ECHOLALIA
The Official UoN Medical School Magazine
The Little Black Book for Medics
Issue 2, Sept 2012
If you missed any of the Olympics or Paralympics this summer, check out some of Echolalia’s highlights in the sports section (p 12—16).
Editorial
A fresh start may mean any number of different things to different people. For some it may be clearing your University inbox so that you can actually send e-mails; for others it may be engaging in a course of meditation in an attempt to discover one’s third eye; for a select few it may be to stop licking frozen flag poles. But for the first year medics joining us, their ‘fresh start’ at Nottingham will undoubtedly involve nervous name-givings, panicked Freshers’ Fayre sign-ups and meetings with their potentially incestuous medic mother or father. Our ‘Little Black Book’ on p 21-25 is there to guide you through the more pleasurable elements of freshers’ year. Perhaps some of our freshlings were inspired to apply for medicine because of BBC Three’s Junior Doctors; a program that envisions most of our daunting futures as foundation year doctors. If so, Echolalia’s interview on p 18 with Ben Allin, one of the willing participants on the show, is a must-see.
Ever wondered what it’s like to have a film crew follow you as you go about your day job? Find out what happened when we spoke to Ben Allin from BBC series `Junior Doctors`.
For the patriots amongst you, we have the lowdown on the sporting event of the century: London 2012. You should flick to p12 faster than Britain can win three gold medals; (your manual dexterity would be a concerning issue if this took forty five minutes) for an article of pure gold. I speak to you from a faraway land of wallabies, shrimp barbies and Hugh Jackman. If you’re mildly interested in how Nottingham’s Australian Exchange came to be and to transform your jealousy into resourcefulness, see p 38 for details! Whether it be a new beginning for first years, a homecoming for second and third years, or if you’ve been stuck in Nottingham all summer, Echolalia welcomes you to its pages and its second ever issue! Enjoy!
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Had an action packed summer? See what other people got up to this year so you can start to plan next year’s holiday.
In This Issue Check out our little black book. It has all you need to know to get the best from your next year in the medical school, from nights out to useful information, and where you can get the best discounts in Nottingham.
News Global News…………………………………………………………………… 4 Is The Tide Turning on Euthanasia?………………………………… 6 Keep Your Rosaries Off My Ovaries……………………………………… 7
Societies What MedSoc Can Do For You…………………………………………… 8 inFOCUS: Marrow...………………………………………………………… 10
Sports Use of Prosthetics in Sport………………………………………………… Faster, Higher, Stronger—Doping in Sport………………………… Inspiration from Perspiration…………………………………………… inFOCUS: Basketball…………………………………………………………
12 14 15 16
Features Taking A History from BBC Junior Doctor Ben Allin……………… Aaron’s Mind Games………………………………………………………… The Little Black Book for Medics………………………………………… Get the Balance Right……………………………………………………… Dark Chocolate: Unlikely Superfood?………………………………… New Tricks……………………………………………………………………… “Is Anyone Here A Doctor?”……………………………………………… Do You Follow?………………………………………………………………
18 19 21 26 28 29 30 31
Arts and Culture Pulling The Plug On Illegal Downloads……………………………… What’s On: Film Reviews………………………………………………… Matt’s Word Salad…………………………………………………………… “Doctor, Doctor”……………………………………………………………… The Ultimate Guide to Hallowe’en………………………………………
32 34 35 35 36
TRavel
With Christmas only a couple of months away, find out why all that chocolate might not be as bad for you as you originally thought.
Home or Away? Taking Part in a Student Exchange…………… This One Time At Camp…………………………………………………… What I Did In My Holidays………………………………………………… New Kid on the Bloc: Visit Montenegro………………………………
38 39 40 42
Essential Lecture Handouts Dinnertime……………………………………………………………………… Case Study: Breath-taking Tackle……………………………………… Puzzle Page…………………………………………………………………… Acknowledgements and Answers……………………………………… —-
44 45 46 47
Echolalia—The Offical UoN Medical School Magazine @echolalia_mag echolaliasubmissions@gmail.com echolaliamagazine@gmail.com echolaliadesign@gmail.com
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GLOBA
USA:
News
Neil Armstrong, possibly the only astronaut the majority of people could name, died on the 25th August at 82 years of age. 20th July 1969 saw him become the first man to walk on the moon. Along with Buzz Aldrin and Michael Collins (who had to wait in the rocket ship) he made up the Apollo 11 mission that lasted only 8 days. The famed astronaut died of complications following bypass surgery earlier in August.
Liam Beamer highlights some of the major news stories from around the world this summer.
USA: Donkey isn't frequently prefixed by adjectives such as rabid, but in light of a recent fatal donkey attack that may all change. A 65 year old man in Texas was found dead after an attack by a large male donkey on his own farm. The perpetrator was quickly identified based on a combination of 'evidence at the scene and what we saw on this donkey', but they didn't go into details. The victim had appeared to make an effort to escape, being feet away from his car when the predator closed in, an expert on donkeys consulted on the case said that the animals can become 'very aggressive and very mean'. In light of these occurrences, anyone intending to donkey ride on elective will have to take out specialised insurance. Do bear in mind though that more people are killed annually by donkeys than they are in aeroplane crashes!
Iceland: A search and rescue party in the volcanic south of the country was called off after it was discovered that the woman they were looking for was actually helping in the search. The woman was part of a coach group visiting a volcano, the driver had raised the alarm after the woman hadn't returned to the bus with everyone else. A group of 50 people searched the sparsely populated area of the country looking for the woman and was then told to stop after 24 hours when they found the woman, rather embarrassingly sat on the bus during a break in the search. When asked, the woman said she hadn't recognised the description of the missing individual as herself and had been taking part in the search effort since the day before.
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L NEWS Sheffield: Researchers at the University of Sheffield have established that human body hair isn't an evolutionary relic as once presumed, it does in fact have a purpose. Hair follicles across the human skin occur at a frequency equal to that of chimpanzees, why then does most people’s pre-Ocean Friday ritual not include a regular back shave? Well it is because what grows from these follicles is fine vellus hair, almost non-visible hair long considered to have no purpose. Until now! A pair of researchers conducted a study in which participants had one arm shaved and the other left as nature made it. A collection of common bed bugs were then placed on the bare arm and the unshaved arm, the researchers asked the participants to close their eyes and click a button every time they felt the bed bugs move, under a microscope the researchers also counted each attempt by a bed bug to bite the research subjects. The results showed that the arm left ‘au naturel’ exhibited increased sensitivity to movement of the bugs and increased the time before the bugs were able to bite skin. They concluded that body hair isn't merely there (or not there) to make some of us feel inadequate as men, but rather serves as a defensive early warning system against small critters not immediately visible to the naked eye.
India: Owners of a newly opened clothing shop in the North Western city of Ahmedabad have been forced to change its name after being alerted to the ever so slightly offensive nature of the name ‘Hitler’. The businessmen professed to be unaware of who Hitler was until several local Jews alerted them to the potential for offense, something quickly re-affirmed by Israeli diplomats in India. The owners have apologised for the misunderstanding, explaining that the store was named in memory of their grandfather who had endearingly been nicknamed ‘Hitler’ in recognition of his strict demeanour. A new name has been promised ‘tomorrow or the day after’.
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Is the tide turning on euthanasia? In the last few weeks euthanasia has Euthanasia will always once again been all over the news be a highly emotive with the recent ‘right to die’ case topic and many people being
brought
forward by
Tony fear that a change in
Nicklinson; a man left with locked-in the law will lead to syndrome following a stroke 7 years vulnerable ago.
people
being taken advantage
Mr. Nicklinson put forward a case to of and ‘killed off’ the high court regarding his desire to before they are ready; choose where and when he wanted to be it for monetary die as he felt his life to be reasons or because the
News
themselves unbearable. The controversy came person with him being unable to commit feels a burden to their Another suicide himself due to the severity of f a m i l i e s . recent court case on his disability; Mr. Nicklinson wanted the law to be changed so a Doctor this topic ended in the could ‘press the button’ to end his life ruling that any close without the fear of being prosecuted. The case was rejected as the three judges presiding over it decided it was a matter for parliament; not for the courts to decide. A decision that left Tony visibly distraught in scenes that were absolutely heartbreaking to witness; he could not believe his plea was rejected after the judges saw the conditions and emotional torment
family
taking
their
family to the Dignitas clinic
in
Switzerland
was ‘highly unlikely’ to face
prosecution
on
their return. So if the
Tony Nicklinson’s reaction to the news of his plea
judges are happy for these patients to sanctity of life argument. At what partake in euthanasia in another point though does majority opinion country, why is it such a stretch to change on such huge questions? allow it to happen here?
Arguably when not changing that
decision is seen as inherently cruel to Tony and his family were facing on a Many patients state that they would those involved. After all, who are we daily basis. Many have described the be happiest to die at home to say what constitutes a life worth judges’ decision as merely passing the surrounded by family. Not slowly living? It is by definition a personal buck, by putting the responsibility slipping away on a life support view and one man’s heaven could onto parliament rather than coming to machine in ICU, not with cracked ribs following many futile rounds of CPR equally be another’s hell. their own conclusion. Mr. Nicklinson passed away less than a
week after the
verdict,
from
pneumonia; no doubt exacerbated by his refusal to take any food in the few
and certainly not thousands of miles As future physicians who should from home in a completely unfamiliar always
have
the
patients’
best
place that is the only place they can interests at heart, are we ready to have their last wish realised.
accept a very uncomfortable truth;
that sometimes ending a life is kinder days prior to his death. It would seem The problem this case brings forward than preserving it? We all got into with his wishes denied he had nothing is that this change would effectively medicine to save lives; will there ever left to live for. It seems incredibly sad legalise murder. This was the barrier be a day when British doctors are that a man so vivacious prior to his that the judges could not get over, prepared to end them? stroke was reduced to going on hun- perhaps because of the potential ger strike in order to achieve what he ripple effect of such a decision, Anouska Lerner wanted, an end to his suffering. 6 25
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perhaps because of the ever strong
Keep Your Rosaries
Off My Ovaries!
If you are in possession of two X chromosomes (or know of anybody who is), breathe a sigh of relief that you are not living in the USA. Thanks to a strategic attack on women’s reproductive rights by the Republican Party it has now become mandatory in multiple US states for every woman seeking an abortion to receive an ultrasound before the procedure.
abortion and some forms of contraception. Contraception is also expensive and difficult to come by and in most places sex education is taught as abstinence only and on an opt-in basis. For a nation that values its separation of church and state so highly it seems a deity is having rather more say in legislation than is appropriate.
Perhaps the most depressing piece of legislature recently passed is the so called ‘women as livestock’ bill in Georgia and 6 other states. In order to restrict abortion as much as possible, these states have managed to criminalize abortion after 20 weeks with no exceptions. That means no exemptions for rape. No exemptions for incest and, unbelievably, women who have their foetus die in utero past 20 weeks now have to legally carry that baby to term because (and I wish I was joking) if cows, pigs and chickens have to deliver babies dead or alive, then so do women, according to Republican Terry England.
