NHS cover-ups 'should be a crime'

6 February 2013 Last updated at 08:08 ET By Nick Triggle Health correspondent, BBC News

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Robert Francis QC delivers his statement, saying: "This is a story of appalling and unnecessary suffering of hundreds of people"

NHS staff should face prosecution if they are not open and honest about mistakes, according to a public inquiry into failings at Stafford Hospital.

Years of abuse and neglect at the hospital led to the unnecessary deaths of hundreds of patients.

But inquiry chairman, Robert Francis QC, said the failings went right to the top of the health service.

He made 290 recommendations, saying "fundamental change" was needed to prevent the public losing confidence.

Responding in the House of Commons, Prime Minister David Cameron apologised to the families of patients.

He said he was "truly sorry" for what happened at Stafford Hospital, which was "not just wrong, it was truly dreadful" and the government needed to "purge" a culture of complacency.

Mr Cameron said a full response to the inquiry would follow next month, but he did immediately announce that a new post of chief inspector of hospitals would be created in the autumn.

Previous investigations have already established in harrowing detail the abuse and neglect from 2005 to 2008.

This inquiry looked at why the system did not prevent the problems or at the very lest detect them earlier.

Continue reading the main story

The Mid Staffs public inquiry

• The public inquiry is the fifth major investigation into what happened
• It has focused mainly on the commissioning, supervision and regulation of the trust from 2005 to 2009 - something campaigners felt had not been properly covered before
• It was chaired by Robert Francis QC, who also led the fourth major investigation
• It sat between November 2011 and December 2012 and cost £13m
• More than 160 witnesses appeared at the hearings and one million pages of evidence have been sifted through
• The final report contains 290 recommendations over nearly 1,800 pages.

In particular, it recommended:

• The merger of the regulation of care into one body - two are currently involved
• Senior managers to be given a code of conduct and the ability to disqualify them if they are not fit to hold such positions
• Hiding information about poor care to become a criminal offence as would failing to adhere to basic standards that lead to death or serious harm
• A statutory obligation on doctors and nurses for a duty of candour so they are open with patients about mistakes
• An increased focus on compassion in the recruitment, training and education of nurses, including an aptitude test for new recruits and regular checks of competence as is being rolled out for doctors

'Remote'

While it is well-known the trust management ignored patients' complaints, local GPs and MPs also failed to speak up for them, the inquiry said.

The local primary care trust and regional health authority were too quick to trust the hospital's management and national regulators were not challenging enough.

Meanwhile, the Royal College of Nursing was highlighted for not doing enough to support its members who were trying to raise concerns.

The Department of Health was also criticised for being too "remote" and embarking on "counterproductive" reorganisations.

The report said the failings created a culture where the patient was not put first.

Continue reading the main story

"Start Quote

This is a story of appalling and unnecessary suffering of hundreds of people"

End Quote Robert Francis QC

But the inquiry said the change needed did not require further reform.

Instead, it urged everyone from "porters and cleaners to the secretary of state" to work together to shift the culture and adopt a "zero tolerance" approach to poor care.

Mr Francis said: "This is a story of appalling and unnecessary suffering of hundreds of people.

"They were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety."

He said the public's trust in the NHS had been "betrayed" and a change of culture was needed to "make sure that patients come first".

Target driven

The "appalling" levels of care that led to needless deaths have already been well documented by a 2009 report by the Healthcare Commission and an independent inquiry in 2010, which was also chaired by Mr Francis.

They both criticised the cost-cutting and target-chasing culture that had developed at the Mid Staffordshire Trust, which ran the hospital.

Continue reading the main story

Time to care?

James Moore, who has left the NHS after working in A&E for 15 years, said reports of abuse made him "ashamed to be a nurse".

He blamed poor management rather than nurses no longer caring.

He drew parallels with being a waitress: "The restaurant gets busier, the waitress works harder and harder with the same resources and things start getting missed, she drops a meal here or there and people don't get their food on time and complaints are made".

Instead of dealing with the workload he said managers made the problem worse: "They'll ask the waitress to fill out more forms to tick that she's done certain things, then the restaurant gets busier and busier and the nurse has more and more forms to fill out."

Receptionists were left to decide which patients to treat, inexperienced doctors were put in charge of critically ill patients and nurses were not trained how to use vital equipment.

