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Three whooping cough baby deaths

Written By Unknown on Jumat, 30 November 2012 | 21.24

29 November 2012 Last updated at 19:03 ET

Three babies died from whooping cough in October as one of the worst outbreaks of the disease in decades continues, Health Protection Agency figures for England and Wales show.

It brings the number of deaths in newborns, who are most at risk of fatal complications, to 13 this year.

There were 1,614 infections last month, bringing the total to 7,728 this year.

A UK-wide campaign to vaccinate pregnant women, to pass protection on to their children, is under way.

There are surges in whooping cough cases every three to four years. However, the current outbreak has affected nearly 10 times as many people as the previous outbreak in 2008.

There have been more than 1,600 cases reported in Scotland and around 280 cases in Northern Ireland, but no deaths.

Immune system

Continue reading the main story

It is also known as pertussis and is caused by a species of bacteria, Bordetella pertussis
Infants are at highest risk of complications and even death
The earliest signs are similar to a common cold, which then develop into a cough and can even result in pneumonia
Babies may turn blue while coughing due to a lack of oxygen
The cough tends to come in short bursts followed by desperate gasps for air (the whooping noise)
Adults can be infected - but the infection often goes unrecognised

The infection can stop a baby breathing or lead to pneumonia, brain damage, weight loss and death.

Newborns are most vulnerable as they are too young to be vaccinated - doses are given at two, three and four months of age.

Pregnant women, between 28 and 38 weeks, are now being offered a whooping cough vaccine. It should prompt the mother's immune system to create more antibodies to attack the whooping cough bacterium. The antibodies should pass from the mother to the child in the womb and offer protection when a baby is born.

In August, there were 72 infections in children under one. That fell to 67 when the vaccination programme started in September and fell again to 46 in October. However, it is too soon to tell if vaccination is making a difference.

Dr Gayatri Amirthalingam, consultant epidemiologist for immunisation at the HPA, said: "The October figures show a continuing rise in the overall number of whooping cough cases.

"While there has been a decline in the number of infant cases it's important to emphasise that it's too early to see any impact from the pregnancy vaccination programme.

"We strongly recommend all pregnant women take up the offer of vaccination."

Routine vaccination was introduced in 1957. Before then cases could affect more than 100,000 people and kill 300 in a single year.

Health experts do not know why the outbreak is so large this year, especially as vaccination for whooping cough is at record levels.

Theories include the bacterium that causes the infection, Bordetella pertussis, mutating or the current vaccine not providing protection for as long as those used in the past.

Another idea is that tight control of whooping cough is part of the problem. People's immunity to whooping cough is boosted throughout life by being regularly exposed to it.

However, after years of low levels of whooping cough the whole population may have been left more vulnerable to the infection.

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Stem cells being made from blood

29 November 2012 Last updated at 19:45 ET By James Gallagher Health and science reporter, BBC News

A patient's own blood has been used to make personalised stem cells, which doctors hope will eventually be used to treat a range of diseases.

The team at the University of Cambridge says this could be one of the easiest and safest sources of stem cells.

In a study, published in the journal Stem Cells: Translational Medicine, the cells were used to build blood vessels.

However, experts cautioned that the safety of using such stem cells was still unclear.

Stem cells are one of the great hopes of medical research. They can transform into any other type of cell the body is built from - so they should be able to repair everything from the brain to the heart, and eyes to bone.

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It's a hell of a lot easier to get a blood sample than a high quality skin sample so that's a big benefit"

End Quote Prof Chris Mason University College London

One source of stem cells is embryos, but this is ethically controversial and they would be rejected by the immune system in the same way as an organ transplant.

Researchers have shown that skin cells taken from an adult can be tricked into becoming stem cells, which the body should recognise as part of itself and would not reject.

The team at Cambridge looked in blood samples for a type of repair cell that whizzes through the bloodstream repairing any damage to the walls of blood vessels. These were then converted into stem cells.

Dr Amer Rana said this method was better than taking samples from skin.

"We are excited to have developed a practical and efficient method to create stem cells from a cell type found in blood," he said.

"Tissue biopsies are undesirable - particularly for children and the elderly - whereas taking blood samples is routine for all patients."

Dr Rana told the BBC the cells also appeared to be safer to use than those made from skin.

"The fact that these appeared to be fairly stable is very promising," he said.

"The next stage obviously is to say, 'OK if we can do all this, let's actually make some clinical grade cells,' we can then move this technology into the clinic for the first time."

Prof Chris Mason, an expert on regenerative medicine at University College London, said there was some "beautiful work" coming out of the lab in Cambridge.

"It's a hell of a lot easier to get a blood sample than a high quality skin sample, so that's a big benefit," he said.

"However, induced pluripotent stem cells [those converted from adult cells] are still very new, we need far more experience to totally reprogram a cell in a way we know to be safe."

The British Heart Foundation said these cells had "great potential".

The Medical Research Council said there was "rapid progress" being made in the this field.

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'Sandwich carers' under pressure

30 November 2012 Last updated at 03:34 ET

The pressure of looking after children while caring for elderly relatives is taking its toll on all aspects of family life, a Carers UK survey suggests.

It found that a third of "sandwich carers" had to give up work, while two-thirds said their marriages had been damaged.

The charity is calling for care services and employers to support the 2.4 million families in this situation.

About 1,000 carers were surveyed.

Four in ten said they were struggling to cope with the demands of caring for children under the age of 18 and an older or disabled adult at the same time.

More than half juggled work and caring for their dependents, but some had had to give up work completely.

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Every day Nina, from South Wales, has an enormous list of things to do.

She cares for her 87-year-old mother, Valentina, who has a heart condition, and her daughter Lara, who is registered blind.

Lara, who lives opposite Nina, has a two-year-old son and six-week-old baby - and a husband who works shifts.

"I go backwards and forwards a lot between the houses," says Nina.

"Lara has only 5% sight, so she needs my help. She's not getting much sleep just now, so when the two-year-old gets up at 06:30, she will call me and say 'help'.

"When she puts one child down, she doesn't know what the other one is doing."

Nina takes her grandson to nursery in the mornings then comes back to check on her mother, who is increasingly frail, and make meals.

