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AQAGeog1 Health Issues
A level reading for the unit Geog1 Health Issues
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YouTube - What Are Diseases Of Affluence?

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YouTube - When HIV Becomes AIDS (HIV #2)

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BBC NEWS | Africa | Food aid reaches famine-hit Swaziland

BBC NEWS | Africa | Food aid reaches famine-hit Swaziland | AQAGeog1 Health Issues | Scoop.it
Food aid starts to arrive in Swaziland, but charity workers say only a change in government policy can solve the crisis.
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AQA A-level Geography

AQA A-level Geography | AQAGeog1 Health Issues | Scoop.it
AQA specification
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New evidence reveals that British American Tobacco is breaking its own Marketing Code in Africa

New evidence reveals that British American Tobacco is breaking its own Marketing Code in Africa | AQAGeog1 Health Issues | Scoop.it

New evidence reveals that British American Tobacco is breaking its own Marketing Code in Africa New evidence reveals that marketing tactics used by the London-based British American Tobacco Company in Africa clearly breach their own marketing code and are attracting young smokers.

 

In an investigation carried out for BBC Two's This World, Dragons' Den entrepreneur Duncan Bannatyne uncovers clear evidence of breaches of the code in relation to marketing to young people.

 

These include: the sale and promotion of single cigarettes (which are particularly attractive to youth); music events in venues which are attractive to youth, which are endorsed by celebrities wearing branded T-shirts; and promotional goods (including bags and hats) which feature the brand name of cigarettes.

 

In a hard-hitting investigation, Bannatyne Takes On Big Tobacco, businessman Duncan Bannatyne travels to Malawi, Mauritius and Nigeria. He discovers BAT are using tactics which circumvent bans on advertising and raise the profile of cigarettes in countries where doctors are already predicting a potential epidemic of smoking-related diseases.

 

 BAT's own marketing code acknowledges that single cigarettes are particularly attractive to youth (who may not be able to afford a whole packet of cigarettes) and BAT claim that they do not encourage the sale of single sticks because it encourages youth access.

 

Yet in Mauritius, Bannatyne discovers special pots which BAT have distributed to shops to make it easier for them to sell single cigarettes. In Malawi and Nigeria he discovers posters that BAT have produced depicting single cigarettes and showing the price of a single cigarette. He also meets children as young as 11 who are buying the single cigarettes and already developing a nicotine habit.

 

With secretly-shot footage, the programme shows the pungwe, or music, events organised by BAT in Malawi which show cigarettes as sexy, exciting and fun. The concert features some of Malawi's most popular bands wearing branded T-shrits. The programme also shows promotional goods showing the Pall Mall brand name on display at a party for the winners of a BAT competition.

 

In an interview with Chris Proctor, Head of Research and Regulation at BAT, Bannatyne challenges him on the issue of single cigarettes and other tactics he believes are breaching their marketing code. He shows Proctor a poster advertising single cigarettes from Malawi. Proctor says: "Yeah, I mean it is a real issue. I agree, Duncan." He continues: "Well, I mean the posters you showed me shows some branding and that will be against the marketing standards that we've just reinvigorated and will be finalised for June 2008. "Anything at a point of sale, a poster like that, could say a price but it'd have to be in black and white with a health warning."

 

When Proctor is shown another poster from Nigeria, he reiterates: "Yeah, no, I agree. The Nigerian one has the price of two sticks but shows the pack and so does the one from Malawi so we're trying to say – this is a pack – the pack has got health warning on. "The practical matter is we do put the price of single sticks here. As I said, in terms of the upgrade of our marketing standards this type of branding saying the name of the product will go away." When challenged about the Pungwe or music event, which had no formal age verification on the door, Proctor says: "Well if that was the case, that is disappointing, it's certainly not what we would wish to happen."

 

On the issue of advertising, Bannatyne confronts BAT with evidence of some shops in Mauritius which were painted the same colour as "Matinee", one of their leading brands of cigarettes. One of the shopkeepers told Bannatyne that BAT painted it for him to advertise their cigarettes three years ago – after the ban on advertising came into force in 1999.

