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Tuesday 30 December 2014

Keeping weight in check - does the weight of the adviser matter?

A wide range of advisers - from family doctors to pharmacists - can be effective in providing lifestyle advice aimed at reducing risk of serious diseases of the heart, brain and circulation - including advice on diet and exercise aiming to help with weight loss.
However a new study, organised by the Royal Society for Public Health, suggests that people seeking advice on weight loss are less likely to take it seriously from someone who is overweight, whether from a health professional or another source, including hairdressers and celebrities.
In response to this report, the Royal Society for Public Health is recommending that NHS staff not only advise 'do what I say'  but also 'do what I do' when it comes to advise on weight loss – ie NHS staff and others involved in advice on reversing overweight should be aware of the importance of acting as role models to help the public at risk to engage in losing weight.
A major challenge for the NHS as "more than half its 1.3 million-strong workforce, are estimated to be overweight or obese".

See more on the study

Wednesday 24 December 2014

Call for papers for 2015 International Symposium on Poetry and Medicine and Hippocrates Awards

Registration is open for the 6th International Symposium on Poetry and Medicine to be held on Saturday 23rd May 2015  in London. The symposium will include poster sessions, lectures, round table discussions and poetry readings (by former President of the Poetry Society Jo Shapcott and 2012 Hippocrates Awards judge Marilyn Hacker). The 2015 Hippocrates Open International, International Young Poet and NHS Awards will be announced at the end of the Symposium

The programme includes sessions on historical and contemporary themes, illness and poetry, poetry as therapy, poetry in the education of medical students, nurses and doctors, and poetry as an aid to health professionals..

Abstract submission is open - deadline 31st March 2015.
 
The Hippocrates initiative was named winner of the Award for Excellence and Innovation in the Arts in the 2011 Times Higher Education awards, announced on 24th November 2011 in London. This award aims to recognise the collaborative and interdisciplinary work that is taking place in universities to promote the arts. 
The deadline for entries for the 2015 Hippocrates Prize for poetry and medicine, which is for unpublished poems in English, is 12 midnight GMT on 31st January 2015.  

The Hippocrates poetry and medicine initiative has been supported by the Fellowship of Postgraduate Medicine, the Wellcome Trust, the Cardiovascular Research Trust, Heads, Teachers and Industry, and the National Association of Writers in Education. 
In its first 5 years, the Hippocrates Prize has attracted over 6000 entries from 61 countries, from the Americas to Fiji and Finland to Australasia.
With a 1st prize for the winning poem in each category of £5,000, the Hippocrates prize is one of the highest value poetry awards in the world for a single poem. In each category there is also a 2nd prize of £1,000, 3rd  prize of £500, and 20 commendations each of £50.  
The judging panel for the 2015 Hippocrates Awards for Poetry and Medicine comprises poet Rebecca Goss, BBC broadcaster and author John  Humphrys poet and psychiatrist and poet Professor Femi Oyebode.

Wednesday 17 December 2014

Digital Health: Catapulting Personalised Medicine Forward

In a new collaboration, on 27th November 2014 the UK’s Digital Catapult, the Fellowship of Postgraduate Medicine, IDEALondon, and Vital Transformation brought together leading experts working at the frontiers of research where personalised medicine and medicines, and health technologies intersect.
 
Round table sessions featured demonstrations of how next-generation technologies and social media will integrate with public health, thus facilitating the burgeoning market for personalised medicines. The symposium included disruptive start-ups and technology practitioners finding common ground in bringing secure personal health data to the public and advice on stratified medicines to prescribers and their patients.
 
The Digital Catapult, launched in November 2014, aims to place electronic and mobile technologies at the forefront of their future public health strategy. 

Publications arising from the symposium will be published in the FPM journal Health Policy and Technology.
 
 

Friday 5 December 2014

Poetry to keep the heart healthy

The Hippocrates Initiative established Healthy Heart Poetry in early 2013 in partnership with the healthy heart charity the Cardiovascular Research Trust. The aim of the Healthy Heart Poetry initiative is to encourage interest among children of all ages in lifestyle that helps to keep the heart healthy. 
We thought that both writing poems on keeping the heart healthy and planning and writing heart healthy recipes would form excellent themes for a school lesson on a number of subject areas.
Selected poems are published in an anthology, the first of which, Love your Heart, was published on 4th December 2014. 

