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Young mum 'child death risk' link

Written By Unknown on Senin, 30 September 2013 | 21.24

29 September 2013 Last updated at 19:07 ET

Children born to mothers under 30 are more likely to die than those born to older mums, a report on child deaths in the UK suggests.

While overall child mortality fell by 50% in the past 20 years, young maternal age was found to be a risk factor for death in early childhood.

Support should be extended to mothers of all ages, not just first-time teenage mums, the report said.

The research was led by the Institute of Child Health at UCL.

It looked at why children die in the UK using death registration data from January 1980 to December 2010.

It focused on child injuries, birthweight and maternal age to assess the risk factors for child deaths.

The research found that in England, Scotland and Wales, the difference in mortality between children of mothers under 30 and those born to mothers aged 30 to 34 accounted for 11% of all deaths up to nine years old.

This is equivalent to an average of 397 deaths in the UK each year, the report said.

Continue reading the main story

"Start Quote

Young maternal age at birth is becoming a marker of social disadvantage as women who have been through higher education are more likely to postpone pregnancy until their 30s"

End Quote Prof Ruth Gilbert Institute of Child Health, UCL

Deaths in children born to mothers under 20 accounted for just 3.8% of all child deaths up to nine years old.

The study compared children with similar birthweight in each age category.

'Alcohol use, smoking and deprivation'

It reported that the biggest difference in deaths was in infants aged from one month to one year.

Among this age group, 22% of deaths in the UK were due to "unexplained causes", the report said, "which are strongly associated with maternal alcohol use, smoking and deprivation".

The report added that the current policy, which focuses support on teenage first-time mothers, was not wide-ranging enough because mothers aged under 30 account for 52% of all births in the UK.

Ruth Gilbert, lead researcher and professor of clinical epidemiology at UCL Institute of Child Health, said the findings were important.

"Young maternal age at birth is becoming a marker of social disadvantage as women who have been through higher education and those with career prospects are more likely to postpone pregnancy until their 30s.

"Universal policies are needed to address the disparities."

Jill Rutter, head of policy and research at the Family and Childcare Trust, said the government needed to do more.

"Disadvantage and maternal age are factors often associated with child deaths. The government has recognised the vulnerability of the children of teenage mothers and given these families extra help with parenting.

"In England the Family Nurse Partnership is an intensive, structured, home-visiting programme, which is offered to first-time parents under the age of 20.

"A specially trained nurse visits regularly from early pregnancy until the child is two years old. This project has excellent results, but is not available to older mothers.

"We would like the Family Nurse Partnership to be extended to take older mothers who need help."

Toll from injuries
Continue reading the main story

"Start Quote

The lack of decline in intentional injuries calls for a concerted focus on reducing violence and self-harm in older children."

End Quote Dr Hilary Cass Royal College of Paediatrics and Child Health

The study, commissioned by the Healthcare Quality Improvement Partnership and published by the Royal College of Paediatrics and Child Health, had other key findings.

First, injuries continue to be the biggest cause of death in childhood, but they are declining,

Between 1980 and 2010, injuries accounted for 31% of deaths in one to four-year-olds and 48% of deaths in those aged 15 to 18.

England had consistently lower rates of deaths from injury than the other UK countries, particularly among older boys.

But there was no decline in deaths due to intentional injury or self-harm over 30 years, the report found.

Dr Hilary Cass, president of the royal college, said this was worrying.

"Injuries remain the biggest cause of child deaths but are declining, so we need to continue to build upon public policy interventions such as traffic calming.

"The lack of decline in intentional injuries calls for a concerted focus on reducing violence and self-harm in older children."

Disabilities and serious diseases

The study also found that up to 70% of children who die in the UK have chronic conditions such as cancer, cystic fibrosis or epilepsy.

This was not necessarily the cause of their death but likely to be an underlying factor in it.

Prof Gilbert said that although the overall number of children dying is falling, the picture was complicated by the increasing number of children now surviving with disabilities and serious diseases, and this meant that proactive care was vital.

"For some children with serious chronic conditions who are expected to die, this means high-quality end-of-life care for the child and to support their families.

"For others, their death may have been premature or completely preventable. Most children with chronic conditions are managed at home by parents with support from primary and community care services as well as hospitals. We need to focus on the quality of long-term care at home for these children as well as in hospital."


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UK A&Es seeing 'drunk children'

30 September 2013 Last updated at 03:14 ET
Professor Sir Ian Gilmore of the UK Alcohol Health Alliance

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Professor Sir Ian Gilmore said ''one in ten'' children aged 11 have drunk alcohol in the last week

Nearly 300 children aged 11 or under were admitted to A&E units across the UK last year after drinking too much, a BBC Radio 5 live investigation shows.

Revealing UK-wide data for the first time, it said a total of 6,500 under-18s were admitted in 2012-13.

Charities and public health bodies say fewer children are drinking overall, but those who do may be drinking more.

The five years of data comes from Freedom of Information requests to 125 of the 189 UK NHS organisations.

Prof Ian Gilmore, chairman of the UK Alcohol Health Alliance, told the BBC: "I think in under-11s, it's mainly experimenting, but I think we see children in the 11 to 16-year-old range who are beginning to drink regularly."

Teenage drinker

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He added: "There are some encouraging signs in that the numbers of under-18s drinking is probably falling, but those that are drinking are probably drinking earlier and drinking more heavily, so we certainly can't be complacent."

Over the last five years A&E departments across the UK have dealt with nearly 48,000 incidents where under-18s have been admitted for drink or drug related illnesses.

During 2012/13 there were 293 cases of children aged 11 or under attending A&E with alcohol-related conditions - a third more than in 2011/12 when there were 216 cases.

'Hiding away'

Among teens, more girls than boys are now being admitted, a reversal of the past trend.

Ayrshire and Arran Health Board dealt with the highest number of cases last year - with 483 alcohol-related attendances.

Morten Draegebo, an A&E consultant at Crosshouse Hospital in Kilmarnock, said children were exposing themselves to significant danger.

Continue reading the main story

"Start Quote

Children... tell us they get alcohol from home, primarily from their parents and from friends"

End Quote Elaine Hindal Drinkaware

He said: "The typical patient may be found in a field. They often need to hide away from any sort of adults in the area so they're picked up by the ambulance service.

"They have difficulty locating where they are because the description comes through from a distressed half-drunk teenager potentially saying that they're under a tree somewhere in a large park.

"Eventually they're found but even in summer-time in Scotland they're vaguely hypothermic.

"They have vomited. The vomit may go down the wrong way into the lungs. They are unable to defend themselves even from assault."

Dr Draegebo added: "We have had many cases where teenage, young teenage females have come in saying that they may have been sexually assaulted and they're that intoxicated and are distressed and say, 'I may have been', but they don't even know if they have been or not.

"On a humane level that is very distressing. I'm a parent, I would hate for that to happen to my daughter."

'Can't take it'

Elaine Hindal, chief executive of Drinkaware, said the incidence of drunkenness among under-11s was "really alarming" and parents must be vigilant.

"It's really unlikely that children are buying alcohol. When children talk to us in our research, they tell us they get alcohol from home, primarily from their parents and from friends," she said.

Continue reading the main story

"Start Quote

Alcohol places a heavy burden on the NHS, costing around £3.5bn every year"

End Quote Department of Health England spokesman

"But parents need to simply be aware of the dangers of drinking, particularly with younger children. Their bodies can't take it, they're more at risk of alcoholic poisoning, they are more likely to be a victim of alcohol-related violence."

Across the UK, experts agree that fewer children are drinking now than several years ago, but say the amount being consumed by those underage has stayed the same - suggesting those who do drink are consuming more.

Public Health England says one in four underage drinkers consumes more than 15 units a week - the equivalent of seven pints of lager.

The official advice from the chief medical officers across the UK is that no children should be given alcohol until they are 16, and alcohol should only be given to older teenagers under supervision of a carer or parent, and never on more than one day a week.

A Department of Health England spokesman said: "We know that fewer young people are drinking and being admitted to hospital as a result.

"But with more than one million alcohol-related hospital admissions overall in the last year we know too many people are drinking too much and that alcohol places a heavy burden on the NHS, costing around £3.5bn every year. "

Hear more on the Victoria Derbyshire programme at 10:00 BST on Monday 30 September on BBC Radio 5 Live.


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Patient safety alerts 'not working'

30 September 2013 Last updated at 07:54 ET Owain ClarkeBy Owain Clarke BBC Wales health correspondent

THE NHS in Wales is putting patients at unnecessary risk by not implementing vital safety alerts according to a leading patients' safety charity.

Action Against Medical Accidents says that despite significant improvements in the past year, all seven Welsh health boards are missing deadlines.

The alerts introduce procedures to minimise risks to patients whose treatment has repeatedly gone wrong.

The charity had particular concerns about two health boards.

Alerts issued by the National Patient Safety Agency, a UK health watchdog, include:

  • procedures to minimise the risks of giving a patient the wrong blood during transfusion
  • promoting the safer use of injectable medicines
  • preventing deaths from incorrect doses of medicines.

