Experts argue for drink price plan

31 August 2014 Last updated at 00:22

Health professionals say they are stepping up efforts to see alcohol minimum pricing in place in Scotland, with a seminar being held in Brussels.

Scottish Health Action on Alcohol Problems (SHAAP) will speak at the event, which will explore Scotland's alcohol policies, on 5 September.

Legislation to introduce a minimum unit price of 50p north of the border, was passed at Holyrood in 2012.

But a legal challenge to the policy has been referred to a European court.

A group led by the Scotch Whisky Association (SWA) and other European wine and spirits producers mounted a legal challenge to the Scottish government's plans, arguing that minimum pricing legislation breaches European law.

'Health case'

The SWA's legal bid was initially rejected by judge Lord Doherty at the Court of Session in Edinburgh last year.

Following an appeal hearing, judges at the court referred the case against the policy to the Court of Justice of the European Union.

Scottish ministers have said they are committed to introducing the policy in a bid to address the country's unhealthy relationship with drink.

SHAAP - a partnership of the Scottish Medical Royal Colleges and Faculties and the Royal College of Nursing - has hit out at what is sees as "the continued opposition by global alcohol producers to the implementation of Scotland's alcohol minimum unit pricing (MUP) policy".

Continue reading the main story

Initiatives in place seem to be working - alcohol-related harms and deaths have been falling in Scotland for many years."

End Quote Rosemary Gallagher Scotch Whisky Association

SHAAP said written opinions from EU member states may be made to the European Court, with the deadline for this being mid-October.

Representatives of the body will head to Brussels to "make the case for health" at the seminar.

The organisation will be joined by industry supporters of the policy, including C&C Group and the Scottish Licensed Trade Association (SLTA).

SHAAP director Eric Carlin said: "We need other member states and the Commission to support or at least not oppose the Scottish policy.

"MUP (minimum unit pricing) is opposed by a consortium of multi-national alcohol producers who, inaccurately, are framing this as a health v industry issue.

"Demonstrating the falseness of this claim, we have speakers from the Scottish alcohol industry who support this policy from an ethical position."

Dr Peter Rice, chair of the body, said a 10% increase in average minimum price in Canada was associated with a 32% drop in alcohol death rates.

"Changes in the price of alcohol are a key determinant in rates of alcohol harm," he said.

"This vitally important health policy will save Scottish lives and it needs to be implemented as a matter of urgency."

'Uneasy relationship'

Paul Waterson, chief executive of the Scottish Licensed Trade Association, said: "The SLTA is delighted to be involved in this very important seminar exploring Scotland's innovative alcohol policies.

"We fully support the most inventive of these, minimum unit pricing, and believe it to be a crucial element in trying to change Scotland's uneasy relationship with alcohol."

SWA spokeswoman Rosemary Gallagher, said: "Initiatives in place seem to be working - alcohol-related harms and deaths have been falling in Scotland for many years.

"It's important to debate the issues to identify the best ways to address the problem of alcohol misuse.

"It's therefore unfortunate that SHAAP continues to call for minimum unit pricing, the legality of which is being considered by the European Court, rather than focusing on steps that have been shown to be effective."

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Sunbed study highlights cancer risk

31 August 2014 Last updated at 00:28

Sunbed users are still at risk of skin cancer even if they do not burn their skin, according to a new study.

Researchers found sunbeds significantly increased the risk of a common type of skin cancer, which is caused by repeated tanning rather than burning.

Squamous cell carcinoma (SCC) accounts for 20% of skin cancers.

The academics, from Dundee University and Leiden University Medical Centre in the Netherlands, will present their findings at a conference in Edinburgh.

The researchers said warnings about sunbeds often focused on melanoma, which is associated with burning and accounts for just 1% of all skin cancers.

SCC is the second most common skin cancer, and is caused by repeated tanning.

UV levels

As part of the research, being presented this week at the World Congress on Cancers of the Skin in Edinburgh, it was calculated that an average sunbed user - who tans for 12 minutes every eight days between the ages of 20 and 35 - is 90% more likely to develop SCC by their 50s.

Although SCC is not as deadly as melanoma, it leads to around 500 deaths a year in the UK.

Continue reading the main story

One defence of the sunbed industry is that sunbeds do not increase your risk of skin cancer if you do not burn, however this study weakens this argument"

End Quote Nina Goad British Association of Dermatologists

In January 2013, the same researchers from Dundee published a study which measured ultraviolet (UV) radiation levels emitted by 400 sunbeds across England.

This showed that nine out of 10 sunbeds emitted UV levels above European safety limits.

This data on UV levels was used in the latest study, which also factored in the average length of sunbed sessions, and the number of sessions each year, as well as a person's cumulative UV exposure from the sun.

For high dose sunbeds the risk of SCC was increased by 180%. The sunbeds giving the lowest UV dose found in the 2013 study were linked to a 40% increased risk of developing SCC.

One of the study's authors, Prof Harry Moseley of the University of Dundee, said: "There is considerable variation in the output of artificial tanning units which people should be aware of.

"The results of our study indicate that the additional UV dose from sunbed use compared to normal day-to-day sun exposure potentially adds a significantly increased risk for development of SCC."

Nina Goad of the British Association of Dermatologists said: "While other types of skin cancer, such as melanoma, are linked to sunburn, SCC is caused by more chronic, long-term, cumulative sun exposure.

"One defence of the sunbed industry is that sunbeds do not increase your risk of skin cancer if you do not burn, however this study weakens this argument.

"It is something that people should be warned about, so they are fully informed of the risks when making choices about sunbed use."

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'Urgent' call for obesity taskforce

31 August 2014 Last updated at 08:41

Health leaders are calling for an emergency taskforce to be set up to tackle childhood obesity in England.

In an open letter to the chief medical officer for England, Prof Dame Sally Davies, they say "an entire generation is being destroyed by a diet of junk food and sugary drinks".

They want an action group, made up of doctors, nurses, dieticians, dentists and schools, to be set up urgently.

Currently, around one in three children under 15 are overweight or obese.

Continue reading the main story

"Start Quote

Many parents don't recognise their children are obese because many of them are obese themselves."

End Quote Dr Nigel Mathers Sheffield GP

The Royal College of General Practitioners and 11 other organisations signed the letter, which has been timed to coincide with the start of the new school year.

In it, health leaders call for better co-ordination of obesity treatment services so that all children can be encouraged to eat healthily from a young age.

They also call for a raft of other measures, including:

• increased support for the National Child Measurement Programme
• improved investment in IT programmes for weight management
• more training in malnutrition and obesity for GPs and other health professionals
• outreach projects to educate families about the dangers of obesity

The letter's signatories recommend setting up a national Child Obesity Action Group to tackle the problem.

'Lifetime of sickness'

Dr Rachel Pryke, clinical lead for nutrition at the RCGP, said a consistent national approach to treating obesity was needed.

"The nutritional patterns laid out in early years can define a child's health for life and the stark fact is that overweight children are being set up for a lifetime of sickness and health problems.

"As parents and health professionals, we need to take responsibility and ensure that every child has a healthy and varied diet and regular exercise."

She added: "Many schools are rising to the challenge and doing what they can in terms of education and outreach.

"Public Health England are already carrying out children measurement schemes and weight-prevention initiatives are widespread - but child obesity treatment provision is a postcode lottery with many areas having limited or no child obesity treatment services at all."

Dr Pryke said simply collating those figures was not enough and that a consistent response to these statistics was needed, right across the country.