Cases have also been documented of patients left crying out for help because they did not get pain relief and food and drinks being left out of reach.

Data shows there were between 400 and 1,200 more deaths than would have been expected between 2005 and 2008, although it is impossible to say all of these patients would have survived if they had received better treatment.

Royal College of Nursing general secretary Peter Carter described it as a "powerful and monumental" report.

He said: "We welcome moves for overarching standards which enshrine what patients deserve from the NHS and from those who work for it.

"Appalling care cannot be tolerated and everything should be done to ensure that it does not happen again."

But campaigner Julie Bailey who's mother, Bella, died in 2007 at Stafford Hospital prompting her to set up Cure the NHS, which had been instrumental in pushing for the public inquiry, called for resignations.

"We've lost hundreds of lives in the NHS and we want accountability.

"We owe that to our society and to the deaths and the respect of all the loved ones that we have lost.

"We will go nowhere until we get accountability."

Katherine Murphy, the chief executive of the Patients Association, said the report was a "watershed moment" for the health service.

She said: "It is clear that he [Mr Francis] has understood some of the very real failings that patients and their families face day in and day out.

"It is clear from the report that there is a lot of blame to go around for what happened in Stafford. Unfortunately too many people have escaped genuine accountability."

BBC West Midlands special investigation, The Hospital That Didn't Care, on BBC One at 10.35pm on Wednesday, 6 February.

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Obesity 'leads to lack of vitamin D'

5 February 2013 Last updated at 20:45 ET

Obesity can lower vitamin D levels in the body, a study suggests.

The report, in the journal PLOS Medicine, analysed genetic data from 21 studies - a total of 42,000 people.

It found every 10% rise in body mass index (BMI) - used as an indicator of body fat - led to a 4% drop of available vitamin D in the body.

As vitamin D is stored in fatty tissue, the authors suggest the larger storage capacity in obese people may prevent it from circulating in the bloodstream.

BMI it is calculated by taking weight (in kilograms) and dividing it by height (in metres) squared. Those with a BMI of 30 or above are considered obese.

Lead author Dr Elina Hypponen, from the University College London Institute of Child Health, said the study "highlights the importance of monitoring and treating vitamin D deficiency in people who are overweight or obese".

Vitamin D is made in the skin after sun exposure and can be taken in dietary supplements.

Healthy levels are about 50 nanomole per litre - less than 30 nanomole per litre can cause the softening and weakening of bones, leading to rickets in children and osteomalacia in adults.

Prof David Haslam, from the National Obesity Forum, said: "Food intake and genetics all play a part in obesity - but this research is a reminder that physical activity, like walking the dog or going for a run out in the sunshine, shouldn't be forgotten and can help correct both weight and lack of vitamin D."

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Warning over NHS doctors' contracts

5 February 2013 Last updated at 21:25 ET

The NHS must manage its consultants better to secure improvements linked to a sharp rise in their pay a decade ago, the National Audit Office has said.

Pay for senior consultants rose by a maximum of 28% after changes in 2003 designed to lift productivity and career development, the watchdog said.

While there had been benefits, it said value for money could still be boosted and performance assessed more widely.

Ministers said discussions were under way on possible changes.

The watchdog's report analyses the impact of the contract, negotiated by the then Labour government in 2003, which was designed to provide a more defined career structure and reward consultants who made the biggest contribution to the NHS.

The package was approved by senior hospital doctors in England after a ballot in 2004 and about 97% of the 40,000 consultants now working in the health service are still employed under its terms.

'Clinical goals'

The new arrangements led to a 28% increase in the maximum pay for senior consultants from £68,505 to £88,010 while the lower end of the pay band increased by 24% from £52,640 to £65,035.

Average earnings by consultant rose by 12% in real terms in the year after the contract was introduced.

Continue reading the main story

Medical contracts need to reward doctors fairly and support high quality training - change in this area is long overdue"

End Quote Dan Poulter Health Minister

The watchdog said desired gains in productivity and performance connected to the pay rise had either been fully or partly achieved.

The amount of private work being taken on had not increased, it found, the rate of decline in productivity had slowed, the ratio of full-time consultants to total staff in the NHS had risen and pay rises not linked to performance had slowed.

But the watchdog said the anticipated benefits had yet to be "fully realised", with most trusts continuing to pay consultants for additional non-contractual work on the basis of locally agreed rates - ranging from £48 to £200 an hour - rather than the "clear structure" set out in the contract.

