Tuesday 6 October 2009
Paul Burstow elderly person
2.6 Particularly at risk are elderly people with dementia. Behaviour such as wandering, poor self-care, restlessness, impaired memory, depression without psychosis, uncooperativeness and agitation that is not dangerous, are common features of the disease. There are no medical reasons for prescribing antipsychotics in such cases. Managing challenging behaviour without trained staff is no excuse for reliance on chemical solutions. Until more trained staff are in post, there will continue to be calls for even more use of antipsychotic medication, to the detriment of the patients well-being.
2.7 In December 2001, following direction by the Labour Government, the National Institute of Clinical Excellence were set to issue guidance concerning the cost and clinical effectiveness of atypical antipsychotic medication for people with schizophrenia. This guidance has now been postponed until March 2002.1 Older people that do not suffer from schizophrenia have been left out. The National Service Framework for Older People and the National Minimum Standards published in March 2001 are steps in the right direction. But they will fail to deliver change for older people unless there is rigorous monitoring and enforcement, yet there are scant resources to do this. Furthermore, international evidence suggests annual reviews of prescribing to older people are inadequate, and that harm can be done to an older person in far less time than a year.
2.8 Successive studies have demonstrated the need for a step-change in the way medication is used in the care of the elderly. The chemical management of older people is a scandal. It denies older people their dignity, and robs them of a better quality of life. Pressure on care providers is not an excuse for inappropriate use of medication. GPs and care home managers should be jointly accountable for safeguarding the interests of the vulnerable elderly people in their care.
Recommendations
2.9 The Department of Health must commission urgent quantitative and qualitative research into the extent and reasons for the overuse of antipsychotic medication in different care settings.
2.10 The National Institute for Clinical Excellence must prepare and publish guidance on the use of antipsychotic drugs and non-drug alternatives in the care of older people. This would include the development of a model for drug list revisions in care homes, to automatically evaluate drug lists according to a quality indicator, and keep track of the drug lists and changes made to that list. The quality indicator should also serve as guidelines for prescribers.
2.11 Review the National Service Framework and National Minimum Standards for care homes to ensure that the standard on medication, (standard 9), provides for prescribing reviews at least every three months. All prescribing decisions must be clearly documented with the reasons for the use of the medication set out in full. By evaluating the Scottish
Long Term Carers
Speech by Paul Burstow MP delivered to Speech to the Sutton & Merton PCT Carers and Employment Conference, The Holiday Inn, Sutton on Thu 15th Jun 2006
Every minute of every day four new carers start caring.
It could happen to any one of us, overnight. Three in five of us will become carers at some point in our lives. For many caring responsibilities will come during their working lives. And that's the challenge.
Taking on caring responsibilities should not force the carer to give up work. Doing so can set in motion a chain of events that ends up with the carer suffering from poorer health and poorer wealth.
The research evidence is compelling: caring can have a serious effect on both the psychological and physiological health.
For many carers of working age the consequences of giving up work can be huge. Quite apart from the compelling social reasons for more flexible employment practices there is also a powerful economic case.
Our economy is estimated to need a further 2.5 million people in the workforce over the next eight years. Currently there are 3 million carers in employment, but there are 4 million of working age.
One in five people have given up work to care. Once a carer has given up work it is harder to get back into work. The longer they are out of the workforce the less likely they are ever to return and more likely to be dependent on income support.
That is why I co-sponsored and helped to pilot onto the statute book the Carers (Equal Opportunities) Act 2004 and before that the Carers and Disabled Children Act.
The Carer Act 2004 extended the rights of carers pacing new duties on local authorities to take account of carer's wishes to work or undertake training when undertaking a carers assessment. But that is only part of the picture. Flexible working practices are essential to retain carers in the workforce.
Flexible because one size does not fit all, carers need different levels of support at different times. Any thing from access to a phone to check on a person, to leaving and start times that fit around hospital appointments.
Without this flexibility the pressure and stress on the carers can become unbearable, making them ill, driving them from the workplace.
A loss to the business in terms of knowledge, experience and training.
A loss to the economy in taxes, extra benefit payments.
Research suggests that employers who introduce more flexible working benefit. For example, a 26 per cent reduction in stress related absences.
So we have the Carers (Equal Opportunities) Act promoting a positive duty on local Councils facilitating carers working. But what about employers? Currently before Parliament is another Bill shortly to become an Act, the Work and Families Bill.
Clause 12 of the Bill extends the right to request flexible working beyond the Employment Relations Act 1999. It does not mandate employers to concede this but it does require proper consideration.
Clause 12 amends the Employment Rights Act and provides a power to make regulations. The question is what the regulations will say and in particular how carers are defined. The Government has consulted on two definitions. First, is a narrow definition restricting the provisions of the Act to 'close relatives' such as husbands, wives, someone living with you, father, mother, son, daughter - including in laws. Second is a 'near relative' definition which includes everyone in the first definition but adds grandparents, brothers, sisters, aunts and uncles.
I think good relation must be simple to implement - that means it should be easily understood. It makes sense to use an established definition of carers. To opt for a narrower 'close relative' definition would draw an arbitrary distinction that would lead to confusion and resentment in the workplace. Why should someone caring for their grandparents or a brother or a sister be treated differently?
I hope that the Government responds positively to the consultation and gets the definition right.
This new right comes into effect from April 2007. There is already plenty of good practice out these: flexible starting and finishing times; compressed working hours; annualised working hours; job sharing or part-time working; homeworking; term-time working.
To conclude we all owe a huge debt to carers; their contribution as carers has been estimated at £57 billion a year. Without them our health and social services would be unable to cope. But words are not enough. Providing carers with the opportunity to work makes good business sense. I hope today's conference proves a useful catalyst to encourage employers and carers alike
Human rights law 'fails elderly'
Elderly people need better protection, the charity said
Human rights legislation is failing some vulnerable older people, according to charity Help the Aged.