Doctors leaders have also previously suggested banning adverts for fast food and introducing a tax on sugary drinks.

Generation in denial

Dr Nigel Mathers, a GP in Sheffield and a member of the RCGP, said there was a culture of denial among many of his patients.

"Many parents don't recognise their children are obese because many of them are obese themselves.

"Obesity is the new normal and we need a unified approach to manage it."

GPs say they are dealing with a generation of patients who may die before their parents.

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Jennifer Taylor explains how a health scare made her lose weight

Also, because few people associate weight with cancer, children are growing up with a range of health problems that could develop into serious lifelong illnesses, such as Type 2 diabetes.

Dr Helen Stokes-Lampard from the Royal College of GPs said: "These kids are going to turn into larger and larger adults, which means they are at much higher risk of serious heart disease, cancers, strokes, as they get older.

"But even more worrying is some of these children, children as young as seven, are developing diabetes - and the sort of diabetes associated with increased weight in middle age."

Continue reading the main story

"Start Quote

We need action now. We've got to start by doing proper monitoring of children's weight from birth and then every year of their lives."

End Quote Tam Fry National Obesity Forum

Tam Fry, chair of the Child Growth Foundation and spokesperson for the National Obesity Forum, says the emphasis should be on stopping children getting fat in the first place.

He is sceptical that "another committee sitting around" will do much good.

"We need action now. We've got to start by doing proper monitoring of children's weight from birth and then every year of their lives - and this has to happen through the GP.

"Then GPs should be talking to them about their weight and acting on it."

A Department of Health spokesperson said: "Tackling obesity is one of our major priorities, but there is no magic bullet to solve the problem, and everyone has a role to play. We know that childhood obesity is at its lowest since 1998 but more should be done. The government is not considering a sugar tax."

The Department of Health added that the Chief medical officer would formally respond to the letter in due course.

Obesity in numbers

The latest figures, from the 2012 Health Survey for England, show that 14% of children aged two to 15 were obese and 28% were classed as overweight or obese.

Those aged 11 to 15 were more likely to be obese with one in five children placed in that category.

In children aged two to 10, 10% of both boys and girls were obese.

So with nearly one-third of children aged two to 15 classed as overweight or obese, the Royal College of Paediatrics and Child Health estimates that the problem is costing the NHS around £4.2bn a year.

It also says children living in the poorest areas of the country are almost twice as likely to be obese compared to those in the most affluent areas when they are at primary school.

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Test Ebola drug '100% effective'

29 August 2014 Last updated at 18:00 By James Gallagher Health editor, BBC News website

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BBC's Tim Allman reports

The only clinical trial data on the experimental Ebola drug ZMapp shows it is 100% effective in monkey studies, even in later stages of the infection.

The researchers, publishing their data in Nature, said it was a "very important step forward".

Yet the limited supplies will not help the 20,000 people predicted to be infected during the outbreak in West Africa.

And two out of seven people given the drug, have later died from the disease.

ZMapp has been dubbed the "secret serum" as it is still in the experimental stages of drug development with, until now, no public data on effectiveness.

Doctors have turned to it as there is no cure for Ebola, which has killed more than 1,500 people since it started in Guinea.

Cocktail

Researchers have been investigating different combinations of antibodies, a part of the immune system which binds to viruses, as a therapy.

Previous combinations have shown some effectiveness in animal studies. ZMapp is the latest cocktail and contains three antibodies.

Trials on 18 rhesus macaques infected with Ebola showed 100% survival.

This included animals given the drug up to five days after infection. For the monkeys this would be a relatively late stage in the infection, around three days before it becomes fatal.

Scientists say this is significant as previous therapies needed to be given before symptoms even appeared.

One of the researchers, Dr Gary Kobinger from the Public Health Agency of Canada, said this was a huge step up from previous antibody combinations.

"The level of improvement was beyond my own expectation, I was quite surprised that the best combination would rescue animals as far as day five, it was fantastic news.

"What was very exceptional is that we could rescue some of the animals that had advanced disease."

Human implications?

However, there is always caution when interpreting the implications for humans from animal data.

A Liberian doctor, one of three taking the drug in the country, and a Spanish priest both died from the infection despite ZMapp treatment.

William Pooley, the first Briton to contract Ebola during this outbreak, has been given the experimental drug ZMapp as were two US doctors who recovered.

The course of the infection is slower in humans than macaques so it has been cautiously estimated that ZMapp may be effective as late as day nine or 11 after infection.

But Dr Kobinger said: "We know there is a point of no return where there is too much damage to major organs, so there's a limit."

The group wants to start clinical trials in people to truly assess the effectiveness of the drug.

Commenting on the findings, Prof Jonathan Ball, a virologist at the University of Nottingham, told the BBC: "Before, ZMapp was a total mystery.

"This is an incredible improvement on those earlier cocktails, to have 100% clearance and most importantly that clearance when they've started to show outward signs of infection."

Referring to the seven treated patients, he added: "Clearly there is the caveat that all evidence in humans is anecdotal and no hard evidence has been released on what happens to the virus in those patients."

Prof Peter Piot, the director of the London School of Hygiene and Tropical Medicine, said: "I never thought that 40 years after I encountered the first Ebola outbreak, this disease would still be taking lives on such a devastating scale.

"This well designed trial in non-human primates provides the most convincing evidence to date that ZMapp may be an effective treatment of Ebola infection in humans.

"It is now critical that human trials start as soon as possible. "

Ebola Virus Disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Spread by body fluids, such as blood and saliva
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

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Post-natal care lacking, say midwives

29 August 2014 Last updated at 14:59

A survey by the Royal College of Midwives suggests that up to 40% of women may be being discharged from hospital before they are ready after having a baby.

The report, entitled Postnatal care planning, says the needs of women and babies after birth are not being met.

More midwives are required to ensure women get the post-natal visits they need, the RCM says.

Surveys of mothers and midwives were used to compile the report.

The RCM surveyed more than 2,000 midwives, 950 student midwives and 98 maternity support workers to find out their views on post-natal care.

Sixty-five per cent of midwives surveyed said the number of post-natal visits was determined by organisational pressures rather than women's needs.

This is contrary to official guidelines from the National Institute for Health and Care Excellence (NICE), the RCM says.

Continue reading the main story

Women are not getting the best possible post-natal care"

End Quote Cathy Warwick Royal College of Midwives

'Massive impact'

Cathy Warwick, chief executive of the Royal College of Midwives, said this had an impact on the care women received.

"The continuing shortage of midwives particularly in post-natal care and the need to ensure cover for women in labour means that organisational needs are preventing midwives giving care based on clinical need and women are not getting the best possible post-natal care.

"This can have a massive impact on the health and well-being of the mother and her baby after the birth and well into the future."

Midwives also say that there is often not enough time to give women all the information they would like to about post-natal care.

In the survey, only a third of midwives and maternity support workers said they had enough time to talk to women about their post-natal care.

The report also highlights the views of nearly 500 women in the UK who were surveyed via the Netmums website in 2013. Around 40% felt they had been discharged too quickly, a figure the RCM described as "a real concern".

NICE recommends that the "length of stay in a maternity unit should be discussed between the individual woman and her healthcare professional, taking into account the health and well-being of the woman and her baby and the level of support available following discharge".

Cathy Warwick said: "We are seeing women being discharged earlier without adequate support. This leads to readmissions later on and more cost to the NHS.

"This is a false economy. It is not good for women and babies and it is not good for the NHS."

