Care For The Elderly Geriatric Medicine & Abuse Prevention
 

Author: Valerie

Virgin Care

Virgin Care is a private provider of publicly funded community health and social services, and has been commissioned by the National Health Service and Local Authorities in England since 2010 (when it was known as Assura Medical).

The company was known as Assura Medical from March 2010 until March 2012. It originated as a division of Assura Group and a majority share was purchased by Virgin Group in 2010, setting it up as a separate company.

Until October 2012 each GP provider company was 50% owned by the surgery GPs and 50% by Virgin; each GP provider company was run by a board consisting of locally elected GPs and one Virgin representative. 358 surgeries were listed as being involved in mid-2012.

In October 2012 the company announced that it would be taking over all jointly owned GP-provider companies, in order to avoid any conflict of interest arising in respect of contracts with clinical commissioning groups.

Following this change, the company has bid for contracts put out by these clinical commissioning groups, NHS England and local authorities and has contracts stretching for more than a decade to a total potential value of £2bn.

The company claims to never have made a profit overall from its NHS services, and that it has invested its own money into the business, although accounts show that individual parts of the Group with NHS contracts have made profits.

Sir Richard Branson wrote in January 2018:

Over the last 50 years, I have been fortunate to build many successful companies and do not want or intend to profit personally from the NHS. Indeed, I have invested millions in Virgin Care to help it transform its services for the better and to improve both the patient and employee experience.
Contrary to reports, the Virgin Care group has not made a profit to date. If and when I could take a dividend from Virgin Care (which would make us a profit over and above our overall investment), I will invest 100% of that money back into helping NHS patients young and old, with our frontline employees deciding how best to spend it.

In 2012, Virgin Care won a contract to provide services in Dorset, at the Lyme Regis Centre, for five years. When the service was inspected by the regulator in August 2015, the Minor Injuries unit was found “not safe” by the Care Quality Commission because “patients were at risk of harm because systems and processes were not in place to keep them safe”.
Inspectors returned in February 2016 and found improvements, and again in August 2016 when a ‘desk based’ inspection based on information the company provided was deemed sufficient to rate the practice ‘good’ in all areas. The service was eventually rated ‘good’ again by the CQC in October 2018, but inspectors again said it needed to do more and rated it ‘requires improvement’ for services for people with long term conditions. This contract ended in 2019 after a short extension, as the NHS merged it with another local GP practice.

Virgin Care runs the Urgent Care Centre at Croydon University Hospital under a £6 million contract for three years that started from April 2012.

At the start of 2016 the company was said to have nearly 330 NHS contracts. According to the reports, In January 2018, Virgin Care won £1bn worth of NHS contracts in one year.

Virgin Care won a contract to provide community health services in Surrey from 2012 until 2017. This includes the Jarvis Breast Centre in Guildford, which in October 2014 was subject to an investigation by North West Surrey Clinical Commissioning Group after 35 patients were not tested within two weeks of their GP referrals during April and July. In 2017, Surrey’s CCGs split the contract again and procured elements of it separately with Virgin Care being awarded some adult community services in the Surrey Heath CCG and North East Hampshire and Farnham CCG areas as well as continuing to operate Community Dental Services and Wheelchair Services.

In September 2019, the company was awarded an £85m contract to run a joint project with an NHS provider in Surrey.

It won a seven-year prime provider contract to run health services in Bath and North East Somerset in 2016. The company will be running adult social work services, something that has not been done by a commercial organisation in the UK before. 43 social workers were transferred to the company, which employed a “senior social work expert”, one of several to be appointed to provide “professional support”. The service experienced significant IT issues during their first three months of operation which resulted in the cancellation of patient appointments, correspondence not being sent out and problems with updating patient records.

The company will be running adult social work services, something that has not been done by a commercial organisation in the UK before. 43 social workers were transferred to the company, which employed a “senior social work expert”, one of several to be appointed to provide “professional support”. The service experienced significant IT issues during their first three months of operation which resulted in the cancellation of patient appointments, correspondence not being sent out and problems with updating patient records.

The company won a seven-year contract worth £270 million for providing long-term and elderly care for about 38,000 people with long term health conditions in East Staffordshire in March 2015 which was canceled on |2 October 2018 after an 18 months long dispute.

Community services in part of Kent, previously provided by Kent Community Health NHS Foundation Trust were transferred to Virgin Care by Swale CCG and Dartford, Gravesham and Swanley CCG in January 2016 in a contract for £18 million a year for the next seven years from April 2016 with an option to extend by a further three years.

In October 2012, a mother of two children mounted a challenge in the High Court against Devon County Council’s decision to award health and social care contracts to Virgin Care. The court allowed Virgin Care to keep the contract.

In early 2017, Virgin Care began legal proceedings against NHS England, Surrey County Council and the county’s six clinical commissioning groups. They took this action after they failed to procure an £82 million children’s community services contract, a decision which Virgin Care claimed was “not in the best interests of the children and families [they] support”.

The lawsuit was settled out of court with a £328,000 payout to Virgin Care, resulting in some controversy. This included a petition signed by over 100,000 people addressed to Richard Branson and Virgin Care, demanding that they “return the NHS’s money, and never sue the NHS again”, as well as criticism in Parliament from Shadow Health Secretary Jonathon Ashworth, who claimed that the NHS is already “underfunded” without having to make payments to private health companies.

Welfare in Sweden

Social welfare in Sweden is made up of several organizations and systems dealing with welfare. It is mostly funded by taxes, and executed by the public sector on all levels of government as well as private organizations. It can be separated into three parts falling under three different ministries. Social welfare is the responsibility of the Ministry of Health and Social Affairs. Education is the responsibility of the Ministry of Education and Research. The labour market is the responsibility of the Ministry of Employment.

