HIV antibodies 'have potent impact'

30 October 2013 Last updated at 20:02 ET By James Gallagher Health and science reporter, BBC News

A potential new HIV treatment has a "profound and unprecedented" impact on the virus, according to animal studies published in the journal Nature.

Potent antibodies were able to wipe a hybrid of human and monkey immunodeficiency viruses from the bloodstream of monkeys within days.

The findings could "revolutionise" the search for an HIV cure, say experts.

The US researchers said trials in patients with HIV now needed to take place.

The immune system produces precisely targeted antibodies to take out HIV, but the virus is able to rapidly mutate to evade the immune assault.

Continue reading the main story

The effect with these potent antibodies is profound and unprecedented. It's probably as large an antiviral therapeutic effect as has ever been seen"

End Quote Prof Dan Barouch Harvard Medical School

However, some antibodies have been discovered that target the "conserved" parts of HIV - those that the virus struggles to change because they are vital for it to function.

'Undetectable'

Two groups, from Harvard Medical School and the National Institute of Allergy and Infectious Diseases, performed the first trials of these antibodies.

They used rhesus macaques that had been infected with simian-human immunodeficiency virus (SHIV), a blend of HIV and the monkey equivalent.

Data from the Harvard team showed that injection of the antibodies drove SHIV from the bloodstream until it reached undetectable levels after three to seven days.

The effect lasted for one to three months, but in three monkeys the virus did not return to the blood during the 250-day study.

Prof Dan Barouch told the BBC: "The effect with these potent antibodies is profound and unprecedented. It's probably as large an antiviral therapeutic effect as has ever been seen.

"But we have to make sure we don't overhype and the limitation is the study is in animals, not humans."

The antibodies were also able to attack the virus in some tissues. Drugs can assault the virus in the blood during normal HIV treatment, but the virus can hide in other parts of the body.

These early findings raise the prospect of using antibodies to clear these tissues as well.

Similar results were produced by the team at the National Institute of Allergy and Infectious Diseases

'Revolutionise'

HIV infection is incurable, although taking a daily dose of medication can keep the virus in check, giving patients a near-normal life expectancy.

The antibodies will be tested in human clinical trials and if successful they could be used alongside antiretroviral drugs as a treatment.

It may also be possible to devise a vaccine that could train the immune system to produce these antibodies.

However, both these ideas are dependent on human trials being successful.

Commenting on the findings, Prof Louis Picker and Prof Steven Deeks said: "The findings of these two papers could revolutionise efforts to cure HIV."

However, they warned that HIV was so prone to mutation that it was "likely that some people will harbour viruses that are resistant to one or more" of the antibodies.

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Breast cancer 'rising in under-40s'

31 October 2013 Last updated at 09:53 ET By Helen Briggs BBC News

Cases of breast cancer in women under 40 are rising across Europe, research suggests.

Experts say it is unclear whether this is due to improved diagnosis or new risk factors.

A study in Cancer Epidemiology found cases rose by about 1% a year between 1990 and 2008 in seven countries.

Breast cancer is the most common cause of cancer among women globally, and the leading cause of cancer death.

Cancer in young women is rare - only about 5% of all breast cancers are in women under the age of 40.

Despite this, it is the leading cause of death in young adult women.

Continue reading the main story

Women can reduce the risk of breast cancer by keeping active and cutting down on alcohol. Also get to know your breasts and, if you notice any change, tell your doctor without delay"

End Quote Jessica Kirby Cancer Research UK

Researchers in France and Italy studied trends in breast cancer in women under 40 in Belgium, Bulgaria, France, Italy, Portugal, Spain and Switzerland over an 18-year period.

They found that on average cases rose by about 1% a year in women under 40, with the greatest rise in women under 35.

It is unclear if this is due to a rise in risk factors or improving methods of diagnosis, they say.

'Worrying'

"The rise in incidence was greater for women under 35 and for ductal carcinomas [a type of tumour in the ducts of the mammary gland]," the researchers, led by Dr Brice Leclere, of the GRELL working group, write in the journal Cancer Epidemiology.

"This increase can be due to a rise in risk factors and/or changes in diagnosis and surveillance practices, but we could not clearly distinguish between these two non-exclusive explanations."

Commenting on the research, Jessica Kirby, Cancer Research UK's health information manager, said: "It's worrying to see a rise in breast cancer rates in younger women in Europe, but this study didn't include the UK.

"Rises in breast cancer rates could be caused by a range of things that can increase the risk of breast cancer, such as women having fewer children and having them later in life, or greater awareness and diagnosis in this group.

"Women can reduce the risk of breast cancer by keeping active and cutting down on alcohol. Also get to know your breasts and, if you notice any change, tell your doctor without delay."

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Vegetative patient 'paid attention'

31 October 2013 Last updated at 10:13 ET By James Gallagher Health and science reporter, BBC News

A patient in a vegetative state was able to pay attention to sounds in his surroundings, a study found.

An analysis of brain activity in 21 patients and eight healthy volunteers showed one of the patients could pick out individual sounds.

The University of Cambridge researchers say the finding marks an advance in understanding levels of consciousness in vegetative patients.

The team hope to develop better ways for some patients to communicate.

A vegetative or minimally conscious state can leave someone with no higher cognitive function. The trauma can be caused by a car accident or heart attack.

While patients may still be able to move their eyes and limbs, they cannot do so on command.

The patients and volunteers had their brains scanned during the experiment.

They were all played a word every second for 90 seconds. They had been told to count the number of times the word "yes" or "no" appeared during the stream of words.

Brainwave records showed one patient's brain activity was "indistinguishable" from the healthy patients, suggesting he was able to focus his attention on the words.

Continue reading the main story

At the moment it's a one size fits all approach. As we don't know what's going on, it's not tailor made to the patient"

End Quote Dr Srivas Chennu

Three other patients showed some brain response, but it appeared to be an involuntary action.

The remaining patients showed no response at all.

Dr Srivas Chennu, from the University of Cambridge, told the BBC that the aim was to change the way patients were treated to match their level of consciousness.

He said: "We are never going to fix these patients, but where we want to get to is doctors having the best information to make decisions for the patient.

"At the moment it's a one size fits all approach. As we don't know what's going on, it's not tailor made to the patient."

In some cases this could include communication with the patient.

Dr Chennu said: "We hope to have tools to help a patient communicate and this takes us a significant step forward."

Dr Tristan Bekinschtein, from the Medical Research Council Cognition and Brain Sciences Unit, said: "Our attention can be drawn to something by its strangeness or novelty or we can consciously decide to pay attention to it.

"A lot of cognitive neuroscience research tells us that we have distinct patterns in the brain for both forms of attention, which we can measure even when the individual is unable to speak.

"These findings mean that, in certain cases of individuals who are vegetative, we might be able to enhance this ability and improve their level of communication with the outside world."

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Swaddling resurgence 'damaging hips'

28 October 2013 Last updated at 22:08 ET By James Gallagher Health and science reporter, BBC News

Parents are risking their babies' health because of a surge in the popularity of swaddling, according to an orthopaedic surgeon.

The technique involves binding the arms and legs with blankets and is used to help calm a baby and prevent crying.

But Prof Nicholas Clarke, of Southampton University Hospital, said swaddling was damaging developing hips.

The Royal College of Midwives and other experts advised parents to avoid tightly swaddling a child.

Restricts movement

Swaddling has been widely used in many cultures globally. It is thought the blanket wrapping can simulate the feelings of being in the womb and calm the child.

But the technique holds the legs out straight and restricts movement, which can alter the development of the hip joint.

Continue reading the main story

Swaddling should not be employed in my view as there is no health benefit but a risk for adverse consequences of the growing and often immature hips"

End Quote Andreas Roposch Great Ormond Street Hospital

Writing in the journal Archives of Disease in Childhood, Prof Clarke argued: "There has been a recent resurgence of swaddling because of its perceived palliative effect on excessive crying, colic and promoting sleep.

"In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints.

"The babies' legs should not be tightly wrapped in extension and pressed together."

Jane Munro, of the Royal College of Midwives, said it was a "seemingly innocuous" thing to do, but it posed "significant problems" for the baby.

She said there was also the risk of the baby overheating and a raised risk of cot death.

She added: "We advise parents to avoid swaddling, but it is also crucial that we take into account each mother's cultural background, and to provide individualised advice to ensure she knows how to keep her baby safe, able to move and not get overheated."

Video guidance

Andreas Roposch, a consultant orthopaedic surgeon at Great Ormond Street Hospital, said: "Similar effects may be seen in all devices or manoeuvres that place the legs in a purely straight position for prolonged periods in this critical age of early infancy.

"Swaddling should not be employed in my view, as there is no health benefit but a risk for adverse consequences of the growing and often immature hips."

Rosemary Dodds, of parenting charity the NCT, advised against tight swaddling.