That’s not so bad you might think, surely that happens here too? But this is not just about lying there with some jelly on your belly; these women are being forced to watch their ultrasounds and listen to graphic descriptions by the physician of what they are seeing. This is so the women involved can “apprehend the full consequences of her decision” because obviously we silly women don’t understand what an abortion is. I had this crazy notion that women were allowed to have control over their bodies, without intervention from right wing evangelical Christians passing themselves off as politicians. Sadly that is no longer the case in some It seems that all the republicans want to states. do is preserve life, but I find it very difIgnoring the fact that ultrasounds are ficult to understand why an as yet unvientirely unnecessary in most first tri- able foetus is worth more than the livmester pregnancies (when the vast ma- ing, breathing, thinking, feeling woman jority of terminations occur) the politi- carrying that foetus. What about her cians who put the bill forward have health? What about her wellbeing? How openly admitted their agenda is to out- is forcing a woman to give birth to an law abortion once again in the USA. unwanted child fair on anyone? And This is just one in a long line of legisla- why time and time again is it thought tion put forward to restrict women’s that women can’t make these decisions access to abortion in the last couple of themselves? The fact is that 1 in 3 years; the state of Mississippi even tried women will have an abortion at some to pass a law defining life as beginning point in their lives and that most of at conception, thus outlawing both those women cite financial reasons as
their main motivation to terminate the pregnancy. Surely it is a heart-breaking enough decision as it is without middle aged white men wading in and giving their 2 cents on the matter and making it far more difficult to get a procedure that you need.
Ultrasound at 13 weeks—women in the USA must now undergo a scan before being allowed an abortion
It is no surprise that the USA has one of the highest teen pregnancy rates in the world (far surpassing us who have the highest in Europe). As women we are constantly told that to be valued in society we must be seen as attractive, and therefore ‘sexy’ and ‘up for it’ and yet simultaneously we must not sleep with anyone but long term boyfriends or else be labelled sluts. Imagine this constant double standard coupled with no sex education and contraception that is a financial and logistical nightmare to get hold of. So if you know or are a woman in the UK today, thank your lucky stars for the NHS, for mandatory sex education and free contraception. And to anybody who tries to stop you from taking these responsible steps to (shock horror) make your own decisions about your body, tell them to keep your rosaries off my ovaries!
Anouska Lerner
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What the new ______________can do for you Before you turn the page and dismiss this article, let’s just dispel some myths about MedSoc.
MedSoc is just a social organisation? FALSE.
MedSoc and Karni are the same thing? FALSE.
MedSoc is elitist towards students on other courses? FALSE.
And, most importantly, MedSoc can do nothing for you? ABSOLUTELY FALSE.
So now that’s out of the way, let’s find out more about what MedSoc can do for you this year. Turn to p10 to see the events hosted by MedSoc this term.
What is MEdSoc? Nottingham MedSoc is a student run union, designed to support medical students of all years in making the most of their time at university. Whether it be providing tutoring or extra support for students who are struggling academically, or putting on the best socials the university has to offer, MedSoc is here to support you. It is the largest association at the university, representing over 1,500 students across three counties.
Societies
NOTE: MedSoc is an all inclusive organisation every single medical student is automatically part of MedSoc when they become a medical student at the University of Nottingham.
Meet the MedSoc Exec 2012-13 Top row (from left):
Mei Henry—Publicity and Communications
Chloe Williams—Welfare Officer
James Lainchbury—President
Bottom row (from left):
Hannah Theobald—ENTS Representative
Joshua Appleby—VP (Sports and Social)
Adam Wright—Sports Secretary
Ellie Wolffe—Sponsorship Officer
Stephanie Weedon—VP (Social and Welfare)
Jamie van Oppen—Societies Officer
Katie Taylor—General Secretary
Pete May-Miller—Social Secretary
Rob Cullum—Treasurer
Anna Wild—Social Secretary
A Word on Extracurricular Activities by MedSoc Societies Officer, Jamie Van Oppen I often get asked how I find time to join societies, how I am able to hold down jobs whilst studying medicine, and why I would want to work all day to then spend the evening volunteering in the community. As medical students, we study one of the most stressful courses on offer at the University, and this pressure will be relentless for the rest of our careers as we aim to complete an intense training programme whilst attending to our professional duties. Any time we can spend away from the medical environment is precious – and not just to our personal lives. Recently the Jefferson Medical College in Philadelphia offered a non-clinical module taught in an environment completely separate from the medical school and found that despite initial raised tension due to new activities, after ten weeks the 300 students enrolled on the course reported lower levels of stress, anxiety and fatigue than other students.
ple who worry that spending time away from their studies will be detrimental to their performance. It only took me a few minutes to find evidence that this isn’t the case; a national survey in the USA (with follow-up research in Nebraska and at the California State University) confirms that extracurricular participants seem to perform better than non-participants in terms of attendance and academic achievement. The sense of engagement within a community also seems to decrease the likelihood of dropping out. In fact the only concerning statistic I found showed that sport-only participants receive more disciplinary referrals than only non-sport participants!
Here in Nottingham there are 222 SU societies and 74 sports clubs. As medical students we also have unique access to another 38 societies and 11 sports clubs within MedSoc, with more being started every month. With a range like this there is something for Despite a full timetable, medical students generally have more absolutely everyone; so why not take advantage of what is on extracurricular interests and greater activity within the SU than offer and develop a hobby or try something new? most other students at the University. However I know many peo-
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MedSoc Dates for Your Diaries 11th Oct ‘12—MedSoc Celebrity Cocktail Party
Watch out for these:
Societies
This shouldn’t really need any explanation! Think big, Meet Your Boss—tbc colourful and outrageous! The 1st and 5th year social, the results of which in29th Oct ‘12—MedSoc Hallowe’en Party clude lots of scribble and oldies dancing with bright, young things. More fun with fancy dress. Winter Ball—tbc 14th Nov ‘12—SCAV The classy way to end term. Don your best dresses SCAV is coming. Let’s just say that what happens at and tuxedos for the most sophisticated night of the scav stays on scav, and leave it at that. But we all year. know this event doesn’t really exist! 29th Nov ‘12—Societies Barcrawl More socials will also pop up during the term so keep Get together with a society of your choice (or year your eyes open to find out when these are. group), pick a dress code for your society and we will take you on a tour of all the MedSoc discount card See you there! places for some fun and games, ending with a messy night with all years involved. Jamie van Oppen, Mei Henry and James Lainchbury
inFocus: MaRrow
Spit happens – Use it to save a life!
Marrow is a student group that works to support the lifesaving work of the pioneering charity, Anthony Nolan. We recruit healthy, young students onto the bone marrow register who, one day, might be given the amazing opportunity to save the life of someone with a blood cancer such as leukaemia. Every 23 minutes, someone in the UK is diagnosed with blood cancer and, often, a bone marrow transplant is their last chance of life. For a successful transplant, a very close “tissue type” match is needed and these are difficult to come
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"It was really easy and it doesn’t take a lot to do. The first thing I felt after my donation was hunger. I remember wanting fish and chips." Alex
by. For every match that Anthony Nolan makes, there is another person for whom a match cannot be found. We therefore need as many people on the register as possible to increase the likelihood that everyone who needs a transplant can get one. Many people are needed on the register but specifically males, and donors from all ethnic minority communities.
Bone marrow donation is not a horribly painful procedure, as myths portray it. Now, it is often much like giving blood. We want students to know the facts and give them the opportunity to save a life. Set up by a group of medical students here at the University of Nottingham, Marrow has been such a success there is now a group at almost every university in the country!
How can I help? 1. Join the register Even if you don’t plan on getting involved with Marrow, we encourage you to sign up to the Anthony Nolan register and become a potential lifesaver. Over the next year we will hold regular Donor Recruitment Events at the QMC and across campus, so look out for the posters, emails, lecture shout-outs and Facebook events. All you need to do is fill out a form and spit in a tube – easy! Your tissue type is identified from your spit and put onto the Anthony Nolan database, and will stay there until you are sixty.
2. Become a Marrow volunteer Marrow volunteers are a fun-loving bunch who make a real difference. Working with us is one of the most varied and hands on experiences that you will ever get from a student group. Last year we signed up loads of potential lifesavers and raised over £13,000 for Anthony Nolan. Our achievements were recognised by the Student Volunteer Centre, who named us runners up for the Project of the Year award, and by Anthony Nolan who gave us tickets to their ‘Daisy Ball’ for our fundraising achievements (where 3 of our committee members got to schmooze with some celebrities!). This year we want to do even better, but we need your help!
Donor Recruitment – Running
tients. As a volunteer you will be trained to take somebody through the whole process of joining the register, from counselling them to ensuring they understand exactly what it is they are signing up for, through to collecting saliva samples.
Join our Facebook group (search Nottingham Marrow) or visit our website to find out more. Also, come along to our training evening on October 4th in the Portland Atrium (check Facebook/website/ emails/posters for confirmation of date and time) for inspiring talks, the training your need to get started with us and details of the events we’ve got planned for the semester. Also cake.
Fundraising - Bone marrow is an expensive business, it costs over £100 to tissue type just one potential donor, so fundraising is a huge part of what we do. Events are always fun and have a strong social nottinghammarrow.wix.com/2011 element so come along! Next year Kate Drewek will include cake sales, street collections, a cinema screening at the Savoy, the London Marathon, the Marrow Run and last but not least selling glow sticks in clubs (something EVERYONE should get involved in as it’s fun to sell drunk people shiny things and mainly because we get into Ocean free).
regular Donor Recruitment Events, where prospective donors can find out about bone marrow and stem cell donation and join the register, is at the heart of Marrow. As well as being enormously satisfying, it’s also great fun and can really help boost your confidence when talking to pa- What next?
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Sports
LIMITLESS Many records have been broken in the 2012 Olympics, but one in particular may have paved the way for a whole new sporting era. Oscar Pistorius became the first double amputee to reach an Olympic final. No small achievement, even if you do have both legs.
prosthetics we could see this change. Where did it all start? Prosthetic limbs have been in use for thousands of years, with the earliest found dating back to almost 1000BC. This false toe was made of wood and leather, and prosthetics continued to be made from materials such as iron, for the majority of the 20th century. With surgical advances in amputations in the 16th century came the first major changes to prosthetic limbs and we began to move on from the historic ‘peg leg’. Limbs with hinges and improved attachment began to be developed. Anaesthesia and cleaner surgeries continued to propel prosthetic development forward with huge progress and investment seen after World War II, and more recent conflicts to create limbs that improved function and appearance for the many amputee veterans.
Research and development in the world of prosthetic limbs is advancing at an amazing speed. Within the realm of sporting prosthetics the advances with new materials such as carbon fibre and new blade designs have seen questions raised asking; not are Paralympians able enough to compete in the Olympics but are they too good? Do their state of the art prosthetics give them an edge over their non-prosthetic wearing competition? The answer to this at the moment is no, not yet. However, the regulations detailing the type of prosthetic limbs allowed in the Games Modern prosthetics have changed are ever expanding and illustrate that dramatically with the relatively recent with the advent of ever improving 12
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introduction of modern materials such as plastic and composites. Modern artificial limbs allow more realistic movement and much improved functioning as surgical, computer design and medical techniques continue to develop. What’s next? There are many aspects to consider in the development of prosthetic limbs and advances are being made in improving the design of the limb-prosthesis interface to reduce pressure and friction on the remaining limb and improve comfort and in trialling new materials to make the limb lighter and stronger. Historically, prosthetics have been attached to the body with straps or harnesses. Currently the most common type of ‘suspension system’ uses suction to create a seal around the limb. A new surgical technique being developed is ‘osseointegration’, which is direct attachment of the
then be used to control a prosthesis as well as non-functional, but present limbs i.e. allowing a person’s thoughts to directly control the prosthesis. Research into ‘brain-machine interfaces’ is ever increasing and although there are still many obstacles to overcome, the impact this technology could have in the future is huge.
