Almost 60 % more women dye from stroke than men in Ireland
Stroke is the third biggest killer disease in Ireland
Women have been warned to be extra vigilant about the signs of stroke after new statistics revealed that on average 60 per cent more women than men are dying from the disease in Ireland.
The latest figures released by the Central Statistics Office showed that 1,258 women died from stroke during 2010 out of a total of 2,053 stroke fatalities nationwide.
In certain counties, a significantly higher proportion of women were found to have died from stroke: in Kilkenny, Sligo, Waterford, Louth and Mayo counties, the number of women dying more than doubled the number of male stroke deaths in those counties.
Louth showed the largest differential, with more than three times as many women died from stroke compared to men. The only two counties to experience marginally more male deaths than women from stroke were Carlow and Monaghan.
In response to the figures, Irish Heart Foundation Medical Director Dr Angie Brown said that every person should make sure they know the symptoms of the disease – and know to call 999 immediately when they spot them.
“The higher death rate from stroke among women is not widely known. The fact is that stroke kills twice as many women as breast cancer in Ireland and we are particularly asking women to be aware of the F.A.S.T. warning signs during this year’s National Stroke Week,” she said.
The F.A.S.T. acronym stands for:
Face – has their face fallen on one side?
Arms – can they raise both arms and keep them there?
Speech – is their speech slurred?
Time – time to call 999 if you see any one of these signs
The main reason more women die from stroke than men is that, typically, they live longer Dr Brown said. However, there is also a higher risk of stroke of women with atrial fibrillation than men with the same condition, she said.
Atrial fibrilliation is the most common form of cardiac arrhythmia or irregular heartbeat and is associated with strokes that are more severe and are more likely to be fatal.
The Irish Heart Foundation says the good news is that because of the wider availability of the potentially life-saving clot-buster treatment called thrombolysis, those who suffer a stroke can “massively influence their own outcome” by getting to hospital FAST.
“It is estimated that service improvements delivered by the HSE in the last 18 months could ultimately reduce the death rate from stroke by up to 25 per cent,” said Dr Brown. “But they can only work for patients who get into hospital quickly enough to benefit from them.
“The fact is that the average stroke destroys around two million brain cells every minute. So the quicker you get to hospital after a stroke, literally the more of your brain the doctors can save,” she added.
Dr Brown also said that lifestyle changes – such as drinking in moderation, not smoking, being more active and improving one’s diet – can have a dramatic impact in lowering stroke risk. Reducing high blood pressure and cholesterol levels is also crucial – with an estimated 40 per cent of strokes being able to be prevented through better control of blood pressure.”
Ireland in China and strikes up a horse racing industry deal
Chinese vice-president Xi Jinping above yesterday with Minister of Agriculture, Food and Marine Simon Coveney TD
Ireland has struck a deal with China to help set up a horse racing industry in the Asian giant.
Agriculture Minister Simon Coveney said the partnership will be worth around 40 million euro to Ireland.
Under the agreement, top Irish stud farm Coolmore - owned by racing tycoon John Magnier and based in Fethard, Co Tipperary - will help China set up a similar operation.
Sited in Tianjin, China’s fourth largest city, the planned world-class equine centre will be the first of its kind in the country.
It is due to open for business next year.
The facility will be stocked with broodmares from Ireland, with more than 100 mares to be exported over the next three years. Stallions will also be sent out.
Mr Coveney said while Coolmore was chosen as the initial partner for the venture, there will be huge opportunities for other Irish companies to get involved.
“This initiative should facilitate the development of a major export market for horses from Ireland and has the potential to provide a range of business opportunities for companies and individuals in Ireland who can bring a wide range of expertise to the project,” he said, during a trade mission to China.
The deal will also see Coolmore hosting seven of China’s top agriculture graduates on two-month stays to learn about the horse racing industry.
John Magnier’s son JP said: “This industry is something we are good at, and today one of the biggest markets in the world has recognised that and has chosen to partner with Ireland.”
Mental health in Ireland costs the economy around €2.5 billion a year? which is a Bitter pill for us to swallow
Catherine Mannion left believes the pros and cons of medication should be discussed and Dylan Tighe likes Empowered and prefers therapy to medication.
