...on with the show

Why oh why the SUN burning? Well, it was on the street just blowing around like a piece of trash. Why not the MAIL? Good question, but it was just time and place. Often the dear old BBC show us images of people in far-off places, waving flags and pictures of our illustrious leaders - whilst setting fire to them - and shouting this and that. I thought I’d simply do a restrained and uptight northern version - I just wouldn’t have wanted to wrap my chips in it. 
Worthless bilge. 

Sorry this weeks blog is slightly shorter and slightly more functional than normal! I’ve got my work cut out over the next few weeks. HOWEVER, I urge you to keep a-checking this blog as I’ll shortly be updating you on the Dementia and Imagination research. Some interesting jobs are imminent. I’ll be facilitating two networking events in January - one in Liverpool, the other in Manchester. They are going to be focused on substance recovery and have a BIG FAT EUROPEAN MANIFESTO feel to them! More soon. Next year will see the return of a Pathways into Arts and Health Course for Artists + responding to your requests, something similar aimed specifically at those of you with medical or public health inclinations - Good Grief! 

So - on with the show...

I am thrilled to be invited to speak at the 5th Art of Good Health and Wellbeing International Conference on Arts and Health in Sydney. Organised by Arts and Health Australia, this years conference will welcome the Director of the Baring Foundation, David Cutler and I'm thrilled to say, Arts for Health 'alumni' - Claire Ford who will be sharing her work on the iPad engAGE project. For my part, I'll be exploring some ideas about authenticity in arts and health, particularly in the way we understand our cultural value. If you've not seen it, the short film below is a 'teaser.'

Centre for Social Action Innovation Fund 

As part of the Cabinet Office Centre for Social Action, the National Endowment for Science Technology and the Arts (NESTA), will run a £14 million Innovation Fund to support the growth of innovations that mobilise people's energy and talents to help each other. The Innovation Fund will focus on four areas. These include:

· Helping people to age well, particularly by supporting people over 50 to have a purpose, a sense of well-being and to be connected to others

· Enabling people with long-term health conditions to have a better quality of life, particularly through the use of peer to peer networks and groups

· Supporting and encouraging young people to succeed and find employment, for example through mentoring, coaching, and peer-to-peer networks

· Using new approaches to "impact volunteering" to mobilise volunteers to increase and enhance the outcomes achieved by public services.

Through the programme, charities, social enterprises, public services and for-profit businesses can apply for grants of between £50,000 and £500,000.  While applicants can be established in any part of the UK, the benefits of their proposals should focus primarily or significantly on England.  To apply organisations need to submit an Expression of Interest form by the 31st October 2013. Read more by clicking on the birds nesta (sorry)

Artist/Designer for Learning Resource

Tate Liverpool and Mersey Care NHS Trust are seeking to recruit an artist/designer with demonstrable experience of designing learning resources in a variety of settings. 

This is a temporary fixed term freelance opportunity, for a six-month period commencing November 2013 – April 2014. The fee is £6,000.

 The successful candidate will be expected to research, design and evaluate a prototype for a portable accessible learning resource. The purpose of the learning resource is to support individuals or groups in facilitating self-directed learning and engagement with art in gallery and community settings. We expect that within the design concept full consideration of digital tools be explored.

Closing Date for Applications: Friday 1st November 2013. 

Interview Date: Monday 11th November 2013.

For an Artist Brief and information about the application process  contact Alison Jones Programme Manager Public and Community Learning on email: Alison.jones@tate.org.uk

Tuesday Sessions

Mai Abu ElDahab and Anthony Huberman

Tuesday 22nd October, 6.30pm
Camp and Furnace, 67 Greenland St, Liverpool L1 0BY

For the first time, curators of the 2014 Liverpool Biennial Mai Abu ElDahab and Anthony Huberman will discuss the material and methods that have informed their thinking for the forthcoming edition of the Biennial.

Mai Abu ElDahab is a curator from Cairo, living in Brussels. From 2007 to 2011, she was director of Objectif Exhibition, a non-profit contemporary art space dedicated to producing and presenting solo shows by international emerging artists, as well as curating many related events and publications, co-published with Sternberg Press. Most recently, she produced a record of artist songs performed by the band Concert entitled Behave Like an Audience, also with Sternberg Press, 2013.

Anthony Huberman is a curator and writer from Geneva currently based in San Francisco, where he is the Director of the CCA Wattis Institute and Advisor/Founding Director of The Artist's Institute in New York. Previously, he worked as chief curator at the Contemporary Art Museum St. Louis, curator at the Palais de Tokyo, Paris, curator at SculptureCenter, New York, and director of education and public programs at MoMA PS1, New York.

