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New techniques in the treatment of gastroesophageal reflux

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The dott. Bruno Benini, specialist in General and Thoracic Surgery, at the S.Camillo de Lellis Hospital in Rome, shows us the benefits of a minimally invasive method: laparoscopic surgery

Gastroesophageal reflux, a disabling pathology that affects one in three people in Italy, can be treated effectively with medical or surgical treatment. The first is based on the intake of drugs that prevent the production of acid at the gastric level, removing the harmful substances for the esophageal mucosa from the material that goes back into the esophagus. The second, instead, aims to reconstruct the natural anti-reflux barrier at the cardiac level, and is performed in centers and by surgeons who have a high experience of laparoscopic surgery.

Dr. Benini, is pharmacological therapy harmful?

In recent years it has been shown that the prolonged intake of proton pump inhibitor drugs (PPI) can be burdened by side effects such as severe heart disease, dementia, intestinal infections and an increased incidence of stomach cancer. This is the reason why we recommend a limited use over time. With the advent of minimally invasive laparoscopic surgery it is possible to definitively and permanently solve the problem of gastroesophageal reflux, with minimal trauma.

What are the advantages of laparoscopic surgery?

Reduced postoperative pain due to the limited extension of muscle wounds; rapid recovery of one’s daily activities; rapid recovery of intestinal function; reduced incidence of respiratory, circulatory and cardiac complications. The results are really excellent even after some time (20 years from the operation!) As evidenced by the recent scientific literature.

More info (www.chirurgia-laparoscopica.com) (dr.benini@gmail.com)

by Roberta Imbimbo

Alivision Transport, leader of the transfers

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The President Luigi Foffo illustrates the mission of this all-Italian company, which has for years become an important reference point for millions of passengers.

President Foffo, what is the strategic objective of the company you direct?

The goal of Alivision Transport, which has a fleet of 36 vehicles, is to offer safe and efficient transfer services, in order to satisfy every single request. To maximize customer care, the company guarantees a prompt, professional and continuous service 24 hours a day, 365 days a year, connecting the airports with the center of the main Italian cities served by the Group (Fiumicino-Roma Termini, Ciampino-Roma Termini; Bergamo Orio al Serio Airport – Milan Central Station, Malpensa Airport – Milan Central Station).

What are the strengths of the company compared to its competitors?

The Terravision brand has an excellent value for money. The key to Terravision’s success is contained in its combative, creative and extensive commercial policy which is essentially based on three direct promotion channels: internet, airport sales points and city center points of sale. This commitment is complemented by numerous indirect channels, including partnerships with affiliates in various European cities. The Group’s success is also due to the experience and high skills of a managerial body that has made quality a hallmark of its work. Thanks to the important awards obtained for the high quality standards offered, Terravision increasingly aims to extend its presence throughout the pan-European territory, expanding its core business.

More info (l.foffo@terravision.eu) (www.terravision.eu)

By Roberta Imbimbo

AF SOLUZIONI, EXCELLENCE AT THE SERVICE OF PA AND ECONOMIC OPERATORS

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Thanks to the internet and the latest technology, it is now possible to award contracts by telematic means, in total security and in compliance with the principles that inspire the work of the public administration.

The Single European Competition Document (DGUE), in force in Italy since July 2016, is a formal self-declaration with which the economic operators declare the presence of eligibility requirements and the absence of grounds for exclusion for participation in a public tendering procedure.

To facilitate the economic operators in the compilation of this model, AF Solutzioni by Francesco Scattaretico and Ferdinando Vigorito, has designed a telematic version in compliance with the requirements of the community discipline and national legislation. This module is an integral part of the AFLink PA solution, a software platform, perfectly in line with the recent legislation regarding online tenders, for the management of public administration contracts.

The solution, already used by thousands of operators, is highly flexible, completely configurable according to the needs of the individual customer; moreover, the simplicity of use and the completeness of the modules allow faster access to tender procedures published online by the administrations.

more info (www.afsoluzioni.it) (info@afsoluzioni.it)

by Roberta Imbimbo

I was dragged under a bus by my hair

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It was January 2000, and I had just finished the final semester of my year abroad in Auckland, New Zealand. A girlfriend and I went shopping for gifts in the city centre to take back to our families in Malaysia. As the day came to a close, we said our farewells and I made my way home.