"It is helpful to raise awareness of hip dysplasia in relation to swaddling. Some parents and babies seem to like swaddling, but it is important that babies do not overheat and their legs are not restricted.

"Videos are available on the NCT website showing parents who want to swaddle their baby how to do so safely."

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Gardening 'linked to longer lives'

28 October 2013 Last updated at 22:10 ET By James Gallagher Health and science reporter, BBC News

Pottering around the garden or fixing up the house has been linked to a longer life in a study of people over the age of 60.

Older people can struggle to exercise vigorously, but the study said simply getting off the sofa and avoiding a sedentary lifestyle was a lifesaver.

The Swedish study of 4,232 people suggested the risks of heart attack and stroke were cut.

The findings were published in the British Journal of Sports Medicine.

The researchers at the Karolinska University Hospital in Stockholm, said elderly people tended to spend more time being sedentary and less time exercising than people in other age groups.

So they looked at the activity levels in-between sitting down and full-on exercise - such as fixing up the car, home repairs, cutting the lawn, blackberry picking or going hunting.

Longer life

The results showed that people who were more active on a daily basis had the lowest risk of a heart attack, but those who were merely active without exercising still had a lower risk than those doing nothing.

Being active reduced the risk of a heart attack or stroke by 27%, and death from any cause by 30%, during the 12-year study.

The report said: "A generally active daily life had important beneficial associations with cardiovascular health and longevity in older adults, which seemed to be regardless of regular exercise."

It said the findings had "high clinical relevance" for older people, who risked spending a lot of time on the sofa or lying in bed.

The scientists involved suggest that sitting for long periods of time may lower people's metabolic rate, or a lack of activity may alter hormones produced in muscle tissue.

These could then have knock-on effects for overall health.

'On your feet'

Dr Tim Chico, honorary consultant cardiologist at Sheffield Teaching Hospitals, said: "Although this study only examined people aged 60, it is reasonable to assume that the more active someone is throughout their life, the lower their risk of cardiovascular disease.

"The message I take from this study is simple. If you want to reduce your risk of heart disease, be more active. Don't sit down for long periods; get up on your feet and do something you enjoy that involves moving around."

Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, said: "Being physically active is important in maintaining good heart health. But, as this study demonstrates, you don't need a gym membership to do that.

"As long as they make you feel warmer, breathe harder and make your heart beat faster, activities such as DIY and gardening count towards the 150 minutes of moderate-intensity [weekly] activity recommended for a healthy lifestyle."

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Hunt loses Lewisham Hospital appeal

29 October 2013 Last updated at 09:44 ET

The Court of Appeal has ruled Health Secretary Jeremy Hunt did not have power to implement cuts at Lewisham Hospital in south-east London.

During the summer, a High Court judge ruled Mr Hunt acted outside his powers when he decided the emergency and maternity units should be cut back.

The government turned to the Court of Appeal on Monday in an attempt to get the decision overruled.

Mr Hunt had previously claimed the move would improve patient care.

'Vital services'

Following the ruling, Mr Hunt said: "I completely understand why the residents of Lewisham did not want any change in their A&E services, but my job as health secretary is to protect patients across south London - and doctors said these proposals would save lives.

Continue reading the main story

This expensive waste of time for the government should serve as a wake up call that they cannot ride roughshod over the needs of the people"

End Quote Rosa Curling Save Lewisham Hospital

"We are now looking at the law to make sure that at a time of great challenge the NHS is able to change and innovate when local doctors believe it is in the interests of patients."

At the High Court in July, Mr Justice Silber said Mr Hunt's decision was unlawful as he lacked power and breached the National Health Services Act 2006.

It was said the cuts would also mean local people having "to travel a long, long way further to get access to vital services".

Under government policy Mr Hunt had appointed a trust special administrator (TSA) to the South London Healthcare Trust, which went into administration after losing more than £1m a week.

To help ease the problem, the TSA recommended cuts at the Hospital.

At the Court of Appeal on Monday Rory Phillips QC, for the Health Secretary and the TSA, argued they had not acted outside their powers.

They challenged Mr Justice Silber's findings that the TSA was not entitled to recommend the changes and that Mr Hunt was not entitled to implement them.

Referring to the 2006 Act, Mr Phillips said its "wording, statutory context and purpose" should have led Mr Justice Silber "to conclude that they were entitled so to act, consistently with Parliament's evident intention".

The challenge against the government was brought by Save Lewisham Hospital and the London Borough of Lewisham.

'Squandered' money

Rosa Curling, who represented the campaign group, said: "We are absolutely delighted with the Court of Appeal's decision.

"This expensive waste of time for the government should serve as a wake up call that they cannot ride roughshod over the needs of the people.

"The decision to dismiss the appeal also reaffirms the need for judicial review, a legal process by which the unlawful decisions of public bodies, including the government, can be challenged by the public."

Andy Burnham, Labour's shadow health secretary, described the decision as a "humiliation" for Mr Hunt that "raises major questions about his judgment".

He said: "Instead of graciously accepting the first court ruling, he has squandered thousands of [pounds of] taxpayers' money trying to protect his own pride and defend the indefensible.

"Today, the secretary of state must accept this decision, apologise unreservedly to the people of Lewisham and give an unequivocal commitment that their A&E will not now be downgraded."

The Department for Health is yet to comment.

Mayor of Lewisham Sir Steve Bullock said: "This is a great result. I was confident of our case but I am still very relieved.

"This is another victory for each and every individual who signed a petition, who wrote to the secretary of state and who marched through the streets of Lewisham."

The decision was made by Lord Dyson, Lord Justice Sullivan and Lord Justice Underhill.

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Fat pledge 'a drop in the ocean'

26 October 2013 Last updated at 07:50 ET

A pledge by food manufacturers to cut saturated fat levels is "a drop in the ocean" in the fight against obesity, a top public health expert has said.

Morrisons, Subway and Nestle are among firms signed up to the voluntary "responsibility deal" between industry and government.

But Prof John Ashton, president of the Faculty of Public Health, said the approach "lacked credibility".

The Department of Health (DoH) said it would "make a huge difference".

It says the average man should eat no more than 30g of saturated fat a day, while the average woman should eat no more than 20g.

According to the British Dietetic Association, most people eat about 20% more than the recommended maximum levels - and a survey of 2,000 people for Sainsbury's found 84% of those questioned did not know how much saturated fat was a healthy amount.

'Healthy options'

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Public health minister for England Jane Ellison says more than 500 big companies have pledged their support

The DoH said cutting the amount of saturated fat in people's diets by 15% could prevent around 2,600 premature deaths every year from conditions such as heart disease and stroke.

Almost half of the food manufacturing and retail industry - based on market share - has signed up to this latest pledge to reduce the amount of saturated fat in products, the DoH said.

Measures planned by companies include Nestle altering the make-up of KitKat biscuits, Morrisons reformulating its range of spreads and Subway replacing biscuits and crisps in its Kids' Pak with healthier options.

Other firms which are cutting saturated fat or have pledged to do so include Tesco, Sainsbury's, Aldi and Mondelez International - which will alter products including its Oreo biscuits.

Prof Ashton said that, while it was "a good thing that some companies are making food that has less saturated fat than before", the pledge did not go far enough.

Continue reading the main story

• Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, and cheese and cream
• Eating a diet that is high in saturated fat can raise the level of cholesterol in the blood, which increases the risk of heart disease, according to NHS Choices
• Most of us eat too much saturated fat - about 20% more than the recommended maximum amount
• The average man should eat no more than 30g of saturated fat a day
• The average woman should eat no more than 20g of saturated fat a day

"They need to ensure that at the same time they lower the sugar and salt that they have used to make foods more tasty as a result of lowering the fat content."

He added: "This announcement is a drop in the ocean in comparison with the scale of the obesity crisis.

"We cannot rely on the voluntary approach of the responsibility deal to solve this problem.

"It now lacks credibility and can be seen as a feeble attempt by the industry to save face."

Labour public health spokeswoman Luciana Berger said: "A few company names on a non-binding plan with no timescale stands little chance of delivering the fundamental change needed to improve our national diet.

"In the week that the chief medical officer warned of the long-term dangers of childhood obesity, we need to go much further."

She said Labour had put forward "bold ideas to set legal limits on our food's fat, sugar and salt content and achieve a cross-party ambition for a more physically-active nation".

'Huge progress'

Tam Fry of the National Obesity Forum, also called for regulation, adding: "The much-vaunted voluntary responsibility deal will never succeed until the government takes a grip and makes everybody sign up to it."

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Prof Alan Maryon-Davis of the Faculty of Health is concerned little is being done

The DoH said that "by reducing the amount of saturated fat in everyday foods, manufacturers and retailers are helping us lead healthier lives".

