Surgerydoor - Health News

The results of a new survey issued last week by The Stroke Association shows that people are more concerned for their wealth than the health of their brain.

Conducted by GfK NOP, the survey found that the prospect of losing a bank card would prompt an immediate reaction from most respondents (88%) whereas when asked what someone should do if they experienced the symptoms of a stroke – which causes immediate brain damage - one third of people would wait up to 24 hours or more before taking action.

It was the 45 – 54 year olds that were most aware of what they should do in the event of a stroke with the 16-24’s and 65+ age groups least likely to take immediate action. Yet 25% of all strokes will happen to those under 65.

Women were more aware of the risk of the symptoms of stroke - 69% of women said call 999 immediately on experiencing the symptoms of stroke - in comparison to just 59% of men. However 87% of women and 89% of men would get in touch with their bank straight away if they lost their bank card.

The charity believes that this is because the general public are still not aware of the devastating impact of stroke – the UK’s third biggest killer. A stroke is a brain attack which, tragically, can strike without warning and leave sufferers paralysed, blind or unable to speak. Only 33% of the public realised that a stroke causes immediate brain damage.

This lack of awareness was further underpinned recently in a survey that showed that people believed they were more at risk of being mugged than having a stroke. Yet official figures show that whilst a mugging occurs up to every 13 minutes, someone has a stroke every five minutes.

Joe Korner, Director of Communications at The Stroke Association comments: These results highlight how stroke continues to be misunderstood by the public and is way down on their agenda. People simply do not realise the devastation that a stroke can cause or that it can be prevented. To tackle this, The Stroke Association has launched an advertising campaign - Leading the fight against brain attacks - to highlight this life-changing condition and the need for increased funding into stroke research”.

When asked how much funding went into stroke research, respondents were also wildly off the mark. Latest figures show that annual charity research funding into stroke was just £2.6 million, yet just under half of people questioned believed funding to be more than 10 million whilst a quarter did not have any idea. 11% of men thought that funding exceeded £50 million.

Professor Joanna Wardlaw is a leading stroke researcher: “Many of the really important advances in stroke care that are now in clinical practice all over the world, have come from doctors, nurses, other therapists and scientists in the UK.

“Stroke is an underfunded area but this research is vital for improving outcomes for stroke survivors. Donating funds for stroke research and encouraging hospitals and patients to participate in stroke trials is crucial for the future of stroke care - not only in the UK but across the world.”

Joe Korner concludes; “The Stroke Association leads the fight against brain attacks by supporting stroke survivors and funding vital research. This research has saved lives. But we need your help to do much more.”

Stroke - Medical Conditions
Life After a Stroke

Labels: stroke, stroke association, wealth

• Chlamydia increased by 4% (from 109,418 in 2005 to 113,585 in 2006)
• Genital warts increased by 3% (from 81,201 in 2005 to 83,745 in 2006)
• Genital herpes increased by 9% (from 19,830 in 2005 to 21,698 in 2006)
• Syphilis decreased by 1% (from 2,804 in 2005 to 2,766 in 2006)
  Gonorrhoea decreased by 1% (from 19,248 in 2005 to 19,007 in 2006)
• Figures for other STIs such as pubic lice and non-specific genital infection decreased by 0.1% (from 135,840 in 2005 to 135,707 in 2006)

Dr Gwenda Hughes, Head of the STI Section at the Agency said, “The groups who we are most concerned about are young adults and gay men and it's crucial that we reach these groups with messages about safe sex, including condom wearing, and the importance of getting tested if they feel they've put themselves at risk of contracting an STI. One way to control chlamydia in young adults is the National Chlamydia Screening Programme, which aims to provide a test each year to sexually active under 25 year-olds in health settings outside of GUM clinics. 51% of primary care trusts are screening and a further 34% of PCTs are about to begin screening.”

“We have seen a continued and substantial increase in infections amongst gay men. This is of concern because by engaging in unsafe sex these men are also placing themselves at risk of HIV infection.

“The continued rise in the number of people being diagnosed with sexually transmitted infections is in part due to more people coming forward for testing as they are more aware of these infections. During 2006, nearly one million people were screened for an STI at a GUM clinic and the number of people having an HIV test has been increasing each year. The more people who are screened the more will be diagnosed and this will help in the control of these infections.”

