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OCTOBER 2002 The outgoing President, Dr M T Spence, welcomed the 2002/2003 President, Dr A M Moloney (Consultant in Public Health, Tameside & Glossop Primary Care Trust). Dr Moloney thanked Dr Spence for his term of office and proceeded to introduce the title of her Presidential Address:- "Is god good for your health?" Dr Moloney explored the current evidence base for religion and spirituality impacting on physical and mental health. Issues about implications for public health practice were also examined. A lively, controversial, question and answer session ensued. The Presidential Dinner was held in honour of Dr Moloney, in the University Refectory, which members and guests attended.
In the absence of Dr A Moloney, President, Dr M Spence, Immediate Past President of the Section, opened the meeting and introduced the afternoon’s speakers as follows:- Professor Tom Kirkwood, Department of Gerontology, Wolfson Research Centre, Newcastle upon Tyne opened the symposium by addressing the question "How will science affect ageing"? He described significant advances in scientific understanding of the mechanisms of biological ageing. Ageing comes about because of a series of molecular damage over the years due to oxidative stress thought to be caused by "free radicals". In the body there is a continuous balance between damage and repair. Professor Kirkwood went on to explore the inter-relationship between ageing and disease. The aged cell is more vulnerable to pathology but we need to understand the mechanisms that lead to damage of the cells to increase knowledge about the contribution that the ageing process itself makes to disease. Genes account for 25% of what determines longevity. Other factors include: nutrition, lifestyle, environment and chance. The use of drugs and improved nutrition and lifestyle may decrease exposure to damage and enhance our natural mechanisms for repair. Many of the problems in old age stem from attitudes such as fatalism, denial, negative stereotyping and abdication of personal responsibility. In his conclusion, Professor Kirkwood emphasised that current science, when properly applied can do much to enhance the well being of older people. New research will identify the causes of age related disability and new evidence –based therapies will identify and overcome the barriers to independence. Professor Cameron Swift, Department of Health Care for the Elderly, Guy’s, King’s and St Thomas’ School of Medicine then addressed the issue "Ageing and Health: evidence, practice and policy". He started by stating that the goals of health care in older age should be the same as those at any age ie healthy, active living and prevention or postponement of dependency. The current clinical evidence demonstrates that advanced age does not necessarily reduce therapeutic benefit to patients e.g. ISIS studies. In some cases, there is equal or better return for therapeutic intervention and interestingly, high tech. intervention may maximally benefit older people. In relation to health care science, the new evidence shows that effective health care intervention is cost-effective. Timely access to specialist staff and services is crucial in preventing or postponing disability. Professor Swift informed the symposium of his involvement in the development of the NSF for older people. He believed that the NSF could be used as a catalyst to produce change on the ground. In conclusion, Professor Swift challenged us to celebrate human ageing as a success, affirm high quality health care for older people and invest responsibly and urgently in skills, services and research and development. Mr G Lishman, Director of Age Concern gave the final presentation on "Age Discrimination: The contribution older people make to society and the community". He began by describing direct, indirect and multiple discrimination using examples from both his personal life and his work. Some health services continue to apply age limits (both covertly and explicitly) to particular services. He cited the withdrawal of nail – cutting services and the impact that this had on mobility and the evidence that older people are not offered health and lifestyle advice. He concluded by challenging both commissioners and providers of services to implement interventions, which contribute to increasing the capacity for independence in older people. Dr A K Banerjee, President of the Manchester Medical Society proposed the vote of thanks to all of the speakers. Members of the audience followed each lecture by a lively question and answer session and the symposium was felt to be an excellent success.
A meeting of the Public Health Forum of the Manchester Medical Society was held on Thursday, 23 January 2003 in Theatre 4 of the Medical School, University of Manchester. Apologies were received from Dr Paul Salmon. Dr Anna Moloney, President, welcomed the speaker for the evening, Mr Andrew Kibble, Senior Chemical Incident Officer, from the University of Birmingham. Mr Kibble addressed the audience on the subject "Contaminated Land and the Link with Health". Mr Kibble began his talk by citing the UK’s long industrial past – a source of much of the contamination of today’s land. Agriculture and the policy of land filling have also contributed. A wide variety of pollutants are found in the soil but those of greatest concern are heavy metals, particularly cadmium, lead and mercury. Exposure of humans to these pollutants in soil can occur from ingestion, inhalation and contact. Ingestion is probably the most important route of exposure and this is most common in infants, particularly those with pica. Mr Kibble described a number of case studies of land contamination from across the world. The most famous case study is that of Love Canal, a heavily industrialised town close to Niagara Falls. In the 1920s the canal site was used for municipal waste. Between 1940 and 1954, the site was used for the disposal of a wide range of chemicals from the Hooker Chemical Company. In 1954, the site was closed and covered with a layer of clay. However the site was subsequently used by the council for re-development; including the building of houses and schools. Very quickly, the local population complained of odours and skin irritation. Investigation confirmed that chemicals had leached into the soil and the basements and gardens of houses. Over 900 families were evacuated and an on-going clearing programme is still underway today. Follow-up studies of the effects on health found no increase in cancers but an increase in the incidence of babies with low birth weight in the most exposed group. Today, these studies continue. Mr Kibble then focussed on the most recent UK studies investigating the relationships between living close to landfill sites and incidence of cancer and congenital anomalies. None of the studies have demonstrated an increase in cancer. However, the Eurohazcon Study (1998) and a recent study by the Small Area Health Statistics Unit (SAHSU) suggest an increase in congenital anomalies. Causal relationships have not been established. Mr Kibble stressed the methodological difficulties in measuring exposure in all of these studies. Landfill sites vary in terms of their pollutants. The main route of exposure is unknown and there is little understanding of personal exposure. Future studies may use biomarkers of exposure. In his conclusion, Mr Kibble informed the audience that there is currently no evidence of a link between land contamination and cancer but that there is growing concern about a possible link with congenital malformation. A lively question and answer session followed the talk. Dr Lorraine Lighton proposed the vote of thanks. She thanked Mr Kibble for providing a comprehensive review of the literature and a useful framework for giving practical advice to members of the public with concerns. The customary dinner which usually follows the evening meetings and is normally held in honour of the speaker was cancelled as Mr Kibble was unable to attend.
