Marks & Spencer. Two steps forward but one step back ethically.

sliding_down_corporate_ladder_500_wht_7258I was impressed by the steps Marks & Spencer (M&S) was making in reducing the number of infected chickens in our supermarkets.

And M&S seemed to be the only company taking a stand against stocking John West tuna on ethical grounds.

So far so good.

Then I read that M&S were refusing to cut the prices of their goods in hospital shops. You might recall that M&S and WH Smith had all been accused of profiteering by inflating prices on hospital sites where they had a captive consumer group. Gift cards, flowers, and snacks were all priced higher than on the high street.

The companies blamed higher operating costs (a bit like petrol on motorways then?). As a result W H Smith promised to review prices to ensure that hospital customers were not overcharged. So good on them.

M&S however, despite meeting with labour MP Paula Sherriff, who has led a campaign against these higher charges, insists it is the fault of the NHS for charging high rents. Sherriff says “Patients feel like they’re getting their pockets picked to prop up the profits of one of Britain’s biggest brands. The biggest premium os on flowers and that’s just wrong – there will be people in desperate circumstances who want to look after loved ones and these shops are making a quick buck. You have to ask what’s happened to the values behind this brand

M&S says “Prices can be higher in these locations due to increased running costs such as longer opening hours and higher rents”

Now I struggle to believe that renting a corner of a hospital is dearer than renting on the high street but what do I know. And why would longer opening hours be more expensive as long as they are selling stuff and have shift patterns in place to avoid overtime (which I doubt they pay anyway).

So shame on you M&S.

Forget expensive cough medicine………..drink honey and lemon (with possibly a dash of single malt whisky)

Kindadukish's Blog - I am not a number, I am a free man (The Prisoner)

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There is little evidence that expensive over-the-counter cough medicines actually work, doctors said today But the NHS Choices website advises: ‘There’s little evidence to suggest cough medicines actually work, although some ingredients may help treat symptoms associated with a cough, such as a blocked nose or fever.’

The webpage adds that the ‘simplest and cheapest’ treatment for a ‘short-term cough’ may be a homemade remedy containing lemon and honey. It continues: ‘There’s no quick way of getting rid of a cough caused by a viral infection. It will usually clear up after your immune system has fought off the virus.’ Dr Tim Ballard, vice chair of the Royal College of General Practitioners, today backed up the NHS claim He said: ‘The medical evidence behind cough medicines is weak and there is no evidence to say that they will reduce the duration of illnesses – as such, GPs are unlikely to…

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Soft Southerners?

stick_figure_sitting_on_pills_1600_wht_13337According to an Atlas of Mental Health created by CentreForum think tank people living in the South of England re more likely to say they are unhappy despite having lower levels of mental illness including depression.

People living in London Bedford, Milton Keynes, Brighton, and parts of Kent claim to be the unhappiest in the country – yet they have some of the lowest levels of diagnosed mental health problems.

Five of Britain’s unhappiest 20 places were in London including the borough of Barking and Dagenham which came in the top five on two measures of unhappiness and yet had the 23rd lowest level of mental health problems.

In the league table of areas with the highest long-term mental health problems only Brighton & Hove (which came 3rd in the table) and Nottingham (7th) were outside the North and North West.  The other worst areas in descending order were: Middlesborough, Blackpool, Manchester, Stockton on Tees, Knowsley, Nottingham, Liverpool, Newcastle, and Salford

Northern areas tend to receive less support for mental health issues and in some areas people are 4 times more likely to die from a mental health problem.

Poor mental health often leads to a poor diet, heavy drinking and smoking, all of which can lead to cancer or heart disease.

One in six adults suffers from mental illness such as depression or anxiety at some time in their lives.

 

Simple tests to predict your life expectancy

elderly_man_holding_a_custom_text_sign_12871With the government planning to tell future pensioners how long they are likely to live so they can better plan their finances this new research might be useful.

