Thursday, 30 December 2010

Looking back

Ducks and gulls converging on bread thrown to them in the river
The last year has been pretty good, I think - at least, casting my mind back has not made me wince as it might have in previous years. We started with a very fine New Year's Eve party at the Cricketers - the last, as it turned out, with Smurf in charge.

Then there was snow, I had a couple of exams, then a weekend break on Dartmoor and then a return to the throes of term time study. Lola II moved house and celebrated her birthday and started going out with Mr M (not necessarily in that order); what a year she has had!. Looking at my diary for January to March, there seems to be little there other than travelling to university and Monday night badminton, before respite comes in April with the Easter break, but ongoing coursework no doubt.

Five exams turned up in May, after which Mr A and I managed a lovely holiday in Bruges. Then it was 12 weeks of clinical placement, which was probably the most intense period of self-examination, skills development and technical progress I have ever experienced. It had its ups and downs, but went very well on the whole - the manager of the department wrote some very encouraging feedback on the review form.

Our bathroom was transformed, but we end the year as we ended 2009 - with a great hole in a ceiling (kitchen rather than living room this time). It's water that does all the damage in this country, but at least we don't have cockroaches, bedbugs, ants or termites. The exterior of the house was also fully restored, and I'm still loving the look of it every time I come home.

Various other entertainments took place over the summer - the beer and film festival, the food and drink festival, a camping trip or two, and then it was back to school for the final year. Mr A took his first exam since leaving uni the first time round, and did rather well (but he's as bad as me, not satisfied unless he's done his best). Unlike previous years, the trusty car had presented no problems at all until someone decided to nudge into it gently, propelling me into a vortex of insurance claim and hire car heaven.

October and November were quite social months: we went to Devon, Bristol, Towcester and London to see various friends and relatives, and then I went to Coventry to see some people with coeliac disease. In December, we even invited people into the hallowed cloisters of Lola Towers for dinner. Monday night badminton continued, and term ended, and I have continued to toil on, getting coursework finished, and hoping to move on to revision before it's too late. And I have also read and written about nearly 30 books during the year.

As might be expected, I have also caught whatever it is that Mr A has. It is not yet serious - a bit of a cough, and three hours in bed on Monday afternoon, but I think we can expect worse over the coming weeks. Typical, just in time for the revision and exam period. But I went for a walk, and it has rained, and the temperature has been above freezing for three whole days with more to come, so much of the snow has now gone. Good news for our New Year holiday in the Peak District, and for travelling 50 miles to the exam in January, and for airport and flight availability for our snowboard holiday (although that's a month away and anything could happen by then). Meanwhile, Mr A continues to cough.

So that's it for 2010, it's been fun. I'm hoping that 2011 will be just as good if not better!

Monday, 27 December 2010

Festival confinement

Snowy scene on the river path
All of Christmas Day was spent on my very favourite activities: opening presents, eating, reading books, watching films, eating some more and reading more books. Mr A gave me Stephen Fry's autobiography and I gave him Mark Kermode's book about the movies, and we had each read about half by the end of the day.

Mr A did most of the cooking, despite being ill, and only asked me to do the Yorkshire puddings and open the oysters, which are my special skillz. I volunteered for breakfast scrambled eggs with smoked salmon duties as well, given that I knew he would be doing everything else, and he's not very well. Christmas day food was a triumph, with the roast beef, potatoes and vegetables done to perfection, and plenty of leftovers for the next few days.

Mr A has also been having a bit of a dessert frenzy over the past few days, considering that he's a bit unwell and at normal times we never have anything sweet after the meal. He made junket with the rennet his dad gave him, and then a magnificent treacle tart, and apple crumble, all over the space of two days. We haven't touched the junket yet, the treacle tart is now in the freezer, and I had one lot of apple crumble but he didn't even finish his. He has not yet emerged this morning, and I wouldn't blame him for staying in bed, he really isn't very well. I'm not sure I mentioned that.

The temperature outside has been as low as ever over the past few days, and with a big hole in the kitchen ceiling and an unreliable central heating controller we have been a little chilly on occasion. I haven't actually stepped outside the house for three days, two of which have been fully occupied by this stupid coursework, which is very nearly finished but always takes longer than it should. I'm determined to go for a walk today. The temperature on my PC widget now shows a balmy 3 degrees, and the forecast is for above-zero temperatures for the next few days, so we might see some thawing at last.

Friday, 24 December 2010

Snow and water

A row of snowy trees
OK, we are a little bit 'had enough of this' at Lola Towers now. It has been a most exciting winter season, but we are ready for the spring now, and would rather like some daffodils to break out along with sunshine and temperatures, oh, I don't know, somewhere above freezing would be good? Definitely above the minus 18 degrees Celsius that it was the other night when I couldn't sleep and got up to service your blog requirements, which is what I do when I can't sleep. My computer has one of those Microsoft widgets that tells you the temperature, and Microsoft are clearly on the ball because Royal Leamington Spa is one of the locations that you can have. It is telling me minus 1 degree at the moment, and it is snowing again, quite hard.

Don't get me wrong, I love the snow. Snow is fun to play in, fun to walk in, tobogganing on Mr A's toboggan is some of the best fun in the world, in fact it is one of the reasons I agreed to go out with him all those years ago. You can see I set quite a high bar with relationships: "You say you don't have a great home-made toboggan? Oh, I'm sorry, I don't think I can see you any more. We're just not compatible."

Snow is particularly good for snowboarding, which is what Mr A and I were forced to do on Tuesday afternoon. I say 'forced' because it would have been quite a good thing if we could have not had our second snowboarding lesson at that point, but it was booked and paid for (and quite expensive) and they are quite firm about non-refundable non-transferable bookings. It would have been nice not to go snowboarding because when we phoned a plumber after that indoor waterfall happened on Monday evening, he said he could come on Tuesday afternoon.

You may be surprised to hear that in a way, it was a good thing after all that we went snowboarding and the plumber didn't come until Wednesday. This was because, after surviving quite nicely with the mains cold water turned off - we still had a full hot water tank to use for essentials - we experienced a second indoor waterfall on Tuesday in much the same location in the kitchen as the Monday event, but this time hooray! it was hot water coming in. That stopped when the hot water tank was empty, but from that point until the plumber finished, we had no running water at all. And we turned the heating off, just because we weren't entirely certain that the heating system is 100% separate from the tap water and didn't want to tempt fate.

Plumber with his head through a hole in the ceilingHaving no water or heating is inconvenient, but actually not too bad in reality. We had an open fire in the living room, many quilts and duvets, thermal underwear, gas to cook with and electricity for the kettle and essential appliances (i.e. the computers, electric blanket). If the electricity were to fail, well, then we'd just have to move out, even if the house were toasty warm. No Internet? I don't think I could cope.

Anyway, the plumbers came, saw and conquered, and we are left with a large hole in the kitchen ceiling and a mystery as to why there were completely unlagged hot and cold water pipes in that location in the first place. I say 'were' because they have now been cut and blocked off, and if we discover anything that no longer works, we will know what they were for. Our best guess is that there was once a sink on a wall that no longer has one. But unlagged copper pipes? and running along an exposed wall? That's just asking for trouble.

What with the cleaning up afterwards, another day passed without a trace of coursework being done. So I spent all of Wednesday on justifying my chosen community nutrition intervention, which will be for people with dementia being cared for in their own homes in Warwickshire. I'm guessing that I've done about half the necessary work for this bit of coursework, and then I have to finish my research project and do some revision. But this will be the last Christmas/New Year holiday ruined by having to study!

So here we are, all ready to go, Mr A poised over the stove and ready to collect the oysters from the fishmonger. I am, as usual, at my desk ready to do some Christmas Eve coursework, presents littered under the large format camera tree substitute. I hope you all have as good a time as we're going to have.