Until recently, Nina cared for her husband, John, too, but he is now in a special care unit for Alzheimer's patients.

"Weekends are chaos. I don't really have any time for myself. I have to do a lot of arranging if I want to go out," she says.

"I do feel tired. I feel like I'm on a roundabout and sometimes I just want to get off."

Women were four times more likely than men to have given up work to fulfil their caring role.

For those who continued to work, they reported feeling stressed and tired while doing their job.

Damaged relationships

Three-quarters of those surveyed said they had suffered a loss of earnings, and 95% said the pressure of caring had affected their ability to work.

When asked about family finances, 52% said the cost of caring for elderly relatives was having an impact while 50% reported they were struggling with childcare costs.

The responsibilities of caring for young and old can be detrimental to family life too, the survey suggests, with two-thirds of sandwich carers reporting damage to their marriages or personal relationships.

Helena Herklots, chief executive of Carers UK, said the reality of family life was changing for many people.

"An ageing population means that caring for older or disabled loved ones is inevitable for all our families.

"Care services and workplaces must catch up with this reality of family life.

"Currently, families too often cannot access the support they need and are finding themselves squeezed between childcare, care for older parents and work - under pressure from all sides, and seeing their finances, careers and personal relationships suffer."

There are thought to be more than 6.4 million carers in total in the UK. Every year two million people become carers, and by 2037 it is estimated there will be roughly nine million carers in the UK.

A Department of Health representative said: "Carers make an invaluable contribution to society, so we want to do all we can to support them.

"We are supporting them to stay in work, encouraging employers to offer flexible working and we have provided £400m to help carers have breaks and holidays. We have also put the rights of carers on the same footing as the people they care for."

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Birth tests 'can predict obesity'

Written By Unknown on Kamis, 29 November 2012 | 21.24

28 November 2012 Last updated at 18:16 ET By Melissa Hogenboom BBC News

Researchers say a baby's chance of being obese in childhood can be predicted at birth using a simple formula.

The formula combines several known factors to estimate the risk of obesity.

The authors of the study, published in PLos One, hope it will be used to identify babies at risk.

Childhood obesity can lead to many health problems, including Type 2 diabetes and heart disease.

Researchers from Imperial College London looked at 4,032 Finnish children born in 1986 and at data from two further studies of 1,503 Italian children and 1,032 US children.

They found that looking at a few simple measurements, such as a child's birthweight and whether the mother smoked, was enough to predict obesity.

Previously it had been thought that genetic factors would give bigger clues to later weight problems, but only about one in 10 cases of obesity is the result of a rare gene mutation that affects appetite.

Obesity in children is rising, with the NHS estimating that 17% of boys and 15% of girls in England are now obese.

Continue reading the main story

Predictors used in the calculation include:

The child's birthweight
The parents' body mass index
Number of people in the household
The mother's professional status
Whether or not the mother smoked during pregnancy

The risk factors for obesity are already well known, but this is the first time these factors have been put together in a formula.

Prof Philippe Froguel from Imperial College London, who led the study, said that prevention was the best strategy. Once obese, a child can find it difficult to lose weight.

"The equation is based on data everyone can obtain from a newborn, and we found it can predict around 80% of obese children.

"Unfortunately, public prevention campaigns have been rather ineffective at preventing obesity in school-age children. Teaching parents about the dangers of overfeeding and bad nutritional habits at a young age would be much more effective.

"The message is simple. All at-risk children should be identified, monitored and given good advice, but this costs money."

Prof Paul Gately, a specialist in childhood obesity at Leeds Metropolitan University, said a tool like this would help the NHS target specific people at risk rather than the "scattergun one-size-fits-all approach, which we know does not work".

"Rather than spending money on a huge number of people, we can be more specific and spend appropriately. We may not save money in the short-term but it will be spent more wisely and could reduce [obesity-related] NHS bills in the future.

"We've done a great job of outlining that obesity is a serious issue but we have made the general public paranoid that everyone is at risk.

"Tools like this will help change that attitude. Once we use the tool, we need intervention programmes for children at a greater risk."

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Highest-ever HIV cases in gay men

29 November 2012 Last updated at 03:58 ET By James Gallagher Health and science reporter, BBC News

The number of gay and bisexual men being diagnosed with HIV in the UK reached an "all-time high" in 2011, according to the Health Protection Agency (HPA).

It said there had been a "worrying" trend since 2007, with more and more new cases each year.

Nearly half of the 6,280 people diagnosed last year were men who had sex with other men (MSM).

Overall, one in 20 MSM are infected with HIV.

Of those diagnosed in 2011, nearly two-thirds had not been to a sexual health clinic in the previous three years.

Continue reading the main story

HIV stands for human immunodeficiency virus and on its own it does not kill you.

The virus can survive and grow only by infecting, and destroying, the immune system.

This continual assault on the immune system makes it weaker and weaker until it is no longer able to fight off infections.

Without treatment, it takes about 10 years from infection to the development of Aids - acquired immune deficiency syndrome.

It is then that "opportunistic infections", ones a healthy immune system could fight off, become deadly.

People can die from pneumonias, brain infections, diarrhoeal illnesses as well as certain tumours such as lymphoma and cervical cancer.

The HPA said the figures showed there was "room for improvement" in testing people in at-risk groups.

Dr Valerie Delpech, the organisation's head of HIV surveillance, told the BBC: "Obviously this is a serious illness and it is worrying that we're still seeing a lot in men who have sex with men and this is a record year.

"Transmission in the UK is largely sexual, so safe sex is the best way to prevent yourself getting HIV."

Rising

The total number of people living with HIV in the UK rose to 96,000, up from 91,500 the previous year. The issue is most intense in London.

Due to advances in drug treatment, having HIV should not affect life-expectancy.

However, the data suggests that one in four people with HIV are completely unaware of the infection, meaning they cannot receive treatment and may still be spreading the virus.

The chief executive of the National Aids Trust, Deborah Jack, said: "It is vitally important that gay men test at least once a year for STIs [sexually transmitted infections] and HIV, and every three months if they're having unprotected sex with new or casual partners.

"HIV-negative gay men diagnosed with an STI should really treat it as a 'wake up call'. You are at serious risk of getting HIV in the near future and need to take steps to prevent that happening - such as consistent condom use and reduction in number of sexual partners."

