Compass Health & Wellbeing Guide, Spring 2017

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COMPASS Your Health & Wellbeing Guide

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HEALTHY DIET SOS!

SECRETS TO

AGING HEALTHILY Signs that you're in a

HEALTHY or

UNHEALTHY Relationship

THESE BOOTS WERE MADE FOR WALKING MAY IS NATIONAL

WALKING MONTH

O GO

O K NOW D T ..

The Health Benefits of Taking a

Spring 2017

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HOLIDAY!

SUMMER IS COMING

10 top tips to get summer ready

Lets talk about...

MENTAL WELLBEING Important facts & tips

DEPRESSION

FACTS. SYMPTOMS. CAUSES. TREATMENT.


March April May

Spring 2017


Contents 3

Signs That You are in a Healthy Relationship Is your relationship a healthy one? Check the signs!

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Signs That You are in an Unhealthy Relationship The warning signs you should look for if you are unsure if you are in an unhealthy or potentially abusive relationship.

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On Your Feet Britain

Friday 28th April is the national day to sit less and get moving! Info on how to register and ideas to help you get moving.

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The Benefits of Taking a Holiday

Good news - a holiday is a valuable experience for relocating your lost mojo.

These Boots Were Made for Walking May is national walking month so

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here are some ideas and reasons to

favourite definitions below and see what

get walking.

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The Definition of Happiness

What's your definition? Read some of our resonates with you.

Find out more about the TOP vegetables

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you should try and get into as many of your

by Public Health England.

The Best Leafy Green Veg

meals as you can.

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Find out more about the facts, symptoms, causes and treatment of depression.

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The Secrets to Aging Healthily

Want to stay young in mind and body? Develop these lifelong habits.

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Mental Health Awareness Week

about Mental Health Awareness Week on 18th - 24th May.

Mental Wellbeing

The mental wellbeing facts & tips you need to know.

Ovarian Cancer Awareness

Expert March is Ovarian Cancer Awareness Month, here are the symptoms and facts.

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Recipe of the Season

Delicious chicken shawarma flatbreads

with yoghurt are a must this spring.

Are you surviving or thriving? Find out more

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New figures released on World AIDS Day 2016

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Depression

Undiagnosed HIV

33 Top 10 Diet Tips

Say goodbye to hunger and hello to your beach bod!

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8 Benefits of Swimming

...Whatever your fitness level! The benefits of swimming are yours to go out and make your own.


Signs That You Are in a

You don't feel pressured to play a particular part When you’re dating someone judgemental and hard to please, you sometimes find yourself walking on eggshells around them or stressing unnecessarily about their opinion. It can be hard to admit that they’re toxic, but that’s usually a pretty good indicator that they are. In a healthy relationship, you’ll feel comfortable just being yourself because you know that your partner loves you for who you really are. You're comfortable being 100% honest In a toxic relationship, you might feel the need to hide how much you spent on something, what you ate for lunch, or who you were hanging out with in order to avoid a conflict. Healthy relationships are exactly the opposite: you know that you can tell your partner anything without fearing that they’ll become verbally or emotionally abusive. If you’ve been in a toxic relationship before, this is one of the most refreshing things about finally finding a healthy love. Your partner relieves your stress, not causes it When you come home from a rough day at work, the last thing you need is someone getting on your case and making it worse. Any partner who’s worth a damn will care about you enough to see that you’re stressed and do anything possible to make your day better. That’s exactly what happens in a healthy relationship: you can actually find refuge from the stress in your partner’s arms. You know you're loved unconditionally Toxic partners make you feel like you have to earn their love every single day, and that’s completely wrong. True love is unconditional, and you only know that feeling when you finally find yourself in a healthy relationship.

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Healthy Relationship

Toxic relationships can destroy you, but healthy relationships do the opposite: they build you up in ways you never imagined possible. When you’ve finally found a healthy relationship, you’ll be able to tell.

They support your career and goals In a healthy relationship, both of you want to see the other succeed and you’ll do just about anything to help each other. While the wrong partners will see your success as a threat to their power over you, healthy partners see your success and happiness as an extension of their own happiness. You can talk freely about the future When you’ve become accustomed to dating non-committal partners, it can be scary to even consider a real future with anyone. You’re used to being ignored or called “crazy” if you should dare to bring up the future, but that behaviour is only commonplace for immature people. In a healthy relationship, you’re allowed to talk about the future because your partner sees it too (and they’re just as excited as you are). You would trust them with your life It’s a deep, heavy thought, but you really shouldn’t be with anyone unless you would trust them with your life. In a healthy relationship, that thought is no problem. You know your partner would do anything possible to protect you because they never want to lose you.

You never worry about being cheated on You never need to worry about your partner cheating because you know they value you and respect you too much to ever do it. Even if an entire evening goes by without receiving a text from them, your first thought is that they fell asleep or their phone died, not that they’re out fooling around in someone’s bed. You give each other personal space Healthy couples naturally spend a lot of time together. But they also recognize the importance of doing things separately. Personal space is important in any relationship. We all need time to explore, reflect, and express ourselves individually. You hold each other up during tough times Life will throw you lemons every now and then. It’s inevitable. A tell-tale sign of a healthy relationship is how you support each other during these times. Don’t be afraid to cry together and experience pain and suffering. Tragic events often take our breath away and make us feel like the world around us is caving in. But the fact that you’re still here means you have a 100 percent success rate with overcoming tough times.


Signs That You Are in an

Unhealthy Relationship

Although your partner may not always physical harm you, there are many other forms of abuse, for example, mental and emotional abuse. Here are some warning signs you should look for to know if you are in an unhealthy and potentially abusive relationship.

Criticism and ridicule One or both people constantly criticise and put the other person down. Or they ridicule their partner in front of other people, trying to shame or embarrass them. Narcissistic or controlling behaviour A person with a narcissistic personality is self-centred, seeks constant attention, considers themselves better than others, and believes they’re entitled to special treatment. Controlling people desire to be in charge, prove themselves, and get their own way by controlling their environment and the people around them. Neither personality is conducive to authentic connection and intimacy. Disengagement Disengagement happens when one or both partners lose the willingness to invest time, energy, and emotion into the relationship. In these situations, there are generally few arguments, or the arguments are onesided and met with passiveness from the disengaged person. Disengagement is often a sign the one person is ready to end the relationship.

Dishonesty and secrecy Dishonesty and secrecy are key reasons couples and marriages end up failing. Being dishonest or secretive with your partner – even about trivial things – reveals you don’t feel safe sharing with your partner or you legitimately have something to hide. Either way, you undermine the trust and respect of your partner when you lie or withhold. Little physical affection Studies show physical affection is a sign of relationship satisfaction and a good predictor of love in the relationship. Relationships that suffer from a deficit of affection will grow lifeless over time. Non-sexual physical touch feeds emotional intimacy and is necessary for the health of your relationship. Loss of emotional intimacy Emotional intimacy is the connection a couple has when the trust and communication between them fosters open sharing, vulnerability, and self-disclosure. Each partner feels completely loved, accepted, and worthy. When this is lacking, the relationship deteriorates into an empty, lonely existence for one or both partners.