'Fair rewards'

It also found that nearly a fifth of consultants had not had an appraisal in the past year while 41% of NHS trusts believed the information obtained was good enough to assess individuals' performance.

"Given the size of the pay increase given to consultants under the 2003 contract, it is reasonable to expect trusts to have made progress in improving how consultants are managed and realising the expected benefits of the contract," its head Amyas Morse said.

"Trusts need to get consultants strongly involved in achieving the trusts' objectives as well as their own clinical goals."

Health Minister Dan Poulter said junior doctors and consultants needed the right training and appropriate rewards to look after patients.

"Medical contracts need to reward doctors fairly and support high quality training - change in this area is long overdue," he said.

"That is why we announced last month we are starting discussions on changes to the consultant contract and clinical excellence awards, so we get the best value from the £5.5bn spent on consultant pay every year."

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Genetic patch 'stops deafness'

4 February 2013 Last updated at 21:33 ET By James Gallagher Health and science reporter, BBC News

A tiny "genetic patch" can be used to prevent a form of deafness which runs in families, according to animal tests.

Patients with Usher syndrome have defective sections of their genetic code which cause problems with hearing, sight and balance.

A study, published in the journal Nature Medicine, showed the same defects could be corrected in mice to restore some hearing.

Experts said it was an "encouraging" start.

There are many types of Usher syndrome tied to different errors in a patient's DNA - the blueprint for building every component of the body.

One of those mutations runs in families descended from French settlers in North America.

When they try to build a protein called hormonin, which is needed to form the tiny hairs in the ear that detect sound, they do not finish the job.

It results in hearing loss at birth and has a similar effect in the eye where it causes a gradual loss of vision.

Patch

Scientists at the Rosalind Franklin University of Medicine and Science, in Chicago in the US, designed a small strip of genetic material which attaches to the mutation and keeps the body's factories building the protein.

Continue reading the main story

There has been something of a flurry of developments in restoring hearing in the past year.

It suggests the future of hearing loss may be more than just hearing aids and cochlear implants.

Stem cells restored hearing in deaf gerbils, a drug could produce new sound sensing hairs in mouse ears, a genetically modified virus led to deaf mice recovering some hearing and now a genetic patch has done the same.

Far more research will be needed if any of these are to be adapted for people.

However, they represent a series of landmark moments in attempts to cure deafness.

Prof Michelle Hastings said: "Humans are going to be the next hurdle, but it looks really promising."

When mice with Usher syndrome were injected with the "genetic patch" they grew up able to hear and had no balance problems.

For the first couple of months their hearing was close to normal in the lower frequencies, but had started to deteriorate by six months.

One of the researchers Michelle Hastings, assistant professor at Rosalind Franklin University, told the BBC: "It was a surprising result that we could treat mice right after they are born and have such a profound effect."

The treatment had to be given early, within the first 10 to 13 days of life.

The researchers do not know if this is because the patch needs to be in place during early development in order to make a difference or if the patch struggles to make it into the inner ear beyond a certain point.

This could raise problems in designing a similar treatment in people. Humans spend far longer in the womb than mice meaning any treatment might need to be given before a baby is born.

Dr Ralph Holme, head of biomedical research at Action on Hearing Loss, said: "It is encouraging that researchers have been able to rescue hearing using an approach which targeted a specific type of inherited deafness.

"More research is now needed to understand how this new therapy could be used to treat this particular type of Usher Syndrome in humans and discover whether vision can also be rescued."

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Sunshine may 'reduce arthritis risk'

4 February 2013 Last updated at 21:34 ET

Living in a sunnier climate may reduce the risk of developing rheumatoid arthritis, according to US researchers.

Their study of more than 200,000 women, published in the journal Annals of the Rheumatic Diseases, suggested a link between sunlight and the risk of developing the disease.

They speculated that vitamin D, which is produced in sunlight, may protect the body.

Experts warned that people should not spend all day in the sun.

Rheumatoid arthritis is caused by the body's own immune system attacking the joints and it can be intensely painful.

It is more common in women, but the reason why a patient's own defences turn against them is unknown.

Sunny side

Researchers at Harvard Medical School followed two groups of more than 100,000 women. The first were monitored from 1976 onwards, the second from 1989.