Free, booking required. To book your place, follow this link. http://eldahabhuberman.eventbrite.co.uk/ 

...here's a song that a friend played to me - shared because its lovely.

Goodbye for now...C.P.

Open Dialogue in Nottingham

“The name Open Dialogue was first used in 1995 to describe two key features of the approach: the use of open family/network meetings and a set of principles for organising the whole psychiatric system that made dialogue possible.” Nottingham Open Dialogue group, September 2013

Back in early September I wrote about the conference I went to in Nottingham – Psychiatry beyond the current paradigm. One of the workshops at the event focussed on an innovative approach to mental distress and crisis work called Open Dialogue, and I promised to write more about it in a future post – so here goes.

Before going to Nottingham I had read briefly about the approach in Robert Whitaker’s book – Anatomy of an Epidemic. “Western Lapland in Finland has adopted a form of care for its psychotic patients that has produced astonishingly good long-term outcomes.” You can read more on Robert’s website here. Robert has subsequently referred to the Open Dialogue approach again in blogs and other writings, quoting it as a clear mandate for change. 

So, what happened at Nottingham? Well, first of all, hour one of the session was absolutely Powerpoint free. That was refreshing in itself. A group of people have been meeting informally in the city to look at what is happening in Finland, and several of them had agreed to lead this workshop. They introduced themselves, and explained that they were considering how Open Dialogue could be put into practice locally. They educate themselves at meetings, having a mailing list of about a hundred, and a core 16 – 18 people attend the meetings regularly. Originally they began as people with “lived experience”, but the group has now expanded to include some professionals “which has changed the dynamics”. 

What followed for the first half of the workshop was a dramatisation and replaying of an actual Open Dialogue meeting which had taken place in Finland some years ago. This was extremely powerful, as for those of us attending it really felt as if we were watching and listening to an actual meeting. The professionals involved listened for a long time without saying anything at all to both the person in distress and the close family members. Eventually, when they did speak, they shared their views amongst themselves and allowed the person and his family to listen in. Further dialogue between the whole group then followed, and throughout the session the sense of absolute crisis seemed to gradually ebb away through use of this continued dialogue. There is no video of the workshop, but if you want a feel read “The Story of Pekka and Maija” on pages 411- 414 of Jaakko Seikkula and Mary E. Olson’s article about the approach.

The second half of the Nottingham workshop was used to explore the Open Dialogue approach in more detail and for this a presentation was used, but again group members took turns to explore the different areas. Some of the key points for me were:

• Psychosis is a temporary, radical disengagement from shared communication practices.
• The need to create safety/trust to allow people to express deep fears.
• Stay with the situation as it is, and allow it to develop (without using specific “tools”).
• The reflection that the team does is in the family meeting.
• Results have been better for those who took no neuroleptic medication or had it at a later point.
• Is the medication for the sake of the individual or for those around them, including the team?

The group reported an 85% recovery rate for psychosis using this approach. So that, rather than a growing number of people going on from psychosis to be labelled as “schizophrenic”, there are actually very few people with this diagnosis in this area of Finland. It is actually disappearing.

A film-maker called Daniel Mackler has produced a number of videos on Open Dialogue, some of which are available on the web. I particularly enjoyed his interview of Jaakko Seikkula, Professor of Psychotherapy in Finland (author of the article quoted above), in which Jaakko states: “All of us could have psychotic problems! Psychosis is an answer to a very difficult life situation.” 

I was truly impressed by what the Nottingham group had found out so far, and how they conveyed their learning at the workshop. You can find further links to documents about Open Dialogue on our new website page here – and thank you to Nottingham Open Dialogue for sending us some of these. What can we do in Powys to bring this innovative approach a little closer to us…? Do you have ideas about this? Let us know by commenting below.

Meanwhile, to finish….  Monica Cassani, “a social worker and … a person whose life was severely ruptured by psychiatric drugs”, created the BeyondMeds blog and posts about the mental health system in the United States, and alternative approaches such as Open Dialogue. This week in the UK the BBC reported on the need for more psychiatric beds – in England…. I’m inclined to agree with Monica’s view that maybe, if the Open Dialogue approach was widely adopted just as has happened in Western Finland, then the psychiatric hospital beds (wherever they are in the world) would lie empty…

Set Fire to THE SUN

Ohhh, so much to say this week, but lets start with the popularist toilet tissue that offers radiant heat and robust forensic analysis of current affairs. This week, perfectly timed to enhance the importance of World Mental Health Day, it chose to report on the underfunded state of our mental health care system, which all too frequently misses out against more sensational health priorities. I’m often mindful, that our mental health - our resilience and wellbeing - are important factors in all health conditions. So the SUN are quite right to point out that the care system is on the brink of collapse and that the poorest people - the most unequal people - are the ones at the most risk of ill-health. Hmmm, but is that exactly what they were hinting at? Did they emphasise the horrible isolation caused by mental distress, or all those other associated health problems? Or perhaps they sensitively explored the potentially self-destructive nature of mental ill-health? Lest we forget, the same rag ran the front cover “Bonkers Bruno Locked Up’ in 2003 and its then, (ever-so-slightly-politically-connected) editor Rebekah Wade, was forced by public pressure to change the headline to, "Sad Bruno in Mental Health Home", going on to describe the boxer as a "hero".

