Inactivity 'pandemic' in poor areas

31 January 2014 Last updated at 04:24 ET By Nick Triggle Health correspondent, BBC News

A "pandemic" of inactivity in poor areas of England is leading to premature deaths, a report shows.

The analysis by UKactive, which represents the leisure industry, found 13 of the 15 local authorities where people were the most inactive were in the most deprived parts of the country.

Between 35% and 40% of adults in these areas are classed as inactive - that is exercising less than 30 minutes a week.

That compares with a figure of 28% nationally.

Where inactivity levels were at their highest, early deaths also peaked, according to the analysis based on the Active People Survey, which is commissioned by Sport England.

Local authority	Proportion of adults not doing 30 minutes of activity a week
Source: UKactive
Manchester	40.24%
Sandwell	39.13%
Salford	39.07%
Bradford	37.68%
Dudley	37.67%
Slough	37.58%
Sunderland	36.99%
Blackburn with Darwen	36.95%
Coventry	36.81%
Oldham	36.28%
Kingston upon Hull	36.07%
Luton	35.88%
Barking and Dagenham	35.14%
Newham	35.11%
Stoke-on-Trent	35.07%

In the 15 most inactive local authorities, there was an average of 342 premature deaths per 100,000 people per year, compared with 242 in those where people exercised the most. The only areas in the 15 most inactive not to be in the most deprived areas of England were Slough and Dudley.

The report urged councils, which took on responsibility for public health last year, to use more of their budgets to promote physical activity.

Data obtained from 85 out of 129 councils under the Freedom of Information Act showed they spent just 2% of their public health budgets on physical activity promotion and investment.

This was in "stark contrast" to the 38% spent on sexual health and 12% on alcohol misuse, the report said.

Researchers also found that the most inactive local authorities have, on average, a third fewer leisure facilities than the least inactive areas.

Cutting physical inactivity by just 1% a year over a five-year period would save the UK economy just under £1.2bn in health and economic gains, the report said.

'Urgent action'

Fred Turok, chairman of Ukactive, said: "It's no longer acceptable that physical inactivity remains the forgotten cause of death in the UK.

"More deprived areas are faring worse in a physical inactivity pandemic - with no national strategy to improve our fitness levels."

Lord Sebastian Coe, who is backing the report, said: "There is no doubt that the issue requires immediate national attention and urgent action."

But Prof Kevin Fenton, of Public Health England, said his organisation and local government were "committed" to increasing physical activity levels.

"Physical activity is undertaken across communities in a range of ways, from walking and cycling, through fitness, leisure and play to structured amateur and elite sport.

"We need to embrace and support this diversity through cross-sector collaboration and action to embed physical activity within daily life," he added.

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Welsh drug testing can 'save lives'

By Steve Holden
Newsbeat reporter in Cardiff

Please turn on JavaScript. Media requires JavaScript to play.

See how legal highs are tested at the Wedinos Project

Wales has become the first part of the UK to run a government-funded drug testing service.

The Wedinos project, run by Public Health Wales, was set up to tackle the increase in new psychoactive substances, or legal highs.

It is designed to identify what chemicals are in circulation in Wales and use the information to reduce harm.

Critics say it is a waste of money and could be open to abuse from drug dealers.

Continue reading the main story

By providing timely and accurate information this service can save lives

Mark Drakeford AM Minister for Health and Social Services

Samples are sent to the Wedinos laboratory in Cardiff anonymously and the test results posted online, identified by a reference number.

All Wedinos requires is a postcode, meaning the substance is not traced back to the user, regardless of whether it contains a legal or illegal drug.

The service is also open to the public.

Welsh Health Minister Mark Drakeford, who signs off the £100,000 a year funding, says the service is vital to protect people.

"It's essential intelligence for our health workers, for our substance misuse workers, for the police, for young people and their families. By providing timely and accurate information this service can save lives."

Mr Drakeford's Conservative opposite, Darren Millar, is sceptical.

Legal highs 'tried by 12 year olds,' claim drug workers

Dan Rowley works for the Kaleidoscope Project in Newport

He said: "The Welsh NHS is still struggling to cope with the legacy of record-breaking cuts imposed by the Welsh Labour government, yet the NHS has the resources to test addictive and harmful drugs for possible addicts for free.

"It is obviously open to abuse by dangerous criminals peddling harmful substances in order to fund other crime."

Continue reading the main story

It helps us because we can treat the symptoms better if we know it's definitely a stimulant that this person had been taking

Dan Rowley Drugs worker with the Kaleidoscope project in Newport

The Welsh government says there are safeguards in place to stop any potential criminality from happening.

The service is mainly aimed at health and substance misuse workers but is available to anybody in Wales.

People who use the service are warned not to send substances they know are illegal through the postal system.

The police also send substances they cannot identify to Wedinos, which stands for Welsh Emerging Drugs & Identification of Novel Substances.

The phrase 'Wedi Nos' also means 'after dark' in Welsh.

Since launching in October 2013, around 150 samples have been sent in, revealing at least 85 substances from caffeine to cocaine.

Legal highs have proved tricky for authorities across the UK as their use and production has increased over the past few years.

Often, once a substance is banned, manufacturers can change the chemical codes to make a similar product that becomes technically legal again.

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Dan Rowley is a drugs worker with the Kaleidoscope project in Newport, a service which helps support people with drug and alcohol problems.

He's says he has used the service several times on behalf of his clients.

"There was one (legal high) called Ivory Dove and Ivory Dove Ultra that people had unexpected experiences with - headaches, hand tremors and seizures.

"I thought it was pretty important to find out what was in it.

"It helps us because we can treat the symptoms better if we know it's definitely a stimulant that this person had been taking.

"For example, there are different therapeutic interventions for a user of a stimulant rather than a user of a depressant."

The UK government says it is carrying out a review of new psychoactive substances to work out a more effective way of dealing with the growth in production and usage.

Follow @BBCNewsbeat on Twitter

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Vodka blamed for Russian death rate

31 January 2014 Last updated at 08:42 ET By Tulip Mazumdar Global health reporter

The high number of early deaths in Russia is mainly due to people drinking too much alcohol, particularly vodka, research suggests.

The study, in The Lancet, says 25% of Russian men die before they are 55, and most of the deaths are down to alcohol. The comparable UK figure is 7%.

Causes of death include liver disease and alcohol poisoning. Many also die in accidents or after getting into fights.

The study is thought to be the largest of its kind in the country.

Researchers from the Russian Cancer Centre in Moscow, Oxford University in the UK and the World Health Organization International Agency for Research on Cancer, in France, tracked the drinking patterns of 151,000 adults in three Russian cities over up to 10 years.

During that time, 8,000 of them died. The researchers also drew on previous studies in which families of 49,000 people who had died were asked about their loved ones' drinking habits.

Study co-author Prof Sir Richard Peto, from the University of Oxford, said: "Russian death rates have fluctuated wildly over the last 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka."

Binge drinking

In 1985, the then Soviet leader Mikhail Gorbachev drastically cut vodka production and did not allow it to be sold before lunch-time.

Researchers say alcohol consumption fell by around a quarter when the restrictions came in, and so did overall death rates. Then, when communism collapsed, people started drinking more again and the death rates also rose.

Sir Richard said: "When President Yeltsin took over from President Gorbachev, the overall death rates in young men more than doubled. This was as society collapsed and vodka became much more freely available.

"There was a huge increase in drinking and they were drinking in a destructive way. They were getting drunk on spirits and then buying and drinking more, producing a big risk of death."

The consumption rates for women also fluctuated according to political events, but they drank less so mortality rates were also lower.

Most drinkers were smokers as well which researchers say "aggravated" the death rates.

Continue reading the main story

Russians have always drunk a lot. They sometimes say it's because of the cold weather but this is just an excuse"

End Quote Prof David Zaridze Russian Cancer Research Centre

Russia brought in stricter alcohol control measures in 2006, including raising taxes and restricting sales.