"We have already made huge progress through the responsibility deal - there are reduced salt levels in many products, calories on high street menus and better information about alcohol units and drinking guidelines," a spokesperson said.

"We know there is more to be done but today's pledge will make a huge difference to our health."

Prof Susan Jebb, chairwoman of the Responsibility Deal Food Network, said the manufacturers' commitments to help reduce saturated fat were "an important step forward".

The announcement of the pledge comes days after cardiologist Aseem Malhotra, a member of the Academy of Medical Royal Colleges' obesity steering group, wrote in the British Medical Journal that the risk from saturated fat in non-processed food was "overstated and demonised".

He said there was too much focus on the fat with other factors such as sugar often overlooked.

He told Radio 4's Today on Saturday that "a sugary drinks tax, banning junk food advertising to children, ensuring compulsory nutritional standards in schools and hospitals... are things that are going to overcome the problems that we face".

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Alzheimer's insight from DNA study

27 October 2013 Last updated at 14:03 ET By James Gallagher Health and science reporter, BBC News

A clearer picture of what causes Alzheimer's disease is emerging after the largest ever analysis of patients' DNA.

A massive international collaboration has now doubled the number of genes linked to the dementia to 21.

The findings, published in the journal Nature Genetics, indicate a strong role for the immune system.

Alzheimer's Research UK said the findings could "significantly enhance" understanding of the disease.

The number of people developing Alzheimer's is growing around the world as people live longer.

Continue reading the main story

We've doubled the number of genes discovered and a very strong pattern is emerging"

End Quote Prof Julie Williams Cardiff University

However, major questions around what causes the dementia, how brain cells die, how to treat it or even diagnose it remain unanswered.

"It is really difficult to treat a disease when you do not understand what causes it," one of the lead researchers, Prof Julie Williams from Cardiff University, said.

Detective work

The genetic code, the instructions for building and running the body, was scoured for clues.

A group - involving nearly three quarters of the world's Alzheimer's geneticists from 145 academic institutions - looked at the DNA of 17,000 patients and 37,000 healthy people.

They found versions of 21 genes, or sets of instructions, which made it more likely that a person would develop Alzheimer's disease. They do not guarantee Alzheimer's will develop, but they do make the disease more likely.

By looking at the genes' function in the body, it allows researchers to figure out the processes going wrong in Alzheimer's disease.

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Prof Julie Williams, from Cardiff University, explained what the findings mean

Prof Williams, the head of neurodegeneration at Cardiff University, told the BBC: "We've doubled the number of genes discovered and a very strong pattern is emerging.

"There is something in the immune response which is causing Alzheimer's disease and we need to look at that."

The way the body deals with cholesterol and the way cells in the brain deal with big molecules in a process called endocytosis also seem to be involved.

It now needs other research groups to pick up on the findings, work out exactly what is going wrong and develop treatments.

This could include drugs, genetic therapies or changes to lifestyle.

Dr Eric Karran, the director of research at Alzheimer's Research UK, said: "By mapping the genetics of the most common, late-onset form of Alzheimer's, these findings highlight new biological processes that could significantly advance our understanding of this devastating disease.

"While this new discovery holds real potential, the true value will come from pinpointing the exact genes involved, how they contribute to Alzheimer's, and how this could be translated into benefits for people living with the disease."

Dr James Pickett, head of research at the Alzheimer's Society, said: "This exciting discovery of genes linked with Alzheimer's disease opens up new avenues to explore in the search for treatments for the condition.

"We now need continued global investment into dementia research to understand exactly how these genes affect the disease process."

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NHS complaints revolution 'needed'

28 October 2013 Last updated at 08:59 ET By Nick Triggle Health correspondent

The culture of delay and denial over NHS complaints in England must come to an end, a review of the system says.

The government-commissioned inquiry - led by Labour MP Ann Clwyd - said too many patients found the current approach unresponsive and confusing.

It said it was putting the health service on a year's notice to improve accountability and transparency.

To achieve this, the review has got 12 key organisations to sign up to a series of pledges.

These include:

Continue reading the main story

The days of delay, deny and defend must end and hospitals must become open, learning organisations"

End Quote Ann Clwyd

• The Nursing and Midwifery Council to include new duties over complaints handling in its code of conduct.
• A pledge from Health Education England to develop an e-learning course to improve training.
• NHS England promising to work with local managers to hold hospitals and other providers to account.
• The Care Quality Commission to place a strong focus on complaints in its new hospital inspection regime.
• Hospitals will also be expected to publish annual reports in "plain English" on complaints.

The review was commissioned by the government after the public inquiry into the Stafford Hospital scandal.

Ms Clwyd was asked to lead it after she broke down in a BBC interview last December while describing the poor care her late husband had received.

She was sent more than 2,500 letters and emails from people describing similar problems and dissatisfaction with the way complaints are handled.

They said they were often unaware of how to make complaints or of the identities of staff they wanted to complain about.

They also said they feared reprisals if they did raise concerns.

Open hospitals

The report concluded there had been a "decade of failure" and called for a revolution in complaints handling.

As well as the steps mentioned above, it said relatively simple measures, such as providing patients with paper and a pen beside their beds and displaying the names of staff on duty, could also help.

Ms Clwyd said: "When I made public the circumstances of my own husband's death last year, I was shocked by the deluge of correspondence from people whose experience of hospitals was heart-breaking.

"It made me determined to do my best to get change in the system.

"The days of delay, deny and defend must end and hospitals must become open, learning organisations."

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Health Secretary Jeremy Hunt welcomed the report and said a full response to the Stafford Hospital inquiry and the reports that have followed, which include this one as well as others on healthcare assistants, mortality rates and patient safety, would be made before the end of the year.

He added: "I want to see a complete transformation in hospitals' approach to complaints so that they become valued as vital learning tools."

But patient groups questioned how committed the government really was.

Peter Walsh, of Action Against Medical Accidents, pointed out that the government appeared to be watering down the duty of candour called for after the Stafford Hospital scandal.

The public inquiry had suggested this should become a legally enforceable duty, but latest plans suggest this will only be applied to the most serious cases of harm.

Call for advice service

Mr Walsh said: "For all the good commonsense proposals contained in the report, they would be rendered useless if the government restricts the duty of candour in this way."

Shadow Health Secretary Andy Burnham said: "The NHS has an unfortunate tendency to push complainants away and pull down the shutters. That has to change."

The report comes as the health ombudsman calls for a 24-hour advice service for unhappy patients.

Writing in the BBC News website's Scrubbing Up column, ombudsman Dame Julie Mellor said: "Too often we hear of patients not having the confidence to raise a concern on a hospital ward."

She said patients and carers should be able to access advice on how to raise a concern "24 hours a day, seven days a week", and that "every patient, carer and relative would have the opportunity to raise an issue in person, by email or over the phone".

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Surgery offer for ex-'fattest man'

25 October 2013 Last updated at 08:20 ET

A plastic surgeon in the US has offered to operate on a British man once dubbed the world's fattest.

At his heaviest, Paul Mason weighed 70 stone (444kg) and was bed bound at his bungalow in Ipswich, Suffolk.

He now weighs about 24 stone (152kg) after gastric bypass surgery in 2010 but says his life is being hampered by a huge amount of excess skin.

New York-based surgeon Dr Jennifer Capla said she was willing to donate her time to help Mr Mason.

In May, Mr Mason, 52, released photographs of his naked body as part of his plea for medical help.

Continue reading the main story

"Start Quote

Helping him get his life back is really the goal"

End Quote Dr Jennifer Capla Plastic surgeon

'High-risk patient'

Mr Mason said he had begun trying to raise the money to pay for flights and a hospital stay in order to take advantage of Dr Capla's offer.

Dr Capla told BBC Radio Suffolk she had read about Mr Mason and his weight loss in the New York Times.

"He is a high-risk patient and he has a lot of medical issues that we need to sort through," she said.

"However, he's a great candidate for this skin removal surgery.

"He has lost over 600lbs (272kg) and he should be very functional and mobile and should be able to live his life but he's still wheelchair-bound because he has all this excess skin.

"Helping him get his life back is really the goal."

Dr Capla said she specialised in "post-bariatric body contouring" but that although she had treated patients who has lost up to 200lbs (90kg) she had never treated anyone who had lost as much weight as Mr Mason.

"The skin is the same in terms of looseness and the areas of target so it's an area I'm very familiar with," she said.

'A normal life'

Mr Mason said he had "things in motion" to raise the money needed.

"All I've got to cover is the medication, the stay in hospital and the flights," she said.

Mr Mason has not been able to have the surgery on the NHS because his weight has not been stable.

Continue reading the main story

"Start Quote

A patient must have a stable weight before he or she is considered"

End Quote NHS spokesman

He said an operation to remove excess skin around his middle would make a huge difference.

"I would be able to mobilise and lead a reasonably normal life, then have my arms and legs done," he said.