The report is the fourth in a five-part series from the Royal College of Midwives looking at post-natal care.

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Missing boy's 'life is in danger'

29 August 2014 Last updated at 18:06

The health of a five-year-old boy taken from hospital by his parents against medical advice will deteriorate rapidly as the battery on his feeding system is likely to have run out, police said.

Ashya King, who has a brain tumour, was taken from Southampton General Hospital and was last seen on a ferry to France.

He was allowed to leave the ward under the supervision of his parents.

It has also been confirmed the family are Jehovah's Witnesses, but there is no suggestion this is why he was taken.

Brett King, 51, and Naghemeh King, 45, removed him from the ward on Thursday.

Assistant Chief Constable of Hampshire Chris Shead, said Ashya was fed through a battery operated tube and the battery was likely to have expired.

While information had placed the family in France, he said: "By now, we cannot be certain they have not moved on".

A spokesman for the hospital, which contacted police six hours after they left, said: "Ashya was a long-term patient who was permitted to leave the ward under the supervision of his parents as part of his ongoing rehabilitation.

"When the length of time he had been absent became a cause of concern to staff yesterday afternoon they contacted police after a search of the site and attempts to contact the family were unsuccessful."

Interpol has issued a missing persons alert to all 190 of its member countries. It was "treating all incoming information relating to the case as high priority", it said.

Earlier, Mr Shead said "time was running out" for Ashya.

"It is vital that we find Ashya today, his health will deteriorate," he said.

"If he doesn't receive urgent medical care, or the wrong treatment is given, his condition will become life-threatening.

"If Naghemeh or Brett or any of their children see or hear this appeal please take Ashya to the nearest hospital."

Mr Shead said they were told by the hospital the youngster was missing at 20:35 BST on Thursday - more than six hours after he had been taken by his parents.

On why the hospital did not alert police sooner, he said: "That is something that we need to look at."

Officers were keeping an "open mind" on the motives behind Ashya being taken, Mr Shead said.

The Office of Public Information for Jehovah's Witnesses said in a statement: "There is absolutely no indication, as far as we are aware, that their decision is in any way motivated by any religious convictions."

Checking hotels

"Jehovah's Witnesses are encouraged to seek the best medical treatment for themselves and their children," it added.

It is believed Ashya's parents and six siblings boarded a cross-Channel ferry from Portsmouth to Cherbourg at 16:00 BST and arrived at 20:00.

Police said Ashya, who recently had surgery, cannot communicate verbally and is immobile. He is likely to be in a wheelchair or buggy.

Becky Kelly, BBC News

According to Ian Pople, a consultant neurosurgeon, the battery in the feeding machine used by Ashya can't be changed easily.

It is integrated within the machine, much like an iPhone, and it means the machine has to be taken apart to replace the battery.

It's also not designed to be run on batteries for a long period and is usually plugged into mains.

In other words, it's only battery-reliant for short periods, such as going to the toilet, or moving between wards.

Cherbourg Police has confirmed it is searching locally for Ashya, checking hotels and CCTV.

But vice-prosecutor Cyril Fournier said: "They may have stayed in Cherbourg, but they may be 500km from here, it's like looking for a needle in a haystack."

An image of Ashya being wheeled out of the hospital by his father has been released by police.

The force said it was working with police in France to activate emergency child rescue alert procedures.

The family, from Southsea, Hampshire, were travelling in a grey coloured Hyundai I800 Style CRDI, registration KP60 HWK.

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Asst Chief Constable Chris Shead: "It is vital that we find Ashya today"

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Naveed King spoke about his brother's illness in a video posted on YouTube

Det Supt Dick Pearson, of Hampshire Constabulary, said: "If we do not locate Ashya today there are serious concerns for his life.

"He is receiving constant medical care within the UK due to recent surgery and ongoing medical issues. Without this specialist 24 hour care, Ashya is at risk of additional health complications which place him at substantial risk.

"He needs to be taken to a medical facility for his urgent health requirements as soon as he is located."

Clive Coleman, BBC legal correspondent

Parents have the right to remove their children from hospital unless they are prevented from doing so by a court order - it has not been confirmed whether Ashya was subject to an order.

If doctors are concerned that parents intend to remove a child, deny it the medical treatment it needs, and expose it to the risk of serious harm, they can seek a court order.

This will normally involve CAFCASS (the Children and Family Court Advisory and Support Service), the non-departmental public body which provides guardians to represent the best interests of children in family court proceedings.

Once an order is in place, any parent who removes their child in breach of the order is committing a contempt of court for which they could be imprisoned.

Police have launched a social media appeal and are urging people to share it, particularly with friends or relatives in France and bordering countries.

Ashya's paternal grandmother, Patricia King, said his parents were "wonderful" and had been left beside themselves at their child's plight.

Speaking from her home in Southsea, she said of her son: "He's the most caring and wonderful father you could ever have. The kids love him."

She praised her daughter-in-law, saying she had kept a bedside vigil while Ashya was in hospital.

She said she did not know whether Ashya's illness was terminal, saying: "I knew he was seriously ill, we all knew that."

Ashya's brother Naveed King posted a YouTube video on 23 July speaking about the five-year-old's illness.

He said: "I haven't slept anything really, I've been awake all night worrying.

"Everyone is sending their love now. We love you so much and we want to see you very soon and I love you so much and can't wait to see you.

"No kid at the age of five deserves to have a brain tumour."

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Plain packs 'no illegal smoking link'

29 August 2014 Last updated at 01:15

A study of smokers in Australia suggests there is "no evidence" that the introduction of 'plain' cigarette packaging has changed the way people buy cigarettes.

Researchers writing in BMJ Open found no increase in the use of illegal tobacco and no sign of cheaper brands flooding the market.

They surveyed 2,000 smokers before and after the laws came into force in 2012.

Tobacco companies said the survey was limited and not statistically robust.

Continue reading the main story

"Start Quote

The comprehensive KPMG report published earlier this year, clearly shows a significant increase in illicit tobacco across Australia."

End Quote Tobacco Manufacturers' Association

The study, from the Centre for Behavioural Research in Cancer in Melbourne, also found no evidence of small retailers, such as newsagents, convenience stores and corner shops, being hurt by the change.

Opponents of 'plain' or standardised packaging in Australia and the UK, such as the tobacco industry, had previously predicted that this would happen.

Standardised packaging of tobacco products was introduced in Australia in December 2012. It was the first country in the world to do so.

Since then, all tobacco products have to be sold in standardised dark brown packaging with large graphic health warnings. There are no tobacco industry logos, brand imagery, colours or promotional text on the packaging. Brand and product names are printed in small text.

'Very low'

Study participants were identified using an annual health survey of adults from the Australian state of Victoria.

They were contacted by phone towards the end of 2011, 2012 and 2013 and asked specific questions about their cigarette purchasing habits.

In all years, the use of low-cost Asian brands among regular smokers was found to be "very low" at under 2%. This figures did not significantly increase between 2011 and 2013.

The percentage of smokers who had bought unbranded illegal tobacco in the past 12 months was found to be between 4 and 5%, which did not change significantly between 2011 and 2013.

In 2013, 2.6% of smokers said they had bought at least one pack of cigarettes which was not packaged according to the new legislation in the past three months.

But the study said there were "too few cases to estimate percentages" of those buying contraband over a three-month period.

Contrasting view

Simon Clark, director of the smokers' group Forest which runs the Hands Off Our Packs campaign, said other reports had come to different conclusions.