Passive aggressive behaviour Passive aggressive behaviour can manifest as non-verbal negativity, resistance, and confusion. It shows up as procrastination, helplessness, stubbornness, resentment, sullenness, or purposeful failure to handle requested tasks. This is childish behaviour used to manipulate and control. Substance abuse Abuse of alcohol or drugs by one or both partners makes it impossible to have an authentic, healthy intimacy. The substance alters one’s behaviour and personality, impairing judgement and self-control. As the abuse continues, it will push you further apart. Verbal abuse When one partner uses verbal abuse, he or she is trying to shame, control, and manipulate the other. This emotional abuse takes the form of yelling, swearing, using threats, blaming and demeaning. This abuse damages self-esteem and makes intimacy impossible in the relationship. Physical abuse Physical abuse is the use of force and violent behaviour in a way that injures or endangers someone. It is impossible to have a healthy relationship when one partner is the victim of abuse. This abuse can include hitting, biting, kicking, punching, shoving, use of a weapon, forced sex, etc. Physical abuse often builds gradually, beginning with emotional abuse. A one-time incident could be a warning sign of future abuse. The only solution is to leave as soon as possible. If you are in an unhealthy or abusive relationship and want help, please contact: For women: Women’s Aid UK - 0808 2000 247 For men: ManKind Initiative - 01823 334244


! y a d o T ign Up

S

Friday 28th April The On Your Feet Britain challenge dares you and your company to convert ‘sitting time’ to ‘standing time’. Take part in this National Day when workers across Britain unite together and participate in a variety of fun and simple activities to #SitLess and #MoveMore at work.

Here are some simple changes to help you take a stand (-literally!): P Stand during phone calls P Stand and take a break from your computer every 30 minutes P Use the stairs P Have standing or walking meetings P Eat your lunch away from your desk P Walk to your colleague’s desk instead of phoning or emailing P Stand at the back of the room during presentations P Park your car further away from the office P Use a printer/fax machine/kitchen/toilet on another floor

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So, Friday 28th April 2017 is your chance to get the ball rolling and encourage your employees to take a stand, ready for the National Walking Month in May! It is expected that over 1 Million office workers will wiggle, waggle and shake it on Friday 28th April so Team up with colleagues and see how much “sitting time” you can reduce on the day.

Health Champions – We Need You! Why not advertise your event by setting up an On Your Feet Britain page on your company website to get the whole office involved. Don’t forget, you can use your PAM Health Manager to track your steps and compete against your colleagues! Don’t have Health Manager? Contact us on 01925 227000 to speak to a member of the PAM Wellness Team or visit www.pamgroup.co.uk

It’s FREE to sign up, simply register at http://onyourfeetday.com/signup Did You Know? British people sit for 8.9 hours each day (on average). In recent years a variety of major international research has produced compelling evidence that sitting for more than 4 hours each day leads to: P P P P

Enzymes responsible for burning harmful blood fats shutting down Reduced calorie burning (Metabolic rate) Disrupted blood sugar levels Increased insulin and blood pressure levels

So get on your feet and get moving!


THESE BOOTS WERE MADE FOR WALKING MAY IS NATIONAL WALKING MONTH

Even if you already exercise, walking is essential to your health and wellbeing. Why? The latest research shows that sitting too much is more dangerous than smoking. May is National Walking Month, designed by Living Streets, to encourage everyone to get more walking into their day. You’ve already conquered On Your Feet Britain, so it’s time for the next challenge – this month we are challenging YOU to #Try20. Simply follow these fun and easy ways to fit 20 minutes of walking into your day...

6. Take the long cut. Walk the long way around to get extra steps into your day. 7. Lunch Alfresco, not Al-desko! As the weather is getting better why not plan a lunch outdoors – invite your friends and colleagues and take your lunch outside away from the dullness of your desk. 8. Invite your friends for walks instead of coffee or lunch. 9. Explore a new area on foot. You’ll notice a lot more than if you’re in a car. 10. Wander around the room whilst talking on the phone.

1. Walk part of your commute – why not get off a train or bus stop earlier and walk the rest of the way.

WHY WALK?

2. Back to Back Meetings? Plan a walking meeting! You’ll probably find your colleagues are more productive too!

P Walking for just 20 minutes a day can transform fitness levels, improve health and reduce stress and anxiety.

3. Get your family involved – go out on a walking adventure with children or grandchildren this weekend, and let the little ones get some training ready for Walk to School Week (16-20th May). 4. Motivate yourself to walk more by putting your equivalent petrol money or bus fare in a piggy bank each time you walk. Watch those pennies add up and treat yourself at the end of the month for being so active.

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5. Get snap happy! Plan a weekend walk and take your camera along and snap your local park, sunset or town center – you’ll be surprised how many hidden reassures you can find in your local area.

P Walking is the cheapest, simplest and one of the most effective forms of exercise.

P A brisk 20 minute walk can burn up to 110 calories. P It’s an easy and accessible way to get active and help maintain a healthy heart. P Walking is a great way to clear your head at the beginning or end of a stressful day. P The results of 2016 study found that a 20 minute walk each day could be enough to reduce an individual’s risk of early death.


CHALLENGE Get yourself a pedometer, and aim to walk 10,000 steps a day. Start with one day a week, and try to build up to 10k most days.

ABOUT LIVING STREETS Living Streets is the UK charity for everyday walking. Their ambition is to get people of all generations to enjoy the benefits that this simple act brings and to ensure all our streets are fit for walking. Each May charity Living Streets celebrates National Walking Month. A month dedicated to encouraging people across the country to take to their feet and feel the benefits of walking. National Walking Month includes the charity’s two flagship events - Walk to Work Week and Walk to School Week. Last year over 8,000 people took part in Living Streets’ Walk to Work Week. By making simple changes to their day such as walking all, or part of their commute, planning a walking meeting or going for a lunchtime walk, they clocked up an impressive 78,679 miles. That’s the equivalent of walking around the world three times.

YOU CAN DO IT A few simple steps in the right direction can make all the difference. Who knows where walking can take you? For more information visit www.livingstreets.org.uk


The best

Leafy Green

vegetables

Everyone knows that you need to eat your vegetables, especially the green leafy ones. Green leafy vegetables are very nutrient-dense and incredibly healthy. They are a vital source of antioxidants that are very beneficial to providing weight loss help. People have often known how nutritious leafy greens are, but still choose to exclude them from their diet. However, if everyone truly understood the powerful capabilities of vegetables, nobody would go without them. Greens are the Number One food you can eat regularly to help improve your health and boost weight loss. This is because leafy vegetables are full of fibre along with vitamins, minerals, and plant-based substances that help protect you from heart disease, diabetes, and even cancer. Many of the vegetables listed below even help stall the aging process. Even so, a large majority of the population are not eating as many vegetables each day as dietary experts recommend. Here are some of the TOP Green Leafy Vegetables you should try hard to get into as many of your meals as you can stand. If you put just a little thought into it, you can sneak these items in many dishes without ever being able to taste or notice them.

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Red & Green Leaf Lettuce A familiar sight in salad bowls, these lettuces are high in vitamin A and offer some folate. Leaf lettuces have a softer texture than romaine, a crunchy variety used in Caesar salads. Fans of Iceberg lettuce may go for romaine, a crispy green that's better for you. The darker the lettuce leaf, the more nutrition it has, making red leaf slightly healthier than green.

Nutritional Info

(One Cup) 4 calories, 0.06 g fat, 0.37 g protein, 0.63 g of carbohydrates and 0.3 g fibre.

Watercress

Watercress is a member of the cabbage family along with other greens such as mustard greens, kale, and turnip greens. Watercress offers similar health benefits as kale and collards and can be used in the same way. The slightly peppery, sour tasting watercress is handy because it can be added raw to salads or sandwiches without a minute of preparation time. Like the other veggies on this list, one cup of the stuff has more than your daily value of vitamin K, and is also linked to cancer prevention.

