The Heart and Associated Problems

The heart is an organ that is responsible for pumping blood around the body, to all of the tissues. In humans, there is a double circulatory system which means that the blood returns to the heart after passing to the lungs to be oxygenated so that it can be sent to the rest of the body, this is to ensure that there is enough blood pressure to pump blood to all of the tissues and organs. Problems begin to arise when the heart becomes damaged or the vessels it is associated with become damaged. This can arise in a number of different ways.

  1. Atheroma

This occurs when fatty deposits build up within arterial walls. White blood cells that have taken up low density lipoproteins result in fatty streaks within the walls, these streaks build up over time. When the streaks enlarge over a long period of time they form what is known as an atheromatous plaque. The deposits push into the lumen, causing it to narrow, reducing blood flow. Atheromas increase the risk of thrombosis and aneurysm.

2. Thrombosis

When an atheroma breaks through the endothelium lining it increases friction at the surface of the lumen which can result in a blood clot, a thrombus. This reduces blood supply, leading to tissue on the other side of the clot being deprived of oxygen, glucose and other nutrients essential for its survival and as a result the tissue dies.

3. Aneurysm

Atheromas weaken arterial walls, the weaker points lead to a balloon like, blood filled structure known as an aneurysm. Aneurysms burst frequently, leading to haemorrhage and lead to a loss of blood to the region of the body served by that artery.

4. Myocardial Infarction

This is known as a heart attack, this results in a reduced supply of oxygen to the heart. This can lead to the heart stopping beating as its blood supply is completely cut off. The heart stops beating as it is at risk of dying. It is caused by thrombosis and atheromas.

References:

https://patient.info/health/atheroma

http://www.thrombosisuk.org/home.php

http://www.medicalnewstoday.com/articles/156993.php

http://emedicine.medscape.com/article/155919-overview

Challenges facing the NHS

In recent years, problems associated with the NHS have been rising. However, for many, it is difficult to understand what exactly is so wrong with our health system in the UK and to understand why it is so vital to our country.

The main challenges facing the NHS:

  1. Ageing Population

At the moment 1 in 6 of the population is over 65 years old and by 2050 it will be 1 in 4. Around 2/5ths of the country’s health spending is spent on those over 65. It is more costly caring for those who are older compared to those who are younger. This is due to the fact that people are more at risk of acquiring a number of diseases as they get older. Therefore, if we have an ageing population, NHS spending will have to rise. This being said, currently, the NHS is unable to cope in terms of spending and a line needs to be drawn between free health care and upholding an adequate standard of health care.

2. Growing Population

A growing population suggests an even larger strain on the NHS, around 8% of funding is used on newborn health care. If the population increases, even more money will need to be spent on healthcare. However, if we do have an ageing population, population growth may come in useful when caring for those over 65 in the coming years. With more people under 65 working, more money can be put back into the NHS. The Nuffield Trust (from this report) estimates that the ageing and growing population alone could mean we need another 17,000 hospital beds by 2022

3. Evolving healthcare needs

There is now an increasing prevalence of diseases related to obesity, diabetes and antibiotic resistance. The NHS is having to change the type of care it offers in order to accommodate the large proportion of the population who suffer from such diseases.

4. Medical Advancements

Despite medical advancements increasing life expectancy and saving lights, the sheer number of them means that expenses increase. Medical technology costs the NHS an additional 10 billion a year.

5. Loss of Local Services

The increasing focus on moving health care to focus on more centralised areas has led to a decline in healthcare for local areas. It is seen to be wasteful to have hospitals only miles apart from one another providing the same basic care, therefore there has been an increase in hospital closures. Many hospitals are being forced to close down individual wards in order to save on spending.

6. Privatised Services

Thousands and thousands of British people are now beginning to opt for private healthcare. Private healthcare is faster and many believe they are given better treatment. This drive towards private healthcare. Despite the move to private healthcare it can be said that the move to private healthcare has reduced the strain on the NHS in terms of patient volume. Is the future of healthcare, a semi-privatised NHS?

One of the most important ways to combat these problems is sorting out the underfunding and inefficiency of the NHS. If these are solved more money can be put back into the NHS to revive the healthcare system both locally and within large city populations. One of the solutions is to move patient care out of hospitals and into clinics in GP surgeries and in the community. But this takes a toll on hospital incomes, driving more and more of them into debt. Some hospitals trusts have even been put into administration over the last few years. Centralisation of services, as mentioned above is being used but this results in cutting wards and local hospitals in number, when with an increase in population and age, will not be effective in coming years.

The government has pledged to give another 8 billion into the NHS by 2020 and will also:

  • “Save money by cutting more of the social care budget.
  • But slightly increase funding for mental health.
  • Attempt to decrease waiting times by guaranteeing access to a GP seven days a week, and appointments within 48 hours for the over-75s.
  • However, they will not reduce the cap on the amount of income NHS Trusts can generate from private patients, which could have a detrimental affect on waiting times and pressure on services.”

 

References:

https://www.theguardian.com/society/2016/feb/01/ageing-britain-two-fifths-nhs-budget-spent-over-65s

https://www.theguardian.com/society/2012/jul/24/nhs-hospitals-need-to-close

http://www.bmj.com/content/349/bmj.g5865

https://www.ft.com/content/c2297076-dde1-11e4-8d14-00144feab7de

http://www.nhsconfed.org/~/media/Confederation/Files/public%20access/Challenges%20facing%20the%20NHS%20guide%20for%20MPs%20and%20peers%2018%20May.pdf

https://www.myhealth.london.nhs.uk/help/nhs-today

https://www.theguardian.com/healthcare-network/2013/may/08/nhs-what-does-evidence-show

http://www.independent.co.uk/life-style/health-and-families/health-news/the-nhs-timebomb-what-s-wrong-with-the-nhs-the-diagnosis-9775930.html

https://www.themedicportal.com/application-guide/the-nhs/challenges-facing-the-nhs/

https://www.nuffieldtrust.org.uk/resource/nhs-hospitals-under-pressure-trends-in-acute-activity-up-to-2022

https://www.nuffieldtrust.org.uk/

 

The Ethics Of Vaccination

Vaccination is a form of artificial active immunity. This is when the production of the bodies own antibodies is stimulated by an outside source, an immune response is induced through injetcion of a dead or inactive form of a pathogen to stimualte antibody produciton. In the majority of cases this prevents an individual from suffering from the symptoms of the disease.

