BBC ALBA AIRS NEW DOCUMENTARY ON STRUGGLES WITH ADDICTION

The latest episode of BBC ALBA’s award-winning Eòrpa current affairs programme sees journalist Ruairidh Maciver marking 10 years of sobriety. In a powerful, personal, and thought-provoking programme, Ruairidh takes us from his childhood in the village of Brue in the west coast of Lewis, into adulthood, and a series of struggles with addiction to alcohol and drugs.

The report contains reflections from friends and family who have known him during this time, as well as those who he met along the way and were instrumental in his journey to recovery.

Since sobriety, addiction dealt another cruel blow to Ruairidh and his family, with the tragic and untimely death of his brother Alasdair in 2022 due to alcohol and drugs. Ruairidh reflects on this painful time and meets one of Alasdair’s closest friends, to remember his brother’s life.

Eòrpa: Recovery also brings together expert testimony from the world of science, academia, and outreach organisations who strive to minimise the effects, and understand the nature of drug and alcohol use in Scotland’s communities. With the festive season approaching, and with it a temptation to consume more alcohol, this is a time of year when worries about problem drinking can grow.

Ruairidh has known his friend Joanne Havinden since childhood.

Reflecting on Ruairidh’s addiction in his teens, she told him: “My memory of you when we were wee – you were so happy.

“And, you know, you were so good at word games and jokes and puns and making up stupid songs and all that kind of thing. 

“And you stopped doing that sort of stuff and you were unhappy. You were really sad. You know, it was just like watching an out-of-control train and we didn’t know what to do to help.”

Kenny Trainer is the Project Manager at the Bluevale Community Club in Haghill and Dennistoun. It started off as a boxing club, but has expanded, with volunteers now helping with a variety of social issues nearby.

Asked if things had moved on since a joint visit in 2021 by then First Minister Nicola Sturgeon, and then Scottish Conservative Leader Douglas Ross, Kenny told Ruairidh: “To be honest with you, probably not.

“I think that, politics as politics go, they want to point fingers at each other and blame each other and say that one is better than the other, when realistically a lot of the time they are the exact same while nothing really changes and they’ve got the power to make it change.”

This is the first time Ruairidh has spoken publicly about his past issues with alcohol and drugs, and of his journey through recovery.

Reflecting on making this special edition of Eòrpa, Ruairidh said: “It’s vital that we have an open, compassionate and non-judgemental conversation about where things stand with alcohol and drugs in Scotland today.

“Addiction is something that could affect any person and any family. The reason I wanted to make this programme is that I’ve reached a stage in my recovery where I feel ready to add to that conversation and share some of my own experience.

“My journey brought me into contact with many individuals and organisations who helped me and it was a privilege to be able to go back and speak to some of them. Everything I have in my life today is rooted in the sobriety that they helped me to achieve.

“If this programme can offer hope to anyone struggling with addiction, or encourage them to seek support, it will have been worthwhile.”

Eòrpa is BBC ALBA’s flagship current affairs programme, covering a variety of domestic and European stories.

Eòrpa: Recovery will premiere on BBC iPlayer and BBC ALBA at 9.00pm on Wednesday 27 November (in Gaelic with English subtitles). Watch live or on demand: https://www.bbc.co.uk/iplayer/episodes/b006mvwb/eorpa

Improving eating disorder services

New guidance for Scotland

People affected by an eating disorder can expect higher and more consistent standards of care following the roll-out of new national guidance for services.

The publication of a national specification will support both the NHS and local services to deliver person-centred, safe and effective care. The new guidance was developed by a working group of experts with academic and clinical practice experience, alongside people affected and their families.

The blueprint aims to ensure that everyone has access to a high-quality standard of service regardless of what stage they are in their recovery and is for care across all stages of treatment, from primary care to specialist inpatient care.

https://twitter.com/i/status/1859167370272444792

Mental Wellbeing Minister Maree Todd said: “We want to create a more supportive, accessible, and effective care system for everyone affected by eating disorders.

“This new guidance is another step on the way to delivering the recommendations from the National Review of Eating Disorder Services and I am grateful to all those involved in putting it together.

“The full implementation of this specification has been a long-term goal but by working alongside clinicians, patients and their families, we aim to build a brighter, healthier future for everyone affected by eating disorders in Scotland.”

