Felicity Kendal explores not just Shakespeare in India, but her own family story

No sooner has presenter Francesco da Mosta finished touring Italy with his version of Shakespeare (for those of you who missed Da Mosta’s BBC2 series, the bard was a secret visitor to Francesco’s native land and its swoopingly romantic people taught him everything he knew about “the arrrrt of loffff”. In return, he laid some of his scenes in Verona and gave a four-century boost to tourism), than up pops the almost-as-fruitily-voiced Felicity Kendal she always sounds to me like oranges being agonisingly squeezed to take us travelling round India to examine his influence there.

Felicity Kendal’s Indian Shakespeare Quest (BBC2) traced the arrival of the plays in India via East India shipping expats and their amdram societies in the 1780s, their spread through the English-style education imposed by colonial rule, and their absorption into the native culture when, post-partition, the people were free to play with and parse this enforced but ultimately precious gift as they saw fit.

Kendal was born in England but grew up in India where her parents had founded the theatre company Shakespeareana, dedicated to bringing his plays to the masses. Her own and her parents’ stories were woven neatly into the larger narrative. For once, the celebrity presenter without which under modern commissioning rules a programme cannot be greenlit seemed sensible, even occasionally helpful and illuminating, rather than madly grafted on 20 minutes before delivery deadline.

The best thing on television last year returned last night 24 Hours in A&E (Channel 4). It is a miracle of form and content. The latter comes from King’s College Hospital in London. Each episode looks at a selection of patients dealt with by the accident and emergency department staff in a single 24-hour period. The form is exquisite. As with the first series, small accidents mingle with great traumas, talking heads fill in the back story as flesh is stitched, scans are ordered, wounds are cleaned, tempers calmed, tears dried, and lives are lost and saved.

Octogenarian Bill comes in with dicky knees, accompanied by his friend John. Their friendship, it emerges as they joke about football and bicker gently over who is to pay the cab fare home, has kept John going since his wife died last year. Kevin, who has fallen eight feet from some scaffolding and Sarah, a cyclist who swerved to avoid a pedestrian, come in with terrible injuries and are not expected to survive. They do and, in all important respects it seems, intact.

The amount of editing and the skill involved to give it such perfect shape and pace it confers a sense of the urgency infusing everything, but never leaves you breathless, or the participants without enough time or space to maintain their dignity gives me the feeling of exhausted wonderment I used to get as a child when I thought of all the drawing making my favourite cartoons must have required. And the same gratitude that someone, somewhere had gone to all that trouble to make something really, really good.

But naturally karmic balance to the television schedules must be restored and Channel 4 stepped unhesitatingly into the breach with the festival of stupidity that was Secret Eaters. It was the first episode of a new series that tries to unravel to a different set of fat people each week the hitherto unknowable mystery of why they are fat.

The fat people allow their houses to be filled with cameras for a week and are covertly shadowed by private investigators whenever they go elsewhere so that clues may be gathered. In last night’s opening effort, a brother and sister pairing Gill and Stuart, both in their late 30s, were baffled by their weight gain over the last few years when she eats nothing but salad and fairy dust and he lives on asparagus tips and mountain dew. What, I think you will agree, a puzzlement.

At the end, the week’s footage is played back to them. They gasp in amazement as it is revealed to be mostly of chips and mayonnaise disappearing down eager gullets, sausages being pushed into mouths like logs into a sawmill, of mountain dew cunningly turning into pints of lager and of the fairies replacing their dust with sambuca shots and cheese. The mystery is solved, though you could be forgiven for feeling that the whole thing raises slightly more questions than it answers. Like, is there any limit to the depths that human denial can plumb? Or to the lengths that television commissioners will go to find fodder for their exercises in schadenfreude? Or to the appetite we the audience have for it? It’s all very unappetising indeed.

TelevisionWilliam ShakespeareHealth & wellbeingLucy Manganguardian.co.uk

Tesco, Aldi, Caffe Nero and Greggs criticised by Which? for failing to print ‘traffic-light labelling’ on the front of packs

Inconsistent and confusing labels on best-selling sandwiches on the high street are making it difficult for shoppers to make meaningful comparisons and choose the healthiest options, a consumer group has warned.

Retailers such as Tesco, Aldi, Caffe Nero and Greggs are criticised by Which? for failing to print so-called ‘traffic light labelling’ on the front of packs which claims that portion sizes and nutritional content vary so much that consumers could be eating three times as much fat and double the amount of salt as the same sandwich bought elsewhere.

Which? researchers looked at the calorie, fat, saturated fat and salt content of three of the most popular pre-prepared sandwiches chicken salad, egg mayonnaise and bacon, lettuce and tomato (BLT) on sale at supermarkets and coffee chains.

