Reflecting on Dementia

Melaine Coward
Head of School, Health Sciences

From the 1st to the 8th March 2017 Dementia UK will be holding their annual Time for a Cuppa event. They encourage people to get together, bake and raise funds. Dementia UK will use all money raised to fund their Admiral Nurses, who are trained to support people diagnosed with dementia and their families. They also provide Admiral Nurses to look after a support line that anyone can call to get advice from. A valuable source of information and advice for all carers and people living with dementia. We will be holding our very own Time for a cuppa morning on the 6th March at the school and we’re encouraging people to come along, bring their own baked goods to sell and to buy some others.

Whilst organising this event, we came to reflect upon what we, as a school, are able to do to contribute to the research into dementia. The Alzheimer’s society tells us that there are 850,000 people living in the UK that have been diagnosed with Dementia and this number is set to rise. There are different types of dementia with 62% of those diagnosed are diagnosed as having Alzheimers and 17% of them being diagnosed with Vascular dementia.

More research is needed, not only to look at possible cures for dementia but also to look for ways in which we can support those diagnosed with dementia and particularly support those caring with dementia.

This week, we’ll be releasing a series of blogs that will discuss the research that we’re doing within the school. From looking at the ways technology is being used to support those with dementia to research examining strategies to help care for dementia. We’ll also look at a scheme in which we pair up our student nurses with families caring for a person with dementia. This Time for Dementia project is collaborative research that aims to improve the care and support we give to people diagnosed with dementia and their carers.

We also encourage all of you to sign up as a Dementia Friend. It’s free, takes minutes to do and it’s designed to give us all more of an understanding of what it’s really like to live with dementia.

So, join us in baking and selling cakes and then sit back and reflect on our research by reading our blog posts.

Keep an eye on our twitter @healthscisurrey and instagram  schoolofhealthsciences feeds for more information.

 

 

Do we need to move beyond Cancer Awareness Campaigns?

For decades governments and charities have launched public health campaigns warning us about our weight, teaching us about the symptoms of cancer and encouraging us to stop smoking. Millions of pounds have been spent on raising public awareness on wellbeing, but are they working?

The simple answer is yes. Such campaigns educate people about symptoms of potentially life threatening illnesses and reassuringly there is evidence that more people go to the doctor following these campaigns. But are they reaching the people at greatest risk?

November is National Lung Cancer Month. Lung cancer is the UK’s biggest cancer killer, and lung cancer deaths are more common in people living in the most deprived areas.

Public Health England has been running a Be Clear on Cancer Campaign focusing on symptoms of persistent cough and inappropriate breathlessness. The campaign is aimed at all men and women aged 50 and over, and encourages people with relevant symptoms to see their GP without delay.

The thinking behind the campaign is that if people know what the warning signs of lung cancer are, they will be more likely to seek help from a doctor promptly, and more likely to be diagnosed at an earlier stage. If lung cancer is caught early, 70 per cent of people will survive for at least 1 year, but this drops to 14 per cent for those diagnosed at a late stage.

Such startling statistics show how important it is to get a lung cancer diagnosis as quickly as possible and highlights the need to find more effective ways to get people to doctors’ surgeries once they start experiencing symptoms.

Public health campaigns are one way to do this but they have limited success. Research published in the British Journal of Cancer suggests that a national lung cancer campaign in 2012 led to a greater increase in GP attendances for practices in less deprived areas but not in more deprived areas.

It’s unclear why such messages are not reaching this key audience – but awareness is only one factor in a vast array of factors influencing whether people a) interpret their symptoms as serious and b) contact a doctor. For example, in the UK we are more worried about wasting the doctor’s time than people living in other international countries with similar healthcare systems (e.g. Canada, Sweden) and this can stop people seeking medical help when they need it.

