To celebrate Blog Action Day 2009, here are two of my articles which were published on the interweb today:

An explanatory introduction to the UN Climate Conference, COP-15 in Copenhagen, published by IslamOnline.com: http://twurl.cc/1q89

A news story on the aquisition of Solel by Siemens, an important step for solar thermal technology, published by RenewableEnergyWorld.com: http://twurl.cc/1q8a

Following the tragic death of a fourteen year-old girl just two hours after receiving the HPV vaccine as part of the UK’s policy to vaccinate all girls under 18, the media has been awash with confused stories regarding the safety of the jab.

The first stages of the postmortem showed she had an underlying health problem, most likely a heart defect which would commonly present for the first time at this age, which was the cause of her sudden death.

However, when the story broke, before the first results from the postmortem became available the media insinuated the HPV vaccine may have caused in her death. 

It is important we do not have a vaccination scare on the scale of the MMR, and young girls (and perhaps their families) are comfortable receiving this potentially life saving jab.

Therefore, here are ten reasons you should have the HPV vaccine:

1. It protects against the two types of HPV which cause 70% of cervical cancers.

2. Women have, on average, a 1.6% chance of developing cervical cancer in their life time; there is less than a 1 in a million chance of severe anaphylaxis due to this vaccine (3).

3. Cervical cancer kills 1,000 women every year in the UK. It is thought the vaccination programme could save 400 of them.

4. The risks are low. All vaccines carry risk, but the HPV vaccine has shown few contraindications. The most common side effect is ’sore arm’.

5. 50% of sexually active women contract HPV by the time they are 30 .

6. Sexually transmitted diseases are on the rise which can increase your susceptibility to HPV and increase your risk of cervical cancer up to six times (1). For example, women who also have genital herpes are more likely to get more invasive forms of cervical cancer (2).

7. Cancer is a killer, but not only that. Treatment for cervical cancer can include surgery and chemotherapy which can leave you infertile, or with difficulty conceiving. This has happened to many women in their twenties.

8. We need as many people as possible to be vaccinated in order to reduce the prevalence of HPV in the population. Normally, vaccination programmes require 80% of the whole population (men included) to be vaccinated in order to eliminate a disease.

9. Promiscuity alone does not cause cervical cancer, as one third of women with only one sexual partner contract HPV within one year. As previously mentioned, 50% of women have been exposed to HPV by the time they are 30.

10. The NHS (and many other health authorities) have emphasised the importance of, and have promised to continue cervical screening. But there is no reason to not use belt and braces girls!

1. P Koskela, T Anttila, T Bjørge, A Brunsvig. (2000). Chlamydia trachomatis infection as a risk factor for invasive cervical cancer.International journal of cancer.

2. 2003. Cervical cancer risk rises if women with HPV also have herpes infection. International Family Planning Perspectives

3.  D. Cooper, (2007). Determinants of sexual activity and its relation to cervical cancer risk among South African Women. BMC Public Health

Ahead of World Contraception Day this Saturday 26 September, a number of studies have come out to hammer home the safe sex message.

Lloyds Pharmacy’s latest research shows the average British adult has indirectly had sex with 2,881,024 people. This shocking statistic is based on the average British adult having sex with 7.65 people in their life time.

 “When we have sex with someone, we are, in effect, not only sleeping with them, but also their previous partners and so on,” Clare Kerr, head of sexual health for the chemist chain,  as reported in the Metro today.

 You can calculate your own figure using the tool on their website.  This will base your answer on your age, your number of sexual partners and the age that they were.

 In a similar vein, the Australian publication, Pharmacy News reported an alarming number of women are ignorant of the potential threat to their health and the risk of pregnancy which can result from unprotected sex.

 The research was commissioned by Sexual Health and Family Planning Australia (SHFPA) and Bayer Schering and they found two out of three adult women admitted to having unprotected sex.

SHFPA’s Dr Christine Read said, “It’s worrying that young women continue to engage in unprotected sex, but it is equally concerning that many women don’t have basic knowledge of their menstrual cycle. For example, many women don’t realise they can get pregnant even if they have unprotected sex outside the time they’re ovulating.”

Dr Read went on to say that women taking hormonal contraceptive pills should be given more information about how to take them properly.

Today Conceptus, a company engaged in women’s health care recognised World Contraception Day. This year’s motto is “Your life, your voice: Talk Contraception.” One of the main focuses is encouraging more women to consider permanent forms of birth control.

This blog has been featured in the 15andcounting campaign’s blog.

They are a campaign group set up petition governments to make young people’s sexual health a policy priority and are well worth a look.

