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Menopause leaves some women struggling to work… what can be done about it?



From depression to anxiety and chronic pain, it can be debilitating to go through the menopause. The Cable spoke to women about their experience and support at work.

Photos: Izzy de Wattripont

Angela* is an experienced senior manager in Bristol’s public sector, who is known for getting results and being ruthless in a male-dominated environment. But for the last four years her menopause symptoms of chronic pain, anxiety and brain fog have peaked resulting in her being diagnosed with burnout.

She’s currently on sick leave from her job and feels unsupported by her manager and HR department. “There is a menopause policy in place but every time I have raised the subject of reasonable adjustments I have been met with resistance and made to feel as though I am making a fuss,” she tells the Cable.

Angela says her line manager turned down her request to compress her working hours because it would “set a negative precedent for other managers”. Still experiencing symptoms and trying to get her hormone replacement right, she doesn’t feel ready to return to work.

“I just feel so let down and with nowhere to go for support,” she says. “After years on the wrong type of HRT [hormone replacement therapy] I am only just beginning to get myself well. I can’t afford not to work but I don’t feel like I am being supported to return,” she says.

Sadly her story isn’t unique. Some women seem to cruise through with very few side effects but for others, menopause is an all consuming, life changing process forcing them from the workplace and leaving them in a financial crisis.

I hadn’t slept for years and I was consumed by anxiety and fear. I turned up for work everyday masking these feelings. I honestly thought I had dementia at 37

The menopause has entered the national conversation lately, highlighted by things like Davina McCall’s: Sex, Myths and The Menopause documentary and Carol Vordamen taking to parliament to speak on menopause in the workplace. But the likelihood of reform was short lived when earlier this year the government declined to make menopause a protected characteristic under the 2010 Equalities Act. Equalities Minister Kemi Badenoch likened the request to that of a short person asking to be seen as short.

Legal changes may have to wait. But in the meantime, the Cable spoke to women across the city about their experience of the menopause and what needs to be done to support women in the world of work.

Getting employers to offer support

“I fell down the menopause black hole,” says Becky Batt, a Unison union rep at Bristol City Council. Becky had worked at the council for years when in 2016 she found herself experiencing a devastating depression with no obvious trigger.

“I was experiencing suicidal thoughts and felt as though I couldn’t continue in work.” Becky, who was in her early forties at the time, visited her doctor who pointed out the likelihood of her symptoms being related to menopause.

“I wrote to the council’s HR department to ask what policies were in place for women like me, only to find out there were none.” Becky says it was her caseload of women, all of a similar age who had either been reprimanded for long-term sick leave or had left their roles entirely, that made her push for the council to provide better support.

“There were just too many women of a similar age who were having long-term health issues, departmental grievances and leaving their roles, for it to be coincidental,’ she says. “It really broke my heart.”

Becky’s campaign for better menopause care at work was met with enthusiasm after she went on a training course and set up focus groups within the council. “The response was great, 120 women all in the same situation came forward saying they needed more support.”

Off the back of training and research Becky went on to work with the council’s HR department to set up health and wellbeing plans and menopause training.

So how well are these working in practice? “I am proud to say the Health and Wellbeing Plan is an effective and robust way to drill down into what women need in terms of support,” she says. “It’s fluid and not fixed, meaning it can be updated regularly.”

“My caseload was previously 75% menopause-related and is down to less than 5% a year. Our menopause group now has over 400 members who support each other, and offer advice on things like symptoms and HRT shortages,” Becky says.

“Asking employees what they need and working with them to ensure they get the right support really works.”

Professor Vanessa Beck with University of Bristol began researching menopause and its social and economic impact back in 2017. Since then she has helped create and cultivate what a good menopause policy looks like, including advising the council on its health and wellbeing plan.

“I have somewhat changed my mind about what a good policy looks like over the years,” says Beck. “A policy stipulates something must be implemented by a line manager and in hindsight without women driving these policies forward and championing them, they have the potential to collect dust on shelves.”

“What really drives a good policy and holds businesses accountable is the culture surrounding menopause,” she adds. “Making it person centred and less of a taboo subject while also allowing for nuance.”

