Swimming pools and skin problems

I wonder if the oxidising chemicals in swimming pools can exacerbate the formation of skin lesions in older and more susceptible people? Lots of my friends at aquarobics have had various small skin cancers other suspicious-looking lesions removed from their skin. Of course we are all at the age when most lesions show up, but is the pool water causing more lesions than we might have experienced otherwise? Most of us attend aquarobics for 2 hours each week and some have home swimming pools as well.

My skin is no gauge, however, since it is that pale European shade that goes with red and sandy blonde hair. It is very susceptible to skin cancers, plus I had multiple bad sunburns as a child and even as an adult. I have only had 2 tiny skin cancers frozen off with nitrogen, one on a forearm and the other next to my nose near my eye.

When I visited a dermatologist after nearly going insane with itchy growths on my scalp he found a suspicious lump near the back of my neck. The head lumps were not even worth investigating! But the back one made him exclaim "I think we have a cancer here!" That gave me the heeby jeebies as I had no idea it was there; so the doc ordered a biopsy and I had to wait two weeks for that appointment.

It occurred to me that anti-oxidants might be good for curing, or at least shrinking, a rough, dry skin patch so I slathered the spot with rosehip oil every day until the biopsy. Please don't treat yourself before seeing a doctor! I certainly don't. I always ask my GP about any "suss" new moles or rough patches and she usually has an answer. When in doubt she sends me straight to the dermatologist.


Meanwhile the biopsy was done and the result was negative! The dermatologist was quite surprised and I was very relieved. Probably the growth was not malignant in the first place, but it was certainly benign when the sample was punched out! Now I routinely apply rosehip oil to any strange, rough or extra-dry spots on my skin and have had no further skin cancer diagnoses.

Yesterday I came across this article which seems well-written and seems quite relevant for people with concerns about pool chemicals. And I am NOT a person who has worries about our lives being ruined by "all those chemicals" that are everywhere these days.

The chemical reactions taking place in your swimming pool

Dear readers, please look up your own references as I have a pile of 37 drafts for blog posts that I haven't put up because I was worried about references!

Article from c & en. Chemical and engineering news. Published by the American Chemical Society. Permission to re-publish sought.


This is the published standard for maintaining pools and spas in South Australia:

http://satic.com.au/images/uploads/documents/6592_SAH_Pool_Standard_Jun13.pdf


All sensible comments welcome.

Fixing Africa. The whole shebang including health.

African governments aren't taxing the rich. Why they should

Rhiannon McCluskey, International Centre for Tax and Development

A great deal of attention has been paid to the obstacles African governments face in effectively taxing the profits of transnational corporations. African governments are frequently urged to widen their tax bases by reducing tax incentives for foreign investors. But what about Africa’s rich? Some Africans are very rich, and in many cases they are not paying their fair share of taxes.

The number of super rich on the continent is growing fast. According to New World Wealth, the number of high-net-worth individuals (people with assets over $1 million) in Africa rose at twice the pace of the rest of the world in the past 15 years. Its 2016 Africa Wealth Report states there are about 165,000 high-net-worth individuals in Africa, with combined wealth of $860 billion. More ultra high-net-worth individuals (with $30 million or more in assets) were created in Africa since 2003 than in any other region of the world. According to Wealth Insight, there are 1,932 in Africa.

But it is challenging for African governments to tax the wealthy.

Why collection is so hard

One of the reasons is the challenge of taxing income in economies that are highly informal. In Organisation for Economic Cooperation and Development countries, personal income taxes make up about a quarter of all tax revenue collected. In Africa, they only make up about a tenth on average, and as little as 4% in countries like Uganda and Rwanda. This is primarily – up to 95% – collected from employees of formal businesses through the pay-as-you-earn system. Self-employed professionals generally evade taxes and formal employees often engage in informal business on the side.

This informality contributes to African tax administrations lacking information on which citizens are high-net-worth individuals. In Kenya, only 100 high-net-worth individuals of a likely 40,000 are registered with the tax authority. In South Africa, up to 114,000 high-net-worth individuals are unregistered, costing the government about $10.9 billion in tax revenue.

It is also hard for African governments to tax the rich because they hide their wealth using the offshore financial system. Gabriel Zucman, from the London School of Economics, estimates that 30% of all African financial wealth is held offshore, amounting to about $500 billion. This means African governments are losing out on roughly $15 billion in taxes from individuals annually, and this does not take into account non-financial wealth. In 2015, Swiss Leaks revealed that HSBC Switzerland alone held more than $6.5 billion for clients from sub-Saharan Africa.

