Friday, June 28, 2013

...our existential choice

STOP PRESS 1
A North West Arts and Health Networking event is happening as part of Culture Shots 13, on Wednesday 3rd July, starting at 6:00pm and ending at 8:30pm at The Manchester Eye Hospital Atrium. FREE Using my recent paper as a starting point - A Bird in a Gilded Cage - I am going to frame an evening of work around innovative approaches to healthy ageing and dementia through two presentations and conversations with Claire Ford who has developed work around iPad's and Sarah Lawton who has been working in India on a craft's project with older people. There'll be lots of opportunities for you to share your work too. Informal and relaxed as ever.

STOP PRESS 2 
On the 5th July, Dr Iona Heath, author of Matters of Life and Death and recent President of the Royal College of General Practitioners opens MORALITY and gives a free public lecture: Memento Mori. On the 8th July, Consultant Oncologist and founder of Medicine Unboxed Dr Sam Guglani; Palliative Care Manager and author Molly Carlile and singer songwriter Victoria Hume all contribute to a range of exhibition themed free events. Details by clicking on the flyer.


THE MAIN EVENT...
This week I attended the Culture, Health & Wellbeing international conference in Bristol and had some amazing conversation with people I had never met before. Thank you to all of you who made the effort to talk with me. Before I forget, I think Alex Coulter of the South West Arts and Health Network and all her team deserve acknowledgement for their co-ordination, planning and seamless delivery! This was the first international conference of its kind in the UK since the one held at MMU in 1999, and it did the UK proud.

As chair of the National Alliance for Arts, Health and Wellbeing it was fantastic to make contacts old and new from Wales Scotland and Northern Ireland and I hope that we can forge even greater links for partnerships with you all (...and of course, those of you from further-flung places).

Chief Executive of the Royal Society for Public Health, (RSPH) Professor Richard Parish opened proceedings and chaired the first day in his own compelling and inimitable way - charming, erudite and astute. John Wyn Owen was the first key note and he invited us, (via his RSPH account of arts/health over the last 15 years), to reflect on the recommendations of the Francis Report encouraging us to adapt and subvert its call for a ‘cultural barometer’, playfully suggesting that we interpret this by freely focusing less on its intended health-culture change and more on reimagining what a caring modern NHS might aspire to be. This was followed by a panel discussion on inequalities and how the arts might impact, or be of relevance. If I’d have had more time here, I’d have shared the work of Kate Pickett and Danny Dorling, which questions some of the points raised in the Marmot review, but time didn’t allow this, so click on the photo of shoe-shining below to read Against the organisation of misery? The Marmot Review of health inequalities.


When a passionate, and well-intentioned voice of one of the delegates stated with seeming authority that Randomised Controlled Trials (RCT) were the only way to influence national policy, I had to stifle a cry of frustration, not least, as I didn’t have opportunity to respond, (and this was a debate on inequalities, not pathology and morbidity). Is this perspective based on the pharmaceutical industries oh-so-honest publication of the ‘positive’ outcomes of its trials and its historical neglect to publish negative data. Or perhaps, in a world where dissatisfaction has been reconstituted as illness and big pharma now has to find ‘virgin’ control groups for RCT’s and is moving into Africa to conduct its objective studies on an as yet, unpolluted public for their tests?

National policy only influenced by hard objective data? What about our governments regular u-turns, based less on hard evidence and more on ‘middle England’s' public opinion and media backlash. Let’s not kid ourselves, we live in a climate of policy based evidence and not evidence based policy and one that is mediated by the vested interests of big business and the media.

I actually believe that there’s a small place for the RCT in the arts/health agenda, but specifically in the health/morbidity arena and less in that of wellbeing. Some of the attempts to understand the impact on physiological outcomes, perception of pain and mental ill health are really interesting and could produce significant results, but for this conversation - about inequalities - it seemed a desperate attempt to yet again, reduce the way we understand impact of the arts to a scientific model, denying the rich data that mixed methodological approaches offer.

In this session, I wanted to discuss inequalities and I’d hoped to ‘tell a story’ of my recent time in Taksim Square to illustrate the potential of the arts to give voice, but alas and alack, no window of opportunity was offered. More of that in a moment.