The modern Swedish welfare system was preceded by the poor relief organized by the Church of Sweden. This was formalized in the Beggar Law of 1642,
and became mandatory in the Civil Code of 1734, when each parish was required to have an almshouse.

This system was changed with the Poor Law of 1847, when the first national poor care system separate from the church was organized: a mandatory public poor care relief fund financed by the public was established in each parish (after 1862 municipality), managed by a public Board of directors for poor relief, and the church was no longer directly involved (though the parish vicar were always to be given a place in the board), transforming the poor care from the church to the state. In the reformed Poor Law of 1871, however, the criteria of whom was eligible to receive benefits was severely restricted to include only orphans, the aged and the invalids, and in parallel, the system was complemented by old customs such as rotegang, Child auction and fattigauktion. This system was in place until 1918.

During the 19th century private sick benefit societies were started, and in 1891 these became regulated and subsidized. The Liberal Party government passed the National Pension Act in 1913 to provide security for the aged and in 1934 the private unemployment societies were regulated and subsidized in a way similar to the sick benefit societies.[citation needed]

The Poor Care law of 1918 replaced the law of 1871, transformed the old fashion poor care law to a more humane modern social welfare system and abolished a number of old outdated customs, such as rotegang, Child auction and fattigauktion, and transformed the old poor houses to retirement homes. The final transformation of the old poor care system to a modern social welfare system was the Social Help Law of 1956 (Lagen (1956:2) om socialhjalp)

In 1961 the private sick benefit societies were replaced with county-level public insurance societies who also handled pensions.[citation needed] The independent and mostly union-run unemployment benefit societies has been more centrally regulated and levels are now regulated by the government.

The Ministry of Health and Social Affairs is responsible for welfare. This is defined as financial security in the case of illness, old age and for the family; social services; health care; promotion of health and children’s rights; individual help for persons with disabilities and coordination of the national disability policies..

Sweden’s entire population has equal access to the public health care services. The Swedish health care system is publicly funded and run by the county councils. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities. The health care providers of the public system are generally owned by the county councils, although the managing of the hospitals is often done by private companies after a public tender. During the last decade several county councils have started using a Fee-for-service system for primary health care under the name “VardVal”.

Dental care is not quite as subsidized as other health care, and the dentists decide on their own treatment prices.

Elderly care in Sweden is the responsibility of the local municipalities. There are both retirement homes as well as home care, with home care on the rise.[citation needed]

The Swedish social security is mainly handled by the Swedish Social Insurance Agency and encompasses many separate benefits. The major ones are:

In its 2017, police stated that welfare fraud was prevalent in vulnerable areas, where benefits administered by Swedish Public Employment Service and the Swedish Social Insurance Agency were targeted. Police had identified resident registry figures that had been manipulated: for instance, 2% of all apartments in Rinkeby had between 10 and 30 persons registered as residents, which led to an inflated number of people receiving welfare benefits.

Education is the responsibility of the Ministry of Education and Research. Education responsibilities includes pre-school and child care for school children as well as adult education.

The labour market policies fall under the responsibilities of the Ministry of Employment. The responsibilities considered to be a part of the welfare system includes unemployment benefits, activation benefits, employment services, employment programs, job and development guarantees, starter jobs, and the European Social Fund. Sweden has state-supported union unemployment funds.

General:

Wernicke encephalopathy


Image by/from Images are generated by Life Science Databases(LSDB).

Wernicke encephalopathy (WE), also Wernicke’s encephalopathy is the presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine (vitamin B1). The condition is part of a larger group of thiamine deficiency disorders, that includes beriberi in all its forms, and alcoholic Korsakoff syndrome. When it occurs simultaneously with alcoholic Korsakoff syndrome it is known as Wernicke-Korsakoff syndrome.

Classically, Wernicke encephalopathy is characterised by the triad – ophthalmoplegia, ataxia, and confusion. Around 10% of patients exhibit all three features, and other symptoms may also be present. While it is commonly regarded as a condition peculiar to malnourished people with alcohol misuse, it can be caused by a variety of diseases.
It is treated with thiamine supplementation, which can lead to improvement of the symptoms and often complete resolution, particularly in those where alcohol misuse is not the underlying cause.[citation needed] Often other nutrients also need to be replaced, depending on the cause.

Wernicke encephalopathy may be present in the general population with a prevalence of around 2%, and is considered underdiagnosed; probably, many cases are in patients who do not have commonly-associated symptoms.

The classic triad of symptoms found in Wernicke encephalopathy is:

However, in actuality, only a small percentage of patients experience all three symptoms, and the full triad occurs more frequently among those who have overused alcohol.

Also a much more diverse range of symptoms has been found in patients with this condition, including:

Although hypothermia is usually diagnosed with a body temperature of 35 °C / 95° Fahrenheit, or less, incipient cooling caused by deregulation in the CNS needs to be monitored because it can promote the development of an infection. The patient may report feeling cold, followed by mild chills, cold skin, moderate pallor, tachycardia, hypertension, tremor or piloerection. External warming techniques are advised to prevent hypothermia.

Among the frequently altered functions are the cardio circulatory. There may be tachycardia, dyspnea, chest pain, orthostatic hypotension, changes in heart rate and blood pressure. The lack of thiamine sometimes affects other major energy consumers, the myocardium, and also patients may have developed cardiomegaly. Heart failure with lactic acidosis syndrome has been observed. Cardiac abnormalities are an aspect of the WE, which was not included in the traditional approach, and are not classified as a separate disease.
Infections have been pointed out as one of the most frequent triggers of death in WE. Furthermore, infections are usually present in pediatric cases.

In the last stage others symptoms may occur: hyperthermia, increased muscle tone, spastic paralysis, choreic dyskinesias and coma.

