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Sunday, 30 December 2012

Dry January




It’s that time of year again – New Year resolutions. After the excess of the festivities – too much food, too much drink, too many relatives, the thought of not feeling bloated and slightly blotto becomes quite appealing. (If it doesn’t then you haven’t been trying.) So this is where Dry January comes in – it’s a campaign launched by Alcohol Concern www.alcoholconcern.org.uk/home to encourage people to give up drinking for the whole of January  www.dryjanuary.org.uk/ –You can fundraise for Alcohol Concern at the same time or perhaps just donate what you would have spent on alcohol. Whilst it’s not necessary to sign up, there’s nothing like announcing it to the world to make you stick with it (gulp). 

Wine O’clock has jokily but steadily become a part of what many of us regard as time off for adults, time to put a lid on a tough day with a pint of beer or a glass of wine. Sometimes wine o’clock is every day and sometimes it gets a little earlier each day or lasts a little longer. At the time it feels like the answer as problems seem to gently melt away but, all too often the next day it can result in lethargy and lack of energy at best and all the symptoms of a hangover at worst. 
Of course being entirely sober may not be what you want in January. You may prefer to cruise through it ever so slightly comatose, avoiding the unpleasant weather, being back at work and dealing with post Christmas debts. In addition, with a failure rate of 88%, are New Year’s resolutions worth the breath we give them?  
Resolutions of any sort – to lose weight, exercise more, smile more, all rely on will power (or as my friend, @GeorginaPerkins calls it, won’t power). And will power is controlled by a part of the brain called the prefrontal cortex that also keeps us focussed, manages short term memory, and solves abstract problems. So, if we are overtaxed in this department, it is harder to remember that we are also keeping off alcohol or not eating cake.  However, if the not drinking becomes a habit in itself (perhaps it will take a month) then it strikes me the prefrontal cortex doesn’t have to consciously think about the not doing something and it will become easier. This link will tell you more www.planet-science.com/categories/over-11s/human-body/2012/01/science-of-new-year%E2%80%99s-resolutions.aspx

I’ve mentioned Dry January to friends to gauge their reaction (mixed) and I’ve suggested it to my other half - who recognising he might be coerced into it - grumpily queried what the health benefits might be. Not a bad question. What are the benefits? There’s the obvious – lose a few pounds in weight, save a few pounds in cash. Your skin will look better (even for January) and you will sleep better and have more energy.

Alcohol can cause raised blood pressure which in turn carries a risk of stroke and heart disease. It can damage the liver, cause inflammation of the pancreas resulting in nausea, pain and vomiting. The pancreas is also the organ that produces insulin, used to regulate our blood sugar and, diabetes can be linked to drinking alcohol. Excess intake of alcohol is also linked to some cancers including mouth, breast, bowel and liver cancer. Go to Cancer Research UK website for more information: www.cancerresearchuk.org/cancer-info/healthyliving/alcohol/alcohol-and-cancer

There is no shortage of information out there so I won’t reiterate it all here. Check out the excellent websites of Alcohol Concern and Drinkaware www.drinkaware.co.uk/  for further information.
Taking up the no alcohol challenge in January has its advantages – many people will be on a similar health drive – the gyms will be rammed, the pavements awash with joggers, so you won’t be alone. You can complain and share stories of success in equal measure (pardon the pun) and at the end of the month you may just regard alcohol as not quite so important.  Cheers!

Friday, 14 December 2012

Under water



You will remember when we were all flooded just recently (before the ice age struck). Well, I woke up to the sound of water dripping steadily. Sadly, it was not a burst of enthusiasm on the part of the shower but the bathroom ceiling that was spilling out. I touched the ceiling and realised I was standing under a giant sponge. Fortunately, I have the kind of neighbours who always ‘know somebody’ and they put me in touch with a friendly plumber who advised me to empty the water tank which lurks in the loft just to the side of the giant sponge and to stick a screwdriver into the ceiling to relieve the pressure of any water.

I did this in my best nurse lancing a boil manner (ie turned away in case anything hit me) but nothing gushed out, the water kept dripping and a bit of the ceiling came away, sodden and rotten.  A quick investigation in the narrow roof space (by nice plumber not yours truly – too many spiders) was that there was a leak in the roof that had been there for some years but someone had thoughtfully placed a washing up bowl under the leak and a few towels. As we have been in the house six years this was a bit mind boggling. However, I have been fortunate enough to find someone to repair the roof and a plasterer is due soon (no really) to repair the inside.

