A smokefree future: a comprehensive tobacco control strategy for England

This new tobacco control strategy for England establishes a vision of eradicating tobacco harms and creating a smokefree future, so that we can support people to live healthier and longer lives. The strategy follows on from a successful public consultation in 2008 on the future of tobacco control, which drew nearly 100,000 individual responses.

To deliver this vision the strategy sets out three overarching objectives to make significant progress towards a smokefree society:

1. To stop the inflow of young people recruited as smokers.
2. To motivate and assist every smoker to quit.
3. To protect families and communities.

Against each objective, we are setting an aspiration of what could be achieved by 2020, including halving the numbers of adult smokers to just one in ten, and reducing the number of children who take up smoking to negligible levels.  Delivering these aspirations will maintain England’s position as a world leader in tobacco control but can only be achieved if all partners across the public, private and voluntary sectors continue to prioritise tobacco control and implement the evidence-based policies set out in this strategy.

10 radical solutions to binge drinking

Pressure to address the UK’s binge drinking grows ever stronger, with a number of radical solutions being put forward to try to help people cut down.

David Cameron last week called binge drinking a “scandal” that costs the NHS £2.7bn a year. He pledged to introduce drunk tanks and booze buses, and there are plans for a minimum price for alcohol.

So what are the most radical solutions to the problem?

No trust in government’s handling of NHS, poll suggests

Over two-thirds of people do not trust the government’s handling of the NHS, a poll commissioned by BBC Radio 5 live‘s Victoria Deryshire programme suggets.

Only 18% of the 1,005 adults surveyed in England think Andrew Lansley is doing a good job as Health Secretary.

Health Minister Simon Burns said the government’s plans for the NHS are safeguarding it for future generations.

The poll was conducted by independent body ComRes.

When asked which political party they trusted most with the health service, one-third (32%) of people surveyed said they trusted none of them.

Labour received the highest vote of confidence at 37% and less than one in ten people said they trusted the Liberal Democrats

Delay NHS 111 phoneline rollout, doctors urge

Doctors’ leaders say they have “serious concerns” about the rollout of the NHS 111 phoneline in England.

The free one-stop number for patients with urgent, but not life-threatening symptoms, is planned for April 2013.

The British Medical Association says existing services may come under strain and wrote to the health secretary asking for the deadline to be relaxed. Other organisations echo its worries.

The government said it would consider the issues raised by the BMA.

Last month the new non-emergency 101 police phone number was launched nationwide and has already received more than 2.5 million calls.

The 101 number is intended for calls that do not require an emergency response from either the police or fire service.

Wilson announces more than £580m investment in roads and hospitals

The finance minister has revealed a series of capital investments in hospitals and the road network.

Sammy Wilson confirmed almost £600m of investment in the assembly on Tuesday.

How we can help children improve their health

The health of our children and young people matters to us, and it matters to them. We want them to understand what makes them healthy, what keeps them healthy, and what to do when they have worries, are not feeling so good, or are simply ill.

In this week’s Scrubbing Up, Barbara Hearn, deputy chief executive of the National Children’s Bureau, says the launch of the government’s Children’s and Young People’s Forum presents a key opportunity to improve services for them.

Teenage years are the transition years. Adolescents face choices that will affect their health now and in the future.

But while they can get information from parents, will it be up to date? When they ask their mates, will they be well informed?

While health promotion plays a key role, a significant and early point of private contact with health services for a teenager is their GP.

Some children and young people express feeling embarrassed and judged when they seek advice from their GP. They can find it hard to describe their own health concerns and find it hard to understand their doctor’s response.

While GPs continue to improve in terms of their own confidence and capacity to make a child patient feel comfortable it is not yet a guaranteed good experience for those under 18′s everywhere.

Practices need to be attuned to just how intimidating an all adult environment can be for teens and pre-teens to enter.

Three changes are required. Firstly, better professional development. GPs do have some training in child development but it is insufficient.