"A KPMG report found clear evidence that illicit trade has grown since the introduction of plain packaging in Australia. That report was based on hard data not anecdotal evidence.

"A recent investigation by a national newspaper suggested that criminal gangs in the Far East can't wait to profit from increased sales of counterfeit cigarettes in the UK if plain packaging is implemented here."

Continue reading the main story

"Start Quote

The findings should reassure the UK government that standardised packaging makes it a policy whose time has come."

End Quote Hazel Cheeseman Action on Smoking and Health

The KPMG report was commissioned by British American Tobacco Australia, Imperial Tobacco Australia and Philip Morris to estimate the consumption of illicit tobacco in Australia.

A spokesperson from the Tobacco Manufacturers' Association referred to the same KPMG report.

"The comprehensive KPMG report published earlier this year, clearly shows a significant increase in illicit tobacco across Australia since the implementation of plain packaging, costing the Australian Treasury around A$1bn in lost taxes.

"The limited telephone survey published in the BMJ only covers one Australian state and does not provide a statistically robust assessment of the impact on the illicit market and retail trade."

However, Hazel Cheeseman, director of policy and research at Action on Smoking and Health (ASH), said the study provided proof that the tobacco industry's claims about the effect of standardised packaging "are just not true".

"Standardised packaging is helping to cut smoking in Australia. The findings should reassure the UK government that standardised packaging makes it a policy whose time has come."

New legislation

In April, the UK government agreed to introduce plain cigarette packaging after an independent report concluded it was "very likely to have a positive impact" on public health and stop children from starting to smoke.

But, at present, the Department of Health in England has not yet made a final decision on whether plain packaging will be implemented.

The latest consultation on packaging will apply to England and Wales. Northern Ireland has indicated it will follow suit with any legislation and Scotland already has plans to introduce plain packaging,

Campaigners are urging the government to speed up plans to ban branded cigarette packets.

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New hospital food rules introduced

29 August 2014 Last updated at 08:09 By James Gallagher Health editor, BBC News website

Hospitals in England will be expected to provide a higher standard of food under new measures being announced by the health secretary.

The new standards, enforced through legally-binding NHS contracts, will focus on quality, choice and promoting a healthy diet for patients and staff.

Hospitals will also be ranked on the meals they prepare.

The Campaign for Better Hospital Food said the changes were "woefully inadequate" and hard to enforce.

NHS hospitals in Scotland and Wales have nutritional standards in place.

'Very vulnerable'

Under the changes, hospitals will be ranked according to quality and choice of food, whether the menu is approved by a dietitian, the availability of fresh fruit and food between meals, the variety of options at breakfast - which should include warm food, and the cost of the food provided.

The rankings will be published on the NHS Choices website.

The new standards will require hospitals to provide:

• Fish twice a week
• Seasonal produce
• Tap water
• Cooked rice, potatoes and vegetables without salt
• Half of all desserts should be fruit
• Half of tea and coffee should be Fair Trade

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Inside Darlington Memorial Hospital's award-winning kitchen

Patients will be assessed for malnutrition when they are admitted and there will also be a greater responsibility placed on staff to ensure patients are well-fed.

The chairman of charity of Age UK, Dianne Jeffrey, has been working with the Department of Health to produce the new NHS standards for England.

She acknowledged that "hospitals are not five-star restaurants," but said meals were an important part of a patient's recovery.

Ms Jeffrey said there had been reports of patients being unable to feed themselves or even reach a glass of water.

She told the BBC: "When a person is in hospital they are in a very vulnerable state.

"It's very important that the food is attractive, it's appetising, it's palatable, it's nutritious, it meets the cultural and social needs of patients and also meets their clinical needs."

'Wet sandwiches'

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Patient Michael Seres: "No clinician has ever advised me to eat the hospital food"

Michael Seres, from Radlett in Hertfordshire, has been a regular hospital patient for 30 years after being diagnosed with Crohn's disease when he was 12.

He says his worst experiences include macaroni cheese containing just four pieces of pasta, ice cream kept on top of hot food and sandwiches so wet "you could wring out the sandwich".

He said: "No doctor or clinician has ever advised me to eat the hospital food.

"If airlines can cope with multiple types of food that needs to be served for varying conditions or allergies, then hospitals can cater for it. Schools do, prisons do, on the high street restaurants and shops do, so why should it be any different in a hospital?"

Readers' pictures of hospital food

BBC News: Readers' photos of grim hospital food

'Woefully inadequate'

But the Campaign for Better Hospital Food said the government had "pulled the wool over our eyes".

Alex Jackson, the campaign's co-ordinator said: "We want to see hospital food standards set down in legislation, similarly to school food standards, and therefore universally applied to all hospitals and protected by publicly elected representatives for generations to come.

"But the government still refuses to do this and has only committed to including the standards in NHS commissioning contracts, which are long documents full of clauses that without proper enforcement and monitoring can be ignored by hospitals.

"The government may have inserted a new clause in a legal document, but that won't be what most people consider to be legally-binding. It's woefully inadequate."

Robin Ireland, also a representative for the campaign, echoed Mr Jackson's sentiments, and said that some hospitals were currently delivering good food, but he wanted to see them all use fresh, local produce not just a few.

Labour described campaigners' concerns as "worrying", and said it was "regrettable" that Health Secretary Jeremy Hunt had published the standards without first consulting patients.

"Everyone wants to see the quality of hospital food improved, but without proper enforcement there is a risk that these new standards will simply be ignored," shadow public health minister Luciana Berger added.

However, Mr Hunt told the BBC that the NHS guidelines would be "treated very seriously" and "hospitals will be obliged" to apply the guidelines.

He added: "All of this is about looking after patients in the same way you would want your own friends or you own family to be looked after."

The chief executive of NHS England, Simon Stevens, said: "It is time for the NHS set a clear example in providing healthier food for our patients, visitors and also our hard-working staff. That's why NHS England has agreed to include hospital standards in the next NHS Contract, which will be published later this year."

The Scottish government introduced minimum nutrient and food provision standards in 2008.

And standards based on those developed in Scotland were adopted by Wales in 2011.

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Police fear for health of sick boy

29 August 2014 Last updated at 13:57

The health of a five-year-old boy taken from hospital by his parents against medical advice will deteriorate rapidly as the battery on his feeding system runs out later, police said.

Ashya King was taken from Southampton General Hospital and is now believed to be in France with his family.

He was allowed to leave the ward under the supervision of his parents.

It has also been confirmed the family are Jehovah's Witnesses, but there is no suggestion this is why he was taken.

Brett King, 51, and Naghemeh King, 45, removed him from the ward on Thursday.

A spokesman for the hospital, which contacted police six hours after they left, said: "Ashya was a long-term patient who was permitted to leave the ward under the supervision of his parents as part of his ongoing rehabilitation.

"When the length of time he had been absent became a cause of concern to staff yesterday afternoon they contacted police after a search of the site and attempts to contact the family were unsuccessful."

Speaking at a news conference, Assistant Chief Constable Chris Shead said "time was running out" for Ashya.

"It is vital that we find Ashya today, his health will deteriorate," he said.

Mr Shead said Ashya was in a wheelchair and needed to be fed through a tube which is battery operated and the battery will run out today.

"If he doesn't receive urgent medical care, or the wrong treatment is given, his condition will become life-threatening.

"If Naghemeh or Brett or any of their children see or hear this appeal please take Ashya to the nearest hospital."

