How to help a friend with the blues

There are plenty of ways in which you can get this situation all wrong!  For example, the often heard “Pull yourself together!” and “Why don’t you just snap out of it?” are guaranteed not to be helpful things to say.

The first thing to do is assess just how bad these “blues” are. The term is usually held to mean a mild and temporary bout of depression, but that may not be the case where your friend is concerned. Mild depression can deepen very quickly. On the other hand, we all feel down at times, and just because someone is not their usual bubbly self does not mean that they must be on the slippery slope towards suicide!

How well do you know your friend? Do they get these moods often? If they do, is this time any different from all the rest? If not, could there be something serious going on?

Depression, whether mild or deep, can come about for various reasons. Sometimes there is a definite cause, such as an incident, that lies behind it. But sometimes the depression is an illness caused by a chemical imbalance in the brain. Sometimes the latter is the underlying cause, but something happens to tip the person over the edge. Finding out what is happening is a good idea, but that does not mean giving your friend the third degree!

Everyone can, and should, learn the art of positive listening. That means giving someone all the time they need to say what they want, or, if it is their desire, not to say anything at all. Silence is not a problem in these situations. If your friend wants to sit there saying nothing, that should not worry you.

However, if they want to unburden themselves, you can be there for them. Just being a sounding-board is a positive thing. If they are confused about how they feel, you can help them to sort things out. Don’t put thoughts into their head or words into their mouth, but ask gently probing questions that help the train of thought to develop.  It is not your job to solve their situation for them, but you can help them to come to their own decision as to what to do next.

If you feel that hand-holding, or an arm round the shoulders, is appropriate, do it. However, you can touch someone in many different ways other than physically. Your tone of voice is a touch, as is the way you look at someone.  You are touching your friend when you make them a cup of coffee, and when you stay with them although you would rather be somewhere else.

The blues, or any form of depression, is at heart a breakdown in communication. As a friend, you can bring that person back into communication with the outside world. But don’t be too hasty. There is nothing wrong with withdrawing from the world at times, indeed it is often a good thing to do. It is a mistake to think that everyone must be happy all the time. But part of being a true friend is spotting when things are going amiss and doing what you can to help.

On the other hand, without the blues no-one would ever have heard of New Orleans!

© John Welford

Lung metastasis

Metastasis is the transfer of cancer from one organ or part of the body to another. Cancer cells are able to invade the bloodstream and end up virtually anywhere in the body. A lung metastasis is therefore a secondary cancer in the lung that has spread from somewhere else.

When metastasis occurs, the lungs are frequently the destination of cancer cells, and a lung metastasis is found in one third of all patients whose cancer proves to be fatal. It is often the discovery of a lung metastasis, as a result of investigating the causes of certain symptoms, that shows that the patient already has a tumour somewhere else in the body.

The lungs are organs the functions of which are closely linked with those of many other organs, such as in the transfer of oxygen and nutrients, but this leaves them vulnerable to secondary infections of many kinds coming from other organs. They are composed of sensitive tissue that is easily damaged. These two factors make metastasis to the lungs a common event.

The primary cancer can be virtually anywhere, but the cancers that most frequently spread to the lungs are those of the breast, colon, prostate and bladder. It is also possible for a lung metastasis to come from a primary lung cancer, but this is usually only after it has spread to another organ and then back to the lungs. A metastasis can be present in the lung in a dormant state long after the primary tumour has been removed and the patient has been thought to be clear of cancer.

Much research has been done to discover why cancers spread in this way. For example, research at the Howard Hughes Medical Institute in Chevy Chase, Maryland, has suggested that a group of four genes, working together, enables cancerous cells from breast tumours to escape into the bloodstream and cause lung metastases. Shutting off all four genes at the same time has had a dramatic effect on halting not only metastasis but also the growth of the original tumour. In all, the researchers have discovered 18 genes that make a contribution to metastasis, and they have also found that targeting the proteins produced by these genes, using drugs that are already on the market, could be effective in reducing metastasis.

Another possible breakthrough has been made at the Cold Spring Harbor

Laboratory, New York, where the cells have been identified that cause a dormant lung metastasis to become aggressive, often with fatal results. These are endothelial progenitor cells, or EPCs, and they are found in the bone marrow. They provide the switch that leads to blood vessel development within a tumour, and hence its growth. Knowing the mechanism involved is a huge step forward in devising treatments that could save many lives.

The symptoms of a lung metastasis include shortness of breath, chest pain, coughing, unexplained weight loss and general weakness, all of which can be symptoms of other conditions, some of them much less serious. It is also possible for there to be no symptoms at all, and for the metastasis to be revealed during other procedures, such as a chest x-ray for another purpose.

