Tuesday, 13 October 2009

What are autism and Asperger syndrome?

http://www.richimag.co.uk/healthy/clever.people with autism and Asperger syndrome the world can appear chaotic with no clear boundaries, order or meaning.
These disorders can vary from very mild, where the person can function as well as anyone else around them, to so severe that they are completely unable to take part in normal society.

They affect more than 580,000 people in the UK

People with autism are usually more severely disabled, while those with Asperger syndrome tend to be more able, although this isn’t always so. Because of the range of severity and symptoms the conditions are collectively known as autistic spectrum disorders. They affect more than 580,000 people in the UK.

Symptoms

The main three symptoms are:

Difficulties with social interaction - being unaware of what's socially appropriate, finding chatting or small talk difficult and not socialising much. People with autism may appear uninterested in others and find it very difficult to develop friendships and relate to others, while those with Asperger syndrome are more likely to enjoy or want to develop social contacts but find mixing very difficult.
Problems with verbal and non-verbal communication – those affected may be able to speak fluently or, more commonly in autism, may be unable to speak at all. There may also be difficulties understanding gestures, body language, facial expressions and tone of voice, making it difficult to judge or understand the reactions of those they are talking to, or to empathise with people's feelings. As a result they may unintentionally appear insensitive or rude to others. They may also take others comments very literally, and so misunderstand jokes, metaphors or colloquialisms.
Lack of imagination and creative play - such as not enjoying or taking part in role-play games. They may also find it difficult to grapple with abstract ideas. There may be overriding obsessions with objects, interests or routines which tend to interfere further with building social relationships (this is known as stereotyped or repetitive behaviour).

These behavioural difficulties can cause a great deal of stress for members of the family.
Babies who develop autism later may appear normal at first and reach the usual developmental milestones, including early speech. But as they grow into toddlers, they may fail to develop normal social behaviour and speech may be lost.
As a child grows, the typical difficulties of autistic spectrum disorders are:

Repetitive behaviour and resistance to changes in routine.
Obsessions with particular objects or routines.
Poor coordination.
Difficulties with fine movement control (especially in Asperger’s syndrome).
Absence of normal facial expression and body language.
Lack of eye contact.
Tendency to spend time alone, with very few friends.
Lack of imaginative play.

People with Asperger syndrome are usually more mildly affected than those with autism. In fact, many people with milder symptoms are never diagnosed at all, and some argue that Asperger syndrome is simply a variation of normal rather than a medical condition or disorder. Even so, many do find that it gives them particular problems getting on in the world and they may become aware they are different from others. This can result in isolation, confusion, depression and other difficulties, all of which could be defined as ‘disease’.
Some children with Asperger syndrome manage (or in fact even do very well) in mainstream schools especially if extra support is available. However, even when children cope well academically, they may have problems socialising and are likely to suffer teasing or bullying. More severely affected children need the specialist help provided by schools for children with learning disabilities.
With the right sort of support and encouragement, many with Asperger syndrome can lead a relatively normal life. Helping them develop some insight into the condition is an important step towards adjusting to, or at least coping with, the way the rest of the world works. Some do very well, especially in an environment or job where they can use their particular talents.
Autism tends to produce more severe symptoms. For example, a child with autism may fail to develop normal speech (the development of spoken language is usually normal in Asperger’s syndrome) and as many as 75 per cent of people with autism have accompanying learning disabilities.
Seizures are also a common problem, affecting between 15 and 30 per cent of those with autism.
Conversely, autistic children are sometimes found to have an exceptional skill, such as an aptitude for drawing, mathematics, or playing a musical instrument.

Causes and risk factors

The cause of autistic spectrum disorders is not yet clear. Genetics play an important role, and researchers are examining a number of chromosome sites that could be implicated. It's likely that autism occurs when a small number of genes interact in a specific way, possibly linked to some external event or factor.
This genetic link means there may be an inherited tendency, so autism and Asperger’s syndrome may run in families. Brothers or sisters of a child with the condition are 75 times more likely to develop it.
Doctors' ability to diagnose these disorders has improved in recent years, but older people, particularly with milder problems, may never have been diagnosed. When a child is diagnosed, parents often realise they've had the same problems themselves.
Boys are more likely to be affected than girls, though research suggests that when girls have the condition they may be more severely affected.
A variety of other environmental factors that affect brain development before, during or soon after birth, also play a part (possibly acting as a trigger). Despite reports suggesting a possible link between MMR vaccination and autistic spectrum disorders, scientific evidence has confirmed the vaccination does not increase the risk.
There's no specific test for autistic spectrum disorders. Diagnosis is based on a consideration of symptoms, and milder cases may be missed.

Treatment and recovery

There is no specific cure or particular medical treatment for autism, but much can be done to maximise a child’s potential and this is key to managing the condition

There is no specific cure or particular medical treatment for autism, but much can be done to maximise a child’s potential and this is key to managing the condition. Appropriate specialist education, speech, language and behavioural therapy are all important. There are many different approaches, some of which are based around theories about possible causes of autistic spectrum disorders (for example, the Son-Rise programme).
While many people feel they've achieved good results with some of these interventions, none of them is a cure-all, and many lack scientific evidence to demonstrate their benefits.
Others claim dietary changes or alternative remedies have helped, but these, too, are mostly unproven.
Medication is sometimes recommended when it's felt to be of benefit to the child, for example to control seizures, depression or other symptoms.
As the precise events that lead to autistic spectrum disorders aren't yet known, it isn't possible to prevent them. Neither is there yet a simple screening test to identify people carrying genes that might increase susceptibility to autism.
This article was last medically reviewed by Dr Trisha Macnair in August 2009.

Monday, 12 October 2009

doubling in cases of serious disciplinary action taken against doctors from other EU states.

page12.html

The number of doctors who have come to work in Britain from other parts of Europe without undergoing safety checks or extra training can be revealed for the first time.

By Laura Donnelly, Health Correspondent
Published: 9:00PM BST 05 Sep 2009

Of more than 20,000 EU doctors registered to practice in this country, 4,061 have arrived since safety checks were removed five years ago.

The figure comes amid increasing concerns about the lack of scrutiny of medics who migrate to this country.

Figures from the General Medical Register show that among the foreign doctors registered to work in the UK, more than 5,000 are from former Eastern bloc countries.

Of those, the greatest exporter was Poland, which trained 1,800 medics now on the British register, followed by Hungary, which sent more than 1,000. More than 700 came from the Czech Republic and almost 800 from Romania.

