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There are apparently no insurers in the UK willing to extend cover to independent midwives, and so independent midwives and their clients operate in an insurance-free zone, which is risky, but it was apparently a risk everyone was willing to take. However, a new EU regulation mandates that midwives operate with insurance, and once that regulation is implemented locally, it will end the practice of independent midwifery in the UK unless there's some drastic action to create an insurance policy to which independent midwives may subscribe.
We had our daughter at home with an NHS midwife, and it was wonderful. Not everyone is lucky enough to live in the cachement of a hospital with midwives who'll help mothers deliver at home (especially now as NHS budgets are being slashed to ribbons across the country). If this rule comes to pass in the UK without any insurance fix, having a baby safely at home will become effectively illegal for families across the country.
A silent protest is scheduled for today at the House of Commons:
This campaign continues with a Silent Protest and march in Westminster on Monday 25 March, from 11am, to lobby Government to protect women's right to choose their maternity care and find a solution to the issues raised by an EU Directive.
Independent Midwives are registered midwives who have chosen to work outside the NHS to be able to offer continuous care and support to women who choose it. This is the kind of autonomous midwifery that you see in the hugely popular programme “Call the Midwife”. Nowadays it is mostly only independent midwives who are able to provide what David Cameron once called “gold standard care”. Due to staff shortages and budgetary pressures very few NHS Trusts are able to provide this kind of care.
Sally Randle is an independent midwife in Bristol, offering local women an alternative to NHS care. Sally says, “I was lucky enough to practise this way in the NHS in London, but local maternity services did not provide this way of working. I decided to become an independent midwife so I could continue this rewarding work. I love my job; I don't even mind getting up in the night to go out to a birth because I know the family well and feel privileged to be involved in this amazing time in their lives”.
I can't figure out why insurers can't sort this out. The actuarial data set is robust and well-established. The potential liability, though high, is calculable. If you can get insurance to juggle machetes in Covent Garden (high potential liability, small data set, massive individual variation), why the hell can't indie midwives get cover?
Silent Protest and March (Thanks, William!)
I like the Exergen TemporalScanner because with a gentle stroke of the forehead, I can get a person’s temperatureaccurately and almost instantly — without having to stick something in their ear, mouth, or any other orifice. I can even check a child’s temperature while they sleep. It’s very easy to use — but do read the instructions to get the right swipe motion.
The device takes 1,000 readings per second, selects the most accurate among them, and adjusts for room temperature to give you the temperature of the temporal artery (near the temple) — which is an earlier signal of disease than rectal temperature. This temporal artery thermometer is more accurate than ear thermometers and is less affected by the sources of error that can make oral or underarm temperatures misleading. (However, for many purposes, temperature precision isn’t that important. Just knowing whether there is a fever or not is far more important than knowing the temp within a few tenths of a degree. And often fever is helpful, anyway.) But accurate thermometer readings can bring great peace of mind.
I use one of these at our home and carry one with me everywhere in my pediatrician doctor’s bag. -- Alan Greene, MD
Scientists are only now beginning to get answers to those questions. In a paper just published online in the journal Gut, Andres Moya of the University of Valencia and his colleagues took an unprecedented look at a microbiome weathering a storm of antibiotics. The microbiome belonged to a 68-year-old man who had developed an infection in his pacemaker. A two-week course of antbiotics cleared it up nicely. Over the course of his treatment, Moya and his colleagues collected stool samples from the man every few days, and then six weeks afterwards. They identified the species in the stool, as well as the genes that the bacteria switched on and off.
What’s most striking about Moya’s study is how the entire microbiome responded to the antibiotics as if it was under a biochemical mortar attack. The bacteria started producing defenses to keep the deadly molecules from getting inside them. To get rid of the drugs that did get inside them, they produced pumps to blast them back out. Meanwhile, the entire microbiome powered down its metabolism. This is probably a good strategy for enduring antibiotics, which typically attack the molecules that bacteria use to grow. As the bacteria shut down, they had a direct effect on their host: they stopped making vitamins and carrying out other metabolic tasks.
A long, investigative feature on junk food, health and the processed food industry in yesterday's NYT consists primarily of interviews with tortured and semi-tortured junk food scientists and execs who have perfected the art of getting you to eat food that makes you sick. It's quite a read:
Eventually, a line of the trays, appropriately called Maxed Out, was released that had as many as nine grams of saturated fat, or nearly an entire day’s recommended maximum for kids, with up to two-thirds of the max for sodium and 13 teaspoons of sugar.
When I asked Geoffrey Bible, former C.E.O. of Philip Morris, about this shift toward more salt, sugar and fat in meals for kids, he smiled and noted that even in its earliest incarnation, Lunchables was held up for criticism. “One article said something like, ‘If you take Lunchables apart, the most healthy item in it is the napkin.’ ”
Well, they did have a good bit of fat, I offered. “You bet,” he said. “Plus cookies.”
The prevailing attitude among the company’s food managers — through the 1990s, at least, before obesity became a more pressing concern — was one of supply and demand. “People could point to these things and say, ‘They’ve got too much sugar, they’ve got too much salt,’ ” Bible said. “Well, that’s what the consumer wants, and we’re not putting a gun to their head to eat it. That’s what they want. If we give them less, they’ll buy less, and the competitor will get our market. So you’re sort of trapped.” (Bible would later press Kraft to reconsider its reliance on salt, sugar and fat.)
Here's another good bit:
To get a better feel for their work, I called on Steven Witherly, a food scientist who wrote a fascinating guide for industry insiders titled, “Why Humans Like Junk Food.” I brought him two shopping bags filled with a variety of chips to taste. He zeroed right in on the Cheetos. “This,” Witherly said, “is one of the most marvelously constructed foods on the planet, in terms of pure pleasure.” He ticked off a dozen attributes of the Cheetos that make the brain say more. But the one he focused on most was the puff’s uncanny ability to melt in the mouth. “It’s called vanishing caloric density,” Witherly said. “If something melts down quickly, your brain thinks that there’s no calories in it . . . you can just keep eating it forever.”
The Extraordinary Science of Addictive Junk Food [NYT/Michael Moss]
"Types of insanity, an illustrated guide in the physical diagnosis of mental disease" from 1883 is not just a frightening look at the inhumane treatment of people with mental health problems in the 19th century, it's also full of sensitive charcoal portraits of inmates in various asylums, along with their tragic personal histories: "X______ has been melancholic for some years, and the disease is drifting into dementia."