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The recent announcement that Berkshire Hathaway, Amazon, and JPMorgan have joined forces to pare down health care costs has sent ripple effects across the health care space. The announcement sent stocks tumbling due to the uncertainty of what influence these companies will have on a deeply complex, unruly and wasteful health care system. Said Berkshire […]

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 82-year-old woman is evaluated for a 2-week history of left-sided headaches with pain on chewing, accompanied by achiness in the shoulders and hips. She has no other pertinent personal or family history. She takes no medications. On physical examination, temperature […]

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Remarkable improvements in advanced life-saving therapies have brought chronic disease management to the forefront of American health care. Today, we see more patients that have complicated conditions. Often, these patients are admitted to the hospital with acute symptoms related to chronically managed conditions such as heart failure, lung diseases or cancer. These patients can end […]

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Anyone who has ever tried to buy health insurance in the open marketplace knows how difficult and expensive it can be. I spent years working at jobs that did not provide health insurance, and I remember the annual feeling of dread when I received notice of the new premium increase. The only way I could […]

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When I started medical school over four and a half years ago (I took a research year), I knew that primary care was my passion. I actually had a dream beyond medicine to be a liaison of sorts between the ivory tower of medicine and the community. Once I stepped onto the scene of my […]

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Concerns over the addictive properties of video games are reasonable but there is a lack of rigorous research behind the WHO’s expected classification

Video games played on smartphones, tablets, computers and consoles have been a popular form of leisure for some time now. In Europe, recent figures indicate that games are played by more than two thirds of children and adolescents, and a substantial number of adults now play games – 38% in the UK, 64% in France, 56% in Germany and 44% in Spain.

The WHO will publish the next revision of its manual – the International Classification of Diseases (ICD-11) – by mid-2018 and gaming disorder has been included in the draft for the first time.

Related: Is there an association between video games and aggression?

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Age UK says many people do not have individual care package to which they are entitled

More than one in three people in England diagnosed with dementia are not getting the follow-up care they are entitled to, a charity has said.

The NHS specifies that everyone diagnosed with the condition should have an individual care plan that is reviewed at least once a year.

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Becca had to relocate to get treatment after being told she would be put on a waiting list

Eating disorders: NHS reports surge in hospital admissions

Even though an eating disorder has disrupted many aspects of Becca’s life, she never expected to have to relocate because of it. But after a spell in hospital while at university, she could not move back home.

“My inpatient unit said I had to start treatment within two weeks but when I approached services in Norfolk, where I am from, I was told I’d be put on their waiting list ... I didn’t know how long that could take,” she said.

Related: Eating disorders: NHS reports surge in hospital admissions

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Exclusive: Experts say NHS services are failing those in need of help as admissions nearly double in six years

‘People shouldn’t have to move away’: getting care for an eating disorder

The number of admissions to hospital of patients with potentially life-threatening eating disorders has almost doubled over the past six years, amid warnings from experts that NHS services to tackle anorexia and bulimia are failing to help those in need.

Related: What are your experiences of eating disorder treatment? Tell us

Related: 'People shouldn't have to move': getting care for an eating disorder

Related: Long NHS delays can be 'devastating' for patients with eating disorders

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Guru Bob Roth, who numbers Katy Perry and Hugh Jackman among his fans, is to set up a TM project in London schools

He studied with Maharishi Mahesh Yogi, the Beatles’ spiritual guru, and claims comedian Jerry Seinfeld, actor Hugh Jackman and designer Stella McCartney as fans. Now America’s most successful contemporary exponent of transcendental meditation is bringing his message to Britain.

Bob Roth’s new book, Strength in Stillness, is published this week and his promotional tour will bring him to Britain on 26 February. And Seinfeld, Jackman and McCartney are all set to host book launches – for free – in New York and London.

The technique involves twice-daily 20-minute sessions. A teacher gives students a personal mantra – a word or sound that has meaning associated with it – and they learn how to “think” it, silently. It differs from more recent mindfulness techniques in that there’s no pushing away thoughts, counting breaths, monitoring sensations, or visualising. It doesn’t require sitting in any particular position; practitioners simply sit comfortably in a chair, at home, at work, on a train, in the park – wherever they feel comfortable. They say it is designed to be 100%...