Tuesday, 21 December 2010

Domestic turmoil

Snowy trees and bench
It is nearly That Time of Year, and I am behind with everything, just because I got a little bit drunk one evening and then it snowed. It snowed a lot, actually, and has been very cold ever since, so the roads are treacherous and I thought that I might walk to badminton, which is quite a long way. I was sure that someone would offer me a lift home, because I made cakes out of cornflakes for everyone. And they did, mentioning that I could have had a lift there as well if I'd asked, but I didn't think of it.

Mr A and The Boy's tobogganing expedition was not a great success, because there was too much snow that had not yet been packed down. The Boy's train to the next stop of his tour was also cancelled, which was a little worrying for him, but the next one ran OK. I started to feel that I was missing the beauty of snow-covered Leamington, so I went out on an expedition to take photos and buy some essential supplies (e.g. chocolate).

Other than that, I have not been working as hard as I might, getting distracted quite easily. Our house has been throwing challenges at us - it experienced a power cut in the middle of the night, which meant the heating timer was reset and the heating didn't come on in the morning as it should, giving us a brief twinge of panic (and frostbite) until the boiler successfully fired up. The timer is Not Very Well though, allowing access to most functions except the one that turns the central heating on and off on demand. It still does everything else, so we are ignoring it for the time being and hoping that it will get better by itself.

The washing machine has also showed signs of rebellion by spewing water over the floor. A process of elimination revealed that the outlet pipe had accumulated a plug of detritus which we removed, but a seal was weakened on some other pipes that we took apart during the process of elimination, so we're catching the drips and will attend to it when we have more strength. It could be a lot worse, but just writing this is tempting fate. There are still a whole lot more appliances and devices around the house that could join in the revolt and make our lives uncomfortable in the current subzero temperatures.

I have done a small amount of work, and my research project supervisor was kind enough to telephone so that I didn't have to turn up in person for a meeting. All is well, she gave me much useful advice, but I need to actually do the work, and time is slipping by. I have a great deal to do before we go on a real holiday to a place where there may be no Internet access for a week.

Final note: I wrote most of the above yesterday. When I got home from badminton, Mr A was in the kitchen mopping up water that had been coming in from above the window. It is a mystery where it is coming from, because there is a flat roof above the kitchen, but we have called a plumber and are living on minimal water until tomorrow. Unfortunately we have our second snowboard lesson this afternoon, which they stress very emphatically is non-transferable and non-refundable. Perhaps there are showers there we could use...

Snow piled on top of two metal bins

Saturday, 18 December 2010

Eating, drinking and snowboarding

Wonton dumpling soupl noodle
Ooh, I've been busy. Really busy. Obviously I finished the first draft of the research project report in time, and emailed it over to my supervisor by the end of Wednesday. This allowed me to have my proper weekend on Thursday and Friday, and boy did I make use of that weekend. A bit too much, really.

On Thursday I tidied up a bit so I could find my desk, but abandoned that to go to Birmingham for the day. I was meeting people at the end of the day, but found a film that I thought might be good, featuring the gorgeous Johnny Depp. But I went early enough so that I could have lunch at Cafe Soya, which has not gone out of business in the three and a half years since I stopped working in Birmingham and single-handedly funding its existence. It is delicious, and so much better than its competitors, and I had wonton dumpling soup noodles, and they were wonderful.

I met up with friends I used to work with, and caught up with some office news, most of it tales of redundancy and jobseeking and pain. But we cheered ourselves up with some Glühwein in the Frankfurt market that sets itself up in central Birmingham every Christmas, and had some schnitzel, and walked about a bit looking at the stalls on the way to the pub that we like which was too full to sit down in so we went to another pub that we like that was too noisy. But we stayed there anyway and had some beer and then I caught the train back home. It was only delayed half an hour for the half-hour journey. All in all, a very long day.

Now this was all very well and I had a lovely time, but Glühwein before any food plus beer afterwards and a late night because of train delays made me rather tired and emotional. In fact, it was a great deal more than my system is used to, and the thing that I should have remembered is that on Friday morning, very early indeed, Mr A and I were having our first snowboard lesson.

We were awake and up in time, and got there ready to go at the allotted time, but I really was feeling rough despite the pints of water I'd drunk (and the paracetamol), and although I took some breakfast with me, I really couldn't eat it. So there I was, out on the slope on my snowboard, telling my legs and feet to do things they really didn't know how to do, without any fuel to allow them to do it. It all made perfect sense based on my newly acquired dietetic knowledge, but the fact was, I couldn't eat the muesli until two hours later when we had a break. I was transformed after that, and by the end of the session was feeling much better, sliding forwards and backwards, and we had even started making turns.

When we came out, it had actually been snowing, which made it feel even more exciting and holiday-like, and we're really looking forward to the second lesson next week and the holiday at the end of January. But the journey home was quite slow, and then all I could manage was a bath and a bit of lunch and then off to bed for a couple of hours. More like three hours, actually.

The Boy came to visit in the evening, as part of his Christmas tour of parents, so I did manage to get up again for supper (another Jamie triumph from Mr A) but then sent them off to the pub so I could complete my rehabilitation ready for work on Saturday. The weekend's truly over for me, so I'm back to coursework this morning. It's been snowing pretty hard here, so the last I've seen of Mr A and The Boy was them heading off for the slopes of the golf course with the toboggan...

Wednesday, 15 December 2010

Markets, and I am a winner (again)

Big bowl of soup
Sunday's fun was promised, so Sunday's fun is what you shall have. We decided to reward ourselves for Saturday's toil by going out somewhere, and settled on Spitalfields and the Columbia Road markets. I suggested that we set off quite early, and then felt quite guilty about that, because as proper employed working people Lola II and Mr M don't get many opportunities to sleep late.

Two types of little spiky plantsWe took a detour to Petticoat Lane, which is a haven for clothes, luggage and the usual tat of an outdoor market. Spitalfields itself is a more upmarket place than I expected - I think I was imagining an indoor Petticoat Lane, but here were beautiful things with prices to match. Lunch was at Wagamama, because we were a bit too cold to enjoy street food, although if I'd seen Brick Lane market beforehand then I might have changed my mind. It would have taken forever, though, because I would have had to examine every stall before making a choice, and there were a lot of stalls. Lola II and I both had pork dumpling soup and shared a portion of noodles. Yum. Mr M had a rice dish that he wasn't that keen on.

Columbia Road market sells plants and flowers, and at this time of year, a lot of Christmas trees too. It was nearing the end of opening hours, and traders were knocking their prices down, and it was quite narrow and there were a lot of people. Mr M bought hyacinth bulbs and Lola II bought a cactus and I bought the same type of cactus and gave it to mum when I visited later in the day. Mum's very good at raising cactuses, and then giving them to me when they are about to flower. I get all the colourful display, and then they die, I don't know why. I also adjusted the security light and had a cup of tea and a square of tiramisu before borrowing a book for the tube journey back to Lola II, because I'd forgotten to bring one and it's too noisy underground to listen to podcasts.

Coming back home on Monday morning, I settled down to carry on writing up my research project. I am glad to report that of course, I will finish it in time to send a draft to my supervisor on Thursday. That won't stop me from worrying, and complaining about having to spend so much time on it.

Anyway, Monday night is badminton night, and the club staged its annual tournament. You may remember that last year, with my partner S, we won! This time things started looking up when we were freakily drawn as partners again. And we won again! The little trophy has returned to its spot on the trophy shelf, and we are better off by another bottle of wine. I think next year the draw will have to be done differently so we don't end up as partners again, just to give someone else a chance.