Of course, the icing on the cake at this conference, was the contribution of Lord Howarth of Newport. Alan Howarth really did us proud and gave an address that not only set us a challenge or two, but that was considered, intelligent and spoken from the heart. The paper is available in full by clicking here, and of course, there’s my awful little video just above. Some of the key points he made (for me at least) are here for your delectation.

“What the Alliance and its international partners are engaged with is of the most profound importance. We are at a moment when western societies face an existential choice. Your mission to mobilise the arts in the service of health and wellbeing symbolises and illuminates that choice. Are we, in our society and in our public services, to embrace the values of creativity, humanity, empathy and reciprocity? Or are we to continue with the barrenness of materialism, competitive self-seeking, anomie and bureaucratic crassness?

The malaise so extensive in our health and social care systems is born of a political culture, in the UK and US at any rate, which has destroyed social capital and devalued the public realm. Monetary and competitive values have been implanted in our public services. Most extremely in the USA, but also insidiously in the UK, healthcare is commercialised; powerful business interests, subsidised by governments, influence health policy; suffering is commodified and exploited for profit; and the poor are excluded or made to put up with inferior service. 

The view of human nature taken by so-called classical economics, the economics of the free market, that people are all self-seeking utility maximisers, is false and degrading. After forty years of that intellectual hegemony we have brought into being societies, and indeed a world, riven by inequalities, as seen in health and morbidity statistics. {…} the time has come for leaders of research to form up and present a manifesto in which they set out where they’ve got to and say these are our methods, they are robust and productive, they demonstrate clear and substantial value of work in arts, health and wellbeing, and those in a position to fund work in the field have no excuse for not doing so.”


The National Alliance for Arts, Health and Wellbeing is indeed working with the partnership that makes up the UK Arts and Health Research Network to do just this, but developing that rich contextual framework, or Cultural Barometer, that isn’t skewed to simplistic reductionism and that allows rich narrative to sit alongside more quantitative methods will only work if its not driven by narrow interpretations of arts/health and that isn’t driven by commercial gain or organisational ego. Critically, this work needs to be developed through receptive consultation and not reductionist dogma.

Let’s not loose sight of what it is that this arts and health agenda is predominantly about - creativity, culture, the arts and humanities - on one hand, how we humanise health provision and on the other, human wellbeing and social justice.

I had a slight frustration on the international panel, that I didn’t get the opportunity to counter what felt like a bias towards clinical environments and addressing disease, (evidenced by an aspiration to develop a Cochrane-like library...dear God, no). I felt the vast majority of the delegates (at least those I’d spoken with) were more interested in tackling inequalities, and who saw health and wellbeing as something to be addressed in the wider world - not just in health settings!


What I’d have liked to have said, but didn’t have the opportunity or time -  particularly around the deeply important issue of giving services users a voice - links into my earlier disability to fully contribute to the inequalities debate. So, here is a thought on this important question.

The crux for me, is key message number 9 in the Marmot Report:

‘Effective local delivery requires effective participatory decision-making at local level. This can only happen by empowering individuals and local communities.’

This is critical if we are to address inequalities, and I argue regularly, that what good arts interventions and processes offer, is the opportunity to ‘have a voice,’  may I shout this? HAVE A VOICE. This is what the MANIFESTO was and is all about.

Think about those people in the Francis Report...the voiceless, marginalised, neglected and abused. OK. Now think about that Big Issue seller, whose eyes you don’t meet. Or that scary character shouting inappropriately in the street. The list is endless (I’m afraid). The marginalised and poor are not only unequal, but they are hated by many. OK that sounds a little strong, but I don’t mean feared, I actually mean reviled and yes in our grotesquely unequal society: hated. Picket and Dorling again illustrate that any attempts of ‘poor’ people to engage with the Marmot Review only opens them to the vitriol of the knee-jerk, sensation-hungry media, best typified by the Daily Mail’s mediated comments pages. Here are some examples of hatred:

“Perhaps Prof. Sir Michael might revise his recommendations from hard working taxpayers being bled even more to pay for feckless wastrels, to relocating ‘poor’ people to remote mountainous regions and subsistence occupations? - Penny, London, 14/2/2010 19:34

another:

“Why are the poor replying to my thread? GET A JOB and stop scrounging. Who is paying for your Internet? I’d sterilise the lot of you! - Anthony, Esher, Surrey, 11/2/2010 12:56

So the question of how we get users voices heard, is a good one (and one I apologise for not being given the opportunity to respond too at the conference), but it’s a premature question. We need to step back even further and ask, if we’re able to allow marginalised voices to be heard, how do we get them to be listened too and taken seriously - and just how the hell do we deal with a media that thrives on vitriol and which mediates wider public debate? Marmot tells us we need to empower people, but when they speak, they are demeaned. Ultimately silenced.

