Friday, 28 October 2011

Daily aspirin 'blocks bowel cancer'

Does and aspirin a day keep the cancer surgeon away?

A daily dose of aspirin should be given to people at high risk of bowel cancer, say scientists.

Two pills a day for two years reduced the incidence of bowel cancer by 63% in a group of 861 at-risk patients, a study reported in The Lancet said.

Newcastle University's Prof Sir John Burn, who led the study, said the evidence "seems overwhelmingly strong".
Other experts said the findings added to a growing body of proof that aspirin could be used in the fight on cancer.
The study was conducted on 861 patients with Lynch syndrome, which affects one in every 1,000 people.
They struggle to detect and repair damaged DNA which means they are more likely to develop a range of cancers including those of the bowel, womb and stomach.
'Good deal'
When looking at all patients in the trial, those in the group given 600 milligrams of aspirin every day developed 19 tumours compared to 34 tumours in the other "control" group, a reduction of 44%.

“Start Quote

People who've got a clear family history of, particularly, bowel cancer should seriously consider adding low dose aspirin to their routine and particularly those people who've got a genetic predisposition”

End Quote Prof Sir John Burn Newcastle University

When the researchers looked at just those patients who took the medication for at least two years the reduction was 63%.

There was also an effect on other cancers linked to Lynch syndrome, which fell by half in the treatment group.
Prof Sir John Burn, from Newcastle University, said there were 30,000 adults in the UK with Lynch syndrome.
If all were given the treatment he said it would prevent 10,000 cancers over 30 years and he speculated that this could possibly prevent 1,000 deaths from the disease.
However, there would also be side effects.
"If we can prevent 10,000 cancers in return for 1,000 ulcers and 100 strokes, in most people's minds that's a good deal," he said.
"People who've got a clear family history of, particularly, bowel cancer should seriously consider adding low dose aspirin to their routine and particularly those people who've got a genetic predisposition."
Aspirin is already well known to reduce the risk of heart attack and stroke in high risk patients.

Audrey Francis: walking time bomb

Audrey Francis describes herself as "a bit of a walking time bomb".
There is a history of cancer in her family and she has been diagnosed with Lynch syndrome.
Seventeen years ago she had a hysterectomy. That was when doctors discovered she had not one but two cancers - in the womb and the ovaries.
Tests showed she had a chunk of DNA missing which was causing the cancers: "I actually had the inability to stop the cancers developing," she said.
She took part in the trial and has since decided to self medicate with aspirin: "I've got my fingers crossed and I'm hoping it'll do the trick for me."

Other studies over the past two decades have suggested the pain killer reduced cancer risk, but this was the first randomised control trial, specifically for aspirin in cancer, to prove it.

In 2010, a study suggested patients given aspirin had a 25% lower risk of death during that trial.
Prof Peter Rothwell, from Oxford University, who conducted that study said the latest research "certainly helps to build a consistent picture, all pointing in the same direction that there is a link with cancer".
Cancer Research UK's Prof Chris Paraskeva said: "This adds to the growing body of evidence showing the importance of aspirin, and aspirin-like drugs, in the fight against cancer."
'Balanced argument'
One of the questions asked by the research into aspirin was whether healthy people with no family risks should take the drug.
The lower the risk of heart attack or cancer, the lower the benefit of taking aspirin, yet there are still potentially deadly side effects.
Sir John said that it was a "finely balanced argument" and that he decided the risks were worth it for him.
"I think where we're headed for is people that are in their 50s and 60s would look very seriously at adding a low dose aspirin to their daily routine because it's giving protection against cancer, heart attack and stroke.
"But if they do that they've got to have their eyes wide open. They will increase their risk of ulcers and gastrointestinal bleeds and very rarely they will have a stroke caused by the aspirin."

Thursday, 27 October 2011

IVF linked to ovarian tumours

Fertility drugs are used to force the ovaries to produce eggs

IVF has been linked to an increased risk of ovarian tumours in later life, according to a preliminary study.

Women given fertility drugs to produce eggs had more than triple the risk of an ovarian tumour that may turn cancerous, say Dutch researchers.

But the absolute risks are very low, they add.

A cancer charity said numbers involved in the study, published in the journal Human Reproduction, were too small to draw firm conclusions.

The study tracked more than 25,000 women attending IVF clinics in The Netherlands in the 80s and 90s.

Follow-up investigations revealed more cases than expected of ovarian tumours in women who had gone through IVF, which involves stimulating the ovaries to make eggs.

The biggest increase was in a type of growth, known as a borderline ovarian tumour, which can sometimes turn into cancer. It is less aggressive than other types of ovarian tumour, but requires surgery.

“Start Quote

Women should be informed about this but the risk should not be overstated”

End Quote Prof Flora van Leeuwen Netherlands Cancer Institute, Amsterdam

It normally affects around one in 1,000 women in the general population, but was found in about 3.5 in 1,000 women who had gone through IVF, say the researchers.