"Five years down the road it would possibly have to be repeated because by then I should be at my goal weight and the excess skin I would have then would still need removing because of the extreme size I was in the first place."

A spokesman for the NHS Ipswich and East Suffolk Clinical Commissioning Group said: "Before a patient has an operation it is important to take a balanced decision that is in the best interest of that patient.

"In cases like this the NHS has a panel of people - including clinicians - who decide whether the patient should have such an operation. A patient must have a stable weight before he or she is considered."

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Campaigners press PM over cold homes

25 October 2013 Last updated at 02:50 ET

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Campaigner Ed Matthews says Britain has "the worst-insulated housing stock in Western Europe"

Fuel poverty campaigners have written to Prime Minister David Cameron demanding cross-party action on the "national crisis" of cold homes.

Campaigners said the UK was second only to Estonia for people struggling to pay their energy bills across Europe.

It came as Public Health England urged people to keep their homes well heated this winter to avoid potentially fatal health problems.

It said living rooms should be 21C (70F) and other home areas 18C (65F).

Campaign group Energy Bill Revolution - an alliance of charities including Age UK and Barnardos - said the biggest problem in the UK was "leaky homes" and called for investment in a domestic insulation programme.

Energy Bill Revolution said "woeful" levels of insulation had left Britain falling way behind comparable European countries such as Sweden, Germany and the Netherlands.

Campaign director Ed Matthew said: "Our political leaders are falling over themselves to come up with headline-grabbing ways to cut energy bills yet they fall woefully short of a true solution to the energy bill crisis.

"By far the biggest opportunity to cut energy bills is to fully insulate the UK's leaky homes. No other investment can do so much for so many. If the government is serious about solving this crisis they must make insulating homes the UK's number one infrastructure priority."

Increasingly anxious

Public Health England's advice came in its Cold Weather Plan for 2013, after four of the big six energy companies announced price rises.

Continue reading the main story

• Set the heating to 18-21C
• Have your flu jab, if you are eligible
• Look out for friends, relatives and neighbours who may be vulnerable to the cold
• Monitor the weather forecast and plan ahead with supplies
• Have regular hot meals and drinks throughout the day and keep active to help your body stay warm
• Get financial support to make your home more energy efficient, improve your heating or help with bills
• Have your heating and cooking appliances checked regularly
• Wear a few layers of thin clothing rather than one thick layer
• When you need to go outside wear shoes with slip resistant, good grip soles

Age UK said older people in particular were increasingly anxious about the cost of heating their homes.

Winter health risks range from flu to falls - but the cold can also make heart and respiratory problems much worse.

On average there are about 24,000 excess winter deaths in England each year, many of which experts say are preventable.

The plan has been produced in collaboration with the Department of Health, NHS England and the Local Government Association.

It contains advice for the NHS and local government, as well as individuals.

This includes having your flu vaccination if you are in an at-risk group, ensuring homes are properly insulated and making sure heating systems are routinely checked.

From November, the Met Office will issue cold weather alerts if the temperature dips to 2C (35F) or less, or if there is severe winter weather such as heavy snow or widespread ice.

'Stay warm'

Dr Paul Cosford, director for health protection and medical director at Public Health England, said: "In colder weather, keeping yourself warm is essential to staying healthy, especially for the very young, older people or those with a chronic condition such as heart disease and asthma."

Public health minister Jane Ellison said: "The elderly and those with long-term illnesses are particularly at risk during winter months so it's crucial that people stay warm."

Age UK's charity director Caroline Abrahams said: "Being cold is a huge health risk for older people so it is absolutely essential that older people stay warm during the winter months.

"But with fuel poverty blighting the lives of millions of households in the UK many older people are feeling increasingly anxious about the rising cost of energy.

"The government must show it has a clear long-term plan to make low income homes more energy efficient."

Labour's shadow energy and climate change minister, Jonathan Reynolds, said: "People are being left in real hardship because David Cameron won't stand up to the energy companies.

"Britain's energy is market is not working for families and business."

21.24 | 0 komentar | Read More

Fat pledge 'a drop in the ocean'

26 October 2013 Last updated at 07:50 ET

A pledge by food manufacturers to cut saturated fat levels is "a drop in the ocean" in the fight against obesity, a top public health expert has said.

Morrisons, Subway and Nestle are among firms signed up to the voluntary "responsibility deal" between industry and government.

But Prof John Ashton, president of the Faculty of Public Health, said the approach "lacked credibility".

The Department of Health (DoH) said it would "make a huge difference".

It says the average man should eat no more than 30g of saturated fat a day, while the average woman should eat no more than 20g.

According to the British Dietetic Association, most people eat about 20% more than the recommended maximum levels - and a survey of 2,000 people for Sainsbury's found 84% of those questioned did not know how much saturated fat was a healthy amount.

'Healthy options'

Please turn on JavaScript. Media requires JavaScript to play.

Public health minister for England Jane Ellison says more than 500 big companies have pledged their support

The DoH said cutting the amount of saturated fat in people's diets by 15% could prevent around 2,600 premature deaths every year from conditions such as heart disease and stroke.

Almost half of the food manufacturing and retail industry - based on market share - has signed up to this latest pledge to reduce the amount of saturated fat in products, the DoH said.

Measures planned by companies include Nestle altering the make-up of KitKat biscuits, Morrisons reformulating its range of spreads and Subway replacing biscuits and crisps in its Kids' Pak with healthier options.

Other firms which are cutting saturated fat or have pledged to do so include Tesco, Sainsbury's, Aldi and Mondelez International - which will alter products including its Oreo biscuits.

Prof Ashton said that, while it was "a good thing that some companies are making food that has less saturated fat than before", the pledge did not go far enough.

Continue reading the main story

• Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, and cheese and cream
• Eating a diet that is high in saturated fat can raise the level of cholesterol in the blood, which increases the risk of heart disease, according to NHS Choices
• Most of us eat too much saturated fat - about 20% more than the recommended maximum amount
• The average man should eat no more than 30g of saturated fat a day
• The average woman should eat no more than 20g of saturated fat a day

"They need to ensure that at the same time they lower the sugar and salt that they have used to make foods more tasty as a result of lowering the fat content."

He added: "This announcement is a drop in the ocean in comparison with the scale of the obesity crisis.

"We cannot rely on the voluntary approach of the responsibility deal to solve this problem.

"It now lacks credibility and can be seen as a feeble attempt by the industry to save face."

Labour public health spokeswoman Luciana Berger said: "A few company names on a non-binding plan with no timescale stands little chance of delivering the fundamental change needed to improve our national diet.

"In the week that the chief medical officer warned of the long-term dangers of childhood obesity, we need to go much further."

She said Labour had put forward "bold ideas to set legal limits on our food's fat, sugar and salt content and achieve a cross-party ambition for a more physically-active nation".

'Huge progress'

Tam Fry of the National Obesity Forum, also called for regulation, adding: "The much-vaunted voluntary responsibility deal will never succeed until the government takes a grip and makes everybody sign up to it."

Please turn on JavaScript. Media requires JavaScript to play.

Prof Alan Maryon-Davis of the Faculty of Health is concerned little is being done

The DoH said that "by reducing the amount of saturated fat in everyday foods, manufacturers and retailers are helping us lead healthier lives".

"We have already made huge progress through the responsibility deal - there are reduced salt levels in many products, calories on high street menus and better information about alcohol units and drinking guidelines," a spokesperson said.

"We know there is more to be done but today's pledge will make a huge difference to our health."

Prof Susan Jebb, chairwoman of the Responsibility Deal Food Network, said the manufacturers' commitments to help reduce saturated fat were "an important step forward".

The announcement of the pledge comes days after cardiologist Aseem Malhotra, a member of the Academy of Medical Royal Colleges' obesity steering group, wrote in the British Medical Journal that the risk from saturated fat in non-processed food was "overstated and demonised".

He said there was too much focus on the fat with other factors such as sugar often overlooked.

He told Radio 4's Today on Saturday that "a sugary drinks tax, banning junk food advertising to children, ensuring compulsory nutritional standards in schools and hospitals... are things that are going to overcome the problems that we face".

21.24 | 0 komentar | Read More

Campaigners press PM over cold homes

25 October 2013 Last updated at 02:50 ET

Please turn on JavaScript. Media requires JavaScript to play.

Campaigner Ed Matthews says Britain has "the worst-insulated housing stock in Western Europe"

Fuel poverty campaigners have written to Prime Minister David Cameron demanding cross-party action on the "national crisis" of cold homes.

Campaigners said the UK was second only to Estonia for people struggling to pay their energy bills across Europe.

It came as Public Health England urged people to keep their homes well heated this winter to avoid potentially fatal health problems.

It said living rooms should be 21C (70F) and other home areas 18C (65F).