Pickett and Dorling again suggest, that what we need is, “the political courage to deal with the root causes of those social determinants. Why people smoke, rather than trying to get them to stop. Why people eat too much, commit violence, trust each other less, invest more money in their children’s education, rather than trying to understand the social inequalities that stand in their way.”

So, what relevance does all this have to my few days in and around Taksim Square? What relevance eh? Well, I don’t mind admitting, I have a jaundiced view of young men in oh-so-distant countries, shouting, rioting, covering their faces and throwing stones at ‘peace-keepers’ in the name of some higher-power. But wait on - I’ve already established that my poor old distorted opinions are mediated by the TV news. It has to be true - its on the BBC!

So, finding myself in Turkey at the height of the ‘riots’, I decided to follow those intriguing sounds I could hear, into the warm night of the city. For one thing, it was easy to find where it was all ‘kicking off’, you could just follow the families - the excited children and their grandparents up the high-street. True, all the cash machines had been spray painted with anarchist logos, but people were still using them and true, the crowds were singing and chanting, but it didn’t feel in the slightest bit daunting, in fact far more family-friendly than any football match crowds I’ve walked with.


And the crowds were seriously big - the largest I’ve ever been in - all laughing, talking, singing. People selling cans of spray paint and V-for Vendetta masks and variants of the Turkish flag had popped up everywhere. It took me about an hour to walk a five minute journey...and then I was there. Taksim Square. And there were vehicles piled up and burnt out, barricades on all streets leading into the square. But here’s the thing. My first thoughts were of Glastonbury - only without the commercialism. People camping everywhere. Kids having graffiti lessons. There are singing groups everywhere. And men, those terrible feral beasts that plague our news bulletins, are linking arms and dancing, SO heartily dancing. This goes on through the night. In the day time, there are stall-holders sharing political manifestos. Variants on socialism I’ve never heard of, but all good spirited and eager to talk about the current situation. I can’t get over all the spontaneous arts sessions happening. There’s one with children decorating a tree with all their aspirations - and the food - oh the food, everywhere you turn something is on offer. Then there’s Taksim Square Book Club, which encourages reading as a silent protest.

Then the police come. BOOM. A small moment of resistance, quickly subsumed and dissenting voices are quashed. Decent, articulate and motivated people, creative and passionate.


I’m constantly taken back to the anti-war demonstrations across the world that saw an estimated 30 million people in 600 different cities across the world, take to the streets on February 15th 2003 and demonstrate against the war in Iraq. What was the impact of such a groundswell of civic voice? Our governments chose to ignore public opinion, because of overwhelming evidence of weapons of mass destruction. You know the rest of the story.

Marmot genuinely wants to hear the voice of marginalised people and the arts in part, enable this story to be told. But if those in power don’t like your contribution, they stop you, or else allow the media dogs on you.

Art and artists tell powerful stories. Participatory and social engaged artists enable others to tell theirs and potentially, change society.

What I’d like to see over the next five years is connected to this, in that I believe we’ve been fixated with describing arts/health in terms of science and medicine, and whilst Evidence Based Design has evolved elegantly from Evidence Based Medicine, I’d like to see 21st century healthcare embrace ‘service users’ voices whoever they might be and influence more enlightened health practitioners towards Experience Based Medicine. This of course, requires our practice to encompass education more systemically, and not only the education of our health and cultural partners, but the personal, social and health education of our children.

The thought of the arts being reduced to a ‘mainstreamed’ intervention, tried, tested and force-fed the passive sick, like great ailing geese, only to provide researchers with a bucket of precious foie gras for their own satiation - repulses me. The argument too, that an arts intervention needs testing just like pharmaceuticals need testing, is a little spurious. Oh that it were so simple - medication after all, may work wonders for one person, but have little effect on another's individual symptoms, or worse, have terrible effects.


