Friday, 29 January 2010

A doctor who prescribed "potentially hazardous" levels of drugs to elderly patients

Misconduct doctor Jane Barton escapes being struck off

Dr Jane Barton
Dr Barton has been banned from giving diamorphine for three years

A doctor who prescribed "potentially hazardous" levels of drugs to elderly patients who later died has escaped being struck off.

Dr Jane Barton will be allowed to continue working under certain conditions despite being found guilty of serious professional misconduct.

She was accused of a series of failings in her care of 12 patients at Gosport War Memorial Hospital in the 1990s.

Relatives and the General Medical Council criticised the panel's ruling.

Family members of those who had died shouted at the fitness to practice panel when the decision was delivered in central London.

Iain Wilson, the son of Robert Wilson, one of the patients who died, shouted: "You should hang your head in shame."

GMC 'surprised'

The panel said Dr Barton was guilty of putting her patients at risk of premature death.

But it said it had taken into account her 10 years of safe practice as a GP in Gosport and 200 letters of support.

Dr Barton said she had to work under "unreasonable pressure" with an "excessive and increasing burden" in caring for patients.

From left to right: Elsie Devine, Robert Wilson and Geoffrey Packman
Three patients were given painkillers inappropriate for their condition

But in a statement after the hearing the GMC criticised the independent panel.

Niall Dickson, GMC chief executive, said: "We are surprised by the decision to apply conditions in this case.

"Our view was the doctor's name should have been erased from the medical register following the panel's finding of serious professional misconduct.

"We will be carefully reviewing the decision before deciding what further action, if any, may be necessary."

Eleven conditions have been placed upon Dr Barton, including a ban on injecting opiates for three years.

In a statement after the panel's ruling, Dr Barton said: "I am disappointed by the decision of the GMC panel.

Throughout my career I have tried to do my very best for all my patients and have had only their interests and wellbeing at heart
Dr Jane Barton

"Anyone following this case carefully will know that I was faced with an excessive and increasing burden in trying to care for patients at the Gosport War Memorial Hospital.

"None of the nurses who gave evidence were critical of my care of the patients in this inquiry.

"The consultants who had overall responsibility for the patients never expressed concern about my treatment and working practices.

"Throughout my career I have tried to do my very best for all my patients and have had only their interests and wellbeing at heart."

The hearing follows an inquest into 10 patients' deaths which found drugs to be a factor in five cases.

Seven of the 10 patients were - (clockwise from top left) - Sheila Gregory, Robert Wilson, Enid Spurgin, Geoffrey Packman, Elsie Devine, Arthur (Brian) Cunningham and Ruby Lake
Seven of the 10 patients whose inquests were held last year

In April last year, a jury inquest at Portsmouth Coroner's Court decided that in the cases of patients Robert Wilson, 74, Geoffrey Packman, 66, and Elsie Devine, 88, the use of painkillers had been inappropriate for their conditions.

Arthur Cunningham, 79, and Elsie Lavender, 83, were prescribed medication appropriate for their condition, but in doses which contributed to their deaths, jurors found.

Dr Barton left the Hampshire hospital in 2000 but still practises as a GP in Gosport.

But she has been under certain conditions since July 2008

Professor John Beddington told the BBC the fundamental science behind man-made global warming was "correct"

Climate change research sound, chief UK scientist says

Prof John Beddington
Prof Beddington is calling for more openness

The UK government's chief scientist says his confidence in climate science remains unshaken despite allegations about the withholding of research data.

Professor John Beddington told the BBC the fundamental science behind man-made global warming was "correct".

He said he was concerned that the debate on climate change was becoming artificially polarised.

But he urged scientists to be more open about the uncertainty of predicting the rate of climate change.

He was speaking in the light of reports that the University of East Anglia's Climatic Research Unit had refused to hand over data for public scrutiny.

The Information Commissioner's Office said messages obtained by hackers in November showed that requests by climate change sceptics under the Freedom of Information Act were "not dealt with as they should have been" under the law.