The Public Health Forum, of the Manchester Medial Society, ‘Presentations of Work in Public Health in the North West’ was held on Thursday 27th February 2003 at 2.00 pm in the Jubilee Room, University Refectory, Manchester. As last year’s arrangement for the presentations went so well, it was decided to repeat the same format once more. Abstracts were invited from public health practitioners, selected for display and each presenter was given ten minutes to discuss their paper. A structured discussion then took place facilitated by Dr A Moloney and Dr Richard Edwards, with interaction from both the audience and presenters. The presenters and their papers were as follows:- Dr Richard Arnold Dr Ann Reid Dr Andy Howe Dr Vicci Owen-Smith Dr Moloney, President of the Section, thanked all four presenters with words of admiration and encouragement for the future. Each presenter will receive a framed certificate commemorating their outstanding efforts and their participation in the meeting.
A meeting of the Section of the Public Health Forum of the Manchester Medical Society was held on Thursday 27th March 2003 at 6.00 pm in Theatre 4 of the Medical School, University of Manchester. The Section of Public Health welcomed Ms Nicola Harwin CBE, Director of Women’s Aid. Ms Harwin spoke on the subject of "Domestic Violence" Ms Harwin began by providing a brief summary of the Women’s Aid organisation. Women’s Aid established the first refuges in the 1970s and has expanded since to run over 500 refuges and a national helpline, undertake research, campaign to change the law and provide services for women and children. Ms Harwin described the prevalence and impact of Domestic Violence based on research undertaken by Women’s Aid and other organisations. One in four women will experience domestic violence during their lifetime, yet only 35% of incidents are reported to the police. As well as leading to physical injury and mental health problems in the victims, domestic violence has an enormous impact on children who in 90% of cases witness the violence. In the UK today, one woman is killed by a current or former partner every 3 days and most are killed around the point of separation. While murders of children by strangers attract huge media attention, four out of five children are murdered by family members. These murders receive scant publicity. Research carried out on survivors has demonstrated the value of support from refuges and outreach services. Women wish to be listened to, directed to appropriate services and the services to be responsive to their changing needs. A multi-agency approach is required with health being an active partner. Ms Harwin described a survey of Health Authorities and Primary Care Groups carried out by Women’s Aid in 2000. The survey sought information on the organisation’s commitment to domestic violence. Only 27% of Health Authorities had a written policy. A strong correlation was found between having someone in the organisation with dedicated responsibility for domestic violence and the availability of policies and procedures. However, domestic violence is not mentioned in the NHS plan and most good practice is dependent on the interest and commitment of staff. Ms Harwin was optimistic about the future as Women’s Aid has experienced an increased demand from health organisations for information, leaflets and guidance. At Government level, Women’s Aid is campaigning with NSPCC and NCH to amend the Children Act to get domestic violence recognised in the legislation. The organisation is also involved in working alongside seven ministerial departments on a number of identified priority areas including enhanced civil and criminal interface; early intervention by agencies and increasing the availability of safe accommodation. Ms Harwin finished her talk by mentioning several new initiatives being undertaken with health including:
Members of the audience welcomed the opportunity to ask Ms Harwin further questions about the work of Women’s Aid and share their experiences of working at local level. The discussion lasted over 30 minutes. In thanking Ms Harwin, Dr S. Bradley paid tribute to Ms Harwin’s enthusiasm and commitment to this important public health issue. The customary dinner which usually follows the evening meetings and is normally held in honour of the speaker was cancelled as Ms Harwin was unable to attend. The fourth Chadwick Lecture was the final meeting for the 2002/2003 session of the Public Health Forum of the Manchester Medical Society. The lecture was held on Thursday 15th May 2003 at 7.00 pm at the Imperial War Museum North. The President of the Section, Dr A Moloney, opened the meeting and thanked members and guests for attending. Dr Moloney then introduced the evening’s speaker and his lecture as follows:- Dr R C Horton "Political violence and Public Health: Fear and justice in the modern nation state" Dr Horton’s objectives of his lecture were to examine whether public health was up to the challenge. In brief, Dr Horton described how violence is commonly treated by the health professions as a series of medical emergencies – gunshot wounds, burns, trauma. Violence considered as a public health challenge has only recently become fashionable. Neglected still, however, is the idea that violence is an inevitable consequence of the way we organise society. If public health is a discipline seriously concerned with diminishing the burden of violence, its practitioners have an obligation to engage politically with sources of power in society. Public health must therefore confront a strategy of political analysis, social transformation, and direct action. A vote of thanks was given to Dr Horton for a most enlightening lecture which inspired a beneficial question and answer session. Following the meeting members and guests joined Dr Horton to a dinner held in his honour which took place in an unusual setting, under the wings of a Harrier Jump-jet. Finally, the evening was rounded off with a private viewing, for the dinner guests only, of the Museum’s Main Exhibition Space. The food, courteous staff and atmosphere of the venue contributed to an excellent evening all around.
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MANCHESTER
MEDICAL SOCIETY