Learning how to talk to 12 -18 year olds; and even more importantly, how to listen to what they have to say; how to encourage them to speak up; and to be confident that they understand what is said to them before they leave, takes time.

Assisted suicide cases guidelines issued by GMC

The General Medical Council is launching its first ever guidelines on assisted suicide.

The new guidelines will help the GMC decide if doctors should face a disciplinary panel if they are alleged to have encouraged or assisted suicide.

A draft version is to be subject to a three month public consultation period.

The GMC’s chief executive, Niall Dickson said “the main message is that assisting suicide is illegal and doctors should have no part of it”.

The GMC, which is the regulatory authority for doctors, decided to produce the guidelines after the case of a severely paralysed man, which was highlighted by the BBC last summer.

The man, given the pseudonym “Martin”, told the PM Programme that he wanted to end his life and was taking legal action to try to get advice and help to do so.

Mutation linked to 42% rise in stroke risk

A “single genetic mutation can double your risk of stroke”, the Daily Mail has reported. The newspaper added that scientists hope the discovery could lead to tailored treatments for the condition.

The news is based on research which looked for genetic variations that were more common in people who had had an ischaemic stroke than in people who had not had one. Ischaemic strokes occur when the blood flow to a part of the brain is blocked. They account for 80% of stroke cases. By testing the DNA of several thousand participants, the researchers identified a new genetic variant that was associated with increased risk of a type of ischaemic stroke called a “large vessel stroke”. In large vessel strokes, one or more of the arteries supplying blood to the brain become blocked. People can carry up to two copies of the variant, and the study’s authors estimated that each copy of the variant a person carried was associated with about a 42% increase in the odds of a large vessel stroke. However, it is not yet known whether this genetic variant raises the risk of a stroke, or if it is found near to another variant that is responsible for the increased risk.

This well-designed study has identified a new association between a genetic variation and strokes. However, the study cannot confirm whether the variation itself causes the increased risk of a stroke. This key issue will need to be clarified before these findings can contribute to the development of the new treatments that many newspapers optimistically predicted.

US-style alcohol tests to be used for problem drinkers

Problem drinkers inLondonare to be given American-style sobriety tests aimed at keeping them dry.

The pilot scheme has been given the go-ahead by the Ministry of Justice to use a concept copied fromSouth Dakota, US.

Those convicted of serious drink-related offences, like assault or criminal damage, will be offered the 24/7 Sobriety Programme as a sentencing option instead of prison.

Electronic tags will be used to monitor alcohol in the blood.

It involves technology that has never been used before in theUK.

Those behind the scheme say if offenders do not curb their drinking they will receive a short prison sentence.

The idea has been criticised both in theUKand theUSas being draconian and an ineffective way of treating genuine alcohol issues.

The plan has been supported by the Deputy Mayor ofLondon, Kit Malthouse, who heard about the programme and has been looking at how to adapt it forUKuse.

Does outdoor play help keep the doctor away?

Is modern living resulting in more people becoming disconnected from green spaces and the natural world, at the expense of our health and well-being?

Most concern is centred around children, who – say campaigners – are missing out on opportunities afforded to previous generations, ones as simple as climbing trees or getting their knees dirty.

In an increasingly urbanised, electronic-based, risk-adverse world, the adults of the future are displaying the symptoms of “nature-deficit disorder”.

The term was coined by Richard Louv, author of Last Child in the Wood.

In the introduction to his book, he said that over the past few decades the way children understood and experienced nature had “changed radically”.

“The polarity of the relationship has reversed,” he wrote.

“Today, kids are aware of the global threats to the environment – but their physical contact, their intimacy with nature, is fading.

“That’s exactly the opposite of how it was when I was a child.”

Difficult to see how C. diff spreads in hospital

“We don’t know what causes deadly hospital superbug to spread, admit scientists,” the Daily Mail has reported. “Hospitals may be adopting the wrong strategy for combating a notorious bug on the wards,” it goes on to say. This story is based on new research investigating the transmission of Clostridium difficile (C. difficile), a hospital-acquired infection that can be fatal.

