Calling Children and Young Adults - NHS Cumbria needs you!

NHS Cumbria's Public Engagement team are looking for feedback from anyone 19 years and under on a new leaflet (below), which has been put together for young people who need care and treatment from any part of the NHS.

If you have had personal experience of using the dentist, local GP, A & E Department or some other part of our local health service, we'd really value your comments on this.

The kind of things we're looking to check on this leaflet are:

• Is the leaflet too long?
  
• Is it aimed at the right age group?
• Does it use words you understand OK?
• Are there important things we've missed from it?
  

This leaflet is one part of an ongoing project done by NHS Cumbria around how young people and children use our services. It's just one aspect of improving how we deal with our younger patients, so please let us know what we can do to make your experience of healthcare from us even better in the future.

Simply click on the photos in the post to read them full-size.

If yould like to help, please comment back at the end of this blog post, our Facebook page at http://bit.ly/awDfYT or at our Twitter account (http://twitter.com/NHSCumbria). Thanks!

Back To School

As sure as that slight autumnal chill signifies the end of summer, it's almost time to go back to school.

For parents of those returning to - or even starting - full-time education, here's a round-up of various useful links to help your child stay healthy and happy throughout their school days:


The First DayThe first day at school is a memorable milestone for little ones, but it doesn't have to be a difficult experience for either parent or child. Parenting expert and mother of three, Dr Pat Spungin offers some advice to help make the transition as easy as possible:
http://www.nhs.uk/livewell/childhealth1-5/pages/firstdayofschool.aspx

Ofsted's tips to prevent first day fears at primary school:
http://www.direct.gov.uk/en/Parents/Schoolslearninganddevelopment/PreparingFortheFirstDayAtSchool/DG_4016576


Lice
It's been a long time since 'Nitty Nora, the Biddy Explorer' did the rounds, so head lice can unfortunately be part of primary school life. Here's some practical advice to treat 'nits' with a video clip from a pharmacist explaining why children get them more than adults:
http://www.nhs.uk/planners/birthtofive/pages/headlice.aspx


Walking to School

It's well worth the little planning required to walk your children to school. Not only will it improve both parent and child's fitness levels, but it saves on petrols costs too. Even two or three times a week will be beneficial. To demonstrate how this can be incorporated with your daily routine, here's a video of Mum Nina starting a new walk-to-school routine with her two young children:
http://www.nhs.uk/livewell/onabudget/pages/walktoschool.aspx

Of course, walking is great for fitness and building confidence, but it's important that children and teenagers cross the road safely:
http://www.nhs.uk/livewell/roadsafety/pages/pedestrians.aspx


Healthy Lunches
Since Jamie Oliver's campaigned for healthy school dinners, getting a nutrituous balanced meal at the canteen isn't so difficult. If you'd like to fine-tune your child's lunchbox too, here's some useful ideas:
http://www.nhs.uk/livewell/childhealth6-15/pages/lighterlunchboxes.aspx

Still stuck for ideas? Here's a whole host of recipes for healthy lunches for kids that the whoel family will enjoy:
http://www.nhs.uk/change4life/pages/lunch-recipe-book.aspx


Bullying
If your child is dreading the return to school, it could be that they've been bullied. If you suspect this, here's some advice and further links to helpful organisations:
http://www.nhs.uk/Livewell/Bullying/Pages/Bullyingadviceforparents.aspx

Despite so many children and teenagers owning their own mobile phones and computers these days, cyberbullying is a new phenomenon for many parents:
http://www.nhs.uk/Livewell/Bullying/Pages/Cyberbullying.aspx


Young Carers
If you have young relatives who are carers, school can be both a haven from the pressures of home as well as causing extra difficulties in juggling homework:
http://www.nhs.uk/carersdirect/young/your-life/pages/school.aspx


Special Needs
If your child has a disability, the major event of starting school for the first time or moving up to secondary can take on extra significance:
http://www.nhs.uk/carersdirect/guide/kinds/pages/schooltransfers.aspx

Festivals Calling

Festival season is well under way now, so with Cumbria's own 'Kendal Calling' at the weekend, here's a round-up of tips and advice to help make your experience memorable for all the right reasons.