Each alert has a deadline for its implementation.

Continue reading the main story

"Start Quote

It is possible that some patients may have suffered harm or even died needlessly as a result of alerts not being complied with"

End Quote Action against Medical Accidents

The total number of alerts outstanding across Wales reduced from 140 to 61 during the past year - a drop of almost 60%.

Every health board has seen an improvement in their rates.

However, Action Against Medical Accidents found some of Wales' health boards had not fully complied with certain alerts even though the deadline for implementation was more than five years ago.

The worst rate of compliance was at Hywel Dda Local Health Board, covering Carmarthenshire, Ceredigion and Pembrokeshire, which had not fully implemented 23 of the alerts by the deadlines.

In response, a spokesman said: "Hywel Dda Health Board takes compliance with patient safety alerts very seriously and has undertaken a review of accountability and responsibility to improve its response.

"As a relatively new organisation we also made the decision to review and revalidate compliance against patient safety alerts dating back to 2002 and believe this good practice will place us in a confident position in terms of compliance moving forward.

"We'd wish to assure our patients that compliance is closely monitored and reported to the health board's quality and safety committee."

Cathy O'Sullivan, acting director of the board of Community Health Councils in Wales, said it was "inexcusable".

"I don't believe that any patient safety alert should be outstanding, it should be completed by the deadline to ensure that we don't have incidents or accidents for patients," she added.

An ambulance at Ysbyty Gwynedd

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The report said the performance of Betsi Cadwaldr University Health Board, which runs health and hospital services across north Wales, was "also of particular concern", with 15 alerts outstanding past their deadlines.

Betsi Cadwaldr health board told BBC Wales that it would be inappropriate to comment until it had seen and considered the report in full.

Two health boards, Abertawe Bro Morgannwg (which covers Swansea, Bridgend and Neath Port Talbot) and Aneurin Bevan (which is responsible for the former Gwent area), reduced the number of outstanding alerts to just four each, the report found.

It concluded: "Whilst there has been significant and welcome improvement in compliance with patient safety alerts, it is very concerning that Hywel Dda and Betsi Cadwaldr health boards still have so many alerts outstanding, some of which are years past the deadline for completion, and that no single health board is fully compliant.

Outstanding patient safety alerts by health board area 2013 2012

Action against Medical Accidents

Abertawe Bro Morgannwg

4

16

Aneurin Bevan

4

11

Betsi Cadwaladr

15

34

Cardiff and Vale

5

12

Cwm Taf

8

25

Hywel Dda

23

27

Powys Teaching Health Board

2

17

"According to Standards for Health Services in Wales there should be 100% compliance. Patients are being left at unnecessary risk.

"It is possible that some patients may have suffered harm or even died needlessly as a result of alerts not being complied with."

The report suggests two health boards - Aneurin Bevan and Betsi Cadwaladr - have failed to fully implement procedures designed to reduce the risk of giving patients the wrong blood transfusion, despite the deadline for its implementation passing in May 2007.

Only three boards - Cardiff and Vale, Cwm Taf (covering the south east Wales valleys) and Powys - had completed actions on an alert designed to improve the safe administration of oxygen.

The deadline for completion of this alert was March 2010.

And three health boards - Aneurin Bevan, Cwm Taf and Hywel Dda - had yet to complete actions to prevent deaths from giving patients an incorrect dose of medicines, missing its November 2011 deadline.

Action Against Medical Accidents has called for an urgent review in the way patient safety is regulated in Wales.

Continue reading the main story

"Start Quote

We continue to monitor this data across health boards and have set up a group to look at particular areas of concern"

End Quote Welsh government

It claims Health Inspectorate Wales (HIW) could not provide it with evidence that it had taken action to ensure compliance with patient safety alerts.

It said: "Health Inspectorate Wales appears to have ignored our previous reports and failed to protect patients' safety by ensuring patient safety alerts are complied with.

"This is a serious dereliction of duty."

The report also accused HIW and the Welsh government of failing to take the issue of non-compliance seriously and said the health minister had refused a meeting to discuss the issues.

Mandy Collins, deputy chief executive of Healthcare Inspectorate Wales, said elements of criticism were "justified".

She said: "I think we failed to properly respond to an FOI (freedom of information) request where we were given an opportunity to give a fuller picture in what we do in relation to patient safety alerts. There's a much better story for HIW to have told and, as I said, we missed that opportunity."

Ms Collins said every clinician had a "responsibility" to keep up to date and make themselves aware of patient safety alerts.

"Boards have a responsibility to make sure their organisations are fit for purpose and that involves making sure your services are safe and are complying with guidance, such as safety alerts," she added.

A Welsh government spokesperson said: "We welcome scrutiny of patient safety - this is a matter we take very seriously.

"While it is encouraging that NHS organisations have made major improvements to compliance on patient safety alerts, more still needs to be done to achieve full compliance.

"We continue to monitor this data across health boards and have set up a group to look at particular areas of concern.

"We have made it clear we expect all organisations to make further improvements in the interests of patient safety and quality of services."


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London 2012 athletes 'had bad teeth'

Written By Unknown on Minggu, 29 September 2013 | 21.24

28 September 2013 Last updated at 19:01 ET

Dentists have found "striking" levels of bad teeth in athletes competing at the London 2012 Olympic Games.

A fifth of athletes surveyed said their oral health actually damaged their training and performance.

The study, published in the British Journal of Sports Medicine, suggested cavities, tooth erosion and gum disease were common.

Researchers said athletes, as a group, had worse dental health than other people of a similar age.

The beaming smiles of gold-medal winners Usain Bolt, Jessica Ennis-Hill and Mo Farah are some of the defining memories of London 2012.

But a team at University College London says many competitors had dental problems.

"Our data and other studies suggest that, for a similar age profile, the oral health of athletes is poor. It's quite striking," said lead researcher Prof Ian Needleman.

He said eating large amounts of carbohydrates regularly, including sugary energy drinks, was damaging teeth.

Continue reading the main story

We know the differences at the high end of elite sport are small, it would not be surprising if oral health was having an impact "

End Quote Prof Ian Needleman Researcher

He added that the stress on the immune system from intense training may leave athletes at risk of oral disease and that a fixation on training, preparation and other aspects of health may leave little time or awareness of oral health.

The study looked at those visiting the dental clinic at the Games, which offered free check-ups and mouth guards.

Competitors using the clinic may have been more likely to have dental problems than other athletes, but the research group say their findings are consistent with previous studies.

Of the 302 athletes examined, from 25 sports, 55% had evidence of cavities, 45% had tooth erosion and 76% had gum disease.

One in three said their oral health affected their quality of life and one in five said it affected training or athletic performance.

Teeth to training

Oral health is already a suspect in other seemingly unrelated conditions such as heart disease. People who do not brush twice a day are at higher risk of a heart attack and inflammation is common to both.

The researchers suggest inflammation elsewhere in the body may also affect recovery time and susceptibility to injury.

They added that tooth pain and the resulting impact on diet and sleep may also damage performance.

Prof Needleman, who is also director of the International Centre for Evidence-Based Oral Health, told the BBC: "We know the differences at the high end of elite sport are small, it would not be surprising if oral health was having an impact on those differences.

"Many sports medics have anecdotes about athletes missing medals at major competitions as a result of oral health problems."


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End war on drugs, says police chief

29 September 2013 Last updated at 06:21 ET

Class A drugs should be decriminalised and drug addicts "treated and cared for not criminalised", according to a senior UK police officer.

Writing in the Observer, Chief Constable Mike Barton of Durham Police said prohibition had put billions of pounds into the hands of criminals.

He called for an open debate on the problems caused by drugs.

The Home Office reiterated its stance and said drugs were illegal because they were dangerous.

'Controlled'

The chief constable - who is the intelligence lead for the Association of Chief Police Officers - said he believed decriminalisation of Class A drugs would take away the income of dealers, destroy their power, and that a "controlled environment" would be a more successful way of tackling the issue.

He said when faced with the "extremely damaging" impacts of alcohol, his argument to decriminalise drugs may appear weakened, but called for an open and honest debate on the matter.

A petition is calling on the government to follow the advice of the Home Affairs Committee and introduce a Royal Commission on drug law reform.

Mr Barton said: "If an addict were able to access drugs via the NHS or something similar, then they would not have to go out and buy illegal drugs.

"Buying or being treated with, say, diamorphine is cheap. It's cheap to produce it therapeutically.

Continue reading the main story

Addiction to anything is not a good thing, but outright prohibition hands revenue streams to villains"

End Quote Mike Barton Durham Constabulary chief constable

"Not all crime gangs raise income through selling drugs, but most of them do in my experience. So offering an alternative route of supply to users cuts their income stream off.

"What I am saying is that drugs should be controlled. They should not, of course, be freely available."

Mr Barton compared drugs prohibition to the ban on alcohol in the US in the 1920s which fuelled organised crime.

Mr Barton told the Observer: "Have we not learned the lessons of prohibition in history?"

"The Mob's sinister rise to prominence in the US was pretty much funded through its supply of a prohibited drug, alcohol. That's arguably what we are doing in the UK."

