Cholesterol 'fuels' breast cancer

28 November 2013 Last updated at 22:54 ET By James Gallagher Health and science reporter, BBC News

A by-product of cholesterol can fuel the deadly growth and spread of breast cancer, according to a group of scientists.

It raises the prospect that taking cholesterol-lowering drugs called statins could prevent cancer.

The work, published in the journal Science, helps explain why obesity is a major risk factor for the disease.

However, cancer charities cautioned that it was too soon to advise women to take statins.

Obesity has been linked with many cancers including those of the breast, bowel and womb.

Continue reading the main story

The results from this early study are promising"

End Quote Dr Hannah Bridges Breakthrough Breast Cancer

The fat in overweight people can pump out hormones, such as oestrogen, which drive the growth of cancers.

A team at Duke University Medical Centre, in the US, showed that cholesterol was having a similar effect.

Cholesterol is broken down by the body into 27HC, which can mimic oestrogen and produce the same effect as the hormone in some tissues.

Experiments on mice showed that a high fat diet increased levels of 27HC in the blood and led to tumours that were 30% larger than in mice on a normal diet.

Tumours were also more likely to spread. And human breast cancer tissue grew more quickly in the laboratory when it was fed 27HC.

One of the researchers Prof Donald McDonnell said: "A lot of studies have shown a connection between obesity and breast cancer, and specifically that elevated cholesterol is associated with breast cancer risk, but no mechanism has been identified.

"What we have now found is a molecule - not cholesterol itself, but an abundant metabolite of cholesterol - called 27HC that mimics the hormone oestrogen and can independently drive the growth of breast cancer."

Treatment

The researchers say their findings raise the prospect that lowering cholesterol can lower the risk of breast cancer developing.

Statins are already taken by millions of people to cut the risk of heart disease. However, studies have already suggested statins can cut the risk of breast cancer.

A healthier diet is another way to cut levels of cholesterol in the bloodstream.

Dr Hannah Bridges, from leading charity Breakthrough Breast Cancer, says: "Up until now research into the links between cholesterol levels, use of statins and breast cancer risk has been inconclusive.

"The results from this early study are promising and if confirmed through further research could increase our understanding of what causes some breast cancers to develop."

Dr Emma Smith, from Cancer Research UK, said: "This study is intriguing as it shows for the first time a direct link between cholesterol and breast cancer in mice - but it's too early to say how this knowledge might help tackle breast cancer in the future.

"As things stand, until we know more about the effects of statins on cancer risk, the best ways to cut the risk of developing breast cancer are to stay a healthy weight, cut down on alcohol and keep active."

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Fresh look at plain cigarette packs

28 November 2013 Last updated at 12:16 ET

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Dr Peter Mackereth said brightly-coloured cigarette packaging was a form of ''silent advertising'' for smoking

The government has announced an independent review of cigarette packaging in England, amid calls for action to discourage young smokers.

David Cameron appeared to distance himself from uniform packaging in July, saying further evidence was needed to show whether it would be effective.

But Public Health Minister Jane Ellison said it was now time to "examine the emerging evidence" on a policy shift.

Labour said immediate action was needed, "not another review".

In a Commons statement, Ms Ellison said standardised tobacco packaging would be brought in after the review if "we are satisfied that there are sufficient grounds to proceed, including public health benefit".

The review, led by paediatrician Sir Cyril Chantler, is set to focus on a pilot scheme in Australia, which became the first country to legislate for standardised packaging in 2011.

Continue reading the main story

It is not really surprising that the government is looking again at the issue of plain packaging for cigarettes.

Out of the two high profile public health measures it championed after the election - minimum alcohol pricing was the other - plain packaging always seemed the more natural fit.

Over the years tougher and tougher measures have been introduced to discourage smoking from bans in public places to forcing shops to sell tobacco products under the counter.

So what has changed? Australia still remains the only country in the world to have introduced unbranded packaging.

But early evidence suggests it was effective.

A study in the state of Victoria found that, not only did it make smokers more likely to think about quitting, it also worked subconsciously - smokers felt the cigarettes were of poorer quality.

For Labour, shadow public health minister Luciana Berger demanded to know why the government was delaying the introduction of plain packaging "still further" having already held a consultation on the issue in 2012.

Opposition leader Ed Miliband added: "The government should have introduced plain packaging earlier this year - we want them to act swiftly, we want them to act now. We don't need another review.

"Every major public health expert agrees this would help the battle against cancer, against young people taking up smoking."

The government has never officially ruled out changes to cigarette packaging laws, but BBC political editor Nick Robinson said that private briefings from Downing Street had previously suggested the idea was "dead".

He said ministers were likely to have been defeated on Lords amendments to the Children and Families Bill, which enjoyed cross-party support, and would have given the government the power to regulate cigarette packaging.

Ms Ellison confirmed that the government would table its own amendment to the legislation, giving ministers the power to introduce regulations "quickly" when Sir Cyril's review is complete in March 2014 - if they decide to proceed with the policy.

'Rise in counterfeiting'

She rejected suggestions the rethink had been prompted by fears of defeat in the Lords, saying: "It's a year this weekend since the legislation was introduced in Australia. It's the right time to ask people to look at this.

"This is fundamentally about children's health. Two thirds of people start smoking when they're children and it's one of the most important public health issues we face in this country."

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"This is what cigarette packets have looked like in Australia since last year", reports Ross Hawkins

A study conducted in Australia found that smokers using standardised plain brown packets were 81% more likely to consider quitting.

Deputy Prime Minister Nick Clegg said the government had an "open mind" on the review, and "personally" he hoped it would show that plain packaging was effective.

But UKIP deputy leader Paul Nuttall accused Mr Cameron of "scandalously auctioning off the freedom and liberty of the British people for his own political ends, cheered on by the Labour Party".

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Branded cigarette packs help smokers avoid buying counterfeit products, suggests cigar-smoking Tory MP Robert Halfon

Cigarette firm British American Tobacco (BAT), which owns brands including Benson & Hedges and Dunhill, said the Australian experiment had "failed" to achieve its public health objectives.

"The evidence shows that the introduction of plain packaging of tobacco products has coincided with an increase in illicit trade," leading to increased profits for "criminals selling black-market tobacco", it argued.

Continue reading the main story

In a 2011 debate in the Australian parliament, Labor Party MP Mike Symon explained that the proposed plain-packaging legislation would "mandate that the brand name is in a standard colour, position, font size and style and that the packaging will be a standard drab dark brown or olive colour".

"Consumers tend to perceive white and lighter colours as being healthier," he continued.

"Research shows that adults and adolescents in scientifically controlled studies perceive cigarettes in plain packs to be less appealing, less palatable, less satisfying and of lower quality compared to cigarettes in current packaging."

Labour has sought to link Conservative election chief Lynton Crosby's work as a consultant for the tobacco industry to delays in the policy, a claim which was rejected by David Cameron at the time the issue was put on hold in July.

The ban on images on packaging came into force in Australia on 1 January after a long-running legal battle between the former Labor government and the tobacco industry.

Manufacturers claimed the law was unconstitutional and infringed on their intellectual property rights by banning the use of brands and trademarks.

But they said they would comply after the legality of the measure was upheld by the country's highest court.

Cancer Research UK said a move to plain packaging would "save thousands of lives".

"Stopping cigarettes being marketed to children as a glamorous and desirable accessory is one of the greatest gifts we can give the next generation," it added.

More than 450 doctors, nurses and other healthcare professionals have signed an open letter saying they also "welcome" the move.