Entries are now open for poems from children for consideration for the 2015 Healthy Heart Poetry anthology, deadline 1st July 2015.

There is an annual Healthy Heart Poetry event at which the Healthy Heart Poetry Anthology is launched, the children have the opportunity to read their poems from the published Anthology, and Healthy Heart Awards are presented to participating schools.
The 2014 Healthy Heart Poetry event took place in London on 4th December and included the launch of the Love your Heart anthology of poems on the heart by children for children, and presentation of Healthy Heart Awards to 19 schools.
Love your heart
2014 Healthy Heart Awards - London, 4th December

Healthy Heart Poetry publications

Love your HeartAn anthology of poems by children for children about heart health.
Edited by Wendy French and Rebecca Goss with notes on heart health by Donald Singer
64 pages. ISBN 978-0-9572571-4-6
Published by The Hippocrates Press, London: 4th December, 2014.

Order Love your Heart online
Love cover

Healthy Heart Awards for schools

Schools participating in our Healthy Heart initiative receive a Healthy Heart Award certificate to recognize their interest in education about how to keep the heart healthy. 
22 schools have since 2011 received Healthy Heart Awards from the healthy heart charity the Cardiovascular Research Trust.
See the list of schools which have received Healthy Heart Awards

YouTube videos of Healthy Heart Poetry by schools

Saturday 15 November 2014

Judges announced for 2015 Hippocrates Prize for Poetry and Medicine

Poet Rebecca Goss joins author, journalist and broadcaster John Humphreys, and psychiatrist Professor Femi Oyebode in the judging panel for the 2015 Hippocrates Prize.
The Hippocrates Prize is one of the highest value poetry awards in the world for a single unpublished poem. The  Hippocrates has a £5000 first prize both for its Open International and for its NHS Awards, and a £500 prize for the best poem in the Young Poets category. All awards are for a single unpublished poem on a medical theme. Entries for the 2015 Hippocrates Prize close at 12 midnight GMT 31st January, 2015.
Rebecca Goss was selected in 2014 by The Poetry Book Society's as a Next Generation Poet. Her first collection The Anatomy of Structures was published by Flambard Press in 2010. Her second collection, Her Birth (Carcanet/Northern House), was shortlisted for The 2013 Forward Prize for Best Collection and winner of the Poetry Category in The 2013 East Anglian Book Awards.
She joins a list of distinguished previous poet-judges for the Hippocrates Prize: Dannie Abse, Philip Gross, Gwyneth Lewis, Marilyn Hacker and Jo Shapcott.

John Humphrys is a distinguished journalist and presenter of radio and television who has won many national broadcasting awards. He has been a presenter on the award-winning Today programme on BBC Radio 4, since 1987. Since 2003 he has also been the host of the BBC2 television quiz Mastermind. From 1981 to 1987 he was the main presenter for Nine O’Clock News on BBC Television. Previous Hippocrates judges representing the public on the panel were broadcasters James Naughtie, Mark Lawson and Martha Kearney, Science Museums' Director of Communications Roger Highfield and Sarah Crown, Editor of Mumsnet.

Femi Oyebode is Professor of Psychiatry at the University of Birmingham and Consultant Psychiatrist at the National Centre for Mental Health in Birmingham. His research interests include clinical psychopathology and medical humanities. He is also a published poet. Hippocrates judges previously representing health professionals were Sir Bruce Keogh, Professor Steve Field, Professor Rod Flower FRS, Dr Theodore Dalrymple and Sir Robert Francis QC. 
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The Hippocrates Initiative for Poetry and Medicine – winner of the 2011 Times Higher Education Award for Innovation and Excellence in the Arts – is an interdisciplinary venture that investigates the synergy between medicine, the arts and health.
 
The International Hippocrates Prize is one of the highest value poetry awards in the world for a single unpublished poem on a medical theme. It is awarded in three categories:
- an Open category, which anyone in the world may enter;
- an NHS category, which is open to UK National Health Service employees, health students and those working in professional organisations involved in education and training of NHS students and staff;
- a Young Poets category in the international Hippocrates Prize for Young Poets  for an unpublished poem in English on a medical theme. Entries are open to young poets from anywhere in the world aged 14 to 18 years.