'Revenue for villains'

He said some young people saw drug dealers as glamorous gangsters and envied their wealth.

The officer said drug addicts must be treated and cared for and encouraged to break the cycle of addiction - they did not need to be criminalised.

He said: "I think addiction to anything - drugs, alcohol, gambling, etc - is not a good thing, but outright prohibition hands revenue streams to villains.

"Since 1971 [the Misuse of Drugs Act] prohibition has put billions into the hands of villains who sell adulterated drugs on the streets.

"If you started to give a heroin addict the drug therapeutically, then we would not have the scourge of hepatitis C and Aids spreading among needle users, for instance. I am calling for a controlled environment, not a free-for-all."

According to UK-wide figures released on Friday by Public Health England, 120 of 6,364 newly-diagnosed HIV cases in 2012 were said to have been acquired through injecting drugs.

New laws were announced in July by Home Secretary Theresa May to allow drug treatment providers the opportunity to offer addicts foil - used as a surface to heat up drugs like heroin - as part of efforts to get addicts into treatment, and to protect their health.

The number of heroin and crack cocaine users in England have fallen below 300,000 for the first time, according to figures by the National Treatment Agency for Substance Misuse.

The figure peaked at 332,090 in 2005-06 before dropping to 298,752 in 2010-11.

War on drugs

Mr Barton said if the "war on drugs" meant trying to reduce illicit supply then it had failed.

There were 43 organised crime groups on their radar in the Durham Constabulary area alone, he added.

Mr Barton is among a small number of top police officers in the UK who have called for a major review of drugs policy.

Danny Kushlick, of Transform Drug Policy Foundation, said the group was delighted to see a serving chief constable willing to stand up and "tell the truth ", that prohibition does not work.

A Home Office spokesman said: "Drugs are illegal because they are dangerous. They destroy lives and blight communities.

"The UK's approach on drugs remains clear, we must help individuals who are dependent by treatment, while ensuring law enforcement protects society by stopping the supply and tackling the organised crime that is associated with the drugs trade."


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Flu vaccine offered to toddlers

29 September 2013 Last updated at 07:57 ET

A flu vaccine nasal spray is being offered to every two and three-year-old in Scotland for the first time.

Previously, only children in "at risk" groups were offered the protection.

Scotland's largest ever immunisation programme was launched by First Minister Alex Salmond, who received the vaccine in a surgery in Aberdeenshire.

He said that as an asthmatic, he gets the injection every year and urged other eligible Scots to get protected before the winter.

A fifth of the Scottish population will be offered a free flu vaccine, including people aged over 65 and those with conditions that put them at greater risk.

For the first time, all two and three-year-olds - about 120,000 children - will be offered the vaccine, as well as 100,000 primary school pupils in health board areas which are taking part in a pilot programme.

The programme will be rolled out to eventually see about one million children aged between two and 17 have the chance to be immunised towards the end of 2015.

The vaccine will take the form of a nasal spray rather than an injection.

Scotland's senior medical officer said the spray, which is being phased in this autumn and rolled out over the next two years, was more effective in children than injections, as well as simpler to administer.

Continue reading the main story
  • Flu is a respiratory illness linked to infection by the influenza virus.
  • Symptoms usually include headache, fever, cough, sore throat, aching muscles and joints.
  • Influenza occurs most often in winter and usually peaks between December and March.
  • The virus was first identified in 1933.
  • There are two main types that cause infection: influenza A and influenza B
  • New strains of the virus are constantly emerging, which is why the flu vaccine should be given each year.

Speaking after receiving his own vaccine, Mr Salmond said it was better to be safe than sorry.

"As an asthmatic, I get my flu vaccination every year to make sure I'm protected and ready for the winter and I'm delighted to launch this national campaign," he said.

"It is hugely successful and the existing programme has seen 2,000 fewer hospitalisations and 25,000 fewer GP consultations.

"For the first time this winter we are taking extra precautions to protect families by making sure children are also offered this vital vaccine."

Senior medical officer Dr Nicola Steedman said every year she sees examples of how devastating flu can be.

She added: "For those with existing health conditions such as asthma, diabetes, heart or liver problems, flu can result in serious complications.

"Furthermore, those who are pregnant or over 65 are also at increased risk of flu and its complications and should be vaccinated to help protect against flu, even if they currently feel healthy and fit.

"Flu can also be very serious for children, particularly the youngest ones who have little or no immunity to the infection, which is why we are rolling out the new childhood flu immunisation programme."

All two and three-year-olds in England and Wales will be also offered the vaccine this winter. In Wales, children aged 11 to 12 will also be eligible, while children aged between two and 10 in certain areas of England will be offered protection.


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Cancer drugs fund 'to be extended'

Written By Unknown on Sabtu, 28 September 2013 | 21.24

28 September 2013 Last updated at 08:53 ET
Jeremy Hunt

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Health Secretary Jeremy Hunt said cancer sufferers in Wales were renting homes in England to access drugs

A £200m-a-year fund for life-enhancing cancer drugs is to continue until 2016, the prime minister has announced.

The Cancer Drugs Fund (CDF) was set up in 2011 to help patients in England access certain drugs before they get approval for widespread NHS use.

The scheme was due to end next year, but David Cameron has pledged £400m to keep it running.

Cancer charities have welcomed the move, but Labour accused the prime minister of "letting down" patients.

Head of policy at Cancer Research, Sara Osborne, praised the valuable role the fund would play in battling the disease and highlighted the tens of thousands of people who received treatment because of it.

She said: "There's about 30 drugs that are available on the Cancer Drugs Fund, and over the last three years about 34,000 patients have had treatment that they would not have otherwise had, had the fund not existed."

'Special case'

The aim of the CDF was to make it easier for medics to prescribe treatments even if they have not yet been approved by the National Institute for Health and Care Excellence (Nice).

Continue reading the main story

An extension of the Cancer Drugs Fund in England means a radical overhaul in the NHS drugs pricing system is now unlikely.

Next year was meant to mark the start of value-based pricing, a system proposed by former Health Secretary Andrew Lansley to promote a closer link between the price the NHS pays and the value a medicine offers.

It could have led to higher price thresholds for medicines for diseases with a greater burden of illness or in areas where there is un-met need, or if it could be demonstrated that there would be wider benefits, such as getting people back to work.

Some of these elements are to be incorporated into the work of the drugs advisory body the National Institute of Health and Care Excellence from January.

But this announcement effectively signals a light-touch version of what was first envisaged.

The scheme was set to run until 2014 and campaigners raised concerns about where patients would turn for help when the funding ceased.

Prime Minister David Cameron said the CDF had been a "massive success" and added that should he be re-elected he would recommend that it be continued beyond 2016.

"People have lived longer and in some cases it has saved people's lives," he said.

Health Secretary Jeremy Hunt said the government had made an exception for cancer because they considered it "the number one killer"

"And we do think that we had a particular problem with a lack of access to these drugs," he added.

Andrew Wilson, chief executive of the Rarer Cancers Foundation, said: "This is a compassionate, common sense announcement which will be warmly welcomed by many thousands of cancer patients."

The Rarer Cancers Foundation estimates that 16,500 extra patients will benefit each year as a result of the extension.

Mr Cameron said the government would also be partnering with Cancer Research UK to conduct new research into the effectiveness of cancer drugs.

"It is only because we have protected health spending that we can afford these life saving treatments," he added.

But another charity, Target Ovarian Cancer, said while the news was "positive", it warned it was "just a stop-gap".

It highlighted the case of Jenny Bogle who failed to meet CDF criteria for Avastin, a drug shown to delay recurrence.

Ms Bogle said: "I have a wealthy friend and an oncologist who are determined to keep me going for as long as possible so I was able to access Avastin privately in the end.

"I'm lucky to be here but it's just not fair.

Cancer patient Steve Evans

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Cancer patient Steve Evans: "For me, what's important is the facility for someone to make that decision quickly"

"It shouldn't be a matter of luck. If I were living in a different postcode, were vulnerable or less pushy or didn't have the support, I would have probably died years ago."

BBC health correspondent Nick Triggle said the move also raised questions about the introduction of a new way of assessing drugs that had been expected to start next year.

Next year was meant to mark the start of value-based pricing, a system proposed by previous health secretary Andrew Lansley to ensure there is a closer link between the price the NHS pays and the value that a medicine offers.

There will now be no full blown overhaul although drug advisory body NICE will be looking to make some changes to improve the assessment process from January.

Shadow health minister Liz Kendall highlighted the fact that expert cancer networks - set up to improve access to high quality services - were scrapped during the reorganisation of the NHS earlier this year.

She added: "David Cameron should also stand up to the tobacco lobby rather than caving in to them over standardised cigarette packaging, which experts say would be a powerful weapon in the long-term fight against cancer."

Alongside plans to extend the fund, Mr Cameron also announced that Genomics England - a government-owned organisation tasked with mapping the DNA of 100,000 patients with cancer and rare diseases - will begin a partnership with Cancer Research UK.