Sunday, 12 December 2010

Interviewing the furniture

Mr A in the pub
I'm now happily taking a break in lovely London with the luscious Lola II and the marvellous Mr M. Before coming down here, Mr A and I celebrated the end of term with a trip to the Red Lion, in which we ate dinner, drank great beer, and caught up with Smurf, who happened to be working there. It's a great feeling, to be welcomed to a pub by someone you know, directed to the best table, given a recommendation for the guest beer, introduced to other punters, and generally looked after.

What with the feeling of end-of-term freedom and a generalised love for all humanity, I became quite tipsy. Which meant that I didn't get up until after 9 a.m. on Friday, gathered all my stuff, mislaid my ipod, found it again, and made it down to London in time for Japanese lunch with Lola II, who took the day off work in my honour. And because she has quite a lot of time owed to her. Salmon hand roll and tempura udon ramen, in case you wondered. Delicious.

We spent the afternoon catching up with Lola Life, which is after all the main focus of this blog. I think I am allowed to reveal (I will check) that she and Mr M are planning to live together, starting in the New Year, so I asked if there were any further preparations. I was expecting to hear about practical issues like hiring a van or complex financial spreadsheets, but what she said was "We've been preparing to interview the furniture." I'm not sure that this statement, written down, conveys the utter lunacy of conducting formal interviews to see which furniture will join them in the combined accommodation, but it still makes me laugh thinking about it now.

In the evening, Lola II's music group was meeting informally at someone's house to play a few things together. Lola II was prepared to miss it on my behalf, but I bravely volunteered to join in, bringing my clarinet out of its sullen retirement on a high shelf in my office. I think it must be at least five years since I took it out of its case, so I was a little nervous, but it went very well. It's extraordinary how your fingers remember things that you don't consciously know, especially when you are plunged into the world of 13/8 time signatures and a double sharp thrown in without warning. I had a wonderful time.

A desk covered in papersSaturday was a day for business. Despite repeated attempts to set her up for independent living, Lola II seems incapable of dealing with the inevitable administration that accompanies an employed adult homeowner. I had to force her into her office and set up an imaginary forcefield, prison guards, and a complicated system of parole to ensure that it was all either thrown away or filed. And I had to fend off Mr M's attempts to evade security on Lola II's behalf, by smuggling a metal file inside a newspaper for 'recycling', to break through the prison bars. He was sent upstairs to assemble a wardrobe, and then to get our lunch (bagels and salt beef).

A tidy, uncluttered deskWe worked through the day, Lola II filed and threw stuff away, and Mr M assembled a great deal of wardrobe. They had a longstanding dinner engagement in the evening, which allowed me to indulge in my second Japanese fix of the weekend: aromatic duck with rice and another salmon roll. Delicious again. Then I did some homework for school, which is starting to make me panic a little bit because I have to hand in a draft next week and it doesn't feel like I've done enough.

More news of Sunday's fun to follow (probably).

Thursday, 9 December 2010

Tube feeding

Hourglass and figure on a board game
The end of term is nigh, but I am prolonging the agony by extending the time to finish a draft of my project report. Looking on the bright side, I have handed in another piece of work, and if my project report looks reasonable then I'll only have one major assignment for the holidays, as well as revising for the one exam that we have in January. So I might be out walking a lot more over the New Year - last time I was revising so much that I could only spend one day out with friends.

Since Monday there have been two whole days at uni, whizzing through a load more 'stuff that might be useful one day'. Patient safety, a carbohydrate counting exercise, the role of research in dietetics and the value of weight management in groups, some peer-assisted learning about psychosocial factors relating to food choice, going through practice exam questions, and a seminar about the upcoming and final clinical placement.

Meanwhile I handed in the coursework where we had to choose an aspect of dietetic practice and plan a research study as if we had a day a week for 12 months to carry it out. I chose to write about tube feeding in hospital, and how patient-centred our dietetic practice is (or isn't).

It's clearly very important to gain consent for placing the tube, either by passing via the nose or by endoscopic and surgical placement directly through the stomach wall - these are invasive processes, one of which involves an incision. But consent is very rarely gained explicitly for the process of feeding, it seems to be implied by consent to the placement of the feeding tube.

It's the dietitian's job to work out how much feed to give through the tube, and make an initial guess at the right type of feed. There are different types: some more concentrated than others, with and without fibre, and some specialised ones like low sodium or lactose-free. The amount needed is calculated on the basis of the patient's nutritional requirements (usually related to the patient's weight, any stress or trauma, level of activity, and desired weight loss or gain), an estimate of what they are managing to eat by themselves, and any other relevant health conditions. But it is always a guess, and the patient needs to be monitored for change in body weight and any unwanted symptoms like constipation.

What I saw on my last placement was that the 'regimen' for feeding was written up by the dietitian for implementation by nursing staff without any discussion with the patient. Admittedly, when feeding is started the patient is often in no fit condition to express an opinion, and just wants the professionals to get on with it and make them better. But sometimes feeding needs to be continued for a prolonged amount of time, sometimes indefinitely, and in those situations it seems to me that there are choices that ought to be discussed, and aren't.

The main ones are method of feeding and timing. There are two options for tube feeding: you can use a pump that delivers a volume at a constant rate over a defined period of time: 100 ml/hour for 16 hours, for example, which could be overnight or through the day. Or you can 'bolus' feed using a 50 ml syringe, to squirt food into the stomach several times a day over a period of about half an hour each time.

The factors that dictate which method is used seemed to be (a) convenience: it's much easier to set up a feed once a day than manage bolus feeding several times, and (b) it is thought to be more convenient for the patient to be attached to a pump through the night so that there is more freedom during the day. So the default feeding regimen tended to be pump feeding for 16 hours overnight.

I'm not sure that this is what I would want long term. Mealtimes become irrelevant if you're being drip-fed overnight, but they are one of the few things that interrupt the boredom of a prolonged hospital stay. Feeding overnight means that you can't sleep flat - you have to be propped up to make sure the food goes down rather than up. Anyway, my research idea is all about asking patients what they would prefer, and I've handed it in now, so I plan to forget all about it as soon as possible.

Today we had our very last ever lecture on this course! The sobering thought, however, is what the future holds: I have a meeting with my project supervisor and with my placement supervisor, an exam and a viva, a 12-week clinical placement, a couple of revision sessions and the final assessment towards the end of May 2011, and then it's all over! In just six months' time, I may have a job. Interesting times ahead...

Monday, 6 December 2010

Dinner party

Meringue roulade with berry fruits
Doesn't time just fly by? I've been trying to churn out something interesting every three days, but my life doesn't have that many thrills, and now that the time for another post has come round again I'm a bit short of material.

Over the past week or two I've been working, occasionally punctuated by badminton, going to the vegetable shop, and last night, a dinner party. It's only the second dinner party we've hosted in this house, and went much better than the first. I was less ambitious with the food, and didn't over-cater too much at all (we've only got soup and some vegetables left). The company was loquacious and congenial, although there was a little bit too much talk of internal combustion engines of various sorts. It turned out that one of the party once sold a precious classic car to the father of another. It's a small world, except that a self-selected group of friends is likely to have something in common - in this case, cars and bikes.
Hot and sour soup
We invited one couple to stay overnight. Our spare bed is in my 'office', and I made the mistake of leaving my computer in there. Given that I was the first to go to bed, at 2 a.m. it is perhaps unsurprising that they have not yet emerged, it is 9.30 a.m. and I have been up for some time and am getting twitchy about losing a morning's work, with deadlines looming.