At the 2014 Awards Ceremony at the Royal Society of Medicine in London, the £5000 Hippocrates Open International first prize was awarded to UK-based poet Jane Draycott for her poem The Return. The NHS first prize was awarded to trainee paediatrician Dr Ellen Storm for her poem Out of Hospital Arrest, and the £500 Young Poet prize was awarded to Connor McKee, an English literature student at Sidney Sussex College at the University of Cambridge.
The judges of the 2014 Open and NHS prize categories were poet Philip Gross, winner of the T.S. Eliot Prize, Philip Mumsnet editor Sarah Crown, and barrister Sir Robert Francis QC.
To find out more about the 2015 prize, or to enter, click here.

Notes to editors
For more on the Hippocrates Prize and the 2015 judges, contact 0759 0478078 or email  hippocrates.poetry@gmail.com


Hippocrates Prize Organisers Professor Donald Singer is President of the Fellowship of Postgraduate Medicine. His interests include research on discovery of new therapies, and public understanding of drugs, health and disease. He co-authors Pocket Prescriber, the 7th edition of which is published by Taylor & Francis in May 2014. Professor Michael Hulse is a poet and translator of German literature, and teaches creative writing and comparative literature at the University of Warwick. He is also editor of The Warwick Review. His latest book of poems, Half-Life (2013), was named a Book of the Year by John Kinsella.

The 2015 Hippocrates Prize is supported by:
The Fellowship of Postgraduate Medicine, a national medical society founded in 1918 and publisher of the Postgraduate Medical Journal and Health Policy and Technology, has supported the Hippocrates Prize since its launch in 2009.

The Healthy Heart Charity the Cardiovascular Research Trust, founded in 1996, which promotes research and education for the prevention and treatment of disorders of the heart and circulation. 

Thursday 13 November 2014

Diet, Lifestyle and Cardiovascular Risk: from Evidence to Policy

Three weeks to go to this Evidence and Policy Symposium organised by the healthy heart charity the Cardiovascular Research Trust in partnership with the Fellowship of Postgraduate Medicine, publisher of the Postgraduate Medical Journal and Health Policy and Technology.

Authoritative, evidence-based information on how to protect cardiovascular health is vitally important for researchers, clinicians, policy makers and the public.

Symposium Sessions include Mediterranean diet and cardiovascular health; the impact of voluntary and mandatory policy; cardiovascular risk in childhood;  cardiovascular effects of dietary bioactives; evidence on risks and benefits of new dietary approaches.

Attendance is limited to 90 delegates.
See the online registration link and the full programme below. 

Friday 5 December 2014 at the Medical Society of London – Map of venue
11 Chandos St, Cavendish Square, London W1G 9DRT
5 minutes walk from Oxford Circus


Register for the Symposium

9.00 – 9.30  Registration and coffee

9.30 – 10.10 am
Impact on cardiovascular disease of voluntary and mandatory policy on diet and lifestyle. See abstract
Dr Martin O’Flaherty, University of Liverpool


10.10 – 10.50 
Emerging ethnic differences in cardiovascular risk in childhood
Professor Peter Whincup, St George’s University of London


10.50 – 11.25 Coffee

11.25 – 11.40
Alcohol consumed ‘with a meal’ or ‘without a meal’ is differently associated with risk of coronary heart disease in a UK prospective population study. See abstract
Lentjes MAH, Khawaja AP, Mulligan AA, Luben RN, Bhaniani A, Wareham NJ and Khaw KT.
Department of Public Health & Primary Care, University of Cambridge.


