The NHS - A reason to moan or celebrate?

The celebration of the NHS at the 
Olympics opening ceremony

With the Olympics opening ceremony last night, many of us were feeling proud to be British. And what I found delightfully refreshing was our celebration of the National Health Service, the NHS. These three little letters that have come under a huge amount of abuse over the years. The NHS is inefficient, unorganised and is a waste of time are the commonly heard spiels from the daily mail. But I really want to question this. Is the NHS actually as bad as the media makes out? 


I personally would argue that the NHS is at its best in treating emergencies and accidents. If you chop your arm off, you will be rushed to hospital, treated, and your life will be saved. I would argue that it is the GP side of healthcare which causes the NHS frustration - and often not at the fault of the GPs. The GP is the port of call to assess your health and if necessary refer you on to the right people for the right treatment - e.g. specialist assessments, MRI scans and so on. These referrals can take many weeks, and if you have a health grumble, this is time that you are not at your best and this can be an agonizing wait for many.


Then again, how can we slate a free system that will save our life in an emergency with efficiency and offer us the services and skills of hard working, frankly, amazing people... because we have to wait 6 weeks for a referral? I think this may also be down to perspective - if you expect the NHS to deliver a guaranteed solution to your health problem in a short time, you will be let down. Do we just have unrealistic expectations of the NHS?

The celebration of the NHS at the
Olympics opening ceremony

Then there is the private sector - having experience working in this area myself, I feel there is a strong vibe that those in a position of wealth who are able to afford private services are increasingly taking it up, often due to frustration with the NHS. People in the middle earnings who would perhaps before have used the NHS are sacrificing a larger proportion of their income than before for their health. And the thing is, I cannot fault private clinics - they eliminate a proportion of the population from using the NHS, which in turn saves the NHS time and resources leaving more for the majority of us who would not afford private healthcare.

Plus, the private sector is undoubtedly more efficient - I would personally advise people to save some money away in case a time arises when you need a treatment or referral done quickly and efficiently as the private sector is much faster than the NHS and if I were to ever need masses of medical treatment I know I would prefer to go private - who wouldn’t? But the private sector is just that - private. It is no different from HSBC or Tesco in terms of business. Private clinics generally offer health assessments - no symptoms needed, but a full health check for a large sum of money. Now, in some cases, things are picked up and lives potentially saved - but for others, hypochondrias causes people to spend their hard earned money on such assessments to be told they are completely fine, which again although reassures, may not be the best way to spend your dosh.

The media are a huge culprit in our lack of faith in the NHS. I know I am like a broken record with my general dislike for the media but the papers never report on 'middle aged man had a heart attack, he was efficiently taken to hospital, taken straight to theatre, had an operation which saved his life, in recovery where he is being attended to by friendly and helpful staff' No. All we see is - 'The GP missed it even though I told them it was cancer' 'Old woman had to wait 10 weeks for a referral' 'GP thought meningitis was the flu'. I think even the most efficient systems have incompetency’s from time to time, so looking at the NHS which is on such a large scale there will be such inefficiencies. And by reporting the worst cases to the world and victimizing doctors and healthcare professionals who make a slip up, the media does not only shake our faith in the NHS, but also encourages the idea that people are wronged by bad service and have the right to sue doctors. This in turn causes doctors to treat people with one eye over their shoulder - extra precautions are taken which can save lives, but can also waste NHS time and money.

Are the government the problem, not the NHS?

A further point is the government - the picture to the right here shows the governments actions have the potential to 'destroy' the NHS - so perhaps it is the government who we should blame, not the NHS. Is it the people working in the NHS who are responsible for the flaws, faults and inefficiencies, or is it the few at the top of the pyramid who oversee things on a larger scale, and set often unrealistic and detrimental targets? GPs, for example, have targets for the amount of referrals they make - and if they keep their referral numbers below this target they receive a financial bonus - so the government tries to discourage GPs referring with cash incentives? Therefore people with borderline problems may not be referred, indirectly due to the government not only rewarding targets, but by putting immense pressure on surgeries and hospitals to meet them.