This week’s front cover ran the legend, ‘1,200 KILLED BY MENTAL PATIENTS’. If this week, you’ve been facing up to your anxiety, your stress or depression - if you’ve been experiencing the extremes of bi-polar or the isolation of psychosis - this will have really lifted your spirits. I’d like to question, just who are the semi-human monsters that it portrays - the increasingly marginalised people that it stigmatises, or those who write such pernicious crap.

Would I ban the SUN? NO, I like having a free press. I like it that it’s virtually impossible to buy in Liverpool, where solidarity over its wretched ‘reportage’ has seen it removed from shelves (insidious, mainstream, lowest-common-denominator-consumer-porn-light). I just wouldn’t buy it and better still if I found a copy in the street, (I did - it was slightly soiled) I wouldn’t have it in my earth closet, I’d set fire to it.

New pathways into Arts and Health Training 2014

I’ve had a few people contacting me by phone and leaving messages about the arts and health training that I offer. Thanks so much for your interest and the key point about training in Manchester, is that it won’t be happening again until the spring 2014. I’ll advertise it on the Arts for Health website and this blog. So I can’t give any more details than this just yet - but thank you for showing interest.

Working in Lithuania this last week has been an inspiration. Working with Socialiniai meno projektai and meeting artists and designers wanting to develop their practice in arts/health, feels a bit of an honour. Aciu. I spent a good deal of time at the Vilnius University Oncology Institute as a guest of the British Council, and developing arts/health training in such a real and emotionally charged environment was a rich experience for myself, as well as the participants. Thanks for looking after me in Vilnius and for taking me to the Kaunas Biennale and introducing me to the wonderful Fluxus Ministerija. Inspiring and beautiful. The training continues until mid-December, when I’ll feed back on the process and outcomes.

ONE TO LISTEN TO

Artist Grayson Perry will be giving the Reith Lectures this year on BBC Radio 4 starting on 15th. They will be available as podcasts too. Click on the quality gauge for more details.

All That is Solid Melts into Air

Not seen it yet, but this Jeremy Deller curated show in Manchester is going to be juicy! Click on the image for more details.

COMMISSION

The Central Laser Facility produces some of the world’s most powerful light beams, providing scientists with an unparallelled range of state-of-the-art laser technology. The Beam Time residency offers a unique opportunity for an artist to engage with scientists and their research using state-of-the-art lasers including – Vulcan, Gemini, Artemis, Ultra and Octopus - which can recreate the extreme conditions inside stars and planets; reveal intricate detail of molecular interactions on a microscopic scale; act as 'tweezers' holding the individual micro-droplets that make up clouds; and take snapshots of chemical reactions in action and electricity travelling through material.

On offer: £3000 artist fee, £350 travel expenses

Deadline for applications: 10am Monday 25 November 2013

Eligibility: Any visual artist living and working in England who has been practising outside of undergraduate education for a minimum of 5 Years is eligible to apply. Applicants may not be enrolled on a course of full-time or part-time study during the residency period.

Great Britain Sasakawa Foundation Grants Programme 

Organisations and schools in the UK that wish to develop links with Japan and Japanese schools are able to apply for funding through the Great Britain Sasakawa Foundation. The Foundation makes small grants to support activities that support the study of the Japanese language and culture, School, Education and Youth exchanges. In the past the Foundation has made grants towards visits the between the UK and Japan between by teachers and young people and the teaching and development of Japanese language and cultural studies in schools.

The next closing date for applications is the 15th December 2013. Read more at: http://www.gbsf.org.uk/

RED/GREEN HARVEST VARIANT

What can I say? Thank you...C.P.

What You May Not Know about ADHD

By Ahmed Khan, MD 



Attention-Deficit/Hyperactivity Disorder (ADHD) is an illness that affects many people living in this country. It's reported that 7-10% of Americans have ADHD - a disorder that alters one’s attention and concentration in a negative manner. 