The Call of Nature

Festival toilets can be notoriously unpleasant at the best of times, so spare loo roll, hand sanitiser gel or anti-bacterial wipes are all a must to minimise bugs and other nasties. One top tip to cope with the smell is to dab some perfume, after-shave or Tiger Balm under your nose to mask the worst.

If you’re going to Kendal Calling, you can get exclusive access to the Best2Know luxury toilets while you ‘pee in a pot’- the quick and painless test for Chlamydia. You’ll also get a goodie bag of festival essentials. More info here.

Mosh safety & crowd-surfing

The lure to be in the first few rows can be very strong, but especially after last week's tragic crush incident at Germany's Love Parade, it's wise to be aware of what can go wrong and make plans to keep yourself safe if there is a crowd surge. Knowing where the exits are, as well as the location of medical and security staff before you get into the arena crowd can help you make split-second decisions if you need to move to safety.

Don’t forget to arrange a meeting point and time with friends in case you get separated. You can’t always rely on your phone as some festival sites, especially rural ones, can have patchy mobile network coverage.

Some hardcore fans claim that crowd surfing can add to the atmosphere of a performance, but it’s a controversial activity carrying risks of injury to both to the person surfing and those underneath. For this reason, it's regarded as anti-social by a majority of fans and even bands themselves, so being ejected from the event is a commonly-enforced penalty.

If your festival hasn't banned it outright and you're determined to do it anyway, follow the link to Chartered Physiotherapist Sammy Margo’s advice on crowd surfing as safely as possible. Girls especially, please think twice before trying to crowd surf: Not only will you get bruised all over, but fansites commonly report female fans getting groped as they move across the crowd. Not the most pleasant memory to take home...

Sound and Vision

When the Royal National Institute for Deaf People (RNID) commissioned a survey of 2,711 festival-goers in 2008, 84% said they experienced dullness of hearing or ringing in the ears after listening to loud music. According to the RNID's Donna Tipping, these are the first signs of hearing damage. Permanent damage is irreversible, so look after your ears!

Like many musicians and DJs, fans in-the-know use earplugs to protect their hearing while enjoying loud performances. There are lots of re-usable, very affordable earplugs around and all work simply to reduce noise levels whilst the wearer can still hear the music perfectly.

Other tips include not standing near the speaker cabs and taking some time out in the chill-out areas to give your ears a break. You can even check your hearing right now via the RNID's Don't Lose the Music site.

Strobe lighting can cause problems for people with photo-sensitive epilepsy, but most bands *should* announce they'll be using these effects before a performance so those affected can retreat to safety. As for laser effects, enjoy the show, but never look directly into the beam of a laser as it can cause permanent eye damage.

Alcohol

Most people know alcohol is very dehydrating, so if you want to enjoy a drink don't forget to have plenty of water to help avoid hangover misery. Try to stay within daily limits, which are three to four units a day for men and two to three for women.

Sun Smarts

Ironically, we’ve had a lot of rain in Cumbria since the hosepipe ban started, but wherever you are even with light cloudy skies, it is possible to get a lot of UV exposure. Take a hat, some sunblock and drink plenty of water to help prevent sunstroke. If you're not able to pee at least three times a day, you might be dehydrated which can lead to headaches and feeling irritable. Most good festivals have free drinking water points around the arena and campsites, so use them often to feel at your best.

Disabled Facilities

Nowadays many festivals offer facilities for disabled people, but as these can vary it makes sense to check them well in advance on the event website. Most commonly, these can include a viewing platform for wheelchair users and their assistants, separate toilets and an accessible campsite area.

Make sure you take enough of your prescription medication as the medical volunteer teams often only have a range of medicines to cope with common situations and they might not have yours to hand.

For more in-depth festival health guidance, including checklists of what to pack, click on: http://www.nhs.uk/livewell/festivalhealth/pages/festivalhealthhome.aspx and

http://www.safeconcerts.com/festival-survival-guide.asp

Sun Smart

At last, it's officially Summer - and the good weather seems set to linger. Getting out into the sun is a great way to relax at lunchtime, the weekend or on holiday, but it's easy to forget why protecting your skin is so important.

Each year around 2,600 people die from skin cancer, caused by damage from the ultraviolet rays in sunlight. Skin cancer is also the second most common cancer in 20-to-39-year-olds.