GBR cyclist, Jody Mundy, and the prosthesis designed for the 2012 games. prosthesis to bone. This provides greater stability, control and greater awareness of the prosthesis. Already this technique is beginning to be put into clinical practice, and although not yet universally approved, amputees who have undergone this two stage surgery ha ve had positive e xpe rie nces. Osseointegration techniques continue to improve and we could one day see this as the standard attachment procedure. Prosthetic limbs aim to imitate natural limb movement and function. We are progressing from simple mechanical joints to intelligent, computerised prosthetics. For example in lower limb prosthetics microprocessors can sense and analyse a person’s gait up to 100 times per second, allowing adjustments to prosthetic limb movement and pressure to be made depending on speed, uneven ground, gradient and position. Externally powered prosthetics can also produce power when walking or standing from sitting.
With so much innovative research taking place, the future of prosthetics is an exciting one. Although there is still some way to go, emerging prosthetics are edging nearer and nearer to providing the same function as a natural limb. Then one day we may see parathletes and athletes competing alongside each other as equals.
been around for many years although these are being developed to allow Sarah Cowan-Rawcliffe simultaneous movement of multiple joints where necessary. One of the most recent advances in control of prostheses is ‘targeted muscle reinnervation’ (TMR). This is a surgical technique which transplants the amputated nerve, whose original target muscles have been lost, to a proximal muscle. Then electrodes in the transplant site allow control of the myoelectric prosthesis from an independent site.
The future is looking bright for development of increasingly technical prosthetics.
If we can interpret nerve impulses and configure them to innervate an intelligent prosthesis, logic follows that we could tap into this and create a pathway which allows the brain to directly control the prosthesis. By recording neuronal activity in the brain and interpreting these signals, they can
Clearly, control of a prosthetic limb is of significant importance to be able to maximise function. Myoelectric prostheses, which are controlled by sensing and using contractions from residual muscles via electrodes, have
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FASTER, HIGHER, STRONGER A History of Drugs in Sport
Sports
Despite the overwhelming success of the London 2012 Olympics, accusations such as those against the Chinese swimmer Shiwen Ye have raised the awareness of drug use in sport. As of the final day of this year’s games, 11 Olympic competitors were discovered to have used prohibited substances and were disqualified as a result, thus preventing London from attaining the squeaky clean reputation that it sought.
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In days gone by however, performance enhancing drugs were considered essential. In running, the gold medallist of the 1904 Olympic Marathon, Thomas Hicks, claimed victory with the aid of his coach, who provided brandy, raw egg and strychnine injections (a stimulant in low doses) mid-race. Furthermore in cycling, the rulebook of the gruelling 1930 Tour De France went so far as to remind athletes that drugs would not be provided by tour organisers, expecting athletes to carry performance enhancing drugs such as the stimulant cocaine to help complete the intimidating 4,822km distance. Although the International Association of Athletics Federations (IAAF) had been the first international institution to ban drugs, with a view to fair sport and competitor safety in 1928, pharmacology had not yet advanced to the point of establishing definitive testing methods, instead relying on the honesty of the athletes. Only 3 decades later in 1966, when the largest sporting bodies in the world FIFA and the International Olympic Committee (IOC) followed the IAAF’s decision to ban drug use, were the first tests detecting perpetrators introduced.
Shiwen Ye, the swimmer whose performance aroused suspicion
Since 1966, both doping and the tests which aim to prevent it have evolved. Although synthesized in the 1930’s, anabolic steroid use became widespread among athletes in the 1970’s, with highly desirable effects mimicking those of testosterone, initiating protein synthesis to boost muscle mass and strength. Anti-doping tests evolved in 1974 to detect anabolic steroids, leading to their eventual ban 2 years later. Initially the prohibition saw success with increases in drug related disqualifications, but as the tensions of the cold war rose, the East German state sought every victory over the US manageable, including on the worldwide Olympic stage. The result was a state funded blanket doping of athletes with or without their consent, until 1990. Besides anabolic steroid use, blood doping was also a major problem in the 70’s. Athletes removed and re-infused their blood to increase the oxygen carrying capacity, which went undetected until the method’s
outlaw in 1986. Similarly to the initial banning of steroids in competition, anti - blood doping had seemingly improved, but as the 1990’s rolled on, erythropoietin became the newer, more potent, less detectable form of blood doping, boosting red blood cell counts and the VO2 max of the endurance athletes it benefitted. Doping still continues to be a problem; highlighted by the US’ 100m sprint star and ex-Olympic champion Justin Gatlin, just returning from a very public 4 year ban. However with organisations such as the World Anti-Doping Agency governing current anti-doping legislation and drugs testing research, a positive future promoting fairness in sport is as promising as ever. Perhaps it is then fitting that the accusations against the Chinese swimmer Shiwen Ye proved unfounded, hopefully representing a clean legacy following our London 2012 Olympics.
David Thomas
London has recently recovered from the hype of hosting the 2012 Olympic Games and despite them being over, it’s success has left a lasting legacy throughout the whole of Britain and internationally. Competing in the Games must be one of the most wanted ‘bucket list’ accomplishments; however, what would top that at least a million times over would be being the face of it.
start thinking ‘was it really worth it?’. Being blessed with bad luck, I had already missed the motivational talk given by Kelly Holmes. However, things looked up when I arrived into work one morning and overheard the managers discussing the arrangements that were going to be made for the afternoon guest speaker they had coming in. I made a bee-line for the nicest manager in an attempt to find out who it was, and upon hearing that it was going to British heptathlete Jessica Ennis has be Jessica Ennis alongside Michael done not just that, but instead has Johnson, my eyes glazed over with taken it even further as she was happiness and my heart began to race. crowned with a gold medal for the heptathlon. Through her eyes, the The atmosphere had completely entire experience must have definitely changed as soon as they both walked been a moment to hold on as her in, and it was an awesome feeling presence within the stadium was so knowing that this would be a great intense she was able to bring the crowd moment to look back on. Michael of 80,000 to a deafening crescendo. Johnson introduced himself first; his humour and wit won over the crowd I was lucky enough to be part of the instantly. Soon after he welcomed Jess Olympics 2012 workforce and was to take the stage who spoke about how promised by my employment agency hard she trained for the event and how that I would be serving VVIP clients in she felt when she took her first step the Olympic sponsor suites. I had high into the stadium. I was taken aback by hopes for what the next two weeks held her beauty but what really struck me in store for me. Many days had gone by was how she spoke about her difficulty where I had just been folding napkins, coping with the fact that she missed serving ‘average-joes’ and clearing entering for the 2008 Games in Beijing tables in the BP suite which got me to
because of a stress fracture in her right foot.. Jess and her coach had serious talks about how she would no longer be able to use her right foot to take-off for the high jump, long jump and javelin and they came to conclusion that the only thing left to do was to retrain her on her left foot. Imagining how hard and how much effort it would take for me to convert from being right to left-handed, I was impressed by her determination. She decided that in that moment, her injury was not reason enough to end her career despite how serious it was. It really spoke out to me and taught me that in life, in whatever I am passionate about, no matter how hard it is, it can be done. She said that at first it was terribly difficult and depressing knowing that she may not ever be as good as she was before; however, it was those same feelings that drove her to train harder. She unlocked so much unknown potential and was able to revel in her successes as she achieved scores even better than the ones she got when using what she thought then as her strongest foot. From now on whenever I am struggling or unhappy with where I am in life, it will be moments like this that will inspire me.
Inspiration from Perspiration
Beverly Sills quoted ‘There are no short cuts to any place worth going’ and I bet the meaning of this has really spoken out to Jess because now through her success she has become part of campaigns for charities, has become an inspiration to all young athletes and moreover has become a legend throughout the entire world. WELL DONE JESS!
Ruby Nainan
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inFocus: Basketball
Sports
What can be said for the greatness that is known as the Medics Basketball team? Some say they are best looking group known to man. Others do not say that. Some say, they are the most talented individuals you’d have the privilege to meet. Again, others would disagree. But what we can comfortably say is that the Medics Basketball team are a great group of individuals who have helped the name of the Nottingham Medics be stamped across the Basketball world. The Medics wolf pack had the privilege of being involved in two NAMS tournaments this year, involving two great days of basketball with med schools from all across the country. The first of the tournaments was a trip to Brighton, which ended with defeating Sheffield Medics in the semi-finals to take the formidable foe Peninsula Medics in the final. All eyes were on Notts and after a long battle on the court, Notts just missed out, but overall still came second in the country. ’Twas a great affair but Sheffield were to have their revenge, again meeting Notts in the second NAMS tournament. This time however they had a sour taste upon their buds and didn’t let up, forcing Notts out in the last moments. All in all, Nottingham Medics established themselves as a force to be reckoned
with and one of the most well rounded not a pretty sight (on the basketball teams there! team’s part) it is one of the most enjoyable events in the calendar, Along with the NAMS tournaments though it comes with the frank Notts entered this year, they were realisation that the basketball team, regular visitors to the infamous “IMS especially the boys, cannot understand league” involving such greats as the the rules of netball! With a hard fought Uni 3rd and 4th teams along with the battle on the court and some tears GEMs and many other teams. Again shed, the basketball team scrounged the medics established themselves as to victory to come out on top by a a team with a reputation to be feared! single point over the netball team. The IMS league was full of excitement Although to this day all agree that the with matches against Hall teams, firing Medics Netballers were by far the up g a specific rivalry against Rutland more elegant players! Hall. One of the highlights of the year was the match against Cypriot Soc, The team welcomes all players though less of a basketball match and regardless of ability and holds weekly more martial arts, with players informal training sessions and team being thrown left, right and playing every Sunday in the IMS centre! All in all, the IMS league league. If you are interested in joining is great fun (bar the dump have a look at our Facebook page or tackles here and there) and email Dan. provides a great way for the We look forward to welcoming some team to get a bit competitive. new faces this year. The team also gets to enjoy an Danish Mirza annual netball match against the mzydm@nottingham.ac.uk. medic Netball team. Although
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TAKING A HISTORY FROM bbc JUNIOR DOCTOR Features
BEN ALLIN Interview by Ali Blatcher
Imagine yourself on the first day of your new foundation job in an unknown place with no friends. Then add in half a dozen cameras, microphones and a TV crew spying on and accentuating your every wrong move. Then imagine being followed home by the same cameras and having them invade on the little relaxation time junior doctors get. All this footage is broadcasted on national television for all your fellow medics, relatives and potential future bosses to witness. This is what the “junior doctors” guinea pigs had to endeavour whilst BBC were documenting “an insight into the lives of newly qualified medics” and Echolalia spoke to Ben Allin, an F2 doctor from the second series based at Chelsea and Westminster Hospital. His specialty on the show was paediatric surgery and we caught him at a talk he gave for Juniors, Nottingham’s Paediatric society: Ali: So you were one of the more “competent under his bed sheet and refused to let me touch that exploits patients’ problems and in return and likeable” characters on the show, is that a him. This scene was particularly painful to pays for them to be bumped up onto the fair comment? watch back. private sector waiting lists. I wouldn’t want to Ben: The editing certainly showed me in a better light than some of my fellow colleagues but I do believe that I came across accurately. The BBC choose beforehand what sort of personalities they want on the show and, being an F2 rather than an F1, I guess I fitted the bill as the capable and friendly chap, who had a vague idea about how to deal with kids.
be a part of that.
Ali: Do you think a scene like this could ever affect your future career? Ali: What advice would you give to medics who want to go into paediatric surgery?
Ben: There is always the chance that my future employers will have seen it, so the trick was reflecting back and showing that I had learnt from it. But, if it hadn’t been filmed in the first place I may have just swept it under the carpet so it could be perceived as a good thing that I Ali: What were the benefits of being on the was confronted with my mistake on film.
show? Was it a good career move? Ben: In some ways yes. One plus side was the surgical experience I gained due to the fame hungry consultants that invited me into their theatre so that they could be on camera! The presence of the cameras also sparked a lot of excitement in the kids I was treating, which helped build my rapport with them!
