits were stopped and frequently not informed by the DWP about hardship payments to which they are entitled.

However, the report only looked at the way sanctions are communicated, not into whether the system is fair in the first place.

Debbie Abrahams, an MP on the Work and Pensions Committee, has repeatedly called for an independent inquiry into sanctions. She did so again this week, following an inquest into the death of a diabetic ex-soldier who had his JSA sanctioned for missing an appointment and subsequently stopped taking his insulin.

According to the Mirror:

“When David died he had just £3.44 to his name, six tea bags, a tin of soup and an out-of-date can of sardines. His electricity card was out of credit meaning the fridge where he should have kept his insulin chilled was not working.

“A coroner also found he had no food in his stomach.

“A pile of CVs for job applications were found near David’s body.”

The Mirror is reporting that David’s sister has launched a petition calling for an inquiry into sanctions.

OTHER BENEFITS NEWS
  IDS is still fighting desperately to prevent the publication of four reports which would show just how badly universal credit is failing and whether the DWP knowingly misled parliament about problems with the new benefit.

So far, the DWP have lost every stage of the battle to prevent the reports being published under the Freedom of Information Act. But with an unlimited amount of taxpayers money to throw at legal challenges and a vested interest in stringing the process out beyond the next election, losing at every stage is not a reason for concern.

And the true cost to the taxpayer will probably never be known, as the politics.co.uk website points out, because the DWP refuse answer Freedom of Information requests on the issue – on the grounds that they do not bother keeping a tally of costs.

If you are not already a member, join the Benefits and Work community before midnight on Friday August 1st and you can get 20% off the cost of your annual subscription. Just type the following code into the coupon box when you pay: 5854

You are welcome to republish part or all of this newsletter, provided you credit Benefits and Work.

Good luck, Steve Donnison, Sangeeta Enright and Karen Sharpe

The Office Team
Benefits and Work Publishing Ltd
Company registration No. 5962666

This message was sent from: Steve Donnison | PO Box 4352 | Warminster,Wilts BA12 2AF, UK. Thanks to Jacqui Barbet Shields for sending this information to me which I felt I should share. Certainly this is one place you can get answers. Thanks also to Steve for keeping me posted.

 

FOUR THINGS YOU PROBABLY NEVER KNEW YOUR MOBILE PHONE COULD DO !!!

 From The FMS Global News Desk of Jeanne Hambleton

There are a few things that can be done in times of grave emergencies…. Your mobile phone can actually be a life saver or an emergency tool for survival.

Check out the things that you can do  with it:

FIRST  Emergency Services

The Emergency Number worldwide for all Mobile Phones is 112.

If you find yourself out of  the coverage area of your mobile network and there is an emergency, dial 112 and your mobile will search any existing network in your area to establish the emergency number for you, and interestingly this number 112 can be dialled even if the keypad is locked.  This works on all phones worldwide and is free.

SECOND Have you  locked your keys in the car?

If your car has remote keyless entry? This may come in handy someday.. Good reason to own a cell phone:

If you lock your keys in the car and the spare keys are at home, call someone at  home on their mobile phone from your cell phone.

Hold  your cell phone about a foot from your car door and have the person at your home press the unlock button, holding it near the mobile phone on their end. Your car will unlock. Saves someone from having to drive your keys to you. Distance is no object. You could be thousands of miles away,

Editor’s  Note: I did not believe this when I heard about it! I rang my daughter in Sydney from Perth when we went on holiday.  She had the spare car key.  We tried it out and it unlocked our car over a mobile phone!’

THIRD  Is your mobile phone battery flat ?

All mobiles have Hidden Battery Power

To activate, press the keys *3370# (remember the asterisk).  Do this when the phone is almost dead.

Your mobile will restart in a special way with this new reserve and the instrument will show a 50% increase in battery life.. This reserve will get re-charged when you charge your mobile next time.

This secret is in the fine print in most phone manuals.  Most people however skip this information without realising.

FOURTH How to disable a STOLEN mobile phone?

To  check your Mobile’s serial number, key in the following digits on your  phone: * # 0 6 # Ensure you put an asterisk BEFORE the #06# sequence.

A  15 digit code will appear on the screen. This number is unique to your handset. Write it down and keep it somewhere safe. If your phone ever get stolen, you can phone your service provider and give them this code.

They will then be able to block your handset so even if the thief changes the SIM card, your phone will be totally useless.

You probably would not get your phone back, but at  least you know that whoever stole it cannot use/sell it either. If everybody did this, there would be no point in people stealing mobile phones.