Under an EU directive passed in 2004, doctors who qualify in any EU state can move to work in any other member state without tests of their language skills or clinical competence – even though experts last night warned that there is little consistency in the medical training, treatments and medications used across Europe.

This newspaper's investigation reveals that since then, the number of EU doctors registered to work in Britain has risen by 4,000 – an increase of 25 per cent – at a time when the number of UK-trained doctors on the register has fallen.

Meanwhile, there has been a doubling in cases of serious disciplinary action taken against doctors from other EU states.

Regulators warned that British lives were being put at "unacceptable risk" by the lack of safety checks covering doctors who come here for permanent work, as well as those flying in to work lucrative shifts at evenings and weekends.

Senior doctors expressed particular fears about the quality of training in some parts of Eastern Europe.

They warned that other countries exporting high numbers of medics to this country were not familiar with the same medications, and had different education systems.

More than 3,500 doctors came from Germany, the figures disclose. Last year, Dr Daniel Ubani killed a pensioner during his first shift working in Britain after flying from Germany to work as an out of hours doctor.

David Gray, 70, died as a result of a massive overdose of the drug diamorphine which is rarely used by family doctors in Germany.

Under the Brussels rules on freedom of labour the General Medical Council, which regulates doctors, cannot force its counterparts abroad to reveal whether a doctor has been previously struck off, or had restrictions placed on their practice.

Instead it relies on voluntary sharing of information, which its officials warn is unreliable.

The GMC has pleaded with the Government and European Union to re-examine the rules, which it believes put patients at risk.

Paul Philip, the deputy chief executive of the GMC, said: "If a doctor applies to go on the register here and they have previously been struck off in France, Germany or Poland we would not necessarily be able to find that out.

"We can try to get as much information as we can – and we do – but there is no legal obligation for regulators to pass on information to us. We think that creates an unacceptable level of risk."

Professor Sir Donald Irvine, former president of the GMC, criticised the Government for failing to block the original EU laws which had created dangers to the public, or to adapt British regulation systems to assess every doctor more rigorously.

While he was GMC president he argued that any medic who wanted to work in this country should undergo a national examination first, using a system which has been used for more than 60,000 doctors who have come to the UK from foreign countries beyond EU borders.

Sir Donald said he feared the risks to patients were being increased by an influx of doctors trained in Eastern Europe.

"I am particularly worried about some of the more recent entrants to the EU – there is huge variation in the quality of training in Europe," he said.

The latest figures from the GMC show that one in 10 doctors registered to work in Britain was trained elsewhere in Europe.

Last year, 30 EU doctors were struck off in the UK, suspended, given a warning or had conditions imposed on their practice, compared with 15 in 2005.

Ray Montague, from the NHS Alliance, which represents GPs, said the current system assumed that medical training in every country was similar, when it is not.

He gave the example of medical training in Italy, which involves little practical experience until after a doctor qualifies, and highlighted the case of Ubani.

Dr Montague said: "Medical education takes years, and it is not something that any employer can assess in an interview. In the Ubani case there was a fundamental hole in the doctor's knowledge, which had fatal consequences.

"But if a doctor is on the medical register, turns up for an interview, sounds charming and talks convincingly about a few medical subjects, specific gaps like this would be unlikely to be picked up".

One in three primary care trusts is flying in foreign GPs because of a shortage of doctors in Britain willing to work in the evenings and weekends.

As "temps" they earn up to £100 an hour, with one Merseyside trust spending £267,000 on nine Polish doctors and two Germans last year.

Since the Ubani case became public, GP leaders have called for a radical overhaul of the system of out-of-hours care.

Dr Steve Field, head of the Royal College of GPs, said doctors should not be allowed to "waltz in and out of this country" without any safeguards for the public.

Other cases to cause concern include a French surgeon who was suspended for 18 months after botching nine of 15 orthopaedic operations he performed.

Roland Istria returned to Paris after the cases at the Nuffield Private Hospital in Cambridge in 2005.

Dozens of elderly patients were left requiring operations to correct botched surgery carried out by Scandinavian doctors flown in to work as locums in Somerset, as part of an NHS initiative which promised to cut waiting times between 2004 and 2006.

A spokesman for the Department of Health said the UK was required to recognise professional qualifications of European Economic Area nationals.

He said NHS organisations had a responsibility to ensure any individual recruited was fit for their role.

paid £300,000 for not working

Doctor paid £300,000 for not working

A senior doctor has earned around £300,000 from an NHS hospital for doing nothing for more than three years while suspended over claims of his incompetence.http://www.richimag.co.uk/nhs2009/

Published: 12:27PM GMT 22 Mar 2009

Consultant cardiologist Sisiresh Chakrabarty, who worked at Ipswich Hospital, Suffolk, has been suspended on full pay since November 2005.

NHS national employment guidelines mean he was kept on the pay roll.

A General Medical Council hearing was eventually held in January and ruled that the Indian-born doctor had "deficiencies" in his professional ability.

He was criticised for the way he dealt with patients, his communication skills, relationships with colleagues, record keeping and working within regulations.

Dr Chakrabarty was also banned from doing private locum work without the approval of his supervisor.

But the hearing ruled that he could work again if he met strict conditions which included being supervised and keeping in touch with the GMC.

However, Ipswich Hospital is still reviewing his contract and has not decided how best to proceed.

It is not known exactly how much he earns - but the NHS pay scale for consultant cardiologists is between £73,000 and £99,000.

Hospital spokeswoman Jan Rowsell said: "We are bound by national guidelines relating to salaries in cases like this.

"We are carefully considering the feedback from the GMC and in accordance with the procedures we will formally meet with the doctor concerned to review the situation."

Dr Chakrabarty, who qualified as a doctor in 1982 at Ranchi University in India, was unavailable for comment.

Britain’s youngest hospital boss.

NHS boss under spotlight over relationship with high-flying colleaguehttp://www.richimag.co.uk/nhs2009/

The chief executive of the NHS has come under scrutiny over his relationship with a high-flying colleague who has become Britain’s youngest hospital boss.

By Murray Wardrop
Published: 10:35PM BST 11 Oct 2009

David Nicholson, 52, has announced that he is to marry Sarah-Jane Marsh, who is 20 years his junior, and who he first met as a graduate trainee.

In June, Miss Marsh was given the £155,000-a-year job of chief executive at Birmingham Children’s Hospital (BCH). She was elevated to the post despite having been in charge of day-to-day operations when the hospital was criticised by the Healthcare Commission for a lack of beds and poor standards of training and care.

