In this week’s blog our cycling club coordinator, Sheila, inspired by a challenging and invigorating cycling session, discusses the benefits of cycling.

This month The Lake Foundation Cycling Club ventured on a 4-hour ride to Greenwich (great!). We cycled in the rain – erm, I’ll see you next month! (I don’t blame you). Had it not been for enthusiastic members and a guest from the USA I’d have headed to Costa Cafe. In hindsight the ride was invigorating. In spite of the rain, I can’t deny the satisfaction pressing through the desire to go home. So we thought we’d share the love and break down some benefits that you too can enjoy on our Saturday morning rides.

Early to Rise

“Early to bed, early to rise makes a person healthy wealthy and wise” so the proverb goes. Sleep experts say going to bed earlier and waking up early is good for your body.

Why? The Circadian Rhythm. That’s the flashy word to describe the internal 24-hour clock that all living organisms have e.g. when to sleep, rise, eat etc.  Our Circadian Rhythm is linked to light, darkness and our environment. The theory says that if we follow this cycle, e.g. through better sleep patterns, we will be in tune with nature. Sleep regenerates the protein molecules that make up our immune system.

Cycling and Psychology

Psychologists say that taking an active role in your exercise benefits mental health. This action can create a sense of control and has the added bonus of boosting self-esteem, which is how we see ourselves, our place in the world and value to others. Self-esteem impacts how much we trust, our relationships and actually spills out into most areas of life.  

Cycling and the Brain

White matter (not to be confused with grey matter) sits below the surface of the brain. It’s likened to a subway that connects different regions of the brain. This brain connectivity is key to everyday life. In developing adults it’s linked to motivation, demeanour and executive function (i.e. our ability for mental control and self-regulation). A study in the Netherlands reported that practising motor skills improves flow between regions. So a repetitive physical activity like cycling is perfect.

Cycling and your mood

Another buzz word today is endorphins ( endorph… what?). Discovered 40 years ago endorphins are a natural painkiller. We generate them through exercise. Activity releases chemicals that interact with receptors in your brain. Their function is to reduce discomfort and make you feel good. Another benefit of cycling is that exercise can be a helpful distraction from worries.

Next time, we’ll inspire ourselves by breaking down the physical benefits of cycling.

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Sources

http://www.health.harvard.edu/staying-healthy/the-top-5-benefits-of-cycling

https://www.psychologytoday.com/blog/minding-the-body/201505/bicycling-can-sharpen-your-thinking-and-improve-your-mood

http://dana.org/Cerebrum/Default.aspx?id=39152

http://blogs.biomedcentral.com/on-biology/2014/03/14/the-subway-of-the-brain-why-white-matter-matters/

https://www.ucdmc.ucdavis.edu/hr/hrdepts/asap/Documents/Self_esteem.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

OpenMinds is a new not-for-profit, specialist mental health organisation based in Croydon which makes recovering from a mental health difficulty the main focus of their work. Their core values are recovering, advocacy and changing mindset.

OpenMinds will be hosting their launch event on Tuesday 22^nd November at the Croydon Voluntary Action Resource Centre, 82 London Road, CR0 2TB from 5pm to 8pm.

The purpose of this event is to promote the work of OpenMinds’ floating support service, but more importantly, to stimulate conversations that will challenge and facilitate change in mindsets, with the goal of reducing stigma and discrimination in mental health service and provision.

All are welcome to attend and for more information please contact: info@openmindssocialcare.co.uk or you can find out more about OpenMinds by downloading their brochure below.

Today, Cancer Research UK and Public Health England announced that a recent analysis of cancer data revealed that black women are twice as likely to be diagnosed with late stage breast cancer as their white counterparts. They found that 25% of black African breast cancer patients and 22% of black Caribbean patients had late stage disease compared to 13% of white patients.

The fact that black women are more likely to be diagnosed at a late stage has been known for some time and has also been observed in not just the UK but in the USA too. The Lake Foundation has conducted work in this area to explore the possible reasons behind this. In 2011, we carried out some qualitative research to explore black women’s beliefs about breast cancer and their help-seeking behaviour to determine whether these two factors may lead to delays in diagnosis. Overall our study suggested that, when it comes to seeking help, black women are quite proactive and there would be no delay in visiting their GP (doctor) if they noticed a breast lump; delays in visiting a GP could occur if black women experience other symptoms as they were less aware of these.