A smaller increase in other types of ovarian tumour was also found. Overall, ovarian cancer rates were twice as high among women who had gone through fertility treatment, the experts said.

Prof Flora van Leeuwen, a co-author of the study, told the BBC: "The absolute risk of these tumours is very low. But there is an increased risk of a borderline malignant tumour that needs surgery.

"Women should be informed about this but the risk should not be overstated."

Another co-author, Prof Curt Burger added: "The main message is that women who have had IVF shouldn't be alarmed. The incidence of ovarian cancer was extremely low."

'Reassuring'

Further research is planned to confirm the finding in a larger number of patients, and to look at whether some women are more at risk.

At present, the numbers involved are small. There were 61 women with ovarian tumours in the IVF treatment group; 31 had borderline ovarian tumours and 30 had ovarian cancer.

Ovarian cancer

Ovarian cancer is the 5th most common cancer in women in the UK
Most cases are in women who are past the menopause
Risk factors include a family history of cancer, being infertile or having fertility treatment, and smoking
The symptoms of ovarian cancer can be very vague, particularly when the disease is in its early stages.
Early symptoms can include pain in the lower abdomen or side, and/or a bloated, full feeling in the abdomen
Source: Cancer Research UK

Commenting on the study, Prof Hani Gabra, of the Ovarian Cancer Action Research Centre at Imperial College London, said:

"Reassuringly, and in keeping with lots of previous research in this area, this study shows that the risks of invasive ovarian cancer are small in populations of patients receiving ovarian stimulation for IVF.

"Although this study shows that ovarian stimulation may increase the risk of much less aggressive borderline ovarian tumours, it underlines the fact that ovarian stimulation for IVF is not a major risk factor for invasive ovarian cancer."

Dr Claire Knight, senior health information officer at Cancer Research UK, said: "This interesting study suggests a possible link between ovarian stimulation for IVF and borderline ovarian tumours, but it certainly doesn't show that IVF causes invasive ovarian cancer.

"There were only a relatively small number of cases in this study, and the researchers didn't find that risk increased with the number of cycles a woman had, making conclusions hard to reach.

"Women can reduce their risk of ovarian cancer by being a non-smoker and keeping a healthy weight, and women who have taken the Pill or been pregnant are also at lower risk." Pill 'lowers ovarian cancer risk' Ovarian Cancer Action humrep.oxfordjournals.org

Wednesday, 26 October 2011

XMRV in Chronic Fatigue Syndrome (CFS/ME) & Fibromyalgia

Myalgic encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Fibromyalgia (FM) are debilitating illnesses which have no cure and can leave sufferers' lives in ruins. Even those best able to adapt and cope often suffer with well-meaning people who think the illnesses was somehow brought upon themselves, or that the illnesses doesn't really exist.

This site was set up following a study, in October 2009, that suggested ME/CFS (and possibly Fibromyalgia) might be caused by a retrovirus called XMRV.

XMRV study in Science

The study was published in the journal Science and found the retrovirus XMRV (xenotropic murine leukemia virus-related virus) in 67% of patients with ME/CFS. Only 3.7% of the healthy controls studied had this infection. Later, the researchers reported up to 95% of patients test positive for XMRV with antibody testing.

Lack of understanding about the causes of ME / CFS

Lack of understanding about the causes of ME / CFS and the lack of any effective treatments can often lead to patients trying, out of desperation, unproven and unscientific remedies. The discovery of the XMRV retrovirus led people to ask whether this virus is a possible cause of CFS.
News of the discovery prompted much needed discussion and a focus on the plight of CFS patients; it gives their illness a long-overdue legitimacy. For many years CFS/ ME went unrecognised as a genuine medical condition. Many doctors say that it has a psychological as well as a physical basis, but few believed it is caused solely by a viral infection.
The Whittemore Peterson Institute (the group behind the research) was founded by Annette Whittemore, whose daughter suffers from ME. This privately funded, not for profit, organisation has finally put ME/ CFS and Fibromyalgia on the media agenda.
It may transpire that XMRV is behind a string of illnesses referred to variously as CFS, ME, Fibromyalgia, Atypical Multiple Sclerosis, Chronic Mononucleosis. Scientists are already using the term XAND, for XMRV Associated Neuroimmune Disease.

Attempts to replicate the findings of the WPI

Since the study appeared, several groups have tried to replicate the findings of Dr. Judy Mikovits (Whittemore Peterson Institute). Two groups in Britain and one in the Netherlands have published studies showing no links to the virus, and three other groups, two in the US and one in Europe, have reported negative findings at conferences.

Most recently a second research team has reported a link between CFS and the same class of virus, a category known as MLV-related viruses. In a paper published in August 2010 by PNAS, scientists found evidence of several MLV-related viruses in blood cells 86.5% of chronic-fatigue patients but only 6.8% of healthy ones. The researchers did not find XMRV. However, XMRV is itself is a MLV-related virus and the author of the PNAS study has stated that this latest research supports the initial study that discovered XMRV in CFS blood samples.

