Can Bosses Help Addicts?

Rehab isn't taken seriously in Britain. It's not taken seriously by the NHS, by HR professionals or by the general public. It may get a mention in the pub if Amy Winehouse's name comes up, but the general assumption seems to be that rehab is too expensive for ordinary people and only the rich and famous can afford it.

Everyone has heard of "detox", as the word is now used on face creams and fruit juices, and there is a vague association in people's minds that detox is rehab. I wonder how many people know that detox is simply the first stage of residential addiction treatment.
GPs don't seem to take rehab seriously either, which isn't surprising considering that addiction is barely mentioned in medical school and many GPs don't even know that it's a disease. The NHS may think it saves money by not referring alcoholics into residential rehab (where success rates are relatively high) but the Home Secretary recently said that the real cost of alcohol abuse is in the region of £21 billion a year.
The one area where there is some hope and where ordinary people can have an impact is at work. Our bosses, managers and supervisors are (one hopes) more able to deliver than politicians (whose promises of reforming the drug treatment problem have come to nothing). What manager wouldn't like to improve the health and productivity of his team, cut down on sick days and avoid costly dismissals?
If company managers are looking for ways to increase efficiency, not to mention health and safety, they should look at the impact of drug and alcohol abuse on their workforce. The International Labour Organisation estimates that, globally, 3-5% of the average work force are alcohol dependent, and up to 25% drink heavily enough to be at risk of dependence. Considering what a boozy nation we are, the figures in British companies are probably higher.

I recently interviewed Dr Mike McCann MD, an occupational health physician based in London. He gave me some useful insights into how organisations can start to deal with drug and alcohol abuse in the workplace.
The first thing that companies should do , says Dr McCann, is a risk assessment. "A good starting point," he says, "would be to look at the number of sickness absences and accidents. If you can identify a significant problem - and work out how to improve efficiency by addressing it - then people will buy into it as an issue."
Dr McCann recently published a book. He told me it is a "unique reference book for HR professionals, managers, employment lawyers and occupational health professionals. The book describes policies for identifying, controlling and treating substance abuse at work."
Hopefully I will get my hands on a copy of this book. I am currently working on a new website which advises companies about addiction issues, and this is exactly what I -- and HR managers across the land -- need to read.

A Winning Year for Women's Health

I went to a delightful Christmas carol service last week. It was held at Saint Bartholomew the Great, one of London's oldest churches. The building was founded in 1123 as an Augustinian Priory and is based in Smithfield, East London.
I had been invited by a fabulous woman I met at everywomen in retail awards event - which just goes to prove networking does work!

The choir were amazing and will be singing services through Advent into Christmas. I cannot recommend them highly enough to anyone who wants to get away from everything stressful in the lead up to Christmas. Listening to their powerful voices was joyous, not a word I frequently use.
The Chief Executive of Penna, a global HR group, read a wonderful poem by Edgar Guest called 'It Couldn't Be Done' which is all about struggling to achieve against the odds.
It seemed an obvious point of reference when I started chatting with two inspiring women from LOCOG after the service. So many people thought the sheer scale and size of the London Olympics were going to be an impossible challenge but the games turned out to be brilliant.
Sadly I'm told, LOCOG is now closing down. Everyone will complete their contract and be out of a job in the coming weeks. For many of LOCOG's younger employees this was a once-in-a-lifetime job.
This dichotomy poses interesting questions for young people at the beginning of their career who are lucky enough to work in a really inspiring environment on a really exciting but finite project. How on earth do they choose their next job?

