The HORRIFYING History of Leprosy

of all the diseases that have plagued humanity very few carry such a heavy
stigma as leprosy, even the word conjures images of the untouchable the unclean and those who lose body parts though. In reality it is a very different disease it is an illness that is perhaps not widely understood yet is widely known about with myths and prejudice clouding what the disease truly means.

For those who are affected whilst you may believe that the disease
is from a bygone medieval age it still affects around 200 000 people per year. In today's BLOG we will cover the history of leprosy how we have sought to combat the disease and how we have treated those who were affected by such a horrendous illness.

leprosy also known as hansen's disease is an infectious illness that primarily affects a person's skin and the peripheral nervous system it is caused by the bacteria mycobacterium leprey it cannot be spread by casual contact such as shaking hands or merely sitting near

an infected person nor can it be spread via sexual contact or spread in the uterus leprosy is mainly spread via airborne droplets often through coughing or sneezing by someone who is affected by the disease

infection rates will vary depending on the health of those exposed leprosy will tend to only infect those with a poor immune system those who are malnourished and those who live in poor conditions what's more around 95 percent of people are naturally immune to leprosy meaning the disease will never affect most people even when infected the disease is so slow to reproduce that

it can take years for symptoms to come to light it is important to note that whilst we have some idea as to how the disease spreads we are still not 100 certain this is because the disease is difficult to grow outside of a living body making it very difficult to study it is important to start with the myth that leprosy can cause the loss of limbs toes or fingers or that flesh will simply fall away from the body this is not the case leprosy is not a flesh-eating bacterium that will devour a person's body rather the infection damages the skin and nervous system which will often result in a person losing all sensation in the hands and feet often cuts and damage to the extremities will go unnoticed leading to infections that if untreated will cause damage the digits on a person's hand can

however be reabsorbed by the body giving the impression they have fallen off corneal ulcers or blindness can also occur if facial nerves are affected due to loss of sensation of the eye leprosy often results in lesions on the skin other signs of advanced leprosy can also include the loss of eyebrows and nose deformity from damage to the nasal septum in men their testicles can also be damaged resulting in infertility leprosy is perhaps one of the oldest illnesses that has affected humanity

there is evidence that leprosy wasactive in the indian subcontinent as early as 2000 bce leprosy was identified as a disease as early as 600 bce both by indian and chinese doctors it is thought that one of the first vectors for the disease to spread were the armies of alexander the great from his invasion of india in the 4th century bce from there it was spread to north africa before being picked up by the roman empire as the disease was not widely understood many ill-devised treatments were developed to deal with leprosy

one such treatment involved bathing in the blood of lambs children are virgins as a form of purification ritual as it was believed that the disease was a punishment from god for some sin other doctors attempted the use of venoms and poisons to kill the infection but by far the most horrific solution to leprosy patients was the implementation of leper colonies at this point it is perhaps important to note that the term leper is no longer the accepted term for

a person suffering with leprosy due to the treatment and practices of the leper colonies such colonies became widespread during the middle ages and were used to contain and quarantine leprosy patients as well as others suffering from a variety of other skin conditions these colonies would be built in isolated areas away from the rest of the populations and were often run by the church the goal of the colony would be to separate the affected from the healthy as a means to stop the spread of the disease

leprosy patients would be made to wear clothing that marked them as lepers and would be made to carry a bell to warn others of their proximity many leper or lazar houses were established in england between the 11th and 14th centuries

often the patients would beg for food and money in exchange for praying for those who would donate to the religious orders the stigma of those shunned by the community combined with the misconceptions about the disease

resulted in the use of such colonies

until very recently one notable example is kalu papa a small hawaiian island that was designated as a leper colony following the enactment of a law that marked patients as little more than criminals despite being enacted in the 1960s the state of hawaii did not repeal the law until