I have always been very conscious of road safety, often teased by my friends, who don’t like crossing the road with me because I take the pedestrian bridge or wait religiously for the green light. But, for some reason, on this day I did not take my usual precautions and quickly ran across the street without looking. At that moment, a minibus turned the corner. I was in the driver’s blind spot so he did not see me, nor I him. I remember touching the side of the bus with my right hand, unaware of what it was or what was happening.

Warm feelings and happy thoughts flooded into my mind. I began thinking about the trip I was due to take with my friends over the summer, across New Zealand. I was distinctly content, a vivid feeling that, to this day, reassures me that dying might not be as bad as we believe.

It was January 2000, and I had just finished the final semester of my year abroad in Auckland, New Zealand. A girlfriend and I went shopping for gifts in the city centre to take back to our families in Malaysia. As the day came to a close, we said our farewells and I made my way home.

I have always been very conscious of road safety, often teased by my friends, who don’t like crossing the road with me because I take the pedestrian bridge or wait religiously for the green light. But, for some reason, on this day I did not take my usual precautions and quickly ran across the street without looking. At that moment, a minibus turned the corner. I was in the driver’s blind spot so he did not see me, nor I him. I remember touching the side of the bus with my right hand, unaware of what it was or what was happening.

Warm feelings and happy thoughts flooded into my mind. I began thinking about the trip I was due to take with my friends over the summer, across New Zealand. I was distinctly content, a vivid feeling that, to this day, reassures me that dying might not be as bad as we believe.

It took 15 minutes to free me from the wheels. An entire fire brigade and an ambulance team had to manually lift the minibus off me. They also tried pumping more air into the tyres to elevate it. The paramedics cut my hair and lifted me on to a stretcher. Later, they told me that a tourist in the crowd had come to help, holding my hand and accompanying me to the ambulance. I don’t remember this. Strangely, I was oblivious to the pain the entire time, even to the point where I felt that paramedics were exaggerating the severity of the situation as they asked me lots of questions to check for brain injuries. When I arrived at the hospital, doctors told me my injuries were life-threatening. They also told me there was a strong chance I could be paralysed.

The morphine made it difficult to realise the severity of what had just happened. I was chatty and confused. I asked the nurses cutting my jeans to be careful as they were my only pair. By some miracle, I was not paralysed. I had a cracked left shoulder blade, broken ribs, and a fractured cheekbone. I needed three skin grafts, taking skin from my right thigh for my left temple, my feet, and my scalp – where I still have a bald patch above my left ear.

Although I insisted the accident was a result of my own lack of awareness, the driver never came to visit me as he felt too much remorse. Afterwards, the police in New Zealand started a Cross the Road Carefully campaign. Little green men were painted on the pavements to remind people to look properly before crossing.

It took me six months to recover. I was sad to miss out on the trip, but my friends were really supportive. They kept me sane by not pitying me. They often pretended nothing had happened to me, something I don’t think would have been the case if I had been at home with my extended family. Eventually, I was able to attend my graduation, crossing the stage on crutches; it didn’t matter, because I was just happy to be alive.

The accident changed my life; it made me think about the terrible things that could have happened. It regularly prompts me to step back and reassess my problems, to be grateful for the second chance I got at life.

source:https://www.theguardian.com/lifeandstyle/2018/jun/01/i-was-dragged-under-a-bus-by-my-hair

Angry Facebook shareholders challenge Zuckerberg over ‘corporate dictatorship’

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In the months since Facebook faced one of the greatest crises in its 14-year history over the Cambridge Analytica data scandal, its chief executive, Mark Zuckerberg, has faced tough questioning and increased scrutiny from his users, the media and governments around the world.

On Thursday, the billionaire executive faced another challenge: from angry shareholders at the company’s annual meeting, where activist investors had forced votes on six proposals to change the company’s governance or institute other reforms.

And while Zuckerberg and his board of directors escaped the election unscathed – a foregone conclusion thanks to the company’s unequal voting structure – the event provided a platform for stinging rebukes of their leadership.

“Shareholder democracy is already lacking at Facebook,” the woman argued, before her microphone was turned off.

Another attendee, Christine Jantz of Northstar Asset Management, said: “If privacy is a human right, as stated by Microsoft’s CEO, then we contend that Facebook’s poor stewardship of customer data is tantamount to a human rights violation.”