Skin type - If you are fair or pale-skinned, or have red or fair hair, your body produces less melanin - the pigment which makes skin tan - which means taking extra care in the sun. Even those with naturally darker skin can still burn - and high levels of melanin do not protect against skin cancer.

Sunburn - Hard to believe, but it's possible to get sunburnt in 10 minutes, even in England. As explained by NHS Choices, "getting sunburnt causes the top layers of skin to release chemicals that make blood vessels swell and leak fluids. Skin turns red, feels hot and painful, and severe sunburn can lead to swelling and blisters." Sunburn also leads to premature ageing, wrinkles, brown patches, freckles and moles, with a much-increased risk of developing skin cancer.

It's not possible to feel UV damage until it's too late, so it's worth remembering the sun doesn't even have to feel very hot. Once skin cells have been changed by ultraviolet exposure, the risk of them becoming cancerous is much greater, with malignant melanoma the most serious concern. 9,500 people are diagnosed with this every year in the UK.

Protect - Covering up with at least short sleeves, a hat and sunglasses is strongly recommended, along with application of a good sunscreen. Good sun creams contain a filter for both UVA and UVB rays and should be rated at SPF (sun protection factor) 15 or higher, depending on your skin type.

Don't skimp on the amount; use at least two teaspoons of suncream on arms, neck and head or if you're sunbathing in a swimsuit, you'll need at least two tablespoon's worth to cover all exposed skin. Reapply every two hours to prevent dispersal via washing or perspiration and always top up again after going in water, even if the sunscreen is labelled waterproof. Children and babies need a much higher SPF as young skin burns very quickly.

Eyes are easily be damaged by sunlight, so a good pair of sunglasses are a must-have. If possible, choose ones with a UV400 label, the 'CE Mark' or ones which state they give 100% UV protection.

Despite what some believe, sunbeds are not a safe alternative. UVA exposure from sunbeds still affects the skin in the same way as 'real' sunlight, carrying risks of skin cancer, itching and rashes, premature ageing and eye irritation. A better option is the safe tan 'from a bottle'. With a wide range of self-tan lotions available, these are much more realistic and easy to apply than ever before, so are worth checking to see if they are right for you.

• Spend time in the shade between 11am and 3pm.
• Make sure you never burn.
• Aim to cover up with a T-shirt, hat and sunglasses.
• Remember to take extra care with children.
• Then use factor 15+ sunscreen.
  

Get Them While They're Young

“… If the tobacco companies really stopped marketing to children, the tobacco companies would be out of business in 25 to 30 years because they will not have enough customers to stay in business.”

Bennett LeBow
CEO of Vector Group, Holding company for Liggett Group Inc.

____________________________

It's very old news indeed that tobacco is one of the most addictive substances around, but there's more to uncover about cigarette companies doing their utmost to get smokers hooked using means way beyond nicotine itself. Advertising is still the key to maintaining cigarette manufacturers' £11.5 billion sales in the UK alone.


Picking up on this perennial issue, it's World No Tobacco Day on 31st May on theme of 'Gender', with particular focus on marketing to women as detailed in this World Health Organisation report. There is also strong evidence to suggest teenage girls are being increasingly targeted by cigarette advertising:


"The Global Youth Tobacco Survey has found that cigarette smoking is higher among girls compared with adult females. Carefully researched marketing strategies by the tobacco industry encourage girls and young women to use tobacco while seeking to weaken cultural opposition in countries where women have traditionally not used tobacco. The tobacco industry targets women through advertisements showing smoking associated with independence, stylishness, weight control, sophistication, power and a fun-loving spirit.

There are also specific “female” brands, supported by marketing campaigns and imagery tailored to adult and young females. Product development and promotion aimed at girls and women include “light” and “slim” cigarettes. Descriptors like “light”, “mild” or “lowtar” are often specifically targeted at women. Half of all women smokers in the European Union smoke “light” cigarettes, as opposed to 33% of male smokers."

According to the WHO, indirect advertising - such as product placement in films - can be one of the most potent persuaders. Studies also show that adolescents who have a favourite film actor who smokes are more drawn to smoking as a result.