11.40 – 12.20
Impact of dietary nitrates on blood pressure
Professor Amrita Ahluwalia,
William Harvey Research Institute, Queen Mary’s University of London


12.20 – 13.00
Diet, lifestyle and cardiovascular risk
Professor KT Khaw, University of Cambridge


13.00 – 14.00 Lunch

14.00 – 14.40
Is chocolate good for you? Health claims versus evidence-based nutrition
Professor Roger Corder, William Harvey Institute


14.40 – 15.30
Effects of Mediterranean diet on cardiovascular outcomes in high risk people
Professor Ramon Estruch, University of Barcelona


15.30 – 16.00
Policy implications of current evidence on diet, lifestyle and cardiovascular risk
Speakers’ Round Table


16.00 Close

Thursday 6 November 2014

Plans announced for a Rwanda Society of Pharmacology


Plans were announced for the launch of a Rwanda Society of Pharmacology at the close of the first International Symposium on Medicines and Patient Safety held in Kigali 5-6 November.
The Symposium was attended by over 170 delegates and speakers from 6 countries (Rwanda, South Africa, Moroccoo, South Africa, UK and USA). who participated in an International Symposium on Medicines and Patient Safety was held in Kigali, Rwanda at the College of Medicine and Health Sciences (CMHS) on Wednesday 5th November 2014, followed on 6th November 2014 by an international videoconference on Prescribing Skills with Professor Simon Maxwell and on Pharmacovigilance with Professor Rita Benabdalleh from the WHO co-ordinating centre in Rabat, Morocco. The meeting included talks on medicines and communicable and non-communicable diseases by national and international clinical and policy experts from Rwanda, South Africa, USA and the UK.
The Symposium was held in partnership with Pharmacology for Africa, a
consortium of 18 Sub-Saharan countries supported by the International Union of Pharmacology, and led by Professor Douglas Oliver and Professor Christiaan Brink, from South Africa, both of whom spoke at the meeting. The 3 major themes of the symposium were: educating health professionals in safe and effective use of medicines; regulating drugs, including pharmacovigilance and quality of medicines, reducing harm from high risk medicines and in patients with high risk conditions.
Outcomes of the Symposium included plans to launch the first Rwandan Pharmacology Society, publication of selected reviews and commentaries in the international journal Health Policy and Technology, and plans for a Second International Symposium on Medicines and Patient Safety in June 2015, themes to include Improving Prescribing Skills and Rational Guidelines for Antibiotics.
Speakers discussed ways to reduce risk from medicines for treating children and expectant mothers, preventing disorders of the heart and stroke, and for treating cancer and kidney disease. There were also round table discussions not only on prescribed medicines, but also on the risks of over-the-counter and traditional medicines.
Co-organizer and Pharmacist Dr Kayumba said: “The Symposium was timely in building on strategy in Rwanda on pharmacovigilance and on developing our undergraduate and postgraduate educational systems for good practice in use of medicines.”
Co-organizer and Physician Dr Musabeyezu added: “The Symposium provided important updates for doctors, pharmacists and nurses from Referrral and District Hospitals from throughout Rwanda on reducing risk of harm from high risk medicines often used for high risk diseases”. 
Co-organizer and Clinical Pharmacologist Professor Singer said: "Medicines have powerful effects to help patients. However medicines also have the potential to cause powerful harmful effects. Education on how to ensure safe and effective use of medicines is therefore vitally important for patients and health services."
Pharmacology of Africa President Professor Douglas Oliver said: “Partnership with Pharmacology for Africa brings important opportunities to improve patient health and safety through engaging with a wide range of international experts in education, training, clinical practice and research aimed at best practice in use of medicines."
The symposium was supported by the World Health Organisation, Pharmacology for Africa, the International Union of Basic and Clinical Pharmacology, Partners in Health, the Rwanda Social Security Board,  the University of Rwanda College of Medicine and Health Sciences, and by unrestricted educational grants by GSK and Roche.

Information for Editors
For further information, including to arrange an interview with the organisers email ISMPS2014@gmail.com.



Symposium National and International Advisory Board

Sunday 2 November 2014

Helping to improve safety in the use of medicines in Sub-Saharan Africa.