Jantz was speaking in favor of a proposal to reform Facebook’s stockholder voting structure. Under Facebook’s current structure, Zuckerberg controls the majority of voting shares despite not owning a majority of the company, because his shares have 10 times the voting power of the shares available to regular investors.

Will Lana of Trillium Asset Management said that his firm had identified “at least 15 distinct controversies” facing the company as he spoke in favor of a proposal to change the board’s approach to risk management.

“The proof of the current structure’s inadequacies is on display in the current headlines,” Lana said.

James McRitchie, a shareholder activist, spoke in favor of a proposal to change the voting structure from what he called a “corporate dictatorship”.

“Mr Zuckerberg, take a page from history,” he said. “Emulate George Washington, not Vladimir Putin.”

In his own remarks, Zuckerberg sounded familiar notes from the recent apology tour that has seen him appear before the US Congress and European parliament as he discussed the various challenges the company faces.

“The big theme we’re focused on is making sure we take a broader view of our responsibility to everyone we serve,” Zuckerberg said, before discussing the company’s various initiatives to increase advertising transparency, improve content moderation, and prevent interference in elections.

During a question and answer session, Facebook’s chief operating officer, Sheryl Sandberg, made one new announcement – that the company would adopt a “diverse slate approach” when it comes to choosing members of its board of directors. The approach, akin to the NFL’s “Rooney Rule”, requires hiring managers to consider candidates from underrepresented groups when filling an open position.

Facebook added the first non-white member, the American Express CEO, Kenneth Chenault, to its board in January. In May, the company announced that Jeff Zients, former director of Barack Obama’s National Economic Council, would replace the WhatsApp co-founder Jan Koum on the board.

source:https://www.theguardian.com/technology/2018/may/31/facebook-shareholder-meeting-mark-zuckerberg

Bank ready to act if UK faces disorderly Brexit, Mark Carney says

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Mark Carney has signalled the Bank of England would be prepared to cut interest rates – or freeze plans to increase them – in order to support jobs and economic growth should Britain be plunged into a disorderly Brexit.

Outlining the options available to Threadneedle Street as the UK moves closer towards leaving the European Union from next year, the bank’s governor said the institution was ready to respond to Brexit in “whatever form it takes”.

Having lowered interest rates as an emergency measure immediately after the Brexit vote almost two years ago, the Bank has gradually returned to raising the cost of borrowing for the first time since the onset of the financial crisis. In recent weeks, Carney has stressed the need to raise rates to curb inflation, which has risen sharply since the referendum.

But while stressing a smooth exit from the EU would leave the Bank on its present course for raising rates over the next few years from their current level of 0.5%, he said a disorderly Brexit “could put monetary policy on a different path”.

In a key speech to the Society of Professional Economists in London on Thursday, he pointed to the central bank’s steps taken straight after the EU referendum as proof of its ability to support jobs and growth.

At that time, economists feared that a loss of confidence in the UK economy after the Brexit vote could have led to job losses and a sharp drop in economic output.

“Observers know from our track record that, in exceptional circumstances, we are willing to tolerate some deviation of inflation from target for a limited period of time,” he said.

The Bank’s rate-setting monetary policy committee has a mandate to steer inflation towards 2%, yet also has the ability to deviate from this course to support the economy through difficult periods.

However, economists fear the Bank would have little options open to support the economy through cutting interest rates.

However, Carney insisted “we have the tools we need”, adding: “We will be prudent, not passive. We will respond to any change in the outlook in these exceptional circumstances to bring inflation sustainably back to target while supporting jobs and activity, consistent with our remit.”

source:https://www.theguardian.com/business/2018/may/24/bank-england-ready-act-uk-faces-disorderly-brexit-mark-carney-says

Every Star Wars film – ranked!

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14. Star Wars: Episode I – The Phantom Menace (1999)

What a disaster. Never was so much anticipation and excitement loaded into a single movie, which shortly after its release in 1999 became known as A New Crushing of Hope. This monumentally obtuse and dull prequel episode utterly failed to answer 15 years’ worth of what-happened-next? (or is that what-happened-before?) excitement, and featured the intensely annoying – and borderline offensive – character Jar Jar Binks.