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Rise of 9% in statements of fitness for work, with 13.5% increase in notes for mental and behavioural disorders

The number of fit notes issued by GPs has risen by nearly a tenth, with a larger increase for mental and behavioural disorders, research has shown.

A fit note is issued after the first seven days of sickness absence if the doctor assesses that the patient’s health affects their fitness for work.

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Salford Foodbank has partnered with local medical practices to help provide care for vulnerable patients

Do you work for the NHS? Please take our survey and tell us about your job. It should only take 10 minutes

The icy wind outside the Height medical practice in Salford is a clear sign to practice nurse Janice Hussey that she will be sending patients – stuck with the choice of eating or keeping warm – to the local food bank.

Related: The GP practice sharing data to transform care for homeless people

Related: Debt, homelessness, domestic violence: the GP practice acting as a one-stop shop

Related: I had to rely on food banks to get me through medical school

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Eleven parliamentarians and experts in children’s welfare sign a letter calling on the government to expand the limited provision for young people exposed to parental conflict

This week is Children’s Mental Health Week. We welcome the recent publication of the green paper Transforming Children and Young People’s Mental Health Provision and its acknowledgment of the impact of inter-parental relationships on children’s and young people’s mental health.

However, we are concerned that having recognised the ubiquitous nature of this issue – with one in 10 of the 11 million children under 16 in the UK being exposed to potentially damaging levels of conflict between parental couples – the green paper proposes addressing the issue solely in workless households, through the Department for Work and Pensions.

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4,500 people have taken their own lives since conflict ended, sparking calls to tackle crisis

More people have taken their own lives in Northern Ireland since the Good Friday agreement than were killed in political violence during the Troubles between 1969 and 1997, the latest regional figures on suicide reveal.

The statistics on the state of mental health in the region show that since the peace deal about 4,500 suicides were registered in the region.

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Inspectors raised significant concerns over services provided by Huntercombe hospital

A psychiatric intensive care facility which provided child and adolescent mental health services has been closed after a damning assessment by inspectors.

The Care Quality Commission (CQC) said it found inpatients at Huntercombe hospital in Buxton, Norwich, had access to dangerous items which they could harm themselves with.

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A recap of week one in our new series about promise, potential and pioneers doing bold things


Welcome to the weekly report from the Upside, a new Guardian series that is all about promise, potential and pioneers doing bold things to bring back the optimism.

Every week we will try and inject a bit of Friday afternoon joy into the proceedings by rounding up some of the great things that are happening around the world.

I would like to see a story on the media’s constant obsession with publicising and thus validating Donald Trump’s inane rhetoric while simultaneously relegating important stories like activism or climate change to the lower echelons of ‘public interest’. You could start with a case study of the Guardian. Martin O’Brien, Ireland, in response to our request for input here.

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My world was rocked at the age of 12 – but my extraordinary English teacher helped me through it. Now we’re reconnecting

I was 12 years old, and my mum had just died from cancer. It was horrific to watch that happen to someone. My dad had an alcohol problem that mum had been managing all these years – suddenly he had a good reason to drink, and no one to stop him any more. He hit the bottle hard.

I went from being quite a high achieving student to being in the bottom quarter for English. But among all this, there was my English teacher, Miss Ward, who was so supportive. She wasn’t trained in mental health: she just saw someone who was distressed and unhappy, but who also had potential. She changed my world.

Related: Children's mental health: it’s time to put wellbeing on the curriculum

#FindMissWard

Dear, lovely people of Twitter - Miss Ward HAS BEEN FOUND!!

Thanks to social media - a load of emails and an old school style letter we’ve exchanged some emails and we’ll be meeting up soon

She wishes to remain anonymous & I’ll respect that

Thank you Twitter!!

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Business incubator Zinc gathers 55 people from 19 countries to rethink the world’s approach to treating mental illness

Will Tanner is building a web hub for those who care for the mentally distressed. Billie Quinlan wants to make women happier with a digital sex guru. Rajshekar Patil is devising tools to help children moderate screen time. Rachel Thomas aims to change how people think using online modules.

