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Have your say in the future of local NHS dermatology services

Skin Care

The NHS Commissioning Alliance for Brighton and Hove, Crawley, East Surrey, High Weald Lewes Havens and Horsham and Mid Sussex are looking in to change how their local dermatology services operate, and they need your help.

If you, a member of your family or someone you care for has recently seen a dermatologist in any of these locations, they want to hear from you. They will be running a range of events to help them gather valuable information on how they can develop their dermatology offering.

In particular, they want to hear what works well, what could be done better and what would you change. This is your opportunity to have an important impact on the new developments the NHS Commissioning Alliance put in place. So, if you would like to have your say, sign-up to one of the events below:

  • Monday 23rd April 2 – 4pm: Crawley Baptist Church, Crabtree Rd, RH11 7HJ
  • Tuesday 24th April, 10 – 12pm: Clair Hall, Perrymount Rd, Haywards Heath, RH16 3DN.

To book a place for the above events call 01293 600300 x 3804 and ask for the Planned Care Team Or email: HSCCG.ContactUs-PlannedCare@nhs.net

  • Wednesday 25th April 2.30- 4pm: Diablo Room – Council Offices, 8 Station Rd East, Oxted, RH8 0BT. To book a place call 01883 772810 or email: emma.vince@nhs.net or Victoria.hill12@nhs.net
  • Friday 27th April from 2 – 4pm: Uckfield Civic Centre, Green Room, TN22 1AE (next to Tesco). To book a place call 01273 403582, register online or email: hwlhccg.dermquestions@nhs.net

If you can’t make it to these events, you can share your views in an online survey from the website below at the beginning of May either for Horsham or Crawley.

To keep up to date with all the goings on, make sure to follow the NHS Commissioning Group for Horsham and Mid Sussex on Twitter and Facebook.

The post Have your say in the future of local NHS dermatology services appeared first on talkhealth Blog.

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Venture capital and the future of dermatology: A reassessment

Dr. Norman Levine offers bits of advice for those considering this type of change in your practice for those considering selling their practices to venture capital-backed enterprises based on his experience with one such company.
Dermatology Times – Dermatology

3 simple steps to help define and secure your child’s future (and take a load off too…)

Ask anyone in your circle that may be in a position to help you.

In my previous blog post I spoke about how the gravity of the choices facing our students could be, amongst other factors, having a demonstrably negative impact on their wellbeing and mental health. This is an idea that has certainly gathered momentum and support in recent years and arguably now more than ever is at the forefront of the Department for Education’s collective minds, with the department clamouring for teachers to have ever more training and understanding of basic mental health issues, how to identify them and what the first line of response should be.

Due to the constraints of the blog format and not wishing to outstay my welcome in the first post I left something of a hanging chad – ‘You need to help your child more!’ – and then departed without offering any practical hints as to what and when you can be doing things that may be beneficial. So, the idea behind this blog post is to identify a few simple things you can practically do that may help alleviate some of the stresses of future planning that your child(ren) are facing.