Researchers say alcohol consumption has fallen by a third since then and the proportion of men dying before they reach 55 years old has fallen from 37% to 25%.

Half a litre of vodka costs around £3.00 (150 rubles). Heavy drinkers in this study were getting through at least a litre and a half of vodka a week.

In 2011, each Russian adult drank on average 13 litres of pure alcohol every year, of which eight litres was in spirits, mainly vodka.

In the UK the comparable figure is 10 litres per adult - but just less than two litres of that is in spirits.

Researchers say the key problem driving the high death rate is the way Russians drink alcohol.

Researcher Prof David Zaridze, from the Russian Cancer Research Centre, said: "They binge drink. That's the main problem. It's the pattern of drinking not the per-capita amount they are drinking."

"Russians have always drunk a lot. They sometimes say it's because of the cold weather but this is just an excuse. This is the nation's lifestyle that needs to change.

"Since the average life expectancy from birth for men in Russia is still only 64 years, ranking among the lowest 50 countries in the world, more effective alcohol and tobacco policy measures are urgently needed."

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Patients told to be pushier with GPs

25 January 2014 Last updated at 03:16 ET

Patients have been urged to adopt a pushier attitude to get doctors to prescribe the drugs they need.

Prof David Haslam, chairman of the National Institute of Health and Care Excellence (NICE) told the Daily Telegraph people should see themselves as equal partners with their doctors.

NICE decides which drugs can and cannot by prescribed on the NHS.

Prof David Haslam said patients had a "legal right" to medicines once they had been endorsed.

He compared the deferential attitude of British patients towards their GPs to that of Americans who "want to know more about their treatment".

'Your body'

In the UK people "tend to be much more, 'thank you doctor, I will take that'," he said in an interview with the Daily Telegraph.

Continue reading the main story

The more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor"

End Quote Prof David Haslam Chairman, Nice

Prof Haslam told the paper "mercifully" attitudes in the UK were changing but that patients should be more proactive about their health.

The NHS faced criticism last week over figures apparently suggesting certain drugs were not being used, despite being given the green light from Nice.

But Prof Haslam told the Telegraph: "When products have been approved for use by the NHS by NICE, patients have a legal right to those drugs - as long as they are clinically appropriate.

"The take-up should be much higher than it currently is."

He added: "Patients have a right under the NHS constitution to these therapies, so I really hope we can improve this."

And he said to get the best healthcare, patients should understand more about the medicines available.

"The fundamental point is, it's your body," he said.

"And the more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor."

'Best care'

The former GP was not suggesting patients should be confrontational with their doctor, the Telegraph said.

But he added: "It is essential for the future of the health service and for the future health of the nation that patients understand their conditions, their treatments and work with their health advisors so they can have the best care."

Prof Haslam became chairman of the Nice board in April.

He warned recently the UK's obesity problem could be even worse than the "doomsday scenario" set out seven years ago.

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Pregnancy fat 'may alter baby brain'

24 January 2014 Last updated at 21:25 ET By James Gallagher Health and science reporter, BBC News

A high-fat diet during pregnancy has the potential to alter a baby's developing brain and increase its chances of obesity later in life, animal studies suggest.

The team at Yale School of Medicine, in the US, showed diet could change the structure of mice brains.

They argue this could explain why the children of obese parents are more likely to become grossly overweight.

Experts said the study had merit, but brain changes in humans were unproven.

Obesity can run in families and shared eating habits are a major factor.

However, there is evidence that diet during pregnancy can also influence a child's future waistline, such as through changes to DNA.

'Signal to the pup'

The latest foray into the field, published in the journal Cell, shows the structure of the brain itself may be changed.

Continue reading the main story

Twenty years of research shows nutrition in early life has lasting effects on cardiovascular disease, obesity, osteoporosis and some cancers. It's extremely well established"

End Quote Dr Graham Burdge University of Southampton

The experiments on mice showed that mothers on a high-fat diet had pups with an altered hypothalamus, a part of the brain important for regulating metabolism.

These mouse pups were more likely to become overweight and develop type 2 diabetes than the pups of mothers given a normal diet.

One of the researchers, Prof Tamas Horvath, from Yale, told the BBC: "It could be a signal to the pup that it can grow bigger as the environment is plentiful in food.

"We definitely believe these are fundamental biological processes also affecting humans and influencing how children may eventually become obese.

"It seems, at least, that this could have a major impact and we need to explore it further in both animal and human studies."

He says a healthy diet during pregnancy may help to break the cycle of obese parents having obese children.

'Neurological circuits'

Commenting on the findings, Dr Graham Burdge, from the University of Southampton, told the BBC: "Twenty years of research shows nutrition in early life has lasting effects on cardiovascular disease, obesity, osteoporosis and some cancers. It's extremely well established.

"This is an intriguing technical advance showing neurological circuits are being changed, which hasn't been shown before."

He said the "concept fits in well with the data" but pointed out there were key differences in the way mice and people process fat, so the same might not be happening in pregnant women.

He added: "Much of what we know about the process comes from animals. The next big thing is to establish the same mechanisms operate in humans and if we can modify that."

For now he advises parents to "have a healthy balanced diet and ensure the diet of your child is balanced as well".

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E-cigarette ban for under-18s

26 January 2014 Last updated at 07:20 ET

Under-18s in England are to be banned from buying electronic cigarettes, the government has announced.

Experts say it is not yet known what harm the tobacco-free devices could inflict and that their contents could be damaging young people's health.

An estimated 1.3m people in the UK use e-cigarettes which were designed to help smokers quit.

Ministers also plan to make it illegal for adults to buy traditional cigarettes for anyone under 18.

Continue reading the main story

Analysis

Electronic cigarettes mimic the effects of real cigarettes, producing a vapour that is potentially less harmful than cigarette smoke and free of some its damaging substances, such as tar.

The vapour does often, however, contain nicotine, the addictive substance that provides the "hit" in cigarette smoke.

The jury is still out about just how safe e-cigarettes are, and nobody knows what their long-term impact is on health.

There are plans to licence e-cigarettes as an aid to quitting smoking from 2016, but at present they are not available on the NHS, unlike other smoking cessation aids such as nicotine patches.

Because they are not regulated, the contents of e-cigarettes can vary. Some have been found to contain toxic chemicals which are also found in tobacco, and have been linked to cancer.

There is also only sketchy evidence that e-cigarettes help people to give up smoking. In fact there is research to suggest that their use among the young may actually encourage them to smoke more.

'Irresponsible adults'

They want to crack down on the number of young people smoking by bringing the law in line with restrictions on the sale of alcohol.

The new rules could be in force by the autumn and may mean anyone caught buying cigarettes for a child could be given a £50 fixed penalty notice or a fine of up to £2,500.

"We must do all we can to help children lead a healthy life," public health minister Jane Ellison said.

"That's why this measure is designed to help protect children from the dangers of being bought cigarettes by irresponsible adults - something that I hope concerned parents and responsible retailers will welcome."

Some 41% of 15-year-olds who smoke say they usually buy their cigarettes from someone else, rather than from a shop, according to Department of Health figures.

But while smoking rates have fallen to their lowest ever level, experts fear the electronic substitutes could be encouraging teenagers to take up the habit.

Mimic smoking

E-cigarettes, popular with teenagers, deliver a hit of addictive nicotine and emit water vapour to mimic the feeling and look of smoking.

The battery-powered devices can be bought online and in some pubs, chemists and newsagents.

The vapour is considered potentially less harmful than cigarette smoke and is free of some its damaging substances such as tar.

Continue reading the main story

"Start Quote

They could be extremely damaging to young people's health"

End Quote Prof Dame Sally Davies Chief medical officer, England

"We do not yet know the harm that e-cigarettes can cause to adults let alone to children, but we do know they are not risk free," Prof Dame Sally Davies, England's chief medical officer, said.