The emerging research has caught the attention of the blood bank industry. Canada recently began banning people with chronic fatigue syndrome from donating blood over concerns about possible XMRV transmission. The American Association of Blood Banks also issued a similar recommendation in June 2010

Elderly dignity charter launch by Wrexham care groups

The charter aims to promote a 'zero tolerance' of 'abuse and disrespect' for elderly people in care

A range of social and health groups in Wrexham have launched a charter aimed at providing older people with dignity as they have medical or social care.

The charter aims to promote a zero tolerance "of abuse and disrespect" for older people by staff and volunteers.

Wrexham council is leading the drive, which also includes professional and charity groups.
Wales' public services ombudsman has said a culture of neglect was failing frail and elderly hospital patients.
Peter Tyndall's comments last week came after older people's commissioner Ruth Marks said some care was "shamefully inadequate".
Wrexham council's launch of the Older Peoples Dignity in Care Charter for Wrexham is part of a national campaign to improve the quality of care and highlight the experiences of service users.
Andrew Figiel, the local authority's chief social care officer, said: "This charter is at the heart of what we do.

“Start Quote

Dignity in care is a fundamental principle in the provision of the services we deliver”

End Quote Andrew Figiel Wrexham council

Society's attitude

"Dignity in care is a fundamental principle in the provision of the services we deliver."

Other groups signed up include Betsi Cadwaladr University Health Board, the Association of Voluntary Organisations in Wrexham, Age Concern North East Wales and British Red Cross.
Meanwhile, Age Cymru was holding a conference in Wrexham on tackling society's attitude to age and ageing.
Dr Ceri Cryer, the charity's Growing Older in Wales programme manager, said: "The population of Wales is ageing - one-in-four Welsh adults are aged 65 or over, and in 20 years' time one-in-three Welsh adults will be aged 65 or over.
"Clearly we need to adapt to the needs of our ageing population and tackling ageism and age discrimination is an important part of this process."

Breast cancer screening under review

The value of breast cancer screening has been a source of controversy

The evidence for breast cancer screening in the UK is being reviewed amid controversy about the measure's effectiveness.

The NHS says screening saves lives, but other researchers have argued that it may cause more harm than good.
The national cancer director for England, Prof Mike Richards, announced in the British Medical Journal that he will lead a review.
He said he was taking the "current controversy very seriously".
When it comes to cancer treatment, earlier is better. Screening programmes for a range of cancers help doctors make a diagnosis sooner. But they also run the risk of false positives, diagnosing someone with cancer when they are healthy.
Life saving
Screening was introduced for breast cancer in 1988 in the UK and now offers tests to women, over the age of 50, every three years.
In 2002, the World Health Organization's International Agency for Research on Cancer estimated that screening reduced deaths from breast cancer by about 35%.
The NHS says 1,400 lives are saved through screening in England alone.

“Start Quote

The decision whether to be screened is a personal one, but that decision should be made with all of the potential harms and benefits fully explained”

End Quote Sara Hiom Cancer Research UK

However, the evidence has been questioned.

A review of clinical trials involving a total of 600,000 women concluded it was "not clear whether screening does more good than harm".
It said that for every 2,000 women screened in a 10-year period: one life would be saved, 10 healthy women would have unnecessary treatment and at least 200 women would face psychological distress for many months because of false positive results.
The authors of that research labelled the NHS Breast Screening Programme's advice "seriously misleading".
Exchange
Professor of complex obstetrics at King's College London, Susan Bewley, has turned down screening.
In a letter to Prof Richards last month, she said: "The distress of overdiagnosis and decision making when finding lesions that might, or might not, be cancer that might, or might not, require mutilating surgery is increasingly being exposed."
In response, Prof Richards said research suggested that up to two and a half lives were saved for every over-diagnosed case.
He added that he would lead a review of the evidence to settle the ongoing controversy.
"Should the independent review conclude that the balance of harms outweighs the benefits of breast screening, I will have no hesitation in referring the findings to the UK National Screening Committee and then ministers.

Mammograms can identify tumours before they would be picked up

"I am fully committed to the public being given information in a format... that enables them to make truly informed choices."
Prof Julietta Patnick, director of the NHS Cancer Screening Programmes, welcomed the review: "The NHS Breast Screening Programme has always been based on the best and latest evidence.
"Where new information has suggested them, a number of changes have been made to the Programme, for example extending the screening age range and using digital mammography."
The review will be led jointly by Prof Richards and Cancer Research UK.
The director of health information at the charity, Sara Hiom, said: "Women need more accurate, evidence-based and clear information to be able to make an informed choice about breast screening.
"The decision whether to be screened is a personal one, but that decision should be made with all of the potential harms and benefits fully explained."
Breakthrough Breast Cancer's chief executive Chris Askew said: "Breast screening is vital as it can detect breast cancer at the earliest possible stages when no other symptoms are obvious.
"The earlier breast cancer is picked up the better for the one in eight women who are diagnosed every year with this disease, as treatment options are more likely to be less aggressive and have successful outcomes."