For all the moaning about the NHS, I would say this is not constructive. The NHS will never meet our expectations - with the whole population to please this simply will never happen. We will look to neighbor countries and say why we aren’t like that, like the jealous child wanting better than what they have. I am by no means staying the NHS is perfect, believe me I’m not, the media may twist things but they do not fabricate stories from nowhere - people are dying while they wait on a list, and others are treated terribly. And I do understand the personal frustration if one has a medical problem and feels they have not been treated as they should. But what I am saying is that so many lives are saved by so many people who go into work day in and day out and really make a difference to the people they help. The NHS isn’t perfect, but it’s the system we have. We should celebrate the success, not dwell on the flaws.

But what do you think? Tweet me @Human_Interests or visit facebook.com/humaninterests.

Interesting reads
http://nhslocal.nhs.uk/blogs/jessica-arrowsmith/2011/03/why-nhs-one-best-healthcare-systems-world

One small step for Robot, one giant leap for Humankind

Technology...where would we be without it? Many of us live in a world where a smart phone is a vital organ and internet access is our oxygen. With the Paralympics fast approaching, we are seeing many athletes on our screens with prosthetic limbs that allow them to hop, skip and jump like any other. And the good news is that the technology is constantly developing to help people with otherwise limiting disabilities live like any other. This got me thinking about the impact of technology on our lives and the potential areas in which it can influence us as humans. So after a bit of research, I'm going to share with you three recent interesting advances in the general area where robot meets human.

1. Making the limited human unlimited

This is the robot which was
controlled by the mind of a student

Just this week,  researchers made the first successful thought-controlled robot avatar...pretty awesome.  So how did it work? Well, the team used fMRI to scan the brain of a university student as he imagined moving different parts of his body - the scanner measured changes in blood flow to the brains primary motor cortex, which the team used to distinguished between each thought of movement. The long term aim is to create an avatar that would allow people who are unable to move but fully concious (known as locked in) to interact with the world using this surrogate body. Although this is still said to be a long way off, this advance is still amazing. The student was able to control the robot with his thoughts, while a camera on the robots head allowed him to see from the robots view. He could imagine moving his legs to make the robot walk forward and could also turn 30 degrees to the left or right. 

2. Increasing our understanding of the human body

The robot legs

Again, just this week US scientists developed the most biologically accurate 'robot legs' yet. These legs arn't intended to be used by humans, but were made to help improve our understanding of the mechanisms of walking, which could impact on people with spinal damage that has limited or inhibited their ability to walk. These legs have a replicated nerve cell network in the lumbar region of the spinal cord to generate muscle signals. Previous robotic models mimic human movement, where as this one actually mimics the human control mechanisms (ie nerves) that drive the movement by stimulating muscles. This could provide a new way to understand the link between problems with control of the nervous system and problems with walking. 

3. A robotic impact on the human arts

Believe it or not this is
Geminoid-F, a robot actor.

In what I feel could be the most interesting development, robot personalities are evolving. Robot actors and comedians have been created in different parts of the world, which questions the impact robots could have in the area of the arts -  laughter, emotion and entertainment. Realistic human models have been made and combined with robotics to form realistic human-appearing actors - this works well as the robots can deliver exact lines at exact times/when prompted. However, this has been taken even one step further. A robot comedian has been made which tells particular jokes, measures the laughter response of the audience and tells more jokes based on the type of humour the audience enjoys - clever huh? This raises the question of the potentials for robots in arts, entertainment and even providing emotional support for humans.

So there you go. Three interesting technological advances making life better for the human. But there is always debate around technology - is too much of it a good thing? Will technological advances lead to a lazy world where human health will deteriorate whilst sitting in front of a 3D television, or will it provide us with advances like those above which could actually improve our health and well being? Personally, I air on the side that technological advances do more good than they do harm, with the benefits outweighing the negative effects. But what do you think?

References

http://www.newscientist.com/article/mg21528725.900-robot-avatar-body-controlled-by-thought-alone.html?

http://www.bbc.co.uk/news/health-18724114

http://www.newscientist.com/article/mg20827920.400-robot-robot-wherefore-art-thou-robot.html

The Rhythm of Life

Have you ever wondered why some people can sing amazingly while others are completely tone deaf? And why some people can dance and others can't tap their foot to a beat? Well, I have. Just this week. And I decided to find out why we have such extremes of singers and dancers, and what it is that separates singers like Adele from the deluded individuals we see on the X-factor. And I found some interesting stuff along the way.