"Cigarette packs are now the key marketing tool employed by the tobacco industry to attract and retain customers," they wrote.

"There is no time to lose and Parliament must act now to protect children from the marketing tactics of the tobacco industry."

The Scottish government has said it is "still committed" to introducing standardised packaging, while New Zealand is also considering the move.

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More hospitals checking Savile links

29 November 2013 Last updated at 11:35 ET

A further 19 hospitals are to carry out investigations after receiving police information about serial sex attacker Jimmy Savile, the government has said.

The Metropolitan Police have passed material about Savile to the Department of Health, which has given it to the 19 hospital trusts to investigate.

Health Secretary Jeremy Hunt said he expected reports on visits by the late DJ to those hospitals by next June.

It brings the total number of hospitals under investigation to 32.

Savile is believed to have abused hundreds of victims.

The former BBC presenter of Top Of The Pops and Jim'll Fix It died aged 84 in October 2011 - a year before allegations that he had sexually abused children were broadcast in an ITV documentary.

The revelations prompted hundreds of victims to come forward, including those who said they were attacked at a number of institutions.

Inquiries into Savile's alleged abuse of patients at NHS hospitals had originally focused on Broadmoor and Stoke Mandeville and Leeds General Infirmary, with a further 10 trusts added in January.

'Further investigation'

The Met passed information on the 19 additional hospitals to the Department of Health after completing a "document review".

Scotland Yard said this did not mean its own investigation was over.

"Inquiries are ongoing, and we continue to work with the Department of Health. Inquiries into criminal offences are not concluded yet," the Met said.

Mr Hunt said the NHS trusts responsible for each of the 19 hospitals would investigate the information provided by the Met.

In a written statement, he said Kate Lampard - a former barrister asked to oversee the Department of Health's investigations into Savile - would ensure the inquiries were properly carried out.

"Names of the hospitals are taken from the information received," Mr Hunt added.

"These include hospitals that may have closed in which case the information has been passed on to the legacy organisation."

'Long time ago'

Mr Hunt said he expected final reports by June next year, with publication "sooner if that is possible".

Jessica Standley, a solicitor from a firm representing more than 70 of Savile's victims, said she was concerned about delays in the Department of Health's investigation.

She said victims gave their statements a "long time ago" and are "eagerly" awaiting the results of investigations.

"What is concerning me is that the Department of Health have taken until now to include those additional hospitals," she said.

The 19 hospitals extra to carry out investigations are Barnet General Hospital, Booth Hall Children's Hospital, De La Pole Hospital, Dryburn Hospital, Hammersmith Hospital, Leavesden Secure Mental Hospital, Marsden Hospital, Maudsley Hospital, North Manchester General Hospital, Odstock Hospital, Pinderfields Hospital, Prestwich Psychiatric Hospital, Queen Victoria Hospital, East Grinstead, Royal Free Hospital, London, Royal Victoria Infirmary, Newcastle, Seacroft Hospital, Leeds, St Mary's Hospital, Carshalton, Whitby Memorial Hospital and Wythenshawe Hospital.

The 13 hospitals already carrying out investigations are Leeds General Infirmary, Stoke Mandeville Hospital, Broadmoor Hospital, High Royds Psychiatric Hospital, Dewsbury Hospital, Great Ormond Street Hospital, Moss Side Hospital (previously part of Ashworth Hospital), Exeter Hospital, Portsmouth Hospital, St Catherine's Hospital Birkenhead, Cardiff Royal Infirmary, Rampton Hospital and Saxondale Hospital.

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Cholesterol 'fuels' breast cancer

28 November 2013 Last updated at 22:54 ET By James Gallagher Health and science reporter, BBC News

A by-product of cholesterol can fuel the deadly growth and spread of breast cancer, according to a group of scientists.

It raises the prospect that taking cholesterol-lowering drugs called statins could prevent cancer.

The work, published in the journal Science, helps explain why obesity is a major risk factor for the disease.

However, cancer charities cautioned that it was too soon to advise women to take statins.

Obesity has been linked with many cancers including those of the breast, bowel and womb.

Continue reading the main story

The results from this early study are promising"

End Quote Dr Hannah Bridges Breakthrough Breast Cancer

The fat in overweight people can pump out hormones, such as oestrogen, which drive the growth of cancers.

A team at Duke University Medical Centre, in the US, showed that cholesterol was having a similar effect.

Cholesterol is broken down by the body into 27HC, which can mimic oestrogen and produce the same effect as the hormone in some tissues.

Experiments on mice showed that a high fat diet increased levels of 27HC in the blood and led to tumours that were 30% larger than in mice on a normal diet.

Tumours were also more likely to spread. And human breast cancer tissue grew more quickly in the laboratory when it was fed 27HC.

One of the researchers Prof Donald McDonnell said: "A lot of studies have shown a connection between obesity and breast cancer, and specifically that elevated cholesterol is associated with breast cancer risk, but no mechanism has been identified.

"What we have now found is a molecule - not cholesterol itself, but an abundant metabolite of cholesterol - called 27HC that mimics the hormone oestrogen and can independently drive the growth of breast cancer."

Treatment

The researchers say their findings raise the prospect that lowering cholesterol can lower the risk of breast cancer developing.

Statins are already taken by millions of people to cut the risk of heart disease. However, studies have already suggested statins can cut the risk of breast cancer.

A healthier diet is another way to cut levels of cholesterol in the bloodstream.

Dr Hannah Bridges, from leading charity Breakthrough Breast Cancer, says: "Up until now research into the links between cholesterol levels, use of statins and breast cancer risk has been inconclusive.

"The results from this early study are promising and if confirmed through further research could increase our understanding of what causes some breast cancers to develop."

Dr Emma Smith, from Cancer Research UK, said: "This study is intriguing as it shows for the first time a direct link between cholesterol and breast cancer in mice - but it's too early to say how this knowledge might help tackle breast cancer in the future.

"As things stand, until we know more about the effects of statins on cancer risk, the best ways to cut the risk of developing breast cancer are to stay a healthy weight, cut down on alcohol and keep active."

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Fresh look at plain cigarette packs

28 November 2013 Last updated at 12:16 ET

Please turn on JavaScript. Media requires JavaScript to play.

Dr Peter Mackereth said brightly-coloured cigarette packaging was a form of ''silent advertising'' for smoking

The government has announced an independent review of cigarette packaging in England, amid calls for action to discourage young smokers.

David Cameron appeared to distance himself from uniform packaging in July, saying further evidence was needed to show whether it would be effective.

But Public Health Minister Jane Ellison said it was now time to "examine the emerging evidence" on a policy shift.

Labour said immediate action was needed, "not another review".

In a Commons statement, Ms Ellison said standardised tobacco packaging would be brought in after the review if "we are satisfied that there are sufficient grounds to proceed, including public health benefit".

The review, led by paediatrician Sir Cyril Chantler, is set to focus on a pilot scheme in Australia, which became the first country to legislate for standardised packaging in 2011.

Continue reading the main story

It is not really surprising that the government is looking again at the issue of plain packaging for cigarettes.

Out of the two high profile public health measures it championed after the election - minimum alcohol pricing was the other - plain packaging always seemed the more natural fit.

Over the years tougher and tougher measures have been introduced to discourage smoking from bans in public places to forcing shops to sell tobacco products under the counter.

So what has changed? Australia still remains the only country in the world to have introduced unbranded packaging.

But early evidence suggests it was effective.

