London bus strike off as talks over Olympic pay continue - The Independent
The debate: Is the submissive relationship seen in 50 Shades of Grey degrading to women?
Both its success and appeal are apparent, but discussions over what the subtext of the book has to s...
London's stroke care success - The Guardian
The transformation of London's stroke services into some of the best in the country owes much to specialist units, multi-disciplinary teams and high standards explains Professor Tony Rudd, consultant stroke physician at the St Thomas' and Guy's NHS foundation trust.
Rudd, who is also London stroke clinical director and vice-chair of the Stroke Association, explains that the government's national strategy in 2007 acted as a catalyst for change for London's stroke services. The document advocated the creation of specialist stroke units and hyper-units built around a multidisciplinary team, as well as better prevention, quicker intervention and intensive rehabilitation.
"The decision was made that we would try and completely transform the way care was delivered," he says. "Now that process has been running for a couple of years or more, and has been enormously successful.
"Mortality has come down quite significantly in London compared to the rest of the country. We have increased our thrombolysis rates up to about 14% of stroke admissions, which is about as high as you would hope to get. The rest of the country is running at about 5-8%."
Before the changes, patients in London were going into hospitals which didn't have the facilities, medical or nursing expertise to be able to deliver the best hyper-acute stroke care, he explains. That care includes giving thrombolytic drugs, but more importantly high quality basic medical care, such as monitoring patients and treating their oxygen and blood sugar levels.
"In order to do that, you actually had to make sure that you did have sufficient staff and sufficient facilities. There was no way we could deliver that in all 32 hospitals," he says.
The plan was to get all stroke patients into just eight hyper stroke units, situated as close to patients as possible, and then transferring them to one of 20 local stroke units for ongoing rehabilitation.
The teaching hospitals in central London were providing good services but Rudd points out that older people tend to live in the suburbs where the hospitals were not performing as well as they should have been. Therefore, the eight hyper-acute centres were spread more widely: in the Royal London, Queen's in Romford, Princess Royal in Bromley, St George's in Tooting, University College hospital, King's College hospital, Northwick Park and Charing Cross.
Designing the centres around patients locations was just one step and Rudd believes that setting stringent standards for stroke care and increasing staffing levels to well above those in other stroke units around the country was key to success.
The scheme was also funded in a way which rewarded high quality care, with London's strategic health authority (SHA) providing an additional £20m to back the reforms, but only if hospitals delivered the required quality of care.
The improvements offer an example for other areas of medicine: "I think the idea of actually getting people into the right place where expertise is, applies not just to stroke. It could apply to vascular surgery, to cardiothoracic surgery - to all the specialisms."
However, Rudd is concerned about the opportunities for similar projects "the London model was developed by the SHA, essentially, and that whole strategic planning process is going to be lost within the health reforms... I think it is very unlikely that the transformation we have seen in London and in other parts of the country is going to happen again, at least until the government's reforms get shown to be nonsensical and reversed."
Rudd believes that cuts and fragmentation of budgets is "clearly going to impose problems." He points out that for their work, an initial investment was required and this has not only improved patient care but they are also saving money in the long run suggesting that "it makes budgetary sense to invest."
He also explains his concerns about a loss of expertise from the NHS. "We are seeing the biggest brain drain from the health service that I have been aware of since I started back in 1978, of really experienced first class managers, commissioners, who are leaving because there are no jobs for them.
Where the NHS is winning at the moment, in Rudd's view, is in access to primary healthcare and the delivery of preventative measures for stroke. "We are certainly better than virtually every country in mainland Europe," he says and that deserves to be celebrated.
This article is published by Guardian Professional. Join the Guardian Healthcare Network to receive regular emails on NHS innovation.
London 2012 Olympics: Campaigners fear for opening ceremony animals - Daily Telegraph
The audience of about 62,000 in the stadium and a billion people watching worldwide will see farmers tilling soil while animals graze.
Ms Newkirk wrote an "urgent letter" to Mr Boyle hoping he would accept that using live animals could trigger "serious problems" for the creatures such as stress and trauma.
Insisting it is not necessary, she wrote: "I would also like to urge you to consider using truly dazzling state-of-the-art animatronics instead of live animals, who are bound to be confused and stressed by the production. Please hear me out.
"There are inevitably serious problems involved when it comes to using live animals in productions, and I don't mean just aesthetically, with animals falling ill, defecating, urinating and so on.
"Animals become stressed and anxious when they are forced into unfamiliar or frightening situations, and stage sets - with their bright lights, heavy equipment and noisy crowds - are obviously traumatic environments for them.
"Then there is the transport to and from the venue, which also proves stressful as animals do not understand what is happening.