Musical competence develops in us spontaneously when we are children without any conscious effort - in the same way as language does. But also in the same way as language impairments, a proportion of individuals grow up to have music-specific impairments. Congenital amusia is the term used for the condition where some people are born without the ability to develop a normally functioning system for music. There are different types and extremes of amusias – for example some can result from brain damage in adulthood.

So what is amusia? Well this is a severe deficiency in processing pitch variations, which relates to impairments in music recognition, singing and the ability to tap in time to music. This can be more than our common understanding of the term 'tone-deafness', used for those who can’t sing on key, as people with the worst cases of amusia can neither produce or perceive music in any way, being unable to distinguish songs. Interestingly, this is completely specific to the area of music, with individuals being completely able to process speech, environmental sounds, voices and language like any other. And surprisingly, this 'condition' affects around 4% of the human population – but of course to differing extremes. 

So what are the basic causes of this amusia? Well genetics as ever plays a huge role, but there has been no specific gene linked to amusia at present. A more recent study has linked amusia to an area of the brain, known as the arcuate fasiculus (or AF). The AF is known to be involved in language, and connects the sound perception and production with each other. This study found tone-dead people had reduced AF connectivity, and hence had pitch-related impairments due to the inability to link sound perception and production in the brain.

There are many conflicting studies relating to the area of amusia, and the ways in which amusia prevents people from being able to perceive/produce music. People with amusia may suffer from a problem with recognition of their music – how they hear themselves may be different to how we hear it. Another reason for such terrible tunes is due to a problem with the voice itself. A person can have poor control over their vocal system – so even if they hear and recognize a musical note, they are unable to reproduce it. Some studies have also questioned memory in relation to this – would remembering the pitch sequences of songs be harder for some, making it difficult to reproduce themselves? Amusia is also linked to the lack of ability to keep in time to music – making some people less able to dance in time than others, impairing their rhythm.

So that explains why some people just cannot sing, and no doubt research in the field will continue so one day we will have a much clearer picture. As for the question of why others can sing so incredibly well? There is no specific reason for this – some people are just born with it, and although I’m sure going to the BRIT school helped artists like Adele, Jessie J and Rizzle Kicks control their voices and develop their talents, they still would have been able to blast out a good tune none the less…lucky sods.

References
http://www.sciencedaily.com/releases/2007/08/070823214755.htm
http://brain.oxfordjournals.org/content/125/2/238.long
news.bbc.co.uk/2/hi/uk_news/magazine/4655352.stm
http://www.jneurosci.org/content/29/33/10215

A Pill to Forget?

Ketamine is a painkiller

If you are ever unfortunate enough to be in an accident and be in extreme pain, then you may be given ketamine by medics. Ketamine is not only an incredibly powerful painkiller but can also cause one to lose memory - for example, if a bone in the leg needs to be 'snapped' back into place, you may first be given this to not just numb the pain, but also to prevent you remembering the moment of pain. Doctors do not ask you first whether you are happy to be given this, because there is no need - there is no question that one doesn't want to remember a moment of such agony. This has got me thinking about drugs that affect memory and question the ethics in relation to this.

In cases of emergency, like the example above, the fact that a painkiller has the side effect of memory loss is a benefit. But the idea of using drugs to remove memory isn't just a lucky side effect - scientists have been researching into this area for years. Drugs that remove memory could be used in order to prevent individuals developing post traumatic stress syndrome, and although there are no drugs fully developed as of yet, the idea of a pill to forget may not be so far away. This could be extremely beneficial for victims of attack, witnesses of horrific events and returning soldiers.

Propranolol
-a drug with potential?

So how would they work? Shortly after a traumatic event, there is a period when the memory of the event is consolidated in the brain. The strength of the memory relates to the release of endogenous stress hormones - such as adrenaline. When too much adrenaline is released levels of noradrenaline increase resulting in over-consolidation of the memory - this is what causes post traumatic stress syndrome. Drugs aimed at undoing this over-consolidation of memory would hence relieve symptoms of this condition. One drug of focus is propranolol, a beta-blocker. In several studies (named in the references if you're really interested), it was found that people given propranolol before being told a tragic story recalled less of the story than those not given propranolol. It was found propranolol had a significant affect on attenuating memory. 