Glacier claims

Prof Beddington, chief scientific adviser to the government, said that even if there were more allegations of wrongdoing by climate scientists or mistakes, the basic science pointing to man-made global warming was very strong.

He told the BBC: "We know that the fundamental physics of the science of climate change is correct. Carbon dioxide, when it is in the atmosphere, increases global warning.

"We know we have increased carbon dioxide in the atmosphere since the pre-industrial period by something of the order of 38%."

He said the Intergovernmental Panel on Climate Change had done an enormous job.

I don't think it's healthy to dismiss proper scepticism. Science grows and improves in the light of criticism
Prof John Beddington

But he added that the organisation was at fault by picking up a false claim that Himalayan glaciers would disappear by 2035.

He said it was wrong to attempt to predict something like that too precisely.

In an earlier interview with the Times, Prof Beddington said public confidence in climate science would be boosted by greater honesty about its uncertainties.

"I don't think it's healthy to dismiss proper scepticism.

"Science grows and improves in the light of criticism. There is a fundamental uncertainty about climate change prediction that can't be changed."

Wednesday, 27 January 2010

faddish beliefs."The New Economics Foundation (Nef)

Economic growth 'cannot continue'

Market trader with his hands on his head (Image: AP)
The world is facing ecological bankruptcy, the report warns

Continuing global economic growth "is not possible" if nations are to tackle climate change, a report by an environmental think-tank has warned.

The New Economics Foundation (Nef) said "unprecedented and probably impossible" carbon reductions would be needed to hold temperature rises below 2C (3.6F).

Scientists say exceeding this limit could lead to dangerous global warming.

"We urgently need to change our economy to live within its environmental budget," said Nef's policy director.

Andrew Simms added: "There is no global, environmental central bank to bail us out if we become ecologically bankrupt."

None of the existing models or policies could "square the circle" of economic growth with climate safety, Nef added.

'No magic bullets'

In the report, Growth Isn't Possible, the authors looked at the main models for climate change and energy use in the global economy.

Magic bullets - such as carbon capture and storage, nuclear or even geo-engineering - are potentially dangerous distractions
Dr Victoria Johnson,
Report's co-author

They then considered whether economic growth could be maintained while "retaining a good likelihood" of limiting the global average temperature to within 2C of pre-industrial levels.

The report concluded that a growth rate of just 3%, the "carbon intensity" of the global economy would need to fall by 95% by 2050 from 2002 levels. This would require an average annual reduction of 6.5%.

However, the authors said that the world's carbon intensity had "flatlined" between 2000 and 2007.

"For each year the target was missed, the necessary improvements would grow higher still," they observed.

The findings also suggested that there was no proven technological advance that would allow "business as usual" to continue.

"Magic bullets - such as carbon capture and storage, nuclear or even geo-engineering - are potentially dangerous distractions from more human-scale solutions," said co-author Victoria Johnson, Nef's lead researcher for the climate change and energy programme.

She added that there was growing support for community-scale projects, such as decentralised energy systems, but support from governments was needed.

"At the moment, magic bullets... are getting much of the funding and political attention, but are missing the targets," Dr Johnson said.

"Our research shows that to prevent runaway climate change, this needs to change."

The report concluded that an economy that respected environmental thresholds, which include biodiversity and the finite availability of natural resources, would be better placed to deliver human well-being in the long run.

Tom Clougherty, executive director of the Adam Smith Institute, a free-market think-thank, said Nef's report exhibited "a complete lack of understanding of economics and, indeed, human development".

"It is precisely this economic growth which will lift the poor out of poverty and improve the environmental standards that really matter to people - like clean air and water - in the process, as it has done throughout human history," he told BBC News.

"There's only one good thing I can say for the Nef's report, and that's that it is honest. Its authors admit that they want us to be poorer and to lead more restricted lives for the sake of their faddish beliefs."

bankers and bosses dominated the agenda

Davos 2010: Bank reform plans to cause controversy

By Tim Weber
Business editor, BBC News website, in Davos

Flags outside the World Economic Forum
Business and political leaders from all over the world are in Davos

Disputes over how best to reform the global financial system are set to dominate this year's World Economic Forum in Davos.