It has been disclosed that Mr Nicholson provided some references for Miss Marsh as she applied for a series of posts during her rise through the NHS ranks.

The couple first met in 2002, when Miss Marsh was selected for a six-month graduate placement in Mr Nicholson’s office, while he was director of health and social care for the Midlands and East of England. The following year, Mr Nicholson gave her a reference when she applied successfully for a job as head of planning and development at Walsall Hospitals NHS Trust. She became director of planning and productivity two years later.

Mr Nicholson also supplied a reference when Miss Marsh landed the post of chief operating officer at BCH in December 2007. The role put her in charge of the day-to-day running of the trust. She became interim chief executive in March this year when the Healthcare Commission issued its damming report.

The Department of Health has denied suggestions that Miss Marsh’s relationship with Mr Nicholson played any part in her appointment as chief executive at BCH. The trust and Mr Nicholson said that he did not provide a reference in her application for the post.

In a statement, Mr Nicholson said: “As a former employer, I agreed to provide a reference for a position at Walsall Hospitals NHS Trust and the Chief Operating Officer position at Birmingham Children’s Hospital. We were not in a relationship then. I did not provide a reference for the chief executive post at Birmingham Children’s Hospital.”

It is unclear when their relationship began, but Mr Nicholson informed Sir Hugh Taylor, the permanent secretary to the Department of Health, of his engagement to Miss Marsh last month.

In his statement Mr Nicholson admitted they had enjoyed a romantic trip early in the year.

“We went on holidays over New Year 2009,” he said. “It was a private holiday, organised and paid for by both of us. We were not on NHS business, nor was any part of the trip paid for by the NHS.”

Patients’ groups raised questions over Miss Marsh’s promotion in the wake of the Healthcare Commission report in March.

Joyce Robins, the co-director of Patient Concern, said: “It’s astonishing when someone who has presided over such a mess in the NHS is then promoted.”

Mr Nicholson became chief executive of the NHS in 2006 after nearly 25 years progressing through the management ranks. He was made a CBE in January 2004 for his services.

The DoH said Mr Nicholson was not obliged to declare his relationship under department or Cabinet office rules.

A spokesman said that because BCH has Foundation Trust status, it is free from Government management and so Mr Nicholson has no influence over staff appointments.LMK ends

iodine rich seaweeds

Iodine Iodine is vital for good thyroid function, which in turn is essential for health. Iodine deficiency during pregnancy and early infancy can result in cretinism (irreversible mental retardation and severe motor impairments). In adults low iodine intake (or very high intakes) can cause hypothyroidism. Hypothyroidism can manifest as low energy levels, dry or scaly or yellowish skin, tingling and numbness in extremities, weight gain, forgetfulness, personality changes, depression, anaemia, and prolonged and heavy periods in women. Goiter, an enlarged thyroid gland visible between the Adam's apple and the collar bone, is often present. Hypothyroidism can also cause carpal tunnel syndrome and Raynaud's phenomenon. Hypothyroidism can lead to significant increases in cholesterol levels and homocysteine levels is implicated in about 10% of cases of high cholesterol levels. Correcting hypothyroidism can lead to a 30% drop in cholesterol and homocysteine levels.

An iodine intake of less than 20 micro grams (��g) per day is considered severe deficiency, 20 -50 ��g/day is considered moderate deficiency and 50-100 ��g/day is considered mild deficiency.

Iodine is typically undesirably low (about 50 micrograms/day compared to a recommended level of about 150 micrograms per day) in UK vegan diets unless supplements, iodine rich seaweeds or foods containing such seaweeds (e.g. Vecon) are consumed. The low iodine levels in many plant foods reflects the low iodine levels in the UK soil, due in part to the recent ice-age. About half the iodine consumption in the UK comes from dairy products. In the US iodised salt is widely used and some other foods are fortified with iodine. In Canada all table salt is iodized. The UK has no iodine fortification strategy for plant foods or salt.

Low zinc intakes exacerbate the effect of low iodine intake. Some otherwise healthful foods contain goitrogens - substances which can interfere with iodine uptake or hormone release from the thyroid gland. These foods are generally only a concern if iodine intake is low. Consumption of brassicas, such as cabbage, Brussels sprouts, broccoli and cauliflower, increase the requirements for iodine, especially if consumed raw. Soy beans, raw flaxseed, cassava (used in tapioca), sweet potatoes, lima beans, maize and millet also increase the requirements for iodine.

It is important not to over-consume iodine as it has a relatively narrow range of intakes that reliably support good thyroid function (about 100 to 300 micrograms per day). Someone consuming large amounts of iodised salt or seaweeds could readily overdo it. Excessive iodine has a complex disruptive effect on the thyroid and may cause either hypothyroidism or hyperthyroidism, in susceptible individuals, as well as increasing the risk of thyroid cancer. Hyperthyroidism may also occur, particularly in elderly people, due to long term slight iodine deficiency as this may result in additional nodules on the thyroid.

Hyperthyroidism may manifest as an enlarged thyroid (goiter), heart rate irregularities, tremor, sweating, palpitations, nervousness and increased activity and eye abnormalities. Some individuals deliberately take kelp to try to lose weight by over stimulating the thyroid. This is a dangerous practice.

Subclinical hypothyroidism, with raised thyroid stimulating hormone (TSH) levels but mild or absent overt symptoms, has been found to be more common among vegans than the general population. Most vegans have low iodine intakes but a significant minority consume excessive amounts of iodine from seaweed, particularly kelp. Both low and excessively high iodine intakes in vegans have been linked to elevated TSH levels.

The key to good thyroid function is adequate, but not excessive iodine intake. Intakes in the range 100-300 micrograms per day are desirable, though intakes up to 500 micrograms per day are probably not harmful. If taking supplements go for about 100-150 micrograms per day, to give a total intake of 150-200 micrograms per day. The supplements supplied by The Vegan Society contain an average of about 150 micrograms, so one a day provides about the right amount. Many kelp supplements contain higher levels and should be restricted to two a week.

If using seaweeds as an iodine source it is best to use seaweeds that have been found to have a fairly consistent iodine content, such as kelp (kombu). Consumption of more than 100g/year (by dried weight) of most seaweeds carries a significant risk of thyroid disorder due to iodine intakes in excess of 1000 micrograms per day.

Nori is low in iodine and several sheets a day can be eaten without any concern about excess iodine. Frequent addition of small amounts of powdered or crumbled seaweed to stews or curries while cooking, or to other foods as a condiment, is an excellent way to provide adequate iodine (in the absence of other supplementation) and is a healthful practice for vegans. 15g of dried kombu or kelp in a convenient container in the kitchen provides one year's supply for one person.

