Doctors 'rely on chemo too much'

Some 80,000 patients undergo chemotherapy each year

Doctors are being urged to re-think their approach to giving chemotherapy during care at the end of life.

A review of 600 cancer patients who died within 30 days of treatment found that in more than a quarter of cases it actually hastened or caused death.

The report by the National Confidential Enquiry into Patient Outcome and Death said doctors should consider reducing doses or not using chemotherapy at all.

England's cancer tsar Professor Mike Richards said he was "very concerned".

The group of patients the independent group was looking at represents 2% of the 80,000 people who receive chemotherapy each year.

This report provides very disturbing information about the safety of treatment for incurable cancer Professor Jane Maher, of Macmillan Cancer Support

They were all severely-ill patients for which the chemotherapy was mostly being used to manage their condition rather than in an attempt to cure the cancer.

After examining case notes, the group said that 35% of patients received good care.

But it found that in 27% of cases it hastened or caused death - the toxic nature of the treatment can lead to a range of problems, the most serious of which is an infection called neutropenic sepsis.

Report co-author Dr Diana Mort said doctors should be more "cautious in prescribing chemotherapy for very sick patients".

And she added: "The process of consent may require more than one discussion.

"Patients must be made aware of the risks and side-effect of chemotherapy as well as the potential benefits."

Transfer arrangements

The report also criticised the facilities made available to patients with nearly half being admitted to general medicine wards during the last 30 days of life rather than a specialist cancer unit.

The authors recommended where hospitals did not have specialist units they should put in place transfer arrangements to centres that did.

Professor Jane Maher, chief medical officer at Macmillan Cancer Support, said: "This report provides very disturbing information about the safety of treatment for incurable cancer.

"It shows that doctors and nurses need to be much better at helping patients understand the pros and cons of such powerful treatments in the last year of life."

Professor Richards said he was "very concerned".

"I am asking all chemotherapy service providers to consider these reports urgently and to reassess their own services immediately against the measures we have set nationally."

But Dr Peter Clark, of the Royal College of Physicians, said while lessons could be learnt it was important to remember that chemotherapy carried "substantial short and long-term benefit" for the majority who undergo the treatment.

News... Plymouth seeks small woman

News

small woman sought, in plymouth
Saturday, November 28, 2009

She has been seen in Staple Hill at the blue Sky cafe, she is being sought in relation to her activity with various men in the westcountry,

Mr. Colin Pugh said, "I would love to see this

woman get what she deserves.

Motorists stranded, homes flooded, roads closed as rains hit Plymouth

News

Motorists stranded, homes flooded, roads closed as rains hit Plymouth

Saturday, November 28, 2009

PLYMOUTH is bracing itself for further downpours as it counts the cost of a weekend during which it was the wettest city in the UK.

More than 20mm of rain fell in a six-hour period on Saturday leaving shops and homes flooded and people stranded in their cars.

In...

(42)

Woman, 60, dies after falling into river

Sunday, November 29, 2009

A WOMAN has died after falling into a river swollen by heavy rain that caused floods across the Westcountry over the weekend. Paula Deacon, 58, fell...

(9)

A38 closed after pedestrian is killed

Saturday, November 28, 2009

A MAN was killed in an accident on the A38 at South Brent at the weekend. The incident happened at about 3.25am on Saturday by the South Brent...

Carbon offset schemes not working

Carbon offset schemes not working, says holiday firm

Schemes allow people to offset emissions from flying or driving

Consumer carbon offset schemes do not lead people to change their behaviour, the first holiday firm to run such a scheme has argued.

Responsible Travel said they were a "distraction" from climate change's real urgency and is ending its scheme.

Such schemes involve individuals paying a premium for the emissions generated by certain choices, such as flying.

The International Carbon Reduction and Offset Alliance says offsetting has an impact, but governments must do more.

Carbon offset schemes also cover things like choosing to drive a car or choices around the way homes are heated.

'Assuage your guilt'

Money raised under the schemes is used to pay for carbon reduction projects in developing countries, such as installing solar power or capturing methane gas released by farm animals.

Some environmentalists argue that while these schemes bring some benefit, offsetting has not changed people's behaviour enough and emissions covered by such schemes should be avoided in the first place.

Justin Francis, founder of Responsible Travel, said: "It's perceived as this magic pill, this get out of jail free card if you like, that means you don't need to change your behaviour.

"You can go on flying just as much as you were before, you can run your hotel the way you were before, but through this magic pill somehow you can assuage your guilt.

People are using offsetting to take responsibility for their unavoidable emissions Jonathan Shopley, International Carbon Reduction and Offset Alliance Send us your comments

"We need to be reducing the amount we pollute and I think carbon offsetting is a distraction from that."

Andy Atkins, director of Friends of the Earth, agreed that introducing offsetting alone allowed individuals and companies to continue with business as usual.

He said: "We understand why people wanted to offset in the belief that it was reducing their emissions, but it isn't working and we have to recognise now that the science says we have to cut our emissions really, at home.

"That means governments and individuals doing everything they can to reduce their genuine carbon impact and offsetting doesn't do that."

'Making a difference'

The body representing those who run the schemes insist they do bring real benefits to the developing world.

Jonathan Shopley, of the International Carbon Reduction and Offset Alliance, said: "It's not going to solve the climate change issue on its own, that's for sure. That needs government action, taxes.

"We need to stop doing certain things, but by the same account people are using offsetting to take responsibility for their unavoidable emissions and they need to understand that is a good thing and is making a difference."

Joan Ruddock, minister for the Department of Energy and Climate Change, said: "Of course [offsetting is] not a solution to climate change - it's a tiny contribution - but it does help people to think about what they are doing.