Leafy greens protect the gut’s immune system

13 October 2011

A chemical compound found in leafy greens plays an important part in maintaining a healthy immune system in the gut, according to new research from the Babraham Institute and the Medical Research Council (MRC).
The findings, reported in the journal Cell, could help scientists better understand the basis of intestinal disorders such as inflammatory bowel disease (IBD) and may offer new treatment opportunities.
In the new study, researchers were able to prove that leafy greens protect a certain type of immune cell known as intra-epithelial lymphocytes (IELs). IELs play a crucial role in keeping the gut lining healthy and preventing ‘bad’ bacteria from entering the gut while maintaining the balance of ‘good’ bacteria which help us to break down our food.
Researchers studied mice fed a diet containing many vitamins and minerals known to be essential for good health, but which lacked vegetables. Over three weeks the mice lost 70 to 80 per cent of IELs.
The research showed for the first time that mice fed a diet low in vegetables rapidly lose these specialised immune cells lining the intestinal tract, but not other immune cells. The team discovered that IELs depend on chemical signals from the digestive breakdown products of a substance called Indole-3-carbinol, high levels of which are found in vegetables like broccoli and cabbage.
Dr Marc Veldhoen, senior author of the paper who conducted the bulk of the research at the MRC National Institute for Medical Research before moving to the Babraham Institute, said:

“This was surprising, since the new diet contained all other known essential ingredients such as minerals and vitamins. I would have expected that cells at the surface would play some role in the interaction with the outside world, but such a clear cut interaction with the diet was unexpected.

“After feeding otherwise healthy mice a vegetable-poor diet for two to three weeks, I was amazed to see that 70 to 80 per cent of these [protective] cells disappeared.”

“It’s already known to be a good idea to eat your greens. Our results provide a molecular basis for the importance of cruciferous vegetable-derived phyto-nutrients as part of a healthy diet.”

Dr Brigitta Stockinger, Head of Division of Molecular Immunology at the MRC’s National Institute for Medical Research added:

“The food we eat plays a crucial role in influencing our immune system and we have been looking at the intricate biology that determines how cells in our intestines maintain an intrinsic protection against microbes.

“This study in mice is an important step towards increasing our understanding of how environmental signals shape immune responses at barrier sites such as the intestine. Marc Veldhoen's continuing studies at the Babraham institute will no doubt take this onto the next step.”

Dr Marc Veldhoen added:

“We don’t yet know the implications of this research for humans, but interestingly, epidemiological studies have linked a diet low in fruit and vegetables with an increased risk of IBD. Our results provide a molecular basis for the importance of nutrients from cruciferous vegetables as part of a healthy diet."

The research was funded by MRC and BBSRC

Kill the calories ,calorie diet nonsense unmasked

Counting calories is an addictive pastime for many a dedicated slimmer. Croissant or toast? Curry or pizza? Sandwich or salad?

Food labels help millions of people decide what to buy and what to eat. So it's important that they are accurate but, according to some experts, the system on which they are based is flawed and misleading.

A calorie is the energy we get from food. Too much energy and we end up getting fat. But how is the calorie content of food calculated?

Back in the 1800s an American chemist, Wilbur Atwater, devised the system on which calorific values on our food labels are still based.

Basically, he burned food and then measured how much energy it gave off.

“Start Quote

What's important is to eat fewer calories so that the body is in negative energy balance. How you calculate it doesn't matter.”

End Quote Gaynor Bussell British Dietetic Association

He then estimated the amount of energy the body used up by calculating the amount of energy in undigested food in waste products.

That thankless task prompted Atwater to conclude that every gram of carbohydrate produced four calories, every gram of fat produced nine, and every gram of protein produced four calories.

These figures have been used as the basis for calculating the calorie content of food ever since.

Energy usage

Nutritionists have always known that these calorific values are approximate.

But recently some nutritionists, including Dr Geoffrey Livesey, are saying that the calorie content of items in our shopping baskets could be up to 25% out.

This is because the texture of the food, its fibre content, and how it is cooked can all affect the amount of energy the body is able to get from food, he says.

Even the process of chewing food uses up energy and, therefore, calories.

The more protein or fibre in a food, for example, the harder the body has to work to process it.

So when we are weighing up which ready meal to buy in the supermarket, we need to think about more than just the calories contained in food before we eat it - we need to consider how our body digests and processes it too.

Dr Livesey says: "People need to be given the right information to make the right choices, following the latest scientific understanding, because if you are not following the science, you're following something else.

"When you consider calories have been used as the only measurement for understanding foods' impact on weight loss for nearly 200 years, despite our huge advancement in nutritional science, you realise how outdated calorie counting is."

'Calorie conscious'

So is it time to overhaul the current system of food labelling?

Dr Susan Jebb, head of nutrition at the Medical Research Council, says it's right to say that some calories are more filling than others but, "in the grand scheme of things, we're talking about really small differences here."