"E-cigarettes can produce toxic chemicals and the amount of nicotine and other chemical constituents and contaminants, including vaporised flavourings, varies between products meaning they could be extremely damaging to young people's health."

Katherine Devlin, president of the Electronic Cigarette Industry Trade Association, welcomed the changes in the law, saying they had been asking for it "for years".

"It's high time that it was mandated in law so that it can be robustly enforced," she added, pointing out that product labelling made it clear e-cigarettes were not for under-18s.

Anti-smoking charity Ash also welcomed the changes but chief executive Deborah Arnott called for a retail licensing system that would mean cigarettes could only be legally sold in shops, not in car boot sales or markets.

No EU ban

The UK currently has few restrictions on the use of e-cigarettes, despite moves in some countries to ban them.

Restrictions have recently been mooted in Scotland and Wales, where health policy is a devolved issue.

In a statement released on Sunday, a Welsh government spokesman said it "fully" supported a ban on e-cigarettes for under-18s and was considering how such legislation could be introduced in Wales.

In Northern Ireland, the NI Chest Heart and Stroke charity is pressing the health minister to introduce a similar ban.

The law change for England will be introduced in Parliament this week as an amendment to the Children and Families Bill.

From 2016, the Medicines and Healthcare Products Regulatory Agency is expected to license e-cigarettes as a medicine in the UK.

This will bring them in line with nicotine patches and gum, and allow the agency to apply rules around, for example, the purity of the nicotine in e-cigarettes.

MEPs have rejected calls for a blanket ban on the sale of e-cigarettes across the EU.

However, under a compromise deal, strict limits will be placed on the amount of nicotine they contain, and individual EU member states will be able to introduce a national ban if they see fit.

If three or more member states chose that path, it could trigger an EU-wide ban.

Smoking remains one of the biggest causes of death and illness in the UK with around 100,000 people dying each year from illnesses linked to the habit.

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Elderly 'not too old for cancer aid'

24 January 2014 Last updated at 05:34 ET

Older cancer patients should not be "written off" as too old for treatment, a charity has warned.

Macmillan Cancer Support said decisions on care should be made based on a patient's fitness, not their age.

It cited data which suggests 130,000 people over 65 diagnosed with cancer between 1991-2010 survived for more than 10 years.

NHS England acknowledged that it needed to deliver better services to people in the over-65 age group.

Macmillan Cancer Support conducted the research alongside the National Cancer Intelligence Network, found of the 130,000 who had lived with the disease for more than a decade, 8,000 had been diagnosed over the age of 80.

Despite that, many patients in the UK are being assessed on age alone, Macmillan said, adding that cancer survival rates in the age group are "poor".

'Care and respect'

A paper published in the Lancet, looking at five-year survival rates for common cancers - including prostate, breast, lung, stomach, ovary and kidney cancers - between 1999 and 2007 showed the UK and Ireland had a lower five-year survival rate than the rest of Europe.

"It's wrong to write off older people as too old for treatment," said Macmillan Cancer Support's chief executive Ciaran Devane.

"With a proper assessment and appropriate treatment, our research shows that many older cancer patients can live for a long time and can even be cured.

"While it's good news that so many older people are benefiting from treatment, many thousands more could live longer if our survival rates for over-65s matched those in comparable countries."

He said barriers to treatment, which include "age discrimination and inadequate assessment methods", must be addressed.

NHS England's national clinical director for cancer, Sean Duffy, said that with an ageing population, the study had come at an important moment in time.

But he added: "We need to deliver better services for people over 65 and 75 because we know there's an issue and interventions need to be designed to that end."

He said treatment for cancer can be complex "and should be based on what is right for each individual patient."

Dr Mark Porter of the British Medical Association said it should be a "key part" of the medical profession to ensure older patients are "treated with the care and respect they deserve".

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Pregnancy fat 'may alter baby brain'

24 January 2014 Last updated at 21:25 ET By James Gallagher Health and science reporter, BBC News

A high-fat diet during pregnancy has the potential to alter a baby's developing brain and increase its chances of obesity later in life, animal studies suggest.

The team at Yale School of Medicine, in the US, showed diet could change the structure of mice brains.

They argue this could explain why the children of obese parents are more likely to become grossly overweight.

Experts said the study had merit, but brain changes in humans were unproven.

Obesity can run in families and shared eating habits are a major factor.

However, there is evidence that diet during pregnancy can also influence a child's future waistline, such as through changes to DNA.

'Signal to the pup'

The latest foray into the field, published in the journal Cell, shows the structure of the brain itself may be changed.

Continue reading the main story

Twenty years of research shows nutrition in early life has lasting effects on cardiovascular disease, obesity, osteoporosis and some cancers. It's extremely well established"

End Quote Dr Graham Burdge University of Southampton

The experiments on mice showed that mothers on a high-fat diet had pups with an altered hypothalamus, a part of the brain important for regulating metabolism.

These mouse pups were more likely to become overweight and develop type 2 diabetes than the pups of mothers given a normal diet.

One of the researchers, Prof Tamas Horvath, from Yale, told the BBC: "It could be a signal to the pup that it can grow bigger as the environment is plentiful in food.

"We definitely believe these are fundamental biological processes also affecting humans and influencing how children may eventually become obese.

"It seems, at least, that this could have a major impact and we need to explore it further in both animal and human studies."

He says a healthy diet during pregnancy may help to break the cycle of obese parents having obese children.

'Neurological circuits'

Commenting on the findings, Dr Graham Burdge, from the University of Southampton, told the BBC: "Twenty years of research shows nutrition in early life has lasting effects on cardiovascular disease, obesity, osteoporosis and some cancers. It's extremely well established.

"This is an intriguing technical advance showing neurological circuits are being changed, which hasn't been shown before."

He said the "concept fits in well with the data" but pointed out there were key differences in the way mice and people process fat, so the same might not be happening in pregnant women.

He added: "Much of what we know about the process comes from animals. The next big thing is to establish the same mechanisms operate in humans and if we can modify that."

For now he advises parents to "have a healthy balanced diet and ensure the diet of your child is balanced as well".

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Patients told to be pushier with GPs

25 January 2014 Last updated at 03:16 ET

Patients have been urged to adopt a pushier attitude to get doctors to prescribe the drugs they need.

Prof David Haslam, chairman of the National Institute of Health and Care Excellence (NICE) told the Daily Telegraph people should see themselves as equal partners with their doctors.

NICE decides which drugs can and cannot by prescribed on the NHS.

Prof David Haslam said patients had a "legal right" to medicines once they had been endorsed.

He compared the deferential attitude of British patients towards their GPs to that of Americans who "want to know more about their treatment".

'Your body'

In the UK people "tend to be much more, 'thank you doctor, I will take that'," he said in an interview with the Daily Telegraph.

Continue reading the main story

The more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor"

End Quote Prof David Haslam Chairman, Nice

Prof Haslam told the paper "mercifully" attitudes in the UK were changing but that patients should be more proactive about their health.

The NHS faced criticism last week over figures apparently suggesting certain drugs were not being used, despite being given the green light from Nice.

But Prof Haslam told the Telegraph: "When products have been approved for use by the NHS by NICE, patients have a legal right to those drugs - as long as they are clinically appropriate.

"The take-up should be much higher than it currently is."

He added: "Patients have a right under the NHS constitution to these therapies, so I really hope we can improve this."

And he said to get the best healthcare, patients should understand more about the medicines available.

"The fundamental point is, it's your body," he said.

"And the more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor."

'Best care'

The former GP was not suggesting patients should be confrontational with their doctor, the Telegraph said.

But he added: "It is essential for the future of the health service and for the future health of the nation that patients understand their conditions, their treatments and work with their health advisors so they can have the best care."

Prof Haslam became chairman of the Nice board in April.