I love the connections between art and science. I’m inspired by science and exquisite engineering and those people who are pursuing a notion, or a hunch based on their investigations and the available evidence. They’re pursuing a hypothesis. Testing, experimenting and refining. Wonderful. But the arts too, have the richest of languages, and it's my hunch that its through our cultural inventiveness, our curiosity and our inherently provocative nature that the way we understand our diverse practice and its impacts, will best be understood by and through the arts.

This is my hypothesis, prove me wrong.


...and finally. The wonderful conference exposed me to some quite profound work - far too much to share. Here is one piece however, that touched me so, so deeply and gives voice to people with dementia. I Will Get Up and Go Now, is a film by Andrew de Freitas commissioned by the Sensory Trust, with Mo Codd in conversation with the poet Karen Heyes. You don’t need any words from me. This is for you.

Wednesday, June 26, 2013

Lord Howarth's address on Arts, Health and Wellbeing


In a passionate and articulate address to the Culture, Health and Wellbeing International Conference in Bristol this Tuesday, Lord Howarth of Newport gave a rousing and heart-felt perspective on the current political climate in relationship to our ever-evolving Arts and Health agenda. Below is a very substandard clip of the speech, and a full video should be available soon. You can read the full transcript by clicking on the photograph below. I'll be blogging fully about this remarkable conference, at the weekend.


His paper was called, Arts, Health and Wellbeing – Personal Reflections and Political Perspectives


Here is a snippet to whet your appetite.

"We are at a moment when western societies face an existential choice. Your mission to mobilise the arts in the service of health and wellbeing symbolizes and illuminates that choice. Are we, in our society and in our public services, to embrace the values of creativity, humanity, empathy and reciprocity? Or are we to continue with the barrenness of materialism, competitive self-seeking, anomie and bureaucratic crassness?"

More very, very soon. C.P.

Sunday, June 23, 2013

I AM - WE ARE: Plucked Poodles, Sad Rabbits and Recovery...

This week I’m attending the Culture, Health & Wellbeing international conference in Bristol and will no doubt, report in full. In the meantime plans for MORTALITY are in full-swing. Don’t forget, it would be great to see you at any of our free events. Click on the image below for details.



I’ve just returned from beautiful Lithuania, where I was invited to talk to Ministers from the Departments of Health, Culture, Social Care and Employment, Education and Science, alongside the Office of the President and at the invitation of the British Council (phew - what a list). The event was planned and facilitated by the team at Socialiniai Meno Projectai (Social Art Projects) who are pulling together a broad range of activity to affect health and wellbeing through participatory practice. It’s been great to be part of this work since the 2009, when the same team convened the international conference on arts and health, Mano Teritorija. Now with British Council support and their recent project evaluation, Menas Žmogaus Gerovei published, they are entering a new phase of activity to embed their emerging work across government departments, whilst delivering and evaluating projects across a range of settings. More news on that soon. Just my big thanks to Roma Survilienė, Ieva Petkutė and Simona Karpavičiūtė for making me so welcome and being so inspiring.

For those of you who haven’t had the opportunity to visit Lithuania, I can strongly recommend it. As Vilnius was bathed in the same sun we felt in the UK, it felt a very vibrant and golden city and I was very sad to leave.


Towards a Recovery Manifesto
I am beginning to work with people in recovery from addiction, and building on our Manifesto for Arts, Health and Wellbeing we are going to be creating a recovery manifesto - think, bill of human rights, think differently. Although this is starting nice and slowly with partners in Turkey and Italy, I expect to work with people across the UK and a number of European countries. Interested? Get in touch. More, much more, very soon. But be warned, this, our first foray into putting some of our thoughts into words (sweet words) is both abstract and eye-wateringly migraine inducing! 
So do not watch this if you are affected by flashing lights.


News coming in from Holly Marland at the Royal College of Music - there’s a new blog that you can catch up with all about Music and Health. Click on the sad rabbit for details. 