Basically, LOGCOG is the story of some really determined people who created something really special that impacted on countless lives in such a positive way.
I hope we share that ambition at Wellbeing of Women. We have a core team supported by a much larger group of enthusiastic supporters and doctors who work together to create changes in women's health.
Reflecting on 2012, I am immensely proud that three of our supported researchers have been appointed to personal Chairs (in other words, given the title of professor due to their exceptional work) at their universities.
It's a massive accolade for the Wellbeing team and certainly demonstrates that we are putting our money into the right places.
In addition this year we have published the results of scientific work which have led amendments to the NICE guidelines regarding caesarean and uterine rupture.
Our study at Oxford University found that women who had undergone a previous caesarean are at a greater risk of womb rupture during a subsequent natural birth than those who have a repeat caesarean. The risk increases with each subsequent caesarean.
Another Wellbeing study published this year demonstrated that Botox is a viable treatment for women with overactive bladder syndrome (OAB). The condition affects one in five women aged 40 plus. Our research team at the University of Leicester found that by making several injections in a patients' bladder muscle they could prevent it from contracting too much, thus saving women from the trauma of urinary incontinence.
This year also saw one of our top researchers, Priya Agrawal, being appointed Executive Director of Merck for Mothers, a pharmaceutical company with a half-billion pound international programme to reduce the number of women and children who die during pregnancy. Here in the UK, my team and I are pleased that we are developing a relationship to work with Merck. She has also been awarded the 2012 Emerging Public Health Professional Award by the prestigious Harvard School of Public Health.
To round off a busy year, Wellbeing of Women held a 'pregnancy and birth' panel discussion featuring four of the most eminent British professors working in the field of pregnancy and neonatology. They had never appeared on the same panel before and their various viewpoints made for a fascinating discussion.
They engaged our audience of supporters, saying what improvements had been made during their careers - and then were all very clear about what they felt needed to be done next to make a substantial difference to number of babies who are born too soon or die.

We were told that maternal health can have huge, life-changing impact on babies' health. For instance, obesity during pregnancy increases the unborn child's risk of developing diabetes or being born premature. The anxiety levels of a mother can also transfer to the baby making them more likely to be anxious babies and potentially grow up anxious adults.
Findings would also suggest that women who suffer post-natal depression (which can it itself be life threatening) tend to have a history of the depression. They could therefore be monitored and supported more carefully during pregnancy and after giving birth.
Another point of interest was that today's mothers are terrified of childbirth because they allegedly see or read horror stories in the media. Downton Abbey has a lot to answer for!
More importantly, our experts all admitted that when they started in their careers they were not encouraged to listen to mothers-to-be. Instead, they told them how things were done. So it's encouraging to see doctors and midwives all agreeing that a key driver in their work today is asking what expectant parents feel is best for them so that they can have a safe, happy and healthy birth.
However, what all of the panel agreed was the impact that Wellbeing of Women had made improving women's health during each of their careers. I felt proud that even though we are quite a small number of people we have been able to save or improve thousands of women's lives.

Sick and Tired

Gentlemen, you may want to skip this article and instead turn to the sports blogs about now...
So ladies, if I can speak frankly, discovering you're pregnant by constantly throwing up your guts seems so unreasonable. It's an utter shock to both mind and body. Now I know that morning sickness is considered a common side effect to the early stages of pregnancy, but for some women it can be so much more debilitating than that. For a desperately unlucky few, it's potentially life threatening for the baby.
My pregnancy experience was somewhere in the middle of the multi-coloured sickness spectrum.
I well remember 20 years ago discovering I was newly pregnant by first experiencing a queasy tummy which quickly manifested itself into full on nausea, then constant, uncontrollable vomiting. By the time my husband called the doctor to make a house call I was very unwell.

He suggested fluids and an anti-sickness injection. Having already started pencilling out my birth plan, and being of the thalidomide generation, I was reluctant to allow even a paracetomol to enter my bloodstream and expressed my reluctance to the doc - between stomach churns.
The doctor told me that the concerns for the baby if I continued throwing up would be far outweighed by the risks of the injections. I had it straight away, followed by fluids and a wet flannel placed on my brow helpfully provided by my concerned mum. Not sure it helped me, but it helped her!
Thankfully, unlike Kate, I didn't need to spend time in hospital but regular fluids and anti-sickness medication became a daily routine - and still the nausea nagged away at me. The doc reassured me that it would pass by 14 weeks or the end of the first trimester. It seemed a lifetime away when I was only seven weeks pregnant and being sick a dozen times a day, but I managed my expectations by crossing off the hours on a specially drawn up chart.

Day after day I tried to comfort myself with the reassurance that sickness denoted lots of foetus hormones and equated, I was told, to a very strong baby. That was of little help though as time and again I hurtled towards the nearest bathroom. I began to plan my day and activities around the closest loo. I knew exactly how many fast paces it was from the Sky News studio to the nearest ladies lavatory and on occasion could have given Usain Bolt a run for his money during a three minute TV commercial break.
As the weeks passed and I reached the magical three months, I woke every morning expecting to be nausea free. For the first few moments, I would think it had gone. That was until I heaved myself out of bed and the waves of sickness would wash over me as I waddled to the bathroom.