We also found that the following factors could delay help seeking in black women: other priorities such as family or work commitments; language barriers; lack of access to information; age (older people are more likely to delay visiting their GP); difficulty getting appointments; cultural insensitivy of the healthcare system, inaction by GPs; and a lengthy referral process. You can read more about this work on our research page (scroll to the bottom of the page).

National data suggests that black women are less likely to take part in the NHS Breast Screening Programme and this could be another reason for the late stage diagnosis. In 2011, our founder Abi Begho worked with Betterdays Cancer Care, the NHS and Cancer Black Care to determine why black women are less likely to attend breast screening and whether patient navigation could be an effective way of improving screening uptake in black women in Peckham and Lewisham. We found that, at the time, black women living in Lewisham and Peckham who were of screening (over the age of 50) were very mobile with many women being unreachable, on an extended trip abroad; having moved from their GP registered address or had relocated and lived abroad,  hence they missed their breast screening appointments. We found that patient navigation was effective at reaching women as numerous and extensive attempts were made to contact women and then support them to attend their screening appointments. You can read more about this work here

Finally, scientific research has also suggested that black women are more likely to develop a more aggressive form of breast cancer which grows rapidly, so this could explain some of the late stage cases. Studies also suggest that black women are more likely to develop breast cancer at a younger age.

This recent analysis by Cancer Research UK has reminded the nation that there is an issue around black women and breast cancer that needs to be addressed. We need to ensure that black women are aware of all the signs and symptoms of breast cancer and that they seek help quickly if they notice any of the symptoms. We also need to understand the biology of the disease and the best ways of detecting and treating the more aggressive forms of breast cancer.

So, the message to black women is:

• Be aware of all the signs and symptoms of breast cancer
• If you’re worried about any symptoms that you have, please visit your doctor as soon as possible
• Eat a healthy diet, keep active and maintain a healthy weight to reduce your risk of developing breast cancer
• If you’re aged 50 or over, consider accepting your invitation from the NHS to take part in breast screening
• Know your family history. If you have a strong family history of breast cancer you may be at an increased risk so visit your GP for some advice and information

Recently we came across a web series called Shrink which is set in London and explores both the mental and physical symptoms of depression. It tackles the fact that depression affects people of all walks of life and highlights that people are affected differently.

The main character in this really interesting web series is cognitive behaviour therapist Natasha Charlton who, as well as having to support her patients, has to deal with her own secret mental health issue.

Episodes are 8-17 minutes long and in each episode we’re introduced to a new patient of Natasha’s.  Through their stories we learn how experiences like childhood abuse,  university life, parent expectations, unemployment, workplace bullying, work stress and body image  can all have a significant impact on our mental health.  Shrink also tackles the stigma associated with mental ill-health, the lengths that people will go to to hide their condition, the destructive ways that people may deal with mental health issues and the discrimination that exists.

So far there has been one series of Shrink and season two will be starting soon with the creators stating that they will be touching on topical issues like Brexit and the Black Lives Matter movement.

In the UK, 1 in 4 people will experience a mental health problem each year and despite the fact that mental health issues are very common those affected still feel very isolated with there being an unease to discuss mental health.

When we look at the black community, statistics suggest that the African-Caribbean community are more likely to be diagnosed with severe mental illness and are 3-5 times more likely to be diagnosed with schizophrenia. Looking specifically at depression, a condition that features highly in Shrink, we know that 2.6% of the UK’s population are affected by depression.

Depression is described as a mood disorder where those affected feel persistently sad and lose interest in day-to-day activities and hobbies. It’s not the kind of sadness that people can just “get over” but needs some form of strategy to overcome. There are different types of depression such as major depression, bipolar disorder, persistent depressive disorder, seasonal defective disorder and postnatal depression, just to name a few. If you or anyone you know may be experiencing depression, please to reach out to your GP or a charity like Mind for some support, do not suffer in silence.

We applaud the makers of Shrink for using drama to raise awareness of depression and other mental health issues. Drama is a powerful way to highlight health issues and another organisation, Know My Mind, has used drama, with their play ‘So You Think I am Crazy’, to tackle the challenges black people face in the UK mental health system.

We found Shrink to be very interesting and look forward to watching the second series.  You can watch the first season of Shrink here

This week, supermarket giant Tesco announced that it will make further reductions to the amount of sugar in its soft drinks and these newly reformulated drinks will be available in-store from 11^th November.