But they found that fat and salt content varied widely while inconsistent labelling across stores meant that healthier sandwich options were not always obvious. The traffic light labelling system uses a colour-coded wheel of red, amber and green symbols to indicate levels of salt, fat and other nutrients but is not compulsory in the UK. Six out of the 15 retailers it compared include the traffic light system, but the rest do not.

Of the inconsistencies singled out by Which? are a Morrisons chicken salad sandwich contains 11.7g fat (amber/medium) compared with one from Waitrose which contains 6.0g fat (green/low). Waitrose uses traffic lights, whereas Morrisons doesn’t. A Lidl BLT has 3.36g salt (red/high) but one from Boots has 1.5g salt (amber/medium). Again, Boots uses traffic lights while Lidl doesn’t. And an Aldi egg mayonnaise sandwich contains 22.3g fat (red/high) and one from Asda contains 10.1g (amber/medium). Asda uses traffic lights, Aldi doesn’t.

This week, the government’s Food Standards Agency (FSA) launched a consultation on nutrition labelling in Northern Ireland and Scotland.

Which? executive director Richard Lloyd said: “With obesity levels reaching epidemic proportions, it’s more important than ever that consumers know exactly what they’re eating. Many retailers are already using traffic-light labelling, but the rest need to catch up and do what works best for consumers. We want to see the government insist that all food companies use traffic lights on their labels, so there’s a clear, consistent system that makes it easier for people to make informed choices about what they eat.”

A spokesperson for the FSA said: “New EU regulations on food labelling were introduced at the end of last year that require manufacturers and retailers to make many changes to their food labels. While providing front-of-pack information is voluntary under the regulations, every company that does so has to provide information about calories alone, or calories plus the amount of fats, saturated fat, sugars and salt.”

A spokesperson for Aldi said: “There is currently a debate about which system of food labelling is best for consumers. We offer our customers the opportunity to make an informed choice by providing Guideline Daily Amount (GDA) labelling as we currently feel that this is the best way of keeping our customers informed. We will continue to review the situation as we approach the implementation of the food information regulation in 2014. As a responsible business, we will continue our work to reduce salt and saturated fats in our food.”

ObesitySandwichesFood & drinkHealthHealth & wellbeingRebecca Smithersguardian.co.uk

Sick days are on the decline and it has been suggested that recent falls are linked to the recession. Tell us your experiences

Good news for UK employers: employees are calling in sick less often. The Office of National Statistics reports that the average worker now takes just 4.5 days because of illness or injury, compared with 7.2 in 1993. A total of 131m work days were lost in 2011, down 6m on the year before. Londoners are least likely to take time off (1.3% of total working hours), whereas employees in Wales and north east England called in sick at the rate of 2.5% of total working hours.

Tell us how often you called in sick last year and whether you noticed any difference in your colleagues’ behaviour. Do you agree with the Work Foundation and the Chartered Institute of Personnel and Development, who say that “presenteeism” rises in recessions because employees worry that they’ll be first in line for redundancy if they take time off.

Follow Comment is free on Twitter @commentisfree

Work & careersHealth & wellbeingHealthguardian.co.uk

Mothers to receive one-to-one care during labour and birth as part of government plans to tackle postnatal depression

Mothers will receive one-to-one care from a named midwife during labour and birth as part of government plans to combat postnatal depression.

Women who have a miscarriage or stillbirth and parents who are forced to cope with the death of a baby will also be offered increased support from the NHS.

Under the plans, health workers will be given enhanced training so they can spot the early signs of postnatal depression.

The move was welcomed by the Royal College of Midwives (RCM) and parenting forums. Cathy Warwick, chief executive of the RCM, said the pledges were “very good news” for women and midwives.

“These are positive plans from the government targeting areas of maternity care that are under prioritised and under-resourced,” she said.

“The impact of a miscarriage or a stillbirth can be devastating for the woman and her family and postnatal depression can be a crippling and sometimes fatal illness. Early detection and treatment is crucial.

“It is also excellent to see an intention to ensure that long-standing NHS commitments, such as one-to-one care in labour and choice about where and how women give birth, become a reality for all women.”

According to the RCM, 5,000 more midwives would be needed to deliver the care proposed.

Justine Roberts, co-founder of Mumsnet, welcomed the renewed support but said a sustained effort was needed to ensure mothers benefit from the changes.

“Sadly there are many experiences shared on Mumsnet of women not getting the best care when they need it,” she said.

“The announcement that services provided during miscarriage are to be monitored is a real advance towards identifying best and worst practice and therefore towards improving the care received.”

Sally Russell, co-founder of Netmums, also welcomed plans to address postnatal depression – a common condition that is often kept hidden.

“Most mums and dads find it difficult to admit they are suffering and yet it can be a blight on their lives,” she said. “Having better support from local services could make a big difference and we’re delighted that the government has identified this as a priority.”