Chair of the National Eating Disorder Network Professor Cathy Richards said: “I’m delighted that the national specification has now been published and want to recognise the hard work of all who have been involved in its development. It is a privilege to work with such a committed group of stakeholders.

“I want to recognise the dedication of those delivering vital care and treatment amidst real and pressing challenges.

“I look forward to working with everyone involved to develop local, regional and national improvements to ensure the new national standards are delivered consistently to benefit all those affected by eating disorders.”

Co-Chair of the National Eating Disorder Specification Working Group, Lived Experienced Peer Researcher, Ellen Maloney said: “The launch of new national guidance is important to make sure that everyone in Scotland who experiences an eating disorder can access the right help at the right time.

“I hope these standards will make a real difference for people with eating disorders, providing the care and support they need.”

Westminster: Biggest overhaul in a generation to children’s social care

The UK Government will today embark on major reform to end years of neglect of the children’s social care support system – breaking the cycle of late intervention and helping keep families together wherever possible so every child has the opportunity to thrive.

A wide range of new reform measures will be set out in Parliament to deliver better outcomes and a more secure life for children across the country. The government will empower social workers, and all those that work with children, to take action against children’s placements providers that deliver subpar standards of care at sky-high costs to councils and focus the system on early intervention.

It comes as local government spending on looked after children has ballooned from £3.1 billion in 2009/10 to £7 billion in 2022/23, with social workers all too often burdened by heavy caseloads, struggling to deliver the help that children and families need before problems escalate.

Bridget Phillipson, Education Secretary, said: “Our care system has suffered from years of drift and neglect. It’s bankrupting councils, letting families down, and above all, leaving too many children feeling forgotten, powerless and invisible.

“We want to break down the barriers to opportunity and end the cycle of crisis through ambitious reforms to give vulnerable children the best life chances – because none of us thrive until all of us do.

“We will crack down on care providers making excessive profit, tackle unregistered and unsafe provision and ensure earlier intervention to keep families together and help children to thrive.”

One of the most entrenched challenges facing children and social workers is some private providers, that are siphoning off money that should be going towards vulnerable children, making excessive profits or running unregistered homes that don’t meet the right standards of care. 

According to analysis by the Local Government Association, there are now over 1,500 children in placements each costing the equivalent of over £0.5 million every year, while the largest 15 private providers make an average of 23 per cent profit.

New rules will require key placements providers – those that provide homes for the most children – to share their finances with the government, allowing profiteering to be challenged. Increasing financial transparency will ensure the providers that have the biggest impact on the market don’t unexpectedly go under and leave children without a home.    

There will also be a “backstop” law to put a limit on the profit providers can make, that the government will introduce if providers do not voluntarily put an end to profiteering. 

Not-for-profit providers and those backed by social investment are being called on to come forward to set up homes to strengthen the system. 

To protect quality and safety in children’s homes, Ofsted will also be given new powers to issue civil fines to providers, working more quickly to deter unscrupulous behaviour than with existing criminal powers. 

More widely, the government is beginning the process of rebalancing the whole children’s social care system in favour of early intervention, giving every family the legal right to be involved in decisions made about children entering the care system. 

Further plans for funding for children’s social care including investment in preventative services, are set to be laid out in the coming weeks in the upcoming Local Government Finance Settlement.

Cllr Arooj Shah, Chair of the Local Government Association’s Children and Young People Board, said: “It is positive to see the Government building on recent progress following the Independent Review of Children’s Social Care, and pursuing an approach rooted in what we know works for children and their families.

“We are particularly pleased to see an ongoing focus on early help and family networks, and a strong commitment to tackling profiteering and other problems in the market for children’s social care placements. 

“Moving forward, progress will be limited by the significant funding and workforce challenges within children’s social care, councils and amongst partners more widely.

“It is vital that the Government uses the forthcoming Spending Review to ensure that all those working to keep children safe and to help them thrive have the resources they need to do that well.”

Children’s Commissioner Dame Rachel de Souza said: “Every child deserves to grow up safe, happy, healthy and engaged in their communities and in their education. With this Bill we have an opportunity to repair how we treat childhood in this country.

“Children are paying the price of a broken social care system that allows profits over protection. They are enduring things no child should ever have to: living in isolation in illegal children’s homes, often at enormous cost, deprived of their liberty without due process, often surrounded by security guards instead of receiving love and care.