13. Caravan of Courage: An Ewok Adventure (1984)

Warwick Davis plays Wicket the Ewok on his home turf, the forest moon of Endor, in this TV movie. He helps two orphaned human siblings, Mace and Cindel, find their abducted parents. Burl Ives narrates.

12. Ewoks: The Battle for Endor (1985)

A classy cast, including Siân Phillips, arguably gives this movie the creative edge over the first Ewok-centred film. Cindel, the orphaned girl from that film, reappears to help the Ewoks against marauders.

11. Star Wars: The Clone Wars (2008)

An animated feature-length one-off that spawned six seasons of a TV series. Set between Attack of the Clones and Revenge of the Sith, this drama recounts the story of Jedi knights Obi-Wan Kenobi and Anakin Skywalker, and their command of a clone army in the war with the Separatists. Lively appearances from Yoda and Jabba the Hutt.

10. Star Wars: Episode III – Revenge of the Sith (2005)

9. Star Wars: Episode II – Attack of the Clones (2002)

This is the best of the prequel trilogy, due to the appearance of Christopher Lee. He plays the wicked renegade Jedi, Count Dooku, who has a mano-a-mano confrontation with Yoda, which is nothing if not very good value. There are some spectacular battle set pieces that still stand up, especially on the big screen.

8. The Star Wars Holiday Special (1978)

The invention of YouTube in 2005 gave an official recognition to the existence of the bizarrely misjudged one-off Star Wars variety “special” transmitted once in 1978 and then never again. For years, a sheepish George Lucas pretty much tried to manipulate fans into thinking they had dreamed it. Everyone hated the Holiday Special at the time, for its jarringly wrong humour’n’music approach – especially the bizarre beginning scenes with Chewie’s family. But it is now regarded with affection for its ingenuous enthusiasm, comedy and energy. These were, after all, the same factors that made the first film, released just a year previously, such a success.

7. Rogue One: A Star Wars Story (2016)

Set just before the events of Episode IV, this shows a group of rebels on a mission to steal the plans for the Death Star, featuring Felicity Jones as Jyn Erso, a known anti-Empire activist sprung from incarceration by the Rebel Alliance. It is notable for using state-of-the-art technology to bring old characters back to life – and digitally refabricate the youthful look of the actors from the original. As well as, Rogue One features some acting heavyweights, such as Mads Mikkelsen, Ben Mendelsohn and Donnie Yen, giving it extra ballast.

6. Star Wars: The Last Jedi (2017)

5. Solo: A Star Wars Story (2018)

This excellent film, directed by Ron Howard, is shaping up to be one of the most underrated in the entire Star Wars series, an episode crammed with the spirit of the original trilogy. Alden Ehrenreich is excellent as young Han Solo; arrogant, secretly unconfident and idealistic. He faces off with another handsome nogoodnik: the dandyish Lando Calrissian, played with great style by Donald Glover. It is this confrontation that brings us into contact with the Millennium Falcon. It has a great meet-cute between the eponymous hero and Chewie, while Game of Thrones’s Emilia Clarke is fantastic as Qi’ra, who holds Solo under her spell.

4. Star Wars: Episode VI – Return of the Jedi (1983)

The last of the original trilogy, a film with a mighty storytelling blast in which Luke struggles to bring his father back to the light side of the force, and in which Darth Vader’s famous black mask is finally removed, at the end of a climactic and redemptive battle scene, revealing the face of English actor Sebastian Shaw. This is the film in which Luke grasps the truth about his relationship with Princess Leia – and it’s when Leia wears her famous, or notorious, gold bikini.

3. Star Wars: The Force Awakens (2015)

This episode is basically an inspired fanfiction remix of A New Hope, but none the worse for that; it was the film that redelivered the saga to its audience on a tidal wave of joy and love. And when Han and Chewie came back on the screen, I felt something I hadn’t experienced since childhood – not knowing whether to burst into tears or applause.

2. Star Wars: Episode IV – A New Hope (1977)

Lyon sweep to Women’s Champions League win over 10-player Wolfsburg

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Lyon’s right-back Lucy Bronze described becoming the first England player to win the Champions League in its current format as “the best thing I’ve done to date.”

Goals from Amandine Henry, Eugénie Le Sommer, Ada Hegerberg and Camille Abily handed Lyon their third consecutive Champions League title after they had fallen behind in an action-packed extra time.