This secret is also in the fine print of most mobile phone manuals.  It was created for the very purpose of trying to prevent phones from being stolen.

Also – ATM   PIN Number Reversal – Good to Know  !! 

If you should ever be forced by a robber to withdraw money from an ATM machine,  (we hope not)  you  can notify the police by entering your PIN # in reverse. For example, if your  pin number is 1234, then you would put in 4321. The ATM system recognizes that your PIN number is backwards from the ATM card you placed in the  machine. The machine will still give you the money you requested, but unknown  to the robber, the police will be immediately dispatched to the location.

All ATM’s carry this emergency sequencer by law.

This information was recently broadcast on by Crime Stoppers. It is, however, seldom used as people just do not know about it.  Please pass this along to everyone.

This is the kind of information people do not mind receiving, so pass it on to your family and friends

See you soon Jeanne

 

UEA RESEARCH FINDS HOPE FOR MORE ACCURATE DIAGNOSIS OF MEMORY PROBLEMS

UEA RESEARCH FINDS HOPE FOR MORE ACCURATE DIAGNOSIS OF MEMORY PROBLEMS

From the FMS Global News Desk of Jeanne Hambleton

 By Laura Potts       Embargo until Wednesday, July 30 2014

More accurate tests could be created to diagnose diseases such as Alzheimer’s or memory problems stemming from head injuries, leading to earlier intervention, according to new findings from the University of East Anglia (UEA).

The research involved investigating the components of memory using a combination of tests and neuroimaging – a method that could be used to create a diagnostic tool for distinguishing between different types of dementia, memory damage from stroke or forms of amnesia caused by head trauma.

Dr Louis Renoult, a lecturer in UEA’s School of Psychology, said: “We are creating a new model of how we look at memory that’s more nuanced and gives us a better picture of how memories, particularly long-term memories, are imprinted.”

The findings, published today in The Journal of Cognitive Neuroscience, are part of a project led by Dr Renoult with contributions from academics at the University of Ottawa, the State University of New York College at Old Westbury, and the Rotman Research Institute, Baycrest, Toronto.

Dr Renoult said: “If patients lose semantic memory, they struggle with knowledge of everyday objects in the world, and have trouble communicating.

“But if you provide some personal application to those objects – for example showing a dog to someone who kept a dog as a pet – the patient may demonstrate they’ve retained memory of that object.

“The research shows this retained memory performance may result from the brain’s automatic activation of personal episodes by related knowledge.

“We haven’t previously been aware of this intermediate form of memory, which combines semantic knowledge with autobiographical, or ‘episodic’ memory.

“The hope is that advanced methods could be developed to test this newly discovered intermediate form of memory, leading to better approaches to rehabilitation.”

The research was undertaken in 2011-2012 and involved a cohort of 19 healthy subjects.

‘Autobiographically significant concepts: More episodic than semantic in nature? An electrophysiological investigation of overlapping types of memory’ is published in The Journal of Cognitive Neuroscience on July 30, 2014.

Fifty Years of the University of East Anglia The University of East Anglia (UEA) was founded in 1963 and this academic year celebrates its 50th anniversary. It has played a significant role in advancing human understanding and in 2012 the Times Higher Education ranked UEA as one of the 10 best universities in the world under 50 years of age. The university has graduated more than 100,000 students, attracted to Norwich Research Park some of Britain’s key research institutes and a major University Hospital, and made a powerful cultural, social and economic impact on the region. UEA was ranked first in the Times Higher Education Student Experience Survey 2013. http://www.uea.ac.uk/50years
 

The University of East Anglia’s School of Psychology is an internationally renowned academic department dedicated to research and teaching. In the Guardian League Table 2014, the teaching of psychology at UEA was ranked 14th in the country. It is also joint eighth for teaching in the 2012 National Student Survey, and joint 11th for overall satisfaction

CAMPAIGN TO STOP PRACTICE GP CLOSURES

BREAKING THE NEWS

PULSE LAUNCHES CAMPAIGN TO STOP GP PRACTICE CLOSURES

From the FMS Global News Desk of Jeanne Hambleton

Practices struggling to keep afloat should be allocated emergency funding to help them survive, urges a major campaign launched by Pulse that has the backing of the BMA, the RCGP and many of the leading names in the profession.

The ‘Stop Practice Closures’ campaign is being launched as a result of the Pulse investigation that revealed that LMC leaders are warning of a dire situation in scores of practices across the country, with nearly 100 practices facing imminent closure and more expected to follow.

The BMA and the RCGP have lent their support to the campaign, which complements the BMA’s current ‘Your GP Cares’ campaign, and the RCGP’s ‘Put patients first: Back general practice’ campaign aimed at increasing funding in general practice.