Nutritional Info

(One Cup) 4 calories, 0g fat, 1g protein, 0g carbs, 0g fibre

Benefits

Watercress contains many phytochemicals, which are plant compounds that offer disease prevention. Glucosinolates are best absorbed from raw vegetables, and since watercress is rarely cooked, it's an excellent source. Watercress has a higher antioxidant concentration than apples or broccoli. Studies have found that baby leaf watercress contains more antioxidants than other greens. Regular consumption of watercress reduces your risk of developing certain types of cancer. Studies have found that the antioxidants and carotenoids in watercress can reduce cellular damage related to the development of cancer. Researchers fed 30 smokers and 30 non-smokers 85 g of raw watercress daily for 8 weeks. While all participants experienced benefits, the smokers benefits were far more significant.

Benefits

While looking at these numbers, you might think that red leaf lettuce is filled with empty calories, but despite the low calorie count, this lettuce is actually packed with vitamins, minerals and amino acids. Red leaf romaine contains minerals essential for your body to make bones, produce hormones and regulate your heartbeat. Deficiencies in minerals can cause health complications like osteoporosis from lack of calcium. That one-cup serving of red leaf lettuce contains 9 milligrams of calcium, it also contains iron, magnesium, phosphorus, potassium, sodium, zinc, copper, manganese and selenium. Vitamins are essential for your health, and each vitamin is necessary for a particular function. For instance, vitamin D is essential for bone growth and the regulation of calcium. A one-cup serving of red leaf lettuce contains vitamin C, thiamine, riboflavin, niacin, pantothenic acid, vitamin B-6, folate, choline, beta-carotene, vitamin A, lutein and vitamin K.


Kale

Known as one of the healthiest vegetables on the planet. This nutrition powerhouse offers everything you want in a leafy green, and takes a first-place ranking. It’s an excellent source of vitamins A, C, and K, has a good amount of calcium for a vegetable, and also supplies folate and potassium. Kale’s ruffle-edged leaves may range in colour from cream to purple to black depending on the variety.

Spinach

Is one of the most nutritious foods available, as it is low in calories and high in vitamins, spinach is one of the most nutrient-dense foods in existence. It’s packed with vitamins A and C, as well as folate. And because heat reduces the green’s oxalate content, freeing up its dietary calcium, meaning cooked spinach gives you more nutrition than raw, but is excellent eaten raw in salads. Bags of frozen chopped spinach are more convenient to use than block kinds, and this mildflavored vegetable can be added to soups, pasta dishes, and casseroles.

Nutritional Info

(One Cup) 7 calories, 0.12g fat, 0.86g protein, 1.09g carbs., 4.3 fibre

Benefits

Containing more than a dozen individual flavonoid compounds, which work together as cancer-fighting antioxidants. These elements neutralize free radicals in the body. It is an excellent promoter of cardiovascular health because the antioxidant properties (water-soluble in the form of vitamin C and fat-soluble beta-carotene) work together to prevent the harmful oxidation of cholesterol. Oxidized cholesterol is a danger to the heart and arteries. Magnesium in spinach works toward healthy blood pressure levels as well. Spinach also contains a carotenoid that makes prostate cancers destroy themselves. This same carotenoid, after being changed by the intestines, prevents prostrate cancer from reproducing itself. Spinach also contains kaempferol, a strong antioxidant that prevents the formation of cancerous cells. Women who have a high intake of this flavonoid show a reduced risk of ovarian cancer.

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Nutritional Info

(One cup) 70 calories, 0g fat, 4g protein, 10g carbs, 5 g fibre,

Benefits

Kale’s health benefits are primarily linked to the high concentration and excellent source of antioxidant vitamins A, C, and K and sulphurcontaining phytonutrients. Carotenoids and flavonoids are the specific types of antioxidants associated with many of the anti-cancer health benefits. Kale is also rich in the eye-health promoting lutein and zeaxanthin compounds. Beyond antioxidants, the fibre content of cruciferous kale binds bile acids and helps lower blood cholesterol levels and reduce the risk of heart disease, especially when kale is cooked instead of raw.


Cabbage

Although paler in colour than other leafy greens, this cruciferous vegetable is a great source of cancer-fighting compounds and vitamin C. It is considered the workhorse of the kitchen. Available in red and green varieties, cabbage can be cooked, added raw to salads, tacos or stir fries, shredded into a slaw, or made into sauerkraut.

Nutrition Info

(One Cup) 22 calories, 0g fat, 1g protein, 5g carbs, 2g fibre.

Benefits

Cabbage ranks right up there with broccoli, cauliflower, and Brussels sprouts with a reputation for fighting cancer. It’s also a good source of vitamin C, fibre, potassium, and other nutrients. Cabbage also offers a major payoff, which is providing the fewest calories and least fat of any vegetable.

Broccoli

From green cabbage you’ll enjoy a fibre boost and a respectable amount of vitamin C. Two types of cabbage, savoy and bok choy, provide beta-carotene, the antioxidant that battles cancer and heart disease. For those who don’t eat dairy products, bok choy is an important source of calcium, which helps prevent osteoporosis and controlling blood pressure.

Is a veritable goldmine of nutrition. It is rich in vitamin C and is also a good source of vitamin A, potassium, and folate. It’s stalks and florets add both crunch and colour to stir-fries.

Nutritional Info

(One Cup) 30 calories, 0g fat, 2g protein, 6g carbs., 2g fibre

Benefits

Cabbage can help you lose weight as it can be eaten in high volumes without providing higher calories. Foods higher in fibre like cabbage are very cleansing and will fill you up faster, resulting in less overall calorie consumption.

Broccoli contains a high amount of potassium, which helps maintain a healthy nervous system and optimal brain function, as well as promotes regular muscle growth. Along with a high amount of potassium, Broccoli also contains magnesium and calcium that help regulate blood pressure. One cup of broccoli contains the RDA of vitamin C, an antioxidant necessary for fighting against free radicals. Broccoli contains high levels of both calcium and vitamin K, both of which are important for bone health and prevention of osteoporosis. Broccoli is helpful in repairing skin damage and helps the skin to detoxify and repair itself. It’s vitamin C is an effective antihistamine for easing the discomfort of the common cold. Also, one cup of broccoli bolsters the immune system with a large dose of beta-carotene. Trace minerals, such as zinc and selenium, further act to strengthen immune defence actions.

The B6 and folate in broccoli reduces the risk of atherosclerosis, heart attack, and stroke. Broccoli contains a powerful antioxidant compound and anti-carcinogen that will not only hinder the growth of breast, cervical and prostate cancer, but it boosts liver function. It contains lutein which can slow down, or prevent the thickening of arteries in the human body, helping fight against heart disease and stoke. Lutein also helps prevent age-related macular degeneration and cataracts.


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Depression WHAT YOU NEED TO KNOW...

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be life-threatening because it can make you feel suicidal or simply give up the will to live. We all have times when our mood is low, and we’re feeling sad or miserable about life. Usually these feelings pass in due course. But if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again for a few days at a time, it could be a sign that you’re experiencing depression.

“It starts as sadness then I feel myself shutting down, becoming less capable of coping. Eventually, I just feel numb and empty.” If you are given a diagnosis of depression, you might be told that you have mild, moderate or severe depression. This describes what sort of impact your symptoms are having on you currently, and what sort of treatment you’re likely to be offered.

Living with depression is difficult for those who suffer from it and for their family, friends, and colleagues. It can be difficult to know if you are depressed and what you can do about it.