Sir Nick Partridge, the chief executive at the Terrence Higgins Trust, said: "HIV is an entirely preventable condition, yet each year we see thousands more people across the UK receive this life-changing diagnosis.

"Reducing undiagnosed HIV by encouraging those in high-risk groups to test more regularly is one way we can put the brakes on the spread of infection."

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Winter death toll 'falls by 8%'

29 November 2012 Last updated at 05:18 ET

Mild weather and low levels of flu contributed to an 8% fall in extra deaths last winter in England and Wales, according to official figures.

The Office for National Statistics (ONS) data compares the number of deaths during the winter months with the average in other parts of the year.

There were 24,000 excess deaths in the winter of 2011-12, compared with 25,700 the year before.

The vast majority of excess deaths, 19,500, were in the over 75s.

The ONS said levels of flu last winter were the lowest on record. It said this, combined with mild weather, would explain why there were fewer deaths.

The charity Age UK welcomed the fall in deaths, but said the overall number was too high and was a "national tragedy".

Its director general, Michelle Mitchell, said: "Every single excess winter death is preventable and represents our failure to meet the challenge of plummeting temperatures in Britain.

"Even in very cold countries such as Finland, excess winter deaths are much lower because they take staying warm seriously and prepare for cold weather."

"This fall does not prove progress in tackling the problem of excess winter deaths, as data shows that colder temperatures in future years could result in another sharp hike in deaths.

A Department of Health spokesman said: "We're pleased to see there was an overall reduction in excess winter deaths however there is no room for complacency.

"We have allocated £20m to local authorities to help vulnerable people stay well during cold weather and get the help they need within their communities.

"And we urge anyone with a long-term condition to get a free flu jab from their GP."

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Cycle and walking 'must be norm'

Written By Unknown on Rabu, 28 November 2012 | 21.24

27 November 2012 Last updated at 21:22 ET By Nick Triggle Health correspondent, BBC News

Cycling and walking should be the norm for all short journeys, experts say.

The National Institute for Health and Clinical Excellence said people should shun their cars if a trip could be done in 15 or 20 minutes on foot or bike.

It said the approach was needed to combat the "silent epidemic" of inactivity posing a risk to the health of people in England.

The advisory body called on councils to do more to make walking and cycling an easier option in local communities.

It said their new responsibility for public health, which the NHS will hand over next year under the government's reform programme, offered a "unique opportunity" to make a difference.

The National Institute for Health and Clinical Excellence (NICE) said councils should look to introduce bicycle-hire schemes, car-free events and better cycle-route signalling and maps.

Continue reading the main story

It's not necessarily about spending more money on transport, but investing existing money in our health by rethinking the way in which budgets are being spent"

End Quote Dr John Middleton Faculty of Public Health

Walking routes should also be better highlighted, with signposts indicating the distance and time it takes to walk to local destinations.

Schools and workplaces should also be encouraged to get more pupils and staff cycling and walking.

NICE has previously given its backing to 20mph speed limits in certain areas.

'Costing lives'

The group said local authorities needed to take action, as the levels of inactivity were costing lives.

A recent report in the Lancet said inactivity was now causing as many deaths as smoking.

Latest figures suggest six in 10 men and seven in 10 women are not doing the recommended levels of physical activity.

The figures are little better for children.

In particular, levels of cycling and walking are falling - with England lagging well behind other European countries, such as the Netherlands and Denmark. Only 11 minutes a day on average is spent cycling or walking.

Prof Mike Kelly, from NICE, said: "As a nation, we are not physically active enough and this can contribute to a wide range of health problems."

Dr John Middleton, vice-president of the Faculty of Public Health, said cycling and walking needed to be made an "easy option".

"It's not necessarily about spending more money on transport, but investing existing money in our health by rethinking the way in which budgets are being spent."

Local transport minister Norman Baker added the new duty on councils should make it easier to ensure transport, planning and health officials worked together to help change the way people travel.

"We want to see more people walking and cycling," he added.

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Hunt plans 'Ofsted for hospitals'

28 November 2012 Last updated at 04:51 ET By Anna-Marie Lever Health reporter, BBC News

An "Ofsted-style" ratings system for hospitals and care homes in England will be proposed by Health Secretary Jeremy Hunt later on Wednesday.

Recommendations on how the NHS could use a grading system similar to that in schools will be reviewed by think tank the Nuffield Trust.

Currently services have only to meet minimum standards set by the Care Quality Commission (CQC).

Mr Hunt hopes a new system can help end the "crisis of care".

Last week's CQC report found services were struggling.

'Tick-box exercise'

The report showed that overall one in four services in England failed at least one of the 16 key standards.

Among the most commonly failed areas were standards relating to dignity and respect, nutrition, and care and welfare.

Critics of the current minimum standards model have said it is a tick-box exercise which does not encourage improvement.

The proposed grading system will be announced by Jeremy Hunt in a speech at the King's Fund in London.

Mr Hunt is expected to say: ""As an MP I know how well each school in my constituency is doing thanks to independent and thorough Ofsted inspections. But because the CQC only measures whether minimum standards have been reached, I do not know the same about hospitals and care homes.

Star system

"I am not advocating a return to the old 'star ratings' but the principle that there should be an easy-to-understand, independent and expert assessment of how well somewhere is doing relative to its peers must be right."

The CQC previously had a quality grading system called "star ratings" - under this ranking, three stars were given to excellent providers and no stars were for those with poor standards. This system was dropped in July 2010, having been criticised for setting too high a level and not giving an accurate picture of care within a health trust.

An independent study to look at how a new ratings system could work is being led by the healthcare think tank, the Nuffield Trust, which is expected to report back with recommendations by the end of March 2013.

Jennifer Dixon, the director of the Trust said:"It's a sensible question to ask about how the quality of care is assessed in health and social care providers, given all the systems currently in place to boost and monitor quality for the public.

Continue reading the main story

No increase in bureaucracy
Easy-to-understand results
Drives organisations to excel
Greater certainty of identifying poor care

"At the Nuffield Trust we look forward to doing an independent analysis of this issue working with a range of groups across the health and social care world in the UK, learning from past experience , from other sectors, and from other countries."