We can also learn something from our recent work in breast cancer, which has shown important educational differences in how women make sense of breast cancer symptoms. Women from lower educational backgrounds lacked confidence in interpreting their symptoms and seeking help compared to women from higher educational backgrounds. The bottom line is that knowledge alone may not explain inequalities in how people respond to cancer symptoms- because although less educated women ‘knew’ that symptoms could relate to cancer, they gave ‘reasons’ not to react. For example, they were ‘too busy’ due to work and childcare or too frightened.

Much more work is needed to understand inequalities in how people interpret and respond to symptoms. We also need to explore why campaigns may not be reaching those at greatest risk. Recognising that promoting symptom awareness is only one avenue to promoting earlier diagnosis is an important step on this journey.

Dr Katriina Whitaker

The role of eHealth in the treatment of lung cancer

The treatment process for lung cancer can have a huge impact on your life, even after treatment has finished. More and more people are surviving cancer as the years go on, and so there are more people than ever before who are lung cancer survivors, trying to resume their interrupted lives after the harrowing experience of diagnosis and the treatment process. I wanted to write about how eHealth, i.e. health technologies that are accessible to patients and their families, can help reduce this interruption.

The government are pushing for care of long-term conditions, like cancer, to be shifted into the home and community settings. But chemotherapy and radiotherapy treatment for lung cancer can be a proverbial Russian roulette of side effects that can vary as treatment progresses. It can therefore be a bit nerve-wracking and exhausting being at home after your latest round of treatment, waiting to see what you’re going to be dealing with THIS time, and wondering whether you can manage it yourself or need to go back to the hospital. This is where eHealth can have a role – it can help you to stay in touch with the people delivering your healthcare, so they can monitor you 24 hours a day, 7 days a week.

There’s a lot to be said for being able to manage your condition and the impact of having treatment for it within the comfort of your own home. Research has shown that being able to receive care within the home environment can provide a familiar and relaxing setting for interacting with healthcare professionals, and the general feeling that the care you receive is more about you – focused on your preferences and needs. But to do that, you need the tech. And this is where it gets a little tricky. The NHS has been a bit behind the tech adoption curve let’s not talk about the National White Elephant Programme for IT and the government admit this in their Personalised Health and Care 2020 report:

“In 2014 59% of all citizens in the UK have a smartphone and 84% of adults use the internet; however, when asked, only 2% of the population report any digitally enabled transaction with the NHS. […] Irrespective of what path is followed by the publicly funded English health and social care system, these developments [in technology and data-enabled services focused on health and care] will proceed rapidly, driven by the scale of the global opportunity. The care system will be changed as a result and not necessarily in a manner which reflects public policies and values.”

There is actually a huge amount of eHealth stuff out there in the world, things like pain tracking apps, medical information portals, and so on. Some of it has been tested and developed in collaboration with patients and healthcare professionals. Some of it has not. One review of apps for asthma found that less than 20% of the apps reviewed had any kind of statement of confidentiality for patient data. And this is the issue the NHS is up against right now – any eHealth system they adopt needs to follow the fundamental NHS code of practice for confidentiality. Your information, whether on paper or in kilobytes, needs to be protected, and you certainly want it to be protected too.

The University of Surrey’s links with 5G internet development put them in a unique position to explore and collaboratively develop answers to these confidentiality and data protection issues, one step at a time. Researchers now working at the University of Surrey have a long history of research in eHealth, dating back to as early as 1997. They have seen the available technology evolve over time, from laborious manual data upload to electronic databases, to chunky PDAs for patients to use at home, to the smartphones of today. Obsolescence is something on everybody’s minds in this day and age – I was at the Health and Care Innovation Expo in Manchester in early September, and some tech company reps there were saying that they don’t have time for long testing, development and scientific validation periods for eHealth technologies. Yet failing to take into account the needs of patients and professionals during this development process can be really detrimental to the success of an eHealth intervention. Patient involvement should be a huge part of the development process – same with healthcare professional involvement too. This is called ‘co-design’. Without that input, the eHealth system can just fail through lack of use.