Gay rights group Stonewall has launched a new poster campaign with the Department of Health encouraging lesbian and bisexual women to take better care of themselves.

The move follows the results of ‘Prescription for Change’, the first major survey ever conducted into lesbian and bisexual women’s health in Britain, which has revealed half of the UK’s 1.8 million lesbians report a recent negative NHS experience. The Stonewall research used over 6,000 lesbian and bisexual women in the study.

Stonewall has developed the slogan ‘Love your inner lesbian’ which is going to accompany the campaign. The research, released last year, found deeply disturbing levels of self-harm, substance abuse and exclusion from routine testing for cervical cancer.

The survey also found lesbian and bisexual women are reluctant to be honest about their sexual orientation when talking to doctors. The poster campaign which will hit healthcare centres and clinics soon, aims to encourage women to talk frankly to their doctors about their healthcare needs.A series of posters is now been available depicting the slogan, as well as key statistics from the report – including smear testing, lesbian parenting, mental health issues and drink and drug habits.

The lack of attendance to cervical screening by lesbian and bisexual women is worrying considering the increasing trend for sexually transmitted diseases which can lead to the development of abnormalities on the cervix which can lead to cancer. However, 30% of cervical cancers  occur without pre-exposure to HPV; a cancer causing virus, meaning groups which are not in a high risk group for HPV, Chlamydia and gonorrohea i.e lesbian women, are still at risk of developing the disease. The report suggested their is an increased cost in treating lesbian and bisexual women who usually present with a disease later than their heterosexual peers.

One of the recommendations of the report is to make lesbian health issues more visible so women are more comfortable discussing them with a doctor.

Source: Utalkmarketing.com

Because it’s Friday, here’s a round up of a week in the blogosphere:

• The American Medical Association endorsed Obama’s healthcare reform bill, marking the end to nearly a century of opposition to ’socialised medicine in the United States. The White House Blog has a video of the speech Obama made explaining why reform is needed now.
• Dr Kathryn Clancy, Assistant Professor of Anthropology at The University of Illinois, gives her opinion on the effects of the pill when considering the population as a whole in her three part series, What does this anthropologist think about hormonal contraception?.
• Twitter fave, His Boys Can Swim are running a contest to see who can guess the time their baby will be born. ‘Jane’ is currently 39 weeks pregnant and has been providing an account of her pregnancy through Twitter since the beginning.

Send your news and round ups to the comments box.

1) It’s not medical advice – Obvious, but something which is often forgotten. People responding to your queries or the queries of others are offering an opinion, not medical knowledge. Plus, though some forums such as Yahoo! Answers has a system which allows medical experts to identify themselves, there are few ways of authenticating the claims of respondents.

2) It’s US dominated – Fair enough if you are living in the United States and have very comprehensive medical insurance, but many people don’t fall into this category. Therefore anybody without patient choice, i.e. most European individuals, are unlikely to be able to use a lot of the ‘get  a second opinion’ advice. The same goes for people without medical insurance in the United States.

3) The anecdote rules – Have you heard the one about the 44 year-old woman who had been trying to conceive through IVF for years and then after giving up, conceived healthy twins? Well it was a one-off and it’s probably not going to happen to you. These forums almost never quote statistics but provide you with stories about how one ‘cure’ worked for someone. Its worst on pregnancy forums too. Every single twinge, absence of twinge, weird feeling and bodily function is analysed within an inch of its life by expectant mothers. Useful for support perhaps, but dangerous if used in place of medical advice at such a vulnerable time.

4) The advice is narrow – As few of the respondents are likely to be medical experts the range of potential causes and complications being discussed is exceedingly narrow. Most threads come to the conclusion the subject is either pregnant or has endometriosis. Sometimes polycystic ovaries. And fften advice is given with only minimal background information provided. A doctor, nurse or midwife is indispensable when it comes to taking medical backgrounds and using them appropriately to diagnose rarer or more complicated problems.

5) It will tell you what you want to hear – Type ‘late period’ into Google and the world will tell you that you are undoubtably pregnant. No matter what your background or circumstances, that is what they will say. Why? Because the internet is dominated by pregnancy forums with women desperate to get pregnant. I recently found a forum where a women who had experienced cramps and bleeding (i.e. a period) was told this was a sign of early pregnancy by numerous women who had experienced the same thing when they were trying. This is confusing and simplified at best, and dismissive and dangerous at worst.

The Associate Professor in Midwifery at Nottingham University has caused a furore over the last few days by suggesting pain during childbirth is a rite of passage, helps strengthen the bond between mother and child and that women should forgoe epidurals as they increase the risk of intervention.