C. difficile is thought to be spread in hospital through contact with infected patients, but newUKresearch has found that this may not be the case. The research found that two-thirds of new cases in hospital were not linked to any cases of patients known to be infected. Less than a quarter of the newly infected patients had the same type of C. difficile infection as a patient on their ward who was known to be infected.

This research challenges the assumption that C. difficile is spread on wards through contact with infected patients. It means that current strategies focusing on preventing person-to-person spread may not stop C. difficile transmission.

This research cannot tell us how good hospital prevention strategies are at stopping C. difficile from spreading. People visiting and being admitted to hospital should continue to follow their hospital’s hygiene advice, particularly regarding hand washing and the use of alcohol hand gels.

Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers

A UK-wide document that presents guidelines on the volume, duration, frequency and type of physical activity required across the lifecourse to achieve general health benefits. It is aimed at the NHS, local authorities and a range of other organisations designing services to promote physical activity. The document is intended for professionals, practitioners and policymakers concerned with formulating and implementing policies and programmes that utilise the promotion of physical activity, sport, exercise and active travel to achieve health gains.

Plans for NHS in England an unholy mess, say journals

Changes to the NHS in England have created an “unholy mess”, the editors of three leading journals have said.

With the overhaul just over a year away, the joint editorial by the Health Service Journal, Nursing Times and British Medical Journal acknowledged it was unlikely it could be stopped now.

But it predicted the changes would be so destructive another reorganisation would be needed within five years.

And it urged politicians to learn from the mistakes that had been made.

The opinion piece, which will be published in the three magazines this week, suggests an independent commission be set up to oversee changes in the future.

The intervention by the journals comes after the major NHS unions have called for the bill underpinning the changes to be scrapped.

Last week the medical royal colleges, which set standards in the NHS, nearly joined them in opposing the plans, before deciding against the move following last-minute pleas by ministers.

It means if the bill completes its passage through Parliament in the coming months the new system will go live in April 2013.

New online test tries to cut deaths from asthma attacks

New online test is being launched that will help people with asthma gauge to what extent they are at risk from a serious attack.

The website will also advise people what they can do to minimise that risk and how to stay well.

At the same time a national review of all asthma deaths over the next year is also getting under way.

It aims to reduce the number of deaths through asthma attacks, which claim the lives of three people in the UK a day.

The online test is called Triple A: Avoid Asthma Attacks.

It asks simple questions about factors which have been linked to increasing the risk of an asthma attack that could lead to a hospital admission.

According to the charity Asthma UK, which is behind the new website, about 75% of asthma-related emergency hospital admissions could be prevented.

Working long hours ‘linked to depression’

“Working eleven hours a day can lead to severe depression,” Metro has today reported. According to the newspaper, staff who put in 11 or more hours a day at the office are twice as likely to suffer a severe bout of depression than those working just eight.

This news is based on a study that examined the working habits of over 2,000 UK civil servants and how their working related to major depressive symptoms in the six years that followed. After accounting for other factors linked to depression, the researchers found that working 11 or more hours a week was associated with a 2.5 times increase the odds of experiencing a major depressive episode compared with their colleagues working the Civil Service’s standard seven to eight hours a day.

This research has found a link between working overtime and the risk of subsequent major depressive episodes. However, the relationship is complicated and this research cannot concretely tell whether or not overtime actually causes depression. Verifying this potential link would probably require controlled studies looking at whether or not cutting back work hours proves effective at reducing people’s risk of depression.

Also, this study found strong links between financial status, seniority and a reduced risk of major depression, making the influence of working hours harder to judge. Overall, it is likely that several factors work together to cause depression and the role working hours play in this is unclear.

Contraceptive pill for period pain: does it work?