The campaign aims to raise awareness about the precarious state of many practices and the potential effects on patients and the local NHS if they are allowed to close.

As part of the campaign, Pulse will:

  • Lobby ministers to ensure practices facing closure are given emergency support to help them restructure and protect their patients;
  • Begin an e-petition calling for a parliamentary debate on the threat of practice closures across the UK;
  • Bring GP leaders together to discuss ideas on how the morale of general practice can be improved and GPs can be funded more sustainably to prevent more practices going to the wall;
  • And create resources for practices to share ideas and campaign locally for better support so
  • that practices and patient services are protected.

Dr Mark Porter, chair of BMA Council, said: ‘Pulse are right to highlight that GP services are under unprecedented strain from a combination of rising patient demand and falling resources that is leaving many GP practices close to breaking point. As the BMA’s Your GP Cares campaign highlights, we need long term, sustained investment in general practice and not closures that will badly affect patient care.’

On behalf of the RCGP, Dr Helen Stokes-Lampard, RCGP honorary treasurer, said: ‘We are delighted that Pulse is joining us in highlighting the crisis facing general practice by launching the Stop Practice Closures campaign, focussing on one of the many very real current threats to patient care. We look forward to working with Pulse to ensure that general practice receives the resources it needs in order to ensure that decent patient care can continue to be delivered by family doctors in every community across the country.’

Other leading GPs have lent their support, including Professor Clare Gerada, the former chair of the RCGP and clinical chair for primary care transformation at NHS England (London). Professor Gerada said: ‘General practice faces extinction. We must protect what we know works for patients – that is continuity of care delivered by expert generalists in the context of their families and communities. We must fight to protect this. Pulse’s campaign is important and together with the RCGP and BMA campaigns will hopefully alert the public to the risks they and the NHS face if GPs disappear. ‘

Dr Michael Dixon, the chair of the NHS Alliance and Dr Kailash Chaand, deputy chair of the BMA also backed the campaign.

Dr Chand said that general practice is ‘imploding faster than people realise’. He added: ‘In this climate, we should be positively supporting GP practices to weather this storm and not allow them to shut. Every practice is a vital hub for the community and we cannot afford to lose any in the current climate. I congratulate Pulse and fully support its campaign.’

Dr Dixon said that good practices should be given all the support they can to prevent them from closing. He said:  Practice closures are symptomatic of the current strain on general practice more generally . Where a practice is faced with closure due to MPIG/PMS changes we will need local flexibility and sensitivity with a good dose of common sense. At very least any contract changes facing a local GP practice should have the sign off of the local CCG and local clinical leaders.’

Pulse editor Nigel Praities said: ‘We had to launch this campaign. If these closures go ahead, then the effect on then it will be a disaster for the patients struggling to find a new GP, and the local practices left who will be left to mop up the mess left behind. We urge the NHS to look at emergency funding for struggling practices, and in the longer term, as the BMA and RCGP have argued, for more sustainable funding for GP services so that they can offer the kind of services patients deserve.’

SCORES OF PRACTICES TEETERING ON THE BRINK OF CLOSURE – ‘Save Our Surgeries’ campaign

From the FMS Global News Desk of Jeanne Hambleton

28 July 2014 | By Jaimie Kaffash  Additional reporting by Christina Kenny

Practices across the country face imminent closure, but the NHS seems happy for them to go to the wall. The time is right to fight back, argues Jaimie Kaffash

General practice is heading towards a precipice. Scores of GPs across the country are facing such hardship that they may be forced to shut their practice doors altogether.

LMC leaders have told Pulse they are aware of more than 100 practices that have either closed or face imminent closure – and this is likely to be the tip of the iceberg.

Local GP leaders say they have ‘not seen anything like it’ and warn of a ‘domino effect’ on surrounding practices if closures cannot be avoided.

‘I think mergers are the only way to keep practices in the hands of the profession’
Dr Robert Morley, West Midlands

Some practices say they have ‘exhausted all other options’ and have no choice but to close, while others are preparing to merge with others in order to continue providing services.

Either way, the grim reality is that, before the year is out, the profession could face an unprecedented mass closure of practices across the UK, unless the NHS steps in with emergency help.

The warning signs were there several months ago. Former GPC negotiator Dr Peter Holden warned in April that there was ‘a year to save general practice’ predicting the profession would see practices going bust within months.

Since January at least 13 have closed, many of which were single-handed practices that had been unable to find anyone to take over their lists. And there are many more that are very close to dropping over the edge.