This reduction in sugar is a direct result of the government’s sugar tax and is part of Tesco’s ongoing commitment to reduce the sugar, fat and salt content of the products the company makes.  This reduction in sugar content means that Tesco’s soft drinks will now have less than five grams of sugar per 100ml meaning that the average Tesco customer will be consuming 20% less sugar than they did in 2011.

Tesco is working in partnership with Diabetes UK and the British Heart Foundation to improve the nation’s health and so far they have reduced the salt, sugar and fat content of over 4,200 products.

Matt Davies, Tesco UK’s CEO said of this recent reduction in sugar:

“This is just one part of our plans to make the food on our shelves healthier by reducing levels of sugar, salt and fat in our own brands”

This reduction in sugar can be seen as a success of the government’s sugar levy (sugar tax) which will apply to drinks with a total sugar content above 5 grams per 100ml. A higher rate will be applied to drinks with more than 8 grams per 100ml. The levy won’t be applied to milk-based drinks or fruit juices. The levy will come into effect from April 2018.

The money raised from sugar levy will be used to double the funding available to primary schools for PE and sports programme. The government has estimated that the sugar levy will raise £320 million a year for primary schools to support healthier more active lifestyles in children. The funding will not only go towards expanding PE and sports programmes but to also expand breakfast clubs in primary schools ensuring that children have access to a healthy breakfast every week day.

The Lake Foundation is happy to hear that Tesco has taken this step to reduce the sugar content of its soft drinks and if more companies follow suit this can make a significant contribution to improving the health of the UK’s population.

Last night, we attended ‘Building Things for Nigeria 2.0’, an event that gave those in the tech industry the opportunity to showcase how they’re using IT solutions to address health, business, finance and social challenges.

One of the presentations that really stood out for us and really demonstrated the power that technology can have in public health was that delivered by the team behind the Playbrush.

What is the Playbrush?

The Playbrush is an award-winning device that aims to promote good oral health in children by making toothbrushing fun. It allows children to play entertaining and instructional games whilst brushing their teeth, these aren’t just games with no purpose but they actually get kids brushing for longer and properly.

The Playbrush is a Bluetooth device that can be attached to most manual toothbrushes and converts them into a game controller. It works by first downloading the Playbrush app to your mobile phone and then pairing the Playbrush, connected to a toothbrush, to your phone and then the games begin. Children can shoot Crobies, fly planes and save the tooth fairy by simply brushing their teeth.

Whilst brushing their teeth, motion sensors in the Playbrush record the duration and speed of brushing. A specific algorithm helps children brush for longer and more thoroughly, ensuring they cover all areas during brushing. Parents and children are given real time feedback through the brushing statistics and children can win rewards when they brush more regularly and accurately.

The games on the Playbrush are fun but educational  and using the theory of action and reaction they teach children the importance of oral health in a fun and engaging way.

Who is Behind the Playbrush?

Giving the presentation at last night’s event was the Nigerian Co-Founder and Chief Technology Officer of Playbrush, Tolu Ogunsina, who worked with his two co-founders to make Playbrush a reality. Tolu described the inspiration behind the Playbrush, which was quite simple, observing children who were reluctant brushers and thinking about how to make a boring task fun.

They have also worked in collaboration with dentists, public health specialists, academics, investors, designers and engineers to create the Playbrush ensuring that the technology behind it does make a real difference to oral health, and their hard work and innovation has paid off as Playbrush has won multiple awards including:

• Winner of the Best Technology Innovation Award (Gamification World Awards 2015)
• UCL Bright Ideas Winner 2014
• eAward Winner 2016
• Dad Rated Bronze Award Winners
• Pioneers Vienna Competition Winner 2015

Now that is how you use tech!

We have heard so many horror stories of technology gone wrong and it was a pleasure to hear of the success of technology in changing health behaviour. The Playbrush has already exceeded expectations with the sales doing exceptionally well, dentist approval and interest from a number of dental companies. We wish them continued success and hope we see an improvement in the oral health of children.

Want to get your own Playbrush? You can pick up one on Amazon

On 8^th November 2016 Target Ovarian Cancer will be holding an event called Being Together in Hertfordshire. This is a free event for all women with ovarian cancer and will take place at the Jurys Inn Hotel in Watford from 10am – 4:30pm and will include lunch and refreshments.

Feedback  from previous Being Together events have shown that these days are extremely beneficial in helping women feel less isolated and more knowledgeable about ovarian cancer:

“The whole day has been brilliant. The hospitality was superb and the quality of the event was excellent”

 The event is an ideal opportunity for women to meet those with similar experiences and put their questions to a panel of experts. Women will also have the opportunity to take part in workshops surrounding living well, such as nutrition and relaxation. Although the event is free booking is essential.