"But we do need emissions reductions on quite a different scale and that is why we have a Climate Change Act and absolute limits on our emissions in this country."

calls for a 'greener' Hajj

Expert calls for a 'greener' Hajj

Dr Mawil Izzi Dien describes a number of ways muslims can make celebrating Hajj greener

An Islamic expert is calling on Muslims to reduce the environmental impact of Hajj, the annual pilgrimage to Mecca.

Dr Mawil Izzidien of the University of Wales, Lampeter, says the event is beset by wasted and misused resources.

He has called on Muslims to avoid air travel to Saudi Arabia where possible and stay in less luxury while there.

The Muslim Council of Wales said avoiding air travel and good hotels was unrealistic but agreed "a practical look" at the event's future was needed.

Between 25-30 November around two million Muslims will converge on Mecca - the holiest place in Islam - to take part in an event which combines piety and passion.

One of the pillars of the Islamic faith, every adult Muslim must undertake Hajj at least once in their life if they can afford it and are physically able.

There is a lot of wastage and there is a lot of misuse of the resources that are available to people while performing Hajj Dr Mawil Izzidien

Many Muslims save for years in order to perform the pilgrimage, often having to travel thousands of miles to do so.

Dr Izzidien, a reader in Islamic Studies who has written about the environmental dimensions of the pilgrimage, said the main green issue surrounding Hajj was "to encourage Muslims to reduce the number of trips towards Mecca if they can."

He said: "Rather than travelling twice, or performing Hajj twice, if they have done the first one then there is no need to do the second one."

Funds to be used for a second Hajj would be better used helping other Muslims make the journey, or to tackle poverty in the world, he suggested.

Dr Izzidien also focused on the luxurious way in which he said many Muslims travel to, and stay in, Saudi Arabia.

"They travel by first class airplanes and when they arrive in Mecca they live like they are living in a five star hotel, and they pay lots of money to do that," he said.

"Hajj is really all about travelling with difficulty. It is encouraged within Islam that the best Hajj is that which is performed with difficulty. The more difficulty a person has, the more reward he will have.

"Of course we are not saying that to travel from Africa or from Europe to Mecca on foot, but to reduce the amount of cost and carbon footprint is in many ways important.

People need to be there for 10 days and if they spend two or three of these days travelling then that is a big problem Saleem Qidwai, Muslim Council of Wales

"Maybe groups of pilgrims can perform Hajj by travelling by sea rather than by travelling by air. If they use a ship in order to travel from their location to Mecca, or to Jeddah and then to Mecca, that would reduce the environmental cost of Hajj."

The amount of food wasted during Hajj, and the wastage of meat from sacrificed sheep are other issues which need addressing, Dr Izzidien said, though he added that the local organisers were to be commended for their efforts so far to make the event more environmentally friendly.

'Realistic'

Saleem Qidwai, general secretary of the Muslim Council of Wales, said he agreed with many of Dr Izzidien's views but a practical view had to be taken on how Muslim pilgrims could lessen their carbon footprint.

"We have to be realistic," he said. "Time is short for everybody.

"People need to be there for 10 days and if they spend two or three of these days travelling then that is a big problem. Also, avoiding good hotels in Saudi Arabia is not always practical."

However Mr Qidwai said he agreed with other environmental concerns raised by Dr Izzidien.

"There is a lot of wastage at Hajj, particularly with regard to leftover plastic bags and bottles," he said.

"But let's look from a practical point of view at what we can do now to change things in the future."

CQC chair Baroness Young says that they inherited a rating system that is not fit for purpose and needs to be scrapped

Barbara Young

Barbara Young is the Chair of the Care Quality Commission.

Barbara's early career was spent in public relations and health services management. She was Chairman then President of the Institute of Health Services Management from 1986-88, and a King's Fund International Fellow in 1985-86 and 1990-1991.

Prior to joining CQC Barbara was Chief Executive of the Environment Agency. She has also been Chairman of English Nature, Vice Chairman of the BBC, and Chief Executive of the RSPB.

She has roles in a number voluntary sector environment organisations, and is on the Policy Committee of the Institute of Public Policy Research.

Barbara Young is a non-affiliated Life Peer as Baroness Young of Old Scone

Can we trust the data on hospitals?

By Emma Wilkinson Health reporter, BBC News

Inspections focus heavily on cleaning

The details of what was uncovered during an inspection in October at Basildon NHS Trust in Essex are shocking.

Floors, curtains and equipment stained with blood; soiled and stained mattresses; and re-use of tubes and other items designed to be thrown away after each patient.

It is the second time in less than a year that standards at a foundation trust - a status awarded to strongly performing NHS institutions - have been found wanting.

"Appalling" standards at Mid-Staffordshire NHS Foundation Trust were exposed in March when it was estimated that 400 patients had died needlessly over a three-year period.

The pattern is remarkably similar - an investigation initially prompted by data showing higher than expected death rates - and will further shake public confidence in how hospitals are monitored.

Especially as league tables published by the Care Quality Commission just last month gave Basildon an overall "Good" rating for quality of services.

It immediately poses the question, can the ratings be trusted and what does that mean for patient choice?

Regulation

The Care Quality Commission is a fairly new body having taking over the responsibility for the monitoring of hospitals from its predecessor the Healthcare Commission eight months ago.

"We need a much more sophisticated system that doesn't just rely on data but takes information from real inspections on the ground Baroness Young Care Quality Commission

CQC chair Baroness Young says that they inherited a rating system that is not fit for purpose and needs to be scrapped.

"We did make it very clear that this is not the way we want to regulate for the future.

"We need a much more sophisticated system that doesn't just rely on data but takes information from real inspections on the ground."

The "Good" rating given to Basildon hospital relates to an earlier time period - the year up until April 2009 - and there will be variation within each hospital, which makes the "single-word summary" misleading, she adds.

The CQC, she says, will have greater power and resources to carry out spot checks and inspections, rather than just relying on tick-box exercises which some argue enable trusts to fudge the data.

"By this time next year there will be a completely different system which will be much more able to spot issues, nip them in the bud, and take prompt action, rather than reporting months and months later."