Because of the frequent involvement of heart, eyes and peripheral nervous system, several authors prefer to call it Wernicke disease rather than simply encephalopathy.

Early symptoms are nonspecific, and it has been stated that WE may present nonspecific findings. In Wernicke Korsakoff’s syndrome some single symptoms are present in about one-third.

Depending on the location of the brain lesion different symptoms are more frequent:

Mamillary lesion are characteristic-small petechial hemorrhages are found.

Korsakoff’s syndrome, characterised by memory impairment, confabulation, confusion and personality changes, has a strong and recognised link with WE. A very high percentage of patients with Wernicke-Korsakoff syndrome also have peripheral neuropathy, and many alcoholics have this neuropathy without other neurologic signs or symptoms. Korsakoff´s occurs much more frequently in WE due to chronic alcoholism. It is uncommon among those who do not consume alcohol abusively. Up to 80% of WE patients who abuse alcohol develop Korsakoff’s syndrome. In Korsakoff’s, is usually observed atrophy of the thalamus and the mammillary bodies, and frontal lobe involvement. In a study, half of Wernicke-Korsakoff cases had good recovery from the amnesic state, which may take from 2 months to 10 years.

Wernicke encephalopathy has classically been thought of as a disease solely of alcoholics, but it is also found in the chronically undernourished, and in recent years had been discovered post bariatric surgery. Without being exhaustive, the documented causes of Wernicke encephalopathy have included:

Thiamine deficiency and errors of thiamine metabolism are believed to be the primary cause of Wernicke encephalopathy. Thiamine, also called B1, helps to break down glucose. Specifically, it acts as an essential coenzyme to the TCA cycle and the pentose phosphate shunt. Thiamine is first metabolised to its more active form, thiamine diphosphate (TDP), before it is used. The body only has 2-3 weeks of thiamine reserves, which are readily exhausted without intake, or if depletion occurs rapidly, such as in chronic inflammatory states or in diabetes. Thiamine is involved in:

The primary neurological-related injury caused by thiamine deficiency in WE is three-fold: oxidative damage, mitochondrial injury leading to apoptosis, and directly stimulating a pro-apoptotic pathway. Thiamine deficiency affects both neurons and astrocytes, glial cells of the brain. Thiamine deficiency alters the glutamate uptake of astrocytes, through changes in the expression of astrocytic glutamate transporters EAAT1 and EAAT2, leading to excitotoxicity. Other changes include those to the GABA transporter subtype GAT-3, GFAP, glutamine synthetase, and the Aquaporin 4 channel. Focal lactic acidosis also causes secondary oedema, oxidative stress, inflammation and white matter damage.

Despite its name, WE is not related to Wernicke’s area, a region of the brain associated with speech and language interpretation.

In most, early lesions completely reversed with immediate and adequate supplementation.

Lesions are usually symmetrical in the periventricular region, diencephalon, the midbrain, hypothalamus, and cerebellar vermis. Brainstem lesions may include cranial nerve III, IV, VI and VIII nuclei, the medial thalamic nuclei, and the dorsal nucleus of the vagus nerve. Oedema may be found in the regions surrounding the third ventricle, and fourth ventricle, also appearing petechiae and small hemorrhages. Chronic cases can present the atrophy of the mammillary bodies.

Endothelial proliferation, hyperplasia of capillaries, demyelination and neuronal loss can also occur.

An altered blood-brain barrier may cause a perturbed response to certain drugs and foods.

Diagnosis of Wernicke encephalopathy or disease is made clinically. Caine et al. in 1997 established criteria that Wernicke encephalopathy can be diagnosed in any patient with just two or more of the main symptoms noted above. The sensitivity of the diagnosis by the classic triad was 23% but increased to 85% taking two or more of the four classic features. This criteria is challenged because all the cases he studied were alcoholics.

Some consider it sufficient to suspect the presence of the disease with only one of the principal symptoms. Some British hospital protocols suspect WE with any one of these symptoms: confusion, decreased consciousness level (or unconsciousness, stupor or coma), memory loss, ataxia or unsteadiness, ophthalmoplegia or nystagmus, and unexplained hypotension with hypothermia. The presence of only one sign should be sufficient for treatment.

As a much more diverse range of symptoms has been found frequently in patients it is necessary to search for new diagnostic criteria, however Wernicke encephalopathy remains a clinically-diagnosed condition. Neither the MR, nor serum measurements related to thiamine are sufficient diagnostic markers in all cases. However, as described by Zuccoli et al. in several papers the involvement of the cranial nerve nuclei and central gray matter on MRI, is very specific to WE in the appropriate clinical setting. Non-recovery upon supplementation with thiamine is inconclusive.

The sensitivity of MR was 53% and the specificity was 93%. The reversible cytotoxic edema was considered the most characteristic lesion of WE. The location of the lesions were more frequently atypical among non-alcoholics, while typical contrast enhancement in the thalamus and the mammillary bodies was observed frequently associated with alcohol abuse. These abnormalities may include:

There appears to be very little value for CT scans.

Thiamine can be measured using an erythrocyte transketolase activity assay, or by activation by measurement of in vitro thiamine diphosphate levels. Normal thiamine levels do not necessarily rule out the presence of WE, as this may be a patient with difficulties in intracellular transport.

There are hospital protocols for prevention, supplementing with thiamine in the presence of: history of alcohol misuse or related seizures, requirement for IV glucose, signs of malnutrition, poor diet, recent diarrhea or vomiting, peripheral neuropathy, intercurrent illness, delirium tremens or treatment for DTs, and others. Some experts advise parenteral thiamine should be given to all at-risk patients in the Emergency Department.

In the clinical diagnosis should be remembered that early symptoms are nonspecific, and it has been stated that WE may present nonspecific findings. There is consensus to provide water-soluble vitamins and minerals after gastric operations.