Pulse asked 47 LMC leaders from across the UK whether they had been contacted by practices that were considering closing. More than half (24) said practices in their area were considering closing, identifying a total of 96 practices.

Dr Mark Sanford-Wood, chair of Devon LMC, says the situation in his area is unprecedented: ‘We have on our radar at least half a dozen practices that we are very concerned about. It is highly likely a good number will end up closing by the end of the year.

‘I’ve been involved with the LMC for 20 years and I’ve never seen this before. For this to start happening now is significant.’

It could get even worse as trainees shun partnerships, Dr Sanford-Wood suggests: ‘I see a lot of bright, young, highly talented GPs. They see
a workforce that is chained to the wheel, and they don’t want in.’

Join the fight to protect your patients

Scores of practices across the country face closure and many more are likely to follow unless better support is given to GPs. If these closures go ahead it will be a disaster for patients struggling to find a new GP – and for all the remaining neighbouring practices who will be left to mop up the mess.
Pulse is launching a campaign to raise awareness of the growing crisis in general practice and to help practices fight for the support they need.

As part of the campaign, Pulse will:

  • Lobby ministers to ensure practices facing closure are given emergency support to help them restructure and protect their patients;
  • Begin an e-petition calling for a parliamentary debate on the threat of practice closures across the UK;
  • Bring GP leaders together to discuss ideas on how the morale of general practice can be improved and GPs can be funded more sustainably to prevent more practices going to the wall;
  • And create resources for practices to share ideas and campaign locally for better support so that practices and patient services are protected.

We are calling on GPs to:

  • Let us know if you are struggling. From your stories we can build up a picture of what is happening across the UK. Email us in confidence at feedback@pulsetoday.co.uk;
  • Sign our e-petition calling for a parliamentary debate on practice closures here;
  • Click here to for regular updates from our campaign and the latest status on practice closures in your area.
Out of options

London has the highest number of practices in danger – with up to 30 practices contacting their LMC regarding closure. In Wales at least 14 practices are preparing to close, while Wessex, Northamptonshire and Devon each have six practices on the brink.

One GP partner, who wished to remain anonymous, says her high-achieving practice has run out of options following struggles with recruitment.

She says:  ‘Despite all efforts to recruit or merge over a two-year period, there is currently one faint hope left. If this goes the way of all past hopes then closure beckons in the next few months.’

She adds that this is not because the practice has failed in any way: ‘This is because of the starvation and withdrawal of primary care funding and resources in the face of the relentless increase in unfunded and underfunded workload.’

Dr Charlotte Jones, chair of the Welsh GPC, says four practices in her area have given notice that they will give up their contract to health boards, while there are ‘more than 10… examples of surgeries that are struggling and for whom the next steps may be that they have to close’.

She adds: ‘Sometimes practices are reluctant to voice concerns; some keep on working over and above what is safe.’

‘I’ve spoken to about six practices who are considering resigning their contract. It’s a mix of practices and areas – it’s a universal problem’ –  Dr Nigel Watson, Wessex

Dr Beth McCarron-Nash, a GPC negotiator and a GP in Cornwall, says there are a clutch of familiar problems that lie behind the closures. She says:
‘I am hearing about more and more practices considering their options.

‘It’s a perfect storm of problems: the contract imposition from 2013, funding swings as a result of MPIG redistribution and difficulty recruiting. That, alongside spiralling workload and increasing demand… is having a catastrophic effect and practices are struggling to cope.’

If significant numbers of practices hit the wall, the level of destruction to the NHS would be unprecedented, with the likelihood of a ‘domino effect’ on nearby practices, GPs say.

Dr Chris Hewitt, chief executive Leicester, Leicestershire and Rutland LMC, says two practices in his region ‘have decided that if their financial situation gets any worse they will formally ask NHS England to take over their contracts’.

But the region is already under strain from branch surgeries closing. He adds: ‘In the past six months, 10 surgeries (out of 152 practices) have been tasked with dealing with a sizeable influx of patients as lists are disbursed as a result of surgeries or branch surgeries closing.

‘The very real threat of practice closures due to retirements or loss of financial viability will start a chain reaction, which impacts on surrounding practices that are only just coping with the demand from their current patient list.’

NHS England unconcerned

But managers seem to be taking a relaxed response. A spokesperson from NHS England tells Pulse that it did not have any intelligence centrally regarding practice closures, as this was a matter for area teams working with CCGs and LMCs.

She says: ‘Practices close – and open – all the time and it should not be assumed that this is a problem or a reduction of service; it needs to be seen in the context of local provision.’