He warned recently the UK's obesity problem could be even worse than the "doomsday scenario" set out seven years ago.

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Babies' heart risk 'shaped early on'

23 January 2014 Last updated at 21:46 ET By Helen Briggs BBC News

A baby's development in the womb in the first weeks of life is critical for future heart health, research suggests.

A link between poor growth in the first trimester and early risk factors for heart disease has been identified for the first time.

The study, in the British Medical Journal, adds to evidence that heart risk is set long before adulthood.

Pregnant women should think about their baby's heart health as well as their own, the British Heart Foundation said.

The evidence comes from a study tracking the health, from early pregnancy onwards, of nearly 2,000 children born in the Dutch city of Rotterdam.

Continue reading the main story

If you smoke, speak to your GP or midwife about quitting, and keep a check on your blood pressure"

End Quote Amy Thompson British Heart Foundation

A team at the Erasmus University Medical School examined links between the child's size at the first scan (10 to 13 weeks) and markers of future cardiovascular health at the age of six (central body fat, high blood pressure, high insulin levels and high cholesterol).

"Impaired first trimester foetal growth is associated with an adverse cardiovascular risk profile in school age children," they reported in the British Medical Journal.

"Early foetal life may be a critical period for cardiovascular health in later life."

Low birth weight is known to be linked to an increased risk of heart disease in later life. But the new research suggests not only birth weight but poor growth in the earliest phase of pregnancy may influence cardiovascular disease risk.

"These results suggest that the first trimester of pregnancy may be a critical period for development of offspring cardiovascular risk factors in later life," study author Prof Vincent Jaddoe told BBC News.

"Therefore adverse maternal lifestyle habits influencing early foetal growth may have persistent consequences for their offspring, many decades later. "

This was the first study showing this link and replication in other studies was needed, he added.

Critical stage

Amy Thompson, senior cardiac nurse at the British Heart Foundation, said the first few months of pregnancy were a critical stage in a baby's development.

"This study suggests that foetal growth within this time may influence their heart health later in life," she said.

"However, as the researchers acknowledge themselves, further studies are needed to understand why this pattern exists and what it might mean for preventing heart disease.

"If you are pregnant, or planning a family, you should be thinking about your baby's heart health as well as your own," she added.

"If you smoke, speak to your GP or midwife about quitting, and keep a check on your blood pressure.

"Your midwife will also advise you on other ways you can make healthier choices during pregnancy."

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'No point in vitamin D for healthy'

23 January 2014 Last updated at 21:50 ET

There is little reason to prescribe vitamin D supplements to healthy adults to reduce the risk of diseases or fractures, say researchers writing in the Lancet.

They found no significant reduction in risk in any area after analysing more than 100 trials.

They added that future studies were unlikely to change the figures.

At-risk groups, including babies, pregnant women and elderly people, are still advised to take supplements.

The research team, from the University of Auckland in New Zealand, had previously carried out a meta-analysis which showed no major effect of vitamin D supplementation on bone mineral density.

Continue reading the main story

GPs shouldn't be rushing around getting blood tests done for the average healthy person"

End Quote Dr Colin Michie Royal College of Paediatrics and Child Health

In this study, they looked at existing randomised controlled trials of vitamin D supplements, with or without calcium.

They found that vitamin D supplementation does not change the relative risk of heart disease, stroke or cerebrovascular disease, cancer and fractures by a noticeable amount, equivalent to 15%.

Vitamin D supplements did not reduce hip fracture risk by more than 15% in hospital patients and, when given with calcium, did not lessen the risk in healthy individuals either.

The study said there was also "uncertainty as to whether vitamin D with or without calcium reduces the risk of death".

The New Zealand researchers concluded: "In view of our findings, there is little justification for prescribing vitamin D supplements to prevent myocardial infarction or ischaemic heart disease, stroke or cerebrovascular disease, cancer, or fractures, or to reduce the risk of death in unselected community-dwelling individuals."

'Far from clear'

Writing in a linked article in the Lancet, Karl Michaelsson, from the department of surgical sciences at Uppsala University in Sweden, said there was continuing debate about whether there were health benefits to taking vitamin D supplements for a mild form of vitamin D deficiency.

"The impression that vitamin D is a sunshine vitamin and that increasing doses lead to improved health is far from clear."

Mr Michaelsson said that until more information was available, it would be wise to choose a cautious approach to vitamin D supplementation for otherwise healthy individuals.

While some nutrition experts say vitamin D deficiency is responsible for a number of diseases, such as fractures, cancer, cardiovascular diseases, diabetes, and a higher risk of death, others say vitamin D deficiency is more likely to be the result of ill health and not the cause.

Dr Colin Michie, consultant senior lecturer in paediatrics and chairman of the nutrition committee at the Royal College of Paediatrics and Child Health, says the study puts Vitamin D supplements into context.

"This shows vitamin D has a relevant role to play, but it's not that important.

"GPs shouldn't be rushing around getting blood tests done for the average healthy person.

"Instead, the old-fashioned advice still holds true. Eat more fish, watch your diet and how you lead your life - unless you're specifically at risk."

People at high risk of vitamin D deficiency include children under five, pregnant and breastfeeding women, the over-65s and people at risk of not getting enough exposure to sunlight.

Those with darker skin, such as people of African, Caribbean and South Asian origin, and people who wear full-body coverings, as well as pale-skinned people have also been shown to be at higher risk.

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Elderly 'not too old for cancer aid'

24 January 2014 Last updated at 05:34 ET

Older cancer patients should not be "written off" as too old for treatment, a charity has warned.

Macmillan Cancer Support said decisions on care should be made based on a patient's fitness, not their age.

It cited data which suggests 130,000 people over 65 diagnosed with cancer between 1991-2010 survived for more than 10 years.

NHS England acknowledged that it needed to deliver better services to people in the over-65 age group.

Macmillan Cancer Support conducted the research alongside the National Cancer Intelligence Network, found of the 130,000 who had lived with the disease for more than a decade, 8,000 had been diagnosed over the age of 80.

Despite that, many patients in the UK are being assessed on age alone, Macmillan said, adding that cancer survival rates in the age group are "poor".

'Care and respect'

A paper published in the Lancet, looking at five-year survival rates for common cancers - including prostate, breast, lung, stomach, ovary and kidney cancers - between 1999 and 2007 showed the UK and Ireland had a lower five-year survival rate than the rest of Europe.

"It's wrong to write off older people as too old for treatment," said Macmillan Cancer Support's chief executive Ciaran Devane.

"With a proper assessment and appropriate treatment, our research shows that many older cancer patients can live for a long time and can even be cured.

"While it's good news that so many older people are benefiting from treatment, many thousands more could live longer if our survival rates for over-65s matched those in comparable countries."

He said barriers to treatment, which include "age discrimination and inadequate assessment methods", must be addressed.

NHS England's national clinical director for cancer, Sean Duffy, said that with an ageing population, the study had come at an important moment in time.

But he added: "We need to deliver better services for people over 65 and 75 because we know there's an issue and interventions need to be designed to that end."

He said treatment for cancer can be complex "and should be based on what is right for each individual patient."

Dr Mark Porter of the British Medical Association said it should be a "key part" of the medical profession to ensure older patients are "treated with the care and respect they deserve".

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Central heating 'may make you fat'

22 January 2014 Last updated at 22:15 ET By James Gallagher Health and science reporter, BBC News

Having the central heating on may be contributing to our ballooning waistlines, Dutch researchers suggest.

They say higher temperatures in homes, offices and hospitals provide more comfort, but mean bodies no longer need to burn extra calories to keep warm.

A Maastricht University Medical Centre group says 19C (66F) is sufficient to provide the right balance.

However, some argue that turning down the thermostat would merely prompt people to eat more.

The weight loss idea, proposed in Trends in Endocrinology and Metabolism, comes down to energy balance.