The charity said gaps in the law left older people exposed to mistreatment which cannot be fully investigated or dealt with under the Human Rights Act.
It said that while statutory services were covered under the Act, the majority of care - which is contracted to the private sector - is not.
It urged the government to push forward with its planned equality bill.
The bill, included in the 2005 Queen's Speech, will establish a Commission for Equality and Human Rights, among other aims.
Champion needed
Help the Aged said such a body would have powers to champion older people's rights and could better protect them from abuse and neglect from carers.
The charity said the majority of older people's services - including more than 90% of care home places and nearly 70% of domiciliary care hours - are contracted out to the private sector, which is not covered under the Act.
In a report titled Rights at Risk - Older People and Human Rights, it said "thousands of older people [were given]... little protection in law if abuse takes place".
The charity identified "institutional cultures" which breach human rights and cites major delays in providing essential services, and limited services with little choice.
'Revulsion and anger'
Lack of hygiene, the use of inappropriate restraints, both chemical and physical, and restricted access to food and water have been reported to it as existing in some health and care settings.
Senior policy advisor Tessa Harding: "High-profile and widely publicised cases of elder abuse and neglect rightly provoke revulsion and anger.
"Unless strong new laws are introduced to give older people specific protection against breaches in their human rights, the sorts of cases seen [recently] will continue to be treated only as a matter of poor standards."
She said a commission was needed to "deliver firm, clear messages about older people's human rights to all providers of health and care services".
Care home residents 'drugged and tagged'
Severe staff shortages face many care homes
Care home residents are being subjected to widespread abuse because they fall outside mainstream society, a charity for older people has claimed.
Counsel and Care said some nursing staff admitted "indiscriminate" use of electronic tags to restrain elderly people against their will, and the use of sedative drugs to control "troublesome" residents.
Alison Clarke, co-author of the report Showing Restraint, told BBC News Online such treatment would not be tolerated for any other social group.
Counsel and Care has demanded new rules to govern the management of care homes and league tables to "name and shame" those mistreating residents.
Underpaid
According to the report the line between restraint and abuse is constantly crossed by overworked and underpaid nursing staff.
In some areas, if a big supermarket opens, half the staff disappear because they can get better pay
Alison Clarke
During a series of more than 50 seminars with care home workers, Counsel and Care also heard of residents being deprived of walking frames and rails placed around their beds to control movement.
Ms Clarke said: "You could say that putting someone in a bed with cot sides so they can't get out is assault, it's imprisoning them.
"It would be considered assault if it was done to you or me, but if it's done to an 80-year-old with dementia it's considered ordinary."
Staff shortages
Ms Clarke said some 500,000 elderly Britons live in care homes, but there are currently no national guidelines enforcing a minimum standard of care.
Substituting chemical management for good care denies older people their dignity
Paul Burstow
Lib Dem MP
Counsel and Care hopes that will change when a new National Care Standards Commission to regulate the industry begins work in April.
It said staff shortages are one of the biggest causes of the misuse of restraint, and called for better training and pay for care home staff.
Ms Clarke said: "There's a real problem in some areas with staff shortages. It's seen as a low status occupation, but it's very hard work and pay is often very low.
"In some areas, if a big supermarket opens, half the staff disappear because they can get better pay."
Calling for league tables showing the number of restraints used, the charity said similar close monitoring of homes in the US had led to better care for residents.
'Unacceptable'
The findings of the report were backed by the charity Action on Elder Abuse, which estimates that one in 20 older people are abused - many of them in care homes.
Its chairman, Peter Westland, said: "We are concerned about the level of denial that such abuse exists. The time has come for people to acknowledge the existence of this serious issue."
Liberal Democrat spokesman for older people, Paul Burstow, said the methods of restraint discovered were "unacceptable."
He said: "The over-medication of older people is a scandal. Substituting chemical management for good care denies older people their dignity."
Mr Burstow said the public needed reliable information about the quality of care in care homes.
The Counsel and Care report is published in the Nursing Times.
Thousands of old people 'drugged'
Thousands of old people 'drugged'
The Lib Dems want tighter checks on care homes
More than 22,000 elderly people in nursing homes are being given powerful sedatives for no medical reason, it has been claimed.
A report by the Liberal Democrats suggests residents who do not need these drugs are being kept sedated to make life easier for staff.
Its health spokesman Paul Burstow said the situation may be even worse in residential homes.
"Quite simply the over medication of older people is abuse," he said.
The report's figures are based on a review of British and international studies in this area and information released to parliament.
Under sedation
It is the Lib Dems' second report on the issue. According to Keep Taking the Medicine 2, up to 22,233 elderly nursing home residents are being given powerful anti-psychotics without medical grounds.
It suggests that another 32,000 elderly people in residential homes may also be at risk.
I find these figures very surprising
Spokeswoman,
National Care Homes Association
The report points to an increase in community prescriptions for antipsychotic drugs - up 6.2% between 1999 and 2002, an increase of 129,000 prescriptions.
It also shows that two out of three GP practices have missed a government target to introduce six-month reviews of medication for all over 75s. These reviews were supposed to have been up and running since April.
Mr Burstow called for tougher action to tackle the problem. He wants tighter checks on care homes and a new criminal offence of neglect of a vulnerable adult.
"Despite mounting evidence that older people are the victims of a chemical cosh in care homes, minister's have failed to get a grip on the problem.
"With serious shortages of specialist staff and little chance of attracting more, the evidence is that care homes are turning to chemical cocktails to make residents easier to manage," he said.
"It can result in death and it denies older people their dignity."
'Homes checked'
The Department of Health said care homes were required to keep "meticulous" drug records on every resident.