However, Angela’s case shows that menopause policies may exist but need to be put into practice.

Using personal experience to support others

Lauren Chiren’s symptoms were so severe she would pass out at work. But now she runs free training to help others cope.

The Cable spoke to women who have used their experience to support others.  One is Lauren Chiren, now 53, who walked out of her job in Bristol as a financial executive aged just 37. At the time of leaving her job, with no idea how she would pay her mortgage, Lauren says her symptoms were so severe she would pass out at work.

“I didn’t know what was wrong with me and couldn’t remember anything.” she says.

“I hadn’t slept for years and I was consumed by anxiety and fear. I turned up for work everyday masking these feelings. I honestly thought I had dementia at 37! And by the time I found out what was causing it, I was out of work and post menopausal.”

Since being alerted by her GP to the driver of her debilitating symptoms, Lauren has dedicated the last 17 years of her life to improving her knowledge on reproductive health and now supports women and girls with theirs. In her role as a menopause coach she supports businesses in providing better training and support for their employees. She also offers a free training course to anybody who wants to learn more about the impact of menopause.

Hazel Hayden used her own experience to found Bristol Menopause Clinic

Hazel Hayden, founder of Bristol Menopause Clinic, had been working as a nurse for eight years when she left her job because of suicidal thoughts brought on by menopause.

“I was working in a role supporting patients with menopause symptoms and nobody was supporting me,” says Hazel, who felt her request for support was ignored.

“Working in the NHS you expect to be supported with your health, but unfortunately I wasn’t. My husband and I had to adjust our lifestyle completely so we could afford to live until I got support and found a job with more flexibility.”

Both Lauren and Hazel have since used their experience to build their careers around the menopause. Hazel offers private menopause care in her Bristol clinic including supporting women to remain in work and manage their symptoms. She hopes to offer community interest services at the clinic in the imminent future that would provide low-cost support.

With waiting lists for outpatient appointments in Bristol’s NHS hospitals currently at a minimum of 21 weeks, it’s vital that open conversations are happening within the workplace. But the women we spoke to say that in order to have those conversations they must first feel confident they’ll be supported by their employers.

*Not her real name



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Helping people living with dementia ‘flourish’ through dance



Dr. Pia Kontos, a Senior Scientist at UHN’s KITE Research Institute, is co-leading an initiative to help people living with dementia flourish. (Photo: Tim Fraser/UHN KITE Studio)

Dr. Pia Kontos believes in the power of the arts to support people to live well with dementia.

The Senior Scientist at UHN’s KITE Research Institute focuses on challenging policies and practices that discriminate against those living with dementia and developing and evaluating arts-based and digital knowledge translation initiatives to reduce stigma, improve social inclusion and quality of care for them.

“The predominant assumption is people living with dementia don’t have the capacity to be creative,” says Dr. Kontos, who is also a professor in the Dalla Lana School of Public Health at the University of Toronto. “However, we know through extensive research that dance…powerfully supports people living with dementia to be creative and to flourish.

“And flourishing should be a goal that we all have.”

Dr. Kontos co-produced in 2023 Dancer Not Dementia, a short documentary film. It captured the power of a dance program for seniors – Sharing Dance Older Adults (SDOA) – to challenge the stigma associated with dementia, support social inclusion and enrich lives. It’s told through the eyes of residents and staff at Alexis Lodge Dementia Care Residence and Cedarhurst Dementia Care Home in Toronto.

SDOA was jointly developed by Canada’s National Ballet School (NBS) and Baycrest Centre in 2013 for older adults with a range of physical and cognitive abilities, including dementia.

Typically, dance programs in dementia care settings are provided as a therapeutic intervention for older adults. However, SDOA’s goal is to provide a creative outlet for participants and opportunities for social interaction with other people living with dementia, staff and loved ones.

Now, Dr. Kontos will look to incorporate traditions from marginalized communities into SDOA through a $750,000 Canadian Institutes of Health Research (CIHR) Institute of Aging Implementation Science Team Grant. Dr. Rachel Bar, Director of Research and Health at NBS is co-principal applicant for the grant.

This CIHR funding supports projects that evaluate the effectiveness of existing programs, services and models of care that show promise for those impacted by cognitive impairment and dementia. An important focus is improving equitable and inclusive access to care and support.