Oftentimes, parents and children conceptualize this lack of attention and concentration leading solely to problems at work and school. Unfortunately, ADHD has a number of adverse health outcomes that you may not be aware of. Hopefully my post will help you understand the various adverse health outcomes associated with ADHD.

Substance Use and Smoking: Several studies show a significantly increased rate of substance abuse disorders and smoking in patients with ADHD. This could be due to the increased impulsivity apparent in many people with ADHD.



Sleep Problems: It's pretty clear that ADHD leads to dysregulation of sleep. This is often displayed by resisting sleep at bedtime, difficulty falling asleep once in bed, and problems awaking in the morning.



Car Accidents: Did you know people with ADHD have a higher risk of traffic violations and car accidents? Some studies found this to be due to increased risk-taking behavior and poor frustration tolerance.



Physical Injuries: Studies have also revealed children with ADHD can have almost twice the injury rate as those without it (20.4% vs. 11.5%). A study looking at an insurance data base of over 100,000 people, from children to adults aged 64, found that those with ADHD had 1.55 times greater chance of injury versus those without ADHD.



Risky Sexual Activity: Studies suggest that the impulsivity, poor self-esteem, and risk-taking behaviors that are prevalent in people with ADHD can lead some to engage in risky sexual behavior and increase their risk of receiving and transmitting sexually-transmitted diseases.



Obesity: There is no direct correlation between ADHD and obesity yet, but some studies show that children with ADHD are more likely to be obese than those without it. This could be due to various reasons, but researchers are looking at genetic similarities between the two conditions which could provide more insight in near future. 

So, did you learn something new about the often misunderstood ADHD? I hope my post provided you with a better idea of the toll that ADHD can take on one's life. With a thorough diagnosis and proper treatment by a trained psychiatrist, a person with ADHD can greatly limit these adverse events and, many times, avoid such negative health issues all together. 

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Unconventional Wisdom: Exploring The Language We Use Workshop and Poem

Philip, Eleanor and Owen working on the poem

Yesterday, 9th October 2013,  I took part in the Powys DIY Futures Celebration Event in Llandrindod Wells.  I for one really enjoyed the event and the chance to talk to so many people.

I ran a workshop called “Exploring The Language We Use – Mental Health”.  You can read more about this below.  

The following poem, being worked on in this picture, was inspired by the workshop and written by the some of those who took part in it.

The Poem By Philip Moisson, Eleanor Barrow, Freda Lacey, Jill Dibling and Owen (Wordsmith for the Day)  

Der dar ... The Poem

More about the workshop: “Exploring The Language We Use – Mental Health”

Us all ... in action ...

The aim of the workshop was to discuss, explore and raise questions around the mainstream language that we use in the field of mental health.   It was not aiming to search for the right words or the words we think we should be using.  

It was not aiming to judge the words we do use.  Instead the aim of the workshop was just to look more closely at the language we do use and hear often.
 


We did this by taking 4 common sentences and asking two participant actors to speak the words to each other.  

One actor was identified as a psychiatrist, another her patient.  The rest of us bore witness to the sentences being spoken.

We were then asked to explore the simple sentences used by breaking the words that were spoken down into three areas:

• The actual words spoken – explicit meaning
• The context of the words spoken – identifying power, authority, emotions
• The assumptions underpinning the words spoken - the unsaid, the unspoken, the unchallenged facts

12 people took part.  The following pairs of sentences were discussed:

You are a service user.  I am a service user

You have a chemical imbalance of the brain.  I have a chemical imbalance of the brain

I am manic.  You are manic.

I am a carer.  You are a carer.

Feedback from the event!

I felt privileged to work with people who were willing to be so open, enthusiastic, thoughtful and supportive. 

I would like to thank those that took part for their time, their ideas, their kindness and their laughter.   

