Prime minister also uses last leg of diplomatic tour to issue warning to Turkish president to respect human rights obligations
Theresa May issued a stern warning to Turkish president Recep Tayyip Erdoan about respecting human rights yesterday as she prepared to sign a 100m fighter jet deal that Downing Street hopes will lead to Britain becoming Turkeys main defence partner.
May was in Ankara on the final leg of a diplomatic tour that had taken her to Washington to meet Donald Trump and underlined the compromises inherent in seeking closer trade and diplomatic links outside the European Union in the build-up to Brexit.
Speaking alongside a stony-faced Erdoan in his opulent office, May said: Turkey is one of the UKs oldest friends our relations stretch back over 400 years but there is much that we can do in the future to build on that relationship together. Im proud that the UK stood with you on 15 July last year in defence of democracy, and now it is important that Turkey sustains that democracy by maintaining the rule of law and upholding its international human rights obligations as the government has undertaken to do.
Erdoan said the two countries would press ahead with talks aimed at boosting business ties, adding that he hoped that trade between the two countries, now worth $15bn, could soon reach $20bn. The pair also discussed security and counter-terrorism cooperation and the conflict in Syria.
Downing Street insisted that there was no contradiction between having concerns about a countrys human rights record and signing trade deals. The PMs approach is quite clear: she thinks it is important and in the UKs interests to engage with Turkey.
But May faced criticism from some politicians for doing business with Turkey at all. The Liberal Democrat leader Tim Farron said: As Theresa May seeks trade deals with ever more unsavoury leaders, she ignores the simple point that the most successful countries around the world respect human rights. Economies flourish in free societies.
The prime minister, who had earlier laid a wreath at the mausoleum of Kemal Atatrk, the founder of modern Turkey, said: This agreement underlines once again that Britain is a great, global trading nation and that we are open for business.
Andrew Smith, of Campaign Against Arms Trade, said the deal signed with Turkey confirmed that the UK was prepared to sell weapons to countries that flouted international human rights laws. There is a hypocrisy at the heart of UK foreign policy, and the message this sends to those being repressed or locked up for their beliefs is that their human rights dont matter. The fawning images and uncritical support are not just a propaganda victory for Erdoan; theyre a slap in the face for human rights campaigners and political prisoners across Turkey.
Speaking before the prime ministers arrival in Turkey, Amnesty Internationals UK director, Kate Allen, said the visit was a vital opportunity for May to ask probing questions about allegations of excessive use of force and ill-treatment of detainees by Erdoans security forces. The human rights situation in Turkey had deteriorated markedly during the state of emergency imposed after last Julys botched coup, said Amnesty.
Separately Downing Street announced that, as a result of her talks with Trump, May had agreed to set up a preliminary trade negotiation agreement with Washington, aimed at smoothing the way to a bilateral trade deal when Britain leaves the EU.
Britain must tread carefully in laying the groundwork for future trading relations, because it is not allowed to open formal negotiations with other countries while still inside the EU. However, No 10 sources suggested there were a series of steps that could be taken, short of drawing up a deal, that could smooth the path to the post-Brexit world. That could include lowering so-called non-tariff barriers, such as bans on particular products, and cutting down on regulations.
Liam Fox, the international trade secretary, has been travelling around the globe seeking to lay the groundwork for future trade talks.
The Turkish defence deal will see BAE Systems collaborate with Turkish companies to build a bespoke fighter jet, the TF-X. It is worth 100m small in economic terms, but Britain hopes it will kick off a long relationship and open the door to becoming Turkeys main defence provider. We would expect this to unlock further deals, a spokeswoman said.
May and Erdoan also agreed to form a joint working group to begin talking about a bilateral trade deal that could be signed after Brexit. Britain currently trades with Turkey through Ankaras trade deal with the EU, which will no longer be valid when Britain leaves. The working group will be the 13th Britain has established to scope out potential agreements.
