CO MPA S S
SUMMER 2022
Your Health and Wellbeing Guide
Mental Health and Summer
Men and Mental Health Managing common stressors for your neurodiverse colleagues
. . . S U L P
Cardiovascular disease in men
Breast Cancer – Get Aware
MORE + MORE Compass Magazine 1
Training Programmes at PAM Group We deliver quality, organisation and people – focused services with a vision of being the best and not the biggest.
We believe in innovation, agility and quality and to achieve that, our colleagues are supported to be the best they can be. We have over 50 colleagues attending PAM funded University courses. We deliver over 40 training, development and awareness sessions every month to our colleagues on a range of different topics.
PAM Group
The world of Occupational Health and workplace wellbeing is constantly developing. Encouraging our colleagues to keep abreast of developments, means our clients and their employees get the best and most up to date advice.
Our colleagues are supported in developing their writing skills and getting published is part of the achievement. Our e-learning platform is going from strength to strength, with a wealth of on-demand webinars for our colleagues from every avenue in the business.
PAM Academy facilitates the growth and development of all colleagues at PAM Group and supports the wider management team with evidence based learning, client focussed insight and delivery of recognised industry acceditations.
www.pamgroup.co.uk 2
Compass Magazine
CONTENTS COMPASS
Summer 2022
Your Health and Wellbeing Guide
12-13
Why use workplace health and wellbeing services including Occupational Health? Page 4-5 Tips on how to reduce back pain when sitting Page 6-7
6-7
Men and Mental Health Page 8-9
10-11
4-5
Cardiovascular disease in men Page 10-11 Mental Health and summer Page 12-13
18 14-15 16-17
Blood clots Page 14-15 Managing common stressors for your neurodiverse colleagues Page 16-17 Reasons why you should be using a balance board Page 18
Compass Magazine is published by PAM Group Ltd Contact us 73-75, Sankey St, Warrington WA1 1SL All rights reserved - Reproduction is strictly prohibited - Copyright 2021 © For more information visit www.pamgroup.co.uk Compass Magazine 3
BY JANET O’NEILL - CLINICAL EDUCATION DIRECTOR AT PAM GROUP
Why use workplace health and wellbeing services including Occupational Health? Many people reading this will not only commission, use or have Occupational Health (OH) services within their organisation but may very well have PAM Group as their provider. But as readers do you understand the full extent of what OH can or does contribute? If not, hopefully, this will be enlightening. Some organisations will view OH as necessary for managing their legal needs relating to Health and Safety, and some will see OH as an important tool in managing attendance (and we all know poor attendance can negatively impact people and the organisation). But increasingly OH is seen as part of a broader wellbeing strategy, especially because of Covid, which is encouraging for us in OH as we understand the impact positive health and wellness can have on people and organisations, for all sorts of reasons including workplace health and safety, attendance and wellbeing. What is so wonderful for OH professionals is to know that the positive impact they have in the workplace will also reverberate out into the wider social sphere, with a knock-on effect on personal lives.
Occupational Health is one of those services which has several roles and tasks, making up a wheel of health in the workplace and public health, which is why OH is being increasingly seen or spoken of as Workplace Health and Wellbeing.
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CIPD states that the role of OH is to
‘promote and maintain the health and wellbeing of employees, to ensure a positive relationship between an employee’s work and health’. However, we believe it goes far beyond that and many employers are now seeing workplace health and wellbeing as a comprehensive leadership service, advising on bespoke preventative (proactive) and reactive health. Individualisation is a very current term for people in the workplace and we’ve identified, following Covid, that every organisation needs to be seen as individual as well as the people in it. Every organisation has different requirements, cultures, risks and people. Getting to know the organisation is paramount for a good OH service when delivering services but also in supporting a health strategy. A partnership relationship elevates the outcomes significantly. Despite the whole person focus of the current definition, for OH, to be successful, we need to support the management and leadership team as the most important people in employees’ lives and the key stakeholders who facilitate effective use of OH services. OH, customer service to employees is a reflection of the organisation’s focus on health.
As health professionals, OH focus on people and health, taking our responsibilities relating to the care of the individual and public health seriously. OH, expertise is aimed at understanding how work can affect health and poor health be prevented as well as how individual health affects work. We understand the impact falling out of work has on both people and wider society and would like to prevent this as far as possible. OH, capability in workplace health includes the effect organisational culture can have on health in the workplace, as we consider the individual as a whole. This is called the Biopsychosocial Model, a framework developed by George L. Engel looking at interactions between biological, psychological, and social factors for the cause, manifestation, and outcome of wellbeing. One fact of life is that people are ageing. Without a retirement age or, with higher retirement age, people need or want to stay at work, This means that keeping healthy or managing health conditions effectively is even more paramount and as such OH health expertise is more important than ever.