“The Pill CAN ease the agony of period pain: scientists confirm what millions of women already know,” the Daily Mail reported today. This headline is based on a study that found that use of the combined oral contraceptive pill (and, to a lesser extent, getting older and childbirth) was associated with slightly less severe period pain.

However, the media have missed the point that this study does not show that the pill reduces period pain. It simply shows that at two points in time, on average, women on the pill assessed their period pain as being slightly less than non-pill users did. It is possible that many other factors played a part in these women’s experience of pain. The study also relied on women self-reporting their pain through a postal questionnaire. Subjective experiences of pain vary and can be influenced by many factors, which means the results are less reliable.

The authors of this research – who advocate that contraceptive counselling sessions should outline the possible benefits of the pill for period pain – have links with the manufacturers of contraceptive pills. However, their study was not funded by pharmaceutical companies.

The pill is currently prescribed by many doctors as an ‘unlicensed’ treatment to reduce period pain, despite there being very little good evidence supporting this practice. The best available evidence (a systematic review of all trials for period pain without underlying causes) consisted of only a few trials but concluded that combined contraceptives with doses less than 35 micrograms were effective for treating period pain. Anyone studying this again should conduct a randomised trial not a survey.

Environment ‘sustains intelligence’

The Daily Mail has reported that “lifestyle is key to staying alert into old age”, and that genes are not to blame for changes in intelligence as we age. The newspaper adds that our environment is the most important factor controlling changes in intelligence – in other words, we can control it.

This news is based on an unusual long-term study that examined how a group of nearly 2,000 Scottish people varied in intelligence across the course of their lives, and whether genetic and environmental factors could be responsible. To do this, researchers mapped the genetics of elderly participants who had first taken general intelligence tests when they were 11 years old. The participants again had their intelligence tested between the ages of 65 and 79, with researchers looking at how closely their genetics were tied to changes in test performance over their lifetimes. The researchers estimated that 24% of the variation in intelligence from childhood to old age is accounted for by genetics.

This research combined relatively new genetic technology with a long-term study of intelligence. It sought to determine how much of the change in intelligence over a lifetime is due to genetic factors. However, while the results were intriguing they were not statistically significant, therefore we cannot tell whether they occurred due to chance. Further research will be now needed to tell if the association holds true.

Synthetic particles ‘could boost vaccines’

“Tiny capsules engineered to mimic part of the body’s immune system could strengthen its response to vaccines,” reported the BBC today. The body’s immune response to a vaccine allows the immune system to learn about potential infections such as the flu, allowing it to prepare defences against genuine infections it encounters further down the line.

The news is based on new vaccine research in which scientists were able to synthetically mimic tiny particles released by certain immune cells when they encounter infections and potential threats.

The scientists theorised that these synthetic particles might improve vaccines by the boosting the immune response, and set about testing the theory in mice. The researchers gave the mice a combination of flu vaccine and the synthetic particles. They found the mice produced a greater number and range of ‘antibodies’ (proteins that help identify and fight specific infections). When mice were exposed to the flu, more of the mice who received the particles in combination with the vaccine survived, compared to those who received the vaccine alone.

This exciting technology may have the potential to boost the effectiveness of vaccinations, especially as the researchers were able to vary the synthetic particles, changing the immune response. By combining particular synthetic particles with different vaccinations, the body could be primed to produce the ideal immune response to a particular threat.

However, the research is at an early stage and so far experiments have only been performed on mice. Further laboratory research would need to be carried out before considering any trials in humans to see whether it would be safe and effective to add synthetic particles to vaccines.

NHS ‘facing neurology disease time bomb’

The NHS in England is facing a time bomb if it does not get to grips with neurological conditions such as Parkinson’s disease, campaigners say.

The Neurological Alliance, which represents 70 groups, said a combination of poor services and rising case numbers was causing problems.

It accused the NHS of having its “head in the sand”.

The government said it recognised that more needed to be done for people with neurological conditions.

Rise in number of ‘younger’ knee replacements

Data suggests there has been a big rise in knee replacement operation rates, particularly for younger patients.