A study in the state of Victoria found that, not only did it make smokers more likely to think about quitting, it also worked subconsciously - smokers felt the cigarettes were of poorer quality.

For Labour, shadow public health minister Luciana Berger demanded to know why the government was delaying the introduction of plain packaging "still further" having already held a consultation on the issue in 2012.

Opposition leader Ed Miliband added: "The government should have introduced plain packaging earlier this year - we want them to act swiftly, we want them to act now. We don't need another review.

"Every major public health expert agrees this would help the battle against cancer, against young people taking up smoking."

The government has never officially ruled out changes to cigarette packaging laws, but BBC political editor Nick Robinson said that private briefings from Downing Street had previously suggested the idea was "dead".

He said ministers were likely to have been defeated on Lords amendments to the Children and Families Bill, which enjoyed cross-party support, and would have given the government the power to regulate cigarette packaging.

Ms Ellison confirmed that the government would table its own amendment to the legislation, giving ministers the power to introduce regulations "quickly" when Sir Cyril's review is complete in March 2014 - if they decide to proceed with the policy.

'Rise in counterfeiting'

She rejected suggestions the rethink had been prompted by fears of defeat in the Lords, saying: "It's a year this weekend since the legislation was introduced in Australia. It's the right time to ask people to look at this.

"This is fundamentally about children's health. Two thirds of people start smoking when they're children and it's one of the most important public health issues we face in this country."

Please turn on JavaScript. Media requires JavaScript to play.

"This is what cigarette packets have looked like in Australia since last year", reports Ross Hawkins

A study conducted in Australia found that smokers using standardised plain brown packets were 81% more likely to consider quitting.

Deputy Prime Minister Nick Clegg said the government had an "open mind" on the review, and "personally" he hoped it would show that plain packaging was effective.

But UKIP deputy leader Paul Nuttall accused Mr Cameron of "scandalously auctioning off the freedom and liberty of the British people for his own political ends, cheered on by the Labour Party".

Please turn on JavaScript. Media requires JavaScript to play.

Branded cigarette packs help smokers avoid buying counterfeit products, suggests cigar-smoking Tory MP Robert Halfon

Cigarette firm British American Tobacco (BAT), which owns brands including Benson & Hedges and Dunhill, said the Australian experiment had "failed" to achieve its public health objectives.

"The evidence shows that the introduction of plain packaging of tobacco products has coincided with an increase in illicit trade," leading to increased profits for "criminals selling black-market tobacco", it argued.

Continue reading the main story

In a 2011 debate in the Australian parliament, Labor Party MP Mike Symon explained that the proposed plain-packaging legislation would "mandate that the brand name is in a standard colour, position, font size and style and that the packaging will be a standard drab dark brown or olive colour".

"Consumers tend to perceive white and lighter colours as being healthier," he continued.

"Research shows that adults and adolescents in scientifically controlled studies perceive cigarettes in plain packs to be less appealing, less palatable, less satisfying and of lower quality compared to cigarettes in current packaging."

Labour has sought to link Conservative election chief Lynton Crosby's work as a consultant for the tobacco industry to delays in the policy, a claim which was rejected by David Cameron at the time the issue was put on hold in July.

The ban on images on packaging came into force in Australia on 1 January after a long-running legal battle between the former Labor government and the tobacco industry.

Manufacturers claimed the law was unconstitutional and infringed on their intellectual property rights by banning the use of brands and trademarks.

But they said they would comply after the legality of the measure was upheld by the country's highest court.

Cancer Research UK said a move to plain packaging would "save thousands of lives".

"Stopping cigarettes being marketed to children as a glamorous and desirable accessory is one of the greatest gifts we can give the next generation," it added.

More than 450 doctors, nurses and other healthcare professionals have signed an open letter saying they also "welcome" the move.

"Cigarette packs are now the key marketing tool employed by the tobacco industry to attract and retain customers," they wrote.

"There is no time to lose and Parliament must act now to protect children from the marketing tactics of the tobacco industry."

The Scottish government has said it is "still committed" to introducing standardised packaging, while New Zealand is also considering the move.

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More hospitals facing Savile checks

29 November 2013 Last updated at 09:00 ET

A further 19 hospitals are to be investigated over links to serial sex attacker Jimmy Savile, the government has confirmed.

The Metropolitan Police have passed material about Savile to the Department of Health, which has given it to the 19 hospital trusts to investigate.

Health Secretary Jeremy Hunt said he expected reports on visits by the late DJ to those hospitals by next June.

It brings the total number of hospitals under investigation to 32.

Savile is believed to have abused hundreds of victims.

The former BBC presenter of Top Of The Pops and Jim'll Fix It died aged 84 in October 2011 - a year before allegations that he had sexually abused children were broadcast in an ITV documentary.

The revelations prompted hundreds of victims to come forward, including those who said they were attacked at a number of institutions.

Inquiries into Savile's alleged abuse of patients at NHS hospitals had originally focused on Broadmoor and Stoke Mandeville and Leeds General Infirmary, with a further 10 trusts added in January.

'Further investigation'

The Met passed information on the 19 additional hospitals to the Department of Health after completing a "document review".

Scotland Yard said this did not mean its own investigation was over.

"Inquiries are ongoing, and we continue to work with the Department of Health. Inquiries into criminal offences are not concluded yet," the Met said.

Mr Hunt said the NHS trusts responsible for each of the 19 hospitals would investigate the information provided by the Met.

In a written statement, he said Kate Lampard - a former barrister asked to oversee the Department of Health's investigations into Savile - would ensure the inquiries were properly carried out.

"Names of the hospitals are taken from the information received," Mr Hunt added.

"These include hospitals that may have closed in which case the information has been passed on to the legacy organisation."

Mr Hunt said that he expected final reports by June next year, with publication "sooner if that is possible".

The hospitals to be investigated are Barnet General Hospital, Booth Hall Children's Hospital, De La Pole Hospital, Dryburn Hospital, Hammersmith Hospital, Leavesden Secure Mental Hospital, Marsden Hospital, Maudsley Hospital, North Manchester General Hospital, Odstock Hospital, Pinderfields Hospital, Prestwich Psychiatric Hospital, Queen Victoria Hospital, East Grinstead, Royal Free Hospital, London, Royal Victoria Infirmary, Newcastle, Seacroft Hospital, Leeds, St Mary's Hospital, Carshalton, Whitby Memorial Hospital and Wythenshawe Hospital.

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New patients' champion for the NHS

27 November 2013 Last updated at 23:39 ET By Nick Triggle Health correspondent, BBC News

The man who led the public inquiry into the Stafford Hospital scandal has agreed to become president of the Patients Association, promising to do all he can to rid the NHS of bad care.

Robert Francis's appointment to the UK's most high-profile patient group has coincided with it publishing its annual dossier of patient stories.

The 14 case studies detail "shocking" examples of poor care.

They include lapses in both hospitals and nursing homes.

Common themes include patients not getting the help they needed eating, drinking or going to the toilet, being treated with a lack of dignity and having delays in their treatment.

The patient stories featured include:

• Eighty-four-year-old Olive Burns, who went into Tameside Hospital in Greater Manchester with a suspected fractured hip. Her condition deteriorated so rapidly her family thought she had been placed on the controversial Liverpool Care Pathway for end-of-life care. The family later came to the conclusion staff had simply "forgotten" to treat her. The hospital has said it is "truly sorry" for the care she received.
• John Moore, who was diagnosed with an aggressive brain tumour in early 2013. An operation was delayed after a junior doctor at Surrey's Frimley Park Hospital forgot to make a critical referral to St George's Hospital in London. One consultant who told Mr Moore he would die from his tumour also said he just had to "accept it and get on with it". He died in August aged 72. Both hospitals have apologised.
• Averil Hart, a 19-year-old student who suffered from anorexia. On her release from hospital, her care plan stated that she was at high risk. Neither of the two NHS teams responsible for her care communicated with each other and so regular checks did not take place. She died following a relapse.

