tonyplant's blog

We Eat Well, Exercise But Die Before We're Thirty

Mon, 08 Jan 2007 12:21:07 +0000

I came across this cartoon that inspired the title and reminded me of something that I've seen attributed to Terry Pratchett:

You can't make people happy by law. If you said to a bunch of average people two hundred years ago "Would you be happy in a world where medical care is widely available, houses are clean, the world's music and sights and foods can be brought into your home at small cost, travelling even 100 miles is easy, childbirth is generally not fatal to mother or child, you don't have to die of dental abcesses and you don't have to do what the squire tells you" they'd think you were talking about the New Jerusalem and say 'yes'.

As ever, I fall back onto consideration of Ben Friedman's The Moral Consequences of Economic Growth. Friedman persuasively argues that economic growth is essential to moral, social, political and cultural progress.

I wonder why we are not happier or more satisified. Are we meant to compare ourselves to others or to an idea of what we wanted for ourselves and find our lives lacking? Or has economic growth given us more diverse and intense sources of hedonism but not provided comparable opportunities for engagement or a meaningful life? I find the latter difficult to believe. Yet I meet so many people who are relying upon an external or a change in circumstance (such as a lottery win) before they will be happy. The idea that we can change ourselves and be happy seems to be ridiculous or dangerous.

The Meaning Behind My Blog Silence

Thu, 04 Jan 2007 13:18:11 +0000

I apologise for the lack of posting lately. From time to time my wife's lower back plays up in teeth-gritting sort of way and that kicked in just before Christmas and is showing no sign of abating.

I enjoyed the pre-Christmas Happystance workshops and have some more dates booked later this month and Februrary.

Happy New Year and I hope that your plans for 2007 are realised for you.

Care Costs and the Number of Elderly People Who Need Care

Fri, 22 Dec 2006 11:21:47 +0000

Interesting story in The Herald about a rethink on how councils assess assets when estimating liability for care costs: Care cost left pensioner on the brink of bankruptcy. Apart from the story itself which is relevant to many people, the item contained the following observations:

The local authority went on to argue that, as he was 79 when the home changed hands, he was at an age when future care cost becomes an issue for most people. But Professor Alice Brown, the ombudsman, argued only 4% of the population are in care homes or long-stay hospitals at that age. When the man needed to go into a home aged 88 the ombudsman argued only 19% of over-85s live in a care home.

The story well expresses the chaos surrounding funding for care in the UK. It is miserable that the worries about care are marring the enjoyment of so many people.

However, despite all the negative publicity about the state of care in the UK, I find the estimates of how few elderly people are in residential care to be quite cheering and much less than the typical media comments imply.

Start Thinking About Your New Year's Resolutions

Sat, 16 Dec 2006 18:05:16 +0000

It is easy to come up with the same-old, same-old flagellating New Year's Resolutions. Bypass all those pious intentions to go to the gym, follow a seaweed diet and learn a new language.

You form resolutions because you want to make yourself a better person or because you believe that the end state of these resolutions (being fitter or thinner) will make you happy. Stop setting yourself up for failure, head straight for the main goal of making yourself happier.

Decide right now, that you will count your blessings and cultivate gratitude for what is in your life, not what might be in your life if only...Instead of those gruelling fitness tests, examine your character strengths and virtues (take the tests at Authentic Happiness) and decided how you can use them more regularly. You can investigate whether you can enjoy your pleasures rather than take them sadly.

There are many benefits to enjoying your pleasures, appreciation and counting blessings and cultivating your personal strengths. The first three can take as little as a minute at a time. The last needs more planning and reminders to use your strengths but it is equally pleasurable.

The Commercialism of Stress and Christmas

Tue, 12 Dec 2006 13:04:16 +0000

Columbia University's Graduate School of Journalism offers a surprisingly funny and informative website about stress. Stress, Inc. : the commerce of coping is a lot of fun. There is a comprehensive history of stress with games and animations. There is an exploration of the commercialisation of stress by pharmaceutical companies, by the fitness industry, and by an astonishing array of other businesses. One particularly fine example details how advertising creates our neuroticism about aspects of life and then offers a solution to assuage those fears and stresses:

Calgon's now-legendary "Calgon...take me away" campaign tapped into anxiety --
stemming from situations such as having dirty dishes, which represented life's mundane stressors. In the television ad, dirty dishes, portrayed as a source of "social disapproval" among one's peers, created intolerable stress for one woman... bathing with Calgon bath gel provided a release from the anxiety. ...(T)he product provided a possible solution to the problem. "The product relieves the stress." That's the key to a successful fear appeal.

The Times is offering a Quiz: testing for festive stress. The quiz has the explanatory preamble:

Christmas has the potential to be one of the most stressful events in the calendar. According toa recent survey, the average preparation time is 13 full days. This involves 288 hours of shopping, four hours wrapping parcels, three hours decorating the house, nine hours cooking and 11 hours cleaning up the mess. And then there�s the sums of money you feel you have to spend. But whether you are time-rich and cash-poor or cash-rich and time-poor, there are ways of minimising the pain with good management.