I say heaved and waddled because I had piled on the pounds. I'd read everything I could about how to combat the effects of nausea. Ginger I was assured would help. Nope, not even a jot. Milk of Magnesia would settle my stomach. It didn't despite downing what seemed like gallons of the stuff.
I even had bottle secreted behind the driver's seat of my car, along with one stashed in the makeup room at work and another in the dressing room there. No, eating and eating and eating seemed to be the only option. A vicious circle given the inevitable consequences, but it was the only way to keep me upright.
Eating and one other secret formula - hot Ribena. Don't know why, but it helped. Can't even bear the smell of it now, though interestingly my son loves it.
Ribena and sucking boiled sweets, but as you can imagine that proved impossible while I was trying to read the news, so hot Ribena in a cup under the desk was the next best thing.
Still the pounds piled on. I well remember a nurse at the ante natal unit suggesting I should watch the calorie intake as I lumbered onto the scales with a flask of Ribena in one hand and a sick bag in the other. You would have thought working with hormone-crazed pregnant women on a daily basis, she would have known better...
By the time I was due to give birth I had gained four stone, 56 enormous pounds, however many umpteen kilos that is and yet was still dealing with nausea at 41 weeks. Trying to wear appropriate clothes to appear on TV had been a daily, tearful challenge. I looked like a galleon in full sail. I couldn't have fitted into a bin bag.
Eventually though the baby arrived, 11 excruciatingly overdue days late. Almost miraculously the sickness disappeared. The doctor was right, my son was healthy, happy and had a full head of hair.
And so my thoughts are very much with Kate and William today, along with every other couple dealing with the distress of pregnancy sickness on whatever level. My only advice, it eventually passes and when you hold your baby for the very first time, the challenges of the previous nine months will be an instant, distant memory.

Healthy Diets Cut Heart Attack And Stroke Risk

A healthy diet significantly reduces the chances of a second heart attack or stroke in at-risk individuals, research reveals.
It also cuts the risk of congestive heart failure and heart disease-related death, scientists found. The five-year global study collected data on almost 32,000 people in 40 countries.
Participants with heart disease were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry. They were also questioned about lifestyle choices such as smoking, alcohol consumption and exercise.

A healthy diet was defined as one including a high intake of fruits, vegetables, whole grains and nuts, with more fish than meat, poultry or eggs.
Eating healthily was associated with a 14% reduction in the risk of new heart attacks and a 19% reduction in the risk of stroke. The risk of dying from heart disease was reduced by 35% and of developing congestive heart failure by 28%.
The findings appear online in the American Heart Association Rapid Access Journal.
Study leader Dr Mahshid Dehglan, from McMaster University in Canada, said: "At times, patients don't think they need to follow a healthy diet since their medications have already lowered their blood pressure and cholesterol - that is wrong.
"Dietary modification has benefits in addition to those seen with aspirin, angiotensin modulators, lipid-lowering agents and beta blockers.
"Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, grains and fish. This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally."
Despite differing food habits, a healthy diet was associated with prevention of recurrent heart disease throughout the world in both rich and poor countries.

Animals Deserve Good Lives

You might not know me, but I'll bet you've heard of my father, Tony Nicklinson. He became famous for something no one would wish on their worst enemy. A stroke in 2005 left him paralysed from the neck down, unable to speak, care for himself or live any semblance of the life he once loved. In August, judges denied his request to let a doctor legally end his life. Heartbroken at the thought of spending the rest of his life trapped in his own body, my father succumbed to pneumonia six days later. It was a difficult end to an agonising seven years.

My dad's ordeal has changed my life in so many ways. Seeing how terribly he suffered, even in spite of my mother's constant, loving care, has made me more sensitive to the ways that others suffer, particularly animals - whom I've loved since I was a little girl. Many people who supported my father's desire to end his life said that if someone were to keep a dog or a cat in the condition my father was in, it would be considered completely cruel. I couldn't agree more. But sadly, many people do let their animals linger in pain and distress, simply because they can't bring themselves to say goodbye.
Animals have feelings and emotions, and they suffer from pain, disabilities and diseases just as humans do. But unlike my father, who could clearly communicate his wishes through a system of blinking his eyes, animals can't tell us (at least not in human language) that they don't feel well, are in terrible pain or even want to die. They depend on us to notice when something is wrong and to be brave enough to make the heartbreaking-but-humane decision to end their suffering when the time comes.