Figures for the UK, US and Finland show an emerging trend of requests for arthritic ‘baby boomers’ in their 50s.

UK experts believe the nation’s growing obesity problem is partly to blame for the rise, putting strain on the knees.

A report in Arthritis & Rheumatism says work is urgently needed to check that replacements in this age group is wise given the product’s unknown shelf life.

The durability of the replacement knee joints has only been assessed in patients in their 60s, 70s and 80s, not in their 50s.

Best estimates suggest the joints last for about 15 years in these “older” and often less physically active recipients.

Nicotine patches may ease mental decline

A small pilot study has suggested that nicotine may aid memory in early dementia, according to BBC News. During the study, researchers gave non-smoking elderly people with mild mental impairment either genuine nicotine patches or dummy patches containing no nicotine.

The 39 patients given genuine nicotine patches showed improvements in some, but not all, memory tests compared to the group that received the dummy patches. However, a medical assessment of overall functioning showed no difference between the two groups. Nicotine treatment was also shown to be safe in the people who received it.

As many newspapers rightly highlighted, this was a small pilot study and further research is needed to see if the results can be replicated in a larger group of people. Importantly, this study did not have a long enough follow-up period to see whether the nicotine treatment could prevent the participants’ mild mental impairment progressing to a more severe form of dementia. It is also not clear from this study whether nicotine could have any effect in treating Alzheimer’s disease, which is characterised by progressive memory loss over time.

Diabetes drug ‘may aid weight loss’

A “fat-busting jab could be the key to battling Britain’s obesity crisis”, the Daily Express has reported today.

The news is based on a study looking at drugs called glucagon-like peptide-1 receptor (GLP-1R) agonists that can regulate blood sugar and suppress appetite. The drugs are currently used to control blood pressure in some diabetic patients, but this new study looked at whether the drugs could aid weight loss, both in people with diabetes and without. To examine the issue researchers combined the results of 25 previous studies involving GLP-1R drugs, looking at weight loss and other outcomes. The review found that those taking the drugs for at least 20 weeks lost an average of nearly 3kgs (7lb) more than those who were not on the drugs. Those on the drugs also had reductions in blood pressure and cholesterol levels.

There are two GLP-1R drugs currently licensed only for the treatment of type 2 diabetes that has not responded to other standard treatments. Whether or not the drugs can “cure” the “obesity crisis”, is not really a question for debate at the current time because they cannot be prescribed for people without type 2 diabetes, and even in people with type 2 diabetes they have very restricted eligibility criteria. As an accompanying editorial points out, these are relatively new drugs and their long-term safety profile is unknown. Further research into the risks and benefits of these drugs – both in people with diabetes and without – is required before they could be considered to be a possible treatment for weight loss in the wider population.

Ambulance break row talks continuing

Talks aimed at resolving a dispute over payments for ambulance staff having their breaks interrupted by emergency calls have resumed.

Union members rejected a new deal to increase payments on Friday.

The death of Mandy Mathieson, of Moray, brought the row to wider public attention. An ambulance technician stationed close to her home did not respond to a call as he was on a break.

The Scottish Ambulance Service said the dialogue was continuing on Monday.

The latest offer would have seen paramedics and technicians receive a one-off payment of £1,500, then £100 each time their rest break is interrupted to attend an emergency call.

Health Secretary Nicola Sturgeon said the rejection was “disappointing”.

Routine aspirin ‘may cause harm’

Healthy people who take aspirin to prevent a heart attack or stroke could be doing more harm than good, warn researchers.

An analysis of more than 100,000 patients, published in Archives of Internal Medicine, concluded the risk of internal bleeding was too high.

The UK-led study said only people with a history of heart problems or stroke should take the tablets.

Experts said any decision should be made with a doctor.