"If an inspector from the National Care Standards Commission finds evidence of over-prescription or maladministration of drugs, they have a duty to report such evidence to the police and the professional bodies of those involved for further action," a spokeswoman said.
"We are aware of concerns about the overuse of antipsychotics for older people, particularly those in care homes.
"Since March 2001, as part of the National Service Framework for older people, doctors, pharmacists and other health care professionals have been implementing a medicines management programme where medication is regularly reviewed to ensure that people receive the right medication."
However, the National Care Homes Association dismissed the claims.
"I find these figures very surprising," a spokeswoman told BBC News Online.
"Care homes don't prescribe drugs. Doctors prescribe drugs. If the Lib Dems are saying these drugs are being prescribed for no clinical reason and just to make the life of care home staff easier then it is doctors that need to be called to account."
Human rights law 'fails elderly'
Human rights law 'fails elderly'
Elderly people need better protection, the charity said
Human rights legislation is failing some vulnerable older people, according to charity Help the Aged.
The charity said gaps in the law left older people exposed to mistreatment which cannot be fully investigated or dealt with under the Human Rights Act.
It said that while statutory services were covered under the Act, the majority of care - which is contracted to the private sector - is not.
It urged the government to push forward with its planned equality bill.
The bill, included in the 2005 Queen's Speech, will establish a Commission for Equality and Human Rights, among other aims.
Champion needed
Help the Aged said such a body would have powers to champion older people's rights and could better protect them from abuse and neglect from carers.
The charity said the majority of older people's services - including more than 90% of care home places and nearly 70% of domiciliary care hours - are contracted out to the private sector, which is not covered under the Act.
In a report titled Rights at Risk - Older People and Human Rights, it said "thousands of older people [were given]... little protection in law if abuse takes place".
The charity identified "institutional cultures" which breach human rights and cites major delays in providing essential services, and limited services with little choice.
'Revulsion and anger'
Lack of hygiene, the use of inappropriate restraints, both chemical and physical, and restricted access to food and water have been reported to it as existing in some health and care settings.
Senior policy advisor Tessa Harding: "High-profile and widely publicised cases of elder abuse and neglect rightly provoke revulsion and anger.
"Unless strong new laws are introduced to give older people specific protection against breaches in their human rights, the sorts of cases seen [recently] will continue to be treated only as a matter of poor standards."
She said a commission was needed to "deliver firm, clear messages about older people's human rights to all providers of health and care services".
Why care home drug errors happen
Why care home drug errors happen
By Hannah Goff
BBC News health reporter
When inspectors said thousands of care home residents were being given the wrong medication - the image of a grotty, poorly run nursing home reared its stereotypical head.
How could something so simple as giving a patient their daily dose of tablets be going so wrong, so many times over?
There is concern about over-use of sedatives on elderly patients
But according to care professionals, management of residents' medication is one of the most complex areas of running a nursing home.
And unless fail-safe practices are adhered to, the results can be very damaging to both the resident and the care worker.
Adrian Webb, who runs a specialist mental health unit for elderly mentally ill people in central Manchester, says the main problem is that there are so many people in the chain.
An ordinary patient would take their GPs' prescription to the pharmacist and then, presumably, take the medication in the advised dose.
Each stage of the process there is potential for error.
Adrian Webb
In the case of a care or nursing home resident, there are so many more people inputting into the system.
The prescription might be written by a GP or consultant.
The pharmacist then has to make it up, then it will go to the staff in the home for storage and then a number of different people may be involved in the issuing the medication to patients.
Mr Webb, who is a registered nurse and oversees the distribution of drugs in the Victoria Park Nursing Home, says: "At each stage of the process there is potential for error.
"It has been known for prescriptions to come from doctors that are incorrect.
"But it's very easy for someone to type 100 instead of 10, for example."
Spotting errors
In the Victoria Park Nursing Home, which he runs with his wife, he checks every prescription that arrives from the doctor and pharmacist for errors.
And because he is a registered nurse, he has some knowledge of the kind of doses that ought to be expected and the drugs that are used.
He recalls one instance of receiving a batch of drugs which came from the pharmacist in the wrong dose.
The only way he knew it was incorrect was because he happened to know the higher dose pills were a different colour.
Here, it was his nursing experience which allowed him to spot the error.
But in a care home, where the administering of medicine is not carried out by a nurse, it is questionable whether a mistake such as that would have been noticed.
'Do not disturb'
"If you have not trained as a nurse are you really going to have the confidence to challenge the doctor or pharmacist about his prescription?," asks Mr Webb.
He also says the fact that a nurse could potentially lose his or her job over a medication error tends to focus the mind.
But Laura, a care assistant in the North West, who has worked in three homes for the elderly and one for people with learning disabilities over the past four years, says medication issues are taken extremely seriously indeed.
She said she spent the majority of her breaks drinking her coffee in front of a poster detailing what to do if a drug error occurs.
There are sheets for everybody coming into the home whether they are there for long or short term care and careful records of what medication is distributed, she says.
"The team leader is responsible for handing out the medication.
"There's a sign on the trolleys saying do not disturb while giving out medication and they are not disturbed," she said.
It's using the so-called chemical cosh instead of more skilled techniques to look after someone
Clive Evers
Alzheimer's Society
As in Mr Webb's nursing home, Miss Bates says the person giving out medication is focussed on that job and is not allowed to run off and answer a phone, for example.
But director of information at the Alzheimer's Society, Clive Evers argues the high turnover of staff and their limited training can been the odds are stacked against good practice.
"The workforce is very under-resourced and under-recognised. There is very limited training of staff.
"This is a workforce that would not be allowed to operate with children but they are allowed to work with adults in this way."
With up to 70% of people in care homes suffering from some form dementia, one might expect staff to have training in how to deal with their symptoms.