In some countries certain foods have been supplemented with thiamine, and have reduced WE cases. Improvement is difficult to quantify because they applied several different actions. Avoiding or moderating alcohol consumption and having adequate nutrition reduces one of the main risk factors in developing Wernicke-Korsakoff syndrome.

Most symptoms will improve quickly if deficiencies are treated early. Memory disorder may be permanent.

In patients suspected of WE, thiamine treatment should be started immediately. Blood should be immediately taken to test for thiamine, other vitamins and minerals levels. Following this an immediate intravenous or intramuscular dose of thiamine should be administered two or three times daily. Thiamine administration is usually continued until clinical improvement ceases.

Considering the diversity of possible causes and several surprising symptomatologic presentations, and because there is low assumed risk of toxicity of thiamine, because the therapeutic response is often dramatic from the first day, some qualified authors indicate parenteral thiamine if WE is suspected, both as a resource for diagnosis and treatment. The diagnosis is highly supported by the response to parenteral thiamine, but is not sufficient to be excluded by the lack of it. Parenteral thiamine administration is associated with a very small risk of anaphylaxis.

Alcohol abusers may have poor dietary intakes of several vitamins, and impaired thiamine absorption, metabolism, and storage; they may thus require higher doses.

If glucose is given, such as in hypoglycaemic alcoholics, thiamine must be given concurrently. If this is not done, the glucose will rapidly consume the remaining thiamine reserves, exacerbating this condition.

The observation of edema in MR, and also the finding of inflation and macrophages in necropsied tissues, has led to successful administration of antiinflammatories.

Other nutritional abnormalities should also be looked for, as they may be exacerbating the disease. In particular, magnesium, a cofactor of transketolase which may induce or aggravate the disease.

Other supplements may also be needed, including: cobalamin, ascorbic acid, folic acid, nicotinamide, zinc, phosphorus (dicalcium phosphate) and in some cases taurine, especially suitable when there cardiocirculatory impairment.
Patient-guided nutrition is suggested. In patients with Wernicke-Korsakoff syndrome, even higher doses of parenteral thiamine are recommended. Concurrent toxic effects of alcohol should also be considered.

There are no conclusive statistical studies, all figures are based on partial studies, and because of the ethical problems in conducting controlled trials are unlikely to be obtained in the future.

Wernicke’s lesions were observed in 0.8 to 2.8% of the general population autopsies, and 12.5% of alcoholics. This figure increases to 35% of alcoholics if including cerebellar damage due to lack of thiamine.

Most autopsy cases were from alcoholics. Autopsy series were performed in hospitals on the material available which is unlikely to be representative of the entire population. Considering the slight affectations, previous to the generation of observable lesions at necropsy, the percentage should be higher. There is evidence to indicate that Wernicke encephalopathy is underdiagnosed. For example, in one 1986 study, 80% of cases were diagnosed postmortem. Is estimated that only 5-14% of patients with WE are diagnosed in life.

In a series of autopsy studies held in Recife, Brazil, it was found that only 7 out of 36 had had alcoholic habits, and only a small minority had malnutrition. In a reviewed of 53 published case reports from 2001 to 2011, the relationship with alcohol was also about 20% (10 out of 53 cases).

WE is more likely to occur in males than females. Among the minority who are diagnosed, mortality can reach 17%. The main factors triggering death are thought to be infections and liver dysfunctions.

WE was first identified in 1881 by the German neurologist Carl Wernicke, although the link with thiamine was not identified until the 1930s. A similar presentation of this disease was described by the Russian psychiatrist Sergei Korsakoff in a series of articles published 1887-1891.

Winchburgh


Image by/from Richard Webb

Winchburgh is a village in the Council area of West Lothian, Scotland. It is located approximately 10 miles (16 km) west of the city-centre of Edinburgh, 6 miles (9.7 km) east of Linlithgow and 3 miles (4.8 km) northeast of Broxburn.

The 2001 census recorded around 2,000.

There are regular scheduled buses to and from surrounding places including Edinburgh, Linlithgow, Falkirk, South Queensferry and Broxburn.

There are 2 main bus routes in the area.
The first following Route number 38 travels to and from Edinburgh via Winchburgh serving the 3 main areas of Linlithgow, Falkirk and Stirling along with various others in between.
The 2nd is the route 600 which travels to and from Edinburgh airport via Winchburgh serving Broxburn, Livingston and onwards to Whitburn.

Previous routes have included some of the following:
22A which travelled to and from South Queensferry and Livingston via Winchburgh and 651 travelling to Dunfermline from Livingston going via Winchburgh.

The mainline railway between Edinburgh and Glasgow Queen Street goes through the Winchburgh Tunnel, under the village. Until it was closed in 1930, there was a passenger station at the north end of the tunnel. The construction of the Winchburgh Tunnel was supervised by the noted Scottish Civil Engineer, John Gibb. West Lothian Council have been promoting a plan to reopen the station by 2018.

Niddrie Castle Golf Club has an 18-hole, 5914 yards long, par 70 golf course, located in and around the grounds of the historic Niddry Castle. The club was established in 1926.

Winchburgh Bowling Club was established in 1913 by local miners and the clubhouse has a 150-capacity function room for social occasions, such as weddings.

In July 2007, parents from local schools formed a boys’ football, taking the name of the former Winchburgh Albion, which had folded in the 1970s. The club now has a team playing in the West Lothian Association of Youth Football Clubs league, at the Under-14 age level. The club was promoted to the A League in the 2008/09 season, as Runner-Up. Burgoyne finished as the club’s top scorer with 21 goals.