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Charities warn on ageing population

27 September 2013 Last updated at 21:54 ET

Ministers should do more to prepare for the impact of an ageing population, a group of leading charities has warned.

A poll by care provider Anchor of 2,200 adults found more than three quarters (77%) said the government was not ready to cope with changing UK demographics.

The survey results prompted the Ready for Ageing Alliance to say that action now was "crucial for a happier old age for future generations".

The government insisted it had an ambitious programme for the elderly.

Some 76% of those polled also said they wanted a cabinet minister appointed to address the issue.

Jane Ashcroft, chief executive of Anchor, said: "We ask government to prove to the public that they can future-proof policy. 137,000 people signed Anchor's petition for a minister for older people.

"Government cannot bury its head in the sand on the issue."

George McNamara, head of policy and public affairs at the Alzheimer's Society, added: "By failing to prepare for the effect of an ageing population, we could be preparing to fail.

"While the government needs to plan for the impact of an ageing society, the public also needs to give more consideration to planning for their own old age.

"We ignore the challenge of an ageing population at our peril."

The survey came as Office for National Statistics figures showed there were 12,320 people aged over 100 in England and Wales in 2012 compared with just 2,560 three decades ago.

Continue reading the main story
  • 1982: 2,560
  • 1992: 4,460
  • 2002: 7,090
  • 2012: 12,320

Source: ONS estimates

The number of people aged over 90 has tripled over a similar time.

The government said changes to pensions and public services meant people would be able to save for retirement and get excellent care when they needed it.

A spokesman said: "We want to make the UK one of the best places to grow old in and we have an ambitious programme to achieve this.

"We are making radical changes to our pension system so people can plan and save for a decent income in retirement.

"We are reforming our public services so that older people get excellent care and support when they need it and are enabled to live independently.

"It is vital to make the most of the skills and talents that everyone has to offer."

The Ready for Ageing Alliance comprises eight charities consisting of Age UK, Alzheimer's Society, Anchor, Carers UK, Centre for Policy on Ageing, Independent Age, International Longevity Centre UK and Joseph Rowntree Foundation.


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Failing GP surgeries 'face closure'

28 September 2013 Last updated at 09:26 ET

Failing GP surgeries in England have been warned they face closure by the NHS's first chief inspector of GPs.

Prof Steve Field, who starts his role on Tuesday, also wants local doctors to offer services seven days a week.

However, the Royal College of GPs says the profession is already at "breaking point" and longer working hours could put quality of care at risk.

Health Secretary Jeremy Hunt has reiterated his calls for GPs to improve their care for the elderly.

Prof Field was appointed by the Care Quality Commission last month to oversee the quality of care provided by GP surgeries across England.

Speaking to the Guardian, the former chair of the Royal College of GPs indicated his willingness to improve standards in poorly performing surgeries by using sanctions, such as fines and the suspension of licences.

He said: "I will not hesitate at all to order the closure of GP practices that we find to be unsafe, or providing poor access, or which do not care for patients properly or treat them with dignity.

"While we've got some of the best general practice in the world, it's let down by a small percentage of practices which aren't providing appropriate access or quality of care," he added.

'Breaking point'

Dr Clare Gerada, chair of the Royal College of GPs, said doctors would be prepared to take on more work but not at the risk of patient care.

She said: "The concept of widespread weekend access is laudable but quality of care must never be sacrificed for access and GPs are already working 11 hour days, with some making up to 60 patient contacts in a single day.

"No doctor in the NHS should be expected to work weekends on top of this without a break. It is not safe or sustainable, for patients or GPs."

Dr Gerada also said GPs should be fairly remunerated for their work.

She added: "GPs currently make 90% of patient contacts within the NHS - for only 9% of the budget.

"We are keen to do more but the profession is now at breaking point and we do not have the capacity to take on any more work, without the extra funding and resources to back it up.

"We are calling on the government for an emergency package of additional investment for general practice to protect GP services and protect the care we deliver to our patients."


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Hip replacement death rate halved

Written By Unknown on Jumat, 27 September 2013 | 21.24

26 September 2013 Last updated at 21:50 ET

Death rates following hip replacement surgery fell by half in England and Wales between 2003 and 2011, a study in The Lancet has found.

Although death within 90 days of surgery is rare, mortality decreased from 0.56% to 0.29% in an analysis of more than 400,000 patients.

The researchers said that fitter patients and better physiotherapy could be behind the decrease.

They added that simple treatment options would reduce the risk further.

Researchers from the universities of Bristol, Oxford, East Anglia and Exeter used data from the UK's joint-replacement database, the National Joint Registry, to look at death rates following this type of surgery.

In their study they found that 1,743 patients died within 90 days of surgery during the eight years.

In 2004, 24,723 patients had hip replacement surgery and 139 of those died within 90 days.

While in 2011, there were 60,727 hip replacement operations carried out and 164 patient deaths.

Quick fix

The reason for the fall in death rates could be down to a number of factors.

The researchers identified the use of a spinal anaesthetic as likely to lead to fewer complications. Specific treatments to stop blood clots after surgery were also linked to a lower risk of death.

Continue reading the main story

We need to concentrate efforts on reducing the risk of death in high risk groups such as those with severe liver disease."

End Quote Prof Ashley Blom University of Bristol

But people are also living longer and patients are recovering more quickly after surgery as a result of better post-operative care. For example, patients are encouraged to get up and start walking around the day after surgery.

The study said: "More recent generations of old people... are generally fitter and less frail than old people at the start of the study.

"Likewise, other aspects of surgery and anaesthesia have improved sufficiently to account for the change in mortality rates."

The research team noticed that people with certain medical conditions were at a much higher risk of dying following surgery - particularly those with severe liver disease, those who had had a heart attack and those with diabetes and renal disease.

Those patients who died were most likely to be elderly men, they said.

'Surprising'

But there were also some unexpected findings. Overweight people (with a body mass index of 25-30) appeared to have a lower risk of death after hip surgery than those patients with a "normal" BMI of 20-25.

Ashley Blom, professor of orthopaedic surgery at the University of Bristol, said: "The finding that overweight people have a lower risk of death is surprising, but has been confirmed by other recent studies, and challenges some of our preconceptions.

"We need to concentrate efforts on reducing the risk of death in high risk groups such as those with severe liver disease."

But he said that the "dramatic" overall fall in death rates was "extremely good news".

"It is also very exciting that we can further reduce the risk of post-operative death by adopting relatively simple measures," Prof Blom said.

A spokesperson from Arthritis Research UK, welcomed the findings.

"This is great news for people in the UK who have osteoarthritis and require hip replacement surgery.

"Although not everyone who has arthritis will need hip replacement surgery, for many people, it's their only hope to reduce the pain, disability and stiffness associated with the disease.

"There are however always risks associated in having major surgery such as hip replacement surgery, so we advise people to discuss these risks with their surgeon before they decide to have a hip replacement."


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'Bottled mucus' may help gut disease

26 September 2013 Last updated at 18:07 ET By James Gallagher Health and science reporter, BBC News

Bottled mucus may one day play a role in some gut diseases, according to US researchers.

A study of the slimy lining of the bowels, published in the journal Science, showed mucus had a role in calming the immune system.

The team at Mount Sinai Hospital, in New York, believe it may be useful in diseases in which inflammation runs rampant in the intestines.

The human body naturally produces around a litre of mucus every day.

Researchers at the hospital and Mount Sinai School of Medicine were investigating why the lining of the bowel does not react to the trillions of bacteria which call the human intestines home. Elsewhere in the body, the immune system would launch a brutal attack against such invaders.

The team investigated the interaction between the mucus produced by the intestines and the immune system.

They showed that a mucus was not only acting as barrier between bacteria and immune system, but a component of the mucus was also calming the immune response. Sugars, or glycans, stuck to the a mucus protein called MUC2 were having the effect.

Lead researcher Dr Andrea Cerutti told the BBC: "We were able to show its ability to dampen the immune reaction in a specific type of immune cell, a dendritic cell, which orchestrates the immune response.

"But these are just initial studies; we know very, very little about mucus."

Mucus treatments?

One area the team think mucus could help in is some bowel problems.

Crohn's disease, inflammatory bowel disease and ulcerative colitis are all poorly understood diseases, but do have inflammation, a part of the immune response, as a common feature.

Dr Cerutti said mucus was often disrupted in these patients and suggested that it may be possible to use mucus as a treatment.

One vision is to artificially synthesise mucus, although this is not currently possible, or a drug which can stimulate the same effect in the lining of the gut.

Whether such approaches to boost the mucus layer of the guts would help patients with bowel disorders is still unknown.

Mucus is not unique to the digestive system. It lines the lungs and streams out of the nose during a cold.

There is speculation that it could be producing similar immune-calming effects in the respiratory system and may be playing a role in allergies and asthma.

Dr Cerutti said even cancer may be affected by mucus: "Several aggressive tumours, such as colon, ovarian, and breast cancers produce mucus, including MUC2.

"Mucus produced by malignant cells may prevent protective immune responses against the malignant cells."

Prof Jon Rhodes, from the department of gastroenterology at the University of Liverpool, said: "There's a massive amount of work in this intriguing paper and it's fascinating to read.