"And as for fireworks, clearly they frighten the bejesus out of animals. By contrast, the use of stunningly clever animatronics would create a show of Olympic proportions - without harming any living beings."
Ms Newkirk even offered to help Mr Boyle make contact with Peta's Los Angeles office if he needed a hand to locate studios which could "create jaw-dropping animatronics that would make your show both spectacular and animal-friendly".
She wrote: "Should you opt to use real animals - and we hope you do not - please do as the producer of Babe did and "pay them their wages" by making sure that they are retired to an animal sanctuary after the performance, rather than being sent back to farms and ultimately slaughtered.
"Your intent is to recreate our 'green and pleasant land' but real animals are not necessary to achieve this aspiration and, in fact, detract from it."
Mr Boyle replied: "In our attempt to present an inclusive, rounded picture of British life, including the countryside of which animals are such an important part, I fear we will never see eye to eye.
"All I can say is that genuine care will be taken of the animals, including judging how they react to the stadium environment.
"They will feature only in the beginning of the show during daylight hours and will leave the stadium shortly after 9pm and before any large effects or noisy sequences take place.
"I had not considered your point about the retirement of the animals but will now follow that up vigorously."
The hand-written letter is on paper which has the word Frankenstein in red running down the side of the page.
It seems to be written on stationary dating back to last year when the Oscar-winning director of Slumdog Millionaire was in charge of a stage version of Frankenstein at London's National Theatre.
Boyle starts his reply by apologising if Peta feels its fears have been treated in an "inconsiderate way".
He notes this is one of many different opinions, pressure groups and organisations which lobby the ceremony, making it impossible to personally respond to all of them.
There is also the added time pressure now the show is just weeks away, he notes.
Peta remains unhappy with Mr Boyle's position.
A spokesman said: "Danny Boyle's reply does not fully address our concerns.
"We are satisfied that the animals won't now end up in an abattoir and that much more attention is now being paid to their welfare.
"But their transport and the stress of unfamiliar surroundings as well as their use as props rather than sentient, sensitive individuals have still not been addressed."
London restaurant voted the best in Europe by holidaymakers - Daily Mail
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London boasts the best restaurant in Europe according to holidaymakers, but America dominates when it comes to the top eateries in the world.
The U.S. boasted an astounding five restaurants in the top ten as voted for by tourists for TripAdvisor’s 2012 Travellers’ Choice Awards.
Best In Europe: Michel Roux Jr's La Gavroche restaurant in Mayfair
While restaurants in New York City, San Francisco, Las Vegas and Chicago were all voted in the top four, Michel Roux Jr’s Mayfair restaurant, Le Gavroche, came in fifth place as the first non-US entry on the list.
When it comes to European eateries, London put its neighbours on the Continent to shame with three additional restaurants in the top ten, making it even more popular than dining in Paris.
It seems Londoners are more spoilt for choice than ever before with Chez Bruce, Barrafina and La Trompette in seventh, ninth and tenth places.
Best in the world: Le Bernardin restaurant in New York
Ironically Barrafina offers Spanish dishes, while Le Gavroche, La Trompette, and Chez Bruce are all French cuisine, so it seems you really can discover that little bit of Paris right on your doorstep.
'London is visited by millions of tourists every year, but in the past it has sometimes been derided for its culinary offerings,' said Emma Shaw, TripAdvisor spokesperson.
'But now millions of TripAdvisor users have spoken, proving that London’s restaurants are not only world-class, but enjoyed by those that really matter – diners.'
In the world rankings, the USA is definitely the hostess with the mostest, with restaurants across the states in the top four.
Le Bernardin, in New York City, Gary Danko, in San Francisco, Le Cirque, in Las Vegas and Girl & the Goat, in Chicago all took top billing.
Though it seems French not American is our favourite cuisine with three French serving diners in the top five including French seafood restaurant Le Bernardin.
The top ten European restaurants:
1. Le Gavroche, London
2. La Pergola, Rome
3. Ciya Sofrasi, Istanbul
4. Guy Savoy, Paris
5. El Club Allard, Madrid
6. Tantris, Munich
7. Chez Bruce, London
8. Pierre Gagnaire, Paris
9. Barrafina, London
10. La Trompette, London
The top ten restaurants in the world:
1. Le Bernardin, New York City
2. Restaurant Gary Danko, San Francisco
3. Le Cirque (Bellagio), Las Vegas
4. Girl & The Goat, Chicago
5. Le Gavroche, London
6. La Pergola, Rome
7. Ciya Sofrasi, Istanbul
8. Guy Savoy, Paris
9. Europea, Montreal
10. Toulouse Petit, Seattle
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