The president must come up with a deal involving significant sanctions relief by the end of the year pro-democracy campaigners in Hong Kong are hoping to attract huge crowds later for a March through the main island for the 1st time since August police have given permission for a rally by the civil human rights front after 6 months of sometimes violent demonstrations Hong Kong has been relatively calm since pro-democracy candidates won a landslide victory in the local council elections 2 weeks ago the city or thirties who were backed by Beijing have appealed for people to express their views peacefully gunman have killed 2 members of a Brazilian Indigenous community in the northern state of. The victims are from the Khwaja Jara ethnic group which would set up armed patrols to prevent illegal logging the road where the attack took place has now been blocked by protesters Brazil's justice minister has condemned the shooting and sent special federal police to the area this is the world news from the b.b.c. The International Monetary Fund has reached a provisional deal to support Ukraine with a 5 and a half $1000000000.00 loan the i.m.f. Said President Volodymyr Selenski is government had made impressive progress in the past few months in advancing reform in October Ukraine reintroduced an anti-corruption law which had been scrapped months before Mr Lenz Zelinsky was elected president in April. The British bought Anthony Joshua has become one of only a handful of fighters including Muhammad Ali to regain their world heavyweight titles after defeat 6 months after being humiliated by the Mexican American Andy Ruiz Jr in New York Joshua outbox stand up to last his opponent to win a unanimous points verdict in a rematch in Saudi Arabia his promoter Eddie Hearn lavished the champion with praise it was an absolute master class it was a shout out a way of boxing in the people didn't believe they could and you know what it's all insults about that would be saying I put a strategy together and the discipline was incredible thousands of people around the world are spending Saturday night sleeping outdoors as part of a charity event to raise money to tackle homelessness organizers of the world's big sleep out say 52 cities are participating our reporter Gigi is going to join those taking part in London's Trafalgar Square rain didn't put off the nearly 2000 people who were the sleeping bags and pieces of cardboard had taken over one of London's most famous landmarks as their bed for the 90 some cities had celebrities like Will Smith Seth Green and Dame Helen Mirren read bedtime stories to those taking part from fees in conditions in Chicago to a heat wave embraced the $60000.00 people braved all weather conditions to come together and sleep off this weekend's event will fund 100 charities with the aim to help more than a 1000000 people around the world b.b.c. News. You're listening to the newsroom from the b.b.c. World Service with me Alex Ritson on Friday a Saudi Air Force officer killed 3 people and injured and 8 at a u.s. Naval base in the state of Florida before he was shot dead by police shortly after the attack Saudi Arabia's King Solomon expressed his sorrow to the u.s. And said the gunman shooter did not represent Saudi Arabia now the f.b.i. Is asking for help from the public because they tried to retrace the movements of Lieutenant Mohammed Saeed Ronnie in the days before he carried out the deadly shooting the newsroom's piece to go off in what we know about Ronnie so far he was a young man just 21 years old and he was already a 2nd lieutenant in the Saudi Air Force and he'd been on training assignments in the u.s. For the past year and just 3 days before the shooting he reported to this naval base in Pensacola Florida for a program that was supposed to build stronger relations with America's allies and u.s. Officials have said that just hours before he launched this attack he was allegedly posting anti American messages on Twitter in one he accused the u.s. Of committing crimes against Muslims and humanity as a whole he also posted a quote by Osama bin Laden the founder of al Qaeda and earlier in the week when he was having dinner with other Saudi officers he allegedly started playing videos of mass shootings now the f.b.i. Has been questioning other Saudi officers who were on the program with him including 3 who according to The Washington Post newspaper were seen filming the attack and Mark Asper the u.s. Secretary of defense has said he's asked for a review of the vetting process for foreign military personnel arriving in the u.s. Anybody that comes to United States to train is or should be is vetted by the Department of State the Department Homeland Security and ultimately us so we need to relook all that but again I think what we need to do is make sure we understand the what's and why's and how's of this and not jump to any conclusions so that's the u.s. Defense secretary Mark Yes but do we. No anything off the shoes is motivation Well what Mark esper and other officials have been trying to stress is that they are not ready to definitively say that this was a terrorist attack and they don't want to make any guesses about the motivation until more information has come in now so far officials have said there's no obvious connection between me and a terrorist group this is actually the 2nd shooting at a u.s. Naval base this week on Wednesday an American sailor killed 2 people at Pearl Harbor in Hawaii before trying to kill himself and in that case the u.s. Media has reported that the shooter had been unhappy with his superior officers so you can see that there are multiple issues that can underlie these attacks now Secretary of State Asper has tried to emphasize that the investigation into the Florida shooting is still ongoing we need to let the investigators the f.b.i. Do its work and tell us give us the facts and we'll move from there in the meantime we have taken precautions yesterday I directed that we look at our security precautions across the services in all of our installations and bases and facilities to make sure that we're at the appropriate degree of security in case of the investigation continues meanwhile what do we know about the victims very little so far has been said by officials about the victims but one of them was identified by his brother in a Facebook post to his name was Joshua Watson he was a recent graduate of the Naval Academy in the u.s. And he apparently dreamed of being a fighter pilot now on Saturday there was a vigil for all of the victims of the shooting so while the f.b.i. Is working to learn more about the man who carried out the attack there are a number of people paying tribute to the victims. Peter coffin after more than 6 months of protests Hong Kong's pro-democracy movement is still going strong and activists have said a demonstration due to take place in the Territory later could be one of the biggest yet the B.B.C.'s Laura Becker reports from Hong Kong millions