People with cancer have been one of the main groups to really benefit from what eHealth has to offer, and the University of Surrey has been heavily involved in the development of eSMART – a system that lets you report your symptoms during and after chemotherapy from home. You fill out a daily questionnaire about what symptoms you’ve been experiencing today, and take your body temperature. Your responses pass through a specially developed processing stream that provides self-management advice in response to your symptoms, and flags up to the nursing team at the hospital if they need to get in touch too. So no more worrying about whether you’re bothering the doctor or not, and you have access to tips to let you manage your symptoms so you can stay at home, knowing you’re being monitored from afar. This has been built out of a set of earlier studies that piloted the whole concept with patients with breast, lung and colorectal cancer, for both chemotherapy and radiotherapy. Yes, ‘with’ patients. Not ‘in’ or ‘for’ patients. The eSMART project has cancer survivors as part of the research team to ensure it really is something fit for purpose, and doesn’t fall foul of the ‘no involvement, no engagement’ trap that has befallen some telehealth projects in the past. In fact, the whole aim of the University’s eHealth endeavours is to collaborate with citizens, companies and engineers to create these kinds of technologies.

And this is where the future of eHealth lies – in collaboration. The rest of the health technology sphere may be rushing ahead with the latest this or that, but behind the scenes the University of Surrey is working away on their own answers to these eHealth questions. And these answers have the patient and healthcare professional involvement, security and the clinical validation to make the difference between boom or bust. Watch this space, because for cancer survivors, there are good things still to come.

Dr Marianne Coleman

CPR

Would you know what to do, if you saw someone collapse in the street? Could you be the person who could give them the best chance of survival?

If you feel like you wouldn’t have a clue how you’d handle that situation, you are not alone. The Resuscitation Council reports that there are around 30,000 cardiac arrests each year that take place out of hospital, in the UK. The average survival rate of these cardiac arrests in the UK is 8.6%. When you compare it to places like Seattle (20% survival rate) and Norway (25% survival rate), it’s clear that we need to find ways to increase survival rates in the UK.

In the UK, we have a 43% rate of bystanders giving CPR, while in Norway there is a 73% rate of bystanders giving CPR. It’s clear that those bystanders able to start CPR immediately (rather than calling for an ambulance and then being instructed to do so) increase the chances of the person’s survival.

When someone has a cardiac arrest, for every minute that goes by without CPR and defibrillation (we’ll cover defibrillation in the next blog) their chances of survival drops by between 7-10%.

That’s a worrying statistic. In the UK, we struggle to recognise the signs of a cardiac arrest and then we don’t recognise what to do. Our lack of knowledge or fear of doing something wrong could lead to someone’s chances of survival dropping dramatically.

This handy chain of survival shows the ways in which we all need to act, in order to ensure that someone has the maximum chances of survival when having a cardiac arrest.

cpr

It’s clear, that in the UK, we need to do more to educate ourselves on the best way to handle a situation where someone is having a cardiac arrest. That’s where Restart a Heart Day comes in. All kinds of life saving organisations (British Heart Foundation, St John Ambulance, Red Cross, Ambulance trusts) come together to teach people CPR. It doesn’t take long and taking those few minutes to learn this technique could really help to save someone’s life.

On the 12th October, our team of Paramedics, along with some Community First Responders will be in the library concourse willing to teach anyone who asks CPR. Take a minute to drop by and learn this life saving skill.

In the meantime, here’s a handy step by step guide on how to do CPR, along with a brilliant video from Vinnie Jones.

Step by Step CPR (taken from the British Heart Foundation website – https://www.bhf.org.uk/heart-health/how-to-save-a-life/how-to-do-cpr

So, what do you do if you see someone become unconscious?