She added: "When it comes to advising the public and getting people to eat fewer calories, I'm not sure this is going to be helpful."

"If you're trying to lose weight you have to be calorie conscious, not calorie counting all the time.

"In any case, we need to test if this is better way of advising people than the current way."

Gaynor Bussell, a dietician and spokesperson for the British Dietetic Association, agrees that overhauling the whole system on which calories are calculated doesn't make sense without backing from scientists and governments.

What matters is eating healthily and that is "not a precise art anyway", she says.

"What's important is to eat fewer calories so that the body is in negative energy balance. How you calculate it doesn't matter."

Weight Watchers is proposing a new system called ProPoints, which it says is a more accurate alternative to calorie counting.

It's based on a daily allowance which takes into account gender, age, weight and height. All fruits and most vegetables contain zero ProPoints.

The system tells you "the amount of energy that is available in a food after you've eaten it," the weight loss organisation maintains.

The UN Food and Agriculture Organization looked at the issue a few years ago and decided that changing the way calories are calculated would need huge upheaval and lots of money - all for marginal gain.

So don't fret too much over the labels at the supermarket - eating sensibly is far more important.

Tuesday, 25 October 2011

Zambia's growing population

You are going to hear a lot about population in the coming week. That's because on 31st October, the United Nations Population Fund will announce that the number of people on the planet has reached seven billion.

Of course no one knows exactly how many people there are - we may have already passed seven billion - but the UN has picked the day as the best estimate.

Catherine Phiri says she wants her children to become important people without suffering

I've been to Zambia because it has one of the world's fastest growing populations.
I have been to many maternity wards around the world but never one as busy at the United Teaching Hospital (UTH) in Lusaka.
They deliver at least 50 babies a day - sometimes 70 or more. The pressure on the maternity unit is significant according to Dr Lackson Kasonga.
"The population is expanding rapidly, especially in the capital where people are moving for jobs. The demand for maternity services is rising each year but that is not matched by the increase in space or resources."
Global fertility
Women in Zambia have, on average, six children. That number has barely shifted in recent decades. Contrast that with global fertility, which has fallen from five to two and a half children since 1950.
Catherine Phiri had just given birth to a daughter when I met her and husband Robert. They have two boys at home. A fourth child died in infancy. They live in poverty, like two-thirds of Zambia's population. The Phiris want more children and, like parents the world over, they are ambitious for their future.
Catherine Phiri told me: "I want my daughter and my sons to be important people in government so as they work they can extend help to us. We grew up suffering and I want it to be different for them."
Although basic education is free, there is often pressure to get older children to begin work so that they can help with the family finances. Robert Phiri said: "We'd like five or six children but I worry if we are going to be able to send them all to school. If we have more it might mean some going to school and some not - we will have to see what happens."
Potential burden
I visited the family home outside Lusaka. It is extremely basic. There is electricity but no running water. Mr Phiri earns below the minimum wage and the couple often don't have enough money to buy clothes.
I asked Anna Sampa from Unicef why so many poor couples in Africa choose to have large families. It's something that I have found on visits to Sierra Leone, Malawi and other developing nations.
She said: "They don't see the potential burden of having more mouths to feed. Rather they look on lots of children as a means of helping them in their old age." Aid agencies do not talk about population control - they fear it smacks of eugenics. Rather, they try to encourage family spacing and getting couples to have the number of children they can support.
At UTH I watched a demonstration on contraceptive methods given to a group of pregnant women. The majority of couples in Zambia still don't use modern methods such as condoms, the pill, implants and injections.
Myths

“Start Quote

This is a vast land, so we need more people. But it is the speed which is the cause for concern - we need to match population growth with resources.”

End Quote Dr Lackson Kasonga consultant obstetrician

Even though contraception is free, many women can't afford to travel to the health centres. There is also a good deal of ignorance about the methods available according to Ruth Bweupe, family planning officer at the Ministry of Health.
"The myth surrounding the implant is that it will go to the heart or the brain and do serious harm. The implant rods are inserted in the upper arm so they feel that it will travel around the body. For the pill they feel it will cause permanent infertility and they'll never be able to have children again."
The rising workload of UTH's maternity unit is a tangible sign of Zambia's growing population. It is 13 million now and projected to triple by 2050 according to the UN Population Division. Even its most cautious projection has the population at 100 million by 2100, with its medium (or best estimate) being 140 million.
Vast land
Does that matter? After all, Zambia is a big country, three times the size of the UK. It has fertile soil and rich mining reserves, so there is huge potential.
The economy is growing and the World Bank recently re-classified it as a "middle income" country. How this works given that two-thirds of families live in poverty is a little baffling, but it is an indicator that Zambia is improving economically.
Despite the heavy workload at the maternity unit, Dr Kasonga was upbeat about the future.
"We are happy to have more babies. This is a vast land, so we need more people. But it is the speed which is the cause for concern - we need to match population growth with resources."
Half of Zambia's population is aged 16 or under and it has a relatively smaller elderly population. Contrast that with most developed countries where the problem is that fewer and fewer people are supporting a growing cohort of elderly.
The potential problem for Zambia is that the population increase is so rapid that the government may struggle to keep pace. Those under 16 need education, healthcare and homes but they are not yet contributing to the economy. Zambia can barely feed 13 million people so how will it cope in the future?
Part of the answer will depend on how Zambia manages and encourages foreign investment - China is a huge player here. It also depends on the life chances given to the young, which starts with education.
Gender equality