But how? Well, Workplace Health and Wellbeing with Occupational Health is made up of experts. These experts come from different approaches to supporting organisations and their people depending on the goal of the organisation. OH is increasingly made up of a multidisciplinary team, and organisations may use one or many of these experts depending on their needs. Certainly, PAM Group has a significant range of experts enabling us to deliver a bespoke service tailored to the needs and requirements of the organisation. Commonly these experts would be OH Doctors, Nurses, and Technicians, Physiotherapists, Psychologists, Paramedics, Occupational Therapists, Physiologists, and Nutritionists. Many with an additional, specialist qualification in Occupational Health or workplace wellbeing and almost all being degree equivalent qualified, or higher as a few of our clinicians have PhD’s or are working towards this. First and foremost, OH needs to be able to give organisations strategic information and bespoke advice that is ongoing and evolving to meet demand. We are well versed in horizon scanning, i.e. understanding what health issues are coming up, keeping up with health research and changes to legislation including case law. At the start of this article, we talked about bespoke advice to the organisation, which includes gaining a deeper understanding of what OH do, but OH also produce statistics so that organisations gain health intelligence thereby enabling them to target interventions appropriately. It is the use of these statistics alongside the knowledge of health and work that can elevate an organisation’s management of health in the workplace. Strategic advice should include guidance on risks and health and safety which could range from psychological to physical health risks. Did you know, that 1.7 million people in the UK are reported to be suffering from work-related ill-health, far outweighing the 0.4 million
with a work-related injury (HSE 2021)? Next should be attendance policies, providing employers with insight into fitness criteria for certain roles, when individuals can be supported with their health to reduce the risk of absence or presenteeism. This marries well with the strategic advice around improving health and managing psychological risks to maximise the well-being of employees at work. Supporting managers and leaders in understanding the health of the employees from a holistic perspective is an important part of managing psychological risk, whilst maintaining an understanding of the needs of the organisation i.e. having that business perspective. Tactical advice from OH on wellbeing initiatives can help to improve general health and wellbeing, enabling employees to take ownership of their health but also to step into the gaps of the NHS by giving individualised health guidance can be really useful. Hopefully, you can see the holistic support and advice OH can provide to organisations which make the business case for investment. (https://www.som.org.uk/sites/som.org.
uk/files/Occupational_Health_The_ Value_Proposition_March_2022_0.pdf)
The range of services from OH can be quite significant, supporting anything that impacts the health and wellbeing of the working population, with the most common being musculoskeletal and mental health disorders. Therefore to be able to tap into this expertise for prevention, assessment of fitness for the role, and early access to treatment meet the needs of organisations as noted by Dame Carol Black as far back as 2008 https://www.gov.uk/government/
publications/working-for-a-healthiertomorrow-work-and-health-in-britain.
OH are also experts in chronic conditions that impact on work and the prevention or best management of these conditions such as diabetes and heart disease amongst many more.
Most modern OH services have a range of specialists or experts that can test for common conditions, assess for fitness in the role, and provide the expertise to enable employees to manage them well, for example, weight management programs and advice on specific individual abilities against the role. One such service we have in PAM is the Long Covid Workplace Rehabilitation Programme that enables us to use the multidisciplinary team in supporting the individual holistically whilst providing managers with advice on how to help that employee at work. Although health is our main focus, there are many employees who have difficulties in work that are related to their neurodiversity and therefore this has increasingly become part of our remit. OH understand that people are all different and need an individualised assessment alongside research and evidenced-based assessments. Our skill is to take these outcomes and match it to the role the person is required to do. A huge development that came out of Covid was the ability of OH to develop new services to match their client’s and their employee’s needs. This is still happening due to the ongoing momentum of changing health needs and capabilities in wider society. Health digitalisation, remote work, hybrid work, burnout, mental exhaustion, increased alcohol use, greater mental health awareness, leadership skills, compassion and care, neurodiversity, and an increased wish to understand epigenetics, the economy, NHS accessibility, a strive for general health and fitness are just some of the changing landscapes that Workplace Health and Wellbeing including Occupational Health keep up to date with and in some cases drive the agenda. I hope I have convinced you that Occupational Health is a unique branch of health that focuses on the employer, the employee and the wider economy with public health.
Compass Magazine 5
BY PAM HEALTH
Tips on how to reduce back pain when sitting Many people experience back pain when sitting but are relatively pain free when standing or moving around. This article covers the typical presentation of back pain which comes on when sitting, the likely causes, as well as tips for how to prevent and treat this type of back pain.
What is a typical presentation of someone who gets back pain when sitting? Many of us have experienced back pain when sitting. Usually, this is after we’ve been sitting for several hours, concentrating on work or after watching a particularly long film or play, whether at home or in a theatre. Back pain is common in students and other whose work or hobby involves sitting at a desk, people who do large amounts of driving, people who spend hours at a computer gaming, as well as anyone who remains seated for prolonged periods of time, as might occur following a lower limb injury or during a long commute by train or plane. Back pain when sitting might be felt in the low back, upper back or both. Pain typically starts as a ‘niggle’ and is not particularly distracting. However, over weeks and months, pain can become so bad that it affects daily activities, and it is not usually until we reach this point that we seek help.
What causes back pain when sitting? There are different types of back pain and the cause of all of these is not known. Assuming a person is relatively well and has not suffered trauma to the back, back pain which comes on when sitting but not when standing and moving about is most likely caused by the retention of a static posture, irrespective of what that posture is. This is because sitting requires muscular effort, often in the form of isometric contraction, and prolonged isometric contraction causes pain. This type of back pain is sometimes referred to as postural strain.
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No one would attempt to hold a house brick in an outstretched arm for a prolonged period of time, yet we often sit for hours on end, expecting the muscles of our back to support our sitting posture. Is it any wonder that they start to fatigue and become painful? Sitting also compresses tissues of the spine and again, this may be one of the causes of back pain when seated for prolonged periods. There are specific exercises that will help alleviate pain in each of these parts of the back, but in all cases, movement of the back is key to overcoming symptoms.