Do the drugs work is the question? The number of antidepressants and drugs being prescribed for mental health problems is increasing – but a growing movement is questioning the true value of the medication
Could it be possible that Ireland is experiencing a hidden epidemic of mental illness? It sounds unlikely. There have been no screaming headlines or siren voices on TV warning about it. But judging by the numbers alone, the rise in the number of people suffering from mental ill-health is chilling.
Take illness-benefit payments for mental health problems. They have jumped by more than 80 per cent over the past decade, up from 9,884 in 2001 to 18,173 last year. And look at the use of drugs. Over the past five years, prescriptions for antidepressants, benzodiazepines and sleeping pills on the medical-card scheme increased by more than 25 per cent.
All of this comes with a heavy economic cost. The three-million-plus prescriptions for mental health drugs on the medical-card system and the Drugs Payment Scheme in 2010 cost the State in excess of €100 million. In addition, mental health problems are estimated to cost the Irish economy around €2.5 billion a year through lost employment, absenteeism, lost productivity and early retirement, according to recent research by the Mental Health Commission, the State’s independent watchdog for psychiatric care.
So, what’s going on? Is the prevalence of mental illness really climbing? Or are we simply learning to recognise and diagnose mental disorders that were always in the community? And what about the drugs that play such a prominent role in treatment: do they work? And if they do, shouldn’t we expect the prevalence of mental illness to be falling, not rising?
These are urgent questions that go to the heart of a growing debate on the efficacy of antidepressants, and about whether we are medicalising common distress. They also pose fresh challenges for a mental health system that, for decades, has been built on the foundation of a “medical model” approach to treatment.
The drugs under challenge include many of the main medicines used to treat anxiety, depression and schizophrenia.
Critics – including patients’ groups and some high-profile psychiatrists – say that fresh scrutiny of scientific literature suggests the benefits of many medications have been exaggerated and that in the long term they might even exacerbate a person’s illness. Further, they say, the medicalisation of distress is serving only the interests of drug companies, which don’t care who is prescribed antidepressants as long as they are prescribed in great quantities.
It’s a challenge hotly disputed by the representative groups for the psychiatric profession, who see mental disorders mostly as diseases of the brain that can be treated effectively with medication. They argue that critics make too much out of often minor technical matters and then ignore an overwhelming body of data supporting the effectiveness of medication.
IN THE 1950s, psychoactive drugs transformed the face of psychiatry. The first was Thorazine, which was used widely in mental hospitals as a tranquilliser for psychotic patients. It was followed by a host of other drugs, aimed at tackling anxiety and depression. In the space of a few years, there were tablets to tackle what were regarded as the three main categories of mental illness: psychosis, anxiety and depression.
According to medical card figures for 2010, the medications most prescribed for mental health problems were Valium (500,550 prescriptions) and Xanax (432,000), both of which are benzodiazepines or sedative-type drugs that can be highly addictive, and the antidepressant Effexor (323,000).
There are many who attest to the benefits of these drugs. Many say they couldn’t survive without them, or that they play a vital role in keeping conditions such as schizophrenia or depression at bay. Lisa, a mother of four, is one of them. She says she experienced severe postnatal depression after the birth of her second child, and she didn’t know where to turn. “It was very scary, and I was worrying about harming my baby,” she says. “I was prescribed an SSRI [an antidepressant] and I began to feel better after two weeks. Everyone is different, but for me, I feel they did work. It cleared my head.”
Set against this backdrop, the increase in the numbers taking medication shouldn’t be seen as something alarming, according to the College of Psychiatry of Ireland, the professional representative body for psychiatrists.
“[Prescriptions] are increasing for lots of medicines, such as anticholesterol drugs for heart conditions,” says Dr Anne Jeffers, a spokeswoman for the college. “When it’s to do with the heart, it’s seen as something good. And it’s time we started to see drugs for treating mental illness in similar way . . . We see people every day who benefit hugely from the mental health system. There is a need to ensure that those prescribing drugs are accountable, but it’s also important to get the message out there that medication does work.”
Far from being over-treated, psychiatrists feel that not enough people, especially young people, seek help soon enough, given the benefits that can follow early intervention.
But recent research is posing a fresh challenge to the notion of how effective these drugs are in the long term, and in the process it is asking unsettling questions about the very foundation of psychiatry.