Laura G

Choosing a Raleigh Dentist

 If you live in Raleigh, NC and are trying to choose a new dentist, you could easily face a dilemma when you start trying to narrow the field to suit your own purposes. Most of the state is underserved when it comes to patient/dentist ratios. Not so for Raleigh, perhaps due to the presence of the nearby UNC Dental School. Ignoring for a moment the existence of clear subspecialties of dentistry (such as oral surgeons and periodontists), there are more than 250 general dentists in Raleigh from whom to choose!
Because there are so many general dentists in Raleigh, many choose to focus on a specific audience, such as children (pediatric dentistry). But you may become confused about what services other types of dentists are actually making available to you, especially if you read the promotional materials for Raleigh dentists. All of the categories that follow are merely areas of focus that, like pediatric dentistry, have to do with the type of people a Raleigh dental practice is trying to specifically serve. This is, after all, an age of specialization, and it just makes good sense for dentists in Raleigh to be responsive to needs of different types of patients. The same approach for choosing a dentist cannot be used successfully in many other areas of the state of North Carolina - especially rural areas, where one or just a few dentists may be trying to serve the needs of an entire county. (That's why plans for a second dental school in the state were recently launched.)
To help you sort through your confusion if you live in Raleigh, the categories most often used by general dentists in the area are defined below. These definitions are provided to assist you in making the best choice possible for your circumstances. The definitions are informal; most being neither formally defined by the American Dental Association nor by the NC Dental Board. Except where indicated in the definitions, there are no specific regulations that govern them. The NC Dental Board requires that all general dentists meet certain guidelines, and general dentists in Raleigh may opt to call themselves any of the following (except where additional requirements apply and have been noted below). In Raleigh, using the first four categories - if they are applicable to your needs - is one of the quickest ways to narrow the field of 250 dentists significantly. If you have needs for Sedation Dentistry, you will narrow the field even more quickly. (Raleigh had only six NC Dental Board certified providers of Oral Conscious Sedation dentistry in June 2009.)
-Cosmetic Dentistry - Dentists who perform work that is primarily aesthetic in nature - in other words, they provide services that will enhance your smile.
-Sedation Dentistry - Dentists who provide additional sedation services (beyond the "standard" anesthetics used by most general dentists) to help manage anxiety and sensitivity to pain. Effective in 2009, the NC Dental Board now regulates the administration of sedation by general dentists - requiring both special training and experience for those who provide sedation services. There are different levels of sedation permits. Most patients who experience anxiety or have sensitivity to pain can be served by the level known as Oral Conscious Sedation.
-Implant Dentistry - Dentists who provide dental implants (replacements for your natural teeth), which are an alternative to dentures and bridges, or may be used in conjunction with them to provide greater stability and/or an improved, more natural appearance.
-Comprehensive Dentistry - Dentists who are interested in being full-service providers for their patients - sparing the patient/family from frequent referrals to specialists. Their services may include cosmetic and implant dentistry services, orthodontic services, and periodontal treatments - in addition of preventive dentistry services. These dentists may have more extensive training in order to offer the broader range of services. (Check the experience.) In addition to convenience, they offer an ongoing and full understanding of the patient (needs, preferences, expectations, general health) to make all aspects of dental care more customized and easier for patients. This is a relatively new type of practice in Raleigh, although rapidly gaining popularity.
-Preventive Dentistry - Dentists who focus on the preservation of healthy teeth and gums and the prevention of cavities and oral disease. All general dentists have training in preventive dentistry, as well as restorative procedures (fillings, crowns, etc.) needed to preserve oral health. Preventive dental care is more likely to be at least partially covered by dental insurance, while cosmetic dentistry services often are not.
-Family Dentistry - Dentists whose focus is on treating patients of all ages (as opposed to pediatric dentists). Family dentists often place primary focus on providing preventive dentistry services, rather than cosmetic dentistry services.
Now that you understand the differences in types of general dentistry service categories that exist for Raleigh dentists, don't be confused if you find that some dentists fall into more than one category. Pick as many categories as you feel apply to your own or your family's needs. Because Raleigh dentists are situated in the state's "cradle of technology," most are likely to have websites that state what their areas of focus are. This is particularly true of dentists who fall into the first four categories. More than likely, you can locate the type(s) of dentists of interest to you by using a search engine, and then explore what each dentist's range of services and experience is within any given focus area.
Even in technology-savvy Raleigh, you may find some Family Dentistry and Preventive Dentistry providers who do not have websites and prefer to focus on the more "traditional" range of general dentistry services. They may choose to limit their listings to conventional print phone advertising directories, or general online directory listings. Remember, too, that Comprehensive Dentistry providers usually provide Family and Preventive Dentistry services, in addition to their broader range of services.
Use the categories identified in this article to help you decide which types of services you want - both now and in the future. Narrow the field down to a much smaller number of Raleigh dentists who are a good match for your needs. Then, contact the ones that look like the best match, and ask any additional questions that might not be answered on their websites or other information that has been made available to you about their practices.
Experience Matters!
As you begin the final round of evaluation to find the general dentist in Raleigh best suited to your needs, remember that experience is very important to consider, too. Check the initial training of the dentist, but also consider what types of additional clinical experience the dentist received, in addition to the number of years he or she has been in private practice. From a reputation standpoint, how long has the dentist been in practice in the Raleigh area? If you plan to use cosmetic or comprehensive dentistry services, it may be helpful to ask about the number of similar procedures your prospective dentist has performed. Certainly, looks matter when it comes to cosmetic dentistry results, but function and oral health are very important to preserve during the smile enhancement process.