How to ease low back pain when sitting The best way to ease back pain from sitting is to get up and walk around for a couple of minutes. Walking moves the pelvis and the pelvis moves the lumbar spine. Walking therefore helps to mobilize the joints of the low back but it also permits muscles of the back and pelvis to change length. Best of all is to get up move before pain comes on, rather than trying to shake off the pain once it is established. For example, if pain comes on after sitting for 60 minutes, then advice would be to get up every 45-50 minutes.
If you’re looking to upgrade your office space to be ergonomic, we have a wide range of chairs, sit-stand desks and ergonomic accessories and much more. Visit our website to see our full range:
www.pamhealth.co.uk
Some exercises you can do while sitting can also ease lower back pain. •
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Start by simply pressing the lower back into the back of the chair and then sitting up straight again, repeated 5 times. This causes the lumbar spine to move from a position of extension (sitting upright), to one of flexion (pressing the low back into the chair). Actively lifting one knee at a time, or temporarily using a foot rest. Lifting the knees brings about hip flexion, a posterior tilt in the pelvis, and slight lumbar flexion. This is likely to be helpful of a person has been sitting in and upright posture.
•
•
•
•
Twisting around in the chair whilst keeping the feet facing forwards helps mobilize the back into a rotatory movement. This also helps stretch muscle of the low back. Hip hitching – raise one side of the pelvis at a time. This encourages lateral flexion of the spine. Stretching the psoas muscle has been postulated to help alleviate low back pain as this muscle originates on the lumbar spine and it is argued that when sitting, psoas is held in a shortened position, pulling the lumbar vertebrae anteriorly. Stretching this muscle helps reduce tension in it, theoretically reducing pull on lumbar vertebrae. Moving the spine when sitting is not as effective at reducing symptoms as getting up and moving around. Compass Magazine 7
BY PRAKASH SOLANKI – EAP COUNSELLOR MBACP AT PAM WELLBEING
Men and Mental Health Men’s Mental Health Week is 13th to 19th June 2022 to raise awareness on male mental health and what help is available. Many cases go undiagnosed and a true picture can be difficult. Men’s Forum Foundation provides some figures.
The Picture
Why don’t men talk about mental health? Society’s expectations and traditional gender roles play a part. Research shows that men who can’t speak openly about their emotions may be less able to recognise symptoms of mental health problems in themselves, and less likely to reach out. Men are more likely to use potentially harmful coping methods such as drugs or alcohol and are less likely to talk about their mental health.
Depression We tend to focus on the physical symptoms such as back pain, headaches, difficulty sleeping, or sexual problems. Resulting in the underlying depression going untreated. Men suffering from depression are four times more likely to take their own lives than women, so it’s vital to seek help
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•
Three times as many men as women die by suicide.
•
Men are less likely to access psychological therapies than women: only 36% of referrals to NHS talking therapies are for men.
before despair becomes feelings of suicide. Talk with a friend, loved one, or doctor. There is plenty you can do to successfully treat and manage male depression and prevent it from coming back.
Signs and symptoms in men A man is more likely to hide his feelings them from himself and others, or to mask them with other behaviours. While men may experience symptoms of depression such as despondent mood, loss of interest, sleep disturbances, and concentration problems, they are more likely than women to experience “stealth” depression symptoms such as anger, substance abuse, and agitation. Sometimes depression in men shows up as physical symptoms—such as backache, frequent headaches, sleep problems, sexual dysfunction, or digestive disorders—that don’t respond to normal treatment.
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Nearly three-quarters of adults who go missing are
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Men are nearly three times as likely as women to become alcohol dependent, and to report frequent drug use.
Anger could range from irritability, sensitivity to criticism, or a loss of your sense of humour to road rage, a short temper, or even violence. A man may exhibit escapist or risky behaviour such as pursuing dangerous sports, driving recklessly, or engaging in unsafe sex. You might drink too much, abuse drugs, or gamble compulsively. There’s no single cause of depression in men. Biological, psychological, and social factors all play a part, as do lifestyle choices, relationships, and coping skills.
Getting help It takes courage to seek help—from a loved one or a professional. Most men respond well to self-help steps such as reaching out for social support, exercising, switching to a healthy diet, and making other lifestyle changes. You’ll feel a little better each day. Many men recovering notice improvements in sleep patterns and appetite before improvements in their mood.
Self Help Tip 1: Seek social support
Research suggests men will access help that meets their preferences and is easy to access, meaningful and engaging. For example, Men’s Sheds provides community spaces for men to connect and chat, often over practical activities. The person you talk to just needs to listen without judging you. Join a support group. Being with others dealing with depression can go a long way in reducing your sense of isolation. Mind’s online community, Side by Side, is a place you can be heard.
Tip 2: Support your health
Aim for eight hours of sleep. Keep stress in check. Figure out all the things in your life that stress you out, such as work overload, money problems, or unsupportive relationships, and find ways to regain control. Getting outside during daytime can help boost serotonin levels and improve your mood.
Tip 3: Exercise
Research shows that regular exercise can be as effective as medication for relieving depression symptoms. It also helps prevent relapse once you’re well. A 10-minute walk can improve your mood for two hours. Small steps regularly can compound more easily. Most beneficial are continuous and rhythmic exercises—such as walking, weight training, swimming—where you move both your arms and legs.
Tip 4: Eat a healthy diet
Sugary snacks, baked goods, or comfort foods quickly lead to a crash in mood and energy. Reduce caffeine and alcohol. Eat more Omega-3 fatty acids for a mood boost. The best sources are fatty fish, seaweed, flaxseed, and walnuts. Try foods such as bananas (decrease anxiety, increase alertness, and spinach (reduce agitation, improve sleep). Avoid deficiencies in B vitamins, eat more citrus fruit, leafy greens, beans, chicken and eggs.