So, why are tobacco advertising, promotion and sponsorship dangerous to young people? According to the World Health Organisation, it -

1. Increases the likelihood of tobacco use
Having a particular brand advertised in a 'sophisticated' setting or by an appealling person creates a fantasy-fuelled mystique about tobacco use which young people can more easily fall prey to.

2. Normalises tobacco use
Seeing cigaretttes marketed in such ways make them seem like any other product in the marketplace, except it "is the only consumer product that kills half of all people who use it as directed."

3. Endangers health
Short-term effects include respiratory problems and associated risks of other drug use, while long-term risks into adulthoo include cancer, heart disease and stroke. "Studies have shown that early signs of these diseases can be found in adolescents who smoke".

Backing up the report with graphic images like these -

World No Tobacco Day pulls no punches in it's aim to deconstruct some of those insidious cigarette marketing messages which can harm our nation's young people.

Step in the Right Direction

After the harshest winter in thirty-one years, our sunny Spring weather presents as a very welcome arrival. Of course, with more daylight in the evenings, it's a lot easier to be tempted outdoors to enjoy a walk after everyday duties.

It's a common assumption to think of your local gym as the first port of call for more physical activity in your life, but stepping out into the Great Outdoors can have worthwhile benefits over and above even the most swish of leisure centres.

If there's any doubt that you're well enough to begin a walking programme, it's always best to check with your GP. If that's not a problem, walking outdoors can help:

• Improve your mental wellbeing: We're so lucky in Cumbria to have such a variety of stunning landscapes to explore, but whether it's a leafy wood, beachside path or a busy urban trail, walking helps to clear the mind and uplift the spirits.

• Awaken your senses: In marked contrast to rushing about in cars or feeling switched off from the world around us, discovering the environment around you on foot offers a self-paced feast for the eyes and mind, whilst connecting you further with your local area.

• Quality time: Going on a walk with friends, family or a walking club is a great way to catch up with each other's company whilst enjoying the surroundings and boosting your health.

• Benefit your bank balance: It’s a rewarding activity that doesn’t cost anything, as long as you have some comfortable shoes.

• Of course, for safety's sake, it's always wise to be mindful of conditions and location, and if you're walking on your own, let someone know where you’re going.

In recognition of how much health benefit we can all get from walking, GPs in Carlisle are working in partnership with Natural England and are referring patients to their Walking For Health scheme:



According to Natural England,

"...the short definition of a health walk is:
a purposeful, brisk walk undertaken on a regular basis

and it can include any walk which is specifically designed and carried out for the purpose of improving an individual's health. It is the relative intensity of the walk for the individual and the regularity of participation that can really have an impact on heart health."

A simple way to work out how briskly you should walk is to aim to walk “fast without overexertion”. You should just about be able to hold a conversation while you are walking - the ‘talk test’.

In addition to specific benefits from being outdoors, a health walk can of course also impact positively on your health by boosting cardiovascular capacity, help ward off heart disease and strengthen bone health. Furthermore, regular walks can help to develop flexibility and confidence in one's mobility, thus also helping to reduce the risk of trips and falls, particularly for mature walkers.

For more information about the benfits of walking for health, check out the links below:

http://www.ramblers.org.uk/info/everyone/health.html#Benefits
http://www.whi.org.uk

Young Hearts and Minds

It's a recurrent theme that Cumbria is a county of extremes: Its mix of rural, sometimes remote communities juxtaposed against industrial landscape and pockets of urban sprawl is just one physical aspect affecting our daily lives.

Yesterday saw publication of the third Annual Report by our Director of Public Health, which addresses the impact of such factors or 'health inequalities' upon our local population. Measuring exactly how inequalities affect a large number of people is a process too complex to detail here, but the elements themselves which enhance or endanger well-being are universal: The quality of family life, education, housing, employment, economic status, proximity to amenities, plus neighbourhood and community 'spirit' all have a bearing on our own individual health. From a public health perspective, indeed no man is an island.

This year's report looks particularly at mental illness, which accounts for a fifth of all diseases in the UK and ranks even higher than cancer or heart disease. One key concern raised was that thirty thousand children in Cumbria could be at risk of developing poor mental health, as emotional problems in early years often undermine long-term health. As a result, the new report recommends greater emphasis and investment into children’s emotional wellbeing.