Friday, 3 December 2010

What I've been reading

Image of the book cover
Second Class Male
by Stan Madeley

"Whether he's offering himself up for adoption to Elton John or attempting to hypnotize Derren Brown by letter, Stan Madeley (by deed poll) is a fearless and dynamic correspondent. Boldly billing himself as Britain's top Richard Madeley lookalike, he uses his so-called celebrity status as an innovative excuse to plague, pester and pen letters to many well-known faces, politicians and organisations, with hilarious results."
Now that I've read this, I can genuinely endorse it as unexpectedly addictive, and laugh out loud funny in places. It's slightly formulaic, but that just means I was looking forward to finding out what tagline the 'Stanley Madeley Experience Live!' would have in the next ridiculous letter. He has a comic turn of phrase that I love, but the gems are the responses from the public figures and companies that he writes to - David Dimbleby, David Attenborough, the Pope, Michael Howard - especially when they enter into the spirit of the joke. The principle is not new (I remember glancing through The Timewaster Letters a few years back) but Stan's letters are much more enjoyable and inventive than the ones in that book. So the offer's still on - if someone would like me to send them a free copy of the book (one that I have bought, not my signed one), just let me know in the comments.


Image of the book cover
The Turn of the Screw
by Henry James

narrated by B. J. Harrison
"The narrator is a young governess, sent off to a country house to take charge of two orphaned children. She finds a pleasant house and a comfortable housekeeper, while the children are beautiful and charming. But she soon begins to feel the presence of intense evil."
This is actually the second time I have listened to this story, with a different narrator this time. Mr A came into the kitchen and heard a little bit, asked who the author was, and concluded that he wouldn't be reading any Henry James in future. My last audio Henry James was awful - the blog post was from when I put up the post before I'd finished the book, so it doesn't say so, but I don't recommend it. This one is just about OK, but disappointing, and I'm now very worried that if I were to read 'Portrait of a Lady' again, I wouldn't like it.


Image of the book cover
My Man Jeeves
by P. G. Wodehouse

narrated by Simon Prebble
"Containing drafts of stories later rewritten for other collections, My Man Jeeves offers a fascinating insight into the genesis of comic literature’s most celebrated double-act. All the stories are set in New York, four of them featuring Jeeves and Wooster themselves; the rest concerning Reggie Pepper, an earlier version of Bertie. Plots involve the usual cast of amiable young clots, choleric millionaires, chorus-girls and vulpine aunts."
I hadn't realised until I scouted for the quote above that this contained stories that later re-appeared in more polished form. I thought I'd just read them before, or seen them in TV form. The narrator, who was so brilliant when reading 'Jonathan Strange & Mr Norrell', somehow isn't as natural with Jeeves and Wooster as Jonathan Cecil is. But Mr Wodehouse's prose makes up for most deficiencies in plot or narration.

Tuesday, 30 November 2010

Working in teams


Given the amount of attention it gets on my course, I sometimes muse on the many and varied teams I have been part of. Three in particular came strongly to mind: the first was relatively early in my working career, when I was put forward for a European-funded project to introduce technology to blind and partially sighted young people in Northern Ireland. The other two were much more recent: a team formed to improve access to an important software product used in social services, and another which put on and managed a number of international conferences in the UK.

Our conference team became expert and well-organised, and produced splendid and enjoyable results. My role for most of the events we held was to elicit papers and sift out the ones for presentation, and then look after the speakers, and sometimes the technicians as well on the day. The real highlight for me was the year that we scheduled a 'debate' between various eminent persons on the topic of whether, thanks to technology, people with sight problems are better off than they were a generation ago, and managed to get Jeremy Paxman to agree to chair the session.

It was brilliant, he signed my conference programme (giving the impression that he thought it was one of the strangest requests he'd ever had), and then I went back into conference organiser mode, collecting one of the speakers and accompanying him to lunch. He was an educator, so I spotted one of the educators from my own organisation and asked my speaker if he'd like to join him for lunch. As we reached the table, I realised that the great Paxman was with the chap from my own organisation, so I was going to be lunching with him. I think that's my only celebrity encounter, but it was a good 'un.

In contrast, the Consortium that we formed in order to improve accessibility to a major piece of software used in UK social services departments was an eye opener, and could have been a case study for my current course. All the theoretical aspects of a serious partnership had to be covered - what exactly are we trying to achieve, who leads, what roles do team members have, how are meetings managed, who pays, and a whole lot more. The lessons I learned were that it's largely the individual characters, motivations and skills of the people on the team who determine whether the project succeeds or not. I think we were lucky, but I wonder whether that software is now accessible or not.

In university, all the options are laid out in a Powerpoint presentation: what makes a good team, why teams often fail, as if you could say to yourself "This piece of work needs a team, let me work out who can be involved and how we should manage the thing." In fact, we just came up with an idea, found someone else who was willing and able to help and even had some money, and then we just muddled through.

The fondest memories of teamwork came from that first European-funded project I was involved with. It came along when I was relatively young and inexperienced, based in Liverpool, and my remit extended over all of the north of England, Scotland and Northern Ireland. At the time Northern Ireland was a battle-scarred place of deprivation that attracted all sorts of funding, and a project was devised that was intended to help blind and partially sighted young people to become computer-literate, and therefore more employable. I think about 12 people needed to be recruited, and I was put in charge of the technology. Except that there wasn't any.

I didn't really understand how this project was being run, who was in charge or what resources there were. It gradually became clear that the first stage required an assessment of what types of technology each of the participants would need in order to use a computer. We were going to gather in some Northern Ireland location, get to know the group, and I needed to do my assessments, except that I still didn't have any computers, nor any budget. I phoned a few people, and managed to cobble together two full systems by cannibalising old machines that didn't work any more.

In terms of social contact and work-related entertainment, that project left us all with stories aplenty. I remember finding out that all the speech synthesiser hardware I'd bought (this was before computers could do sound output) had 3.5 mm audio sockets, but all the headphones had 6.3 mm plugs, and I ended up on the streets of Belfast buying a soldering iron and 3.5 mm plugs and re-soldering the lot in the office.

On another visit, I was over in Belfast with a number of colleagues, one of whom was gay. For an evening's entertainment, one of the staff took him out drinking on the Falls Road (or it could have been the Shankill Road, I really didn't know much about Irish politics in those days). He was warned what he could and couldn't drink - asking for a port and lemon was distinctly discouraged in those tough working class bars. I have never seen a man so grey as my colleague the next day, who had survived the evening's drinking but had to make a number of swift exits from the office during the following morning. I have just looked him up - he's now an eminent politician in Scotland.

Yet another time during the course of this project, we went off for a weekend to a hotel near the Giant's Causeway in the very north of Ireland - I can't exactly remember the reason, but there used to be European Commission money to spend on this type of trip. There's another tourist attraction very nearby, Carrick-a-Rede, consisting of a rope bridge to a rocky island. One of the totally blind participants in the scheme was also partially paralysed down one side, but was insistent that he wanted to cross the rope bridge. With one member of staff behind him and one walking backwards ahead of him, he made it, but we were all anticipating the headlines in the papers should we have lost him.

That project was one of the highlights of my working life, for the feeling that we were doing something worthwhile as well as the social aspect. We have all gone our separate ways now, and I'm not in touch with anyone from that project any more, but I'm sure we all have fond memories of that particular project.

Saturday, 27 November 2010

Progress with coursework

This week has been a busy one, where I've been in to university every day except Friday, and Mr A has been hard at work on his course, but also cooking and trying to sort out our snow holiday with friends. At last it is booked; last night at 11 p.m. the last click was clicked and we are going to Austria in January, between my exams and the clinical placement.

At uni I was working on my research project at the start of the week, and my other research-based coursework at the end of the week, interspersed with a meeting with my project supervisor, presentations from other students about their ideas for a community nutrition intervention, and presentations including mine about Dietetic Support Workers and Assistant Practitioners, who are NHS employees at lower grades than dietitians. A bit like us students operating on our clinical placements, where we're not quite good enough to be dietitians, but there are still a lot of things we can do competently.

