Childhood Immunisations; everything you need to know

studenthealth General, Infectious diseases, minor illness, Students with Children, Uncategorized , ,

In the UK, all children are offered immunisations to protect them from potentially serious or life threatening diseases. The vaccination schedule begins at 8 weeks and at Students’ Health Service (SHS) we offer the full range of vaccines (except BCG). View the current routine immunisation schedule here.

Once registered at SHS, you will be invited to make an appointment for your children if they require vaccination. If you have come to Bristol from another country, please inform us of the vaccination history of your children, so we can continue to protect them while you are here. if you have moved from elsewhere in the UK your child’s records will follow, but please bring your Red Book.

If you require a relative or nanny to bring your child for their vaccinations, you will need to notify us in writing. Please see our consent policy.

It is natural as a parent to feel anxious about bringing your baby/child for their vaccinations. If you have a new baby they will be seen by a doctor at 6 weeks old, for consent to immunisation,  and by a nurse at 8 weeks for their first vaccinations. Older children will not need to see a doctor first.

It is important to bring the child’s ‘Red Book’ or vaccination history with you so the correct vaccinations are given and recorded.

It is a good idea for your child to be dressed in easy to remove clothing and to inform older children about what is going to happen to them. This makes it less stressful for them.

When vaccines are given, you will be asked to sit your child on your knee and hug them firmly. The whole process is very quick!

Sometimes after a vaccination, children will develop a mild fever. It is ok to give them infant paracetamol or ibuprofen to bring their temperature down.

 

For further details see below:

 

http://www.nhs.uk/Conditions/vaccinations/Pages/vaccination-schedule-age-checklist.aspx

Smart drugs; how much of a risk are you prepared to take?

studenthealth Drugs, Mental Health, Uncategorized , , , , ,

“We simply don’t know how chronic drug treatment will affect ‘healthy’ brain function in future years.” So says Professor Barbara Shahakian of the University of Cambridge, on the subject of cognition enhancing medications. The newspapers and their online equivalents have recently been full of stories about using such so called ‘smart drugs’, for example to study for exams, but we know very little about them, or about what effect they might have on us in the long term. Such drugs include both Ritalin, prescribed for ADHD and Modafinil, for narcolepsy.

New figures for drugs used to treat Attention Deficit Hyperactivity Disorder (ADHD) show that prescriptions from GPs have risen 56% in 5 years. The media and certain professionals in the mental health field have been quick to assume that GPs are therefore prescribing them less carefully, and raised concerns that such drugs might be ‘abused’ and ‘diverted or misused’. I have my own theory, which is that as the UK’s psychiatrists have become more confident in diagnosing ADHD (GPs don’t generally diagnose it, as it is such a time consuming process) and they have also relaxed the prescribing of the necessary medications from ‘red’ type (consultant only prescription) to ‘amber type’ (meaning the GP can prescribe with consultant support), this would naturally lead to an increase in numbers of GP prescriptions. GPs are not that easy to hoodwink, and no-one will receive a prescription from our GPs, unless they have a well documented consultant diagnosis. My concern therefore is not the increasing numbers of prescription drugs, but the issue of non-prescribed ‘smart drugs’ being used by students to self medicate with the aim of ‘enhancing’ their academic performance.

Some research suggests up to 1 in 10 UK students uses such drugs, and some have written about their experience online. In Oxford the verdict was that Modafinil made only subtle improvements in concentration, but it did make them poo a lot!

It doesn’t yet seem to be quite clear how these drugs work, but it is generally agreed that they stimulate a part of the brain that changes mental and behavioural reactions. Therefore using them to keep yourself working harder for longer without medical advice seems to be a significant risk with regards to potential long term effects on the brain. A recent study by Dr Nora Volkow and colleagues, based on PET scans, suggested that 400mg Modafinil had effects in brain areas known to be involved in substance abuse and dependence. There is also evidence that it will disrupt sleep patterns in the long term, and the ability to make memories.

