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The Doctor's Consultation 

Agony Column

Camera Class by Snapshot

Money Matters

The Doctor's Consultation:  Melanomas - Are you at risk?

by Dr. Iain Corness

A few months ago I wrote about lumps and bumps on the skin, that fantastic wrapping that we all need to keep forever, if we are to remain healthy! And what a wonderful organ our skin really is. It regulates the passage of water and electrolytes and keeps that internal collection of bones and organs neatly covered with a self-sealing all enveloping wrapping. We can’t live without our skin.

Unfortunately we tend to abuse our skin, and I must admit I am no exception. Sun block is not high on my list of picnic requirements, even though it should be.

Like all of our other organs, the skin organ can have problems too, and these range from minor rashes, fungal infections, cysts, warts and other “lumpy” conditions that we call tumours. Now the very word ‘tumours’ strikes fear in the hearts of many, but this is purely a term to describe growths on the skin, which may or may not be ‘malignant’. In fact, most skin tumours are not malignant (called ‘benign’), and even with the malignant ones, the majority are not going to kill you.

Having said that, it does not mean that you should ignore skin growths. While most will not kill you, they can make the last few years very unpleasant if left untreated, like Squamous Cell Carcinomas (SCC’s), Basal Cell Carcinomas (BCC’s) that eat you away and then the Melanomas that can be fatal.

Yes, while your skin may keep you alive, it can also kill you. Melanoma is also much more widespread than you would imagine. And the statistics can be quite frightening. Take these US statistics - Melanoma strikes people of all ages, all races, all economic levels and both sexes. It is already the most common cancer for women 25 to 29 and the second most common cancer for women 30 to 34 and the incidence of melanoma is increasing faster than any other cancer. An American’s lifetime risk of developing melanoma is about 1 in 75.

Now those American statistics are not so bad compared to some other countries. Two of the worst as far as melanoma statistics are concerned are Australia and New Zealand. Why? Because these sunny countries have become inhabited by fair skinned people from the northern hemisphere, a skin which does not take the sun so well.

So where does that put us Caucasians living in a tropical country like Thailand? At risk, that’s what. And I am sure you have all been like me and suffered sunburn from time to time, one of the predisposing factors in changing seemingly “innocent moles” into malignant Melanomas. Researchers have also shown that overexposure to the sun as a child can result in an increased risk of Melanoma as an adult. In my era, children were actually sent out to play in the sun, because it was ‘healthy’!

The message with the Melanomas is to find the moles before they change - and that takes a trained and skilled eye and sometimes a biopsy as well. But it is worth the look. Melanoma can be fatal, remember. These dark pigmented skin lesions with irregular borders invade the deeper tissues and can spring up as secondary lesions as well. These are truly tumours that can kill you. Wide and deep surgical excision is the treatment of choice, that often leaves a most unattractive scar.

Prevention is much better than cure!


Agony Column

Dear Hillary,
I met a woman at the party last night and I can’t get her out of my mind. I didn’t get her name as we only briefly saw each other across the room, before she flitted away, so I haven’t even spoken to her, but there was that spark of magic there in her eyes promising just so much. Can you help me find her again? I think I am going mad with desire. She was wearing a yellow dress, and with her dark hair and dark eyes, the effect was fantastic. I must find her again.
Peter

Dear Peter,
What sort of a love struck calf are you, my myopic Petal? How would Hillary know where to find your lady with the bedroom eyes? I wasn’t even at your party. Or perhaps I was and enjoyed it too much? Oh my goodness! Perhaps the woman was me? Was I wearing yellow last night? Did she leave a glass slipper by any chance? Back to reality. Have you had your hormone levels checked recently? You are not going mad with desire young man, you are just mad. But to show that Hillary has a heart, I have published your letter. If any woman answering to your description calls, I will let you know.
Dear Hillary,
In this Amazing Thailand, with its Amazing ladies, it is amazing that any young man survives holidays over here. At every turn there is temptation awaiting the unwary and unknowing. My sister’s son, my nephew, is a shy young man, and has been told by my sister that he is to come to Thailand to spend three months with me. She has spoken to me and wishes for me to oversee this young man blossom into adult life. I believe that the responsibility she wants me to take is too great. Do you concur with my opinion on this Miss Hillary?
Marje