Signs & Symptoms • • • • • • • • • • • • • • • •

Tiredness and loss of energy. Sadness that doesn’t go away. Loss of self-confidence and self-esteem. Difficulty concentrating. Not being able to enjoy things that are usually pleasurable or interesting. Feeling anxious all the time. Avoiding other people, sometimes even your close friends. Feelings of helplessness and hopelessness. Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual. Very strong feelings of guilt or worthlessness. Finding it hard to function at work/ college/school. Loss of appetite. Loss of sex drive and/or sexual problems. Physical aches and pains. Thinking about suicide and death. Self-harm

If you experience four or more of these symptoms for most of the day - every day - for more than two weeks, you should seek help from your GP.


How Do I Get Help? Talking therapies such as cognitive behavioural therapy (CBT) and some forms of counselling and psychotherapy work well for depression, although you may have to wait to see a therapist on the NHS. You can pay to see someone privately and your GP may be able to recommend someone. Always check that any private therapist is registered with a professional body. There are several different kinds of talking therapy. Your GP can advise you about which you might find most helpful. Counselling Counselling gives people the chance to talk through everyday issues that may be causing depression and to develop strategies for resolving them. Cognitive therapy Cognitive therapy (sometimes called cognitive behavioural therapy or CBT) addresses the way you think and how this can cause depression. It teaches you skills to identify patterns of behaviour and thinking that are causing you problems and change them.

What Leads to Depression? Depression can happen suddenly as a result of physical illness, experiences dating back to childhood, unemployment, bereavement, family problems or other life-changing events. Examples of chronic illnesses linked to depression include heart disease, back pain and cancer. Pituitary damage, a treatable condition which frequently follows head injuries, may also lead to depression. Sometimes, there may be no clear reason for your depression but, whatever the original cause, identifying what may affect how you feel and the things that are likely to trigger depression is an important first step.

Bi-polar disorder The mood swings in bi-polar disorder can be extreme - from highs, where the individual feels extremely elated and indestructible, to lows, where they may experience complete despair, lethargy and suicidal feelings. Sometimes people have very severe symptoms where they cannot make sense of their world and do things that seem odd or illogical.

Mild depression Depression is described as mild when it has a limited negative effect on your daily life. For example, you may have difficulty concentrating at work or motivating yourself to do the things you normally enjoy.

Post-natal depression Many new mothers experience what are sometimes called 'baby blues' a few days after the birth. These feelings of anxiety and lack of confidence are very distressing but in most cases last only a couple of weeks. Post-natal depression is more intense and lasts longer. It can leave new mothers feeling completely overwhelmed, inadequate and unable to cope. They may have problems sleeping, panic attacks or an intense fear of dying. They may also experience negative feelings towards their child. It affects one in ten mothers and usually begins two to three weeks after the birth.

Major depression Major depression interferes with an individual’s daily life - with eating, sleeping and other everyday activities. Some people may experience only one episode but it is more common to experience several episodes in a lifetime. It can lead to hospital admission, if the person is so unwell they are at risk of harm to themselves.

Seasonal Affective Disorder (SAD) SAD is associated with the start of winter and can last until spring when longer days bring more daylight. When it is mild, it is sometimes called ‘winter blues’. SAD can make the sufferer feel anxious, stressed and depressed. It may interfere with their moods and with their sleeping and eating patterns.

Types of Depression There are several different types of depression, here are the most prominent, and commonly diagnosed, types...

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Psychotherapy Psychotherapy can be more intensive than counselling although people and organisations often use these terms interchangeably. It often looks at how past experience may be affecting your life now, so it may involve delving deeply into early experiences and key relationships. This may take more time, although shorter, more focused ways of doing this have also been developed.Interpersonal therapy focuses on how you relate and behave towards others. It helps you to build a better self-image and communicate more effectively with others. Anti-depressants In many cases your GP will recommend anti-depressants, either on their own or in combination with talking therapies. Anti-depressants do work for many people but inevitably they do have side effects. You can discuss these with your GP.

About Medication Medication will not always be the first choice, especially if your depression is mild. There are a number of different types of antidepressants available. Your GP can explain which they believe is the best for you and why. What your doctor prescribes will depend on the type and severity of depression you have. If you experience problems from your medicine or have any concerns, speak to your GP. If one medication does not work you may be prescribed something else. However it takes a few weeks before your medicine starts to work so you need to allow enough time to see if it is going to be effective.


Hepful Websites Depression Alliance www.mind.org.uk/about-us/what-we-do/depression-alliance Depression Alliance Scotland http://actionondepression.org Samaritans www.samaritans.org Mind www.mind.org.uk NHS Choices: Stress, anxiety and depression www.nhs.uk/Conditions/stress-anxiety-depression Be Mindful http://bemindful.co.uk


Secrets The

Want to stay young in mind and body? Develop these lifelong habits.

To Aging Healthily

1. Watch what you eat and drink Having a balanced diet is crucial for good health, energy and preventing illness. An ideal diet should be low in saturated fat, with lots of fruit and vegetables, wholegrains, oily fish, and small amounts of low-fat dairy and lean meat.

3. Stay active

5. Get a vitamin boost

Daily exercise helps you to stay strong and healthy. This will lower your risk of obesity, heart disease, stroke, diabetes, and even cancer. If that wasn’t enough, staying active can boost your self-esteem, improve your sleep, and give you more energy.

Lots of people have a vitamin D deficiency and don’t know it. In fact, it’s estimated that it affects half of the adult population. Vitamin D deficiency has been linked to cognitive impairment, bone problems and also cardiovascular disease.

If you drink alcohol, keep at least two days per week booze-free to give your liver time to recover from the toxic effects of alcohol, and don’t exceed recommended daily limits for alcohol consumption.

Government guidelines recommend that older adults do 150 minutes of moderate intensity activity per week, as well as strengthening exercises twice a week. If that sounds like a lot, start small and as you get stronger you will be able to work up to those amounts.

Try to get outside in the sunshine for at least 15-20 minutes a day for a vitamin D boost. It can also be found in food such as eggs and oily fish. Alternatively, talk to your doctor about taking a vitamin D supplement.

2. Look after your teeth

4. Make the most of your GP

Brush your teeth twice a day and floss daily. Floss helps to prevent gum disease by removing pieces of food and plaque from between the teeth. If it’s left to build up you might notice sore or bleeding gums, and gum disease can also be linked to diabetes, strokes, heart disease and rheumatoid arthritis.

It’s a good idea to get some routine tests done at the doctors to check your blood pressure and cholesterol levels. High readings increase your risk factor for stroke and heart disease but any problems are completely reversible with medication.

Don’t forget to top-up with lots of water to avoid dehydration, which can make you feel tired and confused. Tea, coffee and fruit juice will also help you to stay hydrated, but avoid sugary fizzy drinks. See our healthy eating guide for lots more information.

Have regular check-ups and, if you wear dentures or have a bridge, ask your dentist to check that they fit properly.

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Whilst you’re there, why not ask your doctor about the seasonal flu jab? It’s free once you reach 65, or if you have a health condition that puts you at risk of more serious problems if you caught the flu.

6. Take care of your feet Look after your feet by applying moisturiser to prevent dry skin and cutting your toenails straight across. Make sure you have footwear that fits properly and supports your feet. If they are sore you may be tempted to stay in slippers, but a pair of trainers could be a good option as they are more supportive. Contact your GP if your feet become painful, feel very hot or cold, or if you have common problems like corns, bunions or ingrown toenails.


7. Sort out your sleep

9. Stay in touch

Many of us have trouble getting – or staying – asleep as we get older. This can leave you feeling tired and grumpy. Avoid insomnia by cutting down on daytime naps, establishing a bedtime routine and going to bed at the same time each night.

Spending time with other people can prevent you from feeling lonely or anxious. If you find that you are no longer able to do things you used to do, try to develop new hobbies.

Also, try having a warm drink such as chamomile tea or hot milk before you go to bed.