The three-year grant to Drs. Kontos and Bar will support SDOA efforts to partner with organizations in Black, Chinese and South Asian communities to integrate their cultural practices into its programming.

Training dancers from these communities to teach the adapted program is central to these partnerships.

“People living with dementia from marginalized communities rarely have their traditions honoured with art and leisure programming,” says Dr. Kontos.

“It’s important to align dance programs with the cultural traditions of these communities. Otherwise, the music and movements wouldn’t reflect the experiences of ethno-culturally diverse populations, and the programs wouldn’t be inclusive.

“We wouldn’t be supporting their capacity to be creative or to be in relationships with others through dance. We would be falling short.”

SDOA has already partnered with Alexis Lodge, Alzheimer Society of Canada, Baycrest, NBS, Indus Community Services, Social Planning Council of Ottawa, and Yee Hong for this initiative.


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CDC: Heat may have contributed to four human cases of bird flu in Colorado



Credit: Alexas Fotos from Pexels

Heat probably played a role in at least four cases of bird flu in poultry workers confirmed by U.S. health officials Sunday—the first cases in poultry workers in two years.

Sweltering temperatures in Colorado rose to at least 104 degrees, which is suspected to have contributed to the human cases, according to Dr. Nirav Shah, principal deputy director at the Centers for Disease Control and Prevention. The barns where poultry workers were culling chickens were “no doubt even hotter,” Shah said during a press conference on the most recent outbreak of bird flu in humans.

The new cases bring the U.S. total to at least nine cases since the first human case of the current outbreak was detected in 2022, also in a Colorado poultry worker. Eight of the nine were reported this year.

The workers were separating chickens that were going to be killed to stop the spread of the virus. The fans may also have contributed to the human infections because, while helping to keep the environment cooler, they “also spread things like feathers around which are known to carry the virus,” Shah added.

The large and strong fans also make it difficult for protective goggles and face masks to stay in place, he said.

About 60 workers at the poultry farm showed symptoms of illness and were tested for bird flu. Four tested positive for bird flu and one additional presumptive case is awaiting confirmation.

The illnesses were relatively mild, with symptoms including conjunctivitis and common respiratory infection symptoms like fever, chills, coughing, and runny nose, according to the CDC. None were hospitalized, officials said. The other U.S. cases have also been mild.

Officials said they are bracing for more cases.

The CDC says the risk to the general public remains low and the health agency is not recommending livestock workers be vaccinated against bird flu given the “mild symptoms noted thus far,” Shah said.

An initial analysis of virus samples from an infected poultry worker does not show any changes in the virus that would make it easier to spread among people and there is no evidence of person-to-person spread in the U.S.

“It’s important to note that this assessment is based on what we know today and may change,” Shah said. “CDC is constantly looking for key changes that may alter our risk assessment of the virus, such as the severity of illness that it causes, the ease with which it can transmit to humans or changes to its genetic fingerprint.”

At the request of Colorado’s officials, the CDC sent a 10-person team to Colorado to help the state manage the bird flu outbreak in humans and poultry. The team included epidemiologists, veterinarians, clinicians and industrial hygienists.

Shah also noted it was a bilingual team. Overall in the U.S., it is estimated about half of farm workers are Latino.

An analysis of the virus from an infected worker indicates that the infections at the chicken farm are “largely the same” as the strain detected in dairy herds in Colorado and other states, according to Shah. But an investigation is ongoing to determine exactly how the outbreak is spreading between wild birds, chicken and cattle.

Since 2022, a highly contagious strain of bird flu has spread across the U.S. at an unprecedented rate.

Georgia’s powerhouse poultry industry, which produces more broiler chickens than any other in the country, has mostly dodged the kinds of major outbreaks that have resulted in the deaths of more 90 million birds in commercial and backyard poultry flocks in the U.S.

About 1.8 million chickens will be killed at the Colorado poultry farm after these latest bird flu cases were detected.

In late 2023, ducks at a commercial breeding farm in Sumter County, Georgia, tested positive for H5N1. This year, in March, the virus made a jump to a mammal species that surprised many scientists: cows.

