Antibiotic resistance is one of the biggest threats facing us today; What do you need to know?

Antibiotics awareness week 14-20 November 2016


This annual, global event aims to raise awareness of antibiotic resistance and encourage people to preserve the antibiotics we have to save lives.


You must have heard the news about antibiotics becoming less effective in treating infections, and you may have seen frightening media reports about antibiotic resistance. It is all true! In fact, resistance to antibiotics and the fact that we (and our children) may die of simple infections in the future may be a global threat that tops the threat of terrorism.


How has this happened?

 Antibiotics are so effective in treating bacterial infections that we use them often and not always when necessary.

In addition, we are beginning to realise that we have discovered all the antibiotics we could possibly discover, and that bacteria are very clever in adapting and developing resistance to the ones we have developed.


Why it is relevant to you?

 There is no doubt that we are on a fast track to…the pre-antibiotic era! The old days when people would die of simple infections and minor injuries!

A warning tale;

Kelly was diagnosed with a urinary tract infection by her GP. She was referred to hospital for antibiotics but not given a complete course. When her condition worsened, she returned to hospital at one point, her parents were called in to see her in the middle of the night as hospital staff feared she might not recover. Follow the link to hear Kelly’s story  ‘They weren’t sure I was going to make it’ – BBC News


Can we do something about this?

 As healthcare staff we need to preserve the antibiotics we have, and only prescribe them to the patients who really need them.

As patients, you could learn how to treat your symptoms of infections without antibiotics. And if you are given antibiotics, make sure that:


  • You only use antibiotics when they are prescribed for you
  • You finish the full course of antibiotics even if you start feeling better
  • Never use leftover antibiotics or share them with anyone
  • Help reduce the spread of infections by regularly washing your hands


Scientists are working hard to find new sources of antibiotics and new methods of killing bacteria. In the meantime, you can join us on the global move against antibiotic resistance and become an antibiotic guardian. Find out more on the following link:


Thesis getting you down? Read this! Help is here…

It has been said that the letters Ph.D. really stand for Permanent Head Damage rather than Doctor of Philosophy.

Sadly it’s not uncommon for doctoral candidates to experience mental health related difficulties during their studies. Some of this can be down to the nature of the degree. Candidates have to spend a lot of time and energy self-motivating to create new knowledge. Their work is solitary, hyper-focussed and generally not well understood by those around them. They have very intense, unequal relationships with a supervisor who holds a lot of power over them and who may be over or under-involved. By its inherent nature research involves a lot of dead ends, false starts and the ever present spectre of rejection from journal reviewers. And that’s all before undertaking the small task of writing up a book the size of a telephone directory and having to face a viva in front of a panel of experts.


As someone who has gone through the doctoral process themselves, supervised several and then ended up working therapeutically with PhD students and academics here is my advice.


  • Anxiety, stress and uncertainty are common, but more common as is the dreaded “imposter syndrome” where your typical PhD student wanders around fearful that they will be found out or people will realise that they are not clever enough. It’s all lies. If you are here in the first place, you are good enough.


  • Faced with writing a thesis it’s an understandable response to feel one that may be better off dead/ running away/ drinking until oblivion. This isn’t often acknowledged and people suffer, thinking they are the only one that feels like this. If you do feel this way, do seek support because there are a lot of resources at university to help with this. The Students’ Health Service, Student Counselling service, the Student Union and Academic departments can all be possible sources of support when it comes to despair, fear or doubts.


  • A good thesis is a finished thesis. It doesn’t have to be perfect, world changing or the last word in your subject area- it just needs to be done. Your PhD is not your magnum opus, it’s really your driver’s licence into the world of research and academia. You may not even be in the same area in the future. I can barely remember what was in mine, and have to think quite hard to even recall the title. However, the research and analytic skills I learned finishing it I still use on a daily basis.


  • Get out more. It’s all too easy to spend all of your time in the library/laboratory and feel massive guilt for doing anything other than your thesis. However, balancing your work with friends/ relationships/ healthy eating/ exercise and interacting with the outside world is incredibly important. It also makes you more effective and is probably the best known defence against procrastination, as you have a shorter window of time where you will need to be focussed. It’s only too easy to spend 20 hours a day occupying yourself with not writing.


  • You are not your work. It’s only a small part of what you do and doesn’t reflect on your capacity for kindness, altruism, empathy or being a worthwhile human being. It doesn’t even reflect on your intellectual ability as your PhD is more a measure of your tenacity and resilience than it is about how smart you are. Others will love you for a variety of reasons, but your PhD is unlikely to be one of them.


