Tuesday 25 June 2019

Stepping out - how Ireland is out of sync with international fitness


Illustration: Eorna Walton
Illustration: Eorna Walton

Maurice Gueret

Ireland has gone missing and could be out of step with a new international fitness study, writes our GP from the top of his greasy pole.

Lazy Assumption

It was reported over the summer that the Irish are distinctly average when it comes to stepping out. Hong Kong citizens are leading the human activity charts with 6,880 steps every day, followed closely by one billion mainland Chinese, who are also comfortably over the 6,000 mark. Close behind are the Japanese, marching Ukrainians and sweaty Spaniards, who must be bidding a hasty adios to marauding bulls. Malaysia, Indonesia, Saudi Arabia and India occupy the other end of the scales.

They come in for international criticism alleging sluggishness. I would have thought that conserving energy in a punishing climate is a true mark of wisdom. Though smartphone data was collected from over 100 countries, just 46 were included in the final study. Ireland was not one of them.

Reports of us being average made the lazy assumption that we probably take the same 5,444 steps a day as our UK neighbours. Don't they know that we all now sleep in Lycra and have a new Dear Leader to step in unison with at a quarter to seven each morning?

Miss Fitbit

Some folk are not taking this new obsession with steps lying down. The deputy head of a girl's academy in England has taken an even wiser step, banning Fitbits, smartwatches and phone apps that measure calories and exercise from her school. "Our pupils are fit and healthy young women," she said "and do not need to be obsessed with steps or calories." This swift action followed reports that in order

to meet targets on their electronic nagging devices, some pupils were skipping lunch to go jogging. Teacher knows best.

Arise, Doctor Cowen

The chattering classes were horrified this summer to learn that erstwhile Dear Leader Brian Cowen had been made an honorary doctor by the National University of Ireland.

His new degree is in law, so it's unlikely that Dr Cowen will be opening up a surgery in the midlands any time soon. I wasn't invited to the ceremony, but am reliably informed that it included a rare quote from Benjamin Disraeli about prime ministers being on the top of greasy poles.

The slide from an Irish greasy pole must be greatly eased by a pension for life of €137,000 that can be drawn down from the ludicrously tender age of 51 and a half.

Finishing Course

The medical world is in turmoil about whether you should finish your course of antibiotics. I tend towards yes, unless your treatment is making you very sick, or your doctor advises otherwise.

As students, the benefits of full 7 to 10 day courses were regularly extolled to us. Heavy sinus infections might take 14 to 21 days to clear, while some urinary tract infections may just require 5. Of course, we do need to prescribe human antibiotics judiciously. But the really scary problems are surfacing in animal populations.

What is happening at present with MRSA and Danish pig products is a warning the world must heed. We can do our bit in medicine, but intensive-farming units are far greater potential enemies than those that administer intensive care.

Admissions Ward

The Health Research Board have released their annual report on activity in psychiatric units for 2016. GPs can struggle to find out basic contact information about mental-health services, so it's a tribute to the HRB researchers that they can come up with such quality data from phantom services. I have been crunching the figures to discover that there are just under 50 admissions every day in Ireland.

Depression, schizophrenia, mania and alcoholism account for most. Highest rates of admissions were people aged 20 to 24. Lowest rates were for those between 25 and 34. Now that's hard to explain. In the old days, we might think that marriage was a factor, but the average age of grooms in Ireland is about 35, and for brides it's 33. A huge 41pc of all patients admitted were unemployed, which suggests to me that equipping patients with new skills and assisting them find future employment is every bit as important in psychiatry as medication and talking therapy.

There is one statistic that should bring deep shame to all who oversee our health services - 67 children were admitted to adult psychiatric units in 2016. In a civilised country, even one such admission should be made a criminal offence.

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