A leading Dentist in Raleigh NC provided these general guidelines for selecting a general dentist in the United States. He is a leading Practicing Dentist in Raleigh NC and is committed to offering high quality dental services and exceptional patient care. The practice provides a wide variety of dental treatments.

A Few Simple Tips For Finding A Great Dentist

Finding a great dentist isn't easy. Whether you live in Hawaii or Wichita, this can be a daunting task, especially if you haven't been to a dentist for a while. But look no further, than this article. Finding a dentist is easier than you think if you simply apply the tips that follow.
Ask People You Know
A great way to find a dentist is to ask other people that you know and trust. Ask your family, colleagues or friends. Often they will have good recommendations. In addition to asking what dentist they recommend, ask about other qualitative factors. Find out if the dentist is friendly, has a nice waiting room and has a great staff.
What if you are new to an area?
If you are new to an area, you may not know anyone who can recommend a great dentist. So what do you do in this scenario? Ask credible people who are in a position to know who the best dentists are. Often hospitals and other health facilities employ the services of a number of dentists. So they are in a great position to know who the best dentists are. All you need to do is call them up and ask for a recommendation.
You can also ask a local dental school. Dental schools are in a great position to know who the best dentists are in the area. In addition, dental schools may even offer lower rates than a regular dentist for dental care. Sure, you will have students performing your dental care, but they will be well supervised by extremely experience dentists who know what they are doing.
Use the Internet
Now days, everything is on the web. Search for a website that lists dentists in your area along with patient reviews. Look for a dentist that is convenient for you and also look at their reviews. Make sure that their patients have a lot of good things to say about them. And if a dentist has a lot of negative reviews, look elsewhere.
Also visit the dentist's website. You can learn a lot by checking out their website. Does the dentist offer all of the dental services required to meet their needs? You can also get a feel for the dentist's personality by the way they have designed their site and what they talk about on their website. And if the dentist has posted a video, then you are really in luck. You can get a good sense of their personality too.
Special Dental Needs
When choosing a dentist, you should also consider your special dental needs. If you have healthy teeth, choosing a dentist is easier as all dentists are able to do the basics like cleanings and taking x-rays. But if you have crooked teeth you may want a dentist that specializes in orthodontics. Or if you want your teeth to look better you may want a dentist that specializes in cosmetic dentistry and so on.
Check Your Dental Plan
Another great way to choose a dentist is to look at the dentists that are pre-approved by your dental plan. In this case, you will already know that they will accept your dental insurance. But you should be sure to ask a lot of questions to confirm that they are the right dentist for you.
Call the Dentist
Once you have narrowed down your list of potential dentists, call them. See how you are treated on the phone. Confirm that they take your insurance. Find out: how to get to the office, what their business hours are and how they handle dental emergencies that are outside of their business hours.
Take a Test Drive
Some dentists will offer free consultations or even free cleanings to prospective patients. Take them up on their offer. You will get free service and also a chance to chat with them so that you can see if you get a long.
Don't Get Taken for a Ride
Some unscrupulous dentists will try to sell you services or treatments that you do not need. In this situation, go with your gut instinct and get a second opinion from another dentist if you are unsure that any treatment is not right for you.
Also, some bad dentists will post fake reviews on review websites. So always take the reviews that you see on these sites with a grain of salt. Make sure that the reviews align with your experience with the dentist and look elsewhere if they do not.
Remember you don't have to go with the first dentist that you find. If you are not happy with them in anyway, keep on looking. Eventually you will find the right dentist for you and your smile.

Smoking and snacking? Saving lives, or life-saving?

by Freda Lacey

The real voyage of discovery consists not in seeking new landscapes, 

but in having new eyes.     Marcel Proust

My life turned for me when I fully accepted what this saying meant many years ago now and I have been reminded of it again, through a recent meeting of Powys Patients’ Council, Felindre Ward, Bronllys Hospital.

I facilitate Powys Patients’ Council, a project which promotes listening to patients’ collective “voice”, in this case, whilst people are staying in the acute mental health in-patient unit at Bronllys. Some volunteers and I visit people once a month and listen to their concerns or issues. We then feed these back, anonymously, to ward management for resolution. If necessary, we also escalate issues to senior health board staff if we do not achieve resolution through ward management. Powys Patients’ Council has been running in Powys since 1989. I took over facilitating the project six months ago. Several volunteers work with me and they all have experiences of being in hospital themselves. 

Last week at Patients’ Council, we had an unusual meeting in that six people joined us. Collectively, there were two main issues they all raised, but another one, has been rumbling for some time now. 