Dear Marje,
Without wishing to be seen looking as if I am ‘buttering’ you up, Marje, I must concur (love using words like that) with your sister. I think the young man should just be brought over here and Hillary will do the honours for you, so to speak. By the time he is ready to return to his mother he will know all about wine, women and song, provided he has been given a decent sized well filled wallet for his and his tutor’s use. Oooh, Hillary is quite looking forward to this. I’ll teach him all about French champagne and Belgian chocolates and onwards and upwards from there. When does he arrive?
Dear Hillary,
Our driver had an accident in our car, which he took without our permission one night, and was taken into custody by the police. Apparently he attempted to flee the scene, but was caught. He now has to stay in jail until there is settlement and agreement between our insurance company and the rider of the motorcycle he crashed into. Is this the usual thing in these instances or should we have intervened?
Unsure

Dear Unsure,
Firstly, never intervene on your own, no matter how well intentioned that intervention might be. Thai law grinds along in its own sweet way, without any need for ‘help’ from others. Just take the advice of a good and trusted Thai lawyer. Your husband’s work will be able to supply you with some names. Unfortunately, you will be without the car until everything is settled, but that’s just tough luck, I’m afraid. Next time make sure your driver can’t get the keys. Be prepared for the fact that you may have to rescue your driver financially too.
Dear Hillary,
I have a 24 year old Thai girlfriend who I met over here in the UK and we have been together now for almost two years and we have always managed to get along well, despite differences in our ages (I am sixteen years older than she is). We have been having a sticky patch recently but now she has decided she wants to go back home to Thailand and leave me in the UK. What can I do to stop her leaving? She says she will go at the end of July. I have told her the weather will be hot and how different she will find Thailand compared to the UK (she left Thailand 4 years ago), but she is adamant. I don’t feel our problems are so bad that we can’t get over them. Hillary, what do you suggest?
Jeff

Dear Jeff,
That’s not a very old head on your 40 year old shoulders, is it? If your girlfriend has decided to leave, then you must go with her decision, my Petal. She is 24 years old and sounds reasonably mature I would assume from your letter (sorry I had to shorten it, but it was a little too long for publication), although the fact that she has lived with you for two years might put a question mark over this. You can ask why she came to the conclusion, (and it is a conclusion, isn’t it Petal) but her decision is her decision - not yours. Sorry. Better luck in the future. Get an older girlfriend next time, or lie about your age.


Camera Class: A new way!

by Harry Flashman

Successful photographers are very often ones who have discovered a “different” way of seeing the subjects they (and you and I) photograph. One such photographer was Man Ray.

He was an artist who used both paints and pictures to express his dreams and fantasies. “I paint what cannot be photographed. I photograph what I do not wish to paint.” With that aim in mind, Man Ray went on and broke just about every ‘rule’ of photography that was ever thought up.

Man Ray rejected the ‘usual’, even his own name! Born Emmanuel Radnitsky in Philadelphia in 1890, he adopted the name Man Ray. He bought his first camera in 1914 expressly to photograph his own paintings for collectors or galleries, but then came to explore the artistic possibilities that this new medium could offer.

In 1921, at the urging of fellow Dadaists Marcel Duchamp and Francis Picabia, Man Ray moved to Paris to join the growing cultural avant-garde movement. There he worked in painting and photography while supporting himself through portrait commissions and fashion photography, which appeared regularly in such magazines as Harper’s Bazaar and Vogue during the 1930s.

However, by this time he had gone past Dadaism and into Surrealism. Man Ray sought to create a Surrealist vision of the female form and began to utilize such photographic techniques as solarization (originating from a dark-room accident), dynamic cropping, over enlargement and over development in an effort to create this. His use of what he called “Rayographs” where he placed objects directly on the photographic paper to get the image, was just another of these.

After the Germans invaded Paris in 1940, Man Ray returned to the United States, settling in Hollywood with the intention of pursuing filmmaking, but this did not really hold him, and in 1951 he returned to Paris, where he lived and worked until his death on November 18, 1976.

Now I am not suggesting that you rush out and place unexposed film on your foreheads in a dark room and ‘think’ the images, print the results and call it ‘art’. (It has been done already, by the way.) What I am suggesting is that you should stop for a while and consider something unusual, compared to your “standard” way of taking shots.

Everyone gets into the habit of taking photographs in one particular way. And habits certainly do die hard, even if it is just always taking shots in the horizontal (landscape) format.

What I am suggesting this weekend is to devote one complete roll of film to some new or different ways of doing things. Many times it is impossible to predict what the final result may be. You may have discovered a radical new approach, a highly individualistic way of presentation. The end result may not be to everyone’s taste, but you will never know till you try. And what is a roll of film worth compared to the fun (and fame and fortune, perhaps) that this weekend could produce for you.