Tip 5: Challenge negative thinking
Once you identify the destructive thoughts patterns, you can start to challenge them with questions such as: “What’s the evidence that this thought is true? Not true?” “What would I tell a friend who had this thought?” As you cross-examine your thoughts, you may be surprised at how quickly they crumble. In the process, you’ll develop a more balanced perspective and help to relieve your depression.
Other Resources:
References:
https://sidebyside.mind.org.uk https://menssheds.org.uk https://andysmanclub.co.uk
Men’s Mental Health Forum https://www.helpguide.org/articles/ depression/depression-in-men.htm Mind
Help Professional treatment for depression If support from family and friends and positive lifestyle changes aren’t enough, seek help from a mental health professional. Be open about how you’re feeling including your physical symptoms. Therapy – If therapy is available to you, it can often bring a swift sense of relief. Medication – Antidepressant medication can help relieve some symptoms of depression, but it doesn’t cure the underlying problem. If you decide that medication is right for you, always pursue self-help steps as well. Therapy and lifestyle changes can address the underlying causes of your depression to prevent it returning when you’re able to come off antidepressants. Help Available: Talk to the Samaritans. Shout Crisis Text Line. Rethink Mental Illness. Mind. Tell someone you trust. Talk to your GP. Specialist mental health services. How to help a man with depression? Suggest a general check-up with a physician. He may be less resistant to seeing a family doctor than a mental health specialist at first. Listen without judgement. Don’t make light of any of the feelings he expresses, but do point out realities and offer hope. Take any remarks about suicide seriously. If he’s prescribed antidepressants, encourage him to follow orders about the use of alcohol. Remember, you can’t take responsibility for someone else’s depression, however your support can be crucial. There is help as opposed to suffering in silence and hopefully this article encourages reaching for help or selfhelp and not remain isolated. Compass Magazine 9
BY ToHealth
Cardiovascular Disease in Men Cardiovascular disease is the leading cause of death for men in the UK and research suggests that around
80%
of it is preventable through diet.
Fat intake is considered a contributing factor but there is often confusion around nutrition findings and recommendations. In reality, there are several different types of fats including trans fats, saturated fats and unsaturated fats. Trans fats, such as those found in margarine can result in a host of health problems as they can cause cells to become stiff, increasing inflammation and accelerating ageing. Saturated fats are commonly found in animal products such as butter, cheese and processed meats. There is an abundance of research linking high dietary intakes of saturated fats with raised cholesterol levels and therefore an increased risk of cardiovascular disease (British Nutrition Foundation, 2019).
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The current recommendations are not to exceed more than 10% of total energy intake from saturated fats, and to replace them with unsaturated fats when possible (British Nutrition Foundation, 2019). For men, the recommendation is no more than 30 grams per day and for women, no more than 20 grams per day (NHS Live Well website, 2020). Unsaturated fats are found primarily in oils from plants and oily fish. These fats can be further broken down into polyunsaturated or monounsaturated fats. Increasing amounts of unsaturated fats in the diet can help to maintain or reduce blood cholesterol levels, which can decrease the risk of heart disease and may help reduce the risk of type 2 diabetes. Remember, some fat in the diet is essential, it is the excessive amounts that can lead to carrying excess weight and elevate body fat, increasing risk of cardiovascular disease, insulin resistance and type 2 diabetes.
Whilst understanding the different types of fats and their impact on health is important, it must also be said that cholesterol is not completely bad. It is vital and the human body cannot function correctly without it.
More and more research is demonstrating that higher LDL blood cholesterol readings may also be affected by poor gut health, stress and certain genetic factors.
An introduction to cholesterol
Nature v Nurture
LDL and HDL aren’t actually cholesterol – they are the lipoproteins which transport cholesterol around the body. They are also responsible for transporting fatty acids, amino acids, vitamins and minerals etc.
Genes can influence cholesterol levels and how it is used throughout the body. For instance, choline found in foods such as chicken, salmon, beef and eggs will affect the gene and enzyme PEMT (Phosphatidylethanolamine¬ N¬methyltransferase). This plays and integral part in keeping the cell membrane healthy.
Cholesterol forms the membrane of the cell which is essential for its effective functioning. It is also extremely important for keeping cells healthy, as each time a cell is damaged or gets replaced, cholesterol is required. This is especially true when training or exercising regularly, as cholesterol is needed to repair the damage sustained to muscles. In a normal situation, healthy cholesterol gets transported around the body to cells by LDL. Once it arrives a tiny piece is removed, with the remainder being transported by HDL back to the liver to be recycled. This reduces the chances of cholesterol building up. It is also where the relationship between an unhealthy gut, cholesterol and cardiovascular disease comes into play.
The Gut Each of us has over 100 trillion bacteria within our gut. The bacteria is required to metabolise the foods that we eat each day, turning them into fatty acids, proteins, amino acids and metabolising vitamins and minerals. The highest concentration of immune cells are also found within the gut. The proposed reason for this is the exposure of the gut to the external environment. Immune cells are separated by the gut barrier and if this becomes run down and compromised then immune cells can start to kill the bacteria within the gut, attacking the bacterial membrane. The bacterial membrane is also made up of an endotoxin, which then gets taken into the blood stream and binds to LDL cholesterol through ‘docking sites’. The ‘docking sites’ that the endotoxin use are the same as those used by cholesterol. This can create a problem as cholesterol cannot get back to the liver, leaving it in circulation. Immune cells then attack the endotoxin bound to the LDL, resulting in a prolonged immune response. As the immune system cannot destroy the LDL, inflammation results. This may contribute to plaque formation on the LDL particle.