1969. even to this day the island has not been developed with those who remain on the island who are well into their 70s and 80s left unable to reintegrate into society not all that suffered from leprosy would be outcast one of the most famous leprosy patients was king baldwin iv of jerusalem as a child it was clear that he had contracted the illness though was not formally diagnosed as to avoid the stigma as the only son his assession was tolerated by the ruling elites despite having no feeling in his right arm baldwin was able to lead his armies against saladin and his saracen forces successfully defeating them in five engagements and taking part in the fighting himself in today's world we now have access to medications and treatment

for leprosy though it is vital that such intervention happens as soon as possible the tell-tale sign of numbness or loss of feeling ought to be referred to a doctor as soon as possible it is then the case of taking a number of antibiotic drugs together in what is known as a multi-drug treatment to deal

with the bacteria it is when the illness is left untreated that major damage can be inflicted the disease is most commonly found in india brazil and indonesia with more than half of all new cases of leprosy being diagnosed in india very often the stigma of the disease results in people particularly women and girls not wishing to disclose their symptoms for fear of being shunned as a result the disease will go untreated and progress to a stage that is debilitating whilst the indian government has developed and distributes a vaccine it does not offer a full level of protection the world health

organization is working to reduce the impact and spread of leprosy with the two key components being to combat this stigma and ensure the early treatment early detection and the treatment will result in fewer people

developing more debilitating symptoms in stopping the stigma associated with leprosy more and more people will be willing to seek help which will go hand in hand with early detection whilst we have come a long way from leper colonies and not understanding the illness there is still more work to be done

there is no doubt that plenty of you would have held misconceptions about the disease but it is through better understanding that we can look to remove the stigma which will set us on the right path to eliminating the disease

the stigma of leprosy has undoubtedly caused a great deal of unnecessary suffering and whilst it can be somewhat understood when we had little to no idea about the disease we have today a much better understanding

i would invite you all to look further into the work that has been done to rid the world of the disease and the consequences of shaming those affected..

Top 10 Ranking of Healthcare Systems Worldwide...

 A good healthcare system is vital as the inhabitant’s quality of life depends on it largely.But, there are several factors used to measure the health of a country.The factors are normally the mental and physical health of the country,its health infrastructure and definitely the availability of resources. 

When a country is announced as a well-developed health care system, it can serve its people the best way.
As per the report of 2019, the top 10 best healthcare systems worldwide are listed down here.

01:-Denmark:

Denmark took the first place which is the most well-developed healthcare system in the globe.The reason they could reach this place is their highest income tax rate. And as per the report, this income tax only alone finances the health care system.

02:-Sweden:

Sweden is in the 2nd position.They too have an excellent healthcare system.This country has a good network of the private clinic, public hospitals and plenty of doctors.The fees are very reasonable while the prescriptions too are subsidized.

03:-Canada:

The third well developed healthcare system in the world as of 2019 is Canada.This Country’s healthcare system is funded by the public and each and every resident of the country are provided with the best treatment when needed.

04:-New Zealand:

This is another top 10 healthcare system worldwide that has a great life expectancy of about 81.5 years.This country is highly active which take part in the international sport actively.

05:-United Kingdom:

Britain’s National Health Service is a stuff which is talked about by almost everyone.They are no doubt one of the best healthcare systems in the planet which has created several controversies from time to time.

06:-France:

The health service quality is a matter of thing in France which is praised by all other countries.France has a great life expectancy of about 83 years which clearly indicates about their health care system.

07:-Germany:

It is true that German people love beer and sausage the most.But, that does not keep them from winning the tag of the top 10 healthcare systems in the world.Surprisingly, they are really good at it with an average life expectancy of 81 years.

08:-Australia:

Australia is a very beautiful country with low pollution and excellent weather.This country’s healthcare system is far more developed which has an amazing life expectancy of 82.4 years

09:-Netherlands:

It would be wrong if we do not consider Netherlands as one of the top best healthcare systems in the world.This country has won the title of number 1 at the Annual Euro health consumer index for three consecutive years.

10:-Austria:

Austria too comes in the top 10 healthcare system worldwide.Their healthcare system is very improved and it is funded by the Austrians only.The Austrians pay an amount of 25 Euro per month for the health services.This country too has good life expectancy years.

 

How COVID-19 has hurt health care workers’ mental health

The COVID-19 pandemic has taken a significant toll on our mental health, with many Americans feeling anxious, depressed and hopeless about what is to come. This is especially true for those working in health care, who are continually inundated by the traumas of the pandemic.  

To better understand the psychological consequences of the pandemic on health care workers, Stanford Medicine clinical psychologist and postdoctoral fellow Sarah Hagerty, PhD, and Leanne Williams, PhD, director of the Stanford Center for Precision Mental Health and Wellness, surveyed 1,122 health care workers from across the United States early in the pandemic.