  1. Talk to them – It sounds like an absurd truism but in amongst everything else in our respective lives sometimes shushing the external becomes an obstacle that gets in the way of the practical things like making dinner, work, activities and so on. Try and make time to really talk and more importantly really listen to what your child’s hopes and expectations are for the future. It may be you have very strong opinions about what your child should do but it’s important that you listen to what they want to do. Bear in mind the prescribed routes of your youth are no longer necessarily as pertinent to the current job climate as you might imagine. If you are trying to convince them to go to university that’s fine, if that’s what they genuinely want. Whilst it’s reductive to suggest that university is only useful if it’s geared towards a career, if your reasoning for wanting them to go is for job prospects it may be there are other better routes. Additionally in an attempt to please you it will be a debt they are burdened with for the first half of their working life. If your desire for them to go to uni is based on helping them forge a better life then saddling them with an enormous debt, unless there is a solid basis to think a degree will deliver them into the waiting, lucrative arms of a well paid position, it may not be in their best interests. It’s impossible to overestimate how much anxiety is a direct response to children wanting to please their parents. Through our ambition for them, our desire to see them succeed we may be unwittingly creating an environment of tension and panic and perhaps worse making one where honest discussions about their own ambitions cannot be had due to their fear of disappointing us. So listen to what they say, hear them out, give them an opportunity to articulate what/how they see the next few years unfolding and when you have a clearer view of an endpoint (because higher or further education is not an end in and of itself, merely a stepping stone), explore which of the available options is likely to be the most realistic and supportive of those aspirations.
  2. Be shameless – Most children aren’t fortunate enough to have a fully realized plan for their futures, they might have loose ideas about where they might want to live or a field of interest. Something in the law for instance. Now to take that an example, something in the law is pretty vague but by exploring the field they may be able to refine and hone that field and start to narrow it down into a potential career path which in turn will reveal which of the educational options best suits them. When I say be shameless I mean really wrack your brains, who do you know in that field that may be able to offer them some work experience, answer some questions, refer them to others working in the area? Ask your friends, neighbours, relatives, parents at the school gates, the school themselves, local businesses, your colleagues and so on. Every social interaction you have may also possibly throw up some opportunity, don’t be British about it, if you’re afraid to ask – imagine how your child feels. The single greatest thing a student can do when faced with these decisions is to get some work experience, firstly because it’s good fodder for either a personal statement or a CV and secondly because it will help either confirm or deny their interest in an area and it’s much better to learn something isn’t for you before you commit to a 3 year degree. With the Christmas holidays coming up there’s an opportunity to organise some work experience activity, even a few days regularly can make a huge difference, hell when you’re writing your Christmas cards you have an opportunity to ask whether anyone in your circle might know someone who could help your child and you can dress it up as season’s greetings! (https://edducan.com/2017/07/25/careers-planning-starts-with-good-work-experience-thats-what-the-holidays-are-for/) If you don’t ask you don’t get and as most students view the present as an inconvenient preamble and the future as too abstract to worry about anything you can do to help them in spite of themselves is going to make a big difference.
  1. Be proactive – They will likely assure you that everything is fine, it’s all in hand and so on but don’t take it on faith. Hector them as much as you can to make sure they are hitting their marks so to speak. This is a busy time of year, particularly for children in the Sixth Form. Lower Sixth – if they are university bound or at least thinking about it need to have a personal statement ready to go as soon as possible and with a largely homogenized cohort of students any work experience they can cram in to distinguish themselves from their competition would be immeasurably helpful. The personal statement was once seen as filigree but the evidence suggests it is becoming increasingly crucial to a selection or admissions committee in deciding whether the candidate has not just the academic chops to stay the course but also the wider commitment and interest in the field. That’s an argument that’s easier made when you have demonstrable experiences of having sought out opportunities whilst at school (see point 2 about work experience). Whilst I’m speaking about personal statements here the idea of being proactive and using the holidays and free time is a universally applicable one and honestly the younger the better. The sooner a child can engage with the world of work and the place they want to inhabit within it the better. There is too large a disconnect between education and careers, as if one has nothing to do with the other. If a child is interested in an area and they secure and enjoy work experience in that area it immediately gives a purpose to their school work, knowing what their goal is and having it be tangible is invaluable as it links two previously disparate ideas.

I appreciate that hounding them may not be enviable and certainly not at the cost of heaping on additional pressure but like any leviathan of a task the longer it sits about your shoulders the more it weighs you down. The short term annoyance will hopefully give way to longer term relief, the more they do now and the more you help them do what they need to now – the easier their lives will be when it comes time to revise etc. Knowing that an area is boxed off and dealt with may remove those feelings of being overwhelmed as they only have to deal with the bite sized nuggets that are directly in front of them.

So there you are, three reasonably simple practical things you can start doing today to help secure their futures and remove their anxieties. They are by nature repetitious and deliberately so. To best help your child or indeed anyone exploring their options, looking at their futures, the best and easiest thing to do is it develop a plan, even a loose one and then start to tick off little jobs, one at a time so that attacking it all at the last minute when you’ve a million and one other things to do doesn’t happen. It is my sincere belief that little and often from an earlier age is the surest way to develop a keen sense of purpose regarding their futures and removes the crushing anxiety attached to having to make what will feel like knee jerk decisions moments before committing themselves to those decisions for potentially years.