To get you going, try these. Take photographs of everyday things, cars, houses or even people, while lying on the floor looking up. A baby’s eye view. It would certainly be worth re-viewing some items from this very low viewpoint. OK, I know you will end up looking up people’s noses - but it just might work. You won’t know till you get the pictures back.

Other possibilities are taking shots with your car’s headlights as the source of light. (Yes, it has been done before too, and the end results were spectacular.) Put a red filter over the flash on your camera and see what you get, taking photographs in the daylight.

Can you see where this week’s column (and Man Ray) is taking you? Into the realms of the unknown, because it is from there, that true ‘art’ photography comes. I do not mean great technical expertise. Just art.

Let your imagination run wild and try it this weekend. You never know! The ladies out there could even change their name to “WoMan Ray”!


Money Matters:  Investment structure

Graham Macdonald
MBMG International Ltd.

One of the basic problems with many of the consistently top performing investment funds is that originally they were not set up to accept investments from retail investors and therefore they are almost invariably structured as non-distributing offshore funds (roll-up funds).

This means that, for UK investors, while income can roll up gross when the capital remains invested, a charge to income tax arises on disposal of units. A disposal for tax purposes includes encashment of units, switching between funds, and assigning units to someone else, for example to children or into trust.

The fact that gains are subject to income tax makes such funds unattractive on purely tax grounds in comparison to authorized unit trusts and offshore distributor funds, as gains on these funds can be reduced by CGT taper relief and they can be offset against the annual CGT exemption.

Whilst you retain your UK residence, one way of sheltering such funds is to invest through a tax free ISA. There are several kinds of fund plans on the market which qualify as ISAs. The problem with this route, however, is that the type of individual who will understand fully investment in such funds will tend to be wealthy. Such funds also generally have high minimum entry levels, usually between GBP 50,000 and GBP 100,000, so the GBP 7,000 ISA limit restricts choice and the level of return that is tax sheltered. Also most of our readers have already given up their UK residence and therefore are ineligible to invest in ISAs.

An alternative for investors is to invest via an offshore bond wrapper. Most funds are capable of qualifying as investment links within non-personal collective investment bonds. The tax-efficient bond wrapper can add considerable value to the overall investment story. The tax treatments of encashments of funds held within offshore bonds can produce attractive results through the use of the 5% withdrawal allowance, top slicing and time apportionment relief.

However, even leaving the ability to encash tax efficiently, returns can be improved by investing in roll-up funds via a bond wrapper because of the benefit to tax-free switching. This is an important, as sooner or later almost all investors either want or need to switch funds, whether because of changes in economic conditions, a change of fund manager, better alternatives or simply changed investment objectives.

It’s doubtful whether direct investments into funds can be effected as cheaply as via the institutional terms passed on to investors through bonds, but for the purposes of this article, let’s assume that somehow the investor manages to negotiate institutional terms for himself and thereby saves the bond company’s charges of around 1% upfront and ฃ600 p.a.

To illustrate this point, let us assume an investment of GBP 500,000 and a return of 7% pa after fund charges. After five years, the return before tax but after charges would be ฃ690,723 for the bond and ฃ701,276 for the direct holding in the fund. The difference is due to the ‘additional’ bond wrapper charges.

However, if one assumes that a fund switch occurs in year five, and the client is a 40% taxpayer, then the picture changes significantly. The amount available for re-investment through the bond remains at GBP 690,723 as no tax is payable.

However, the amount available for reinvestment on the direct holding drops to GBP 620,766 because over GBP 80,000 income tax is payable at the time the switch occurs.

Carry this example forward for a 25 year term, and assume full fund turnover every five years, and the net returns after tax would be GBP 1,788,589 for the bond, and GBP 1,474,884 for the direct holding. A total difference in return of GBP 313,705, solely as a result of the ability to switch tax free within the bond wrapper.

Part of our job at MBMG International is to devise exit strategies from the bond to further increase net returns for our clients by, for example, utilising the 5% per year exemption, timing withdrawals to avoid/reduce UK tax, or assignment to a spouse or children who may be in lower tax bands.

Remember that UK nationals fall out of the income tax net as soon as they become non-resident (effectively as soon as they go overseas if they remain there for a complete tax year or more) whereas the Capital Gains net still applies until they’ve been overseas for 5 complete tax years.

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Graham Macdonald on [email protected] ter na tional.com