How health care works around the world

In a doctor's waiting room in South London sit three people of varying ages and ethnicities, waiting among a sea of empty green plastic chairs. It's Tuesday afternoon in the Hetherington Group Practice, which serves more than 8,500 people from dozens of miles in every direction from its base in the bustling area of Brixton. Adorning the many notice boards on the walls are posters asking people to get flu vaccinations, to embrace more walking as part of their day to day and to speak up if they feel that they may have symptoms of bowel cancer. Another poster informs that the Accident and Emergency room at the local hospital "won't kiss it better," appealing to people not to visit their local ER when something is not urgent. Records from the National Health Service show that the numbers of people visiting an emergency room in England have risen from just over 4.5 million per quarter in 2004 to almost 6 million per quarter by the end of 2017 -- almost a 25% increase. In the corner of the waiting room sits a "patient pod" consisting of a computer, a blood pressure machine and scale, for people to measure their vitals in their own time. They can even monitor their mood by answering a series of questions about how they're feeling and what they're thinking. The practice has more than 230 patients registered with severe mental health problems, such as psychosis. "It's about managing demand," said Dr. Steve Mowle, one of the nine physicians at the practice and a spokesman for the Royal College of General Practitioners. This "pod" and the option of a phone consultation aren't the norm for all general practitioners' facilities but Mowle -- like any other GP in the United Kingdom -- has a budget to spend on his practice each year, based on a capitation, an amount paid from the government's budget per patient registered. He and his partners may use it how best they see fit to meet the multiple needs of their large patient base. Demand on the practice has increased significantly in recent years. Unusually, the rise is not in terms of patient numbers, which have in fact fallen, but by people living longer with greater numbers of increasingly complex conditions to manage. Each day, Mowle will have contact with 40 to 50 patients, he explained, with 60% of those in person and the rest through phone consultations. "My clinics are longer," Mowle said. A clinic represents a half-day of seeing patients and is meant to last three hours each. His clinics routinely last at least five hours. Steve Mowle works at the Hetherington Group Practice in London, contacting 50 patients, on average, each day. "Being a full-time GP is impossible," he said, adding that there is "more and more administration" on top of seeing patients. The demographic of his patient base is as vast as the region the practice covers, ranging from the homeless, newly arrived refugees and blue-collar workers to high-earning middle-class and lawyers and bankers whose houses are worth millions. More than 140 languages are spoken locally. Despite their differences, the patients at this clinic -- and anywhere else in the UK -- have one thing in common: Not one of them will pay or receive a bill for the care they receive here. Their health care is free and universal and has been since the formation of the country's National Health Service in 1948. The population's health care is funded through tax and compulsory national insurance contributions deducted from income, which go toward many state benefits. But as the demand for health care has increased across all levels of care -- primary, secondary and tertiary -- so has the strain on this once-coveted health system -- particularly on its finances. A changing climate for health care Health care budgets in the UK have been plateauing, with only minor increases in spending, as percentages of gross domestic product spent on it have been declining. According to the Kings Fund, an independent health care charity, the National Health Service is halfway through its most austere decade ever. Figures from the World Bank reflect this: In 2009, the UK spent 9.8% of its GDP on health care; by 2014, it fell to 9.1%, according to the World Bank. Along with this came more people, who are living longer and with multiple conditions like diabetes and heart disease that require treatments also rising in cost. Meanwhile, hospital bed numbers have fallen, numbers visiting emergency rooms have risen, and the demand for social care -- such as home care or equipment -- in the community has increased with limited services in place to provide it, again leaving more people with fewer hospital beds. "The current situation is unsustainable," said Dr. Ian Eardley, vice president of the Royal College of Surgeons in the UK and practicing surgeon at a hospital in Leeds. "There are patients who are medically fit but can't get help in the community, or support, to leave hospital." Austerity has brought extended wait times for people seeking elective or routine treatments, such as knee or hip surgery, while emergency treatments for serious issues such as cancer or heart attacks continue to be treated promptly, as they should, according to Mowle. Guidance requires anyone in the UK with signs of cancer be seen within two weeks. "(But) you can't bring patients in for elective surgeries," said Eardley, who further stressed the complexities surrounding people living longer. "People often live longer with other medical problems being controlled and managed," he said, adding that greater expectations by patients today and the tendency to discuss cases in greater detail all add time and strain to an already overwhelmed system. Another financial constraint is the increasing, but important, role of computing. "Most of these countries have seen a need for increased spending with changing technology," said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine. Real National Health Service spending in 2015-16 increased by just 1.6%, according to the Kings Fund. "The budget has been frozen for too long," McKee said. More funding is needed, he said, to decrease the debt owed by hospitals whose budgets were not enough and to ensure a greater transition from care settings into the community. http://edition.cnn.com/2017/03/17/health/health-care-global-uk-national-health-system-eprise/index.html