Continue reading the main story

If you didn't compensate you would lose weight, but that's not really how it happens. You will want a chocolate bar."

End Quote Dr Michael Daly University of Stirling

People will gain weight if they consume more calories in food than they burn off in day-to-day life.

Cooler and thinner?

The report said people spent 90% of their time indoors and yet "we cool and heat our dwellings for maximal comfort while minimising our body energy expenditure necessary to control body temperatures".

The energy balance is shifted towards weight gain and can require a drop in temperature to help burn off some calories.

Dr Wouter van Marken Lichtenbelt told the BBC: "19C is enough - and not for the whole day.

"Energy increases were in the order of 6% in mild cold, and in the long term that could really make a difference.

"It could be a substantial influence and help in combination with food changes and exercise."

He said people could "try turning the thermostat down" at home or "go outside".

About two in every three adults in the UK are classed as overweight or obese, and it is a growing problem globally.

Cases have quadrupled to about one billion in the developing world since 1980.

Cold comfort

However, temperature control may not be the perfect solution and is the source of some debate.

Dr Michael Daly, who investigated the issue at the University of Stirling, told BBC News: "If you didn't compensate you would lose weight, but that's not really how it happens. You will want a chocolate bar."

"Also, studies suggest that in cold indoor temperatures you are more likely to get a stroke, and there is a [overall] winter mortality effect."

His research on 100,000 homes in England suggested people in houses heated above 23C tended to be slightly thinner, because at this point the body needed to lose heat - and sweating used up energy.

He said higher temperatures also lowered appetite and the amount of food being consumed.

Tam Fry, from the UK's National Obesity Forum, argued: "A cold environment switches on brown fat deposits, which are said to generate 300 times more heat than any organ in the body.

"They are its natural thermal resource. The heat kept us warm as babies and is still capable of keeping us warm now.

"Losing weight at the same time is a bonus. Turn your stat down now and see for yourself."

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NHS waiting time data 'unreliable'

23 January 2014 Last updated at 03:14 ET By Nick Triggle Health correspondent, BBC News

Patients in England cannot rely on information on waiting times for non-emergency operations, such as knee and hip replacements, a watchdog says.

The National Audit Office (NAO) found wrong and inconsistent recording after reviewing 650 cases in seven trusts.

The watchdog said it was unable to discern whether this was deliberate, but overall the practices concealed delays rather than over-recorded waits.

The government said the issue would be investigated.

The NAO said that the lack of reliability, whatever the causes, was harmful to patients because it hampered their ability to make informed choices about where to choose to have their treatment.

It also called into question whether the NHS was actually meeting its waiting-time targets.

Greater scrutiny

There are more than 19 million referrals for elective operations each year.

Patients are meant to be treated within 18 weeks of a referral and the NHS is currently meeting its targets on this - but only just and the report noted there was growing pressure on waiting times.

The waits are monitored and recorded by hospitals themselves.

They have the power to pause the clock if a patient is unavailable for appointments for personal or social reasons.

The patient can also be sent back to their GP - which means the clock starts all over again - if they fail to attend appointments.

But the watchdog said this leeway was being applied wrongly or inconsistently.

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NHS patient Sue Walker: "I had built myself up... and the plug was pulled just in a few seconds"

Of the 650 orthopaedic cases reviewed, the watchdog found that more than half were "not supported by documented evidence or were incorrectly recorded".

• In 281 cases, waiting times had been correctly recorded and were supported by documented evidence
• In 202 cases, waiting times were not supported by enough evidence to say whether they had been correctly recorded
• In a further 167 cases, there was "evidence of at least one error, leading to under and over-recording of waiting time", with an overall under-recording of three weeks per patient

The NAO also highlighted other cases that were brought to its attention during the review.

These included North West London Hospitals Trust failing to record the waiting times of 2,700 of its inpatients, while Barnet and Chase Farm failed to properly monitor more than 2,000 patients. The problems have now been rectified.

There is also the well-publicised case of Colchester Hospital's misrecording of cancer waiting times.

'Deliberate manipulation'

The report urged NHS England to apply greater scrutiny to waiting-time statistics to establish what was really happening.

NAO head Amyas Morse said: "Performance information should be reliable.

Continue reading the main story

"However, we have found significant errors and inconsistencies in how trusts record waiting times, masking a good deal of variation between trusts in actual waiting times."

Katherine Murphy, of the Patients Association, said the findings were "concerning", accusing the NHS of deliberately manipulating the figures.

"The care and welfare of patients must always come first, and managers' efforts to try and 'fudge' their figures to meet targets will inevitably divert attention from providing high-quality care for the patients."

Shadow Health Secretary Andy Burnham said: "What this report reveals is real, huge questions now over what we are being told by the government about the NHS and waiting times.

"I'll be writing to Jeremy Hunt today to say there must be an urgent review into NHS waiting time statistics so that the public can have confidence in them."

NHS England said action would be taken.

"We firmly believe it is essential to have accurate information provided in a timely way to ensure better care for patients," said NHS England's director of policy and strategy, Bill McCarthy.

A spokeswoman for Health Secretary Jeremy Hunt said: "It's crucial that reporting is always accurate, and we will work with the NHS to make sure hospital staff get the support they need to get this right."

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Deadly bird flu cases surging

23 January 2014 Last updated at 07:56 ET By James Gallagher Health and science reporter, BBC News

A surge in cases of the deadly new strain of bird flu has been reported in China at the beginning of 2014.

Only a handful of people had been infected with H7N9 since June, but health officials have reported 63 cases so far this month.

Influenza researchers argue the winter season and preparations for Chinese New Year may be driving the increase.

The World Health Organization called for vigilance, saying the virus was likely to remain present for some time.

H7N9 made the jump from infecting domestic chickens and ducks to infecting people at the end of March 2013.

Within a month, 126 cases and 24 deaths had been recorded.

Continue reading the main story

Is it time to worry?

H7N9 does kill a high proportion of infected people and is capable of evolving resistance to anti-viral drugs with relative ease.

But it's always worth putting the figures for emerging infections into context.

Up to five million people get severe cases of seasonal flu each year, causing up to half a million deaths.

By comparison 209 cases of H7N9, causing 55 deaths, seems small.

The global concern is not what this bird flu is doing now, but how it might develop.

So far there have been no cases of sustained human-to-human transmission; however, the virus could mutate, allowing it to spread more easily in people.

If that happened, the virus would pose a much greater global threat; for now, there is no sign of this.

The virus was stopped in its tracks as control measures, such as closing live poultry markets, were introduced.

There were just five cases between June and November.

The recent jump takes the total number of cases to 209, including 55 deaths.

Apart from a couple of cases in close family clusters, the virus has not been able to spread from person to person.

Gregory Hartl, spokesman for the World Health Organization (WHO), said flu viruses circulated more easily during the colder winter months.

"Our calculation was always that we were going to have to watch the winter, and that's where we are at the moment.

"We need to remain vigilant, but so far the virus does not seem to have mutated in any way," he says.

"Some people will be looking very closely at the Chinese New Year, when there will be lots of people travelling.

"It will be crowded on trains and they'll also be travelling with chickens."

Prof John McCauley, the director of a WHO collaborating centre on influenza in London, said: "I've been worried all the time about H7N9; it's highly virulent and the case fatality is about one in three, so it poses a threat."

The range of the virus had also spread, he added, with cases in Guangdong province, further south and east than previously.

He said the winter might not be the whole explanation, particularly in southern provinces closer to the equator.

"It may be seasonal, or an alternative is more poultry exposure in the build-up to Chinese New Year, and more poultry going through the markets.

"They might need to reconsider closure of the markets."

'Good position'

The H7N9 virus itself, however, does not appear to have mutated in a way that could make it more likely to spread around the globe.

Prof Wendy Barclay, an influenza researcher at Imperial College London, did not think the virus had changed.

"There's still no evidence of human-to-human transmission or mutations to make it closer to a pandemic.