Accurate data

The jury seems to be out on whether figures such as death rates are reliable indicators of poor performance - although in these two cases they started the alarm bells ringing.

Data from Basildon NHS trust showed a death rate 36% above the national average for the past three years.

When initially questioned, the trust had said the data was misleading - the same response given by Mid-Staffordshire when asked to account for higher than expected deaths.

Professor Sir Brian Jarman, who has developed systems for monitoring death rates - known as hospital standardised mortality ratios - and other data on a monthly basis, says the whole idea is to adjust for factors, which may affect the figures such as an unusually high elderly population.

He believes the data can be relied upon and that Basildon, along with some other hospitals, had higher than average rates since they started collecting the figures a decade ago but initially people had not taken any notice of the information.

"We now have a very good relationship with the CQC and they do listen closely."

"What we have found in virtually every hospital we have drawn attention to is there are usually dramatic reductions in the figures.

"Even in Basildon - from April this year they are down to normal."

Complaints

But Kieran Mullan, director of policy and public affairs at the Patients Association says death rates are a very "blunt tool" which only highlights problems once they get severe.

He is also critical of CQC plans to change the rating system.

"The bulk of it will still be data driven self-assessment, that's not going to change.

"It will just be a form where the trust can tick, yes we do this and then it's up to chance whether the CQC will choose your hospital to look at more closely.

"They say they will do more going into wards and talking to patients but the framework is basically the same."

A far simpler way to monitor whether hospitals are up to scratch is to pay closer attention to and follow up patient complaints, he says.

Almost every complaint they receive has already been logged with the trust and therefore accessible to the regulator.

"If you treat a complaint seriously we wouldn't need anything else because patients tell you when something has gone wrong."

who has a form of autism,

Hacker Gary McKinnon to appeal after extradition blow

Supporters make the point that Gary McKinnon has Asperger's syndrome

The "devastated" lawyers for computer hacker Gary McKinnon are to challenge the home secretary's decision not to block his extradition to the US.

They said they would make a last-ditch attempt after Alan Johnson said medical grounds could not prevent it.
Glasgow-born Mr McKinnon, 43, who has Asperger's syndrome, is accused of breaking into US military computers. He says he was seeking UFO evidence.
Now of Wood Green, London, he faces up to 60 years in prison if convicted.
'American poodle'
His lawyer, Karen Todner, said: "It's a devastating blow but we are not going to give up. We are certainly coming to the end of the road.
"We're just hoping at some point someone sees sense and steps in. All the legal team do know is we cannot give up because in some ways it's like dealing with a death row case, and we genuinely believe that Gary's life is at stake here."

She said she would issue judicial review proceedings next week - a process she said she was given just seven days to complete, rather than the more normal three months.

If that failed, they would take the case to the European Court of Human Rights, she added.
Mr Johnson said he had carefully considered the representations but concluded that sending Mr McKinnon to the US would not breach his human rights.
"Due to legitimate concerns over Mr McKinnon's health, we have sought and received assurances from the United States authorities that his needs will be met," he said.
But Ms Todner said he had gone against independent legal advice which said he could have used his discretion.
Mr McKinnon admits hacking into 97 US government computers, including Nasa's and the Pentagon's, during 2001 and 2002.

The shoddy treatment of this vulnerable man should demonstrate that our rotten extradition laws need urgent reform Shami Chakrabarti Liberty

He has told the BBC he was on a "moral crusade" to prove US intelligence had found an alien craft run on clean fuel.
His mother, Janis Sharp, told the BBC she was "devastated" by the news and that her son, who has a form of autism, had reacted "very badly".
"It's a disgusting decision. Gary has been in a heightened state of terror for almost eight years.
"To force a peaceful, vulnerable, misguided UFO fanatic like Gary thousands of miles away from his much-needed support network is barbaric," she said.
She said she was not comforted by the home secretary's advice that her son would not be held in a "supermax" jail, which hold the highest-security prisoners.
Extradition treaty
Liberal Democrat home affairs spokesman Chris Huhne said it was appalling the government placed a higher value on a "deeply unfair" extradition agreement than on the welfare of a British citizen.
"The home secretary should stop being an American poodle and start being a British bulldog," he said.
And Shami Chakrabarti, director of Liberty, said: "The shoddy treatment of this vulnerable man should demonstrate that our rotten extradition laws need urgent reform."
Mr Johnson had last month agreed to study new medical evidence before deciding on the extradition. The High Court had previously refused permission to appeal to the Supreme Court.
Mr McKinnon has been the focus of a campaign to prevent his removal to the US.
Earlier this month, the Commons' Home Affairs Committee said the move should be halted owing to his "precarious state of mental health".
They concluded there was a "serious lack of equality" in the way the extradition treaty deals with UK citizens compared with US citizens.

Iraq inquiry to focus on Bush-Blair relationship

Many UK politicians criticised Tony Blair's closeness to George Bush

UK-US relations in the run-up to the Iraq war are to come under scrutiny as ex-US Ambassador Sir Christopher Meyer gives evidence to the war inquiry.

His evidence is expected to touch on the personal relationship between Tony Blair and former President Bush and the extent to which this influenced policy.

The inquiry was told on Wednesday of reports days before the war that Iraq had dismantled its chemical weapons.

But Foreign Office officials insisted the war was still justified.

The inquiry is looking into UK involvement in Iraq between 2001 and 2009, with the first few weeks focusing on policy in the build-up to the 2003 US-led invasion.

Intelligence claims

Sir Christopher, UK Ambassador to Washington between 1997 and 2003, will take centre stage on the third day of public hearings.

Critics of the war claim that the US had already decided to topple Saddam Hussein in 2002 and that the UK had agreed to go along with this - claims both countries have denied.

The reasons for going to war in Iraq - including the now discredited claim that Saddam Hussein had weapons of mass destruction which could be used within 45 minutes of an order being given - remain a long-standing source of controversy.