They discovered that respondents had elevated levels of post-traumatic stress disorder, and 15.4% had contemplated suicide in the time period just before the survey -- a prevalence that's roughly three times higher than seen in the general population. Additionally, the pandemic is threatening the basic human needs of health care workers, including safety and security.

Though the research was done between May and August of 2020, Hagerty suspects that health care workers who participate in follow-up research will show the same or even higher levels of trauma, stress and insecurity.

I spoke with Hagerty about what the research reveals, the mental state of health care workers and how the industry can help moving forward. The paper was published Jan. 10 in Clinical Psychological Science.

Many studies have shown that the COVID-19 pandemic is detrimental to individuals' mental health. Why is it important to dig into this issue with regard to health care workers?

At this point, all of us probably know somebody who has contracted COVID-19 or become severely ill or died from the disease. But many health care workers have confronted that all day, every day for the past two years. So, it's a chronic, ever-present stressor. Their experience is going to be different from the general public because of the intensity of their work with COVID-19 patients and beleaguered coworkers. This felt really important to capture.

How has the year and a half of continued COVID-19 cases following this study further impacted health care workers?

I'm following this study up with a second phase of data collection, so we'll get to observe what's going on with health care workers now. What I would say, given what I know about how humans both psychologically and biologically react to chronic stress, is that all of these findings will hold true and be more exaggerated.

When this study was initially collected, we were looking at an acute stressor that was novel. Nobody in modern era had experienced a pandemic at this scale that interrupted our lives in this way.

During the past year and a half, it's the chronicity piece that I think has probably taken a huge toll. Because chronic stress, we know, just does different kinds of things to people -- we tend to see things like a reduced interest in things they once found enjoyable and stress turning into depression.

Are you concerned that Omicron has pushed health providers to capacity?

It feels like this is really pushing everybody to the brink. Health care workers are perceived to have this hero quality to them -- that they always have extra capacity, they always have another reservoir after it looks like they're pushed to the brink.

What we're seeing now, based on anecdotal reports from frontline clinicians, is that they actually don't. They're human and they really can't do it anymore.

I'm concerned about what we're going to find when we check back in on health workers' experiences and how difficult it is for them in terms of depression, trauma and serious thoughts of suicide, as well as what it means for all of us who rely on the health care system and personnel.

What should be done to protect people in the health care industry moving forward?

Ideally, all of us would to do our part to mitigate how many patients are coming into the hospitals. The second piece of it is how we can mitigate the stressors health care workers experience and help manage the trauma and psychological reactions to it.

I'm working on a web-based prevention targeted towards people who have experienced trauma to make those reactions less likely. Interventions that can be rolled out to a large amount of people are needed because the traditional ways of handling this -- for example, having people go through a course of gold-standard evidence-based PTSD treatment, one-on-one with a highly skilled therapist -- aren't sufficient. We're going to need something in addition to that.  

How can this study inform future research on the psychological consequences of the pandemic?

It feels natural to see the psychological consequences of the pandemic, not just for health care workers but for the population at large, through the lens of moral injury -- or a type of psychological distress or injury resulting from experiences that violate one's morals and values.

For example, as a result of high volumes of extremely ill COVID-19 patients and lack of adequate resources, health care workers might be or already have been forced to decide which patients receive critical care and which don't.

Dehumanization and betrayal, which are key facets of moral injury, are impacting a lot of the psychological consequences of folks during the pandemic. What I've been hearing from others is that they feel anger towards other people -- sometimes friends, family members, government agencies and, right now, employers. At its core, the anger probably centers on feelings of betrayal because they believe other people don't necessarily have their backs.

In dehumanization, there's a diffuse sadness and uncertainty over how to feel about the fact that almost a million Americans have died in the past couple years. I think that will have long-term psychological impact.

 

Mental health hygiene can improve mood, decrease stress

For most people, the concept of hygiene conjures up images of brushing your teeth, applying deodorant or taking a shower: simple, daily practices to keep your body clean and healthy.

But mental health providers say your mind can also benefit from a quick morning tune-up. Spending even 15 minutes on mental health hygiene each day can bring a host of benefits, from improved mood and better relationships to even deeper concentration and enhanced creativity.