of people have taken to the streets over the past 6 months in protests that began after the government tried to push through and abandoned extradition bill the movement has never falls into a campaign for greater democracy fueled by concerns that China is encroaching on the civil liberties promised when Hong Kong was returned to Chinese rail in 1907 the city has been relatively calm since pro-democracy candidates won a landslide victory in local council elections 2 weeks ago organizers of today's rally the civil human rights front have said this is the government's last chance to meet their demands which include an independent inquiry into the police handling of the protests and amnesty for those arrested and free elections and $6000.00 people have been arrested and hundreds injured including the police since June Laura Becker in Hong Kong the British boxer Antony Joshua became a 2 time world heavyweight champion on Saturday night with a unanimous points victory over and dearest Jr in a tense rematch in Saudi Arabia 6 months ago stunned the boxing world by defeating Joshua in New York but the Mexican American never looked close to pulling off a repeat victory correspondent and he added Dorian watched the fight in Riyadh. So before the parts that he had worked a lot on his technical ability a lot of sparred since that. And less time in the weights room and he was very light on his feet it's up to the right game plan stayed out of trouble just kept at long range and technically in the box in terms they call it a boxing clinic he completely. Right from the doubt then get close enough to turn it into a slugfest which was a mistake you made. I'm around and there will be some people who criticize it and say maybe it was a bit safety 1st but look it was facing the guy who put him down 4 times in the last fight a guy who stopped him his mission was to win the belt and go home with it and as far as I'm cheating and he just was concerned that's mission accomplished and what does this mean for Anthony Joshua what he didn't get his career back on track for a stance it was him but other leads groups of 5 just like Mohammed Ali that it's the us Evander Holyfield's who won the heavyweights hisor more than one occasion it's your time heavyweight champion now and more importantly it really does save his career because defeats would have put him in a very bad place through defeats in a row in this era it's been a very very hard for him to get that sort of get in such a position to challenge for the sides of again what's the significance of this fight I mean held in Saudi Arabia Yes it was the 1st time a fight of this magnitude was has been held in the Middle East obviously as you know it resulted in a lot of criticism of human rights organizations saying this is an attempt by Saudi Arabia sports watch to use sports as a way of promoting the country following you know accusations of human rights abuse the professor at the hand made no mistake about it and said that you know parts of the reason why they came here was financial Saudi authorities offered a big sign see the 3 men who paid a very handsomely their reports eventually Joshua and between $50.00 and $70000000.00 for this finds out on the Ruiz were close to $15.00 to $20000000.00 for this fight so it had the permits it was very open about that and said you know money played a big part of it but it was also quick to point out the fact that it wasn't the 1st major heavyweight fight to happen in the venue deems controversial remember George Foreman in Zaire back in the seventy's and just crazy in the city and in the jungle Exactly and then you know and the country was run by sake of what it's armistice we have as a dictator and when he for Joe Frazer in the Philippines their regime on their president Mark was also questionable So Eddie had in the sense of bringing the fight here said he is wrong to criticize the 3 boxes. When you consider as well that's other major sports of come here formally been. Wrestling it's been later on this month there's going to be a tennis events and then the question of events in the venue which has the fights so Eddie Hamm was quick to point out that it was wrong to point the finger criticizes boxes when there isn't a blanket sporting ban on the country Addie added go in in Riyadh and after the fight Antony Joshua paid tribute to his defeated a pennant He's very humble aside in the ring most people Humberside injuring they're definitely a friend inside the ring because I don't feel a need to build up a false sense of an ego to prove that. There's something that they're not he has his countrymen behind him not just people who support you when you're winning the people who support him because they have the same blood as him and that is like a real type of energy that can be denied and you know she was speaking at the post fight news conference in Saudi Arabia well and New York she was parents from Nigeria and founds who had gathered in Lagos to watch the fight were full of praise for his performance. Just how she supports him is not just that there is also a result from ages making also proud. That is British This is Nigeria. Our correspondent my knee Jens joined crowds now people were very excited about the fights coming up to it there was a bit of a pretension because of the results the last time many people worried that Joshua might lose against Ruiz again but in the end people very happy very exotic scenes we went to a sports bar in the area of Lekki which is a suburb of Lagos and hundreds of people had piled into this rooftop bar or to fight on giant screens and the moments with declared the winner the place absolutely erupted it was music hugging dancing so I think overall the Germans are very proud of Joshua's achievement What does Anthony Joshua mean to people in Nigeria you know Anthony Joshua is an interesting figure because he's obviously British but his parents an 8 year eons and the Germans have a very strong sense of identity they're very proud of their descendants both at home and in the diaspora So I think because in recent years he's made efforts to come back here he describes himself as a Nigerian he's associated with the country there's a sense of pride but it was interesting there was a conversation in a couple of the balls he went to tonight people were saying they were surprised that he didn't play the Nigerian. Before going up against receiving they felt that because he's come here and kind of associated with the country he should be representing both countries and city which he'd also played for before fighting My any Germans the authorities in Somalia are trying to assess the damage caused by a tropical storm Cyclon power on board wind interventional rain to parts of the northern coast on Saturday and so i Reports strong winds and heavy rain hits the coast of North and Somalia as nothing was heard from the epicenter of the storm the old town of. Authorities believe there have been some casualties they're only beginning to see the extent of destruction. As it came ashore power was expected to weaken into a deep depression residents of the same U.