We can know when it's that time by carefully observing their body language, appetite, energy level and overall demeanour and by talking to our veterinarians. When our normally happy, vigorous companion animals become very old, sick or injured without hope of recovery, and when they can no longer enjoy their lives, having them euthanised is our final act of love and kindness towards them.
That's not to say it's an easy decision. I know how gut-wrenching it is to face the thought of losing someone you love. But as much as I didn't want to lose my dad, I didn't want him to suffer even more. Yet some people let the very animals whom they claim to love live in agony for weeks, months or more because they can't handle the thought of losing them. This isn't kind - it's selfish.
Some animal shelters even operate under this mentality, keeping animals caged for years, rather than euthanising them. Just as being trapped in his own body killed my father's once-buoyant spirit, being constantly caged kills cats' and dogs' spirits. Many animals become depressed and withdrawn. Others lose their minds, spinning endlessly or gnawing their own flesh to pass the hours. Some become aggressive, baring teeth or hissing at anyone who tries to pet them. This is no life for any living being.
Sometimes, the kindest thing a shelter can do for a dog or a cat who has spent months in a cage with no adoption prospects is to give him or her a peaceful send-off, cradled in a shelter worker's arms. Of course, many of these deaths could be prevented if breeders stopped churning out animals for profit while our shelters are bursting at the seams - and if people spayed or neutered their animal companions. That's why it's so crucial for each of us to boycott breeders and pet stores and adopt our animals from shelters.
Some people seem to think that death is the worst thing that can happen. But I've seen firsthand that a pain-filled, hopeless life can be far worse. Caring for animal companions means giving them a good life and a good death, when that time comes. One thing is certain: if my family's beloved dog, Tyson, ever ends up in a state like my dad was in, he won't have to suffer. Surrounded by the people who love him, the needle will go in, and he'll breathe out his last without suffering. It will be a peaceful end to a good life, just as it should be.

William, Kate and Women's Health in Celebrity Media

Monday's announcement that the royal couple is expecting their first child was quickly dampened by reports of the Duchess of Cambridge's hospitalisation for hyperemesis gravidarum, or acute morning sickness.
Although Victorian novelist Charlotte Brontë is rumoured to have died from hyperemesis gravidarum in 1855, the condition - which affects approximately 1% of pregnancies and is characterised by vomiting, weight loss and severe dehydration - was not widely recognised until the 1950s. It is now, thankfully, easily managed with intravenous rehydration and anti-nausea medication. Despite inroads in treatment, however, "there is a real lack of understanding about the condition," argues Caitlin Dean, a registered nurse and trustee of the UK charity Pregnancy Sickness Support.
Dean, a mother of three, has also suffered from hyperemesis gravidarum, which typically affects first-time mothers and women expecting twins. "One of the big issues with it is isolation because it causes many women to be bed-bound," she notes. "I had hyperemesis gravidarum whilst pregnant & its horrible," British model Peaches Gedolf tweeted on 2 October, sharing a link to Pregnancy Sickness Support's website.
The celebrity media's role in bringing a previously obscure maternal condition to the forefront of popular culture - just imagine the pub quiz questions to be mined from hyperemesis gravidarum's Wikipedia entry this week - carries important implications for health communication.
Despite predominantly catering to tabloid entertainment, in recent years celebrity media has fostered open dialogue about reproductive health and the challenges of motherhood. American actress Brooke Shields' struggles with post-partum depression prompted her to pen the best-selling memoir, Down Came the Rain, which resulted in a widely-publicized feud with Tom Cruise over her antidepressant use. "I hope this will help new moms not feel alone or desperate, and that there is no shame in their feelings," the actress stated. "PPD is out of their control, but the treatment and healing process is not." In her memoir, Shields - who describes herself as "cervically challenged" - also detailed several failed attempts at in-vitro fertilisation and five miscarriages.
In promoting awareness and encouraging positive health-seeking behaviours, the three D's of health communication - demystification, de-stigmatisation, and dialogue - are key touchstones. Celebrity coverage has proven to be an unexpected and effective medium for promoting reproductive health and highlighting common challenges. Pop star Lily Allen and English model Kelly Brook have both publicly discussed their miscarriages. Their stories undoubtedly resonate with many women coping with similar losses - and the numbers are high: 11 babies are stillborn every day in the UK.

