Unhappy childhood heart risk link

1 February 2013 Last updated at 21:26 ET

Emotional behaviour in childhood may be linked with heart disease in middle age, especially in women, research suggests.

A study found being prone to distress at the age of seven was associated with a significantly higher risk of cardiovascular disease in later life.

Conversely children who were better at paying attention and staying focused had reduced heart risk when older.

The US researchers said more work was needed to understand the link.

Their study looked at 377 adults who had taken part in research as children. At seven they had undergone several tests to look at emotional behaviour.

They compared the results from this with a commonly used risk score for cardiovascular disease of participants now in their early 40s.

After controlling for other factors which might influence heart disease risk, they found that high levels of distress at age seven were associated with a 31% increased risk of cardiovascular disease in middle-aged women.

For men with high levels of distress in childhood - which included being easily frustrated and quick to anger - the increased risk of cardiovascular disease was 17%.

For 40-year-olds who had been prone to distress as a child, the chances of having a heart attack or stroke in the next 10 years increased from 3.2% to 4.2% for women and 7.3 to 8.5% for men.

Adversity

The researchers also looked at positive emotional factors such as having a good attention span and found this was linked with better cardiovascular health, although to a lesser degree.

Other studies have linked adversity in childhood with cardiovascular disease in adults.

And research in adults as linked poor emotional wellbeing with higher levels of cardiovascular disease, the researchers pointed out in the Journal of Epidemiology and Community Health.

Study leader Dr Allison Appleton, said more research would now be needed to work out the biological mechanism that may underpin the finding.

"We know that persistent distress can cause dysregulation of the stress response and that is something we want to look at."

Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said it was already known that a child's health could often have a bearing on their future wellbeing.

But she added that more research was needed before it could be clear that any possible link existed between emotions in childhood and the risk of cardiovascular disease in later life.

"There are positive steps parents can take to protect their child's future heart health.

"What we learn when we're young can often set the tone for our habits later in life, so teaching children about physical activity and a balanced diet is a great place to start."

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Midwife 'role' to target mutilation

2 February 2013 Last updated at 18:57 ET

Midwives may be asked to routinely raise the subject of female genital mutilation with women from communities where it is known to take place, the Department of Health has indicated.

The partial or total removal of external female genitalia is illegal in the UK but the practice occurs in parts of Africa, the Middle East and Asia.

The DoH says the NHS has a "key role... in supporting anyone affected".

It also hopes to identify girls who may be at risk in the future.

Guidelines for health professionals in England and Wales on how to safeguard children and adults affected by FGM were published by the DoH in 2011.

The possibility of midwives asking their patients more questions about the procedure comes after the Crown Prosecution Service launched an action plan in November to target FGM and moves by the Royal College of Midwives to improve its own monitoring efforts.

FGM is said to be typically inflicted on girls aged between four and 13 and women who have been cut can also experience problems during child birth.

No prosecutions

A DoH spokesperson said: "FGM is a serious criminal offence. Health professionals should always take action when they believe a child or young person has been assaulted in any way, to protect them and others from further harm.

"The health system plays a key role in identifying and supporting anyone affected by FGM.

"That is why we are exploring the collection of FGM data in the NHS, including in the maternity and children's dataset."

FGM is known to be carried out in more than 28 countries, mainly in western and southern Asia, the Middle East, including Yemen and Saudi Arabia, and parts of Africa such as Somalia, Egypt, Ethiopia and Sudan.

According to the Metropolitan Police, there is no evidence of FGM being performed in UK, but it says anecdotally it is reported to have happened.

There have been no prosecutions to date in the UK.

But it is also illegal for British nationals or permanent residents to be taken to another country for the procedure. Anybody convicted of involvement in FGM can be jailed for up to 14 years

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'Steep decline' in child epilepsy

2 February 2013 Last updated at 23:44 ET

The number of children being diagnosed with epilepsy has dropped dramatically in the UK over the past decade, figures show.

A study of GP-recorded diagnoses show the incidence has fallen by as much as half.

Researchers said fewer children were being misdiagnosed, but there had also been a real decrease in some causes of the condition.

Other European countries and the US had reported similar declines, they added.

Epilepsy is caused when the brain's normal electrical activity result in seizures.

Data from more than 344,000 children showed that the annual incidence of epilepsy has fallen by 4-9% year on year between 1994 and 2008.

Overall the number of children born between 2003-2005 with epilepsy was 33% lower then those born in 1994-96.

When researchers looked in more detail and included a wider range of possible indicators of an epilepsy diagnosis the incidence dropped by 47%.

