Llandudno on a Day Trip

I recently paid a visit to the town of Llandudno. Situated on the coast of North Wales, the town boasts an immaculate seafront, a well-maintained stony and sandy beach, a vibrant pier, an impressive headland (the Great Orme) with awe-inspiring views of the sea and the Snowdon mountain range, cable cars, a vibrant pier and a quaint holiday feel that envelopes you in the sense that you are in exotic territory, yet entirely at home.

 

The promenade, for the most part, is separated from the sea by a stony beach that is less than forty metres wide. This lends the beach to the enjoyable challenge of throwing pebbles on the sea to bounce them or see how far they can go.

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As would be expected in any modern city with such a clean beach, the seafront has a lot of hotels, all of which looked well-presented. I did not stay in any of them and therefore cannot give an opinion as to the standards of accommodation, service or food quality.

At the top end of the esplanade, just before the pier, is a sandy beach that appeared to be popular with holiday makers on the sunny day on which I had visited.

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While stone-throwing and lying on the beach are free, there are a number of other non-free activities on offer. Among these are boat rides as can be seen below:

 

There is an option of a fast boat or a more sedate ride on a bigger vessel.

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The pier itself juts into the sea about a mile and has the obligatory food kiosks, arcades and amusements rides that you might expect. It also presents commanding views of the seafront and the activities by the beach, as the following 360-degree video attempts to show.

For those concerned about parking, there are parking charges along the seafront, but further into the town there is free parking for up to 90minutes if you are prepared to walk for about five to ten minutes to the seafront; not that you should mind because the town itself has a cosy, local village look.

Once you leave the town and the beach you can choose to drive round the headland known locally as the Great Orme, which is about a file mile drive. Should you choose to take a detour, and I would encourage you to, you can go up to the summit and catch magnificent views of the surroundings for miles around. The following time lapse gives an indication of some of the challenges of the drive, including the narrow roads and the need to give way to oncoming traffic on the way to the summit.

The rewards of perseverance are the following splendid views on a fine day.

The Orme itself is littered with old mines and packs a surprise or two, including cable cars and an occasional fresh water spring, such as this one.

In summary, Llandudno is a great place to visit for a day or even a few days, as are undoubtedly other parts of North Wales. There are other activities I did not engage in or photograph, such as walking up the mountain, going on the cable cars, riding on the train at the summit or going on the ski slopes. These will have to be reserved for another day.

 

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Parkinson’s Disease: Towards Finding a Cure

The BBC has reported exciting developments in the treatment of some of the symptoms of Parkinson’s disease. Researchers in Canada have managed to develop a new treatment that helps restore the ability to walk in affected patients through an implant that provides electrical stimulation in the spine. The following video, provided courtesy of the BBC, provides further details.

The British National Formulary (BNF) defines Parkinson’s disease as a progressive neurodegenerative condition resulting from the death of dopaminergic cells of the substantia nigra in the brain.

Substantia Nigra
Substantia Nigra

Motor-symptoms may include hypokinesia (decreased bodily movement), bradykinesia (slowness of movement), rigidity (stiffness), rest tremor, and postural instability. Non-motor symptoms include dementia, depression, sleep disturbances, bladder and bowel dysfunction, speech and language changes, swallowing problems and weight loss. Patients with suspected Parkinson’s disease should be referred to a specialist and reviewed every 6 to 12 months.

Both the BNF and the National Institute for Health and Care Excellence (NICE) highlight the need for both pharmacological and non-drug treatment options for the various symptoms. In respect of non-drug treatment, patients should be offered physiotherapy if balance or motor function problems are present, speech and language therapy if they develop communication, swallowing or saliva problems, and occupational therapy if they experience difficulties with their daily activities. Dietitian referral should be considered.

Drug treatment has centred on negating the effects of the loss of dopamine through replacing dopamine (via levodopa), using dopamine agonists or using a range of drugs that offset the negative effects of dopamine loss. The medical challenge is being able to attain the fine balance that mimics normal brain and motor function without the development of unacceptable side effects from the drugs themselves.

NICE highlights that initial drug treatment should be subject to a consideration of the relative benefits and harms of the treatment options, using the following comparative chart for reference:

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The guidance highlights that in early stages of Parkinson’s disease, patients whose motor symptoms decrease their quality of life should be offered levodopa combined with carbidopa (co-careldopa) or benserazide (co-beneldopa), which help prevent the peripheral metabolism of levodopa. Parkinson’s disease patients whose motor symptoms do not affect their quality of life, could be prescribed a choice of levodopa, non-ergot-derived dopamine-receptor agonists (pramipexole, ropinirole or rotigotine) or monoamine-oxidase-B inhibitors (rasagiline or selegiline hydrochloride).

The NICE guidance goes on to provide more guidance on what to do in the event that a patient develops motor fluctuations, uncoordinated movements or simply that the medicines stop being as effective due to progression of the disease.

The news of the development of new treatment via electrical stimulation therefore offers promise as an option with comparatively low side effects, particularly where traditional approaches have reached their limits. It also comes on the back of recent findings that Parkinson’s disease may start in the gut, a promising field of research that may yet yield other avenues towards treating, preventing or reversing this debilitating condition.