Most vegans know that B12 deficiency can cause neurological complications and tingling sensations or numbness. B 12 deficiency is also a common cause of elevated homocysteine levels in vegans. It should be noted that hypothyroidism (myxedema) can also cause nerve damage, tingling sensations and elevated homocysteine and should be considered as an alternative diagnosis for these symptoms

Arctic sea ice extent remains low; 2009 sees third-lowest mark

6 October 2009http://www.richimag.co.uk/biofools/

Arctic sea ice extent remains low; 2009 sees third-lowest mark

This is a press release from the National Snow and Ice Data Center (NSIDC), which is part of the Cooperative Institute for Research in Environmental Sciences at the University of Colorado at Boulder.
Media Relations Contact: Katherine Leitzell, NSIDC: leitzell@nsidc.org or +1 303.492.1497

At the end of the Arctic summer, more ice cover remained this year than during the previous record-setting low years of 2007 and 2008. However, sea ice has not recovered to previous levels. September sea ice extent was the third lowest since the start of satellite records in 1979, and the past five years have seen the five lowest ice extents in the satellite record.

NSIDC Director and Senior Scientist Mark Serreze said, “It’s nice to see a little recovery over the past couple years, but there’s no reason to think that we’re headed back to conditions seen back in the 1970s. We still expect to see ice-free summers sometime in the next few decades.”

The average ice extent over the month of September, a reference comparison for climate studies, was 5.36 million square kilometers (2.07 million square miles) (Figure 1). This was 1.06 million square kilometers (409,000 square miles) greater than the record low for the month in 2007, and 690,000 square kilometers (266,000 square miles) greater than the second-lowest extent in 2008. However, ice extent was still 1.68 million square kilometers (649,000 square miles) below the 1979 to 2000 September average (Figure 2). Arctic sea ice is now declining at a rate of 11.2 percent per decade, relative to the 1979 to 2000 average (Figure 3).

Sea surface temperatures in the Arctic this season remained higher than normal, but slightly lower than the past two years, according to data from Mike Steele at the University of Washington in Seattle. The cooler conditions, which resulted largely from cloudy skies during late summer, slowed ice loss compared to the past two years (Figure 4). In addition, atmospheric patterns in August and September helped to spread out the ice pack, keeping extent higher.

Figure 2. The updated time series plot puts this summer’s sea ice extent in context with other years. The solid light blue line indicates 2009; the dashed green line shows 2007; the dark blue line shows 2008, the light-green line shows 2005; the solid gray line indicates average extent from 1979 to 2000, and the gray area indicates the two standard deviation range of the data. Sea Ice Index data.
—Credit: National Snow and Ice Data Center

The ice cover remained thin, leaving the ice cover vulnerable to melt in coming summers. Scientists use satellites to measure ice age, a proxy for ice thickness. This year, younger (less than one year old), thinner ice, which is more vulnerable to melt, accounted for 49 percent of the ice cover at the end of summer. Second-year ice made up 32 percent, compared to 21 percent in 2007 and 9 percent in 2008 (Figure 5). Only 19 percent of the ice cover was over 2 years old, the least in the satellite record and far below the 1981-2000 average of 52 percent. Earlier this summer, NASA researcher Ron Kwok and colleagues from the University of Washington in Seattle published satellite data showing that ice thickness declined by 0.68 meters (2.2 feet) between 2004 and 2008.

NSIDC Scientist Walt Meier said, “We've preserved a fair amount of first-year ice and second-year ice after this summer compared to the past couple of years. If this ice remains in the Arctic through the winter, it will thicken, which gives some hope of stabilizing the ice cover over the next few years. However, the ice is still much younger and thinner than it was in the 1980s, leaving it vulnerable to melt during the summer.”

Arctic sea ice follows an annual cycle of melting and refreezing, melting through the warm summer months and refreezing in the winter. Sea ice reflects sunlight, keeping the Arctic region cool and moderating global climate. While Arctic sea ice extent varies from year to year because of changeable atmospheric conditions, ice extent has shown a dramatic overall decline over the past thirty years. During this time, ice extent has declined at a rate of 11.2 percent per decade during September (relative to the 1979 to 2000 average) (Figure 6), and about 3 percent per decade in the winter months.

Figure 3. September ice extent from 1979 to 2009 shows a continued decline. The September rate of sea ice decline since 1979 has now increased to 11.2 percent per decade. Sea Ice Index data.
—Credit: National Snow and Ice Data Center

NSIDC Lead Scientist Ted Scambos said, “A lot of people are going to look at that graph of ice extent and think that we've turned the corner on climate change. But the underlying conditions are still very worrisome.”

Reference:
Kwok, R., and D. A. Rothrock. 2009. Decline in Arctic sea ice thickness from submarine and ICESat records: 1958–2008, Geophys. Res. Lett., 36, L15501, doi:10.1029/2009GL039035.

For a full listing of press resources concerning Arctic sea ice, including previous press releases and quick facts about why and how scientists study sea ice, please see "Press Resources" on the NSIDC Arctic Sea Ice News & Analysis Web page (http://nsidc.org/arcticseaicenews/).

Sunday, 11 October 2009

Doubts raised over MRSA screening

Doubts raised over MRSA screening

MRSA rates have been falling in recent years
The wisdom of screening all hospital patients for MRSA in England is being questioned by a leading expert.

Dr Michael Millar, who is involved in the screening programme at a top London hospital trust, said the tests produced too many false results.

He also said the risks and consequences of delayed operations and isolation were not fully explained to patients, the British Medical Journal reported.

But the government said screening was an important part of the MRSA fight.

It was announced by Prime Minister Gordon Brown as one of his flagship policies in the fight against superbugs - and has been implemented as MRSA rates have been falling.

Research has shown that isolating patients means they have less contact with staff and family which can lead to more accidents

Dr Michael Millar
All hospitals in England have had to screen patients being admitted for non-emergency surgery since April 2009.

They have until 2011 to make sure emergency cases are tested - although many trusts have already started doing this.

Most other countries, including the US, rest of the UK and much of mainland Europe, only screen the most at-risk patients, such as those who have been in and out of hospital in recent months.

Dr Millar, a microbiologist from Barts and The London NHS Trust, said that was a much more sensible policy and should be re-instated in England.

"We used to just screen the at-risk group and that was a much better way of doing it.

"The problem with screening everyone is that in low risk groups you get as many false positives as positives, if not more.