After a dull 90 minutes with the score at 0-0, the game sprung to life in style when a deflected strike from the Wolfsburg forward Pernille Harder, massively against the run of play, was followed by Henry’s top corner strike from a wonderful Hegerberg chip. In between Harder’s goal and the leveller, Wolfsburg had gone down to ten as Alexandra Popp picked up a second yellow for a rash challenge on Delphine Cascarino. The fresh legs of Shanice van de Sanden then sealed the tie for the French side as she three times raced clear on the right, first providing the assist for Le Sommer, then for an unmarked Hegerberg – her record-breaking 15th Champions League goal in a single campaign – and finally for Abily, on her final appearance for Lyon at 33.

Lyon had dominated in normal time and had felt aggrieved when a Le Sommer header seemed to cross the line, only to be waved away. “Watching their goal go in was heartbreaking, and having just had a goal disallowed that definitely crossed the line was a very up and down situation,” said Bronze.

“We push for more and more in these big games. Lyon and Wolfsburg are trendsetting and pushing women’s football. We do as much as we can as players on the pitch, but we need the referee and goalline technology to be up to standard as well,” she added.

Bronze was full of praise for the Lyon substitutes, particularly the former Liverpool player Van de Sanden, whose pace was just too much for the exhausted legs of the German side. “Shanice was a game changer in the end, she got three out of four assists, came on and made the difference with the pace she’s got getting in behind. Both teams were tiring and she’s so energetic, works so hard and won us the game. She deserves every credit.”

This was the third meeting of the two sides in a Champions League final. Both previous encounters were tight affairs; in 2013 only Martina Müller’s penalty for Wolfsburg at Stamford Bridge could separate the European giants, and in 2016 Lyon won on penalties.

The first chance of this match fell to Lyon after five minutes, after Griedge M’Bock Bathy was brought down in the middle of the park. A swung-in free-kick fell to Henry but her shot bounced clear off a Wolfsburg body. Minutes later, up the other end, Popp’s ball across the front of Sarah Bouhaddi’s goal was teasingly out of reach of the incoming Ewa Pajor.

The tree-lined Valeriy Lobanovskyi Stadium was close to empty shortly before the whistle, perhaps thanks to heavy security. However, 35 minutes into the match the little 17,000-seater was heaving, mainly with locals.

Lyon edged the first 45 with the tricky winger Amel Majri and the left-back Selma Bacha causing plenty of trouble for Anna Blässe on the left.

However, the half had failed to light up, half chances and misplaced passes the order of the day. After 15 minutes Lyon began to up the pressure a little, and a Dzsenifer Marozsán corner was cleared as far as Bronze, whose volley went wide.

With the Wolfsburg defence resolute and well organised, Lyon were forced to try their luck from distance, a swerving shot from the left-hand corner of the box by a frustrated Marozsán comfortably collected by Almuth Schult. As the half drew to a close, Harder, the heartbeat of the Wolfsburg attack, was increasingly forced to go deeper to get the ball.

With Wolfsburg struggling to make anything happen, their manager, Stephan Lerch, swapped the winger Caroline Graham Hansen for Tessa Wullaert at the break to try to shake things up. An uneventful opening to the second half was brought to an abrupt halt when Sara Bjork Gunnarsdóttir crumpled to the ground, on her own, clearly in pain – the exertions of the German cup final win after extra time and penalties at the weekend starting to show in the legs of the players.

Lyon spent much of the second period camped in the opposition half and they were denied a breakthrough in the 69th minute when a corner from the left found Henry, who flicked the ball goalwards. Replays seemed to show the ball crossed the line, but Noelle Maritz cleared and the referee waved away appeals. Lyon kept pushing for what would surely be a winner. Cascarino, on for the bright Bacha, sent in a low cross but Le Sommer’s shot was nicely saved by Schult.

Wolfsburg came out fighting in extra time, as Harder raced forward and her deflected strike from outside the box gave the German side a surprising lead. It was then that the game exploded. Popp received her second yellow before Hegerberg’s lovely chip found the onrushing Henry, who put the ball into the top of the net. Moments later the holders took the lead as Van de Sanden raced down the right and her cross was met by Le Sommer to poke past the keeper.