The publication of the dossier comes just a week after the government published its response to the public inquiry into the Stafford Hospital inquiry, which was chaired by Mr Francis.

The "blueprint" promised the introduction of set nurse-to-patient staffing levels, a new law of wilful neglect and a barring system for poor managers.

The measures were set out after the Francis Inquiry, published in February, highlighted a series of cultural problems in the NHS.

Continue reading the main story

His name has become synonymous with the Stafford Hospital scandal. Mr Francis chaired the first inquiry in 2010 which laid bare the abuse and neglect suffered by patients from 2005 to 2009.

When the coalition government announced there would be a full public inquiry following the 2010 election, he was the obvious choice to lead it.

His report, published in February, has led to a series of other reviews, culminating in a detailed "blueprint" for change last week.

He has been described as "formidable" and "forensic" in his day job as a medical negligence barrister.

Katherine Murphy, chief executive of the Patients Association, said: "The government needs to ensure that the changes made to the NHS in the next few years put the patient and their needs at the centre of everything they do, in order to ensure that the sort of cases shown in this report are not repeated."

Learning from mistakes

Mr Francis praised the Patients Association for being "ardent campaigners" and promised he would be doing his best to continue the "invaluable work".

"The experiences of patients and relatives remain the best way to detect care that is being delivered without care and compassion.

"Let us all hope that in the near future we will stop having to listen to disturbing reports of poor and unsafe care in many different places and instead be looking at a service which has learned from the mistakes, and has ensured that the excellent practice we know exists has become the norm."

The role of president of the group has remained vacant since Claire Rayner, the previous incumbent, died over three years ago.

Royal College of Nursing general secretary Peter Carter said the cases highlighted by the Patients Association were "deeply shocking".

He added: "This report comes at the end of a tumultuous year for the health service. It is vital that the reports and reviews we have seen this year do not simply gather dust, and it would be unforgivable if this opportunity to learn and make improvements for patients was missed."

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Body piercing controls wheelchair

27 November 2013 Last updated at 23:42 ET By James Gallagher Health and science reporter, BBC News

Body piercings have been used to control wheelchairs and computers in a move scientists believe could transform the way people interact with the world after paralysis.

The movement of a tiny magnet in a tongue piercing is detected by sensors and converted into commands, which can control a range of devices.

The US team said it was harnessing the tongue's "amazing" deftness.

The development is reported in the journal Science Translational Medicine.

The team at the Georgia Institute of Technology made the unlikely leap from body art to wheelchairs because the tongue is so spectacularly supple.

A large section of the brain is dedicated to controlling the tongue because of its role in speech. It is also unaffected by spinal cord injuries that can render the rest of the body paralysed, tetraplegic, as it has its own hotline to the brain.

"We are tapping in to the inherent capabilities of the tongue, it is such an amazing part of the body," Dr Maysam Ghovanloo told the BBC.

A lentil-sized piercing in the tongue produces a magnetic field, which changes as the tongue moves. Sensors on the cheeks can then detect the precise position of the piercing.

In the trial, on 23 able-bodied people and 11 with tetraplegia, six positions in the mouth were programmed to control a wheelchair or a computer such as touching the left cheek to turn the chair to the left.

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Watch the wheelchair controlled by a pierced tongue courtesy of Dr Maysam Ghovanloo

On average, people with tetraplegia were able to perform tasks three times as fast and with the same level of accuracy as with the other technologies available.

The researchers believe they will be able to have a command for every tooth in the mouth and that by using combinations of tongue positions would be able to develop an "unlimited" number of instructions.

These could dial a phone, change the channel on the television or even type.

Continue reading the main story

The tongue is capable of the most exquisite commands through the act of speech so why not use that range of motion to command assistive devices "

End Quote Dr Mark Bacon Spinal Research

Dr Ghovanloo said: "People will be able to do more and do more things more effectively."

He said patients were "all very cool with it" but some older people did not take part in the trial due to tongue piercing reticence.

At the moment the device is limited to university laboratories. The team is trying to fit the sensors into a dental brace to make it more stable on the road, get it approved by the US regulators and come up with a way of getting the expensive kit into the hands of patients.

Dr Mark Bacon, the director of research at the charity Spinal Research, said the ultimate goal remained regenerating the spinal cord but living aids were "needed now".

He told the BBC: "While this may only be beneficial to those with the profoundest motor dysfunction, being able to capture the tongue's complex range of motion to command other assistive devices seems a valuable avenue to explore.

"After all the tongue is capable of the most exquisite commands through the act of speech so why not use that range of motion to command assistive devices more discretely.

"We should bear in mind that the tongue does other things and a smooth and safeguarded mechanism to ensure against potentially dangerous engagement whilst eating, speaking or even swallowing may not be trivial."

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Fresh look at plain cigarette packs

28 November 2013 Last updated at 08:17 ET

Please turn on JavaScript. Media requires JavaScript to play.

Dr Peter Mackereth said brightly-coloured cigarette packaging was a form of ''silent advertising'' for smoking

The government has announced an independent review of cigarette packaging in England, amid calls for action to discourage young smokers.

David Cameron appeared to distance himself from uniform packaging in July, saying further evidence was needed to show whether it would be effective.

But Public Health Minister Jane Ellison said it was now time to "examine the emerging evidence" on a policy shift.

But Labour said immediate action was needed, "not another review".

In a Commons statement, Ms Ellison said standardised tobacco packaging would be brought in after the review if "we are satisfied that there are sufficient grounds to proceed, including public health benefit".

The review, led by paediatrician Sir Cyril Chantler, is set to focus on a pilot scheme in Australia, which became the first country to legislate for standardised packaging in 2011.

Continue reading the main story

It is not really surprising that the government is looking again at the issue of plain packaging for cigarettes.

Out of the two high profile public health measures it championed after the election - minimum alcohol pricing was the other - plain packaging always seemed the more natural fit.

Over the years tougher and tougher measures have been introduced to discourage smoking from bans in public places to forcing shops to sell tobacco products under the counter.

So what has changed? Australia still remains the only country in the world to have introduced unbranded packaging.

But early evidence suggests it was effective.

A study in the state of Victoria found that, not only did it make smokers more likely to think about quitting, it also worked subconsciously - smokers felt the cigarettes were of poorer quality.

For Labour, shadow public health minister Luciana Berger demanded to know why the government was delaying the introduction of plain packaging "still further" having already held a consultation on the issue in 2012.

Opposition leader Ed Miliband added: "The government should have introduced plain packaging earlier this year - we want them to act swiftly, we want them to act now. And they seem to be offering another review. We don't need another review.

"Every major public health expert agrees this would help the battle against cancer, against young people taking up smoking."

The government has never officially ruled out changes to cigarette packaging laws, but BBC political editor Nick Robinson said that private briefings from Downing Street had previously suggested the idea was "dead".

He said the move to reopen the issue follows the tabling of amendments in the House of Lords which would have given ministers the power, but not the obligation, to impose regulations on plain packaging and enjoyed cross-party support.

The government was likely to be defeated if it opposed the changes to the Children and Families Bill, he added.

