On the bus

Up at the front of th 16A two women were having an intense chat about cleaning products. I tuned in and out, only interrupted by the tooth-chattering vibration every time the driver put his foot on the clutch at stops, instead of putting it into neutral.
Power sprays are the best for showers, apparently, but you shouldn't use them on tiles - too harsh.
Tuned in again, and they were talking about the ad in the back of The Irish Times. "That film The Artist. Have you seen it?"
"Saw the ad; I was saying to Ciaran, but he said: 'I don't know; there's no dialogue. An hour and a half without talking?'
"'Well, that's nothing new to me,' I said. He laughed."

How to make sure your kids won't be nearsighted

  OUT you go, dear, into the fresh air. Better still, out to the mountains with you and walk. Breathe! Air like wine! Look! The rolling hills of Ireland! Sorry to sound like a scoutmaster, but shocking research has apparently discovered the reason for a growing proportion of the world’s kids growing up into specky-four-eyes. 

Those types who said kids who stayed indoors with their nose in a book were right. Not about the nose in a book - about being indoors. 

There’s a worldwide epidemic of short-sightedness (or near-sightedness, as the Americans call it). Myopes are everywhere. A study by Susan Vitale of America’s National Eye Institute found that myopia had risen from 25pc of the US population in the early 1970s to 41.6pc in the early 1990s.

By 2020, it’s estimated that 2.2 billion people worldwide will be myopic. It’s in your genes - but not really. Humans are naturally slightly long-sighted - handy for spotting those gazelles on the ancient plains - but lifestyle has crippled our eyesight. 

Kathryn Rose of the University of Sydney made a monster study of 2,300 Australian 12-year-olds, and found the answer: it’s light. If you’re outdoors, your eyes are unlikely to become crippled by short sight.

Her research was backed up by a study of 1,250 Singapore teenagers by Seang-Mei Saw of the Yong Loo Lin School of Medicine. 

Dr Rose continued her work with an even larger sample. “In 2005 we concluded a study of 4,000 schoolchildren,” she told me on a dodgy mobile phone line from Australia. We were looking at eye health in Australian children on a population basis sample, but we were also very interested in the development of myopia.

“Myopia had increased very dramatically over a period of decades - especially in East Asian countries - which implied that there were environmental factors.”

The obvious culprit was close work - take your nose out of that computer, you - but studies hadn’t borne out the link. Some scientists were now suggesting that it was the lack of outdoor exercise that caused the eyes to freeze in place, and lose their ability to change focus - the basic problem with myopia. Kathryn wanted to test this theory.

“We did a very complicated study, looking at a range of environmental factors. What we were able to demonstrate was that time spent outside was in fact protective against developing myopia.

“Crucially, because we’d asked our questions in such detail, we were also able to show that it wasn’t related to activity itself.

“It was actually related to the hours spent outside.”

The scientists, fascinated, started doing what scientists do best: hypothesising.

Could it be retinal dopamine, they wondered. It’s been well known for some time that retinal dopamine is an inhibitor of eye growth and is released in response to light. 

“The jury’s still out on whether it’s retinal dopamine, but the jury’s not out on the effect of light,” says Kathryn.

“What I’ve really enjoyed from this is the fact that now parents are telling their children to go outside and play.”

http://www.ncbi.nlm.nih.gov/pubmed/18294691

Feelthy feelthy feelthy

  DIRTY hospitals are making patients sick. The superbugs are waiting in badly-cleaned wards and private rooms.

C difficile causes reaming diarrhoea. MRSA (Methicillin-resistant Staphylococcus aureus) eats away at open wounds and develops into pus-filled boils. VRA (vancomycin-resistant Enterococcus) bugs don’t just make you sick, they can also pass on their antibiotic-resistant genes to other bacteria.

All these breed on unwashed bedrails, gowns, buttons and machinery in hospitals. 

But Professor of Clinical Medicine in Boston University School of Medicine Philip Carling’s sneaky study of just how clean hospitals were has already started to revolutionise hospital hygiene.