Professor Troop continued: “Monitoring of STIs and other infectious diseases forms only one part of the Agency's work in safeguarding the UK 's public health. Our fourth annual report illustrates the many other areas in which the Agency has made significant progress in protecting people's health over the last year. For example, the extensive follow-up of those involved in the Polonium-210 incident, work in tackling blood borne infections such as hepatitis B and C in the prison community, and continuing to assist the NHS in tacking healthcare associated infections such as MRSA and Clostridium difficile . The Agency also runs exercises to strengthen emergency planning, such as exercise Winter Willow which was the largest live exercise since the Cold War and tested pandemic flu planning. "

Labels: chlamydia, genital herpes, genital warts, sti, syphilis

Faster and more appropriate treatment for patients at risk of sudden death is the outcome of a new imaging technique developed by cardiologists at Royal Brompton Hospital, according to research supported by the British Heart Foundation and published this week in the Journal of the American College of Cardiology.

The technique can reveal the presence and extent of scar tissue on the hearts of people with a life-threatening condition called dilated cardiomyopathy (DCM).

DCM is the second most common cause of heart failure in the UK, with more than 11,000 people developing the condition every year.

By detecting the scar tissue, cardiologists involved in the research were able to better determine the risk of hospitalisation or death and could therefore ensure patients received timely, appropriate care for their individual needs.

The cardiologists found that scar tissue, known as midwall fibrosis, occurs in approximately 30% of patients with DCM and that these patients are three times more likely to be hospitalised or die suddenly.

Lead researcher, consultant cardiologist at Royal Brompton and professor of cardiology at Imperial College London, Professor Dudley Pennell, explains: “Prior to this technique, we found it difficult to identify which patients with DCM were at greater risk than others without using invasive procedures.

"Therefore, it was difficult to decide which patients could be treated effectively using drugs alone, and which patients needed life-saving devices implanted."

The technique developed by cardiologists involves injecting a dye called gadolinium into a vein in patients prior to having an MRI (Magnetic Resonance Imaging) scan.

The gadolinium sticks more in the scar tissue than the surrounding tissue because scar tissue has a lower blood supply than normal tissue. The special magnetic properties of gadolinium makes scar tissue appear brightly on the scan and very easy to detect.

The research team studied 101 patients with and without scar tissue for approximately two years to determine the affect of scar tissue on the patients' health outcomes.

Professor Peter Weissberg, medical director of BHF, said: "In this BHF-supported study, magnetic imaging has provided a crucial window on why some people with DCM are at high risk of dangerous heart rhythm disturbances.

"This is an important advance that will help doctors prevent lives being lost to the condition."

'Alcohol makes you feel invincible when you are most vulnerable' says a hard-hitting new campaign launched next week which will urge young people to know their limits when they have a drink.

The new alcohol ad campaign will illustrate a series of different scenarios where young people, thinking they are 'superheroes' while drunk, take risks with their health and safety, for example, falling off high scaffolding, walking home alone, running into a busy road, getting into fights and coming to serious harm.

The joint Department of Health and the Home Office campaign primarily aims to encourage 18 to 24 year olds to drink responsibly and be aware of the possible serious consequences of drinking to excess.

However, the campaign is also designed to appeal to a slightly younger age group, which research suggests may already be drinking illegally. It is hoped that we may be able to influence their future drinking habits if messages are targeted to them earlier.

Latest figures show that:
- 70 per cent of peak time A & E admissions are alcohol related
- One in three reported rapes happens when the victim has been drinking
- Around half of all violent crime is alcohol related
- Figures show that for 16 to 24 year olds in England, 33 per cent of men drank more than 8 units on at least one day and 24 per cent of women drank more than 6 units on at least one day.
- Younger people are likely to drink heavily
- 48 per cent of males and 39 per cent of females aged 16 to 24 drink above the daily recommendations.

The Know Your Limits campaign will start on October 16 with a thought provoking TV advert. Advertising will be spread across cinema, radio, magazines and online throughout November.
Public Health Minister Caroline Flint said: "In England is it estimated that 5.9 million people drink to get drunk. Males and females aged 18 to 24 are our priority in this campaign as they are the most likely to drink irresponsibly.