NHS Cumbria’s Director of Public Health, Dr John Ashton, said: “As we prevent the physical causes of ill health and early death, the emotional and psychological side has become more prominent. We spend a lot of resource making sure babies are healthy, but by the time children leave school, around 10-20 per cent are in trouble of one kind or another; either emotional, behavioural or lifestyle due to obesity, alcohol or drugs."

“This is where a lot of the inequality in health comes from. We need to make sure
that we are doing our best by the next generation. That begins with planned parenthood, and more support for parents. In this age of fragmented extended families, the support that used to be on hand isn’t around in many cases."

“We therefore need to build on the support that’s available through Sure Start, health visitors, children’s centres and of course schools. Through these parents need help to set boundaries, provide good guidance for children and get them into good habits for life. The cost of not doing this from delinquency, crime and poor health is vast."

Dr Ashton continued: “All children need mental health coping skills, a personal life plan, and a passion for something that isn’t going to get them into trouble."

Read the report in full here.

A problem shared, problem solved

If you're one of the thousands of people who gave up smoking as 2009 became 2010, how's it going? Don't be discouraged if your resolve has wavered or even gone the way of an abandoned January sale banner. The road to a nicotine-free life can often be a rocky one without that old coping mechanism to fall back on, so it's important to find new ways to relieve stress as well as get solid support with the goal of giving smoking for good.

Those who have struggled with quitting usually gather some valuable insights along the way about what really challenges their ability to go smoke-free. Is it cravings, the same old routine or stress that triggers a relapse? Knowing these can make a big difference in achieving your goal.

Don't forget too, the reasons why you wanted to give up in the first place. Some of the most common ones are:

• Your family are getting worried about your habit;
• Financially you'd be much better off;
  
• Your kids' - or even pets' - health is suffering;
• You're sick of smelling of smoke all the time...
• ...or maybe you just want to lead a healthier life.

Whether you fancy trying a (new) form of nicotine replacement therapy or if you want someone to talk to with real understanding of how hard it can be, the Stop Smoking Service is there to help. Contact them on 01900 324222 or text 'QUIT' to 82540.

One popular approach is to meet together in a group, run by your local Stop Smoking Advisor. There's nothing like a roomful of people who share that common goal to help boost your own motivation to stay stopped. Here's how it works:




If you'd like more information on groups or any of the free services provided by our Stop Smoking Advisors, ring the helpline. The number again is 01900 324222. And don't give up giving up!

Always Best2Know

One of our current campaigns is 'Best2Know', urging adults under 25 to take a chlamydia test as part of a national screening programme.

Unlike other sexually-transmitted infections (STIs), chlamydia is a very commonly-occuring infection, as it can often go unnoticed with no symptoms at all.

Across England, an average 10% of all 16 to 24 year olds have chlamydia, while in Cumbria, 720 people tested positive for chlamydia out of more than 9,000 tested back in 2008.

For anyone squeamish about having a test, chlamydia screening is simple, fast and painless, as a urine sample is all that's required. The sample can then either be handed in at the local GP surgery or nearest sexual health clinic. Alternatively, it can also be posted straight to a lab in a pre-paid envelope which is part of screening kit, available free to anyone aged 15 to 24.



Should the test result return positive, the person will be contacted in total confidentiality via their mobile phone and advised how to get treatment. A week's course of antibiotics is usually all that's needed to clear chlamydia.

Jane Muller is NHS Cumbria’s Associate Director for Public Health. She said: “Chlamydia is a big problem as it’s widespread in young people as they often don’t know they’ve got it so continue to pass it on to new or multiple partners. If left untreated it can have serious long-term consequences, particularly for women where it can lead to pelvic inflammatory disease, ectopic pregnancies and infertility.

“The best way to check if you’ve caught Chlamydia through unprotected sex is by having a simple and painless urine test. This is why we’re asking everyone in Cumbria under 25 to get tested, as it’s the only way you’ll know.”

You can get a chlamydia testing kit by visiting your GP, local participating pharmacy, sexual health clinic, by calling 01228 608036 (or 608035) or by filling in a form online at http://www.best2know.co.uk.