Press Release: 00.00h Monday 3rd November 2014


Medicines have powerful effects to help patients. However medicines also have the potential to cause powerful harmful effects. Education on how to ensure safe and effective use of medicines is therefore vitally important for patients and health services.
An International Symposium on Medicines and Patient Safety is being held in Kigali, Rwanda at the College of Medicine and Health Sciences (CMHS) on Wednesday 5th November 2014, followed by an international videoconference on Prescribing Skills and on Pharmacovigilance on Thursday 6th November with contributors from the UK and the WHO. The meeting will include talks on medicines and communicable and non-communicable diseases by national and international clinical and policy experts from Rwanda, South Africa, USA and the UK.
The Symposium is being held in partnership with Pharmacology for Africa, a consortium of 8
Sub-Saharan countries supported by the International Union of Pharmacology, and led by Professor Douglas Oliver and Professor Christiaan Brink, from South Africa, both of whom will be speaking at the meeting.The 3 major themes of the symposium are: educating health professionals in safe and effective use of medicines; regulating drugs, including pharmacovigilance and quality of medicines, reducing harm from high risk medicines and in patients with high risk conditions.
Speakers will discuss ways to reduce risk from medicines for treating children and expectant mothers, preventing disorders of the heart and stroke, and for treating cancer, retroviral disease and kidney disease. There will also be round table discussions not only on prescribed medicines, but also on the risks of over-the-counter and traditional medicines.
Pharmacist Dr Kayumba said: “The Symposium is timely in building on strategy in Rwanda on pharmacovigilance and on developing our undergraduate and postgraduate educational systems for good practice in use of medicines.”
Physician Dr Musabeyezu added: “The Symposium will also provide important updates for doctors, pharmacists and nurses from Referrral and District Hospitals from throughout Rwanda on reducing risk of harm from high risk medicines often used for high risk diseases”. 
Clinical Pharmacologist Professor Singer noted: “Partnership with Pharmacology for Africa brings important opportunities to improve patient health and safety through engaging with a wide range of international experts in education, training, clinical practice and research aimed at best practice in use of medicines.
The symposium is supported by the World Health Organisation, Pharmacology for Africa, the International Union of Basic and Clinical Pharmacology, Partners in Health, the Rwanda Social Security Board and the University of Rwanda College of Medicine and Health Sciences

Information for Editors
For further information, including to arrange an interview with the organisers, and for a press pass to attend the symposium on 5th November 2014, email ISMPS@gmail.com





Sunday 19 October 2014

New words: 'Mewsing' on medical risk

'She's mewsing 6, doctor'.

New medical shorthand for an urgent message for the duty doctor, part of an 'escalation protocol'. The word 'mewsing' derives from Modified Early Warning Score (MEWS), a red flag system for identifying patients at risk of a rapid deterioration in their medical condition, either as assessed in the community by emergency medical services or by health professionals in hospital.

A recent systematic review of the value of early warning scores (EWS) concluded that "scores perform well for predicting cardiac arrest and death within 48 hours although the impact on (other) health outcomes and resource utilization remains uncertain ...".

Current forms of  Early Warning Scores (EWS) have their origins in the 1990s, arising from efforts aimed at development of a simple scoring system suitable for bedside application for identifying patients at increased risk of rapid deterioration in their medical condition, irrespective of the illness involved.

The EWS protocol describes a clinical pathway which starts with health workers making standard physiological measurements - systolic blood pressure, heart rate, respiratory rate, body temperature and level of consciousness.  If these recordings are outside the expected rates, the early warning score increases. The higher the score the greater the risk of worsening in the medical condition due e.g. to progression in infection, development of acute cardiac complication and other serious medical problems.

In response to a high EWS score practitioners are called to respond urgently to reassess the at risk patient and institute with appropriate escalation  in clinical treatment.

Modified Early Warning Score (MEWS) were later devised to improve identification of surgical and medical patients "at risk of catastrophic deterioration". Modified scores may for example include weighting for the level of saturation of oxygen in the blood, urine output and pain.











Tuesday 7 October 2014

Is cannabis dangerous? A review of research over the last 20 years ...

From commentary in The Independent
7.10.14


"A newly published paper reminds health professionals, policy makers, and the public, of the potential acute and long-term risks of cannabis use

In his report, Professor Wayne Hall at The University of Queensland Centre for Youth Substance Abuse Research, considers how the evidence has evolved over the past 20 years. He points out potential risks, both in the short term, and higher risks for three settings: long-term heavy use, use in adolescence, and during pregnancy."