 

Proctor concedes that the shops should not have been painted by BAT. He says: "Yeah, no, I've seen that and you're right, there were a series of shops that had been painted a yellow, the same colour as one of our brands there. "We had a look at it recently. Wasn't against the law but it didn't look right so we've been back in there and we've been making sure those are repainted."

 

When Duncan shows him a pot taken from a shop in Mauritius, Proctor argues that they should have been withdrawn completely from the market in 2006. Proctor explains: " …this should be an old one, if it's not an old one, we need to look at it." He continues: “Well, I talked to our company there and they said they've stopped that since 2006 so we'll certainly re-look at that." At the end of the interview, Proctor adds: “"Well, I think your criticism helps all companies like ourselves. Because we listen to those criticisms and we will be looking at those issues."

 

Bannatyne's final verdict on BAT is that they are "the unacceptable face of British business."

 

Interesting and Important Facts

 

British American Tobacco are a London-based company. Africa is one of their key markets. Their profits last year were £2.9billion.

 

The World Health Organisation (WHO) estimates that smoking-related deaths in Africa will double in the next 20 years and that by 2030 smoking-related deaths in Africa will be greater than TB and Malaria combined.

 

 30% of 11-15-year-old children in Mauritius smoke (Global Youth Tobacco Survey). In the classroom that Bannatyne visited, more than half of the 11-14-year-olds smoke. Some had started smoking when they were as young as eight years old.

 

BAT have a significant presence in Zimbabwe. In 2005 they were heavily criticised when they awarded the tobacco grower of the year prize to the wife of Justice Minister Patrick Chinamasa.

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1984: Extent of Ethiopia famine revealed

Michael Burke investigation into the Famine in Ethiopia.