In a speed-pitching session (like Dragon’s Den on fast-forward with better coffee and fewer self-interested billionaires) these and 20 similar propositions are rattled out by teams of two or three people who met only weeks ago.

What is The Upside?

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Royal Exchange, Manchester
Kendall Feaver’s striking debut pits a daughter who wants to give up medication against the mother who wishes to keep her safe

When Anna (Norah Lopez Holden) was seven she bequeathed her toys to her friends and threw herself out of a window. She survived, but her mother, Renee (Julie Hesmondhalgh), was so disturbed by the stories her precocious daughter was writing that she took her to see a child psychiatrist, Vivienne (Sharon Duncan-Brewster). She prescribed a cocktail of drugs.

Related: The Almighty Sometimes: the drama that asks ‘how much of me is my medication?’

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As a private practice specialist in an affluent metropolitan area, I am often inundated with requests for consultation by local residents and primary physicians. That’s fine — it’s what I do, and it’s what I enjoy doing. Hey, it pays the bills, and I won’t complain about that. Concierge medicine has taken a foothold locally, […]

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 75-year-old man is seen for routine follow-up for very severe COPD. He has constant dyspnea and air hunger and spends most of the day in a chair. He has had no change in baseline cough and sputum production. He has […]

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Early this month, it was reported that President Donald Trump, having grown frustrated from discussions regarding a bipartisan deal on immigration, asked why proposals continued to provide special protections for immigrants from the countries of El Salvador and Haiti, and the continent of Africa. He reportedly exclaimed, “Why are we having all these people from sh*thole […]

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This week I had some particularly emotionally tough cases at work, and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it. When I think of childhood diseases, there are the ones that are chronic, the ones that let you process that […]

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The final year of any residency is a time of accelerated independence, moonlighting, and an intense search for that first job as an attending. This decision is critical as one embarks on a life-long career in medicine, and it will undoubtedly blend a mix of analytics, emotion, and finance into the final analysis. With a […]

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There’s an interesting article in the Journal of Hospital Medicine on what to do when a patient wants to leave the hospital against medical advice. After reading and rereading it, I had to disagree with the conclusion, but it took me a bit to get there because the article, with its confusing use of terms, is a […]

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Lunchtime meditation might reduce workers’ stress – but it does nothing to tackle the rat-race culture that causes it

Mindfulness meditation is being offered at some of the world’s biggest companies, such as Google, GlaxoSmithKline and KPMG, to cut workplace stress and boost productivity. With workplace stress costing UK businesses £6.5bn a year, it’s no surprise that companies are investing in mindfulness: business magazines and HR journals are open about how it can boost profits. And research has shown how mindfulness reduces sunk-cost bias, where business leaders obsess about lost causes at the expense of more pressing concerns and decisions.

Yet mindfulness experts, aware that the technique could be used to turn us into placid worker drones, are taking rearguard action. Mark Williams, the founder of the Oxford Mindfulness Centre, said that seeing more clearly what is happening in their lives could make employees more subversive and critical. In other words, businesses may be cultivating an army of mindful rebels. But he said that three years ago – so where’s the revolution?

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Health secretary to tell trusts that scores of suicides on NHS wards are due to ‘failure of care’

Jeremy Hunt is urging mental health units to prevent the scores of suicides by patients that occur on wards every year, which he says are due to failings of care by NHS providers.

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I’ve been sectioned and know plenty of ‘nutters’ but none is a bombastic bully like Trump. Politics and psychiatry don’t mix

There is no question that Donald Trump makes many people, myself included, profoundly uncomfortable. His politics are repulsive enough, but it’s more the way he conducts himself personally. Above all, it’s the apparent belief that he can bulldoze his version of reality through clear evidence to the contrary – that, a year on from his inauguration, has many still struggling to process the fact that this man is US president. Those of us who have been diagnosed with mental health problems face an additional head-twister.

We are repeatedly told by friends and colleagues and commentators in the media that the man is “barking”, a certified “nutter”, a “lunatic”, and any number of other choice terms used to describe the tribe of which I am officially a member. For I am indeed a certified nutter. I have been sectioned, and it doesn’t get more certified than that.