Bangladesh’s 4.6pc Adults Mentally Depressed

Nearly 30 crore people across the world are suffering from depression, while the rate of such a mental disorder among the adults in Bangladesh is 4.6 per cent, Health and Family Welfare Minister Mohammad Nasim revealed the information today based on a survey report. ‘Around 30 crore people in the world are suffering from depression ... the number of mentally-depressed people are varied from 3 to 17 in countries while in Bangladesh 4.6 per cent adults are mentally depressed,’ he said quoting the survey report compiled by the World Health Organisation (WHO) and the National Institute of Mental Health, reports BSS. The health minister disclosed the survey in a press conference ahead of the World Health Day-2017 on April 7 in the ministry conference room here this afternoon. Quoting the survey findings, Nasim said in most of the cases, the symptom of depression is first noticed at the age between 30 to 40 years. The survey said the risk of depression is more among the people aged between 15 and 18 and above 60 years. Pro-longed illness, poverty, unemployment, loneliness, family and relationship problem, divorce, physical and mental torture, living abroad, migration and drug addiction, during pregnancy and post-delivery period have been identified as the root cause of the mental depression. The WHO survey showed that around 3,000 people commit suicide every day across the world which accounts 11 lakh in a year and most of the suicide cases are depression related. As the disease burden, the place of depression in the present world is third. The theme of this year’s World Health Day — ‘Let’s talk about depression’ (Asun, Bisonnota niye kotha boli) has been fixed for taking effective steps to solve depression problems and achieve universal support. At the national level, the inaugural programme of the World Health Day will be held at Osmani Memorial Auditorium in the capital at 10:30 am on March 7. The day will also be observed in other districts and upazilas across the country through different programmes. With Health Secretary Sirajul Islam in the chair, Additional Secretary Roksana Quader and Director General of Directorate of Health Professor Dr Abul Kalam Azad spoke at the press conference.

The 5 Qualities of an Ideal Man

If you are searching for the ideal man, here is a list of 5 essential qualities that he must possess in order to assume that position. If you are a candidate seeking to become an ideal man, work on the following traits: 1. Character – This is the main attribute in making another person happy. If a man’s character lacks truth, honesty and sincerity, then he lacks everything a relationship requires in order to survive. Beware! 2. Maturity – Immature men like showing off: they are afraid of commitment, they are insecure about their future and they are naive. There’s nothing worse for a woman then having to submit to an insecure man. A woman needs a strong and mature man by her side, one that knows where he’s going in life, that is brave enough to solve problems with his own hands and that will be able to care for her like any good husband should. 3. Intelligence – intelligent men think before acting or saying anything. This makes them capable of thinking about the consequences- giving women that extra admiration, respect and assurance for them. With so many women throwing themselves at married men out there, this is by far, a crucial quality to ensure faithfulness. 4. Compatibility – This is the quality that allows a man and women to fit well with each other like puzzle pieces . 5. Fear of God – The man that fears God will never betray his wife, especially when she’s not around. Of course, this list does not apply to all women because unfortunately, not all have the above qualities. To have the ideal man, you have to first be the ideal woman.