When I left the ward last week, I realised I was feeling all sorts of feelings - anger, sadness, compassion, delight, amazement, warmth, empathy. I have also been feeling something else that I hadn’t acknowledged until just now, writing this, and it is a deep sense of connection. These feelings have led me to want to write about the issues raised during our ward visit and a question I have, is “Smoking and Snacking, life saving?" 

I saw a statistic recently that indicated 47% of tobacco in the UK is consumed or bought by people who have been diagnosed with having a mental illness. In researching a bit more about this, there are a great number of articles on the web that could be viewed as supporting this statistic. Most of the documents describe, in some detail, what is bad about smoking. If you type in just that “why is smoking bad for you”, you’ll get approximately 92,400,000 responses. We all know the reasons smoking is not beneficial for people’s physical health, I don’t need to add one more to this.
Instead, I want to ask a different question. How many responses would come back if I asked “Does smoking save lives”? Interestingly, of the 6,580,000 responses that came back, most on the first page were related to “stop smoking and save lives”. 

You see, most of the people I come into contact with, on a weekly basis, if they are connected with mental health services, smoke. I have spent most of my adulthood finding smoking very difficult because of the links between smoking and my Mother’s death just before I turned 12. 

However, I find myself questioning my relationship and judgement of smoking and this has certainly increased since the recent Patients’ Council. I found myself asking why? 

Why do most people I’m in contact with as part of my role, smoke? I didn’t feel comfortable about asking this question of people but I did find this article thought provoking, particularly the list of positive intentions the author relates to smoking. 

I wonder if some of these “positive intentions” are why people, especially if they are involuntarily placed in acute mental health in-patient units, not only depend on smoking, but actually need to. I wonder what would happen if people weren’t allowed to smoke, what affect this may have on their state of well-being? I wonder if people are trying the best they can to exercise some of their own control over their feelings and emotions and are in fact, choosing to self-medicate, especially if they feel they are not free to exercise control over most other aspects of their stay in hospital. I wonder if, in some paradoxical way, the fact that people are given medication to suppress or regulate severe emotions, if choosing to smoke is, in fact, trying to do the very same thing as the medication people are prescribed. The only difference perhaps, is free will?

The ban of smoking in public places has had an effect on patients in hospital settings. Indeed, a full ban on health sites in Cardiff and the Vale of Glamorgan, as of 3rd September, 2013, is being implemented with the recruitment of a “smoking enforcement officer”.

I’m wondering if any thought is being given to patients’ choice in this enforcement, especially people who are obliged to stay in hospitals and/or in-patient units, for long periods of time. Will they be forced to stop smoking altogether, or given no choice? I came across this article on a patient in Scotland and some more in-depth reasoning about why smoking should not be enforced here. 

The next issue raised by patients is intrinsically linked with the constancy or need to smoke whilst staying on the ward. One of the patients spoke very poignantly of how grateful he’d been last week, when two medical students had taken time to play a game of scrabble with him. Of the six people who came to speak with us last week during Patients’ Council, all of them spoke of the need for more activities on the ward to keep them occupied. The man went on to say that because of this, he was focusing more on his issues, he started to feel worse and then he found he was smoking more. Another woman told us she hadn't smoked before arriving into hospital, but she’d taken it up because she felt there was very little to occupy her.

So, this process could be seen as a cycle:

When you look at the reality of staffing issues on Felindre Ward, they are down one Occupational Therapist at the moment, due to a staff member leaving. The only other Occupational Therapist on the ward tries to run regular cooking classes which are successful and wanted but she also spends time assisting people to return home and helps manage this transition. So, if she is off the ward, there isn’t much for people to do. We will be raising this as a key area of concern or an issue in the next few months.

The final point relates to food and particularly, the removal of “Vending Machines” from Felindre Ward. Again, there has been a directive from Welsh Government that only “healthy” snacks will be sold within hospitals or health centres. This feels very akin to the smoking ban or enforcement and while there is no dispute about the health reasons for enforcing only health snacks or food to be dispensed through hospital facilities, this could be seen as taking away a patients’ right to whatever food they wish to eat, when they wish to eat it.

The vending machines were removed (and it’s not very clear why) but they only sold drinks anyway. While there is a snack trolley which comes around once a week, patients are obliged to ask staff to go off-site to a garage to purchase snacks for them, not to mention, cigarettes as most people are unable to leave the ward. We had a meeting about this issue today with ward management and we have found very good alternatives to the lack of vending machines, such as an on ward store of snacks, including chocolate and extra trolley possibilities, staff have been very helpful in trying to come up with alternative solutions.