'True picture'

However, there are warnings that the system needs to be well managed with frequently updated information to work.

David Rogers from the Local Government Association said: "Providing greater clarity would undoubtedly provide much needed assurances for those who are naturally looking for the very best care and support in old age.

"But for a rating to be reliable and trusted it also needs to be current and reflect the true picture of the level of service a care home provides. This means ratings would need to be provided regularly, and certainly be no more than two years old.

"For assessments to reflect a true picture they should also take into account the information that is already available, the views of people who use the service, and information from local authorities and other organisations involved in providing care."

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Plan for 45p minimum alcohol cost

28 November 2012 Last updated at 05:34 ET By Nick Triggle Health correspondent, BBC News

Ministers are proposing a minimum price of 45p a unit for the sale of alcohol in England and Wales as part of a drive to tackle problem drinking.

The Home Office has launched a 10-week consultation on the plan, arguing it will help reduce the levels of ill-health and crime related to alcohol.

It is also considering banning multi-buy promotions, such as two-for-the-price-of-one.

The 45p proposal is 5p higher than the figure suggested by ministers in March.

It comes after pressure has been mounting on the government to follow Scotland's lead, where 50p has been proposed.

The aim of a minimum price would be to alter the cost of heavily-discounted drinks sold in shops and supermarkets. It is not expected to affect the price of drinks in many pubs.

The Home Office said the consultation was targeted at "harmful drinkers and irresponsible shops".

A spokesman added: "Those who enjoy a quiet drink or two have nothing to fear from our proposals."

The 45p minimum would mean a can of strong lager could not be sold for less than £1.56 and a bottle of wine below £4.22.

Research carried out by Sheffield University for the government shows a 45p minimum would reduce the consumption of alcohol by 4.3%, leading to 2,000 fewer deaths and 66,000 hospital admissions after 10 years.

The number of crimes would drop by 24,000 a year as well, researchers suggested.

There has been evidence of some outlets selling alcohol at a loss to encourage customers through the doors, with cans of lager going for 20p and two-litre bottles of cider available for under £2.

'Pre-loading'

Ministers have been particularly critical of such practices, blaming them for what has been dubbed "pre-loading", where people binge-drink before going out.

They have linked this phenomenon to the rising levels of alcohol-related violence and hospital admissions, of which there are more than a million a year.

But the idea of introducing a minimum price - first proposed at 40p in the government's alcohol strategy published in March - has been met with opposition by the industry.

The Scottish government plan, which is not due to start until April 2013, was challenged on legal grounds by the Scotch Whisky Association and the European Spirits Organisation.

Continue reading the main story

What's a unit?

Half a pint of standard strength (4%) beer, cider or lager
A single pub measure of spirit (25ml)
Half a standard 175ml glass of wine

They claimed it was up to Westminster, rather than Holyrood, to decide such an issue and they said it was also incompatible with the EU's "general principles of free trade and undistorted competition".

The legal challenges were heard in the Court of Session in Edinburgh last month and a judgement is expected before the end of the year.

Separately the European Commission is looking into the legality of the Scottish government's actions.

In Northern Ireland, consideration is also being given to minimum pricing, although no final decision has been taken yet.

Andrew Opie, of the British Retail Consortium, said: "Most major retailers believe minimum pricing and controls on promotions are unfair to most customers. They simply penalise the vast majority, who are perfectly responsible drinkers, while doing nothing to reduce irresponsible drinking.

"The government should recognise the role of personal responsibility. It should not allow interfering in the market to regulate prices and promotions to become the default approach for public health policy."

Miles Beale, chief executive of the Wine and Spirit Trade Association, agreed, saying there was "no evidence" minimum alcohol pricing would be effective in tackling alcohol misuse.

Continue reading the main story

The 45p effect

On the face of it, there seems to be little difference between the 45p minimum unit price for alcohol now being proposed and the 40p figure put forward earlier this year.

But in terms of consumption levels - and the subsequent criminal and health costs - the shift is significant.

Research by Sheffield University shows that at 45p consumption drops by 4.3% - a 75% greater effect than would be seen at 40p.

In terms of deaths over a 10-year period, the impact is nearly double. A 45p minimum will save over 2,000 lives compared to under 1,200 for 40p. The effect on crime is also two-fold.

But what the research also shows is that another 5p on the minimum price to bring it to 50p - as Scotland has done - would see a similar increase in impact, which is why campaigners have been pushing for more.

Another area of interest - and possible controversy - is the effect this will have on moderate drinkers.

The research shows a 45p minimum price also effects their buying habits, reducing consumption by 2.3%. That is greater than the reduction likely to be seen in young hazardous drinkers - the so-called binge drinkers.

But health campaigners believe a minimum price is an important step in tackling problem drinking.

Dr Vivienne Nathanson, from the British Medical Association, said the changes in pricing could help to stop young people binge drinking.

She told the BBC: "Alcohol is a dose-related poison, in other words the more you drink the more harm it causes, so by reducing the amount they are drinking over the safe limit you are helping to save them.

"It isn't a small minority of the population who are drinking excessively, it's nearly a quarter. That's a huge number of people who are drinking at levels that are hazardous to their health and we really have to throw everything we can (at it) to save lives."

Eric Appleby, chief executive of Alcohol Concern, said: "We're paying a heavy price for alcohol misuse and setting a minimum unit price will help us on the road to changing this.

"But we cannot cut the misery caused by excessive drinking, whether it's crime or hospitalisation, through price alone.

"We need tighter controls around licensing, giving local authorities and police forces all the tools they need to get a firm grip on the way alcohol is being sold in their area. We have an opportunity to make an enormous difference to the lives of thousands of people - we must seize it."

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Autism 'linked' to heavy traffic

Written By Unknown on Selasa, 27 November 2012 | 21.24

26 November 2012 Last updated at 22:14 ET By James Gallagher Health and science reporter, BBC News

The possibility that autism is linked to traffic pollution has been raised by researchers in California.

Their study of more than 500 children said those exposed to high levels of pollution were three times more likely to have autism than children who grew up with cleaner air.

However, other researchers said traffic was a "very unlikely" and unconvincing explanation for autism.

The findings were presented in the Archives of General Psychiatry journal.

