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Diary of a reluctant allergy sufferer - How the British National Health Service deals with allergy.
Dog owners should be made safe - doctors
Fri February 23rd - Dog owners should be required to undertake "parenting" classes, a paediatrician declared today amidst growing concern about the savaging of children. More
Crisp and sweet ads banned
Fri February 23rd - A major crackdown on advertising of junk food, such as crisps and sweets, to children will begin within weeks, it was announced yesterday. More
Natural method rivals pill
Thur February 22nd - German researchers have found that a natural family planning method works as well as the pill to prevent pregnancy, Human Reproduction journal reports. More
Happy Brits keep blood pressure down?
Wed February 21st - According to its blood pressure levels, Britain is one of the happiest European countries, researchers have claimed. More
Health spending at odds with health workers' priorities
Tues February 20th - Global healthcare spending doesn't reflect the priorities of health professionals, a new survey suggests. More
NEWS CARRIERS - A new deal between unions and health ministers signalled a return to "beer and sandwiches" dispute resolution today. - Survivors of Hodgkin's disease are left with an elevated risk of death from heart attack, but could their risk be linked to the specific chemotherapy used? - Doctors have been urged to ensure their patients get copies of all correspondence about them.
Nurse-Mail - Nursing site with news, chat and jobs.
HepQuest - Developed nations face a rapidly growing cost of caring for people with hepatitis C, according to a new study. - For Australian doctors.
Medilink East - Medical technology information and resource site.

UK News for July

Eczema, hay fever has peaked: study

Thursday August 31st, 2006

Rates of eczema and hay fever may be falling for the first time in decades, suggests new research published today.

But rates of systemic allergic reactions, such as anaphylaxis and food related reactions, have soared.

Professor Aziz Sheikh and researchers from the University of Edinburgh carried out a time trends analysis on rates of illness and death for allergic disorders in the UK, excluding asthma.

They found that diagnoses of allergic rhinitis and eczema in children had trebled over the past three decades, but the prevalence of symptoms seemed to have fallen recently.

Hospital admissions for eczema had also stabilised since 1995, while those for allergic rhinitis had fallen to about 40 per cent of their 1990 levels, according to a report in the journal Thorax.

And while doctors visits for hay fever treatment jumped by 260 per cent and 150 per cent for eczema between 1971 and 1991, rates had stabilised in the past decade.

Consultations for allergic rhinitis were stable from 1981 to 1990, but rose to a rate of 44 per 100,000 per week in 1992. Since then rates have fallen to about 20 per 100,000 per week in 2004.

Hospital admissions for anaphylaxis rose by 700 per cent (five per million of population in 1990/1 to 36 in 2003/4) and for food allergy by 500 per cent.

The authors said while the findings suggested eczema and hay fever may have peaked, systemic allergies could be increasing.

"Although changes in treatment and other healthcare factors may have contributed to these trends, there may also be a change in the aetiology of allergic disease in the UK," said Professor Sheikh.

Thorax 2006: doi: 10.1136/thx.2004.038844.

New campaign against violence

Wednesday August 30th, 2006

A fresh drive against violence in surgeries is being launched by doctors in Northern Ireland.

The BMA is beginning the project by asking the province's doctors to supply information about assaults in their places fo work.

Local BMA chairman Dr Brian Patterson said he believed the level of assaults was rising.

He said: "We believe that assaults on NHS staff have risen to well over 5,000 in the last year and urgent action is needed to put a halt to this totally unacceptable situation.

"We want to see the Department of Health here taking more affirmative action by encouraging all staff to report any abusive or violent acts perpetrated against them and as frequently as possible to involve the police."

Mary Hinds, of the Royal College of Nursing in Northern Ireland, said: "Our own research shows that from April 2005 to March 2006 over 3,200 nurses experienced acts of verbal or physical abuse.

"This type of violence simply cannot continue."

Breastfeeding law call

Tuesday August 29th, 2006

Welsh doctors and midwives have joined forces to promote the rights of mothers to breastfeed babies in all public places including restaurants, cafes and shops.

The British Medical Association Cymru Wales and the Royal College of Midwives believe new legislation on breastfeeding would help change public attitudes - and have called on the National Assembly for Wales to act.

Royal College of Midwives Director for Wales, Helen Rogers, said studies have shown the short and long-term benefits of breastfeeding.