INQUIRY TIMELINE November-December: Former top civil servants, spy chiefs, diplomats and military commanders to give evidence January-February 2010: Tony Blair, Gordon Brown and other politicians expected to appear before the panel March 2010: Inquiry expected to adjourn ahead of the general election campaign July-August 2010: Inquiry expected to resume Report set to be published in late 2010 or early 2011 Iraq inquiry: Day-by-day timeline

On Wednesday, senior Foreign Office official Sir William Ehrman told the inquiry that a report shortly before the invasion suggested Iraq's chemical weapons may have been "disassembled".

"We did... get a report that chemical weapons might have remained disassembled and Saddam hadn't yet ordered their assembly."

A separate report suggested Iraq might also "lack" warheads capable of spreading chemical agents, he added.

However, Sir William - the Foreign Office's Director general of defence and Intelligence between 2002 and 2004 - said there was "contradictory intelligence" and these reports did not "invalidate" the fact that Iraq had chemical weapons.

"It was more about their use. Even if they were disassembled the (chemical or biological) agents still existed."

'WMD surprise'

Sir William insisted that the role of intelligence in the decision to go to war was "limited".

He also said it was a "surprise" no weapons of mass destruction were ever found in Iraq, saying "it was not what we had expected".

WITNESSES ON THURSDAY SIR CHRISTOPHER MEYER-UK Ambassador to Washington 1997-2003 Q&A: Iraq war inquiry Analysis: tolerant or critical? How US has investigated Iraq war Iraq inquiry 'suffocated' - Clegg

The Lib Dems said Sir William's comments seemed to contradict Tony Blair's statement in Parliament that Iraq posed a "clear and present danger" to international security.

Asked to explain the absence of WMD and why the UK government had got this wrong, Sir William noted a "great deal" of the intelligence about Iraq's chemical and biological weapons production provided before the war had been withdrawn afterwards as false.

Addressing the overall threat posed by Iraq in 2001, officials said it was "not top of its list" of countries causing concern because of their stated desire to develop weapons of mass destruction.

With sanctions in place against Iraq, the Foreign Office believed Saddam Hussein could not build a nuclear weapon and, even if sanctions were removed, it was estimated it would take him five years to do so.

Officials said most evidence suggested Iraq's chemical and biological programme had largely been "destroyed" in 1991.

Although reports in late 2002 suggested Iraq was rebuilding its capability, they said intelligence about its actual position had been "patchy" since weapons inspectors were expelled in 1998.

But they maintain the threat posed by Iraq was viewed as "unique" because it had shown itself willing to use weapons of mass destruction on its own people and its neighbours.

Terrorist links

The inquiry also learnt that the UK investigated and rejected suggestions of links between Saddam Hussein and al-Qaeda.

Following the 9/11 attacks, the Foreign Office looked at the matter "very carefully" but concluded the two were not "natural allies".

The inquiry, looking at the whole period from 2001 to 2009, was set up by Prime Minister Gordon Brown, who also chose the panel.

Mr Brown and predecessor Tony Blair are expected to be among future witnesses, with the final report due early in 2011.

Previously, the Butler inquiry looked at intelligence failures before the war, while the Hutton inquiry examined the circumstances leading to the death of former government adviser David Kelly.

UK has failed in its attempt to get Tony Blair chosen as the new president of the EU Council after the Belgian prime minister was handed the job.

EU foreign head dismisses critics

Tony Blair has never publicly commented on the EU president role The UK has failed in its attempt to get Tony Blair chosen as the new president of the EU Council after the Belgian prime minister was handed the job. Downing Street abandoned its campaign to put the ex-prime minister in the prestige job on Thursday after it was clear he did not have enough support. But, in a surprise move, Labour peer Baroness Ashton was appointed to the new role of EU foreign affairs chief. Gordon Brown said this "reinforced" the UK's place "at the heart of Europe". 'Effective' "It will ensure Britain's voice is very loud and clear," he said. Baroness Ashton is currently the EU's Trade Commissioner, a job in which Mr Brown said she had been "highly effective". Mr Brown said Baroness Ashton - who will also become vice-president of the European Commission - would represent the EU on the world stage. Little-known outside the UK and not a high-profile figure in British politics, Baroness Ashton was formerly leader of the House of Lords. Gordon Brown spent a great deal of energy and political capital trying to secure the presidency for Tony Blair William Hague, shadow foreign secretary In choosing Baroness Ashton, Mr Brown said he had been determined to protect the UK's national interest in Europe. Mr Blair had never publicly said he was in the running for the job of EU President - given to Belgium's Herman van Rompuy - despite vocal support from Mr Brown. The prime minister said that his predecessor would have made an "excellent candidate" and that he did not "apologise" for backing him. However, he said it had become clear that the job was destined for a centre-right candidate and that the nature of the post had changed - making it less suitable for Mr Blair. 'Defeat for PM' The Conservatives and the Liberal Democrats welcomed the fact that Mr Blair had not got the job, saying he would have been a divisive figure. "We did not agree with the Lisbon Treaty's establishment of these posts but they are now a fact," said shadow foreign secretary William Hague. "We look to the President of the Council and the High Representative to ensure that the EU's business as an association of nation states is conducted efficiently." "Gordon Brown spent a great deal of energy and political capital trying to secure the presidency for Tony Blair. The summit's result is a defeat for him."

world's leading climate research units

Hackers target leading climate research unit

www.richimag.co.uk/biofools/

Experts warn that universities' e-mail systems are vulnerable to attacks

The e-mail system of one of the world's leading climate research units has been breached by hackers.

E-mails reportedly from the University of East Anglia's Climatic Research Unit (CRU), including personal exchanges, appeared on the internet on Thursday.

A university spokesman confirmed the email system had been hacked and that information was taken and published without permission.

An investigation was underway and the police had been informed, he added.

