Friday 19th August 2016

Love Supreme

Robbie Williams

Oh it seemed forever stopped today
All the lonely hearts in London
Caught a plane and flew away
And all the best women are married
All the handsome men are gay
You feel deprived

Yeah are you questioning your size?
Is there a tumour in your humour,
Are there bags under your eyes?
Do you leave dents where you sit,
Are you getting on a bit?
Will you survive
You must survive

When there’s no love in town
This new century keeps bringing you down
All the places you have been
Trying to find a love supreme
A love supreme

Oh what are you really looking for?
Another partner in your life to
abuse and to adore?
Is it lovey dovey stuff,
Do you need a bit of rough?
Get on your knees

Yeah turn down the love songs that you hear
‘Cause you can’t avoid the sentiment
That echoes in your ear
Saying love will stop the pain
Saying love will kill the fear
Do you believe
You must believe
When there’s no love in town
This new century keeps bringing you down
All the places you have been
Trying to find a love supreme
A love supreme

I spy with my little eye
Something beginning with (ah)
Got my back up
And now she’s screaming
So I’ve got to turn the track up
Sit back and watch the royalties stack up
I know this girl she likes to switch teams
And I’m a fiend but I’m living for a love supreme

When there’s no love in town
This new century keeps bringing you down
All the places you have been
Trying to find a love supreme
A love supreme

Come and live a love supreme
Don’t let it get you down
Everybody lives for love

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Treating carpal tunnel syndrome

Treatment for carpal tunnel syndrome (CTS) depends on the severity of the condition and how long you have had it.
In some cases, CTS will improve after a few months without treatment. Moving your hand or shaking your wrist can often help relieve the symptoms.
You should try avoid any activites that make your symptoms worse.
If your work involves using a computer keyboard, there is little evidence that modifications at your workplace are likely to be of any help in relieving your symptoms.
If symptoms persist, there are a range of non-surgical and surgical treatments available that aim to relieve the pressure on the median nerve.
If CTS is caused by an underlying health condition such as rheumatoid arthritis, treating the condition should improve your symptoms.
The various treatments for CTS are outlined below. You can also read a summary of the pros and cons of the treatments for CTS, allowing you to compare your treatment options.
Non-surgical treatments
Unless there is thought to be an immediate need for surgery, treatments such as wrist splints and corticosteroid injections are often recommended initially.
There is a lack of evidence to support the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for treating CTS, or for diuretics to help relieve fluid retention.

Wrist splints

A wrist splint is worn to support the wrist and keep it in a neutral position. It should not apply direct pressure over the carpal tunnel.
The splint prevents the wrist from bending, which can place pressure on the median nerve and aggravate your symptoms.
You should begin to notice an improvement in your symptoms within four weeks of wearing the wrist splint. Wrist splints are usually available from larger pharmacies, or your GP may be able to recommend a suitable supplier. They can also be ordered online.
Corticosteroids
Corticosteroids are a type of steroid medication. Steroids are hormones that are naturally produced in the body. They are powerful chemicals that can help reduce inflammation.
If a wrist splint does not work, corticosteroids may be recommended.
Corticosteroids can be taken as tablets, although for CTS it is likely that you will have a corticosteroid injection directly into your wrist.
One injection is usually recommended to begin with. If the condition responds well to one injection but then recurs, the treatment may be repeated.
Carpal tunnel release surgery
Surgery is usually recommended for cases of CTS, when other treatments have failed to relieve symptoms.
Surgery for CTS is known as carpal tunnel decompression or carpal tunnel release surgery and is performed on an outpatient basis, which means you will not have to stay in hospital overnight.
During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist.
A local anaesthetic is used to numb your hand and wrist, but you will remain awake throughout the operation.
The surgery can be performed as open surgery, which involves making a single cut in the wrist, and is the traditional type of operation.
Some surgeons use keyhole surgery, where special instruments and a long tube with a light at one end and an eyepiece at the other are inserted through small cuts in your wrist, and sometimes your palm. This allows the surgeon to see the carpal ligament on a monitor throughout the operation.
There are no long-term differences in the outcomes of the two approaches.
Your surgeon will be able to discuss the most appropriate method of surgery with you.

Things to consider

A number of things may affect your decision to have surgery. These include:
possible complications after surgery (see below)
the recovery time
how successful non-surgical treatments have been
In most cases, carpal tunnel release surgery provides a complete and permanent cure. However, as with any form of surgery there is always a small risk of complications.

Reported complications of CTS include:

infection
failure during surgery to fully separate the roof of the carpal tunnel, usually resulting in persistent CTS symptoms
bleeding after the operation
nerve injury
scarring
persistent wrist pain, which may be different to the original symptoms
in rare cases, the return of CTS symptoms long after apparently successful surgery
complex regional pain syndrome – a rare but chronic (long-term) condition that causes a burning pain in one of the limbs

After surgery

Following carpal tunnel release surgery, your hand will remain in a bandage for a couple of days and you may need to wear a sling. You should keep your hand raised for 48 hours to help reduce any swelling and stiffness in your fingers.
To help prevent stiffness, gently exercise your fingers, shoulder and elbow. You may be able to start these gentle exercises on the day of your operation.
After having surgery for carpal tunnel syndrome (CTS), you can use your hand to do light activities that do not cause excessive pain or discomfort. Try to avoid using your hand for more demanding activities until it has completely recovered, which may take several weeks.
The recovery time for open release surgery is usually slightly longer than the recovery time for keyhole surgery. Studies have also shown that there is less pain during the first three months after keyhole surgery compared with open release surgery. However, both methods have proven to be equally effective in treating CTS.