Their health was then compared with estimates of the levels of UV-B radiation they were exposed to, based on where they lived.

In the 1976 group, those in the sunniest parts of the US getting the highest levels of sunshine were 21% less likely to develop rheumatoid arthritis than those getting the least UV radiation.

Continue reading the main story

We cannot advocate everybody sitting in the sunshine all day to protect from rheumatoid arthritis, because UV-B burns people and increases the risk of skin cancer"

End Quote Dr Chris Deighton British Society for Rheumatology

However, UV levels had no affect upon the risk of rheumatoid arthritis is the 1989 group.

The report's authors said: "Our study adds to the growing evidence that exposure to UV-B light is associated with decreased risk of rheumatoid arthritis."

They suggested that "differences in sun protective behaviours, eg greater use of sun block" could explain why the younger group of women showed no benefit from living in sunnier climes.

One theory is that difference in levels of vitamin D, which is produced when UV radiation hits the skin, could affect the odds of developing the disease. Low levels of vitamin D have already been implicated other immune system disorders such as multiple sclerosis.

Dr Chris Deighton, the president of the British Society for Rheumatology, said it was an "interesting study" which "gives us more clues" about how the environment can affect the chances of getting rheumatoid arthritis.

He added: "We cannot advocate everybody sitting in the sunshine all day to protect from rheumatoid arthritis, because UV-B burns people and increases the risk of skin cancer.

"The treatment options in rheumatology have transformed the lives of patients with this crippling disease in recent years and anything that adds to our knowledge is welcomed."

Sunshine vitamin

Prof Alan Silman, medical director of Arthritis Research UK, said: "Studies that have been undertaken have not shown, thus far, that vitamin D is a useful treatment for rheumatoid arthritis.

"We know that many people with arthritis have low levels of vitamin D and this can have a powerful effect on the types of immune cells which may cause this condition.

"We're currently doing research to find out how this happens and are performing lab studies to find out whether vitamin D can alter the aggressive immune response found in rheumatoid arthritis and turn it into a less harmful or even a protective one.

"In the meantime, until we know more, the best thing that people can do is to go out in the sunshine for up to 15 minutes in the summer months and expose their face and arms to the sun to top up their vitamin D levels."

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Sperm count 'linked to TV viewing'

4 February 2013 Last updated at 21:42 ET

Men who do little exercise and spend much of their spare time watching TV have lower sperm counts than more active men, a study suggests.

Clocking up 20 hours a week of TV time appears to be detrimental, the US authors from Harvard say in the British Journal of Sports Medicine.

Yet 15 hours or more of exercise a week boosts semen quality, according to the results in nearly 200 college students.

The researchers said more studies were needed to explore the possible causes.

And some experts say men wanting to conceive need to be selective about the sport they do as some types may harm sperm.

Too much time riding a bike or doing long-distance running in tight clothing may not be good, other studies suggest.

Continue reading the main story

My advice would be everything in moderation - and that includes time in the gym as well as watching TV"

End Quote Dr Allan Pacey Fertility expert

Similarly, wearing tight underwear rather than boxer shorts has been linked with lower sperm levels.

Sedentary lifestyle

In the latest study, the researchers from the Harvard School of Public Health asked 189 young men who were students at a university in New York to record how many hours they had been spending doing physical activity and watching TV in a typical week.

The volunteers, all aged between 18 and 22, were also asked to provide a sperm sample for lab analysis.

When the researchers compared the survey findings with the sperm test results they found the link between sedentary lifestyle and low sperm count.

Men who were the most physically active, doing 15 hours or more of moderate to vigorous exercise each week by playing football, baseball or basketball for example, had sperm counts which were 73% higher than those who were least physically active.

Those who spent lots of time watching TV or DVDs - at least 20 hours a week - had a sperm count that was 44% lower than men who spent little time in front of the box.

None of the men had sperm counts so low that doctors would classify them as sub-fertile.

Sperm motility (how well it swims) and shape were unaffected.

Warm lap

The researchers say their findings are not conclusive but suggest that men who want to improve their fertility might want to look at increasing the amount of physical exercise they do if they currently do little.

It is not clear why sitting on the sofa watching TV might lower sperm count. It might be down to temperature - sperm prefer cooler conditions and production halts if the scrotum gets too hot.