  • Best of luck with it. It’s tough. Remember, a thesis is written a line at a time. Keep doing that and it will eventually get done.

SHS Consultant Psychologist Dr Ian Barkataki

Flu; should YOU be immunised?!

Influenza or ‘Flu’ is a word that can fill even the healthiest of us with dread.


Flu is characterised by the sudden onset of fever, chills, headache, muscle pain, and extreme fatigue. Other common symptoms include diarrhoea and vomiting, a dry cough, sore throat, and runny or stuffy nose. For otherwise healthy adults, influenza is an unpleasant but usually self-limiting disease with recovery typically within 2 to 7 days. Symptoms in children can last up to 2 weeks. See below for a link to advice on managing flu symptoms.


For some of us with certain health conditions it poses an even greater risk, with complications such pneumonia and higher rates of hospitalisation. For this reason the NHS provides flu vaccination to certain ‘at risk’ groups.


You could be eligible for free flu vaccination if you fall into one of the following categories:


  • Chronic respiratory disease, such as severe asthma (not mild) or COPD/chronic bronchitis
  • Chronic heart disease, such as heart failure
  • Chronic kidney disease at stage three, four or five
  • Chronic liver disease
  • Chronic neurological disease, such as a stroke, TIA, motor neurone disease, MS or learning disability
  • Diabetes
  • Pregnancy
  • Asplenia or splenic dysfunction including sickle cell anaemia
  • A weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment/ immunosuppressant’s)


You could also be eligible if you are a carer or a household contact of someone who is immunosuppressed e.g. on cancer treatment. Children aged 2-7 and those aged 65 or over are also eligible.


If you are not eligible you can still seek flu immunisation privately, this can cost as little as £5 via some pharmacies.


Studies have shown that the flu jab definitely works and will help prevent you getting the flu. However, it won’t stop all flu viruses, so it’s not a 100% guarantee that you’ll be flu-free. The vaccine works by stimulating your body’s immune system to make antibodies that attack the flu virus. If you catch the flu virus after you’ve had the vaccination, your immune system will recognise it and immediately produce antibodies to fight it.


You need the injection each year so it’s important to book your vaccination as soon as you get your text. Patients known to be in eligible groups should have received their first text inviting them to book an appointment. If you think you are eligible but have not received a text then please call the office at the Students’ Health Service on 0117 3302720.

Below is a link to the 2016 information booklet on flu vaccination-



Why does the receptionist need to know what is wrong with me?

Written by a receptionist at SHS;

This quote recently appeared on my Facebook feed: “It takes seven years to train a doctor and 2 minutes for the receptionist to think she’s one as well”.   I think this highlights the popular misconception that receptionists are either nosey or intentionally obstructive (and are always female!).  In fact, receptionists are trained to triage.  Triage is the process which is used in many areas of health provision to enable the prioritising of sick or injured people for treatment according to the seriousness of the condition or injury.  Using triaging ensures that the highly sought- after timeslots available are used effectively to provide the best service for the patient.


The Students’ Health Service is staffed not only by General Practitioners (GPs) but also by nurses and clinical pharmacists, who can see patients and provide a prescription where necessary.  Some nurses and pharmacists also have particular areas of clinical interest (e.g. dealing with patients with asthma and diabetes, offering contraception advice, providing advice and vaccinations for overseas travel etc.).  When patients call for an appointment the receptionist will ask what the general nature of the illness is in order to ensure that the patient is seen as quickly as possible, by the practitioner that can best deal with their illness or query.  The receptionist will always respect the right of the patient to decline to give details of their illness.


Please don’t feel offended if the receptionist asks for the reason for your appointment request.

You can be assured that the staff in the Students’ Health Service will deal with any requests for appointments in the most appropriate manner possible for both the patient and the practice, and that any information you give us about your illness is shared only with your practitioner.




Meningitis; what is it? What to watch for!

What is it?

Meningitis is an inflammation of the lining that covers the brain and spinal cord.  It is caused by bacterial or viral infections.  The bacterial form can be fatal and causes serious long term health complications – especially if not treated early.

How do you get it?

Close contact is needed to pass it on to others such as kissing, coughing or sneezing near to others.  Living close together in shared accommodation can pose a risk, as does sitting close together in lecture theatres, though less so. Thats why all Freshers should be immunised!