You can book a place at www.targetovariancancer.org.uk/hertfordshire or by calling Target Ovarian Cancer on 020 7923 5475.

We love social media. It really does open up the world to us and provides access to a vast amount of information that we would have struggled to find a decade ago.

Yesterday, we found ourselves mentioned in a Tweet. We thought: ‘interesting, thanks for the mention’ and then we proceeded to click on the link to explore further. We were taken to a summary of a British Heart Foundation funded research project about the African-Caribbean community and heart failure.

We just love this about social media. Information is so accessible; it literally falls into your lap (or Twitter feed!). It’s great when people take the time to seek you out and bring relevant information to your attention.

What exactly was being brought to our attention?

The research that was being brought to our attention by our fellow Twitter user was a study published in the journal of Circulation Heart Failure conducted by lead researcher Dr Jason Dungu from St Georges University of London. His work explored the causes of heart failure in different ethnic groups with a particular focus on the Afro-Caribbean population.  This research revealed that the cause of heart failure is dependent on ethnicity.

What did the researchers do in this study?

They looked at all patients with heart failure who attended St George’s Hospital Heart Failure Clinic between 2005 and 2012. These included 1392 patients, 211 of these patients were Afro-Caribbean.

Participants’ diagnosis of heart failure was confirmed through a medical history, an examination and various tests. The cause of their heart failure was determined by an initial assessment and then confirmed by a review of the patient’s records and through any investigations and findings.

What did they find?

The researchers found that the causes of heart failure varied based on ethnic group. For example the most common cause of heart failure in white patients was coronary heart disease; this was the cause of heart failure in 41% of white patients.  When they looked at Afro-Caribbean patients coronary heart disease was the cause of heart failure in just 13% of these patients.

In Afro-Caribbean patients the most common cause of heart failure was non-ischaemic dilated cardiomyopathy. This was the cause in 28% of Afro-Caribbean patients compared to 20% of white patients.  Other causes of heart failure in Afro-Caribbean patients included:

• hypertensive cardiomyopathy (12% of black patients; in white patients this was the cause in 2.2% of cases);
• cardiac amyloidosis (11% of black patients; in white patients this was the cause in 1.6% of cases)
• valvular heart disease (7% of black patients)

The finding that 11% of Afro-Caribbean patients developed heart failure due to cardiac amyloidosis was very significant. This is because whilst, generally speaking, cardiac amyloidosis is considered a rare condition, it features in 11% of Afro-Caribbean heart failure patients, making it the fourth most common cause of heart failure in this ethnic group. Additionally it was found that patients who develop heart failure due to cardiac amyloidosis had a lower survival rate than those who develop heart failure due to coronary heart disease. This means that more attention needs to be paid to these patients.

The Importance of this Research

This research reveals that when diagnosing and treating heart failure ethnicity needs to be taken into account and Afro-Caribbean patients have to be handled differently.

Thank you social media!

It’s great that through social media we can easily gain access to the latest research and we thank those that continue seek us out when relevant research is published.

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References

Afro-Caribbean Heart Failure in the United Kingdom: Cause, Outcomes, and ATTR V122I Cardiac Amyloidosis. Circulation: Heart Failure 2016; 9: e003352

Voices for Autism host coffee mornings every month in a warm, relaxed environment. Families are invited to come along for two hours to enjoy some refreshments and conversations surrounding autism, or not.

Voices for Autism has been created to raise awareness of autism as well as create a community for parents/carers to feel a part of. Being an autism parent/carer can sometimes feel like a lonely place and we want you to know that you are not alone; autism affects approximately 70,000 people in the UK alone.

Voices for Autism is striving to create a haven where those affected by autism can come together to share advice, ideas, good news stories and so on. They want to echo the message that young people with autism are unique and they should be able to access the same services and opportunities as those without a disability or additional needs.

The organisation is a friendly bunch who have a mixture of skills, knowledge and experience. They are not medical professionals but walk and breathe autism on a daily basis.

Do pop along to one of their coffee mornings if you can. No booking required. Details are posted on their website www.voicesforautism.co.uk or alternatively you can drop them a line on info@voicesforautism.co.uk

Their next coffee morning is on Saturday 12^th November at The Vaughn Room, Christ Church Southwark, 27 Blackfriars Road, London, SE1 8NY

On 1^st October, we attended the Fibroid Forum. This was an excellent informative event organised by a group of ladies affected by fibroids.  In our previous blog we discussed the first half of the event and in today’s blog we’ll summarise the second half of the event.