French President Nicolas Sarkozy is likely to add to the pressure on banks in a keynote speech on Wednesday.

Numerous sessions on banking reform are expected to see clashes between bankers and regulators.

The forum, meanwhile, is publishing a report on how to redesign the "global financial architecture".

Regulators set Davos agenda

Until two years ago, bankers and bosses dominated the agenda for the 2,500 top business leaders and politicians meeting in the Swiss Alps.

Last year, after the crisis struck, there was no tussle for dominance. Everybody tried to understand what had happened and searched for ideas to recover from the crisis. And most bankers stayed away, firefighting the crisis at home.

This year the bankers are back, but the talk is of reform and restructuring, with politicians, regulators and central bankers setting the framework for discussions.

Some well-known economists appear ready to chip in. "There are few financial innovations that are not just designed to generate profits for banks," mutters one of them at the forum's welcome reception.

Delaying tactics

But listening to bankers here in Davos and elsewhere, it is obvious that they won't just roll over. They are admitting the need for reform, but warn of over-regulation that could undermine any economic recovery. Delaying tactics could be the bankers' best ploy.

World Economic Forum logo in snow

The forum's own proposal on financial reforms may be a case in point. The report's high-powered steering committee includes top bankers and investors from institutions like Allianz, Barclays Capital, Blackstone, Carlyle Group, JP Morgan Chase and KKR.

But the report's grand title - Restoring Trust and Rethinking Business Models Critical to Financial System Resilience - hides vague recommendations like the need to "address equity stakes separately from other types of crisis intervention", "restrict government influence on owned institutions to board-level issues", and a plea to be "realistic about securing and incentivizing the best available talent" (i.e. the need to pay bonuses).

"Everyone understands that appropriate changes are warranted, that excessive risk-taking should be discouraged and that regulatory reform is called for," Jacob Frenkel, the chairman of JP Morgan Chase International, tells me, but adds: "I do worry however that any reforms may give way to bad regulation rather than good regulation."

Recovery, what recovery?

The state of the global economy will be the background to the Davos discussions.

Already I've heard words like "slow recovery", "jobless recovery", "bumpy recovery" being bandied about.

The jobless will be asking: "Which recovery?"

Business leaders and politicians from Asia, meanwhile, will be asking: "Which recession?" Most economies in the region experienced slower growth rates at best and a brief downturn at worst.

The spirit of Davos

But beyond the disputes about regulation and macroeconomics, the much-vaunted Spirit of Davos is alive and well.

Already the networking and schmoozing has begun. For Jeffrey Hamilton, director of global public policy at pharmaceutical giant Merck, the week in Davos is the best opportunity to meet customers and health officials from around the world.

Dr Joel Selanikio (L) and Jock Mendoza-Wilson
Business contacts are already being made

For Richard Reddy, it is a chance to spread the word about technology start-up BioFuelBox. The company develops a process to transform industrial waste grease into biodiesel. That sharply reduces landfill waste, he says, and returns seven times the energy that's put into the process.

Mr Reddy is a Davos first-timer, soaking up the atmosphere.

"I've signed up for many sessions that have nothing to do with our industry - just to get new ideas," he says.

And he just loves Davos: "Look, it's the first hour of the first event, and already it's overwhelming!"

Dr Joel Selanikio has a very straight-forward ambition for his Davos visit: "Fundraising."

The medical doctor is the founder of DataDyne, a company based in the US and Kenya that develops software for the health industry in developing countries.

His mobile phone software - written by engineers in Nairobi - could dramatically cut the cost of vaccination programmes, he says. It could also ensure that patients far away from medical supervision actually take their medication when they are supposed to.

But a couple of grants have run out and he is now drawing on his savings to nurture the company.

Listening in on our conversation is Jock Mendoza-Wilson, in charge of investor relations at Ukrainian steel and banking conglomerate System Capital Management.