"We are aware that information from a server used for research information in one area of the university has been made available on public websites," the spokesman stated.

"Because of the volume of this information we cannot currently confirm that all of this material is genuine.

"This information has been obtained and published without our permission and we took immediate action to remove the server in question from operation.

"We are undertaking a thorough internal investigation and we have involved the police in this enquiry."

Researchers at CRU, one of the world's leading research bodies on natural and human-induced climate change, played a key role in the Intergovernmental Panel on Climate Change's (IPCC) Fourth Assessment Report, which is considered to be the most authoritative report of its kind.

'Inside information'

Graham Cluley, a computer security expert, suggested that December's key climate summit in Copenhagen, which has made headlines around the world, could have increased the university's profile as a possible target among hackers.

"There are passionate opinions on both sides of the climate debate and there will be people trying to knock down the other side," Mr Cluley, senior technology consultant for Sophos, told BBC News.

"If they feel that they can gather inside information on what the other side is up to, then they may feel that is ammunition for their counterargument."

Mr Cluley added that universities were vulnerable to attacks by hackers because so many people required access to IT systems.

"You do need proper security in place; you need to be careful regarding communications and make sure your systems are secure.

"I trust that they will now be looking at the systems, and investigating how this happened and ensuring that something like this does not happen again."

Tribes resistance could help CJD

Kuru attacks the brain tissue

natural selection could help halt human "mad cow disease", experts say after finding a tribe impervious to a related fatal brain disorder.

The Papua New Guinea tribe developed strong genetic resistance after a major epidemic of the CJD-like disease, kuru, spread mostly by cannibalism.

Medical Research Council experts assessed more than 3,000 survivors of the mid-20th Century epidemic.

Their findings appear in the New England Journal of Medicine.

Kuru, a prion disease similar to CJD in humans and BSE in animals, was transmitted at mortuary feasts where - until the practice was banned in the late 1950s - women and children consumed their deceased relatives as a mark of respect and mourning.

But a gene variation, G127V, found in people from the Purosa valley region of the Eastern Highlands seems to offer high or even complete resistance to the disease .

The fact that this genetic evolution has happened in a matter of decades is remarkable MRC Prion Unit director Professor John Collinge

And experts believe this could be the strongest example yet of recent natural selection in humans.

MRC Prion Unit director Professor John Collinge said: "It's absolutely fascinating to see Darwinian principles at work here.

"This community of people have developed their own biologically unique response to a truly terrible epidemic.

"The fact that this genetic evolution has happened in a matter of decades is remarkable.

"Kuru comes from the same disease family as CJD, so the discovery of this powerful resistance factor opens up new areas for research taking us closer to understanding, treating and hopefully preventing of a range of prion diseases."

Survival advantage

University College London's Institute of Neurology geneticist Professor John Hardy said the findings were fascinating.

"It's fantastic demonstration of natural selection.

"Because people who have this mutation were protected from this fatal disease their proportion in society increased massively."

But he said a similar resistance to CJD would be less likely to develop.

He said: "In Papua New Guinea kuru became the major cause of death, so there was a clear survival advantage and the selection pressure was enormous.

"Here in Britain the numbers with CJD are very small and so the selection pressures will be less."

savage Brown’s free care

Labour peers savage Brown’s free care plan

Sam Lister, Health Editor and Philip Webster, Political Editor

A key plank of Gordon Brown’s re-election strategy was condemned by members of his own party yesterday as irresponsible, unaffordable and based on a myth.

The Prime Minister’s plan to offer free care at home to the elderly, outlined yesterday in the last Queen’s Speech before the general election, was compared to “an admiral firing an Exocet into his own flagship”.

Lord Lipsey, a former member of the Royal Commission on Long-Term Care, also accused the Government of peddling a “pernicious myth” that people are better cared for in their own homes than in a nursing home.

The measure, aimed at 400,000 of the neediest people, amounted to a “demolition job on the national budget”, he said, as the Government would be forced to cover unnecessary claims made by the better-off. He said that it threatened to undo current work on building a system to help the elderly and those most in need of care.

Related Links

• 
  human rights in old age
• nhs / abuse of elderly

“I’m not looking forward to the night of the next general election but, if the result goes as I expect, one of the consolations will be that one of the most irresponsible acts to be put forward by a prime minister in the recent history of this country will be swept away with his government,” he added.

Lord Warner, a former health minister, described the care Bill as totally misjudged. “There has been no proper impact assessment, and no data to show how this would work,” he said. “There’s a big question mark as to whether there’s even actually a Bill ready.”

Other peers are known to oppose a Bill that many see as a last-minute, back-of-the-envelope proposal. Mr Brown, criticised by the Conservatives for what they said was a blatantly electoral programme of 15 Bills, faced more attacks from his own side. Charles Clarke, the former Home Secretary, said that the Prime Minister’s attempts to impose political dividing lines was “neither the best way to govern the country nor the best way for Labour to win in 2010”.

David Cameron said that the “biggest omission of all” was the failure to mention MPs’ expenses or the report by Sir Christopher Kelly, the chairman of the Committee on Standards in Public Life. Sir Christopher joined in the criticism, issuing a statement pointing out that party leaders had agreed that his recommendations should be implemented in full. It was disappointing, he said, that the speech failed to address the remit, powers and independence of the new body being established to regulate expenses.

A Downing Street spokesman said: “We are not standing in the way of any of Kelly’s recommendations. Everything related to sweeping away the old, discredited expenses system . . . can and should be implemented without further legislation.”

The criticisms of the care Bill were echoed by health economists. Niall Dickson, of the King’s Fund, said: “These latest proposals seem to have been hastily put together and appear to cut across the options set out in the Government’s own Green Paper.”

you want to understand other people and how they think

AFTER AN ASSESSMENT OF AN AUTISTIC SPECTRUM DISORDER… WHAT NEXT?