"It is a tragedy that breastfeeding mothers continue to be treated in a negative manner, by being asked to leave premises or made to feel uncomfortable in carrying out what is, in fact, an entirely natural practice."

Legislation would give clear guidelines for proprietors to deal with complaints about breastfeeding mothers and would also send a clear message that the National Assembly of Wales actively supported and promoted breastfeeding.

A recent National Childbirth Trust survey found that 79 per cent of mothers would like a law to protect their right to breastfeed.

NCT policy researcher Rosie Dodds said all women should be able to feed their baby in public without feeling uncomfortable or unwelcome.

"We know that by far the majority of adults don't have a problem with women breastfeeding their babies while they are out," Ms Dodds said.

BMA Welsh secretary Dr Richard Lewis said: "Breastfeeding in infancy has a protective effect against many childhood illnesses including gastro-intestinal infections, respiratory infections, urinary tract infection, ear infections, eczema, asthma and wheezing and insulin-dependent diabetes mellitus.

"Women who have breast fed have lower risks of pre-menopausal breast cancer, epithelial ovarian cancer and hip fracture in later life."

Books on Women's Health

England needs to slim down - ministers

Monday August 28th, 2006

More than 13 million people in England - nearly a quarter of the population - will be obese within four years, according to a shock government report.

As many as one in three men and one million children could be dangerously overweight, the department of health warned.

And although the male population tends to be heavier than the female, this may change. By 2010 one in five girls under the age of 11 will be obese, government researchers found.

The research found that children are most at risk when their parents are obese. Just five per cent of children of "healthy" parents are obese.

Health secretary Patricia Hewitt said the government needed to take action "now".

She said: "With children heading back to school in September - these statistics should give parents food for thought on how to make their kids'
lifestyles healthier.

"It's about thinking of what's in their packed lunches, educating them to choose the healthy option on their school dinner menu and encouraging them to play outside instead of on their computers.

"We are intervening and helping to make a difference, but we want today's figures to act as a stark reminder of the problem we and our children will face if we don't act now and start making healthier lifestyle choices."

Dr Susan Jebb, of the Medical Research Council warned it could take many decades to reverse the trend.

She told reporters: "People are not thin one day and fat the next, or vice versa."

Books on Healthy Eating Ideas

Should the UK follow US-style doctor certification?

Friday August 25th, 2006

US-style certification of doctors would improve medical standards in the UK, academics claimed today.

Dr Kim Sutherland of Cambridge University, UK, and Dr Sheila Leatherman of the University of North Carolina, USA, support the chief medical officer Sir Liam Donaldson's recent call for certification of doctors.

Writing in the British Medical Journal, they state that this would improve professional regulation, and they highlight research which shows certification is linked to better care.

"In the UK, routine data continue to highlight uneven quality of care compared with other countries," they write. Recent cases such as Harold Shipman "point to failures in underlying systems for detecting and preventing unsatisfactory performance at an early stage".

In the US, certification is renewed every 6-10 years. The authors reviewed US studies and found that more than half showed a link between certification and improved outcomes across a range of specialties. Conversely, a lack of certification has been linked to more frequent disciplinary action.

The key strengths of certification include objective measures of doctors' knowledge, subjective approval ratings by peers, requirements for ongoing learning and self-auditing, and information that is useful to patients, the authors write.

"As the NHS strives to secure improvements in quality of care, it is important to consider the central part played by the professions," they conclude. "Individual professional conduct ... will always provide a patient with the best quality assurance."

Sutherland, K. and Leatherman, S. Does certification improve medical standards? British Medical Journal, Vol. 333, August 26, 2006, pp. 439-41.

Self harm revealed among teenagers

Wednesday August 23rd, 2006

As many as ten per cent of teenaged girls harm themselves every year, according to a major new study.

About two thirds of these cause themselves harm by cutting - although hospitals most commonly see girls with overdoses.

Researchers questioned some 6,000 teenagers aged 15 and 16 in Oxfordshire, Northamptonshire and Birmingham for the study.

They found girls were four times as likely as boys to harm themselves.

Only about one in six incidents were likely to lead to a teenager going to hospital.

Researchers found bullying and physical and sexual abuse were among the major problems provoking teenagers to harm themselves.

Researcher Professor Keith Hawton, from Oxford University, called for schools to develop initiatives to help teenagers at risk.

