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Monday, December 19, 2011

How to cope with Seasonal Affective Disorder (SAD)

With the clocks going back and nights getting longer, some specialists are arguing that coffee bars, which provide high-strength lighting along with their lattes, might help the one in five people who suffers from seasonal affective disorder (SAD), a type of depression triggered by lack of light in winter. An estimated 7 per cent of Britain’s population suffer from SAD, with a further 17 per cent experiencing a milder form of the condition, commonly known as the “winter blues”. SAD kicks in as the days get shorter, the loss of natural daylight triggering depressive symptoms such as lethargy, a lack of interest in sex and sleep problems.

Light cafés have taken off in Sweden, which has nearly a million SAD sufferers and where winter gloom is a far greater problem than in the UK. Stockholm, for example, gets only five hours of daylight in the winter months. But the city’s commuters can stop off in cafés, such as the Iglo, and sit bathed in UV-free lighting to the strength of 3,000 lux (the technical measure of brightness).

This intense light, which compares with the 200-500 lux emitted by domestic or office lighting, simulates natural light and is thought to correct the hormone imbalance that causes SAD, although its effectiveness has not been conclusively proved.

Dr Victoria Revell, an expert in chronobiology (the study of circadian rhythms) at the University of Surrey, says that the cafés would benefit British SAD sufferers.

“They are beneficial both physiologically and socially. Using light therapy in this way can help our sleep patterns, energy levels and performance.”

Dr Revell explains: “One key role of light is to synchronise our circadian body clock to the 24-hour day.” SAD sufferers, she says, require a higher light intensity to regulate their body clocks. In the winter, when light levels are lower, they produce too much melatonin (the hormone which helps us sleep) and less of the “feel-good” hormone, serotonin.

The latest thinking is that the disorder has genetic origins. In America, for example, research suggests that mutations in a gene associated with melanopsin – a light-sensitive pigment in the retina of the eye thought to help regulate our circadian rhythms – may be involved.

Not all doctors agree: the Royal College of Psychiatrists recommends 30 minutes to one hour of light therapy daily, which some studies show is effective for 50-85 per cent of cases. Commercial lightboxes vary in price from £35 to £200, depending on the light intensity delivered, but 2,500 lux is the minimum needed to work. Some light devices are portable for travel or office use.

Hundreds of preteen children treated for eating disorders

Almost 600 children below the age of 13 have been treated in hospital for eating disorders in the past three years, new figures have revealed.
The statistics include 197 children between the ages of five and nine – with cases within this age group almost doubling over the period.

Experts blamed the trend on a “pernicious” celebrity culture which glorified size zero figures, leaving increasing numbers of young girls struggling to cope with their growing bodies.

The figures, from 35 NHS hospitals in England, show more than 2,100 children were treated for eating disorders before they reached their sixteenth birthday.

They include 98 children aged between five and seven at the time of treatment and 99 aged eight or nine. Almost 400 were between the ages of 10 and 12, while more than 1,500 were aged 13 to 15.

Even these statistics, disclosed under the Freedom of Information Act, are likely to be an underestimate.

Some NHS hospitals treating such patients refused to provide any data, while among the 35 hospitals, some would only disclose the figures for those children admitted to wards after becoming dangerously emaciated – excluding those undergoing psychiatric therapy as outpatients.

Susan Ringwood, chief executive of eating disorders charity B-eat said the figures reflected alarming trends in society, with young children “internalising” messages from celebrity magazines, which idealised the thinnest figures.

“A number of factors combine to trigger eating disorders; biology and genetics play a large part in their development, but so do cultural pressures, and body image seems to be influencing younger children much more over the past decade,” she added.

Research carried out by the charity with the Brownies found that even by the age of seven, girls who looked at outline drawing of women thought the thinner ones were happier and more popular than those with slightly larger outlines.

Mrs Ringwood said young girls felt increasingly frightened by the prospect of gaining weight in puberty. She said: “Children are receiving very pernicious messages.

“The ideal figure promoted for women these days is that of a girl, not an adult women. Girls see the pictures in magazines of extremely thin women and think that is how they should be.

“That can leave them fearful of puberty, and almost trying to stave it off.”

In 2009, Kate Moss, the supermodel, was accused of encouraging girls to become anorexic when she said she lived by the phrase ‘nothing tastes as good as skinny feels’ – a mantra of pro-anorexic groups.

While disorders among men are increasing, cases involving boys were often sparked by specific incidents, such as being bullied because of their weight, she said.

Separate research published in the British Journal of Psychiatry earlier this year suggests one in five children diagnosed with an eating disorder have a history of early feeding problems, such as fussy eating.