Uganda as a case study

A recent study undertaken by the Uganda Revenue Authority with support from the International Centre for Tax and Development, revealed the extent to which the political and economic elite evade taxation in Uganda.

The researchers examined lawyers from top commercial law firms and found that out of a group of 60, only 12 had paid personal income tax in 2012, and only 13 did the following year. The team also investigated individuals who paid large import duties. They found that although 12 people paid more than $180,000 in customs duties in 2014, none of them had paid personal income tax.

The researchers also investigated the links between government officials, business and tax compliance. Looking at a group of 71 high-ranking government officials owning large business assets (like hotels, schools and media houses), they found that only one had ever paid personal income tax between 2011 and 2014. Further, the companies the officials were associated with were largely non-compliant, with 47 out of 56 not paying any corporate income tax in 2013.

Political challenges

Increasing tax compliance among the wealthy is challenging because economic elites have great political influence. They are also often members of the political elite. In Kenya, for example, the government tried to implement a capital gains tax on the sale of property and shares, but was forced to scrap it due to resistance from business.

Uganda tried to introduce a system requiring income tax clearance from people buying land valued over $18,000 in 2011. This was also stopped due to political pressure.

Still, great progress is possible. Spurred by the results of the study mentioned above, the Uganda Revenue Authority established a high-net-worth individual unit in September. The new unit has been a significant success, raising an impressive $3.3 million in revenue by February.

Although enforcing tax compliance among the rich can generate significant additional revenue, what is at stake is much greater. The injustice of those with the most money not contributing to the public purse erodes the legitimacy of the whole system, leading those with less to feel even less willing to comply. As Ugandan researcher Ronald Waiswa said:

If you let the big crocodiles swim freely, the small fish will follow.

Rhiannon McCluskey, Researcher Officer, International Centre for Tax and Development

This article was originally published on The Conversation. Read the original article.

One of the quietest and best public health achievements I have come across. Guinea worms OUT!

Thank you Jimmy Carter and Motherboard.

"Toxins" don't exist

As I've been telling anyone who will stick around long enough for decades YOU CANNOT DETOX YOUR BODY!

Human bodies have evolved to de-toxify themselves, mainly via the liver and kidneys. There are substances which are truly toxic to some individuals, or for all of us, but we don't tend to have "de-toxifying" regimes thrust on us for those. For people with Wilson's disease the toxic substance is Copper and for the rest of us it can be excess headache tablets in the form of paracetamol/acetominophen. As that reference tells you, even a small overdose can be fatal! As a freely available over-the-counter medicine in most countries, we should give the community Public Health reminders about Paracetamol's easy toxicity.

Finally, a prominent and popular newspaper has made a headline out of it. You could do worse than reading this article from the Guardian. [Copyright rests with The Guardian].

You can’t detox your body. It’s a myth. So how do you get healthy?

I definitely agree - obesity reflects the food environment.

I wish I had written this piece!

Jacob Shelley presents the case for simplifying health policy by framing obesity as an accidental risk from a calorie-heavy food environment. Children learn to eat too much for their energy needs from parents and others who encourage over-consumption. Since when have you seen parents encouraging toddlers to move more?

www.biomedcentral.com/content/pdf/1471-2458-12-1042.pdf

And apparently, parents aren't very realistic about their toddlers' size anyway...

http://pcmlifestyle.com/2012/05/is-your-toddler-overweight-study-says-most-moms-cant-tell/
[Image credit: from the linked article "Is you toddler overweight?"]

Don't mess with my insides, OK?

Flexocrats: The Donut Is Not The Problem, It's Us

It's all very well to say we have to live in the same food-abundant and exercise-deficient environment no matter what happens in Westernised economies, but I don't want you messing with my insides! Having distrusted aspartame and Xenical for their "interference" with bodily "expectations" of nutrition and thus metabolism, I don't want to see scientists invent something that will artificially speed up my metabolism and do untold harm to another aspect of it! What if they discovered something that worked fine for about five years and then started to turn your liver cells into cancer because their functions had been subverted?

I still say we have to establish old-fashioned habits in childhood and make the environment fit the human body, not the other way round. Farmers could even get better prices for their produce if it wasn't put through all the artificial processes we impose on food so we can put it in plastic and make it last forever!