"To extrapolate this to just swallowing mucus would be hopelessly naive, but what might actually be interesting to speculate is that when the nature of the glycans are better understood it could lead to a very exciting and new type of therapeutic"


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Dancers' brains 'adapt to spins'

27 September 2013 Last updated at 06:28 ET

Ballet dancers develop differences in their brain structures to allow them to perform pirouettes without feeling dizzy, a study has found.

A team from Imperial College London said dancers appear to suppress signals from the inner ear to the brain.

Dancers traditionally use a technique called "spotting", which minimises head movement.

The researchers say their findings may help patients who experience chronic dizziness.

Train hard

Dizziness is the feeling of movement when, in reality, you are still.

For most it is an occasional, temporary sensation. But around one person in four experiences chronic dizziness at some point in their life.

When someone turns or spins around rapidly, fluid in the vestibular organs of the inner ear can be felt moving through tiny hairs.

Once they stop, the fluid continues to move, which can make a person feel like they are still spinning.

Ballet dancers train hard to be able to spin, or pirouette, rapidly and repeatedly.

They use a technique called spotting, focusing on a spot on the floor - as they spin, their head should be the last bit to move and the first to come back.

In the study, published in the journal Cerebral Cortex, the team recruited 29 female ballet dancers and 20 female rowers of similar age and fitness levels.

Reflexes

After they were spun in the chair, each was asked to turn a handle in time with how quickly they felt like they were still spinning after they had stopped.

Continue reading the main story

It's not useful for a ballet dancer to feel dizzy or off balance"

End Quote Dr Barry Seemungal Imperial College London

Eye reflexes triggered by input from the vestibular organs were also measured.

Magnetic resonance imaging (MRI) scans were also taken to look at participants' brain structures.

Dancers' perception of spinning lasted a shorter time than rowers' - and the more experienced the dancers, the greater the effect,

The scans showed differences between the dancers and the rowers in two parts of the brain: the cerebellum, which is where sensory input from the vestibular organs is processed, and the cerebral cortex, which perceives dizziness.

The team also found that perception of spinning closely matched the eye reflexes triggered by vestibular signals in the rowers, but in dancers there was no such link.

Resistant

Dr Barry Seemungal, of the department of medicine at Imperial College London, who led the research, said: "It's not useful for a ballet dancer to feel dizzy or off balance. Their brains adapt over years of training to suppress that input.

"Consequently, the signal going to the brain areas responsible for perception of dizziness in the cerebral cortex is reduced, making dancers resistant to feeling dizzy."

He added: "If we can target that same brain area or monitor it in patients with chronic dizziness, we can begin to understand how to treat them better."

Deborah Bull, a former principal dancer with the Royal Ballet, who is now the executive director of the Cultural Institute at King's College, London, told BBC Radio 4's Today programme: "What's really interesting is what ballet dancers have done is refine and make precise the instruction to the brain so that actually the brain has shrunk. We don't need all those extra neurons."


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England's MMR jabs 'highest ever'

Written By Unknown on Kamis, 26 September 2013 | 21.24

26 September 2013 Last updated at 06:30 ET

The number of two-year-olds who have received the MMR vaccination in England is at its highest level since the jab was introduced more than 20 years ago.

But at 92.2%, coverage is still lower than the 95% target set by the World Health Organization (WHO).

The MMR jab protects against measles, mumps and rubella.

The WHO says 95% is the level that offers "herd immunity" - where the whole population is protected because diseases are prevented from spreading.

The data for 2012-13, issued by the Health and Social Care Information Centre (HSCIC), showed coverage in nine out of 10 areas in England was above 90%.

It was highest in the north-west at 94.9%, but lowest in London at 87.1%.

Routine vaccination 'vital'

The MMR jab was introduced to the UK in the late 1980s.

But a decade later vaccination rates plummeted after now discredited claims of a link between the MMR jab and autism.

The HSCIC report also looked at other childhood vaccinations. It found rates for most vaccinations were increasing.

Mary Ramsay, head of immunisation at Public Health England, said: "Routine vaccination in childhood is vital in protecting children from a range of infectious diseases, many of which have now been consigned to history.

"The findings from HSCIC's report are a good indication that parents and children are increasingly able to access primary care to receive these vaccinations and to protect their health for the years to come.

"This is a good reminder to parents to ensure their child's vaccinations are up-to-date, and, if not, to contact their GP."


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'Chemotherapy-sparing' test offered

26 September 2013 Last updated at 04:47 ET By James Gallagher Health and science reporter, BBC News

A breast cancer test that could spare thousands of women the ordeal of chemotherapy has been approved for use in the NHS in England and Wales.

The test works out the odds of a some tumours spreading round the body and can be used to decide whether the gruelling course of drugs is necessary.

The National Institute for Health and Care Excellence approved the test, saying it was a significant step forward for patients.

Cancer charities welcomed the decision.

Breast cancer is the most common cancer in the UK, affecting 48,000 women each year. About 9,700 would be suitable for the test.

Chemotherapy can be used after surgery to reduce the chance of breast cancer spreading or coming back.

However, the drugs kill both cancerous and healthy tissue, which can lead to side-effects including fatigue, feeling sick, hair loss, change in appetite and hot flushes.

Continue reading the main story

We know that chemotherapy can have side effects such as sickness and hair loss and many patients find it to be extremely gruelling; so a test which enables patients to avoid it will be welcomed by many."

End Quote Sally Greenbrook Breakthrough Breast Cancer

The Oncotype DX test, which looks at characteristics of the cancerous cells to see how likely they are to spread, should help doctors decide more accurately which patients will need chemotherapy.

Prof Carole Longson, from NICE, said testing some patients would be cost effective.

She said: "Breast cancer patients face significant emotional and psychological strain when considering chemotherapy.

"A test that can help to predict better the risk of the breast cancer spreading, and therefore the potential likely benefit of additional chemotherapy, represents a significant step forward for patients.

'Good decision'

The test will not be used on all women with breast cancer. Those considered at intermediate risk - and with oestrogen receptor positive (ER+), lymph node negative (LN-) and human epidermal growth factor receptor two negative (HER2-) subtypes of early breast cancer - will be tested to see if chemotherapy is necessary.

Sally Greenbrook, a senior policy officer at Breakthrough Breast Cancer, said: "This is a good decision from NICE.

"We know that chemotherapy can have side-effects such as sickness and hair loss and many patients find it to be extremely gruelling, so a test which enables patients to avoid it will be welcomed by many.

"It's important to remember that Oncotype DX is only suitable for certain types of breast cancer, so some patients will still need chemotherapy.

"It's also important to make sure that this test is made available to doctors and that systems are in place to ensure that patients are able to benefit from it."


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London's A&Es face 'very bad winter'

26 September 2013 Last updated at 09:58 ET

Accident and emergency units in London are facing a "very bad" winter, politicians and doctors are predicting.

Latest data shows the capital's major A&E units are already missing the four-hour treatment target - despite summer just coming to a close.

Ministers have already set up a bailout fund for struggling hospitals.

But a London Assembly meeting was told it would not be enough to guarantee hospitals would cope this winter in London - and the rest of the country.

Royal College of GPs president Dr Clare Gerada told the London Assembly's Health Committee that, like many areas of the country, London was facing a difficult time.

"We are going to have a bad winter - very bad," she said.

Andrew Dismore, a Labour member of the committee, added: "We have a sticking plaster solution to A&E, but the plaster is going to come off as soon as it starts to rain.

"A sticking plaster solution for London is not going to work."

Earlier this week a leaked NHS England report showed that just over 91% of patients were waiting longer than four hours in A&E - below the 95% target - a figure which is normally only seen during the winter.

'Better placed'

The London Assembly meeting was also held just weeks after the government set out how the first tranche of the £500m bailout fund would be shared across the NHS.

The sum is to be spread evenly over the next two winters.

This year 10 London hospitals will be sharing £55m, although this will be spent on both hospitals and community services, such as social care.

Dr Anne Rainsbury, director of NHS England in London, said the money meant the NHS was "better placed to cope".

But she acknowledged longer-term solutions were needed to make the system "sustainable".

She added that that included creating 24/7 speedy access to specialist services for the sickest patients and investing in community and out-of-hours services to encourage those who needed less urgent care to use alternatives to A&E.


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No action over Stafford doctors

Written By Unknown on Selasa, 24 September 2013 | 21.24

23 September 2013 Last updated at 08:00 ET By Nick Triggle Health correspondent, BBC News

Four senior doctors who worked at Stafford Hospital at the height of the neglect and abuse scandal will not face disciplinary action.

Dr John Gibson, Dr Valerie Suarez, Dr David Durrans and Dr Dermot Mulherin, who all held senior management positions, were investigated by the General Medical Council.

But the regulator has now said it is dropping the cases.

Legal advice found there was "no realistic prospect" of success.

The decision comes after widespread criticism when the public inquiry was published in February that those responsible for the scandal have not been held to account.

At the time, Prime Minister David Cameron said the likes of the GMC and the Nursing and Midwifery Council had "some difficult questions to answer".