In the 12 hospitals of the Kaiser group in southern California, staff are using his methods and sharing their cleaning results - and have doubled their hygiene standards.

Professor Carling’s study of cleaning in 82 hospitals was demonically simple. He mixed up a fluorescent marker with detergent and a flour-and-water glue. “It makes a solution that’s hard to see after it dries, but it can be picked up with a fluorescent light,” he says.

This solution is easy to wash off - even plain water will wipe it away, never mind detergent or disinfectant.

His team marked the ‘high touch objects’, the 14 things patients and staff touch most. “We let a few patients cycle through the room to be sure the cleaning was adequately evaluated.”

To their shock, they found that a lot of things that should have been cleaned, weren’t, in most hospitals.

About half of what should be scrubbed was actually being cleaned. (What should be cleaned in hospitals: about 14 ‘high-touch’ surfaces, like bedrails, call buttons, tray tables, phones, handles, and also the controls and medical gadgets that nurses handle all the time.)

So they went and talked to the people in the hospitals. “We worked on the problem through education as well as through repeated feedback”. 

The researchers kept testing, using  the invisible marker - and the thoroughness of cleaning improved from 50pc to 80pc, 90pc and even close to 100pc of the touch surfaces. 

Cleaning is vital in hospital, where very sick people can be at risk from deadly superbugs. “For each improvement of 10pc in thoroughness of cleaning, there’s probably going to be a 10pc decrease in acquisition of those pathogens by patients that occupy that room,” says Philip.

But cleaners are often terrified to wash the controls on ventilators, or the touchscreens and keyboards of monitors, for fear of changing a setting and endangering a patient.

“Nurses touch these all the time, then touch the patients,” says Prof Carling. So medical staff need to do some cleaning too, as well as keeping their own hands and clothes spotless.

Kaiser have succeeded because they’re sharing their results and benchmarking - with their names listed on their results. 

Cleaning the right things, and cleaning them well, can save the health service money, as well as saving people’s lives, Prof Carling says. An average C diff infection costs from €5,000 to €7,000 to the health service. Soap and water and dedicated, benchmarked cleaning could save thousands of euros - if the hospitals want to tackle it.

The Ministry of Special Cases

 Nathan Englander's debut novel The Ministry of Special Cases is set in Argentina, and deeper, in the Jewish community of Buenos Aires, and deeper still, in a family of outcasts of that community. Kaddish Poznan, a man with the sometimes irritating feyness of the traditional Yiddish hero, is the son of a prostitute, a girl who sold herself in Odessa to save her family, and transshipped to be part of the stable of the Jewish pimps 'and alfonses' (still wondering what an alfonse is) who take care of the appetites of Argentina.

Kaddish, a name redolent with death, and Lillian, his disappointed wife, have a squabblesome love fuelled by his only work: chipping the names of the dead - at least those with currently wealthy descendants - from the gravestones in the Jewish graveyard's own ghetto, the place where these whores and pimps were laid to rest; names like Talmud Harry and Bryna the Vagina.

Lillian's own job in an insurance firm is giving her an exceptional insight into the Argentina of the 1970s, because everyone wants the life insured now, even the general and his wife who turn up with a new baby that's obviously not theirs. 

Englander has used the Yiddish tradition, and a sophisticated sense of plot and character, to open the graves of the Disappeared. Just as babies are appearing in unlikely families, other families' children are disappearing, and nobody says a word.

As Kaddish and Lillian try to protect their 19-year-old son, Pato Poznan, a university student at a time when sociology lecturers and scientists and girls of 16 are seen one day and never seen again the next, Englander brings them and his quivering reader on a tour of murder. Every word of his book is based on what actually happened in Argentina, and throughout South and Central America, in those years: the murder-complicit priest taking bribes, supposedly to find out what happened to the desperate parents' child; the drugged children thrown from planes into the river ("like hitting a brick wall" from that height), the torture with electricity, the babies of murdered people given to the families of their murderers and of the directors of their murders. 