It seems to defy logic to use drugs to get through exams/ academic work when all the good evidence- based advice is that for sustainable performance humans do best with regular breaks, planned meals, and quality sleep, and even mindfulness/ exercise.

 

With all these possible risks, I would strongly encourage you to think hard before taking any non prescribed psychostimulants, or cognition enhancing drugs. There might be short term benefits, but are the risks worth taking?

 

Put the MOVE into MOVEMBER

studenthealth Uncategorized

Why move? Sitting is the new smoking! The more you sit, the poorer your health and the earlier you may die.

 

We love to sit – in cars, at the desk, on the sofa, at the match. Research shows that sitting and inactivity are linked to increased risk of heart disease, diabetes, cancer and depression.

The human body is designed to move; when sat for extended periods the body shuts down at the metabolic level. When muscles (especially certain leg muscles) aren’t moving, circulation slows, using less blood sugar and burning less fat.

  • Men who sit more than six hours a day have an 18% increased risk of dying from heart disease and a 7.8% increased chance of dying from diabetes compared with someone who sits for three hours or less a day.
  • In 2013, more deaths will be attributed to physical inactivity (5.3 million) than smoking (5 million).
  • Today’s 10-year-olds are the first generation expected to have a shorter life expectancy than their parents

 

So move that Mo!

Research at SHS

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Research is crucial to all parts of the NHS, helping us to understand, adapt and respond to the challenges faced. Traditionally, research was viewed as the job of academic departments in large hospitals, but that is no longer the case. The vast majority of peoples’ contact with the NHS takes place in general practices like Students’ Health Service (SHS), so it makes sense that more research is taking place in this setting too.

SHS has been a research active practice for several years. We participate in a wide variety of studies, most of which are featured on our research notice board. We are only involved in NHS funded studies approved by our local Primary Care Research Network (PCRN). They will also have been considered in detail and approved by a Research Ethics Committee. Some studies involve our GPs, nurses or Health Care Assistants recruiting students during consultations. We have recruited to studies which have resulted in important findings and been published in very well known journals. For example, we were one of the main recruiters to a study called IPCRESS, published in the Lancet in 2009. IPCRESS showed that Cognitive Behavioural therapy (CBT) seemed to be effective when delivered online in real time by a therapist. This method of delivery of CBT has since grown, enabling broader access to CBT, impacting significantly on how mental health problems such as depression are managed. We also recruited students to a study published in the British Medical Journal (BMJ) earlier this year, which found that offering people initial telephone contact with physiotherapists (PhysioDirect) was equally clinically effective as usual care, provided faster access to physiotherapy, and seemed to be safe, (although it could be associated with slightly lower patient satisfaction). These findings will be shaping how physiotherapy services are delivered nationally.

Interestingly, there is also growing evidence to suggest that people who take part in a research study, even in the control arm, tend to do better than equivalent individuals who are not involved in research!

We are very grateful to those students who respond positively when we approach them about taking part in research (almost all of you do!). The studies we take part in are designed to be user friendly, both for us and for you, and the rewards of taking part for the NHS as a whole can be really significant. So don’t be surprised if we mention research to you, and take a look at our research notice board next time you visit the practice.

Remember, remember the 5th of Movember….

studenthealth Men's health ,

Five days into the month of November and quite a few men are sporting some dodgy-looking facial hair.  It suits some, but for many the words that spring to mind are “wispy”, “scruffy” and “have you lost your razor?”

 

The reason for things getting hairy is the global phenomenon that is Movember.  It isn’t an irreverent opportunity for men to indulge their inner Tom Selleck (Link for anyone too young..: http://www.youtube.com/watch?v=3CquMO3vJvo); rather a massive drive to change the face of men’s health one moustache at a time. Participants (“Mo Bros”) start the month clean-shaven, and then grow and groom their moustache all month long, for the 30 nights and hairy days of Movember, raising funds and much needed awareness of men’s health issues – specifically prostate cancer, testicular cancer and men’s mental health.