It did not escape me that I was lucky enough to fix this problem easily and although emptying a huge hot water tank was enough to make me cry (bad enough when it’s a house full of teenagers emptying it for you but to be pouring it away was criminal) but I knew I could afford to do so. I knew too that the damp built up over the years was fairly minimal and unlikely to have been harmful to our health (although it explains the mould that kept growing in the bathroom). 

Others are not so fortunate and damp is all too often a result of poverty caused by poor housing and a lack of heating. Damp leads to mould which can be associated with a range of breathing problems from wheezing to asthma, coughs as well as serious infections such as meningitis.

Nowhere is this brought home so profoundly as by the tragic story of baby Telan Stone featured in the Guardian in association with Joseph Rowntree Trust. http://www.guardian.co.uk/society/video/2012/nov/19/child-damp-temporary-housing-video
The Stone family lived in a one bedroom flat where the damp was bad enough for there to be fungus growing out of the walls. Whilst no direct connection has been made between the damp and Telan’s death, it is absolutely true that people should not be living in such conditions. The Stone family has since been rehoused. 

Six years ago the charity Shelter produced a report highlighting the impact that bad housing had on children’s health http://england.shelter.org.uk/__data/assets/pdf_file/0009/66429/Chance_of_a_Lifetime.pdf  In the report, Shelter recommended the building of affordable homes, doing more to help those on low incomes to stay in their homes, increasing resources to improve the quality of rented homes – both social and private - and called for a target deadline for overcrowding to be a thing of the past.  
 
All these recommendations were made six years ago and still, judging by the Guardian’s poverty series (http://www.guardian.co.uk/society/poverty) or reports from any number of charities, the problems are the same, if not worse now, with welfare cuts and housing benefit caps destroying an already wobbly infrastructure.

From a position of public health, the answer is mostly obvious. Start upstream. If the beginning is poverty, that is what needs to be addressed. Cutting benefits and dividing the world into deserving and undeserving does not solve the problems, it merely tries to cover them up.

It’s a bit like sticking a washing up bowl under a hole in the roof and hoping that the next occupants won’t notice the leak. Eventually it will cause damp, damage and potentially disaster which might not be put right so easily.

Reference
Marmot M, Wilkinson R, (eds) (2004) Social Determinants of Health, Oxford University Press

Sunday, 2 December 2012

Down the drain



Toilet rolls are the latest ‘saving’ that the NHS is making. Staff at one hospital trust, at least, in England (and most likely it’s not the only one), are no longer provided with toilet rolls in staff lavatories so must bring in their own from home. This latest inconvenience in the name of austerity is just one more penny pinching exercise at the front line of the NHS that doesn’t seem to be replicated further up the chain where organisations closer to the DH and the as yet ephemeral Public Health England are struggling to offload their budget under spends before 31 March 2013.
However, the sense of being undervalued that having to bring your own loo roll to work can only inspire, pales into insignificance in the light of the news that 2.5 billion people do not have access to a toilet, worldwide. November 19th was World Toilet Day. For more information go to: http://www.worldtoiletday.org/index.php
And watch this short film produced as part of that event which brings home the indignity and embarrassment this might entail for us in the comfortable developed world: bit.ly/wtd2012a
But what the film does not demonstrate is the disease and despair that a lack of basic toilet hygiene brings.  The non disposal of human waste is an environmental health problem added to which the lack of hand washing means that disease can spread quickly and, according to the World Health Organisation (WHO), diarrhoeal disease is the second leading cause of death among children under five years old. It is both treatable and preventable http://www.who.int/mediacentre/factsheets/fs330/en/index.html  
Improving access to sanitation is a basic and essential step to preventing these deaths. It is also a vital step in providing security and dignity to whole communities.  Public health, as is so often joked, is about drains. Of course it is so much more but even if it weren’t, it’s difficult to think of more essential health needs than good sewerage and a clean toilet (and loo roll).
Let’s hope that the NHS with all its talk of hand washing and reducing the spread of hospital acquired infections does not decide that toilets for staff are an unnecessary luxury.