But I think this raises another issue - if such drugs become mainstream, would they be used recreationally to extremes? If drug development allowed us to pop-a-pill to forget a specific memory from our life, would we? Would we "take one with water" to forget the memories of the lover who broke our heart? Would we forget our embarrassing moments? Or the memories of our bad days at work? Neuroethics are becoming increasingly acknowledged, as advances in neuroscience are now allowing us to manipulate the functioning of the brain, and we have to question the ethics of such tampering.

Homer has made his mind up

It could be argued that this principle of erasing memories already exists with alcohol when we head to the pub after a rough day to "drown our sorrows", for the purpose of escapism to forget our problems - however a temporary distraction is less severe than the permanent erasure of a memory, and drugs could take this to a new level. There is also the opportunity for misuse - would witness's of crimes be spiked so they would not remember the criminals face? Would they be used to manipulate others for financial benefit?

At present this is not so much of an issue, as such drugs are far from being ready to use on the human population and only tone down memories as opposed to erasing them - but with scientific advances, I would expect one day for there to be such memory altering drugs available. From a more philosophical view it could be argued that experiences make us who we are and we learn from difficult times. This leads to a very grey areas in neuroethics - would the benefit of relieving post traumatic stress syndrome outweigh the damage caused by misuse?

Would you erase?

Personally, I think the current prospect of using drugs to reduce the impact of tragic events on those with post traumatic stress syndrome is only a good thing. Propranolol, as a mainstream drug, is a front runner in the race to reduce the impact of such memories, although this is still far from the finish line.  However, I would say that we should not tamper further with our personal memories, as tempting as this would seem. But if such drugs were available, would you remember your pills to forget?

References

http://www.talktofrank.com/drug/ketamine

http://www.newscientist.com/article/dn15025-eternal-sunshine-drug-selectively-erases-memories.html

http://www.cbsnews.com/2100-18560_162-2205629.html

Cahill et al. 2002

Maheu et al. 2005

Reist et al. 2001

van Stegeren et al. 2005

http://ajobonline.com/journal/j_articles.php?aid=1338

Proud to be Human

The Queens Diamond Jubilee

With the Queen's Jubilee this weekend, it's got us all rather patriotic and proud to be British. Everyone seems to be coming together into their communities, with the lighting of over 2000 beacons across the UK, street parties and more bunting than you can shake a stick at. This has got me thinking, what is the effect of coming together as a community and why do we do it?

As humans we have evolved as social animals. In an evolutionary sense, being in a group offered protection and the sharing of resources such as food to our ancestors - making the idea of a group appealing to an individual. On a social level, groups offer emotional support and a sense of belonging. Furthermore, research shows that happiness spreads through social networks - making the jubilee an opportunity for happiness and positivity to spread through the nation. This happiness can spread through even three degrees of separation - so for example, if a friend of a friend is happy, your chances of happiness increases by around 6%. Although sadness spreads in the exact same way, this spreads slightly less compared with the spread of happiness. So national pride this weekend may be making many of us feel slightly more chipper.

When will we unite as human?

One of the main things I think of when I think of a united Britain is war time. Being British doesn't make us come together in spirit daily, but when threatened this can make us unite against the opposing force. Which leads to the question - do we only unite when faced with opposition? Interestingly, Jason Manford actually sums this up pretty well. Let's start with someone from Newcastle, who would stereotypically rival someone from Sunderland (football team rivalry shows this well). But if a Londoner comes in, they unite as Northerners. If a Scotsman comes in, they unite as English. If a European comes in, they unite as British. As Manford puts it, will we only unite as human when something non-human comes into the picture? Either way, uniting together under a leader we become a stronger unit, and science can show the benefit of being a member of a community to the individual.