Related: Trump is now dangerous – that makes his mental health a matter of public interest | Bandy Lee

Related: Trump mounts extraordinary defence of his 'mental stability'

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In her prizewinning play, Kendall Feaver charts the relationship between a young woman with mental health problems and her mother

When Kendall Feaver was going through her old school reports, certain phrases stood out: “dominates play”, “bossy”, “attention seeking”. The negativity of the language shocked the Australian playwright. “You could flip that and say ‘leadership potential’ or ‘vivid imagination’.” But, she believes: “If you’re going to be a playwright, or pursue any kind of creative career, you need to switch off all those negative voices.”

Her debut play took her five years to write. The Almighty Sometimes, which opens at Manchester’s Royal Exchange in February, charts the relationship between a mother and a daughter (played by Julie Hesmondhalgh and Norah Lopez Holden) and the emotional toll of growing up and leaving home. The daughter, Anna, is diagnosed with a mental health condition and “has lived with a label for most of her life”. As well as the usual questions that adolescents ask themselves, Anna wonders: How much of me is me? How much is my medication? The mother, on the other hand, has had to make a medical decision on behalf of another person and is left...

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Whistleblower reveals failings at DCMH Tidworth in Wiltshire outlined by top Navy psychiatrist

A major mental health unit for armed forces personnel was condemned as “wholly unsatisfactory and unsafe” by one of the most senior psychiatrists in the services, it has been revealed.

A 2015 report into the mental health unit at Tidworth in Wiltshire obtained by the Guardian found that targets set for the department were “unsustainable and dangerous” and that “the clinical workload expected of staff is unsustainable and is putting patients at risk”. Concerns about mental healthcare for thearmed forces have been raised for years, especially following the conflicts in Afghanistan and Iraq.

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Compassion is the antidote to anger and revenge. So maybe it is time to be a little kinder, and start with yourself

What is compassion? It is the feeling you get when you see someone suffering and are moved to help them. Somehow though, the idea of self-compassion has become tarnished as selfishness. However, to show yourself compassion is far from selfish because, if you can, you won’t drain other people by expecting them to make you feel good or, when you’re beating yourself up, blame them for your bad feelings. Learning to throw yourself a bone of self-compassion increases your resilience and stability. When you have that security blanket of self-compassion, you feel as if you can take more risks.

A selfish reason to exercise compassion is that it makes you feel good. When you respond to your own or someone else’s distress, you automatically go into caring mode, which promotes the release of opiates and oxytocin, the bonding hormone, in your brain. Great friendships and relationships are the result of the exchange of these hormones, which create trust, rapport and closeness. Your heart rate goes down, as does your blood pressure and cortisol, leaving you much healthier.

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Those with a psychosocial disability are having significant difficulty accessing the scheme, University of Sydney study finds

The national disability insurance scheme is failing those with severe mental health problems and risks creating significant gaps in support services, a new report warns.

The University of Sydney report, titled Mind the Gap, warns problems with the NDIS’s handling of serious mental health issues could leave many without proper support.

Related: Fears those with severe mental health issues are falling through NDIS cracks

Organisations are losing staff with expertise in psychosocial disability

Related: Disability sector risks losing volunteers over NDIS uncertainty, groups warn

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Industry figures question research that ‘pathologises’ compulsive gaming, while scientist involved defends move to address addiction

The World Health Organization (WHO) has included “gaming disorder” in its draft for the next edition of its diagnostic manual, the International Classification of Diseases (ICD-11), which is due for final release this year. The disorder is characterised by behaviours such as impaired control of time spent playing video games and prioritisation of gaming above other activities, in a way that negatively affects other areas of a person’s life such as their education, occupation and relationships.

Games industry bodies the US Entertainment Software Association (ESA) and UK Interactive Entertainment (Ukie) have expressed doubts about the classification. “We are very concerned about the inconclusive nature of the research and the evidence that WHO is using to base this potential classification on,” says Ukie’s chief executive, Jo Twist.

There is a small minority of people out there where gaming has completely taken over their lives

You have to look at pre-existing mental health disorders. This is risking misdiagnosing of other underlying issues

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Despite increasing concern about the long-term risk of dementia and other problems from heading a ball or tackling, children are still playing contact sports. Should you play it safe and stop them?