"So you have people ending up having their treatment delayed or being put into isolation when they do not need to be.

"None of this is explained to patients and I think that in unethical."

Rapid tests

Dr Millar said part of the problem was that the NHS was increasingly relying on rapid tests, which could be leading to false positives 2.5% of the time.

That is as high - if not higher - than the rates of MRSA in the average hospital patient population, he said.

He went on to say that isolation, in particular, could have serious psychological and physical consequences.

"Research has shown that isolating patients means they have less contact with staff and family which can lead to more accidents."

Dr Millar said the focus on MRSA also meant that other infections, such as E. coli, were not getting the attention they deserved.

Dr Millar is not the first infections expert to question the screening policy.

But the Department of Health maintained it was an important part of the fight against MRSA.

A spokeswoman said: "Although the chance of acquiring MRSA is relatively low, when a patient does it is extremely distressing for them, their family and the NHS staff treating them.

"By screening patients for MRSA, the NHS is reducing a patient's risk of developing an MRSA infection themselves or passing it on to others within the hospital that may be more vulnerable."

Biofuels cause 75pc increase in food prices

Biofuels cause 75pc increase in food prices, report says
By Paul Eccleston
Last Updated: 12:40pm BST 04/07/2008
http://www.richimag.co.uk/biofools/
Environmental campaigners have called for a change in policy on biofuels after a report that they have caused a 75 per cent increase in food prices.

G8 'acting too slowly' on climate change
Extinction threatens more species than thought
Telegraph Earth homepage
An unpublished World Bank study claimed the EU and US drive towards biofuels was having a massive impact on both food supply and prices.

Palm oil plantations produce fuel instead of food
The US Government had claimed that biofuels - mainly ethanol produced from crops such as corn, palm and soya - was responsible for only a three per cent rise in food prices.

President Bush had linked higher food prices to a bigger demand by wealthier consumers in China and India.

But the World Bank report, drawn up by an internationally-respected economist, states unequivocally that income growth in developing countries was not a major factor in price rises and that a shortage of grain caused by droughts had had only a marginal impact.

"Without the increase in biofuels, global wheat and maize stocks would not have declined appreciably and price increases due to other factors would have been moderate," the report states.

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Saturday, 10 October 2009

The Global Climate Network

10 October
Global Climate Network: Home
Global Climate Network: Home

Latest report
Creating Opportunity:
Low carbon jobs in an interconnected world
If governments are bold and ambitious in developing markets for low-carbon technologies, then they will maximise the economic benefits and stand a greater chance of creating more jobs.

Early findings from the study - presented in this interim report - suggest that creating markets for low-carbon technologies will in turn create new job opportunities and that these will be greater than the number of jobs lost in carbon-intensive sectors. The study also finds that the creation of markets for low-carbon technologies in one country will lead to greater opportunities in others. Interconnectedness means policy coordination is required.

Read more.

Welcome
Bright ideas are the foundation stones of prosperity. They will also help us build a future free from carbon.
The Global Climate Network is an alliance of nine influential, progressive think tanks located in countries where action on climate change really matters. We bring together some of the world’s brightest brains to propose progressive solutions to climate change that will also help lay the foundations for a new era of prosperity.

Our focus is on policy. We will work with decision makers on innovations that help clear space for progressive action on climate change. Each of us enjoys international renown, but understands that domestic change is the key to successful global action.

We think that climate change policy has to be led by governments, acting independently and together. But because each of us is well connected domestically, we understand that governments as yet do not have the political space to implement the depth of policies needed.

We are committed to producing high-quality research and bright policy ideas that help governments link climate change policy with human and economic progress, including with poverty eradication. Our focus is therefore on technological progress, economic development and policies that reduce not entrench inequality

Global Climate Network: Home

12:25

Charlie confused about climate issues

10 October
HRH The Prince of Wales: 'The countryside is in crisis. The stakes could not be higher' - Telegraph

HRH The Prince of Wales: 'The countryside is in crisis. The stakes could not be higher'
The Prince of Wales explains how computer technology can save our rural communities and the landscape they have nurtured.
By HRH The Prince of Wales
Published: 7:00AM BST 10 Oct 2009

HRH The Prince of Wales believes farmers must be supported and rural communities sustained Photo: GETTY

The countryside means different things to all of us. For some, it is a place of beauty and tranquillity - somewhere to go to escape the stresses and strains of urban life, to be closer to Nature and enjoy our wonderful landscapes. For many of us, it is a place to live and work. But whatever our relationship with rural Britain, we surely all agree that it is one of the greatest treasures of our nation.

That is why, after the horrific outbreak of Foot and Mouth in 2001, when millions of people were, perhaps for the first time, made aware of the fragility of the rural economy and the way of life it sustains, I launched my Rural Action Programme under the aegis of Business in the Community, of which I am President. I wanted to engage business leaders in finding solutions to many of the problems faced by rural communities – just as they had done so effectively in the inner cities in the 1980s. Since then, good progress has been made, but there is no doubt that our countryside remains in crisis and we have to continue to find new ways to help. The provision of services – without which no community can survive, let alone flourish – must be central to our efforts. And it has become clear that one of those services – the lack of access to high speed broadband – is putting many of those who work in rural communities at a severe disadvantage.

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Access to the Internet is increasingly being considered a necessity. There is not a business in the country, with any ambition to succeed, that does not have an email address or a website. Yet still too many rural households are currently unable to access the Internet at satisfactory speeds. The handicap this places on those rural businesses, schools, doctors' surgeries and local authorities, which inhabit these so-called "broadband deserts", is immense. And, even more worryingly, many of those who are being left in the Internet's "slow lane" are the very same people who look after the countryside on our behalf – Britain's livestock farmers – and they are struggling as never before.

In real terms, livestock farmers are receiving less now than they were two decades ago. The costs of production have increased hugely and, of course, since 2005, when subsidies ceased to be linked to production, support from the European Union has been diminishing. The problem is that, try as they might, livestock farmers have not been able to make up the shortfall from the market. The dairy sector is not faring very much better, with real consequences for this country's future milk supply. How many people, I wonder, realize that the number of dairy farms has declined by over fifty per cent in the last decade and each week fourteen farmers are giving up? The situation is desperate and the result is that we are now importing one million litres of fresh milk every day – and yet this country has some of the best dairy farming conditions in the world.