In Wales, on the other hand, the Government is working with the RCGP, the GPC, health boards and deaneries to try to ease recruitment problems.

In Scotland, the Government is directly tackling the problems for dispensing practices with new regulations brought in from last month.

But in England, on the various issues of recruitment, MPIG withdrawal and PMS reviews, local leaders are receiving patchy help from area teams.

‘There are only three health boards where practices are not closing. It is due to an inability to recruit partners – and remaining partners can’t cope’ –  Dr Charlotte Jones, Wales

Dr Robert Morley, chair of the GPC contracts and regulations subcommittee and executive secretary of Birmingham LMCs, whose area has already seen two practices close this year, says the only way for many practices to survive will be to merge with others.

He says: ‘The only way to safeguard the profession and safeguard these practices is for partners to merge. [It’s] the only way forward to keep these practices in the hands of the profession, but also, from a business perspective, to try and work within a business model that allows general practice to continue.’

Other practices have used their relationship with patients to campaign for better support. The Jubilee Practice in Tower Hamlets, east London, has been at the centre of a major campaign in the borough to prevent practices going under.

The ‘Save Our Surgeries’ campaign has already seen marches organised with neighbouring practices, articles in The Guardian, a meeting with health minister Earl Howe and co-ordinated actions with MPs – all with little help from BMA or RCGP. They have managed to win some guarantee of emergency payments from NHS England to protect them from the withdrawal of MPIG, but are continuing their campaign for more sustainable funding in the future.

‘There are several practices that are in trouble and threatened with closure, because of dispensing being withdrawn’ – Dr Alan McDevitt, Scotland

Dr Naomi Beer, a partner at the practice, says: ‘We are having to do the co-ordinating for ourselves – working to get the message across to practices, developing tools for practices to do up to a seven-year forecast on income, pushing for co-ordinated action by local MPs and councillors to press for meetings, raising questions in Parliament and delivering a petition to Downing Street.

‘These ideas all come from us and we have little communication from the BMA or GPC except during an event such as the marches we organised in Tower Hamlets.’

It may be that galvanising local patients in this way can help practices fight back against the threat of closure, and that is why Pulse is launching a campaign to help practices do just this.

For many practices, this could be the last resort.

GMC FIGURES REVEAL 12% INCREASE IN DOCTORS CONSIDERING WORKING ABROAD

From the FMS Global News Desk of Jeanne Hambleton

Exclusive The number of doctors applying to the GMC for certificates that enable them to work abroad has increased by 12% in the last five years, figures obtained by Pulse have revealed, leading to fears that GP talent is being ‘lost’ because of workload pressures.

The figures reveal that Certificates of Good Standing (CGS) – a document that doctors must present if they want to register with an overseas regulatory body or employer – were issued to 4,726 doctors in 2012, compared with 4,222 in 2008.

Over the same period the number of doctors on the GMC register during the same period has risen by only 2%.

The number of CGSs issued is the closest measure available of the number of doctors who are considering a move abroad, as official figures are not kept for the number of doctors moving overseas.

Overseas employment agencies said the figures supported their experience that that there had been a ‘significant increase’ in GPs interested in moving abroad over the past few years, with GPs looking at alternative destinations to the more popular Australia.

Pulse has also obtained figures from the Medical Council of New Zealand that show a 49% increase in registrations from the UK and Ireland between 2007/08 and 2011/12, with 624 doctors registered with the council in 2011/12, compared with 420 in 2007/08.

The Australian Medical Council recorded steady numbers of doctors from the UK applying to be registered in Australia, with 974 in 2008 and 939 in 2011.

GP leaders said it was ‘worrying’ that doctors feel their career is best served away from the NHS and said pressure on pay and pensions would only make the situation worse.

Mr Paul Brooks, managing director of overseas doctors recruitment agency EU Health Staff, said he has seen more UK GPs looking for work overseas in the past two years.

He said: ‘We’ve seen a significant increase in the number of UK GPs looking to work overseas in the past couple of years. Australia is the favoured country, but recently, doctors have also been looking to move to Canada and New Zealand.’

Mr Brooks added that all of these countries ‘offer something different for UK GPs despairing of the UK or NHS’ and give doctors the chance to escape ‘NHS bureaucracy and unwelcome changes to the way things are being run’.

These figures come after Pulse yesterday revealed that one in seven GPs had had to make redundancies following the contract changes in April, with many partners also reducing their drawings by more than 20%.

GPC deputy chair Dr Richard Vautrey said some of the departing doctors would be GPs as they were feeling ‘undervalued and unsupported’.