My project about food and visual impairment is plodding along at the moment. Having done the interviews and transcribed them word-for-word, I have then had to try and pick out common aspects from the transcripts, and see if they can be grouped logically in themes. For example, all of them mentioned the importance of good lighting, particularly for shopping, cooking and reading menus, and some also highlighted the difficulties they have when lighting is not good, in restaurants for example. Some of the areas that interest me most are about how they feel about living with sight loss, sometimes making light of it with jokes, but also more seriously speculating on what the future holds.

I identified some themes that I think make sense, and then was advised to use a software package called NVivo to help with coding. That took a solid day and a half non-stop at the computer. I've now been given some guidance and reading to do around the next step, which is to start to make a story out of what I find, ready for writing into a paper. There's a lot to do, and as always, not enough time.

My supervisor is also very enthusiastic about the possibility of publishing this research in various academic journals, and even submitting it for inclusion in the British Dietetic Association Conference next year. Inconveniently, the conference takes place in the week before the final exam period next May, and the submission deadline for proposed papers is two days before the submission deadline for this coursework.

But I must away, Lola II is visiting this weekend and is due any minute. And we've had snow! The first snow of the season, and in November. The temperature outside is zero (Celsius) and Lola II is a cold-blooded creature, so we've got the heating on and some emergency clothing for her.

Lola II wrapped up in front of the fire

Wednesday, 24 November 2010

So how's it going at university?

Construction of a new university building
There hasn't been any university news on here for three weeks or so, but obviously I've been beavering away at various course-related projects. I was expecting a great deal from this semester, thinking it might provide as much interest, stimulation and challenge as previous years or the clinical placement. In fact it's been rather disappointing on all counts.

We only have two taught modules, one termed 'Nutrition in the Community', and the other advertised as 'Advanced Dietetic Practice', but the latter turned out to have the qualification 'and Professional Issues'. The Professional Issues bit, it seems, are the things that are deemed useful for a basic grade dietitian to be taught before they leave university, rather than learning over time from the University of Life. Like last week's lectures: aspects of business management, coping with stress, time management, teamwork, managing change, leadership and motivation, and the role of the Human Resources department.

I got the distinct impression that the lecturer, who is also the university course manager, felt the same way about it as I did, but is forced to deliver the material because the Health Professions Council (who regulate the profession, and therefore the course) demands it. Certainly she would have picked up our reaction on being asked, yet again, to consider what might be the advantages and disadvantages of working in teams.

For me, it was an exercise in nostalgia and reflection. I don't think anyone can have reached my age without considering their response to stress, and I have had a few close calls. I have a vivid memory of the one time that I was properly affected, and how I was helped out of that particular hole. I was brought down by the end to a relationship, and what prompted me to recover was the recommendation by my boss at the time to seek help. I didn't seek help, and I managed to recover under my own steam, but I would never underestimate the illness that is depression - I have stood on the edge and looked down, and it isn't pretty.

I attended a time management course in my 30's - it was one of the most useful courses I ever did, and I continue to use some of the techniques that were introduced to me. I also spent some considerable time even earlier in my career trying to unpick whether management is something one can learn or is born with, joined an evening class to consider the subject, and then much later on had to grapple with the reality of being a manager. I have come to the conclusion that one can learn to be a manager, but to be a good manager requires something extra. I have also determined that I don't wish to be a manager ever again. I have some warm thoughts about teamwork, which I may share in a future post.

So all of these subjects are relevant to a working life, but I don't know whether introducing them to 21-year-olds in their final year at university makes much difference. Perhaps other people learn to avoid disaster through classroom teaching - I have only ever learned anything about avoiding disaster from living through it.

More useful in this module were two practical tutorial sessions, where we were given case studies to discuss in small groups, directed by an experienced practitioner, and a mock job interview conducted by a dietetic manager. The interview was particularly valuable, giving an insight into what skills and knowledge might be demanded by an interview panel. As it happened, my interviewer recently retired from the location where I am to do my next clinical placement, and was able to answer my very real questions about that department. I don't think I would have got the job, but I can now prepare much more effectively for the real thing.

We have also had some external speakers topping up our knowledge on various random topics: I have mentioned diabetes, communication skills and obesity but there was also a lecture from a Sports and Exercise Dietitian, who also provided an introduction to dietetics in private practice. While most of these lectures were relatively interesting, they were more like seminars, and I didn't feel as though I was learning very much, either in terms of the evidence base, theory of dietetics or dietetic practice.

The other taught module has been even worse. It has been a random series of lectures on Public Health to an mutinous group of students under pressure of work who really don't want to be there but have to turn up to sign a register of attendance. It is convened rather than taught, and I don't think the group has a great deal of respect for the convener. And rather than Nutrition in the Community, it should probably be called Public Health Nutrition, and that subject is definitely not one of my favourites.

Despite this, I was almost looking forward to the talk about mental health, and the lecturer definitely had plenty of experience as a Community Psychiatric Nurse, but she wasn't that good at conveying the specifics of the job. She also confessed that she knew nothing about dietetics, and had never worked with a dietitian, so she made a number of misplaced assumptions e.g. about our knowledge of legislation relating to vulnerable adults and children. All I really learned was that if I were presented with a patient who had a mental illness, then I should go find a CPN with proper expertise to help me.

I wasn't looking forward to the talk about food service in Derbyshire schools, but it was actually very good, and surprisingly interesting to hear about what can be done for £1.85 per child per day in primary schools and £2.15 in secondary schools. That's a really rewarding role for a dietitian, and it was very clear how we might fit in and contribute our expertise.

There are only one or two lectures left, thank goodness, and for the next few weeks I have coursework to deliver and more to do on my research project, which is going quite well at the moment, and you will definitely hear more about that. This week I have to present a poster about Assistant Practitioners and Dietetic Support Workers and where they fit into the dietetic profession, and next week I must outline my thoughts about a community nutrition intervention of my choice. The main coursework this term apart from my project is to define and scope a research idea, which has given me no end of trouble, and is threatening more. My project tutor has been wonderfully helpful with that, and is substituting for the supportive group of fellow students that I lack.

And for light relief on my day off this week, I attended a local group meeting of Coeliac UK. I joined the organisation as a 'professional' member some time ago, when I had that project to do about eating out with coeliac disease. I thought it might be interesting and educational to go along to a meeting, and it was.

There was a presentation about the new EU labelling regulations for gluten content of food, then a demonstration of a gluten-free dough mix made of cassava, and then tea, gluten-free cake and chat. The biggest shock was at the beginning when everyone was welcomed to the meeting, "and we have a student dietitian here, would you raise your hand?" Not what I was expecting at all, but luckily there was also a 'real' qualified dietitian, so I was able to deflect difficult dietetic questions*, and also talk to her about the employment situation in the region where I live, rather than in the regions where I attend university or go on clinical placements. The best bit was when one of the attendees asked me for my recipe for gluten-free lemon drizzle cake. In front of the dietitian. Yes!

As ever, the final weeks of term leading up to deadlines is hard work, and I'll be doing 6-day weeks until mid-December, but Mr A is doing a magnificent job with meals and research into our proposed snowboarding holiday. Maybe there will be lighter and more amusing news to report next time - this post has been a bit of a rant. I don't do it often, so I hope I'm forgiven.

* "Apart from having coeliac disease, I have no salivary glands, what do you suggest?" and "Are oats contaminated with wheat gluten in the field where they are grown, or in the factory where they are processed and packaged?"

Sunday, 21 November 2010

Party food


We had a family celebration last weekend - another birthday. I find that I have very little to say about it, because all the people that I have in mind when I write this blog were there. But I can write about the food, which was, as always, very good.

Mum offered to put on a feast of Jewish food, such as we occasionally experienced either on a festival or special occasion or at a relative's house for tea. There was chopped liver, smoked salmon, fish balls, gefilte fish, beetroot salad, pickled cucumbers, egg salad, vienna sausages, and a whole lot more. Afterwards, we had a choice of lemon meringue pie and chocolate pudding (and dad very nearly poured Dr Pepper on it instead of sherry). It was all very delicious. And later on there was birthday cake.