Future generations hope to have smaller families. Norah Zulu says she only wants two children

Unicef supports education projects in Zambia and believes empowering women is vital if couples are to be lifted out of poverty and have the number of children they can support.
At Munali High School in Lusaka, most of the teenage girls I spoke to came from large families. But all wanted careers first and motherhood second. Their attitudes seem a world away from the older generation.
Norah Zulu, who is 16, told me things were very different from her parents' day: "They never learned about family spacing. We do. And they did not have gender equality - rights for girls and boys. I want two kids, no more."
Mercy Mushindu, who is 17 and one of eight children, said she also wants two kids "to reduce the population". Things are changing in Zambia and it will be the next generation who will have to ensure that population increase is a benefit rather than a burden

Monday, 24 October 2011

Immune system defect may cause ME

24 October 2011 Last updated at 08:46

Immune system defect may cause ME

Chronic fatigue syndrome may be due to the immune system, researchers think.

Researchers in Norway believe Chronic Fatigue Syndrome (CFS), also known as ME, may be caused by a wayward immune system attacking the body.

The illness, the cause of which is uncertain and has no known cure, has attracted significant controversy.

A small study, reported in PLoS One, showed a cancer drug, which inhibited the immune system, relieved symptoms in some patients.

The ME Association said the findings were "very encouraging news".

Doctors in Norway stumbled across their first clue in 2004 when treating a patient with both Hodgkin's lymphoma, a cancer of the white blood cells, and CFS.

When she received cancer treatment, her fatigue symptoms improved for five months.

'Dramatic'

The latest study, carried out at the Haukeland University Hospital in Bergen, built on the previous discovery by testing 30 patients with CFS.

“Start Quote

Their life was turned completely around very dramatically”

End Quote Øystein Fluge Consultant oncologist

Half were given two doses of Rituximab, a cancer drug which eliminates a type of white blood cell, while the other half were given a fake treatment.

In those patients receiving the drug, 67% reported an improvement in a score of their fatigue levels. Just 13% showed any improvement in the sham group.

Øystein Fluge, an oncology consultant at the hospital, told the BBC: "There was a varied response: none, moderate, dramatic relief of all symptoms.

"Two had no recurrence [of their symptoms], their life was turned completely around very dramatically."

Their theory is that a type of white blood cell, B lymphocytes, are producing an antibody which attacks the body.

The drug wipes out the lymphocytes which in some cases may "reset the immune system", however, in other patients the fatigue symptoms would return when more B lymphocytes were made.

Caution

Chronic Fatigue Syndrome

The disease is thought to affect some 250,000 people in the UK
Symptoms include extreme tiredness, problems with memory and concentration, sleep disturbances and mood swings
There is currently no accepted cure and no universally effective treatment
The cause is not clear either, with many doctors thinking the term CFS/ME is being used for several different diseases.
Some patients have sent death threats to researchers after disagreements over a cause or cure

What causes Chronic Fatigue Syndrome?

Mr Fluge said: "I think the fact that patients responded to treatment, improved cognitive function, fatigue and pain makes us believe we're touching one of the central mechanisms.

"But we're scratching at the surface, I would not characterise this as a major breakthrough."

The researchers are now investigating the effect of giving more doses over a longer period of time.

If their hunch is right it will throw up more questions, such as what is the immune system actually attacking and whether or not an actual test for CFS/ME be developed.

Dr Charles Shepherd, the UK ME Association's medical adviser, said: "The results of this clinical trial are very encouraging news for people with ME.

"Firstly, they help to confirm that there is a significant abnormality in immune system function in this disease.

"Secondly, they indicate that altering the immune system response in ME could be an effective form of treatment for at least a subset of patients.

"We now need further clinical trials of such anti-cancer agents to see if other research groups can replicate these findings."

can industrialised farming make Africa feed the world?

British-owned Chayton Atlas manages a 25,000 acre farm in Mkushi

The vision unfolding across the Mkushi plain in Zambia is at odds with the doleful imagery of modern Africa to which we have become accustomed.
Three hours from the capital Lusaka the wheat crop glows under the tropical sun. A combine harvester moves methodically across one portion of a vast field. Nearby a giant sprinkler irrigates the soya bean crop.
One might as easily be standing on the plains of the American Mid-West or among the grain fields of the Ukraine.
These are fields of plenty, a productive Africa that challenges the narrative of conflict and hunger that so dominates our idea of the continent.
"If we just increased the yields to 80% of world averages, Africa would become a net exporter of food. We believe that Africa can feed itself and the rest of the world too," Dabney Tonelli of Chayton Atlas, the British-owned company that manages the 25,000 acre farm at Mkushi, says.