With acute use, risks of cannabis include psychological effects – some people have an unpleasant dysphoric rather than euphoric response – and impaired concentration and coordination, with risk of road and other accidents, enhanced in the presence of alcohol or other drugs. Risks from exposure during pregnancy include reduced birth weight and impaired post-natal educational development, at least until adolescence. Risks of sustained use from adolescence also include impaired intellectual development. Other reported adverse effects of long-term use of cannabis include dependence, the risk higher in those who start in adolescence, and an increased risk of psychotic symptoms, especially in those with a family history of psychotic disorders or those who start young.  Regular use in older adults increases the risk of heart attack and chronic bronchitis. Cardiovascular and respiratory risks of cannabis are increased by concomitant tobacco use.

 See more from the commentary ...

Thursday 25 September 2014

International Symposium on Medicines and Patient Safety: Kigali, Rwanda – 5th November, 2014

Logo-PharfAEducation on how to ensure safe and effective use of medicines is vitally important for patients and health services.
Registration and abstract submission on the themes below is now open for the International Symposium on Medicines and Patient Safety in partnership with Pharmacology for Africa. The symposium will take place on Wednesday 5th November 2014 in Kigali, the capital city of Rwanda, under the auspices of the College of Medicine and Health Sciences of the University of Rwanda.
 
The 3 major themes of the symposium are:

  • Educating health professionals  in safe and effective use of medicines
  • Regulating drugs, including pharmacovigilance and quality of medicines
  • Reducing harm from high risk medicines and in patients with high risk conditions
University Hospital, Kigali
Key topics to be discussed and welcome as submitted abstracts include

  • education in pharmacology and clinical pharmacology
  • developing good prescribing skills
  • developing rational treatment guidelines
  • drug regulation including quality of medicines
  • Drugs and Therapeutics Committees
  • medicines for non-communicable diseases
  • pharmacovigilance
  • safe systems for using medicines for high risk therapeutic areas, including retroviral disease, maternal and paediatric health, cancer, and renal disease
  • traditional medicines
This Symposium will be of particular interest to health professionals and policy makers
View over Kigali hills
interested in the safe and effective use of medicines.
These include doctors, pharmacists, nurses and managers working in referral, district and community hospitals, community pharmacists, experts interested in the safe regulation and supply of medicines, health professionals interested in pharmacovigilance, and educators interested in postgraduate and undergraduate training of health professionals in clinical pharmacology, therapeutics and safe dispensing.
The symposium will also be of interest to professionals working in NGOs and patient safety organisations concerned with public health and with disease prevention and treatment.
UR-CMHS

Wednesday 24 September 2014

More on the Ebola West African epidemic from the WHO Ebola Response Team

The WHO Ebola Response Team has reported in the September 23 issue of the New England Journal of Medicine its analysis of 3343 confirmed and 667 probable Ebola cases collected up to September 14 in 4 of the 5 West African countries to have experienced
Ebola virion CDC Public Health Image Library
cases of Ebola Virus Disease: Guinea, Liberia, Nigeria, and Sierra Leone. The team reports a typical age range of 15-44 years with no difference in gender of those affected. Its estimate of case fatality rate is higher than that noted by the Centers for Disease Control at 71% for people for whom the outcome their infection is known. Based on the number of cases to date, from this they estimate a 95% confidence interval [CI] of 69 to 73% for mortality risk.  The team notes that features of the disease, including a typical incubation period of 11 days to be similar to that for  previous outbreaks. Based on the initial periods of exponential growth of the outbreaks, they have modelled the doubling times are EVD to be 16 days for Guinea, 24 days for Liberia, and 30 days for Sierra Leone, with by November 2 the cumulative reported numbers of confirmed and probable cases predicted to be "5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone", i.e. over 20,000 total cases for this EVD epidemic.

The CDC update to 25 September notes a case count for EVD of 6263, with 2917 reported deaths and 3487 laboratory confirmed cases.