Scientists grow sperm in lab

Infertile men may soon be able to father children with their own sperm grown outside their bodies, the Daily Mirror has today reported. The article explained that researchers have successfully created mouse sperm in the lab, raising the possibility of couples no longer having to rely on sperm donors.

The story is based on a laboratory experiment in which scientists were able to take cells obtained from the testes of young mice and grow them into mouse sperm in the laboratory. They grew the sperm using a special nutrient-rich jelly in a 3D environment, which they say more closely resembles the environment found in the testes than the systems used in previous, unsuccessful experiments.

Although the research is of interest, there is a long way to go before scientists can know if the same techniques could be used to grow human sperm in the laboratory. In particular, it is unknown whether appropriate cells could be obtained from humans, and whether they would behave in the same way as testicular cells taken from immature mice when grown in the laboratory. It should also be noted that the scientists were unable to isolate live mouse sperm in this experiment or test if they were capable of fertilising mouse eggs.

Do trauma survivors miss out on valuable treatment?

Hundreds of thousands of people every year in the UK suffer from the severe stress reaction, post-traumatic stress disorder (PTSD).

But Dr Jennifer Wild of the Institute of Psychiatry at King’s College London says in this week’s Scrubbing Up that they are not getting the help they need.

I’m treating Paul, a young man who was stabbed in London in 2001. Terrifying memories of the attack replay over and over in his mind. He can’t concentrate, feels scared, and has been unable to leave his house.

He has post-traumatic stress disorder (PTSD) and has been suffering for 10 years. But it is only now that he’s getting treatment.

Sadly this is a common story for trauma survivors.

They wait years before getting the help they need because they’re ashamed they’re coping so badly and many don’t even know that their symptoms can be treated.

But that’s not the only problem. GPs don’t know enough about what PTSD is and how it should be treated.

British Heart Foundation says ‘no kissing, just hard CPR’

The British Heart Foundation is urging people to forget “mouth-to-mouth” and to concentrate on chest compressions when performing CPR.

“Hands-only CPR” has previously been supported by the Resuscitation Council (UK).

But it is now being promoted in a new advertising campaign featuring footballer-turned-actor Vinnie Jones.

New polling by the BHF suggests many feel worried about the idea of giving the “kiss of life”.

The official position of the BHF is now that anyone who does not have CPR training should ignore the kiss of life in favour of hard and fast compressions in the centre of the chest.

Heartburn reflux rise ‘triggered by fatty diet’

“Obesity could be driving a 50% rise in people suffering acid reflux over the last decade,” reported the Daily Mail. In acid reflux, stomach acid is regurgitated into the oesophagus, the tube that food passes down after it is swallowed.

The news comes from a study that found that the number of people experiencing at least one acid reflux attack a week has risen from 11.6% to 17.1% in just over a decade, while those suffering severe symptoms is up from 5.4% to 6.7%.

The large study was well-conducted, although it had some important limitations, including its reliance on people self-reporting their symptoms of acid reflux; also, much of it relied on people themselves deciding if their symptoms were minor or severe.

Most people get occasional symptoms of acid reflux, causing indigestion, or heartburn. When symptoms occur on a regular basis, the condition is called gastro-oesophageal reflux disease (GORD). While the findings are of concern, it is possible that the increase may partly be accounted for by the increasing number of older people, since the risk of GORD increases with age. The study did not look at the role of obesity, although it can increase the risk of GORD.

Paracetamol research is not cause for concern

“Taking too much paracetamol in pills and cold remedies could kill you,” the Daily Mail has today reported. BBC News said researchers have found that even taking slightly too much paracetamol day after day “can cause overdose”.

People should not be alarmed by this news, which is based on an analysis of over 600 paracetamol users admitted to a Scottish liver transplant unit over a 16-year period. Rather than looking at how often small overdoses caused hospitalisation or death, the research actually looked at the pattern of paracetamol use in those people that ended up needing special liver care after accidental and deliberate paracetamol overdoses.