Signs and Symptoms

Symptoms can appear in any order and some may not appear at all;

  • Fever
  • Headache
  • Vomiting
  • Muscle pain
  • Fever with cold hands and feet
  • Drowsy – difficult to wake
  • Confusion and irritability
  • Stiff neck
  • Dislike of bright lights
  • Pale blotchy skin
  • Spots/rash (that do not fade under pressure, do the ‘glass test’)
  • Convulsions/seizures

What can I do?

Get vaccinated – MenACWY vaccine directly protects vaccinated people from 4 strains of meningococcal meningitis and stops them from carrying the bacteria.

Familiarise yourself with signs and symptoms and be alert.

Look out for yourself and friends.  Share awareness and care for each other – don’t assume an illness is hangover or touch of flu – if you think a friend or housemate is ill trust your instincts and seek medical help.  Keep an eye on your friends if they are getting a lot worse quickly seek help.

How do I get help?

Call the GP or NHS 111 if out of GP opening hours

Describe the symptoms and say that you think it could be meningitis.

In an emergency dial 999 for an ambulance or go to your nearest Accident and Emergency Department.

Download our ESC Student Health App for more info, on your phone. on the App Store now.


For further information







World Sleep Day 18th March 2016

It’s World Sleep Day on 18th March 2016: intended to be a celebration of sleep, and this year the slogan is “Good sleep is a reachable dream”! About 25% of us struggle with our sleep, and this can negatively affect our health and wellbeing in many ways. We should be aiming for about 7 or 8 hours per night, but it’s well known that many students are missing out on a good night’s sleep-probably the most powerful performance enhancer in the world. It’s not unusual for students to work longer than they sleep, especially in the run up to exams.

So how can you stop your sleep suffering at times of stress? There are some basic dos and don’ts. First alcohol, which is both sedating and stimulating, so although we can use it to fall asleep, drinking close to bedtime makes us more likely to wake up in the early hours. Second caffeine and stimulant drugs: it’s best to avoid these within 6 hours of bedtime and some of us find cutting caffeine out completely during the day can help. Third, LCD phone and tablet screens last thing at night: they emit “blue light” similar to sunlight, confusing our body clocks. Fourth, we should avoid taking a nap during the day however tired we are, as this disturbs our body rhythm. Fifth, regular daytime exercise (but not too near to bedtime) can help us feel more tired and relaxed at the end of the day. All of these general tips for sleeping better are often called “sleep hygiene” and more detail about them can be found at
Whatever the initial cause of our poor sleep, worrying about it, about feeling tired the next day and about how this might impact on our life can often make the problem a lot worse. Once this situation arises, the trick can actually be to accept our anxieties. Dr Guy Meadows has written “The Sleep Book“, an excellent self-help manual with clever exercises to prevent intrusive anxious thoughts from disturbing sleep, such as giving our worries nicknames and learning to merely observe them. The Student Counselling Service runs mindfulness groups, which can also help students break their bad sleep patterns. If you feel that your sleep problems are significantly impacting on your physical and mental wellbeing and self-help and counselling don’t feel like enough, the GPs at Students’ Health Service can advise you further. It’s important to prioritise sleep, because without it University life can definitely be more stressful and less productive.

Eating Disorders Awareness Week 2016 #EDAW16 by Dr Hugh Herzig

Did you know that next week 22nd – 29th Feb is Eating Disorders Awareness Week? Perhaps you already feel bombarded by news bulletins about the rising incidence of EDs… or how these days younger and younger people are affected. So why the need to be made more aware of EDs?

At Student Health we have good reasons to want to raise awareness of EDs:
• Eating disorders are not rare and exotic illnesses. They are common in the UK population, particularly so in adolescence and early adult years, and particularly so in student populations.
• They have a profound effect upon mental health, eroding well being and self esteem, so that nothing the sufferer does is ever good enough.
• They have serious physical effects on pretty much every biological system of the body such as skin and dental damage, gastrointestinal and heart problems, bone marrow and liver damage, hormone suppression and hastening the onset of osteoporosis. In fact, EDs lead to greater mortality than any other group of mental illnesses.
• Living with an ED can make life very hard indeed… friendships and social activities are deprioritised, leading to people feeling more and more isolated, anxious and depressed.
• Concentration and stamina can be much affected, so the sufferer cannot perform physically and academically to her/his potential
• Family and friends often don’t know what to say, or worry they will cause upset or have their head bitten off if they express their concern
• Some of our patients at Student Health get so unwell that they need to take time out from university. For those such as medics, vets and dentists whose degrees lead on to accreditation with a national professional body, their ED may make them unfit to practice as a registered professional.