Actress Gwyneth Paltrow, Friends star Courtney Cox, and British TV personality Jodie Kidd are among numerous other celebrities who have opened up about fertility setbacks and post-partum depression in the past years. Some have harnessed their social capital and public visibility to promote health issues. Christy Turlington's maternal mortality awareness campaign, Every Mother Counts, has earned the former model and activist global recognition. "Social media and Twitter have been really helpful to get our message out," Turlington observes. "It's all wellness and health oriented. I don't talk about my favorite latte."
Over the coming weeks, I wish the Duchess of Cambridge a healthy and speedy recovery as the world anxiously looks on, and possibly learns a thing or two about women's health.

The Sky Women in Film and TV Awards 2012

Forget Friday the 13th. The most terrifying day of my year is the first Friday in December. I'm CEO of Women in Film and Television (UK) and today, Friday 7 December, is our annual awards lunch, where 1,000 industry people show up at the Hilton, Park Lane, ready to kickstart the holiday season with a gloriously fun-filled celebration of this year's fifteen honorees.
It's like organising 10 weddings on the same day. Certainly, my daughter's wedding was never as stressful as this: performers from the West End musical We Will Rock You, presenters including Mitchell and Webb, Evan Davies, Danny Boyle, Davina McCall, Peter Snow and Julie Walters, all held together by Sue Perkins at her most hilarious.
There's so much to go wrong at a largely unrehearsed one-off event. Will the sound system balance the music? Will the sponsors' logos all be perfect? Will the video acceptance speech from director Lynne Ramsay (We Need to Talk About Kevin) arrive from Los Angeles in time? Can everyone get on and off the stage? Will someone drop their crystal vase award? (It has been known!) At least I never worry about the food. The Hilton do us proud.

We've had our problems. Two years ago, when Julie Walters was our Awards host, she rang to say she was snowed in on her farm in Sussex. We went into emergency mode - but couldn't even find a helicopter prepared to land on her snow-covered fields. Finally, in desperation, we contacted a tank hire company. Julie quite fancied the idea of being driven up Park Lane swivelling her gun turret but, in the end, the tank driver manoeuvered a four wheel drive triumphantly over the snow and Julie wowed an audience that had no idea how close we came to not having a host at all. Julie has a history as a persistent trouble-maker at our awards. When Colin Firth, who had just shot to stardom as Mr Darcy in Pride and Prejudice, walked onstage to present one of our awards Julie started a chant from the floor "Co-lin! Co-lin! Co-lin!" Hundreds of women in the Grand Ballroom joined in. Colin Firth blushed. Whatever would Jane Austen have thought?
We have our place in history too. During last year's awards Helen Boaden, BBC Head of News, approached soon-to-be BBC Director-General George Entwistle to warn him about an up-coming Newsnight film about Jimmy Savile. If he'd picked up on that, he'd probably still be director general. George later told a parliamentary select committee that he didn't ask any questions about it because "It was a busy lunch". I think it was simply bad timing: Miranda Hart had just shared her favourite chat-up line with the room: "When I roll over in bed my breasts clap!" All very distracting.
The awards are massively oversubscribed. This year the 1,000 places sold out in 28 minutes. Of course, people come because they have a great time, but there's a more serious purpose to the event. Women have made tremendous progress in my lifetime but, in the media as in so many other professions, they're still paid less for equivalent work, they still find it harder to get promoted, they still get harassed and, in many areas - from technical jobs to directing films - they are still a small minority.
WFTV is determined not to whinge about all this. Instead, throughout the year, we network, we mentor, we encourage and we celebrate the extraordinary achievements of women in every area of our industry. Last year we gave our ITV Achievement of the Year Award to three courageous war correspondents - Alex Crawford, Zeina Khodr and Sara Sidner - who covered the fall of Tripoli. This year we have Barbara Slater, the BBC's first woman Director of Sport and the mastermind behind the coverage of the 2012 London Olympics. And Clare Balding, a presenter who makes the idea of women commenting on sport seem as natural as breathing.
We celebrate unsung heroes and great actors, behind-the-scenes technicians and onscreen presenters. Above all we celebrate talented and successful women in all their glorious diversity. It's the most stressful day of my year, but also the most satisfying. Onwards!