Mr Shead said they were told by the hospital the youngster was missing at 20:35 BST on Thursday - more than six hours after he had been taken by his parents.

On why it took six hours for the hospital to alert police, he said: "That is something that we need to look at."

Officers were keeping an "open mind" on the motives behind Ashya being taken, Mr Shead said.

The Office of Public Information for Jehovah's Witnesses said in a statement: "There is absolutely no indication, as far as we are aware, that their decision is in any way motivated by any religious convictions.

Checking hotels

"Jehovah's Witnesses are encouraged to seek the best medical treatment for themselves and their children," it added.

It is believed Ashya's parents and six siblings boarded a cross-Channel ferry from Portsmouth to Cherbourg at 16:00 BST and arrived at 20:00.

Police said Ashya, who recently had surgery, cannot communicate verbally and is immobile. He is likely to be in a wheelchair or buggy.

Cherbourg Police has confirmed it is searching locally for Ashya, checking hotels and CCTV.

An image of Ashya being wheeled out of the hospital by his father has been released by police.

The force said it was working with police in France to activate emergency child rescue alert procedures.

The family, from Southsea, Portsmouth, were travelling in a grey coloured Hyundai I800 Style CRDI, registration KP60 HWK.

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Asst Chief Constable Chris Shead: "It is vital that we find Ashya today"

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Naveed King spoke about his brother's illness in a video posted on Youtube

Det Supt Dick Pearson, of Hampshire Constabulary, said: "If we do not locate Ashya today there are serious concerns for his life.

"He is receiving constant medical care within the UK due to recent surgery and ongoing medical issues. Without this specialist 24 hour care, Ashya is at risk of additional health complications which place him at substantial risk.

"He needs to be taken to a medical facility for his urgent health requirements as soon as he is located."

Clive Coleman BBC legal correspondent

Parents have the right to remove their children from hospital unless they are prevented from doing so by a court order.

If doctors are concerned that parents intend to remove a child, deny it the medical treatment it needs, and expose it to the risk of serious harm, they can seek a court order.

This will normally involve CAFCASS (the Children and Family Court Advisory and Support Service), the non-departmental public body which provides guardians to represent the best interests of children in family court proceedings.

Once an order is in place, any parent who removes their child in breach of the order is committing a contempt of court for which they could be imprisoned.

Police have launched a social media appeal and are urging people to share it, particularly with friends or relatives in France and bordering countries.

Ashya's brother Naveed King posted a YouTube video on 23 July speaking about the five-year-old's illness.

He said: "I haven't slept anything really, I've been awake all night worrying.

"Everyone is sending their love now. We love you so much and we want to see you very soon and I love you so much and can't wait to see you.

"No kid at the age of five deserves to have a brain tumour."

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Ebola vaccine to be tested in UK

28 August 2014 Last updated at 13:18 By Smitha Mundasad Health reporter, BBC News

A test vaccine against Ebola could be given to healthy volunteers in the UK in September, according to an international health consortium.

The trial will start as soon as ethical approval is granted, experts at the Wellcome Trust say.

If the vaccine works well, the study will extend to The Gambia and Mali.

The World Health Organization (WHO) says the virus could affect 20,000 people during this outbreak which is expected to continue for many months.

Global outbreak

The latest figures show that more than 1,550 people have died from the virus, with more than 3,000 confirmed cases - mostly in Guinea, Liberia and Sierra Leone.

Researchers hope the vaccine will prevent people from catching the disease in these countries, but will first test the medicine in unaffected populations.

The vaccine consists a single Ebola virus protein which triggers an immune response once it enters the body - but they say this cannot cause anyone who is given it to become infected.

In the first part of the study it will be trialled on 60 healthy volunteers and if shown to be safe and working well it will then be administered to 80 volunteers in The Gambia and Mali.

The vaccine could then start to be offered more widely in affected countries during 2015.

'Future epidemics'

Dr Jeremy Farrar, director of the Wellcome Trust, said: "This epidemic has shown how difficult it can be to control Ebola.

"How useful drugs and vaccines might be in complementing existing public health interventions can only be assessed in epidemics.

"The initial safety work we're announcing with our international partners will hopefully make that possible during this crisis and for inevitable future epidemics."

Dr Moncef Slaoui, at GlaxoSmithKline, the company working on the vaccine, said: "Developing a new vaccine is complex with no guarantees of success and it is still early days for our Ebola vaccine candidate.

"But we are encouraged by progress so far and will do the best we can, along with WHO and our partners, to speed up development and explore ways in which the vaccine could contribute to the control of this or future Ebola outbreaks."

The vaccine study, led by scientists at the University of Oxford, is planned to run alongside similar trials in the United States.

The Wellcome Trust, the UK Department for International Development and the Medical Research Council are providing a £2.8m grant for this project.

Ebola Virus Disease (EVD)

• Symptoms include high fever, muscle pain, bleeding and intense weakness
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• The virus is spread through close contact with the bodily fluids of infected individuals
• There is no proven vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

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Depression in cancer 'overlooked'

28 August 2014 Last updated at 01:36 By Smitha Mundasad Health reporter, BBC News

Three-quarters of cancer patients who are clinically depressed do not get the psychological therapy they need, according to research in the Lancet.

This "huge unmet need" is partly due to a focus on physical symptoms at the expense of good mental healthcare, researchers say.

They argue depression is often overlooked but could be treated at a fraction of the cost of cancer drugs.

Charities say the current situation is "heartbreaking".

Continue reading the main story

It is heartbreaking to think cancer patients who are already dealing with the toughest fight of their lives are also struggling with depression, without adequate support"

End Quote Jacqui Graves Macmillan Cancer Support

'Persistent sadness'

People often wrongly assume that major depression is part of a natural reaction to cancer - but this is much more than transient sadness, the Edinburgh and Oxford university researchers say.

Their report suggests a new nurse-led treatment could help thousands of people.

In a series of studies they analysed data on 21,000 cancer patients living in Scotland.

They found 6% to 13% of people had clinical depression, compared with just 2% of the general population at any time.

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Cancer survivor Sonia Wilson said cancer made her feel "like a burden to society"

Sufferers of major depression feel persistently low, may find it difficult to sleep and have poor appetites.

But researchers found 75% of people reporting these symptoms were not receiving treatment, partly because they did not consider seeking help and professionals did not pick up on their illness.

The reports also show that, even when given a diagnosis and standard NHS treatment, the majority did not feel better.

Scientists say a new nurse-led approach designed specifically for patients with cancer can substantially reduce depressive symptoms.

In their study of about 500 patients, the therapy halved the depression scores of more than 60%.

Patients reported they were less anxious, less fatigued and experienced less pain.

Only 17% of those who had standard NHS care had similar results.

'Profound impact'

In contrast the new intensive, tailored approach is delivered by a trained cancer nurse and involves the wider medical team.

It includes:

• antidepressant drugs
• encouraging patients to become as active as they can be
• problem-solving therapy

Researchers argue that if their programme were rolled out widely it could improve the quality of life for thousands of people.

Their final paper suggests the therapy improves quality of life, regardless of how good a patient's prognosis is.

Dr Stefan Symeonides, of the University of Edinburgh, said: "Day-to-day oncologists like myself see the profound impact depression can have on a patient with cancer."

He added: " [This is] a huge area of unmet need missed by current practice."

Researchers say the therapy costs around £600 per patient.

Jacqui Graves, of the Macmillan Cancer Support charity, said: "It is heart-breaking to think cancer patients who are already dealing with the toughest fight of their lives are also struggling with depression, without adequate support.