Phosphatidylcholine is required for the liver to secrete triglycerides into very low-density lipoproteins (VLDL cholesterol). The gene ApoE encodes for lipoproteins that bind to cholesterol and recycles it back to the liver. 1 in 4 of us will have a specific variant of ApoE that reduces our ability to recycle LDL effectively and possibly, lead to higher blood readings. These individuals may find that they have a family history of high cholesterol and an increased risk of needing pharmaceutical intervention. Some people also have a variant which makes them more able to recycle LDL. Of course the majority of us sit in the middle where our diet and lifestyle are major factors in its regulation. It’s very easy to see how the body can become compromised and inflamed. Bacteria and immune cells within the gut are separated by a substance called mucin, which looks a little bit like mucus. Having healthy mucin is extremely important in stopping immune cells from attacking the gut bacteria and causing elevated levels of inflammation. In order for the gut cells to make mucin, they require energy and gut bacteria prefers this energy to come from short chain fatty acids. These can be made up from fermentable fibres such as beans, legumes and sauerkraut and are often referred to as prebiotics. These foods get fermented by commensal (good) bacteria in the gut, making short chain fatty acids such as lactate, butyrate, propionate and acetate.
With 70-90% of the energy created going to fuel the cells and making mucin, it is understandable how important these foods and nutrients are to improving gut health, reducing inflammation and avoiding harmful
Compass Magazine 11
BY KENNY RALPH – DEPUTY TRAUMA MANAGER AT PAM WELLBEING
Mental Health and Summer
Whisper it, but summer is nearly here! This year the 21st of June marks the official start of summer. While most of us look forward to the longer evenings and the (hopefully!) warmer weather, summer can bring with it some challenges to our mental health and wellbeing. We’re going to look at some of the challenges today, and offer some solutions.
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1. Loss of Routine
3. Exercise
Routine can be an incredibly important aspect of maintaining our wellbeing, particularly for those that suffer from any common mental health issues such as depression and anxiety. It’s so easy to lose our routine during the warmer months; staying up later than we usually would; keeping children occupied all day, every day. If you have kids at University, it may mean putting up with the disruption of having them back home again! You may also have some time away planned, this can frequently lead to unintended changes to our sleep and eating habits, amongst others. While it is definitely important to make the most of our time, we need to be careful that we don’t accidentally sacrifice our routine. So try to stick to your normal routines when it comes to going to bed, waking up and eating, regardless of the weather outside.
Regular exercise is effective at alleviating symptoms of mild to moderate depression and anxiety. (1) Doing 30 minutes three to 5 times a week has been shown to be beneficial but as little as 10 minutes a day can also make a difference, so try to keep active and take advantage of the improved weather by taking regular exercise. Being in nature and spending time with friends and loved ones are other ways of boosting our moods, so we’d advise trying to kill as many birds with as few stones as possible by going for a walk with a friend or family member in nature. You’ll get the benefit of exercise and all the endorphins that it brings as well as extra serotonin and endorphins from being out in nature. By spending time with people we care about and feel close to, we’ll benefit from the release of oxytocin, another one of our feel-good hormones. Research has shown that low levels of oxytocin have been linked with symptoms of depression. (2) So a relatively simple action, such as going for a walk with a friend in nature can have a disproportionately positive benefit!
2. The Heat Although most of us look forward to more warmth, excess heat can be difficult to adjust to, and it can have a profound impact on our wellbeing if we don’t make adjustments. So make sure to change your heavy winter duvet to a lighter summer one. When it’s hot we use more fluids, so make sure to keep well hydrated. The heat can also bring it’s challenges in a less direct way; for those who have body image issues. As it gets hotter we generally have to remove clothing to compensate. Those who suffer with body image issues may feel very embarrassed in swimwear and may choose to dress as they would normally, thus becoming uncomfortable, or they may withdraw from social occasions to avoid any embarrassment. Being sensitive to how others may feel can in and of itself be helpful in making someone feel more comfortable.
4. Ask for help It sounds simple, and it can be, but it can also be very difficult. If you notice levels of anxiety rising, or if there are signs of becoming depressed, try to step into the process as soon as you see the first signs. The earlier you take action the better. So, no matter what time of year, get help. Talk to your GP, or a therapist, call your EAP, or talk to a trusted friend or loved one. Sometimes acknowledging that we’re struggling can feel like a failure, but the sooner we ask for help the sooner we can return to feeling like our normal selves.
5. Plan ahead For some of us, the pressure we feel, coming from both external and internal sources, to make the most of summer can take away from our enjoyment of this time of year. Planning our activities in advance can be a really useful way of maximising the fun and satisfaction that summer can help us provide. Also, having something to look forward to can help mitigate stress in the present moment. We may like the idea of being spontaneous, and there’s certainly nothing wrong with it, but by diarising our activities in advance, we can bring peace of mind and enjoy the anticipation that comes from having something to look forward to.