Quite frankly, the fear that many of us hold is that after 2012, when support from the E.U. will alter so dramatically, it may be simply impossible for our family farmers to continue – particularly in the remote uplands, where farming is at its toughest. If they are to stay on the land they will need all the help they can get, and denying them broadband, and effectively cutting them off from the Internet, will only be more likely to drive them off the hills and into the towns and cities taking with them generations of inherited knowledge.

Does this matter? I, for one, think it does. Just pause for a moment and picture in your mind one of the upland areas you know best. Perhaps it is the Lake District, the Yorkshire Dales, Snowdonia, the Highlands of Scotland or Dartmoor? These are ancient landscapes which, over centuries, have been managed by Man in harmony with Nature to produce some of the most glorious countryside in the world. The intricate pattern of villages, fields and winding lanes; the stonewalls, stone houses and stone barns – none of this happened by chance. It was created by the hand of Man working with Nature to produce food for the people of this nation.

I have heard some people argue that it would be better to see no more farming in these areas, that they should be left to return to their original wild state. But this would be disastrously short-sighted, not to mention harmful to this country aesthetically and economically, let alone socially. It would be vandalism on a grand scale, akin to tearing down our historic cathedrals – they, too, were built by Man, but have become an integral part of our national and spiritual consciousness.

In addition, it is worth remembering that when tourists visit these areas it is invariably the charm and character of the communities that attracts them, as much as the scenery. But who keeps them all going? The Church, the village school, the shops and pubs all depend on a local economy, the backbone of which is agriculture and the family farm. Take all this away, and we are left with ghost communities, populated by little more than second-home owners. Is that the countryside we want at the end of the day? Because unless we take action, that is where I am afraid we are heading…

Fortunately, the group of business leaders on my Rural Action Programme share my anxiety and want to tackle this issue. It is led by Mark Price, the Managing Director of Waitrose, and he and his team have analysed the problem and are identifying some of the solutions, building on the work which Business in the Community has been doing since 2001. I am indebted to them for their time and commitment and am hopeful that we may find answers, driven from the business and wider community. In particular, the group is considering the creation of a fund which could help both support the farmers as they care for our most fragile landscapes and sustain our rural communities. Access to broadband must surely have a part to play in this, and I hope that everyone involved in this important issue - from both the public and private sector - will be able to come together to deliver a solution.

In Britain we are rapidly losing what is left of our local culture. When we finally wake up and find it all gone, it will not be possible to reinvent it – or 'grow' it in a test tube. The countryside is a living, delicate organism that must be nurtured because agri-"culture" should be exactly that – a subtle blend of a production system with a profoundly important psychosocial component. The stakes could not be higher. Perhaps, at the end of the day, it is worth remembering the words of the great French writer, Antoine De St-Exupery: "Only he can understand what a farm is, what a country is, who shall have sacrificed part of himself to his farm or country, fought to save it, struggled to make it beautiful. Only then will the love of farm or country fill his heart."

an attempt to manipulate people with alarmist language and apocalyptic imagery

Ministers target climate change doubters in prime-time TV advert
Ben Webster, Environment Editor
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Climate change sceptics are to be targeted in a hard-hitting government advertising campaign that will be the first to state unequivocally that Man is causing global warming and endangering life on Earth.

The £6 million campaign, which begins tonight in the prime ITV1 slot during Coronation Street, is a direct response to government research showing that more than half the population think that climate change will have no effect on them.

Ministers sanctioned the campaign because of concern that scepticism about climate change was making it harder to introduce carbon-reducing policies such as higher energy bills.

The advertisement attempts to make adults feel guilty about their legacy to their children. It features a father telling his daughter a bedtime story of “a very very strange” world with “horrible consequences” for today’s children.

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The storybook shows a British town deep under water, with people and animals drowning.

Carbon dioxide is depicted as rising in clouds of black soot from cars and homes, including from a woman’s hairdryer. The soot gathers into a jagged-toothed monster menacing the town.

The daughter asks her father if the story has a happy ending and a voiceover cuts in, saying: “It’s up to us how the story ends” and directs viewers to the Government’s Act on CO2 website.

The Department of Energy and Climate Change publishes research today showing that 52 per cent of people think climate change will not significantly affect them. Only 33 per cent think that it will and 15 per cent do not know.

Fourteen per cent of people think that climate change will have no effect on Britain, even in their grandchildren’s lifetime. Twenty-six per cent said they could think of no action they could take that would help to reduce climate change.

When asked how they would react if they knew climate change were going to have a serious effect on their children’s lives, 74 per cent said that they would be willing to change their lifestyle. Fifteen per cent said that they would not make any changes.

The Met Office has predicted that the 2003 heatwave, which resulted in 2,000 premature deaths in Britain, could happen every other year from the 2040s.

Joan Ruddock, the Energy and Climate Change Minister, said: “The survey results show that people don’t realise that climate change is already under way and could have severe consequences. With over 40 per cent of the UK’s C02 emissions a result of personal choices, there is huge potential for individual behaviour change to lower emissions.”

But Philip Stott, Emeritus Professor of Biogeography at the University of London and a critic of the Government’s plan to cut CO2, said the advert was an attempt to manipulate people with alarmist language and apocalyptic imagery. “It is straight out of Orwell’s 1984: an attempt to control with images of a perpetual war against something, in this case climate change.”

Wednesday, 7 October 2009

delicious foods

http://www.richimag.co.uk/food/ Redwood, we specialise in producing delicious foods that are totally free from animal ingredients. From tasty, kinder alternatives to meat and fish to dairy-free ‘cheeses', we're passionate about creating the very best in natural plant-based foods. Foods that help protect not just animals but also people and the environment. Foods that are free too from hydrogenated fats, eggs, GMOs, cholesterol, artificial colours and preservatives.

What makes our foods special? The fact that they're just that little bit different. From fish-style fingers, smoked salmon pate and spicy falafel to meat-free ‘bacon', nuggets and Schnitzels, Redwood foods are inspirational, healthy and nutritious and a great source of protein. We've even picked up a few awards along the way. And been awarded ethical company status.

So whether you're vegetarian or vegan, have special dietary needs, don't eat meat for religious reasons or simply want to eat more healthily, take a look at what Redwood has in store. You'll find our Vegideli , Cheezly and Cheatin' ranges in good health food stores nationwide including Holland and Barrett, selected supermarkets or from our online shop

proves that vegetable alternatives for milk and meat can be just as tasty and versatile

proves that vegetable alternatives for milk and meat can be just as tasty and versatile. Because all the organic ingredients in the Provamel products come from organic farming, they taste pure and fresh. They can be used in many dishes (e.g. added to breakfast cereals, in sauces, cakes, pancakes, but also in coffee or tea, etc.). Just try it, you won't be disappointed.