Continue reading the main story

Autism and Asperger's syndrome are part of a range of disorders that can cause difficulties with communication and social skills
The conditions can lead to isolation and emotional problems for those living with them
Conditions can vary from very mild, where the person can function as well as anyone else, to so severe they cannot take part in normal society
The conditions are collectively known as autistic spectrum disorders and affect more than 580,000 people in the UK

Source: BBC Health

Data from the US Environmental Protection Agency were used to work out levels of pollution for addresses in California.

This was used to compare exposure to pollution, in the womb and during the first year of life, in 279 children with autism and 245 without.

The researchers from the University of Southern California said children in homes exposed to the most pollution "were three times as likely to have autism compared with children residing in homes with the lowest levels of exposure".

They have previously shown a link between autism and living close to major roads.

They warn that there could be "large" implications because air pollution is "common and may have lasting neurological effects".

But how?

However, other researchers questioned how pollution could alter the brain's development and lead to autism.

Uta Frith, a professor of cognitive development at University College London, said: "It seems to me very unlikely that the association is causal."

She said the study did not "get us any further since it does not present a convincing mechanism by which pollutants could affect the developing brain to result in autism".

One of the challenges with this style of study is that it is difficult to account for every aspect of life which might affect the probability of developing autism, such as family history.

It means the study cannot say that autism is caused by traffic pollution, merely that there could be a link between the two.

Sophia Xiang Sun, from the University of Cambridge's autism research centre, argued that cutting pollution would be a good idea anyway.

"We know that traffic-related air pollution can contribute to many other diseases and conditions, and it is biologically plausible it also has a role in pathways of autism.

"However, whether or not the potential association between autism and traffic-related air pollution exists, reduction of traffic-related air pollution would be good for public health."

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Screening 'cuts' aneurysm deaths

27 November 2012 Last updated at 03:11 ET By Michelle Roberts Health editor, BBC News online

Far fewer patients who have surgery for abdominal aortic aneurysm (AAA) now die on the operating table - an improvement experts say is partly due to screening.

Men in most areas of England aged 65 and older are invited for a scan to check for AAA - when the body's main blood vessel is abnormally enlarged and without repair risks a fatal rupture.

Before screening began in 2009 the UK had the highest death rate in Europe.

The Department of Health said screening would be rolled out by April.

The UK's death rate for AAA repairs was 7.5% in 2009 but in England it is now 1.6%.

As some people get older, the aorta - the large blood vessel that carries blood from your heart to your body - can get weak and swell up.

It is estimated that about 1 in 25 men in England aged between 65 and 74 have an abdominal aortic aneurysm.

Most of these are small and not serious but with larger ones comes a greater risk of rupture - a medical emergency that is fatal in about 80% of cases.

Studies suggest that screening should reduce AAA-related deaths by up to half by detecting aneurysms early so they can be repaired.

For every 200 men screened by the NHS AAA Screening Programme (NAAASP), eight will have an aneurysm but only one will have one large enough to require treatment.

By April 2013, the programme should cover the whole of England - Scotland, Wales and Northern Ireland are in the process of adopting it.

Annual data from the NAAASP shows that 190 men had elective surgery in 2011-12 to repair aneurysms detected by screening and there were three deaths - a mortality rate of 1.6%.

'Justifiably proud'

Of a reported 8,380 patients in the UK who had AAA surgery between 2008 and 2010, 197 died, giving an elective hospital mortality rate of 2.4%.

Experts say the improvement is partly due to the introduction of screening - which means more patients are being treated earlier when complications are less likely.

Another reason cited is the reorganisation of services to ensure that only hospitals with the most expertise in treating AAA carry out this type of surgery.

Jonothan Earnshaw, NAAASP director, said: "Research shows hospitals that do a lot of these operations get better results, and this is also reflected in the latest mortality figures."

Prof Ross Naylor, president of the Vascular Society of Great Britain and Ireland, said: "The UK can be justifiably proud of being one of only a few countries to have implemented a national aneurysm screening programme which has met every quality target regarding deliverability and low procedural risks."

A Department of Health spokesperson said: "Screening can save lives and improve the health of the nation - by detecting abdominal aortic aneurysms early, they can be monitored or treated where necessary, saving the lives of thousands of older men.

"Full roll-out of the screening programme is expected by April 2013."

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MMR jab uptake at 14-year high

27 November 2012 Last updated at 07:43 ET

MMR vaccine coverage has reached its highest level in 14 years in young children, says the Health and Social Care Information Centre (HSCIC).

In England, 91% of children under the age of two received the first dose of the jab between 2011 and 2012, a rise of 2.1% on the previous year.

But this is still short of the 95% that experts believe is required to stop the spread of measles.

Measles outbreaks were seen in Sussex and Merseyside earlier this year.

Tim Straughan, chief executive from HSCIC, said: "Today's report marks a significant point in the continued rise of MMR coverage since it hit a low in 2003-04 - as for the first time in 14 years, nine out of 10 children in England have had the MMR vaccine before they turn two.

"However although MMR coverage at two years has risen in all regions of England, and overall the country's coverage has increased in recent years, the national figure remains below the World Health Organization (WHO) target of at least 95%."

This is the first time coverage in England has passed 90% since 1997-98, when immunisation fell due to the controversial claims against the vaccine that were completely without foundation.

Continue reading the main story

How safe is it to take children to mainland Europe who have had two doses of the MMR vaccine?

It gives 99% protection against the measles virus.

What if they have had only one dose of MMR?

One dose is better than none, but two doses is better than one. If you are concerned about travelling to an outbreak area you can bring forward the second MMR dose. Speak to your GP about it.

What if my children are not vaccinated at all?

The advice is to go to your GP and arrange for them to be immunised as soon as possible before you travel. Measles is a dangerous viral illness that can be fatal.

BBC Health - Measles

Two dose protection

Since 2004 MMR vaccination coverage has generally increased each year - in June 2011 quarterly figures showed it had reached 90% in the UK, for the first dose taken before the age of two.

The first dose of the MMR vaccine should ideally be given to children between 12 to 13 months of age.

They are given the second dose before they start school, usually between three and five years of age, although it can be given three months after the first.