Care staff say drugs are closely monitored
But guidelines have only recently been adopted by the watchdog, the Commission for Social Care Inspection.
One of the other key worries in care homes is the over-use of anti-psychotic drugs and sedatives.
Over-medication is something that Mr Webb fights against in his nursing home for elderly patients with challenging behaviour.
Patients can take months to get over the heavy sedatives they are given during a visit to hospital, he says.
Good working relationships with GPs and consultants however allows his staff a certain level of control over what the patient is given.
"We give the minimum amount that is needed and it is reviewed regularly.
"We favour as little medication as possible to allow people to be themselves. The more medication people are on - the more problems they have."
But according to Mr Evers, not all homes have even this limited control over what their residents are prescribed.
"Neuroleptics (drugs) are used to limit behaviour that the care workers are not trained to deal with.
"It's using the so-called chemical cosh instead of more skilled techniques to look after someone. And unfortunately we know that this is still happening."
victims of drug errors,
There are more than 20,000 care homes in the UK
Elderly people living in care homes are being put at risk because of sub-standard systems for handing out medicine, according to a report.
University of London researchers found seven in 10 residents were victims of drug errors, having carried out half-day snapshot inspections of 55 homes.
They blamed inadequate information, over-worked staff, poor teamwork and often complex courses of medication.
The government said a review was focusing on medication "weaknesses".
Nurses are part of some of the workforces in specialist units caring for people with severe problems, such as late stage dementia.
This is just one of the many flaws in the current care system which can have a huge impact on the quality of life for many older people
Andrew Harrop, of Age Concern and Help the Aged
But the majority of teams working in more than 20,000 care homes across the UK do not include people with clinical training.
Instead, they rely on pharmacists and GPs signing-off repeat prescription requests without any or little face-to-face contact with residents.
The report, published in the journal Quality and Safety in Health Care, said the system meant vulnerable residents were put at risk.
During the inspections, which took place in the mornings when two-thirds of the daily drug courses would be taken, researchers gathered data on 256 residents.
In total, mistakes were made in 178 cases with many the victims of more than one error.
The most common mistakes involved wrong dosages, insufficient monitoring of residents after medication had been taken and people being given the drug at the wrong time.
But rather than blaming the care home staff, the researchers said they were often not given enough training or information about handing out medication.
The report said part of the problem was that care home residents were increasingly being given complex courses of medication - each resident was taking eight different pills on average a day.
Lead researcher Professor Nick Barber said: "It is a cause for concern. Residents are usually taking a cocktail of medicines and are more susceptible to drug side-effects as a consequences of ageing.
"I think care homes need more help. Pharmacists and GPs should be taking more responsibility and visiting care homes more than they do."
Consequences
The researchers also collated information on the consequences of the mistakes.
Most were only minor, although one resident did suffer a thyroid complication.
Sheila Scott, of the National Care Association, agreed care homes needed help.
"Mistakes are always indefensible, but this is a problem we keep hearing about," she said.
"We need to face this challenge and find a solution. Staff working in care homes are not medically trained and yet they are being asked to look after people with more and more complex needs."
Andrew Harrop, of the newly merged Age Concern and Help the Aged charity, said the findings were "shocking".
"This is just one of the many flaws in the current care system which can have a huge impact on the quality of life for many older people."
The Department of Health said the government was aware of the issue and was now working with the regulator, the Care Quality Commission, which was carrying out a review of healthcare in care homes.
A spokeswoman added: "The review will take into account the findings of the research and will focus on strengthening weaknesses in the systems involving medication."
Monday 5 October 2009
Seasonal Affective Disorder
/ that time of year again in Britain , 6.00 a.m. in the morning and it is still very dark. The autumn equinox has passed
and the hours of daylight are decreasing rapidly, this will continue until December 21st the shortest day of our year ,
after that the light will increase gradually peaking on June 21 next year.
Enter SAD seasonally affected disorder, or lack of daylight,
SAD () is a type of winter depression that affects an estimated
7% of the UK population every winter between September and April, in particular during
December, January and February.
It is caused by a biochemical imbalance in the hypothalamus due to the shortening of daylight hours and the lack of sunlight in winter.
For many people SAD is a seriously disabling illness, preventing them from functioning normally without continuous medical treatment.
For others, it is a mild but debilitating condition causing discomfort but not severe suffering. We call this subsyndromal SAD or 'winter blues.'
It is estimated that a further 17% of the UK population have this milder form of condition.
Feeding 'speeds surgery recovery'
Feeding 'speeds surgery recovery'
Gastrointestinal surgery patients are often starved after the operation
Cancer patients recover faster from gastrointestinal surgery if given liquid food directly into the intestine, a study suggests.
The research, on 121 patients, was carried out by Cardiff University.
Its authors said widespread adoption of the practice could potentially save the NHS millions of pounds.
Oesophageal, stomach and pancreatic cancer patients usually fast, or are nil by mouth, for up to 10 days after gastrointestinal surgery.
We turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits
Dr Rachael Barlow
Cardiff University
It had been thought nutrition hampered patients' recovery.
But the latest trial suggests that theory is wrong.
It found that patients given nutrition directly into the intestine through a feeding tube recovered around three days faster than those who were fasted and only given basic hydration.
Patients also developed fewer major complications following their surgery.
The researchers believe that if liquid food is given after all major abdominal and thoracic surgery it could save the NHS millions of pounds.
Lead researcher Dr Rachael Barlow said: "In our trial we turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits.
"The striking find that nutrients straight after surgery meant patients recovered quicker and tended to have fewer complications has major implications for the NHS.
"It may result in a saving of millions of pounds and could mean fewer bed shortages in hospitals."
High cost
Dr Barlow said a day in an NHS general or surgical ward costs up to £400 and in an intensive care unit it can cost in excess of £1,200.