Teaching the public the truth about food and obesity

Brief 4: Public engagement with science - NeuroFAST, NeuroFAST

This account of a presentation about food, addiction and obesity is so good it makes me want to get something like this started in Australia. I thnk it would be worthwhile for the government Preventive health Taskforce or a sponsored NGO to tour the whole country. The style of presentation and inclusion of the audience in the nitty gritty of debate seems as good as any I've heard.

Let's give it a go!

LGBT support group sign removed at Festival by Lord Mayor!

Twenty10 - a place to be you

I believe that discrimination against support groups for LGBT citizens is a Public Health issue and that we need action on the following:


I complained about the behaviour of the Lord Mayor of Parramatta in ordering the removal of a sign promoting support services for gay, lesbian & transgender citizens and youth at the Rediscover the River Festival on 17th January 2013.

The sign from the Twenty10 Organisation was not offensive in the eyes of the vast majority of people who saw it, on report of local individuals (not me, but relatives in Parramatta). My attention was drawn to the matter by my trans-gender cousin (F to M), on Facebook, where a good deal of anger has been generated.

Banning this sign is not in agreement with national or state government policies and I doubt it is  congruent with their own council policies. I noted that the words "gay", "lesbian" and "homosexual" do not appear on the entire council website, although they do include a sexual health clinic in their community services links: 
Parramatta Sexual Health Clinic Phone: 02 9843 3124 Fax: 02 9893 7103 Jeffery House, Level 1, 162 Marsden St, Parramatta 2150 

The council states in their "Year in Review" publication that they are against discrimination, inlcuding that against new and emerging groups:


Some of Council’s services, such as running libraries and 
childcare centres and collecting waste and recycling, 
are easy to see. Behind the scenes, Council continues to 
look after members of the community who are less able 
to look after themselves because of age, disability or 
discrimination, including new and emerging communities. 
We lobby other tiers of government on key issues like 
transport and housing. 

NSW state law says it is against the law to vilify or discriminate against people who are homosexual nor their relatives; not even against people you think are in a sexuality-associated social group. Is somebody going to report this highly influential Lord Mayor? Come on somebody!

The Australian Government in line with the Human Rights Commission also has anti-discrimination laws that can be enforced in situations resembling the Parramatta case.

Mayor makes city policies to boost mental health

Somerville: the city where policies are based on how happy they make residents

This sounds like an advance for public mental health that could be tried in many other places! Does anyone know of examples where they reside? I wish the Adelaide City Council (South Australia) had asked the residents of the entire metropolitan area before spending our rates and taxes on yet another sports stadium renovation.

Not only does Adelaide have plenty of mentally ill homeless people who live in the city centre, sheltering in parks and gardens, but it also has homeless and displaced people living in quite well-concealed tents in the parklands. They recently decided to evict them all, and a homicide resulted.

We Have Lift Off!! at PLoS Public Health Blog

Have a look here on PLoS blogs, where a separate Public Health stream took off on November 27 2012.
We Have Lift Off!!

No health without public mental health!

This was the title of the Royal College of Psychiatrists position statement in October 2010, see:
http://www.rcpsych.ac.uk/pdf/Position%20Statement%204%20website.pdf

Quote:

...costs of mental illness will double in real terms over the
next 20 years [98]and it is also expected that demand for health and mental
health services will increase as a result of unemployment, personal debt,
home repossession, offending and other forms of ‘economic fallout’[245].
A strategy which invests in promotion, prevention and early intervention not
only can reduce the burden of mental ill health and inequality but also makes
sound economic sense [246]. page 31.

Have we seen any signs that mental health promotion is taking hold in the UK or elsewhere since the Global Financial Crisis put the contrast between needs and compulsory funds reduction in the spotlight?

I haven't gone into the background on this topic yet, but I'm certainly intrigued enough to make a study of it over the next few weeks. Has anyone else discovered any evidence that national health systems have extracted their digits??

On the positive side, I have heard of early intervention centres for psychosis and other youth mental health difficulties having success with numbers of individual cases in Australia. There has been no news about the category I'm in: mature, unemployed skilled white-collar workers, suddenly deprived of income, ineligible for pensions or state benefits and very depressed. Yet the RCP report (above) mentions my category as a real standout in the push for greater consideration of mental health as a public health, community-wide issue.