8. Take the tests As we age our hearing and eyesight can be affected, so it’s important to get them checked regularly. Hearing loss is common in older people so see your GP if you have to have the TV on loud or having trouble tuning into conversations. If you need a hearing aid, some are available on the NHS. Have your eyes checked every year if you are aged 70 or over, and every two years if you are under 70. This means that changes in your vision can be corrected and any problems can be picked up before they seriously affect your sight. Eye tests are free if you are over 60.

Here are a few ideas: Volunteer with a local charity or good-cause, join a book or dancing club, attend pub quizzes, join a church group, join or start a walking group with friends. Also, don’t forget that you can use Skype (it’s very simple to use and free!) to make video phone calls to friends and family who don’t live nearby.

10. Give up smoking As everyone now knows, smoking is bad for your body and your brain. It is linked to a whole range of different health problems, including heart disease, lung cancer, and bronchitis. The good news is that if you stop smoking, regardless of your age, your circulation, your lung capacity and your energy levels will improve along with your life expectancy!


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MENTAL HEALTH AWARENESS WEEK 8-14 MAY 2017 SURVIVING OR THRIVING? Good mental health is more than the absence of a mental health problem. This Mental Health Awareness Week, 8-14 May 2017, the Mental Health Foundation are going to look at mental health from a new angle. Rather than ask why so many people are living with mental health problems, they will seek to uncover why too few of us are thriving with good mental health. With people struggling to cope with the demands of life and stuck on getting through the day, they will explore: P How many of us are surviving or thriving, and the difference between the two P Why some communities are under strain and what the government can do to support them to thrive P What steps we can take to look after our mental health, building resilience to cope with the demands of life. Throughout the week they will also highlight the personal stories of people who are surviving or thriving. Join the Mental Health Foundation on 8-14 May and help ignite a national conversation about whether we are surviving or thriving and what we can do to bring about change. Visit www.mentalhealth.org.uk for more information.


Let's Talk About...

Mental Wellbeing 21


Talking about our Mental Wellbeing can often be a scary topic, but it needn’t be – your health is not merely the absence of illness or disease, but a complete state of physical, mental and social wellbeing. Wellbeing is that one-size does not fit all, which can be examined by using the illness-wellness continuum outlined by Travis (2004).

Disease developing

DISEASE Multiple medications Poor quality of life Potential becomes limited Body has limited function

Wellness developing

POOR HEALTH Symptoms Drug therapy Surgery Losing normal function

It refers to the fact that health extends beyond just prevention and avoiding illness, but reaching to achieve balance, happiness and a better quality of life. Even if one is free from physical symptoms of illness, they may still present with emotional symptoms such as boredom, depression and unhappiness. Often, these emotional states can be the foundation for physical and mental illnesses, so it is important to consider one’s awareness and education to allow them to achieve a high-level of wellness and a better quality of life. But why is all of this important? Firstly, for the employer there is a HUGE cost risk of poor mental wellbeing: 2 out of 5 organisations have noted an increase in stress related absences in 2014/15; 9.9 million working days were lost in 2014/15 and there is an estimated annual cost of £15.1 billion due to presenteeism. Moreover, there is a strong link to our health too because… People with lower positive wellbeing scores are: P Twice as likely to have died (2,800 people, two year follow up; 850 people, five year follow up) P Almost twice as likely to die from coronary heart disease as the general population P Four times more likely to die from respiratory disease P At a higher risk of being overweight or obese People with higher positive wellbeing: P Live 6-10 years longer P 19% reduction in all-cause mortality risk P 29% lower mortality in cardiovascular patients P Have a 23% lower mortality in renal patients P Have a 19% lower mortality in HIV patients P Experience positive emotions shown to undo any adverse physical effects of negative emotions So how can you improve your metal wellbeing? It’s important to be resilient – resilience refers to being able to prepare for, adapt to and recovery from adverse situations. As the great Charles Darwin said; “It’s not the strongest of the species that survive, nor the most intelligent, but the

NEUTRAL No symptoms Nutrition inconsistent Exercise sporadic Health not a high priority

GOOD HEALTH Regular exercise Good nutrition Wellness education Minimal nerve interference

most responsive to change”. Being resilient can help use cope more effectively with stressors and enjoy life, work more productively and efficiently, make meaningful contributions, build and maintain positive relationships, live longer and above all, being resilient makes us feel good and happy!

Wellbeing Tips

1. Get a good night’s sleep: Poor sleep is often

a result of the lingering effects of stress and poor resilience from the day. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety. 7-9 hours sleep a night is recommended for adults.

2. Eat well: typically, foods that are high in

sugar affect our energy levels and consequently our mood – does that afternoon slump sound familiar? So, ditch the 3pm chocolate bar and try to incorporate foods that will give you a slower release of energy such as oats, nuts and seeds. Don’t forget your 5-a-day, vegetables and fruits contain a lot of the minerals, vitamins and fibre you need to keep physically and mentally healthy. Make sure you’re getting the right fats too – fatty oils such as omega-3 and omega-6 keeps your brain working well, so opt for oily fish, poultry, nuts, olive oils, seeds and avocados.

3. Grab your water bottle: ditch the caffeine

and make sure you drink plenty of water. Caffeine is a stimulant so having too much can make you feel anxious, depressed and disturb your sleep. Drinking at least two litres of water a day will boost your concentration and hydration.

OPTIMAL HEALTH 100% function Continuous development Active participation Wellness lifestyle

Heart-Focused Breathing Technique Focus your attention in the area of the heart. Imagine your breath is flowing in and out of your heart or chest area, breathing a little slower and deeper than usual. Suggestion: Inhale 5 seconds, exhale 5 seconds (or whatever rhythm is comfortable). After reading the step, stop for a moment and try it for a full minute. Heart-Focused Breathing is an on-the-go technique. Practice doing it with your eyes open! Also, try doing Heart-Focused Breathing at different times during the day and see what you notice. If you want to learn more about increasing your own or your team’s resilience contact PAM Wellness. Our Expert team can deliver 1-2-1 and group resilience workshops and provide training for managers to identify poor mental wellbeing. Call our team on 01925 227000, visit www.pamgroup.co.uk or email alex.duthie@pamwellbeing.co.uk.

Support Toolbox If you or someone you know needs help and support, early access is important.

4. Move more: physical activity is important

for reducing stress levels and can be even more beneficial by getting yourself outside and enjoying some green space. Let’s get those happy hormones flowing!

5. Use relaxation techniques: find an activity

that helps you feel more relaxed and make sure you set aside time to do it; this could be having a bath, listening to music or trying our deep breathing technique below.

P PAM OH / Wellbeing (Occupational Health, Counselling, CBT, Physio) 01925 227000 P EAP – PAM Assist www.pamassist.co.uk P PAM Wellness – Resilience Programmes 01925 227000 Or vist www.pamgroup.co.uk for more information.


The Health Benefits of Taking a Holiday: Getting Away and Recharging the Batteries

Some people are always ready to take off and travel to “get away.” Other people get so much into their regular lives that they seldom even consider taking a holiday and going somewhere else for a while. However, many people keep busy with regular routines, but they know the benefits of taking a holiday where they go and spend some time in a different place. Like batteries that are rechargeable, people need the recharging of a change, and travel can provide that needed power-up. A holiday is a valuable experience for relocating your mojo. If you are tired and run down, a holiday is just the tonic. Learn the health benefits of taking a holiday and start planning your next vacation.