"We are not trying to demonise alcohol or stop people enjoying themselves. This is about encouraging young people to still have a good time but to know their limits, and to take responsibility for how much they drink. "Drinking too much alcohol alters your judgement and perception and can lead to people taking risks with their health and safety that they would never normally even consider while sober.

"This high profile advertising campaign will support the actions that the Government is taking to tackle the problem of alcohol related harm and we hope it will help create a culture where drinking responsibly is the norm. "We need to get the responsible drinking message across as 80 per cent of pedestrian deaths on Friday and Saturday nights are drink related and nearly three quarters of peak time A & E admissions are alcohol related."

Home Office Minister Vernon Coaker said: "We all have the right to enjoy a few drinks with friends and family but in doing so we have a duty of care to behave responsibly and not risk the safety and wellbeing of ourselves or other people.

"People who drink to excess put themselves in unnecessary danger and have to live with the consequences of their actions, whether that's being arrested, an £80 fine or the unpleasant prospect of physical harm.

"This new £4 million advertising campaign illustrates the consequences people could face for drinking to excess. I want people to continue enjoying their nights out but urge them to drink sensibly to avoid situations that could result in police involvement, injury or worse.

"The Government is dedicated to reduce alcohol related harm and will continue to work with the police to clamp down on irresponsible drinkers and retailers while strengthening our partnerships with the alcohol industry to entrench responsible alcohol sales."

Srabani Sen, CEO of Alcohol Concern said: "We're delighted to see the launch of this campaign. Alcohol Concern has long argued that messages promoting sensible drinking need to be actively promoted and designed with specific groups in mind if they are to have any impact. This is especially true of 16-24 year olds, where binge drinking is widely considered to be a 'rite of passage' into adulthood.

"This campaign marks an important starting point in changing young people's attitudes to binge drinking but there's still a great deal more to do if we're to change the way young people in this country think about their relationship with alcohol."

David Poley, Chief Executive of the The Portman Group said: "Drinks companies have no wish to see their products misused by binge drinking young adults. We therefore warmly welcome this Government campaign which complements the educational work already carried out by the industry". Professor Ian Gilmore, President of the Royal College of Physicians, said:

"This launch is really important. If we can start to change young people's drinking patterns, there is a chance that we may begin to turn the tide of escalating cirrhosis deaths that we are currently seeing in people in their 30s and 40s."

The Government is failing to ensure that quality health care is being delivered to people with the worst health. And it could face a legal challenge under new disability equality laws unless discriminatory practices, uncovered in an 18 month long investigation by the Disability Rights Commission (DRC), are eliminated.

The DRC’s Formal Investigation, ‘Equal Treatment: Closing the Gap’, probed the experience of people with mental health problems and/or learning disabilities of primary care services in England and Wales (1) after international research showed that these two groups were at higher risk of serious physical health problems.

From December 2006, the NHS – including Primary Care Trusts in England and Local Health Boards in Wales - will come under the Disability Equality Duty which places them under an obligation to ensure that their policies and practices do not discriminate, and do promote equal opportunities for disabled people. But a wide range of current practices, identified by the investigation, could clearly breach this duty.

The investigation provides important new evidence that people with learning disabilities and people with mental health problems are more likely to experience major illness, to develop serious health conditions at an earlier age and to die of them sooner than other people. Yet they are also less likely to receive some of the important evidence-based treatments and health checks than others with the same condition but without a mental health condition or learning disability. They also face real barriers to accessing services.

In the course of the investigation the DRC encountered complacency and a lazy fatalism that these groups ‘just do’ die younger, or ‘just won’t’ look after their health or attend appointments, often with no efforts in place to make it possible for these groups to use the services on an equal basis to everyone else.

The investigation argues for a clear shift in approach – not only to root out unequal treatment but also explicitly to target these very high risk groups for health checks and follow-up treatments. This will prevent the extra costs of serious ill health being passed on to other parts of the National Health System and enable these groups to be healthier and participate fully in society.