"Mental health hygiene includes simple practices that improve our quality of life by preventing negative behaviors and providing emotional stability," said Hui Qi Tong, PhD, a Stanford Medicine clinical associate professor of psychiatry and behavioral sciences who directs the Mindfulness Program at the Stanford Center for Integrative Medicine.

This concept of daily maintenance for mental health dates back to 1909, when former psychiatry patient and mental health advocate Clifford BeersOpens in a new window founded the National Committee for Mental Hygiene, dedicated to preventing mental illness through positive behaviors.

For some people, mental health hygiene means dedicating a few minutes of their morning routine to meditation, stretching or walking -- but Tong says just about any activity can qualify, as long as you are paying attention to what you are doing while you perform the task. In fact, even brushing your teeth can become part of mental health hygiene when practiced with deliberation.

"Mindfully brushing the teeth is actually part of the home practice assignments for the Mindfulness-based Stress Reduction program," Tong said. "In the program, group members are asked to carry out these seemingly trivial, often overlooked routines intentionally, rather than on auto-pilot as we usually do."

A focused mind is a happy mind

Studies have shown that American adults spend nearly half their waking hours in a state of mind-wandering, with their attention focused on something other than the task directly in front of them. "So often we are absent-minded," Tong said, "and not really mentally there with the things we are doing."

In addition, research also shows that when participants reported paying attention to a task at hand -- even a simple, repetitive task -- they report high levels of happiness.

"This is why paying attention to daily routines can make such a big impact, especially for busy, highly accomplished people," Tong said. "We all want to achieve big things, but ironically, it's paying attention to the smallest things that can help us get there."

Having a happy, focused mind helps us be more creative and productive, Tong said, and likely to have better relationships with others. Thankfully, learning to focus doesn't have to mean heading off to a monthlong meditation retreat; you can start practicing mental health hygiene wherever you happen to be.

Pay attention to the five senses

Tong recommends starting with one activity you do every day. Brushing your teeth is one of the most popular choices of participants in her courses. "To begin," she said, "you simply make sure that from now on, whenever you are brushing your teeth, you stay with the activity of brushing."

This means not planning out your day or mulling over what your partner said at breakfast, but instead focusing on the myriad sensory experiences associated with toothbrushing.

"Feel the sensation of the bristles against your gums and teeth," Tong said. "Notice the temperature of the water and the taste of the toothpaste, and be aware of what your other hand is doing. When I ask my group members, they usually say, 'Oh! I have no idea what my other hand is doing.'"

One great thing about this mindfulness practice, Tong said, is that it doesn't take extra time -- you spend the same two minutes brushing your teeth regardless of whether you're paying attention, and that's also true of mindful driving, mindful eating and even mindful dishwashing.

"I used to hate washing the dishes," Tong said. "But now, my family will joke, 'It's your opportunity to be mindful.' And they are right. I stand at the sink, intentionally washing each dish and, if my mind wanders off, I just bring it back to the soap and the water. If you're using a dishwasher, apply the same attentiveness to how you load the bowls, plates and utensils."

Building a calmer brain

This practice may sound simple, but Tong says achieving sustained attention is incredibly difficult, especially with so many devices and distractions vying for our attention. For example, a 2015 study commissioned by Microsoft found that the average human attention span has shortened from 12 seconds in 2002 to eight seconds in 2015.

Thankfully, Tong said, research also suggests that the brain is incredibly adaptable. "Neuroplasticity means that our nervous system has flexibility and can change how it functions and even how it's structured."

For example, after eight weeks of a mindfulness-based stress reduction program, researchers at Harvard found decreased activity in and thinning of the amygdala -- the brain structure that is responsible for fear and stress responses.

"The point is that the brain is not fixed," Tong said. "It's an organ of experience. So if you do something repeatedly, like meditation or playing the piano or exercising, they all have the potential to change the nervous system."

Tong starts her day with 15 minutes of sitting meditation, followed by some gentle exercise like Tai Chi or Qi Gong, which involves body-centered conscious movements with well-established benefits of improving wellbeing, both physical and mental.

She encourages anyone interested in the concept of mental health hygiene to find what works for them by experimenting with bringing mindful attention to different activities.

"People might worry this feels like just one more thing to do and wonder if it's worth doing at all. But these trivial routines are already part of our lives," Tong said. "We cannot skip cooking, eating or brushing our teeth, right? But if you do these activities with mindfulness, they can change your experiences and how you relate to the activities, and can bring lasting benefits."