"So from that perspective there's nothing new to worry about."

She said overall "we're in as good a position as we could hope" and the early steps of producing a vaccine were now completed.

"We're back to waiting to see if if does mutate."

The WHO does not advise any travel or trade restrictions because of bird flu, while the European Centres of Disease Control rates the virus as a "significant long-term threat".

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Call for safe staff levels across NHS

21 January 2014 Last updated at 20:18 ET By Nick Triggle Health correspondent, BBC News

Safe staffing levels should be extended beyond nurse numbers in England to include midwives and doctors, especially in A&E units, MPs say.

The Health Select Committee also suggested breaches should automatically trigger inspections by the regulator.

Currently ministers have ordered only nurse staffing levels to be routinely monitored and published.

The system - ordered in response to the Stafford Hospital scandal - comes into place in April.

But the cross-party group of MPs said there was no reason why it should not be extended across the NHS and social care systems.

Committee chairman Stephen Dorrell said: "This should be applied across the delivery of health and care - doctors, midwives, practice nurses and social workers.

"Part of the difficulty in A&E is driven by the fact there are not enough doctors of all levels."

'Tick-box culture'

Figures from the College of Emergency Medicine show that there are shortages among trainees, middle-grade doctors and consultants.

For example, the college recommends 10 consultants for each A&E unit and 16 for the largest ones. But the current average is just below eight.

Continue reading the main story

We are not yet saying all the challenges have been met. But by and large we agree with the management of the CQC about their objectives and we endorse them"

End Quote Stephen Dorrell Health Select Committee

Labour MP Barbara Keeley, who is also a member of the committee, added: "Staffing levels are absolutely fundamental. It is ludicrous not to be transparent about something that patients and their families can see every day."

The suggestion was put forward in a report that looked at the progress the Care Quality Commission has been making.

The regulator has been under fire ever since it was created in 2009.

Reports in the past by the National Audit Office and the Health Select Committee have criticised the Healthcare Commission for a "tick-box" culture and failing patients.

But the MPs said the regulator had a "renewed sense of purpose" since a new chairman and chief executive were appointed in 2012.

Last year the leadership appointed three new chief inspectors, covering hospitals, GPs and social care to herald an era of tougher, more specialist investigations.

It has also sought to recruit more inspectors - although it is still 150 short of its 1,100 target.

Mr Dorrell said: "We are not yet saying all the challenges have been met. But by and large we agree with the management of the CQC about their objectives and we endorse them."

CQC chairman David Prior said: "This report marks an important milestone."

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EU pollution target 'still too high'

21 January 2014 Last updated at 20:23 ET By Michelle Roberts Health editor, BBC News online

A study confirming a link between atmospheric pollution and heart-attack risk strengthens the EU case for tougher clean-air targets, experts say.

Research in the BMJ looking at long-term data for 100,000 people in five European countries found evidence of harm, even at permitted concentrations.

Experts stressed that the risk to an individual was still relatively small.

And some argued the results were not conclusive as they did not take account of previous exposure to higher levels.

Continue reading the main story

One can only hope that our European politicians will be persuaded of the importance of these findings and reassess their position on air pollution in Europe"

End Quote Prof Jon Ayres University of Birmingham

Other factors, such as smoking or having high blood pressure, contribute more to a person's risk of heart attack than pollution from traffic fumes and industry, they say.

But repeated, long-term exposure to air pollution - living next to a busy road in a city, for example - does take its toll, the research, involving a collaboration of European universities and institutes, reveals.

Tougher limits

The BMJ study found that for each 5 µg/m3 increase in annual exposure to fine-particulate (PM 2.5) air pollution - thought to be the most damaging type, as smaller particles can penetrate deep into the body - there is a 13% relative increase in the incidence of heart attacks, even after taking into account other risk factors such as smoking.

Similarly, rising levels of larger-particulate air pollution (PM 10) were also linked to heart-attack risk.

And these associations remained even when exposure concentrations were below the current European limits.

Authors of the study - the largest ever looking at the impact of pollution exposure in European people - says its results support the case for lowering EU limits for particulate matter air pollution.

Current EU legislation sets the annual mean limit on PM 2.5 at twice that recommended by the World Health Organization.

Case 'not made'

Jon Ayres, professor of environmental and respiratory medicine at the University of Birmingham, said: "There is no doubt that further reduction of PM levels would result in improvements in cardiac health in Europe.

"One can only hope that our European politicians will be persuaded of the importance of these findings and reassess their position on air pollution in Europe."

Prof David Coggon, from the Department of Occupational and Environmental Medicine at the University of Southampton, was more cautious.

"This study adds to the evidence that particulate air pollution is a cause of heart disease, but it does not establish that there are important health risks from levels of exposure below current exposure limits," he said.

"This is because the differences in risk that were observed may have been a long-term effect of exposures in the past when levels of pollution were higher."

UK estimates suggest nearly 30,000 people die prematurely each year as a direct result of exposure to air pollution, which has been linked to asthma and other lung diseases, including cancer, as well as heart problems.

A recent report by Defra on the issue says evidence suggests that there is no "safe" limit for exposure to PM 2.5, and that this type of man-made pollution cuts the average life expectancy of people living in the UK by seven to eight months.

A Defra spokeswoman said: "Air quality has improved significantly in recent decades and the UK currently meets the EU limits for this type of pollution.

"We want to keep improving air quality and reduce the impact it can have on human health and the environment."

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Obesity measure 'too high' for many

21 January 2014 Last updated at 20:31 ET

Millions of people from ethnic minority groups who may be at risk of weight-related diseases are not showing up as obese under current tests, experts say.

Medical advisory body NICE says the method of calculating body mass index does not work for some groups.

And it wants the BMI "fatness" thresholds to be lowered to ensure up to 8m people of African, Caribbean and Asian descent in the UK are covered.

NICE says it would help identify those at risk of diabetes and heart disease.

BMI assesses weight relative to height.

NICE says a lower BMI threshold should be used as a trigger for action in people from ethnic minority groups since they are more prone to such diseases.

BMI 'meaningless'

Continue reading the main story

• Body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height.
• It is calculated by measuring weight (in kilograms) and dividing it by height (in metres) squared to give a BMI score
• Asian and other minority ethnic groups are at higher risk of diabetes than white populations and should ideally aim for a BMI below 23

For good health, ethnic minority groups need to be slightly slimmer for their height than people who are white.

NICE says the typical healthy BMI score of 18.5-24.9 is meaningless for people of African, Caribbean and Asian descent, and suggests a range of 18.5-23 instead.

It also wants a lower cut-off for the "obese" category. It says for ethnic minority groups that means a BMI score of 27.5 or more, rather than 30-plus.

Professor Mike Kelly, director of the Centre for Public Health at NICE, said: "Type 2 diabetes, heart disease and stroke are potentially life-threatening conditions, which people of African, Caribbean and Asian descent and other minority ethnicities are significantly more likely to develop than the wider population.

"So it's vital that local authorities are supported in taking action to prevent these illnesses in people who have a high risk of developing them.

"Not only are people from these ethnic backgrounds up to six times more likely to be diagnosed with type 2 diabetes, they are 50% more likely to die from cardiovascular disease. And they also suffer from these conditions at a younger age."

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Football 'can tackle male obesity'

20 January 2014 Last updated at 20:40 ET

Football participation is a good way to get men to slim down, a Scottish study published in The Lancet shows.

Some 374 overweight soccer fans were invited to take part in a 12-week programme of training sessions at their local football club.

A year later, the men had lost and kept off about 11lb (5kg) each compared with 374 overweight fans put on a waiting list for the programme.

The Glasgow researchers say it proves male-friendly weight loss plans work.

All 748 men in the study were offered healthy-eating advice and tips on weight management, but only half were invited to professional football clubs for weekly training sessions.