Since then three nurses have been struck off the register - with one disciplinary hearing ongoing.

Continue reading the main story

We are not a doctors club. We are not here to protect doctors"

End Quote Niall Dickson General Medical Council

The GMC has given warnings and advice to other doctors who worked at Stafford Hospital.

But as yet no-one has been struck off for their role in providing medical care - one doctor has been erased from the register for fraud.

'Systematic management problems'

GMC chief executive Niall Dickson said: "Following the extensive investigations we have undertaken there is not the evidence to establish either misconduct or impairment against any of the doctors."

The GMC got legal advice from Tom Kark QC, who worked on the public inquiry, after taking statements from 26 witnesses.

Mr Kark advised the GMC that while there was evidence that would have demonstrated there were systematic management problems at the trust - none of it could be attributed to any individual doctor.

However, Mr Dickson said he was in talks with the Department of Health to relax the regulatory framework under which the regulator operates.

At the moment, the GMC has to not only prove that a doctor's performance fell below what was expected, but that they also provide an ongoing risk to patients.

The GMC believes the system would be improved if cases were only judged on what the individual has done.

"We are not a doctors club. We are not here to protect doctors," Mr Dickson added.

But Katherine Murphy, of the Patients Association, said while it would be unfair to comment on the four individuals, serious questions needed to be asked about the regulatory process.

"The general delay in holding individuals to account for failings at Stafford is outrageous.

"Years on, and after huge numbers of avoidable deaths, we have still only just scratched the surface of holding the nurses, clinicians and managers to account for the failings that occurred."


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'Needle risk' over beauty treatments

23 September 2013 Last updated at 20:58 ET By Michelle Roberts Health editor, BBC News online

A health watchdog is concerned that people having beauty treatments like Botox could be at risk of infection from dirty needles.

The National Institute for Health and Care Excellence says growing numbers of people are injecting tanning agents, dermal fillers and Botox at home and in salons, and some are lax about hygiene.

Sharing needles can spread blood-borne diseases like HIV and hepatitis C.

Nice is updating its advice for England and Wales accordingly.

The guidelines, which are out for public consultation, aim to encourage people to use sterile needle and syringe programmes to stem the spread of infections.

Sharps bins

Most blood-borne diseases occur among people who inject drugs like heroin and anabolic steroids.

But NICE says people seeking out cosmetic fixes are also at risk.

Continue reading the main story

The dangers of sharing needles in cosmetic injectables are so great that any practitioner who does this should be considered guilty of a criminal offence and nothing less"

End Quote President of BAAPS Rajiv Grover

A spokeswoman said: "We are seeing an increasing issue with drugs that are used for vanity purposes."

This includes the anti-wrinkle treatment Botox, dermal fillers and tanning agents.

Prof Mike Kelly, Director of the NICE Centre for Public Health Excellence, said: "Since we last published our guidance on needle and syringe programmes in 2009, we've seen an increase in the use of performance-and-image-enhancing drugs such as anabolic steroids, Botox, tanning agents and the use of dermal fillers like collagen.

"We've also heard anecdotal evidence that more teenagers are injecting these performance-and-image-enhancing drugs too.

"We're updating our guidance - and our public consultation on the draft update is an important part of this process - to make sure all of these groups of people are considered in the planning and delivery of needle and syringe programmes."

One of the recommendations proposed in the new guidelines is that local councils consider providing sharps boxes for people to dispose of used needles and syringes.

Rajiv Grover, consultant plastic surgeon and president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said: "Due to the lack of regulation in the cosmetic sector it is impossible to know how many patients could be at risk of blood borne diseases from needle sharing with either Botox or fillers.

"These should be considered medical procedures and BAAPS has campaigned for over a decade to have this field of non-surgical cosmetic treatments tightly regulated. The dangers of sharing needles in cosmetic injectables are so great that any practitioner who does this should be considered guilty of a criminal offence and nothing less."

Allergan, a healthcare company that provides Botox, said that Botox is a prescription-only medicine which should only be administered by a trained and qualified medical healthcare professional.

"These treatments should be carried out by appropriately trained and qualified medical practitioners, who have high levels of expertise in full-face anatomy and can provide sufficient aftercare and redress for the patient in the event of an adverse event," said a spokesman.


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Daytime naps 'can boost learning'

23 September 2013 Last updated at 20:59 ET

Getting young children to take an hour-long nap after lunch could help them with their learning by boosting brain power, a small study suggests.

A nap appeared to help three-to-five-year-olds better remember pre-school lessons, US researchers said.

University of Massachusetts Amherst researchers studied 40 youngsters and report their findings in Proceedings of the National Academy of Sciences.

The benefit persisted in the afternoon after a nap and into the next day.

The study authors say their results suggest naps are critical for memory consolidation and early learning.

Continue reading the main story

This is important, because pre-school nurseries are divided on whether they should allow their children a nap"

End Quote Paediatrician Dr Robert Scott-Jupp

When the children were allowed a siesta after lunch they performed significantly better on a visual-spatial tasks in the afternoon and the next day than when they were denied a midday snooze.

Following a nap, children recalled 10% more of the information they were being tested on than they did when they had been kept awake.

Close monitoring of 14 additional youngsters who came to the researchers' sleep lab revealed the processes at work in the brain during asleep.

As the children napped, they experienced increased activity in brain regions linked with learning and integrating new information.

Memory aid

Lead investigator Rebecca Spencer said: "Essentially we are the first to report evidence that naps are important for preschool children.

"Our study shows that naps help the kids better remember what they are learning in preschool."

She said while older children would naturally drop their daytime sleep, younger children should be encouraged to nap.

Dr Robert Scott-Jupp, of the Royal College of Paediatrics and Child Health, said: "It's been known for years that having a short sleep can improve the mental performance of adults, for example doctors working night shifts. Up until now, no-one has looked at the same thing in toddlers. This is important, because pre-school nurseries are divided on whether they should allow their children a nap.

"Toddlers soak up a huge amount of information everyday as they become increasingly inquisitive about the world around them and begin to gain independence.

"To be at their most alert toddlers need about 11-13 hours of sleep a day, giving their active minds a chance to wind down and re-charge, ready for the day ahead. We now know that a daytime sleep could be as important as a nighttime one. Without it, they would be tired, grumpy, forgetful and would struggle to concentrate."


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Universal flu vaccine 'blueprint'

Written By Unknown on Senin, 23 September 2013 | 21.24

22 September 2013 Last updated at 13:00 ET By James Gallagher Health and science reporter, BBC News

Scientists say they have made a significant leap towards creating a vaccine that would protect against every form of flu.

The influenza virus is a constantly shifting target so seasonal flu vaccines rapidly become useless and new ones are needed each year.

A team at Imperial College London say they have made a "blueprint" for a universal flu vaccine.

Their discovery is published in the journal Nature Medicine.

Influenza is able to change the proteins that protrude from the surface of the virus as readily as people change outfits.

However, the material on the inside is common to many strains of flu. Vaccine researchers believe targeting the core of the virus may be the way to develop a universal vaccine.

Continue reading the main story

We have the know-how, we know what needs to be in the vaccine and we can just get on and do it"

End Quote Prof Ajit Lalvani Imperial College London

A specific part of the immune system, called T-cells, is thought to be able to recognise proteins in the core. A team at Imperial used the 2009 swine flu pandemic to test the theory.

Milder symptoms

Swine flu was a new virus from a mix of bird and pig flu.

The outer shell should have been a completely new experience to the immune system, but the core may have been encountered before in other flu viruses.

The team compared levels of one kind of T-cells at the start of the pandemic with symptoms of flu in 342 staff and students at the university.

They showed that the higher the levels of the T-cells a patient had, the milder their symptoms were.

Researchers then teased out the specific part of the immune system that offered some pandemic flu protection and which part of the virus it was attacking.

Prof Ajit Lalvani, who led the study, told the BBC: "It's a blueprint for a vaccine. We know the exact subgroup of the immune system and we've identified the key fragments in the internal core of the virus. These should be included in a vaccine.

"In truth, in this case it is about five years [away from a vaccine]. We have the know-how, we know what needs to be in the vaccine and we can just get on and do it."

'Long journey'

This would be a distinct approach compared with other forms of vaccination, such as the MMR jab. These trigger the immune system to produce antibodies that can attack an invader.

The prize could be huge. Seasonal flu kills between 250,000 and 500,000 people each year and new pandemics have the potential to take doctors by surprise and kill large numbers of people.

Yet the researchers admit it is "generally harder" to develop a T-cell vaccine than provoke an antibody response. The challenge will be to get a big enough T-cell response to offer protection and a response that will last.

Prof John Oxford, of Queen Mary University of London, said: "This sort of effect can't be that powerful or we'd never have pandemics. It's not going to solve all the problems of influenza, but could add to the range of vaccines.

"It's going to be a long journey from this sort of paper to translating it into a vaccine that works."