While you were wondering whether you had an autistic spectrum disorder, you probably read quite a few articles on the

subject. You are an expert on the disorder that the consultant has said you have: you understand the problems of people

who have a form of autism – because you have lived with it all your life.

Quite often, when we know that there is a problem and we know what that problem is, we can fix it. But you should

only attempt to address your own problems if:

�� you understand and accept that you have a disorder

�� you accept that having this disorder means you may have some problems in your life

�� you are willing to talk about your disorder and your difficulties

�� you want to understand other people and how they think

�� you want other people to understand you and how you think

�� you want to understand what is expected of you in certain situations

�� you want to live as independently as possible.

Talking about your autism or Asperger Syndrome with the people you meet will help them understand you better if they

themselves are not autistic, and if they don’t know anybody with autism. It should not become a major topic of

conversation at every meeting or every occasion! But it is very much a part of you and how you function in this world.

For some people the fact that they have had a hip replacement, or cannot see very clearly, or suffer from migraines, is

very much a part of them: it might limit their abilities in some areas, but affect them not at all in others. It is the same

for you: your abilities with factual and technical subjects may well be far higher than average; your understanding of

what others are thinking, however, might be limited.

All of us, after all, are individuals, with very individual likes, dislikes, abilities, limitations and interests. We do not all

have to be exactly the same in order to get on with each other: we would all benefit from becoming more understanding,

tolerant and accepting of people as individuals.

rights in care

National Minimum Standards - Your Rights

24 June 2009

Find out about the minimum standards care services have to meet and what you have a right to expect.

The following guidance is from the Care Quality Commission (CQC), the regulatory body for care homes in England.

The Government has set national minimum standards for care services. The standards set out the quality of care, service and facilities you should expect from your care provider.

These are just some of the issues the national minimum standards cover:

• you have a right to be treated politely and with dignity

• you have a right to privacy for yourself, and your relatives and friends when they visit

• you have a right to deal with your own finances and spend your money in the way you choose

• you have a right to eat food that is prepared in line with your faith, and to worship when and where you want to

• you have a right to choose the food that you eat and be given the time and space to relax and enjoy your meal

• you have a right to get up in the mornings and go to bed at night when you choose

• you have a right to complain if you are not happy with the care you get.

The national minimum standards enforceable by law but are important guidelines to help providers, inspectors and people who use services to judge the standard of service.

They are designed to make sure everyone understands what's expected and so services can be measured against the same standards.

37 BBC staff earn more than the Prime Minister

(Gill Allen, The Times)

Nearly 300 senior BBC managers earn more than £100,000

Patrick Foster, Dan Sabbagh and Francis Elliott

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At least 37 BBC executives earn more than the Prime Minister, it was revealed yesterday, as the corporation disclosed the scale of its senior salaries for the first time.

The broadcaster said that its 107 “most senior decision makers” earn £22 million a year and said that the disclosures made it the nation’s most transparent public body. This claim was undermined when it emerged that hundreds of its highest earners were hidden from the published figures.

Nearly 300 senior managers earning more than £100,000, were kept off the list, The Times has learnt. Some earn more than Gordon Brown. Many are paid more than double the £81,100 earned by the lowest-paid manager whose salary was made public. Gordon Brown’s salary is £197,689 but he draws only £192,414.

The revelations put pressure on the Tories to spell out how they would restrain pay in the corporation. In his speech to the Conservative conference last month George Osborne, the Shadow Chancellor, said: “The excessive salaries at the top have to go. In the current climate, anyone who wishes to pay a public servant more than the Prime Minister will have to put it before the Chancellor. I am not expecting a long queue.” Mr Osborne’s spokesman admitted last night, however, that BBC executives in line to receive more than the Prime Minister would not be required to line up alongside other public sector chiefs.

Related Links

• Long way to go to full BBC disclosure

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• The top ten BBC expenses claimants

Multimedia

• BBC senior staff salaries and expenses

The pay of on-screen stars, such as Jonathan Ross, who earns an estimated £6 million a year, was also left out. Those who were on the list ranged from Mark Thompson, the Director-General, who earned £834,000, down to Tom Sleigh, the chief adviser for operations, earning £81,100.

The BBC’s annual report shows that there are at least 281 staff earning more than Mr Sleigh but who were not featured in the disclosures. Excluded were any who work for the commercial subsidiary, BBC Worldwide, and more than 150 core staff on more than £100,000 who were deemed not to have enough responsibility.

A BBC spokesman said: “The senior managers have been selected according to their salary, responsibility, influence and membership of a BBC board. They are those who have the greatest responsibility for spending public money and for overseeing the BBC’s services and operations.”

Dementia drug use 'killing many'

By Nick Triggle Health reporter, BBC News

Anti-psychotic drugs do not benefit many dementia patients

Needless use of anti-psychotic drugs is widespread in dementia care and contributes to the death of many patients, an official review suggests.

About 180,000 patients a year are given the drugs in care homes, hospitals and their own homes to manage aggression.

But the expert review - commissioned by ministers - said the treatment was unnecessary in nearly 150,000 cases and was linked to 1,800 deaths.

The government in England has agreed to take steps to reduce use of the drugs.

These include:

• Improving access to other types of therapy, such as counselling
• Better monitoring of prescribing practices
• Guidance for families explaining what they can do if they are worried about drug use
• Specialist training in dementia for health and social care staff
• Appointment of a new national director for dementia to oversee the measures

The review - and the government pledge to take action - comes after long-running concerns about the use of anti-psychotic drugs.

Over the past 30 years, the NHS has increasingly turned to the treatment, which was originally aimed at people with schizophrenia, as it has struggled to cope with the rise in people with dementia.

'Different mindset'

There are currently 700,000 people in the UK with the condition, but this is expected to rise to one million in the next 10 years because of the ageing population.

The review, led by King's College London expert Professor Sube Banerjee, accepted that for some people anti-psychotic drugs would be necessary.