I have volunteered to be in charge of food at a dinner party that Mr A is instigating, when we are inviting the people who hosted the recent bonfire party and our neighbours over the road. The last dinner party we put on was probably about five years ago - we aren't natural hosts, and on that occasion I overcatered to an extreme extent and was eating reheated broccoli for days afterwards. So I've been thinking about the food.

I think that there will be nibbles like olives and something small and cheesy when they arrive. The first course will be soup with homemade bread, the main course will be something that has been cooked in the oven and which isn't sensitive to timing, with roast potatoes and roast vegetables. Afterwards there will be something that has been prepared earlier and has been waiting in the fridge. Mr A is in charge of drinks.

So if you have any ideas about what sort of soup is best, what main course oven dish works for you, and which is the best dessert to prepare earlier, feel free to let me know. All comments much appreciated.

Thursday, 18 November 2010

The pleasure of reading

My experience with reading that last paperback by Audrey Niffenegger reminded me of how I can get so engrossed in reading that the whole world disappears except for the words streaming directly into my brain, and I'm almost absorbing the story rather than reading it. It can be a similar experience with a really good film or play, when you forget where you are, but the difference is that there is no sound or living people involved, it's all done by the power of the written words.

I distinctly remember a moment from my childhood, in Miss Francis' class when I must have been 8or 9 years old, in one of the old Portakabin* classrooms that had that particular smell of pencils and plimsolls and polish. I had a book that I really wanted to carry on reading. Really really wanted to. But reading time was ending, and I knew we were going to have to do something else, but I really wanted to find out what happened next.

I knew for certain that if I read even one more word I would lose all consciousness of my surroundings for goodness knows how long, and then I wouldn't know what I was supposed to do, and everyone might be doing something completely different and I'd realise suddenly that I was in trouble. So with an enormous physical and mental effort I closed the book, and it was one of the most self-disciplined things that I'd ever had to do in my life up to that point.

The other slight disadvantage to my reading immersion problem is that at moments of great excitement, my reading speed accelerates to the point that all subtlety of language is lost. It's a bit like eating food too fast, where sustenance is achieved, but all the subtlety of flavour disappears as the food whizzes past the tastebuds.

That's one of the reasons that I enjoy audio books so much. Although it's possible to speed up the pace of narration slightly (using the wonder of the ipod) I don't do that, and I listen at the rate of the human voice - about five times slower than my normal print reading speed, and at least ten times slower than when my speed-reading gets out of control. The subtleties of language that speed by when I'm greedy for more story are fed to me morsel by morsel, and I have to savour each word before being allowed to move to the next.

Mr A reading at his desk wearing a full face crash helmet
Talking of reading, here is Mr A, hard at work on his Computing degree. In order to be certain that the crash helmet you have bought is not too tight, it is important to wear it for a significant period while keeping it relatively clean - i.e. not out on a bike ride where it can accumulate road debris and insects. So it all makes sense really.

* until I was quite old (probably teens), I thought that this word was pronounced 'Por-taka-bin'. It made a lot more sense when I realised how it ought to be said.

Monday, 15 November 2010

What I've been reading

Image of the book cover
At Home: A Short History of Private Life
by Bill Bryson

"Bill Bryson was struck one day by the thought that we devote a lot more time to studying the battles and wars of history than to considering what history really consists of: centuries of people quietly going about their daily business - eating, sleeping and merely endeavouring to get more comfortable. This inspired him to start a journey around his own house, wandering from room to room considering how the ordinary things in life came to be."
This is a stream of factoids, loosely associated with rooms in a house, but so loosely as to be quite unconnected with any coherent thread of narrative. It's fun to read, even though I take issue with some of the 'facts', and was moved to look up the nutritional value of cornflakes and peanuts in response to one sentence (he is wrong about which contains more calories per gramme). I liked it, but there isn't much substance to it.


Image of the book cover
Cotillion
by Georgette Heyer

narrated by Phyllida Nash
"Young Kitty Charing stands to inherit a vast fortune from her irascible guardian - provided she marries one of his great-nephews. Kitty devises an escape route: she convinces one of these gentlemen, the honourable Freddy Standen, to pretend to be engaged to her. Her plan would bring her to London on a visit to Freddy's family and allow her a glimpse of society denied to her by her guardian."
I do like a bit of Georgette Heyer - Regency 'chick lit' really, about women loving clothes, wanting to look attractive and needing a husband, but somehow more acceptable than the modern stuff. When I analyse it in that way, I wonder how I can hate modern woman-oriented fiction so much, and yet find this not only inoffensive but enjoyable. Maybe it's the passage of time and the change in society - women had vastly fewer options in the 1700's, and no safety net for the poor. Nowadays when women can do pretty much what they want in this country, it seems pitiful to be so very obsessed with shoes, clothes and personal grooming.


Image of the book cover
Life On Air: A History of Radio Four
by David Hendy

"David Hendy's book tells how the favourite radio station of the British middle class has, over four decades, weathered internal faction-fighting, political intimidation, managerial bullying and the tough love of its all-too-devoted listeners. It describes a rich mix of talk-based programming, combining varied pleasures with a judicious degree of uplift, and resistant to both elitism and ratings-chasing."
This is more reminiscent of a volume of political history than an entertaining read, but interesting enough to plough through nevertheless. In more recent years I remember the fuss about 'Anderson Country', the move of 'Woman's Hour' to the morning and the ditching of 'Kaleidoscope'. It was all very dry, yet I carried on reading in the hope that it would improve. It didn't.


Image of the book cover
Her Fearful Symmetry
by Audrey Niffenegger

"When Elspeth Noblin dies, she leaves her beautiful flat overlooking Highgate Cemetery to her twin nieces, on condition that their mother is never allowed to cross the threshold. The twins hope that in London their own separate lives can finally begin. But their aunt doesn't seem quite ready to leave her flat, even after death."
This is the first fiction book I've read in print (rather than audio) for quite a long time. I bought it on the basis of her other book, 'The Time Traveler's Wife', which I like a lot - this is good, but not as good as that one. Anyway, she ramps the pace up towards the end, to the extent that I read the final third of the book in one sitting and I HAD to finish it, which you can't do with an audio book, and then I couldn't sleep, but perhaps the two weren't related. So I'm really tired today, and a little bit cross that the ending wasn't quite as good as I hoped it would be, but was still OK.

Friday, 12 November 2010

A prize from a Madeley


Now this may be a little confusing. As I sit ready to write, I'm not sure exactly how much detail to go into, but here goes anyway: I have won another prize from a fellow blogger. Except he's not really a blogger nowadays, and he wasn't who he said he was when he did blog, and the prize is from him, but in another name that isn't his own either.

Soon after I first started blogging in 2007, I chanced upon the Richard Madeley Appreciation Society, which I found to be most entertaining, even if I suspected it might not have been written by the great man himself. Readers from outside the UK may not have heard of Richard Madeley, and to be honest I don't know much about him myself, not being a TV viewer. But he's a B list celebrity, and seems to be a pretty sound person, not given to racism or outlandish religious or political philosophies.

Anyway, Richard (or Dick) left some comments on my posts, and I commented on his, and there was a bit of banter, and we exchanged some emails outside the blog, until it eventually became clear that Dick wasn't Richard, but that was OK with me because if I enjoy the writing I don't mind who holds the pen. Or the keyboard, or whatever.

Then Dick became a little disillusioned, because the reason he was blogging as Richard Madeley hadn't worked out (it's a little confusing, actually) and there were some other issues in his life. And then things went a bit quiet, until all of a sudden, up popped Stan Madeley. With a book: Second Class Male. And I guessed the name of Stan's favourite Norwegian fjord, and he sent me a signed copy of the book.