Correct diagnosis

Better use of specialist services and increased caution over diagnosing the condition explains some, but not all, of the decline in the condition, the researchers reported in Archives of Diseases in Childhood.

Introduction of vaccines against meningitis and a drop in the number of children with traumatic brain injuries, both of which can cause epilepsy, has probably also contributed to falling cases, they added.

Continue reading the main story

Epilepsy remains one of the most prevalent neurological conditions in children in the UK"

End Quote Simon Wigglesworth Epilepsy Action

Study author Prof Ruth Gilbert, director of the Centre for Evidence-based Child Health at University College London, said: "The drop is consistent with what has been seen in other countries so it is reassuring that we are seeing the same pattern.

"We're getting better at diagnosing and deciding who should be treated and then there is also probably an affect of factors like fewer cases of meningitis."

She said in the past, there was an issue with variable diagnosis and some children being treated who did not need to be.

"There is a more rigorous approach and that is partly down to NICE guidance.

"It is very troubling to have a misdiagnosis because once you have a diagnosis it sticks and that does blight the life of a child."

Simon Wigglesworth, deputy chief executive at Epilepsy Action, said: "It may indicate a reduction in misdiagnosis rates in children, which we know to be high. However, our discussions with leading clinicians suggest that this may not be the complete picture.

"They tell us that they are not seeing a reduction in the number of children with epilepsy presenting at their clinics and epilepsy remains one of the most prevalent neurological conditions in children in the UK."

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Twin born with 'orange-sized' tumour

1 February 2013 Last updated at 08:33 ET By James Gallagher Health and science reporter, BBC News

A baby girl has been born in Sheffield with a huge tumour that accounted for a sixth of her body weight.

The orange-sized growth was so large it was crushing Isabel Roberts's throat, leaving her unable to breathe naturally.

Doctors needed to rapidly fit a tube to help her breathing before she stopped getting oxygen from her mother.

The tumour has since been removed and doctors expect Isabel to make a full recovery.

Sometimes things go wrong during a baby's development in the womb and tumours can form. In 2012 surgeons in the US removed a tumour while the baby was still in the womb.

'Race against time'

Doctors at Sheffield Children's Hospital and Jessops Maternity Hospital noticed an abnormal growth in a scan after 33 weeks.

Continue reading the main story

The baby was so small and the tumour so big, it was a very difficult job to secure the airway"

End Quote Dr Ayman Eissa Consultant anaesthetist

The twins were delivered by Caesarean section and doctors then started a "race against time" as soon as Isabel's head was free.

Consultant anaesthetist Dr Ayman Eissa said: "We estimate the placenta will continue to supply oxygen through the cord for up to five minutes, but you can never be sure. It could break off at any time.

"The baby was so small and the tumour so big, it was a very difficult job to secure the airway."

While Isabel weighed 3lb 9oz (1.6kg), the tumour alone weighed 0.6lb (0.3kg).

"The relief when I secured the tube was unimaginable. It was definitely the most stressful few minutes of my career," Dr Eissa said.

Isabel's tumour was removed 10 days later.

She is now at home in Hoyland, near Barnsley, with her twin sister Alexandra, older sisters Sarah and Olivia and mother and father Maureen and Simon.

Mrs Roberts said: "The few weeks leading up to and after the twins' arrival were a blur. It's crazy to think just how much has happened to my baby. I can remember walking into the operating theatre to have the Caesarean and not knowing what was going to have happened when I woke up."

The consultant who removed the tumour, Neil Bateman, said: "When we weighed the tumour it accounted for one-sixth of her entire body weight.

"It is very rare for a baby to develop a tumour of this size in the womb."

The cancer did not spread, but Isabel is now on a course of chemotherapy. She is expected to make a full recovery and is "getting stronger every day".

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Sperm donors can seek access to kids

1 February 2013 Last updated at 12:12 ET By James Gallagher Health and science reporter, BBC News

Men who donate sperm can apply to seek a role in the lives of their biological children, the High Court has ruled.

The decision could have implications for families using donated sperm and donors, who have no legal role as parents of their biological child.

Mr Justice Baker ruled that two men, whose sperm was used by lesbian couples they were friends with, could apply through the courts for contact.

The judgement does not mean that any future application would be successful.

The cases, heard at the High Court's Family Division, centred around two men in a civil partnership and two lesbian couples they were friends with.

There was contact with the couples after the birth of the children involved. However, there were disagreements about the level of the men's involvement and they applied to the courts.

Legal rights

Continue reading the main story

The possibility of donors being able to apply for courts orders will be a scary prospect for many parents, both gay and straight"

End Quote Kevin Skinner Goodman Ray

Mr Justice Baker said that lesbian couples and their children had exactly the same legal status as any other parent and child, however "it is still open to the court, after considering all relevant factors, to grant leave to other persons to apply for (contact) orders".