-Turn amass region of point land where advice to avoid low lying areas and the rough sea the rains have focused to continue into tomorrow and move inland toward southeastern Ethiopia and soy tens of thousands of people in 52 countries are doing their part to reduce homelessness by participating in the world's big sleep Ousmane one night outdoors our reporter Karen Barlow has been interfered with Square in central London or in the center of London the iconic Trafalgar Square it's much as you would normally see there's no sense column those the Christmas tree but then beneath all of that 2000 people camped now in the wind and the rain it's about 11 degrees and they're all taking part in the world's big sleepover is raising the profile and raising money the millions of people around the world who are experiencing homelessness Well I'm joined by Dame Louise Casey who is the chair of the world's big sleep out why are you doing this we're doing it because basically the world has a homelessness problem it has a displaced people problem as refugees and this is all of these people here tonight . Walking in the shoes of people who are homeless or people who are refugees we just experiencing it for one minute we're experiencing something that people have to experience all the around so it's a privilege to be here the same thing wet and cold as it is it's still a privilege and we've got 60000 I think 62000 people across the globe are sleeping out yesterday tonight and tomorrow for exactly the same thing in 2005 the United Nations estimated around 100000000 people around the world don't have a home is this situation getting better or is it getting worse I think the truth of the matter is this is really tough which is homelessness is getting worse and if you think of things like the war that we've hired across the globe floods all sorts of things that is displacing people all the time and some of those people are very poor and they can't cope so it's not just homelessness in places like the United Kingdom where right now we've got the highest number of people sleeping out in the streets of this country than we've ever had it is actually a global problem and the United Nations as he said estimate that next year we run into the United Nation is prioritizing homelessness for the 1st time so it's amazingly important for us just very briefly do you think there's not enough compassion do we need to care in sync more for people who don't have a home oh my God yes I do I think at a time that the world for so divided and so fractured this is symbolic we do we are kind and we can be compassionate and that's what these folk are doing it and I know they're here for one night only is Casey thank you very much indeed the sleeper continues the rain continues falling and the message here is around the world millions of people this is their everyday life care of polo in London's Trafalgar Square at 520 g.m.t. . 2 members of an indigenous community in northern Brazil have been murdered and 2 others injured the deaths came after unidentified attackers opened fire from a pickup truck the victims belong to the quad Jar Jar ethnic group which shut up armed propose. To propose patrols even several years ago called The Guardians of the forest to try to protect their land from illegal loggers America's editor Leonardo Russia described the region where the killings took place it's on the edge of the Amazon where there's a lot of land conflict because it's a border area you have the Amazon forest Basically it's where is the indigenous group has been very active in the these people they were not specifically members of the Guardians of the forests they had been in the meeting to discuss compensation from the government and they left they were in the major road in the 2 of them were on the motorbike what the survivors said is this white car white pickup slowed down almost to a halt and they opened fire at the group of indigenous people they knew who they were indigenous. To people were killed 2 people injured and the community is really scared this group may consider themselves the guardians of the forest but this almost goes against Brazilian government policy doesn't it the policy of. Present both sonar was criticised because he openly declared that the indigenous people didn't have more right to their land than anyone else he defended very controversial policies like the logging in mining on the Indigenous Land officially I mean you had the condemnation from the government of the attack they're very aware of the international impact of incidents like that so minister the justice minister says you most of his deploying at the gym of. Police in the area he condemned the attack but what the indigenous group says and there was an official note from the garden group is the rhetoric of the government encourages people that like him illegal loggers illegal minus they feel that they can do anything and they're not going to be punished and that has been the case we had a month ago one of the members one of the leaders of the Guardians of the forest was killed in an ambush and he was killed by an illegal logging and we know that because he fired back and he killed is illegal logging so we have a problem there with that situation there in Brazil America's editor Leonardi Russia rescuers in South Africa have recovered the bodies of 3 miners who were trapped several kilometers underground following a rock fall on Friday a 4th person at the tower the chemical mine southwest of Johannesburg is still missing in their last contact with emergency teams the miners said they were running out of oxygen use rooms Stephanie Prentice has been following the story and told me more we know a tremor the mine cause devote full initially and that led to teams on the site becoming trapped under debris one person was immediately pulled out with serious injuries and that left 4 underneath the rubble still this all happened in a gold mine south of Johannesburg and of course gold mines are known for that depth those trapped miners with several kilometers below ground they were initially able to communicate with rescue teams but crucially those teams struggle to reach 7 as you mentioned they were running out of that now will not 100 people made up of volunteers from the company's work force and specially trained rescuers try to save them all around 1350 meters below ground level now that plans were severely hampered by rocks which continue to fall underground we know the last person the rescuers talked to said those trapped was suffocating so finding the remaining mine alive seems to be a real race against time and yes again the industry there is being criticized for its safety record. Yeah the National Union of Mineworkers in South Africa has been calling for strict to safety standards for a long time last year 81 people died in