Ms Ellison confirmed that the government would table its own amendment to the legislation, giving ministers the power to introduce regulations when Sir Cyril's review is complete in March 2014 - if they decide to proceed with the policy.

The options which would then be considered include packs having a uniform colour (dark olive green has been suggested previously) or using graphic images of smoking-related diseases on all packs.

'Rise in counterfeiting'

Ms Ellison rejected Labour suggestions the rethink had been prompted by fears of defeat in the Lords, saying: "It's a year this weekend since the legislation was introduced in Australia. It's the right time to ask people to look at this.

"This is fundamentally about children's health. Two thirds of people start smoking when they're children and it's one of the most important public health issues we face in this country.

"Asking an independent body to take a look and survey the evidence for us is a sensible next step. We are going to take the opportunity to put regulations in place which will enable us to act quickly."

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"This is what cigarette packets have looked like in Australia since last year", reports Ross Hawkins

Deputy Prime Minister Nick Clegg said the government had an "open mind" on the review, but "personally" he hoped it would show that plain packaging was effective.

"If the review... suggests that the emerging evidence argues in favour of plain packaging, it's a measure which we would then proceed with," he said, on his weekly LBC radio programme.

But the government faced criticism from the UK Independence Party.

Prime Minister David Cameron was "scandalously auctioning off the freedom and liberty of the British people for his own political ends, cheered on by the Labour Party", the party's deputy leader Paul Nuttall said.

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Branded cigarette packs help smokers avoid buying counterfeit products, suggests cigar-smoking Tory MP Robert Halfon

The Times newspaper says a study conducted in Australia found that smokers using standardised plain brown packets were 81% more likely to consider quitting.

Continue reading the main story

In a 2011 debate in the Australian parliament, Labor Party MP Mike Symon explained that the proposed plain-packaging legislation would "mandate that the brand name is in a standard colour, position, font size and style and that the packaging will be a standard drab dark brown or olive colour".

"Consumers tend to perceive white and lighter colours as being healthier," he continued.

"Research shows that adults and adolescents in scientifically controlled studies perceive cigarettes in plain packs to be less appealing, less palatable, less satisfying and of lower quality compared to cigarettes in current packaging."

Labour has sought to link Conservative election chief Lynton Crosby's work as a consultant for the tobacco industry to delays in the policy, a claim which was rejected by David Cameron at the time the issue was put on hold in July.

Health campaigners say packaging is a "key tool" for the industry to get new customers but manufacturers say uniform packets will increase counterfeiting and the focus must be on reducing under-age smoking.

The ban on images on packaging came into force in Australia on 1 January after a long-running legal battle between the former Labor government and the tobacco industry.

Manufacturers claimed the law was unconstitutional and infringed on their intellectual property rights by banning the use of brands and trademarks.

But they said they would comply after the legality of the measure was upheld by the country's highest court.

Cancer Research UK said the move would "save thousands of lives": "Stopping cigarettes being marketed to children as a glamorous and desirable accessory is one of the greatest gifts we can give the next generation."

The Scottish government has said it is "still committed" to introducing standardised packaging, while New Zealand is also considering the move.

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Salt in medicines 'a health risk'

26 November 2013 Last updated at 21:13 ET By Michelle Roberts Health editor, BBC News online

Soluble painkillers used by millions of people in Britain could pose a health risk because they are high in salt, UK researchers are warning.

Some formulations taken at maximum dose tip users over the recommended daily sodium intake for an adult, with potentially dangerous consequences, the study authors say.

Their work in the BMJ looks at the outcomes for 1.2 million UK patients.

It found a link between effervescent tablets and heart attacks and stroke.

Continue reading the main story

Without clear labelling on these products, it is impossible to know how much additional sodium you would be eating"

End Quote Prof Gareth Beevers Blood Pressure UK

All medicines that contain at least 1mmol (or 23mg) of sodium - a component of salt - in each dose are required to declare on their labelling that the product contains sodium.

The accompanying patient information leaflet provides information on the quantity of sodium and includes a warning to patients on a low-sodium diet to take the amount of sodium in the medicine into account.

Compared with patients taking the same drugs without salt, those who regularly took effervescent or soluble medications increased their risk of having a heart attack, stroke or dying from a vascular cause by a fifth

They were also seven times more likely to develop high blood pressure or hypertension, which the researchers say is at the root of the problem.

Lead researcher Dr Jacob George, from Dundee University, said: "We know that high salt causes hypertension and that hypertension leads to stroke."

The British Heart Foundation said it was important to remember that the research applied to people who were taking these medicines every day - it did not mean that occasional use could damage your heart health.

Hidden salt

Effervescent medicines contain a substance called bicarbonate, which helps them fizz and dissolve, and this is often combined with sodium.

The study looked at 24 different prescribed effervescent medicines, including common painkillers such as paracetamol and aspirin, as well as supplements.

But Dr George said many more people bought these types of treatment from chemists, without a prescription.

He said that people needed to be aware of the risks and drug manufacturers should look at cutting the salt content of their products.

In the study, sodium levels in tablets ranged from as low as 3mmol to as high as 18mmol - approximately a fifth of a teaspoon.

The recommended sodium intake for an adult in the UK is 104mmol per day.

A person who takes the maximum daily dose of eight tablets of soluble paracetamol, for example, would ingest 148.8mmol of sodium, which exceeds their daily salt allowance.

If you then took in to account the dietary salt a person was likely to get from the food that they ate, their overall salt intake could be dangerously high, said Dr George.

The Medicines and Healthcare products Regulatory Agency (MHRA) said it kept a close check on the safety of all licensed medicines.

"We will carefully review the findings of this new research," said a spokeswoman.

"We recommend that people with questions about their salt intake should read the patient information leaflet and speak to their GP," the MHRA said.

But Prof Gareth Beevers, of Blood Pressure UK, said many consumers would be unaware of the risks.

"It is extraordinary to think that sodium has been hiding in our medicines all this time.

"Without clear labelling on these products, it is impossible to know how much additional sodium you would be eating, so it is shocking to find you could be having more than your daily maximum from medicines alone.

"Eating too much sodium - in any form - puts up our blood pressure, which puts you at increased risk of strokes and heart attacks, the biggest killers in the world."

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MRSA found in farm poultry

26 November 2013 Last updated at 12:23 ET

The first case of MRSA in poultry in the UK has been found in turkeys and chickens on a farm in East Anglia says the Department of Health (DH).

A spokesman said that two thirds of the turkeys on the farm, which hasn't been named, were found to be infected.

It is thought that hundreds of turkeys have already been sold to local retail outlets and farm gate sales. The farmer is cooperating.

Experts say the risk to the public is very low.

Continue reading the main story

There are many different strains of MRSA that cause illness in people but this is not one of the strains that we are overly concerned about"

End Quote Prof Angela Kearns of Public Health England

The spokesman said the strain of the disease found in the poultry - Livestock-Associated (LA) MRSA - "rarely caused disease in humans" and if it did would involved a mild skin infection which cleared up quickly.

LA-MRSA is different to the MRSA that causes the healthcare associated infections seen in people.

It can potentially pass from animals to humans through direct contact or through dust in animal housing, meaning poultry workers are at risk.

But LA-MRSA rarely causes disease in people and in most cases the bacteria clear within 24 hours.

Appropriate handling and cooking of raw meat should eliminate any risk of transmission to people.