The investigation, which took evidence from senior health professionals, policy makers and disabled people themselves, undertook research in four areas (one local health board in Wales and 3 Primary Care Trusts in England) and analysed eight million health records, from the EMIS general practices contributing to the QRESEARCH database - the largest study ever undertaken anywhere in the world. The evidence from primary care records shows that:

• people with mental health problems (schizophrenia, bi-polar disorder or depression) have higher rates of obesity, smoking, heart disease, diabetes, respiratory disease and stroke than other people. Those with bi-polar disorder or schizophrenia also have higher rates of hypertension and breast cancer;
• people with learning disabilities have higher rates of obesity and respiratory disease, and high levels of unmet health needs;
• people with schizophrenia are almost twice as likely as other citizens to have bowel cancer - the second most common cause of cancer death in Britain. This is a completely new finding internationally;
• both people with mental health problems and people with learning disabilities are likely to die younger than other people. People with mental health problems are more than twice as likely as others to get illnesses like strokes and coronary heart disease (CHD) before the age of 55.

Once they have them, they are less likely to survive for 5 years.

The investigation also identified serious weaknesses in addressing these groups’ healthcare needs. It would be expected that more attention from health services would be offered to address these very high levels of health need. In some cases it was, but some important health checks and treatments are provided less often:

• people with learning disabilities who have diabetes have fewer measurements of their body mass index than others with diabetes; those with stroke have fewer blood pressure checks than others with a stroke. They have very low cervical and breast cancer screening rates;
• for people with mental health problems, some tests and standard treatments – such as spirometry to diagnose respiratory illness, or cholesterol checks and the prescriptions of statins for people with heart disease – are given less often than to people without mental health problems.

On the positive side, there was no evidence that mental health patients with serious symptoms such as abnormal bleeding, which could signal cancer, received a worse follow up than other patients. People with learning disabilities and mental health problems also experience ‘diagnostic overshadowing’, that is, reports of physical ill health being viewed as part of the mental health problem or learning disability, and so neither fully investigated nor treated appropriately.

Despite high levels of ill health, over 50% of people with mental health problems and/or people with learning disabilities said they experienced difficulties when trying to see their GP. Key barriers include the attitudes of reception staff, inflexible appointment systems and inaccessible information, including information on the side-effects of psychiatric medication. A small number said that they were not registered or struck off a GPs’ list because they were deemed too demanding.

This lack of access could be easily remedied by GPs by offering simple services such as making appointments by email, providing treatment information in large print on tape or in Easyread.
All of these are legally termed ‘reasonable adjustments’ - to make services more user-friendly for disabled people under the Disability Discrimination Act 1999.

Bert Massie, Chairman of the DRC, said: “This investigation has revealed shocking levels of ill health among people with learning disabilities and people with mental health problems, yet their needs are often unmet or they face unnecessary barriers to accessing services.

“The acid test of a national health service is not whether it works for those who are generally healthy, but whether it benefits those with the greatest risk of poor health. Tackling health inequalities is high on the Government agenda, yet there has been a deeply inadequate response from health services and Government to target these groups which, in some cases, is compounded by a dangerously complacent attitude and a lazy fatalism that they ‘just do’ die younger. This is completely unacceptable. We need to see a radical change in the commissioning, targeting and delivery of health services in order to close this gap quickly.”

While the Formal Investigation identified some impressive examples of good practice in primary care, these services are frequently working in isolation. Despite positive policy and practice developed by mental health and learning disability specialists, the lessons have neither become part of mainstream health programmes – nor part of primary care delivery on the ground.

Many of the health professionals who were interviewed wanted to redress the low levels of treatment currently being offered. However the fragmentation of the policy-making process, together with Government inertia in implementing policy drivers and incentives, have ensured that people with mental health problems and/or learning disabilities are getting unequal treatment from primary care services.