"That's just the kind of software that our company's foundation needs to help TB patients in the Ukraine," says Mr Mendoza-Wilson.

Business cards are swapped, and Dr Selanikio may be be one step closer to building a successful company.

Tuesday, 26 January 2010

I will not go, says climate chief

I will not go, says climate chief

Climate chief: 'I'm here to stay'

The chairman of the UN's climate science body said he would not resign in the wake of a row about a mistake on glaciers that appeared in a key report.

Rajendra Pachauri told BBC News: "I am not going to stand down, I am going to stand up."

The Intergovernmental Panel on Climate Change (IPCC) admitted that it had made a mistake in asserting that Himalayan glaciers could disappear by 2035.

Critics say the mistake has damaged the scientific credibility of the IPCC.

"I was re-elected by acclamation, essentially - I imagine - because everyone was satisfied with my performance on the fourth assessment report," Dr Pachauri said.

"I am now charged with producing the fifth assessment report, which I will do faithfully and to the best of my abilities."

Credibility concerns

Last week, IPCC vice-chairman Jean-Pascal van Ypersele admitted that the inclusion of the 2035 date in a key report was a mistake.

Himalayan glacier
Dr Pachauri blamed "human error" for the mistake

The date appeared in the IPCC's Fourth Assessment Report (4AR), which read: "Glaciers in the Himalayas are receding faster than in any other part of the world... the likelihood of them disappearing by the year 2035 and perhaps sooner is very high."

A number of scientists had recently disputed the date, after a row erupted in India late last year in the run-up to the Copenhagen climate summit, which BBC News reported on 05 December.

Opposing factions in the Indian government gave radically different opinions of what was happening to Himalayan ice.

Dr Pachauri said the inclusion of the 2035 date in the 4AR, which was published in 2007, was "a case of human error", adding that it was unfortunate that it had happened.

"However, let me emphasise that this does not in any way detract from the fact that the glaciers are melting, and this is a problem that we need to be deeply concerned about."

He told BBC News that he became aware of the error "maybe around the 16th or 17th of January".

"Then we swung into action," he explained.

"I got the entire top team of the IPCC to go through the details of this case, and we decided that this was an error but we also saw that this did not in any way move away from the reality that these glaciers are melting."

FROM THE TODAY PROGRAMME

The claim that Himalayan glaciers could disappear by 2035 appears to have originated in a 1999 interview with Indian glaciologist Syed Hasnain, published in New Scientist magazine.

The figure then surfaced in a 2005 report by environmental group WWF - a report that was cited in AR4.

An alternative genesis lies in the misreading of a 1996 study by a Russian researcher that gave the date as 2350.

Gathering storm

In a separate development, a report in the UK's Sunday Times newspaper said the IPCC faced "new controversy for wrongly linking global warming to an increase in the number and severity of natural disasters", in its 2007 milestone report.

However, the IPCC issued a statement that said the story was "misleading and baseless".

It stated: "The assessment addresses both observations of past changes and projections of future changes in sectors ranging from heat waves and precipitation to wildfire.

"Each of these is a careful assessment of the available evidence, with a thorough consideration of the confidence with which each conclusion can be drawn.

"In writing, reviewing, and editing this section, IPCC procedures were carefully followed to produce the policy-relevant assessment that is the IPCC mandate."

Some commentators maintain that these developments, taken together with the contents of e-mails stolen last year from the University of East Anglia's Climatic Research Unit, it undermines the credibility of climate science.

"It is about the process with which it comes to its conclusions; how they pick and choose papers, how they emphasise certain problems and how they exaggerate certain potential risks - that is at issue here," Dr Benny Peiser, for the UK-based Global Warming Foundation, told BBC News.

But a defiant Dr Pachauri said: "I want to tell the sceptics... who see me as the face and the voice of the science of climate change, I am in no mood to oblige them; I am going to remain as chairman of the IPCC for my entire term."

AstraZeneca 'suppressed' drug test data

AstraZeneca 'suppressed' drug test data

Seroquel pills
Seroquel brings in almost 10% of AstraZeneca's revenues

The marketing team sued over a drug's alleged side effects tried to suppress key data, an ex-employee has claimed.