Campaign group Energy Bill Revolution - an alliance of charities including Age UK and Barnardos - said the biggest problem in the UK was "leaky homes" and called for investment in a domestic insulation programme.

Energy Bill Revolution said "woeful" levels of insulation had left Britain falling way behind comparable European countries such as Sweden, Germany and the Netherlands.

Campaign director Ed Matthew said: "Our political leaders are falling over themselves to come up with headline-grabbing ways to cut energy bills yet they fall woefully short of a true solution to the energy bill crisis.

"By far the biggest opportunity to cut energy bills is to fully insulate the UK's leaky homes. No other investment can do so much for so many. If the government is serious about solving this crisis they must make insulating homes the UK's number one infrastructure priority."

Increasingly anxious

Public Health England's advice came in its Cold Weather Plan for 2013, after four of the big six energy companies announced price rises.

Continue reading the main story

• Set the heating to 18-21C
• Have your flu jab, if you are eligible
• Look out for friends, relatives and neighbours who may be vulnerable to the cold
• Monitor the weather forecast and plan ahead with supplies
• Have regular hot meals and drinks throughout the day and keep active to help your body stay warm
• Get financial support to make your home more energy efficient, improve your heating or help with bills
• Have your heating and cooking appliances checked regularly
• Wear a few layers of thin clothing rather than one thick layer
• When you need to go outside wear shoes with slip resistant, good grip soles

Age UK said older people in particular were increasingly anxious about the cost of heating their homes.

Winter health risks range from flu to falls - but the cold can also make heart and respiratory problems much worse.

On average there are about 24,000 excess winter deaths in England each year, many of which experts say are preventable.

The plan has been produced in collaboration with the Department of Health, NHS England and the Local Government Association.

It contains advice for the NHS and local government, as well as individuals.

This includes having your flu vaccination if you are in an at-risk group, ensuring homes are properly insulated and making sure heating systems are routinely checked.

From November, the Met Office will issue cold weather alerts if the temperature dips to 2C (35F) or less, or if there is severe winter weather such as heavy snow or widespread ice.

'Stay warm'

Dr Paul Cosford, director for health protection and medical director at Public Health England, said: "In colder weather, keeping yourself warm is essential to staying healthy, especially for the very young, older people or those with a chronic condition such as heart disease and asthma."

Public health minister Jane Ellison said: "The elderly and those with long-term illnesses are particularly at risk during winter months so it's crucial that people stay warm."

Age UK's charity director Caroline Abrahams said: "Being cold is a huge health risk for older people so it is absolutely essential that older people stay warm during the winter months.

"But with fuel poverty blighting the lives of millions of households in the UK many older people are feeling increasingly anxious about the rising cost of energy.

"The government must show it has a clear long-term plan to make low income homes more energy efficient."

Labour's shadow energy and climate change minister, Jonathan Reynolds, said: "People are being left in real hardship because David Cameron won't stand up to the energy companies.

"Britain's energy is market is not working for families and business."

21.24 | 0 komentar | Read More

Surgery offer for ex-'fattest man'

25 October 2013 Last updated at 08:20 ET

A plastic surgeon in the US has offered to operate on a British man once dubbed the world's fattest.

At his heaviest, Paul Mason weighed 70 stone (444kg) and was bed bound at his bungalow in Ipswich, Suffolk.

He now weighs about 24 stone (152kg) after gastric bypass surgery in 2010 but says his life is being hampered by a huge amount of excess skin.

New York-based surgeon Dr Jennifer Capla said she was willing to donate her time to help Mr Mason.

In May, Mr Mason, 52, released photographs of his naked body as part of his plea for medical help.

Continue reading the main story

"Start Quote

Helping him get his life back is really the goal"

End Quote Dr Jennifer Capla Plastic surgeon

'High-risk patient'

Mr Mason said he had begun trying to raise the money to pay for flights and a hospital stay in order to take advantage of Dr Capla's offer.

Dr Capla told BBC Radio Suffolk she had read about Mr Mason and his weight loss in the New York Times.

"He is a high-risk patient and he has a lot of medical issues that we need to sort through," she said.

"However, he's a great candidate for this skin removal surgery.

"He has lost over 600lbs (272kg) and he should be very functional and mobile and should be able to live his life but he's still wheelchair-bound because he has all this excess skin.

"Helping him get his life back is really the goal."

Dr Capla said she specialised in "post-bariatric body contouring" but that although she had treated patients who has lost up to 200lbs (90kg) she had never treated anyone who had lost as much weight as Mr Mason.

"The skin is the same in terms of looseness and the areas of target so it's an area I'm very familiar with," she said.

'A normal life'

Mr Mason said he had "things in motion" to raise the money needed.

"All I've got to cover is the medication, the stay in hospital and the flights," she said.

Mr Mason has not been able to have the surgery on the NHS because his weight has not been stable.

Continue reading the main story

"Start Quote

A patient must have a stable weight before he or she is considered"

End Quote NHS spokesman

He said an operation to remove excess skin around his middle would make a huge difference.

"I would be able to mobilise and lead a reasonably normal life, then have my arms and legs done," he said.

"Five years down the road it would possibly have to be repeated because by then I should be at my goal weight and the excess skin I would have then would still need removing because of the extreme size I was in the first place."

A spokesman for the NHS Ipswich and East Suffolk Clinical Commissioning Group said: "Before a patient has an operation it is important to take a balanced decision that is in the best interest of that patient.

"In cases like this the NHS has a panel of people - including clinicians - who decide whether the patient should have such an operation. A patient must have a stable weight before he or she is considered."

21.24 | 0 komentar | Read More

Fat pledge 'a drop in the ocean'

26 October 2013 Last updated at 07:50 ET

A pledge by food manufacturers to cut saturated fat levels is "a drop in the ocean" in the fight against obesity, a top public health expert has said.

Morrisons, Subway and Nestle are among firms signed up to the voluntary "responsibility deal" between industry and government.

But Prof John Ashton, president of the Faculty of Public Health, said the approach "lacked credibility".

The Department of Health (DoH) said it would "make a huge difference".

It says the average man should eat no more than 30g of saturated fat a day, while the average woman should eat no more than 20g.

According to the British Dietetic Association, most people eat about 20% more than the recommended maximum levels - and a survey of 2,000 people for Sainsbury's found 84% of those questioned did not know how much saturated fat was a healthy amount.

'Healthy options'

Please turn on JavaScript. Media requires JavaScript to play.

Public health minister for England Jane Ellison says more than 500 big companies have pledged their support

The DoH said cutting the amount of saturated fat in people's diets by 15% could prevent around 2,600 premature deaths every year from conditions such as heart disease and stroke.

Almost half of the food manufacturing and retail industry - based on market share - has signed up to this latest pledge to reduce the amount of saturated fat in products, the DoH said.

Measures planned by companies include Nestle altering the make-up of KitKat biscuits, Morrisons reformulating its range of spreads and Subway replacing biscuits and crisps in its Kids' Pak with healthier options.

Other firms which are cutting saturated fat or have pledged to do so include Tesco, Sainsbury's, Aldi and Mondelez International - which will alter products including its Oreo biscuits.

Prof Ashton said that, while it was "a good thing that some companies are making food that has less saturated fat than before", the pledge did not go far enough.

Continue reading the main story

• Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, and cheese and cream
• Eating a diet that is high in saturated fat can raise the level of cholesterol in the blood, which increases the risk of heart disease, according to NHS Choices
• Most of us eat too much saturated fat - about 20% more than the recommended maximum amount
• The average man should eat no more than 30g of saturated fat a day
• The average woman should eat no more than 20g of saturated fat a day

"They need to ensure that at the same time they lower the sugar and salt that they have used to make foods more tasty as a result of lowering the fat content."

He added: "This announcement is a drop in the ocean in comparison with the scale of the obesity crisis.

"We cannot rely on the voluntary approach of the responsibility deal to solve this problem.

"It now lacks credibility and can be seen as a feeble attempt by the industry to save face."

Labour public health spokeswoman Luciana Berger said: "A few company names on a non-binding plan with no timescale stands little chance of delivering the fundamental change needed to improve our national diet.

"In the week that the chief medical officer warned of the long-term dangers of childhood obesity, we need to go much further."

She said Labour had put forward "bold ideas to set legal limits on our food's fat, sugar and salt content and achieve a cross-party ambition for a more physically-active nation".

'Huge progress'

Tam Fry of the National Obesity Forum, also called for regulation, adding: "The much-vaunted voluntary responsibility deal will never succeed until the government takes a grip and makes everybody sign up to it."

Please turn on JavaScript. Media requires JavaScript to play.

Prof Alan Maryon-Davis of the Faculty of Health is concerned little is being done

The DoH said that "by reducing the amount of saturated fat in everyday foods, manufacturers and retailers are helping us lead healthier lives".