Crucially, this research does not undermine the fact that paracetamol is a safe and effective painkiller when taken correctly. The research provides valuable information on this specific group of patients, particularly the impact of ‘staggered overdose’, when people take two or more paracetamol doses above the recommended level over a period of more than eight hours. Approximately 6 out of every 10 patients in the staggered overdose group survived for 30 days at the clinic, whereas 7 out of 10 survived in a group that had overdosed at single point in time.

While this research does not undermine the safety of paracetamol, it reminds us to always read the label or leaflet that comes with the medication we take and ensure we do not accidentally exceed the recommended dose, especially when taking different medications for different ailments.

Dreams ‘can ease painful memories’

“Dreams are a form of therapy to help us cope with painful memories,” according to the Daily Mirror. The newspaper said scientists have found that during deep sleep the body’s “stress chemistry” shuts down to take the edge off the day’s problems.

The research looked at a type of sleep called Rapid Eye Movement (REM) sleep, the phase of deep sleep when dreams occur. In the small study, researchers exposed people to images designed to trigger an emotional response and looked at how the time of day they were viewed affected their emotions and brain activity. The researchers found that those participants who slept between viewings showed reduced activity in brain areas linked to emotion, and reported finding the images less intense.

This small study highlights some interesting theories as to why sleep may promote emotional wellbeing. Generally, it seems to support the commonly held belief that a good night’s sleep can put our worries and emotions in perspective. However, it only involved 34 participants, and looked at the short-term outcomes in an artificial setting. It would therefore be unwise to draw any firm conclusions from its findings, or to assume that sleep is therapy for traumatic experiences.

The study was generally overinterpreted by the press. In particular, the claims that dreams can help ease bad memories is not supported by its findings.

Scan can spot ‘curable cause of high blood pressure’

Doctors say they have found a medical test that can diagnose the most common curable cause of high blood pressure.

Conn’s syndrome – a disease of the adrenal glands that sit above the kidneys – is thought to be the cause behind one in 20 cases of hypertension.

But until now it has been difficult to detect, requiring a complex series of tests on blood taken from a vein supplying the adrenal gland.

Experts at the University of Cambridge say a simple scan can spot the problem.

The hi-tech PET-CT scan looks for small growths in the adrenal glands that are about the size of a five pence piece, the Journal of Clinical Endocrinology and Metabolism reports.

The hospital guide 2011

This report shows that patients are less likely to get treated promptly and more likely to die if they are admitted to hospital at the weekend. It finds that the chances of survival are better in hospitals that have more senior doctors on site but some hospitals with A&E departments have few senior doctors in hospital at weekends or overnight. It also identifies trusts with low levels of staffing and high mortality. It calls for re-organisation of services to ensure safe care 24/7.

Patients in a vegetative state ‘may be aware’

It may be possible to have conversations with patients who are in a vegetative state, The Daily Telegraph has today reported. The newspaper says new research into their brain activity has suggested they are “able to understand what is being said to them and follow commands to think certain thoughts”.

The research examined the electrical activity in 16 vegetative patients’ brains when they were asked to perform simple tasks such as wiggling their toes. Although they were unable to respond physically, measurements of their brain activity using electroencephalography (EEG) scans suggested that three were able to respond mentally to the command. When the technique was then tested in 12 healthy, conscious participants, the EEG results of three of them did not show the normal brain patterns for following the command. This result was unexplained.

This was only a small study so it is not easy to tell whether the results apply to larger groups of patients in a vegetative state. However, if it is proven to be effective in other patients it might have a role in checking whether patients who seem to be in a vegetative state actually have some level of mental function and consciousness.

Many newspapers have suggested that the method could be used to devise two-way communication systems, but this seems to be far from certain, particularly as the study only tested responses to simple commands and did not test responses to more complex messages.

Doctors call for ban on smoking in cars

“Doctors want to ban smoking in cars… even if you’re on your own,” the Daily Mail has reported. The Mail and most other newspapers and news broadcasters covered the call from the British Medical Association (BMA) for a government ban on drivers and passengers smoking in private vehicles.