BBC Children in Need - Main Grants Programme 
BBC Children in Need has announced that the next applications deadline for its Main Grants Programme is the 15th September 2013. Funding is available to organisations that work with young people who are suffering from:
·         Illness
·         Distress
·         Abuse or neglect
·         Are disabled
·         Have behavioural or psychological difficulties
·         Or are living in poverty or situations of deprivation. 
The Main grants programme is open to applications for over £10,000. 
http://www.bbc.co.uk/programmes/b008dk4b/features/grants 



...and finally! Good grief...does this constitute abuse? C.P.

Monday, June 17, 2013

Türkiye Yeşilay Cemiyeti

I have been thrilled to be a guest of the Turkish Green Crescent Society, Kütahya branch this last week. As part of the I AM: art as an agent for change, I’ve been part of a small team of people from the UK, Italy and Turkey who are working together to better understand recovery from addiction in different cultures and contexts, whilst developing an arts project with people in recovery, based on self-portraiture. We’ll be facilitating artists exchanges/residencies in all three countries over 2013/14 and having an exhibition in 2014 alongside a symposium in Manchester. For me one the the key parts of this work is around cultural exchange and its been an honour to meet and work with so many people in Kütahya who have made me welcome and shown me so much of their remarkable country: from the artisans and Türkiye Yeşilay Cemiyeti members, to the Governor of the region. The artists studios in Kütahya were particularly outstanding, and I made one or two lovely purchases. 


It was such a varied visit and included a visit to the untouched and beautiful Aizonai Temple. Thank you to Ali Osman Ozleblebici for arranging this - and with your colleagues - absolutely everything else. How do you photograph a Greek temple, or Roman amphitheatre? I chose to sit for a couple of hours (beautiful solitude). Here’s a small moment, sat under the loud-speakers that call people to prayer in the village in which the ruins are. 


It was a strange and exciting time to be in a country whose politics and culture are different and unknown to me. I was inevitably drawn into the seemingly carnival atmosphere of the demonstrations in Taksim Square and whilst I didn’t find myself in the firing line of the security services, it was exhilarating to be in such a huge area of the city that had no policing and was under the control of the people. Yes, the streets were barricaded, but it didn’t feel lawless - it seemed in fact, that it had developed its own rules and regulations pretty seamlessly. Artists had built all sorts of facilities and were engaging with families in lively debate. Political groups set out their turf, and a range of stunning banners, (that alas, I could’t bring myself to liberate - for they were things of beauty indeed) and groups of people took it in turns to street clean.


Whilst different political groups vied for attention to their cause, it was the passion that really hit me the hardest and made me acutely aware of how biased journalism is. The images I get from the television are of angry young men and are always of of ‘extremism’, not rational, articulate, inspirational people, eager to share what they see as inequity. That said, these same young men and women let out much of their frustrations through the most euphoric dancing and singing I have ever been part of in a public space. Forget your flash-mob - this is the real McCoy. Exhilarating. Like any demonstration, you’ll get people who want an excuse to fight and that’s a real shame for all those families that simply wanted to express themselves. Of course the ballot-box is preferable to riots - I only hope that those in power have listened to such a loud expression of frustration and the country doesn’t descend into a divisive civil conflict.

Ironic that Burger King seemed to be the busiest restaurant on the fringes of the Square and to be sure, Istanbul is certainly a city that is building and building like mad. It was a quiet moment of bliss for me to escape to the impossibly beautiful - and even more impossible to describe, film or photograph - Hagia Sophia. Forgive my little film which I hope, though a little oblique, gives some sense of the place. Museum, mosque and basilica and over 1000 years old...if anything gives me a feeling of the numinous, it’s this. With all my cynicism to monotheistic religions put to one side, the beauty and craftsmanship is a thing of wonder. The things humans can do eh? Just a shame about all the other stuff we do too.


So, the blog is a little add-hock whilst I am fulfilling commitments away from my desk, so bare with it over the next few weeks and normal service will resume as soon as possible.

A reminder of those free MORTALITY events
Dr Iona Heath at 3:00 on Friday 5th July. Details by clicking on MORTALITY.


Dr Sam Guglani, Molly Carlilie and Victoria Hume on Monday 8th July from 2:00 - 6:00. Click on MORTALITY for details.