The HSCIC's NHS Immunisation Statistics, England , 2011-12 report shows coverage in England is still below that of other UK nations.

Scotland has the highest uptake of 94.3%, followed by Northern Ireland at 93.3% and then Wales at 92.7%. Overall the UK is at 91.6%.

In England, London had the lowest uptake at just 86.1%.

The highest coverage was in Thames Valley, Hampshire and the Isle of Wight where 93.5% of children were vaccinated.

'Never too late'

While uptake has improved in recent years- children who do not get vaccinated on time, and older children who missed out when the uptake was lower, mean that there are still enough unvaccinated people to allow measles outbreaks to occur.

Dr Helen Bedford, from UCL Institute of Child Health, said: "It is good news that parents have regained their confidence in this highly effective vaccine.

"However, some teenagers and children have never caught up with missed vaccines and remain at risk of these potentially harmful infections.

"It is never too late to have the two doses of MMR vaccine needed to protect against measles, mumps and rubella which can be more severe in adulthood."

Figures from the Health Protection Agency earlier this year showed measles cases in England and Wales almost doubled between January to June compared with the same period in 2011, rising from 497 cases to 964.

Measles can cause serious illness and can, in some cases, be fatal.

Complications can include meningitis and encephalitis - inflammation of the lining of the brain. Rarer disorders of the eye, heart and nervous system can also develop.

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Secret NHS death reports released

Written By Unknown on Senin, 26 November 2012 | 21.24

25 November 2012 Last updated at 19:04 ET

Hundreds of previously secret NHS reports into serious incidents, including 105 deaths, have been published by BBC Scotland.

More than 300 reports into the most serious incidents in Scotland's hospitals last year have been released.

The reports include a person being blown up while on oxygen therapy after lighting a cigarette.

They also detail deaths from fatal doses of medicine and missing equipment during a cardiac arrest.

Other reports show procedural problems in hospitals meaning patients died before they could be transferred and supplies of drugs or emergency equipment not being available.

The reports were released after a Freedom of Information request.

BBC Scotland has now published all the incident reports, which can be read by clicking through from the dropdown box below.

Continue reading the main story

Find your area

Former NHS staff have accused health boards of covering up mistakes rather than learning from them.

Scottish Public Services ombudsman Jim Martin said the bureaucracy in the NHS seemed to be more important than learning when things go wrong.

The Scottish government is conducting an urgent review of incident reporting and said there was no evidence that the system was putting patients at risk.

Research suggests about one in ten hospital admissions result in an "adverse event".

Health boards decide how they should be investigated and what lessons can be learned from any mistakes.

Huge variation

But the BBC Scotland Investigation, How Safe is Your Hospital? found a huge variation between NHS boards in the numbers of incidents reported and what sorts of investigations are conducted.

It was given access to 345 reports which demonstrate a big discrepancy surrounding what boards consider to be serious.

These range from a nurse injured while hanging up Christmas decorations and a toaster used in an inappropriate area to a baby that died during labour and a surgeon removing a healthy organ.

Continue reading the main story

Scottish Public Services Ombudsman Jim Martin

I think if we had a simple national system it would be far easier to ask a simple question of the health service "

End Quote Jim Martin Scottish Public Services Ombudsman

There is also a huge disparity in the way incidents are reported and investigated.

The biggest health board, Greater Glasgow, reported relatively few incidents (95) despite serving the largest population.

Meanwhile Shetland recorded 138 serious incidents in a year and Tayside's reports all listed almost identical learning points.

The public services ombudsman said it was "a confusing picture".

Mr Martin said: "I think if we had a simple national system it would be far easier to ask a simple question of the health service and get a clear statistical answer."

Dr Alastair Ross, a specialist in risk management at the King's Patient Safety and Service Quality Research Centre, said: "In the NHS we are very conscious that process and medical treatment has to be evidence-based.

"You wouldn't implement a drug or a treatment protocol without feeling that the evidence was very reliable and that it was going to make a real difference to patient safety and I don't think we should be doing that with the organisational side of things either."

International research suggests one in 10 hospital admissions can result in some kind of adverse event, whether that is a patient fall or an unexpected death, so learning from these mistakes can save lives.

Earlier this year, the health secretary ordered an investigation into NHS Ayrshire and Arran after the health board was severely criticised for withholding more than 50 reports on serious incidents at its hospitals and clinics.

Over a period of five years, NHS Ayrshire and Arran refused to release the critical incident and adverse event reports to staff.

National picture

A mental health nurse employed by the health board became concerned when he was involved in a critical incident, but never received a copy of the findings.

Rab Wilson was told he was not entitled to read the report, and would have to apply under FOI legislation.

Mr Wilson said he felt bullied by the NHS when he tried to raise his concerns.

Another nurse had to leave her job when she repeatedly asked for concerns about patient care to be addressed.

She said NHS Ayrshire and Arran tried to cover up mistakes rather than learn from them.

Having exposed serious weaknesses at NHS Ayrshire and Arran, Healthcare Improvement Scotland said it did not know the situation for other health boards in Scotland.

Robbie Pearson, from HIS, admitted they have no idea of the national picture.

He said: "At present we don't know. That's why we're going out to all the NHS boards. We're starting this month and we'll be around all the boards by the end of next year."

BBC Scotland Investigates: How Safe is Your Hospital is on BBC One Scotland at 22:35 on Monday 26 November.

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Acne drug is 'grossly overused'

By Adina Campbell
Newsbeat reporter

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Will has suffered from acne but decided not to take Roaccutane

An acne drug, which it is claimed is linked to depression, is being given to a growing number of young people who don't need it, says one of the UK's top dermatologists.

Roaccutane is the most powerful drug to treat acne and has been prescribed to more than half a million people.

Campaigners say it is dangerous and can cause serious mental health problems.

"Roaccutane is grossly overused," said Doctor Tony Chu, who thinks it should be used as a last resort.

Continue reading the main story

I've seen patients who have been to see a local dermatologist to treat four of five spots and still been offered it

Doctor Tony Chu Dermatologist

"I've seen patients who have been to see a local dermatologist to treat four or five spots and still been offered it.

"If you read the guidelines it should only be used for people who have severe acne."