References: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depressionand-exercise/art-20046495
Compass Magazine 13
BY STEPHANIE FOSTER - CLINICAL TRAINING LEAD AT PAM GROUP
Blood clots Thrombosis (Blood clots) are a major cause of death and disability and can affect anyone at any age. However, many of us have little or no knowledge about the condition, including what signs to look out for, who is at most risk and what we can do to reduce this. Blood clots are a normal response to an injury. They form due to a chemical reaction between specialist blood cells called platelets and proteins known as clotting factors. They stop bleeding from an injured blood vessel by forming a semi solid clump, plugging the wound preventing further blood loss. The clot then dissolves over time as the blood vessel heals. So, as you can see, they are essential to keeping us alive. Unfortunately, sometimes blood clots can break free or form when there isn’t an injury and end up blocking a blood vessel. This can reduce or stop the flow of blood and oxygen to an organ, which without prompt medical treatment can be life threatening. NICE highlight that Thrombosis is the third most common cardiovascular disease after heart attacks and stroke (NICE 2022).
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Thrombosis, most often occur in the deep veins of the legs, but they can also form in the arms or abdomen. Commonly referred to as a Deep Vein Thrombosis (DVT) symptoms include:
If you suspect you or someone you know has a DVT it is essential to seek medical help as soon as possible. Getting prompt treatment can reduce the risk of life threatening or life changing complications.
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A study in Norway showed having a DVT in your leg can affect your ability to work and carry out normal daily activity. They noted an 80% increased risk of long-term disability compared to someone without the condition (Brækkan et al., 2016).
• • • •
throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh swelling in 1 leg (rarely both legs) warm skin around the painful area red or darkened skin around the painful area swollen veins that are hard or sore when you touch them
This was mainly due to Post Thrombotic Syndrome (PTS). The DVT causes permanent damage to the valves in the veins which can lead to long term problems with chronic leg pain, fatigue, swelling, loss of sensation and permanent discoloration of the skin.
PTS can also result in recurrent leg ulcers, which are hard to treat. These symptoms can make activities such as prolonged periods of walking or standing difficult. Sitting for long times can also be a problem as it can be difficult to manage swelling. Understandably this can have a big impact on mental well-being and quality of life. The charity Thrombosis UK state that “Up to 30% of people who have had thrombosis in the leg will develop some post thrombotic symptoms within five years.” Where the blood flow has been significantly disrupted for a long time, there may be severe tissue damage and amputation may become necessary. An embolism is a dangerous and potentially life-threatening complication of a Thrombosis or DVT. This is where part of the blood clot breaks away and is carried to another part of the body. If it lodges in and blocks a blood vessel in the heart, it can trigger angina or a heart attack. While if it reaches the brain, it can cause a stroke. If it reaches the lungs, it can cause a Pulmonary Embolism
“If left untreated, about 1 in 10 people with a DVT will develop a pulmonary embolism” If you experience symptoms of a PE you should seek urgent medical advice as it can be life threatening. • Sudden shortness of breath • Chest pain-sharp, stabbing; that may get worse with deep breaths • A rapid heart rate • Unexplained cough, sometimes with blood-streaked mucus
Who is at risk? Normally blood clotting occurs in response to an injury, but some health conditions or lifestyle choices can make it easier for them to form. This is because of one or more of the following factors: • reduced blood flow • changes in the blood vessel walls such as inflammation or injury,
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or changes in the blood that make the platelets stickier.
This is more likely to happen: During prolonged periods of sitting or being immobile. When we walk and move the calf muscle contracts and squeezes the leg veins helping the blood flow. So conversely when our legs are still for a long time, such as when traveling long distance or sitting at a desk, the blood flow is reduced, increasing the risk of clots forming. Thrombosis UK emphasise “Sitting for 90 minutes reduces the blood flow behind your knees by 50% - increasing the risk of blood clots” Recovering from surgery or injury. The highest incidence of Thrombosis is associated with being hospitalised following illness, injury, or surgery. Blood clots form normally in response to trauma, plus mobility tends to be limited. To reduce the risk of blood clots forming in the first place you may be given blood thinning injections and encouraged to wear compression stockings. Prevention is always better than cure. After a diagnosis of cancer and some types of cancer treatment. Inflammation and changes in blood chemistry, coupled with fatigue and side effects limiting movement can all increase the risk. During pregnancy. Hormonal changes encourage blood clotting to reduce blood loss during labour and delivery. Towards the end of pregnancy, the blood flow to the legs and pelvis may be reduced because the growing baby is pressing on the blood vessels around the pelvis. Physical activity and movement may also become more difficult as baby gets larger. The risk remains higher until 3 months after baby is born. Having treatment with female hormones. These mimic the changes in pregnancy.
can also increase your risk such as diabetes, kidney and respiratory conditions. Heart disease can result in plaques forming narrowing the blood vessels and increasing the risk of blood clots. Atrial fibrillation (a type of irregular heartbeat) or a damaged heart valve can reduce blood flow through the heart, increasing the risk. That is why people with these conditions are often given “blood thinners” to help offset the risk. There is also an associated increased risk of blood clots related to a COVID 19 infection. Due to lifestyle issues. Being overweight is an increased risk factor. As is smoking, as this changes the surface of the platelets making them “stickier.” Having had a previous blood clot: Unfortunately, if you have had one in the past, you are more likely to have a future clot.
How to reduce your risk While having a healthy lifestyle is important, remaining active is essential, our bodies are not designed to stay still for long periods of time. If sitting: • avoid sitting crossed legged • get up and move every 90 minutes. If you can’t, make sure you do leg exercises to pump the calves to help blood flow. • on long trips wear flight socks • keep well hydrated • and if you work in a sedentary role, make sure you take your lunch away from your desk. Taking a walk at lunch time away from your desk, not only helps your mental health, but could quite literally be a life saver.