With Wolfsburg forced to push forward they were left even more exposed, and again, Van de Sanden found an unmarked Hegerberg to put the game out of an exhausted Wolfsburg’s reach in the first half of added time. Then Abily put a lovely curling strike beyond Schult with two minutes to play, giving her an emotional send-off as she rounded off Lyon’s record fifth European title, one she said was “amazing, I couldn’t hope for a better end. I came in and scored and we won, it was a perfect night for me.”

source:https://www.theguardian.com/football/2018/may/24/wolfsburg-lyon-womens-champions-league-final-match-report

Rotten teeth health warning on sugary drinks could deter buyers

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Graphic health warnings like those on cigarette packets, showing rows of rotten teeth on cans of cola and other sugary drinks, could deter some young adults from buying them, a study has shown.

Sugary drinks are blamed for fuelling the obesity epidemic, but in spite of the large quantities of sugar they contain – nine teaspoons in a can of Coca Cola – they do not carry a red traffic-light warning, which is voluntary in the UK. Sugar taxes, like that recently introduced in the UK, may reduce sales, but obesity experts believe more action is needed.

Prof Anna Peeters from Australia’s Deakin University and colleagues looked at the feasibility of introducing health warnings about the links between sugary drinks and obesity, type 2 diabetes and tooth decay. They tried out four different kinds of warnings – from plain text about the disease risk, number of teaspoons of sugar, to a picture of rotten teeth.

The researchers showed the drinks with the warnings to 994 young adults, aged between 18 and 35. Participants were asked to imagine they were entering a shop, a cafe, or approaching a vending machine to choose one of 15 drinks to buy, some sugary and some unsweetened. Some of the sugary drinks had no label. Others carried a warning or a health star rating.

The effect was bigger than Peeters expected. All the warnings reduced the inclination of the subjects to buy the drinks, but there was a 20% drop in imagined purchases of those drinks bearing a picture of rotten teeth.

“If there was political palatability for graphic warnings, that [one] had the strongest effect, so that’s the one I would go for,” said Peeters at the European Congress on Obesity, where she was presenting her research.

“You are going to get pushback from the industry and possibly the community,” she said. “If you had good social acceptance of graphic warnings, you’d go for that. But if government found that too difficult the other three are pretty good too.”

A written warning about the raised risk of type 2 diabetes as a result of obesity would not have quite the same impact as the picture, she said, “unless you go for amputations”, which can be a consequence of the disease.

Peeters said the study showed the potential of front-of-pack warnings to change people’s behaviour. “While no single measure will reverse the obesity crisis, given that the largest source of added sugars in our diet comes from sugar-sweetened drinks, there is a compelling case for the introduction of front-of-pack labels on sugary drinks worldwide,” she said.

Prof Jason Halford of Liverpool University, treasurer of the European Association for the Study of Obesity, said there was a need for manufacturers and retailers like the supermarkets to bring in traffic-light warnings on sugary drinks. If they do not, “We’d have to adopt something regulatory and the regulatory might be this. And it might be the most effective,” he said.

Barbara Crowthers, a Children’s Food Campaign coordinator, said: “There is definitely a role for honest and clear health labelling in discouraging people from consuming too many sugary drinks, alongside other measures such as product reformulation, marketing and advertising restrictions, tackling portion sizes and introducing price disincentives such as the UK’s new sugary drinks tax. Whilst, as we’ve seen on cigarettes, not everyone will be put off by graphic labels, making it clearer that consuming sugary drinks may also lead to the dentist’s drill could provide an additional powerful deterrent for many young people.”

Gavin Partington, director general at the British Soft Drinks Association, said sugar intake from soft drinks was already dropping. “Experience in the UK suggests that the action industry is taking – around reformulation, portion size and switching advertising spend to low/no calorie products – is having ample effect in changing consumer behaviour,” he said.

“In fact, sugar intake from soft drinks in the UK has fallen by almost 19% since 2013 – five times as much as other categories according to latest PHE data – and no- and low-calorie beverages now account for the largest category in the UK soft drinks sector.”

source:https://www.theguardian.com/society/2018/may/24/rotten-teeth-health-warning-on-sugary-drinks-could-deter-buyers

Gel, wand, belly, ultrasound: the moment life as I knew it ended

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It’s late 2001 and Crown Princess Masako of Japan is having a baby. Her husband, Crown Prince Naruhito, is heir to the Chrysanthemum Throne, the world’s oldest hereditary monarchy. Sinking into its fourth recession in a decade, Japan hungers for good news and hopes Masako might have a boy. The Imperial Household Law of 1947 decreed that only men could assume the throne as emperor.