The Turkish prime minister, Binali Yldrm, said that, as well as signing the so-called heads of agreement for the jet aircraft deal, May and Erdoan discussed security cooperation and counter-terrorism.
Washington (CNN)The White Housestatement on International Holocaust Remembrance Day didn’t mention Jews or anti-Semitism because “despite what the media reports, we are an incredibly inclusive group and we took into account all of those who suffered,” administration spokeswoman Hope Hicks told CNN on Saturday.
Hicks provided a link to a Huffington Post UK story noting that while 6 million Jews were killed by the Nazis, 5 million others were also slaughtered during Adolf Hitler’s genocide, including “priests, gypsies, people with mental or physical disabilities, communists, trade unionists, Jehovah’s Witnesses, anarchists, Poles and other Slavic peoples, and resistance fighters.”
Asked if the White House was suggesting President Donald Trump didn’t mention Jews as victims of the Holocaust because he didn’t want to offend the other people the Nazis targeted and killed, Hicks replied, “it was our honor to issue a statement in remembrance of this important day.”
The presidential reference to the “innocent people” victimized by the Nazis without a mention of Jews or anti-Semitism by the White House on International Holocaust Remembrance Day was a stark contrast to statements by former Presidents George W. Bush and Barack Obama.
Anti-Defamation League Director Jonathan Greenblatt tweeted that the “@WhiteHouse statement on #HolocaustMemorialDay, misses that it was six million Jews who perished, not just ‘innocent people'” and “Puzzling and troubling @WhiteHouse #HolocaustMemorialDay stmt has no mention of Jews. GOP and Dem. presidents have done so in the past.”
Asked about the White House explanation that the President didn’t want to exclude any of the other groups Nazis killed by specifically mentioning Jews, Greenblatt told CNN that the United Nations established International Holocaust Remembrance Day not only because of Holocaust denial but also because so many countries — Iran, Russia, Poland, and Hungary, for example — specifically refuse to acknowledge Hitler’s attempt to exterminate Jews, “opting instead to talk about generic suffering rather than recognizing this catastrophic incident for what is was: the intended genocide of the Jewish people.”
Downplaying or disregarding the degree to which Jews were targeted for elimination during the Holocaust is a common theme of nationalist movements like those seen in Russia and Eastern Europe, Greenblatt said.
Initially, after being asked about the ADL criticism and the omission of any mention of Jews or anti-Semitism, Hicks provided a statement from Ronald Lauder of the World Jewish Congress that seemed to criticize Greenblatt and the ADL.
“It does no honor to the millions of Jews murdered in the Holocaust to play politics with their memory,” the Lauder statement read in part. “Any fair reading of the White House statement today on the International Holocaust Memorial Day will see it appropriately commemorates the suffering and the heroism that mark that dark chapter in modern history.”
How James Bond, an abusive Parisian cabbie, and one mans frustration with going out in San Francisco led to a transport revolution
The whole thing might not have happened without Bond James Bond. It was mid-2008, the Canadian entrepreneur Garrett Camp had just sold his first company, the website discovery engine StumbleUpon, to eBay for $75m. Now he was living large, enjoying San Franciscos nightlife, and when relaxing at his apartment in the citys South Park neighbourhood, he occasionally popped in the DVD of Daniel Craigs first Bond movie, Casino Royale.
Camp loved the movie, but something specific in it got him thinking. Thirty minutes into the film, Bond is driving his silver Ford Mondeo in the Bahamas on the trail of his adversary, Le Chiffre, when he glances down at his Sony Ericsson phone. Its brazen product placement and by todays standards the phone seems comically outdated. But at the time, what Bond saw on his phone startled Camp: a graphical icon of the Mondeo moving on a map toward his destination. The image stuck in his head and to understand why, you need to know more about the restless, inventive mind of Garrett Camp.