Thirteen clubs took part: Aberdeen, Celtic, Dundee United, Dunfermline Athletic, Hamilton Academical, Heart of Midlothian, Hibernian, Inverness Caledonian Thistle, Kilmarnock, Motherwell, Rangers, St Johnstone and St Mirren.

As well as losing weight when they were on the 12-week programme, nearly 40% of men who participated in the programme maintained a weight loss of at least 5% of their original body weight 12 months later.

Co-author Prof Kate Hunt, from Glasgow University, said: "Weight management and dieting are often wrongly viewed as women's issues, meaning that some men do not want to take part in existing weight management programmes."

But given the right circumstances, men are also keen to slim, she says.

"Participants really enjoyed being with other men like them, with a shared interest in football and similar health issues to address. They loved having the opportunity to spend time at the club, using parts of the stadium that they couldn't ordinarily access.

"And they appreciated the chance to be encouraged, trained, and informed by the club's coaches. This model has real potential for the future."

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Night work 'throws body into chaos'

21 January 2014 Last updated at 08:09 ET By James Gallagher Health and science reporter, BBC News

Doing the night shift throws the body "into chaos" and could cause long-term damage, warn researchers.

Shift work has been linked to higher rates of type 2 diabetes, heart attacks and cancer.

Now scientists at the Sleep Research Centre in Surrey have uncovered the disruption shift work causes at the deepest molecular level.

Experts said the scale, speed and severity of damage caused by being awake at night was a surprise.

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The human body has its own natural rhythm or body clock tuned to sleep at night and be active during the day.

It has profound effects on the body, altering everything from hormones and body temperature to athletic ability, mood and brain function.

The study, published in Proceedings of the National Academy of Sciences, followed 22 people as their body was shifted from a normal pattern to that of a night-shift worker.

Continue reading the main story

"Start Quote

This really explains why we feel so bad during jet lag, or if we have to work irregular shifts"

End Quote Dr Simon Archer University of Surrey

Blood tests showed that normally 6% of genes - the instructions contained in DNA - were precisely timed to be more or less active at specific times of the day.

Once the volunteers were working through the night, that genetic fine-tuning was lost.

Chrono-chaos

"Over 97% of rhythmic genes become out of sync with mistimed sleep and this really explains why we feel so bad during jet lag, or if we have to work irregular shifts," said Dr Simon Archer, one of the researchers at the University of Surrey.

Fellow researcher Prof Derk-Jan Dijk said every tissue in the body had its own daily rhythm, but with shifts that was lost with the heart running to a different time to the kidneys running to a different time to the brain.

He told the BBC: "It's chrono-chaos. It's like living in a house. There's a clock in every room in the house and in all of those rooms those clocks are now disrupted, which of course leads to chaos in the household."

Continue reading the main story

Night shift tips from Twitter

Dave Tilley, who worked night shifts as a radio controller for an emergency doctor service, said: "I found the hardest part was a wall around 04:30. Strong coffee and Polo mints helped."

Wendy Smethurst, a doctor, said: "Have a dirty breakfast bap in the morning, sleeping tablet in the morning, shed loads of coffee, tea and chocolate. Also, getting to cuddle a new-born baby at 04:00 or see a baby born helps keep you awake."

Journalist Victoria Scott said: "Ear plugs and a visor. Vital for trying to sleep during light, noisy summer days with the windows open."

Philippa Perry said: "When I was working at McDonald's I tried to mend a toaster at 07:00 after I had been on all night. Forgot to unplug it. Shock threw me across room. Don't tackle or mend electrical appliances when you're tired."

Paramedic Rich Carter said: "Always listen to the shipping forecast around 01:00 as it means you are over halfway through the shift. I try never to miss it."

Studies have shown that shift workers getting too little sleep at the wrong time of day may be increasing their risk of type-2 diabetes and obesity.

Others analyses suggest heart attacks are more common in night workers.

Prof Dijk added: "We of course know that shift work and jet lag is associated with negative side effects and health consequences.

"They show up after several years of shift work. We believe these changes in rhythmic patterns of gene expression are likely to be related to some of those long-term health consequences."

Prof Hugh Piggins, a body-clock researcher from the University of Manchester, told the BBC: "The study indicated that the acute effects are quite severe.

"It is surprising how large an effect was noticed so quickly, it's perhaps a larger disruption than might have been appreciated."

He cautioned that it was a short-term study so any lasting changes are uncertain, but "you could imagine this would lead to a lot of health-related problems".

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Savile links with NHS home probed

21 January 2014 Last updated at 08:28 ET

The NHS is to investigate Jimmy Savile's connections with a former home for children recovering from illness.

Woodhouse Eaves Children's Convalescent Home in Leicestershire is the 33rd NHS organisation to come under review for links with the serial sex attacker.

Savile is believed to have abused hundreds of victims - many of them children.

Health Minister Norman Lamb said reports on Savile's links to NHS institutions should be ready by June.

Mr Lamb said the inquiry into Woodhouse Eaves - now closed - would be carried out by University Hospitals of Leicester NHS Trust.

The Trust said it believed "an incident may have occurred more than 40 years ago", and it would "thoroughly investigate the evidence".

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

A report by the Metropolitan Police and NSPCC said Savile had "used his celebrity status and fund-raising activity to gain uncontrolled access to vulnerable people across six decades".

Broadmoor, Stoke Mandeville and Leeds General Infirmary are among the NHS hospitals where investigations are already under way.

An independent inquiry into what the BBC knew about Savile is being led by Dame Janet Smith.

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Clegg attacks NHS mental health care

20 January 2014 Last updated at 01:02 ET By Michael Buchanan BBC News

Nick Clegg has launched a strong attack on how the NHS treats mental health patients.

In a BBC interview, the deputy prime minister said it was "just plain wrong" to treat the illness as the "poor cousin" of physical health in the NHS.

There remains, he says, "too much prejudice, too much discrimination" around the issue.

Mr Clegg was speaking ahead of a major conference at which the government will unveil its mental health strategy.

A poll from the charity, Time To Change, highlights some of the problems faced by patients.

Its survey of almost 5,000 people with mental health problems found:

• More than half said that stigma and discrimination associated with mental health was as bad or worse than the illness itself
• More than a quarter waited for over a year to tell their family about their problem
• Nearly a quarter of young people said discrimination and stigma stopped them going to school

Mr Clegg said: "There is too much ignorance, too much prejudice, too much discrimination.

"We've got to take this out of the shadows."

In an effort to do that, Mr Clegg is chairing a major conference on Monday in which he will unveil the government's mental health strategy.

Among the initiatives will be efforts to make it easier for people to continue to access mental health services once they reach adulthood.

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Melanie Denyer waited for more than six months to get treatment after a suicide attempt

'Suffered for too long'

At the moment, many young people with mental health illnesses have difficulty getting support once they reach 18.

Recent reports by BBC News and the online magazine Community Care have highlighted hospital beds being reduced and budget cuts for mental health trusts.

The deputy prime minister said both developments were "unacceptable".

"It is just plain wrong to treat mental health as the poor cousin to physical health in the NHS.

"There are too many parts of the country that have suffered for too long with commissioners in the NHS not providing mental health services with the same support as other parts of the NHS."

The government has made parity of esteem between physical and mental health a legal obligation in the NHS, but Nick Clegg admitted that getting true equality between the two would take time.

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Many adults have 'no-one to turn to'

19 January 2014 Last updated at 20:45 ET By Hannah Richardson BBC News education reporter

As many as a third of British adults feel they have no-one to turn to in a crisis, a survey has suggested.

Nearly three-quarters of those questioned online for the Red Cross said they had already been through a period of crisis in their lives.

And 37% thought they could suffer one again within the next five years.

The main worries for people as they get older were cited as being the loss of independence and not being able to cope on their own.

About a quarter of the 2,043 people surveyed were concerned they would not be able to get around in the same way, and would be lonely and isolated.