“Children in the social care system today are living week to week in limbo. They need action without delay, not plans or strategies, so I welcome the urgency with which this government is setting out plans to tackle some of the most entrenched challenges. There must be no limits on our ambition for these children and I will look forward to working closely with ministers to push for radical reform.”

Sir Martyn Oliver, Ofsted’s Chief Inspector said: “These new powers will allow Ofsted to do more to make sure all children’s homes are safe and nurturing places, and to combat illegal and poor-quality homes quickly and effectively.

“We welcome these reforms and stand ready to deliver the Government’s new asks as soon as possible.”

Sarah Cardell, CEO of the CMA, said: “We are pleased to see the government taking this next step towards reforming the children’s social care market, in line with our recommendations.

“Our market study found multiple concerns – including a shortage of appropriate places – which need to be tackled to ensure vulnerable children and young people are getting the homes they need. We will continue to work with the government to make sure the plan delivers longstanding improvements.”

Other key measures set to be announced today include: 

  • New powers for Ofsted to investigate multiple homes being run by the same company, acting on the recommendations made in response to the vile abuse uncovered at the Hesley group of children’s homes. 
  • Delivery of the manifesto commitment to introduce a consistent child identifier, making sure information can be shared between professionals so they can intervene before issues escalate.  
  • The requirement for every council to have ‘multi-agency’ child safeguarding teams, involving children’s schools and teachers, stopping children from falling through the cracks. 
  • The requirement for all local authorities to offer the Staying Close programme – a package of support which enables care leavers to find and keep accommodation, alongside access to practical and emotional help, up to the age of 21, ending the cliff-edge of support many experience at 18.  
  • A new duty on parents where if their child is subject to a child protection enquiry, or on a child protection plan, they will need local authority consent to home educate that child.

The government will continue to work closely with the sector and local authorities as these changes are introduced to ensure the best possible outcomes for all children and young people, and their families.

Space to Grow: Children First launches free emotional health and wellbeing support for children

Children in Edinburgh and Glasgow can now access free face-to-face emotional health and wellbeing support from Children First thanks to funding from BBC Children in Need, in partnership with The Children’s Society and MACS Supporting Children and Young People.

Glasgow and Edinburgh are two of 13 areas chosen to host the new Space to grow programme, which aims to support around 6,000 children aged 8 to 13 over the next two years across the UK.

From November, Children First will be able to extend its existing services and reach in Scotland’s two largest cities, working with schools and other local partners to help even more children. 

The service isn’t just for children. Parents, carers, and school staff will also receive resources to help them talk about tough topics with youngsters. Parents and carers across Scotland will also be able to access help for any young person they are worried about via Children First’s support line on 08000 28 22 33.

Space to grow specifically targets children who are often underrepresented in emotional health services, including those from the global majority, young carers, and LGBTQ+ youth. Alongside direct support, the programme will build an evidence base to advocate for improvements in emotional health and wellbeing services.

Debbie Noble, assistant director at Children First, said: “At Children First we’re passionate about protecting Scotland’s children. So, we’re delighted to be working with BBC Children in Need, the Children’s Society and MACS through the Space to grow partnership to give thousands of children hope and a brighter future.

“Any adult in Scotland who is worried about a child’s emotional health and wellbeing can call our support line, 365 days a year for help and advice, or contact us via our website – www.childrenfirst.org.uk.”

Mark Russell, Chief Executive of The Children’s Society, said: “We’re thrilled to launch Space to grow and support so many children before they reach crisis point.

“The £1 million from Children in Need lets us reach children who often miss out on early help. We look forward to seeing thousands more children happier, healthier, and thriving by the end of the programme.”

Dr Alex George said: “I was honoured to meet with the brilliant team at The Children’s Society back in May to present them with the BBC Children in Need A Million & Me Award.

“It has been a pleasure to follow their journey since and see them make great strides in the early intervention approach to mental health in such a short amount of time.

“I look forward to seeing their continued impact in the space with the launch of the programme, inspiring safe and regular conversations around mental and emotional wellbeing”.  

Free SAMH event to help boost physical activity and sport as a mental health solution in Edinburgh

Scotland’s largest mental health charity is hosting a free panel discussion exploring how physical activity and sport can help tackle the current mental health crisis.