Research at University College London, and published in the BMJ, found that people in their early 50s who scored poorly on three simple tests of strength and co-ordination were nearly four times as likely to die in the next decade as those who did well.

The three tests were:

  • grip strength
  • chair rise speed
  • standing balance time

You can do two of these tests at home.

The chair rise test is: see how quickly you can get up and down from a chair 10 times. 16.5 seconds puts you in top fifth and 26.5 seconds in the bottom fifth.

The balance test is to see how long you can stand on one leg with your eyes closed. More than 10 seconds puts you in top fifth and less than 2 seconds in bottom fifth.

The research was carried out using a cohort of people born in 1946 who had had their health monitored all their lives. They were tested at age 53. In the following 13 years there were 177 deaths in the group (of around 2,800), half from cancer and a quarter to coronary heart disease (CHD).

Those who had performed poorly on the tests were more likely to have died regardless of other factors such as wealth or exercise.

The few who couldn’t do any of the tests were 12 times more likely to have died than all those who performed the tasks. Those in the bottom 20% of scores on these tests were almost 4 times more likely to have died than the others.

Fitness levels drop off from age 45 on average but there are wide variations. Separate research, also published in the BMJ, found that walking or taking similar light exercise for an hour a day could stave off the onset of osteoarthritis.

In the UK the NHS has been accused of ageism in its reluctance to offer surgery to older patients. Now scientists at Seoul University in South Korea have developed a test to predict whether or not a patient will survive an operation to stop doctors using age alone to decide whether they can cope with treatment.

They found that patients with a high frailty score were more likely to die within a year of having an operation.

They assessed patients over 65 on their ability to walk, dress, wash and carry out other tasks as well as their performance on memory tests, their nutrition and the number of drugs they were taking. In the following year 9% of these patients died, 10% experienced complications, and 9% had to go into a nursing home. These were all patients who had scored highest on the frailty assessment.

The researchers found that post-operative one-year all-cause mortality rate, length of hospital stay, and discharge to a nursing facility, could all be predicted from their assessments.

Finally back to the grip test referred to above. Researchers at the International Institute for Applied Systems in Austria have found that the strength of a handshake is a good way to assess how fast people are ageing. Using grip strength as a marker of biological age people who did poorly at school age about 4 years faster than those who did well.

Reviewing 5o studies on grip strength they found that weakness in the hands is linked to high levels of disease and early death.

If you’re younger and relying on the body mass index (BMI) remember it’s no longer considered reliable.

NHS tests for over-40s useless

checking_blood_pressure_anim_500_wht_8476-1According to world-wide research by the Nordic Cochrane Centre the governments £300 million NHS Health Check programme is failing to deliver benefits and putting patients at risk of unnecessary treatment.

The researchers also say (in a letter to the Times) that it’s in conflict with the best available evidence and results in patients taking unnecessary drugs.

“Screening programmes should be based on evidence from randomised controlled trials that show they do more good than harm – as the UK screening programme explicitly states  – but there hasn’t been any proven benefit”.

In a paper published in the British Medical Journal last year the researchers analysed 14 randomised trials of international health check programmes which included 183,000 people. They found that none of the programmes cut deaths, kept people out of hospital, or prevented disability.

This is the centre that reported on breast screening last year and found that for every life saved four women had unnecessary surgery.

The Royal College of GPs is backing the findings saying that “routine checks were devaluing medicine” and that the routine tests were taking up time that could be used for treating patients who were actually sick rather than on the “worried well” who often  have to be re-tested to reassure them.

There is also a risk that health checks will show up diseases or risk factors which wouldn’t have caused any symptoms in a person’s lifetime.

The programme, introduced on a pilot basis on 2009 in some parts of the country, invites people aged 40 to 74 for a routine check every five years for conditions including heart disease, kidney problems, and diabetes. The NHS has now been told to offer it all across England and public health chiefs have to make it a priority as the Health Secretary believes it will save hundreds of lives.