Camp was born in Calgary, Canada, and spent his early childhood playing sports, learning the electric guitar and asking lots of questions. Eventually, his curiosity settled on the world of personal computers. An uncle gave the family an early model Macintosh, from the days of floppy disks and point-and-click adventure games, and Camp spent hours on it during the frigid winters, toying with early computer graphics and writing basic programs.
By the time Camp graduated from high school, his parents had a three-storey home that included a comfortable office and a computer room in the basement. There wasnt much reason to leave, he says. He enrolled at the nearby University of Calgary, saved money by living at home and spent the next few years there (aside from one year in Montreal, interning at a company called Nortel Networks). He got his undergraduate degree in 2001 and stayed at the university to pursue a master of science, finally leaving his comfortable nest after he turned 22 to move into a campus apartment with classmates.
Camp met Geoff Smith, who would become his StumbleUpon co-founder, through one of his childhood friends and they started the site as a way for users to share and find interesting things on the internet without having to search for them on Google. By the time Camp finished his degree in 2005, StumbleUpon was starting to show promise. Camp and Smith met an angel investor that year who convinced them to move to San Francisco to raise capital. Over the next 12 months, the number of users on StumbleUpon grew from 500,000 to 2 million.
With the trauma of the first dot-com bust fading and the scent of opportunity again wafting across Silicon Valley, offers for StumbleUpon started pouring in. In May 2007, eBay bought StumbleUpon for $75m, turning it into one of the early successes of what became known as Web 2.0, the movement in which companies such as Flickr and Facebook mined the social connections among internet users. For Camp, it seemed the highest possible level of success in Silicon Valley and it was, by any reasonable standard until the one that he achieved next.
One report tweets in regards to the St Louis, a boat taking Jews fleeing Nazi Germany that was turned from the United States
Twitter users have enlisted the social networking platform to help bring to light private narratives of the victims of the Nazi regime on Holocaust Remembrance Day.
Within the length of the day, the St Louis Manifest report told the stories of the passengers of the German transatlantic liner that has been turned from the United States in 1939. There were 937 folks onboard, nearly all were Jews fleeing from the Third Reich.
Following the boat was denied permission to dock in Florida and sent back across the Atlantic, 532 passengers were immobilized when Western Europe was seized by Germany. Just over half survived the Holocaust.
Other moving posts on Twitter marking Holocaust Remembrance Day featured men, girls and kids who perished in Nazi death camps across Europe through the 2nd world war.
To mark the 72nd anniversary of the liberation of Auschwitz, photographer Marina Maral recoloured a picture shot in Auschwitz of 14-year old Polish Catholic Czeslawa Kwoka. Czeslawa was killed in 1943.
Writer Leah Bobet used Twitter to tell the story of her grandfather, who survived a Nazi concentration camp.
Saint Louis Manifest was still tweeting as news of Donald Trumps executive order prohibiting Syrian refugees in the US issued.
(CNN)Reagan and Thatcher. Bush and Blair. Obama and Cameron. And now? Trump and May.
The close relationship between US and British leaders goes back to Winston Churchill and Franklin D. Roosevelt, but how the longstanding “special relationship” will do under US President Donald Trump’s isolationist government and UKPrime Minister Theresa May’s Brexit Britain is still in question.
May will function as the first foreign leader to fulfill with President Trump on Friday. Here is a look at the world is seen by every one of these.
Trump campaigned on protectionist trade policies throughout his candidacy and he is spent the first day or two as president signing executive orders that strengthen his vow to set “America first.”
Trump has expressed openness to carry out a fresh trade handle the UK, but has said he’ll prioritize American occupations.
May is a proponent of free trade and globalization — branding her vision of a “Global Britain” that’s “open for company” in her Brexit strategies.
But May’s international vision may not reach as far as she trusts.
When the UK leaves the single market, which ensures the free movement of services, products and individuals inside the 28 member bloc, it’s going to have to negotiate a fresh trade deal featuring all participant states.
The UK mightn’t get the deals it needs as the EU will give preference first. This can be among the reasons May might look to get a fresh free trade handle the US.