In Australia, we were dismayed by the dismantling of the Better Access to Mental Health Care Program (known as Better Access by most), cutting the number of mental health care visits available on Medicare (the national health insurance scheme paid with 1.75% of income) to people without extra private cover. Worldwide it is known that the lower socio-economic strata have worse health and more worries to contend with, yet they are the ones worst hit by cuts to publicly subsidised services. Hello, rich company executives... do you want your workers collapsing in nervous heaps, becoming unproductive and ruining your bottom line? How about campaigning for better value for everyone's health dollar so that you'll receive better returns on your investment dollar??

Since psychiatrists put out the rallying paper two years ago, psychiatrists haven't been noticeable on their soapboxes calling for better care for their less well-heeled neighbours. One or two psychs in Australia have been heard uttering encouraging phrases,, but most are still attending drug-company sponsored seminars and social activities- they're not down at the local community centre joining the depressed and unemployed on any mutually engaging tasks! My own shrink seems personally more warm and willing to try less well-tested aids to recovery, and I have certanly benefitted. However, she really has NO IDEA "how the other half lives", and I'm sure most of her colleagues are the same. They just never mix with the likes of us, who are just as worthy human beings, well educated, but down-trodden by social and financial circumstances we have little resources to cope with. Psychologists are much more likely to feel some affiliation with the average mental health client as their training and remuneration are not congruent with somewhat insulated upper-class backgrounds. However, the upper echelons of the psychology profession are also the province of may rich and remote people who don't see why their increasingly high recommended fees are way beyond the capacity to pay of folks like me. You see, psychologists, at least in Australia, have been concerned that they deliver almost the same services as psychiatrists, yet have always been paid far less. In recent years, many have increased their fees to equal those of the cheapest psychiatrists. At the same time the Medicare fee-setters have increased the amount psychiatrists can receive from Medicare per visit, plus the Scheduled Fee allowed to be charged (the maximum a psychiatrist is advised to ask for on the open market), while they haven't increased corresponding amounts for psychologists very much at all. Fair enough, psychiatrists have done a whole lot longer training and know how the physical health interacts with the mental, so they can prescribe powerful medications. However, psychologists usually have a far greater array of techniques available to them for creating change in the minds of their clients, particularly along the lines of Cognitive (Behavioural) Therapy. Either of these professions continually increasing their fees seems to put the public and their mental health more at risk, so I'd like to see everyone come to an agreement to moderate their desires for a while!

Meanwhile, if you're interested, have a look around your own community and see if psychiatrists are becoming more open and friendly and if psychologists are showing their faces in public, willing to mix with people who might become their clients. A lot of the mystery and stigma of mental illness and psychological difficulties might be relieved by professionals making themselves known as human beings and saying "Hello" to their neighbours. I don't mind that my neighbour is a Social Worker (also currently unemployed and rather depressed)- why should you worry if yours is a shrink?

How about making public mental health an open topic rather than keeping the professionals and clients in separate paddocks?

Here, at least, is a report on public mental health and schools:

Mental Health in Schools and Public Health from UCLA.

It's not only the mental health field that needs more doctor engagement; Web 2.0 working means modern folk need it from primary care as well, as Bill Sinn says here:

New age of patients wants a new age of engagement from doctors

Amazing & simple: Cherries May Prevent Gout Flares

Cherries May Prevent Gout Flares

Several years ago I wrote about gout because it is mistakenly believed to be due to "high living". Really, it's just a special version of arthritis that requires different medicine. Discovering that something as easy to get and delicious to eat as cherries can improve gout so much is fantastic, I think!

I'm not a doctor, but I can't see any harm in regularly consuming some fresh, dried or preserved cherries- as long as they're not the brandy-soaked ones!

You thought being an early riser was virtuous? Nah- just genetic!

Gene distinguishes early birds from night owls and helps predict time of death

Not really an account of common, garden variety mental illness

A Young Reporter Chronicles Her 'Brain On Fire' : NPR

This is a good story & I will read the book as soon as I can... But this story is not going to change the stigma surrounding long term mental illness.

This young woman suffered a devastating and un-hingeing brain infection that left her temporarily as nutty as a fruitcake. She can't remember very much of what it felt like to  have hallucinations, and paranoid delusions that her family & friends were "after her". She didn't get a chance to compare what real thoughts felt like vs. crazy ones within the same day or hour. She has had an awful experience, but it wasn't the experience of schizophrenia, bipolar disorder or psychotic depression.

If you suffer from one of those nasty chronic mental health conditions, this book won't make other people understand you much better; in fact, some of your friends and relatives might be trying to get you diagnosed with something else so you WILL miraculously recover & never look back.