Public Health England concedes that there is no direct evidence that health checks work but said that some of the trials examined by the Cochrane Centre were old and that “precautionary principles” justified the use of the checks.

A spokeswomen said (spin alert!) “The existing relevant evidence, together with operational experience accruing on the ground is compelling support for the programme. The NHS Health Checks offer a real opportunity to reduce avoidable deaths and disability, and tackle health inequalities in England”. No mention of real outcomes or evidence though?

We can’t just ignore the F word

stick_figure_overweight_scale_1600_wht_3853It seems it’s not PC to use the word fat about someone – or even the clinical term obese.

New NHS guidance says school nurses and public health official have to tone down the way they tell parents their child is overweight.

The NHS doesn’t want parents to think their parenting skills are being criticised (even though they are) and that letters sent to parents should be “non-judgmental and positively phrased”.

So the new letters, redesigned after consultation with parents and experts, contain no references to obesity and its potential consequences such as heart disease or cancer.

So even if your child is very overweight, or obese, the letter will only refer to possible effects on self-confidence and facing health problems later in life – nothing specific.

Campaigners at the National Obesity Forum say they are horrified that such letters have been sent in the past rather than speaking with parents face to face and offering “tough love” and calling a spade a spade.

Last year more than a million children were measured at school and almost a quarter of children in reception year were found to be overweight or obese. By year 6 this had risen to 1 child in 3. Almost 10% of children were clinically obese when they started primary school and the percentage had doubled to 20% by the time they left.

The Observer yesterday reported on a 10-yr old girl weighing more than  24 stones (with a BMI of 71) and an 11-year old boy who weighed 23 stones (with a BMI of 84). I know BMI has been discredited of late especially for athletes and muscular people but given that the normal range of BMI is between 18.5 and 25 and over 40 is considered morbidly obese, you have to admit the weight of these kids is scary.

But back to the NHS advice: Public Health England said it had “listened to feedback from parents and local authorities and as a result the template letter has been simplified to make it easier to read and more personal”.

This sounds like a load of  PC rubbish to me. How is it more personal? Which parents have they listened to? Isn’t it better to upset a few parents if you are potentially improving their child’s health?

Obese people  – and 26% of the UK population falls into this category – are at a higher risk of hear disease, diabetes, cancer and joint problems and obese children also run the risk of being bullied. If you count overweight people they make up 60% of the UK population.

Contrast this softly, softly approach with Mayor Bloomberg in New York. He’s been trying to change things by banning super-size sugary drinks ie 16oz and over. He’s had his decision overturned in an appeals court which thought he was over-reaching his authority. The soft drinks industry is fighting a strong rearguard action similar to the tobacco giants.

Why simply worrying about being stressed can make you ill: If you fear it, it will happen

Kindadukish's Blog - I am not a number, I am a free man (The Prisoner)

Experiencing stress can increase the likelihood of a heart attack by almost 50 per cent

Experiencing stress can increase the likelihood of a heart attack by almost 50 per cent Just thinking about being stressed can make you  seriously ill, a study has revealed. The increased perception of stress almost doubles the risk of suffering a heart attack, researchers found.

It is the first time a link has been discovered between heart disease and people’s own view on how stress is affecting their health. The research suggests doctors should take a patients’ perspective into account when managing stress-related complaints. It could also mean that helping patients to unwind can reduce the risk of cardiovascular disease.

The study followed more than 7,000 civil servants over a period of up to 18 years. Participants, who had an average age of 49.5, were asked to what extent they felt day-to-day stress had affected their health. They were also asked about lifestyle factors such as smoking,  alcohol consumption, diet, and exercise, and their medical background…

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We keep on taking the pills

orange_medication_bottle_blue_white_pills_1600_wht_1953I’ve previously written about the fact that prescriptions for depression, anxiety and sleeping problems had increased dramatically over the last few years.

I’ve also posted about psychotherapy or talking therapies being as effective as medication (see original post below).