Englander tries for the black Yiddish humour - Lillian and Kaddish 'cut off their nose to spite their face', accepting erased noses in payment for an erased name; this makes them suddenly handsome; a last desperate kidnap attempt fails because the kidnapper has not factored in the coldness of heart of the ransom source; bureaucracy is at the root of everything, because if they're frightened of nothing else, the forces of law and order are always afraid of a paper trail. 

Englander's incisive eye is merciless: no government can succeed in anything without the complicity of the majority, he points out (a point that could well be noted in Ireland today). 

His dialogue is heartrending; at one point a wealthy military couple explain that there are no disappearences, it's merely a question of lax discipline - all over South America undisciplined youngsters are taking off to go and sun themselves on the beaches of neighbouring countries. 

At last, the most memorable character isn't Kaddish or Lillian, or the tousle-haired, rebellious Pato, the crooked plastic surgeon or the smooth insurance man, but the broken man whose job it was to push the children from the planes, sleeping children.

Fostering happiness

  DANA Johnson’s research on Romanian orphans was picked up by astonished reporters all over the world. The paediatrics professor studied 136 toddlers in six Bucharest orphanages.  When half of the children were sent into foster care, the difference between them and those left in orphanages was stunning. 

The children had been underweight and undersized. Now, with loving care from dedicated parents, they shot up in height and weight. 

Amazingly, their intelligence also skyrocketed, with their ability to learn and remember improving in line with their sturdiness. 

“Each incremental increase of 1 in standardised height scores between baseline and 42 months was associated with a mean increase of 12.6 points  in verbal IQ,” the study says. “Growth and IQ in low-birth-weight children are particularly vulnerable to social deprivation,” Dr Johnson’s study found. 

Deirdre McTeague, director of services of the Irish Foster Carers Association, wholeheartedly agrees. She has seen a child of 12 arrive into foster care taking size 5 shoes, and within three months he grew two shoe sizes and was taking size 7 - with a simultaneous cognitive boost. He’s now a successful professional who took time to come home last year to mind his ill father. 

Over 5,500 children in Ireland are in foster care, in roughly 3,500 foster families. 

Deirdre moved from social work into fostering in the 1970s, when nearly 90 per cent of children in care were in institutions. Gradually the giant institutions were replaced by smaller group homes. “Now we’ve moved almost full circle, and 90 per cent are in foster care,” she says.

Foster kids - who typically come from troubled homes - can have a hard time with their self-image, says Deirdre. They may feel rejected by their birth families, and conflicted about where they belong - who they should be loving, where their loyalties lie.

The trend today is to try to foster children within their own extended family, so that it is as if the wider family has opened its arms to accept them. 

This has its own problems, though, since legally - and quite rightly - children can only be assigned to people with Garda clearance and references, through a court order or voluntary care order. 

And foster parents don’t have the same rights as birth parents. Until children have been with you for four or five years, for instance, you can’t apply for a passport for them without a social worker’s ok.

Since there is a long queue for services, some foster families just don’t go abroad on holidays. 

There can be huge delays in speech and language therapy, occupational therapy, psychological services for children - even where there are excellent services, like the Mater and Castleknock child guidance service clinics. 

Some foster parents, desperate for help for a child they love, have simply - and this is not acceptable - paid for private services. 

“They’re living with the child, and living through the difficulties the young person has,” Deirdre says. “You get very attached to the child. You can see the blossoming, and the reward of that is great.”

The best foster parents are down-to-earth people who don’t have specific expectations of a child. “Salt of the earth types, who can absorb a child with its own needs and its own quirky nature - the old kind of family who’d say ‘That’s Sean, he likes to play football, and that’s Tom, he likes to read’.”

