This is the group of fabulous students Professor White and I worked with at the Shanghai JiaoTong University. They are all Post graduate students undertaking research projects of various kinds. They are motivated, keen and a joy to work with. We have taken two workshops in addition to our undergraduate cancer nursing sessions. The latter has taught me the skill of brevity. I have found it difficult to tailor the content to undergrad levels and quantity and fear that i have lost the students for much of my lectures. Although – I have used a critical population of about 6 students around the room to watch carefully for nods of agreement and/or understanding. I have two sessions today, two tomorrow and then home. Much as I love travel, it has been a long 9 days. Shanghai is a vibrant cosmopolitan mix of ancient and modern and I also wish I had more time to explore.
I hope that this programme is able to continue and that the links we have developed grow strong – but it these are very difficult to assess here.
Restarted back at the gym this morning – having been a serial gym joiner at least returning to the same one is a step in the right direction I feel! It’s amazing: -I know the evidence; understand the links between exercise and health; teach patients and nurses about the wonders of exercise (notably with regard to fatigue management); have set up exercise rehab clinics for patients on treatment and post bone marrow transplant; even feel great and energetic when in a ‘must go the gym everyday’ phase of life ….. yet why is it so hard? and, why can’t i remember how great I feel when in the phase! Somehow sloth and icecream takes over. I blame the Magnum Gold for much of my downfall, although some of the sloth may be self induced! But … this is it …. this phase is THE ONE. I plan to lose a few kilos, run 15 km, take a spin class (without making a complete fool of myself or requiring an ambulance) and be able to lift 30kg (this is so that I can change a wheel on the fourbie! It’s all very well having terrific butch all terrain tyres but one has to able to deal with the flat versions of them). We’ll see …. ahhhh, already slipping!
I have been thinking more about the notion and practice of ‘health promotion'(HP). When thinking about health promotion do we need to be mindful that the ‘good’ in HP sits within a spectrum (all be it a wide spectrum) and there are limits beyond which HP becomes a risk to health? I was discussing HP with students yesterday and one of talked about a recent clinical event which caused me to ponder this idea of limits. Within the last month two teenagers had presented to the student’s (Mental Health) unit – both suicidal and both citing the extreme demands of maintaining a healthy lifestyle and body. I know that this is a much more complex issue than the inference I am alluding to but i think that it relevant. How difficult (and sometimes for some people read stressful) is it to find time to fit in a visit to the gym 5 days a week for 30-60 minutes or to fit in walking 10,000 steps, or even to try and measure 10,000 steps? What impact does it have if you can’t afford or source five vegetables a day and two fruit? Is it a paradox to undertake major and potentially high risk surgery as a health promotion activity? Recently a study revealed that loneliness is one of the greatest risks to health – are the social implications of the non acceptability of smoking implicated? I wonder if Talcott Parson’s rights and responsibilities of the sick role underpin some of our societal beliefs about HP and by this I mean; to have the right to be a member of society do people have a responsibility to seek and pursue HP activities? In other words, are smokers, drinkers and couch potatoes deviants?
I am being devil’s advocate here and, of course am cognisant of the the evidence and various strengths of evidence linking environment, lifestyle and disease and death but I think that we must remain open to question and critique blanket assumptions that can glaze over the complex detail.