He ruled that, in this case, it was "appropriate" for the biological fathers to apply for a contact order, which would set out when they could see the child such as on certain weekends or during school holidays.

Kevin Skinner, who is from the firm Goodman Ray and represented one of the lesbian couples in the case, said: "Although the judge's decision makes clear that the family unit should be protected, the possibility of donors being able to apply for courts orders will be a scary prospect for many parents, both gay and straight.

"What is crucial is that anyone planning on having a child through the use of fertility treatment should make sure that proper plans are in place before the process begins."

However, it is thought the cases may be solved through mediation rather than returning to the courts.

The fertility regulator, the Human Fertilisation and Embryology Authority, said: "This raises the question of whether, following donor conception treatment, a known donor can seek access to a child that he is biologically related to, even if he is not the legal father.

"The case has not yet been heard so we do not know whether access will be granted.

"If contact is granted this may raise concerns for families who have had donor conception treatment using a donor known to them - whether through a private arrangement or through a licensed clinic."

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Unhappy childhood heart risk link

1 February 2013 Last updated at 21:26 ET

Emotional behaviour in childhood may be linked with heart disease in middle age, especially in women, research suggests.

A study found being prone to distress at the age of seven was associated with a significantly higher risk of cardiovascular disease in later life.

Conversely children who were better at paying attention and staying focused had reduced heart risk when older.

The US researchers said more work was needed to understand the link.

Their study looked at 377 adults who had taken part in research as children. At seven they had undergone several tests to look at emotional behaviour.

They compared the results from this with a commonly used risk score for cardiovascular disease of participants now in their early 40s.

After controlling for other factors which might influence heart disease risk, they found that high levels of distress at age seven were associated with a 31% increased risk of cardiovascular disease in middle-aged women.

For men with high levels of distress in childhood - which included being easily frustrated and quick to anger - the increased risk of cardiovascular disease was 17%.

For 40-year-olds who had been prone to distress as a child, the chances of having a heart attack or stroke in the next 10 years increased from 3.2% to 4.2% for women and 7.3 to 8.5% for men.

Adversity

The researchers also looked at positive emotional factors such as having a good attention span and found this was linked with better cardiovascular health, although to a lesser degree.

Other studies have linked adversity in childhood with cardiovascular disease in adults.

And research in adults as linked poor emotional wellbeing with higher levels of cardiovascular disease, the researchers pointed out in the Journal of Epidemiology and Community Health.

Study leader Dr Allison Appleton, said more research would now be needed to work out the biological mechanism that may underpin the finding.

"We know that persistent distress can cause dysregulation of the stress response and that is something we want to look at."

Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said it was already known that a child's health could often have a bearing on their future wellbeing.

But she added that more research was needed before it could be clear that any possible link existed between emotions in childhood and the risk of cardiovascular disease in later life.

"There are positive steps parents can take to protect their child's future heart health.

"What we learn when we're young can often set the tone for our habits later in life, so teaching children about physical activity and a balanced diet is a great place to start."

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Whooping cough cases 'falling'

1 February 2013 Last updated at 05:42 ET By James Gallagher Health and science reporter, BBC News

The largest outbreak of whooping cough for 20 years shows signs of slowing as cases fall for two months in a row, Health Protection Agency figures for England and Wales show.

There were 832 new cases in December, nearly half the figure from October.

One baby died in December, bringing the total number of deaths in newborns during the outbreak to 14.

Experts warn the outbreak may not be over as there is a seasonal dip in cases.

The current outbreak has been significantly worse than in previous years, affecting 9,741 in England and Wales in 2012.

There are surges every three to four years. However last year there were 10 times the number of cases than in the last outbreak in 2008. A similar pattern has been seen in Scotland and Northern Ireland.

'Welcome decrease'

Dr. Mary Ramsay, head of immunisation at the HPA, said: "The December figures show another welcome decrease in the overall number of whooping cough cases since the peak in October.

"However, it is very important to note that we usually see a reduction in cases of whooping cough at this time of year so this decrease is in line with normal seasonal patterns."

Anyone can catch whooping cough, but it tends to be deadly only in newborn babies as their immune systems are not yet ready to fight off the infection.

Vaccination does not start until they are two months old and requires multiple jabs until the baby is protected.

In response a UK-wide programme of vaccinating pregnant mothers was launched close to the peak of the outbreak.

Women between 28 and 38 weeks pregnant are being offered the whooping cough vaccine, which should pass protection onto their child in the womb.

Figures suggest around 55% of pregnant women have had the jab in December, up from 40% in October.