Obesity may also affect fertility - although most of the men were not overweight.

Dr Audrey Jane Gaskins and colleagues say more studies are needed to confirm and explore the possible causes behind their findings.

Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: "It remains to be seen if coaxing a TV-watching couch potato into doing some regular exercise could actually improve his sperm count. Or whether there exists an unknown fundamental difference between men who like exercise and those who do not which might account for the findings.

"This should be a relatively easy study to perform, but before all worried men hunt for their sports bag it's important to note that other research suggests that doing too much exercise can be harmful to sperm production.

"My advice would be everything in moderation - and that includes time in the gym as well as watching TV."

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Fear of music safety limit override

3 February 2013 Last updated at 22:30 ET

A safety limit on volume levels which comes into force on all new personal music players this month could be ignored by 40% of young people, says a hearing loss charity.

All personal music players and mobile phones sold in the EU must now have a sound limit of 85 decibels (dB), but users can increase it to 100dB.

Action on Hearing Loss says overexposure to loud music can trigger tinnitus.

Experts say the limit is "good news".

Tinnitus is a medical term used to describe a ringing or buzzing noise that people can hear permanently in one ear, both ears or in the head.

It is often caused by exposure to loud music and can be accompanied by hearing loss.

Paul Breckell, chief executive of Action on Hearing Loss, said the new EU standard is important because increasing numbers of young people listen to music through a personal music player.

Survey results

"I urge music lovers to consider the long-term risks of overriding the safe setting as overexposure to loud music can trigger tinnitus, and remember that a good pair of noise cancelling headphones can make all the difference."

A survey of more than 1,500 16 to 34-year-olds by Action on Hearing Loss suggests that 79% of young people are unaware of new standards coming into force this month.

Although 70% of survey respondents said they would take steps to protect themselves against tinnitus, nearly 40% said they would override the new default setting on their music devices.

In October 2008, the European Commission warned that listening to personal music players at a high volume over a sustained period could lead to permanent hearing damage.

As a result, the European Committee for Electrotechnical Standardisation (CENELEC) amended its safety standard for personal music players.

Continue reading the main story

Marc Nicholson, 31, from Essex, is a DJ who has always loved loud music. He started playing drums at 10 and got decks at 20.

"I used to go home after a night out and my ears would be ringing. It was the sign of a good night."

But two years ago he woke up with ringing in his ears and a week later it was still there.

He was diagnosed with chronic tinnitus in his right ear.

"It gets worse when I'm stressed or tired. Sometimes I think 'How could I have done this to myself?'

"It has affected my life. The ringing is the last thing I hear going to sleep and first thing I hear in the morning."

Marc has returned to DJ-ing but now wears professional ear plugs.

"I felt very depressed for a year but I'm coping with it. Doing charity work has helped me to come to terms with it."

Now all personal music players sold in the EU after February 2013 are expected to have a default sound limit of 85dB.

The user can choose to override the limit so that the sound level can be increased up to maximum 100dB. If the user overrides the limit, warnings about the risks must be repeated every 20 hours of listening time.

The European Commission's assessment said: "Listening to music at 80dB or less is considered safe, no matter for how long or how often personal music players are used. This sound level is roughly equivalent to someone shouting or traffic noise from a nearby road."

But turning the volume control to 120dB, which is equivalent to an aeroplane taking off nearby, is exceeding safe limits, it said.

The commission said an estimated 20% of young people are exposed to loud sounds during their leisure time - a figure which has tripled since the 1980s.

An estimated 5-10% of of people in the EU are thought to be at risk of permanent hearing loss if exposed to unsafe noise limits for five years or more.

Dr Michael Akeroyd, from the MRC Institute of Hearing Research in Glasgow, said of the new EU standard: "This is good news for the volumes of personal music players. The volumes they can give has been of concern for many years, going back to at least the advent of portable cassette players."

He added that headphones can vary in quality and design.

"Few designs of headphones remove background sounds, and indeed some designs remove none. But ear-defenders or ear-plugs can remove a substantial amount of noise. Earplug design has advanced greatly in recent years."

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13,000 cancer deaths 'can be saved'

3 February 2013 Last updated at 22:32 ET

At least 13,000 premature deaths from cancer could be prevented each year in the UK, says the World Cancer Research Fund (WCRF).

It says the government could do more to raise awareness of how people can reduce their cancer risk.