The 8 Qualities of an Ideal Woman

I love women. And since I spent a lot of time either chasing, seducing or writing about them, I feel I have a pretty good grasp about what makes a woman truly perfect. In no particular order, here are the characteristics of a perfect woman: THE PERFECT WOMAN MUST BE ATTRACTIVE First and foremost, the perfect woman must be physically attractive. Humans are animals, so physical appearance is what always molds the first impression. Some say that physical attributes are subjective, and are really in the eye of the beholder, but I disagree. I think that they’re really objective: certain physical characteristics are always considered attractive by any man. Some men like to rate attractiveness on a scale, but I’m a simple man: in my world, a woman is either attractive or not; she’s either pretty or average; she’s either “I gotta talk to her” or “nah, I’ll pass.” If I see a woman, and I just can’t peel my eyes of her, as hard as I try, she’s attractive in my book. Coupled with an attractive face, she must have an attractive body, too. The body should be slim, but not too slim that she looks bulimic, with her rib cage bones protruding out. I’m also breast man, so I like my woman to have a nice pair of breasts, which don’t need to be enormous. A nice ass and legs are a bonus but not requirements. THE PERFECT WOMAN MUST BE CONFIDENT Physical attractiveness is only one side of the coin; mental attractiveness via confidence is the other. Combine an attractice women with confidence, and you have an unbeatable human being who can conquer the world and help you do the same. Confidence is one of the best—if not the best trait that a human can have. Confidence is a woman’s way of projecting that she knows exactly what she’s doing out in the world. She’s self-assured that she doesn’t give a shit what you or anyone else thinks. It also an instant reflection that she knows—and is ready to leverage—her intrinsically high value. Just like there’s nothing more attractive than a confident man, nothing can beat an attractive and confident woman. THE PERFECT WOMAN MUST BE FEMININE Long ago, we didn’t even need to discuss or debate this; saying that a woman must be feminine was as absurd as buying a car and specifying that you want the “steering wheel option.” However, nowadays, women come with all sorts of personalities, so, as men, we must be explicit with our requirements in what we seek in a woman. Femininity means that the woman doesn’t act like a man: less sarcasm, less ball-busting remarks, and less trying to outcompete with the men themselves. Essentially it means a woman should behave like a woman. Even the most physically attractive woman instantly losses major points if she’s acting like the manliest man. Not only is femininity a woman’s gift to the world, it also provides a counterbalance to a man’s strong masculinity. THE PERFECT WOMAN MUST BE INTELLIGENT Looks are what initially attract a man to a woman, but her intelligence keeps him coming back for more. She doesn’t have to have a Ph.D. in advanced mathematics, but a good grasp of common and practical sense is usually more than enough. Intelligence can be either of the street or book variety: either of each is equally attractive. Intelligent and clever men respect intelligent and clever women. It duly sets the woman apart in a sea of similarly attractive women who have no outside interests besides constantly checking what their friends are sharing on the social networking sites. Furthermore, if a woman lacks intelligence, then there’s only one other reason why a man is keeping her around — but that will get real old, real quick. THE PERFECT WOMAN MUST BE MATURE Since women generally mature quicker than men, this is usually not a problem. But something changed in the past couple of decades that resulted in women becoming more and more immature. It’s a strange and erratic experience to meet an attractive woman in her mid 30s only to have her acting like someone in her early 20s (or younger). That’s