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Sicko notes

Sicko: A Look at Different Approaches to Health Care Sicko is a 2007 documentary film by American film maker Michael Moore. The film investigates the American health care system, focusing on its health insurance and pharmaceutical industry. The film compares the for-profit, non-universal U.S. system with the non-profit universal health care systems of Canada, the United Kingdom, France and Cuba. According to Sicko, almost fifty million Americans are uninsured and those who are covered are often victims of insurance company fraud and red tape. Interviews are conducted with people who thought they had adequate coverage but were denied care, as well as former employees of insurance companies who describe cost-cutting initiatives that encourage bonuses for insurance company physicians to deny medical treatments for policy holders. In Canada, Moore describes the case of Tommy Douglas, who was voted the greatest Canadian in 2004 for his contributions to the Canadian health system. Moore also interviews a microsurgeon and people waiting in the emergency room of a Canadian public hospital. Against the backdrop of the history of the American health care debate, opponents of universal health care are set in the context of 1950s-style anti-communist propaganda. A 1960s record distributed by the American Medical Association and narrated by Ronald Reagan warns that universal health care could lead to communism. In response, Moore shows that socialized public services like police, fire service, postal service, public education and community libraries have not led to communism in America. The origins of the Health Maintenance Organization Act of 1973 are presented using a taped conversation between John Ehrlichman and President Richard Nixon on February 17, 1971; Ehrlichman is heard telling Nixon that "...the less care they give them, the more money they make", a plan that Nixon remarked "appeals to me". This led to the expansion of the modern HMO-based health care system. Connections are highlighted between Pharmaceutical Research and Manufacturers of America (PhRMA), the lobbying arm of the largest drug companies in the United States, lobbying groups in Washington D.C., and the United States Congress. Hillary Clinton, a champion of the Clinton health care plan, is shown as a crusader for change, appointed to reform the health care system in the United States by her husband, newly elected President Bill Clinton. Her efforts are met with heavy-handed criticisms by Republicans on Capitol Hill, and right-wing media throughout the country, who characterize her plan as the harbinger of socialism. When she is defeated, her punishment is to "never speak of it again while in the White House." Seven years later, her silence is rewarded, as she becomes a Senator for the State of New York, a victory made possible in part by money from the health care industry; she is second only to Rick Santorum as the Senate's highest recipient of health care industry campaign donations. Michael Moore interviews a physician from the British National Health Service. In the United Kingdom, a country whose National Health Service is a comprehensive publicly-funded health care system, Moore interviews patients and inquires about in-hospital expenses incurred by patients, only to be told that there are no out-of-pocket payments. Moore visits a UK pharmacy, where pharmaceuticals are free of charge for persons under 16 or over 60, and subsidised in most cases for everyone else; only a fixed amount of £6.65 per item on a prescription is charged, irrespective of cost to the NHS. Further, NHS hospitals employ a cashier, part of whose job is to reimburse low-income patients for their out-of-pocket travel costs to the hospital. Interviews include an NHS general practitioner, an American woman residing in London, and Tony Benn, a Labour politician and former Member of Parliament. Benn compares a hypothetical attempt to dismantle the NHS with reversing women's suffrage and says it would result in a revolution. In France, Moore visits a hospital and interviews the head of obstetrics and gynaecology and a group of American expatriates. Moore rides with the "SOS Médecins", a 24-hour French medical service that provides house calls by physicians.[7] Moore discovers that the French government provides social services, such as day care for $1 an hour and neonatal support that includes cooking, cleaning, and laundry services for new mothers. Returning to the United States, interviews disclose that 9/11 rescue workers who volunteered after the September 11, 2001 attacks were denied government funds to care for physical and psychological maladies they subsequently developed, including respiratory disease and PTSD. Unable to receive and afford medical care in the U.S., the 9/11 rescue workers, as well as all of Moore's friends in the film needing medical attention, sail from Miami to Cuba on three speedboats in order to obtain free medical care provided for the enemy combatants detained at the U.S. Guantanamo Bay detainment camp. The group arrives at the entrance channel to "Gitmo" and Moore uses a megaphone to request access, pleading for the 9/11 victims to receive treatment that is on par with the medical attention the "evildoers" are receiving. The attempt ceases when a siren is blown from the base, and the group moves on to Havana, where they purchase inexpensive medicine and receive free medical treatment.[8] Providing only their name and birth date, the volunteers are hospitalized and receive medical attention. Before they leave, the 9/11 rescue workers are honored by a local Havana fire station. Finally, Moore addresses the audience, emphasizing that people should be "taking care of each other, no matter the differences". To demonstrate his personal commitment to this theme, Moore decides to help one of his biggest critics, Jim Kenefick, webmaster of MooreWatch. According to a blog posting, Kenefick was planning to shut down his anti-Moore website because he needed US $12,000 to cover the costs of medical treatment for his sick wife. Not wanting the U.S. health care system to trump Kenefick's ability to express his opinion, Moore sends Kenefick the money anonymously.

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YHPHO - Diabetes in England

Diabetes in England report

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YouTube - The Origin of AIDS (Full Documentary)

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newcastle upon tynr health profile 2007 - Google Search

newcastle upon tynr health profile 2007 - Google Search | AQAGeog1 Health Issues | Scoop.it
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Geography Past Exam Papers - The Student Room

Where GCSE, A Level and university students share academic and social knowledge: from study help, to choosing a university, careers, and student life...
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Newcastle%20DPH%20Rpt%2008-09.pdf

newcastle NHS primary care trust the annual report of the director of public health for newcastle 2008-09

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‘This World’ – Bannatyne takes on tobacco (BAT)

‘This World’ –   Bannatyne takes on tobacco (BAT) | AQAGeog1 Health Issues | Scoop.it

‘This World’ –

 

Bannatyne takes on tobacco (BAT)

 

Mauritius

• ½ a class of 11-14 year olds smoke

• Are aware of the British American Tobacco (BAT) brands Embassy and Pall Mall

• Children are not aware of the dangers of smoking

• 1/3 of all children in Mauritius aged 13-15 are smokers. They are generally from the poorest sector of society.