Step 1: Check
Check for danger – don’t put yourself at risk, make sure it’s safe for you to approach the person
Check for a response – Shake the person and speak loudly, asking “are you alright? Can you hear me?”
Shout for help – You may need someone to help you, by either phoning for help or fetching equipment nearby. Ask people to stay with you.
Step 2: Open their airway
Tilt their head back, by placing one hand on their forehead and 2 fingers under their chin
Step 3: Check for breathing
Listen to see if you can hear them breathing, or feel your breath on their cheek, look for their chest moving
Step 3: Call 999
If the person is not breathing, call 999 and ask for an ambulance. If you have someone with you, ask them to do it.
If you have someone with you, they may be sent to collect a defibrillator, your ambulance operator should be able to tell you if there is one nearby.
Step 4: Start Chest compressions
Kneel beside the person. Place the heel of your non dominant hand in the centre of their chest and place your dominant hand on top, locking your fingers together.
Keep your arms straight and use the heel of your hand to push down 5-6cm on the breastbone. These should could be quite fast, managing around 2 compressions per second.
Give 30 of these compressions
Step 5: Give rescue breaths
Make sure the airway is open (as in step 2). Pinch the person’s nose, take a breath, place your mouth around theirs, creating a seal and breath out normally. You should see their chest rise and fall. Do this twice.

Repeat steps 4 and 5 until either:

• Professional help arrives
• The person begins to show signs of regaining consciousness
• Or you become exhausted.

If you’d rather not give rescue breaths, then do hands only CPR, watch Vinnie Jones demonstrate here:

Vinnie Jones/British Heart Foundation CPR:

References:

Statistics taken from the Resuscitation Council UK Consensus Paper:

Statistics taken from the Resuscitation Council UK Consensus Paper: https://www.resus.org.uk/publications/consensus-paper-on-out-of-hospital-cardiac-arrest-in-England/

Nikki Legg & Claire Horsfield

Students at University: how to keep a check on your mental health

Coming to University for the first time is an incredibly exciting time, but it can also be immensely stressful. For many students it will be their first experience of living away from home, and of being entirely responsible for managing money, food, time, sleep and so on; before even thinking about the demands of their degree course. Also, most people will have left behind the long-standing friendships of school and local area, and it can be hard (and very tiring) to have to meet new people and establish a friendship group.

For others, becoming a student after many years can also be stressful. Most Universities will have a comprehensive programme of events for the first weeks, designed to introduce students to University life, but this can be a heady mix of hectic levels of activity fuelled by convenience foods and washed down with larger than usual amounts of caffeine and/or alcohol.

Add to this the insecurities that many people will feel at being faced with so many new and unfamiliar challenges, and it is hardly surprising that many students quickly feel isolated and overwhelmed.

Reminders to keep yourself healthy

Most people have an idea of what contributes to their physical well-being. We can recognise the habits and behaviours that will help to keep us fit and well, but thinking about our mental health and emotional well-being is not really something we are used to doing. Given that this week hosts World Mental Health Day, it seemed appropriate to look at a few reminders for everyone to help reduce stress and keep ourselves mentally fit and healthy.

Friends drinking in a Bar

Watch what you eat

Do look after your physical health: try to eat at least one sensible meal a day, and to include fruit and vegetables in your diet. Putting a little thought into shopping and meal planning will also help to structure your time and will save you money. What do you want to eat for dinner this week?

Keep hydrated

Remember to stay hydrated, especially after a heavy night out. Drinking plenty of water is not only good for us physically, but it has also been proven to improve mental performance, particularly when it comes to exam time.

Keep an eye on alcohol

Be mindful of your alcohol intake, not only will a hangover play havoc with your concentration the next day, but it also acts as a depressant; if you are feeling very down it is worth cutting down for a bit and noticing the difference in how you feel.Students eating pizza

Get enough sleep

Sleep is really important, and you will quickly find yourself struggling with work if you don’t get enough; not everyone needs 8-9 hours a night but listen to your body and learn how much you need to function effectively. Having a bit of down-time each day just to refresh your mind and body can work wonders – you can download many different kinds of relaxation or meditation apps to use if you find them helpful.

Find time to relax

Plan in time to switch off, and do something unrelated to your course. It is probably the best time in your life to try something new, to find a new challenge or develop an interest or skill to a whole new level. It is also much easier to meet new people and make new friendships if there is a task or an activity involved.