Prof Sarah Gilbert, who is developing a universal flu vaccine at the

Jenner Institute in Oxford, said: "Live attenuated influenza vaccines which are given by nasal spray and will be used in children in the UK from this autumn are much better at increasing the number of influenza-specific T cells, but these vaccines only work in young children who haven't yet had much exposure to influenza virus, so we need an alternative approach for adults.

"The new publication contains information on the precise characteristics of the influenza-specific T cells which were protective, and this information will be useful in monitoring the immune response to vaccination when testing novel influenza vaccines which are designed to provide protection against pandemic as well as seasonal influenza viruses."


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No action over Stafford doctors

23 September 2013 Last updated at 08:00 ET By Nick Triggle Health correspondent, BBC News

Four senior doctors who worked at Stafford Hospital at the height of the neglect and abuse scandal will not face disciplinary action.

Dr John Gibson, Dr Valerie Suarez, Dr David Durrans and Dr Diarmuid Mulherin, who all held senior management positions, were investigated by the General Medical Council.

But the regulator has now said it is dropping the cases.

Legal advice found there was "no realistic prospect" of success.

The decision comes after widespread criticism when the public inquiry was published in February that those responsible for the scandal have not been held to account.

At the time, Prime Minister David Cameron said the likes of the GMC and the Nursing and Midwifery Council had "some difficult questions to answer".

Since then three nurses have been struck off the register - with one disciplinary hearing ongoing.

Continue reading the main story

We are not a doctors club. We are not here to protect doctors"

End Quote Niall Dickson General Medical Council

The GMC has given warnings and advice to other doctors who worked at Stafford Hospital.

But as yet no-one has been struck off for their role in providing medical care - one doctor has been erased from the register for fraud.

'Systematic management problems'

GMC chief executive Niall Dickson said: "Following the extensive investigations we have undertaken there is not the evidence to establish either misconduct or impairment against any of the doctors."

The GMC got legal advice from Tom Kark QC, who worked on the public inquiry, after taking statements from 26 witnesses.

Mr Kark advised the GMC that while there was evidence that would demonstrated there were systematic management problems at the trust - none of it could be attributed to any individual doctor.

However, Mr Dickson said he was in talks with the Department of Health to relax the regulatory framework under which the regulator operates.

At the moment, the GMC has to not only prove that a doctor's performance fell below what was expected, but that they also provide an ongoing risk to patients.

The GMC believes the system would be improved if cases were only judged on what the individual has done.

"We are not a doctors club. We are not here to protect doctors," Mr Dickson added.

But Katherine Murphy, of the Patients Association, said while it would be unfair to comment on the four individuals, serious questions needed to be asked about the regulatory process.

"The general delay in holding individuals to account for failings at Stafford is outrageous.

"Years on, and after huge numbers of avoidable deaths, we have still only just scratched the surface of holding the nurses, clinicians and managers to account for the failings that occurred."


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'Dramatic' drop in global HIV infections

23 September 2013 Last updated at 09:10 ET By Tulip Mazumdar Global health reporter

The number of HIV infections and Aids-related deaths has fallen dramatically, according to a UN report.

Death rates fell from 2.3 million during its peak in 2005 to 1.6 million last year, says UNAIDS.

The number of new HIV infections fell by a third since 2001 to 2.3 million.

Among children, the drop was even steeper. In 2001 there were more than half a million new infections. By 2012 the figure had halved to just over a quarter of a million.

The authors put the fall in deaths and infection rates in children down to better access to antiretroviral drugs which help suppress the virus.

Without treatment, people with HIV can go on to develop Aids which makes simple infections deadly.

By the end of 2012 almost 10m people in low and middle income countries, including South Africa, Uganda and India, were accessing antiretroviral therapy, according to the report.

The improved access is being attributed to drugs being more affordable and available in communities, as well as more people coming forward for help.

Way to go

According to UNAIDS, the world is "closing in" on its Millennium Development Goals to stop and reverse the Aids epidemic by 2015.

But it says the world can go beyond its target of getting 15m people on HIV treatment by 2015. The World Health Organization has now revised its guidelines making even more people eligible for treatment.

The report also found that progress has been slow in providing HIV services to people who are most at risk of infection, like those who inject drugs.

And it highlights the need to do more to deal with sexual violence against women and girls. They make up a key group of people vulnerable to infection.

Bev Collins, Health Policy Advisor at Doctors without Borders said: "Huge leaps forward have been made to make sure that millions of people - especially in the developing world - can access lifesaving HIV treatment at an affordable price.

"But this is no time for complacency. We need to keep on rolling out access to better treatment strategies, expanding access to accurate, cost-effective testing, and to care"


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Many 5-year-olds 'have tooth decay'

Written By Unknown on Minggu, 22 September 2013 | 21.24

19 September 2013 Last updated at 20:57 ET

More than a quarter of five-year-olds in England have tooth decay, although the number is down, a survey suggests.

The analysis by Public Health England looked at data from 133,000 dental examinations across the country, covering 21% of five-year-olds.

It suggested 27% of all five-year-olds had tooth decay, down from 30% in a 2008 survey.

The British Dental Association (BDA) said there remained a "deep chasm" between the best and worst areas.

Deprived areas had the highest numbers affected by decay.

Figures ranged from 21.2% of five-year-olds in the south-east to 34.8% in the north-west.

When the researchers looked at more localised data, Brighton and Hove was found to have the lowest percentage affected by tooth decay, at 12.5%, compared with the highest figure of 53.2% in Leicester.

Ingrained habits 'danger'

Tooth decay is caused by a build-up of plaque on the teeth. Bacteria in the plaque feed on sugars from food and drink, and produce an acid that slowly destroys teeth.

Continue reading the main story

It reminds us of the deep chasm that exists between those with the best and worst oral health"

End Quote Dr Christopher Allen, British Dental Association

Decay stems largely from a poor diet, but also poor dental care - not brushing teeth properly and not visiting the dentist often enough.

Although healthy adult teeth will come through in children whose milk teeth have been affected by decay, if such bad habits become ingrained, there will also be problems with those teeth.

A five-year-old normally has 20 milk teeth.

Children with decay had, on average, between three and four affected teeth.

The analysis found 3% of those with decay had one or more teeth removed, a painful procedure often carried out in hospital under anaesthetic.

There have been improvements - 72% of five-year-olds have no tooth decay, up from 69% in 2008.

Public Health England suggests part of this improvement may be down to increased levels of fluoride in most children's toothpastes.

'Lowest decay rates'

Prof Kevin Fenton, director of health and well-being at Public Health England said: "This latest survey shows the numbers of five-year-olds free from tooth decay have improved but there is still much to do, dental decay is preventable.

"Parents should brush their children's teeth for at least two minutes twice a day, once just before bedtime and at least one other time during the day.

"Also supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it."

From April this year, local authorities have taken over responsibility for oral health.

Health Minister Lord Howe, said: "We know more work is needed to make sure good oral health is more consistent right across the country.

"However, we have some of the lowest decay rates in the world."

Dr Christopher Allen, chairman of the BDA's public health committee, said: "This report highlights a welcome improvement to the overall oral health of five-year-old children across England, but it also reminds us of the deep chasm that exists between those with the best and worst oral health.

"That divide is based not just on geography, but also on deprivation."

The BDA's scientific adviser, Prof Damien Walmsley said: "There remain pockets of inequality. It's really about targeting resources so we can get to those people."

He said trying to instil healthy eating habits as early as possible was key, as was ensuring parents regularly took their children to the dentist.


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Nurse struck off over hospital death

20 September 2013 Last updated at 09:35 ET

A nurse has been struck off after failing to identify a patient who died at Stafford Hospital was diabetic.

Gillian Astbury, 66, died at the hospital in April 2007 after not receiving insulin.

In July, a Nursing and Midwifery Council panel found former Stafford nurses Jeannette Coulson and Ann King guilty of misconduct.

King has been struck off by the panel, while Coulson was given a caution for a period of three years.

During the earlier hearing, King was also found to have lied about changing patients' dressings and giving them medication, while Coulson admitted swearing at staff.

The panel heard the pair had failed to carry out blood-sugar level tests on Ms Astbury.

She was admitted to Stafford Hospital a week after suffering a stroke on 1 April 2007.

She did not receive insulin for 48 hours, and was discovered collapsed in a bed at 22:30 on 10 April.

'Appalling care'

In a statement, Ms Astbury's daughter Kate Beeson said: "While we are happy that the conclusion of the NMC hearing draws a line under the case, whatever the ruling, nothing can bring my mother back, and nothing can truly reflect the severity of the nurses' negligence.

"We have been fighting for justice for several, very tiring years. Since her tragic death, I have been unable to put my mother to rest.

"Today's judgment, and all of the effort that has gone into getting to this stage, will be completely in vain if others in a similar position do not step out and make their voices heard.

"It is important that those responsible are brought to account and people need to speak up in order to make that happen."

In a statement, the Mid Staffordshire NHS Foundation Trust said its thoughts were with Ms Astbury's family and apologised for the "appalling care" she received.

It added that both nurses had since left the trust.

The trust is itself facing a prosecution over Ms Astbury's death, brought by the Health and Safety Executive, under the health and safety at work act.