"In this economic climate of financial deficits, finding new ways of improving care is important for NHS managers.
"The next step is to find out if we can adopt the same practice in other types of surgery and we are hoping to run more clinical trials in this area."
The research will be presented to the National Cancer Research Institute Conference (NCRI).
Professor Sir Kenneth Calman, chair of the NCRI, said: "This result shows that a small change in follow up care after operations for oesophagus, stomach and pancreas cancer could benefit patients and have huge cost saving implications for the NHS.
"We look forward to seeing the results of further clinical trials to see if the same technique of food after surgery can be applied to patients who have had operations for other types of cancers."
Feeding 'speeds surgery recovery'
http://www.richimag.co.uk/healthy/
Gastrointestinal surgery patients are often starved after the operation
Cancer patients recover faster from gastrointestinal surgery if given liquid food directly into the intestine, a study suggests.
The research, on 121 patients, was carried out by Cardiff University.
Its authors said widespread adoption of the practice could potentially save the NHS millions of pounds.
Oesophageal, stomach and pancreatic cancer patients usually fast, or are nil by mouth, for up to 10 days after gastrointestinal surgery.
We turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits
Dr Rachael Barlow
Cardiff University
It had been thought nutrition hampered patients' recovery.
But the latest trial suggests that theory is wrong.
It found that patients given nutrition directly into the intestine through a feeding tube recovered around three days faster than those who were fasted and only given basic hydration.
Patients also developed fewer major complications following their surgery.
The researchers believe that if liquid food is given after all major abdominal and thoracic surgery it could save the NHS millions of pounds.
Lead researcher Dr Rachael Barlow said: "In our trial we turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits.
"The striking find that nutrients straight after surgery meant patients recovered quicker and tended to have fewer complications has major implications for the NHS.
"It may result in a saving of millions of pounds and could mean fewer bed shortages in hospitals."
High cost
Dr Barlow said a day in an NHS general or surgical ward costs up to £400 and in an intensive care unit it can cost in excess of £1,200.
"In this economic climate of financial deficits, finding new ways of improving care is important for NHS managers.
"The next step is to find out if we can adopt the same practice in other types of surgery and we are hoping to run more clinical trials in this area."
The research will be presented to the National Cancer Research Institute Conference (NCRI).
Professor Sir Kenneth Calman, chair of the NCRI, said: "This result shows that a small change in follow up care after operations for oesophagus, stomach and pancreas cancer could benefit patients and have huge cost saving implications for the NHS.
"We look forward to seeing the results of further clinical trials to see if the same technique of food after surgery can be applied to patients who have had operations for other types of cancers."
Saturday 3 October 2009
Probiotic health claims dismissed
www.richimag.co.uk/yoga/be happy may help
Probiotic health claims dismissed
Lactobacillus bulgaricus is one of the probiotics found in health drinks and yoghurts
General health claims for "probiotic" drinks and yogurts have been dismissed by a team of experts from the European Union.
Their opinions will now be voted on by an EU Committee which is drawing up a list of permitted health claims.
Scientists at the European Food Safety Agency (EFSA) looked at 180 health claims for the supplements.
They rejected 10 claims and said a further 170 had not provided enough evidence of their effects.
The manufacturers of best-selling yogurt drinks Actimel and Yakult have submitted claims that will be considered at a later stage.
EFSA is reviewing all health claims made for food products following the introduction of a new EU law in 2006 which stipulated that all medical-sounding marketing claims must be verified.
The European Commission will eventually consider the list drawn up by the EU committee and develop legislation which will be voted on by member states.
No products or health claims will change until that legislation is published.
Albert Flynn, who chairs the EFSA panel which looked at these claims, said the first stage had been to look at general health claims for the products.
More specific claims from individual manufacturers will be considered next.
He said: "It's been an issue for some time that general health claims are made about these products using the family name for the active ingredient and not saying which member of the family is in the pot.
"We expect the claims that will come now from the companies will be much more specific."
A Yakult spokesman said: "Yakult has submitted claims for Lactobacillus casei Shirota, a well characterised probiotic strain unique to Yakult.
"Evidence for its health benefit is based on over 70 human studies and over 70 years of research.
"Opinions on claims submitted for this strain are not expected until 2010."
Friday 2 October 2009
“What’s driving this new pessimism?
by Julie Walsh
September 29, 2009 @ 1:14 pm
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Mr Krugman in Sunday’s New York Times is worried.
In his article “Cassandras of Science” he says, “What’s driving this new pessimism? Partly it’s the fact that some predicted changes, like a decline in Arctic Sea ice, are happening much faster than expected. Partly it’s growing evidence that feedback loops amplifying the effects of man-made greenhouse gas emissions are stronger than previously realized. For example, it has long been understood that global warming will cause the tundra to thaw, releasing carbon dioxide, which will cause even more warming, but new research shows far more carbon locked in the permafrost than previously thought, which means a much bigger feedback effect.”
He’s worried about the Arctic ice. Here’s the latest, though. Information from the National Snow and Ice Data Center shows that the Arctic has been rebounding for the past two years. (It hasn’t recovered yet, though.) The minimum sea ice extent in September of 2007 was 4.3 million square kilometers. In 2008, it was 4.7 mill sq km. And in 2009, it was 5.1 mill sq km. If the Arctic ice continues to rebound at this rate of 0.4 mill sq km per year, in two years it will be back to the level seen in 2006 of 5.9 mill sq km. And if it continues at this rate for three years? It will pass the Arctic sea ice minimum in 1995 of 6.1 mill sq km.