The original Winchburgh Albion FC had produced several senior football players, including Willie Thornton (1920 – 1991), who had a long career with Rangers as player and later, Assistant Manager, after managing Dundee and Partick Thistle. John Gorman is another former Winchburgh Albion FC player. He started his senior career with Celtic, before going on have playing success with Carlisle, Tottenham Hotspur and as a coach with several clubs, including his present role at MK Dons. He was also assistant manager of the England international team, from 1996 to 1999, under the management of Glenn Hoddle.

There is a small number of convenience store sized shops, a pharmacy, a doctor’s surgery, a post office and a Community Centre. Housing ranges from late-19th Century brick built cottages (purpose-built to house miners & their families) to modern social housing in the forms of houses, cottages and flats. There is also sheltered housing for elderly residents, as well as an elderly care home within the village.

The Edinburgh to Falkirk Union Canal passes through Winchburgh. It follows a contour south to Broxburn and eventually Edinburgh. Westwards it goes through Linlithgow, and then Falkirk. The Union Canal was used in the past to transport goods between places situated in and between Edinburgh and Glasgow – there was a connection with the Forth and Clyde Canal at Falkirk. The Bridge 19-40 Canal Society has a base at Winchburgh on the canal, and it operates seasonal boat trips departing from Port Buchan located in neighbouring Broxburn on West Main Street.

The village has two primary schools and a nursery located in Winchburgh. The ‘Holy Family Primary’ school serves Roman Catholic (term) pre-secondary school children, whereas ‘Winchburgh Primary’ is a non-denominational school. Both of these are state run schools, and share the same building (the Holy Family Primary School’s original building was demolished). Secondary School aged children mostly attend schools in neighbouring Linlithgow, Livingston, Queensferry and Broxburn. However, there are proposals to build a high school in Winchburgh to alleviate overcrowding in Linlithgow Academy.

There has been a settlement in Winchburgh for over one thousand years. Early spellings include Wincelburgh (1189); Wynchburghe (1377); from ‘wincel’ and ‘burh’ meaning ‘Town in the nook or angle’. It is possible that it was named after the bend in the Niddry Burn that runs through the village. The early settlement was probably near to Niddry Castle.

After the Battle of Bannockburn in 1314, Sir James Douglas followed King Edward II and the remnants of his army to Winchburgh. Both sides rested at Winchburgh before riding on to Dunbar, where King Edward took ship for England.

Quhill that the king and his menye

To Wenchburg all cummyn ar.
Than lychtyt all that thai war
To bayt thar hors that wer wery,
And Douglas and his cumpany

Baytyt alsua besid thaim ner.

In 1568, Mary, Queen of Scots, escaped from Loch Leven Castle, and was met by Lord Seton, before crossing the Firth of Forth from South Queensferry. Mary stayed at Niddry Castle, Seton’s property in Winchburgh, on 2 May 1568.

In the 19th century, Winchburgh had a thriving oil shale mining industry, the remnants of which are the distinctive red “shale bings”, large hill forms, created by the deposition composed of used shale. The bings support a variety of flora and fauna, such as bushes and heather, rabbits and, occasionally, old deer. The bings are also known locally as “tips”, although it is a generally less common name for them.

On 13 October 1862 on the Edinburgh and Glasgow Railway a mile and a half northwest of Winchburgh was the scene of a head-on rail crash in which 15 people were killed.

In the Ordnance Gazetteer of Scotland (1892-1896), Winchburgh is described:

Winchburgh, a village in Kirkliston Parish, Linlithgowshire, 11¾ miles W of Edinburgh. It has a station on the North British Railway, a Post Office with money order and savings bank departments, an Established mission church (opened 1891) and a public school. Pop. (1881) 115, (1891) 424.

The early 21st century has seen the construction of several new private housing estates on the periphery of the village.

Woodland Park, Columbus, Ohio


Image by/from Krupin.1

Woodland Park is a residential neighborhood located in the Near East Side of Columbus, Ohio that houses approximately 1,500 residents. The neighborhood was previously home to such figures as artist Emerson Burkhart, cartoonist Billy Ireland, and judge William Brooks. Established in the early 20th century, Woodland Park has grown from its planned neighborhood roots into a modest neighborhood that contains various faith communities, schools, sources of entertainment and recreation, and borders an extension of the Ohio State University medical center.

Woodland Park, one of Columbus’ first planned neighborhoods, is named for Woodland Avenue and the Woodland Park Addition. Woodland Park Addition is a subdivision that can be identified as early as 1899. The first homes in the area were built in the mid-1890s. At the center of Woodland Park Addition is Hawthorne Park bounded by Hawthorne Park Road. Development of Woodland Park Addition was limited and located primarily along Long Street and Woodland Ave. An advertisement in the Columbus Dispatch on June 26, 1904 boasted the amenities offered in the neighborhood; “We give you paved streets, cement sidewalks, water, gas, sewerage, electric lights, plenty of fine forest trees and one of the best school districts in the city. Woodland Park Addition has the advantage of three electric car lines by which you can reach High Street in fifteen minutes.”

Throughout the 20th century, owners motivated by racism put restrictions in deeds preventing those of African descent from purchasing homes. However, these restrictions eventually became irrelevant, as wealthy African American professionals and musicians could pay the sellers overwhelming amounts of money for said homes. Wexner Heritage Village can cite its beginnings back to Woodland Park. In an interview conducted by the Columbus Jewish Historical Society, Annette Tanenbaum notes that the Heritage House was located on Woodland Avenue near Long Street. She adds that it was the first facility in Columbus dedicated to taking care of elderly Jewish people. Heritage House was built in 1951. Today the Wexner Heritage Village continues to provide elderly care to people in the Jewish community.

Woodland Park is located within the Near East Side of Columbus, Ohio. It is a centrally located neighborhood and two miles away from Downtown Columbus. It is also under the jurisdiction of the Near East Side Area Commission.