"We have already made huge progress through the responsibility deal - there are reduced salt levels in many products, calories on high street menus and better information about alcohol units and drinking guidelines," a spokesperson said.

"We know there is more to be done but today's pledge will make a huge difference to our health."

Prof Susan Jebb, chairwoman of the Responsibility Deal Food Network, said the manufacturers' commitments to help reduce saturated fat were "an important step forward".

The announcement of the pledge comes days after cardiologist Aseem Malhotra, a member of the Academy of Medical Royal Colleges' obesity steering group, wrote in the British Medical Journal that the risk from saturated fat in non-processed food was "overstated and demonised".

He said there was too much focus on the fat with other factors such as sugar often overlooked.

He told Radio 4's Today on Saturday that "a sugary drinks tax, banning junk food advertising to children, ensuring compulsory nutritional standards in schools and hospitals... are things that are going to overcome the problems that we face".

21.24 | 0 komentar | Read More

Women 'stigmatised' over infertility

25 October 2013 Last updated at 03:46 ET By Philippa Roxby Health reporter, BBC News

New research suggests that many women aged 35-45 who do not have children feel judged for not having had a baby.

Even if they plan to have a child, nearly 60% have at some point felt stigmatised for leaving it late.

About 40% are too embarrassed to talk about fertility, especially with family and friends, often the biggest source of pressure.

Susan Seenan from Infertility Network UK says this prevents some women from seeking help for fertility problems.

Continue reading the main story

"Start Quote

When women are labelled as infertile they feel a failure, because they have let themselves and their partner down"

End Quote Susan Seenan Infertility Network UK

The organisation, which interviewed 500 women for its survey, said it was a common problem.

"Trying for a baby is a very personal thing which people don't always want to talk about, but there is constant pressure from families saying 'Isn't it about time...?'," said Ms Seenan.

"And if you don't say anything, then friends and family assume you like your lifestyle too much to be bothered about children."

If women are then diagnosed with fertility problems, the sense of isolation can become even worse, she says.

"Unfortunately, infertility is still a taboo subject. When women are labelled as infertile they feel a failure, because they have let themselves and their partner down.

"Their basic biological instinct to have a child is kicking in - and at that point everyone seems to have babies, but they can't."

Ms Seenan suggests that for women in this position, it is easier to talk about mental health problems than infertility problems, which is the reason behind the forthcoming National Infertility Awareness Week.

Hurtful

Neela Prabhu, 36, from London, knows how hard it is to spend years trying to become pregnant. She and her husband tried for over a year before seeking help, and that took its toll on them both.

"My mental state at the time wasn't great and although some friends tried to be well-meaning, they kept saying unfunny things about our situation. They were trying to be helpful but sometimes it just hurt. All I could think about was having a baby."

Neela's parents are from India and are very supportive, but she says her mother couldn't relate to her problems, partly because it is an issue rarely discussed in Asian communities.

She says she wants this to change.

"I want there to be more openness. I want women to talk about infertility even if they are dying inside, and I want to give women the confidence to talk about the journey of having a child.

"But it just seems to be a taboo subject - why should this be?"

Neela finally had a daughter four years ago after IVF and has recently discovered she is pregnant again with her second baby, following two failed cycles of IVF last year. She has never found out the cause of her fertility problems despite numerous investigations.

Continue reading the main story

"Start Quote

Many couples try for years before seeking help and before they know it they are in their late 30s - and in some areas that's too old."

End Quote Tim Child Oxford Fertility Unit

Neela started trying for a baby at 27, but many women leave it much later and by doing so they decrease their chances of conceiving naturally and risk missing out on treatment under the NHS.

'Fallback solution'

Current guidelines recommend that women up to 39 should be offered three full cycles of IVF and women aged between 40 and 42 should have access to one cycle.

But there are huge variations in criteria across the UK. In Oxford, for example, 35 is the limit for IVF treatment on the NHS.

Tim Child, medical director at the Oxford Fertility Unit at the University of Oxford says people are leaving it too long before before going to see their GP about their fertility problems.

"When couples start talking about their fertility, that's the point to speak to a healthcare professional.

"Good advice can be given early on about weight, diet, alcohol intake etc which could help, but many couples try for years before seeking help and before they know it they are in their late 30s - and in some areas that's too old."

He says that women wrongly assume that IVF is a good fallback solution when in fact the success rates are 40-50% for the under-35s, dropping to 20% for the under-40s and just 5% for women aged up to 43.

Neela hopes that people can be more understanding and supportive towards women "who can't just fall off a log and get pregnant" so that people like her can feel more comfortable talking about it.

Instead of asking personal, intrusive questions, she wants people to be aware that one in seven heterosexual couples in the UK is affected by infertility.

Being judged has made Neela speak out.

"People used to ask me, 'Don't you want another child?' It's really nobody's business but mine."

National Infertility Awareness Week runs from 28 October.

21.24 | 0 komentar | Read More

Campaigners press PM over cold homes

25 October 2013 Last updated at 02:50 ET

Please turn on JavaScript. Media requires JavaScript to play.

Campaigner Ed Matthews says Britain has "the worst-insulated housing stock in Western Europe"

Fuel poverty campaigners have written to Prime Minister David Cameron demanding cross-party action on the "national crisis" of cold homes.

Campaigners said the UK was second only to Estonia for people struggling to pay their energy bills across Europe.

It came as Public Health England urged people to keep their homes well heated this winter to avoid potentially fatal health problems.

It said living rooms should be 21C (70F) and other home areas 18C (65F).

Campaign group Energy Bill Revolution - an alliance of charities including Age UK and Barnardos - said the biggest problem in the UK was "leaky homes" and called for investment in a domestic insulation programme.

Energy Bill Revolution said "woeful" levels of insulation had left Britain falling way behind comparable European countries such as Sweden, Germany and the Netherlands.

Campaign director Ed Matthew said: "Our political leaders are falling over themselves to come up with headline-grabbing ways to cut energy bills yet they fall woefully short of a true solution to the energy bill crisis.

"By far the biggest opportunity to cut energy bills is to fully insulate the UK's leaky homes. No other investment can do so much for so many. If the government is serious about solving this crisis they must make insulating homes the UK's number one infrastructure priority."

Increasingly anxious

Public Health England's advice came in its Cold Weather Plan for 2013, after four of the big six energy companies announced price rises.

Continue reading the main story

• Set the heating to 18-21C
• Have your flu jab, if you are eligible
• Look out for friends, relatives and neighbours who may be vulnerable to the cold
• Monitor the weather forecast and plan ahead with supplies
• Have regular hot meals and drinks throughout the day and keep active to help your body stay warm
• Get financial support to make your home more energy efficient, improve your heating or help with bills
• Have your heating and cooking appliances checked regularly
• Wear a few layers of thin clothing rather than one thick layer
• When you need to go outside wear shoes with slip resistant, good grip soles

Age UK said older people in particular were increasingly anxious about the cost of heating their homes.

Winter health risks range from flu to falls - but the cold can also make heart and respiratory problems much worse.

On average there are about 24,000 excess winter deaths in England each year, many of which experts say are preventable.

The plan has been produced in collaboration with the Department of Health, NHS England and the Local Government Association.

It contains advice for the NHS and local government, as well as individuals.

This includes having your flu vaccination if you are in an at-risk group, ensuring homes are properly insulated and making sure heating systems are routinely checked.

From November, the Met Office will issue cold weather alerts if the temperature dips to 2C (35F) or less, or if there is severe winter weather such as heavy snow or widespread ice.

'Stay warm'

Dr Paul Cosford, director for health protection and medical director at Public Health England, said: "In colder weather, keeping yourself warm is essential to staying healthy, especially for the very young, older people or those with a chronic condition such as heart disease and asthma."

Public health minister Jane Ellison said: "The elderly and those with long-term illnesses are particularly at risk during winter months so it's crucial that people stay warm."

Age UK's charity director Caroline Abrahams said: "Being cold is a huge health risk for older people so it is absolutely essential that older people stay warm during the winter months.

"But with fuel poverty blighting the lives of millions of households in the UK many older people are feeling increasingly anxious about the rising cost of energy.

"The government must show it has a clear long-term plan to make low income homes more energy efficient."

Labour's shadow energy and climate change minister, Jonathan Reynolds, said: "People are being left in real hardship because David Cameron won't stand up to the energy companies.

"Britain's energy is market is not working for families and business."

21.24 | 0 komentar | Read More

Surgery offer for ex-'fattest man'

25 October 2013 Last updated at 08:20 ET

A plastic surgeon in the US has offered to operate on a British man once dubbed the world's fattest.

At his heaviest, Paul Mason weighed 70 stone (444kg) and was bed bound at his bungalow in Ipswich, Suffolk.

He now weighs about 24 stone (152kg) after gastric bypass surgery in 2010 but says his life is being hampered by a huge amount of excess skin.