The doubleness of the term “confinement” – imprisonment and childbirth – seems especially apt for Masako. Though she lives secluded in a palace, she is such an object of scrutiny that she may as well reside in a glass cube at the centre of Shibuya crossing.

Looking back now, I would have given birth on the Shibuya crossing if doing so would have changed the outcome for my baby.

People always ask me if there were any warning signs. But everything seemed fine. A few days before Christmas I’d gone to the obstetrician, who measured the baby’s position and heartbeat, and my vitals. I lay down with a band around my enormous middle for 20 minutes and left with reassurances that everything was as normal as it could be. Not long till the baby came now.

Later, in a taxi on the way to the airport to meet my sister and her son, the baby seemed to be going berserk in utero. Super-active, in the way that books said sometimes babies behaved when they were getting ready to be born. And the way I remember Isabella being before I went into labour with her. Looking back, though, I wonder if what I was feeling were convulsions.

I woke the next morning crushed by tiredness. I wanted to sleep for a thousand years. I could hardly move. And I hadn’t felt the baby move. I lay in bed waiting for one of the kicks, usually like clockwork, but there was nothing. It was odd. Adam, my husband, said before he went to work – as anyone in that situation would because it nearly always is – “Don’t worry, I’m sure it’s fine.” All I could do was go back to sleep. I woke mid-morning. Still nothing. My sister gave sensible advice: ring the obstetrician, go to the hospital, get reassured, and then let’s do whatever we are doing today with the kids. But it was going to be the day life as I knew it ended.

We sisters and our children headed off, geared up for a quick scan at the Mount Elizabeth hospital, in and out and on our way. I was shown into one of the ultrasound rooms, all very matter-of-fact. A nurse I’d met before drew the short straw. Gel, wand, belly. Here we go. Nothing. She smiled and said the baby must be asleep so she would try a different position. Nothing. No more smiling as she tried and tried, the wand pressing into my belly from every angle. I could see my baby on the screen. I heard that zhoosh-ing sound but not the chugga chugga chugga of the heartbeat. The nurse went to get help.

I lay there alone, alone with the baby inside me, desperate. “Please please please baby, please move. If you’re ever going to kick again, do it now.” All was still. So still, this baby I had felt grow for nine months, had loved and couldn’t wait to meet. This would be the moment to pray, I remember thinking, as tears ran down my cheeks.

My obstetrician appeared. They had told me she was away but here she was. I felt a flicker of hope now that the big guns were here. She could fix this. But when I saw her face and the glazed look of her offsider, hope receded. She tried to find a heartbeat but there was no heartbeat in my body but my own.

Anyone who has had a baby, or has watched a baby being born, knows that the gap between life and death narrows throughout labour. Sometimes the gap is as thin as a membrane. The mother is alive, the baby is alive, but will both emerge alive? When women say the pain is killing them, they don’t mean it metaphorically. Babies are rushed for tests within minutes of emerging into the world – will they make it? Women haemorrhage to death after giving birth. These things aren’t confined to pre-modern times or the developing world. It’s not for nothing that the standard phrase of the joyous birth announcement is “mother and baby are both well”. Because often they aren’t.

I had to call Adam. You can never predict where you will be when you get the worst news of your life. It was lunchtime and he was at a busy crossing on Orchard Road, about to grab a sandwich with colleagues. I told him bluntly, as I would tell my poor parents a few hours later. “The baby is dead.” I hope I prefaced it with, “Sit down, prepare yourself, I have bad news.” But how else to say it?

Usually when a person is felled by bad news they don’t have to get up and run a marathon. But the business of giving birth had to happen. I could choose my starting time. The doctor said we could let labour start naturally but it might take days. Or I could be induced. That night. That’s what we chose.

We went home to pack. I chose the only outfit my baby would ever wear from a cupboard full of tiny baby clothes.

Mum told me later, or told one of my siblings who told me, that she thought I was going to die. That never occurred to me but I was in such a state that if a giant crater had opened up and swallowed central Singapore I wouldn’t have been surprised. I might have stepped towards one of the fissures.