Almost half of those diagnosed with disorders by the age of 12 had a close family member with a mental health problem such as anxiety or depression.

The study by the University College London’s Institute of Child Health found more than 80 per cent of cases involved girls, with anorexia – which involves drastically reducing the intake of food and drink – far more common than bulimia – which involves sufferers binge eating and then making themselves sick.

Last year a survey of women suffering from anorexia found almost half said they had a problem with food by the age of 10.

Experts say there is no clear relationship between “fussy eating” and the later development of a disorder.

But Mrs Ringwood said some particular behaviours with food – such as cutting it into tiny pieces, or insisting that foods were eaten separately, could indicate early signs of a more significant problem.

Other types of behaviour which had nothing to do with food could provide some clues, she said.

“If children become very rigid in their routines and get upset if changes are made that can be an indicator of the type of anxiety associated with disorders,” she said.

Even young children who were trying to restrict their diet could be stealthy about it, she said, hiding food up their sleeves at mealtimes, in order to throw it away.

Killer quango NICE rejects MS pill as too costly

The Government’s drugs spending watchdog has decided that the first pill to treat multiple sclerosis (MS) is too costly to be prescribed on the NHS.The draft decision dashes the hopes of thousands of sufferers with the auto-immune disease who receive little benefit from current drugs.

There was enormous excitement among Britain’s 100,000 MS sufferers in January when EU drugs regulators gave fingolimod preliminary marketing approval.

Novartis, which markets fingolimod under the brand name Gilenya, subsequently applied for it to be prescribed on the NHS in situations where existing drugs do not work.

To receive these drugs, called interferon therapy, patients either have to self-inject every few days or go to hospital for supervised infusions.

A trial, published last year in the New England Journal of Medicine, showed that fingolimod halved the number of disabling relapses compared with interferon beta.

However, the National Institute of Curbing Expenditure (Nice) has decided that – at £20,000 a year – fingolimod “would not be a cost effective use of NHS resources”.

Prof Carole Longson from Nice said: “Unfortunately our independent committee wasn’t given sufficient evidence to show that fingolimod could reduce relapses considerably better than the other treatments currently being used.”

MS charities last night said the decision was “disappointing”.

Simon Gillespie, chief executive of the MS Society, warned: “It will leave some people with no effective treatment option.”

He added: “Access to MS treatments in the UK is very poor – in fact people with MS would be better off living almost anywhere else in Europe, and this decision will only deepen that inequality.”

The German health service is already paying for 2,000 people to receive fingolimod for highly active relapsing-remitting MS (RRMS).

Fingolimod is an immumosuppressant and, while it is well tolerated by most patients, it does have side effects in some.

Labour own goal on postcode lottery claims

Deprived areas in England will lose out to affluent parts of the country under health spending reforms Labour has claimed- despite repeatedly creating those same postcode lotteries when they were in power.
Changes to funding formulas means poor health rates will be given less consideration when cash is allocated, the party said.

It suggested areas like Manchester and the London borough of Tower Hamlets would lose out to parts of the wealthy south east, such as Surrey and Hampshire.

Labour based the claims on an assessment of funding reforms by public health bodies in Manchester.

But the government has disputed the allegations and claimed Labour’s figures were misleading.

Department of Health officials said primary care budgets in Surrey and Tower Hamlets would go up by a similar amount this year.

The Conservatives claimed every area would have suffered health funding cuts under Labour.

A Conservative party spokesman said: “This is yet another own goal from Labour. If they had won the last election, the NHS would now be being cut by £28 billion across the country. Every area would have seen spending on the NHS cut – as it is in Labour-run Wales.

“This Government is increasing spending on the NHS in real terms over this parliament, and every region of the country will receive more money as a result of this investment.”

Health Direct has repeatedly tracked Labour’s proud boast when it was in power of creating postcode lotteries based on it’s voting constituencies:

Labour wasted cancer cash on NHS salaries and PFI schemes

Cancer care on the NHS lags behind that in many other developed countries because Labour wasted billions of pounds on PFI schemes, bureaucracy and inflated salaries for managers. A report by the Organisation for Economic Co-operation and Development (OECD) has found that, despite record spending on health care, cancer survival rates in Britain are worse than in Slovenia and the Czech Republic.

Survival rates for breast cancer, prostate cancer and cervical cancer were below the average for the 34 developed countries in the study.

Mr Lansley lays the blame for the poor performance on the previous government’s failure to make sure that extra investment in the NHS reached the front line. He claims patient care was ignored in favour of increased salaries and botched computer systems.