SAMH (Scottish Action for Mental Health) are inviting anyone involved in local sport, such as coaches, personal trainers, jog leaders and more, to join the event, hosted at the stunning Playfair Library Hall at the University of Edinburgh on Friday 29 November.

Speaking at the event will be Stuart Campbell, Director of the World Athletics Indoor Championships in Glasgow—the first major event in Scotland to pledge to Scotland’s Mental Health Charter. Stuart will be joined by Professor Larissa Davies, a specialist in the economic impact of sport and physical activity. Attendees will also hear first-hand from people with lived experience of mental health problems, and the role physical activity had in their recovery.

Stuart Campbell, Director of the World Athletics Indoor Championships 2024, said: “My goal is to highlight what can be achieved through a social impact campaign in partnership with a major sporting event. We need input from all corners of our communities to challenge us to improve.

“This is a chance to start working together to ensure that upcoming sporting events truly resonate and prioritise your best interests. A Scotland that values wellbeing, supports mental health, and cares for its citizens is a stronger, prouder, and more prosperous Scotland.”

Attendees will have the opportunity to create connections with industry peers, share best practice, spread awareness of their work and ask questions directly to our panel of leading experts during a Q&A session.

Professor Larissa Davies, Professor of Applied Sport Economics at the Manchester Metropolitan University, said: “Physical activity is an important preventative health tool for combating poor mental health. 

“Being active reduces the likelihood of depression and anxiety, as well as the risk of non-communicable health conditions such as dementia. In addition, it also improves life satisfaction and general wellbeing.

“The case for investing in physical activity to address Scotland’s mental health crisis has never been stronger.

“My research focuses on measuring and valuing the social value of sport and physical activity, including the impacts on health, wellbeing, and social capital, both in the UK and internationally.

“Recent projects include the new social value model for sport and physical activity in England, and a study of Gaelic Games on the island of Ireland.

“I am looking forward to sharing more about my social value research, which spans across more than 15 years.”

The event is delivered in partnership with sportscotland and the University of Edinburgh and is free to attend for anyone who is interested.

Sign-up here Active Lifestyles: A high impact, low cost mental health solution Tickets, Fri, Nov 29, 2024 at 10:00 AM | Eventbrite

Scotland’s most advanced skin cancer clinic launches on Granton Waterfront

LEADING experts in dermatology and plastic surgery have joined forces to create a skin cancer facility for patients seeking rapid and expert treatment. 

Waterfront Private Hospital in Edinburgh has officially launched Scotland’s most advanced and efficient skin cancer clinic, enabling rapid access consultations, one-stop biopsies and direct access to definitive surgical treatments – all under one roof.

Led by Dr Ben Aldridge, the UK’s only dual-qualified Consultant in both Dermatology and Plastic Surgery, the service is supported by Dr Kazem Nassar, an esteemed NHS Consultant Plastic and Reconstructive Surgeon.

After graduating in 2002 from University of Edinburgh Medical School, Dr Aldridge has gone on to become a preeminent skin cancer expert. He completed multiple skin focused advanced training fellowships including at the UK’s National Skin Hospital.

He has a PhD in skin lesion diagnostics, publishing extensively in this subject along with co-authoring national skin cancer guidelines and is also Chairman of South East Scotland’s Melanoma Multidisciplinary team.

He said: “Our dual approach means we can combine dermatology and plastic surgery expertise in one consultation, saving patients multiple visits.

“Our focus is not just on removing patients’ skin cancer effectively but also ensuring the best cosmetic results for each individual, with a bespoke approach that draws on our extensive aesthetic surgical training.

“Many skin cancers are on the head and neck, requiring reconstruction due to limited spare tissue, which we handle expertly using advanced plastic surgery techniques and cosmetic surgical principles.

“We’re confident in saying we provide the fastest and most efficient private skin cancer service in Scotland and our goal is to be the definitive place for private skin cancer treatment, making a tangible difference to patients’ lives.”

NHS waiting lists have expanded significantly since the pandemic, with patients often waiting up to 12 months or more for non-high risk dermatological assessments.

Waterfront Private Hospital is stepping in to help address this crisis, removing many of the steps typically required in the process.

Even within an urgent skin cancer pathway both NHS and Private patients can expect multiple different and separate steps; starting with a GP referral, often followed by dermatology consultations, diagnostic biopsies, plastics surgery consultations, before final definitive treatment.