The Emotional Benefits Breaking Out of the Routine This is probably one of the most important benefits of taking a holiday. Why do many people need to take a holiday? It’s mainly because they are so stuck in a rut. They wake up early, get dressed, commute, work a nine hour day, go home, eat dinner, watch some TV and go to bed. They do this five days in a row and follow it up with two non-descript days. After a while, this takes a toll. You feel flat and you feel uninspired. Going on holiday is the complete opposite. Every day is a dynamic and varied

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experience. You are seeing new things and going to new places. A different location for rest and relaxation as well as for stimulating activities that are different from the norm is often the best reason for getting away. People on holiday can take part in activities that are completely new and unlike things done every day at home like sky diving, sleeping in late and letting someone else do the cooking. A few familiar things to do in the holiday spot are also enjoyable like golfing, walking and cycling. One of the great things about a vacation is making the most of every hour in the day. Instead of spending time at the bus stop waiting for a bus and then being stuck in traffic, you can be busy doing stuff and seeing things. You are constantly being stimulated and that is a great feeling. Even if you aren’t doing anything and just chilling on a beach or by a pool, it’s great to be able to do this without any stress or worries. Meeting New People When one talks about health benefits of taking a holiday, one shouldn’t just be talking about the health of the body but mental health as well. Sometimes people find their life is in a funk and they feel

depressed or miserable. Sometimes the best way to deal with this is to get away and go on holiday. This could especially be the case if one is depressed from breaking up with a girlfriend or boyfriend. Lonely people are sometimes depressed and going out and meeting new people and making new friends definitely makes people feel better about themselves. There is no doubt that having more human interaction and contact is healthier for your self-esteem. When you return from holiday you could keep in touch with these new friends and it may inspire you to go on more holidays, so you can visit them. Improved Mood One of the important benefits of taking a holiday is improved mood. This improved mood is important because it makes people realise that their regular life doesn’t have to be so boring and uninspired. They will return to their homes and everyday life and try to instil some of their positive holiday mood into it. What this means is they will make more of an effort to live an active lifestyle whether it’s going to the beach or going for walks. On weekends, instead of staying at home, they may go away and head off to someone they’ve never been to before.


Sun Safety Tips The sun's rays feel good, but they're no friend to your skin. You won't notice right away, but they cause wrinkles, age spots and they're the top cause of skin cancer. Over time, the sun's ultraviolet (UV) light harms fibres in the skin called elastin. When these fibres break down, the skin begins to sag and stretch. It also bruises and tears more easily, taking longer to heal. Spending too much time in the sun can also give your skin freckles, rough texture, white spots, a yellowing of the skin, and discoloured areas of the skin (which doctors call "mottled pigmentation"). It can also widen small blood vessels under your skin.

9 Ways to Protect Your Skin P Wear sunscreen whenever you spend time outdoors. It should have a sun protection factor (SPF) of 30 and say "broad-spectrum" on the label, which means it protects against the sun's UVA and UVB rays. Put it on at least 15 mins before going outside. Use 1 ounce, which would fill a shot glass. P Reapply sunscreen at least every 80 minutes, or more often if you're sweating or swimming. P Wear sunglasses with total UV protection.

The Physical Health Benefits Getting Some Sun The message that sunlight can cause skin cancer is loud and clear. Skin cancer is the most common cancer in the UK, so make sure you use a high factor suncream, keep reapplying and seek shade at the hottest time of day. However, evidence suggests that sunlight can help prevent some conditions. Lack of sunlight is thought to trigger seasonal affective disorder (SAD) - a depressive condition experienced in the winter months. So if you suffer from bouts of sadness, going on holiday may help to alleviate symptoms of depression. Research also shows blood levels of vitamin D are lowest in winter months when the sun is rarely out. When exposed to sunlight, the body has the ability to convert vitamin A from the sun into vitamin D, to help strengthen the immune system. Sleep Holidays provide the perfect opportunity to catch up on sleep. Sleep deprivation through stress or work can lead to poor

mental performance, premature ageing and even illness. While we are asleep our bodies undergo certain important processes - from repair and renewal to energy restoration. According to scientists, deep sleep - rather than length of sleep - is the time when the brain recharges itself so we can function effectively during the day. Sleep is also important for our immune system - the part of the body that is responsible for fighting infection. Some scientists believe that during sleep we secrete higher levels of cortisol - the hormone secreted by the pituitary gland that protects the immune system. These benefits show that it’s not enough just to leave the office, you also need to switch off when you take time off. Try not to think about all of things that annoy you in work, don’t log into your email unless absolutely necessary and limit your use of electronic devices. So don’t feel guilty about taking the time off you’re entitled to. Holidays are important for a healthier you, a happier office and a more productive workplace.

P Wear wide-brimmed hats, and longsleeved shirts and pants. P Avoid being out in the sun as much as possible from 10a.m. to 2p.m. P Check your skin regularly so you know what's normal for you and to notice any changes or new growths. P Choose cosmetics and contact lenses that offer UV protection. You still need to use sunscreen and wear sunglasses with broad-spectrum sun protection. P If you're a parent, protect your child's skin and practice those habits together. P Don't use tanning beds.


WHAT'S YOUR DEFINITION OF [ Happiness ] ? Research in the field of positive psychology and happiness often define a happy person as someone who experiences frequent positive emotions, such as joy, interest, and pride, and infrequent (though not absent) negative emotions, such as sadness, anxiety and anger. Happiness has also been said to relate to life satisfaction, appreciation of life, moments of pleasure, but overall it has to do with the positive experience of emotions. The key to these definitions is that positive emotions do not indicate the absence of negative emotions. A "happy person" experiences the spectrum of emotions just like anybody else, but the frequency by which they experience the negative ones may differ. It could be that "happy people" don't experience as much negative emotion because they process it differently or they may find meaning in a way others have not. In fact, using the phrase "happy person" is probably incorrect because it assumes that they are naturally happy or that positive things happen to them more often. Nobody is immune to life's stressors, but the question is whether you see those stressors as moments of opposition or moments of opportunity. Regardless of where you are on the happiness spectrum, each person has their own way of defining happiness. Philosophers, actors, politicians, and everybody in between have all weighed in on their own view of happiness. Read some of our favourite definitions below and let us know what resonated with you.

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The ancient Greeks defined happiness as: "Happiness is the joy that we feel when we’re striving after our potential." Shirley MacLaine, Academy Award winner, said: "To be happy, you have to be willing to be compliant with not knowing." Michael J. Fox said: “My happiness grows in direct proportion to my acceptance, and in inverse proportion to my expectations.” Mastin Kipp, the founder of Daily Love, said: "I don’t expect to always be happy, I simply accept what is. And that acceptance is key. This is what self-love is all about, really, acceptance and the ability to love yourself right where you are." Gabrielle Bernstein, author, said: "Choosing happiness is the path of least resistance." Aristotle said: "Happiness is a state of activity." Dr. Shefali Tsabary, psychologist and author, said: "Only when we fill our own need and feel satiated from within can we truly be fulfilled and happy." Eleanor Roosevelt said: "Someone once asked me what I regarded as the three most important requirements for happiness. My answer was: A feeling that you have been honest with yourself and those around you; a feeling that you have done the best you could both in your personal life and in your work; and the ability to love others."