The boundaries of the Woodland Park Addition are Clifton Avenue to the north, Long Street to the south, Woodland Avenue to the east and Parkwood Avenue (formerly Mulberry Street) to the west. Over time, recognized boundaries of the neighborhood expanded, and the modern boundaries are I-670 or Maryland Avenue to the North, Broad Street to the south, the Norfolk and Western Railroad to the east, and Taylor Avenue to the west.

Woodland Park is adjacent to the neighborhoods of Shepard to the north, Franklin Park to the south, Eastgate to the east, and King-Lincoln Bronzeville and Mount Vernon to the west. Portions of Woodland Park also overlap with Eastwood Heights.

Woodland Park includes a stretch of Broad Street that is included in the East Broad Street Historic District. East Broad Street contains multiple structures that were constructed in the early 1900s, with 88% being residential in nature. These structures represent the height of Broad Street’s development.

Other landmarks include the following:

Woodland Park’s southern boundary, Broad Street, is notable because of its history as the National Road. Woodland Park’s eastern boundary, the Norfolk and Southern Railroad, is notable as well. Originally constructed as the Scioto Valley Railroad, and later operated as the Ohio Subdivision of the Norfolk and Southern Railroad. The railroad terminated about a mile and a half, or less, north of Fifth Avenue in the modern day Americrest neighborhood.

The neighborhood once had a streetcar line that connected it with downtown. The streetcar went east-to-west along Long Street, and turned north-to-south to connect Long to Broad Street, and to the north side of Franklin Park. The Streetcar began service prior to 1905 in ceased operations shortly after 1940. Additionally, there are 10 Central Ohio Transit Authority, or COTA, Bus Stops in the Neighborhood with access to the No. 6, the “Sullivant” route, and No. 10, the “East Broad Street” route. Other COTA routes include the No. 16 and No. 81 routes.

Demographically, the primary residents of Woodland Park are African Americans with the second most residents classifying themselves as White. Median household income in Woodland Park is slightly below the median income of Columbus, measuring at $24,568 in 2011. Accordingly, median rent in the neighborhood measured at $456 per month in 2011 also. The median age of men and women in Woodland Park is 35, with an average of 2.1 people per household.

The residential area of Woodland Park can be described as a variety of houses with different architecture styles. It is made up of large homes and mansions, town-homes, bungalows, and apartments. Architecture styles of Woodland Park homes range from Queen Anne, Tudor, Greek Revival, Cape Cod, Colonial Revival and Dutch Colonial styles. Woodland Park is home to a Lustron Home that was built in 1950 at 1818 East Long Street. The home is a Westchester Deluxe model. The Lustron Corporation of Columbus built these prefabricated homes after World War II to meet housing shortages.

Park Towers is a collection of condominiums found at 1620 East Broad Street in the Woodland Park neighborhood. The structure was built in the early 1960s. Park Towers includes office suites on the first floor and 141 private residences available for purchase on the remaining floors. Common areas of the Park Towers building include a lobby, exercise facility, and community garden for residents.

Artist Emerson Burkhart moved to Woodland Park in the mid 20th century and resided at 223 Woodland Avenue until his death in 1969. Annually Burkhart opened his Woodland Avenue home to the public for an open house art show. Thousands of people visited the 22 room home to view the artist’s pieces and his home.

The largely residential neighborhood boasts several churches, including the Saint Phillip Lutheran Church, Ashbury United Methodist Church, United House of Prayer, and the Jerusalem Tabernacle Baptist Church.

The St. Philip Episcopal Church held its first service in 1891 on the corner of Cleveland Avenue and Naughten Street in downtown Columbus, Ohio. In 1962 the church was relocated to Woodland Park at 166 Woodland Ave. The church continues to congregate in Woodland Park.

In addition to serving its community in a religious role, Woodland Christian Church serves the community in a political role. The church’s website claims that it values justice and provides residents such resources as the opportunity to register to vote, election information, and encourages political organization through its Political Action Team.

What is today known as The Mansion Day School was originally a mansion built by William A. Miller in 1904. The structure, known as Miller’s “statement house” has 24 rooms with 15 fireplaces and includes imported Italian tile and mahogany. William A. Miller was the president of the H.C. Godman shoe company, which had four factories in Columbus, Ohio and four factories in Lancaster, Ohio. The H.C. Godman shoe company had up to 3,000 employees at the time of William A. Miller’s death in 1921. William A. Miller’s wife Anna was a philanthropist and opened the third floor of their home to homeless children. In 1934 the structure was purchased by the Glenmont Home for Christian Scientists and turned into a nursing home.

The structure has operated for 2 decades as The Mansion Day School. The elementary school is headed by executive director Dee James and serves students from across greater the greater Columbus, Ohio area, including the cities of Gahanna, Pickerington, and Dublin. The school is unique because it features a competitive application for admittance. Some of the many purposes the school has in its mission statement is its commitment to “Celebrating excellence and cultivating a personal commitment to learning, developing the confidence to lead, compete in, and contribute successfully to a global community, and developing critical and creative thinking skills”

Woodland Park is also home to East High School, a historic public school located at 1500 East Broad Street that is part of Columbus City Schools. Architects Howell and Thomas designed the original school which was built in 1922. East High School was one of five high schools built in accordance with the Smith-Hughes Act whose purpose was to provide federal funding to communities and expand educational opportunities. The school is notable for its connection to the African American population of Columbus and the various famous students that graduated from there, including actor Philip Michael Thomas and athlete and actor Bernie Casey. Today, the school is led by principal Ernest C Wood, Jr. and teaches from the 9th-12th grade. East High School prides itself in offering a college preparatory curriculum and claims that over $3.5 million worth of scholarships were awarded to the graduating class of 2013. Various clubs offered by East High School include a Science, Technology, Engineering, and Mathematics Club, National Honor Society, a poetry slam, and marching band and drill team.