New York-based surgeon Dr Jennifer Capla said she was willing to donate her time to help Mr Mason.

In May, Mr Mason, 52, released photographs of his naked body as part of his plea for medical help.

Continue reading the main story

"Start Quote

Helping him get his life back is really the goal"

End Quote Dr Jennifer Capla Plastic surgeon

'High-risk patient'

Mr Mason said he had begun trying to raise the money to pay for flights and a hospital stay in order to take advantage of Dr Capla's offer.

Dr Capla told BBC Radio Suffolk she had read about Mr Mason and his weight loss in the New York Times.

"He is a high-risk patient and he has a lot of medical issues that we need to sort through," she said.

"However, he's a great candidate for this skin removal surgery.

"He has lost over 600lbs (272kg) and he should be very functional and mobile and should be able to live his life but he's still wheelchair-bound because he has all this excess skin.

"Helping him get his life back is really the goal."

Dr Capla said she specialised in "post-bariatric body contouring" but that although she had treated patients who has lost up to 200lbs (90kg) she had never treated anyone who had lost as much weight as Mr Mason.

"The skin is the same in terms of looseness and the areas of target so it's an area I'm very familiar with," she said.

'A normal life'

Mr Mason said he had "things in motion" to raise the money needed.

"All I've got to cover is the medication, the stay in hospital and the flights," she said.

Mr Mason has not been able to have the surgery on the NHS because his weight has not been stable.

Continue reading the main story

"Start Quote

A patient must have a stable weight before he or she is considered"

End Quote NHS spokesman

He said an operation to remove excess skin around his middle would make a huge difference.

"I would be able to mobilise and lead a reasonably normal life, then have my arms and legs done," he said.

"Five years down the road it would possibly have to be repeated because by then I should be at my goal weight and the excess skin I would have then would still need removing because of the extreme size I was in the first place."

A spokesman for the NHS Ipswich and East Suffolk Clinical Commissioning Group said: "Before a patient has an operation it is important to take a balanced decision that is in the best interest of that patient.

"In cases like this the NHS has a panel of people - including clinicians - who decide whether the patient should have such an operation. A patient must have a stable weight before he or she is considered."

21.24 | 0 komentar | Read More

Poor care risk 'at 1 in 4 hospitals'

24 October 2013 Last updated at 04:30 ET By Nick Triggle Health correspondent, BBC News

Please turn on JavaScript. Media requires JavaScript to play.

Sir Mike Richards from the Care Quality Commission said the screening tool would help identify higher risk hospitals

A quarter of hospital trusts in England are at raised risk of providing poor care, a review by the regulator shows.

The findings are based on monitoring by the Care Quality Commission (CQC) of a host of data, including death rates, serious errors and patient surveys.

It found 44 out of 161 trusts fell into the two highest risk categories.

The exercise has been carried out as part of the regulator's new hospital inspection regime, which will see inspectors go into every trust by 2015.

The first inspections got under way in September and by Christmas the first 18 will have been completed.

Continue reading the main story

This is the first time such comprehensive data has been pulled together in this way.

The work has involved the regulator poring over a mountain of data.

But what does it tell us? The Care Quality Commission is being careful to stress it is not a final rating. Instead, it is being dubbed a screening tool - and like any screening it can throw up erroneous results.

For example, the scoring system actually suggests two of the 11 trusts already placed in special measures should be in band three (medium risk) - although they have been bumped up to band one anyway.

But even taking that into account, it provides one of the clearest indications yet of how trusts are performing against each other.

Patients will undoubtedly be interested in the results until the inspection programme is completed.

It will result in every trust being given a rating of either 'outstanding', 'good', 'requires improvement' or 'inadequate' as part of a shake-up in the system ordered after the Stafford Hospital scandal.

The CQC said the latest information was not a final judgement, but would be used to prioritise which trusts to inspect earlier in the process.

Hospital chief inspector Prof Sir Mike Richards likened the risk review to a form of "screening".

He added: "Our intelligent monitoring helps to give us a good picture of risk within trusts, showing us where we need to focus our inspections."

The regulator has assessed each trust's performance against up to 150 different indicators.

Those performing worse than would be expected on each indicator get marked down as being at risk or elevated risk for that topic.

The number of risk scores they have determines which of the bands they are placed in.

Bands one and two - those at highest risk - include 24 trusts and 20 trusts respectively.

The trusts in band one include the 11 trusts already placed in special measures after a review of high mortality rates.

They are joined by Croydon Health Services, which was rated high risk in 12 areas for issues such as patient survey results and whistle-blowing.

Also in band one are Barking, Havering and Redbridge, which was rated high risk in 13 areas including A&E waits and patient surveys, and Aintree, rated high risk in 11 areas including an elevated risk for mortality rates.

How the highest risk trusts compare

Health Foundation chief executive Dr Jennifer Dixon, who is also a CQC board member, said: "It makes sense to use the wealth of routinely available data in the NHS to try to spot patterns which might identify or predict poor quality care for patients.

"The intelligent monitoring tool can never by itself be a crystal ball, but it is a great start and will surely develop over time."

Dr Mark Porter, head of the British Medical Association, said publishing the data was an "important step" towards improving transparency across the NHS, informing and empowering patients and identifying under-performing hospitals.

But he added: "Hospitals are large, complex organisations so we need to avoid oversimplifying or reducing vast amounts of data to a simple band or rating."

Labour Shadow Health Minister Jamie Reed said: "David Cameron should be ashamed that he's put so many of England's hospitals in this position.

"He siphoned £3bn out of the NHS front-line to blow on a back-office re-organisation nobody voted for. Hospitals were left on a financial knife-edge and they are clearly struggling to maintain standards of patient care after more than three years of chaos."

But Health Secretary Jeremy Hunt said: "Sadly, under the last government, a lack of transparency about poor care meant problems went unchecked for too long, some times with tragic consequences for patients.

"This government is being honest with the public about the quality of care at their local hospitals, and taking tough action where standards aren't up to scratch. Patients and staff deserve nothing less."

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Boys catching up on life expectancy

24 October 2013 Last updated at 07:12 ET

Boys are narrowing the gap on girls when it comes to life expectancy in England and Wales, statistics show.

The Office for National Statistics says baby girls born 30 years ago were expected to live six years longer than boys - and now it is less than four.

The latest figures show boys born between 2010 and 2012 can expect to live for 79 years and girls for 82.8 years.

Life expectancy has continued to rise for men and women since the 1980s.

In 1980-82, men's life expectancy was 71 and women's was 77 years old.

Women continue to live longer than men, but the gap in life expectancy has been closing.

Although both sexes have shown annual improvements in life expectancy at birth, over the past 30 years the gap has narrowed because larger numbers of people are surviving to an older age. This is contributing to the ageing population of England and Wales.

Older groups

The ONS also looked at how life expectancy has changed at the age of 65 in England and Wales.

It found that men can expect to live for another 18.3 years, up from 13 years in 1980-82.

Women aged 65 can expect to live for another 20.9 years, an increase of 3.9 years since 1980-82.

The difference between male and female life expectancy at age 65 has decreased over the last 30 years from four to 2.6 years in 2010-12.

The report said male life expectancy at age 65 was now the same as female life expectancy in 1994-96 at age 65.

At 85 years old, a man in England and Wales had a life expectancy of 5.8 years in 2010-12, the stats showed.

For women at 85 in 2010-12 life expectancy was slightly higher at 6.8 years.

The ONS compared life expectancies in England to those in Wales and found that those in England were consistently, although marginally, higher than those in Wales at birth, age 65 and 85.

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NHS Direct to close down next year

24 October 2013 Last updated at 07:24 ET By Nick Triggle Health correspondent, BBC News

NHS Direct - one of the most recognisable names in the NHS - will be closed down in England next year.

The organisation, which is an NHS trust, got into financial difficulty after winning a number of the contracts for the 111 phone line.

It had already said it was pulling out of those - and this latest decision means its other services will be closed or transferred to other NHS bodies.

The NHS Direct service began 15 years ago.

It ran the national telephone advice line from the late 1990s until April this year, when the 111 service was launched.

The 111 service was split into 46 different contracts and NHS Direct won 11 of them.

But during the summer it announced it wanted to end these deals - nine of which had already started and two of which were get to be launched - as they were "unsustainable". Replacement providers have already been found.

NHS Direct also runs a number of other services, including an information website, GP appointments booking phone line and complaints service. Many of these are expected to be transferred to other parts of the health service or put out to tender.

Innovation

NHS Direct used to be paid more than £20 per call when it ran the old 0845 number. The payment was between £7 and £9 per call for the new 111 service - and call volumes were lower than expected.

Projections reported earlier this year showed NHS Direct had lost £2.8m from April to June and was heading for a deficit of £26m if it continued until March.