the country's mines and in 20174 other workers the trapped in died in the shaft at the same mine in open a where the current situation is actually unfolding now we know that Africa has the deepest mines in the world as well as death a lot of accidents happen there every year and that's just the stats in the registered mines there's also a lot of unregulated mining going on as well now officials do say some improvements have been made but that far more does need to be done Stephanie Prentice Stewart has some other stories from our news desk talks have resumed between the u.s. And the Taliban 3 months after President Trump abruptly ended diplomatic efforts to achieve peace in Afghanistan the 2 sides had appeared close to reaching a deal in September but Mr Trump declared the process dead after a u.s. Soldier in Afghanistan was killed in a suicide attack. Palestinian officials have said Israeli warplanes have struck the Gaza Strip targeting 3 sites belonging to the military wing of Hamas there have been no reports of casualties the raids came after militants fired 3 rockets at southern Israel and Lieberman an American actor whose career on Broadway and in Hollywood spanned 6 decades has died at the age of $82.00 Mr Lieberman won a Tony Award for his role in the acclaimed stage play Angels in America he was introduced to a new generation of fans with guest appearances on the hit u.s. Sitcom Friends playing Rachel Green's father Stuart thank you. You are so basic income in the u.s. Isn't a new idea nor is it that complicated every individual is given a small amount of money to prevent them falling below a certain level of living one of the 1st advocates was the civil rights leader Martin Luther King in the 1960 s. And it's gaining popularity again Sophie long has been to Stockton in California where a trial is underway to see if the idea could actually work $125.00 families being given $500.00 a month no strings attached the genea Medina a 61 year old retired state employee is one of them why are all the back where they said my We're going wow what and I said I'm going to next to $500.00 a month and then he said what and I said nothing and he said I mean for nothing what did you spend your fast food payment on I paid off a bill that I had not been able to pay off and about extra groceries when they were put some extra food in the freezer the genius says her health is better she's less stress and able to. Tell us about this was not dealt a great hand in life he was sleeping rough by the age of 10 in one year he lost 13 friends most to gun crime he had. No reason to believe his life would end any differently but having children made him want to change that and the seed project has helped him to do it it meant he could afford to take a day off work to interview for a better job of our people here we don't have a Christian right that time we can't go without a couple days without having can come in and it's easier to stick where you're at and just be there miserable than it is to try to make a. Lot of people to scared because they can't before seed Tomas said he felt he was drowning he was depressed and miserable constantly concerned about how he got his family through the month. The impact of this program on the lives of many of those taking part goes way beyond financial stability people talk about feeling more connected to their families the neighborhood and the city but it's small and it's funded by a private grant so could it ever work on a statewide or nationwide scale Hilary Holmes is Professor of Economics and Public Policy at the University of California Berkeley it comes down to the revenues necessary to fund it so taking the same program National had a fully universal rate costs about $3.00 trillion dollars and that's more than we spend collectively and the United States on all of our social safety net. Universal basic income is extremely expensive but it's an old idea with new advocates which is gaining momentum and there's a sense of pride here among those in the Seed program that they're part of the growing compensation that could potentially help others across California and even the country safe the long reporting from Stockton in California a developing story Indian police say more than 40 people have been killed in a huge factory fire in the capital Delhi The blaze in the and Mandy area broke out in the early hours of the morning the prime minister in the render Modi has described the fire as a rethink Thanks for listening to the news from distribution of the b.b.c. World Service in the us is made possible by American Public Media producer and distributor of award winning public radio content a.p.m. American Public Media with support from Progressive Insurance offering a way to buy home insurance with their home quote Explorer tool custom quotes and rates are available online learn more at progressive dot com or 1800 progressive Now that's progress. Hello Jack is coming out from the b.b.c. With me Claudia Hammond what age should you start having your cholesterol tested we look at the new research suggesting that your levels in your thirty's and forty's have a bigger effect on your future risk of heart disease and stroke than we used to think and raising mental health awareness by attempting to break the record for the largest mental health lesson ever given and the women Ethiopia finding a new life after serious birth injuries to join me for health check b.b.c. News with Stuart McIntosh Indian police say more than 40 people have been killed in a huge factory fire in Delhi The blaze in the Monday area broke out in the early hours in the morning it's thought that many of those who died were asleep in the building the Indian prime minister Narendra Modi described the fire as horrific North Korea says it's carried out a very important test and its satellite launching site to the state news agency gave no details but analysts believe it could have been a ground based test of a rocket engine which could be used to power a satellite launcher or an intercontinental ballistic missile the f.b.i. Has appealed for help in tracing the movements of the Saudi Air Force officer who shot dead 3 people at a naval base in Florida a hotlines been set up for information about Muhammad. Ronnie who carried out the killings in Pensacola on Friday before being shot dead by police. Pro-democracy campaigners in Hong Kong are hoping to attract huge crowds later for a March through the main island for the 1st time since August police have given permission for a rally by the civil human rights front thousands of people in one's areas have taken part in a farewell rally for Argentina's outgoing president ritzier Mark 3 he promised to be constructive in his opposition to the newly elected leader or better finances the i.m.f. Has a provisional deal to support Ukraine with a 5 and a half $1000000000.00 loan the i.m.f. Said presidents Alinsky government had made impressive progress in advancing reform the British boxer