With the NHS under increasing strain, Waterfront Private Hospital provides a streamlined alternative, easing the pressure on public health services while delivering state-of-the-art care.

Patients can expect a premium healthcare experience, where the hospital’s boutique aesthetic is paired with cutting-edge medical expertise. The hospital is known for its highly personalised care, ensuring each patient receives attentive follow-up from their surgical team.

Opened in recent months, Waterfront Private Hospital in Granton, Edinburgh, is a family-owned institution founded by the renowned Dr Omar Quaba and his father, Dr Awf Quaba. The Quaba surname is among the most recognised in UK cosmetic surgery.

To find out more about skin cancer treatments at Waterfront Private Hospital, please visit: https://www.waterfronthospital.co.uk/treatments/skin-surgery/skin-cancer

Six Ways To Celebrate World Kindness Day & To Boost Your Own Wellbeing

wellbeing expert has urged people to get involved in World Kindness Day to boost their own well-being. 

Lynn Crilly says kindness is much more than ‘a nice thing to do’ as it can have a positive effect on both our mental and physical health. 

Her comments come ahead of World Kindness Day, ( 13 November) and urges individuals and communities to embrace kindness in all their actions. 

Lynn said World Kindness Day is a great opportunity to come together. 

“When we experience kindness, our brain releases a hormone called dopamine which boosts our mood,” she explains.

“When a stone is dropped into water it creates waves. Acts of kindness have that same ripple effect. Studies have shown that when we are kind, it inspires others to be kind, spreading outwards to friends, their friends and their friends. 

“That three degrees of separation means when a person is kind to another it could positively affect up to 125 people.”

The saying is that kindness costs nothing, and with many people concerned about their income, Lynn has provided ways of including kindness into your everyday life  which don’t cost a penny:

  1. Volunteer your time

You might be cash poor but if you have a little extra time in your schedule, you should try to volunteer. Giving up some of your free time to help others can make their day. This can make you feel good in the process. By giving your time to causes you support you can also meet new people who share your interests and perhaps create new friends. Helping out in an animal shelter or visiting elderly people who may be lonely are just two ideas where your time can make a real impact. 

  1. Hugging Helps

One of the best ways of showing kindness and support to friends and loved ones is to give them a hug.  “Oxytocin, also called the ‘cuddle hormone’ , is released from human contact,” she says. “It can help lower the heart rate and reduce stress levels and can even help reduce pain from inflammation and promote wound healing.”

  1. Provide a helping hand

Random acts of kindness can be easier than you think. Whether it’s holding a door open for someone who has their hands full or the person behind you entering a store, it takes about ten seconds of your time and shows that other person that they do matter. Another way to offer a helping hand is to check in on a neighbour to see if they need any help with jobs. You can double up the social interaction by taking them shopping or to an appointment, rather than just doing the task for them. 

Offering a random act of kindness can be easier than you may think. One of the easiest ways to share your positive energy is to hold the door open for someone. Whether it’s an elderly person, a person with their hands full, or just the man or woman following you into the store, you don’t need a reason to hold the door. It costs you roughly ten seconds of your time and can make the other person’s day.

  1. Pay a compliment

We tend to gravitate towards people that show us kindness. This is mainly because kindness reduces the emotional distance between each other and helps us to feel more bonded. One way of showing kindness to someone else is to pay them a compliment. It costs nothing, can help boost self-esteem and it could even help bridge a gap which might exist between two people. 

  1. Donate your unwanted items

We all have things in our houses – and particularly our wardrobes – we don’t use. The items you take off the shelf only to dust aren’t doing you any good, but they could make a real difference to someone else. Those on the lowest incomes rely on charity shops or sites like recycle for everyday items. And the charity shops themselves need good quality donations so they can continue to support their work. 

  1. Offer technological help

For younger people who are more likely to be short of cash, their knowledge of digital technology can be so helpful to the older generation. As more of life moves online, including access to healthcare, taking time to help someone get online or show them how to use an app is a great way of helping others. Plus, it allows you to spend time with someone who might be lonely – but also has a lot of life experience they can share. 

PCHP: Men’s Wellbeing Tuesdays

Join PCHP every Tuesday from 1-3 PM for a variety of activities designed to boost your wellbeing! From sports to mindfulness, there’s something for everyone.