Dabney Tonelli says Africa can become a net exporter of food

Chayton acquired a 14-year lease on the land from the Zambian government with the promise of hugely increasing yields, providing jobs for locals and passing on skills to the small farmers who live on subsistence plots nearby.
After years of misrule and corruption Zambia, which recently elected a new government, is seen as a beacon of stability on the continent.
"The political environment is stable, excellent conditions for agriculture in terms of climate and the quality of soil. For the agricultural investor Zambia is where you want to be," says Ms Tonelli.
Zimbabwean expertise
White farmers who were driven off their land in Zimbabwe have been hired to run the Chayton operation, bringing with them the intensive farming skills they have honed over decades.
The farm manager at Mkushi, Stuart Kearns, became a full-time farmer as a teenager after his father was killed in the Bush War in what was then Rhodesia. Despite his experiences in Zimbabwe he is optimistic about the future of farming in Zambia:
"There is huge potential here and I think the thing with Africa is that you have to keep trying again and again. That is something you learn when you grow up here."
Chayton promises to "create jobs, introduce sustainable farming methods… provide support and training to small-scale farmers".

Zambia's vice-president Dr Guy Scott voiced concern about job losses

But there are considerable obstacles - poor infrastructure and bureaucracy stand in the way of Zambia becoming a major exporter of food to the continent. At the moment Chayton is only producing for the local market.
And in an interview with Newsnight, the country's new vice-president, Dr Guy Scott, a farmer himself, was sceptical of some of the claims made by the company:
"I am very sceptical because I've been around a lot and I know what proposals look like and what justifications look like in the investment game and I would say that 90% of what is promised turns out not to be true… not necessarily because of any venality or any deliberate fraud.
"I mean people hope for the best. They hope it is going to work. And the government hopes it is going to work. And we all get each others hopes up. And then you find 'oh dear we didn't actually succeed in having the social impact or economic impact we'd hoped for'."
Displacement fears
Dr Scott worries about the social impact of job losses due to more intensive farming where machines take the place of people:

Local small-scale farmers complain about problems securing capital

"I think the main problem is that the population for Zambia is that the population is about four times too big for the economy. And I think that is the danger with large scale intensive farming; it tends to be capital intensive, it tends not to create jobs and at the same time tends to displace people who are unemployed from their fallback position which is to be subsistence farmers."
Chayton acknowledge that their modernised farming methods have already led to job losses, but insist that as the business grows it will create employment in spin-off businesses:
"Yes, over time some of the less skilled work goes as a result of mechanisation, but we are building a large scale business so over time we are creating other jobs," Ms Tonelli says.
"What we are able to do is train people to do highly skilled jobs which they can continue to use in a career in agriculture of transfer to other sectors as well."
Local feeling
The local subsistence farmers I meet say they welcome the principle of commercial farming, but have yet to see it bring any benefit to them.
Chayton has only been operating in the area for a year but Brighton Marcokatebe, a farmer in the nearby village of Asa, says other commercial farmers have failed to help their smaller neighbours.

Most of Zambia's farmers are small-scale subsistence farmers

"If they come with help then I will accept it, but so far they don't help," he says.
The villagers also complain that they cannot access capital. Most land in Zambia is owned by the state and administered by village chiefs. Without any legal title to the land small farmers cannot get bank loans to buy machinery and expand their production.
But according to Dr Guy Scott, Zambia's small farmers can look forward to a better deal:
"We're elected by Zambians and their interests have to come first. If their interests can be made to coincide with those of the international markets or whatever then great, but at the end of the day we are responsible for their protection, their social protection."
Matching that commitment with the agreements already made with foreign investors will require considerable political skill.

Sunday, 23 October 2011

Henry David Thoreau

"Christianity, on the other hand, is humane, practical, and, in a large sense, radical. So many years and ages of the gods those Eastern sages sat contemplating Brahm, uttering in silence the mystic "Om," being absorbed into the essence of the Supreme Being, never going out of themselves, but subsiding farther and deeper within; so infinitely wise, yet infinitely stagnant; until, at last, in that same Asia, but in the western part of it, appeared a youth, wholly unforetold by them,—not being absorbed into Brahm, but bringing Brahm down to earth and to mankind; in whom Brahm had awakened from his long sleep, and exerted himself, and the day began,—a new avatar. The Brahman had never thought to be a brother of mankind as well as a child of God."

-Henry David Thoreau

Dutch court convicts five for Tamil Tiger fundraising

Tamil Tiger rebels fought for a separate homeland in Sri Lanka for decades

Sri Lanka After War

A Dutch court has convicted five Dutch ethnic Tamil men for raising funds for the banned Tamil Tiger rebels.