engineered Joshua has become one of only a handful of fighters including Muhammad Ali to regain their world heavyweight titles after defeat he beat the Mexican American and the reason Junior Joshua outboxed is posted to win a unanimous points verdict in a rematch in Saudi Arabia b.b.c. News. Hi there I'm Jodi Hammond and this is health check from the b.b.c. World Service the show where we dissect the latest health stories from around the world today the Ethiopian nurses looking after the minds of women whose bodies have been terribly injured during childbirth the curious tale of the people who lost their ability to swim after having a treatment for symptoms of Parkinson's disease and an attempt to break the world record for the lower just mental health lesson ever how Electra a rapper and a poet a breaking down barriers it does take a village to raise a child and if we can provide education to young people for free in a very exciting and engaging way we are doing our bit where comfortable and safe to discuss these topics to are so neatly tucked away and my guest is family doctor and Robinson 1st today what age should you start having your cholesterol checked after retirement middle age according to the findings of the most comprehensive study so far on this the answer might lie much earlier in adult hood cholesterol is a fatty substance which is found in some foods and also produced in the liver the good kind is fine but the back and is not it clogs up our author is the study just published in The Lancet used the results from 38 big studies conducted in Europe Australia and North America in order to examine cholesterol levels at different ages and people's risk of having heart disease or stroke one of the team's authors Professor Frank key from Queens University Belfast told me why they picked these data sets to analyze these are studies of healthy people who we follow over time and we have nearly 5 and a half 1000000 person years of follow up but we have used a bite 400 citations individuals across these populations and that is a huge numbers you say almost 400000 people in always different studies and you're looking at their cholesterol levels at different ages and then whether they had a heart attack or stroke lead. And what did you find out that was interesting about these younger ages was novel and interesting from the analysis we did is related to what is traditionally used as the threshold for intervening whenever you have a high cholesterol existing guidelines both in Europe and in the us would estimate an individual's risk of a cardiovascular event over the following 10 years and because we had such long follow up on many of the individuals we were able to ask to me at the lifetime risk I'm totally at the end an age of 75 rather than limiting they follow up to 10 years and what we find was that you are prone to underestimate the lifetime risk in younger people we classed younger people as under the age of $45.00 if experiencing a cardiovascular event compared to just using the 10 year risk is typically estimated and clinical practice so this suggests that your cholesterol levels in your forty's say matter more than we have thought previously yes we find a greeted relationship between the bad cholesterol the cardiovascular lifetime risk and it was a steeper gradation of risk and the younger people compared to the older people so for example the older people got to the age of 60 without experiencing a cardiovascular event in our study because to be enrolled in our study you had to be free of cardiovascular disease at the outset so if you're if you think about it if you have reached the age of 60 you're probably in a low risk category to start with because you've reached that age without cardiovascular disease and of course the older we get the more prone we are to die of many other causes so any single risk factor has to be pretty strong to produce a gradation of risk. In older people so does this suggest that if people say in their forty's or maybe younger who have high cholesterol levels were to take statens which can lower their cholesterol levels that this might have a bigger impact on whether they have a heart attack or stroke later on than when people take statens later should we be looking at much younger ages Well we were very careful in the paper not to talk about stuff because what we're talking about is the risk attributable to the bad cholesterol there might be different ways to lower that lifetime risk we produced a risk calculator and estimated the impact of tackling some sort of intervention and lowering the bad cholesterol status would be one option but as a public health doctor I would say that you know we need to adopt a healthy lifestyle which would be keeping our wits under control and taken a better more healthy diet cutting our trans fats in the food chain Tekken regular physical exercise stopping smoking if we're smokers so reducing the lifetime risk of a cardiovascular event you know has many different options not everybody will want to take a pill and indeed to medicalize the issue actually might not be the most sensible thing the message from the paper is we might underestimate lifetime risks if we just look at the next 10 years and the other message is getting your cholesterol measured at a younger age is maybe something that could be considered if people did it and if that was then tackled how much difference would that make later on do we know well within the paper we have estimated how many people you would need to treat in order to prevent a single event and not that varies according to what category of riskier end for the bad cholesterol but I was surprised to see that when we did the modeling this number needing to treat was as good as many medications that are right there you know numbers needed to treat below 10 for example. So for every 10 people treated you're preventing one a vent so how important are cholesterol levels in your forty's say compared with cholesterol levels in your sixty's you saying there might be more important yes one of the messages from this paper is that relatively speaking the cholesterol levels if they're elevated in a young person they have much more significance than they might have if you measured it in a 70 year old what our message is that this should be used to have a sensible conversation between the doctor and the patient about it those lifetime risks we're not saying that this tells us to give stop and store all these young people that's exactly not the message that we want to communicate we're always a better place whenever the doctor has the information to be the patient's advocate and so discussing the information is one of the things that we would like to happen Franky so and presumably before young people start taking statens if they have high levels of back less strong really wouldn't you need to have a long term trial where you gave some people statens and not others to then see whether it made a difference to whether