Meet New People: Connect with others and build lasting friendships.

Take Time for You: Prioritize your mental and physical health.

Improve Wellbeing: Engage in activities that promote overall wellness.

Men Together: A supportive environment for men of all cultures.

Be Yourself: A safe space to express who you are.

Explore the Community: Discover local gems and beyond.

Nature Heals: Experience the therapeutic benefits of nature.

Come as you are and join us for an enriching experience! 🌿

New to PCHP? Get in touch via email hello@pchp.org.uk

#MensWellbeing

#Community

#Mindfulness

#Sports

#NatureTherapy

#AllAreWelcome

Almost 1000 people sit on waiting list for ‘life changing’ diabetes technology in NHS Lothian

New figures have revealed that almost 1000 people within the NHS Lothian region are waiting for life changing hybrid closed loop (HCL) system.

This is a devastating blow for diabetic patients who face extensive wait times to receive the technology.

Hybrid closed loop systems work to automatically adjust glucose levels depending on a patient’s blood sugar.

This is in stark contrast to the current system where the patient must manually adjust and administer the insulin themselves.

Paul Hughes, who works for Edinburgh Council and has had diabetes for 24 years, finds himself stuck on the waiting list for a HCL system.

Mr Hughes originally requested to be added to the waiting list in 2021 but found out, after inquiry, that he had not been added until 2023.

He is concerned that the ‘postcode lottery’ will mean he is not able to access an HCL system for the foreseeable future.

Mr Hughes has previously suffered a broken cheek and elbow from collapsing due to his blood sugar levels dropping too low.

He believes an HCL system is critical to improving his diabetes control and avoiding similar incidents in the future.

These figures were first revealed via FOI, by Labour MSP for Lothian, Sarah Boyack.

Ms Boyack has written an open letter (above) to Cabinet Secretary for Health, Neil Gray to ask what actions the Scottish Government is taking to urgently reduce these waiting lists.

Earlier this year, Ms Boyack hosted a roundtable of diabetic constituents who raised access to diabetes technology as a critical issue.

Commenting on these figures, Ms Boyack said: “The size of the waiting list is extremely alarming. This is life changing technology and patients across Lothian are in limbo waiting to receive it.

“I have had many constituents contact me, anxious about the lack of clarity for when they will receive an HCL system.

“The Scottish Government have announced funding to expand the HCL rollout, but it means nothing if it is not reaching people on the ground. That is why I have written to Neil Gray to ensure that type 1s across NHS Lothian are not left out in the cold when it comes to getting a HCL system”.

Paul Hughes added: “This technology would be life changing for me. I would no longer have to worry about my blood sugar dropping during the night, which currently keeps me awake.

“I am incredibly concerned about the long waiting list for those in NHS Lothian.

“I have sustained serious injury from collapsing due to low blood sugar so this technology cannot come soon enough.”

PCHP: Embrace Nature and Connection This Winter

As the days grow shorter and the nights longer, it’s more important than ever to prioritize our well-being. Spending time in nature and with loved ones can be a powerful antidote to the winter blues.

Here’s why:

Boosts Mood and Reduces Stress: Nature has a calming effect on our minds. A walk in the park or a hike in the woods can lower stress levels and improve mood. 🌳

Enhances Physical Health: Fresh air and physical activity are great for our bodies. Even a short outdoor stroll can boost your immune system and keep you active. 🚶‍♂️

Strengthens Relationships: Spending quality time with friends and family fosters deeper connections and provides emotional support. Whether it’s a cozy indoor gathering or an outdoor adventure, these moments are invaluable. ❤️

Combats Seasonal Affective Disorder (SAD): Exposure to natural light, even on cloudy days, can help alleviate symptoms of SAD. Pairing this with social interactions can further enhance your mental health. ☀️

Encourages Mindfulness: Nature encourages us to slow down and be present.

This mindfulness can help us appreciate the beauty around us and find joy in the little things. 🌼

So, bundle up, step outside, and make time for the people who matter. Let’s make this winter a season of connection and wellbeing! ❄️

PCHP’s Community Wellbeing Programme has lots to offer you this #Winter, why not pop in and take a look at our sessions or speak to one of the team.

#WinterWellness

#NatureTherapy

#StayConnected

#MentalHealthMatters