Now there’s more evidence that that is true. See this post “Psychotherapy just as effective at beating the blues”

Original post from August 2012

According to data from the NHS Health and Social Care Information Centre more than 43 million prescriptions were dispensed in 2010, a 28% increase from the previous 3 years. Prescriptions for anxiety were also up by 8% and up 3% for sleeping problems.

And things haven’t improved. Last year total prescriptions for anti-depressants alone increased to around 47 million, almost 10% up on the previous year, at a cost of £2 billion.

The NorthWest has the highest use of anti-depressants and sleeping medication. It may be no coincidence that this has been a period of economic downturn with many job losses – which contribute to mental health problems.

The mental health charity MIND points out that there has been a steady increase for the last decade as people are more open about their mental health problems and GPs have become more adept at spotting the symptoms.

Unfortunately doctors may see medication as a quick fix because waiting lists for talking therapies are so long – 20% of patients wait for up to a year.

The Chief Executive of the Mental Health Foundation said; “Doctors may just be relying on anti-depressant prescribing rather than offering patients alternative evidence-based interventions such as psychological therapies or exercise prescriptions”.

Wine, Women, and Health

I tweeted last week about the latest research showing that after marriage men tend to drink less but women drink more – and there are probably some women who would say “do you wonder?”

In a recent Times’ Body & Soul section John Naish gave a really good overview about women and alcohol consumption which was also a reminder of how stingy recommended allowances are.

A standard 175ml glass of wine = 2 units. So one glass of wine each day of the week is the UK government’s recommended upper limit for women.

And it’s a class thing but not what you might think. The more middle class or the better educated you are the more you are likely to drink. Graduates are twice as likely to drink every day compared to non – graduates, too much practice on cheap booze in the student bars perhaps?

And according to official statistics 1 in 6 professional women drink more than 6 units at least once a week. That’s three glasses of wine in one session which is the NHS definition of binge drinking!

Experts say it’s probably because better educated women have wider social circles or are more likely to work in male-dominated environments. And that’s part of the problem.  Women can’t tolerate alcohol in the same way as men. Not only do they have lower body weight and less water in their bodies but their livers don’t deal with alcohol as efficiently as mens’.

A major US study of over 100,000 women over 20 years showed that women who drink 2 glasses of wine a day have 50% more chance of developing breast cancer, probably because alcohol raises levels of oestrogen which can trigger tumour growth.

Women who drink more than recommended are also more vulnerable than men to developing a whole range of cancers. Perhaps slightly less seriously excess alcohol consumption is also linked to fatigue, weight gain, and depression.

Drinking in excess in middle age is linked with increased risk of dementia and memory loss even for people who were abstinent earlier in their lives.

Women in their 30s and 40s are also more likely to be prosecuted for drink-driving than men, according to research at Nottingham University. Naish’s article said it wasn’t because they are more reckless but because they drive over the limit when picking up stranded children who need a lift home. So no good deed goes unpunished.

However a report on the same research published in Clinical Psychology Review last May said the profile of  women drink-driving offenders was; ” divorced, widowed or separated with fewer previous convictions than their male counterparts. … they may be distressed by their situation and turning to drink”.

But giving these women rehabilitation programmes designed to shame them, such as meeting bereaved families, doesn’t work with middle-aged women because the negative emotions induced will increase emotional distress which could lead to more drinking and their committing more alcohol-related offences – as these researchers found had happened in the USA.

So women should stick to 1 glass a day and not be tempted to finish the bottle. Wine boxes help in that regard as you don’t feel the same need to finish the box!

And there is some good news if you can stick to that level of drinking.

A range of research studies show that women who drink no more than a glass and a half a day are less likely than teetotallers to get rheumatoid arthritis; they are also less likely to develop a stroke than those who stop drinking, and less likely to develop Type 2 diabetes.

Harvard School of Public Health found that women who drink moderately in middle age are more likely than non-drinkers to be in good physical and mental health in their retirement.