Dr Ramsay said: "Parents should be alert to the signs and symptoms of whooping cough - which include severe coughing fits that may be accompanied by the characteristic 'whoop' sound in young children; older children or adults will usually just have a prolonged cough."

Prof David Salisbury, director of immunisation at the Department of Health, said: "I'm pleased that more than half of pregnant women took up the offer of the whooping cough vaccine in December, but I'd urge more women to get it to protect their baby.

"Whooping cough is highly contagious and infants are particularly vulnerable.

"Fourteen infants died as a result of whooping cough in 2012 and there were 429 cases of the disease in children under three months old. It's vital that babies are protected from the day they are born - that's why we are encouraging all pregnant women to be vaccinated."

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HIV levels in gay men 'not falling'

1 February 2013 Last updated at 07:17 ET By James Gallagher Health and science reporter, BBC News

Huge improvements in treating and testing for HIV have failed to curb infections in gay and bisexual men in England and Wales, a study suggests.

New infections were static at about 2,300 a year between 2001 and 2010, despite rises in early diagnosis and far more people taking medication.

Scientists, writing in the Lancet Infectious Diseases, said there had been a return of risky sexual practice.

Campaigners said there were "real challenges" in HIV prevention.

There is concern about the spread of HIV in men who have sex with other men. The Health Protection Agency's latest report said HIV had reached an "all-time high" in this group, with more and more new cases reported each year.

Infections

Continue reading the main story

Matthew Nolan, who is 40, was diagnosed with HIV in 2009. He says the findings are "quite disheartening" but reflect a culture of "complacency" that has emerged.

"When you're young you think you're invincible."

Matthew, who runs a support group in Walsall, also said the internet was making it easier to find men and "encouraged unsafe sexual practice".

James Johnson, from London was diagnosed 11 years ago. He told the BBC: "There was certainly in the 80s and 90s a massive amount of fear and that isn't there anymore, so there is maybe a more liberal attitude since then."

He said the only solution was reducing the stigma around HIV so people were more open about their HIV status.

Working out the number of new infections each year is complicated, as many people are undiagnosed and there can be a long delay between someone being infected and finding out.

Researchers at the Medical Research Council Biostatistics Unit, in Cambridge, estimated when people were infected based on the state of their immune system.

Their study showed little difference between the spread of HIV in 2001 and 2010.

"We found the number of new infections remained quite stable over the decade, there was no evidence of a decline," researcher Dr Daniela De Angelis told the BBC.

In that time the number of gay or bisexual men being tested in clinics went from 16,000 to 59,000 a year, the time from infection to diagnosis fell from four years to just over three and the numbers taking antiretroviral therapy went from 69% to 80%.

Unsafe sex

Dr De Angelis said: "Perhaps a resurgence of unsafe sexual practice might be fuelling the spread of HIV or perhaps testing is not very targeted."

The Health Protection Agency said it was "seriously concerned" about the level of transmission and that unsafe sex was "the most plausible explanation" for the findings.

The organisation's head of HIV surveillance, Dr Valerie Delpech, said: "Men who have sex with men should get an HIV and STI [sexually transmitted infections] screen at least annually, and every three months if having unprotected sex with new or casual partners - and we urge clinicians to take every opportunity to offer the test to this group."

Sir Nick Partridge, the chief executive at Terrence Higgins Trust, which campaigns on sexual health, said: "These findings highlight the real challenges faced by HIV prevention work, which need much greater attention."

He said that spending on safer sex campaigns had "fallen dramatically" over the past 10 years and "we must challenge the assumptions some gay men make about HIV and re-energise gay communities to tackle a real and growing threat to their sexual health".

Yusef Azad, the director of policy at the National Aids Trust, said: "Around seven gay or bisexual men a day in the UK are getting HIV.

"Prevention services so far have been under-resourced, without a clear focus on outcomes or effectiveness.

"They often do not address the cultural and structural drivers of HIV transmission amongst gay and bisexual men - including drug use, mental health issues and the gay scene."

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Twin born with 'orange-sized' tumour

1 February 2013 Last updated at 08:33 ET By James Gallagher Health and science reporter, BBC News

A baby girl has been born in Sheffield with a huge tumour which accounted for a sixth of her body weight.

The orange-sized growth was so large it was crushing Isabel Roberts' throat leaving her unable to breathe naturally.

Doctors needed to rapidly fit a tube to help her breathing before she stopped getting oxygen from her mother.

The tumour has since been removed and doctors expect Isabel to make a full recovery.

Sometimes things go wrong during a baby's development in the womb and tumours can form. In 2012 surgeons in the US were forced to remove a tumour while the baby was still in the womb.