It will cease to exist at the end of the financial year.

NHS Direct chair Joanne Shaw said the organisation should be proud of the innovation it had championed as it had helped pioneer "remote assessment, advice and information".

The NHS Direct group in Wales is unaffected.

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TB challenge over 'missing' millions

23 October 2013 Last updated at 05:08 ET By Helen Briggs BBC News

About three million people who developed tuberculosis in 2012 have been "missed" by health systems, the World Health Organization has said.

Finding these missed cases is one of the biggest challenges in TB care and control, the WHO's report says.

Twelve countries including India, South Africa and Bangladesh account for the majority of undiagnosed individuals.

But the WHO says the target to halve the number of TB deaths by 2015 is still within reach.

Global TB programme director Dr Mario Raviglione said 56 million people had been cured and 22 million lives had been saved in the past 15 years and half of the highest-burden countries were on track to achieve the Millennium Development Goals targets, but there remained a number of major challenges.

"The two major challenges we identified are that of detecting in the system what we call the missed cases," he told the BBC.

" There are about three million people that we estimate had TB and that are not officially in the system, that are not reported.

"Some of them may actually be never detected, some of them are in fact hidden in the private sector, in the non-state sector, that does not notify the cases.

"So that is I think one of the biggest challenges we have to face and there are opportunities there because we know where these cases may be."

Drug-resistant TB challenge

The WHO says TB testing services need to be urgently improved in many countries, with help from non-governmental organisations NGOs and volunteers.

And in others, particularly Asian countries, more needs to be done to ensure figures on TB are compiled and reported centrally.

Continue reading the main story

Unless we take urgent action, we will continue to see an increase in harder-to-treat drug resistant strains of TB"

End Quote Dr Philipp du Cros Medecins Sans Frontieres

The other major challenge highlighted is drug-resistant TB.

The WHO estimates that 450,000 people became ill with multidrug-resistant TB (MDR-TB) in 2012. China, India and Russia have the highest rates.

But the report adds that by 2012, deaths from TB had been reduced by 45% since 1990, meaning the target of a 50% reduction by 2015 is within reach.

Charity Medecins Sans Frontieres' (MSF) infectious disease specialist Dr Philipp du Cros said: "Three in four people with multidrug-resistant tuberculosis are still not diagnosed, and 17,000 of those diagnosed in 2012 did not even start treatment."

He said: "These shocking figures are an indictment of the global failure to tackle drug-resistant tuberculosis head on. People are paying for this failure with their lives."

Dr Du Cros added: "Unless we take urgent action, we will continue to see an increase in harder-to-treat drug resistant strains of TB."

He said more research was needed to make treatments for TB shorter, more effective and less damaging for patients.

"An extra $2bn was needed to plug a funding gap in the treatment of TB, he added.

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Obese children 'should keep diaries'

22 October 2013 Last updated at 19:00 ET By Michelle Roberts Health editor, BBC News online

Children who are overweight or obese should be encouraged to keep a food-and-activity diary, say new public health guidelines for England.

The National Institute for Health and Care Excellence says more needs to be done to tackle child obesity.

It says getting parents and their children to track what they snack on and how much TV they watch could help.

Although rates are levelling off, three in every 10 children aged between two and 15 are overweight or obese.

The guidelines make a raft of recommendations, including greater support from local authorities, but say families are at the heart of managing the issue.

Continue reading the main story

We are recommending family-based lifestyle programmes are provided which give tailored advice"

End Quote Prof Mike Kelly Director of the Centre for Public Health at NICE

Children from around the age of 12 - depending on their ability - should be encouraged to monitor their eating, physical activity and any sedentary behaviour, say the guidelines.

"For example, encourage them to keep a record of time spent watching television or playing computer games, and what they snack on and when, to identify areas that need addressing," says NICE.

For younger children, parents and carers should keep tabs.

The guidelines also stress the importance of helping parents and carers recognise that their child is overweight.

Life-long changes

A National Opinion Poll involving more than 1,000 parents of children aged between four and seven showed that only 14% of those with an obese child considered that their child was overweight.

Schools already monitor their pupils by measuring and weighing them at around age five when they start primary school and again as they leave at around the age of 11.

NICE says all family members need to be on board, regardless of their own weight, to encourage healthy eating patterns and promote physical exercise - by walking to school, for example.

Prof Mike Kelly, Director of the Centre for Public Health at NICE, said: "We are recommending family-based lifestyle programmes are provided which give tailored advice.

"These programmes will also support parents to identify changes that can be done at home to tackle obesity - and maintained over the long term. Many of them are things we should all be doing anyway, including healthy eating, getting the whole family to be more active and reducing the amount of time spent watching TV and playing computer games.

"Being overweight or obese has a significant impact on a child's quality of life. It can affect their self-esteem and they are more likely to be bullied or stigmatised."

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Saturated fat heart disease 'myth'

22 October 2013 Last updated at 19:37 ET

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Dr Assem Malhotra explains why some saturated fats may not be so bad after all

The risk from saturated fat in foods such as butter, cakes and fatty meat is being overstated and demonised, according to a cardiologist.

Dr Aseem Malhotra said there was too much focus on the fat with other factors such as sugar often overlooked.

It is time to "bust the myth of the role of saturated fat in heart disease", he writes in an opinion piece in the British Medical Journal.

But the British Heart Foundation said there was conflicting evidence.

It added reducing cholesterol through drugs or other means does lower heart risk.

Studies on the link between diet and disease have led to dietary advice and guidelines on how much saturated fat, particularly cholesterol, it is healthy to eat.

Millions of people in the UK have been prescribed statins to reduce cholesterol levels.

Dr Malhotra, a cardiology registrar at Croydon University Hospital, London, says the "mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for almost four decades".

Continue reading the main story

• Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, and cheese and cream
• Eating a diet that is high in saturated fat can raise the level of cholesterol in the blood, which increases the risk of heart disease, according to NHS Choices.
• Most of us eat too much saturated fat - about 20% more than the recommended maximum amount.
• The average man should eat no more than 30g of saturated fat a day.
• The average woman should eat no more than 20g of saturated fat a day.

He says saturated fat has been "demonised" and any link with heart disease is not fully supported by scientific evidence.

The food industry has compensated for lowering saturated fat levels in food by replacing it with sugar, he says, which also contributes to heart disease.

Adopting a Mediterranean diet - olive oil, nuts, oily fish, plenty of fruit and vegetables and a moderate amount of red wine - after a heart attack is almost three times as powerful in reducing mortality as taking a statin, writes Dr Malhotra.

However, Prof Peter Weissberg, medical director at the British Heart Foundation, says studies on the link between diet and disease frequently produce conflicting results.

Unlike drug trials, it is difficult to carry out a controlled, randomised study, he says.

"However, people with highest cholesterol levels are at highest risk of a heart attack and it's also clear that lowering cholesterol, by whatever means, lowers risk."

Cholesterol levels can be influenced by many factors including diet, exercise and drugs, in particular statins, he adds.

"There is clear evidence that patients who have had a heart attack, or who are at high risk of having one, can benefit from taking a statin.

"But this needs to be combined with other essential measures, such as eating a balanced diet, not smoking and taking regular exercise."

Statins are a group of medicines that can help lower rates of cholesterol in the blood.

Cholesterol can also be reduced by eating a healthy, balanced diet, maintaining a healthy weight and doing regular physical activity.

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Exercise 'boosts academic success'

21 October 2013 Last updated at 19:59 ET

Intensive exercise improves the academic performance of teenagers, according to new research.

The study, of about 5,000 children, found links between exercise and exam success in English, maths and science.

It found an increase in performance for every extra 17 minutes boys exercised, and 12 minutes for girls.

The study by the universities of Strathclyde and Dundee found physical activity particularly benefited girls' performance at science.

The authors said this could be a chance finding or reflect gender differences in the impact of physical activity on the brain.

Children who carried out regular exercise, not only did better academically at 11 but also at 13 and in their exams at 16, the study suggested.

'Low exercise levels'

Most of the teenagers' exercise levels were found to be well below the recommended 60 minutes a day.

The authors speculated what might happen to academic performance if children got the recommended amount.

They claimed that since every 15 minutes of exercise improved performance by an average of about a quarter of a grade, it was possible children who carried out 60 minutes of exercise every day could improve their academic performance by a full grade - for example, from a C to a B, or a B to an A.

However, the authors admitted this was speculation given that very few children did anywhere near this amount of exercise.

Dr Josie Booth, one of the leaders of the study, from Dundee University said: "Physical activity is more than just important for your physical health.

"There are other benefits and that is something that should be especially important to parents, policy-makers and people involved in education."

The authors of the study, published in the British Journal of Sports Medicine, said further research backing the findings could have implications fore public health and education policy.

The study was funded by a grant from the BUPA Foundation to the University of Strathclyde.

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