Steve Wearne, Director of Policy at the Food Standards Agency, said: "Any risk of contracting MRSA through meat from animals with these bacteria is very low when usual good hygiene and thorough cooking practices are observed. All poultry should be handled hygienically and cooked thoroughly to destroy any bacteria that may be present."

Prof Angela Kearns of Public Health England said: "There are many different strains of MRSA that cause illness in people but this is not one of the strains that we are overly concerned about given the very low number of clinical infections that have been seen in people."

In the UK, since 1999, there have been published reports that MRSA has been isolated from dogs, cats and from a rabbit and a horse.

Other countries have reported cases in cattle and poultry.

Prof Peter Borriello, Chief Executive of the Veterinary Medicines Directorate, said: "LA-MRSA has been identified in livestock in a number of countries and is not considered to represent a significant risk to animal health and welfare."

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NHS told to get tough on smoking

27 November 2013 Last updated at 02:53 ET By Nick Triggle Health correspondent, BBC News

The NHS must stop turning a "blind eye" to smoking and ban it in all hospital grounds in England, according to new guidance.

The National Institute for Health and Care Excellence said it wanted to see smoking shelters scrapped so patients, visitors and staff could not light up.

Staff should also stop helping patients out of their beds to go for a smoke.

And patients who smoke must be identified and offered help to quit, the guidance added.

It said nurses, doctors and other staff could give brief advice and then refer smokers on to NHS stopping smoking services.

Smoking rates are particularly high among mental health patients with one in three smoking, rising to 70% in psychiatric units.

That compares with the one in five among the general population who are smokers.

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How one hospital in Cambridge has struggled to stub out smoking

The guidance, which is voluntary for the NHS to follow, even suggested staff caught smoking should be disciplined.

'Too long'

The National Institute for Health and Care Excellence (NICE) conceded some parts of the NHS had already adopted these approaches, but said the idea of the guidance was to make sure it became consistent across the health service.

NICE public health director Prof Mike Kelly said the NHS had turned a "blind eye" for too long.

"It has been tolerated by the NHS and it is high time that stopped.

"NHS hospitals and staff have a duty of care to protect the health of people who use or work in their services.

"We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances."

In practice, he said, doctors and nurses could provide nicotine replacement therapies and advise patients about counselling to ensure they were not "going up the wall" with nicotine cravings.

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He acknowledged that stopping a determined smoker from going outside to light up was "clearly very difficult".

"This is not about imposing some sort of penal regime in which doctors, nurses, administrators spend all their time trying to enforce a series of rules and regulations."

He said it was about a culture shift and removing smoking shelters would help eliminate any subliminal message that it was ok to smoke around a hospital.

Stress relief

Stephen Dalton, of the NHS Confederation, which represents NHS trusts, said the guidance was welcome.

"A total ban on smoking complements the duty of care on healthcare staff and the organisation to protect the health of people in their care and promote healthy behaviour."

Dr John Moore-Gillon, a lung specialist, said there was no doubt that smoking rates fell in environments where it was banned, pointing to smoking bans in pubs, clubs and public buildings.

"And they're actually more likely to give up smoking if they're given this advice when they're in a hospital or other health care setting," he added.

But Simon Clark, of smokers' lobby group Forest, said: "NHS staff have a duty of care to protect people's health, but that doesn't include the right to nag, cajole or bully smokers to quit.

"Tobacco is a legal product and a lot of people smoke to relieve stress.

"It's not only heartless and inhumane to ban patients from smoking outside hospitals and clinics, it's almost impossible to enforce without installing CCTV cameras and employing wardens to monitor the grounds."

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Steep rise in winter deaths

26 November 2013 Last updated at 04:43 ET

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Claudia Wells, head of mortality analysis at the ONS: "Last winter was unusually cold"

There was a big rise in the number of winter deaths last year, official figures for England and Wales show.

An estimated 31,100 excess winter deaths occurred in 2012-13 - a 29% increase on the previous winter.

The Office for National Statistics data, which compares deaths in winter months with averages in other seasons, shows most of the deaths involved people over 75.

Cold weather and flu largely explain the trends.

Although last winter was milder than average in December, there followed a prolonged period of lower than average temperatures.

March 2013 was the coldest since 1962 with an average monthly temperature of just 2.6°C.

The number of winter deaths peaked in the first week of January, which coincided with a peak in rates of influenza-like illness over the Christmas weeks.

The death rate remained higher than average for a prolonged period between February and April 2013.

While excess winter deaths are linked to low temperatures, hypothermia is not the main cause.

Experience shows that the majority of such deaths are due to heart disease, stroke and respiratory illness.

The charity Age UK said the figures were "shameful" and urged the government to lower energy bills so that those who are most vulnerable - the frail and elderly - can keep their homes warm during winter.

The energy regulator Ofgem has criticised the profit margins of the big gas and electricity suppliers.

Age UK's director Caroline Abrahams, said: "Excess winter deaths are preventable and today's figures are a damning indictment of our failure to address the scandal of cold homes in this country.

"We strongly believe that the only sustainable solution is investment to increase the energy efficiency of our housing stock so cold homes become a thing of the past."

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Modern life 'turning people off sex'

26 November 2013 Last updated at 03:39 ET By Nick Triggle Health correspondent, BBC News

Money worries and the distractions of social media mean people are having sex less frequently, researchers say.

A once-a-decade poll of 15,000 Britons found those aged 16-44 were having sex fewer than five times a month.

The figure compared with more than six times a month on the last two occasions when the official National Survey of Sexual Attitudes and Lifestyles was carried out, in 1990-91 and 1999-2001.

The study's authors say modern life may be having an impact on libidos.

Dr Cath Mercer, from University College London, said: "People are worried about their jobs, worried about money. They are not in the mood for sex.

"But we also think modern technologies are behind the trend too. People have tablets and smartphones and they are taking them into the bedroom, using Twitter and Facebook, answering emails."

She also said the survey suggested that couples aged 16 to 44 may be using online porn as a substitute for sex.

Continue reading the main story

• Couples having less sex each month on average
• More women having sex with women
• For both men and women, the average number of partners of opposite sex has increased
• Younger people having sex at an early age

Men polled in 2010 to 2012 reported having sex 4.9 times a month and women 4.8. In both previous surveys the averages were more than six for both sexes both times.

The survey carried out by NatCen Social Research and analysed by researchers from University College London and the London School of Hygiene and Tropical Medicine also asked older people about their sex lives.

It found 42% of women and 60% of men aged 65 to 74 had had sex in the past year.

Nonetheless, they were the age groups having the least sex - 2.3 times a month for men and 1.4 for women.

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Dr Cath Mercer: "If we think about the amount of sex that the population has, we've seen a decline in frequency"

Among men, the 25-to-34 age group were having the most sex - 5.4 times a month - and for women it was the 16-to-24 age group, 5.8 times.

The latest survey, which is carried out every 10 years, also shows the age at which people start having sex is lower in the younger age groups.

The average age for the under-25s is 16 compared with 19 for men and 18 for women in the 65-to-74 age group.

Among other findings:

• One in six pregnancies in the UK is unplanned.
• About half of men and women have had a recent sexual problem, but only a 10th of those interviewed were distressed or worried about their sex lives.
• Lack of interest in sex is one of the most commonly reported problems, and one not confined to women - around 15% of men had experienced loss of libido.
• Since the last survey in 2000 people have become more accepting of same-sex relationships but less tolerant of cheating spouses. For more about how attitudes have changed read more here.
• The average woman aged under 44 said they had had 7.7 partners over their lifetime, while for men it was 11.7.
• Some 3.6% of men had paid for sex in the last five years. Hardly any women had.