Having an underlying health issue which increases your risk. Such as an inherited blood clotting disorder (thrombophilia). Other health issues
References:
disability’, Journal of thrombosis and haemostasis : JTH, 14(10), pp. 1978–1987. doi:10.1111/jth.13411.
https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
Pulmonary Embolism: How common is it (2022) NICE. Available at: https://cks.nice.org.uk/topics/
Thrombosis UK https://thrombosisuk.org/signs-symptoms.php
pulmonary-embolism/background-information/prevalence/
Brækkan, S.K et al. (2016) ‘Venous thromboembolism and subsequent permanent work-related
Thrombosis UK (no date). Available at: https://thrombosisuk.org/post-thrombotic-syndrome.php Compass Magazine 15
BY ToHealth
Managing common stressors for your
NEURODIVERSE colleagues
The past few years has seen stress levels soar. In fact, a recent study by The Stress Management Society, in partnership with Huawei AppGallery and Headspace, identified that 65% of people in the UK felt more stressed than ever before, since COVID-19 restrictions began in March 2020. With the spotlight firmly on stress and its negative effects, a positive outcome has seen increased awareness of the importance of supporting mental health. Unfortunately, even though there is increased awareness, a study by MIND found that 30% of employees would feel uncomfortable talking to their manager about feeling stressed. These statistics demonstrate a need for organisations to implement strategies that support the mental health of their workforce. In doing so, organisations will benefit from reduced absenteeism, increased productivity and a more cohesive workforce. As the topic of mental health grows, let’s not forgot our neurodiverse colleagues. Stress may manifest itself in different ways compared to their neurotypical counterparts. This could lead to an increased susceptibility to mental-ill health. Whilst this isn’t always the case, having an awareness of possible additional stressors and potential coping mechanisms can support a more inclusive, happy and diverse workforce.
Potential stressors Potential stressors can include: • The office environment itself • Distractions • Workload pressure • Unexpected changes to working patterns 16 Compass Magazine
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Receiving incomplete information to effectively carry out the job role Training that doesn’t support an individual’s learning style
to focus. These headsets often have an on/off switch enabling the user to easily converse with colleagues, ensuring they do not feel socially isolated.
Open plan offices can appear more appealing. They do; however, tend to have more reflective surfaces and allow sound to travel further. Lighting can also be harsher and overly bright. For an individual who is neurodiverse, these elements can create a form of ‘sensory overload’ which can have an impact on emotional wellbeing. Neurodiverse colleagues, particularly those with Sensory Processing Disorder (SPD), Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Condition (ASC) may experience difficulties when faced with too much stimulus. This can result in feeling overwhelmed, creating a loss in focus and a general sense of discomfort. It is important to therefore consider sound absorption in the office, the reflective properties of surfaces, natural light, quiet areas and the use of low stimulant colours on walls. Biophilic design can also positively impact mood.
Working memory is necessary for taking on new information. It can be a challenge for colleagues with ADHD, Dyslexia, Dyspraxia, Dyscalculia and ASC. Pressure at work can negatively affect ‘working memory’ and for an individual who already struggles with this, additional worries, doubts and fears (whether they come from personal or work life) can further exacerbate the problem.
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As specific sounds within the office can create a negative physiological response, a consideration could be to invest in good quality ‘active’ noise cancelling headphones. This is a hybrid of standard noise cancellation that uses a microphone and speakers to reduce background and white noise, providing an opportunity to achieve a quiet space
Executive function skills enable an individual to manage time, concentrate, plan, organise and multi-task. Disordered executive functioning can interfere with the ability to do these tasks and can be a struggle for those with ADHD, ASC and Tourette’s Syndrome. It can also prove to be an obstacle for individuals struggling with their mental health such as those experiencing depression, anxiety, OCD, Schizophrenia and Bipolar Disorder. Add to this the pressure of targets, time constraints, unexpected changes in procedures/ tasks, complex tasks that have not been fully explained (leading to gaps in knowledge) and a situation of elevated stress and coping difficulties may arise.
Coping Strategies: Coping Strategy Coaching with experienced coaches, trained in working with both Neurodiverse and Neurotypical people is available to those who need it. This one-to-one coaching explores an individual’s learning style and strengths, and enables them to develop strategies and effective working methods to overcome their barriers in the workplace. Co-coaching sessions with their manager can also prove beneficial (if required). It can open up communication, develop relationships and create a greater understanding of difficulties, as well as identify opportunities to improve areas of working, together. One of the many coping strategies that could be used and developed during coaching time, is the Pomodoro Technique. This technique promotes focused concentration time with planned breaks. Francesco Cirillo coined the term back in the 1980’s and since then, it has grown in popularity. For a neurodiverse individual, this technique can prove useful when confronted with larger tasks. Breaking them down into more manageable tasks can make them appear more achievable.
How it works: 1. 2. 3. 4.
Set a timer for 25 minutes, then take a 5-minute break (also timed). When you have completed the 4th sprint, take a 20–30-minute break. Repeat until your allotted working period is complete. If 25 minutes is too much, cut it down to 20 and build up.
Why it works: It can be difficult for some neurodiverse individuals to initiate activity, without seeing an end to the particular activity. Focussing for longer periods of time can also prove challenging for those who are easily distracted. With the Pomodoro technique, an individual gets structure. There is a clear beginning and end to each sprint, this allows that individual to work with the time they have available, instead of working against it.
An optimised workspace can be developed individually or with a Coach. By optimising the workspace, a colleague proactively ensures that they have everything they need for their working day before they start, minimising the chance of distractions. Optimising the workspace is useful for neurodiverse individuals who are easily distracted and need help organising their workspace. Coping Strategy Coaching is developed around the individual and one technique does not fit all, it is there to create a toolkit of strategies to enable that individual to achieve, in the workplace.