But it said they should be used only for a maximum of three months and when the person represented a risk to themselves or others.

Professor Banerjee estimated that of the 180,000 people given the drugs each year, only 36,000 benefited.

He said health and social care services needed to develop a "different mindset".

Allan Trueman's father "became a totally different person"

He believes if the steps the government has agreed to are followed, anti-psychotic drug use could be reduced by two-thirds within three years.

Care services minister Phil Hope agreed action was needed.

"We know there are situations where anti-psychotic drug use is necessary - we're not calling for a ban, but we do want to see a significant reduction in use."

Neil Hunt, chief executive of the Alzheimer's Society, said the long-awaited review was a welcome recognition of the scale of the problem.

He added: "This goes beyond quality of care. It is a fundamental rights issue.

"Our members tell us of enormous worry and distress over what is happening to their loved ones."

The Royal College of GPs - in most cases the drugs are prescribed by family doctors - admitted the situation was "unacceptable".

President Dr Steve Field said: "People deserve much better."

While the review was commissioned by the government in England, ministers elsewhere in the UK have agreed to study the recommendations.

how do you raise money

You've got a project with potential, but how do you raise money for it?

The good news is that there are thousands of funders, large and small looking for worthwhile initiatives to support.
However, the competition is strong with countless good causes chasing a finite pot of money. To be successful you have to find out what's out there, make your case and stand out from the crowd.
There are a number of ways that Green Communities can support you, you can:
•search our funding database
•get step by step advice on how to successfully apply for funding
•Funding how to guide
•get advice on making your project more attractive to funders
•get regular updates through our monthly e-news alerting you to new sources of funding

Penny Brohn Cancer Care

New healthy eating guidelines for cancer survivors released10/06/2009

Penny Brohn Cancer Care has launched a new set of guidelines called The Bristol Approach to Healthy Eating, designed specifically for people living with cancer and informed by the most up-to-date research evidence.

Based on the charity’s near 30 years of experience of working with people with cancer, The Bristol Approach to Healthy Eating gives practical advice for anyone living with the disease.

The guidelines show how a plant-based diet may support the health of those living with cancer. Highlighted foods include those that are high in compounds thought to inhibit the cancer process, and low in compounds that may undermine overall health.

A 2006 nutritional survey undertaken by Penny Brohn Cancer Care shows that 82 per cent of the survey’s respondents were not given any dietary advice by a member of their healthcare team when diagnosed. 61 per cent of respondents would have liked to have received such advice, and over a third (38 per cent) sought information about healthy eating outside of their healthcare team.

Liz Butler, Senior Nutritional Therapist at Penny Brohn Cancer Care, said: “There is a wealth of information on diet and cancer in books and on the web but much of it has little scientific basis. From our 2006 survey we know that people living with cancer are generally not receiving dietary guidance or being encouraged to adopt a healthy diet by their healthcare professionals. This can often lead to patients conducting their own investigations into nutrition and cancer and collecting information from sources of questionable quality.

“We have produced the Bristol Approach to Healthy Eating guidelines that are informed by the most up-to-date evidence, including studies that directly examine the effects of diet on the health of cancer survivors.

“The evidence showing that healthy eating can benefit those living with cancer has grown significantly in the last few years. We feel it is time that all cancer patients are offered healthy eating advice and that doctors regard this as an essential part of long-term care, as they already do for people with cardiovascular disease.

“There is no one diet that suits every person with cancer, but the basic healthy eating principles will always apply. Practical and informative guidelines such as these provide strong foundations which can be further adapted for those needing more specialist advice.”

The guidelines encourage people to eat plenty of fruit and vegetables, together with other plant foods – whole grains, pulses, nuts, seeds, herbs and spices. It is recommended that people include moderate amounts of animal products, particularly unprocessed meat, fish and eggs. For some people, moderate amounts of dairy products may also be included. Foods containing refined sugar and processed fats such as crisps, cakes, biscuits, margarine, and ready meals should be cut down or avoided. The guidelines also encourage people to keep alcoholic drinks to a minimum.

Penny Brohn Cancer Care (formerly known as Bristol Cancer Help Centre) is the UK’s leading and oldest provider of complementary care for people with cancer. The charity has almost thirty years of experience of providing healthy eating advice to people living with cancer, delivered as part of a person-centred package of physical, emotional and spiritual support known as The Bristol Approach. The Bristol Approach works as a natural partner to medical treatment, and is delivered by the charity’s experienced team of doctors, nurses and complementary therapists.

The full guidelines are available to download in PDF format by clicking here.

- Ends

Asia

Asia slips into cold war
Under a deal signed in August, India is installing radar across the Maldives, linked to its coastal command

Jeremy Page in Delhi
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You have to go to a tropical paradise to find the latest front in the brewing cold war between China and India.

On the southernmost tip of the Maldives lies the island of Gan, a tiny patch of coconut palms and powdery white beaches. It was here that Britain set up a secret naval base in 1941, building airstrips and vast fuel tanks to support its fleet in the Indian Ocean during the Second World War.

The RAF then used it as a Cold War outpost until 1976, when the British withdrew and the officers’ quarters were converted into a resort called Equator Village.

Now, 33 years later, India is preparing to reopen the base to station surveillance aircraft, helicopters, and possibly ships, to monitor Chinese vessels in the Indian Ocean. Under a deal signed in August, India is also installing radar across the Maldives, linked to its coastal command.

Related Links
China and India in ‘scramble for Africa’
Both sides blame US for worsening relations
China offers its hand in friendship - and £10bn
Multimedia
Graphic: Asian giants face off
Both countries publicly deny that the move is aimed at Beijing, but privately admit that it is a direct response to China’s construction of a giant port at Hambantota in nearby Sri Lanka.