• Children can buy single sticks, single cigarettes for 4 rupees (7p) each.

• The selling of single sticks makes smoking more accessible to children.

• Bat gives free pots to shopkeepers in order to keep single sticks therefore they are promoting the use of single sticks and therefore smoking by children.

• BAT controls 98.9% of the market in Mauritius. Advertising is banned but still goes on in disguised form.

• For example, leaflets are given to children and shops are painted by BAT in the colours of matinee cigarette packets. Brand recognition is vital.

• BAT offered to paint the cardiac hospital which treats smoking related diseases in the same colours and provide sponsorship.

 

Nigeria

• BAT controls 92% of the market

• Lagos state government is suing BAT for £9 billion which is the amount needed to treat people with smoke related illnesses.

• BAT run campaigns to target children. For example, they hold Benson and Hedges music festivals.

• BAT deny targeting children and say the music festivals are supposed to be for over 18s.

• The B&H music festival was attended by 120,000 people and also televised.

• It used to be socially unacceptable to smoke in Nigeria but there has been a 50% increase in the last 10 years and is now seen as sophisticated.

• Advertising is banned but BAT give away free B&H umbrellas

• 5 cigarettes costs the same as 1 cheap biscuit.

 

Malawi

• Less than 10% of people smoke in Malawi but Tobacco is the biggest commercial crop and accounts for 60% of exports.

• A farmer can make 8x more from tobacco than from any other crop.

• The poor in Malawi don’t worry about not being able to afford food but do worry about not being able to afford cigarettes.

• Most children don’t smoke but know the brands well.

• The country is going through change. Single sticks are being advertise with the cost being 2p for a single stick.

• More than ½ the children at a project for street children smoke.

• Some of these children are selling cigarettes to make money.

• Many children can’t read so can’t read the warning labels on the packets.

• BAT have promoted Pall Mall and Embassy music events where they promote a competition where the entrant buys a packet of cigarettes, they write their name on the back of the packet and then enter it into a draw to win a prize.

• BAT are working hard to promote cigarettes in a country where smoking is not part of the culture.

• They hold a party for the winners of the competition during which they give away free cigarettes. BATs response

• Outside the BAT AGM protesters lay out 1000 empty shoes. Each shoe represent 1000 deaths from tobacco.

• “It is an example of a British industry doing abroad what they would never do at home” (protester)

• A BAT spokesperson says they are disappointed with the evidence found. The posters advertising single sticks also advertise the pack price with the warning about smoking.

• From 2006 they have withdrawn the free pots for holding single sticks so these should be old.

• Shops which have been painted with the brand colours are not against the law, but they have repainted them so they are not advertising.

• Concerts are not targeted at youths and police are used to check age verification.

• BAT encourages criticism as it helps them to look at the issues.

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BAT’s Response to BBC article A BBC TV programme on 1 July 2008, called ‘Bannatyne takes on big tobacco’

BAT’s Response to BBC article A BBC TV programme on 1 July 2008, called ‘Bannatyne takes on big tobacco’ | AQAGeog1 Health Issues | Scoop.it

BAT’s Response to BBC article A BBC TV programme on 1 July 2008, called ‘Bannatyne takes on big tobacco’, painted a very negative picture of our business in three countries in Africa, including alleging that we target children to sell cigarettes and break our own strict International Marketing Standards.

 

Viewers who trust the BBC to be fair, impartial and balanced should know that this was not a BBC news documentary, governed by BBC rules obliging news reporters to be fair, impartial and balanced. By the producers’ own admission, it was “a personal view”, putting across very strong opinions, subjective views and judgements made by one individual, a TV personality called Duncan Bannatyne, who has a campaigning anti-tobacco stance.