May has said she’ll seek free trade deals with individual nations in and out of Europe and will use her meeting with Trump to begin preliminary discussions. But even if Trump is open into a UK commerce venture that is new, the UK will not be able to sign any deals until it formally leaves the EU, a procedure which has not formally began and is likely to take at least two years.
Trump has sent mixed messages on NATO. He is repeatedly known as the organization dated and committed campaign air time to rally against members of the 28-nation coalition for not bringing to the recommended defense spending amounts of around 2% of GDP.
Mattis, a solid supporter of NATO, talked with Secretary General Jens Stoltenberg and three coalition partners such as the UK this week and reaffirmed that the US had an “unshakeable commitment to NATO.”
Mattis and Stoltenberg said they “looked forward to working together to strengthen the Alliance, including by increasing defense spending and doing even more to fight terrorism,” according to your statement released by NATO.
May lately reaffirmed her commitment to the coalition, saying that NATO has helped to “defend Europe and its Allies.” After discussing with Stoltenberg last week, she stated that she’d reiterate to Trump the coalition’s value inside their assemblies.
As stated by the British Ministry of Defence, the UK spends 2.1% of their yearly GDP on NATO.
He campaigned hard on developing a border wall with Mexico, making a Muslim registry and getting tough on illegal immigration.
Trump’s refugee prohibition would last for four months if enacted. After 120 days, the US would then prioritize entries of refugees who are fleeing religious persecution from Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen, “provided that the religion of the individual is a minority religion in the individual’s country of nationality,” according to the draft order got by CNN.
Entries for Syrian refugees could be frozen indefinitely before an overhaul is seen by the checking procedure. The strategy would limit the total variety of refugees accepted to the United States in half throughout the 2017 fiscal year.
In her address to the 2015 Conservative Party Conference, May, then Home Secretary, laid out her position on immigration — repeating precisely the same hardline stand she is taken as Prime Minister. Inside it, she indicated the fury and bitterness felt by Brits out of work was spurred by immigration, she also maintained a considerable variety of asylum seekers were “foreign criminals” and asserted immigrants made society less “cohesive.”
How immigration will appear under Brexit is still uncertain, even though the Prime Minister has said she needed to ensure the rights of EU citizens already in Britain and British citizens in other EU states “as early as we can.”
Seeing future immigration from European nations, May said: “Brexit must mean charge of the amount of people that come to Britain from Europe. And that’s that which we’ll deliver.”
Trump has expressed an openness to work with Putin, and has said that Russia could be a partner in the struggle against ISIS. While President elect, he also indicated he was amenable to the chance for lifting sanctions on Russia — using the caveat the state helps the US in its continuing fight against terrorism. Both states are trying to improve their atomic capacities, increasing the prospect of a new arms race involving Russia and the United States.
For the present time, Trump said he intends to keep sanctions for “at least a period of time.”
He also recently admitted that Russia was behind the hacking of the Democratic National Convention through the campaign — but added they “were totally open to be hacked.” Russia has denied any participation in america election campaign.
May appears less inclined to open up relationships with Russia.
May vowed to ratify the Paris deal to slow climate change during her first address to the UN General assembly this past year.
But May’s dedication to the environment is not clear.
Among her first acts as Prime Minister shut down the Department of Energy and Climate Change — folding its into the Department for Energy Business & Industrial Strategy.
She is also supported hydraulic fracturing (fracking), a contentious approach that raises oil and gas generation that also includes devastating environmental threats, a few of including human induced quakes as well as the pollution of water sources.
For nine years under Canadas preceding authorities, science endured severe limitations. Now US scientists might be facing the same destiny
Canadian scientists who have been muzzled for almost a decade from the preceding Conservative authorities that was countrys happen to be making contact by making use of their counterparts in america to provide solidarity and their support amid mounting fears that Donald Trumps presidency will seek to curb climate science.