The Medicines and Healthcare products Regulatory Agency (MHRA) is the government body responsible for licensing drugs and treatments in the UK.

Dr June Raine, who speaks for the group, insists most people respond well to the drug and some are depressed before taking the drug.

"It's been a highly effective treatment for tens of thousands of people," she said.

"Depression is linked with a severe skin condition but it tends to get worse as the condition gets worse."

Derek Jones says Roaccutane was partly to blame for the death of his son Jesse

Twenty-four-year-old Jesse Jones, from Dorset, took his own life last year.

He had been taking Roaccutane and his family believe the drug was partly to blame for his death.

'Self-loathing'

His father, Derek Jones, says the acne deeply affected him.

"His absolute self-loathing was because he had bad acne," he said.

"The acne was to blame in the beginning but the Roaccutane added to what happened."

Roche, the company which makes Roaccutane, says there is no cause or link between the drug and depression, or suicidal thoughts.

Figures show only one in 10,000 people will experience such serious side-effects.

More than half a million people have been prescribed Roaccutane worldwide.

Latest figures show there were nine suicides of people who were taking Roaccutane recorded between September 2010 and September 2011.

Watch the full programme, Dying for Clear Skin, on BBC Three at 21:00 GMT on 26 November.

Follow @BBCNewsbeat on Twitter

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Hospital at risk as floods spread

26 November 2012 Last updated at 08:26 ET

Fire crew at Northallerton's Friarage Hospital

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The BBC's Danny Savage: "The stream is threatening to flood the main operating theatre in the Friarage Hospital"

Flood warnings are in place across the whole of England and a hospital is at risk as the heavy rain that hit the South West at the weekend moves north.

High volume pumps have been deployed at the Friarage Hospital in Northallerton, North Yorkshire, as a nearby beck threatens to flood the hospital.

There are currently 190 flood warnings across the country with the majority in the Midlands.

The Environment Agency has also issued more than 270 flood alerts.

Fire crews spent the morning trying to maintain water levels at Friarage Hospital and safeguard vital services such as electrical systems and heating equipment.

The hospital car park is flooded and there are drainage issues in three theatres. The occupational therapy department has also had to close.

As a result the trust has made the decision to cancel all elective surgery.

Woman killed

A woman and her three-year-old child have been rescued from their car in Woodley, in Berkshire, after it became stuck in flood water.

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Martin Weiler, Environment Agency: "West Country has taken a major hit"

Forecasters have warned the rain is likely to remain until Tuesday night.

The storms have already caused devastation across large swathes of the country.

A 21-year-old woman was killed and two people were injured by a falling tree in Western Way, Exeter, Devon, on Saturday as strong winds whipped southern England.

An elderly man was pulled from his car which was partially submerged in flood water at Keynsham, in Somerset, on Sunday.

Breakdown services reported surges in flood-related callouts as roads were closed due to standing water.

Rail disruption

Some residents in villages in the Tewkesbury area of Gloucestershire cut off by flood water have had to decide whether to be rescued or not.

Deputy chief fire officer Geoff Sallis, from the county's fire and rescue service, said people had been given the option of being brought "into safer areas" but most were choosing to stay at home.

Homes in Sturminster Marshall, in Dorset, were protected by a flood barrier around the village.

Resident Holly White said: "The road has turned to a river and the village green is a lake.

"Our main concern would be if the flood barrier doesn't hold - we don't need any more rain."

National Rail said the severe weather is disrupting services across the South West.

Train services have also been hit by a landslide at Dawlish, in Devon, and by flooding at Church Stretton in Shropshire.

John Baker, from Network Rail, said it could be mid-week before services improved.

He said: "We are struggling to get routes back up and running. Further flood damage on Saturday and Sunday has washed out more ballast from under the tracks."

Owen Paterson, Secretary of State for Environment, is visiting the area around Cowley Bridge in Devon.

In developments around England:

Hundreds of householders are being urged to take flood precautions in the East Riding of Yorkshire and North Lincolnshire area
A number of roads in County Durham, Teesside, Greater Manchester and Derbyshire remain shut
National Rail said the lines would remain closed between Exeter St Davids, Tiverton Parkway and Yeovil Junction on Monday
Horse racing has been cancelled at Southwell in Nottinghamshire and Wetherby, in West Yorkshire
Floodwater has closed several A roads in Herefordshire and Worcestershire and flood barriers are up on Worcester's Hylton Road
People who had to leave their homes at Billing Aquadrome in Northamptonshire last Thursday are still in temporary accommodation
In Warwickshire, Kingsbury Water has been shut after it became flooded and two car parks at Coventry University Hospital that were closed have since reopened
Some schools are closed in the West Midlands, Worcestershire, Leicestershire and Devon
In Staffordshire fire crews were called to the Rugeley bypass, where the river has burst its bank and 20 sheep were stuck in flood water
Several homes have flooded in Oxfordshire due to heavy rain at the weekend

In other parts of England residents are beginning to clean up their homes, including in Cornwall where more than 100 properties were flooded.

Continue reading the main story

Weather information

From the BBC:

Elsewhere:

Among the worst-hit places were Millbrook, Mevagissey, Polperro, Newlyn, Perranporth and Trenear near Helston.

A clear-up is also being started in the Wiltshire town of Malmesbury.

Part of the High Street was cut off by waist-deep water and roads in and out of the town were closed.

Duncan Hadland said his home had been flooded up to skirting board level but added his was one of the least affected.

He said: "The carpets, washing machine and lino have all been ruined - we have insurance but we're not sure what they might pay out - if anything."

Chris Fawkes, from the BBC Weather Centre, said there had been about 60mm (2.5in) of rain in south-west England over the weekend.

He said: "A weather front will slowly move across north England and north Wales on Monday, and it's here that we are likely to see some further serious flooding."

Up to 30mm of rain is expected to fall in pockets of the West Country with 40mm to 50mm possible in the North.

The Environment Agency has warned that 170 houses in Oundle, in Northamptonshire, could be in danger of flooding early on Tuesday.

Homes are also expected to flood in areas close to the River Thames.

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Warning care standards 'slipping'

Written By Unknown on Minggu, 25 November 2012 | 21.24

22 November 2012 Last updated at 22:08 ET By Nick Triggle Health correspondent, BBC News

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CQC chief executive David Behan: ''We don't want staff taking at people, but talking to them''

The quality of services provided to people across the health and care sectors in England is beginning to suffer, according to the regulator.