The exhibition is open to the public from Monay the 8th July until 16th August at the Holden Gallery here at MMU. It features work by Ian Breakwell, Felix Gonzalez-Torres, Douglas Gordon, Julian Opie, Cornelia Parker, Bob and Roberta Smith and Sam Taylor Wood.

If you are a health professional, work in palliative care, or at in hospices - if you have been affected by bereavement, if you find conversations around death difficult or if you are an artist that works in end of life settings - these sessions and the exhibition are for you and offer a rare opportunity to hear from some truly original and inspirational thinkers.

If you’re curious, please get in touch by emailing valeriaruizv@gmail.com
You can follow MORTALITY on twitter @mortality2013


ARTS INCLUDED IN WELLBEING MEASURES
This is important stuff! Our engagement in the arts is for the first time to be recognised as one of the factors that contributes to wellbeing in the Office for National Statistics’ (ONS) Measuring National Wellbeing Programme. I know a number of us have lobbied the ONS to include the arts, and this is our just-deserves.

 “...important contributors to well-being, for example, measures relating to arts and culture were excluded as there is no single UK measure. Classing the UK criterion as aspirational provides a more balanced approach. Every effort will still be made to include UK measures. Where this is not possible, flexibility exists to ensure that measures widely considered important for inclusion in the set of measures of national well-being can still be adopted.”

Furthermore, “...it was agreed that a measure of mental well-being based on the Warwick Edinburgh Mental Well-being Scale should be added to the personal well-being domain in order to provide a more holistic view of subjective well-being.”

Read the report by clicking on the ruler...it’s short and it’s highly significant.


WINSTON CHURCHILL MEMORIAL TRUST
Do you work in any of the Creative Industries? Would you like the chance to research new and innovative ideas overseas? Have you thought of applying for a Churchill Travelling Fellowship? They send over 120 people each year, from all walks of life and every corner of the UK, on an overseas travel sabbatical. Would you or someone you know, benefit from this experience? The application deadline is 5.00pm on 24th Sept 2013. Click on the anarchists armchair for more details.
  

INSPIRING WOMEN
The Royal Bank of Scotland (RBS) has announced that the next funding round of its Inspiring Women in Enterprise opened on the 3rd June 2013 and will close for applications on the 17th June 2013. Through the programme organisations that support women setting up their own business can apply for grants of up to £50,000.  This can include:
·  Delivering enterprise education
·  Innovative networking events
·  Developing entrepreneurial knowledge and skills, etc. 
The total fund available each year is £500,000. Click on the beautiful building above. 

Live, here and now from LT...C.P

What is your optimal weight? Maybe it is the one that minimizes your waist-to-weight ratio


There is a significant amount of empirical evidence suggesting that, for a given individual and under normal circumstances, the optimal weight is the one that maximizes the ratio below, where: L = lean body mass, and T = total mass.

L / T

L is difficult and often costly to measure. T can be measured easily, as one’s total weight.

Through some simple algebraic manipulations, you can see below that the ratio above can be rewritten in terms of one’s body fat mass (F).

L / T = (T – F) / T = 1 – F / T

Therefore, in order to maximize L / T, one should maximize 1 – F / T. This essentially means that one should minimize the second term, or the ratio below, which is one’s body fat mass (F) divided by one’s weight (T).

F / T

So, you may say, all I have to do is to minimize my body fat percentage. The problem with this is that body fat percentage is very difficult to measure with precision, and, perhaps more importantly, body fat percentage is associated with lean body mass (and also weight) in a nonlinear way.

In English, it becomes increasingly difficult to retain lean body mass as one's body fat percentage goes down. Mathematically, body fat percentage (F / T) is a nonlinear function of T, where this function has the shape of a J curve.

This is what complicates matters, making the issue somewhat counterintuitive. Six-pack abs may look good, but many people would have to sacrifice too much lean body mass for their own good to get there. Genetics definitely plays a role here, as well as other factors such as age.

Keep in mind that this (i.e., F / T) is a ratio, not an absolute measure. Given this, and to facilitate measurement, we can replace F with a variable that is highly correlated with it, and that captures one or more important dimensions particularly well. This new variable would be a proxy for F. One the most widely used proxies in this type of context is waist circumference. We’ll refer to it as W.