Scientific libraries were shut, programmes endured severe cutbacks while national scientists were prohibited from speaking to media on subjects that ranged from snowflakes to salmon and even a 13,000-year old flooding.
It turned out to be a dramatic departure from previous practices, said Robert MacDonald, that has worked for almost 30 years as a government scientist.
MacDonald pointed to an 2013 survey of authorities scientists in which 24% said they’d been directly requested to exclude or change advice for non-scientific reasons. Thats something you’d be prepared to listen to in the 1950s from eastern Europe, not a thing you expect to listen to in 2013 from a democracy like Canada, he explained. And I believe, by all sign, thats what brothers and our sisters will be faced with down in the United States.
Recent days have found the Trump government apparently contemplate scrubbing all references of climate change from the Environmental Protection Agency site, while the Associated Press reported that EPA scientists could be subject to some short-term hold, pending review by political appointees.
The reports have triggered concern north of the boundary. Were already reaching out to our counterparts in the US as well as in the international science community, said Debi Daviau, head of the Professional Institute of the Public Service of Canada, a union that represents more than 15,000 authorities scientists, engineers and research workers.
On Thursday, her organisation released a statement calling the activities of the Trump management a chilling reminder of the years under Stephen Harpers premiership. We thus stand in solidarity with our co-workers and fellow government scientists in the United States by once again declaring science shouldn’t be quieted, and by expressing our hope the present limitations on US government scientists will shortly be revoked , nor indicate an enduring change in US policy on science, like the one we fought so long to overturn in Canada.
In 2013, hundreds of individuals clad in white lab coats collected on Parliament Hill in Ottawa for what became among the very observable actions of opposition from the repression of Canadian government scientists. A mock funeral procession was held on the passing of scientific evidence, whole with eulogies that took aim in the years of escalating from your Conservative authorities. Similar demonstrations were held throughout the nation.
Signs for Democracy, the group behind the Canadian demonstrations, has been in touch using the organisers of the March for Science in the US. Why opposition has galvanised so rapidly in america, the Americans pointed to the Canadian experience to spell out, said Katie Gibbs of Evidence for Democracy. They saw what occurred under Harper and so theyve seen so theyre not taking a wait and where it leads -and-see strategy, theyre acting now.
Gibbs described the reports this week in regards to the activities of Trumps team torwards climate science shocking. It certainly harks back to what we saw in the States under George Bush and what we saw under Harper, except its so much speedier than that which we saw under Harper and much more brazen, she said. But in precisely the same time theres been a tremendous opposition coming from thats been heartening to find out and the scientific community.
The Canadian expertise offers myriad lessons for the US government scientists, said Kristi Miller-Saunders who was one of Canadas first authorities scientists to be prohibited from talking to the media above a newspaper investigating the 2009 fall of the sockeye salmon population in British Columbia.
Chief among these lessons is the trustworthiness said the molecular geneticist and also the connection involving treating scientists.
She said, in the event the authorities can suppress info coming from a programme that info isn’t in the public eye anymore. When the advice just isn’t in the public eye, the people believes theyre actually not doing much for the reason that place, there hasnt been any inroads. And its much more easy for the authorities to subsequently gently cut on the plan.
Science is manufactured inside a community, that community stands willing to fight for US authorities scientists and said MacDonald.
Among the amazing things that happened during our darkest days for us using the Harper government was from our brothers and sisters down in the States and the support we’d received from international scientists, he explained. Were there to stand with them shoulder to shoulder. Well be there for them.
(CNN)Britain’s defense secretary had some extreme words for the Russian armed force on Wednesday as UK warplanes and warships tracked Russia’s only carrier through the English Channel.
“We are keeping a close eye on the Admiral Kuznetsov as it skulks back to Russia; a ship of pity whose objective has actually just extended the suffering of the Syrian individuals,” Defense Secretary Sir Michael Fallon stated.
At the time, Russia stated the Kuzentsov’s trip was “to guarantee marine existence in the essential locations of the world ocean. Unique focus will be made on securing security of maritime traffic and other kinds of Russian maritime financial activity as well as reacting to brand-new sort of modern-day risks such as piracy and global terrorism.”