Seroquel's former UK medical adviser told the BBC he was pressured to approve promotional material which said weight gain was not an issue.

Maker AstraZeneca, which faces fresh legal action next month, said it took concerns about its conduct seriously.

In the same programme, the British Medical Journal editor urged that the medicine licensing system be reviewed.

Dr Fiona Godlee said industry should no longer provide the evaluations of its own drugs which the licensing body considered.

'Job threat'

Thousands of patients are suing AstraZeneca in US courts, claiming the anti-psychotic drug Seroquel caused weight gain and diabetes.

The patients allege Seroquel, its second biggest selling drug worth $4.5bn (£2.7bn) a year, was marketed without adequate warning about possible side effects such as massive weight gain and the development of diabetes. However, this is denied by the company.

AstraZeneca, which is facing renewed legal action next month, said the company took concerns about its conduct seriously.

FROM FILE ON 4

Seroquel was launched in 1997 for treating schizophrenia and later for bipolar disorder. Dr John Blenkinsopp, the company's former UK medical manager, claimed he was pressurised by the company's marketing arm to approve claims about the drug which he felt did not reflect the medical evidence.

"The clinical studies at the time of the launch of Seroquel showed patients developed significant weight gain, significant both statistically and clinically," he told the BBC's File on 4.

"They [the marketing team] came at me with a number of potential claims all of which were trying to intimate that Seroquel was not associated with weight gain - the data pointed in the opposite direction," added Dr Blenkinsopp who was speaking publicly for the first time since he left the company in 2000.

He said: "I understood where they were coming from. I had some robust discussions and exposed them to the data but that didn't seem to stop them because they were desperate for a differential advantage over one of the competitor products and they didn't have one.

"In the end I was put under quite a significant amount of pressure by the marketeers to sign off claims with regards to the lack of weight gain and I was unwilling to sign that off. The marketeers made it clear it could be career limiting for me," Dr Blenkinsopp added.

In the US the drug was marketed with claims that it would not cause weight gain. That was not done in the UK except for one advertisement, published in the British Journal of Psychiatry in April 2004.

Licensing reform

Astra Zeneca said it would not comment specifically in reference to its former employees, but said it took seriously any concerns regarding the firm's conduct and compliance procedures and it was currently reviewing issues raised by File on 4's investigation.

It said Seroquel was an important medicine and its safety and efficacy has been evaluated in clinical trials with thousands of patients

Dr Godlee, Editor of the British Medical Journal, told File on 4 that the system of developing and licensing drugs needed a major overhaul to give an independent evaluation of the effects of medications.

She said the pharmaceutical industry had grown enormously and delivered many good and effective drugs. But she warned that its power and influence needed to be controlled.

She has called for independent trials for all new drugs. At present, the regulator - the Medicines and Healthcare products Regulatory Authority - has to rely on research provided by the drug companies when it licences a medicine.

Dr Godlee said the regulator could sometimes be swamped by the amount of information it was given.

The MHRA says it has seen no evidence of this and maintains it carries out thorough and detailed reviews of any application.

File on 4 is on BBC Radio 4 on Tuesday, 26 January , at 2000 GMT, repeated Sunday, 31 January, at 1700 GMT. You can also listen via the BBC iPlayer after broadcast or download the

Monday, 25 January 2010

Rich nations urged to provide $10bn in climate funds

Rich nations urged to provide $10bn in climate funds

Environment ministers from Brazil, India, China and South Africa during talks in Delhi
The ministers promised an action-plan to battle global warming

Brazil, China, India and South Africa have urged wealthy nations to hand over $10bn (£6bn) pledged to poor nations in 2010 to fight climate change.

The group - known as Basic - said the money must be available at once "as proof of their commitment" to address the global challenge.

The plea was issued after a meeting of the four nations in Delhi.

The funds were pledged in a non-binding deal agreed at last year's Copenhagen global climate conference.