Krugman is also worried about the warming tundra releasing carbon dioxide and methane. But CO2Science .org says, “Another scare story came from a scientist who said the last IPCC report underestimated the vast amount of carbon contained in the world’s permafrost, which could be released to the air by rising temperatures. However, a detailed study of this phenomenon (Delisle, 2007) indicates that “permafrost will mostly prevail in this century in areas north of 70°N,” even for an unbelievable warming of 8°C, and that “permafrost will survive at depth in most areas between 60° to 70°N.” This scenario is also supported by the small amount of organic carbon released from permafrost during previous periods of warming, such as the Medieval Warm Period and Holocene Climatic Optimum, when no significant methane excursions were detected in ice core records of either Antarctica or Greenland.” If the Medieval Warm Period, which was warmer than today, didn’t have increased methane, then we won’t see it either.
If Mr Krugman is concerned about the sea bed deposits of methane called clathrates, he would be comforted reading about this six-year study by Petrenko at the University of Colorado, then. Petrenko says, “The results definitely help us to say that it doesn’t seem methane clathrates respond to warming by releasing lots of methane into the atmosphere, which is really good news for global warming.” Petrenko also said that temperatures in Greenland 12,000 years ago had increased about 10 degrees Celsius in 20 years. But it took 150 years for methane levels in the atmosphere to increase by 50 percent. Therefore, the methane did not contribute to that increase.
Arctic hockey stick graphs that claim that the Arctic is warmer now than in the past two thousand years such as this one, rely upon “previously published data from glacial ice and tree rings that were calibrated against the instrumental temperature record.” That tree ring data is now known to have been incorrect. When those graphs are corrected, they will likely show that around 1000AD the Arctic was warmer but that runaway global warming obviously did not occur.
I can understand that Krugman hasn’t followed the science, but to make comments like this one, Krugman just looks very deceived: “And the industries of the past have armies of lobbyists in place right now; the industries of the future don’t.” The money behind “green” is actually enormous.
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India's water use 'unsustainable'
By Richard Black
Environment correspondent, BBC News website
Much of the water used in paddy fields is pumped from underground
Parts of India are on track for severe water shortages, according to results from Nasa's gravity satellites.
The Grace mission discovered that in the country's north-west - including Delhi - the water table is falling by about 4cm (1.6 inches) per year.
Writing in the journal Nature, they say rainfall has not changed, and water use is too high, mainly for farming.
The finding is published two days after an Indian government report warning of a potential water crisis.
That report noted that access to water was one of the main factors governing the pace of development in the world's second most populous nation.
The situation has to stop today or tomorrow
Dr Raj Gupta
CIMMYT
New crops needed to avoid famines
About a quarter of India is experiencing drought conditions, as the monsoon rains have been weaker and later than usual.
But weather and climatic factors are not responsible for water depletion in the northwestern states of Rajasthan, Haryana and Punjab, according to the Nasa study.
"We looked at the rainfall record and during this decade, it's relatively steady - there have been some up and down years but generally there's no drought situation, there's no major trend in rainfall," said Matt Rodell, a hydrologist at Nasa's Goddard Space Flight Center near Washington DC.
"So naturally we would expect the groundwater level to stay where it is unless there is an excessive stress due to people pumping too much water, which is what we believe is happening."
State of Grace
The Grace (Gravity Recovery And Climate Experiment) mission uses two satellites flying along the same orbit, one just in front of the other.
Minute differences in the Earth's gravitational pull cause the two craft to shift slightly in their positions relative to one another.
The Grace satellites provide a twin eye on Earth gravity
Grace twins measure 'potato' Earth
The mission can measure groundwater depletion because the amount of water in aquifers has a small gravitational attraction for the satellites.
Three years ago, Grace scientists noted a loss of water in parts of Africa - but the Indian result is more striking.
"Over the six-year timeframe of this study, about 109 cubic kilometres of water were depleted from this region - more than double the capacity of India's largest reservoir is gone between 2002 and 2008," Dr Rodell told the BBC.
The northwest of India is heavily irrigated; and the Indian government's State of the Environment report, published on Tuesday, noted that irrigation increased rice yields seven-fold in some regions compared to rain-fed fields.
Dr Raj Gupta, a scientist working for the International Maize and Wheat Improvement Center (CIMMYT), said that the current drought would lead to more groundwater extraction.
"Farmers receive no rains so they are pumping a lot more water than the government expected, so the water table will fall further," he said.
"The farmers have to irrigate, and that's why they're pumping more water, mining more water. The situation has to stop today or tomorrow."
Dr Gupta noted that some farmers might be able to switch from rice to crops that demand less water, such as maize or sorghum.
But, he said, that would depend on government policies - which have traditionally promoted rice - and on market demand.
Climate change is likely to be a constraint too, with the area of South Asia suitable for wheat forecast to halve over the next 50 years.
Thursday 1 October 2009
forcing motorists to use biofuels
Biofuels To Be Added To All UK Petrol
1:42pm UK, Monday April 14, 2008
New rules forcing motorists to use biofuels are about to come into force - even though some campaigners say they may actually make climate change worse.
Fuel should be 'greener'
The introduction of the Renewable Transport Fuels Obligation (RTFO) on Tuesday will mean that all petrol sold in the UK will have to include at least 2.5% biofuels, rising to 5% by 2010.
But some scientists and green groups have voiced fears that they may contribute more greenhouse gases through deforestation and the use of fertilisers than they save.
There are also concerns the switch to energy crops from food production - including a large-scale drive in the US to produce bioethanol from maize - is contributing to rising fuel prices around the world.
Ahead of the RTFO's introduction, the Government insisted the gradual introduction of biofuels will cut millions of tonnes of carbon dioxide, and said it would not go beyond the 5% target unless it was sure it could be done sustainably.
But Friends of the Earth demanded transport's greenhouse gases, which account for around 28% of overall UK emissions, be tackled by investing in better public transport and mandatory emissions limits on cars.