Hold onto your hobbies

Giving ourselves the opportunity to succeed or master a new skill is good for our feelings of self-worth, and being part of a group provides a sense of belonging, all of which is good for our mental health. Volunteering or doing things for others also makes us feel good about ourselves, and the benefits of exercise or just activity in general are well documented for having a positive effect on mood.

Student in library surrounded by books

Signs of stress

Learn what the signs and symptoms are that will tell you that you are experiencing stress. These will be different for each individual, but often include:

• Feeling anxious and worried, or miserable and lethargic, particularly if this is interfering with your sleep, or stopping you from doing the things you would normally do, like socialising.
• Feeling irritable or emotional about things that wouldn’t usually upset you.
• Being more forgetful than usual.
• Struggling with coursework or missing deadlines.
• Finding that you have either lost or gained weight because you have been either skipping meals or are comfort eating because of how you are feeling.
• Turning to alcohol or other substances to help you to feel better or to help you sleep.

If any of these sound familiar then it is really important not to ignore them in the hope that they will just go away. Have a think about what you are doing to keep yourself well, and try to talk to someone about how you are feeling, whether that is a friend, a personal tutor or perhaps someone from your student union. There will be various avenues available should you need some support, but in order to access them you will need to let someone know that you are struggling. You’re unlikely to be the only one!

Liz Langley

We’d rather be walking

This year, the School of Health Sciences has taken part in the University of Surrey GCC walking challenge. Colleagues have come together to form teams made of 7 people to compete for the most number of steps they can walk, run, cycle or swim. We are very pleased to say that this year we have 8 teams totalling 56 staff taking part:

Healthsciences3
• The Globetrotters R Us
• The TrueNTH Surrey Researchers
• The Blank Hack Racers
• Trotting Tutors
• The Pick and Mix
• The Pod Plodders 2016
• The BlueEmotion and
• Annette’s Intensive Walkers.

To support the fantastic success of our teams so far we thought we might use this blog to share the activities we have done to increase our steps.

1. Create a Leader board

Competition seems to be key (in this school anyway). We’ve all been gently pushing each other to go a little bit further, to walk a few more steps, so our teams aren’t last. Watching us all jostle for top position on the leader board has led to some clever tactics to ensure our steps increase.

2. Create a Motivation board

Create a notice board that people can share tips on. We’ve included all sorts of things on ours. From posters about nutrition, to tips on books you can buy that feature local walks and information on local fitness clubs.

3. A Lunch time stroll

We now run a weekly lunch time walk. The aim was to show that in 30-40 minutes you could escape from your desk and add an extra 5000-6000 steps to your daily total. We always have the same meeting point and time, but the day of the week we hold it on varies, to try and include everyone. We go anywhere and invite people to create and lead walks too. What’s great is that you get to speak to people you wouldn’t normally get time to speak to and see bits of the area that you might not have seen before.

4. Encouraging people to take the long cut

Gently encouraging people to use the stairs some times, or walk a longer route to the loo or the kitchen can all lead to an increase in the steps you’ve walked. No more short cuts for us!

5. Make it a game

We’re finishing our walk with a treasure hunt. There’s no walking route for our one, but we’ve divided the campus up into zones, with 5 questions per zone. It’s designed to be completed over the course of several lunchtimes, completing it section by section and hopefully leading to lots of steps as we try to complete it. If you’re on campus and want to take part in the treasure hunt for fun, we’ve attached it below. We’ll post the answers in another blog post in a few weeks time.

Treasure Hunt Map

Campus Treasure Hunt – QUESTIONS blog

The main thing we’ve found is to make it fun. Constantly pushing people to walk more steps is not at all motivational and can often have the opposite effect, but gently supporting each other, with a little friendly competition thrown in, can lead to some great lifestyle changes and help to make us all feel a little bit healthier.

Happy Stepping! 🙂