The final part of the fibroid forum focused on treatment and we heard from two speakers on this topic, Dr Raj Das, Consultant Diagnostic and Interventional Radiologist at St Georges and Professor Isaac Manyonda, Consultant Obstetrician and Gynaecologist at St Georges.

Uterine Artery Embolisation

Dr Raj Das focused his presentation on uterine artery embolisation (UAE), an established procedure which has been used by doctors since the 1990s to treat fibroids; it involves cutting off the blood supply feeding the fibroid.  Dr Das spoke about the evidence that demonstrated the benefits of UAE. The benefits include patients having a good clinical outcome, patients reporting a good outcome themselves, lower blood loss, a shorter hospital stay and a quicker return to work than  some other procedures.  He also added that for UAE the rate of infection is less than 5% and that after the UAE procedure the fibroids are still there and what they are looking for is symptom improvement rather than disappearance of the fibroids, but in 3-5% of cases the fibroids do clear themselves. He stated that UAE is a viable treatment for those wishing to retain fertility.

Dr Das also mentioned that UAE can be used when women with fibroids have any of the following: severe heavy bleeding,  painful periods, anaemia and pressure on the bladder or bowel.  He also touched on aftercare and suggested that women take 1-2 weeks off work after the procedure, avoid driving for five days and only engage in light activities at home during the recovery period.

Surgical and Medical Treatment

Following Dr Das’ presentation we then heard from Prof Isaac Manyonda. Prof Manyonda discussed surgical and medical interventions for treating fibroids and started by explaining that it is very important that doctors optimise the care that women receive because of the changing demographics of childbirth – women are delaying pregnancy until later in life when fibroids are more common and more likely to be symptomatic.  He said the old adage “babies, then fibroids, then hysterectomy” no longer works.

 Prof Manyonda focused his talk on two areas:

• The surgical removal (myomectomy and hysterectomy)
• The medical management (drug treatment – ESMYA)

With regards to surgical removal, Prof Manyonda stated that a myomectomy is more complex than a hysterectomy (removal of the womb) and there can be more blood loss. He mentioned that for the same sized fibroid it takes 40 minutes to perform a hysterectomy compared to  sometimes 150 minutes for a myomectomy. He also described the benefits of a hysterectomy which are: it provides a definitive cure, there is no possibility of a recurrence of the fibroids and it has one of the best outcomes  in terms of quality of life, but it does remove all fertility potential.  Prof Manyonda talked about the recovery period saying that a hysterectomy requires a 3-4 night hospital stay and an 8 week recuperation period with a phased return to work.

Prof Manyonda then discussed a myomectomy which is the removal of the fibroids while preserving the womb so there is the possibility of pregnancy in the future.  He explained that it requires a 4 night hospital stay and, like a hysterectomy, women will need an 8 week recuperation period with a phased return to work.  He also advised that women wait 6 months before attempting pregnancy. He did warn that whilst one of the main benefits of a myomectomy is to preserve fertility it can actually compromise the very same fertility that it is intended to preserve due to the formation of scar tissue, so it needs to be done carefully. Furthermore he explained that with a myomectomy we’re dealing with the fibroids that are there and it doesn’t tackle the cause so new fibroids can develop. He also said that it’s best that all the fibroids are removed and none are left behind to give women the best chance of a good outcome long-term.

He mentioned that many women are only offered a hysterectomy because it is felt they are too old for child-bearing or their fibroids are too large, too many or in the wrong place, but research has shown that women should also be offered a myomectomy and age, size, number nor location of fibroids should be a barrier.

Finally Prof Manyonda touched on the medical management of fibroids with the drug ESMYA. He stated that we need as many weapons as possible to fight fibroids as not everyone is suited for surgery or UAE. ESMYA is a drug that initially was licensed to be used 3 months prior to surgery but now it can be used as a standalone therapy. Research has shown that it can reduce the size of fibroids and improve a number of fibroids-related symptoms. He said whilst it is promising we have to exercise caution as its unclear what the long-term impact of this treatment will be. He said ESMYA is a good option for older women or for those who are not keen on surgery.

This was a really informative event which ended with an open discussion where women were able to ask Prof Manyonda and Dr Das questions and share their personal stories.

We’d like to thank the House of Bread for organising this much-needed conference and we were very pleased to have been given the opportunity to have a stall at this event.