Treatment for a lung metastasis is usually chemotherapy, as surgical removal does not guarantee that all secondary growths have been treated. As the patient’s cancer is likely to be at an advanced stage, major surgery may not be advisable in terms of the patient’s general condition. However, surgery can be an option under certain circumstances, for example when there is a good chance that all the tumours have been detected and can be removed. As mentioned above, current research provides hope of new treatments becoming available in the foreseeable future.

© John Welford

Asthma

Asthma is a chronic disease (in other words, it lasts a long time) of the airways. It cannot be cured, and it can be fatal. However, there are plenty of Olympic athletes who suffer from it. It is an unpleasant disease to have, but it can be controlled.

In a person with asthma, the lining of the airways becomes inflamed and produces excess mucus, which narrows the airways. There may also be muscular contractions that make the condition worse.

The end result is that the patient finds it difficult to breathe, and may cough or make wheezing noises as the air tries to force its way through. The chest will feel tight during an attack. An episode can last for about an hour, or persist for a day or longer, especially if it is untreated. After the attack subsides, the airways return to their normal state and the sufferer feels perfectly OK.

Some people get an attack only once every week or so, whereas others can suffer daily attacks. In the worst cases, patients can suffer asthma symptoms for much of the day, every day, and their quality of life is affected very seriously. Night-time attacks are experienced by most sufferers, but again the frequency varies considerably from patient to patient. The frequency of attacks is not normally related to their severity; a very severe attack can be suffered by someone who only gets them rarely.

Asthma is a common complaint, without about 20 million of the current population of the United States having a diagnosis of it. It can begin at any age, but it is usual for it to start in childhood. In developed countries, around 15% of children of school age are likely to have asthma attacks of a greater or lesser severity. Although there is no cure for asthma, many children “grow out of it” as they get older.

In most people, asthma is a severe form of allergy, as the attacks are brought on by the presence of one or more “triggers” to which the patient is sensitive. However, asthma also tends to run in families, so there are probably genetic causes as well.

The substances to which the sufferer is allergic are typically such things as dust mites, animal fur and pollen. But attacks can also by triggered by tobacco smoke, bad air, perfumes and strong cooking smells.

Attacks can also arise from taking exercise, or viral infections.

It is therefore the case that asthma varies considerably from patient to patient, in terms of causes, triggers, frequency and severity of attacks. It is therefore vital that the individual’s condition be analysed carefully, so that the treatments are correct and the sufferer is able to adjust their lifestyle so as to make attacks as infrequent and mild as possible.

People who are liable to suffer an attack should always carry an inhaler with them. This delivers a shot of a relieving drug directly to the airways, acting very quickly to relax the muscles that are constricting the flow of air into the lungs. A typical drug for this purpose is salbutamol or terbutaline. Teachers of children with asthma need to be able to recognize the symptoms and make sure that a child can use an inhaler when they need to.

There are also inhalers that can be used on a daily basis to help prevent an attack. These are steroid-based and work by reducing the inflammation in the airways, thus making the chance of mucus blockage much less likely.

Tablets can be prescribed in addition to inhaler use, as a preventative measure.

Proper diagnosis of an asthmatic condition is necessary so that the correct treatment can be offered. Diagnosis includes measuring the rate of airflow into and out of the lungs, and testing for allergic reactions.

Apart from medication, treatment includes the avoidance of potential triggers and making lifestyle adjustments. For example, bedsheets may need to be changed more often than normal, and mattresses and pillows covered in material that is impermeable to dust mites. Carpets in bedrooms can harbour mites, and may need to be removed.

It cannot be denied that living with asthma is a thorough nuisance, but, with careful management, the symptoms can be controlled and the frequency and severity of attacks reduced to a minimum.

© John Welford

What is societal marketing?

There seems to be a lot of confusion over what is meant by “societal marketing”. For one thing, it has nothing at all to with using social networking sites as a marketing tool. Also, it is not the same as niche marketing, or the targeting of marketing towards particular social groups, although there are connections.

It must also be distinguished from “social marketing”, which refers to the deliberate use of marketing techniques to achieve a social end, or what night be termed social engineering via the marketplace. Marketing condoms with the stated aim of reducing HIV/Aids infection would be an example of this.

Societal marketing has only one meaning, which is the consideration of the wider social aspects of marketing a particular product to a particular group. It is therefore an aspect of ethical marketing.

A blatant example of where this concept was ignored was the marketing by the Nestle company of infant formula in developing countries. Although the company has since modified its practices in response to international pressure, it was accused in the late 1970s of marketing its formula on the premise that its product was better for babies than breast milk. The main problem was that, in order to prepare the formula for use, it had to be mixed with water, and if the water was contaminated, which is frequently the case in African villages, the milk would be as well.