Ali: Tell me about “Alfie”, your nemesis on the show Ben: Alfie was a child I was asked to take blood from and who, after I foolishly showed him the needle, proceeded to bury himself
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Ben: It is fiercely competitive so be prepared for some hard work. To guarantee myself a registrar position, I am taking a detour and doing clinical academic pathway to gain a PhD for 6 years, which proves it’s a long and difficult process. To show a keen interest in surgery I would recommend keeping a logbook of every Ali: Do you think this sort of show warps the time you attend theatre and write down exactly audience’s view of doctors? how you assisted. Ben: Patients’ perception of doctors is Ali: And finally Ben, would you recommend this ever-changing; we are certainly not regarded as experience to future foundation year doctors? the superheroes and Jesus-like characters we used to be considered. As long as the public Ben: I would say that overall the experience understand that the show is produced for the had a positive impact on my life; some of the purpose of entertainment, we should be safe. other participants would not say the same! I think having your every move in medicine Ali: Would you ever consider a career in TV? filmed would improve a lot of people’s practice. Ben: I actually disagree with a lot of the It was a huge commitment but it helped me medical shows on television. Embarrassing gain an insight into my doctoring and I believe I bodies in my opinion is an unethical programme came out the other side a more confident physician.
Tony’s Trivia Titbits: The antigens of Brazil nuts can be passed on
Aaron’s Mind Games Can Aaron Calvert rise to new heights with his latest show?
Aaron Calvert is the Psychological Illusionist and Hypnotist responsible for the stage shows INSIGHT and CONNECTED. Aaron has spent the last 5 years practicing, inventing and perfecting his techniques of predicting, controlling and influencing people’s behaviours. Originally from Manchester, Aaron came to Nottingham to pursue his medical career. He spent his first year of medical school writing his first and international show CONNECTED, which he first performed for Lincoln Hall students in the June of 2011. He then took CONNECTED to New York, where he performed and edited the show and returned in the September with a full two-hour stage show that was barely recognisable from his previous raw content, now including a second half full of mesmerising hypnotic feats. In late 2011 Aaron performed shows solely for his New York Marathon Charity Effort. Following this he brought CONNECTED to Re-Freshers week of 2012 in front of an audience of 2 00. Over the pa st ye a r CONNECTED has changed considerably from the original I first saw, with lots of acts cut and brand new ones added in. However the structure of his show remains the same, with a variety of psychological and social experiments, manipulating the audience’s decisions leading to a climatic, emotional and stunning end revelation, which always leaves audiences gobsmacked, in rapture and disbelief.
showmanship and control of his audiences. His full stage shows last 2 hours, which always holds the attention of the whole audience effortlessly, teetering on the edge of their seats as they fight to get involved. He always brings a light-hearted air to the show and the audience’s amazement is childishly delightful. In my opinion CONNECTED is phenomenal and will no doubt be modified and changed over the coming years to become even more magnificent. In March of this year he brought Nottingham University INSIGHT. This show was a huge production for half a thousand people, which showcased brand new experiments, never seen before, along with a phenomenal £1,000 bet between two audience members and Aaron. Audience members were captivated in suspense for the outcome, with plenty of chances for the couple to change their minds. They left the stage empty handed, whilst the a u d i e n c e applauded with the relief from the tension of
the last 10 minutes. INSIGHT pushed Aaron’s abilities to their limit as he attempted to influence the decisions of 4 random people, with minimal contact and the chance to make their free decision anytime within the week run up to the show. INSIGHT was without doubt a great show and to the audience a series of miraculous events, but for me Aaron was not at his best, a very rare occurrence, but we all have our off days and if
Although Aaron is relatively new to the stage he shows an incredible
through semen, thus having the ability to cause an allergic reaction.
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INSIGHT was Aaron at his worst, I am excited to see him at his very best. In the last couple of months Aaron announced tickets for his newest show MIND GAMES, which will see its first performance in Nottingham in November. Aaron has recently welcomed co-writer Sam Fitton and co-director Tim Berryman to his team, which he says have brought a brand new atmosphere and fresh ideas to the show, making this a very exciting time. Very little is known about MIND GAMES as its content remains a closely guarded secret, the same with all of Aaron’s shows, as he asks the content not to be disclosed, leaving the public holding his secrets.
Features
Aaron is without doubt an upcoming star in the entertainment industry, constantly growing and bringing us new ways to be amazed and baffled. Certainly one to watch.
James Devonport
MIND GAMES will be showing from 2-4th November at Nottingham arts theatre (01159 9476 096).
Hypnosis: Myths and Limits For those of you who haven't studied the wonders of FBN, hypnosis is a naturally occurring state of sleep. Therefore, if you can sleep, you can be hypnotised, a common misconception by those who claim they cannot be hypnotised. Two things cause people to go into hypnosis, fatigue of the nervous system and overload of the nervous system, that's it. Subjects are induced into a trance state followed by a process of deepening, to increase the responsiveness of subjects to suggestion. Once in a trance, which mimics the appearance of REM, post-hypnotic suggestions can be given, these are ultimately used to produce the desired behaviour. Some people may not realise they have been hypnotised whilst in the trance state, as REM subjects are unaware when they are dreaming, subjects are unable to tell reality from the altered reality and their subconscious makes the suggestions real. I love to see how far I can push the boundaries of hypnosis. We've all seen the classic chicken walk, but this is a feat that can be achieved without hypnosis. Tell you what, try it now; stand up walk like a chicken, cluck and flap wildly. Didn't do it, did you? Why? Most likely because you're embarrassed. But a subject doesn't feel embarrassed, their subconscious makes being a chicken real. The more interesting area though are feats that can't be achieved without hypnosis. For instance, I recently convinced two girls to put needles through their hands whilst hypnotised, telling them they would feel no pain. Without anaesthetic or pain relief, both participants completed it and experienced no pain. One of the girls also had needle phobia but my suggestion was stronger than her belief of phobia. You can see this on YouTube, search 'Aaron Calvert Painless'. A suggestion such as removing pain, presents a variety of uses in the medical field. However, the limit of how much pain a person can endure is unknown and, interestingly, the possibility of performing operations using hypnosis as anaesthesia is yet to be fully explored. The prospect of misuse must also be questioned, what can people be made to do through the power of suggestion? Is it possible to make someone do something they would not normally?
Aaron Calvert
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Tony’s Trivia Titbits: The psoas major muscle of cattle is the one that is butchered to give a beef fillet.
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The Little Black Book for Medics
“It ’s not what you know, it ’s who you know,” Whether you’re a newbie or an old-hand in the medical school, take a look at our little black book to find out how to make the most of Nottingham medical school life.
Written and researched by Mei-Ling Henry through semen, thus having the ability to cause an allergic reaction.
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A B C D E F G
Features
H I J K L M N
Being a Do-Gooder Given the nature of our future professions, it is little wonder that the medical school has more than its fair share of do-gooders. For those of you organised enough to make time to volunteer, just pop along to the Student Volunteer Centre (B Floor, Portland Building; 0115 846 8750) to find out more. There is a wide range of on-going projects, student-led projects and one-off opportunities available, so whatever floats your boat, you won’t be short of chances to get more involved with the community.
Cocktail Party Attire and Dressing-up Debauchery As any self-respecting Notts Medic knows, the MedSoc Cocktail Party is kind of a big deal. We know how to party and fancy dress is a serious business. So to give your cocktail party outfit maximum impact you’ll need to be creative. If you’re feeling ambitious then why not try making something afresh or combined with cheap high-street basics. Sharma Fabrics (Victoria Market, Victoria Centre) does a wide-range of fabrics and furs at a good price and are always more than willing to help find suitable materials. For more inspiration, try Luv Ya Babes (222 Victoria Centre) and Balloon And Party Ideas (Corner of Howard Street and Glasshouse Street), both of which are excellent places to pick up those finishing pieces to add that little bit of extra detail to your apparel.
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Essential Reading With each new module started, reading lists seem to grow faster than Pinocchio’s nose. Most books you’ll get by without and can always borrow from the library. In general there are a couple for each year that you will find indispensable so should really consider investing in. The cheapest place to look is generally www.amazon.co.uk unless you are lucky enough to stumble across someone the year above who happens to be selling. For those times you just can’t wait then Blackwell’s Bookshop (Jubilee Campus or Portland Building, University Park) usually stocks all the most popular books on the prescribed reading lists so it’s worth checking those out. You’ll also find a couple of very handy books and resources at Lenton Print Shop (3 Church Square, Lenton).
Grabbing a Pint There is very little better in life than the first cool sip of a well-deserved pint, all tipples of choice included. Nottingham boasts a real selection of establishments that are perfect for any mood. Fighting for the crown of oldest pub in England is Ye Olde Trip to Jerusalem Inn (1 Brewhouse Yard) is a great place for a small gathering and has a real homely feel, with several rooms built into the caves underneath Nottingham Castle; the other contenders are The Bell Inn (18 Angel Row) and Ye Olde Salutation Inn (Hounds Gate). The Johnson Arms (59 Abbey Street) is another gem. Serving real ale and food with a great beer garden to sit in on sunny days, it is situated very close to the medical school and is the ideal place for a cheeky pick-me-up after a hard day of lectures.
A B C D E F G H
Here To Help Healthcare courses can be tough. Fact. When things get difficult there are people who are there to help you. There are welfare officers in MedSoc, NUMID and SUPA and these friendly people can lend you a shoulder to cry on or point you in the direction of where to get more specific help. Check your association’s committee page on su.nottingham.ac.uk to find out who your officers are. If you need someone to speak to anonymously, then call Nightline (01159 514 985 – free to call from internal campus phones), where specially trained volunteers are there to help you. They also run a nifty little information service so you can find out general UoN information, Discounts here? Yes p healthcare numbers and links to other helplines. lea se!!
I J K L M N
Investment
O
Being a logically minded bunch (well, most of us anyway!) I like to think that we are all smart with our money and that’s why the MedSoc discount card makes sense. At £50 a pop, it may not seem like the wisest idea to start with but if you think about it in terms of how much it costs a year, these magical little bits of plastic get you a surprisingly good deal. The best discounts included are for places to eat and drink, so even if you only go out once or twice a term you’ll easily make your money back over the five years. See, rather smart after all, aren’t they?
P Q R S
See su.nottingham.ac.uk/medsoc/shop/card/ for a full list of discounts and to buy your card.
T U
Journey Home As appealing a sobering walk home sounds, there are times when that simply won’t cut the mustard. For those times, just hop in a taxi from Nottingham Cars (01159 700 700) and don’t forget to ask for a fixed price with your MedSoc card when you call ahead. Problem solved. With walking taken out of the equation you need no longer decide between heels or flats.
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=
Perfect solution!
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A Looking the part
B
One of the most important things you will need to look the part of a doctor is your stethoscope. Don’t even think about using your old MedLink one or you’ll look like a keen bean work experience student. There are several places you can pick up one of these but by far the most popular is the Littman stethoscope, which you can, rather handily, get a voucher for in your first year. You’ll find your Littman II S.E. Stethoscope at www.bmamedicalsuppliesdirect.co.uk and then comes the most important bit – choosing which colour to buy.
C D E F
Pen torches also come in handy, particularly when practising for second year OSCEs. If you’re feeling flash then treat yourself to a sophisticated looking model, again on www.bmamedicalsuppliesdirect.co.uk. You can also find multipacks of more basic looking pen torches on www.amazon.co.uk so if you’re the type of person to lose things easily this is ideal, or if not then you can club together with your friends and everyone’s a winner.
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Features
H I J K
Add this to your
L
Christmas list.