 

On average, men die at a significantly younger age than women – the average life expectancy for men in the UK at birth, and at age 65, is lower than for women, yet there is no biological reason for this. There are some hair-raising facts:

  • Men have a 14% higher risk of developing cancer than women and a 37% higher risk of dying from it
  • Testicular cancer is the most common cancer in men aged between 15-45 years with just over approximately 2200 new cases a year
  • 1 in 4 people in the UK will experience some kind of mental health problem in the course of a year
  • Suicide is the single most common cause of death in men under 35
  • 25% of men in the UK were categorised as obese in 2011 compared to 13% of men in 1993
  • In England more men than women have been diagnosed with diabetes. 6.3% of men reported that they had diabetes and 5.3 % of women
  • A quarter of deaths of men under 34 can be attributed to alcohol

 

The reasons for the poor state of men’s health in the UK and around the world are numerous and complex, and include:

  • lack of awareness and understanding of the health issues men face
  • men not openly discussing their health and how they’re feeling
  • reluctance to take action when men don’t feel physically or mentally well
  • men engaging in risky activities that threaten their health
  • stigmas surrounding mental health

 

In 2012, over 1.1million Mo Bros and Mo Sista’s pledged their allegiance to the moustache and raised over £92 million globally.  In the UK, there were over 363,000 participants raising over £27 million

 

Anyone can get involved, growing a moustache or supporting friends that do.  The University of Bristol has an online network set-up to bring staff and students together at: http://monetwork.co/Bristol

 

If you are growing face fuzz then sign up, and if you aren’t make sure you sponsor someone that is.

 

To find out more and register your involvement, go to: http://uk.movember.com/get-involved/

 

Most importantly, respect the moustaches you see appearing.  They may not be pretty, they may be patchy, scraggly and itchy, but they are there for a very important reason. The Moustache is a ribbon for men’s health. Support your local Mo!

if you have any health concerns yourself, then please do give the Students’ Health Service a call and we will be happy to help!

http://www.bristol.ac.uk/students-health/

 

Critics of the NHS I have two words for you… Breaking Bad!

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For those who would criticise the NHS I have two words; Breaking Bad!

 

The NHS is not perfect, few things in life are, but I do find myself dismayed when people complain about the wait to see a specialist for routine problems, or that certain things are not available without charge, such as cosmetic procedures, or letters for charity sky dives.

The NHS cares for people’s health from cradle to grave, and is free at point of contact, and I am hugely proud to work for it, and it frustrates me to hear people complain, rather than appreciate, how unique and amazing the system is.   No matter what your background, employment, financial situation, you will be cared for if you need healthcare. Sometimes that care is not as good as it should be, and I am as disappointed as anyone when I hear of situations such as the poor care given at Mid Staffs Trust last year, but the NHS principle is sound, and fair to all. It was when I started watching Breaking Bad recently that it seemed to hit home particularly hard how well our welfare state works! The concept of this American drama is brilliant, (middle-of-the-road chemistry teacher Walt White has cancer, but no medical insurance to pay for treatment, so starts ‘cooking’ crystal meth to earn cash fast, with all it’s attendant adventures!) and it is completely addictive to watch, but when you hear “$13000 and counting” from Walt’s wife, the cost of a 3 day stay in a US hospital, and therefore the drive for Walt to ‘cook’ even more, that is when you really appreciate what many of us take for granted!

NHS resources are limited, and if we are to continue to care for all who need healthcare, we need to use what we have judiciously.

You may have to wait to see a specialist for a routine problem, but when you do see them they will be highly trained, closely monitored under national regulations, and working in healthcare for the love of it, not for the money!

So perhaps ponder this;

Every time we ‘pop into’ A&E instead of using a more appropriate source of care, we cost the NHS extra money.

Unnecessary visits to a GP for colds, and viruses, or missed appointments without cancelling, they all cost the NHS money.

Writing non NHS letters, such as for travelling/ insurance/ working for charities etc, take GP time away from seeing patients, and are therefore subject to a charge at the practice’s discretion (although NHS GPs don’t have to do them at all). So we really appreciate it when people recognise that this is an additional service, and don’t complain about a cost.