So, being in a group is better for our survival and spreads our happiness - but why do groups have leadership? Why have we evolved from cave men to a current society ruled by the Queen? The evolutionary leadership theory shows how leadership was important for the survival and reproduction of our ancestors. Leadership is a behavioural strategy which has evolved to solve social coordination problems from ancestral times - such as moving areas, and conflicting with other groups. Furthermore, research shows groups with leaders do better than those without leaders, as the leader improves group performance and effectiveness. If leadership helps the individual then it’s wise to follow.

This guy's having none of it...

Interestingly, a study found that community spirit can backfire. Feelings of social power and connections may lead us to dehumanise people outside our own community. This relates to something called the fundamental attribution error (FAE). Now as scary as this sounds, in simple terms, this is the idea that you favour people and sympathise with them more when they identify with you socially. The FAE occurs when we overestimate how much someone's behaviour is explained by their personality, and underestimate the importance of situational factors. An example is if you were to trip over an uneven pavement, you would know that the pavement tripped you. But if someone else were to trip you may consider them clumsy, putting it down to their personality not the situational factor of a pavement slab sticking out. You are more likely to see someone as clumsy if they do not relate to you socially. This explains why people from different social backgrounds can be judged with inaccurate character traits.

What a happy bunch coming together this weekend
to celebrate the Queen's Diamond Jubilee.

So it’s not all good news to be part of a community. It can help spread sadness, cause us to misjudge those outside our social groups, and a united community can often be driven by opposition to an outside factor. Despite this, I think being proud and British this weekend should bring out the best in people - through sharing happiness and encouraging community spirit. Now I'm no royalist, but I think the Queen inspires unity, pride and good will for a lot of people, so for this, I wish you all a merry jubilee. And for those who don't favour the royals 
- it's two days off work.

Now, this week I decided to go a bit out of my usual scientific box and branch into the world of psychology and human behaviour. This isn't my speciality and although I have read around the subject, I'm no expert on this. If you have any comments, share them on facebook.com/humaninterests.

References
http://www.newscientist.com/article/mg20827882.300-how-community-spirit-can-backfire.html
http://www.newscientist.com/article/dn16194-happiness-spreads-like-the-plague.html
http://www.newscientist.com/article/mg21328472.800-the-happiness-equation--the-making-of-a-satisfied-scientist.html
http://www.buzzle.com/articles/fundamental-attribution-error-examples.html

How to Save a Life

Step one you say we need to talk...no The Fray, that's not step one. Step one is to assess the area around the casualty for danger, but I guess the song might not have had the same emotional depth to it with those lyrics.

So how do you save a life? Well, obviously that depends on the state of the casualty. If they are unconscious and not breathing, then the answer is CPR. Most of us have been taught this at one time or another either at school or for work, but without a refresh it’s easy to forget the steps of CPR. And if you were to find yourself unexpectedly in a situation with an unconscious casualty, nobody wants to be standing in a helpless panic.

So you walk into a room to find somebody lying on the floor unconscious. What do you do?

Step 1: you say we need to talk...joking!

Real step 1: Danger - check for danger to yourself and the casualty. Clear the area around the casualty, and do not move the casualty unless they are in immediate danger where they are. 

Step 2: Response - give the casualty a command, like "can you hear me? open your eyes!" gently shake their shoulders to see if they respond.

Step 3: Airway - open the airway by putting one hand on the forehead and two fingers from the other hand under the chin to tilt the head back.

Step 4: Breathing - now the airway is open, check for breathing. Do this by putting your ear to the casualty's mouth and listening for breath, feeling for breath on your cheek and looking to see if the chest rises. Do this for no longer than 10 seconds.

*Note here that steps 1-4 make up the DRAB sequence - Danger, Response, Airway Breathing*

Step 5: The casualty isn't breathing? Go for help if alone or ask someone else to. This step is very important before you carry on with anything else.

Step 6: Chest compressions. This involves placing the heel of your hand on the centre of the chest, and placing your other hand on top to interlock your fingers. The fingers should stay off the rib cage. Press directly down, with elbows straight to push the chest down 4-5cm. Release the pressure fully but keep the hands on the chest. This should be repeated 30 times at a rate of 100/minute. A handy trick is to sing the Bee Gees "Staying alive" to get the right pace.