The investigation calls on the Government to make the following urgent improvements to close the gap in healthcare outcomes for disabled people:

• include positive incentives in the GP contract to offer regular health checks for people with learning disabilities and/or mental health problems;
• centrally target these high risk groups in national health inequalities programmes and track progress over time, so that it is known whether poor health and preventable early death are being tackled effectively;
• expect every local health service to analyse the needs of the whole population – including these groups – and make sure that any contracts for health services meet their needs;
• ensure screening programmes are targeted correctly at people with learning disabilities and/or mental health problems;
• the national bowel cancer screening programme should consider offering screening to people with schizophrenia and consider prioritising them in the future;
• ensure that all medical and nursing training explicitly tackles ‘diagnostic over-shadowing’ – ensuring they look for physical health problems, rather than assuming everything is to do with psychiatric problems or a learning disability;
• ensure all policy is subjected to Disability Equality Impact Statements and that tackling poorer health outcomes is part of primary care’s Disability Equality Schemes;
• all GP surgeries and other primary care services should invite disabled people to record their access needs on their medical record, and then meet them;
• governments in England and Wales must produce detailed actions to deliver the DRC’s recommendations, which will be checked for progress by an independent inquiry panel in a year’s time.

An overwhelming 92 per cent of Scottish bar staff say their workplaces are healthier since the introduction of the smoking ban six months ago – according to an opinion poll commissioned by Cancer Research UK published this week.

And more than three quarters (78 per cent) of those surveyed believe that the legislation will benefit their health in the long term.

To celebrate the success of the ban, Cancer Research UK is re-launching the iconic poster campaign that welcomed the introduction of the historic law in March. The revamped posters show the stubbed out cigarette crushed into the shape of Scotland but bear the new message ‘Smoke-free and saving lives’ underneath. The image will appear on poster sites, in press and on buses.

Professor Gerard Hastings, Director of Cancer Research UK’s Centre for Tobacco Control Research at Stirling University, said: “This is great news. The survey results show that, in just six months, the people of Scotland are already reaping the health benefits of the going smoke-free.”

Even bar workers who smoke are overwhelmingly positive about the health effects of the new law with 89 per cent reporting that their work environment is now healthier because of it, and 69 per cent believing that it will benefit their health in the long term.

Professor Hastings added: “By protecting people from secondhand smoke and helping smokers to quit, Scotland’s smoking ban will save many thousands of lives in the next decade."

The survey also shows that more young people than older people think the ban is benefiting their health. Eighty-two per cent of 18-29 year olds compared to 67 per cent of those over 50 years believe their workplace is now much healthier. This echoes previous research that found that young people are most proud of Scotland leading the way on smoke-free legislation.

More than 500 bar workers from across Scotland took part in the opinion poll. There were no significant regional differences in terms of whether bar workers felt healthier since the ban.

Cancer Research UK’s chief executive, Professor Alex Markham, said: “Scotland should be proud of having moved so fast to embrace smoke-free legislation. While the rest of the UK plays catch up, Scotland has led the way in showing how to ensure a smoke-free future.

“Most smokers want to quit. And the ban gives them a golden opportunity to stop smoking for good.”

Delegates on the second day of the Health Protection Agency's annual conference will learn about updated diagnostic tests developed to simultaneously detect the avian influenza H5 or seasonal human flu virus.

As awareness regarding avian flu increases in the UK and flu season starts, increasing numbers of ‘possible' human cases, may be reported to the Agency from GPs, A&E and other healthcare settings and it is essential to quickly rule out H5.

The updated tests based on detection of viral genetic material, called a Polymerase Chain Reaction (PCR) assay ensures results can be given to patients quickly and any necessary treatment or public health actions can be taken. The test is available to all Agency laboratories and will be used for flu surveillance this coming winter.

Dr Martin Curran, who developed the test for the Agency said, “Although the risk of someone returning to the UK with H5 is quite small, it is crucial that we have tests available in case we do see a suspect case. The added bonus is that this test can also provide laboratories with information on seasonal flu strains, which is essential to our knowledge of how flu is circulating in the community.”

“The test was used in the recent outbreak of avian flu in Norfolk where we identified a poultry worker suffering from conjunctivitis caused by an avian virus.”

Professor Pat Troop , Chief Executive of the Agency said "We do not expect to see many suspect cases of avian flu this winter; however this ability to test more efficiently for both infections is reassuring. Most people tested for flu like symptoms; will be suffering from regular seasonal flu. However, if the pandemic alert levels were to change or we had an outbreak of avian flu in the UK , it's vital that we have the capacity to respond as effectively as possible. “