 

With a new Chief Exec of the NHS arriving soon, a man who supports the introduction of private providers into healthcare, we need to be very careful as a nation not to lose sight of our fantastic, value for money, socially responsible NHS, and to appreciate its principles. I hope our new CE, Simon Stevens, arriving soon from the USA, has watched Breaking Bad and taken note!

Camping; a cure for insomnia?

studenthealth General, Mental Health, sleep, Uncategorized , ,

I was fascinated to read a new bit of research published in August, when so many of our students were off camping. Sadly I don’t think festival camping will count, but if you were in the outback, somewhere with minimal night lights and sitting by the camp fire, then well done!

http://www.bbc.co.uk/news/science-environment-23530408

 

It seems that living by the maxim “up when it’s light and asleep when it’s dark” is based in science… it’s one of the pieces of advice we give our students who suffer from insomnia, along with;

 

  • Avoid napping in the day
  • Avoid alcohol/ caffeine 4-6 hours before bed time
  • Exercise regularly, but not just before bed
  • Go to bed at the same time and get up at the same time, every day
  • Block out light/ noise as much as possible
  • Don’t use the bedroom as an office or place of work
  • If you cannot sleep having woken in the middle of the night, then after 20mins get up and do a quiet activity, have a bath etc before going back to bed and trying again.

 

If your insomnia persists then please come and talk to a doctor.

What I like about the camping research is that it is so simple and pares back all the stuff we do to ourselves that stops us sleeping, so that within just a few days of a simple routine being followed sleep returns.

 

Good sleep habits are vital for our wellbeing, health and mood. If you are suffering, then please come and see us.

Organ Donation; I’ve signed up, have you?

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Almost 20 million people are on the organ donor register in the UK. Are you one of them?

Most of us would take an organ if we needed a transplant, so perhaps more of us should join the register as potential donors. What do you think? It’s easy to sign up online, and carry the card somewhere easy to find if the situation arises. You can even sign up by texting SAVE to 62323.

NHS Blood and Transplant, the body that oversees transplant registers, blood donation, and houses the UK’s blood and transplant experts, is based in Bristol, so maybe as neighbours we should try especially hard to help out!

 Here at Bristol Uni there are a few students that we care for who have received organs, or blood, without which they might not have come to university. Similarly there will be those who are awaiting donors, or have not been able to come to study yet as they are too unwell.

 

Some interesting facts;

 

Last year, 4,212 organ transplants were carried out, thanks to the generosity of 2,313 donors; and 1,160 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney or liver/pancreas transplant.

However, more than 10,000 people in the UK currently need a transplant, and sadly, of these, 1,000 will die each year (3 a day) because of a lack of organs.

All the major religions of the UK support the principles of organ donation and transplantation

People from South Asian, African and Afro-Caribbean communities living in the UK are more likely to need a kidney transplant than the rest of the population. Unfortunately donation rates are relatively low among black and South Asian communities, thus reducing the chance of a successful match being found.

There is no upper age limit for becoming a donor.

 

So if you think you would like to help save up to 9 lives, or make just one better, have a look at http://www.organdonation.nhs.uk/

 

Sign up, let your family know, and pass it on!

 

If you are interested in giving blood look at www.blood.co.uk

Regular blood donor sessions are held in Bristol throughout the year.

 

Coughs, Colds and Sore Throats – what you need to know…

studenthealth General, minor illness, Uncategorized, Wellbeing , , ,

Coughs, Colds and Sore Throats are very common particularly at this time of year.

There is no magic cure for the common cold! There is no treatment that will shorten the length of the infection. Treatment aims to ease symptoms whilst your immune system clears the virus. Note: antibiotics do not kill viruses, so are of no use for colds.

For more information and advice about colds please visit http://www.patient.co.uk/health/Common-Cold.htm

Most coughs are caused by viral infections, and usually soon go. There is no ‘quick fix’ for a cough due to a viral infection. You need to be patient until the cough goes, which can be up to 4 weeks.