Irish Foster Care Association: http://www.ifca.ie

TimeWise fostering for teenagers: http://www.timewisefostering.ie 

Sign's on it: the craft still lives

THE LYF so short, the crafte so long to lerne, as Chaucer had it - and so, all over Dublin, tacky vinyl signs are replacing the beautiful hand-lettered shop signs that once beckoned customers in.
But not everywhere. There are a few signmakers still left, like the Painted Signs crew at http://paintedsigns.ie/
You see them working, changing and restoring the lovely old gold leaf signs that were the pride of Dublin, bringing them back to their glory. And in the case of the Welcome sign on McCormack's Celtic Jewellery in Grafton Street, producing a glorious piece of fantasy.
In the multilingual welcomes, there's a curly fada over the 'Fáilte', and a 'kickout' - a dropping decorative serif on the 'N' of 'Benvenuto' that leads the eye into the centre line. The use of English and Irish in a larger face in the centre, and the longer welcoming words on the top and bottom line framing them, gives an impression of many more welcomes than the six there.
There are a few streets the vinyl bandits haven't got to yet, and there are a few shops that are searching out true signpainters who can give their premises signs of timeless beauty and lasting quality.
In a city that has abandoned the beautiful green street names with their white cló Gaelach and English lettering surrounded by a delicate curled line, and replaced them with a slamming industrial blue with misspelled, non-standard names in Irish, it's a real pleasure to see that someone keeps the faith yet.

Bad dentistry will mean bad health

“A YOUNG farmer came to me to have his teeth cleaned, and I looked into his mouth and saw something on the side of his cheek.” Wicklow dentist Dr James Turner says: “I didn’t like the look of it, so I sent him to a specialist. He had early stage dysplasia - a cancer in his mouth - which is completely curable, if it’s caught in time. The man has three young kids!”

But the changes in dental treatment for medical card holders mean that many people won’t be going for routine teeth cleaning. It’s no longer covered for anyone over 16 on a medical card. 

If you’ve lost your job and you’re trying to support your family on the dole, and you’re looking at that €50 note, what are you going to choose to spend it on? Getting your teeth cleaned, or buying food for your kids?

A fortnight ago [in May 2010], anyone with a full medical card had access to a range of dental care: examination, cleaning, fillings, extractions, dentures, front tooth root treatments. But last week the HSE decided that these people could only attend a dentist if they have an emergency - and then they can have one tooth out, or one filling.

“The mouth is the mirror of your body,” says James. “When we look in the mouth as dentists, people assume we’re there for the teeth, but we’re not, actually - we have to examine for all manner of conditions and the risks they present.”

There is a known link between bacteria in the mouth and cardiovascular disease - heart attacks and strokes. And expectant mothers who have periodontitis - a gum disease - are in danger of having underweight or overweight babies.

“Complications of diabetes will present in the mouth,” says James. “Therefore, dentists can be the first people to refer a patient to a GP or a specialist to have these symptoms checked out.”

Osteoporosis is obvious in your mouth: the terrible thinning and weakening of older bones that can end in a broken hip and ruined life. 

So is bulimia. “Sometimes we get young people - girls mostly - who show a striking pattern of erosion on the insides of their teeth where they eat too much and force themselves to get sick,” James says. “The acid in the vomit wears away the enamel.

“We can have a discreet word with the parents - and a disease that could destroy the young person is picked up early, and they can get help.”

And there are gum diseases. “If people have swollen or bleeding gums, that affects their physical health, because they can’t eat properly, and their mental health, because they’re dealing with long-term pain.” 

James has been in private practice for just eight years, and has already saved three patients with early stage cancer. But he’s heard the stories of older dentists, about the bad old days when people could only afford emergency treatment: “People in lines in their waiting rooms, with swollen faces, lots of kids in terrible bad condition with lots of pain, and they spent most of their days just extracting and trying to deal with emergency care.”

This changed with the introduction of preventative dentistry. “Since 1994, people’s dental health has improved immeasurably - the Government has got great bang for its buck. We were winning the battle,” he says. 

“Those huge gains are going to go. We’re picking up approximately three oral cancers every week in Ireland. By not allowing people these visits, all these oral cancers - the third biggest killer in the cancer ranking - will not be caught until a very late stage.”

Evening Herald, May 2010