What's great about all these definitions is that commonalities start emerging. Shirley MacLaine and Michael J. Fox tell us to accept life's situations and to accept uncertainty as a natural part of life. And the greater we are able to do that, the greater we can lean into happiness. Mastin Kipp tells us it's ok to not strive to be happy, but accept whatever we're feeling. He hints at an important concept, which is that we so often try to fix things and get to be "happy" or "at peace" or "over a situation," but sometimes we need to acknowledge what we're feeling (whatever that is). What you often find is that acknowledgement will allow you to move into the "happy space" more quickly because your emotions aren't trying to get your attention. Your emotions aren't screaming at you, telling you that you're sad or angry. You've already begun the work of processing it. Lastly, Aristotle shares a crucial part of happiness, which is staying active. How many "happy" people do you know who sit at home all day, everyday? They might be content or "ok" temporarily, but are they truly thriving in happiness? Happiness is often found in the doing of what you're passionate about and in building connections that are meaningful to you. Research has supported this with findings showing that strong social support is correlated with a number of positive outcomes. You might be in a rut now and you might have moments where you lose your connection to life, but you always have the opportunity to rebuild that connection. So now it's your turn to begin finding the happiness in you. What brings you joy? Maybe it's a night in watching TV. Maybe it's a night out at a new restaurant in town. Maybe it's staying up late watching a movie with your significant other. Maybe it depends on your mood. Wherever your happiness resides, go enjoy it.


13,500 people living with an undiagnosed HIV infection in the UK New figures released on World AIDS Day 2016 by Public Health England (PHE) also estimate 101,200 people in the UK are living with HIV. 27


published guidance to support increased uptake of HIV testing. The guideline recommends HIV testing is offered in hospitals, A&Es and GP practices in areas of high HIV prevalence. Dr Valerie Delpech, Head of HIV surveillance at Public Health England, said:

It is very worrying that so many people with HIV are living with an undiagnosed infection and may be putting sexual partners at risk.

Regular HIV testing ensures that people who are unaware of their infection are quickly diagnosed and start receiving safe and effective treatment. There are now several effective ways to prevent HIV transmission. We are again working with local authorities to fund the HIV homesampling test kit, so that those people who are less likely to visit their GP, sexual health clinic for a HIV test – can take the test at home. It is essential that health services are aware of the prevalence of HIV in their local area and the potential demand for HIV testing.

According to new figures released on World AIDS Day 2016 by PHE, an estimated 101,200 people are living with HIV in the UK. Of these more than 13,500 are living with an undiagnosed infection. PHE is working to reduce the number of people living with undiagnosed HIV by improving access to testing and funding HIV homesampling tests which can be ordered online. It is critical that anyone who is at risk of HIV, such as those living in high prevalence areas or who have recently had sex with a new or casual partner, gets tested because those diagnosed early can have a life expectancy almost matching that of people who are HIV free. 96% of people diagnosed with HIV are receiving treatment, which is good for their long term health, but also means almost all (94%) on treatment will have undetectable virus levels and pose virtually no risk of passing the virus on to sexual partners. Of the 6,095 people diagnosed with HIV in 2015, 39% were diagnosed at a late stage of the infection. People who are undiagnosed or diagnosed late have poorer health outcomes and are more likely to die prematurely, they are also more likely to pass on the infection to others. NICE has

Ultimately, it is important that people avoid the risk of developing HIV by wearing a condom and practicing safe sex.

In 2015, 6,095 people (4,551 men and 1,537 women) were diagnosed with HIV in the UK, 54% (3,320) of which were gay and bisexual men. The HIV epidemic still remains largely concentrated among gay and bisexual men and it is estimated that in 2015, 47,000 gay and bisexual men were living with HIV - 12% of who were undiagnosed. However, anyone can acquire HIV regardless of age, gender, ethnicity, sexuality or religion.

How is HIV transmitted? You can get or transmit HIV only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. HIV is not spread easily. Only certain body fluids from a person who has HIV can transmit HIV: • • • • • •

Blood Semen Pre-seminal fluid Rectal fluids Vaginal fluids Breast milk

These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected into your bloodstream (by a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth. If you think you may have been exposed to HIV, get tested. You can get tested at your doctors, a sexual health walk-in clinic, and other locations. You can also get a HIV home test kit from your local pharmacy. Use the AIDS.gov HIV Testing and Care Services Locator to find a testing site near you.

I have HIV, does that mean I have AIDS? No. The terms “HIV” and “AIDS” can be confusing because both terms refer to the same disease. However, “HIV” refers to the virus itself, and “AIDS” refers to the late stage of HIV infection, when an HIV-infected person’s immune system is severely damaged and has difficulty fighting diseases and certain cancers.

Before the development of certain medications, people with HIV could progress to AIDS in just a few years. But today, most people who are HIV-positive do not progress to AIDS. That’s because if you have HIV and you take ART consistently, you can keep the level of HIV in your body low.

This will help keep your body strong and healthy and reduce the likelihood that you will ever progress to AIDS. It will also lower your risk of transmitting HIV to others.

Nicola Blackwood, the Minister for Public Health said: Stopping HIV is still a priority. It is clear that we must do more to reduce the number of undiagnosed cases however, significant progress is being made to diagnose HIV early and the proportion of people with undiagnosed HIV fell from 25% to 13% since 2010.

We will keep working with Public Health England and NHS England to encourage people, particularly those from African communities who are often diagnosed late, to get tested and fight the stigma associated with HIV.


March 2017 Ovarian Cancer Awareness Month Do you know the symptoms? P P P P

Persistent abdominal pain Persistent bloating Feeling full or difficulty eating Needing to wee more urgently

If you have any of these symptoms more than 12 times a month and they are not normal for you, see your GP as soon as possible.

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The Facts...


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n o s a e S e h t f o e p i c e R CHICKEN SHAWARMA FLATBREADS WITH YOGHURT

Bring the flavours of the Middle East to your midweek meals with this stunning chicken shawarma. The ideal meal for sharing – pile a platter full of warm flatbreads, mint-yoghurt, crisp lettuce and cucumber and sumacspiced chicken, then let everyone dive in and wrap up their own delicious dinners.

INGREDIENTS 6 skinless and boneless chicken thigh fillets, fat trimmed 2 tbsp olive oil

METHOD 1. Put the chicken in a freezer bag. Massage in the olive oil, 1 tsp sumac, juice of half a lemon, garlic, thyme and chilli flakes; season. Leave to marinate for 10 minutes or chill overnight. 2. Preheat the grill to high. Put the chicken on a baking tray and grill for 10-12 minutes, until the outside is lightly charred and the middle is cooked through with no pink showing. Remove from the grill and set aside. 3. Meanwhile, combine the yoghurt, mint, remaining sumac and a squeeze of lemon juice in a bowl; season to taste. Set aside until needed.
 4. To assemble, spread each flatbread with a spoonful of the yoghurt mixture, then top with lettuce and cucumber. Slice the chicken into bite-size pieces and divide between the flatbreads. Top with the pomegranate seeds, then drizzle over a little pomegranate molasses (if using). Roll up the flatbread and serve warm.

2 tsp sumac 1 lemon, halved 2 garlic cloves, crushed or grated 3 thyme sprigs, leaves picked 1/2 tsp chilli flakes 200g (7oz) Greek yoghurt handful mint, leaves chopped 4 flatbreads, warmed through 2 little gem lettuces, shredded 10cm (4in) piece cucumber, cut into cubes 2 tbsp pomegranate seeds pomegranate molasses, to serve (optional)


The 10 Top

Diet Tips You Need to Know

If you’ve ever tried to lose weight (and who hasn’t), you’ve got to be mindful of whose advice you take. Your colleague says you need to cut out carbs. Your gym buddy knows the secret is to stop eating after 7 p.m. Your Facebook friend swears she’ll be in swimsuit shape by March if she only eats once a day. But do any of these tips really work? To help you shed those extra pounds—and keep them off— without starving yourself, ditching your social life, or eating only at odd times of the day, we talked to experienced nutritionists for real-world advice you can actually live with, day in and day out. We’ll tell you how to focus on the delicious foods you can add to your diet, why you should always eat breakfast and how preparation is key to a successful path to weight loss. So here are our top 10 best diet tips of all time. Say bye bye to hunger and hello beach bod.

