| Nearly ¼ of 
patients say mechanical heart valve disturbs sleep NEARLY ¼ of patients with a 
mechanical heart valve say it disturbs their sleep, according to research 
presented at 'EuroHeartCare 2017.'
 "I will never have silence around me again..." said 1 patient.
 
 "For some patients the closing sound of their mechanical heart valve 
reduces their quality of life, disturbs their sleep, causes them to avoid social 
situations, and leads to depression and anxiety..." said lead author Dr 
Kjersti Oterhals, a nurse researcher at Haukeland University Hospital in Bergen, 
Norway.
 
 This study investigated how the noise of a mechanical heart valve affected 
patients' lives, in particular their sleep, and whether there were any 
differences between women and men.
 
 In April 2013 all 1,045 patients who had undergone aortic valve replacement at 
Haukeland University Hospital between 2000 and 2011 were invited to participate 
in a postal survey. Of the 908 patients who responded, 245 had received a 
mechanical valve and were included in the current analysis.
 
 Patients were asked if the valve sound was audible to them or others, if they 
sometimes felt uneasy about the sound, if the sound disturbed them during 
daytime or during sleep, and whether they wanted to replace the mechanical valve 
with a soundless prosthetic valve if possible. Patients ranked the noise on a 
scale of 0 (does not disturb them at all) to 10 (causes maximum stress). The 
Minimal Insomnia Symptom Scale, which consists of 3 questions about sleep, 
was used to give patients a score of 0 to 12 for insomnia.
 
 Patients were 60 years old on average and 76% were men. 23% said the valve sound 
disturbed them during sleep and 9% said it disturbed them during the day. Some 
28% wanted to replace their valve with a soundless prosthetic valve if possible. 
51% said the noise was often or sometimes audible to others, but only 16% said 
they sometimes felt uneasy about others hearing it.
 
 The researchers found that 87% of men and 75% of women said that they were able 
to hear the closing sound of their mechanical valve. Women were more disturbed 
by the valve sound than men.
Some 53% of the respondents had no insomnia, 31% had subclinical insomnia, and 
17% had moderate to severe insomnia. Valve noise perception was the strongest 
predictor of insomnia, followed by age, and female gender. There was a linear 
association between insomnia and valve noise perception. And the more patients 
considered the valve noise a disturbance in daily life, the more insomnia they 
reported.
Dr Oterhals said:- "Almost ¼ of patients said 
that the sound of their mechanical heart valve makes it difficult for them to 
sleep. Most of us need a quiet environment when we are going to sleep and these 
patients found it hard to ignore the noise from the valve."
 
 Not all patients are aware before surgery that they may hear their mechanical 
valve, and while most get used to it, for some it is troublesome for many years.
"One female patient said to me... 'I will never have silence around me 
again' when she realised she would hear the noise 24 hours a day for the rest of 
her life..." said Dr Oterhals.
The most common ways patients coped with the noise when trying to sleep were to 
sleep on their right side which reduced the valve noise, put the duvet around 
their bodies to isolate the sound, listen to music, and do relaxation exercises. 
Ear plugs were not effective and made the valve noise louder. 
Dr Oterhals said:- "We are not very proactive about this issue at the 
moment. It would improve many patients' quality of life if we asked them about 
valve noise and provided advice to those who find it distressing."
 |  | ₤1m of green farming 
	subsidies in Southport could be lost after general election ₤1M of funding given to farms in 
	the constituency of Southport to help protect nature and wildlife could be 
	lost after the general election unless the next government acts, according 
	to fresh analysis by Friends of the Earth.
 The environmental charity has crunched the numbers for Southport to find out 
	how much money is going to farms in the constituency under Environmental 
	Stewardship funding agreements. The money is vital for both farmers and the 
	local environment in Southport and it goes towards activities like restoring 
	hedgerows, planting trees, reducing flooding and creating wildlife habitats.
 
 The cash is paid to farmers as part of the European wide Common Agricultural 
	Policy but after Brexit this money will come to an end after 2020 unless the 
	next government agrees on a replacement scheme. Without a new system to 
	support farmers to manage their land sustainably, precious wildlife and 
	habitats already under threat will suffer further.
 
 Friends of the Earth are asking all parliamentary candidates standing in 
	Southport to commit to maintain and increase support for farmers to protect 
	the environment after Brexit.
 
 Friends of the Earth food and farming campaigner Clare Oxborrow said:- 
	"This funding is vital for nature and for local farmers. It helps to 
	reduce flooding, create wildlife habitats, plant trees and restore hedgerows, but all of this could be lost after the general election. 
	We're asking all parliamentary candidates to commit to keeping and 
	increasing this critical funding post Brexit."
 As Northern refuse to 
	settle guards' safety dispute, fares rip off RAIL UNION RMT condemned the 
	shocking fact that while Northern Rail continue to knock back moves to 
	resolve the current guards' safety dispute, the German state owned operation 
	will be pressing ahead with plans to increase fares substantially from this 
	Sunday, 21 May 2017. The increase follows a previous hike less than 9 months ago in September 
	2016, as Arriva seek to milk the franchise for every penny they can get.
 Despite the pretence of 'rail devolution' it is clear from the 
	announcement that value for money for passengers travelling in the North of 
	England has been shunted into a siding to ensure that profits continue to 
	flow out of the country to subsidise the publicly owned and operated railway 
	in Germany.
	A shocking example of this latest rip off is the revelation that the 
	so called Cheap Day Return fares, in Greater Manchester, will increase by up 
	to 50p, or up to 9.25%, taking the maximum fare to ₤5.90.
 
 The announcement also includes new fares, which are only available to buy 
	from the Northern mobile phone app or website, with fulfilment via m-ticket. 
	RMT says that this is the clearest possible recognition of the complete lack 
	of infrastructure, such as ticket offices or even ticket machines, which the 
	union believes will lead to further attacks on the jobs and conditions of 
	on-train staff.
 RMT General Secretary Mick Cash said:- 
	"This weekends latest fares rip 
	off is just another example of industry costs being shifted to the 
	passenger, whilst the profits made continue to be leaked away from Britain's 
	railways and shipped across the Channel. Northern should be forced to pull 
	back from their twin strategy of axing guards and raising fares in the dash 
	to fatten up the profits for the German state operator Arriva. This is a 
	scandalous situation that puts the issue of public ownership of our railways 
	right at the top of the agenda." |