The announcement comes as a survey showed that a third of Britons still believe that developing cancer is due to fate.

About 157,000 people die of cancer every year in the UK.

Although the mortality rate is predicted to continue declining, due to a growing and ageing population the number of deaths is expected to rise to about 182,000 deaths by 2025.

The WCRF survey of more than 2,000 adults suggested that 28% of people think there is little that can be done to prevent cancer.

Cancer myths

But Dr Kate Allen, executive director of science and public affairs at WCRF, said: "These results are a real concern because they show that a significant proportion of people don't realise that there's a lot they can do to reduce their risk of cancer.

"By eating healthily, being physically active and keeping to a healthy weight, we estimate that about a third of the most common cancers could be prevented.

"Everyone has a role to play in preventing cancer but governments and health professionals are key to raising awareness and making it easier for individuals to change their lifestyle habits."

The Union for International Cancer Control, a non-governmental organisation working across 155 countries, estimates that 1.5 million lives could be saved worldwide if urgent action is taken to raise awareness about cancer.

Otherwise, it says, there could be six million premature cancer deaths by 2025.

The UICC and the WCRF want governments and the public to dispel four important myths and misconceptions about cancer, namely that cancer is just a health issue, that it is a disease of the wealthy, developed countries, that it is a death sentence and that getting cancer is down to fate.

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Tuberculosis vaccine hopes dashed

4 February 2013 Last updated at 07:18 ET

A major trial of a new booster vaccine has ended in failure, marking a major setback in the fight against tuberculosis (TB).

It was the first major trial of a TB vaccine since Bacillus Calmette-Guerin (BCG) was introduced in 1921.

BCG is only partially effective against the bacterium that causes TB, which is why several international teams are working on new vaccines.

The latest, known as MVA85A, failed to protect babies who had already had BCG.

The trial, in South Africa, involved 2,794 healthy children aged four to six months, half of whom received MVA85A and the rest a placebo.

They were followed up for an average of two years.

The researchers, reporting in the Lancet medical journal, found 32 cases of TB in those who had received the vaccine compared with 39 in the placebo group.

This gave an effectiveness of 17%, which is so low as to be statistically non-significant.

'Disappointing'

Designed to boost the immune responses that have been primed by the BCG vaccine, MVA85A has been undergoing human trials for more than a decade, showing it to be safe and to stimulate a high level of immune response in adults.

Prof Helen McShane, from the University of Oxford, who developed the vaccine, said: "[It] induced modest immune responses against TB in the infants, but these were much lower than those previously seen in adults, and were insufficient to protect against the disease.

"This is the first efficacy trial of a new TB vaccine since Bacille Calmette-Guérin, a significant step in itself, and there is much that we and others can learn from the study and the data it has produced."

In an accompanying editorial Christopher Dye, of the World Health Organization (WHO), and Paul Fine, from the London School of Hygiene and Tropical Medicine, said although the results were disappointing they were "not a terminal prognosis for MVA85A, or for any of the other tuberculosis vaccines in development".

They added: "Now is a key moment in tuberculosis vaccine research.

"If the history of tuberculosis vaccine research teaches us anything, it is to expect surprises. We need to go on playing the high-stakes game."

The MVA85A study was funded by AERAS, the Wellcome Trust and Oxford-Emergent Tuberculosis Consortium.

AERAS, a not-for-profit organisation, was set up to develop new TB vaccines. MVA85A was the most advanced of six vaccine candidates it is helping develop.

Dr Tom Evans, interim CEO of AERAS said: "Because of the urgency to control the global TB epidemic, and despite these trial results, we remain steadfast in our belief that an improved TB vaccine will be developed and represents the best hope for eliminating the disease."

TB is a major global health problem with an estimated 8.7 million cases and 1.4 million deaths a year, according to the WHO.

The disease is the leading cause of death among people with HIV in South Africa.

Historic

Dr Richard White, an epidemiologist at the London School of Hygiene & Tropical Medicine and Director of the TB Modelling and Analysis Consortium, said:

"This is a very disappointing result, but this was just the first of around 12 new tuberculosis vaccines currently being tested in humans and around 50 vaccine candidates currently being tested in the lab. It was a historic trial, the first of a new TB vaccine for nearly a century. It will lead to much valuable knowledge to help us design effective vaccines in the future. "

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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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