Brno, Innovations and Illustrations, Water and other Areas of Risk

Whilst it was great having last Monday off, it did mean the rest of the week felt more packed than usual. That I was in Brno (in the Czech Republic) on Friday didn't help. I was there to present 2 papers to the National Oncology Conference. I had been invited to speak on compassion and nursing care and on managing the tensions often involved in providing person centred care to patients at the end of their life. It was a very interesting conference, and in an age of Twitter, there was great audience in the hall participation. It also felt good to be able once again to spend time with colleagues I have known for a number of years, but seldom get to see in person.

I also felt good about my outcome in the innovation survey I took part in last week. This was a survey that the Nesta  organisation are undertaking  to ascertain the UKs views on innovation. Nesta is an innovation charity with a mission to help people and organisations bring great ideas to life. The first phase of the survey tested people’s attitudes to innovation, technology and progress. They found people could be grouped into 5 attitudinal groups. Innovation Futurists, Romantics, Creatives, Realist and Sceptics.

Back came the result that I am an Innovation Creative – which apparently means I am confident, sociable, on-trend, and interested in new ideas that use creativity to solve practical problems. I'm an early adopter of new technology and ideas and I'm likely to recommend new products to my peers. However, I can sometimes struggle to bring innovation together as a single concept and it appears I tend to think about innovation in the context of my own hobbies. Innovation Creatives represent 19% of the UK population – so there you are, and you can check out which group you belong to here.  

The most stunning, and thought provoking image for me last week was the one published on Twitter to show what one year of twice a day insulin injections would look like. Many people with type 1 diabetes are on 4 or 5 injections a day. No more words necessary.

I was also reminded last week of another daily intake requirement – water. I have never really been a fan of drinking water just as water (although don’t mind it in a good malt). The World Health Organisation estimates that we need 2 litres of clean water a day. Apparently this is to replace the litre we pee and the litre we lose through sweat and breathing out. I am assured that tap water is as good for you as bottled water, and much better for the planet – see here if you are not convinced. Thankfully we don’t need to guzzle our 2 litres in pure water, most food has a lot of water in it, fruit and fish 80-90% water and for those who like meat, most meat contains a staggering 30% of water.

However, drinking excess water won't harm you (well unless you are drowning that is), but perhaps where you live might. Last week Imperial College published the so called Health Atlas. This is an online map of England and Wales (does Imperial already know the outcome of the Scottish vote?) which allows you and I to enter our postcode and find out what the risk is for those living in our community of developing 14 conditions such as heart disease and a range of cancers.

As one would expect, such developments coming on the back of pensioners being given advice on how long they might live (see here) the Health Atlas has attracted a great deal of comment. My favourite comes from the fabulously and alliteratively named Professor Paul Pharoah, working in the University of Cambridge Department of Oncology (but he wasn't in Brno) who said, ‘this atlas doesn't enable anyone to judge their individual absolute risk, and people should definitely not use this atlas to decide where to live’ Priceless Professor Paul Pharoah.

The saddest story of the week was hearing of the deer that wandered onto the M61 between Junction 6 and 5 – close to where the House in Bolton is located. The deer was hit by a car and had to be put down. I hope it wasn't the same one who earlier on in the week was tucking into my next door neighbours spring flowers. Perhaps Imperial College could put a special page in the Health Atlas just for visiting deer.

The Evolution of Extremes, and Speed Dating in Wigan

Last week it appeared difficult to avoid tales of evolutionary nature. There was the story published by the evolutionary biologist Professor David Haig (Harvard University) about babies waking up during the night needing to be breast fed being linked to the baby wanting to delay the birth of a brother of sister. It was a neat story with the possibility of there being some truth in the idea. The act of breast feeding does block the hormonal signals that lead to ovulation – ergo – the longer a woman breast feeds, the longer she will have to wait to get pregnant again.