The deal - the Copenhagen Accord - envisages that $30bn (£18.5bn) of aid will be delivered for developing nations over the next three years.

Basic members were instrumental in fashioning a political accord at the December climate summit.

The next round of negotiations is due to be held in December in Mexico.

'Soft' deadline

After the Delhi talks, environmental ministers from the four nations issued a joint statement calling for rapid distribution of $10bn that industrialised nations promised to the developing world to tackle climate change in 2010.

The first funds should go to the least developed countries, including small island states and African nations, China's top climate negotiator Xi Zhenhua said, the Associated Press reports.

The four nations also broadly endorsed the Copenhagen agreement, the BBC's Sanjoy Majumber in Delhi says.

And they said they would come up with some sort of action-plan on battling global warming, our correspondent adds.

This comes just a week ahead of a deadline for nations signing up to the accord to send figures on how much they will curb emissions.

But amid uncertainty over who is going to sign up, UN climate convention head Yvo de Boer said earlier this week the deadline was "soft".

He said the Copenhagen summit had not delivered the "agreement the world needs" to address climate change.

Friday, 22 January 2010

Pirates seize second UK-flagged vessel

Map

A UK-flagged cargo ship with 25 crew has been seized by pirates off Somalia, media reports say.

The Asian Glory was taken 620 miles (1,000km) off the Horn of Africa nation's coast, the Bulgarian foreign ministry said.

The vessel, which has a multi-national crew, is the second UK-flagged ship hijacked in days, after chemical tanker the St James Park was seized on Monday.

The waters around Somalia are among the most dangerous in the world.

As well as eight Bulgarians, the other nationalities making up the Asian Glory's crew are said to include Ukrainians, Romanians and Indians.

British officials said there were no UK nationals on board the vessel.

The exact time and location of the hijacking are not yet clear.

The 13,000-tonne ship was reportedly transporting cars from Singapore to Jeddah in Saudi Arabia.

It is estimated the ship could take up to three days to reach the Somali coast, from where pirates usually hold ransom talks.

The St James Park, which has 26 crew from nine different countries, is currently anchored off the Somali coast, where negotiations for its release are expected to start.

Correspondents say the upsurge in piracy in the region is a consequence of the failure to find a solution to Somalia's continuing political disarray.

Gastric dumping syndrome

Gastric dumping syndrome

Gastric dumping syndrome



Gastric dumping syndrome, or rapid gastric emptying is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. It happens when the upper end of the small intestine, the jejunum, expands too quickly due to the presence of hyperosmolar[jargon] food from the stomach. "Early" dumping begins concurrently or immediately succeeding a meal. Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. The syndrome is most often associated with gastric surgery.

It is speculated that "early" dumping is associated with difficulty digesting fats while "late" dumping is associated with carbohydrates.[citation needed]

Rapid loading of the small intestine with hypertonic stomach contents can lead to rapid entry of water into the intestinal lumen. Osmotic diarrhea, distension of the small bowel (leading to crampy abdominal pain), and hypovolemia can result.

In addition, people with this syndrome often suffer from low blood sugar, or hypoglycemia, because the rapid "dumping" of food triggers the pancreas to release excessive amounts of insulin into the bloodstream. This type of hypoglycemia is referred to as "alimentary hypoglycemia".

[edit] Diagnosis

Physicians diagnose dumping syndrome primarily on the basis of symptoms in patients who have had gastric surgery. Tests may be needed to exclude other conditions that have similar symptoms. Two ways of determining if a patient has dumping syndrome include Barium fluoroscopy and radionuclide scintigraphy.

In the first procedure, a contrast of barium-labeled medium is ingested, and x-ray images are taken; early dumping can be easily recognized by premature emptying of the contrast medium from the stomach.

The second method, scintigraphy (or radionuclide scanning), involves a similar procedure in which a labeled medium containing 99mTc (or other radionuclide) colloid or chelate is ingested. The 99mTc isotope decays in the stomach, and the gamma photons emitted are detected by a gamma camera; the radioactivity of the area of interest (the stomach) can then be plotted against time on a graph. Patients with dumping syndrome generally exhibit steep drops in their activity plots, corresponding to abnormally rapid emptying of gastric contents into the duodenum.