 

We don’t want children to smoke. That’s why our policy everywhere in the world is only to market to adults who have decided to be tobacco consumers and not to direct any of our marketing to minors. Our marketing is not aimed at ‘selling smoking’ – it’s all about brand preference amongst adults who have chosen to be tobacco consumers.

 

 We gave a very long interview answering a lot of questions accurately and openly, but almost all of it was cut. Here are a few things you might have heard if this had been a news programme that had to operate to the BBC’s rules on impartiality.

 

Single cigarette sales in some African countries

 

We never supply shops with single cigarettes, anywhere. We only sell retailers packs marked with health warnings. But in some countries, retailers break up packs to sell ‘single sticks’, usually to people on lower incomes who don’t smoke very much and only want to buy one or two cigarettes.

 

In these countries ‘single stick’ sales are legal, although we don’t like this practice and try to discourage it. But we can’t change consumers’ preferences or stop retailers from doing it overnight. Refusing to supply retailers who split up packs would simply open up a gap for other suppliers, who are likely to be less concerned than we are about how cigarettes are sold in the market.

 

In some countries, we provide ‘recommended price’ notices for single sticks in shops. This is to prevent adult consumers from being ‘ripped off’ by retailers who break up packs and sell at a very high mark-up. It is not to advertise brands but to discourage unfair mark-ups.

 

Sales to children

 

Whether cigarettes are sold in packs or singly, we do not want retailers to sell any cigarettes to children. Our companies have lobbied governments for minimum age laws in countries where there are none. We try to educate retailers about the law and that they should never sell to children. But some retailers do sell to children. We agree this is very wrong and we want to see better enforcement of laws against under age sales and penalties for retailers who break the law.

 

Pots holding single sticks in Mauritius

 

Our local company used to supply pots for retailers to hold ‘single sticks’. In 2006, it stopped this, but some retailers still use old ones. Our business is working to ‘sweep’ the market to remove these from retailers. Although the programme made much of the pots as if they were commonplace, our business in Mauritius tells us it is making good progress in getting them out of shops.

 

Painted shops in Mauritius

 

Before 2006, as part of relationship building with a small number of retailers, our company in Mauritius arranged for 70 shops to be painted yellow, the colour associated with the Matinee brand. Painting the shops was not against the law. However, this is not done now and before the TV programme was made, our local company was already paying for all 70 shops to be repainted in neutral colours and they have all now been done. The programme filmed some shops that had not yet been repainted and ignored our explanation.

 

Pall Mall event in Malawi

 

The programme alleged - apparently on the word of one un-named person - that there were no age checks at the door of a music gathering for some of our adult consumers.

 

 Our subsidiary in Malawi vetted attendees in advance through forms that consumers had filled in stating their age; ages were verified by a driver’s licence, passport or affidavit from a relative. There was age-verification on the door and the Malawi Police attended to help our staff ensure that the event was strictly for adults over 18.

 

The programme showed Pall Mall branded items such as t-shirts and caps for attendees, which by the way all carried health warnings. But it did not report that this is already something our companies no longer do. Under our revised International Marketing Standards, which apply to all our companies from 30 June 2008, our companies no longer produce items like clothing with cigarette branding.

 

Nigeria

 

The programme touched on some allegations being made by plaintiffs in a legal action in Nigeria. It would not be appropriate to comment on any pending legal cases or discuss matters that might be evidence in court, except to say that our business in Nigeria will be vigorously defending the claims, which we believe are flawed and lack merit. But we can say that children are not and will never be any part of our target consumer universe.

 

We are open minded to fair, accurate and factually-based criticisms and want to hear about any alleged breaches of our International Marketing Standards so that we can take appropriate action. However, we do not believe this programme showed any clear evidence of our Marketing Standards being breached or of any laws being broken by our companies.

 

Like Duncan Bannatyne, we really do not want children to smoke, but sadly, we don’t think this programme ever really got to grips with effective ways to prevent this from happening.