they actually had heart attacks or strokes Yes In an ideal world you'd make that intervention then you'd follow people up for life that's not that likely to happen and we probably have got enough evidence from this extremely well conducted study and others to say that that small proportion of people we're talking about probably one in about 250 of the population who walking around not realizing in their twenty's that they're already storing up massive trouble for themselves by having genetically determined high levels of cholesterol that if they were to have an intervention early on and that might be statens they could save themselves that tragic heart attack before the age of 60 the thing is you don't know if you're that person you may be slim you may be active you may have never smoked and you may not know that in your family there is this. Because people don't always know their family history so what sort of age do your patients tend to start getting their cholesterol tested hit here in the u.k. At the moment well the average age for most people if they have it done a tour will be at their 40 year lifestyle checkup which is done now on the n.h.s. But I mean arguably and from what Frank was saying really that's a bit too late for these individuals who might have been walking around with a lifetime of high cholesterol there is a really strong argument for knowing what family history is know what your level is of cholesterol and then know what your risk is and yes because the numbers can be confusing so do you sit down with patients and go through those numbers and then work out what what actually means for them so most people just compare numbers don't like people get really competitive about it have patience to say oh you know my my cholesterol is 6 but my my husband's is 7 or something is it but it is as you correctly say is all about your risk just knowing an absolute level tells you absolutely nothing your risk is dependent on your age your gender with use met with you have diabetes and the actual level of the cholesterol so will the study change what you say to your patients well I was already starting to say to people if you know you have a family history of early heart disease that's before the age of 60 Please get your cholesterol checked at in your early twenty's and for people who don't but curious there are these kits over the counter now and I think is an argument for saying to people if you want to you could do a check like that over the counter as long as and this is the big proviso that you don't panic if you get the result and you discuss it with someone to assess your risk school Good advice there thanks Sam Now mental health is not something you might expect there to be world records in but just the other day mental health experts and some top performers got together to try to break the record for the world's largest mental health lesson thousands of 14 to 18 year olds arrived at a huge conference venue in Birmingham in the u.k. . Ready for the class to be given by psychologist Professor Dame tyll Wykes from King's College London she held the record previously and telestrator matched it away so would she be able to win it back and the rules are strict with checks that every single one of the thousands of teenagers was concentrating throughout and never distracted by their phones best of luck with that you might think but still had her own strategies for keeping it lively with a show featuring rapper lady leisure and poet and mental health activist Hussein Manawatu. Guys. This. Was a. Bank. That. Was. But you know some pretty. Tough words from a White House situation. Yes a lot of people I'm going to be open to you know how much. This is a part of my head it's to say. My name because. I'm going to let you know. Now the bully maybe you don't mind a bit of whoa. Holy shit to me off 1st full of this idea 4 years ago coming from an area in east London that doesn't really have much money to help support somebody who went through depression himself and didn't have much guidance I felt like I wasn't the only person out there from me don't touch me he likes me have become my son and so to me I'm not going home to my home. My Greek home I don't know who will come when I. Reached out to Professor till from King's College and also to help me a lot of teachers in today's society are overwhelmed it does take a village to raise a child and if we can provide education to these young people for free in a very exciting and engaging way we are doing our bit we have to gray environments where it's comfortable and safe to discuss these topics so neatly tucked away when I meet. The i'm the president's son there was nobody from my truth of the by somebody. That you. Know everybody likes to think it's very difficult I'm 28 and I'm able to talk like this only now in life by feel as if being a poet that allowed me so. In education we're also promote in these traditional methods of expression that really gives that much it will helps on today was just a big ingredients of mixed emotions oh I hate the gentleman I hope nobody I'm going to have 1 nothing no I don't. Think tonight I will. I'm white so I'm a clinical psychologist and a professor at King's College London so this is a record that actually reset at Hackney Empire 2 years ago and then last year in Australia they broke our records because we did challenge them to do that and now we're going to try and bring it home to the u.k. . Oh. Yeah what we're trying to do is to make sure that young people and they're all in their teens understand a lot more about mental health problems but also to learn how to talk about it because we really want to reduce the stigma and discrimination around it if they know what it is and what the symptoms are that maybe they'll recognize it in their friends or maybe they'll recognize it in themselves and then we want them to try and seek help. Yeah Ok. I think it's really important to have role models we now have stories on television and also that the young people particularly on this to have young role models who talk about their mental health problems and how they have recovered and then of course we need the whole community to stop discriminating against people with mental health problems and starting much more to open up conversations and I did. Something. In this last. Week. Today's event was very very positive regardless of the outcome of whether or not we set a Guinness World Record and it was so beautiful to ask hundreds of people to put their hand up if they've experienced mental health issues or know somebody that I have and it really honestly freely and. I mean. The outlets and I really. Like that. If you know how to look after each other it makes Chairman legs because it's good to see several summit how to frame makes you realize that it's not just God passing on the street electric kind of anybody anywhere and it's all going to learn all watch the mental health rationale for it was quite helpful when outrageous