Alongside beefed-up training for health visitors – who provide services for expectant and new parents after birth – the government has pledged to improve maternity care by ensuring women have one named midwife to oversee their care during pregnancy and after they have their baby, making sure every women has one-to-one midwife care and giving parents-to-be the choice over where and how they give birth.

The NHS will also be judged on how well it looks after parents who have miscarried, suffered a stillbirth or cot death, with patients asked to rate their care.

According to the Royal College of Psychiatrists, 10-15% of women suffer from postnatal depression.

Several celebrities, including actor Gwyneth Paltrow, have spoken of their experience of the condition, which usually starts within a few months of birth. Around one in three women experience symptoms in pregnancy, which then continue. Treatment options depend on the severity of the depression, but include medication and counselling.

The health secretary, Andrew Lansley, said: “We have listened to the concerns of women about their experiences of maternity care, which is why we are putting in place a ‘named midwife’ policy to ensure consistency of care.

“Not least, we will focus on the quality of care given to mothers-to-be and measure women’s experience of their maternity care for the first time.”

NHSHealthChildbirthHealth & wellbeingguardian.co.uk

The downside to having a good memory

A genetic variant associated with an enhanced capacity for emotional memories is also linked to increased susceptibility to post-traumatic stress disorder (PTSD), according to new research published yesterday in Proceedings of the National Academy of Sciences.

The study, led by Dominique de Quervain of the University of Basel, used a combination of behavioural genetics and functional neuroimaging, and was carried out in three phases, two involving healthy European volunteers and the third involving Rwandan refugees who fled the 1994 civil war. I describe the work in more detail in this news story for Nature.

It’s widely believed that memories are formed by the strengthening of connections within distributed networks of neurons. This process involves the orchestrated activity of dozens of proteins the neurotransmitter receptors embedded in the nerve cell membranes, and their “effectors,” the components of the biochemical signalling pathways inside the cells that are activated by the receptors. These molecules work together to make the signalling between neurons more efficient, so that synapses are strengthened.

The gene in question here, called PRKCA encodes an enzyme called protein kinase C-á (PKCá), and contributes to these processes by chemically modifying the receptors and their effectors. It does so by catalysing a reaction called phosphorylation, in which a phosphate group a small organic compound consisting of one phosphorous and four oxygen atoms is added to specific sites on the target protein. This enhances the activity of the protein, but the reaction is reversible the phosphate group can be removed by another enzyme, called a phosphatase, which has the opposite effect on the function of the target protein.

In 2007, de Quervain and his colleagues reported that variations in the gene encoding the á2B-adrenoreceptor are related to emotional memories, and that the variants are associated with differences in susceptibility to stress but not with an increased risk of PTSD.

In their latest study, the researchers found that a variant of the PRKCA gene is associated with an enhanced capacity for emotional memories in a large group of healthy Swiss volunteers. In phase two, they showed that the same variant is also linked to differences in brain activity during memory encoding. Finally, they examined the DNA of a large group of Rwandan refugees, all of whom had experienced multiple traumatic events during the civil war, and found that those carrying the variant were twice as likely to suffer from PTSD than those who don’t.

The variant is referred to as the A allele, because it contains an adenine residue at a specific position in the DNA sequence. The G allele, by contrast, has a guanine residue at the same position, but was not linked to enhanced memory. Intriguingly, the effect of the A allele on memory was dose-dependent it was, in other words, influenced by the number of copies of the A allele that an individual carries. People with two copies of the A allele performed best on the memory test, and those carrying two copies of the G allele performed worst. The performance of people carrying one copy of each was somewhere in between.

It’s almost certain that these variants encode slightly different versions of the PKCá that function differently from one another. The A allele may, for example, encode a version that is more active than the one encoded by the G allele, and this is something that can easily be tested. Exactly how this would lead to increased activity in the brain networks encoding emotional memories is, however, a more difficult question to answer, but this will probably be addressed in future work.

“This is an elegant study that uses multiple measures to validate the genetic findings with fMRI and behavior, and replicates the observations in a traumatized group,” says neuropsychiatrist Rachel Yehuda, director of the Traumatic Stress Studies Division at Mount Sinai School of Medicine in New York. She urges caution, however, about how the findings could translate in the clinic.

“Most of the time, the distress of PTSD is caused by avoidance of traumatic memories, or the inability to remember key aspects of the trauma,” she says, “so while it is important to gain as much understanding as possible of the biological basis of PTSD, we have to be careful to not misinterpret the findings to suggest that treatment involves tampering with or obliterating memory.”

Reference: de Quervain, D. J. -F., et al. PKCá is genetically linked to memory capacity in healthy subjects and to risk for posttraumatic stress disorder in genocide survivors. PNAS, DOI: 10.1073/pnas.1200857109 [PDF]

NeurosciencePost-traumatic stress disorderMental healthHealthHealth & wellbeingMo Costandiguardian.co.uk