The Care Quality Commission's (CQC) warning comes after it looked at data from more than 13,000 inspections.

The regulator said staff pressures and the rise in complex cases seen in the ageing population meant everyone from hospitals to care homes was struggling.

Overall, one in four services failed at least one of the 16 key standards.

Among the most commonly failed areas were the standards relating to dignity and respect, nutrition, care and welfare and the workforce, which covers both numbers and skills of staff.

The regulator said the pressures on the system meant staff were increasingly unable to focus on the individual needs of people for whom they were caring.

Instead, they were essentially running through to-do lists in the way they approached their responsibilities.

'Challenge'

The CQC said it had created a culture in places that were struggling where the "unacceptable becomes the norm".

It said it was taking enforcement action in places where the most serious failings had been identified.

CQC chief executive David Behan said despite the pressures there was no excuse for poor performance.

Continue reading the main story

NHS - The regulator looked at all 291 providers from hospitals to mental health services. In total, 22% failed at least one standard. It came amid ever increasing demand for care, the report said.
Social care - Inspections covered care homes, nursing homes and the help provided to people in their own home. Some 28% failed at least one standard. Problems were most acute in nursing homes, the CQC said.
Independent healthcare - Dominated by private hospitals that are increasingly involved in NHS care. But the most worrying performance seen in mental health, learning disabilities and substance misuse. A fifth failed at least one standard overall.
Dentistry - The industry had been growing over the past decade, the CQC noted. NHS care accounts for 58% of the market. In total, 12% failed on at least one standard.

"Health and care services need to rise to the challenge," he added.

The stock-take is the most comprehensive yet provided by one regulator.

It covers every corner of the health and social care sectors with the exception of GP practices, which will come under the regulation regime from next year.

The 13,000 inspections cover a third of the health and care sectors.

They incorporate NHS services, such as hospitals and mental health services, care homes, nursing homes, home help, dentistry and the independent sector, which includes private hospitals and charity-run services.

Broken down by sectors, the report showed 22% of the NHS had failed on at least one standard, 19% of the independent healthcare, 28% of social care and 12% of dentistry.

It is the first year the CQC has had such comprehensive data and so a comparison with 2010-11 is not possible.

However, the regulator said during its inspections the picture emerging was one where providers of care were finding it more difficult.

The report comes just a day after the Patients Association warned about standards of care after publishing a dossier of 13 "appalling" cases of care given to NHS patients.

Katherine Murphy, of the Patients Association, said the findings were "scandalous", adding patients were receiving substandard care across the country every day.

And Peter Carter, general secretary of the Royal College of Nursing, said the CQC warning echoed what the union's members had been saying.

"We hope that this report acts as a warning that cutting staff at a time when the country's health care needs are becoming more complex is a recipe for disaster."

Health Secretary Jeremy Hunt said: "While there is much to praise about the NHS and social care today we still need to do much more to raise standards of care across the board.

"I've made it absolutely clear that quality of care needs to be valued as highly as the quality of treatment. And that there can be no hiding place for those providing poor care or sub-standard practice."

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Trust 'operated on wrong patient'

23 November 2012 Last updated at 07:54 ET

A health watchdog is taking action against a Cambridgeshire hospital trust which performed eye surgery on the wrong person.

Cambridge University Hospitals NHS Foundation Trust performed four botched operations, including leaving instruments inside two people.

Surgeons also operated on the wrong part of the body of a patient, Monitor said.

The trust said it was "determined to improve".

It has been ordered to look at the effectiveness of its services and improve the quality and organisation of healthcare for its patients.

The trust also has to report to Monitor every month.

The regulator said that since September 2011, eight "never events" - instances which are never supposed to happen - had happened at the trust, including four between September and October last year.

Wrong lens

Monitor said that the "wrong person surgery" related to a patient who had the wrong surgical lens fitted.

Several patients were attending the hospital for similar operations at the same time, a trust spokeswoman said.

The wrong lens was fitted to the wrong patient and then quickly removed.

The patient did not suffer any ill effects, the spokeswoman said.

Continue reading the main story

This is not the first time we have called the trust in to explain itself"

End Quote Stephen Hay Monitor

Monitor said it was also stepping in because the trust had failed to give cancer patients treatment in the recommended time and had not treated emergency patients within four hours.

It said the trust was in "significant breach" of the terms of its authorisation and was concerned that the hospital board had not dealt adequately with the range of issues the trust had faced over the years.

Monitor's chief operating officer, Stephen Hay, said: "This is not the first time we have called the trust in to explain itself.

"We are disappointed that the board has not resolved these issues."

Jane Ramsey, who became chair of the trust at the beginning of the month, said: "We are determined to reverse the situation as soon as possible.

"We will be focusing on turning this trust around.

"Our priority remains the care of our patients - they are at the heart of everything we do."

The trust, which runs Addenbrooke's and the Rosie hospital in Cambridge, has been ordered to commission a "governance and effectiveness review".

A board-level "experienced turnaround expert" should also be appointed, Monitor recommended.

Monitor is an independent regulator of NHS hospital trusts, ensuring they have good leadership and are financially robust.

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Second coronavirus death reported

23 November 2012 Last updated at 10:14 ET

A second person has died from a new respiratory illness similar to the Sars virus, according to the World Health Organization.

The WHO said three fresh cases had also been reported bringing the total to six.

All are linked to either Saudi Arabia or Qatar. However, one man has been transferred to the UK for treatment.

Doctors say the virus does not appear to readily spread from person to person.

Both reported deaths were in Saudi Arabia.

Coronaviruses are a group of viruses ranging from the common cold to the Sars (severe acute respiratory syndrome) virus. They infect a wide range of animals.

In 2002 an outbreak of the Sars coronavirus killed about 800 people after it spread from Hong Kong to more than 30 countries around the world.

The WHO is still trying to work our where the infection came from. Studies show that the virus it is closely related to one found in some species of bats.

It said in a statement: "Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases."

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Warning care standards 'slipping'

Written By Unknown on Sabtu, 24 November 2012 | 21.24