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Diseases of Affluence research

Diseases of Affluence Research Coronary Heart Disease Diseases of affluence are diseases associated with increasing wealth in a country, so are most common in MEDCs. They aren’t contagious and tend to be caused by poor lifestyle such as smoking, drinking, lack of exercise and intake of fatty and processed foods. Common examples of diseases of affluence include coronary heart disease, type 2 diabetes, obesity, some types of cancer and even depression. The symptoms Coronary heart disease is the biggest killer in the UK, with almost 300,000 people having a heart attack per year. Coronary heart disease occurs when blood, and therefore the oxygen carried in the blood aren’t transported to the heart and the surrounding tissue due to a build up of lipids in the coronary arteries, known as atherosclerosis. A partial blockage can cause anginas, which are chest pains, often more noticeable during exercise or a feeling of indigestion. Further blockage can lead to a heart attack which is where part of the heart muscle dies due to lack of oxygen. There are several common symptoms of coronary heart disease, including shortness of breath due to the lungs filling with fluid. This happens because the heart becomes too weak and can’t pump fluids around the body efficiently. Another symptom is heart palpitations, or an irregular beat of the heart, although this is not always necessarily linked with coronary heart disease. The symptoms of heart attacks are often much more severe, including the same feelings related to anginas, such as being short of breath, and a feeling of indigestion; but also sweating and severe shooting pains, often down the left arm or in the chest. When the symptoms last for over 15 minutes, someone is likely to be having a heart attack rather than angina. The causes Coronary heart disease, as already mentioned is caused by a build up of fatty deposits or lipids, known as atheroma in the coronary arteries. The atheroma is mainly made up of VLDL and LDL cholesterol, although there are other contributors. This build up of fatty deposits begins to block the coronary arteries and this slows down the flow of blood to the heart. This is known as atherosclerosis. The actual causes of atherosclerosis, the primary causes, are often linked to poor lifestyle, smoking being one of the main causes. This is because; smoking results in carbon monoxide and nicotine in the bloodstream, which puts a larger strain on the heart. Also, carbon monoxide takes up the place of oxygen which is carried in the haemoglobin, meaning there is less oxygen in the blood, which can also increase the risk of part of the heart muscle dying, due to lack of oxygen. The nicotine and carbon monoxide also mean that blood clots are more likely, which linked with the atherosclerosis can cause a heart attack as it means an entire artery can become blocked. Another danger with smoking is that the other chemicals in cigarettes can damage the lining of the arteries making them much weaker, and therefore unable to pump blood around the body as there will be less pressure. According to the NHS, smoking is the main cause of about 20% of deaths by coronary heart disease in men and 17% in women. Another major cause of coronary heart disease is having a low HDL to LDL cholesterol level. This means having less high density lipoproteins and more low density. This is bad for the body as the liver will carry on making cholesterol if there is a lot of LDLs, meaning there will be an excess which is then deposited on the walls of arteries, where as HDLs are recognised by the liver, so it will only produce enough cholesterol for the body to function, for example, cholesterol is used in order to give the phospholipid bilayer in the cell membrane more stability. Cholesterol links directly with poor diet, as a diet high in LDL and VLDL cholesterol, of which there is meant to be about 70% means there will be too much cholesterol, and it will begin to be deposited, rather than being broken down and excreted as a waste product from the body by the liver. A further cause of CHD is high blood pressure, also known as hypertension. This can also put a strain on the heart and lead to the secondary stages of coronary heart disease. Finally, thrombosis, which is more commonly known as a blood clot, in the coronary artery can lead to a narrowing of the arteries and eventually a heart attack. More often than not, thrombosis will occur where atherosclerosis has already began to form, as the fact that the arteries have already been narrowed means a clot can easily get stuck, causing further problems. Obesity, high alcohol consumption, and family history of CHD can also lead to someone getting coronary heart disease. The solutions There is no real cure for coronary heart disease, however a change in lifestyle can often greatly reduce the risk of getting it, or the at least reduce the effects of CHD. Quitting smoking, changing diet and doing regular exercise