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Rise in A&Es failing to hit targets

21 September 2013 Last updated at 19:08 ET

The number of NHS trusts in England failing to meet target A&E waiting times has more than doubled in the last year, the regulator Monitor has said.

Between April and June, 31 trusts failed to meet their target of seeing patients within four hours of their arrival.

Just 13 trusts missed their waiting times commitment over the same period last year.

The Department of Health said A&Es saw 95% of patients within their targets.

But Monitor raised concerns that services - which usually improve over the spring and summer months - had instead remained challenging.

The regulator's report looks at the key trends drawn from individual reports of England's 146 foundation trusts.

Winter warning

It warned that ongoing problems meeting A&E targets may result in "unsatisfactory care" for patients, adding that trusts should prepare for the winter months by putting the right funding in place.

The number of trusts running a financial deficit increased from 36 in the first quarter of 2012/13, to 48 over the same period this year.

During that time, trusts generated £57m less in cost savings than originally planned.

Jason Dorsett, Monitor's financial risk and reporting director, said: "The increased demand has also prevented trusts from delivering their planned financial savings.

"We expect to see trusts planning now for how the increased demand will impact on their finances, so that they are not storing up trouble for the future."

'Severe storms ahead'

Labour responded to the figures by warning there will be "severe storms ahead" for A&E units this winter unless the government addresses issues in staffing and social care.

Shadow health secretary Andy Burnham said: "David Cameron's ill-judged... re-organisation has placed the NHS in the danger zone."

A Department of Health spokesperson said the ageing population had put pressure on departments across the UK - with more than a million extra visits made to A&E over the past four years.

The spokesperson said: "A&E departments have been seeing 95% of their patients within four hours since the end of April - as they were before last winter. This is testament to the hard work of staff working throughout the health and care system."

The government is investing £500m over the next two years to help ensure A&E departments are prepared for the winter.


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Warning of three-person IVF 'risks'

Written By Unknown on Jumat, 20 September 2013 | 21.24

19 September 2013 Last updated at 15:10 ET By James Gallagher Health and science reporter, BBC News

Concerns about the safety of a pioneering therapy that would create babies with DNA from three people have been raised by researchers.

The advanced form of IVF could eliminate debilitating and potentially fatal mitochondrial diseases.

Writing in the journal Science, the group warned that the mix of DNA could lead to damaging side-effects.

The expert panel that reviewed the safety of the technique said the risks described would be "trivial".

The UK is leading the world in the field of "mitochondrial replacement". Draft regulations to allow the procedure on a case-by-case basis will be produced this year and some estimate that therapies could be offered within two years.

Power source
Continue reading the main story

"Start Quote

One of our prime interests is about the safety of these techniques."

End Quote Prof Doug Turnbull Mitochondrial replacement researcher

Mitochondria are the tiny, biological "power stations" that provide nearly every cell, which make up the body, with energy. They are passed from a mother, through the egg, to her child.

But if the mother has defective mitochondria then it leaves the child starved of energy, resulting in muscle weakness, blindness and heart failure. In the most severe cases it is fatal and some families have lost multiple children to the condition.

The proposed therapy aims to replace the defective mitochondria with those from a donor egg.

Continue reading the main story

But mitochondria have their own DNA, albeit a tiny fraction of the total. It means a baby would have genetic information from mum, dad and a second woman's mitochondria.

The concerns raised - by scientists at the University of Sheffield, the University of Sussex and Monash University in Australia - are about a poor match between the mitochondrial DNA and that from the parents.

Continue reading the main story

The woman who lost all her children

Every time Sharon Bernardi became pregnant, she hoped for a healthy child.

But all seven of her children died from a rare genetic disease that affects the central nervous system - three of them just hours after birth.

When her fourth child, Edward, was born, doctors discovered the disease was caused by a defect in Sharon's mitochondria.

Edward was given drugs and blood transfusions to prevent the lactic acidosis (a kind of blood poisoning) that had killed his siblings.

Five weeks later Sharon and her husband, Neil, were allowed to take Edward to their home in Sunderland for Christmas - but his health slowly began to deteriorate.

Edward survived into adulthood, dying in 2011 at the age of 21.

Now Sharon is supporting medical research that would allow defective mitochondria to be replaced by DNA from another woman.

They said there was an interaction between the DNA in the mitochondria and the rest which is packaged in a cell's nucleus.

Their studies on fruit flies suggested that a poor match of genetic information between the nucleus and mitochondria could affect fertility, learning and behaviour.

"Describing it as like changing the batteries in a camera is too simplistic," Dr Klaus Reinhardt from the University of Sheffield told the BBC.

He added : "It is not at all our intention to be a roadblock, we think it is fantastic that for women affected there could be a cure.

"We have pointed out one or two points which need to be looked at."

'Trivial'

The Human Fertilisation and Embryology Authority, which regulates fertility treatment in the UK, commissioned a review into the safety of the technique.

Prof Robin Lovell-Badge, who was on the review panel, disagreed. He said humans had diverse mitochondrial and nuclear DNA, so any consequences of poor matches would have already become apparent.

He told the BBC news website: "Humans are breeding between races and producing healthy children all the time. If there is an effect then it must be very trivial as it's not been noticed."

He has called for further safety testing, such as research into the risks posed by any defective mitochondria which might still be passed onto a child.

Prof Doug Turnbull, who is developing the mitochondrial replacement therapy at Newcastle University, insisted: "One of our prime interests is about the safety of these techniques.

"It's perfectly reasonable to draw some of these concerns, I just don't share the same concerns.

"Mismatch between the mitochondrial and nuclear genome is a potential risk, but I don't think it's personally as big a risk as they're saying."

The idea has also raised ethical concerns from groups concerned about the impact of altering human genetic inheritance.

In a statement, the Human Fertilisation and Embryology Authority said: "The panel of experts convened by the HFEA to examine the safety and efficacy of mitochondria replacement carefully considered the interaction between nuclear and mitochondrial DNA and concluded that the evidence did not show cause for concern.

"As in every area of medicine, moving from research into clinical practice always involves a degree of uncertainty. Experts should be satisfied that the results of further safety checks are reassuring and long term follow-up studies are crucial.

"Even then patients will need to carefully weigh up the risk and benefits for them."


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Many 5-year-olds 'have tooth decay'

19 September 2013 Last updated at 20:57 ET

More than a quarter of five-year-olds in England have tooth decay, although the number is down, a survey suggests.

The analysis by Public Health England looked at data from 133,000 dental examinations across the country, covering 21% of five-year-olds.

It suggested 27% of all five-year-olds had tooth decay, down from 30% in a 2008 survey.

The British Dental Association (BDA) said there remained a "deep chasm" between the best and worst areas.

Deprived areas had the highest numbers affected by decay.

Figures ranged from 21.2% of five-year-olds in the south-east to 34.8% in the north-west.

When the researchers looked at more localised data, Brighton and Hove was found to have the lowest percentage affected by tooth decay, at 12.5%, compared with the highest figure of 53.2% in Leicester.

Ingrained habits 'danger'

Tooth decay is caused by a build-up of plaque on the teeth. Bacteria in the plaque feed on sugars from food and drink, and produce an acid that slowly destroys teeth.

Continue reading the main story

It reminds us of the deep chasm that exists between those with the best and worst oral health"

End Quote Dr Christopher Allen, British Dental Association

Decay stems largely from a poor diet, but also poor dental care - not brushing teeth properly and not visiting the dentist often enough.

Although healthy adult teeth will come through in children whose milk teeth have been affected by decay, if such bad habits become ingrained, there will also be problems with those teeth.

A five-year-old normally has 20 milk teeth.

Children with decay had, on average, between three and four affected teeth.

The analysis found 3% of those with decay had one or more teeth removed, a painful procedure often carried out in hospital under anaesthetic.

There have been improvements - 72% of five-year-olds have no tooth decay, up from 69% in 2008.

Public Health England suggests part of this improvement may be down to increased levels of fluoride in most children's toothpastes.

'Lowest decay rates'

Prof Kevin Fenton, director of health and well-being at Public Health England said: "This latest survey shows the numbers of five-year-olds free from tooth decay have improved but there is still much to do, dental decay is preventable.

"Parents should brush their children's teeth for at least two minutes twice a day, once just before bedtime and at least one other time during the day.

"Also supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it."

From April this year, local authorities have taken over responsibility for oral health.

Health Minister Lord Howe, said: "We know more work is needed to make sure good oral health is more consistent right across the country.

"However, we have some of the lowest decay rates in the world."

Dr Christopher Allen, chairman of the BDA's public health committee, said: "This report highlights a welcome improvement to the overall oral health of five-year-old children across England, but it also reminds us of the deep chasm that exists between those with the best and worst oral health.

"That divide is based not just on geography, but also on deprivation."

The BDA's scientific adviser, Prof Damien Walmsley said: "There remain pockets of inequality. It's really about targeting resources so we can get to those people."

He said trying to instil healthy eating habits as early as possible was key, as was ensuring parents regularly took their children to the dentist.


21.24 | 0 komentar | Read More
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