More on the Ebola Virus Disease epidemic in West Africa

Information on Ebola virus from the Centers for Disease Control and Prevention

Tuesday 2 September 2014

Community work - Umuganda - in Rwanda

Quiet streets on Umuganda morning in Kigali
On Saturday, around 100 members of the international Human Resources for Health faculty and their families met in Rwanda's capital Kigali for early breakfast. We had been invited to join local Rwandans for Umuganda, a countrywide community integration and work programme which takes place thoughout the morning on the last Saturday of the month. No traffic on these mornings is allowed except by permit to contribute to a Umuganda activity. 
Other countries may have community work times on an annual calendar - for example the embryo Mandela birthday (18th July) 67 minutes call for of community contribution in South Africa and internationally; or the annual post-winter melt environmental clean-up by students in Kazakhstan. However the scale of engagement in the Rwandan programme is astonishing, with an estimated up to 80% of those eligible taking part.
 It is estimated that these monthly Rwandan communiity efforts, for example through land clearance and building projects, may be saving the Rwanda economy in the order of $60 million per year.
Rural Rwanda
The traditional form of Umuganda is said to date back at least 150 years, and continues to be coordinated by local village (Umudugudumayors. In modern, post-genocide Rwanda, the Umuganda process has also been applied as an important tool to help to promote local and national integration and reconciliation. Citizens with mental health problems currently may be exempt, however, in recognition of the potential benefits, there are plans to engage these people too in Umuganda, where practical.
We travelled in convoy in small white buses around 10 km into the countryside, passing wetlands and a turbid, storm-swollen river. Once off the excellent main road, we had a challenging drive into the hills, up unmade roads crevassed by early Autumn rains.
Our task was to work with villagers to clear weeds from the brick-walled grounds of the Mwendo 
HRH team and villagers 
Community Hospital, preparing the area for planting vegetables for patients and staff. Under a hot late August sun, we formed a close line, armed with pick-axes, mini-ploughshares and hoes to break the hard earth and remove at least the worst of the deep roots. The atmosphere was relaxed and happy, with frequent ad lib breaks to make new friends. In the background, loudspeakers played cheerful Rwandan instrumental music.
The morning ended suddenly with a call to refreshments - the typical conscious Rwandan
Local HRH staff with Permanent Secretary Dr Solange Hakiba
choice of warm or chilled soft drinks, speeches by local and national Rwandan leaders, and invitations to join energetic village Rwandans in free-for-all dancing.
Our brief first experience of Umuganda showed its power to bring together visitors and Rwandans in a spirit of mutual understanding and respect, while making a modest but real contribution to a local community - a good 300 man and woman hours of tough manual effort donated by and for the community. From our shady marquee, we had however a glimpse of other realities of local cooperative life: an ill farmer borne at speed towards the hospital doors on a makeshift stretcher held shoulder high by four young men.

Friday 22 August 2014

Benefits and risks of aspirin in the context of its anti-cancer potential

Aspirin has been reported to have the potential to prevent selected cancers of the digestive tract. Aspirin also reduces the risk of serious vascular diseases in patients already at higher risk of them. A team led by researchers from the University of London has published their assessment of the risks and benefits of aspirin by analysing previous reports of the effects of aspirin.

Aspirin is a powerful drug with powerful adverse effects, including bleeding into the digestive tract or brain, causing some forms of asthma, exacerbating gout and causing rare but serious complications in children under 16 years of age ...

See more on this in Spanish on the BBC World Service website.

Below is an English version of the BBC World Service report:

" Myth and reality of aspirin to prevent disease

Writing

BBC Mundo



Aspirin is one of the world's best selling drugs. More than two thousand years ago, Hippocrates, the Father of Medicine, discovered the active ingredient in aspirin, which he extracted from the willow plant, and used to soothe fevers and headaches.


But it was not until 1897 that the German Felix Hoffman developed the drug as such. More than a century later, aspirin, acetylsalicylic acid, is one of 10 generic best sellers in the world, with annual sales of about $ 1.7 billion.

Besides being a recognized analgesic, aspirin has gained ground as way to prevent certain diseases. Multiple studies have highlighted its benefits in preventing cardiovascular disease and various cancers.
However, taking aspirin regularly involves significant risks. BBC News spoke to several experts to discuss how and when it is advisable to take a dose of this medicine each day.

Cardiovascular Benefits

Taking a daily dose of aspirin is a method widely used to prevent cardiovascular disease in people who have had this disorder already.