Handle with care.

Dismay over anti-obesity program cuts

Dismay over anti-obesity program cuts

I'm not dismayed by where the cuts ARE; I'm distressed that funds aren't put into change management in neighbourhoods. Why not fund some people to go into neighbourhoods & work with locals to find solutions to sedentary habits. Regular community walks, runs, swims, dancing, gym work in parks etc. could gradually become part of local community routine. It would be better than stupid advertisements that only get to us if we do something sedentary- like watch TV or read the bus shelter walls! No good telling humans what to do if they don't want to do it- SHOW THEM HOW and encourage them to keep doing it. How many times have you told your kids to tidy their rooms or your wife to walk the dog?? Help the kids by organising a routine and if you think the dog MUST be walked- do it yourself!

Less mouth, more action!

No antidotes to these two new drugs- why use them?

Since the 1950s, people have had their lives extended significantly by the availability of the anti-clotting drug warfarin. It's a nasty substance by nature (still used as rat poison!), but when used wisely, provides life extension and better quality of life for many users. It has created a public health revolution by allowing many formerly "doomed" sufferers from various heart conditions to survive for many years- many achieving a normal lifespan. It doesn't have side effects like nausea or dizziness, doesn't give you a dry mouth or stop you from doing normal, everyday activities.

Both of the new drugs can also be swallowed rather than injected and they have no real side effects either. Their promoters are saying they have a huge advantage over warfarin in that their dosage doesn't need adjustment once the correct amount is worked out for you at the beginning of treatment. Warfarin has always been anxiety-provoking for doctors prescribing it because dosing is uncertain; a doctor can't say "OK, you're 75 kilos, therefore you need 5 mgs a day to stop your blood clotting inappropriately". You may need to change the dose up or down depending on what you eat or if you're on other medications. Making sure the clotting ability of your blood is reasonable, even though suppressed, can be a tricky balancing act.

Warfarin is tricky to take because it only works correctly if the clotting level of the blood is kept in a narrow range. Obviously you wouldn't want to stop the blood from clotting when you sliced your finger with the vegetable knife! However, if you had an artificial heart valve or your heart had irregular rhythm (eg. atrial fibrillation), you wouldn't want your blood to clot on its own in the spots where it wasn't flowing along fast enough- like near faulty valves or in the bottom of your heart. So sometimes people have to change their dose up and down frequently and that's inconvenient, however, if they do accidentally take more than they need, a doctor can give them some Vitamin K via injection. This usually works unless the high dose has been continued too long, when even transfusions of blood plasma might not stop the bleeding. Luckily, not many people reach this stage and there are only occasional deaths due to the medicine rather than the disease [Seventeen deaths in Australia in 5 years; hundreds would have died from their heart conditions if not on warfarin].

However, with these newly introduced drugs, Dabigatran & Rivaroxaban, there is NO ANTIDOTE a doctor can give if too much is swallowed. All they can do is cross their fingers and advise praying to your deity of choice. Meanwhile you could bleed to death or have a blood vessel burst in your brain & disable you for life.

This review claims both new medications are REVERSIBLE, just like warfarin. That's OK if there is nothing wrong with you, but if you're bleeding for some reason it takes hours for the drug to flush out of your system and allow blood to clot normally again. Saying these new drugs are "reversible" IS WRONG in my opinion because they're not instantly reversible via antidotes! Read and educate yourself if you haven't heard about the controversy.

https://www.cardiology-review.com/lessons/pdf/PER_201202-01.pdf

Get those numbers crunched for advances in public health

2012 WIRED Health Conference | Living By Numbers

Don't complain when the government uses your dollars wisely!

NHS accused of age discrimination over lifesaving surgery | Society | The Guardian

IMHO, misuse of health skills & services

A womb of her own: risking uterus transplant for pregnancy

Why national health insurance is good for everyone, not just the "poor".

When the Australian government taxes us at least 1.75% of our income IF WE EARN ABOVE $20 000 as an individual (then we are FREE), it provides us with free medical & hospital care, plus screening for all the common cancers. We also get any prescribed item for $35, even expensive cancer drugs, up to around $1200/year, then they are $5.

If the USA made everyone pay a similar levy (and didn't call it tax), that's Obamacare. People would be fools to knock it back.

Nicholas Kristof writes about his dear friend from childhood & university who is dying far too young because there was no system in place that looked after the health problems no one wants to think about:

A Possibly Fatal Mistake - NYTimes.com