With a significant dairy industry, plus even larger beef and poultry interests, the potential arrival of the virus here threatens Georgia’s economy and the health of residents.

As of Monday, the H5N1 virus has been confirmed in 158 dairy herds in 13 states, according U.S. Agriculture Department.

So far in Georgia, there have been no bird flu cases in cattle, and there have been no human cases.

Since the unprecedented spread of H5N1 in poultry in 2022, the Georgia Department of Public Health has quietly monitored 132 people for signs of the virus, according to DPH spokeswoman Nancy Nydam. Those tracked were either first responders to one of the state’s few virus outbreaks in backyard and commercial poultry flocks or farmworkers where the infections occurred. Of those monitored, fewer than 10 people were tested for H5N1 and none came back positive.

Since the virus was discovered in cattle, a small number of first responders from Georgia who went to other states to help with investigations—fewer than 15—have also been monitored for signs of illness.

Federal officials said Tuesday they still believe they can eliminate the bird flu virus from , even as the number of herds infected continues to grow. The latest state to recently report infected dairy cattle was Oklahoma. North Carolina is the only state adjacent to Georgia to report an infected dairy herd.

Eric Deeble, acting senior adviser for the H5N1 response at the USDA, said investigations show the is spreading among cattle through cattle moved from one herd to another and the shared use of milking equipment. It can be contained through enhanced biosecurity measures such as thoroughly cleaning milking “parlors” and equipment, separating sick cows, and having dairy workers wear protective equipment.

Deeble also noted USDA scientists are also working with partners to develop a cattle-specific H5N1 vaccine—a process requires many steps and will take time.

The USDA is also exploring the possibility of developing a poultry vaccine as the number of cases soar, and outbreaks lead to the slaughter of millions of farmed birds. But USDA and industry stakeholders point to challenges that would hinder a vaccination program.

The biggest sticking point is around trade.

Mike Giles, president of the Georgia Poultry Federation, said mass vaccination would be impractical for several reasons, including the fact that the industry would lose its lucrative export market: The United States and many of its trade partners restrict the import of products or eggs from countries affected by the highly pathogenic strain or flocks that have been vaccinated against it.

“(Bird flu) has been, from an animal health standpoint, our top concern,” Giles said. “The challenge, and I think the industry has responded to it well, has been maintaining the state of preparedness and urgency and focus on biosecurity, and I think that has been accomplished.”

2024 The Atlanta Journal-Constitution. Distributed by Tribune Content Agency, LLC.

CDC: Heat may have contributed to four human cases of bird flu in Colorado (2024, July 17)
retrieved 17 July 2024

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Here is the new guidance for RSV vaccines



Health officials recently changed the guidelines for respiratory syncytial virus vaccines. Here’s what Canadians need to know about the guidance and the virus itself.

New guidance on vaccines

As of July 12, the National Advisory Committee on Immunization (NACI) now recommends RSV vaccines for individuals who are 75 years old and older, especially those who have a greater risk of developing severe RSV.

Based on current evidence and expert opinion, NACI said in a news release, it also strongly recommends vaccines for those aged 60 and older who live in nursing homes and other chronic care facilities.

What is RSV?

RSV is a common contagious virus that often causes bronchiolitis, a lung infection, and pneumonia.

Infants face the highest risk of developing severe RSV disease, however, this risk also increases with age and with certain medical conditions, according to the Public Health Agency of Canada (PHAC). It can lead to serious complications for older people, including hospitalization and death.

What are the symptoms?

RSV typically causes mild, cold-like symptoms that usually begin two to eight days after exposure to the virus, according to PHAC.

Those with RSV may experience a runny nose, coughing, sneezing, wheezing, fever and less appetite and energy. Infants may be irritable, have trouble breathing and have less appetite and energy.

What is the treatment?

RSV infections are usually mild and last about one to two weeks. If you are infected, health officials recommend you stay home and limit contact with others.

They also recommend lots of rest and drinking plenty of fluids. Take over-the-counter products, such as acetaminophen or ibuprofen, if you have a fever. Seek immediate care or go to the hospital if you’re having trouble breathing or become dehydrated, PHAC adds.

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