However, it was also interesting to hear today that one man, currently in hospital, is asking for increased amounts of food, but it is due to the medication he is taking and the side effects, that of increasing appetite. Staff were indicating that they’d have to control or not allow him extras as he may not be aware of how much he’s actually consumed as his body is still telling him, he’s hungry. Staff will have to monitor more closely people’s consumption of snacks (such as muffins or biscuits), etc. I found this article of interest, particularly a point made that “75% of overeating is caused by emotions, so dealing with emotions appropriately is important”.

It appears a great deal of time is spent, both by staff and patients, trying to cope with emotions or feelings that may be coming up. What’s really come up for me, this last Patients’ Council are the ways people are trying to cope and while it’s never definitive, most people seem to be smoking to help themselves and are desperately trying to fill their time up with other things to occupy themselves. Perhaps for some people, they use food. 

I’m curious if choice is taken away from people in hospital environments, the ability to choose to smoke or not, eat snacks or chocolate or drink fizzy lemonade or not, choose which activities they can do or not, are we truly expecting a compliant patient or “rather catching a tiger by its tail”.

7 Things to Keep in Mind When Finding the Right Dentist for Your Family

Is your dentist providing you with the best services you require? Are you having difficulty deciding who to give the responsibility of keeping you well informed about your teeth? Are your teeth in the best care they can possibly be in? These are the critical questions every patient should consider when seeking aid concerning dental care. Having an unqualified dentist can be the difference between a set of perfectly healthy teeth and a dental disaster. Here are a few tips that can serve as a guide for finding the right dentist for you, your family, and your loved ones.
1.) The word around town
The first thing you should do when looking for a dentist is to ask around. If you think that performing a small research on the person who will be responsible for you and your family's dental care is too 'stalk-ish', then perhaps you need to educate yourself on how important your teeth are to you. Do not be afraid to ask around about dentists you may have found or heard about. Many life situations have shown that good information about other people can be gathered from others who have also gone through the same.
2.) Do your homework
Nowadays, you can find plenty of the information you need right from your desk at home. The Internet is a good place to start when you have a few names in mind. Find out as much as you can about the backgrounds of the dentist you are about to take up. As classy as a dentist educational history may be, take care to also check how much experience your future dentist has had. Official recommendations from other institutes and even other dentists can help you decide whether the dentist is right for you and your family.
3.) What is there to know?
Now that you know who to ask about the dentists in your area, what kind of information are you looking for? Not only should your dentist be able to give you all the preventative information about your oral health, you also need to be comfortable with asking questions and sustaining a friendly relationship with the professional. You need to find a dentist that you can trust. This is far easier to achieve if your dentist is friendly and communicative. For this reason, it is crucial to book appointments and meet with the candidates. Like in any relationship, you need to know whether your dentist is someone you will be able to work with in a long run.
4.) While you're in...
Now that you are aware of the importance of making appointments with your dentist candidates, take the opportunity to perform a different kind of investigation. Just like a person's bedroom says a lot about their personality, so does a dentist's office. It is not a bad idea to look around and be attentive to your dentist cleanliness. A office that in not well-kept will not only present further health risks to you and your family, it will also tell you about your dentists work habits. A good dentist does not only practice hygiene and organization during operations but also in other areas. Negligence, just are cleanliness, is a habit.
5.) "You get what you pay for"
Although the most expensive dental clinic in the area is not necessarily the best choice for your family, it is important to understand the fundamental necessities for a good dentist. Shying away from paying a few extra notes could lead to larger cost in the future when you find that your dentist is ill-equipped for an important procedure. A dental clinic with all the facilities will not have to send you around town for various procedures. This will save lots of time and energy. That is why it is important do your research and find out exactly what a common dentist should have. Good equipment may not necessarily mean expensive. What is important is that all the equipment is in proper working order and is always clean.
6.) When trouble comes
Imagine a scenario, perhaps very early in the morning, when you need an emergency visit to your dentist, will your dentist be available? The availability of your dentist is also an aspect that deserves keen attention and thorough thought. How far is your dentist? What are the open hours? Depending on your needs, these questions may be the deciding factors for your new family dentist. If your dentist is more than a 30 minute drive away, then it is time to think about whether the drive is worth it. On another note, make sure the working hours of the dentist are suitable to your family's needs. The decisions you make now based on these questions will save you lots of trouble and pain in the future.
7.)There is a fit for everyone
The most important thing to remember when finding the right dentist is that there is no perfect dentist. The right dentist for you and your family solely depends on you, your needs, and your circumstances. You need to weigh all the aspects that have been treated earlier and find the right balance. You may not be able to afford the most expensive dentist, but you may not need to. Many dentists are qualified enough to do a good job of taking care of your family's oral health. Your first priority should be making sure you are well informed about your health and maintain a healthy communicative relationship with your dentist.