Furthermore, since Provamel is 100% vegetable, it naturally contains no cholesterol. Soy beans are also rich in proteins, fibres and vitamins. With their unique composition and properties, soy based products are suitable for:

a healthy balanced and varied diet
a vegetarian/vegan diet (*)
a lactose free diet (**)
a cow’s milk protein free diet.
a cholesterol free/low diet
a gluten free diet
* all Provamel products are 100% free of animal ingredients
** with the exception of Provamel Bio Muesli Crunchy Choco

The Prostate Care Cookbook

is probably the most delicious cancer treatment yet devised. A recipe book built around foods known to help to fight prostate cancer is the first example of “evidence-based cooking”, its author said yesterday.

The Prostate Care Cookbook has been written by scientists for people with prostate cancer or at risk of developing it.

“There is growing scientific evidence that strongly suggests that diets rich in certain foods can help prevent this disease or its spread,” the authors write. “For those living with the condition, a controlled diet may be the only means of active treatment.”

Prostate cancer is the most common form of cancer in men, but aggressive treatments can often be worse than the disease, said Margaret Rayman, Professor of Nutritional Medicine at the University of Surrey and lead author of the book.

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“It’s often quite indolent and slow-growing. So there may be something you can do with diet.” Foods such as onions and garlic, broccoli and cauliflower, fish and tomatoes, have all been shown to lower the risk of developing the cancer, or slowing its spread.

But Professor Rayman said: “It’s not just what you eat but how you cook it.” When garlic or onions are chopped, they produce an enzyme, alliinase, that produces anti-cancer compounds. But these are destroyed if they are heated immediately.

“The secret is you’ve got to leave the vegetables to stand for ten minutes before cooking to allow the alliinase to do its work,” Professor Rayman told the British Science Festival.

Cruciferous vegetables, which include broccoli, cabbage, rocket and radish, also need to be chopped but not overcooked. “Cook them lightly, steam them or eat them raw,” Professor Rayman advised.

Tomatoes are also best chopped or processed, and she said “a sauce made from a tin of plum tomatoes would be ideal”.

Chefs including Raymond Blanc and Antony Worrall Thompson have contributed recipes to the cookbook, which has been produced in association with the charity Prostate Cancer Research Foundation.

Professor Rayman said that her aim was to offer “food that everyone in the family can eat, not something precious”.

The recipes also aim to avoid foods that may worsen risks for prostate cancer, including dairy products, processed or overcooked meats and saturated fats.

There is no need to cut out milk in your tea, Professor Rayman say, but “you shouldn’t be pigging out on milk or yoghurt”.

Every year 35,000 men in Britain have prostate cancer diagnosed, and the condition accounts for 22 per cent of all cancers. However it is responsible for only 12 per cent of cancer deaths in men, and in older patients doctors often recommend “watchful waiting” rather than radical surgery, which can have serious side-effects including erectile dysfunction.

Managing such patients’ diet more effectively will allow them to take control of their treatment, Professor Rayman said.

“There’s also a psychological benefit to doing something about your own condition,” she added.

Roasted tomato and sweet potato soup (Serves 4) 450g sweet potatoes, peeled and sliced 1.2kg tomatoes, halved Two tablespoons olive oil One large onion, chopped into wedges Two garlic cloves, sliced Salt and pepper One small bunch of basil leaves, torn, plus extra to garnish One tablespoon of tomato puree

1 Preheat the oven to 200C/400F/gas 6

2 Parboil the sweet potatoes in a saucepan for five minutes, drain and leave to cool

3 Place all the ingredients except the tomato puree on a roasting tray and drizzle with the oil

4 Roast in the oven for 30 minutes, turning the vegetables halfway through

5 Once removed from the oven, pick any burnt skins off the tomatoes, which will come away easily

6 Whizz all the ingredients, along with 600ml water and the tomato puree, in a blender or processor

7 Reheat to serve and garnish with basil leaves

Tuesday, 6 October 2009

Lethal food bug found in two-thirds of chickens

Lethal food bug found in two-thirds of chickens
(Ben Gurr/The Times)
Most cases of campylobacter are caused by consumption of undercooked chicken or cross-contamination

A food poisoning bug that kills an estimated 80 people a year in Britain is found in two thirds of all chickens on sale in the country.

A survey for the Food Standards Agency (FSA) found that contamination in “home-produced” chickens was even higher, with 76 per cent of all samples of whole birds and chicken portions, including those farmed to free-range and organic standards, infected by campylobacter.

About 460,000 people a year suffer diarrhoea, cramps and abdominal pain caused by the bacteria, which can also be picked up from untreated water, unpasteurised milk and red meat. In the very young, the elderly and those suffering underlying medical conditions, campylobacter can be fatal.

However, about 337,000 of the annual sickness cases are linked to eating undercooked chicken or handling fresh poultry meat and cross-contaminating other foods or work surfaces in household and professional kitchens.

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Andrew Wadge, chief scientist at the FSA, said the figures reinforced the need for the highest possible hygiene standards in the home and in professional kitchens.

The bug can be destroyed by thorough cooking and, so consumers should eat the meat only when the juices run clear. Anyone handling chicken should also wash their hands and clean knives and work surfaces to prevent contamination of other foods.

Dr Wadge said: “Campylobacter is not just a risk from eating undercooked chicken, it’s about cross-contamination and getting campylobacter on your hands and transferring it to salads and fresh vegetables.”

The bacteria has been present in the environment and in poultry for years and is not caused by modern farming practices.

He suggested that the ideal solution was to find a vaccine for chickens.

A more immediate remedy would be to press the European Commission to allow fresh poultry to be soaked in a chlorinated wash in abattoirs before being distributed for sale to retailers.

Such a wash is used elsewhere in the world and is harmless to human, but is banned in the European Union.