different cards are better wishers or you can have your own voice rebels in order for the seller says stories about the previous one well there's really good forward yes it's up there. And after all that's when the final count was dumb they didn't get the numbers to break the record bad luck maybe next time now and I want to talk to you about 2 stories in the past week which relate to women seeking to terminate a pregnancy and we've seen attempts to bring in legislation to restrict the number of abortions taking place in various countries in recent years and now are some new developments and I want to start with Slovakia in Eastern Europe where some people have been demonstrating against proposed new legislation which would affect women seeking to terminate a pregnancy what are they saying they would have to do well apparently they're saying that they're going to be rolled back the clock on women's reproductive rights by a pretty easy to me mean spirited a nod piece of legislation which very specifically will make women have to have an ultrasound scan of the developing embryo and in particular to see the heartbeat that's after about 7 weeks of gestation that you can often see that. In order to then make that decision to have a temptation a pregnancy presumably even more emotionally difficult and of course some people have very strong views about this and there are all sorts of ethical debates about it and we are very much concentrating on the medical side and in Ohio in the u.s. a Bill is being proposed which would not only ban abortion but if a woman's had an ectopic pregnancy it needs to be reimplanted back into the womb how would that work that topic present. In the chips isn't it absolutely an ectopic pregnancy is there a pregnancy that is developing but will never develop to turn on the tube and there is absolutely no biological plausibility or scientific basis for this most peculiar idea of somehow taking the embryo off the tube and shoving it in the uterus I mean it's never been done it has no reason it would work I mean it's just the most peculiar idea is punitive it will drive a potion seeking underground it will make it illegal in a criminal offense if these things are not offered thanks Dan You're listening to health check from the b.b.c. I'm Claudia Hammond and my guest today is family Dr Robinson next to a project in Ethiopia to help women to cope psychologically with the consequences of a very serious birth injury called a fistula and can you explain what official or it will fistula as an abnormal tunnel that develops between 2 spaces organs in the body that are normally separate Like for instance the vagina and the bowel and it can happen after a retro Matic childbirth as we'll hear the consequences can be very serious but in Ethiopia nurses are being trained to run group counseling sessions for women on a daughter who is a child psychologist and she's based at the University of Texas and as works with a team in Ethiopia to train nurses she told me why fistula can affect every aspect of a woman's life usually they lose their husbands they lose the ability to have children in they lose the child they were having in that moment so they often lose their value in the society or in their family and so they're shunned by their husbands and husbands families sometimes are able to return to their families but even within communities these are women who often live on their own in a hut kind of isolated from other members of the village because of these problems and so the intervention you were working on was to try to help them to to come to terms with what has happened to them I guess in. It to move forward well what does it consist of the Fischler repair surgery is incredibly important to help these women restore their physical functioning but these women who have often been experiencing official it for years have lost so much and anxiety and depression shame and guilt are often huge emotional problems for these women and they don't have the support to talk to other people about this and so our intervention was a cognitive behavioral therapy intervention to help women process what had happened to them to help them reduce the shame and guilt that they often felt like there was a reason this happened to them and not other women in their village and how unusual with this kind of psychological approach be in a theater here I think very unusual I think Ethiopia doesn't have mental health service programs and when we did qualitative interviews in the hospital the nurses and doctors were telling us like these women need a motional support we don't know how to talk to them we can fix them physically but we don't know what to say to help them improve their functioning outside of the surgery and so you trained nurses to become counsel us yes we train nurses who were working on the fistula unit so these were women that the patients would already know from day to day activities so we did a week long training in Gondar Ethiopia with these wonderful nurses who are great therapists and really took to the program easily and did a wonderful job implementing it and it was in groups and what sort of things did they do in the groups so there were groups or 5 to 6 and that was because usually for the surgery to occur they wait till they have about 5 or 6 women in their surgeon will fly in from Addus and do all the surgeries in the day so these women are usually in a war there are an individual room so we thought a group would make perfect sense also given the collective is nature of Ethiopian culture so it was very nice that the women could participate in this together and they did different session so there was one on. Educating women about emotional problems and the connection between thoughts feelings and behaviors we did sessions on behavioral activation or encouraging women to do pleasurable activities and goal directed behavior we did problem solving relaxation we helped women change the way they thought so instead of thinking it's all my fault my baby died how they think about that and the broader sense to understand that there are lots of things that contributed to them developing official and losing their baby not just them do they tend to blame themselves they're absolutely I think of it was very common for women to think I did something to bring this on almost like it was a curse or a punishment and that must be quite hard to convince people that isn't true if that's their belief I think it is we had one session that was really dedicated to this and I think the nurses bring such medical expertise to this as well and because they're from the same culture and they know the difficulties in the country around social services and medical services they can also say well things like you know the nearest hospital was over 100 miles away or you didn't have transportation or we don't have train many wives in your community to help with face things and of course we know all of those things play a huge role