Assistive Technologies To be proficient and productive, we all need the right tools at work. By having a clear understanding of the types of assistive technologies available, organisations can empower their neurodiverse colleagues to succeed. Some examples include: Mind mapping Software This software enables: • Easy categorisation • Contextualisation • Simplification
Text to speech This software offers: • Read aloud facility • Screen masking • Advanced spelling and grammar • Dictionary
Why it works Speech to text software can be useful for dyslexic colleagues, as it allows scripting. This can reduce the need for writing. Text to speech software can prove beneficial as it speaks the text while an individual is reading the text. This can increase retention for those who struggle with information processing. Mind mapping software can be particularly beneficial to individuals who are visual thinkers, those who are creative and those who may be overwhelmed by reams of text. Neurotypical strategies for supporting mental health can also prove useful for neurodiverse colleagues; however, understanding the impact of the additional stressors that neurodiverse colleagues may be experiencing in the workplace, is a good step in proactively addressing overall mental health.
Speech to text This software enables: • Easy dictation Compass Magazine 17
BY 66FIT
Reasons why you should be using a balance board Whether you are walking, lifting weights, running or even just cleaning the house, you are using muscles and joints to perform movement. Particularly, you are using your balance and core strength to maintain the correct posture throughout these actions and prevent you from falling or hurting yourself. Balance is an especially important health component of fitness along with flexibility, cardiovascular endurance and muscular strength, and as the rest of them, it can be trained and improved. A great way to do so, is by using a balance board. Balance boards can be incorporated in your gym or home workouts, and they can be used to perform an array of compound and combination exercises, from single leg squats all the way to mountain climbers. PROPRIOCEPTION: THE KEY TO STRENGTH AND REDUCED INJURY Balance boards have been used for years to condition athletes to not only improve their balance, but also their core strength, so to reduce the risk of suffering from injuries. In fact, this fitness equipment was found to be specifically useful to reduce the incidence of ankle sprains through training athletes’ proprioception. Proprioception can be described as one’s awareness of his or her own
body parts at resting states as well as the reception of both conscious and unconscious stimuli. Ultimately, proprioceptive training leads to improved ability to perceive posture, speed of movement and resistance. Balance boards enable you to improve your proprioception via the ability to offer sensorimotor-focused training alternatives to conventional exercises. This is achieved thanks to the unstable working surface of the balance board, which forces you to contract the correct muscles to maintain stability and perform a given exercise as smoothly and controlled as possible. IMPROVED BALANCE CAN HELP YOU SUCCEED IN YOUR FITNESS JOURNEY Due to the increased stability requirements to maintain a correct posture throughout the exercise, balance boards can be a perfect way to also improve reflex and reaction time, as new muscles would need to be promptly tensed to keep yourself up whenever
you are about to lose your balance or switch position. But more importantly, by developing a stronger abdomen, you will also be able to gain more strength while also keeping a correct posture throughout the execution of weightlifting exercises, as one of the keys to safely lifting heavy is a well engaged core. Another incredible benefit of this fitness tool is the opportunity to improve joint stability, which is ultimately linked to decreased risk to incur into injuries. This is thanks to the conditioning ankles, knees and their ligaments are exposed to when working on unstable surfaces. By decreasing injury occurrence, you are also able to progress faster and better at the gym, as you won’t have to deal with long recovery periods. This suggests that balance board are useful for athletes, as well as for that portion of population that is at higher risk of falling, such as the elderlies or those who already incurred in ankle sprains in the past.
Shaped To Fit Your Regime We have a range of balance boards available on our website, from plastic boards, wooden boards or, why not try a core trainer?
www.66fit.co.uk 18 Compass Magazine
Compass Magazine wishes to thank its contributors from PAM Groups businesses:
PAM OH Solutions is a national Occupational Health provider. We work with clients across all industry sectors, delivering a flexible range of high quality, pro-active and cost-effective services. Combining the traditional values of professional integrity and good customer service with a modern progressive approach to service delivery.
We deliver efficient and fit for purpose Occupational Health solutions to improve attendance and reduce absence in full compliance with legislation. Our approach extends beyond simply providing a reactive management referral service, we aim to forge strong working relationships with our clients, working in partnership to deliver tailored absence management solutions.
PAM Wellbeing was born out of a need to support our customers and their employees from a holistic health and wellbeing perspective in 2009, expanding on the physical health and rehabilitation services that our occupational health sister company has expertly provided since 2004.
a strategic wellbeing partner to support their employee’s whole health and wellbeing needs, and for their employees to benefit from the multidisciplinary expertise of our extensive team.
Our suite of mental health, psychological and wellbeing solutions enables organisations the option to engage with
PAM Health is one of the UK’s leading healthcare-product suppliers. Based in Liverpool, providing a wide range of solutions to workplace-health challenges including:
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Posture and musculoskeletal problems Chronic neck and back pain Carpal tunnel syndrome Headaches and migraines
We work strategically to implement proactive workplace mental health and wellbeing solutions, to help organisations and their people thrive.
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Injuries to employees Hygiene and infection control
Working in partnership with all of PAM Group, we provide a range of products to assist with continued occupational health processes. From ergonomic chairs to sit/stand desks and everything in between.
Compass Magazine 19
Holly House, 73-75 Sankey Street, Warrington, WA1 1SL
20 Compass Magazine