'Tis the season for tension and re-hashing old scores

Sun, 10 Dec 2006 10:38:24 +0000

There are lots of kill-joy stories circulating about elderly people being upbraided for asking about the switching-on of the Christmas Lights rather than Winter Lights. And stories about singing services being cancelled for being insufficiently multi-denominational. In the US, some groups have brought successful law suits against towns whose public displays are reportedly too secular. In contrast to these stories, the Guardian has a thoughtful piece that suggests that many of these Grinch stories have little or no basis in fact: The phoney war on Christmas.

Rather than the usual, “the personal is the political”, it seems as if the personal experience is spreading to the political. If your family’s version of holiday spirit has usually been interpreted rather too literally (and liberally), leading to family tension and the annual re-hashing of old scores, then this is your kind of public holiday season. And, by and large, no alcohol has been required, just plain mean-spiritedness.

A friend works for a dictionary publishers and is the go-to person in many circles for linguistic niceties. She and her siblings now have their own families and gather together at her mother’s on set-piece days. A while ago, her mother was watching a reality programme and asked her, “What’s a dysfunctional family?”. In an admirable economy of words, my friend replied, “You know the way we all get on Boxing Day”; her mother nodded, “Well, dysfunctional families are like that the whole year round”.

Admin post

Fri, 08 Dec 2006 16:44:44 +0000

Just to verify a request from a crawler.

Answering "How are you?": counting blessings

Wed, 06 Dec 2006 15:18:36 +0000

Apparently, in Latin, you can ask a question that anticipates the answer. So, you use some grammatical forms if you expect the answer ‘No’, and others (presumably), if you expect the answer ‘Yes’. It sounds like an ancient form of mind-games and casts a new light on the art of conversation. But so often, our conversations can be formulaic, and this is especially true when it comes to social comments.

When I worked in Loughborough I was initially taken aback when the response to my polite enquiry, “How are you?”, was met with, “Fair to middling”. I was so accustomed to, “Fine”, that I didn’t know if the correct social action was to overlook it, or to enquire further and run the risk of learning more about IBS or the agonies of an enlarged prostate than I cared to know.

Throughout the UK there are local customs that dictate the answer to the question “How are you?”. I came across an item on blessings and the tricky task of navigating the appropriate answer to this question.

When someone asks me: How are you? 99% of the time I will answer “fine”. In Hebrew, you say, beseder, literally, in order, ok. It’s, “thanks for asking but I don’t need any special consideration right now, I’m ready to proceed”.

The Cost of Being Upbeat

Tue, 05 Dec 2006 15:33:28 +0000

An article in the Sunday Times discusses The price of keeping up a brave face. Cathy Galvin gives her own response to the news that friends of Gordon and Sarah Brown report that they have remained upbeat since learning that their baby son Fraser has cystic fibrosis, a chronic, incurable condition.

Galvin doesn't pull her punches and paints a picture of poor support and family tensions that is too familiar to too many families in the UK. She says that being "upbeat" had become

the ultimate betrayal of the estimated 1.9m families in Britain whose children have some kind of special educational need, who play down the load they are carrying and rarely tell it how it is. Why? Because to say, �Well, he�s doing well on the medication but we were up all night because he couldn�t breathe. And we�re worried because his sister is being bullied at school because he�s different. And we�re running short of money because one of us needs to be at home in case there�s an emergency during the day� is not what people want to hear...

To hint at the daily, gruelling realities of looking after a disabled child is to risk � especially if you move in healthy, wealthy circles � being boring, to sound as though you�re not coping, to awaken in your listener the worrying prospect that the gap between their lives and yours is so vast that you and your family have become something alien and other and, among your colleagues, the suggestion you might not be up to the job.

It's a good piece but I have to criticise the Sunday Times for failing to provide an outline of what adequate provision would look like or what it would cost (an UnLtd colleague attempted a costing of mental health care and school provision for 1 million children earlier this year).

You Tube's Contribution To Well-being

Thu, 30 Nov 2006 22:44:06 +0000

Rachel on Sisyphus' Ledge has a discussion going about Hugh Laurie in the comments of her post, Just a note. I had to echo the House, MD/Laurie support and call attention to the many excellent clips of both Fry & Laurie and House on You Tube.

You Tube lots of montages of clips from the various series of House set to music. There are some superb angsty pieces that Frank Zappa might have had in mind when he made his, �It�s like listening to Weber at 4 am on a foggy November morning� (such as 4 a.m.). However, because Rachel recently commented that she enjoyed the smiles on the pictures that I posted from a recent Happystance event, I�m going with a couple of recommendations for smiley, blithe montages: Shoop Shoop Song and Smile.

I've previously enthused about blogging as a creative outlet. I think that facilities like You Tube and affordable software are providing even more creative and entertainment opportunities for people: both as creators and consumers.

Happiness Adjusted Age Relative To Chronological Age?