A survey for the environmental group showed almost nine out of 10 people did not know that the renewable fuels - made from crops such as sugar cane or maize - would be required in their vehicles.
Of the 55% of those questioned who knew what biofuels were, fewer than one in seven thought they were the best way to reduce emissions from road transport, the YouGov poll found.
Friends of the Earth also said two-thirds were not aware that biofuels could be contributing to the destruction of rainforests cleared to make way for growing the crops.
FoE's biofuels campaigner Kenneth Richter said: "People want to see real green transport solutions that will make a difference to their lives - like better transport and smarter cars that burn less fuel.
"It's now up to the Government to set us on the right track."
But TransportMinister Jim Fitzpatrick said: "Gradually introducing biofuels could help save millions of tonnes of carbon dioxide in the next few years and the UK has done more than any other country to make sure they are produced sustainably."
CONTRACEPTION IS “GREENEST” TECHNOLOGY
CONTRACEPTION IS “GREENEST” TECHNOLOGY
Family planning cheapest way to combat climate change
/wakeup Milliband Brown Harman
Contraception is almost five times cheaper than conventional green technologies as a means of combating climate change, according to research published today (Wednesday, September 9).
Each $7 (£4) spent on basic family planning over the next four decades would reduce global CO2 emissions by more than a tonne. To achieve the same result with low-carbon technologies would cost a minimum of $32 (£19). The UN estimates that 40 per cent of all pregnancies worldwide are unintended.
The report, Fewer Emitters, Lower Emissions, Less Cost, commissioned by the Optimum Population Trust from the London School of Economics*, concludes that “considered purely as a method of reducing future CO2 emissions”, family planning is more cost-effective than leading low-carbon technologies. It says family planning should be seen as one of the primary methods of emissions reduction.
Meeting basic family planning needs along the lines suggested would save 34 gigatonnes (billion tonnes) of CO2 between now and 2050 – equivalent to nearly six times the annual emissions of the US and almost 60 times the UK’s annual total.
Roger Martin, chair of OPT, said the findings vindicated OPT’s stance that population growth must be included in the climate change debate. “It’s always been obvious that total emissions depend on the number of emitters as well as their individual emissions – the carbon tonnage can’t shoot down, as we want, while the population keeps shooting up. The taboo on mentioning this fact has made the whole climate change debate so far somewhat unreal. Stabilising population levels has always been essential ecologically, and this study shows it’s economically sensible too.
“The population issue must now be added into the negotiations for the Copenhagen climate change summit in December.** This part of the solution is so easy, and so cheap, and would bring so many other social and economic benefits, from health and education to the empowerment of women. It would also ease all the other environmental problems we face – the rapid shrinkage of soil, fresh water, forests, fisheries, wildlife and oil reserves and the looming food crisis.
“All of these would be easier to solve with fewer people, and ultimately impossible to solve with ever more. Meanwhile each additional person, especially each rich person in the OECD countries, reduces everyone’s share of the planet’s dwindling resources even faster. Non-coercive population policies are urgently needed in all countries. The taboo on discussing this is no longer defensible.”
The study, based on the principle that “fewer people will emit fewer tonnes of carbon dioxide”, models the consequences of meeting all “unmet need” for family planning, defined as the number of women who wish to delay or terminate childbearing but who are not using contraception.*** One recent estimate put this figure at 200 million. UN data suggest that meeting unmet need for family planning would reduce unintended births by 72 per cent, reducing projected world population in 2050 by half a billion to 8.64 billion. Between 2010 and 2050 12 billion fewer “people-years” would be lived – 326 billion against 338 billion under current projections.
The 34 gigatonnes of CO2 saved in this way would cost $220 billion – roughly $7 a tonne. However, the same CO2 saving would cost over $1trillion if low-carbon technologies were used.
The $7 cost of abating a tonne of CO2 using family planning compares with $24 (£15) for wind power, $51 (£31) for solar, $57-83 (£35-51) for coal plants with carbon capture and storage, $92 (£56) for plug-in hybrid vehicles and $131 (£80) for electric vehicles.
However, the study may understate the CO2 savings available because the estimates of unmet need are based on married women alone, yet some studies suggest up to 40 per cent of young unmarried women have had unwanted pregnancies.
Mr. Martin added: “The potential for tackling climate change by addressing population growth through better family planning, alongside the conventional approach, is clearly enormous and we shall be urging all those involved in the Copenhagen process to take it fully on board.
David Milliband thought this was a good idea,?
Severn's tidal barrage rejected
The inquiry said a larger barrage would seriously damage the estuary |
The inquiry said it feared the large barrage would damage the estuary.
It recommended instead that a smaller barrage is built near the Second Severn Crossing.
The inquiry also urged investment in technology to help store tidal power.
'Economic damage'
It also claims the larger barrage option is less cost-effective than the shorter barrage and "would cause serious economic damage to the port of Bristol".
The inquiry held evidence sessions at Cardiff, Bristol and Portishead and has studied the documents which have been prepared by the government as part of its own appraisal of options for Severn Tidal power.
The commission was jointly chaired by Northavon MP Steve Webb and Mike German AM.
"We believe that a smaller barrage offers the best mix of power output with reduced environmental impact and also offers the chance for a major upgrade to public transport through Wales and the West of England," said Steve Webb.
Morgan Parry, Head of WWF Cymru said: "We welcome the rejection of the Cardiff -Weston barrage which would undoubtedly cause significant environmental damage to the internationally-important Severn Estuary."
not green atall
Department of Energy and Climate Change
South West of England Regional Development Agency
Welsh Assembly Government
Consultation
Consultation Summary
Download
Severn Tidal Power Phase One Consultation.pdf3.1 MBYou will need Adobe Reader to view this file Download Adobe Reader free
Each chapter of the entire Severn Tidal Power Feasibility Study Consultation can be accessed from the sidebar.