not a woman; that’s simply a girly girl. She’s like an unripe fruit, childish, confused and gullible. Maturity is a trait that only comes via experience. It can’t be easily faked. It’s the reward you get for transcending certain obstacles that were in the way of your dreams and ambitions. An immature girl is someone who never tried, never suffered, and, as a result, never left her childhood behind. It’s someone who hasn’t lived. No experience, no growth and no maturity. She can be a nice girl, but she’ll never be a perfect woman. THE PERFECT WOMAN MUST BE SEMI-INDEPENDENT Successful sovereign men are ruthlessly independent by nature. They are highly focused, constantly carving out their piece of the pie while building their empires. Thus, it’s no surprise that such men strongly despise clingy people, whether that’s other men or women. A clingy woman might be a good match for a clingy man, but she will absolutely drive away any man with even a stench of ambition. There’s something wrong if a woman must be constantly by her man’s side. Perhaps that means she doesn’t have a social circle of her own, fully independent of him and his friends. Maybe she is a social recluse who doesn’t know how to form social connections, or is simply not liked by anyone else. It can also be a canary in a coal mine for graver problems just down the road. The perfect woman must be semi-independent. She must have her own goals and ambitions. She must have her own friends. The only thing that’s preventing an all out independence is loyalty to her man (see below). THE PERFECT WOMAN MUST BE LOYAL I know guys love going for easy women. That was me — maybe ten years ago. Nowadays, I’ve come to respect a woman’s bitch shield. I understand that today I can be hitting on a woman with a boyfriend, but tomorrow that boyfriend can be me with some other smooth player hitting on my girl. Loyalty is one of my favorite human traits. One can be loyal to a cause or to another person. One of the sexiest things that a woman can possess is loyalty to her man. That means she has values and is stands for something for concrete and static instead of blindly following her emotions for any new guy comes along, which doesn’t require much effort. Loyalty means she knows how to think logically instead of being held captive by her whimsical emotions. Popular culture is busy portraying women who are perpetually free from any commitments, and are sleeping with anyone who catches their eyes. I don’t find such behavior sexy at all; in fact, it personifies a woman that no man will ever take seriously. After all, if a woman can’t be loyal, then there’s no reason to invest anything like time and money in such woman: she’ll just pickup and leave at the next available opportunity. Easy come, easy go. THE PERFECT WOMAN MUST BE DECISIVE If there’s something that can piss off a man as much as an overly dependent or clingy woman, it’s a woman who can’t decide anything when faced with the most trivial choices, like picking a cheese in a supermarket. Long ago I dated a nice girl who had the biggest challenge making even the most minor decisions. Her favorite response when left to her own devices was always: “it’s up to you.” That was over eleven years ago, but her foolish indecisiveness is now permanently etched into my cerebral neurons. As a man, I hereby accept the responsibly for taking the biggest risks and making the important decisions, like choosing where to build a new power plant or what small country to conquer. But I also like—and feel that I’m entitled—to come home and have the woman be freely able to decide what color towels to buy or what meat to cook for dinner. Are you interested in building your own location-independent business? The Maverick Entrepreneur Bootcamp, is a comprehensive video course that teaches you how to convert your passions and interests into a sustainable location-independent business. It’s the result of my experience after living abroad for more than 10 years and mentoring hundreds of guys.