An example of the opposite approach would be the marketing of wind-up radios to developing countries. These are radios, invented and developed by Trevor Baylis, that do not require batteries or mains electricity, but contain a spring that drives an electrical generator. The spring is cranked up by means of a winding handle. These radios therefore fit perfectly in communities without guaranteed power supplies, and also satisfy local needs for keeping in touch and providing entertainment.

Societal marketing is about not selling foods that are high in sugar content in countries where there are hardly any dentists. It is also about selling healthy snacks to western schoolkids, rather than burgers and fries.

Societal marketing involves the whole chain of production, from the producer through to the consumer. The Fair Trade movement, by which producers of, for example, coffee and cocoa, are given a fair price for their goods, even if the end products are more expensive, is a form of societal marketing, particularly because the end-user is targeted as being the sector of western society that has a social conscience.

Another example is the marketing of dolphin friendly tuna, again because of the sensibilities of the consumer.

The Body Shop is an organization that has taken the societal marketing concept firmly on board. It sources its products solely from sustainable resources, embodies the fair trade concept, and markets safe and effective products to consumers who are socially conscious and have adopted the green agenda. However, its success has been achieved because it does not rely entirely on the beads and kaftans brigade for its customers. It is a mainstream retailer that sells vast quantities of goods to people who have never given a thought to where they came from.

The societal marketing message is that social responsibility is also about making profits. It does not require companies to go out of business simply because they have a conscience. Clever societal marketing makes it clear that, although profit is the bottom line, it is not the whole story.

Consumer attitudes can be influenced by a marketing strategy that emphasises the good things that a company is doing in poorer societies. For example, to go back to the wind-up radio, the company that markets it, Freeplay Energy Ltd (formerly BayGen), now makes more money from selling to western markets than to developing ones.

Societal marketing works.

© John Welford

Why soccer is so popular around the world

The worldwide popularity of soccer is undoubted. There is scarcely a corner of the globe in which the game is not played to a high standard and at a professional level. There are some notable exceptions, such as the United States and Australia, where, although the game is played, it is overshadowed by national sports that occupy the greater attention of players and spectators.

The finals of the four-yearly FIFA World Cup have been played on every continent except Australia. Competing nations have come from all over the world, and there are very few countries that do not have a national team.

The game is played by both men and women, and at every level from primary school to professional. It is truly the sport that just about all the world plays.

The reason for this popularity is not hard to work out, namely that it is a natural game to play.  If you roll a ball towards a young toddler who has just learned to walk, its first instinct might be to try to pick it up, but in doing so it is quite likely to kick it instead. The youngster soon discovers that a kicked ball will go further than a ball propelled by hand, and it is in any case easier to control where it goes. When he or she starts wearing shoes, the action of kicking a ball becomes painless, and fun to do.

The young child in the garden or the street will soon discover that kicking a ball towards a target is rewarding. You don’t always hit the target, so it is good fun to practice until you develop the techniques that improve your success rate. You may only be young, but you have a “goal” to aim for!

If you have a ball, your next discovery is that other kids want to kick your ball too. You can make marks on a wall, or put your coats down a few feet apart. One of you can stand in the way and try to stop the ball going between the coats or hitting the wall. It makes sense to let him use his hands for this job, but you need a rule that he is the only one. He can be the goalie, then.

Kids therefore discover that they can make friends if they let other kids play with their ball, and they can make up any rules they like to suit their circumstances, such as where the edges of the playing area are, and whose turn it is to ask for the ball back when it goes over somebody’s wall.

Because the game is so natural and easy to learn, it has developed anywhere that people want a game to play, have a bit of ground to play it on, and have nothing more sophisticated in the way of equipment than something round. Even an old tin can will do until somebody treads on it, and then you can always get another.

It is therefore played in the back streets of English towns, in the favelas of Brazilian cities and the dusty spaces between the huts in African villages. Some kids will prove to be better at aiming and passing a ball than others, and they will probably want to take the game a bit further, playing on a marked-out field with proper goals and a referee to settle any arguments. If they get really good, they might even make a living at it and end up playing for a professional club and eventually a national team.

Soccer therefore provides a way out of poverty for the most deprived of young people, and a real incentive to succeed. All you need is talent.

Play is a basic human instinct, and a ball is the simplest plaything one can imagine. Given that the action of kicking a ball is also so natural, and every human being the world over has a pair of feet, is it any wonder that soccer is the world’s favourite sport?

© John Welford

A few facts about football (soccer)

One fact about soccer is that every man understands the offside rule, but no woman does!