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OCEAN
N
Like hating Rutland but not being exactly sure why everyone does, shirt-swinging at OCEAN (Greyfriar Gate) is a quintessential part of being at the University of Nottingham. It has a feel-good playlist which always ends with those songs that are guilty pleasures and oh so right for topping off a night danced away with friends. What’s even better is that you get to queue jump with a MedSoc card so there really is no excuse for not taking a dip in the Big O on a Friday.
O P Q R S
Everybody now, “I’ll be there…”
T U
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Ocean
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Queen (dancing)
!
ade are m s e i r o e mem Wher
On the whole, the folks of the medical school are a pretty talented bunch so what better way to plot which of your friends to secretly enter for Britain’s Got Talent – and yes, I have done this to someone – than by a good old karaoke session at Walkabout (15 Friar Lane)? Their Sing Shack karaoke booths are sound-proofed and a sneaky `record` button makes for much hilarity, with 50% student discount to further sweeten the deal.
Shaken , not stirred
A
Whether a dry martini or a cosmopolitan is more to your taste, there are plenty of cocktail bars dotted about Nottingham city centre to make for a more sophisticated evening out. Situated on the top floor of Cornerhouse, Saltwater (Forman Street) boasts a lovely rooftop terrace which is great for sipping cocktails on a warm evening.
B C D
Across the city, head to Brass Monkey (11 High Pavement) for soft lighting and a relaxing feel, to work your way down the extensive menu and watch the bar staff with impossibly acrobatic cocktail making skills.
E F
For live music, check out Tilt (9 Pelham Street) – a delightful blues bar that serves cocktails – but make sure you get there early as it tends to fill up quickly.
G H I J K
Think you know your cocktails? Name these (answers at end of article).
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Writing
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Got a literary streak? Feeling arty? If either of these sound like you then drop us a short email on echolaliasubmissions@gmail.com to get involved with writing or to echolaliadesign@gmail.com to volunteer your skills with photography, art or design.
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We are always happy to welcome new contributors to the team so don’t be afraid to give it a go.
O P Q R S T
X-Rated
U
Meeting lots of new people and with a social calendar like a merry-go-round, it’s hardly surprising that sometimes things get a little steamy or out of hand, and let’s face it, we spend enough time in QMC without coming back for an impromptu trip to the emergency department after a few drinks too many. Easy Tiger is a campaign run by the Students’ Union to promote safe sex and alcohol awareness.
W X
For more information or to get involved, email suwelfare@nottingham.ac.uk.
Cocktails from left: Mojito, Brandy Alexander, Singapore Sling, Martini, White Russian.
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Features
Get the balance right Medical school can be summarised by a series of developmental pressures in successively more challenging situations. As we advance through the years, our professional responsibilities make studying geography seem like an enlightened choice. One facet of medical school, im po s si bl e t o a v o id , is t he competition. No matter how many times our senior colleagues tell us “this year doesn’t count” or to “just enjoy yourself”, the nature of successful, intelligent, hand-picked students means there is absolutely no way we are going to ‘enjoy ourselves’ when we could be bettering ourselves.
Whilst this is a hallmark of the medical student, there is a constant pressure of upgrading ourselves on paper which means that for some of us, we are at risk of not enjoying our free time. Many students have no idea why or how their extra-curricular activities are helping them in their future career. Is working on the committee for a charity a reflection of good medical practice? Does pestering consultants to participate in audits distinguish us as good doctors? We need more information. Every year in the autumn, thousands of fresh first year medical students step through the lecture room doors feeling fantastic. They’ve worked hard, got the grades, nailed the personal statement, flown through interviews, moved away from home and are only just discovering the many joys of Freshers’ week and life as a medical student. As the lectures stretch on, career decisions could not be further from mind, nothing more than a question asked by family or friends. The many CV-boosting offers
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of societies and committees are shrugged off as something to do in the future.
At the same time second year students, no longer the smallest fish in the faculty, get back to work after a relaxing summer. The more astute student begins to take up positions in student led charities in the hope of setting themselves above the masses when it comes to filling out the mystical foundation training application ‘form.’ Although little is known about this form, rumours regarding the value of committees and volunteering abound. Other students will found brand new societies in every conceivable area, certain there will be some section on the form to list all their hard work. Consultants are approached for audits, and previous dissertations are sent out to any potential conference that is advertised to us. But one can’t help asking whether all of this is truly a good gauge on the most worthy medical students. So what if we haven’t played a sport internationally or written as tenth author on an audit we know nothing about? In no time at all, the clinical years commence and students begin to learn about the foundation application process in more detail. They realise that all the charity work and volunteering they’ve been doing is perhaps not as useful as originally thought and that the process requires something very different entirely. Amidst the struggle of clinical e x pe ri e n ce a n d e xa m i na ti o n s students desperately try to complete audits and publications in anything they can, often flying out to far-flung destinations to present a poster at a
conference. All of a sudden the deadline approaches, leaving many a final year student wishing they had done more to help them get into that competitive FY1 post. The weightings of different achievements are also a shock to undergraduates as they approach the job application period. In 2011, the difference in points between achieving academically in the top quartile and the second quartile was two published/nationally presented audits. It is important for students to understand what is truly valued for job applications. In short, committee positions and volunteering abroad should only be pursued for personal interest and enjoyment - there is no space to write about these on the foundation job application. A slight advantage can be gained by achieving within the top quartile/ decile of your year, presenting/ publishing audits and research nationally, and prior degrees. The relative weighting of the new Situational Judgement Test eclipses any small point differences between candidates anyway. Whilst it is nice to have your name on a published piece of research, the bottom line is to enjoy these 5 years in Nottingham - and focus on becoming a rounded individual rather than endless CV buffering.
Tris Mehta and Alex Lomas
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Dark Chocolate: Unlikely Superfood?
Features
We’ve all been there. It’s been a long, hard day, full of cutting up dead people, barely pronounceable cranial nerves or running around wards, and by the time you collapse onto your bed, there is only one thing that is going to take the pain of medical student existence away: chocolate. Everyone loves chocolate. Except dogs and people who are allergic, who have my sincerest condolences. No one should have to go through life without chocolate. Not least because as well as being warmly delicious, it has some surprising health benefits. We’ve all heard about its qualities as an aphrodisiac (which there is actually very little evidence for), but were you aware that dark chocolate especially has potential cardiac benefits, may prevent type II diabetes, can promote emotional wellbeing and could even be used to fight cancer? Most of these amazing properties are down to the fact that chocolate has a surprisingly high concentration of antioxidants – chemicals that neutralise oxygen free radicals thus protecting cells. Free radicals have been linked to a number of chronic conditions, such as heart failure and cancer; so any food with the power to fight them is currently hot property in the field of medical research.
By the ounce, chocolate has been shown to have more antioxidants than more well-known ‘health foods’, such as blueberries and green tea.
Antioxidants make up over 10% of the dry weight of raw cocoa beans.
In terms of cardiac benefit, the particular A normal sized bar of dark class of antioxidant that chocolate chocolate has 14% of an adult’s contains, flavonols, cause a release of nitric oxide around blood vessels. As recommended daily requirement everyone remembers from CRH of copper, and 7% of their iron. (I definitely didn’t need to look this up), Dark chocolate has been shown nitric oxide is a potent vasodilator, so its release causes a reduction in blood to boost antioxidant levels in the pressure and improved blood flow. So far, blood by almost 20% so good; but there’s more: the flavanols 57% of the lipid content in dark also combat free radicals in oxidising LDL, preventing it from carrying as much chocolate is stearic acid, which is cholesterol to the tissues – so chocolate neutral with regard to cholesterol also helps to prevent atherosclerosis. More Chocolate is 100% yummy. research shows that on top of all of this, chocolate has some anti-platelet effects; which combined with the previous activities, make it a pretty solid defence oxide to increase cells’ sensitivity to insulin, resulting in a decreased risk of against heart disease. developing insulin-resistant diabetes. However, this isn’t the only health benefit attributed to chocolate. Despite its sweet Another of chocolate’s benefits is its ability taste, chocolate has actually been shown to induce a good mood. It’s an almost to have a low glycaemic index, meaning magical quality that’s made it the staple that it doesn’t cause the extreme increases food of the post-breakup blues, PMS, and in blood glucose levels that are a let’s not forget birthday, Christmas and precursor to type II diabetes. Valentine’s Day presents. Chocolate’s feel Furthermore, the flavonols are again good factor can be mainly attributed to capable of recruiting our old friend nitric two chemicals, theobromine, a stimulant, and phenlyethylamine (PEA). PEA is the chemical that causes a release of endorphins in the brain when someone falls in love, so it’s no wonder that it makes you feel good! As a final note, it should also be mentioned that research into more of chocolate’s healthy properties is currently on-going; as scientists explore the benefits of antioxidants in combatting cancer, immunosuppression against autoimmune diseases and improvements in cognitive ability. Of course, chocolate is still high in calories, so despite all the benefits, it is best enjoyed in moderation. But the next time you’re feeling low and find yourself reaching for the Galaxy Caramel, Bourneville or, if you’re posh, Hotel Chocolat’s 100% Dark Organic Chocolate d’Ecuador, just remember, it’s quite possibly saving your life. And it’s pretty tasty too.
Esther Westwood
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New tricks
I don’t know about you but I can’t help but feel overwhelmed by the ever-expanding body of medical research; barely a day goes by when my BBC homepage doesn’t feature a headline boasting the discovery of the latest “wonder drug”. So to help keep you all in the loop, I’ve cherry picked three of the latest innovations that I feel will have an enormous impact in both treating and curing some of our world’s biggest killers.
High intensity (HIFU)
focused
ultrasound
A combination of ageing population and increasingly sensitive imaging has seen rates of prostate cancer soar by three times over the last 30 years. In current practice, patients normally undergo either a radical prostactectomy (traditionally open but more recently laproscopic), a course of internal radiotherapy (brachytherapy) for low risk disease, or external radiotherapy for intermediate to high-risk patients. In addition these patients may require courses of hormone therapy. Even if these interventions rid the individual of cancer, can we really claim them successful if they can result in incontinence and erectile dysfunction? Recent advancement in this field has uncovered a new revolutionary technique; High intensity focused ultrasound (HIFU) or photo dynamic therapy (PDT) which involves MRI scanning the prostate to accurately localise the tumour. Imaging is then followed by targeting these cancerous cells with intense heat (80-90°C), thereby destroying them and leaving the surrounding healthy cells unharmed. The first formal study conducted using 20 men with endstage prostate cancer, found 95% trialling HIFU remained continent and were sexually active within a month of the treatment. Other benefits include reduced hospital stay (1 day vs 2-3 weeks with a radical prostatectomy) and no follow up drugs being required.
Photodynamic therapy for treatment of PaM2 brain tumours Tuberculosis resistance is rapidly becoming Conventional treatment for brain tumours a major public health epidemic and is may involve surgical resection of the growth spreading, alongside HIV, particularly in with an aim to improve not only symptoms areas where treatment compliance to but also prognosis. Alternatively current regimens remains low. It is therefore chemotherapy, radiotherapy or a unsurprising that the leading cause of death combination of the two may be among HIV positive individuals is TB. administered. The obvious disadvantages A promising new trial of three drugs, used in with these current approaches are the combination, has been shown to wipe out unavoidable and often irreversible damage 99% of TB bacteria within an infected host done to healthy tissue, particularly in the in just two weeks! Even more encouraging developing brain. still is the new therapy’s equal efficacy in Photodynamic therapy is carried out, under treatment of drug-resistant TB, which in general anaesthetic usually at the end of current practice takes up to two years to tumour resection, in an attempt to destroy successfully eradicate as well as being costly those cancerous cells that have escaped and requiring vigilant adherence. surgical removal. A photosensitising agent is The new regimen, termed PaM2, consists of injected either intravenously or directly into the new (currently unlicensed drug) PA-824, the tumour site, and then activated by along with moxifloxacin (an antibiotic) and illuminating the ‘desired’ area using a laser pyrazinamide (current TB drug). Additional source. The agent then absorbs the light, benefits, as well as reduced treatment forming high-energy oxygen molecules, period, include a cost of less than 90% of which cause tumour necrosis via a current multi drug resistant TB therapy and photochemical effect. This highly targeted it’s safe use in conjunction with HIV therapy greatly reduces the impact on medication. normal neighbouring tissue, in an organ where preserving millimetres is crucial to an Sophie Jackson individual’s overall functioning.