He said: "This study provides more information about why young people engage in deliberate self-harm and helps us to recognise those at risk, to develop explanatory models and to design effective prevention programmes.

"In many cases, self-harming behaviour represents a transient period of distress, but for others it is an important indicator of mental health problems and a risk of suicide."

He said many teenagers said the greatest support came from their friends.

He said: "This responsibility places a great burden on adolescents to support their peers, yet most adolescents have not in any way been coached in how best to do this."

The researchers worked with the Samaritans and the findings are published in the organisation's new guidebook for teachers "By their own young hand".

Cancer drug row

Tuesday August 22nd, 2006

Campaigners reacted in anger yesterday to a proposal to block the use of two bowel cancer drugs in Britain.

Avastin and Erbitux have been used to treat patients with metastatic cancer.

But the National Institute for Health and Clinical Excellence says neither drug should be used as their cost does not justify their limit benefits.

The controversy surrounds the ability of the drugs to extend the life of terminally ill patients - said to be four or five months.

Avastin costs nearly 17,000 for a patient while Erbitux costs nearly 12,000.

NICE said existing patients who are taking the drug should be allowed to continue with it.

Hilary Whittaker, chief executive of Beating Bowel Cancer, said: "We are now the only nation in the EU not to offer cetuximab and bevacizumab to bowel cancer patients in the disease's advanced stages.

"We feel extremely disappointed that bowel cancer - the second biggest cancer killer - is not being given the attention or funding it deserves."

Professor Karol Sikora, of Imperial College, London, told reporters: "These drugs are expensive but they are effective, trials have shown them to be effective.

"The difficulty for the NHS is they are costly. The way it is done is simply to calculate the amount of cost for prolonging survival by one year. The average NHS limit is around 30,000."

Anthrax death alert

Thursday August 17th, 2006

A drum maker has become the first person in Scotland to die from anthrax in the last 20 years, it was announced yesterday.

Public health officials are trying to trace the source of the infection, thought to be from animal skins imported from eastern Europe for the making of drums.

They stressed there was little risk of an epidemic.

Because the dead man worked with animal hides he would have been at high risk of contracting the disease from an infected animal, officials said.

Anthrax gained notoriety in the last century as it formed the basis of germ warfare experiments - but, according to Scottish public health officials, most strains are very difficult to contract.

The man, aged 50, died in Edinburgh on July 8th from a blood infection but it took extensive laboratory testing to diagnose the source of the illness.

A spokesman for Health Protection Scotland said: "Anthrax is a difficult disease to contract and is not passed from person to person. The risk to individuals who had contact with the deceased during his illness, either locally at Borders General Hospital, or the Royal Infirmary Edinburgh where he was treated is negligible."

Open spaces key to child health crisis

Wednesday August 16th, 2006

Investment in open spaces and play areas for children could make a massive difference to their fitness, an international conference, held in Bristol, UK, has been told.

Children can no longer play safely on the streets whilst play areas and parks are increasingly "unchallenging" because of health and safety fears, the conference was told.

Loss of children's play is leading to physical idleness and a health "time bomb", delegates claimed.

The conference was organised by the University of the West of England's faculty of the built environment.

Professor Lamine Mahdjoubi, who chaired the conference, said: "As councils cut their spending on outdoor spaces and society encourages physical idleness, obesity is becoming an epidemic. Young people now face heart problems, diabetes and other diseases because of their sedentary lifestyles.

"This puts them at risk of premature death and confronts the NHS with a rocketing bill."

Marie Forsyth, a campaigning mother from Glasgow, Scotland, told the conference: "The streets are unrecognisable from our youth.

"Now, they are full of traffic, and play spaces are desolate and scarred by drug-taking. We were poor but at least we had a childhood."

The conference heard that open spaces are more cost effective than indoor fitness centres - and had much more appeal to children.

Professor Lamine said: "Open urban spaces cost 600 million to run for 2.5 billion visits.In contrast, the fitness culture costs 400 million for 100 million visits and 80 per cent of customers use their cars to get there."

Books on Child and Adolescent health

Better heat wave planning needed for UK

Friday August 11th, 2006

Health protection during heat waves must be improved as the British climate continues to get warmer, warns a public health expert today.

Dr Sari Kovats of the London School of Hygiene and Tropical Medicine, UK, argues in the British Medical Journal that the current response is not enough. Vulnerable people must be actively identified and protected, she believes.