Most viral coughs clear without complications.

See a doctor if any of the following occur.

  • If symptoms such as fever, chest pains, or headaches become worse or severe.
  • If you develop breathing difficulties such as wheezing or shortness of breath.
  • If you cough up blood. Blood may be bright red but dark or rusty coloured sputum may indicate blood.
  • If you become drowsy or confused.
  • If you develop any symptoms which you are unhappy about, or do not understand.
  • If you have a cough that persists for longer than 3-4 weeks.

For more information and advice about coughs please visit http://www.patient.co.uk/health/Cough-Caused-by-a-Virus.htm

A sore throat usually goes after a few days. Simple treatments that you can buy from a pharmacist can ease symptoms until the sore throat goes. Usually, you would only need to see a doctor if symptoms are severe or if they do not ease within 3-4 days. Have plenty to drink, but avoid alcohol as this can make you more dehydrated, take regular paracetamol or ibuprofen to ease pain, headache and fever and consider lozenges and gargles to soothe a sore throat.

For more information and advice about sore throats please visit http://www.patient.co.uk/health/sore-throat

 

The unwelcome memento…

studenthealth Contraception and Sexual Health, Embarrassing problems, Wellbeing , , ,

Welcome to a new academic year at university!

Many of you will have enjoyed Freshers week or simply seeing your friends back in Bristol again..…perhaps there has been a bit more celebration than study? Alcohol can contribute to risk-taking behaviour that could lead to unwanted pregnancies and sexually transmitted infections.

A survey of 16 – 24-year-olds (Define 2008) found that after drinking alcohol

 •            One in seven have had unsafe sex (i.e. Not using a condom)

•             One in five had sex and later wished they hadn’t

•             One in 10 were unable to remember whether they had sex the night before

•             Many (40%) agreed that they would be more likely to have casual sex

How many of you are nodding in agreement..?

Worryingly, Public Health England (PHE) published data in June that showed that new sexually transmitted infection (STI) diagnoses rose 5% in 2012 to almost half a million….HALF A MILLION!!!!

Although in part due to improvements in data collection, the high STI rates in England suggest too many people are still putting themselves at risk through unsafe sex, especially young adults, and men who have sex with men (MSM). Does this include you?

Chlamydia remained the most commonly diagnosed STI (46%), but considerable numbers of genital warts (16%) and genital herpes (7%) cases were also reported last year. New gonorrhoea diagnoses rose 21%. Those aged under 25 experienced the highest STI rates, contributing 64% chlamydia and 54% of genital warts diagnoses in heterosexuals in 2012.

But “I don’t have any symptoms……so I am ok…..right?”

Wrong!

50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection.

You have up to a 1 in 10 chance of testing positive to Chlamydia!

 That’s why the National Chlamydia Screening Programme exists- its target is to control Chlamydia and its complications, which can include pelvic inflammatory disease (PID), ectopic pregnancy and infertility in women and epididymitis in men.

The advice is that sexually active under 25 year olds should be screened for Chlamydia EVERY year, and on change of sexual partner. Over the age of 25 you should still seek a test following any change in partner.

 

So “how can I reduce my chances of picking up an STI?”  Well, you could just stay home and study, but if that isn’t appealing then consider the following options.

 Recalling that many people with infections are unaware of their status, as they don’t have any symptoms (and therefore cant warn you), the best advice is therefore to  –

  • Reduce the number of sexual partners  you have
  • Avoiding overlapping sexual relationships
  • Always use a condom when having sex with casual and new partners
  • Get tested regularly if you’re in one of the higher risk groups (eg MSM)
  • Get screened for chlamydia every year (if aged under 25) and on change of sexual partner.

 

You can access testing through the Students’ Health Service- see the contraception and sexual health section on our website for more details. You can also pick up a self-testing kit for Chlamydia (and it also tests for Gonorrhoea too) in the practice- they are on the windowsills along the corridors and in the waiting room.

So make sure it’s a memorable start to the new academic year…for all the right reasons and that your not left with an unwelcome memento of that big night out!