Genevieve Edwards, from Marie Stopes International, said: "A key insight from the survey is that people are having sex earlier and having children later, which means that, on average, women in Britain spend about 30 years of their life needing to avert an unplanned pregnancy, yet many are not being informed about or offered the full range of services.

"Long-acting contraceptives, for example, can be extremely effective and convenient but too many are never offered the choice."

But the poll - the full details of which have been reported in the Lancet - also revealed the extent to which people are forced to have sex against their will.

One in 10 women and one in 70 men said they had experienced it.

However, fewer than half had told anyone about it and even fewer (13% of women and 8% of men) had reported the crime to the police.

A selection of your comments:

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Boots recalls cough and cold remedies

26 November 2013 Last updated at 09:09 ET

Pharmacy giant Boots is recalling tens of thousands of bottles of cough and cold medicines over fears that plastic might have got into the liquid.

As a precautionary measure Boots is asking UK shoppers to return any of five of its branded medicines that were purchased since September.

This includes a strawberry flavoured suspension of oral ibuprofen for infants older than three months.

People with questions can telephone the Boots Customer Care on 0800 915 0004.

The medicines being recalled are:

• Boots Pharmaceuticals Chesty Cough Relief 100mg/5ml Oral Solution
• Boots Pharmaceuticals Dry Cough Relief Oral Solution
• Boots Pharmaceuticals Mucus Cough Relief 100mg/5ml Oral Solution
• Boots Pharmaceuticals Paracetamol 6 years Plus 250mg/5ml Oral Solution 200ml
• Boots Pharmaceuticals Ibuprofen 3 Months plus 100mg/5ml Oral suspension Strawberry flavour

Customers will be offered a refund.

Although there have been no reported incidents as yet, a possible fault in the manufacturing process of the tamper seal may have resulted in small pieces of plastic being found in the liquid medicines, says Boots.

The Medicines and Healthcare products Regulatory Agency said people should check their medicine cupboards at home for these products.

In a statement, Boots said: "The health and safety of our customers and patients is always our highest priority so as a precaution we are recalling some Boots Pharmaceuticals medicine lines.

"Whilst we're not currently aware of any customer incidences, we have taken the decision to ask customers to return these products to our stores for a refund. We're sorry for any inconvenience this may cause our customers and would like to offer our reassurances that these actions are taken as a precaution, while we fully investigate the situation."

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Amazon workers face ‘illness risk’

24 November 2013 Last updated at 21:17 ET

A BBC investigation into a UK-based Amazon warehouse has found conditions that a stress expert said could cause "mental and physical illness".

Prof Michael Marmot was shown secret filming of night shifts involving up to 11 miles of walking - where an undercover worker was expected to collect orders every 33 seconds.

It comes as the company employs 15,000 extra staff to cater for Christmas.

Amazon said the safety of its workers was its "number one priority."

Undercover reporter Adam Littler, 23, got an agency job at Amazon's Swansea warehouse. He took a hidden camera inside for BBC Panorama to record what happened on his shifts.

He was employed as a "picker", collecting orders from 800,000 sq ft of storage.

A handset told him what to collect and put on his trolley. It allotted him a set number of seconds to find each product and counted down. If he made a mistake the scanner beeped.

"We are machines, we are robots, we plug our scanner in, we're holding it, but we might as well be plugging it into ourselves", he said.

"We don't think for ourselves, maybe they don't trust us to think for ourselves as human beings, I don't know."

Prof Marmot, one of Britain's leading experts on stress at work, said the working conditions at the warehouse are "all the bad stuff at once".

He said: "The characteristics of this type of job, the evidence shows increased risk of mental illness and physical illness."

"There are always going to be menial jobs, but we can make them better or worse. And it seems to me the demands of efficiency at the cost of individual's health and wellbeing - it's got to be balanced."

Amazon said that official safety inspections had not raised any concerns and that an independent expert appointed by the company advised that the picking job is "similar to jobs in many other industries and does not increase the risk of mental and physical illness".

The scanner tracked Mr Littler's picking rate and sent his performance to managers. If it was too low, he was told he could face disciplinary action.

When Mr Littler worked night shifts his pay rose from the daily rate of £6.50 per hour to £8.25 per hour.

After experiencing a ten-and-a-half-hour night shift, he said: "I managed to walk or hobble nearly 11 miles, just short of 11 miles last night. I'm absolutely shattered. My feet are the thing that are bothering me the most to be honest."

Amazon said new recruits are warned some positions are physically demanding and that some workers seek these positions as they enjoy the active nature of the work. The company said productivity targets are set objectively, based on previous performance levels achieved by the workforce.

Those on the night shift work a four-day week with an hour's break per shift.

Experts have told Panorama these ten-and-a-half-hour night shifts could breach the working time regulations because of the long hours and the strenuous nature of the work.

Barrister Giles Bedloe said: "If the work involves heavy physical and, or, mental strain then that night worker should not work more than eight hours in any 24-hour period.

But Amazon said its night shift is lawful. They said they sought expert advice to ensure the shifts "comply with all relevant legal requirements".

Amazon said it had invested £1bn in the UK and created 5,000 permanent jobs.

It added that it relied on the good judgement of thousands of employees. The company said: "Together we're working hard to make sure we're better tomorrow than we are today."

Panorama: The Truth Behind The Click, BBC One, Monday 25 November at 20:30 GMT and then available in the UK on the BBC iPlayer.

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Scan cuts child radiation risk

24 November 2013 Last updated at 19:39 ET

A new method for scanning children's livers for tumours could prevent them being exposed to unnecessary radiation, according to doctors in London.

Children are more vulnerable to radiation, which can increase the odds of them developing cancer later in life.

The team at King's College Hospital are trialling a scan that turns organs into a "field of gold" to find tumours.

The findings were presented in the European Journal of Ultrasound.

Nodules or lesions on the liver can be detected when children with liver disease or fatty livers have an ultrasound scan.

However, these could be malignant tumours that need treating or benign growths that can be ignored.

A CT scan can tell the difference, but this exposes the patient to X-ray radiation.

"We are trying to stop children having unnecessary radiation as the long-term effects show a substantial increase in cancer," Prof Paul Sidhu, a consultant radiologist at King's College Hospital, told the BBC.

Accurate diagnosis

The team at the hospital is testing an upgraded version of ultrasound, which has been used in adults for a decade but not yet in children.

A harmless chemical, injected into the arm, forms temporary microscopic bubbles in the bloodstream. It acts as a "contrast agent" in the ultrasound scan.

Prof Sidhu said: "It makes the arteries light up and then the veins and the whole liver. It looks like a field of gold."

If the liver lesion is benign, it lights up like the rest of the liver. But a cancerous growth will rapidly get rid of the contrast agent.

"It looks like a black hole. It's so clear it is like day and night," Prof Sidhu said.

In a trial on 44 children with chronic liver problems, the test was able to accurately diagnose patients.

Prof Sidhu concluded: "This is an exciting breakthrough, but it now needs multicentre trials probably involving up to a couple of thousand patients [to prove it works]".

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Friendship line for elderly launched

25 November 2013 Last updated at 07:42 ET

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Joseph Day, who has been using the service, said that he found losing his wife almost unbearable

A free 24-hour dedicated helpline for older people across the UK has been launched by Esther Rantzen.

'The Silver Line' aims to combat loneliness in the over-65s by providing friendship, information and advice through calls to trained volunteers.