A gross oversimplification, of course, and horribly sexist!  The rule is that a player is offside if there are fewer than two players between him and the opposition goal line at the moment that the ball is passed forward to him from a member of his own team. This leads to all sorts of debates, because the decision is usually made by a linesman (assistant referee) who has to make a split-second judgment based on his view of two things, namely the position of the offending player and the moment of the pass being made. If he is parallel with the play at the time, he has a reasonable chance of doing this, but if not …

The FA Cup is the world’s greatest club competition. That is surely true, because it is watched by people all over the world, and has a history of bringing together the giants and the minnows on the same pitch. And sometimes the minnows win!

A word of explanation for the uninitiated.  Every club in the country (that is, England and Wales - Scotland has its own competition) that is registered with the Football Association is entitled to enter the competition. This includes a whole host of amateur clubs that play in local leagues as well as the professionals. After several preliminary rounds there will be a number of these clubs who reach the “first round proper”, which is when the lower tier professional clubs join in. All the rounds are drawn from scratch, so a small amateur non-league club can find itself playing a professional league club. 

When the third round is reached, the top clubs (i.e. from the Premiership and the Championship) enter the draw. If any of the minnows have survived to this stage, they stand a chance of drawing a club that is oozing with international players who earn millions and own private jets. 

The draws for the later rounds are televised and watched eagerly as the small clubs hope to draw a much larger club. Although the chances of winning such a match are not as great as when a club of equal or lower status is drawn, there is a huge financial incentive for the smaller club, because it stands to fill its own ground if the draw is a home fixture, or, if drawn away, share in the gate receipts of the larger club, which may well be able to accommodate tens of thousands of fans at its ground.

The best result – from the smaller club’s point of view – is neither to win nor lose the game when drawn against a larger club but to earn a replay, because the second match is always played at the ground not used for the original match. It is even better if one or both matches is televised, because the fees earned from TV companies are well worth having.

The history of the competition includes many examples of ‘giant killing’, when a minnow has defeated a major club from the top flight of English football. A moment of brilliance or luck can turn a match upside down and produce an unexpected result that will bring a minnow club, and its players, very welcome fame and publicity, if only for a few weeks. It is the possibility of an upset that excites the public imagination and makes the FA Cup such a fascinating competition.

Any more facts about soccer? It’s a game of two halves, the winners are over the moon, the losers sick as parrots, and referees have to leave their guide dogs in the changing room. That should be enough to be getting on with.

© John Welford

How to pronounce 'ough'

How do I pronounce thee? Let me count the ways!

Once upon a time a Frenchman was travelling via the Channel Tunnel from Paris to London (OK, so the time wasn’t all that long ago). As his English was not all that good, he spent the time reading a book of tips on the language, and as the train approached St Pancras he found the page that read:

“tough” proounced tuff

“though” pronounced tho

“through” pronounced throo

“thorough” pronounced thurru

“cough” pronounced coff

“bough” pronounced bow

“lough” pronounced loch

As he got off the train and walked into the London streets he looked up at a theatre billboard and saw “The Sound of Music – Pronounced Success”, and that was when he shot himself!

So that makes seven. For the uninitiated, a lough is to an Irish person what a loch is to a Scot (i.e. a lake or a sea inlet), and is pronounced the same way, that is to say with a slightly guttural sound that is a cross between “lock” and “shhh”.

I have to sympathise with the unfortunate (and mythical) Frenchman, because there are no rules that can help the learner of English to know which pronunciation applies when. You just have to learn these things as you go along.

It is place names that are most likely to trap the unwary. For example, Slough (pictured above) is a town to the west of London that is known to most Brits for only two things. It is the setting for Ricky Gervais’s modern classic “The Office”, and it was once famously pilloried by the poet John Betjeman in the lines:

“Come friendly bombs and fall on Slough!

It isn’t fit for humans now.

There’s isn’t grass to graze a cow.

Swarm over, Death!”

Unkind maybe, but at least it taught a generation that the place wasn’t called Sluff.

During a visit to Baltimore I once met a young American lady who said that she was about to visit my country for a conference at a town called Lowborow.  It took a while before I realised she was actually going to a place that is only few miles from where I live, called Loughborough. I had never appreciated before that this name would cause anyone a problem, but it actually has two “ough” syllables which are pronounced differently, namely numbers one and four on my list above.

I therefore had a pleasant half hour teaching this delightful person to say “Luffburru”.

As to why English presents such eccentric difficulties, that would take a long and boring time to explain. Suffice it to say that ours is a language that has evolved over many centuries, based on many complex roots, with the sole purpose, it would seem, of baffling those poor benighted ones who have had the misfortune to be born elsewhere.

© John Welford