and why this happens to women because it doesn't happen to women in westernized countries without ways in which you had to change House abt might be done in a different country to make it more culturally specific to the women that he was talking to him Well what we needed to keep in mind was that these women were very poor and then educated in the literate so a lot of time c.t. Requires a lot of writing and reading and worksheets and things like this and that wasn't possible so we often use pictures so women would have reminders of pictures of things they could do for example for behavioral activation to help improve their functioning and thereby feel better so these might be pictures of a woman dancing or singing or talking with friends or having coffee which is a very. Important cultural part of Ethiopia and as well as to help them remember the skills we would give them a bead for each skill they learned so by the end of the treatment they had a bracelet of different color b. As a reminder of the different skills but I think also a reminder of the program they participated and because everyone was kind of going back to different situations and if they were still being very isolated or shine perhaps they could look at the bracelet and also feel connected to the women that they completed the program with what sorts of psychological improvements did you say in the women after great improvements in depression and anxiety and trauma scores between the time before they began the intervention program to the time afterwards we also followed the women 3 months after the end of the program because they would come back to the hospital for a physical check up and we saw improvements in anxiety and depression even from the end of the study so they continue to improve which was very encouraging and if it does make a big difference how easy would it be or how difficult would it be to then scale this up so that more women who might benefit could access this kind of thing I think if we continue to use nurses in the hospital it's very scalable and it's possible to that if women had participated in the program and perhaps wanted to continue as a fair Appice in the program it might actually create jobs for these women who don't have jobs outside of this. Now and before we go I want to ask you about an extraordinary story about something which happens to people with Parkinson's disease who've been treated with deep brain stimulation so before we get to that what is deep brain stimulation Well it's a marvelous technique the office hyped a lot of people with Parkinson's with the drugs aren't helping that trend and movement to silica electrodes implanted in the brain and there's a little device that controls it just under the skin on the chest will with an on off switch and people can effectively kind of by. Themselves with it with an electrical current to stimulate the movement in the muscles so it's a fantastic device and does it work and it sometimes works and it can work well all drugs have stopped working so it's a marvelous thing it's not quite the panacea that was perhaps hoped but yes it's got its place and so for some people it can help calm these tremors and an unwanted movements but it seems from a small number of cases that after the treatment there's one thing people might not be able to do anymore and that is to swim when they could swim before this this sounds really old what was this about thing is this really odd thing but it's a report of only 9 people who used to be able to swim very well and then after they had this surgery found that they couldn't swim effectively. I think that what it shows is that possibly the deep brain stimulation is slightly altering pathways that are involved in learning complex tasks perhaps winning perhaps riding a bike or things that most of us don't get to do like getting skiing it is quite possible that people then have to relearn these complex abilities like swimming but I think for people who with Parkinson's who are helped by d.b.s. Where the drugs have failed they might feel that's quite a small price to pay you know it's fascinating thank you very much Dr Anne Robinson for coming in to health check today and thanks to the producer Paula McGraw You can find me on Instagram and Twitter at Claudia Hammond and I speak on how we take a tour of the biggest medical gallery in the world it's in London and it's brand new and why a fatal illness in pigs is affecting human health but not in the way you might think. I'm Liam Moriarty news director here at Jefferson Public Radio like you I listen to j p r I tune in because I hear programs that capture my interest in my imagination programs that help me learn something I didn't know programs that keep me informed about my community and my world programs that help me empathise with people and issues I want to understand as we approach the end of the year when many people contribute to worthwhile community organizations I hope you'll take a moment to support so that we can continue to create new compelling programs for you in the year ahead please take a moment to contribute at i.g.p. Org or reach us by phone and 85526191 from all of us here thanks so much for your support this is the news and information service of southern Oregon University's Jefferson Public Radio 12 30 am k s j k talent at 9 30 am k a.g.i. Grants Pass also heard in the road Valley at one o 2.3 f.m. News of the region the nation and the world. B.b.c. World Service at 6 hours g.m.t. This is weekend with Elian Hatton protesters in Hong Kong are hoping to rally huge crowds for a March through the main island we speak to a probate Ging politician who actually hoping today would be a very peaceful well. It might be a good situation. Also the United States and Iran have carried out a rare prisoner swap. Degree of hostage taking frankly on both sides to the audience scientist was arrested on very dubious charges 7 the Chinese American clearly was not a spy you can universal basic income reshape one of the poorest cities in the u.s. And the British boxer Anthony Joshua has become one of only a handful of fighters to regain their world heavyweight titles after defeat that's here on Weekend. I'm Stuart Macintosh with the b.b.c. News Hello Indian police say more than 40 people have been killed in a huge factory fire in Delhi The factory is located in one of Delhi's largest markets about 50 people have been rescued and taken to hospital the prime minister Narendra Modi described the incident as extremely horrific and sent his condolences to the families of the victims practitioner Gallard girl are the reports from Delhi the fire reportedly broke out in a building in the early hours of Sunday in a congested part of the city dozens of workers were sleeping inside at the time according to rescue services official said that it was difficult for fire trucks and ambulances to reach the spot because of the narrow alleyways.

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