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Features
“Is anyone here a doctor?” These are words that often scare most of us into an awkward silence. As a medical student when friends and family ask you how they can fix their dodgy knee or whether they should change tablets it’s all too easy to say I’m only a student and pass them off to their GP. However, when something more acute happens and emergency help is required we are obliged to provide assistance to those in need. Suddenly all that anatomy and pharmacology you revised for before the summer seems useless as you struggle to remember those 3 hours of basic emergency care you were taught in the first few months of first year. So just in case you do find yourself in that situation, here’s a bit of revision of those basic skills needed to keep someone alive along with a few handy hints from someone who’s been there, done that and got quite a few t-shirts along the way.
All you need to know to keep someone alive is your DR’S ABC. It’s the same as the ABCDE approach used in A&E which you will have heard about but with a few extra bits at the beginning because you’re not in a hospital. Danger: When you are treating a patient in hospital you are in a safe environment, however, when you are out in public this is often not the case. Whatever injured your patient can also injure you and there are cases of people being killed whilst trying to help others. So use all your senses before you rush in. Response: Before we start treating someone we should find out if they actually need help. That person collapsed on the street could just be a homeless person having a nap, so try and talk to them and if that doesn’t work gently shake their shoulders and hey presto you’ve just done a response check. Forget GCS for now as it takes too long and isn’t relevant at the moment, save it for later. Right now we want to know whether they are Alert, respond to Voice, Pain or are Unresponsive. Remember AVPU! Shout for Help: If your patient is anything other than alert you’re probably going to want some help, so ask for it. We all know this one is the easiest one to forget, especially when it comes to OSCEs. Airway: Biochem taught me that without oxygen we die and anatomy
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taught me that the tongue can fall back, block our airway and stop us getting any air in. So put one hand on their forehead, two fingers under their chin and tilt their head back. This alone can save a life, but don’t forget, once you have opened an airway you must keep it open. Breathing: Once the airway is open, air will only get in if your patent is breathing. If it’s not obvious that they are, then check. Put your ear close to their mouth for 10 seconds and Look for chest movement as well as Listen and Feel for the breath on your cheek. If your patient is breathing then we need to keep them that way, put them on their side to allow for drainage from the mouth. The recovery position is nice if you can remember it, but if not don’t worry, just get them on their side with their airway open and that’s what is going to keep them alive. If your patient is not breathing then you need to do CPR. Put your hands on the centre of the chest and push hard and fast to the beat of Staying Alive (probably not the best thing to sing if the family is standing near by!). If you can remember how to do the breaths and you have a face shield then give it a go but remember that Haemoglobin is still 75% saturated on entering the lungs which is enough until your ambulance arrives. If there’s a n AE D (A u to ma te d E xte r na l Defibrillator) lying about as there often is at train stations and shopping centres then don’t be afraid to use it.
The voice prompts talk you through step by Joshua Feddon step, you don’t need any training to use one Second year GEM and unless you hit them with it you can’t do St John Ambulance Emergency Transport Attendant any harm. Medical Response Team Full Member
Circulation: If you get to this point then stop British Red Cross Commercial First Aid Trainer and any major blood loss with direct pressure, Assessor elevation and bandages. Faculty of Pre Hospital Care of the Royal College of Just remember to keep it simple and stick to Surgeons of Edinburgh Full Member (VAS)
the basics, your job is not to diagnose or create a management plan, it is to keep them alive until an ambulance arrives. Above all try and stay calm; everyone panics when out of their comfort zone, even doctors! For more information download one of the many apps available, just search “first aid” or join a society such as Nottingham University St John Ambulance LINKS to practice your Pre Hospital care skills both in training and for real at events.
Do you follow? The myth of the medical student: It’s a new year with brand spanking new freshers, so I should probably start by congratulating you on getting here against all the odds; studying for your exams and doing 15 years of work experience bathing hospice patients, while working 25 hours a day down t’pit AND paying t’pit owner to come to work, etc, etc. You truly are a shining beacon of perseverance and a model citizen.
You went to a good school; it was probably a provincial grammar school, but private schools in North London and even the less dreadful end of state comprehensives are well represented. Your family may not be rich but you are comfortable and well supported, and by a spectacular stroke of luck, you aren’t as thick as cold treacle. There are only so many careers that these clever middle class kids are allowed to pursue; you were always going to end up doing one of them to avoid disappointing father, so well done on picking the one with the longest university course and lowest pay. Oh, and since this is Nottingham, you are also an Oxbridge reject with a barely concealed chip and a new found sense of inadequacy. Have fun with that.
superiority. You may not realise this yet; in fact, there are plenty of sheltered 3rd years who have yet to have this drilled home, but the rest of the university hates us. They think we are arrogant, overly posh, overly whiny and so obsessed with the myth of the ‘work hard, play harder’ medic that we lose any and all sense of perspective. If you ever feel like complaining about any aspect of pre-clinical medicine; for example the sheer horror of having to write fewer than 4 sides of A4 for ECPD, try doing it in front of an architect or engineer. They will laugh at you all the way back to the library where they are cranking out the 3rd or 4th massive coursework of the term.
As I said, I should congratulate you for this. Should… but I won’t. We all got here the same way, with one or two interesting exceptions per year group; (here’s a piece of genuinely good advice for free; find out who these interesting exceptions are and So shut up and enjoy the easy ride for make friends with them. Your time the first 18 months or so, you’ll never here will be much more entertaining Being all of these things does not have it so good again. Do you follow? for it), and the standard medical confer any kind of moral or social student is not an exceptional being.
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FILM reviews The Dark Knight Rises
3.5/5
Arts and Culture
The conclusion to Christopher Nolan’s Batman franchise has been one of the most anticipated films of the summer; marred by tragedy in its first week with the Aurora shootings an air of sadness and stark reality seems to have followed it since. The film itself is a fitting end to the trilogy, those who love action movies will find everything they want; epic car chases and fighting sequences, witty one liners and women in skin tight clothing... With the latest installment comes another villain in Bane; whom, along with his underlings is intent on destroying both Batman and Gotham. In many ways a classic and fitting villain with his imposing stature, unnerving mask and gruesome backstory but what Tom Hardy’s Bane has in physicality he lacks in personality. Unfortunately he can’t match the mania and insanity brought by Heath Ledger’s Joker in the previous film made all the more moving by his tragic death by overdose soon after the films’ release. Christian Bale gives another impressive turn as the Batman proving more than a capable match for Bane. The supporting cast are impressive, Joseph Gordon Levitt gives us an endearing character to get behind in his portrayal of a rookie cop with strict morals. Michael Caine is as brilliant as you would expect and it is nice to see some women get screen time in a predominantly male genre with Marion Cotillard and Anne Hathaway’s Catwoman although I can’t help but feel they were underused and their characters could be built much more. There were a huge number of side characters and sub plots in this film giving it a very long (probably too long) running time, although it is nice to see our very own Wollaton Hall on the big screen. This is an impressively made and engaging film which will satisfy those who have followed this trilogy. The effects are undoubtedly impressive and for the most part the acting is good, however, this film wastes time on subplots and minor characters as opposed to developing others and does not pack the same punch of terror or suspense that came with The Dark Knight.
Anouska Lerner
Brave
3/5
When I saw the trailer for Brave, I was thrilled to see that Pixar had returned to animating actual human beings, as opposed to the talking scrap heap that was Cars 2. Not only that, Brave is the first Pixar film to feature a stand-alone female protagonist, with the voice of that wicked-cool schoolgirl from Trainspotting. I‘m thinking: this more than allows me to go and see it without dragging along my 6 year old cousin for credibility. Overall I wasn’t disappointed the 10th century Scottish setting (probably what most Americans think Scotland looks like now) makes it one of the most visually impressive animated films to date and the short film proceeding it, loosely based on a short story by Italo Calvino, is just beautiful. However, whilst Brave gets top marks for style and humour, with most laugh-out-loud moments provided by comic king Billy Connolly in his role as Merida’s father, it is unfortunately lacking in narrative force. The comedy is consistent and well-timed - just before I found my attention wavering there was always a joke to draw me back in, but the story itself just isn’t as good as it could be. One gets the impression that Pixar have striven for a more minimalist approach, like Studio Ghibli’s ‘Ponyo’ (if you’re unfamiliar; not following any traditional plot arcs, the closest thing to peril that any characters face is the chance of getting a bit wet). Brave should have taken inspiration from one of its Disney ancestors, Mulan, which also features a heroine inclined to wield dangerous weaponry, by throwing an entire army at her just to lend the film more urgency. Not that in Brave there isn’t a large cast of characters all perfectly capable of a little inter-tribal warfare, but with a flick of her creepily Rebekah Brooks-reminiscent hair, protagonist Merida actively dissuades the William Wallace wannabes from combat and chooses instead to meander about in the woods. A lot! Making her, and the film overall, not nearly as bad-ass as I’d hoped.
Imogen Firth-Jones
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Matt’s Word Salad Today I'd like to contemplate one of the great debates of the medical world; are women the ‘sicker’ sex? When something goes wrong with our bodies, we men tend to ignore it right up to the point we decide that it is definitely going to kill us, whereupon we demand to see the doctor immediately. The Royal College of General Practitioners have found that women, on the other hand, are more likely to just go to the doctor straight away. Are men more resilient or just plain ignorant about their own health? Are women weaker or just more sensible? To me, it seems that men tend to have a binary switch when it comes to health, whereas women have more of a sliding scale. We like to think of ourselves as ‘well’ or ‘ill’. Perhaps this is the basis of man-flu? Where a man may deny having a cold, and refuse to make any concessions to it, or declare himself ‘ill’ and take to his bed, like the heroine of a Victorian novel. I don't know, but it seems that men’s attitude to health is either one of denial or panic. We ignore any bad signals our body sends us, until our bodies or our denial can take it no longer. Women seem to have a more proportional response. But no wonder, for their bodies are much more complicated than ours. From their teens they take on a lifetime of maintenance and upkeep that would prove an Everest to any of us simple men. No wonder they are more practical when something does go wrong. Women's bodies are equipped to perform an amazing trick. Attempting to compare it to the modest tricks of the male body is like trying to top the parting of the Red Sea, with something out of a cracker. It seems fair that in order to carry out this trick, women are programmed to keep themselves in good working order. What it boils down to, is that women's bodies are capable of producing life as well as losing it; plenty of incentive to keep them in good nick, whereas men's bodies, however, are only going in one direction.
Matthew Halls
Could man-flu be real?
“Doctor, doctor… I think I have SARS?
Zollinger-Ellison syndrome?
Mortimer’s Disease?”