The Franklin Park Conservatory is located just south of Woodland Park, on the south side of Broad Street. The greenhouse, now known as the Palm House, was inspired by the architecture of the Chicago World’s Fair and Columbian Exposition and the City Beautiful movement. Franklin Park Conservatory opened to the public in 1895 and in addition to the greenhouse provided the public with carriage paths, a lake, and a boathouse. The park was run by the Columbus Recreation and Parks Department until 1989 when ownership was transferred to a 10 member board of trustees and executive director

Woodland Park is also home to a branch of the Columbus Metropolitan Library. The “Martin Luther King” branch located on E. Long Street offers programming such as a TedX club, where teenagers can work with students from the Ohio State University to come up with inspirational speeches based on their own life experiences. Other programs include reading workshops to help children develop reading comprehension skills outside of the regular classroom. Daily programs include homework help for children in school and job searching advice for older individuals.

Originally known as the Spring Street YMCA, The Eldon and Elsie Ward YMCA was founded in 1919. It was one of the first YMCAs in the United States that was principally designated to serve a black community. In 1962, the YMCA moved to the Woodland Avenue location where it presently sits and was renamed the East Side YMCA. In 1997 it again underwent a name change and was named the Eldon and Elsie Ward YMCA to honor their lifelong support of the Columbus community. Eldon Ward was most well known as the head of the E.E. Ward Moving and Transit Company, but he was also a Sunday school teacher and leader in the community. Today, the YMCA named after the late couple offers community members recreational classes as well as facilities such as a gymnasium and a pool. The YMCA of Central Ohio cites part of its key tenants as “youth development, healthy living, and social responsibility”.

Woodland Christian Church is one of many churches found in the Woodland Park neighborhood

East High School

The entryway to the Franklin Park Conservatory from Broad Street

Ohio State University has a branch hospital that immediately borders the Woodland Park neighborhood

Workers’ Party (Sweden)

The Workers’ Party (Arbetarpartiet) is a Socialist political party in Sweden. It was founded in 2010, when almost the entire Vasterbotten County section of the Socialist Justice Party (RS) broke off ahead of the 2010 general election. It adopted the name Rattvisepartiet Socialisterna enhetslista for jobb – mot nedskarningar (Socialist Justice Party Unity list for jobs – against cutbacks) for its party list. In early 2011, it was renamed the Workers’ Party. It currently holds two seats in the municipal assembly of Umea (since 2014). The Workers’ Party publishes the New Workers’ Journal (Nya Arbetartidningen).

The party labels itself democratic socialist. The goal is to participate in building a new workers’ party that struggles for democratic control over the financial institutions and corporations that direct the economy.

Party members have a history of conducting policies that benefit workers employed in public services such as healthcare and elderly care. Elderly care workers and party members cooperated in organising four waves of warning strikes against cutbacks in 2000, 2001 and 2005.

Since the 2010 elections, a regular part in the party’s policies has been to push for the need for investment in green industrial production.

Yiya Murano

Previously, we talked about a public servant called Ylva Johansson, who performed several roles in the Swedish government, including one relating to elderly care and improved quality of life in the aging population.

Today it’s almost the opposite – a murderer who ended up depending upon elderly care services and support. As a near polar opposite, comparison of the two stories demonstrates how two individuals can offer such a different contribution to society, yet end up being linked.

Here’s what Wikipedia has to say, with a little commentary of our own included.


Maria de las Mercedes Bernardina Bolla Aponte de Murano (20 May 1930 – 26 April 2014), better known as Yiya Murano, and also referred to as the Poisoner of Monserrat was an Argentinian serial killer and swindler. Convicted of three murders, she was imprisoned for 16 years before being sent to an elderly care facility to serve out the remainder of her sentence, due to her advanced age.

That obviously blows out of the water the stereotype of offenders being young down and out criminals.

Nilda Gamba, a neighbor of Murano’s died on 10 February 1979. On 19 February, Murano’s friend, Leila Chicha Formisano de Ayala, died. Murano owed money to both women, and both bodies showed signs of cyanide poisoning.

It’s hardly a crime of the moment, such attacks would need a huge degree of planning to execute. It’s clearly an act in cold blood.

On 24 March 1979, Murano’s cousin, Carmen Zulema del Giorgio de Venturini, fell and died on the stairs of a building on Hipolito Yrigoyen Street, where she lived. Zulema’s death was initially attributed to cardiac arrest. Zulema’s daughter found that a promissory note worth 20 million Argentine peso ley was missing from her mother’s belongings. The building’s doorman said that Murano arrived for a visit carrying a mysterious package (which was later discovered to contain masas finas), and had casually asked for a copy of the keys to Zulema’s apartment keys, saying, “I need her notebook to warn her relatives”. Murano entered her cousin’s apartment and left quickly, carrying papers and a jar. She complained loudly: “My God, it’s my third friend to die in a short time!” During the autopsy, examiners discovered cyanide in Zulema’s body. Investigators discovered the poison in the jar mentioned by the doorman, and in the masas finas.

It’s rather brazen to announce the passing of three friends as such a coincidence, perhaps a glimpse of the nature of the individual’s state of mind.

On 27 April 1979, the police arrested Murano at her home on Mexico Street. In 1980, she was found unconscious in the prison where she was being held; later, they removed one of Murano’s lungs.

Murano was convicted in 1985, during the Trial of the Juntas. She insisted upon her innocence, saying: “I never invited anyone to eat.”

Murano was released from prison after 16 years. It was learned that she sent the judges who released her a box of chocolates as a token of her appreciation.

I suspect the recipient of that gift would not be inclined to consume those chocolates, given the past crimes.