In a briefing paper from its board of science, the BMA argues that there is strong evidence that smoking in cars exposes non-smokers to high levels of secondhand smoke (SHS), with about 23 times more toxins than in a smoky bar. A blanket ban on smoking in cars, it argues, would protect vulnerable groups such as children and the elderly, who often have no choice about taking a journey in a smoky vehicle. The BMA’s report also highlighted the risk of injury and death from road traffic accidents as a result of the distraction of smoking while driving. However, the report provided only a small amount of evidence on this issue.

The briefing paper coincided with the second reading of a private members’ bill calling for a ban on smoking in private vehicles when children are present. The bill is due to be debated on November 25.

Archbishop calls for NHS bill to cover spiritual health

Spiritual health must be a feature of the NHS bill for England, the Archbishop of York has insisted during debate in the House of Lords.

Dr John Sentamu told peers: “I am one of those who believe that human beings are psychosomatic spiritual entities.”

The archbishop then told how he freed the spirit of a young girl, left petrified by seeing a goat sacrificed.

During a debate on an amendment he said: “Illness can be physical or mental but it can also be spiritual.”

The amendment, tabled by psychiatrist and crossbench peer Baroness Hollins, called for the words to be inserted into a clause about the duty of the secretary of state, the NHS Commissioning Board and clinical commissioning groups to improve the quality of services.

Making his case, the Anglican archbishop argued that schools now emphasised students’ spiritual dimensions, and said hospital chaplains’ work addressed spiritual issues, as well as the physical and mental.

New pill to halt ageing, papers claim

Scientists may have “found a cure for ageing”, the Daily Mirror reported. According to the newspaper, the answer could lie in a “forever young” drug that will allow us to grow old gracefully.

However, this seemingly marvellous news is based on a small study which looked at an extremely rare form of a genetic condition called progeria. This causes children’s bodies to rapidly age and leads to a number of physical health problems, limiting their lifespan to an average of around 13 years.

The researchers examined the cells of people with the condition. They found that, compared to cells from healthy individuals, they produced five times the level of chemicals that damage the internal cell structure (called reactive oxygen species or ROS). These higher ROS levels were associated with more breaks in the cells’ DNA and abnormal cell growth. However, when the cells were treated with a drug called N-acetylcysteine, which is already used to prevent liver damage in people who have overdosed on paracetamol, the researchers were able to largely prevent this DNA damage and improve cell growth and division.

The findings of this study are at a very early stage and suggest some potential ways to help people with rare but devastating forms of progeria. However, it is too great a leap too suggest that the research provides a “cure for ageing”, as some fanciful reports have done.

Learn dementia signs, public urged

The government has today launched a campaign urging the public to learn the early signs of dementia. Several news sources have reported on the new initiative, designed to help boost early diagnosis by encouraging people to speak to their doctor if they detect the signs.

Many news sources have focused on the estimate that 6 in 10 people with dementia go undiagnosed, and that there may be up to 400,000 people in the UK who have not had their condition formally assessed.

The Department of Health campaign also highlights how the fear of dementia can put people off seeing their GP, which can stop them receiving the medical support that is most effective when started in the early stages of the disease. While dementia is not curable, getting an early diagnosis is essential, because there are services and treatments that can slow its progression and help people with dementia to enjoy a better quality of life.

Cardiff University new Parkinson’s therapy hope

A new technique could improve the quality of life for patients with Parkinson’s Disease, according to research led by Cardiff University.

Patients with the early stages of the disease were trained to control areas of the brain associated with movement by using the power of thought alone.

A clinical evaluation later found their movement had improved by up to a third.

The charity Parkinson’s UK described the research as “exciting” but stressed “these are very early days”.

The study, published in The Journal of Neuroscience, involved ten patients with the disease that affects the brain and results in slow movements and a tremor.

Five patients received the brain regulation feedback technique and five acted as a control.