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1

Never get too hungry You make poor decisions when your judgment is compromised. Hunger is a primal urge that’s difficult to deny. When you’re famished, it’s hard to hold off until you can find healthy food. As a result, you end up eating anything that’s not nailed down, and typically, regretting it. Planning meals and snacks works wonders to head off the intense hunger that can do a number on your best intentions to eat right. Always tote healthy snacks, such as an ounce of pistachios, a hard-cooked egg and some whole grain crackers, Greek yogurt, or 1/4 cup raisins. Don’t skip meals or skimp on them, either. Here, 6 portable, protein-packed snacks that fill you up!

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Be honest about your daily calorie allowance Everyone has a calorie budget, whether you’re trying to maintain your weight or lose a few pounds. I’ve found that people ignore this simple fact. Your calorie budget allows you to build a healthy diet, and it helps prevent frustration about weight control. The 2010 Dietary Guidelines for Americans provide suggested daily calorie intakes based on gender, age, and physical activity level. When you know your calorie budget, then you can plan on how many servings of fruits, vegetables, whole grains, low-fat dairy, and other protein sources to include every day. Eat right post-workout People are notorious for overestimating how many calories they burn during physical activity, which is often far less than actual calories burned. When you overestimate the calories you burn during exercise, you may eat more than you need, making weight loss and maintenance difficult. High-intensity exercise may drive women to eat more, and moderate exercise may be the key to easier weight control. To see how many average calories you’re burning during everyday activities and exercise, check out this chart from the CDC. You can see how easy it is to wipe out the calories burned during a workout with just a few extra nibbles during the day.

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Kick the salt habit Salt is a big contributor to weight gain and often a reason why the numbers on the scale aren’t going down. The average American consumes twice the amount of salt they should have each day, leading to weight gain, bloating, and the inability to lose stubborn pounds. Salt can also make you feel hungrier and thirstier, so check the nutrition labels for high sodium levels and choose fresh over packaged or restaurant foods. You’ll see a puffy face and belly go down quickly just by cutting back on your sodium intake and choosing more natural foods.

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Use the red, orange and green rule At each meal include at least one food that is any of these three colours. By focusing on these foods, you’ll be sure to get some fresh and healthy produce on your plate, meaning won’t have as much space on your plate for higher-calorie fare. Basically, the more colours on your plate and the wider the variety of fruit and veg - the better! Bonus: Colourful fruits and veggies help your skin look healthier and younger! Drinking water is vital The importance of water just can’t be stressed enough. A person can go for weeks without food, but only a few days without water. It plays a vital role in nearly every vital bodily function we have. If your body doesn’t get enough water, it becomes dehydrated. When you’re dehydrated, you can’t function at your best and may be sluggish or have trouble concentrating, imagine what that’s doing to your organs, your skin, your brain! When you’re dehydrated, your body also can’t flush out toxins or regulate itself as easily. By not flushing out these toxins you will be more susceptible to sickness, disease, weight gain and premature aging.

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Take your time Rapid eaters are often heavier than slow eaters, research has found. It takes 20 minutes for your stomach to send a message to your brain that you have eaten enough and are satisfied. If you rush your meal and eat rapidly, your body’s satiety cues won’t be tuned in to those feelings of fullness yet and it’s easier to overeat. Try slowing down by chewing each bite at least 10 times, putting your fork down in between bites, and eating in a relaxed environment rather than eating on the run. Plate food away from where you’re eating By keeping food within eyesight as you are eating, you may find yourself reaching for a second helping even if you really aren’t hungry. Place the food on the kitchen counter or stove, portion out a serving on your plate and then sit down at the table and eat. This way, if you want additional servings, you’ll have to get up, which helps you to be more mindful of what you are eating.

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Preparation is key When it comes to weight loss we need to devote 80% of our efforts to nutrition and 20% to exercise. One way to do this is to schedule time and make a date with your supermarket and kitchen. Restaurant dishes are outside of your control, and the fact is, most times, those outrageous portions come loaded with salt and fat. Start cooking at home to better monitor your calorie intake. Schedule a day, like Sunday afternoon, to pre-cook for the week. Plan to roast a whole chicken. Cut up a batch of vegetables— like squash, peppers, eggplant, and sweet potatoes—toss them with a little olive oil and roast them in another pan alongside the chicken. Boil a pot of brown rice. Do all of this simultaneously and it should only take about an hour. Now you have the makings for Monday’s burritos, Tuesday’s stew, Wednesday’s pasta dish, and so on. Each working evening, you should only need about 15 minutes in the kitchen to put it together.

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Eat breakfast without fail A study published in the British Journal of Nutrition tracked the diets of nearly 900 adults and found that when people ate more fat, protein, and carbohydrates in the morning, they stayed satisfied and ate less over the course of the day than those who ate their bigger meals later on. Unfortunately, many people start off on an empty stomach. In one survey, consumers reported that even when they eat in the morning, the meal is a full breakfast only about one-third of the time. If you’re feeling full-blown hunger before noon, there’s a chance you’re not eating enough in the morning. Shoot for a minimum of 250 calories and aim to get a serving of protein in so you’ll feel fuller longer.


8 benefits of

swimming ...whatever your fitness level

No matter what your fitness level, the general benefits of swimming are yours to go out and grab and make your own. It has the power to give your muscles a makeover, transform you into a cardio king, turn back the clock, and calm you quicker than a secluded beach in the Bahamas. But if this isn’t enough to get you reaching for your cossie, here are our top benefits of swimming to show you there is no such thing as being too cool for the pool.

The top 8 benefits of swimming 1. Full body workout. Swimming uses all the muscles in the body so whether you swim a gentle breaststroke or hammer butterfly, you will get a full body workout. Plus, exercising in water makes your body work harder so 30 minutes in a pool is worth 45 minutes of the same activity on land.

5. Lowers the risk of diseases. As well as being a great form of cardiovascular exercise, swimming just 30 minutes a week can help to guard against heart disease, stroke and type 2 diabetes. 6. Supports the body. Water supports up to 90 per cent of the body’s weight. So if you sprained an ankle at Monday night football or have a long term injury or illness, swimming is a brilliant way to stay active.

2. Great for general wellbeing. Just 30 minutes of swimming three times a week alongside a balanced, healthy diet and lifestyle is one of the best ways to stay fit and healthy and maintain a positive mental outlook. Do it with friends, and it’s even more fun! 3. De-stresses and relaxes. Whether it’s work stressing you out, the kids being a nightmare, or just life in general, we all get times we just want to SCREAM. Well, help is at hand. Swimming regularly can lower stress levels, reduce anxiety and depression, and improve your sleep patterns. Feeling the mental benefits of swimming takes just a light swim. No lane pounding needed.

7. Increases your energy levels. Inactivity and not ageing is often responsible for people’s lack of energy. Just 30 minutes of swimming three times per week can boost your energy levels through increased metabolic rate. 8. Exercising without the sweat. If sweating puts you off other forms of exercise, fear not! As a swimmer, you’ll never feel sweaty no matter how hard you work because the water around you is constantly cooling you down.

4. Burns those calories. Swimming is one of the most effective ways to burn calories. A gentle swim can burn over 200 calories in just half an hour, more than double that of walking. And a faster swim would see that indulgent chocolate bar gone quicker than if you went running or cycling.

PAM Group Ltd. Holly House, 73-75 Sankey Street, Warrington, WA1 1SL

T:01925 227000

www.pamgroup.co.uk


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