In this golden-age of the internet, Wikipedia and Google, I am starting to see more and more people I like to call ‘superhypochondriacs’. In days gone by, all you needed to be a proper hypochondriac was a copy of Black’s medical dictionary, and maybe a rectal thermometer if you wanted to take things one step further. That way, you could start at A and work your way through all the diseases in alphabetical order, with particular reference to ‘bubonic plague’ and ‘consumption’ (if you had a much earlier edition). Nowadays, almost everyone is just a mouseclick away from a sometimes gruesome diagnosis. Just type in your symptoms, and ‘Dr Wikipedia’ will give you a list of possible conditions, but any true hypochondriac will look over anything too trivial, but will jump for joy when they can turn up at my surgery to tell me that the internet has confirmed a diagnosis of ‘valley fever’ (coccidiodomycosis) as opposed to the more likely flu. Strangely, one of the largest groups of chronic hypochondriacs are medical students, in fact ‘medical student syndrome’ is really rather common. All it takes is a couple of lectures in first year, or maybe a lab session, and self-diagnosis becomes rife. When you first listen to your chest with a stethoscope; is that an irregular heart beat you hear? Or maybe a murmur? Do you have mitral valve disease? Or an atrial septal defect? The answer to all of these questions is almost definitely not, you have just fallen into the trap of diagnosing yourself with every condition you learn the signs and symptoms of. I prescribe a nice, healthy dose of common sense with the occasional reality check.
All characters featured are fictitious and any resemblance they may bear to persons living or dead is coincidental.
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Pulling the plug on illegal downloads Arts and Culture
Website Ban Ineffective Against Piracy
The ruling of the High Court in April this year against the flagship (pun not intended) file-sharing site The Pirate Ba y ca used a nguish a mongst students. No more could we create the perfect playlist for predrinks, or work our way through IMDB's Top 250 movies, unless we downloaded them all legally and paid for them. Or at least, that had been the idea. The High Court’s ruling, sought by BPI (the music industry’s trade body), forced internet providers to block access to The Pirate Bay on the grounds that the site encouraged piracy and copyright infringement. With the block in place, illegal downloading decreased - for one week. Since then peer to peer filesharing is now back at its original level and it’s easy to see why; not only are there many other file-sharing sites just a Google search away, but The Pirate Bay itself is still accessible through alternate IP addresses. Free access to music, films and computer software is as easy as ever. The ruling's ineffectiveness has prompted artists and producers including Elton John and Professor Green to sign a petition urging stricter enforcement of copyright laws, and the removal of illegal download sites from search engine results. Their appeals are understandable; with four out of five downloads illegal, piracy cuts severely into profits - although one could argue (particularly with
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Simon Cowell, another signatory) that these people have enough money as it is. However for less established artists, where profits are small to begin with and with record labels taking a large cut, piracy can be incredibly damaging. Many argue that blocking access to websites is not the answer to illegal music downloads, with Virgin Media stating that “changing consumer behaviour to tackle copyright infringement needs compelling legal alternatives to give consumers access to great content at the right price”. But whilst both artists and consumers would benefit from the production of more competitively priced material, music executives seem unlikely to opt for this kind of pay cut.
receive three or more of these letters will be taken to court. If this still fails in reducing piracy, the next proposed step would see those accused having their Internet access capped or shut off entirely. Despite everything, The Pirate Bay is still a force to be reckoned with, still in the top 300 most popular websites, and until we are provided with more reasonably priced music downloads, or until stricter Internet censors are implemented, that seems unlikely to change.
It’s not surprising that companies such as Spotify are thriving; by providing legal access to an almost endless number of songs for a small cost, it seems like a good alternative to both piracy and overpriced official downloads. But even Spotify is not without criticism; since its launch in Katie Jeffs 2011 it has received hundreds of complaints about how little the featured artists are paid. If there is a solution which benefits everyone, it seems unlikely to arrive before the government implements a new and harsher anti-piracy system. As of 2014, those suspected of illegally downloading content will be sent ‘warning letters’ and those who
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The ULTIMATe GU HALLOWEEN MOVIE MARATHON
By Rohan Tharakan
Arts and Culture
I offer you my guide for the perfect movie marathon to scare yourself senseless this Halloween... MY TOP 10
CLASSICS
1. Trick ‘r Treat (Brilliantly original Halloween film)
1. Halloween series (especially 1,2,4 and H20)
2. The Blair Witch Project
2. A Nightmare on Elm Street Series
3. Insidious
3. Friday 13th Series
4. Paranormal Activity
4. The Shining
5. The Woman in Black
5. The Exorcist
BROADWAY’S MAYHEM HORROR FILM FESTIVAL
Broadway Cinema, 31st Oct-4th Nov Broadway Cinema’s annual Mayhem Horror Film Festival showcases the best of the horror genre, from old classic horror films to brand new spine tingling releases. Brilliantly different way to spend Halloween this year.
6. Ju On: The Grudge 7. Silent Hill
CREEPIER FILMS
8. Jeepers Creepers
1. The Orphanage
9. REC
2. Hellraiser
10.The Descent
3. The Mothman Prophecies 4. The Dark
LESS FEAR, MORE FUN
5. Audition
1. The Nightmare before Christmas
HALLOWE’EN HOUSE PARTY Transform your house into a the ultimate haunted
carve the Jack o Lanterns, get out the costumes,
dig out the Halloween playlist contain
’Tribute’
‘Thriller’). THEME:
and
You can
only drink from a pumpkin. It will
3. The Rocky Horror Picture Show
be an amazing Halloween night to remember.
4. Scary Movie 5. From Dusk till Dawn
BOOKS Get in the Halloween mood with a scary book, such as Stephen King’s ‘IT’ or ‘Salem’s Lot’ or Justin Cronin’s ‘The Passage’. If you don't’ have the time for a book, there are some amazing short story collections out there. Stephen King’s ‘Night Shift’ ,‘Just After Sunset’ and ‘Nightmares and Dreamscapes’ (particular the story Crouch End) have some truly terrifying short stories. And make sure you also head over to Radio4 Extra to listen to some seriously spooky stories for the Halloween season.
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prepare the
gruesome Halloween food and (must
2. Hocus Pocus
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house party–
ide To Hallowe’en CAMPFIRE TALES GHOST WALKS AND SPOOKY TALES Head down to one of Nottingham’s many incredible ghost walks and have a truly unique Halloween. The Original Nottingham Ghost Walk— The original fantastic ghost tour of Nottingham. 31st Oct, £6, booking only. Also on 27th Oct and 3rd Nov 7PM, no booking needed with these. Gore in the Gorge – Spooky storytelling in the Robin Hood Cave in Creswell Crags. Come along for an amazing atmosphere. 31st Oct, 7PM. £12 Adults. Ezekial Bone: Guts & Gore Halloween Tour— Come on this brilliant tour to hear the ghoulish and gory history of Nottingham. 6PM OR 8.30PM - £6 Galleries of Justice Museum After Dark Tours – Check out these after dark tours of the creepy Galleries of Justice. Ghost Tour 22nd-23rd Oct, 6.30PM and Terror Tour 24th-25th Oct, 6PM, booking only.
ALICE COOPER’S NIGHT OF FEAR Alice Cooper’s amazing rock’n’roll fright fest is back in Nottingham for the third time ,as part of his worldwide tour. This spectacularly unique concert will be an unbelievable way to spend Halloween (30th Oct - 7PM, Nottingham Royal Concert Hall).
For the ideal Halloween, spend the night under the stars in Sherwood Forest or the Peak District, spinning chilling tales of terror by the glow of the fire. If you need inspiration check out ‘The Tell-Tale Heart’, ‘The Black Cat’, ‘The Willows’, ‘The Tomb’ or ‘The Legend of Sleepy Hollow’.
VIDEO GAME MARATHON How long you can play these games, in the dark? 1. Silent Hill 2 2. Call of Duty World At War: Nazi Zombies Mode 3. Resident Evil 4 4. Dead Space
SCARY TV SHOWS Warm up with a few episodes of The Simpsons: Treehouse of Horror, then delve into nostalgia with the following. Goosebumps– I suggest ‘The Haunted Mask’, ‘Welcome to Dead House’, ‘Night of the Living Dummy’, The Haunted House Game’, ‘Attack of the Mutant’ or ‘Don’t Go to Sleep’ Are You Afraid of the Dark- ‘The Laughing in the Dark’ (remember Zeebo the clown?), ‘The Twisted Claw; ‘ The Nightly Neighbours’, ‘The 13th Floor’ or ‘The Phantom Cab’ Want something a little scarier? Try...
MEDSOC
X-Files: ‘Pusher’, ‘Chinga’
Don’t miss out on MedSoc’s annual spectacular Halloween event—the best excuse to dress up.
Masters of Horror: ‘Incident On and Off a Mountain Road’, ‘Cigarette Burns’, ‘The V Word’, or ‘The Black Cat’
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HOME OR AWAY?
Info Where? John Hunter Hospital, Newcastle, New South Wales, Australia When? July-December fourth year
of
Who? Top 2 quartiles of the year, must not have failed any exams (something to aim for!) Placements? Paediatrics and Obstetrics and Gynaecology
Travel
Course structure? 2 weeks introductory lectures then ward based and PBL. Includes 2x 2weeks electives (mine are neonatal intensive care and indigenous birthing services) Exchange students Chris, Hazel, Ali, Victoria and Gina
SWAPPING NOTTINGHAM FOR NEWCASTLE Studying abroad was always one to tick off on my uni bucket list and for the first 3 years of my medicine degree, I was disappointed in what Nottingham medical school had to offer in this department- a big fat nothing. But along with the wonders of women in labour, old people, little people and overly sexually active people that fourth year brings (patients, not students), comes a career changing opportunity. Newcastle by air: Nobby’s beach
I first heard about the Nottingham-Norway -Australia love triangle when I was told that the students were on their way back from Newcastle (New South Wales, not Upon-Tyne) just in time to hit up the Medics’ Winter Ball. It was hard to grasp that just months after this that I was
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packing my 46kg to fly down under, where I would be studying for the remainder of the calendar year. This exchange was originally set up by Dr Symmonds, an ex-Nottingham lecturer who wished to create a link between his two most treasured cities, throwing in Oslo just for good measure. Each year there is a shuffle round of six students across the globe to offer them an insight into a whole new world of medicine that stretches far beyond the walls of the QMC. The differences are vast: in Australia the medicine witnessed can vary from scabies to shark attacks and even envenomation from a black widow spider - hardly a regular occurrence in the less than tropical East Midlands. The friendliness of Oz is reflected in its teaching of medical practice. Here, all the doctors are called by their first names; PBL tutors buy you coffee and top surgeons will invite you on a 9 hour car journey with them to an outreach clinic. (Australia is big. I politely declined.) All you need to know about the city of Newcastle itself is that there are 5 stunning beaches to choose from, that
Highlights? The friendly doctors, the beaches, exploring a new place and the 2 weeks holiday!
Sydney is a 3 quid train away and that you will be swapping Nottingham’s beloved “Ocean” for Newcastle’s not so beloved “Fanny’s”. Until a few years ago, the hospital used to be based right next to the beach; the doctors went surfing in their lunch break and were alerted to the fact that a patient needed seeing not via a pager, but by a code of different coloured towels being hung out over the balconies by their ever so amenable colleagues. This experience so far has offered me a chance to envision what practising medicine abroad is like, something other medical students will not find out until after completion of their degrees. Hopefully this heads up about the exchange will encourage pre-clinical students to have more ambition than “just passing” years 1 and 2, because even if they mean a negligible amount towards your BMedSci, those good marks could get you a first class ticket to Australia! Additional advice: for those who are successful next year, contact Hazel Gilbert the highlighter whore for heaps of info about what to do next.
Ali Blatcher
“This One Time at camp...” American summer camps have, for a long time, been the summer destination of choice for British university students. Spending the last two summers at Skylake Yosemite Camp, nestled somewhere in the Californian Sierra Nevada Mountain Range, has been one of the best things I have ever done. Where else can you play all day in the sun and get paid for it?
OR 8-late – Dance Night – Campers take this VERY seriously. Be prepared to break up any young Romeos and Juliets for getting too frisky.
Sounds like it might be for you?
Skylake is a private, family But what is the job of a camp counsellor and run camp full of very is it really as easy as it sounds? My typical wealthy children from LA daily schedule went something like this: with attitudes to match. Its 7.15 – Reveille – Get out of bed, drag parental clientele include your cabin group out of bed, washed and Antonio Banderas, Don dressed (easier said than done if you get the Johnston, Michael Jordan teenagers). and the family of Estee Lauder. If you ever 7.45 – Flag Raising –This is a time when need to phone a parent for any reason, everyone gathers to hear announcements, hearing Mr Banderas’ voice on the other end raise the flag and the American pledge of of the line may not be something you are prepared for! allegiance is said. 8-9 – Breakfast – Ro Sham Bo (aka rock, paper, scissors) is played to determine whether boys camp or girls camp get to go first – this gets VERY competitive.
Camp America, BUNAC and CCUSA.
Camp is a fantastic way to experience a new country, develop leadership and meet some amazing people from all over the world. It’s a very easy job at times but during my 2 If you fancy a different type of challenge summers I had to deal with some difficult there are other options: issues too. It provided me with my own perYMCA or other charity run camps - fect escape from the stresses of Medical Providing summer camp experiences for School – something very much needed after underprivileged children. a year in LT1! Religiously affiliated camps – Jewish Top Tips from summer camps have a long running tradition in the USA but there are others. Previous Counsellors
9-12 – Activity Periods – During these times you lead an activity to which you are a specialist for. Some counsellors have specialist coaching qualifications but for others, you simply need enthusiasm. Special Needs Camps – Demanding, chal12-1 – Lunch lenging but immensely rewarding, so I have 1-2.30 – Siesta – You may think that you been told. do not need this hour to sleep… And you Specialist Sport Camps – Americans are would be very wrong! big on sport and unlike here often don’t 2.30 – 4.30 – Cabin Group Activity – require any formal qualifications to teach it Organise an activity for your cabin to do as to a high level, only experience. a group. The activity range is wide and you are allowed to make up your own (within reason). One male counsellor was famous for getting his cabin group to turn their cabin into a pirate ship using various arts and crafts materials – use your imagination!
If you find a camp you are interested in, email them and ask them about whether they recruit international staff and how you should go about applying. You need a visa and most camps will only recruit international staff through an agency. The main 3 are
4.30-5.45 – Shower Hour – Exactly as it sounds, however, this is much more difficult for the male counsellors dealing with 7 year old boys! 5.45 – Flag Lowering – Camp gathers to lower the flag, announcements are made as to the evening’s activities.
Any gossip will be common camp knowledge within 2 hours of said incident occurring.
Prank wars between male and female counsellors get nasty – think crickets in sleeping bags and underwear up the flag pole.
Be prepared to be asked if you are Australian
Don’t go to California if you don’t like Mexican food or sushi
If you have campers over the age of 13 they will try to sneak out to boys/girls camp. If you suspect this is happening, sleep by the door and watch their faces – PRICELESS.
6 – 7 – Dinner – Again its boys vs girls in Ro Sham Bo for who gets to go first. 7-8 – Twilight Sports – Leading activities that range from a beauty spa (in the girls shower block) to very competitive games of touch American football. 8-9 – Camp fire – You will be expected to get up and lead camp fires. You cannot be afraid to look stupid, which you will!
Alexandra Edwards
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WHAT I DID IN MY HOLIDAYS We asked for your photos and here are our favourites.
Wish you were here! xxx
Travel
om Greetings fr New York!
Get inspired for the next holiday.
Il Colosseo, Roma
Dubrovnik
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Scotland
Hello from Bo
snia and Herze g
ovina!
Echolalia Magazine c/o Medical Course Office University of Nottingham NG7 2UH
e Venic
New York, New Yo rk
Niagara falls
CittĂ del Vatic ano
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The New Kid
Travel
on the bloc
STATS:
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Population – 621,000
Only non-EU country to use the Euro
Capital – Podgorica
Official Language – Montenegrin
Life Expectancy - 73
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Essential Lecture Handouts
Dinnertime with George Hulston
Bucatini all'amatriciano This is an incredibly simple and frugal dish originating from the town of Amatrice just outside Rome. One of my favourite things about cooking this meal is that it still tastes delicious using cheaper ingredients. However I would suggest using the best quality tomatoes you can afford as they really are the essence of the dish. Bucatini is an unusual type of pasta, similar to spaghetti but with a small hole in the middle, meaning that it holds sauce better. Pecorino is similar to parmesan and is the hard cheese of Rome - using it if you can find it makes a pleasant change. Great for all us medics, this recipe contains one of your five a day and fills you for longer as pasta is one of the lowest GI foods. Ingredients (to serve one): Half a small onion 1 tablespoon of olive oil A pinch of dried chilli - not powder, either the whole dried ones or the crushed ones 1 tablespoon of white wine— Sainsbury's sell small 125ml bottles ideal for cooking 50g of pancetta - if you can't find it use chopped smoked streaky bacon (2 rashers for one person) 125g of the best quality tomatoes you can afford 100g of bucatini - sold at Sainsbury's, but if you can't find it use spaghetti Pecorino or parmesan to serve Salt and pepper to season
Roughly chop the onion into small pieces (about 1cm). Add about a tablespoon of olive oil in a frying pan and add the onion. Fry the onion on a medium heat for about five minutes the onion should be starting to soften but not brown. Whilst this cooking chop your tomatoes into rough chunky pieces. Add the pancetta and cook for another 2-3 minutes. Then add the wine and the dried chilli, leaving for about 30 seconds to allow the alcohol to cook off. Add your tomatoes, season to taste and cook for 20 minutes. Meanwhile boil a pan of water for the pasta. Remember pasta likes plenty of water and a fair old pinch of salt in the water (don't worry most of the salt is lost when you drain the pasta). A frequent error is to add oil to the pasta water
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- this isn't necessary provided you use enough water and give it a stir from time to time. Add the pasta to the water and cook according to the packet instructions. You should only add the pasta when the water is bollente - fast boiling. Pasta doesn't like to be simmered! When the pasta is al dente (it should still have a little bit of bite to it), drain it and add to the pan that has the sauce in. Stir quickly and allow it to cook in the sauce for another 30 seconds or so. This allows the flavour of the sauce to infiltrate the pasta. Put the pasta in your bowl, sprinkle with grated pecorino or parmesan and enjoy!
Buonissimo!
Case Study: Breath-taking Tackle It’s your first day on A&E as an F1 doctor. Your very first patient is an 18 year old male, who is 6ft3, very athletic with no other health problems. He is extremely breathless and his friend explains that he took a knock during a rugby match and became short of breath, unable to form sentences, and has painful ribs on the right side.
[Q1 Based on the history, what is the most likely diagnosis?]. Your initial assessment shows the patient is tachycardic, tachypnoeic, with tracheal deviation to the left, reduced breath sounds over the right lung which is hyper-resonant to percuss. The patient is clearly in distress and is becoming cyanotic, with a blood pressure of 85/55 and 02 sats <92% on air.
[Q2 Based on the initial assessment, what is your immediate management?]. As part of your management, you decide to order a chest x-ray (CXR), which looks like this:
[Q5 Explain the management of the patient’s condition and how long it usually is before discharge?]. [Q6 Which blood test would you choose to do to assess the recovery of this patient?]. [Q7 After 3 days repeat CXR is done, why?] The repeat CXR shows good expansion of the affected lung and your consultant is happy to let him go home.
[Q3 What does the CXR show?] [Q4 What was the rationale for doing the CXR?] The patient’s parents have arrived and are very concerned to see that a tube has been placed into their son’s chest, and would like to know why this has been done.
Before he is discharged, you have a chat with the patient who admits to smoking and drinking quite heavily on rugby socials with his mates most weekends after games.
[Q8 The patient asks you if his lifestyle has any relevance to what’s happened to him and if it will affect him in the future, what do you say?] Answers on page 47
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Essential Lecture Handouts
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1—NaOH (7,4)
2—Remove (6)
8—Pale complexion (6)
3—Thin
10—Mid-west state (6)
4—Thailand (old name) (4)
11—Musical note (5)
5—Athletic discipline(6)
12—HIV treatment acr. (1,1,1,1)
6—Neural tube deformation (5,6)
13—Pulp
7—_ coli (11)
14—Green, stoned fruit (5)
9—Herb (4)
18—Alloy (5)
10—Ukraine capital (4)
22—Fake (clothes etc) (4)
14—Sphere (3)
23—Soft mineral, bathroom product (4)
15—Antibody isotype acr. (2,1) 16—Greek goddess of dawn (3) 17—Desk (6)
26—Fuel (6)
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19—Rivulet (4)
27—Base (6)
20—Couch (4)
28—Having four legs adj. (11)
21—Hat, S American country (6)
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24—Curve (4) 25—Ice sheet (4)
WORD WHEEL
Easy: 15 words
Y T
Intermediate: 25 words
A M
O C G I Z
Difficult: 30+ words
QUICK QUIZ 1)
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24—Mislead (5)
Find as many words as you can. Plurals are not allowed and each words must contain the middle letter. There is one 9 letter word to be found.
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Across
Who won most gold medals in the 1992 Barcelona Summer Olympics?
2)
How many standard bottles of wine fill a Nebuchadnezzar?
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What is measured by the Scoville scale
4)
Who is the current poet laureate?
5)
Which gemstone is associated with being born in November?
6)
What is atelophobia?
7)
Who was the Greek god of healing?
CODEWORD A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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| 47 Case Study Answers: 1) The most likely diagnosis in this case is a tension pneumothorax. This is one that isnâ&#x20AC;&#x2122;t particularly tricky to spot, but has dire consequences if it is missed and so even the junior staff need to be confident in diagnosing this! 2) This is an EMERGENCY! An ABC system should always be employed in situations where the patient is critically ill. Sit the patient up and give 15l/min 02, followed by placing a wide bore cannula into the 2nd intercostal space, mid-clavicular line, prior to doing a CXR. The diagnosis will be confirmed by the presence of air hissing from the cannula. A chest drain should then be placed in the 4-5th intercostal space mid-axillary line on the same side. 3) There are several key features of a tension pneumothorax: Tracheal deviation away from the affected lung with shift of the mediastinum; An absence of the usual pulmonary vasculature on the affected side (looks completely black); In pneumothoraces as large as this, you can often see the compressed lung against the heart border. 4) It would usually be done after the chest drain has been placed, to check correct placement of the drain and ascertain the severity of the pneumothorax. 5)The main aim of treatment is to achieve re-expansion of the compressed lung. This is done by placing a chest drain which allows air to escape the pleural cavity, relieving the pressure. It can be up to 2-3 days before the chest drain is removed and the patient discharged, depending on the severity and the patient recovery. 6) Arterial blood gas. This would allow you to assess the degree of hypoxia, and give you a comparison between admission and discharge. 7) As mentioned, the main aim is re-expansion! So another plain film is done to ensure treatment has been successful before the patient is discharged. 8) Yes it does!! It is important to ascertain how much he is smoking and encourage him to stop, giving the relevant advice. Smoking has been found to reduce the chance of reoccurrence and so this preventative measure should be taken before the patient leaves!! Quick Quiz Answers: 1) Former USSR 2) 20 3) Comparative heat of chillies 4) Carol Ann Duffy 5) Topaz 6) A fear of imperfection 7) Asclepius
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