You can also download PDFs of the entire consultation and the Strategic Environmental Assessment (SEA) scoping report from the Downloads section or read the Executive Summary of the consultation on this page.
The purpose of this consultation is to seek views on:
- The scope of the Strategic Environmental Assessment that is being carried out within the feasibility study.
- Which of the 10 possible Severn tidal power schemes under consideration will be short-listed for detailed impact assessment during 2009.
- How the feasibility study is being conducted, the issues it is considering and how these are being approached.
If you do not wish to respond online, please see
Severn tidal power
Severn tidal power – an NSIP?
This is entry number 17 of a blog on the implementation of the Planning Act 2008. Click here for a link to the whole blog.
Last month the government reported on its consultation to harness tidal power from the River Severn. This is likely to be the first major project to tap into one of the last unexploited types of natural energy in and around the UK. Unlike wave and wind power, tidal power is predictable in terms of timing and scale. Today’s entry looks at the shortlisted schemes and examines whether they will have to seek approval under the Planning Act 2008 as Nationally Significant Infrastructure Projects (NSIPs).
Five schemes were shortlisted (the list was not made any shorter by the consultation). Three of them are barrages – i.e. they span the estuary – and two are lagoon projects – i.e. they impound water at one shore and let it in and out. The options are therefore not mutually exclusive.
The Beachley Barrage is the furthest upstream – it is upstream of the Wye near Chepstow. It is estimated to generate 2.7 terawatt hours per year (TWh/year).
The Shoots Barrage is next – it crosses the Severn near the road bridges from north of Avonmouth to south of Caldicot, and is estimated to generate 1.6TWh/year.
The final barrage is the Cardiff-Weston Barrage, whose name suggests its route. It is the most expensive and the furthest downstream, estimated to generate 16.8TWh/year or 5% of the UK’s electricity needs.
The upstream lagoon on the Welsh side is the Fleming Lagoon between Newport and the road bridges, estimated to generate 2.3TWh/year.
Finally, the downstream lagoon on the English side is the Bridgwater Bay Lagoon between Hinkley Point (another source of low-carbon electricity as it is the site of a nuclear power station) and Weston-super-Mare. It would generate 2.6TWh/year.
Would any of these be NSIPs? The two questions are whether the Act applies to generating stations in Wales or off Welsh waters, and whether these projects are above the size threshold as offshore ones of at least 100MW.
The answer to the first question is that the Act does apply to generating stations in Wales as well as England (although note that not all NSIP categories do apply in Wales), and also to Welsh as well as English waters.
For the answer to the second question, as is fairly often the case in assessing NSIPs, the project is given in different units and must be converted. In this case, one must convert terawatt hours per year to megawatts. A terawatt is a million megawatts (from the Greek for ‘monster’, rather than the Greek for just ‘big’) and there are about 8766 hours in a year, so one can calculate that 100MW is equivalent to 1.147TWh/year.
All five projects are therefore, not surprisingly, above the threshold and will have to use the new regime if they are applied for after 1 March 2010. As the next step is to look into the feasibility of each scheme, and applications are not expected to be made until 2014, this will certainly be the case for those that go ahead. So the answer to the question posed in the title is 'yes - and it may be more than one'.
If you would like to find out more about the application of these schemes to the new regime, please
Colostrinin
Colostrinin™
ReGen Therapeutics Plc was formed in February 1998 to develop Colostrinin™, a proline-rich polypeptide complex derived from mammalian colostrum. The complex and the peptides within it are viewed as having potential utility in neurodegenerative illnesses such as Alzheimer’s disease, Parkinson’s Disease, Multiple Sclerosis and Amyotrophic Lateral Sclerosis.
Colostrinin™ was originally identified by scientists working in Poland, where early clinical studies, dating back to 1995, had indicated a significant potential benefit to Alzheimer’s disease sufferers. ReGen therefore conducted a placebo-controlled clinical trial of it’s own on Alzheimer’s sufferers in Poland, which completed in mid-2002. Results from the trial showed 33% of patients achieved stabilisation or improvement in their disease condition after 30 weeks of treatment, with efficacy demonstrated in both mild and moderate symptom groups. A good safety profile and no Serious Adverse Events or other safety concerns were observed. An article reviewing the results of this trial was published in the February 2004 issue of the Journal of Alzheimer’s Disease.
Since 2003 ReGen has been investigating the possibility of developing a nutraceutical version of Colostrinin™. The natural origin and nature of Colostrinin™ means that it conforms to the general criteria for non-pharmaceutical health supplements, so the Company formulated a nutraceutical development plan which has run in parallel with the continuing development of pharmaceutical drug-candidates based on the constituent peptides of the Colostrinin™ complex. ReGen has filed a substantial number of patent applications with various patent authorities throughout the World. These patents are targeted at protecting both discoveries in the field of the treatment of Alzheimer’s disease and at wider applications for Colostrinin™ and its constituent peptides in other neurodegenerative disease areas. Most of ReGen’s patent applications are still in the process of examination by the various national patent authorities, but up to September 2007, the Company has had its main “use” patent on Colostrinin™ granted in the United Kingdom, USA, Australia, New Zealand, Russia, China, Turkey, Israel, South Korea, Czech Republic and South Africa and another three patents (under licence from University of Texas Medical Branch) granted in the USA. ReGen’s subsidiary, ReGen Biotech Ltd had a patent on the use of Colostrinin™ in combination with other materials as a dietary supplement, granted in the UK in October 2002.
Last updated January 2008
'Celtic fringe'
http://www.richimag.co.uk/chickenoregg/ tests on British populations of small mammals show a genetically distinct "Celtic Fringe", say scientists at The University of York.
The authors say the work sheds light on the origins of the Celtic people.
This paper suggests that the study of small mammal populations could help resolve the controversy.
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