Mon, 27 Nov 2006 20:50:29 +0000

There are several age-adjusted health scales used to horrify or shame us about our lifestyle choices and health. Real Age claims to calculate the biological age of your body, based on how well you maintain it. HeartAge can be used to tell a 42-year-old man that after a cardiovascular risk-adjustment, he has the heart of a 70-year-old man. There are anxiety and depression scores and quality of life scores. I'd like to propose an risk-adjusted happiness and resilience score for age. Imagine hearing, "You have the body of a 23-year-old but your lifestyle choices and general grumpiness gives you the Mind-Body score of 58-year old".

HeartAge is a novel use of the Framingham Heart Score: it has been reported in Patients' Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies. A series of focus groups compared three strategies for communicating cardiovascular disease (CVD) risk. Participants saw three visual displays that represented the CVD risk for a 42-year-old man with a Framingham Heart Score that predicted a 25% probability for a CVD event within the next 10 years. A crowd chart showed 100 stick figures with 25 of them shaded to indicate the proportion predicted to have a CVD event over the next 10- years: this was contrasted with a similar chart for a same-aged man with no risk factors (1 figure shaded). Similarly, this same information was compared and contrasted in a simple bar graph. The HeartAge was also presented as a chart. But this time, a horizontal bar chart represented age. The first bar depicted the chronological age (42 years);

the second bar showed how this individual compared with the average age of a same-sex person in the Framingham Heart Study having the same 10-year probability of experiencing a CHD event. For the demonstration case, the 42-year-old had the same risk as a 70-year-old.

Analysis of the participants' reactions and responses revealed that the standard visual representations that show statistical probabilities of risk are confusing and uninspiring. However, a strategy that provides a cardiovascular risk-adjusted age calculation was

evaluated as clear, memorable, relevant, and potentially capable of motivating people to make healthful changes.

The BODE index is gaining in popularity for assessing people with chronic obstructive pulmonary disease (COPD). BODE is a combination of physical and physiological indices and measurements: it can be used in conjunction with quality of life questionnaires to present a full picture of a patient's health and well-being.

The BritMeds 1:1

Sun, 26 Nov 2006 19:33:06 +0000

The excellent Dr. Crippen of NHS Blog Doc has launched The BritMeds, a carnival round-up of the best of british medical blogging.There is a diverse range of topics and it has a charmingly eccentric british flavour/

Laughing with the Greater Manchester Police

Thu, 23 Nov 2006 17:16:38 +0000

I was pleased to be invited to participate in a Carer's Day, organised by the Women's Group of the Greater Manchester Police. So, if you've ever wondered what a Happystance workshop looks like, this is it!

Here, a Laughter Chorus performed Happy Birthday with laughs of different tones rather than in song.

We finished with a laughter conga line and some ingenious shoulder and neck rubs.

The picture is generally bleak for carers in the UK but it is essential that carers have some attention paid to their own needs. After the Happystance slot a number of the participants came up to say how much they had enjoyed the event. They had been a little apprehensive that the day would be worthy but very dull and had appreciated the unexpected levity.

Flexible Working Arrangements for Carers

Sat, 11 Nov 2006 15:18:40 +0000

Depending on a number of factors you will either believe that flexible working arrangements for carers is the ruination of good business practice or you will think that it is a innovation that is long overdue. A lot of time and discussion has been spent in defining carer.

The definition of carer is an employee who is or expects to be caring for an adult who is either their husband or wife, their civil partner, or a close relation.

The employee will also fall into the government category of carer if they look after somebody who lives at the same address.

If you fall wihin that definition of carer, then you will have the legal right to request adaptable hours from 6 April 2007. Community Care, amongst others, is unhappy that the definition of carer is quite narrow. It is a little confusing, because by the definition that I quoted above, step-relatives are excluded. Blended families have been a social reality for some time and the omission of step-family members does seem to be quite striking. However, according to Community Carer, step-relatives are included.

It rejected calls from campaigners to apply the right, enshrined in the Work and Families Act 2006, to all carers, keeping to original plans to cover employees caring for a partner, relative or someone else living at the same address.

Dr. Crippen's Perspective on Children with Depression

Thu, 09 Nov 2006 18:42:52 +0000

The excellent Dr. Crippen has posted a remarkable discussion of children with depression. He goes through the NICE guidelines for managing depression in children and young people.

The discussion makes for grim reading. Earlier this year, the Great and the Good of the BMJ's Science Committee published a very dispiriting report about the state of children's mental health in the UK. What makes Dr. Crippen's analysis particularly disappointing is the news that GPs seem to be so overlooked despite their front-line position.

Crippo has left a comment on Dr. Crippen's post. He articulates much of the pain and difficulty experienced by families who care for a family member who is depressed.

I don't know what the solution is to the estimated mental health treatment needs of 1 in 10 children. I strongly suspect that the only probable large-scale delivery mechanism that is practical will be based in schools. I am confident that any multi-agency solution must involve the family doctor.