ED Awareness week may provide an opportunity to break the taboo that surrounds EDs.

You may feel able to bring up this sensitive topic with that friend you’ve been worrying about, but who seems always to want to keep herself to herself. It is likely that doing so will help her… even if she seems not to appreciate it at the time.

If you have severe eating and weight anxieties yourself, this week may be the time to tell someone a bit about it, allow a friend to support you, maybe even seek help from your doctor. All the staff at Student Health are experienced in helping people with EDs, and in Bristol we have good services to treat eating disorders, including the First Step service which offers psychological treatments in our very own Health Centre

We are here to help YOU!

Boost your finances this New Year- Stop smoking!

If you need motivation other than possibly saving over £270 a month (20/day @£9) then read on about the benefits of stopping.

Better sex– Stopping smoking improves the body’s blood flow, so improves sensitivity. Men who stop smoking may get better erections. Women may find that their orgasms improve and they become aroused more easily. It’s also been found that non-smokers are three times more appealing to prospective partners than smokers (one of the advantages, perhaps, of smelling fresh).

Better skin– Stopping smoking has been found to slow facial ageing and delay the appearance of wrinkles. The skin of a non-smoker gets more nutrients, including oxygen, and can reverse the sallow, lined complexion that smokers often have.

Reduce stress– Nicotine addiction makes smokers stressed from the ‘withdrawal’ between cigarettes. The pleasant feeling of satisfying that craving is only temporary and is not a real cure for stress. Also, the improved levels of oxygen in the body mean that ex-smokers can concentrate better and have increased mental wellbeing. Scientific studies show that people’s stress levels are lower after they stop smoking

Better teeth– Giving up tobacco stops teeth becoming stained, and you’ll have fresher breath. Ex-smokers are less likely than smokers to get gum disease and lose their teeth prematurely. Kicking the smoking habit gives your senses of smell and taste a boost. The body recovers from being dulled by the hundreds of toxic chemicals found in cigarettes.

Better breathing– people breathe more easily and cough less when they give up smoking because their lung capacity improves. In your 20s and 30s, the effect of smoking on your lung capacity may not be noticeable until you go for a run, but lung capacity naturally diminishes with age. In later years, having maximum lung capacity can mean the difference between having an active, healthy old age and wheezing when you go for a walk or climb the stairs.

Live longer– Half of all long-term smokers die early from smoking-related diseases, including heart disease, lung cancer and chronic bronchitis. Men who quit smoking by 30 add 10 years to their life. Quitting not only adds years to your life, but it also greatly improves the chance of a disease-free happier old age.

Live well– Within two to 12 weeks of stopping smoking, your circulation improves. This makes all physical activity, including walking and running, much easier.
Quitting also boosts your immune system, making it easier to fight off colds and flu. The increase in oxygen in the body makes ex-smokers less tired and less likely to have headaches.
You are 4 times more likely to quit with help from your local NHS Stop Smoking Service especially with the use of medication. So don’t wait! Start stopping today and contact your GP surgery or local Stop Smoking Clinic.

National Stress Awareness Day 2015- a reflection by a Student Health Service (SHS) GP