The plan is also being seen as the latest move in a low-level, but escalating struggle for economic and military supremacy between Asia’s two emerging giants. This week the flashpoint is their disputed Himalayan border, as China protests over the Dalai Lama’s visit to a northeastern Indian state that it claims. But they are also competing over naval control of the Indian Ocean, resources and markets in Africa, strategic footholds in Asia — and are even in a race for the Moon.

“It doesn’t have the same proportions as the Cold War,” said Alexander Neill, head of the Asia programme at the Royal United Services Institute, a research centre. “But there is potential for this to spiral out of control. Allies of both countries need to think carefully about the consequences of this rivalry.”

Relations were cordial for the first decade after India’s independence in 1947, and the founding of communist China in 1949. They quickly deteriorated, however, when the Dalai Lama escaped from Tibet in 1959 and was granted refuge in India. China then humiliated India in 1962 when its troops briefly occupied the northeastern state of Arunachal Pradesh and seized the region of Aksai Chin. Beijing also began to provide aid and weapons to Pakistan — India’s rival.

In the past decade, the frost had been thawing as bilateral trade expanded from $3 billion in 2000 to $51 billion last year — the two even began joint military exercises.

Yet this year, things have taken a sudden turn for the worse as China seeks to project its economic and military clout, and a more assertive India tries to respond. Militarily, India frets over China’s recent efforts to improve infrastructure around its frontiers and force a compromise on the disputed border. It also worries about China’s plans to develop a “blue water” navy capable of protecting trade routes through distant waters, including the Indian Ocean.

India feels particularly threatened by China’s “string of pearls” strategy, building ports in Burma, Sri Lanka and Pakistan that could be used by its navy. Beijing is concerned that a nuclear deal finalised last year between India and the US, was designed as a counterbalance to China. The deal not only lifted a ban on India buying US nuclear supplies, it also opened the door for India to take part in joint military exercises and buy billions of dollars of US weaponry.

“Since 1962, I think Chinese strategists have basically decided that they can deal with India on their own terms,” said Evan Feigenbaum of the Council on Foreign Relations, an American research centre. “But when you introduce the United States into that equation, it introduces all kinds of uncertainties. I think we’re in for a period of India-China tension.”

Economically, the competition is most intense in Africa, where India and China are vying for resources and markets in a rerun of the “Scramble for Africa” by colonial powers.

China began courting African nations a decade ago, offering investment and trade in exchange for soft loans and development aid with no political conditions attached. But India is catching up fast, pledging $5 billion in credit and hundreds of millions of dollars in financial help at an inaugural India-Africa summit last year. At stake is not just access to industrial raw materials, but support for India’s bid for a permanent seat on the UN Security Council, which China opposes. India is also trying to make up lost ground in South, South-East and Central Asia.

China has been trying to negotiate a friendship treaty with Nepal to replace the one that has tied the country to India since 1950. Beijing’s growing clout in Bangladesh was highlighted last week when armed police closed a photo exhibition organised by Tibetan activists. India has poured $1 billion in aid into Afghanistan, while a Chinese company has invested $3 billion in a giant copper mine in the country. Technologically, the contest is playing out in a 21st-century Asian version of the Cold War space race. India launched its first unmanned lunar mission, Chandrayaan-1, last year and plans to land a man on the Moon by 2020. China sent its first taikonaut into space in 2003, and plans its first manned lunar mission by 2024.

Yet the most fundamental source of rivalry is also the most abstract: the relative merits of Indian-style democracy and Chinese-style autocracy. Although neither promotes its political system, they are seen as rival models for the developing world. And if this is the “Asian Century”, as many agree, then it will be defined to a large extent by that ideological contest.

on genes

Early life stress 'changes' genes
By Victoria Gill
Science reporter, BBC News



Mice that are abandoned as pups have behavioural problems later on
A study in mice has hinted at the impact that early life trauma and stress can have on genes, and how they can result in behavioural problems.

Scientists described the long-term effects of stress on baby mice in the journal Nature Neuroscience.

Stressed mice produced hormones that "changed" their genes, affecting their behaviour throughout their lives.

This work could provide clues to how stress and trauma in early life can lead to later problems.

The study was led by Christopher Murgatroyd, a scientist from the Max Planck Institute of Psychiatry in Munich, Germany.

He told BBC News that this study went into "molecular detail" - showing exactly how stressful experiences in early life could "programme" long-term behaviour.

To do this, the researchers had to cause stress to newborn mouse pups and monitor how their experiences affected them throughout their lives.

"We separated the pups from their mothers for three hours each day for ten days," Dr Murgatroyd explained.

"It was a very mild stress and the animals were not affected at a nutritional level, but they would [have felt] abandoned."

The team found that mice that had been "abandoned" during their early lives were then less able to cope with stressful situations throughout their lives.

The stressed mice also had poorer memories.

Programming genes

Dr Murgatroyd explained that these effects were caused by "epigenetic changes", where the early stressful experience actually changed the DNA of some of the animals' genes.

"This is a two-step mechanism," Dr Murgatroyd explained.

When the baby mice were stressed, they produced high levels of stress hormones.

These hormones "tweak" the DNA of a gene that codes for a specific stress hormone - vasopressin.

"This leaves a permanent mark at the vasopressin gene," said Dr Murgatroyd. "It is then programmed to produce high levels [of the hormone] later on in life."

The researchers were able to show that vasopressin was behind the behavioural and memory problems. When the adult mice were given a drug that blocked the effects of the hormone, their behaviour returned to normal.

This work was carried out in mice, but scientists are also investigating how childhood trauma in humans can lead to problems such as depression.

Professor Hans Reul, a neuroscientist from the University of Bristol, UK, said that this was "a very valuable addition to the body of work on the long-term effects of early-life stress".

"There is strong evidence that adversities such as abuse and neglect during infancy contribute to the development of psychiatric diseases such as depression," he told BBC News.

"This underscores the importance of the study of epigenetic mechanisms in stress-related disorders."