But others took a various view.
“It’s a program of force and a program of abilities,” Peter Felstead, editor of Jane’s Defence Weekly, informed CNN in October. “In regards to strike objectives, they (the Russians) might simply as quickly have actually performed them with the land-based airplane they currently have in Syria.”
(CNN)Walls in between nations are absolutely nothing brand-new. The Romans constructed Hadrian’s Wall about 120 years after the birth of Christ to safeguard the Roman province of Britain from the heathens who resided in exactly what is now Scotland– individuals the Romans described as “barbarians.”
And let’s not even speak about the Great Wall of China, the building which started centuries prior to that.
But isn’t really this expected to be a brand-new period in worldwide affairs? The period following the fall of the Berlin Wall and the lifting of exactly what Winston Churchill called an “Iron Curtain” dividing Europe? An age where the worldwide system surpassed all and nationwide borders were softened since of worldwide monetary connection?
Guess once again.
North Korea and South Korea have actually been divided by a demilitarized zone because fight in between them ended in 1953. Each side consented to pull its soldiers back 2,200 lawns from the cutting edge, developing a 2.5-mile no-man’s land.
But exists a wall?
North Korea states there is one. Authorities from the North state that South Korea and the United States constructed a concrete wall along the DMZ in the late 1970s. South Korea and the United States reject this.
But North Korean authorities firmly insist the wall exists, with earth mounded up versus it so that it can not be seen from the southern side.
In any occasion, the DMZ would be tough for anybody to cross without bring in attention of the soldiers on either side of it. And Korea– wall or no wall– stays divided in 2.
Hungary– A wall in development
As Europe comes to grips with a wave of migration of historical percentages, different nations are developing fences and walls to attempt to keep back the flood, especially Hungary .
The nation– where authorities state that approximately 1,000 individuals each day are crossing its borders unlawfully– has actually started developing a fence on its southern border with Serbia. The fence will be 13 feet high, authorities state.
Approximately 80,000 migrants have actually crossed into Hungary this year, the majority of them from Iraq, Afghanistan and Syria, where a ruthless civil war continues unabated after more than 4 years.
Most of the migrants wish to relocate to wealthier EU nations such as Germany.
In addition, Bulgarian authorities are protecting the nation’s border with Turkey by developing a fence topped with coils of razor wire.
And Britain has stated it will construct a fence more than 2 miles long in Calais, France, at the entryway to the tunnel under the English Channel. Migrants have actually collected in great deals in Calais, wishing to stash in trucks and make the crossing into Britain.
The Long Read: Suffering is difficult to describe and impossible to see. So how can doctors tell how much it hurts?
One night in May, my wife sat up in bed and said, Ive got this awful pain just here. She prodded her abdomen and made a face. It feels like somethings really wrong. Woozily noting that it was 2am, I asked what kind of pain it was. Like somethings biting into me and wont stop, she said.
Hold on, I said blearily, help is at hand. I brought her a couple of ibuprofen with some water, which she downed, clutching my hand and waiting for the ache to subside.
An hour later, she was sitting up in bed again, in real distress. Its worse now, she said, really nasty. Can you phone the doctor? Miraculously, the family doctor answered the phone at 3am, listened to her recital of symptoms and concluded, It might be your appendix. Have you had yours taken out? No, she hadnt. It could be appendicitis, he surmised, but if it was dangerous youd be in much worse pain than youre in. Go to the hospital in the morning, but for now, take some paracetamol and try to sleep.
Barely half an hour later, the balloon went up. She was awakened for the third time, but now with a pain so savage and uncontainable it made her howl. The time for murmured assurances and spousal procrastination was over. I rang a local minicab, struggled into my clothes, bundled her into a dressing gown, and we sped to St Marys Paddington at just before 4am.