The men got sentences of up to six years for their activities on behalf of rebels who fought for an independent homeland for Tamils in Sri Lanka.
Prosecutors said the men extorted millions of euros from the Tamil diaspora through blackmail and threats.
But the defence counsel for the five men argued that they were freedom fighters.
In a complex ruling, the judge said the men were not convicted of supporting terror but that he found them guilty of involvement in a criminal organisation.
The Liberation Tigers of Tamil Eelam [LTTE] was outlawed by the European Union in 2006.
They fought a decades-long and bloody war against Sri Lankan authorities for a separate Tamil homeland in the north and east of the country, but were defeated by the Sri Lankan army in 2009.
Prosecutors also accused the men of "brainwashing" children by teaching them to make pictures of bombs and grenades.
This case is one of a number of prosecutions concerning both sides of the Sri Lankan conflict that are currently being considered in foreign courts.

UN finds polio among Madagascar's children

Archive photo of a child receiving an oral polio vaccine in Ivory Coast

Vaccination programmes have to reach 80-90% of the population to be effective

An outbreak of polio in three children from the south of Madagascar has raised concerns over a possible resurgence of this crippling disease.

The UN children's fund (Unicef) has called for urgent action to prevent its spread.

Unicef spokesman Daniel Timme says three cases of polio without symptoms have been identified.

The disease was discovered during Unicef's Mother and Child Health week following tests and urine samples.

Mr Timme said that the symptoms could emerge in these children at any time.

Polio vaccination programmes must reach at least 80 to 90% of the population of the region to be effective.

Otherwise there is a risk that non-vaccinated children could produce a mutation of the polio disease.

Vaccination campaigns disrupted

Unicef experts believe this may be the case in Madagascar, as has been seen elsewhere in Africa, including Nigeria.

The political crisis in Madagascar since 2009 has interrupted vaccination programmes across the country.

Shortages of fuel for refrigerators to store the vaccines, and the closure of 250 clinics, have reduced vaccination rates to less than 40% in the south.

Two further vaccination campaigns are now required to ensure 90% of the 700,000 children are vaccinated to curb a potential epidemic.

NHS reforms: Audit areas to be extended

NHS reforms: Audit areas to be extended, Lansley says

Andrew Lansley said offering patients more choice did not amount to privatisation

Monitoring of NHS healthcare is to be extended to 11 extra areas of medicine, the health secretary has announced.

Andrew Lansley told GPs in Liverpool that auditing would be extended to areas including HIV and breast cancer.

He said publishing better data would allow patients to make more informed choices and specialists to "compare themselves with the best".

Mr Lansley also defended plans to give GPs more commissioning responsibility under the government's NHS reforms.

In his speech to the Royal College of GPs' conference, Mr Lansley said the government's Health and Social Care Bill would encourage competition and that GPs wanted more say in the running of the service.

"For years, GPs have been telling me, 'if only they would listen to us, we could do it so much better'," he said.

"Well as I say, I am now 'they'. I am listening to you. And I do want you to do it better.

"At the heart, then and now, of doing it better for patients is for clinicians to be at the heart of commissioning."

Speaking to BBC News before Saturday's conference, Mr Lansley said that offering more choice for patients did not mean privatisation.

"We're not looking to turn the NHS into some kind of private industry, far from it.

"It's a public service and it has to be integrated around the needs of patients.

"But there is a role, a big role, for patients in being able to exercise choice and therefore by extension where patients exercise choice, you have to have a choice amongst providers."

Mr Lansley told the conference outcomes for patients in areas of medicine including breast cancer, prostate cancer and chronic obstructive pulmonary disease would be "audited, monitored and regularly published in the future".

"From December we will pilot the publication of clinical audit data to detail the performance of clinical teams. This will then be rolled out across England from April next year," he said.

"Better data means better quality in the NHS - for patients, for their specialist clinicians, and crucially for you - both as their GPs and as the future commissioners of those services," he said.

Controversy over policy

The NHS reforms in the Health and Social Care Bill would increase competition and put GP-led groups in control of buying care in their areas.

Ministers say the changes are vital to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.

The reforms have been one of the most controversial areas of government policy over the past year and had to be put on hold in the spring amid mounting criticisms from the medical profession, academics and MPs.

It led to ministers making a number of concessions, including giving health professionals other than GPs more power over how NHS funds are spent as well as watering down the role of competition.

Earlier this month, the House of Lords rejected a proposed amendment that would have referred parts of the bill to a special select committee.

It will now proceed to a normal committee stage in the Lords.

However, Labour's shadow health secretary Andy Burnham has said his party will continue to fight for "substantial and drastic changes" to the bill.

Friday, 28 October 2011

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13 October 2011

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Tuesday, 25 October 2011

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Monday, 24 October 2011

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Sunday, 23 October 2011

Dutch court convicts five for Tamil Tiger fundraising

Sri Lanka After War

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Sri Lanka After War

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UN finds polio among Madagascar's children

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NHS reforms: Audit areas to be extended, Lansley says

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