I love to watch my daughter play football, but when she heads the ball, I feel a surge of pride (she isn’t one of those who duck out the way) and a surge of fear. How many brain cells did she knock out? And what goes on inside her head when the ball hits it?

Since the case of Jeff Astle, the former West Bromwich Albion footballer who died of a degenerative brain disease in 2002, the potential risks of heading have come under intensive scrutiny. The coroner cited “industrial disease” as the cause of Astle’s death. At about the same time, Bennet Omalu, the forensic pathologist played by Will Smith in the film Concussion, was establishing a link between the sudden death of NFL player Mike Webster and a form of brain disease, chronic traumatic encephalopathy (CTE), that had previously been associated only with boxers.

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The celebrated psychotherapist explores the works that help you get to grips with your psyche

Please don’t look to the ever expanding Diagnostic and Statistical Manual (DSM) that lists many of our quite understandable moods, behaviours, desires and states of mind – such as grief following loss – as pathological. It is easy to find yourself in the descriptions of “disorders” and yet it doesn’t teach us very much about ourselves or our psyches. For that we need to look to the poets, artists, musicians and writers, and, of course, the psychoanalytical theorists, who spend years listening to and learning from individuals in clinical situations.

Donald Winnicott, who worked with children and their parents in a kind of snack bar consultation method at Paddington Green hospital, London, as well as running a regular psychoanalytic practice, did not see himself as a theorist, but his propositions about how and why we feel authentic or false are beautiful and profound. I go for his technical rather than his popular writing. Paradoxically it’s easier and more comprehensible. My favourite collection is The Maturational Processes and the Facilitating Environment.

Alison Bechdel's – she of the...

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Baroness Thomas says the Lords should have stopped personal independence payment regulations last March, and Dr Stephen Pacey, a former judge, who for decades heard appeals from DWP decisions, says the government should take full responsibility for the cost of the review

The personal independence payment (PIP) regulations which the high court has quashed, thus allowing claimants with overwhelming psychological distress to potentially receive enhanced mobility payments (Report, 30 January), could have been stopped at a much earlier point in the House of Lords. The government lost an upper tribunal case, which it decided to appeal. But it didn’t wait for the appeal, instead deciding to change the law, immediately with a new regulation barring those with a severe mental health condition from entitlement to enhanced rate mobility.

In exceptional circumstances the Lords should not flinch from voting against regulations. This was surely such a case, where physical and mental health conditions were being treated very differently. Voting against regulations very occasionally is something the joint commission on the conventions of parliament, chaired by Lord Cunningham of Felling 12 years...

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The Church of England is looking at priests’ wellbeing as many feel the pressures of a changing role

On a bad week, the job of a parish priest is “like triage”, said Alan Bartlett. “What do I do first? What’s most urgent?”

Bartlett has just come to the end of a nine-year stint as vicar of three parishes in one of the most deprived areas of the country in north-east England. On a daily basis, he dealt with people on the frontline of austerity and social exclusion.

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Mitchell was 58 when she was diagnosed with early-onset Alzheimers. She began to write about the experience of losing herself, and the result is this remarkable memoir

Things begin, as so often, with a fall. A hard fall, while out running along the River Ouse in York, hard enough that Wendy Mitchell has to go to A&E; hard enough that when she goes back later to find the flagstone that caused it, the blood from where her face hit the pavement serves as a bright marker. Yet there is no obvious hazard.

Then, another day, another fall. And another. The year before, she had completed the three peaks challenge; now she finds she must give up running. Then, after a couple of unsafe incidents on the road, driving. Parts of herself crumbling, or, one day, when she looks up from her desk at work and finds she has no idea what she’s doing there, dropping so fast it’s like “ripping a plaster away”. When she finally gets an official diagnosis it’s as though she already knows: early-onset Alzheimer’s. She is 58.