'Race against time'

Doctors at Sheffield Children's Hospital and Jessops Maternity Hospital noticed an abnormal growth in a scan after 33 weeks.

Continue reading the main story

The baby was so small and the tumour so big, it was a very difficult job to secure the airway."

End Quote Dr Ayman Eissa Consultant anaesthetist

The twins were delivered by caesarean section and doctors then started a "race against time" as soon as Isabel's head was free.

Dr Ayman Eissa, consultant anaesthetist, said: "We estimate the placenta will continue to supply oxygen through the cord for up to five minutes, but you can never be sure. It could break off at any time.

"The baby was so small and the tumour so big, it was a very difficult job to secure the airway."

While Isabel weighed 3lb 9oz (1.6kg), the tumour alone weighed 0.6lb (0.3kg).

"The relief when I secured the tube was unimaginable. It was definitely the most stressful few minutes of my career," Dr Eissa said.

Isabel's tumour was removed 10 days later.

She is now at home in Hoyland, near Barnsley, with her twin sister Alexandra, older sisters Sarah and Olivia and mum and dad Maureen and Simon.

Mrs Roberts said: "The few weeks leading up to and after the twins' arrival were a blur. It's crazy to think just how much has happened to my baby. I can remember walking into the operating theatre to have the caesarean and not knowing what was going to have happened when I woke up."

The consultant who removed the tumour, Neil Bateman, said: "When we weighed the tumour it accounted for one sixth of her entire body weight.

"It is very rare for a baby to develop a tumour of this size in the womb."

The cancer did not spread, but Isabel is now on a course of chemotherapy. She is expected to make a full recovery and is "getting stronger every day".

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Many A&Es 'not sharing crime data'

31 January 2013 Last updated at 06:20 ET By Branwen Jeffreys Health correspondent, BBC News

A coalition pledge to make hospitals share violent crime data with police is being carried out in only a third of areas in England, an audit shows.

The government has written to hospitals and chief constables for an explanation after the Department of Health audit.

Accident and emergency departments are meant to share information about where knife or gun attacks are happening with the police and local council.

This was part of the government's programme for government in 2010.

'Disappointed'

In 2010 the coalition promised in its programme for government to make hospitals share non-confidential information with the police so crime hotspots could be identified.

Continue reading the main story

I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities - just get on with it"

End Quote Prof Jonathan Shepherd Cardiff University

In the government's mid term report, which measured progress against their programme for government they said "we have established a national scheme requiring hospitals to share information on gun and knife crime".

But an audit carried out for the Department of Health has revealed that is happening effectively in only a third of community safety partnership areas, and not at all in one-fifth.

The charity Victim Support said it was very disappointing that the plan was not being implemented.

Susannah Hancock, its assistant chief executive, said: "The NHS is the second most likely public service after the police to come into contact with victims of violent crime, many of whom will not have reported such incidents to the police at all. "

It is thought that police are aware of fewer than a third of assaults that lead to the victim being treated in hospital.

Pioneering research carried out in Cardiff tested the idea of regularly sharing collated information about the type and location of attacks, with all confidential patient information removed.

As a result, the city saw a 35% fall in the numbers of assault victims turning up at A&E for treatment between 2000 and 2005.

Professor Jonathan Shepherd, from Cardiff University, said the research showed sharing information costs little, and saves money in the longer term for the NHS and the criminal justice system. He said the findings of the audit were surprising, giving the strong evidence, and the commitment from government.

"I feel disappointed that it hasn't been taken up faster than this, and I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities - just get on with it."

'Win-win'

Arrowe Park hospital, in the Wirral, has seen some impressive results from setting up systems to share information every month with the police and local council. Anyone arriving at A&E with an injury caused by a violent assault is taken through a standard set of questions about the location and circumstances of the attack.

The information has all patient data removed from it before it is shared. Between 2004 and 2010, the number of alcohol-related assault victims arriving for treatment fell by 30%.

Chris Oliver, from the Wirral University Hospital Trust, said the results had convinced busy staff in A&E to get involved: "It's owned by everyone within the department. The reception staff are very proactive when going through the questions. It's very rewarding for our staff to see the reduction in people coming into the department. It's a win-win."

The Department of Health said Health Minister Anna Soubry had written this week to all hospital chief executives and chief constables in England to remind them of the government's commitment on sharing information.

The letter says there are no legal reasons for not sharing anonymous information, and asks for any "good reasons why it cannot be done" in areas which have failed to put systems in place.

Despite this slow progress in implementing the approach in England, the idea has attracted international interest and there are pilot schemes under way in other countries.

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