It’s all to do with the Fathers genes apparently. Number two tale involved beards – although Prof Haig sports one, this was a different set of researchers (pogonphiles), who were looking at the attractiveness or not of beards. Apparently, the more beards there are, the less attractive they become, giving clean shaven men a competitive advantage. According to Professor Rob Brooks, it’s an evolutionary phenomenon. His research, involving 1453 women and 213 men, both the women and men judged heavy stubble and full beards to be more attractive. I have started growing my beard longer, obviously.

However, as interesting as such research might be, I was more inclined to take seriously the work sponsored by the Bill and Melinda Gates Foundation and reported last week – this was on the need to re-invent the toilet. Melinda noted that for 2.5 billion people, finding a clean and private toilet to use when needed was impossible. Indeed in some parts of India, almost 70% of rural households have no access to a toilet, and most cases of rape of women and girls happen when they are forced to urinate and defecate out in the open.

Good sanitation isn't just a problem in places like rural India. As the world’s population continues to grow, so do the number of people who don’t have access to proper sanitation. Flush toilets as we know them are not the answer – the technology doesn't work anywhere except the developed world. New solutions are required, and needed now. I pondered this problem while also reading a story last week of research undertaken by Dr Jay Widmer from the Mayo Clinic. His work was on how a phone app when used by patients with cardiac problems reduced the need for hospital care, particularly re-admissions. Great from the perspective of those parents needing long term cardiac care and rehabilitation, but this health care intervention assumes patients have access to technology far greater than that needed to ensure good basic sanitation for all.

Last week I met a man who has a passion to make sure all those living in his community gain fair access to high quality health care when they need it and help create a community that promotes improving the health and well-being for all people. This man was Robert Armstrong, who last week was appointed Chairman designate of the Wrightington, Wigan and Leigh NHS Foundation Trust. Robert was selected from a pool of very high calibre candidates. My role was to take part in the selection process and assessment centre – which included a 'speed dating' session where each candidate was quizzed about quality,finance and so on. It was the first time I have been speed dating in Wigan. Many congratulations Robert, and a Happy Easter to all.  

3 Nations in 7 Days, Compassion and Evidence Practice, Muslim Prisoners and Goats on the Pill

Last week was a week of numbers. Over the week I've been in 3 different countries, Scotland, England and Wales. In Scotland I was finishing my holiday, England I was working and Wales, well it was to celebrate my Mother's birthday (she tells me she's 21 again). Going to Wales was a long day but it was good to see so many of my many brothers and sisters, their partners, and children (19).  It was great to see so many friends an relatives and to spend time catching up on what people were doing or had done. 

Thursday, it was our student led pre-registration nurse conference looking at compassion and evidence practice. Sam Sherrington (Head of Nursing and Midwifery Strategy, NHS England) was the students key note speaker. Sam talked of the great progress being made to the implementation of the 6Cs plans for action. The students then presented the work that they had been involved with. This included the RADAR programme (Recognition of the Acutely Deteriorating patient with Appropriate Response), the Student Quality Ambassadors Scheme and a number of poster presentations around compassion fatigue, 6Cs across the life span and care pathways for those at the end of their life. The 70 tweets sent during the conference really did capture the high quality of presentations and discussions. Well done to all involved.

Well done also to my colleague Muzammil Quraishi, one of our Schools criminology Senior Lecturers’ who was in the news last week. He was part of the debate exploring the notion that many young Muslim men are under the official gaze of the State from their school days onwards, and can become ‘suspect populations’ in the eyes of law enforcement agencies. It seems there is something in what Muzammil has to say. The UK Ministry of Justice have reported that the number of Muslims in the prison population has reached nearly 12000 over the last 10 years. Whilst Muslims represent only 4.7% of the population in England and Wales, 1 in 7 prisoners (14%) is a Muslim. With 33% of these prisoners being under the age of 25, it’s worth noting that between 2003-2010 there were 143 deaths of young people in prison.