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A different perspective on venture capital and the future of dermatology

If we do not evolve … we will soon be an extinct species of medical practitioner, Dermatology Times Editorial Advisor says in his column this month. He shares his experience and considerations with negotiating the sale of his practice to a venture capital backed firm.
Dermatology Times – Dermatology

Negative food experiences make future histamine reactions more likely 

Conditioned taste aversion is a survival mechanism whereby animals learn to associate taste with a food that has made them sick; usually because it’s toxic or spoiled. In some cases the conditioned association between a food and sickness is so strong that the amygdala, the primitive part of the brain whose role it is to identify whether something is dangerous, can send the danger signal based on just the smell of a food alone. Sound familiar? Read on…references always at the bottom of post.

Chemotherapy has taught us a lot about taste aversion. Patients undergoing treatment who experience extreme nausea or sickness during it may develop a long term aversion to foods eaten during those months.

Granted, that’s an extreme example,  but some of us (myself included) have experienced years, if not decades of nausea (and worse) as a result of excess histamine or negative food reactions.

Histamine, dopamine, acetylcholine and serotonin are involved in the control of nausea and vomiting.

I stashed Motilium, a dopamine agonist that prevents nausea/vomiting in my handbag, by my bedside, and in my car for years. Really years. Took it pretty much every day.

As a kid I projectile vomited regularly. As an adult too really. Most memorably it’s happened while walking down the street, behind a curtain at a black tie function (while sober), and many others.

I think I may have, like chemotherapy patients, developed a conditioned taste aversion to foods (which triggered  major nausea every time I ate), or my inflammation bucket was so very full (read more about the bucket theory here) that it kept spilling over no matter what I ate.

So how does behavioural conditioning like taste aversion actually work?

Exciting research by scientists and those studying behaviour have shown that our beliefs affect the immune system. For example, they have found that placebos work (when they do) because people believe their doctor. They have faith that the medicine will heal them.

But a more exciting discovery was made in the last few years: that the immune system can be conditioned to  respond in a certain way by association with a subconscious stimulus. In her fascinating book CURE, investigative reporter Jo Malone interviews doctors and researchers at the cutting edge of the field of psychoneuroimmunolgy. They believe, and have proven, that behavioural conditioning can reproduce the effect of certain medications on the immune system, regardless of whether the patient believes it will heal them.

The scientists came up with variations on: giving an open placebo pill to patients (that’s there someone knows the pill is sugar/an inert substance), with a real medication, paired with a certain piece of music, and a liquid with an incongruous taste (ie a red drink that tastes like banana), at the same time in the same place. A few weeks and the medication would be reduced (or eliminated depending on the severity of the patient’s condition) but the rest would continue (music, drink, open placebo).
They found that the immune system continued to behave as it did when given the full dose of the real medication.

So despite the patient being fully aware that the medication was removed, their immune system had been conditioned to behave in a certain way.

Researchers have proven this in particular with asthmatics and measuring histamine released when the patients were stressed by believing they were being exposed to an allergen.

That’s how powerful conditioning can be.

That’s also how negative conditioning could be tripping us up.

If our immune system has been conditioned to respond to certain foods by releasing massive amounts of histamine, then this could keep going on even if the original issue has resolved.

Let’s say you were going through a time of immense stress, or eating while stressed at your desk always, or struggling to keep your cool with kids at your hem while cooking and eating, or had unpleasant family meal times, or were sick for a time, whatever, and your immune system came to associate stress with food and sickness.

That’s why when people ask me how I’ve managed to add so many foods back to my diet, including higher histamine ones, I attribute most of my gains to getting my diet right, but also fixing how my brain processes my body’s response to food and stress. I discuss my approach to healing this here and here.

It’s finally here! Man Food – a high nutrient antihistamine and anti-inflammatory ingredient filled book geared towards guys, women who love to work out, yoga like they mean it, or just load up on healing nutrients. Features my personal shopping list of antihistamine and anti-inflammatory foods.