"Anyone experiencing depression should get in touch with their GP."

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NHS complaints rise to 480 every day

28 August 2014 Last updated at 10:38

The number of complaints made about NHS care in England increased to an average of 480 every day, official data shows.

The Health and Social Care Information Centre (HSCIC) figures on written complaints showed an 8% rise in 2013-14, compared with the previous year.

The complaints cover all aspects of the NHS from hospitals and GPs to dental practices and ambulances.

However, a patients' watchdog said the official figures were just the tip of the iceberg.

In the year 2013-14 a total of 174,900 complaints were made about the NHS. It compared to 162,019 the previous year and 131,022 in the 2007-08 financial year.

The most complaints - 34,400 - were focused on inpatient hospital care.

The largest percentage increase in complaints was for ambulance crews - up 28.5% to 5,700.

'Pay close attention'

Kingsley Manning, the chairman of the HSCIC, said: "Our latest figures show that the NHS is receiving a large number of written complaints each day.

"Today's report also shows a rise over the last year in the number of written complaints made against NHS hospitals and community services.

"I'm sure staff who manage NHS complaints will want to pay close attention to these statistics."

The patients' watchdog Healthwatch England said most people do not report poor care.

A survey by the body suggests there were 500,000 unreported cases of unsatisfactory patient care across the NHS in the past two years.

Anna Bradley, the chairman of Healthwatch England, said: "The report out today really is just the tip of the iceberg when it comes to complaints about health and social care services in this country.

"The need to improve the way the complaints system operates is well documented and we have been working with the government to simplify the often baffling process for patients and their families.

"But for things to work properly, health professionals clearly need to do more to make people feel less intimidated about making their voices heard."

A Department of Health Spokesperson said: "We welcome the fact that more people have felt able to raise their concerns with hospital trusts, as listening to patients is one of the best ways to improve standards and this has been a priority in the wake of the appalling events at Mid Staffs."

They called for a "culture of openness" in hospitals where it was clear how patients could complain.

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Hormone 'protects premature babies'

27 August 2014 Last updated at 09:01 By Helen Briggs Health editor, BBC News website

The hormone erythropoietin (EPO) could prevent brain injuries in very premature babies, a study suggests.

Brain scans show EPO - used illegally by athletes to boost performance - may help infants when given after birth.

The study, published in the Journal of the American Medical Association, involved almost 500 babies born between 26 and 31 weeks in Switzerland.

The researchers are calling for wider trials of the hormone, which is already given to some babies to treat anaemia.

Erythropoietin is a hormone that stimulates production of red blood cells.

Continue reading the main story

This is the first time that the beneficial effect of the EPO hormone on the brains of premature babies has been shown"

End Quote Dr Russia Ha-Vinh Leuchter University of Geneva

Synthetic EPO is used to treat conditions such as anaemia, where there are fewer red blood cells than normal.

It may also be given to premature babies to reduce the need for blood transfusions.

In the Swiss study, a team at the University Hospital of Geneva found that premature infants had a reduced risk of brain injury, as assessed by brain scans, when given three doses of EPO shortly after birth.

Babies given EPO had lower rates of injury to both the brain's white matter (22% compared with 36% in the control group) and the grey matter (7% versus 19%).

"We found that the brains of the children who had received the treatment had much less damage than those in the control group, who had been given a placebo," said Dr Russia Ha-Vinh Leuchter, co-researcher of the study.

"This is the first time that the beneficial effect of the EPO hormone on the brains of premature babies has been shown."

Further review

The researchers are calling for wider clinical trials of EPO to see if it may help protect the brains of premature babies in the critical weeks after birth.

Dr Jane Hawdon, a consultant neonatologist at Barts Health NHS Trust, who was not involved with the study, said any treatment that may reduce long term problems in preterm babies warranted further review.

"We should note that the authors are not recommending immediate inclusion of this treatment into routine practice," she said.

"It is also important to note that the majority of preterm babies do not sustain significant brain injury."

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Nigeria closes schools over Ebola

27 August 2014 Last updated at 14:34

All schools in Nigeria have been ordered to remain shut until 13 October as part of measures to prevent the spread of the deadly Ebola virus.

The new academic year was due to start on Monday.

But the education minister ordered the closures to allow staff to be trained on how to handle suspected Ebola cases.

Five people have died of Ebola in Nigeria. The West Africa outbreak has centred on Guinea, Liberia and Sierra Leone, killing more than 1,400 people.

It is the largest ever outbreak and has infected an estimated 2,615 people. About half of those infected have died.

Continue reading the main story

There are many other diseases right now not being attended to because Ebola has overstretched the capacity of the health sector"

End Quote Donald Kaberuka AFDB president

It spread to Nigeria - Africa's most populous country - in July, when a man infected with Ebola flew from Liberia to Lagos.

The head of the African Development Bank (AFDB), Donald Kaberuka, has called on airline companies to restart their services to the worst-affected countries.

Several African countries and airlines have banned flights to Guinea, Liberia and Sierra Leone despite World Health Organization (WHO) advice that travel bans do not work.

The virus is not airborne and is spread between humans through direct contact with infected bodily fluids.

"It is very important that as you combat Ebola, we also continue to ensure that ordinary economic activity is not disputed," Mr Kaberuka told BBC Africa on a visit to Sierra Leone.

'Cataclysmic'

The Nigerian government says it hopes its efforts to contain the virus are working, as there is only one confirmed case of Ebola remaining.

"All state ministries of education are to immediately organise and ensure that at least two staff in each school, both private and public, are trained by appropriate health workers," said Education Minister Ibrahim Shekarau.

Mr Kaberuka said the AFDB had signed an agreement with the WHO to quickly release $60m (£36m) of funds to help with the immediate fight against Ebola.

He described the situation as "cataclysmic" as many health workers were being infected with Ebola.

"It is decimating the health sector," he said.

"There are many other diseases right now not being attended to because Ebola has overstretched the capacity of the health sector."

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The current outbreak is the deadliest since Ebola was discovered in 1976

On Tuesday, the WHO said the "unprecedented" number of doctors and nurses infected was due to a shortage of protective equipment and staff.

Only one or two doctors are available for 100,000 patients in some of the affected countries.

The bank chief said after the Ebola emergency was over, it was important that these countries health systems were strengthened, which the AFDB could do through budget support.

Meanwhile, a WHO epidemiologist from Senegal who contracted Ebola while working in Sierra Leone has been flown to Hamburg in Germany for treatment.

He had been working at an Ebola testing centre in Kailahun, one of the worst-affected districts in eastern Sierra Leone which is currently under blockade.

The WHO says the laboratory in Kailahun has been temporarily closed.

There have been 392 Ebola deaths in Sierra Leone, according to the latest UN figures released on 22 August.

Ebola Virus Disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

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Tomatoes linked with fighting cancer

27 August 2014 Last updated at 14:43 By Helen Briggs Health editor, BBC News website

Eating tomatoes may lower the risk of prostate cancer, research suggests.

Men who consume more than 10 portions of tomatoes each week reduce their risk by about 20%, according to a UK study.

Prostate cancer is the second most common cancer in men worldwide, with 35,000 new cases and around 10,000 deaths in the UK every year.

Cancer experts recommend eating a range of fruit and vegetables to lower the risk of developing the disease.