Chairwoman Ms Rantzen said she hoped the phone line number, 0800 4 70 80 90, would be remembered by all older people when they needed friendship or advice.

The phone line is funded by a £5m grant from the Big Lottery Fund.

The Department of Health has said that loneliness causes serious physical and mental damage. More than half of the UK's over-75s live alone.

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"We will signpost them to the services in their community, and by showing them we value them and care about them we will restore their confidence and feelings of self-worth."

She added: "It is tragic that older people are so undervalued and isolated that they believe life is not worth living and that they are no longer part of the human race."

Befrienders

Last year, the Campaign to End Loneliness estimated that more than a million people in the UK feel trapped in their homes and around five million older people consider television their main form of company.

Continue reading the main story

• According to Age UK, 450,000 older people face Christmas alone this year
• More than half of people over 75 live alone
• About 5m people consider TV their main form of company, according to The Campaign to End Loneliness
• Over three quarters of GPs believe up to 1 in 10 of the patients they saw in a day were really attending surgery because they were lonely, a poll of 1,000 found

Recently the Health Secretary Jeremy Hunt said it was shameful that as many as 800,000 people in England were "chronically lonely".

Volunteers answering helpline calls will be encouraged to befriend older people and make regular friendship calls to them over a period of months.

Care and Support Minister Norman Lamb said: "In our busy lives we too easily forget the thousands of older people who often go for days without seeing or speaking to anyone, or rely on the television for company.

"This service will help provide people with the companionship and support they deserve in their older years."

During an earlier pilot phase in the North East and North West of England, the Isle of Man and Jersey, the helpline was able to answer 7,000 calls from older people.

The helpline can be used by older people throughout the UK.

The charity Age UK, which runs its own telephone befriending service, welcomed the launch of Silver Line.

A spokeswoman said: "Older people can get in touch with their local Age UK to see how the charity can help through a range of services such as befriending which might include home visits and telephone calls for people who are feeling lonely or isolated.

"If anyone is worried about an older person this winter call Age UK Advice on 0800 169 65 65 for expert advice. Lines are open from 8am to 7pm, 365 days a year."

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Delayed hospital discharges examined

22 November 2013 Last updated at 19:03 ET By Adam Brimelow Health Correspondent, BBC News

NHS figures have highlighted the growing impact of delays in discharging patients in England once they are fit to leave hospital.

Last month the number of days "lost" by patients who needed the beds was the highest for more than three years.

Senior doctors working in accident and emergency departments say it is a major cause for concern.

NHS England said it was aware of the problem, but care working groups across the country were tackling it.

The problem facing the health service is about making sure patients who are fit to leave hospital can recover in the right place, and their beds are made available to others who need them.

Figures from NHS England show the number of hospital bed days lost because of delayed discharges in October was 78,424.

That is up nearly 8,000 on the same time last year, and the highest since monthly data was first published in August 2010.

Growing problem

Continue reading the main story

These figures are a cause for concern. The delays are a key cause of overcrowding in emergency departments, which is associated with higher mortality"

End Quote Dr Clifford Mann College of Emergency Medicine

The figures also indicate that getting appropriate social care in place - so patients can be discharged safely with the right support at home or in a care home - is a growing problem.

The number of hospital bed days lost where the delay was caused by social care difficulties was 14,830 in October. This is the highest since April 2011.

The President of the College of Emergency Medicine, Dr Clifford Mann, said the figures were not a surprise, but were a cause for concern.

"The delays are a key cause of overcrowding in emergency departments, which is associated with higher mortality," he said.

However, he added that the announcement this week of extra funding to relieve pressure on A and E departments was "very welcome"

"Intense pressure"

For Labour, shadow health secretary Andy Burnham said the figures exposed the intense pressure faced by hospitals in England.

"David Cameron's severe cuts to older people's home care services have left people without adequate support and at risk of hospitalisation. Once admitted, a growing number are trapped on wards because they can't be discharged."

A spokesman for the Local Government Association said councils had worked hard to protect social care services from the full impact of cuts, but added: "Unless local government finance is put on a sustainable footing, social care will remain substantially underfunded and services will suffer as a result."

In a statement, NHS England said it was very aware of the pressures hospitals faced when they could not discharge patients.

"Across the country we have urgent care working groups set up so the whole health and social care system is pulling together to tackle these important issues. The extra £150 million that we have just released will help. We need to get every penny we can working hard for patients."

A spokesperson for the Department of Health in England said in an average week NHS hospitals in England admitted a quarter of a million patients, and in that context the number of delays was very low.

"But no patients should experience unnecessary delays. We know hospitals need to join up better with social care and community services and are investing £3.8 billion in making this happen."

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Concern at brain haemorrhage delays

22 November 2013 Last updated at 19:05 ET

Delays in the diagnosis and treatment of patients with brain haemorrhages caused by aneurysms, especially at weekends, may be harming patient care.

A report says GPs are failing to recognise symptoms, and rehab support and out-of-hours hospital care is poor.

However, the National Confidential Enquiry into Patient Outcome and Death report did find good care in 58% of cases.

Subarachnoid haemorrhages affect 5,000 people in the UK each year.

The NCEPOD report is based on the confidential analysis of 427 cases of aneurysmal subarachnoid haemorrhage, covering England, Wales, Northern Ireland, the Channel Islands and the Isle of Man.

Overall, the report describes the massive change in the care of patients with this type of haemorrhage as "a welcome and real achievement".

It also says 90% of hospitals were found to be able to provide CT head scans seven days a week, and 86% of patients were treated using the latest endovascular techniques.

But in other areas, it found patient care to be lacking.

Weekend delays

These included GPs failing to recognise a severe headache as a potential symptom of a subarachnoid haemorrhage, and 18% of patients not receiving a neurological examination when admitted to hospital.

Once in hospital, delays in treatment were found to be more common at weekends with 30% of patients receiving care within 24 hours of admission - compared with 70% on weekdays.

Continue reading the main story

An aneurysmal subarachnoid (or brain) haemorrhage is a type of stroke caused by bleeding in and around the brain.

It results from the rupture of a cerebral aneurysm - a ballooning in an artery wall, causing it to thin and become weak.

Symptoms include a sudden and very severe headache, being sick, seizures and loss of consciousness.

Survival outcomes are poor. Half of patients die within a month and only 25% go on to live a normal life.

Aneurysmal subarachnoid haemorrhages account for 5% of all strokes in the UK.

The NCEPOD report found that rehabilitation care, after surgery and following discharge from hospital, could also be improved.

Prof Michael Gough, co-author of the report and a consultant vascular surgeon, said: "Many aneurysmal subarachnoid haemorrhage patients will be dependent for help with their daily living activities for the rest of their lives.

"So it is vital that all patients not only receive early in-patient rehabilitation, but also rehab support that continues in the community.

"This is essential to help them make as good recovery as is possible."

The report recommends that hospitals be linked to a specialist neurological centre in their region which could treat patients, and that standard procedures of care be used to improve diagnosis and management of patients.

Dr Alistair Douglas, president of the Society for Acute Medicine and a consultant at Ninewells Hospital in Dundee, said that although acute headaches were a common complaint of people presenting at A&E, only a small minority (10% or fewer) were caused by an aneurysmal subarachnoid haemorrhage or another serious condition.

He added that there were many positive aspects to the report.

"The good news is that the majority of cases were felt to have no room for improvement in care, 96% received adequate investigation in secondary care and there was no delay in CT scan requesting in 90% of cases.

"But there were cases where care could have been better, and all involved in acute medicine are encouraged to read the report."

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