When Prof Irving Kirsch of the department of psychology at the University of Hull in the UK, and his colleagues in the US and Canada, obtained complete data for all drug trials submitted to licensing authorities in the US, their findings sent a jolt through the medical community. They found that Prozac, Seroxat and other antidepressants of the same class performed no better than dummy pills – or placebos – in the earliest trials. No such analysis had been done before because of the reluctance of the pharmaceutical companies to hand over the full trial results.
In his recent book Anatomy of an Epidemic, investigative journalist Robert Whitaker has found that questioning the efficacy of some psychiatric drugs is not a new phenomenon. He points to an article in the 1976 American Journal of Psychiatry co-authored by Jonathan Cole, regarded as the father of American psycho-pharmacology, titled “Is the Cure Worse Than the Disease?” In the paper, Cole reviewed all the long-term effects the drugs could cause and observed that studies had shown at least 50 per cent of all patients with schizophrenia could fare well without medication. “Every schizophrenic outpatient maintained on antipsychotic medication should have the benefit of an adequate trial without drugs,” Cole wrote at the time.
Whitaker maintains that the psychiatry profession, in effect, shut off further public discussion of this sort. In the 1970s, he says, psychiatry was fighting for survival. The two main classes of drugs – antipsychotics and benzodiazepines such as Valium – were increasingly regarded as harmful, and sales declined.
At the same time, there was a dramatic increase in the number of counsellors and psychologists offering talk therapy and other non-drug-based approaches. “Psychiatry saw itself in competition for patients with these other therapists, and in the late 1970s, the field realised that its advantage in the marketplace was its prescribing powers,” he says. “It consciously sought to tell a public story that would support the use of its medications, and embraced the ‘medical model’ of psychiatric disorders.”
In fact, he goes so far as to argue that the natural history of mental illness is changing. Where once conditions such as schizophrenia and depression were episodic and shorter, now they are more likely to be chronic and lifelong. This, he believes, is due to the damaging long-term effects of some drugs.
However, Kirsch’s and Whitaker’s findings and assertions are challenged by many psychiatrists who say they distort the vast body of wider research which shows these drugs can be very effective, especially in the short term.
This debate over medication and how best to treat mental health problems comes at a time when the voices of patients and advocates, especially those critical of the system, is growing louder. Groups such as Mind Freedom Ireland, Mad Pride and many others are rejecting the labels and language of psychiatry, which views mental ill-health as a bio-medical problem.
Instead, these organisations tend to see mental health problems as forms of emotional distress or an underlying vulnerability, and are demanding a much greater emphasis on choice and on being involved in their route to recovery.
For people such as Dr Terry Lynch, a Limerick-based GP and psychotherapist, it is time our debate on how best to treat mental health problems focused more on developing a genuinely recovery-oriented approach. While he says he is not “anti-medication or anti-psychiatry”, he says the process of recovery requires therapy and time.
“The mental health system doesn’t sufficiently understand the emotional and psychological aspects of mental health problems, nor the importance of exploring in detail the individual’s experiences, whatever they may be.”
This failure, he says, is not due to limited resources, but to an ideological blind spot within the medical approach to mental health problems. In his experience, successful treatment involves becoming an “accompanier” with a person on their journey of life and creating a relationship based on trust, equality, safety, acceptance and positive regard.
Despite the public perception of the psychiatric profession as enthusiastic supporters of a medicine-only approach to care, consultants on the ground say the reality is very different.
For example, Dr Anne Jeffers of the College of Psychiatry says the profession is fully behind the State’s mental health policy, A Vision for Change, which advocates a recovery ethos where psychiatrists work in partnership with patients to support them on their own journey.
The reality on the ground, according to many, is that while this approach is practised in some areas that offer a wide range of services, often due to the influence of individual consultant psychiatrists, many others are still rooted in the more traditional medical approach.
Continuing to invest in the mental health system will be crucial to modernising it. The roll-out of community mental health teams, to be staffed by psychiatrists, therapists and social workers, will be key to giving patients more options.
The attitude of GPs is also crucial. Many say they feel forced to prescribe drugs as the only solution, because they don’t have access to “talking treatment” such as cognitive behavioural therapy.
Meanwhile, the debate about whether drugs work or not seems set to rumble on. It’s a reminder that, despite all our scientific advances, our basic understanding of how mental illness affects the brain is evolving slowly.
The lack of biological markers – for example, there is no blood test for depression – leads to theories about how various treatments work. And as long as the inner workings of the brain remain a mystery, there are likely to be precious few definitive answers.