Continue reading the main story

Men should still eat a wide variety of fruits and vegetables, maintain a healthy weight and stay active"

End Quote Vanessa Er Bristol University

The Bristol team analysed the diets and lifestyles of around 20,000 British men aged between 50 and 69.

They found men who consumed more than 10 portions of tomatoes each week - such as fresh tomatoes, tomato juice and baked beans - saw an 18% reduction in prostate cancer risk.

Eating the recommended five servings of fruit or vegetables or more a day was also found to decrease risk by 24%, compared with men who ate two-and-a-half servings or less.

"Our findings suggest that tomatoes may be important in prostate cancer prevention," said Vanessa Er, from the School of Social and Community Medicine at Bristol University.

"However, further studies need to be conducted to confirm our findings, especially through human [clinical] trials.

"Men should still eat a wide variety of fruits and vegetables, maintain a healthy weight and stay active."

Dietary index

The cancer-fighting properties of tomatoes are thought to be due to lycopene, an antioxidant which can protect against DNA and cell damage.

The researchers also looked at two other dietary components linked with prostate cancer risk - selenium, found in flour-based foods such as bread and pasta, and calcium, found in dairy products such as milk and cheese.

Men who had optimal intake of these three dietary components had a lower risk of prostate cancer.

The research, published in the journal Cancer Epidemiology, Biomarkers & Prevention, was carried out in collaboration with the Universities of Cambridge and Oxford.

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Ebola: 'heavy toll' on health staff

26 August 2014 Last updated at 12:55

An "unprecedented" number of doctors and nurses have been infected with Ebola virus in west Africa, according to the World Health Organization.

More than 2,600 people in Guinea, Liberia, Nigeria and Sierra Leone have been infected since March, including more than 240 health care workers.

Infections in medical workers are due to a shortage of protective equipment and staff, said the health body.

Only one or two doctors are available for 100,000 patients in some countries.

The WHO said the "heavy toll on health care workers" had consequences that further impeded control efforts, such as the closure of health facilities.

"Ebola has taken the lives of prominent doctors in Sierra Leona and Liberia, depriving these countries not only of experienced and dedicated medical care but also of inspiring national heroes," the WHO said in a statement.

"In many cases, medical staff are at risk because no protective equipment is available - not even gloves and face masks."

The current outbreak is the largest ever, and has infected an estimated 2,615 people.

About half of those infected have died.

A US health official visiting the three hardest hit countries - Liberia, Sierra Leone and Guinea - said the virus had the "upper hand'' in the outbreak, but experts had the tools to stop it.

"Lots of hard work is happening, lots of good things are happening,'' said Dr Tom Frieden, the director of the US Centers for Disease Control and Prevention. "But the virus still has the upper hand.''

Analysis

Helen Briggs, Health Editor, BBC News online

Medical staff faced with Ebola in west Africa face a number of challenges. Infectious diseases such as malaria and typhoid fever may mimic the early symptoms of Ebola while protective gear is in short supply, and is hot and cumbersome in a tropical climate.

With severe shortages of doctors and nurses in some countries, many are working beyond their physical limits, says the WHO.

Past outbreaks have been brought under control fairly rapidly, once the virus was identified and protective measures put in place. The current outbreak - the largest ever - has overwhelmed struggling health systems in some of the world's poorest countries.

Meanwhile, doctors in London have begun treating a Briton who contracted Ebola in Sierra Leone.

William Pooley, a 29-year-old volunteer nurse, was flown home in a specially equipped military aircraft on Sunday and taken to Hampstead's Royal Free Hospital.

He volunteered to go to care for victims of the Ebola outbreak.

There is no cure for Ebola but with intensive care treatment and proper hydration, patients have a chance of survival.

The virus is spread between humans through direct contact with infected bodily fluids.

Ebola Virus Disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

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Gut bugs 'help prevent allergies'

26 August 2014 Last updated at 03:15 By James Gallagher Health editor, BBC News website

Bacteria which naturally live inside our digestive system can help prevent allergies and may become a source of treatment, say US researchers.

The team at the University of Chicago showed a group of bacteria - Clostridia - could block peanut allergies in mice.

They hope to harness the bacteria in a pill form - or replicate their effects with a drug - in order to treat allergies.

Experts said it was a "very exciting" discovery.

For every one cell that builds up the human body there are ten bacteria living on or in us.

There is an emerging school of thought that this "microbiome" may be helping to fuel a rise in allergies around the world.

Peanuts in mice

The research group performed experiments on mice brought up in perfectly sterile environments and had no bacteria in their gut.

These animals had a strong immune response to peanut - an allergy that can be deadly in some people.

The team then investigated whether adding different bacteria to the digestive tract of the animals had any effect.

Only the Clostridia group of bacteria - which includes some disease causing species such as C. difficle - could prevent the allergic reaction.

Lead researcher Dr Cathryn Nagler told the BBC News website: "The first step is for an allergen to gain access to the blood stream, the presence of Clostridia prevents the allergens getting into the bloodstream.

"Clostridia are known to be closely linked to the intestinal lining, they are spore forming which makes them tricky to work with, but down the road they would be a candidate to put in a to pill as they are highly stable."

Another option the researchers are investigating is finding a drug which would have the same effect as the bacteria.

It is hoped that using bacteria can help with desensitisation therapies, which involve giving people regular, but tiny, doses of the substance provoking the allergic response until the immune system becomes used to it.

Previous research has suggested roles for our microbiome in everything from obesity to autism.

Dr Cathryn Nagler says we should not be surprised how powerful an effect these bacteria, fungi and viruses can have on our body.

"We have co-evolved with our microbiota and it has an enormous impact on our health.

"It's having a negative impact now because we've disturbed it with antibiotics, a high fat diet and c-sections."

Commenting on the findings, Prof Colin Hill, a microbiologist at University College Cork, told the BBC: "This is really interesting.

"This paper identifies a group of bacteria which could be important in protecting against these prevalent diseases.

"While we have to be careful not to extrapolate too far from a single study, and we also have to bear in mind that germ-free mice are a long way from humans, it is a very exciting paper and puts this theory on a much sounder scientific basis."

If you want to find out more about what you can do to reduce you or your children's chances of becoming allergic watch Horizon - Allergies: Modern Life and Me, broadcast on BBC Two at 9pm on Wednesday 27th August.

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'Ban E-cig use indoors,' says WHO

26 August 2014 Last updated at 14:33 By Smitha Mundasad Health reporter, BBC News

The World Health Organization says there should a ban on the use of e-cigarettes indoors and that sales to children should stop.

In a report the health body says there must be no more claims that the devices can help smokers quit - until there is firm evidence to support this.

WHO experts warn the products might pose a threat to adolescents and the foetuses of pregnant women.

But campaigners say regulations must be proportionate.

Tempting flavours

According to the WHO legal steps need to be taken to end the use of e-cigarettes indoors - both in public spaces and in work places.

And the report focuses on the potential for products to spark wider cigarette use in children.

The health experts call for a ban on advertisements that could encourage children and non-smokers to use the devices.

And they say fruit, candy or alcoholic-drink style flavours should be prohibited too, while the sales of electronic cigarettes from vending machines should be heavily restricted.

1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on

2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge

3. Liquid nicotine becomes vapour and is inhaled. The 'smoke' produced is largely water vapour. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow.

'Health threats'

The WHO warns exhaled e-cigarette vapour could increase the background air levels of some toxicants and nicotine.

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Observing a lab test comparing traditional smoking with e-cigarettes

According to the team while e-cigarettes are likely to be less harmful than traditional cigarettes, they may pose threats to adolescents and the foetuses of pregnant women who use these devices.