Argentinian writer Marisa Grinstein included Murano in her book Mujeres Asesinas (Killer Women). In 2006, an episode of the Canal 13 television series of the same name featured a recreation of Murano’s crimes. At the end of the episode, the real Yiya Murano appeared and proclaimed her innocence, citing evidence.

The second season of Mujeres Asesinas, the Mexican adaptation of the series, featured an episode based on Murano entitled “Tita Garza, Swindler,” starring Patricia Reyes Spindola.

Ylva Johansson


Image by/from Frankie Fouganthin

Most governments around the world have politicians to represent the elderly.

It may be that these responsibilities form part of a wider role, however some nations are better than others at allocating time and resources to the elderly, especially when it comes to addressing specific needs for support.

One great example of a politician taking on a role of this nature is Ylva Johansson of Sweden. Let’s look a little closer at her achievements.


Ylva Julia Margareta Johansson (born 13 February 1964) is a Swedish politician who served as Minister for Employment in the Swedish Government from 2014 to 2019. She previously served as Minister for Schools from 1994 to 1998 and as Minister for Welfare and Elderly Healthcare from 2004 to 2006. She has been a member of the Swedish Riksdag since 2006.

In addition to public service in politics, Ylva has led a career dedicated to helping other, particularly in the field of teaching.

Ylva Johansson studied at Lund University and the Stockholm Institute of Education 1983-88 and 1991-92 and holds a Master of Science in education. Upon graduating, she worked as math, physics and chemistry teacher.

In the 1988 general elections Johansson was elected as a member of the Riksdag for the Left Party – Communists (VPK). She later left the party and joined the Social Democrats.

From 1992 to 1994 Johansson worked as a teacher, until Prime Minister Ingvar Carlsson made her Minister for Schools in his government. In 1998, she and the then Minister for Finance Erik Asbrink announced their wish to “publicly confirm that we are in love” and their intention to separate from their respective partners. Soon afterwards, Johansson left the government. The following years, she worked in the private sector.

In 2004, Prime Minister Goran Persson appointed Ylva Johansson to the government in a new position, as Minister for Health and Elderly Care, succeeding Lars Engqvist.

This was the period where she was known for her dedication to support and resolve the issue facing the more elderly members of the Swedish population.

From 2014, she served as Minister for Employment in the government of Prime Minister Stefan Lofven. During her time in office, she worked to tighten labor immigration laws.

In the 2013 Social Democrat party congress, the goal was set that Sweden should have the lowest rate of unemployment in the EU. While the Social Democrats and Green Party were in power, unemployment decreased more in other EU countries than Sweden and by 2019, Sweden’s place in the unemployment ranking slipped to 18 with an unemployment rate of 6.2%, where the first spot was occupied by Czech Republic at 1.7%.

Following the 2019 European elections, Lofven nominated Johansson as Sweden’s candidate for the post of European Commissioner.

During a question & answer session in October 2019 in the European Parliament, Johansson was asked on whether Swedish policy on gang crime and migration would be exported to the EU level. Johansson responded that she was “proud that Sweden received so many refugees”. Due to Johansson’s vague answers on her ideas about an EU asylum and migration policy would be handled in practical terms. Instead of being approved she was asked to return with answers to the questions left unanswered in the session.

Johansson has been described as the “left wing of the Social Democrats.”

In March 2018, Johansson appeared on the BBC, where she claimed that the number of reported rapes and sexual harassment cases in Sweden “is going down and going down and going down.” Johansson later apologized and admitted that the opposite is true.

Johansson has two children with her former husband Bo Hammar and a son with Erik Asbrink. She an honorary member of Hammarby football club.

Young carer


Image by/from Produnis

Many of the world’s elderly are cared for by members of their family, friends or other good Samaritans. Inevitably, that means that carers are often unpaid, and almost always younger than the person they look after.

Let’s find out a little more about young carers, with some discussion from Wikipedia with our commentary below.


A young carer is a young person who cares, unpaid, for a person who has any type of physical or mental illness, physical and/or mental disability or misuses substances such as alcohol or drugs. The age of a young carer is different between countries. In Australia a young carer is a person under the age of 25 years old.

While Australia defines a young carer as someone responsible up to the age of twenty five, other countries have no such definition. In other countries, such as the UK, the term is used for those offering help up to the age of 18, so generally refers to children looking after parents.

The roles taken on by a young carer are exhaustive and are carried out often behind closed doors on top of the normal pressures of a young persons life. The care they give may be practical, physical, and emotional. Responsibilities may range from providing practical support such as helping to cook, clean or wash, giving personal care, emotional support, providing medication or helping with financial chores.

The person they care for may be a parent, a partner, their own child, a sibling, another family member, a friend or someone who does not necessarily live in the same house as them.

When carers are of school age, especially those looking after parents, it will inevitably impact on their education. In countries where schooling is commonplace, this will typically mean days absent, with a significant proportion of lessons missed.

There are support programs to assist young carers both emotionally and financially with day-to-day tasks and making decisions. These programs offer face-to-face counselling, online programs, and phone helplines.

There are estimated to be around 272,000 young carers in Australia. Each Australian state and territory has a carer association that assists unpaid young carers and can be reached on 1800 242 636. The Young Carers Network is a national website that provides young carers with information on their local support services, helpful resources and a platform to share their story and opinions.

Again, while Australia is well documented, the problems associated with young carers apply around the globe, with the same issues cropping up time and time again.

There are estimated to be around 700,000 young carers in the UK which is approximately 1 in every 12 teenagers and around 2 in every classroom. Some support programmes for young carers have been cut due to austerity. The amount of support young carers get varies from area to area and is subject to a postcode lottery.

The issue in the UK is becoming more recognised, with awareness efforts appearing in places including doctors surgeries and libraries to advise those affected how to seek additional help and support.