Yesterday was the UK’s ‘National Stress Awareness Day’. As part of this, the ‘International Stress Management Association’ has produced some excellent resources to help combat stress that can be accessed using the following link:
Reading the material on this website led me to reflect on how much of the work I do as a GP, on a day-to-day level is, in part, attributable to stress. Stress is of course a normal and natural part of everyday life that is necessary for our survival. At its best, stress helps us to function and optimise our performance, e.g. during exams. At its worst, stress can be destructive, causing both mental health issues as well as physical symptoms.
The link below gives a 10 point plan to help ‘stress bust’. As a GP at Student health, I would recommend reading these whether you are currently stressed or not. Practising stress busting techniques as part of everyday living e.g. exercise and taking time out, will prepare you well if times become tough.
The main problems that I see with stressed students often involve the following:
1. Lack of sleep habit/ structure leading to exhaustion, making stress all the more worse. Sleep issues are all consuming. Self-help advice ( may be all that you need, or else please consider talking to the professionals at Student Counselling Service or SHS.
2. Forgoing meals due to lack of time to eat/ prepare food or nausea associated with stress. Eating little and often will provide the brain and body with the much needed ‘fuel’ and usually combat associated nausea.
3. Stress leading to a sense of work becoming overwhelming so that it is impossible to consider prioritising. provides a list of work-shops that might help students with study skills. Making a timetable of tasks can help a stressed individual establish clear goals. Please also remember that tutors will be able to help prioritise tasks if you are struggling.
4. More and more I am seeing how recreational drugs and too much alcohol are playing havoc with my patients’ mood and ability to tolerate stress. They also cause problems with sleep quality and are known to have a serious potential impact on mental health.
5. Not taking any breaks as there is too much work. Very few people can work all day and night and keep going. Regular breaks and natural stress busters such as a quick burst of physical activity and laughter can be a fantastic way to recharge your batteries.
Please consider looking at the National Stress Day resources and if you are concerned about your ability to manage your stress, remember that there are many people at the university who would be delighted to discuss this e.g. tutors, hall wardens, the SCS, the chaplain and Student Health Service.

Please see our website for links to related mental health resources and self-help material (; ;

Sports injury? What to do, when to do it and why it matters

For many of you, the summer break means relaxing and perhaps doing less sport. Now that you are back at Uni and doing familiar, and in some cases, new sports, your fitness and agility are being challenged. If that results in joint, muscle or ligament injury, it can mean not only pain and swelling, it might mean time away from the sport, and the socialising that goes with it. So what do you do when you’re injured? When and where should you seek help?

Here are the basics.
The first 24 hours after injury: PRICE principles
PRICE stands for Protection, Rest, Ice, Compression and Elevation.

These principles guide care of joint, muscle and ligament injury.
Protection: Stop the activity which caused injury. Immediately post injury you should avoid excessive and painful movement. Use support such as taping, bracing, splints or crutches as needed.
Rest/relative rest: Give the injury time to heal by taking load off it
Ice: use for at least 10 minutes (but no longer than 20 minutes). Time between icing should be guided by pain, but can be less than 2 hours between applications. Take care not to give yourself an ice burn.
Compression: If there is swelling, you can apply compression with a bandage or tubigrip. Don’t use high levels of compression with elevation unless advised to do so by a Doctor.
Elevation: in most cases, this can help. To elevate, you bring the injured body part above the level of the heart, e.g. resting with leg up and well supported if ankle is swollen. It is important to slowly lower the injured and elevated body part when bringing it back towards the ground.
Though perhaps tempting to dull pain with alcohol, it’s best avoided, as it slows recovery. It may lead you to use the injured area more than you should.
After the acute phase of injury (i.e. once the injury starts to subside), you need to progressively load the injured part. For example, after an ankle sprain where there is no fracture, it is important to gently start walking as normally as you can for short distances when you feel you are able and pain has subsided a little.
When to seek help
Seek help immediately if there is
• severe pain and/or deformity
• joint dislocation
• concussion/head injury
• bone fracture
• significant bleeding/skin and tissue trauma
• severe pins and needles, numbness unexplained muscle weakness
For these significant injuries, attend a nearby hospital Accident and Emergency department.
Seek help from a GP or Physio if there is
• Ongoing severe, persistent pain and swelling which is failing to respond to PRICE after 48 hours
• Ongoing swelling
• Loss of range of movement (e.g. can’t lift arm fully or take weight on foot and ankle) strength and joint stability
• If you are unable to continue to do normal activities and sport due to your injury
Physiotherapists help reduce pain and dysfunction through using manual techniques and exercises. The sooner you seek help, the better the health professionals can help you get back to your best. If you don’t follow through on treatment, injuries can become recurrent, meaning more time on the side lines and away from the great social and health benefits sport brings. It might impact your studies too.
If you are worried that you will be told to stop sport and exercise, be assured that your physio or GP can help you consider options to reduce impact on the injured area and maintain your fitness.
Old and recurrent injuries
If you have an old injury that’s recurrent, or an injury from overuse, that can be managed too. It’s normal to feel the occasional ache or pain after trying a new activity or returning to sport after a break, but symptoms that persist or recur are usually a sign that your body is not working at its best. Physios are experts in body mechanics, and can help you understand the cause of the pain and manage it. They work closely with Student Health to manage medical issues and investigations if required.
See here for more on Physiotherapy at University of Bristol



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