Front page, signed and dedicated to Lola: May your chisels fly straight and true!I haven't read it yet, but no doubt it will feature in one of my regular 'What I've been reading' posts. But I think this must be the first ever book that I've been given by the author, even if the author in real life isn't actually Stan Madeley, or Dick, or Richard, but someone else. So I'm pretty pleased with it, and thanks, Stan!

Anyway, he's got another book in the pipeline but the publisher is waiting to see how this one does, so I shall buy one to give away to someone seeing as how my copy probably hasn't contributed to sales figures. I thought about putting it up as a prize to a reader of this blog, but I don't have enough readers to avoid embarrassment if I tried a stunt like that - the response to the 200th post taught me that. If any readers wish to comment on whether they would like a free book, just go ahead. And just so you know, this is our 400th post, so happy blogaversary to me and Lola II.

Tuesday, 9 November 2010

Bonfire night, and diabetes revisited

For the first time in ages, we went to a friend's house for a bonfire party with fireworks. K is an interesting chap, and Mr A met him through a common interest/passion for motorbikes. He'd helped out when Mr A bought his latest bike a few weeks ago, and stayed to dinner, and invited us to this party. Although Mr A and I tend to avoid parties if we can, we were persuaded not only to attend, but to stay over. And it was great fun, although as usual I faded out long before anyone else was ready to turn in, and woke up next morning about an hour earlier than anyone else.

Fireworks have moved forward since the last time I went to a private firework event. The public displays are amazing, with a constant stream of colours and patterns and bangs and fizzes and pops and whooshes going on for some minutes. In the old days, shops would sell you tiny rockets that could be launched from milk bottles, weedy Catherine wheels that had to be nailed onto a post, Roman candles that gently threw coloured sparks into the air for a few seconds. Nowadays the rockets need heavy duty firing tubes, and you can buy a whole display in a box, where you light the fuse and it shoots up all sorts of choreographed delights for a minute or two. Amazing. Although I suspect that the cost of this type of box would make me flinch.

Bonfire and fireworks
Apart from the fireworks and the enormous bonfire and the beer and wine and the company and the home-brewed plum brandy and the enormous amount of food consumed, one of the best parts was that our mode of transport there and back was the new motorbike. It took me a while to get back into the pillion mindset, but this bike is so well-designed and comfortable - the footpegs are in the right place, the pillion is high enough for a good view but not so high that you are blasted by the wind, the grab handles are perfectly placed, the seat is wide, and there is a top box for a backrest.

Coming back in the morning was one of the most beautiful rides I've ever had, in autumnal sunshine with the golden trees, smells of woodsmoke as we rode through villages, fields in various stages of cultivation, earthy dampness riding through shady valleys. An hour with nothing to do but sit still, enjoy the scenery and the motion, thinking my own thoughts about everything and nothing. It has made me feel both deeply peaceful and also invigorated. Obviously slightly colder than a nice car with a radio and the opportunity to hold a conversation with one's significant other, but the benefits are there. In a warmer country that is less prone to rain it's a fine way to travel.



I have also done the second set of video-recorded consultations with two qualified dietitians, now that they have been on a communications skills course. I was using the same scenario as we had before, when I was acting as a patient with newly diagnosed type 2 diabetes, and I was expecting to have a much better experience. Surprisingly, I didn't. I do think both dietitians were communicating better, but I still didn't come out of the consultations with a better understanding of diabetes or what I should eat.

I've been back to review what I wrote after the first recording, and I still think that it's better than what either of the qualified dietitians told me. I'm not saying that in the pressurised situation of a 30-minute consultation with a real person, I could convey those messages perfectly, but I hope I could do a better job than these two. I'll have to wait and see.

Saturday, 6 November 2010

Car damage

Rear impact zone marked up
There has been some progress with the car incident. I was instructed to take the vehicle to an insurance-approved garage where they would assess the damage and produce an estimate for repair for the insurer.

Now this is a vehicle that has more than 140,000 miles on the clock, and although we have maintained the mechanical workings in top condition, the bodywork has not received the same level of care and attention. If I were not comprehensively insured, then I might rub down and touch up a tiny area of damage over the wheel arch, but otherwise it's perfectly fine to drive for another 140,000. The worst case scenario would have been if the damage had been sufficient to make it undriveable and uneconomic to repair, because its value to me as a truly reliable runner would not be reflected in the insurer's book value.

Grid highlighting dents and creases in bodyworkAnyway, I had a most enjoyable time at the garage, watching the process of estimating the damage. First of all, the assessor showed off his encyclopedic knowledge of cars, as might be expected from one who has chosen this particular career path. He pointed out creases and dents that I hadn't even seen, and then marked the side of the car where all the damage was and took lots of photos, while I took photos of him. Then he got out a plain grid that showed any distortion when reflected by the car panel. Seeing my interest, he asked if I'd like a copy of the report which would contain all of the best pictures - well, I jumped at the chance. After it was all done, he cleaned off all the markings, and politely declined my invitation to clean the rest of the car.

The emailed report makes interesting reading too. It lists and estimates the time required to address around 40 separate operations, and estimates the whole job at just under £1500. I won't pay any of it, because the insurance company has accepted that I wasn't at fault and will claim it all back from the other driver's insurance. Still, this seems to me to be an enormous amount for a car that isn't new, and quite frankly doesn't really need all this attention, given that it's perfectly sound mechanically. The trouble is that once you're in the system, it's difficult to dictate what does and doesn't get fixed. It's this type of job that must raise all our insurance premiums.

Anyway, I always like to see how things work, whether it's painting a house or dealing with insured car repairs or servicing the boiler. I like to see inside other people's lives, which is one reason why I enjoyed some of my previous jobs, and why I look forward to poking about in patient's diets when I eventually qualify as a dietitian.

Cleaning the markings off the car

Wednesday, 3 November 2010

A Special Day

Hello, Lola II here.

Today is our mummy's birthday! There's really nothing that she wants or needs and she is always adamant that she doesn't want any old rubbish, just for the sake of giving her a present. Lola and myself wholeheartedly agree with this view of birthday presents. However, this blog is one of the things Mum loves most in the world, so it is fitting, therefore, to celebrate her 29 (again) years by posting something especially for her.

For interest, the other things Mum loves most in the world are her family (I'm assuming), her garden, mushroom vol au vents, finishing off biros, helping others, the colour of horse chestnuts fresh off the tree, the look on Dad's face when she makes chocolate mousse, the annual photo calendar from our sister D, people who speak clearly, times when her daughters don't look like they've been dragged through a hedge backwards, good quality jokes that she's not heard before, and a little taste of chocolate at the start of a journey home.

Mum's love for this blog is so great, that if ever I make the mistake during a telephone call of mentioning that Lola has posted a new entry, she will bring the conversation to a rapid close and race to her computer to view the latest. Lola II vs Blog? Lola II loses every time. I don't mind, though. I love Lola and her blog too.

So you've heard all about our mummy and now you'll have to hang on until May to hear the same about our lovely daddy.

I have a film to show you how truly magical our mum is, with her trick of a mouse made from a handkerchief. Unfortunately, Mr M has been working all evening to try and upload it onto Lola's Blog and it's not working.

In the meantime until we get it sorted, take it from me, she's wonderful. Happy Birthday Mum xxx

Sunday, 31 October 2010

South West weekend

Sky, houses, boats and the river Avon
Mr A and I have had a short holiday, which has refreshed and invigorated us. We went to Devon to visit friends, and then Bristol, which is a city I know of old and where I would be happy to live if I had to. I think I would also be happy in Edinburgh or Cambridge, but Bristol is likely to be generally warmer than either of these two other options.