Writing in The Daily Telegraph, Mr Lansley says: “Unfortunately this report shows how much work there is to do to deal with Labour’s legacy of neglect and mismanagement of our NHS.

“They hugely increased spending on the Health Service, but wasted much of it on managers, failed IT projects and unsustainable PFI projects.

“They failed to focus on what really matters – patients – which is why we still have some of the worst cancer outcomes amongst comparable countries.”

Under Labour, spending on the NHS trebled, reaching almost £100 billion in 2009, but money for treating cancer still lags behind much of the rest of the world.

A report by the Policy Exchange think tank last year found that England spent around 5.6 per cent of its health care budget on cancer care, compared with 7.7 per cent in France, 9.6 per cent in Germany and 9.2 per cent in America.

In September it emerged that private finance initiatives, introduced by Labour to fund capital projects, have left 60 NHS hospitals on the “brink of financial collapse”. Meanwhile, the pay of NHS chief executives has risen, with typical earnings now more than £150,000.

The OECD figures reveal that the best breast cancer survival rates were in the US, where 89.3 per cent of women were alive five years after being diagnosed. The average across all OECD countries was 83.5 per cent, while in the UK it was 81.3 per cent.

Survival rates for cervical cancer were worse. Norway topped the table with 78.2 per cent still alive after five years, compared with 58 per cent of women in the UK. There were also more hospital admissions for asthma and other lung conditions than the average and infant mortality was higher.

The report also showed that consultations by doctors have fallen, and were below he OECD average in 2009.

Katherine Murphy, the chief executive of the Patients Association, said: “The NHS provides some excellent care but it does fall down on many counts. We know from patients phoning our helpline that the quality of care that they have experienced can be very poor and sometimes it is downright neglectful.

“Rather than trying to tackle the issue of poor care, the Department of Health is demanding that the NHS makes £20 billion of efficiency savings while spending a million pounds a day on a reform plan that doctors, nurses, patients and NHS managers all say risks irrevocably damaging the NHS.”

Luxury car makers build bigger cars for fat drivers

Luxury car makers are building bigger cars as a result of drivers and passengers becoming more overweight. Typical family cars have become more than a foot wider and almost double the weight over the past 50 years as manufacturers struggle with the world’s obesity crisis.

Consequently some luxury manufacturers have begun road testing the next generation of larger sized vehicles.

In plans dubbed “plump my ride” – in a play of words from the television show Pimp My Ride – BMW has recruited 800 volunteers, ranging from the slim to the obese, for a study to gauge how obesity affects mobility while driving.

The unnamed volunteers were put through a series of tests designed in part to examine factors such as getting in and out of cars or looking over their shoulder while reversing.

“People are getting more obese and we want to find out how that limits their range of motion and how our vehicles can adapt to the changing needs of our customers,” Ralf Kaiser, a member of BMW’s ergonomics team, told the Sunday Times.

“We know that a lot of overweight and obese people have problems in daily life, and in the car this starts with getting in and getting out.  In general, these aren’t sporty people. We already have things like the parking distance control, which shows obstacles on a screen when you are reversing.”

He added: “For someone who can find it difficult to turn 140 degrees to look behind them, they can now just look at the screen.  The study will mean we can look at things more scientifically and build a car that at least 95 per cent of people can use.”

Mercedes has unveiled plans to strengthen grab handles above its doors, in part to help heavier passengers support themselves.

Porsche, meanwhile, is installing “electrically-powered steering columns” on top-of-the-range models that rise when the engine is switched off.

Over the past decade, Honda has widened its seats by up to 2 inches to accommodate larger bottoms while its new range of vehicles will also have buttons that will allow for so called “sausage fingers”.

Other manufacturers are installing reversing aids and blind spot detectors as standard.

According to the latest figures a Ford Prefect was 4ft 9in wide with an 18 inch long seat cushion in 1953. This compared to a 2011 Ford Focus that was 6ft 1in wide with a 23 inch long seat cushion.

Government statistics show that more than 60 per cent of adults in England and a third of 10 and 11-year-olds are obese.

In August The Lancet medical journal said that by 2030 more than 11m would classed as obese, with a body mass index (BMI) above 30, compared with a healthy BMI score of between 18.5 and 25.

Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, it was claimed last month.

It was recently disclosed that over the past five years Yorkshire Ambulance Service spent nearly £10 million on specialist vehicles to transport obese patients.

Speaking earlier this month at a launch that unveiled plans to cut obesity levels by 2020, Andrew Lansley, the Health Secretary, said Britain had to become a nation of calorie counters to counter the obesity crisis.

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