But some researchers suggest tough regulations may prevent smokers having access to products that are potentially less harmful than conventional cigarettes.

A spokesman for the British American Tobacco company said: "We have always said that given nicotine is addictive, minimum age laws of 18 for the sale of e-cigarettes should be introduced.

"However, if overly restrictive regulations are introduced hampering innovation or adult usage, then this could simply stifle the growth of new products and prevent smokers from being aware of and having access to them - this can only be bad thing for public health."

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Charles Hamshaw-Thomas, E-Lites: Ban on indoor use would be "troubling"

'Proportionate regulation'

Hazel Cheeseman, at the charity Action on Smoking and Health, said there was no evidence of any harm to bystanders and warned regulation needed to be proportionate.

She added: "Smoking kills 100,000 people in the UK alone.

"Smokers who switch to using electronic cigarettes in whole or in part are likely to substantially reduce their health risks.

"Although we cannot be sure that electronic cigarettes are completely safe, as the WHO acknowledges, they are considerably less harmful than smoking tobacco and research suggests that they are already helping smokers to quit."

Global guidelines

A UK Department of Health spokeswoman said: "More and more people are using e-cigarettes and we want to make sure they are properly regulated so we can be sure of their safety.

"We have already set out our intention to change the law to ban the sale of e-cigarettes to children under 18.

"The UK has an existing licensing system for higher strength products and those that claim to help people quit.

"We are also bringing in new European rules to cover lower strength products which will ban most advertising, limit nicotine levels and set standards for ingredients, labelling and packaging."

The WHO's recommendations were published ahead of a meeting involving all countries that have signed up to an international convention on tobacco control.

New global guidelines could be agreed during the October meeting.

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Whole organ 'grown' in world first

24 August 2014 Last updated at 18:07 By James Gallagher Health editor, BBC News website

A whole functional organ has been grown from scratch inside an animal for the first time, say researchers in Scotland.

A group of cells developed into a thymus - a critical part of the immune system - when transplanted into mice.

The findings, published in Nature Cell Biology, could pave the way to alternatives to organ transplantation.

Experts said the research was promising, but still years away from human therapies.

The thymus is found near the heart and produces a component of the immune system, called T-cells, which fight infection.

Grow your own

Scientists at the Medical Research Council centre for regenerative medicine at the University of Edinburgh started with cells from a mouse embryo.

These cells were genetically "reprogrammed" and started to transform into a type of cell found in the thymus.

These were mixed with other support-role cells and placed inside mice.

Once inside, the bunch of cells developed into a functional thymus.

It is similar to a feat last year, when lab-grown human brains reached the same level of development as a nine-week-old foetus.

The thymus is a much simpler organ and in these experiments became fully functional.

Structurally it contained the two main regions - the cortex and medulla - and it also produced T-cells.

Prof Clare Blackburn, part of the research team, said it was "tremendously exciting" when the team realised what they had achieved.

She told the BBC: "This was a complete surprise to us, that we were really being able to generate a fully functional and fully organised organ starting with reprogrammed cells in really a very straightforward way.

"This is a very exciting advance and it's also very tantalising in terms of the wider field of regenerative medicine."

Patients who need a bone marrow transplant and children who are born without a functioning thymus could all benefit.

Ways of boosting the thymus could also help elderly people. The organ shrinks with age and leads to a weaker immune system.

However, there are a number of obstacles to overcome before this research moves from animal studies to hospital therapies.

The current technique uses embryos. This means the developing thymus would not be a tissue match for the patient.

Researchers also need to be sure that the transplant cells do not pose a cancer risk by growing uncontrollably.

Prof Robin Lovell-Badge, from the National Institute for Medical Research, said: "This appears to be an excellent study.

"This is an important achievement both for demonstrating how to make an organ, albeit a relatively simple one, and because of the critical role of the thymus in developing a proper functioning immune system.

"However... the methods are unlikely to be easy to translate to human patients."

Advances

The field of regenerative medicine has developed rapidly.

There are already patients with lab-grown blood vessels, windpipes and bladders. These have been made by "seeding" a patient's cells into a scaffold which is then implanted.

The thymus just required an injection of cells.

Dr Paolo de Coppi, who pioneers regenerative therapies at Great Ormond Street Hospital, said: "Research such as this demonstrates that organ engineering could, in the future, be a substitute for transplantation.

"Engineering of relatively simple organs has already been adopted for a small number of patients and it is possible that within the next five years more complex organs will be engineered for patients using specialised cells derived from stem cells in a similar way as outlined in this paper.

"It remains to be seen whether, in the long term, cells generated using direct reprogramming will be able to maintain their specialised form and avoid problems such as tumour formation."

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Experts to review stroke clot-buster

22 August 2014 Last updated at 19:20 By Adam Brimelow Health Correspondent, BBC News

The UK medicines watchdog is to review the safety of a clot-busting drug often used to treat strokes.

The Medicines and Healthcare products Regulatory Agency believes the benefits of alteplase outweigh the risks.

But it is revisiting the evidence. Some experts say previous assessments may have been flawed.

The Academy of Medical Royal Colleges welcomed the investigation, saying the review has "huge implications" for patient safety.

A stroke is a medical emergency - and there is one every five minutes in the UK.

Most strokes are caused by a clot blocking the flow of blood to the brain.

Many patients are given alteplase to break down and disperse the clot - treatment known as thrombolysis.

Concerns over 'balance'

There is an increased risk of dangerous bleeding in the brain, but regulators have concluded this is outweighed by the benefits of improved recovery. However, some experts disagree.

Dr Roger Shinton, a stroke specialist, set out his concerns in a letter published in the Lancet.

He told the BBC: "My concerns using alteplase for stroke have always been that the risks of this drug are quite considerable, particularly with bleeding into the brain. The question is, do the benefits justify that risk? And I am not myself convinced that they do."

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I have met with some of the regulatory bodies, and I think they understand there may have been a problem with the balance in the way that this drug was reviewed at the time, and that is why there is some movement to re-look at the whole matter"

End Quote Dr Roger Shinton Stroke specialist

Dr Shinton said many stroke specialists shared his concerns.

Responding in the Lancet, the Medicines and Healthcare products Regulatory Agency (MHRA) said it had recently examined the issue and concluded that the balance of benefits and risks was still favourable. But it also confirmed it was setting up an expert working group "to ensure all relevant sources of evidence have been taken into consideration".

'Great progress'

It said it expected the inquiry would report its findings early next year.

Jon Barrick, chief executive of the Stroke Association, said treatment by thrombolysis using alteplase was part of the great progress in stroke treatment.

"No treatment is without risks. The NICE [National Institute for Health and Care Excellence] recommendation on the use of alteplase is based on current evidence that shows overall the benefits outweigh the risks.

"Eligible patients treated with thrombolysis are more likely to have a good outcome and more people are surviving stroke and leading independent lives."

The manufacturers, Boehringer Ingelheim, say they stand by the safety of the drug.

'Huge implications'

"Our medicine is an emergency clot-busting treatment for someone who has just suffered a stroke. Our medicine increases the proportion of patients who are alive and leading independent lives following this life-changing event."

Dr Aseem Malhotra, consultant clinical associate to the Academy of Medical Royal Colleges, welcomed the MHRA announcement.

"We support the MHRA in carrying out an investigation as a matter of urgency as this has huge implications not just for patient safety but also for the provision of acute stroke services."

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