There is still a person in there, forgetful, yes, confused, often, but still in need of love, conversation and laughter

Related: Wendy Mitchell on her extraordinary Alzheimer’s memoir

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In 2017, more women than men were accepted into medical school for the first time. 2017 also brought attention to the sexual harassment many women face that often goes ignored. Medicine is not immune to behavior that objectifies women and ignores their complaints. My experiences are mild in comparison to many of my peers, but […]

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Solving major problems in medicine through innovation can be boiled down to a process that teaches doctors how to be inventors. It’s called biodesign. In this episode, surgeon David Hindin  traveled to Silicon Valley to visit Stanford University and learn more about their biodesign program. Your patients are rating you online: How to respond. Manage […]

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“Same team!” bellowed all the frustrated parents from the sideline of a lacrosse game as we watched two teammates clash sticks while fighting to catch the same pass. Both players missed the ball, and the other team scooped it up and scored, perfectly illustrating to our kids what happens when they battle among themselves. It’s […]

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The fact that unexpected outcomes and rare events occur is one of the realities of medicine that is difficult to comprehend until you have personally experienced it. There are over 130 million emergency department visits annually, over 16 million of which require admission to a hospital. With that many encounters, even the rarest of events […]

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The frontlines of health care have been transformed over the last decade as electronic medical records have been rolled out across America. Unfortunately, information technology has yet to live up to its immense promise in health care­ — a topic that I frequently write about. As somebody who has worked with every single major EHR […]

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Sometimes life just walks right up and slaps you in the face. It happened to me while attending the dynamic FIX17 conference in NYC, and it led to an epiphany: At the ripe old age of 59, I am officially a dinosaur. I was giving a talk on the history of women in medicine. Passionate about the […]

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High court ruling says policy was discriminatory against people with mental health issues

Up to 164,000 people are in line for increased disability benefits after ministers gave in to a high court ruling that said government policy had been “blatantly discriminatory” against people with mental health conditions.

In a major U-turn, the new work and pensions secretary, Esther McVey, said she would not challenge the December ruling that found changes to personal independence payments (PIPs) could not be justified.

Related: The new work and pensions secretary is an insult to disabled people | Frances Ryan

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It is time to base the economy on a more rounded view of human nature than that one that just considers individuals as selfish calculators of utility

The zero-sum game of competition for money and status that has gripped societies over the past 30 years have made their publics richer overall and given them longer lives of better quality. It has led to an embarrassing wealth of consumer goods. But it is also increasingly clear that the me-first model of modern economies is a big source of unhappiness. When life feels like a cut-throat contest each one of us is encouraged to chase income and rank. In a rat race improving one’s income causes others to feel dissatisfied with theirs. One person’s pay rise is another’s psychic loss. Envy spreads despair, encouraging workers to devote more time to making money than to family or community.

Such competition weighs heavily on national wellbeing. A slice of Britain seem to be losing hope; the lives of poorer citizens are unhappier than their richer peers in ways that simply having less money cannot explain. Our story revealing that private insurers refuse policies to people suffering even mild mental health conditions shows how those who...

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Music can help reduce symptoms but only 5% of care homes are using it effectively, finds report

The symptoms of hundreds of thousands of vulnerable people with dementia could significantly improve by listening to and playing music, according to a report.

The study, which compiled existing evidence as well as talking to experts, found music can help people with dementia recall information and reduce symptoms such as anxiety, agitation and aggression.

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Study finds abused or neglected children who play sports are less likely to develop mental illness

Taking part in sport protects children who are abused or neglected from developing mental health problems in later life, according to a major public health study.

People who had adverse childhood experiences (ACEs) but regularly played sports as children were less likely to have a mental illness as an adult, the study found. People who had traumatic childhoods were also more likely to be mentally healthy if they took part in sport as adults.

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Overworked? Stressed? Got a bad boss? In a new series we invite you to send in a short description of your predicament – so that other readers can offer solutions

Work has changed, and in many ways for the better. Hours have become more flexible, so parents and carers can spend time with those they love. We have more holidays. Smartphones, tablets and laptops have unshackled us from our desks. It’s illegal to discriminate on the grounds of race, gender, religion, disability or sexuality. There’s a minimum wage.

But much is just the same, or worse than ever. Too many firms now expect you to be available round the clock, to answer their stupid emails or talk to clients on the other side of the world. Cameras and GPS track your every movement and toilet break; software counts each keystroke. And while we never dreamed of some of the jobs that have come into being, we have also watched the collapse of industries that once seemed indestructible.

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About this site

Mental health is a level of psychological well-being, or an absence of a mental disorder; it is the "psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment".