• Frome it may concern 27 February 2018 | View comments

  • Our Friday sessions are lively and informative affairs. This week was almost exhausting in the range of topics which required a least a mention:

    We had Von Economo neurons and Super Agers: www.theguardian.com/society/2018/feb/19/scientists-unravel-secrets-of-superagers The story is that a study of the brains of 10 people, who had remained lucid and exceptional in the preservation of their intellect until immediately prior to death in old age, found unusual concentrations of the large bipolar neurons which were first described by Von Economo and colleagues 1925. For most of us the name is just about recognisable but has no links. Earlier studies have remarked on reduced or increased numbers of Von Economo cells in subjects with Autism. They are present in the brains of all the great apes as well as human beings. What the significance of these reported findings will turn out to be we do not know – but it gives an alternative to confinement to the cul-de-sac which the Amyloid Hypothesis has become.

    We are reassured to find that a meta-analysis confirms that antidepressants are effective. It is particularly satisfying that this elegant study, which is free of drug house sponsorship, found that amitriptyline – one of the oldest tricyclics – stands out as the most effective: https://www.theguardian.com/science/2018/feb/21/the-drugs-do-work-antidepressants-are-effective-study-shows This paper will bear closer examination in the future. 

    We will need to return to Alan Maynard, whose obituary is untimely but reminds us of his contributions to the change in thinking and values which has occurred since the 1970s: www.theguardian.com/society/2018/feb/16/alan-maynard-obituary

    Mostly we were swept along by unexpected enthusiasms released by the report which begins: ‘It could, if the results stand up, be one of the most dramatic medical breakthroughs of recent decades. It could transform treatment regimes, save lives and save health services a fortune….’ https://www.theguardian.com/commentisfree/2018/feb/21/town-cure-illness-community-frome-somerset-isolation

    The project has been described more fully previously:

    http://www.swscn.org.uk/wp/wp-content/uploads/2015/07/Community-development-in-Frome-the-GP-perspective-Dr-Helen-Kingston.pdf

    and in a current issue of Resurgence and Ecology:

    https://www.resurgence.org/magazine/article5039-compassionate-community-project.html

    The essence is that one General Practice in the village of Frome determined to break free from a model of treating illness, preferring to get to know people and to help them see themselves as individuals who are part of a local community. They brought together information of activities which might be of interest and have some therapeutic value and supported people in joining where they had previously been shy or reluctant. In Frome people like it and have derived personal benefits and contributed to enriching their community.

    This is an example of approaches which are being championed, especially by the palliative care community: www.kingsfund.org.uk/sites/default/files/media/Catherine_Millington-Sanders.pdf

    Wonderful – but it will never happen around here. It is all very well in Frome and maybe in Gnosall and rural Norfolk, but it could never work in urban Manchester – could it?

    The amazing turn of Friday was that there was a flush of excitement at the possibility of doing just that. Wythenshawe is made up of a series of village-like communities on much the scale of Frome. General Practices could become centres of similar social engineering for health and well-being. It will need more thought and work but we made a start by listing activities which might be core elements of most community networks:

    • Dog walking (animal welfare)
    • Community bus/taxi
    • Shopping
    • Men in sheds
    • Park
    • Handyman jobs
    • Intergenerational lunchtimes
    • Allotments

    Would Tesco help? – We heard of models based on sharing ‘out of date’ food to provide food for people who are short of funds and food but can learn how to make use of unwanted cast-offs to produce wholesome meals. 

    We heard of models from Scandinavia – Norway https://www.ijic.org/articles/10.5334/ijic.2217/

    So there is literature to help.

    But could we really do something like this in Wythenshawe?

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