The flurry of action made the pain subside, if only through distraction, and we sat for hours while doctors brought forms to be filled, took her blood pressure and ran tests. A registrar poked a needle into my wifes wrist and said, Does that hurt? Does that? How about that? before concluding: Impressive. You have a very high pain threshold.
The pain was from pancreatitis, brought on by rogue gallstones that had escaped from her gall bladder and made their way, like fleeing convicts, to a refuge in her pancreas, causing agony. She was given a course of antibiotics and, a month later, had an operation to remove her gall bladder.
Its keyhole surgery, said the surgeon breezily, so youll be back to normal very soon. Some people feel well enough to take the bus home after the operation. His optimism was misplaced. My wife came home the following day filled with painkillers. When they wore off, she writhed with suffering. After three days she rang the specialist, only to be told: Its not the operation thats causing discomfort its the air that was pumped inside you to separate the organs before surgery. Once the operation had proved a success, the surgeons had apparently lost interest in the fallout.
During that period of convalescence, as I watched her grimace and clench her teeth and let slip little cries of anguish until a long regimen of combined ibuprofen and codeine finally conquered the pain, several questions came into my head. Chief among them was: Can anyone in the medical profession talk about pain with any authority? From the family doctor to the surgeon, their remarks and suggestions seemed tentative, generalised, unknowing and potentially dangerous: Was it right for the doctor to tell my wife that her level of pain didnt sound like appendicitis when the doctor didnt know whether she had a high or low pain threshold? Should he have advised her to stay in bed and risk her appendix exploding into peritonitis? How could surgeons predict that patients would feel only discomfort after such an operation when she felt agony an agony that was aggravated by fear that the operation had been a failure?
I also wondered if there were any agreed words that would help a doctor understand the pain felt by a patient. I thought of my father, a GP in the 1960s with an NHS practice in south London, who used to marvel at the colourful pain symptoms he heard: Its like Ive been attacked with a stapler; Like having rabbits running up and down my spine; Its like someones opened a cocktail umbrella in my penis Few of them, he told me, corresponded to the symptoms listed in a medical textbook. So how should he proceed? By guesswork and aspirin?
There seemed to be a chasm of understanding in human discussions of pain. I wanted to find out how the medical profession apprehends pain the language it uses for something thats invisible to the naked eye, that cant be measured except by asking for the sufferers subjective description, and that can be treated only by the use of opium derivatives that go back to the middle ages.
When investigating pain, the basic procedure for clinics everywhere is to give a patient the McGill pain questionnaire. Developed in the 1970s by two scientists, Dr Ronald Melzack and Dr Warren Torgerson, both of McGill University in Montreal, it is still the main tool for measuring pain in clinics worldwide.
Melzack and his colleague Dr Patrick Wall of St Thomas Hospital in London had already galvanised the field of pain research in 1965 with their seminal gate control theory, a ground-breaking explanation of how psychology can affect the bodys perception of pain. In 1984, the pair went on to write Wall and Melzacks Textbook of Pain, the most comprehensive reference work in pain medicine. It has gone through five editions and is currently more than 1,000 pages long.
In the early 1970s, Melzack began to list the words patients used to describe their pain and classified them into three categories: sensory (which included heat, pressure, throbbing or pounding sensations), affective (which related to emotional effects, such as tiring, sickening, gruelling or frightful) and lastly evaluative (evocative of an experience from annoying and troublesome to horrible, unbearable and excruciating).
You dont have to be a linguistic genius to see there are shortcomings in this range of terms. For one thing, some words in the affective and evaluative categories seem interchangeable theres no difference between frightful in the former and horrible in the latter, or between tiring and annoying and all the words share an unfortunate quality of sounding like a duchess complaining about a ball that didnt meet her standards.
But Melzacks grid of suffering formed the basis of what became the McGill pain questionnaire. The patient listens as a list of pain descriptors is read out and has to say whether each word describes their pain and, if so, to rate the intensity of the feeling. The clinicians then look at the questionnaire and put check marks in the appropriate places. This gives the clinician a number, or a percentage figure, to work with in assessing, later, whether a treatment has brought the patients pain down (or up).