In New Zealand, where the wash has been introduced in chicken production, the number of people suffering food poisoning from campylobacter has halved.

vegan

I didn't become vegan to be healthy , it was a mental thing , I decided to not
use animals for my benefit , I grew as a meat eater , about the age of 30
I met a veggie woman and we ate together and at the time I enjoyed cooking .
I was working as a K.p in a carvery in eastbourne england ,at the time I needed work I was
broke and needed work and food it did the job and an interesting story is attached,

I grew up in a fertile country which was fertile and able to have a good amount of food ,
1953 was 8 years after the second world war, the was fresh .

fatty acids

Benefits of Essential Fatty Acids
Essential Fatty Acids are a key issue right now - and mainly because we are generally deficient in them. These fats are considered necessary for human health and must be available from food sources as the body cannot manufacture them itself. EFA's are also known as Omega 3 and Omega 6 and are available from seeds, nuts and oily fish.
Although there are arguments for the use of fish oils as a source of EFA's, there are also concerns about the high level of toxicity in fish oils. A preferable source therefore maybe organic seeds and nuts.
However, a balance between omega 3 and omega 6 intake is also very important, as too much omega 6 can have detrimental effects. EFA guru Udo Erasmus considers hemp seed to have the ideal ratio of Omega 3 and 6 for sustainable human health.
EFA's benefit the body in many ways but two stand out - the effect on the cells and on the brain. EFA's help repair cell damage as they are part of the cell membrane, and they also help keep the cells fluid - important in maintaining the correct function of the skin, whilst also improving the energy flow between cells, as well as the nutrient absorption and detox function. In short, healthy glowing skin! EFA's are readily absorbed into the skin when applied direct.
Meanwhile, our brains are 60% fat! And over 1/3rd are EFA's. Therefore the quality of fats is imperative for proper brain function. And a lack of EFA's has been associated with learning difficulties and behavioural problems with children

Age Concern is also calling for

Health

Elderly care 'needs radical overhaul'

Elderly people should not pay for health and social care, says Age Concern

Radio 5Live on Age Concern's report
Britain's growing elderly population need a cheaper, more equal and more open system of long-term care, according to charity Age Concern.
In its final submission to the Royal Commission on Long Term Care, Age Concern calls for a radical overhaul of the existing system, including:

new locally based community care authorities to administer long-term care
a state-funded scheme which allows the young to save for possible future care costs
free health and social services care for all elderly people.
Sally Greengross, Age Concern England's director general, said: "If the services of the future are to support the growing older population, the Royal Commission must look closely at the experience of the past and resist the temptation to patch up and paper over the cracks in the current system."

Sally Greengross: long-term care needs a total overhaul
Although the Royal Commission, set up last December, is supposed to look at funding for long-term care, Age Concern says it should first define what the term covers.

It wants a new national definition of long-term care which clearly distinguishes between the cost of the nursing element of care homes and other 'hotel' costs, such as food, accommodation and cleaning.

This would ensure elderly people did not have to fund health costs and would make for smaller nursing home bills.

The charity says many elderly people in nursing homes now pay for health care which should be free on the NHS.

Age Concern also wants a national system for subsidising hotel charges.

Community care authorities

The charity is also proposing that new locally based community care authorities be set up.

Some old people fall between the health and social services nets
Currently, long-term care costs are split between health and social services departments.

Age Concern says this can be confusing for elderly people and can cause funding battles between departments, leading to delays in people getting the care they need.

For example, bathing services for the elderly can be defined as either a medical or a social need.

The government is due to set out its recipe for reducing the so-called "Berlin Wall" between health and social services on Wednesday.

National guidelines

Age Concern is also proposing national guidelines on charges for long-term care.

"There is quite a lot of disparity across the country. What you get access to and whether you pay for it depends on where you live," said a spokeswoman.

"Elderly people need to know what is available, what they can expect, what kind of financial support they can have and how much they will have to contribute," she added.

Age Concern is also calling for:

ring-fenced funding for long-term care
a system which takes into account every aspect of a person's ability to pay for long-term care
an annual independent review of care standards and costs
a review of benefits for the elderly, particularly those who are disabled
government to meet any shortfall between local and health authorities' resources and elderly people's needs.
Age Concern gives oral evidence to the Royal Commission on 24 September.

It has so far submitted nine papers to the commission, which is due to report its findings in December.

The politics of long-term care

UK Politics

The politics of long-term care

The report's plans could cost the state £800m

The government has yet to respond to the main recommendations of a major study into caring for the elderly.
Four months after the Royal Commission on Long-Term Care for the Elderly called for free nursing and personal care to be available for all, there is still silence from ministers.

The commission was set up by the government to look into the complex issue of who funds long-term care.

The motivation was concerns over Britain's ageing population.

Currently, the ratio of people of working age to people over 65 is 3.7 to one.

In the next 40 years that is likely to fall to two to one, meaning there is less tax money around for the government to fund long-term care.

Recommendations

The commission's key recommendations include:

That the costs of care for those individuals who need it should be split between living costs, housing costs and personal care
That personal care should be free and funded by general taxation
That elderly people should pay for housing and accommodation costs, but that payment should be subject to a means test
That the government should establish a National Care Commission to monitor trends in the nursing and residential care market, demography and spending, to represent elderly people, to encourage innovation, to ensure transparency and accountability in the system and to set national benchmarks for long-term care.
The commission also recommended that the value of a person's home should be disregarded for up to three months after admission to residential care.

It stated that quality of care needed to be improved so that it was more client-centred and that budgets should be shared between health, social services and other statutory bodies, but accessed by clients through a single point of contact.

The commission also made recommendations relating to carers and called for a national carer support package.

Selling homes

Under the current system, people who are in care homes run by the NHS are exempt from charges for nursing care, while those in other types of homes often have to contribute towards their care costs, based on means-testing.

The growing elderly population will need long-term care
People with between £10,000 and £16,000 in savings get some help from the state to pay for their care.

Those with under £10,000 get the maximum state support, but are still expected to use their savings to pay towards some of their care.

The commission recommends that level should be raised to £60,000.

Many elderly people have been forced to sell their homes to pay for long-term care.

Nursing organisations and charities campaigning for the elderly have long oppposed what they say is an arbitrary division between nursing and personal care.

The cost of funding the commission's proposals over funding personal care is thought to be about £220m a year.

Unveiling the commission's report in the House of Commons in March, Health Secretary Frank Dobson said the government would respond after an informed debate, but no formal response has yet been issued.

The Commons health select committee has criticised the government for its lack of response.

On Thursday, the government responded to the select committee's report on long-term care, saying it backed many of its findings.

However, it was once again silent over the committee's comments on the Long-Term Care Commission.

Charities have also been critical of the delay.

They have welcomed the commission's proposals, but some organisations are disappointed that it did not endorse concerns about a "demographic timebomb".

Paul Burstow elderly person

5 http://www.richimag.co.uk/hrioa/ elderly person living in a care home is likely to receive four times as many prescription items as a person living in their own home. As many as 1 in 5 admissions to hospital are linked to inappropriate drug therapy.
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

Flexible Working Practices for 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'

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'

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.