The GRA & Garda officers slam plan to shut stations
The Garda Representative Association is demanding a reverse of planned cost-cutting measures
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Further Garda station closures will reduce the force’s ability to fight crime throughout the country, grassroots officers have warned.
The Garda Representative Association (GRA) will demand Justice Minister Alan Shatter reverse planned cost-cutting measures. The organisation which represents rank-and-file members is meeting for its annual conference in Athlone, Co Westmeath, and Mr Shatter is expected to attend on Tuesday.
Damien McCarthy, GRA president, said the Government plan to close more stations next year is ill-thought out and will hit crime-fighting.
He said: “We are concerned that gardai will not be in a position to continue the first-class service that the public deserve and what our members are committed to achieving. This policy is unnecessary and will not provide significant savings for the exchequer – so this conference will be urging the minister to reconsider before irreparable damage is done.”
Earlier this month, Mr Shatter shocked the Association of Garda Sergeants and Inspectors annual conference by announcing a second wave of station closures next year. Delegates were already reeling over the decision taken late last year to shut down 39 stations around the country.
Mr McCarthy said there is a palpable fear of crime in both urban and rural areas, and the presence of local gardai is vital to protect the vulnerable and reassure the public.
“The recent increases in burglary have spread the fear of crime, particularly among the most vulnerable,” he said, ahead of the two-day conference. “The stress particularly affects the elderly and those living alone in rural Ireland.”
Mr McCarthy also said international experience shows crime increases as police numbers decrease, police morale dips and economic recessions take grip. The Garda has had no new recruits for three years and retirements are continuing “unabated”, he added.
A lack of basic policing tools such as effective patrol cars was also impacting on the ability of officers to provide a proper service, he said.
The conference will hear calls for action to boost rank-and-file Garda morale, against a backdrop of pay cuts and stalled promotion opportunities. Concerns will also be raised about the ability of the legal system to protect officers from vicious assault as well as issues regarding the sentencing of convicted criminals.
Man dies in fatal road crash accident near Gort in Galway
Gardaí are today appealing for witnesses to a single-vehicle crash at Gortaloman, Peterswell, Galway, early on Sunday. in which a 39-year-old man died.
He was driving a car on the Gort to Lough Rea road, when he struck a sign post at Gortaloman just before 1am.
The victim was pronounced dead at the scene, which remains sealed off for a technical examination.
Witnesses are asked to contact Gort Garda Station on 091 636400, the Garda Confidential Line 1 800 666 111 or any Garda station.
Whooping cough alert in Ireland as the HPSC urges parents to get Children the Jab
Whooping cough cases have soared in the first three months of this year.
Some 76 cases have been confirmed, compared to just 16 cases for the same period last year, according to the Health Protection Surveillance Centre (HPSC).
A similar increase in cases has also been recorded in the UK, where the authorities have written to family doctors urging them to stress the importance of vaccination.
Last year there were 229 notified cases of the disease here.
The HPSC says that “immunisation is the most effective way to prevent infection and limit the spread of pertussis (whooping cough)”.
It recommends that infants should be vaccinated with three doses of vaccine at two, four and six months of age with a booster dose recommended at 4-5 years of age.
Last September the HSE also introduced a whooping cough booster for adolescents in the first year at secondary school.
This followed a recommendation of the National Immunisation Advisory Committee.
In the UK a rise in whooping cough has prompted the authorities to urge parents to get their children vaccinated.
CHILDREN
According to the Public Health Authority of Northern Ireland (PHA) more children have contracted whooping cough in the first three months of 2012 than in the entire year of 2011.
The PHA says that by the end of March of this year there were 27 confirmed cases in comparison with 13 confirmed cases in the whole of last year.
According to the Health Protection Agency there have been 665 cases in the UK this year, compared with 1,040 cases for the whole of last year.
The agency says the rise is particularly sharp among young children where there have been 65 confirmed cases in babies under three months compared with about 35 in a typical year.
Normally 95pc of one-year- olds receive their first doses of the five in one vaccine — which includes whooping cough vaccine — in their first year.
The figure has dropped to 88pc by the time the booster vaccination becomes due at age five.
Whooping cough, says the agency, tends to run in cycles, with the previous peak year in 2008 when there were 902 cases.
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