Before we left, back on Thursday, I received notification that I'd be doing my third clinical placement in a northern location much too far for commuting. This will be for 12 weeks from February to May 2011, so I'll be trying to arrange accommodation for weekdays and most probably coming home at weekends. I've already had a look at the options for weekday badminton up there.

On Friday morning I went to the drop-in session of the local Society for the Blind where I recruited my research volunteers, took a cake to share, and stayed for a while to chat. Then Mr A and I set off for the South-West, and reached our friends in Devon in time for dinner.

We had a lovely evening, and next morning was fun for me too, as I was awake first. I thought I'd just sit in the lounge with a book, but was joined by their two lovely daughters, and we had a sing-along to the DVD of Annie. Thirty-six hours later I have very nearly stopped humming 'Tomorrow, tomorrow, we love ya, tomorrow' which has to be one of the stickiest tunes in the world.

Looking up the mast to the crow's nestWe went to Bristol because as I mentioned before, The Boy has moved there. He wasn't answering his phone at the beginning of the day, though, so we wandered about the town looking in the art gallery, museum, and trying to find our way to the SS Great Britain.

He joined us for coffee later on, and I now understand a bit more about his music, which is a blend of Dubstep, Jungle, Drum 'n Bass and Glitch Hop plus a few other styles I can't remember. So now you know. We stayed in an area called Cotham, which is very nice, and has about thirty restaurants of all sorts next to one another in one or two nearby streets. We chose an informal Thai noodle place where Mr A chose one of the best seafood soups I've ever tasted.

Over the past few days I have also been wildly, unfeasibly, unreasonably excited about our snowboarding holiday in January, in between exams and vivas and the start of my placement. We have a few location options which we are debating between ourselves and a couple of friends whom we hope will come too, and we are gearing up to book some lessons before we go. I am already much too excited about this.

Thursday, 28 October 2010

Social Marketing

We had a different sort of test this week, where we had to write an essay in near-exam conditions, the difference being that we'd been given details of all that was required in advance. Which meant researching and essentially writing the essay in advance, and then regurgitating it in a classroom for 90 minutes. In previous years, we might have been expected to write the whole thing in our own time and hand it in to a deadline. Having considered this alternative, I think I prefer this 'seen test' method - the other sort would have needed a great deal more research and a ton of references.

The subject, Social Marketing, started being considered in earnest in the UK for health in 2004, although the idea had been around since the 1970's. It arose from the realisation that telling people what was good for them was not achieving a great deal, and resistance to change, habit and convenience was enough to keep people not exercising, smoking and eating too much. Even though goodness knows enough information had been provided and they should know better.

Those concerned with improving public health turned to this idea of social marketing, which simply means selling a behaviour in the same way as cigarettes or hamburger-and-fries. Not only by providing information, but also by making the behaviour attractive and desirable, considering the competition, and addressing the true price of change in terms of abandoning one activity and/or adopting another.

The change in the way that smoking cessation was approached is a good example: a whole mix of other things was added to the simple message that smoking is bad for you. Taxation and legislation banning smoking almost everywhere raised the financial and behavioural cost of smoking; prominent smoking cessation clinics, prescribable nicotine patches and fake therapeutic cigarettes lowered the 'cost' of giving up. Adverts that showed how smoking isn't cool by rubbing the contents of an ashtray into an attractive model's hair made smoking less desirable. Addressing individual behaviour, environmental factors and social norms together is a much more powerful 'product' combination than a sentence on a packet of cigarettes and the absence of sponsorship in sport.

This is the approach that will need to be taken in addressing obesity. Telling people not to eat so much will never work on its own because eating is a much more addictive behaviour than smoking, and unlike cigarettes we can't cut it out completely. Eating too much, or eating the less healthy kinds of food needs to become something we simply don't want to do, but this is an incredibly difficult proposition, because no food is inherently bad as long as it forms part of a healthy balanced diet. Chocolate should never become as socially unacceptable as cigarettes, but it should be easier to find something healthy, tasty and reasonably priced to eat at a motorway service station. The approach taken with smoking appears to me to be hugely encouraging, and time will tell if it is successful. Perhaps the next big campaign in a similar style will be weight management.

Anyway, the particular example of Social Marketing that I wrote about in my essay was a small project in a district council office in Norfolk in 2007-8, where they tried to address the issue of employees eating no fruit and veg at work, and eating lunch at their desks.

I've worked in various places, some of which had a strong 'lunch away from your desk' ethos, and others where there simply wasn't anywhere to go. When I worked in Coventry the whole team took a break and sat together around a proper table for lunch. At my clinical placement over the summer, the dietitians had nowhere in the building to sit other than their desks, or there was the hospital canteen 10 minutes walk away, and only 30 minutes allowed for lunch.

Honesty Fruit BowlIn Norfolk they provided one-to-one consultations with a dietitian, refurbished the staff eating area, invited a chef to provide taster sessions and advice at a launch event, and worked with local businesses to provide an 'Honesty Fruit Bowl' and a 'Healthy Lunch Pack'. Evaluation after a year showed modest improvement, with more people rating their lunch as 'healthy', more fruit and veg being eaten at work, and fewer people eating at their desk.

There isn't any more recent information about the project, and I'd be very interested to know whether the eating area has been maintained or allowed to deteriorate, and whether the fruit bowl and lunch packs are still going. Until I'd had the experience of eating away from my desk at work, I didn't realise what a difference it made. Of course, it helped that I liked nearly all the people in that office, but even so, if I'd been a permanent member of staff instead of on a 12-week placement, I would have looked into ways of improving my lunchtime in that dietetic department.

Monday, 25 October 2010

Bits and pieces

Lattice patterns formed by the metalwork of the side of the bandstand
There have been several events of note, none worthy of a headline. At uni, apart from the odd lecture and my research, I attended an optional talk given by dietitians working for Nestle Nutrition - yes, the same company that makes Quality Street also makes prescribable nutritional products for people in hospital.

In the real, not academic world, Mr A has bought another bike in anticipation of a mammoth odyssey that he is planning - riding to Volgograd (formerly Stalingrad) and back, with a friend, next summer. His bike of preference up until now is a fairly esoteric make (Cagiva Elefant) which isn't suited to this type of journey, so he has bought a Honda Pan European. It's the first time I've ever viewed one of his bikes and thought "I wouldn't mind riding pillion on that one". Up until now, pillion seats have been razor thin and I've needed a ladder to get up there - this one's like an armchair in comparison. Not that I'm likely to be riding anywhere with him, but you never know.

We have also been visited by The Boy, who is now marketing himself as a freelance web designer while attempting to 'make it' in the world of young people's music (but I couldn't tell you exactly how the music is produced). He imparted some valuable insight into his life: he has moved to Bristol where the music scene is a bit more accessible, he is not romantically attached to any one female, he hopes to set up a tour of Europe and/or America in which he will be paid for gigs. He is good company and he seems to be doing OK, so that's fine.

Decorator adding finishing touches to the bathroom paintI haven't mentioned the bathroom for a while, but it was finished at the same time as the exterior painting. It is now a vivid shade of blue-green-turquoise that still surprises me as I come up the stairs. It now needs pictures, to tone it down a little.

I have played in two more badminton matches with a new partner who is very tall and can smash rather well. We have won one or two of our games each time, but overall our team always loses. My previous partner had a foot ligament problem, which he ignored until he was accepted as a special policeman, and now I believe he's getting it treated. Either that, or he hasn't got time for badminton any more. If I am posted in some distant backwater for my next clinical placement, I will have to give up my local badminton - I will need to find a replacement club for those three months.

Lastly, I had an 'incident' in the car on the way home from school last Thursday, when a car pulled out into my lane and hit the back of my car. Not very hard and not much damage was done, but annoying because now there's quite a lot of admin to do. I spent 45 minutes on the phone to the insurance company at 5p a minute, and will definitely find a cheaper way to communicate next time.