At the hospital they hooked me up to the drugs to induce labour. I sat up in bed and Adam and I watched Survivor. I remember thinking, through my hysteria, “I’ll show you a fucking survivor, you bandana-wearing, gruel-eating, mud-dwelling, wannabe-celebrity idiots. The tribe has spoken all right. I’ll vote you right off your island.”

On it went. The baby wouldn’t be born for 24 hours. Labour is long, whether your baby is alive or not. I ate winter melon soup served out of an actual winter melon. Hospital food is better in Singapore. Finally, they sent me to the labour ward. There was a band around my belly designed to measure my contractions and a baby’s heartbeat.

On the monitor you could see what was going on in all the other rooms of labouring women. Their babies all had heartbeats. They must have thought, “What the hell is going on in room six?” I would hear their babies crying when they were born.

Contractions kicked in on waves of pain. Some epidural magic meant I fell asleep. When I woke up there was a flurry because the baby was about to be born. I had to push. The baby emerged. It was Daniel. I didn’t know what to expect but he was perfect. I remember the doctor saying in her calm voice, he looks good, he has the right number of toes and fingers, he’s 3.5kg. The placenta looked OK. Everything about him was right. Except, in the most fundamental way of all, it wasn’t.

Then we were alone. The three of us. Adam and I held Daniel. We talked to him. His little lifeless body. But he was ours and we loved him. And then they took our son away. I don’t ever want to feel so sad again.

There was no social worker, no grief counsellor. Just us. That night, lying in my hospital bed with my husband next to me in a camp bed, my son somewhere in the hospital (in the morgue, I guess) and my daughter with her aunty and cousin in our apartment 500 metres away, my thoughts raced. They had offered me a sleeping tablet but for some reason I refused, thinking I had to remember. Bereft was the word that kept popping into my head. I am bereft. I lack what I most want. Death had come for my own child. But not for me. I wondered, why not?

The next morning I lied about the bodily functions I was supposed to have performed; we signed the discharge papers and walked out of the hospital. “But where’s the baby?” asked my little nephew when we arrived home. Some things are too hard to explain. Indeed, it has taken me 17 years to write this.

All life’s big events involve paperwork. Adam had to go to the police station; a person had died and it had to be reported. There was no box on the form that covered our situation. I don’t know about Singapore but now it is possible to get a birth certificate for a stillborn baby in Australia. We had to do something about a funeral or a burial, the demands of the rituals of death. Adam had to choose a coffin. I found myself staring into my wardrobe wondering what to wear to my son’s funeral. The cruel joke was that it had to be a maternity dress.

Adam and I went back to the hospital to meet the hearse and go out to Choa Chu Kang cemetery. We rode in the hearse, with Daniel in his tiny white coffin in the back. The driver said to us that the only good thing about babies’ funerals was that they are cheaper.

A young Sri Lankan priest met us, giggling and smiling because he was nervous. We were all out of our depth. Blah blah into the earth blah blah commend his spirit. Our small group stood around a tiny plot in the tropical cemetery. The miracle was that I remained upright. My body was wrecked. “My child is dead,” I thought, thinking it must be the saddest line in the saddest scene imaginable and wishing I wasn’t in it.

Flowers and messages had been arriving for days from family, friends and neighbours. Most of the blooms were white lilies, Lilium candidum, and I would happily never lay eyes on a single stem again. How I hate those flowers. One reason might be because they’re called Madonna lilies. Another might be because they are said to symbolise innocence restored to the soul of the departed after death. But mainly I hate them because our house was full of flowers for the worst reason. What should have been a celebration was mourning, raw and untrammelled. I didn’t know where it would take us. All I could smell was those flowers.

Friends in holiday mode read the email about Daniel we sent to everyone in the wrong order – after they’d wished us happy new year. For it was New Year’s Eve. Daniel had finished his year as a statistic: in Australia one in 135 births is a stillbirth – six babies a day – and the numbers are similar in Singapore. No cause was found for his death. But he wasn’t a statistic for us. 2001 was over but in all the years to follow we wouldn’t forget him.

source:https://www.theguardian.com/lifeandstyle/2018/may/24/gel-wand-belly-ultrasound-the-moment-life-as-i-knew-it-ended-stillbirth-book-extract23

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