can greatly help to diminish the effects. However, once someone has signs of atherosclerosis, or has angina or even a heart attack, there are many forms of treatment, both medicinal and surgical used to clear the arteries, stop clots forming, and repair the heart. For early signs of atherosclerosis small amounts of aspirin can be used as it can stop blood clotting. In more serious cases, anticoagulants, in particular, warfarin, are used as they are much more effective at reducing blood clots, however, have certain side-effects, mainly that they can cause bleeding, and the fact that they thin the blood leads to serious risks. In order to lower levels of LDL cholesterol, statins can be used. These are useful as they alter receptors within the liver, meaning the LDL cholesterol can be removed from the body more easily and also that the liver won’t produce as much cholesterol which will slow down the build up of atheroma in the arteries. In order to combat high blood pressure, beta blockers are used as they as they can stop certain effects of hormones which result in either irregular, or fairly fast heart beats. This means that the heart will pump the blood more efficiently and in return get more oxygen, which is used to keep the muscle alive. ACE inhibitors and angiotensin II receptor antagonists can also be used to reduce blood pressure by blocking the hormone angiotensin II which can actually narrow blood vessels, in particular, arteries. These are often very useful, but ACE inhibitors in particular can have extreme side-effects, including kidney problems, meaning they are only prescribed in certain cases. Finally, nitrates are used to induce vasodilation by relaxing the blood vessels and lowering the blood pressure. The surgical procedures which can be used to treat coronary heart disease start from mild measures such as a coronary angioplasty, which involves opening a narrow, or even blocked artery and therefore increasing blood flow. A coronary artery bypass is a much more complicated procedure, yet due to the amount, about 28,000 per year, the risk is still fairly minimal. This entails bypassing the coronary artery, often by using part of the artery found in the leg. One of the most risky options is an actual heart transplant, which is only done after severe or multiple heart attacks as there will be a lot of dead muscle. However, as this is actually replacing the entire heart, they often aren’t preferred to a bypass as there is a great risk of rejection, and also, the waiting lists for donor hearts are very long. Incidence of coronary heart disease in the UK This map shows that coronary heart disease is more prevalent in industrial and poorer parts of the UK. The pink colours, which show the higher rates of deaths from heart attacks and chronic heart disease, are in areas such as Glasgow and a lot of west Scotland. Cities such as Manchester and Liverpool in the North West of England also have fairly high rates. Even in London, there is a lot more deaths than in most of the country, which could also be due to the fact that it is a very industrial city with some areas with relatively high poverty rates. This map also shows that there is a clear north- south divide, the north of the UK having a lot more deaths as a result from coronary heart disease than the south. Again, the north is often the poorer, more working class part of the UK. The patterns which are shown in this map; a higher rate of coronary heart disease in the more poor areas could be due to the fact that smoking rates are much higher in working class areas, and there are also trends of bad diet, as ready-meals and cheaper foods often tend to be cheaper, and have high LDL cholesterol levels which begin to create a build up atheroma which then causes CHD. Incidence of coronary heart disease in the world This map shows the number of deaths in thousands, per region, per year. This shows that Europe has the highest rates of coronary disease by far, with over 2,373,000 deaths per year. This is because most of Europe, in particular the west are MEDC areas, so are much more affluent. The rates are so low in Africa as this is an LEDC area, especially sub-Saharan Africa, shown in the fact there is a slightly higher rate in the north. This is due to the fact that diseases of poverty, i.e. AIDS, malaria and tuberculosis are much more prevalent in Africa, and many will not contract coronary heart disease as their diet is too low in cholesterol and many do not smoke compared to the rest of the world. The Americas seem to have a fairly low rate of coronary heart disease, only 921,000 deaths per year, but North America should be expected to have a much higher rate, due to the fact that it is a rich area. However, this may be due to the fact that South America is quite a impoverish area, so balances out the data from the North.

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NHS_Diabetes_Audit_Mortality_Report_2011_Final.pdf

Diabetes mortality analysis 2007-08

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