In her editorial, Dr Kovats states: "The UK has recently had its hottest month since records began in 1660. The full impact on health is not yet known."

Research on the social and environmental causes of heat-related mortality is scarce. And England's heat wave response plan, set in motion for the first time in July, can often involve just passive dissemination of advice on heat avoidance.

Instead, Dr Kovats calls for active help for people with psychiatric disorders, depression, heart disease and diabetes as these are at higher risk of death during a heat wave.

Heat illness among elderly people in nursing and residential homes can be prevented by keeping the patient cool, hydrated, and with adequate salt balance, she writes.

A group set up by the World Health Organisation is working on good practice for health protection during heat waves, and the mayor of London, Ken Livingstone, is calling for an infrastructure that can cope with future climates.

"An inter-agency approach - involving key health and social care providers as well as stakeholder groups - is needed," Dr Kovat states.

"Heat wave systems also need to be better integrated within the disaster response agencies."

Kovats, R. S. Heat waves and health protection. British Medical Journal, Vol. 333, August 12, 2006, pp. 314-15.

Health service must help ignorant men - campaigners

Tuesday August 8th, 2006

Ignorance about condoms may lie behind some of the spread of sexual disease in Britain, campaigners claimed today.

Marking Sexual Health Week, planners called for sexual health clinics to move away from standard issue condoms.

The former Family Planning Association - now known as "fpa" - said men did not realise they need to obtain protection to fit them - and often if they took advice from the NHS were not warned of this.

An fpa survey found that more than third of condom users had experienced problems caused by using items of the wrong size.

And one quarter did not even know they could be purchased in different shapes and sizes.

Toni Belfield, of fpa, said: "Men come in different shapes and sizes and so do condoms.

"Poor use of condoms can have devastating consequences on people's sexual health. Recent new figures showed the UK has the highest ever number of new cases of chlamydia and continued high rates of unwanted pregnancies3.

"Problems such as condoms splitting or coming off are directly related to people choosing the wrong size and shape or not using them correctly. When this happens, people lose trust and confidence in the method. As a direct consequence, people are then far more likely to use condoms erratically or stop using them altogether."

She added: "The NHS is the largest distributor of free condoms in the UK. We would like to see a much wider variety of condoms made available so that people can chose a fit that is right for them from a good selection."

Kathy French, sexual health adviser to the Royal College of Nursing sexual health adviser, said: "The fpa's findings on condom usage show that there is much to be done to educate people about the different types and sizes of condoms available to them.

"Every day sexual health nurses see the devastating impact of Sexually Transmitted Infections (STIs) and are continually improving, developing and extending services to meet patients' needs."

Meanwhile in Scotland some 15 million was promised to help improve access to sexual health services.

Saying the cash would be spent over three years, health minister Andy Kerr said: "Our message for good sexual health is 'delay until you're ready but be safe when you are active'."

Stroke patients miss out on clot-busters

Thursday August 3rd, 2006

Improvements in emergency stroke treatment still leave the NHS a long way short of a decent service, according to a report published today.

Just 50 per cent of British hospitals have special units for emergency stroke patients, the report found. This represents an improvement on 34 per cent in 2004.

About ten per cent of emergency patients should get clot-busting treatment - but just one in a thousand actually do, researchers found. This represents just 218 patients a year.

And in Wales hospitals have reduced the number of beds on stroke units, so the average hospital now has 20 beds compared with 21 two years ago.

The report, compiled by the Royal College of Physicians and funded by the Healthcare Commission, found just 12 per cent of hospitals had set up arrangements with the ambulance services for handling emergency admission to hospital.

Dr Tony Rudd, chair of the Intercollegiate Stroke Group, said: "Although there are some areas where stroke care has improved significantly over the last few years we are still lagging a long way behind the services provided for heart patients.

"Treating stroke as a medical emergency could prevent a large number of people ending up with severe long term disability. Providing effective longer term rehabilitation to people who need it would also be a good investment, not only reducing dependency but also saving resources for society."

Dr Jonathan Boyce, head of audit at the Healthcare Commission, said emergency care for stroke patients was "deficient".

Joe Korner, of the Stroke Association, said: "Despite welcome increases in the number of stroke units, lives are still being lost because of huge gaps in emergency and acute care for stroke. Last year only 218 stroke patients got the potentially life saving clot-busting treatment they needed, but as many as 12,000 people lost out."

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