Let's Rebuild Our World

Crowds massed in the US capital and around the world Saturday to support science and evidence-based research -- a protest partly fueled by opposition to President Donald Trump's threats of budget cuts to agencies funding scientists' work. At the main March for Science, demonstrators gathered at Washington's National Mall to hear speakers laud science as the force moving humanity forward, and rail against policymakers they say are ignoring fact and research in areas including climate change. "Today we have a great many lawmakers -- not just here but around the world -- deliberately ignoring and actively suppressing science," one of the event's speakers, TV host and scientist Bill Nye, told a rain-soaked crowd from a stage. "Their inclination is misguided and in no one's best interest. Our lives are in every way improved by having clean water, reliable electricity and access to electronic global information." Besides the Washington march, organizers said more than 600 "satellite" marches were taking place globally in a protest timed to coincide with Earth Day. 'That guy over there' in the White House The march, whose beginnings reflect the viral birth of the Women's March on Washington, was billed by its organizers as political but nonpartisan. But many messages were leveled at Trump and his party, which holds majorities in Congress. Scientists have raised alarms over Trump's budget blueprint, which would cut $12.6 billion from the Department of Health and Human Services, including $5.8 billion from the National Institutes of Health alone. One speaker said the administration "tries but fails to silence scientists." Several contrasted rationality and scientific thought to "alternative facts," a phrase that's attracted popular derision since a White House aide uttered it. With the White House in view, protesters held signs with messages such as "In peer review we trust" and "It's the environment, stupid." The crowd fended off a steady rain with umbrellas and jackets as event co-host Questlove alluded to Trump. "That guy over there," the musician and producer said from a stage north of the Washington Monument. "It's been frustrating to watch as certain forces in our society try to squelch science or their refusal to believe in it or propose alternative realities and facts -- alternative facts, whatever that (expletive) is." Demonstrators push forward Saturday in Chicago's March for Science. Demonstrators marched from the National Mall to Union Square. Joni Wright, a neurophysiology graduate student at the University of Florida, cited the Trump administration as a reason why she was in the crowd. "Science is really important, and the current administration is making decisions that are counter to climate change, genetically modified food and vaccinations," Wright, 38, told CNN. Thousands of people also marched in Boston, Los Angeles, San Francisco and New York. In Chicago, throngs marched from Grant Park to the Field Museum for a science exposition, CNN affiliate WBBM-TV reported. "Science has always strived to remain nonpolitical, nonpartisan -- and we're still striving for that," Liz Homsey, a co-organizer, told the station. "Every single scientist at this event feels that it is much more pro science than anti anything." Marches start in Australia Demonstrators in Australia kicked off the day of protest. In Sydney, marchers carried banners, many homemade, with slogans such as "Science makes sense," "Science-based policy = stuff that works," and "Climate change is real, clean coal is not." Another placard displayed the message, "Governments: stop ignoring inconvenient science!" 'We're not going to be silent': Why scientists are marching It wasn't only major cities where scientists and their supporters came out. Rebecca McElroy, an astrophysics doctoral student at the University of Sydney, tweeted video of a "mini march for science" around the dome of the Anglo-Australian Telescope in New South Wales. Demonstrators also turned out in New Zealand cities, including Wellington, Auckland, Dunedin and Christchurch. New Zealand Green Party co-leader James Shaw tweeted a popular chant from the marchers: "What do we want? Evidence-based science! When do we want it? After peer review!" Marches were also held in Durban and Cape Town, South Africa, and in Tokyo. Scientists and their supporters were urged to turn out in force in London as well as other marches in France, Ireland, Finland, Germany, Portugal and the Netherlands. David Johnson, 35, a doctoral student in London, said he was marching because he felt climate change was being sidelined by the US administration and that science was being demonized. Another London marcher, 24-year-old student Rachel Denley Bowers, said science was important and that budget cuts affected research. Roger Morris, professor of molecular neurobiology at King's College London, said: "These marches are brilliant -- a spontaneous, global response led by young scientists empowered by social media, keenly aware of the global challenges that need to be addressed if their world is to have a civilized, sustainable future. "Insular populist politics, which have temporarily triumphed in the US and UK, need to be balanced by the broader vision of youth." Katherine Mathieson, chief executive of the British Science Association, said she hoped the marches would be a catalyst for people to think about the role science plays in their lives and a chance for scientists to demonstrate the public benefit of their work. "Protecting the government's investment in science, particularly when that includes funding for public engagement, is incredibly important," she said. "Science is not just for scientists, and I believe that all of us, whether we work in a lab or not, should have a voice on its future." Trump's budget proposal, unveiled in March, outlined $54 billion in cuts across government programs to make way for an increase in defense spending. US scientists said they fear such a plan would have a major impact on research and science-based policy as well as undermine the importance of science in society and limit future innovation. "It might have been ignited by Trump, but it's not about Trump," march honorary co-chair Lydia Villa-Komaroff ahead of the event. "It's about the importance of science in society and continuing the support for the science community in keeping our edge." CNN's Ray Sanchez, Meera Senthilingam and Christina Zdanowicz contributed to this report.