‘It is not all perfect here but it does seem better’

Cornwall to Queensland Australia

Dr Mark McCartney said: ‘It’s worrying that doctors feel their career can be best served leaving the NHS. Pressure on pay, attack on pensions have a negative impact on the morale of doctors.

‘It’s a big waste in the resources that have gone into training the doctors, and they can’t support patients in the UK. Their skills and talent will be lost. We need to urgently address morale so that young doctors feel that NHS best serves their career aspirations.’

Dr Mark McCartney, who left his practice in Cornwall for Queensland, Australia, last year, said part of his reason for leaving was that GPs felt under ‘continued assault’ from politicians and the press.

‘It is not all perfect here but it does seem better, although I am probably still in the “honeymoon” period.’

Moving across the world to work as a GP has given me a new challenge and allowed me to escape the constant denigration of our profession, explains Dr Mark McCartney

Twelve months ago I took the decision to apply for medical registration in Australia. It was big step to leave, with two sons at university and other family too, not to mention the friends, patients, partners and staff at my practice in Cornwall.

I had worked in Australia previously so I knew a little bit about the system, which appeared to offer more opportunity than the treadmill of NHS general practice, which was coming under continued assault by politicians and the press, particularly the Daily Mail. There had also been constant chatter in social media from GPs who are unhappy with their lot in the NHS, talking about employment in Canada, New Zealand or Australia.

I had already left the NHS pension scheme and the denigration by our leaders and managers was beginning to wear me down. My previous commitment to the NHS was beginning to wane.

It was not an easy decision, but there did not seem to be any issues with the paperwork and when I was offered a nice job after an early morning telephone interview I quickly accepted it. From there it was a short period of time before the journey to the Sunshine Coast in Queensland.

General practice here is a lot different and it is a new professional challenge. One thing I don’t miss is QOF, and the pop up computer messages exhorting me to carry out various irrelevant tasks in the consultation. I now realise what a negative effect they were having on me and the way I was consulting with patients.

It is not all perfect here, but it does seem better, although I am probably still in a ‘honeymoon’ period with my new situation. I intend to return occasionally to the UK to work to try to maintain my registration, but it seems that this might be a difficult for me, as there are issues with staying on a performers list.

I have met a few other recent refugees from the NHS and all appear to be settling into professional life in Australia. We have escaped from CCGs, CQC, QOF, LATs, OOH, falling income, pension cuts and adverse taxation changes. No doubt some of these things will catch up with us here in Australia, but we might be better equipped to deal with them.

Some of us will return for the comfort of family and friends, but in the meantime we can enjoy the challenge and adventure, not to mention the outdoor living and the fantastic climate.

I am not surprised to hear that many more GPs are thinking of making the move abroad. For any that are hesitating, I can understand that, especially if there are family ties and commitments. It is a big decision, but sooner is often better and here in Australia at least, you will be made very welcome.

Dr Mark McCartney is a GP who emigrated from Cornwall to Australia last year

 

 

 

SIX SECONDS OF EXERCISE

SIX SECONDS OF EXERCISE ‘CAN TRANSFORM HEALTH’ FOR ELDERLY SAY SCOTTISH RESEARCHERS

From the FMS Global News Desk of Jeanne Hambleton

Posted on July 27, 2014 by Stone Hearth News

Short six-second bursts of vigorous exercise have the potential to transform the health of elderly people, say researchers in Scotland.

A pilot study involving 12 pensioners showed going all-out in very short bursts, reduced blood pressure and improved general fitness over time.

The team at Abertay University believe it could help avert the “astronomical” costs of ill health in elderly people.

Experts said the study emphasised the benefits of exercise at any age.

High Intensity Training (HIT) has attracted a lot of attention for promising some of the same benefits as conventional exercise but in a much shorter time.

Instead of a comfortable half-hour jog or a few miles on the bike, HIT involves pushing yourself to your limits for a short period of time.

A group of pensioners came into the lab twice a week for six weeks and went hell for leather on an exercise bike for six seconds.

They would allow their heart rate to recover and then go for it again, eventually building up to one minute of exercise by the end of the trial.

The results, published in the Journal of the American Geriatrics Society, showed participants had reduced their blood pressure by 9%, increased their ability to get oxygen to their muscles and found day-to-day activities like getting out of a chair or walking the dog easier.