A group of Portuguese researchers from IBMC and FMUP at the University of Porto has found the reason why patients with chronic pain often suffer from impaired short -term memory. The study, to be published in the Journal of Neuroscience, shows how persistent pain disrupts the flow of information between two brain regions crucial to retain temporary memories.

Chronic pain suffers often complain of short term memory’s problems. The neural mechanisms why this occurs are however not understood. Recent studies in animals showed that pain can disturb several cognitive processes as well as change the brain pathways for how we think and feel. Of the many cognitive disturbances observed the most important include problems in spatial memory, recognition memory, attention and even emotional and non-emotional decisions.

In the new  article the team of researchers from the University of Porto led by Vasco Gallardo describes in a rat model of neuropathic pain how a neuronal circuit crucial for the processing of short-term memory is affected by pain. The circuit, established between the prefrontal cortex and the hippocampus, is essential for encoding and retaining temporary memories on spatial information. The researchers used multi-electrodes implanted in the brain to record neuronal activity during a behaviour dependent of spatial memory – the animals were trained in a maze where they had to choose between two alternative paths and then asked to recall their chosen path.

The results show that after a painful injury there is a significant reduction in the amount of information that passes through the circuit. This could mean a loss of ability to process information on spatial localization memory, or that those regions critical to memory are now “overwhelmed” by the painful stimuli disrupting the flow of information for memory.

According to Vasco Gallardo, the team ” has  already demonstrated that peripheral nerve injury induces an instability in the spatial coding capacity of hippocampus neurons “, where is seen “a clear reduction in their capacity to encode information on the location of the animal.”

So to the author “this new work contributes to the demonstration that chronic pain induces alterations in the function of brain circuits that are not directly connected to tactile or painful processes”.  So as a result of chronic pain it is seen that “are also affected neuronal circuits linked to the processing of memories and emotions, what might mean a need for larger and more integrative strategies in the treatment of painful pathologies”, says the researcher.

GB women win historic hockey gold in Rio

The Netherlands were considered the rulers of world hockey and GB’s win came entirely against the run of play. The defending Olympic champions had dominated but a goal in the final 10 minutes from Britain’s Nicola White levelled the scores at 3-3 and took it to penalty shuffles.

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It was Hollie Webb, one of the youngest members of the team at 25, who scored the winning goal. “I watched it go into the net and then I can’t remember anything else since then,” she said. “We practise them so many times and I just tried to imagine I was training at Bisham Abbey. I knew what I was going to do against their keeper, so I just stared her in the eye.”‘To win an Olympic medal with your wife standing next to you is so special’ The first four shuffles had gone begging before the Dutch keeper Joyce Sombroek was ruled to have deliberately fouled Sophie Bray, and Helen Richardson-Walsh stepped up to score from the consequent penalty stroke.

There were two more misses – including Margot van Geffen’s shot hitting the post – before Webb stepped up to the 23-yard line to take Britain’s first potshot at gold. The ball clanged into the back of the goal like Calamity Jane shooting a tin can off the head of a drunk. It was a nerveless finish for a team who had said repeatedly throughout this tournament that nothing but gold would do. Eight of the players had been forced to settle for an Olympic bronze at London 2012 after a heartbreaking semi-final defeat. They included captain Kate Richardson-Walsh and her wife Helen, who came into this match with 657 caps between them.

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They are the first married couple to win gold for Britain since Cyril and Dorothy Wright, who took the 7m sailing class in Antwerp in 1920. To be fair, there were so few yachts competing in that Games only one team went home without a medal. The Richardson-Walshes and the rest of the GB team have bossed this Olympics, defeating all eight sides they faced. The main grandstand was full of Dutch fans. Some wore inflatable crowns while one man had a giant slice of Edam on his head. A tiny pocket of British fans sat right in the middle of the orange mass and made considerably more noise.

Britain scored first nine minutes into the game after Bray took on three Dutch players to shoot from the edge of the D and the rebound was tucked away by White. The Netherlands equalised immediately after the first break, when Lidewij Welten stole the ball in midfield. She and Kitty van Male stepped on the accelerator, catching Britain on the break and allowing Van Male to run around Maddie Hinch entirely unhindered. She finished with a flick into the top right corner. For much of the match the Netherlands had set up camp in Britain’s half so comfortably they may have considered lighting fires and sending a few players off for provisions. A penalty corner reached Maartje Pauman 10 minutes into the second quarter and the Dutch captain, who was looking for her third consecutive Olympic title, sent it skimming past Hinch’s outstretched leg.

There were army tanks parked forbiddingly on the road leading to the arena. Hinch did much the same job protecting Britain’s goal. A series of brilliant saves kept her team in the game from as early as the 12th minute when Sam Quek fouled Laurien Leurink and conceded a penalty stroke. Paumen’s shot came high and straight at Hinch’s head but she deflected it wide. There were plenty more where that came from, including a brilliant double save against Naomi van As.

Team-Great-Britain

A long ball that was deflected past a hapless Caia van Maasakker landed in prime scoring position for Crista Cullen who scored to keep Britain in the hunt. But after three penalty corners in as many minutes the Dutch went ahead again, Van Male scoring her second goal. Going into the final quarter, the Dutch had won 10 penalty corners, their opponents none. Britain’s first and second came with nine minutes to go, both ungainly scrambles in the goalmouth. Sombroek saved the first but the second drew her a foot further out of her ground, leaving a gap for White to slot home Alex Danson’s rebound.

For Danny Kerry, Britain’s coach, the gold medal had seemed almost preordained. “I know this will sound corny but some days you know you’re going to win,” he said, “and even though we didn’t play very well in the first three quarters of the match I thought we were going to tough it out.

“We have probably the best goalie in the world when it comes to shootouts. As soon as it went there, I knew.

Team-Great-Britain-pose-with-their-gold-medals

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