The Daily Mail quoted him saying, “A large number of women want to avoid pain, but more should be prepared to withstand it. Pain in labour is a purposeful, useful thing which has a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.” He also said, “emerging evidence shows that normal labour and birth prime the bonding areas of the mother’s brain more than Caesarean or pain-free birth.”

Much of the focus has been on the Associate Professor’s sex – Dr Denis Walsh is a midwife and a man – rather than the evidence behind his research. Published in Evidence Based Midwifery Dr Denis Walsh has claimed epidural rates are already too high and are rising.

His terminology has rightly been called into question by Maureen Freeley in Comment is Free in The Guardian. She has asked “Even if this man had a degree in anthropology, I’d want to question his terms. And what the hell does he know about Bonding with Baby?” She goes on to argue this most recent commentary on childbirth is typical, “As is so often the case in discussions about motherhood, it is laden with moral assumptions.”

The Times’ Alpha Mummy blog points out “his attitude that pain prepares women for motherhood sounds a bit old Testament to me.” The Alpha Mummy team go on to argue that yes, childbirth is a natural process, but so is infant mortality. They also make the interesting point the tables appear to have turned on the assumption The Man was trying to push interventionist approaches to childbirth on women, but now things are going in a different direction.

In the good old-fashioned name of balance the papers have been providing other expert opinions on the matter, many of which are surprisingly blunt in suggesting Dr Walsh’s analysis is lacking.”He’s exaggerating the risks of epidurals. They aren’t overused. In the main they’re a good thing and almost always necessary.” says Dr Justin Clark, an ObGyn based at Birmingham Women’s Hospital in The Telegraph.

Our very own Dr Maggie Blott, mother and head of the Royal College of Obstetricians warned the BBC, “Do not under-estimate the pain of having a baby – it is a very, very intense and painful experience. If it is happening hour after hour in a very prolonged labour it is very tiring and wears people down and I think epidurals are very useful in that situation.” She was backed up in her comments by Cathy Warwick, general secretary of the Royal College of Midwives who said, “At the moment it is very easy for most women to ask for an epidural, and if they want one they definitely should get one.”

For a more irreverent look at the realities of obtaining an epidural on the NHS, have a look at Zoe William’s brilliant Anti-Natal column in the Guardian here.

Today, the wonderful Scarleteen website published an article on ‘The Buddy System’, explaining the benefits behind using two forms of contraception at a time. 

After a lot of statistical scribbles, the women behind this website have found that no combination leaves you with less than a 95 percent protection rate. The most effective form of contraception is the implant with condoms. 

They are careful to admit that adding a third contraceptive method makes such a slight statistical difference that it is not worth dealing with and some pairings are not suitable, for example two hormonal forms of contraception or the nuva ring and spermacide. 

In a time when the focus of contraceptive choice is being questioned, with more and more doctors recommending long term forms of contraception and the public appearing resistant to the suggestion, then ‘The Buddy System’ seems like a sensible half-way house. 

You can find the article and Scarleteen’s calculations of the rates of protection for various combinations here.

Endurance training could exacerbate heart problems, particularly among middle-aged individuals according to scientists this month. They are adding to the ongoing debate on whether endurance training can cause heart attacks, by claiming cycling and marathon running can increase the frequency of cardiac arrhythmias in certain participants.

The researchers from Spain however, stress any risk is very low and may only occur in people with pre-existing heart problems. Sports scientist Dr Luis Mont, who led the research team said pre-training screening is crucial, but more research needs to be done. He said, “It is certainly of great interest to define which recommendations for sport should be implemented in an individual patient, and how best to manage arrhythmias in participants.” at the European Society of Cardiologists conference last month.

The paper he presented is the latest in a long line of papers which have debated the problems endurance training can cause.

Ellen Mason, a senior cardiac nurse at the British Heart Foundation says any risk to triathletes is very low explaining, “There is a term called athlete’s heart syndrome that is sometimes used for this condition.

“The general feeling is that having an athletic heart is a good thing overall, and does not pose significant risk. Although the ventricles can become thickened and the heart larger, the risk of dangerous heart rhythm disturbances is low.This is compared to people who have heart muscle dysfunction caused hypertrophic cardiomyopathy (HCM), where the heart is enlarged and the muscle thicker. The risk of dangerous ventricular rhythms in people with HCM is often quite high, requiring treatment including anti-arrhythmic drugs and/or an implantable cardioverter defibrillator (ICD). Basically one condition is considered generally benign and HCM is pathologically abnormal. 

“The reason for testing young athletes at the start of their careers, with an ECG and echocardiogram is to identify any with underlying cardiomyopathies”

Not all is lost though, the study suggests that the drug losartan could be used to counteract the most common causes of heart arrhythmias in endurance