Another unsettling reading last week was the story on Friday that the current test used to predict how aggressive a tumour is in prostrate cancer, underestimates the severity of the disease in 50% of all cases. Prostate cancer is the most common male cancer in UK. There are nearly 42000 new cases and nearly 11000 deaths each year. Current guidelines advise that men with low-grade, early stage cancers are offered the choice of an operation to remove the prostate (often leading to problematic side-effects) or active surveillance – with a 50% chance of getting it right it’s not much of a choice really.

My favourite story of last week, was told by Sally Pidcock, the Great Orme Countryside Warden, on Farming Today (I find listening to radio 4 programme a wonderful way to start my working day).This was the story of the annual count of goats who live on Great Orme in Wales. The population had grown too large (220 goats), and so 75% of the female goats had been put on the contraceptive pill. However a large number of kids have been seen already this year, prompting worries that some goats might be ‘forgetting’ to take their pill every day. And the final score of children and grandchildren (kids ?) seems to be my parents 7, me 5 (+8) Philip 2 (+1), Peter 3, Ruth 2 (+1) Christopher 4 (+1), Mark 2, Sarah 2 (+ 2) and the Great Orme goats 100 (+20)

#bedpansandbandages, Getting your 10 a day, and the Dangers of Dusting!

Last Friday saw the screening of the 8th and last episode of Student Nurses: Bedpans and Bandages. For the last 8 weeks the ITV programme has followed the often complicated and challenging lives of student nurses from our School as they have progressed through their nurse education and training. I have to say that Alistair, Graham, Kelsie, Abu, Danielle, Kelly, Helen and Joanne did the School and the nursing profession proud.

The programme was shown every Friday, between 2 episodes of Coronation Street. It achieved an average audience of 3 million viewers, with one episode reaching nearly 5 million. It’s estimated that some 25 million people watched the programme, a programme that placed the good work of the School, its academic staff, professional support staff, students and colleagues in practice on prime time TV. Have a look at #bedpansandbandages for the many comments posted on Twitter over the 8 weeks.

ITV approached a number of universities in England and only our university and Birmingham City University were selected. Many people have contributed to making the programme a success, but the real dynamo behind this achievement is undoubtedly my colleague Moira McLoughlin. Moira is our Student Experience Lead and reminds me on a very regular basis that we are committed to ensuring we are student centred in all our activities. She organised our response to the production team, ensured the students were supported throughout, liaised with our local hospitals, and didn't let any obstacle get in the way. Well done, and many thanks Moira!

In 1990, the World Health Organisation (WHO) recommended that we all ate 5 portions of fruit and vegetables daily to reduce the risk of heart disease, stroke, type 2 diabetes and obesity. However, despite the UK Department of Health spending huge sums of money on advertising its ‘5 a day’ campaign, only 30% of us have heeded this advice and changed our diets. Then in 2012, research undertaken at the University of Warwick suggested that we should increase our intake to 7 portions of fruit and vegetables a day. In children this is a diet that is said will help prevent depression in later life.

And it seems that 7 portions is not enough, last week research published by the University College London suggested that 10 portions is now considered to be the optimum number as the protective effect increases with every extra portion taken. Others have been here before, the French are told to eat 10 portions a day, the Canadians between 5 – 10 portions, and the Japanese, 13 portions of vegetables and 4 portions of fruit a day. I'm taking positive action in heeding this advice. I am now putting 2 olives in my pre-vegetarian dinner G&T instead of just the usual single slice of lime.

Here is my own health warning. One rainy morning last week, while on holiday in the House in Scotland I decided that the wooden beams in the living room needed dusting. It wasn't a task that I felt required a full risk assessment being undertaken. How wrong can you be? I had only been up the stepladders for a few minutes when I dislodged a lump of loose plaster. It hit my eye and caused much pain and dramatic bleeding. Thankfully, the pain is now just a gentle throb and I am left with a bloodshot eye. However, next time, I will don protective goggles, hard hat and high visibility jacket. Last day of the holidays today, back to work tomorrow, might wear a pirate’s patch...