A more recent variant is the National Initiative on Pain Controls pain quality assessment scale (PQAS), in which patients are asked to indicate, on a scale of 1 to 10, how intense or sharp, hot, dull, cold, sensitive, tender, itchy, etc their pain has been over the past week.
The trouble with this approach is the imprecision of that scale of 1 to 10, where a 10 would be the most intense pain sensation imaginable. How does a patient imagine the worst pain ever and give their own pain a number? Some men may find it hard to imagine anything more agonising than toothache or a tennis injury. Women who have experienced childbirth may, after that experience, rate everything else as a 3 or 4.
I asked some friends what they thought the worst physical pain might be. Inevitably, they just described nasty things that had happened to them. One man nominated gout. He recalled lying on a sofa, with his gouty foot resting on a pillow, when a visiting aunt passed by; the chiffon scarf she was wearing slipped from her neck and lightly touched his foot. It was unbearable agony.
A brother-in-law nominated post-root-canal toothache unlike muscular or back pain, he said, it couldnt be alleviated by shifting your posture. It was relentless. A male friend confided that a haemorrhoidectomy had left him with irritable bowel syndrome, in which a daily spasm made him feel as if somebody had shoved a stirrup pump up my arse and was pumping furiously. The pain was, he said, boundless, as if it wouldnt stop until I exploded. A woman friend recalled the moment the hem of her husbands trouser leg snagged on her big toe, ripping the nail clean off. She used a musical analogy to explain the effect: Id been through childbirth, Id broken my leg and I recalled them both as low moaning noises, like cellos; the ripped-off nail was excruciating, a great, high, deafening shriek of psychopathic violins, like nothing Id heard or felt before.
It seems a shame that these eloquent descriptions are reduced by the McGill questionnaire to words like throbbing or sharp, but its function is simply to give pain a number a number that will, with luck, be decreased after treatment, when the patient is reassessed.
This procedure doesnt impress Professor Stephen McMahon of the London Pain Consortium, an organisation formed in 2002 to promote internationally competitive research into pain. There are lots of problems that come with trying to measure pain, he says. I think the obsession with numbers is an oversimplification. Pain is not unidimensional. It doesnt just come with scale a lot or a little it comes with other baggage: how threatening it is, how emotionally disturbing, how it affects your ability to concentrate. The measuring obsession probably comes from the regulators who think that, to understand drugs, you have to show efficacy. And the American Food and Drug Administration dont like quality-of-life assessments; they like hard numbers. So were thrown back on giving it a number and scoring it. Its a bit of a wasted exercise because its only one dimension of pain that were capturing.
(CNN)Two of 2016’s most significant food patterns from leading chefs consisted of boundary-pushing meals that blurred the lines in between science, cooking and art, and going “locavore”– eating in your area produced foods.
It was likewise the year that supergrains and veggies discovered their method into the cooking areas of virtually every dining establishment in the world.
Many excellent young Asian chefs trained in leading dining establishments in Europe and the United States will return the home of begin their own food, states Andre Chiang of Singapore’s 2 Michelin-starred Restaurant Andre .
They’ll bring with them a”European soul”to a brand-new Asian taste which will utilize regional components.
This Europe-meets-Asia pattern will spread out all over Asia– consisting of Japan, China, Korea, Taiwan, Thailand and the Philippines, inning accordance with Chiang.
Hospitality is king for 2017, states chef Daniel Humm of Eleven Madison Park, a routine finest dining establishment of the year heavy player.
Now more than ever, Humm states individuals desire real hospitality when they go out for a meal.
“Whether that comes at a great dining restaurant, or counter-service area, it’s still appropriate, due to the fact that it’s exactly what makes the experience unique,”he stated, including that he’s delighted to see restauranteurs and chefs handle the obstacle.