SHORT BURSTS OF INTENSE EXERCISE BEFORE MEALS CONTROL BLOOD SUGAR BETTER THAN 1 CONTINUOUS 30 MINUTE SESSION

From the FMS Global News Desk of Jeanne Hambleton

Posted on May 8, 2014 by Stone Hearth News

Diabetologiamonique.francois@otago.ac.nz

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) indicates that brief bursts of intense exercise before meals (termed exercise ‘snacking’ by the study authors) helps control blood sugar in people with insulin resistance more effectively than one daily 30-minute session of moderate exercise. The research was conducted by exercise science and medicine researchers, including Monique Francois and Associate Professor James Cotter from the University of Otago, Dunedin, New Zealand.

The study used a cross-over design, meaning that each participant acts as their own control, and questions can be answered with a much smaller number of participants. Nine individuals (2 women, 7 men) were recruited. All had blood test results showing insulin resistance, were not on cardiovascular or diabetic medication, were aged 18-55 years (mean age 48), and had a mean BMI 36 kg/m2. They included two newly diagnosed type 2 diabetics only detected as part of the screening.

The participants completed three separate exercise interventions in randomised order. Measures were recorded across 3 days with exercise performed on the middle day, as either:

(1) traditional continuous exercise (CONT), comprising one 30 min moderate-intensity (60% of maximal heart rate) session of incline walking before dinner (evening meal) only;

(2) exercise snacking (ES), consisting of 6×1 min intense (90% maximal heart rate) incline walking intervals finishing 30 min before breakfast, lunch and dinner, with one minute slow walking recovery time after each minute of intense exercise; or composite exercise snacking (CES), encompassing 6×1 min intervals alternating between walking and resistance-based exercise (with a one-minute slow walking recovery minute after each minute of exercise), again finishing 30 min before breakfast lunch and dinner. ES and CONT were matched for energy usage, whereas ES and CES were matched for time but CES provided a brief workout for all of the body’s major muscle groups across the day. Meal timing and composition were the same for all three exercise interventions, and monitored using diet records, daily verbal discussion, and dietary analysis software.

Female participants completed the trials in the early follicular phase of their menstrual cycle (across three separate cycles), whereas male participants had a minimum of 7 days between trials.

The researchers found that the ES and CES routines controlled blood sugar more effectively than the CONT routine, particularly 3-h post-meal glucose following breakfast (17% reduction compared to no exercise) and dinner (13% reduction compared to CONT).

Across the day this represented a 12% reduction in mean post-meal blood glucose concentration. The effect of the pre-lunch ES on blood glucose levels after lunch was unclear. Moreover, the reductions in blood glucose with ES compared to CONT persisted for a further 24 hours across the day following exercise.

While acknowledging that further work is required to determine the clinical significance of their study, the authors say their work adds to the recent interest in ‘accumulating physical activity’ as brief, repetitive bouts of intense exercise (as opposed to a single, prolonged, continuous exercise session) to prevent cardiometabolic disease. Many international guidelines prescribe exercise to maintain health (for example 30 min of moderate exercise 5 times a week), but such regimes still leave many people with prolonged sedentary time or inactivity, which has already been highlighted in previous research as harmful to health.

Previous research has also shown more frequent breaks in sedentary time are beneficial for waist circumference, blood glucose control and other metabolic parameters.

Exercise ‘snacking’, whether before meals or not, provides breaks in sedentary time, and thus may be important for public health. In this study, 30 min of moderate-intensity exercise (CONT) did not improve blood sugar control, whereas distributing the same volume of exercise as three brief pre-meal HIT ‘exercise snacks’ resulted in a mean 12% reduction in the average post-meal glucose level (the mean across the three meals), an effect that was also sustained across the subsequent day. Walking-based (ES) and combined-exercise (CES) snacks improved blood sugar control similarly, and both forms of exercise involved similar levels of exertion in the nine patients.

In this study ES lowered 24-h glucose levels relative to the control day, whereas CONT did not. Although compared to the control day ES was more effective than CONT on the day after exercise (subsequent 24 h), on that day the 24-h mean glucose for ES was not statistically significantly lower than CONT.

Other research focussing on several weeks of interval training versus continuous exercise has found that interval exercise every second day is just as effective as continuous exercise every day, despite the significantly lower volume of exercise. The current study and others show that if the exercise is intense, it may only need to be performed every second day, further adding to the time efficient nature of this interval exercise.

“The notion of doing small amounts of interval exercise before meals is a unique and very important feature of this study,” says Francois.

“Sustained hyperglycaemia following meals is an important feature of insulin resistance. Reducing these post-meal spikes is important for reducing the risk of developing type 2 diabetes and its associated complications.”

She adds: “Dosing these small amounts of high intensity exercise before meals (particularly breakfast and dinner) may be a more time efficient way to get exercise into people’s day, rather than devoting a large chunk of the day.”