Step 7: Rescue breaths. Give two rescue breaths by ensuring the airway is open, then supporting the chin with finger tips and pinching the soft part of the nose. Take a breath in and make a mouth to mouth seal with the casualty, and steadily breath out for 1 second whilst looking to see if the chest rises. Remove your mouth and watch the chest fall before starting the next rescue breath.

Step 8: Continue to do 30 chest compressions to two rescue breaths until professional help arrives or the casualty breaths normally.

So that's how to save a life. But there are a few extras you should know:

After the DRAB sequence (steps 1-4), you may find the casualty is breathing. Now if the casualty is making short, infrequent gasps for breath (known as agonal breathing) you should continue with CPR in the same way as if the casualty was not breathing. However, if the casualty is breathing normally, then you should put them into the recovery position and call for help. The recovery position is a position which keeps the airway open.

Another potential problem is a blocked airway - now, if visible you can attempt to take it out of the mouth, however strictly speaking you should not interfere as this could push the object further down. In this instance you should perform chest compressions alone without rescue breaths. This is hands only CPR, as demonstrate by Vinnie Jones in this advert here. What a legend of a man.

Another problem can arise at step 5 - the chest doesn't rise when you give a rescue breath. In this case, check the head position, check the mouth to mouth seal is tight and look for any obstructions in the mouth. Limit yourself to two attempts at rescue breaths before performing only chest compressions.

And that there folks is how to potentially save a life.

Have a comment? Go to facebook.com/humaninterests.

References:

St John’s Ambulance Teaching Materials

Don’t stand so close to me...

Did you know that a sneeze shoots out from the nose at up to 100 miles per hour? With each sneeze, 40,000 droplets of germs travel up to six feet through the air.  Plus, the droplets of sneeze seen to the eye only make up about 4% of the total volume expelled…pretty grim no?

The NHS campaign poster

With germs spreading through sneezes, coughs and surfaces like door handles that we all touch regularly, why aren’t we ill all the time? Well, our immune systems can build up resistance after being exposed to a bacteria/virus, so that upon a second exposure, antibodies are produced to fight the germ quickly, stopping us getting the same illness again. However, in the case of the common cold, as there are more than 200 types of virus which can cause a cold we would need to be exposed to all of them to become ‘immune’, which is why adults get 2-4 colds on average per year.

Nowadays we have all sorts of ways to stop the spread of these germs. Many of us carry around a little alcohol hand gel in our bags to keep our hands germ free. Interestingly, people of the Muslim faith cannot use alcohol hand gel – hence in hospitals there are soap dispensers next to the alcohol gel dispensers. Many of us also carry around a pack of tissues – sneezing into a tissue stops a lot of the horrible droplets spreading to other people, as the NHS tries to inform us all of with its ‘catch it , bin it, kill it’ campaign.

Despite all these nifty new ideas to improve hygiene, we all still sneeze, cough and spread germs around every day. Luckily for us, the human race has good enough immunity due to strategies such as vaccinations, to boost our immunity and stop the outbreak of many diseases which would otherwise be out of control. However, there is still the potential for epidemics – a current concern is that of a measles outbreak.  Between January and April 2011 there were over seven thousand cases of measles in France, extremely higher than the usual numbers. There is concern that this epidemic will spread from France other countries, as measles is a highly infectious and potentially dangerous illness which spreads very easily. There has since been increased pressure on people to be fully immunized, particularly if traveling abroad.

Now that's just taking
it too far...

But it is by no means all doom and gloom. With increasing research into infection control, the knowledge of how diseases spread and the use of vaccines to stop them, we have everything in place to try to prevent and end outbreaks of diseases. Government campaigns such as catch it, bin it, kill it are spreading the knowledge of good hygiene to try to reduce the number of sick days people take with the flu. We all know the importance of hand washing, using tissues, and we are even now told to sneeze into our elbows not our hands to cut down the amount of germs being spread. So not covering your sneezes may not lead to the end of the world, but it can definitely spread your germs around the office and make you less popular with your colleagues...

References

http://www.bbc.co.uk/programmes/b00rmrmm

http://www.nhs.uk/Conditions/Cold-common/Pages/Introduction.aspx 

http://www.bbc.co.uk/news/health-13561766