'Lasting impact'

A significant minority, about one in eight, said they felt those in the UK did not suffer crises in the same way as people in other countries.

The charity, which offers help and support in the UK as well as abroad, said support for the elderly would become "more vital" with an ageing population, shrinking budgets and health and social care services "struggling to meet demand".

The chief executive of the British Red Cross, Sir Nick Young, said: "We understand that every crisis is personal and can have a lasting impact on the individual affected.

"There are a growing number of people facing crisis in this country and our research shows over 30% of people would be reluctant to turn to a voluntary organisation because they are embarrassed to ask for help, or a fear of diverting resources."

A recent survey for the BBC suggested as many as half of all England's adults experienced feelings of loneliness.

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Hospital withholds death findings

20 January 2014 Last updated at 06:37 ET By Laura Devlin BBC News, East

A hospital where a girl bled to death has refused to publish the findings of its inquiry for fear of "endangering the mental health" of staff.

Victoria Harrison, 17, was found dead the day after an appendix operation at Kettering General Hospital in 2012.

Coroner Ann Pember later criticised the hospital over missed opportunities.

The hospital subsequently conducted a serious incident investigation but has revealed it will not be making the full report public despite an FoI request.

It claimed putting some of its findings into the public domain would risk staff identifying colleagues, who would then be put under "additional stress and pressure in addition to that already experienced during the investigation and inquest".

'Pain and bleeding'

The latest refusal was made in the hospital's response to a Freedom of Information (FoI) request by the BBC.

It was submitted after the hospital declined to comment on its action beyond a statement it released to the media after Miss Harrison's inquest last month.

The teenager, from Irthlingborough, had been an emergency referral by her GP on 14 August 2012, when she appeared to be suffering from appendicitis.

An artery was damaged during surgery, with the surgeon rectifying the issue.

Continue reading the main story

Section 38 of the Freedom of Information Act provides an exemption if disclosure would endanger any individual's mental health or safety.

It is a qualified exemption, meaning a public authority is under a duty to consider whether disclosure should nevertheless be made in the public interest.

The Information Commissioner states there should be evidence of a "significant risk" to the physical or mental health or the safety of any individual.

Factors in favour of disclosure include allowing individuals, companies and other bodies to understand decisions made by public authorities affecting their lives.

Source: Information Commissioner's Office

But Miss Harrison texted her boyfriend from her hospital bed to say she was in pain and bleeding later that day.

Not all nursing staff were aware of the bleed and some did not routinely read medical notes and could not always decipher surgeons' handwriting, the inquest heard.

Her last written formal observations were taken at 20:15 BST on 15 August, nine hours before she was found by nursing staff.

Ms Pember criticised the poor handover from theatre staff to the recovery nurse and in turn to the ward staff and the failure to carry out post-operative observations.

"Windows of opportunity to treat Victoria were lost - had these been acted upon the outcome may have been different," said the coroner.

"I believe her chances of survival would have significantly increased."

'Stress and pressure'

Kettering Hospital said at the time it had "strengthened guidance for hospital staff around post-operative care and observation/pain assessment" but would not comment further.

Asked under the Freedom of Information Act how many mistakes had happened, and when and where, it revealed 43 "care delivery problems" had been identified, six of which had a direct impact on the case.

It added: "The trust has undertaken a public interest test with regard to providing a chronology of events.

"It believes that Section 38 (1) (a) should be engaged as it is likely to endanger the mental health of individuals [staff] linked to the events leading up to the tragic death of Victoria Harrison, should the information be in the public domain.

"The reason for this is due to the risk of colleagues and peers being able to identify the individuals [staff] involved in the incident, and placing the individuals concerned under additional stress and pressure in addition to that already experienced during the investigation and inquest."

In response to a request for its investigation's recommendations, it said it had used the same section of the Act, for the same reason.

It also refused to reveal how many staff had been disciplined, or their rank, claiming individuals would be identified, but did reveal that no staff were dismissed.

Corby Labour MP Andy Sawford, whose constituents use the hospital, said: "I'm concerned that information about what went wrong hasn't been made available to the public.

"It is important to be transparent when things go wrong, and I will be raising my concerns with the hospital."

Miss Harrison's mother Tracey Foskett has previously told the BBC she did not want people to lose their jobs over her daughter's death.

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Sight restored to partially blind man

15 January 2014 Last updated at 20:55 ET By Pallab Ghosh Science correspondent, BBC News

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Jonathan Wyatt likened his blindness to being at the edge of an abyss

Surgeons in Oxford have used a gene therapy technique to improve the vision of six patients who would otherwise have gone blind.

The operation involved inserting a gene into the eye, a treatment that revived light-detecting cells.

The doctors involved believe that the treatment could in time be used to treat common forms of blindness.

Prof Robert MacLaren, the surgeon who led the research, said he was "absolutely delighted" at the outcome.

"We really couldn't have asked for a better result," he said.

BBC News exclusively reported on the start of the trial two years ago. The first patient was Jonathan Wyatt, who was 63 at the time.

Mr Wyatt has a genetic condition known as choroideremia, which results in the light-detecting cells at the back of the eye gradually dying.

Improved vision

Mr Wyatt was still just about able to see when he had the operation. His hope was that the procedure would stop further deterioration and save what little sight he had left.

He, like another patient in Professor MacLaren's trial, found that not only did the operation stabilise his vision - it improved it. The other subjects, who were at earlier stages in their vision, experienced improvements in their ability to see at night.

Mr Wyatt is now able to read three lines further down in an optician's sight chart.

"I felt that I had come to the edge of an abyss," he told BBC News.

"I looked down at total blackness. Professor MacLaren tapped me on the shoulder and said 'come this way, it's possible to see again'."

Mr Wyatt's wife, Diana, confirmed that the prospect of total blindness had made him feel very depressed.

"Now he is very optimistic," she explained.

"He is more independent, he can find things he couldn't before, he can go to the shops on his own and he's less of a nuisance!"

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Trees and flowers seemed much more vivid and I was able to see stars for the first time since I was 17 when my vision began to deteriorate"

End Quote Wayne Thompson Patient

Another of the patients who underwent the treatment, Wayne Thompson, said he had noticed an immediate effect after the operation.

Seeing stars

"My colour vision improved. Trees and flowers seemed much more vivid and I was able to see stars for the first time since I was 17 when my vision began to deteriorate," he told BBC News.

Mr Thomson said he had spent his life resigned to the fact that he would go blind.

"I've lived the last 25 years with the certainty that I am going to go blind and now (after the operation) there is the possibility that I will hang on to my sight," he said.

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A surgeon operates on the eye

When Mr Thompson was first diagnosed, he was told that he would not be able to see his daughter, who is now nine, grow up.

"Now I hope I'll see my grandchildren grow up," he told BBC News.

If the improvements seen in the patients continue, the aim will be to offer the treatment to younger choroideremia patients to prevent them from losing their sight.

The condition is relatively rare: it is thought to affect a thousand people in the UK.

But Professor MacLaren believes that success with choroideremia demonstrates the principle that gene therapy could be used to cure other forms of genetic blindness including age-related macular degeneration.

This condition causes blindness in 300,000 people in Britain and causes a deterioration in the vision of one in four people over the age of 75.

"The mechanisms of choroideremia and what we are trying to do with the treatment would broadly be applicable to more common causes of blindness," the professor explained.

"Choroideremia shows some similarities with macular degeneration in that we are targeting the same cells. We don't yet know which genes to target for macular degeneration but we do know now how to do it and how to put the genes back in."

Clara Aglen of the Royal National Institute of Blind People is also cautiously optimistic.

She told BBC News: "It is at an early stage at the moment, but it does offer hope for other conditions that have a genetic basis such as macular degeneration and glaucoma.

"As this process advances there is hope that it could be transferred across and provide a cure for these common causes of blindness."

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