W may well be a very good proxy, because it is a measure that is particularly sensitive to visceral body fat mass, an important dimension of body fat mass. W likely captures variations in visceral body fat mass at the levels where this type of body fat accumulation seems to cause health problems.

Therefore, the ratio that most of us would probably want to minimize is the following, where W is one’s waist circumference, and T is one’s weight.

W / T = waist / weight


Based on the experience of HCE () users, variations in this ratio are likely to be small and require 4-decimals or more to be captured. If you want to avoid having so many decimals, you can multiply the ratio by 1000. This will have no effect on the use of the ratio to find your optimal weight; it is analogous to multiplying a ratio by 100 to express it as a percentage.

Also based on the experience of HCE users, there are fluctuations that make the ratio look like it is changing direction when it is not actually doing that. Many of these fluctuations may be due to measurement error.

If you are obese, as you lose weight through dieting, the waist / weight ratio should go down, because you will be losing more body fat mass than lean body mass, in proportion to your total body mass.

It would arguably be wise to stop losing weight when the waist / weight ratio starts going up, because at that point you will be losing more lean body mass than body fat mass, in proportion to your total body mass.

One’s lowest waist / weight ratio at a given point in time should vary depending on a number of factors, including: diet, exercise, general lifestyle, and age. This lowest ratio will also be dependent on one’s height and genetic makeup.

Mathematically, this lowest ratio is the ratio at which d(W / T) / dT = 0 and d(d(W / T) / dT) / dT > 0. That is, the first derivative of W / T with respect to T equals zero, and the second derivative is greater than zero.

The lowest waist / weight ratio is unique to each individual, and can go up and down over time (e.g., resistance exercise will push it down). Here I am talking about one's lowest waist / weight ratio at a given point in time, not one's waist / weight ratio at a given point in time.

This optimal waist / weight ratio theory is one of the most compatible with evidence regarding the lowest mortality body mass index (, ). Nevertheless, it is another ratio that gets a lot of attention in the health-related literature. I am talking about the waist / hip ratio (). In this literature, waist circumference is often used alone, not as part of a ratio.

Tuesday, June 11, 2013

...a taste of mortality

STOP PRESS: 
I’m working out of the country for a couple of weeks and will be posting the odd spontaneous reflection on different places and spaces (see below). I hope it’s not too self-indulgent and of some interest to you!

Please make a note in your diaries and share the following information which, along with other exhibition-related events, is on a dedicated MORTALITY blog page.


Mortality: Death and the Imagination
8th July – 16th August 2013

Ian Breakwell | Felix Gonzalez-Torres | Douglas Gordon | Julian Opie 
Cornelia Parker |  Bob and Roberta Smith | Sam Taylor Wood

The Holden Gallery
Manchester Metropolitan University, Grosvenor Building, Cavendish Street, Manchester, M15 6BR

To mark the opening of Mortality, Dr Iona Heath will present a new paper, MEMENTO MORI.

“Today, we who live in the richer countries of the world have the unprecedented good fortune of a gratifyingly extended expectation of life but, apparently still dissatisfied with this, we seem to want to push it further and pretend that life can be indefinitely extended.”

For full details of this free public lecture on Friday 5th July and the private view go to: http://mortalitydeathandtheimagination.webs.com

                   +

From DEATH-TALKING to DELIRIUM
On Monday 8th of July we are pleased to welcome some truly creative minds from the field of health, medicine and the arts to share some of their passions and ideas from their practice and as a response to the exhibition.

Dr Sam Guglani is a consultant in clinical oncology and curates ‘Medicine Unboxed’ an NHS initiative engaging the public and front-line NHS staff with a view of medicine that is infused and elaborated by the humanities. Molly Carlile has a clinical background in specialist palliative care nursing, counselling and education and manages Palliative Care Services at Austin Health in Australia. Victoria Hume is an NHS arts manager, who has written a series of songs about hallucinations in intensive care, based on interviews with people who have been through this extraordinary experience, and with the staff who care for them.

For dates and times and more details about this free event, go to: http://mortalitydeathandtheimagination.webs.com

Please don’t write to Clive as he is not able to reply to email at the moment. Contact details for MORTALITY are on the dedicated pages.