Vaccination leads to the production of memory cells from B Cells, these memory cells remain in the blood after infection and allow for a greater, more rapid response to future infection with the pathogen. This means that in the future if infected the body will be quickly be able to destroy the pathogen preventing the individual from the full extent of the symptoms.

However, vaccination may not eliminate disease in those with defective immune systems, where individuals may develop the disease and go on to infect those around them. In addition, pathogens mutuate so frequently, that by the time a vaccine is created, it may be rendered ineffective. This mutuation involves the changing of viral antigens as new antigens on the surface of a virus will not be recognised by the vaccine, this is known as antigenic variability.

In some cases, individuals may reject vaccination due to religious, ethical or even medical reasons. This occured with the MMR vaccine, which eventually led to a large number of infant deaths, due to a public scare created by a lack of knowledge and understanding.

This being said, if someone does reject a vaccine, should we be able to force them to have the vaccine? Those who are not vaccinated make the world more dangerous for those in the community at a high risk – children, the terminally ill and the elderly. By enforcing vacciantion, those who are physically unable to have the vaccine will be to some extent protected from being infected by unvaccination individuals. But, is this not a direct violation of human rights? Everyone should be able to choose whether ot not they themselves or those in their care should be vaccinated.

The ability to opt out of vaccination isn ot the only ethical issue that surrounds vaccination, another issue is the testing of vaccines. At present the production and development is tested on animals such as mice, and after this human trials are used. To what extent should a person be asked to accept such a risk for public health? In most cases, the first few screenings and attempts at vacciantion lead to a large array of different side effects. Animal testing has always been a taboo subject, but since vaccines are so essential, shouldn’t we use the Earth’s resources to protect out own species, or is this simply the selfish nature of the human race? Another problem with the trialing of vaccines is the uknown health risks posed to the wider community. In countries that are rife with a particular disease is it morally acceptable to trial a new vaccine with unkown health risks even if the country will gain a lot if the trial is succesful.

In addition, many argue that vaccination programmes are too expensive to be carried out fully. A vaccination programme requires a sufficient quantity of the vaccine to be produces, trained staff for administration, a means of producing, storing and transporting the vaccine. Surely, if most of the population has had the vaccine and the disease is mostly eradicated, the money should be used to treat other diseases? However, this leaves those who are not vaccinated susceptible.

Finally, some individuals may be unable to have a vaccine due to personal health risks, but should every single health risk be taken into account when producing a vaccine for the whole population. Which diseases are we required to accomodate for? Surely, the aim should be to vaccinate as large of a proportion of the population as possible.

In conclusion, the ethics surrounding vaccination has always been an area of interest in the wider community. The need to balance the advantages to the health of the population with economic, social and ethical views has proven to be difficult no matter which way you look at the issue.

 

Female genital mutilation

Female genital mutilation (FGM) refers to the procedures involving removal of parts of female genitalia. The genitals may be cut, injured or deliberately altered for non-medical reasons. FGM usually takes place when girls are infants until the age of puberty. The practice is banned in the UK.  FGM is globally recognised as a human rights violation, but despite being banned, some people choose to carry the procedure out illegally at home or in a private community.

As it has no medical/health benefits FGM is usually carried out for cultural, religious and social reasons. In some communitites it is seen to prepare a woman for marriage or to preserve her virginity. It must be stressed that there is no justification for these kinds of procedures and as a society we must continue to strive to prevent more women from having to suffer throught such a harmful and dangerous procedure.

There are four main types:

  1. Clitoridectomy – this is a removal of the clitoris and can be partial, sometimes only the skin around the clitoris is removed.
  2. Excision – removal of the clitoris as well as of the labia minora, but not the labia majora, which is a larger flap of skin around the vagina.
  3. Infibulation – implanting a seal over the vaginal opening and narrowing it, this is done by removing pieces of skin from elsewhere and placing them over the vaginal opening using stitches in most cases.
  4. Other – harmful procedures include: pricking, cauterizing and scraping the vaginal area.

 

It is clearly evident that undergoing FGM is traumatic for any woman involved and the effects will be with a woman for the rest of her life., but sometimes women and girls can die from the procedure due to unsanitary conditions and lack of medical guidance when carrying out the mutilation. Some of the side effects include:

  • Severe pain
  • Urinary problems
  • Shock
  • Haemorrhage – severe bleeding
  • Swelling of the genital area
  • Scar tissue malformation
  • Childbirth complications risk increasing
  • Infections
  • Sexual problems, during and after intercourse
  • Psychological problems following the emotional trauma

Treatment:

In some cases, treatment will not help, but in others procedures can be undertaken such as deinfibulation to widen the vaginal opening and to recontruct damaged areas of tissue.

If you know someone who is having an FGM procedure, has had one or if you have had one or will have one yourself it is essential to call the police and to obtain aid. You can see your GP or visit a gynaecologist for additional help.

Police: 999

NSPCC: 0800 028 3550

Childline: 0800 1111

References:

http://forwarduk.org.uk/key-issues/fgm/

http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx

http://www.who.int/mediacentre/factsheets/fs241/en/