Mike Knapton, associate medical director at the BHF, told the BBC that for people who have had heart attacks, angina, some types of stroke and diseases of the arteries, a low dose of aspirin a day can prevent the occurrence of new episodes. This practice is well established and several studies have demonstrated these benefits.

The reason is that aspirin inhibits platelet adhesion in blood vessels reducing blood clotting.  But research also points that the drug may not prevent cardiovascular events in healthy people.  Rather, "the risks of taking a daily dose of aspirin outweigh the benefits of taking it in the case of people who have never had this kind of disorders," said Dr. Mike Knapton.

Reduction of cancer

In recent years, several studies have also pointed to the benefits of the drug as a way to prevent certain types of cancer. Experts also point out that aspirin increases the risk of bleeding. In fact, Peter Elwood, a British expert who participated in the scientific team that first showed the benefits of this analgesic in cardiovascular disease states that "the future is aspirin in reducing certain types of cancer."

Recent research by Queen Mary University of London, argues that for people between 50 and 65 years, a dose of daily aspirin can significantly reduce the risk of developing colon, esophageal and stomach cancer.
"This study showed a 35% reduction in cases of colon cancer and 40% in the number of deaths from this disease," Julie Sharp, Director of the Health Information Department of the British charity Cancer Research UK told the BBC.

"In relation to stomach cancer and esophagus, a reduction of 30% in the number of cases and between 35% and 50% in deaths was recorded, "said the expert. The study recommends that people between 50 and 65 take a dose of 75 and 100 grams of aspirin for at least 5 years, preferably 10 years.

Significant risks

But some studies in the UK have indicated that in some cases, taking the drug may have more risks than benefits. One of the side effects of this drug is the possibility of internal bleeding, including brain. Experts agree that a daily dose of aspirin helps prevent cardiovascular problems in people who already suffer from these disorders.


As he explained to the BBC, Donald Singer, professor of clinical pharmacology in the department of medicine at Yale University in the United States, "as a result of its blood thinning effect, aspirin can cause bleeding, for example in people who have a stomach or intestinal ulcer, and in some cases it can also cause bleeding in the brain. "


Research from Queen Mary University of London recognizes these risks and stresses that in the case of persons 60 years of age who take a daily dose of aspirin for 10 years, the risk of bleeding in the digestive tract increased from 2.2% to 3.6%, and in a small proportion of these cases (5%), can lead to death. " It is important that in each patient assessment is done to establish who can take aspirin and who should not".



Julie Sharp, of the British charity Cancer Research UK said the risk increases significantly for people over 70 years.


But to what extent do the risks outweigh the benefits of aspirin?


Here is a point on which not all experts agree. "I have no doubt that the balance is in favor of taking aspirin for people over 50 years," Professor Peter Elwood told the BBC. He noted that, although the risk of bleeding is increased, there is no evidence aspirin is associated with fatal bleeding. "The evidence suggests that there is minor bleeding, but not fatal."


But a study from the University of London published in 2012 concluded that the medicine, taken daily, can do more harm than good to a healthy person.
Julie Sharp notes that precisely because it is not known with certainty who may suffer side effects, "it is important that in each case testing done to establish who should take aspirin and who is not."

Consult your doctor

The active ingredient of aspirin has been used to treat headaches for centuries. With so many studies highlighting the benefits of aspirin, thousands of people in several countries take the drug to prevent disease before presenting with any symptoms, something that according to Professor Donald Singer, a member of the British Pharmacology Society, can be very dangerous. "It's very important that people are aware of the risks and consult your physician" before taking long term aspirin treatment.

He explained that people who suffer from indigestion, or asthma, or who have gout or who are taking other drugs that inhibit blood clotting are at increased risks of the side effects of aspirin.


And that also applies to children under 16 years of age. "One might be tempted to give aspirin to a child, in the case of families with a history of colon cancer, such as prevention. But this is very dangerous because in the case of minors, a daily dose may cause liver damage."

It is also important not to take more than the dose of 75 mg, or a quarter of a standard dose of aspirin.


The benefits of aspirin to prevent disease in specific cases are well established, but experts insist that consulting a doctor is essential to reduce risks of adverse effects."