She concludes: “We found exercise snacking to be a novel and effective approach to improve blood sugar control in individuals with insulin resistance. Brief, intense interval exercise bouts undertaken immediately before breakfast, lunch and dinner had a greater impact on post-meal and subsequent 24 h glucose concentrations than did a single bout of moderate, continuous exercise undertaken before an evening meal.

“The practical implications of our findings are that, for individuals who are insulin resistant and who experience marked post-meal increases in blood glucose, both the timing and the intensity of exercise should be considered for optimising glucose control.”

The researchers are continuing the work in this area, and are set to publish further studies, including one other acute 24 hour response to high-intensity exercise using different forms of exercise in younger sedentary individuals, and a longer-term training study on other health-related measures. They also plan to study such exercise targeting younger insulin-resistant individuals.

ACSM’S TOP FITNESS TRENDS FOR 2014

From the FMS Global News Desk of Jeanne Hambleton

Posted on November 13, 2013 by Stone Hearth News

INDIANAPOLIS – A new winner has been crowned in the 2014 top fitness trends.

High Intensity Interval Training has topped the list of the 20 trends in its debut year. This spot was previously held since 2008 by Educated, Certified and Experienced Fitness Professionals. More than 3,800 fitness professionals completed an American College of Sports Medicine survey to determine the top fitness trends for 2014.

The survey results were released today in the “Now Trending: Worldwide Survey of Fitness Trends for 2014” article published in the November/December issue of ACSM’s Health & Fitness Journal®.

“High Intensity Interval Training made its first appearance on this list this year. Its appearance in the top spot on the list reflects how this form of exercise has taken the fitness community by storm in recent months,” said Walter R. Thompson, Ph.D., FACSM, the lead author of the survey.

The survey, now in its eighth year, was completed by 3,815 health and fitness professionals worldwide (many certified by ACSM) and was designed to reveal trends in various fitness environments. Thirty-eight potential trends were given as choices, and the top 20 were ranked and published by ACSM.

The top ten fitness trends predicted for 2014 are:

  1. High-Intensity Interval Training (HIIT): HIIT, which involves short bursts of activity followed by a short period of rest or recovery, jumps to the top of this year’s list. These exercise programs are usually performed in less than 30 minutes.
  1. Body Weight Training:This is the first appearance of this trend in the survey. Body weight training uses minimal equipment making it more affordable. Not limited to just push-ups and pull-ups, this trend allows people to get “back to the basics” with fitness.
  1. Educated and Experienced Fitness Professionals. Given the large number of organizations offering health and fitness certifications, it’s important that consumers choose professionals certified through programs that are accredited by the National Commission for Certifying Agencies (NCCA), such as those offered by ACSM.
  1. Strength Training. Strength training remains a central emphasis for many health clubs. Incorporating strength training is an essential part of a complete physical activity program for all physical activity levels and genders. (The other essential components are aerobic exercise and flexibility.)
  1. Exercise and Weight Loss. In addition to nutrition, exercise is a key component of a proper weight loss program. Health and fitness professionals who provide weight loss programs are increasingly incorporating regular exercise and caloric restriction for better weight control in their clients.
  1. Personal Training. More and more students are majoring in kinesiology, which indicates that they are preparing themselves for careers in allied health fields such as personal training. Education, training and proper credentialing for personal trainers have become increasingly important to the health and fitness facilities that employ them.
  1. Fitness Programs for Older Adults. As the baby boom generation ages into retirement, some of these people have more discretionary money than their younger counterparts. Therefore, many health and fitness professionals are taking the time to create age-appropriate fitness programs to keep older adults healthy and active.
  1. Functional Fitness. This is a trend toward using strength training to improve balance and ease of daily living. Functional fitness and special fitness programs for older adults are closely related.
  1. Group Personal Training. In challenging economic times, many personal trainers are offering more group training options. Training two or three people at a time makes economic sense for the trainer and the clients.
  1. Group Personal Training. In challenging economic times, many personal trainers are offering more group training options. Training two or three people at a time makes economic sense for the trainer and the clients.

Yoga. Based on ancient tradition, yoga utiizes a series of speific bodily  postures practiced for health and relaxation. Includes Power Yoga, Yogalates, Bikram, Ashtanga, Vinyasa, Kripalu, Anurara, Kundalini, Sivananda and others.

The full list of top 20 trends is available in the article “Now Trending: Worldwide Survey of Fitness Trends for 2014.”   (http://journals.lww.com/acsm-healthfitness/fulltext/2013/1100/now_trending__worldwide_survey_of_fitness_trends.5.aspx)