Sleep apnoea therapies can help people with chronic enhance their memory.

There is increasing recognition of the important role sleep plays in our brain health. Growing evidence suggests disturbed sleep may increase the risk of developing dementia. I and University of Sydney colleagues have published a new study showing treating sleep apnoea in older adults with mild cognitive impairment can improve memory, but not other areas of cognition, in the short term. As there is no current treatment or cure for dementia, increasing efforts have focused on developing novel approaches to slow its progression. Mild cognitive impairment is the stage between the expected cognitive decline of normal ageing and the more serious decline of dementia. In mild cognitive impairment, the individual, family and friends notice cognitive changes, but the individual can still successfully carry out everyday activities. Mild cognitive impairment is associated with an increased risk of developing dementia in subsequent years. Researchers believe this is the optimal time to intervene to help prevent a future dementia diagnosis. Finding new ways to slow cognitive decline in those with mild cognitive impairment is therefore important.

How is sleep important for our brain health?

Sleep optimises the ability of our brains to stabilise and consolidate newly learned information and memories. These processes can occur across all the different stages of sleep, with deep sleep (also known as stage 3 or restorative sleep) playing a key role.

We also now know the glymphatic system, or the waste management system of the brain, is highly active during sleep, especially during deep sleep. This process allows waste products, including toxins, our brain has built up during the day to be cleaned out.

Toxins in the brain include beta-amyloid, one of the key proteins in the development of Alzheimer’s disease. Disturbing sleep could disrupt this cleaning process and lead to more accumulation of beta-amyloid in the brain.

The important role of sleep in these vital processes has led to the investigation of whether sleep disruption, including sleep disorders, could be associated with changes in our cognition when we age, and a possible link to the development of dementia.

What is sleep apnoea?

Sleep apnoea is estimated to affect 1 billion people worldwide. In Australia, 5-10% of adults are diagnosed with the condition. Sleep apnoea causes the throat (also called the upper airway) to close either completely (an apnoea) or partially (a hypopnoea) during sleep.

These closures or obstructions can range from ten seconds up to one minute and can lead to a drop in blood oxygen levels. To start breathing again, a short awakening occurs without the individual being aware.

In a person living with severe sleep apnoea this process can happen 30 times or more an hour, causing very fragmented sleep. People with sleep apnoea may snore, toss and turn, and others may notice them stopping breathing, choking or gasping for air during sleep. These repeated disruptions to sleep can cause sleepiness and reduce alertness during the day which, for some people, leads to difficulties performing tasks.

Does sleep apnoea increase our risk of dementia?

The sleep fragmentation, as well as the drops in blood oxygen at night time, are a double blow in dementia risk. Studies have shown sleep apnoea to be associated with a 26% increase in the development of cognitive impairment, as well as greater amounts of beta-amyloid in the brain. However, it is not clear if treating sleep apnoea could reduce this risk.

The gold-standard treatment for sleep apnoea is continuous positive airway pressure therapy, commonly known as CPAP, in which a mask connected to a pump blows continuous air down the upper airway, keeping it open. When the machine is being used it stops the airway from closing. It is not known whether treating sleep apnoea will reduce the risk of dementia. Our new research, however, shows CPAP could be beneficial for memory in the short term.

Our study aimed to understand whether treating older adults with both sleep apnoea and mild cognitive impairment could improve thinking and memory skills in the short term.

The trial assessed the effect of CPAP treatment on memory and thinking skills compared to no treatment. This was a crossover study, which means all participants had both CPAP and no treatment during the trial, but at different times. Some had CPAP first, then swapped. The others had no treatment first, then swapped. Trained staff helped participants get established with the therapy, and after using it for three months, participants underwent a series of cognitive tests.

The researchers found that compared to not treating sleep apnoea, thinking skills were not improved with CPAP, whereas some improvements in memory were observed. This suggests treating sleep apnoea could potentially improve outcomes in the short term, but it is unknown whether it would have any impact on long-term cognitive decline.

A previous study suggested CPAP could slow cognitive changes over one year in older adults with mild cognitive impairment and sleep apnoea. However, studies of longer duration are needed before we can say what the long-term effects look like.