The Anti-cookbook and all liquid Anti-Detox Book, don’t treat any conditions, but feature a plethora of the high nutrient antihistamine and anti-inflammatory ingredients that have been instrumental in helping me feed myself on a limited diet. The Anti-cookbook features a four page list of antihistamine and anti-inflammatory foods and comes in regular and Paleo.

—-REFERENCES—

“Conditioned taste aversion.” Wikipedia. Wikimedia Foundation, 21 May 2017. Web. 15 June 2017.

“Classical Conditioning (Pavlovian Conditioning).” SpringerReference (n.d.): n. pag. Web

Bernstein, Ilene L. “Conditioned food aversions as a consequence of cancer and its treatment.” PsycEXTRA Dataset (n.d.): n. pag. Web.

Bernstein, Ilene L. “Conditioned food aversions as a consequence of cancer and its treatment.” PsycEXTRA Dataset (n.d.): n. pag. Web.

“Domperidone.” Wikipedia. Wikimedia Foundation, 12 June 2017. Web. 15 June 2017.

Dark, Kathleen, Harman V. S. Peeke, George Ellman, and Mary Salfi. “Behaviorally Conditioned Histamine Release. Prior Stress and Conditionability and Extinction of the Response.” Annals of the New York Academy of Sciences 496.1 Neuroimmune I (1987): 578-82. Web.

“Chemoreceptor trigger zone.” Wikipedia. Wikimedia Foundation, 13 June 2017. Web. 15 June 2017.

Wager, Tor D., and Lauren Y. Atlas. “The neuroscience of placebo effects: connecting context, learning and health.” Nature Reviews Neuroscience 16.7 (2015): 403-18. Web.

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What’s the future of freefrom skincare?

Reading the Telegraph Saturday magazine this weekend I read a feature by Victoria Hall, their acting beauty director who said that, and I quote…

“Two thirds of women believe that what they eat directly impacts on how their skin looks so expect to see edible ingredients increasingly listed on your creams and serums.

Rhassoul clay - Image from Natural Spa Supplies

Rhassoul clay – Image from Natural Spa Supplies

From superfoods such as chia, broccoli and kale to fermented supplements and even turmeric, the latest products could just as easily be found in your kitchen as the bathroom.

The bigger brands may not jump on the natural and organic bandwagon just yet, but you will see an influx of US beauty labels offering superfood serums tha are devoid of toxins – or even entirely natural.

Look out for Drunk Elephant and Farmacy, which are both coming to the UK in January.”

You can read more of her predictions for The 2017 skincare trends you need to have on your radar here.

One of my favourite finds over the years include 100% organic coconut oil, tea tree oil, aloe vera, shea butter and rhassoul clay. All incredibly versatile, flexible and great for my skin in so many different ways.

So great news for the UK’s natural skincare movemment. It’s something we’ve seen in the UK for some years already from independent and organic skincare companies who have been making delicious, natural skincare and cosmetics ahead of the trend.

Natural and organic doesn’t necessarily mean it will be suitable for all skin types because even some natural essential oils and ingredients can be irritants for some. However, having companies who are looking at the ingredients in their products to avoid including unnatural, harsh and even sometimes harmful things can only be a good thing.

Free From Skincare Awards at the Allergy Show 2015

Free From Skincare Awards

One of my favourite jobs is helping on the judging panel for the FreeFrom Skincare awards every year. Having what is called ‘problem skin’ I get invited along to review all the entrants in that category, as well as other categories.

I have discovered some amazing new products such as Organic Babies, NAT Origin and Pure Potions to name just a few… so this can only be good news for 2017.

One of my real bugbears and struggles is finding good, natural shampoo that doesn’t make my scalp dry, itchy and sore.

Rhassoul clay, pictured above, is a fantastic natural alternative DIY shampoo. Mix the clay to a paste with water, massage into the scalp and along the hair shaft and rince with vinegar and water conditioner. Find out more in a previous blog, Pros and Cons of rhassoul clay shampoo.

One of my next blogs will be all about the search for a natural, organic commercial shampoo that is good for sensitive scalps, because I rarely give myself the time to make fresh rhassoul clay shampoo. Stay tuned…

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