[edit] Treatment

Dumping syndrome is largely avoidable by avoiding certain foods that are likely to cause it, therefore having a balanced diet is important. Treatment includes changes in eating habits and medication. People who have gastric dumping syndrome need to eat several small meals a day that are low in carbohydrates, avoiding simple sugars, and should drink liquids between meals, not with them. Fibers delay gastric emptying and reduce insulin peaks. People with severe cases take medicine such as octreotide, cholestyramine or proton pump inhibitors (such as pantoprazole) to slow their digestion. Doctors may also recommend surgery. Surgical intervention may include conversion of a Billroth II to a Roux-en Y gastrojejunostomy.

[edit] Source

Most of the text of this article is taken from http://digestive.niddk.nih.gov/ddiseases/pubs/rapidgastricemptying/index.htm


Thursday, 21 January 2010

London healthcare 'heads towards crisis', say doctors


Hospital ward
BMA predicts the NHS will need to cut hospital services in London

London hospitals "could close as healthcare in the capital heads towards a major financial crisis", the British Medical Association (BMA) has said.

As much as £5bn could be cut from NHS London's budget by 2017, it claimed.

The BMA's report, London's NHS On The Brink, predicts that from 2011 there will be a freeze on NHS budgets, with the worst cuts falling in London.

But an NHS spokesman said: "To give people leading expert care we also need to centralise some services."

'Unproven polysystems'

The BMA's report, written by health expert Dr John Lister, criticises some of the proposals that NHS London has made public, including:

  • Cutting the number of people going to hospital A&E departments by a target of 60% and the number going to hospital outpatients by 55%
  • Diverting millions of patients to "unproven polysystems" or clinics that have not yet been built
  • Cutting up to £1.1bn from London hospital budgets "forcing wide scale cutbacks and closures"
  • A 66% reduction in staffing of "non-acute services", including community services for older people and district nurses
  • A 33% cut in the length of GP appointment times

The report surveyed board papers and other published material from primary care trusts (PCTs) in London.

An NHS London spokesman said: "To give Londoners a better standard of NHS care we need to provide more of the services people use the most, closer to where people live.

"To give people leading expert care we also need to centralise some services to create, for example, dedicated stroke and trauma units," he added.

"This will save hundreds of lives every year."

UN climate body admits 'mistake' on Himalayan glaciers


UN climate body admits 'mistake' on Himalayan glaciers

By Richard Black
Environment correspondent, BBC News website

Satellite image of Himalayas (SPL)

Neither satellites nor ground observations give a complete picture

The vice-chairman of the UN's climate science panel has admitted it made a mistake in asserting that Himalayan glaciers could disappear by 2035.

The Intergovernmental Panel on Climate Change (IPCC) included the date in its 2007 assessment of climate impacts.

A number of scientists have recently disputed the 2035 figure, and Jean-Pascal van Ypersele told BBC News that it was an error and would be reviewed.

But he said it did not change the broad picture of man-made climate change.

The issue, which BBC News first reported on 05 December, has reverberated around climate websites in recent days.

It is so wrong that it is not even worth discussing

Georg Kaser, University of Innsbruck

Himalayas glacier deadline 'wrong'

Some commentators maintain that taken together with the contents of e-mails stolen last year from the University of East Anglia's Climatic Research Unit, it undermines the credibility of climate science.

Dr van Ypersele said this was not the case.

"I don't see how one mistake in a 3,000-page report can damage the credibility of the overall report," he said.

"Some people will attempt to use it to damage the credibility of the IPCC; but if we can uncover it, and explain it and change it, it should strengthen the IPCC's credibility, showing that we are ready to learn from our mistakes."

Grey area

The claim that Himalayan glaciers could disappear by 2035 appears to have originated in a 1999 interview with Indian glaciologist Syed Hasnain, published in New Scientist magazine.

The figure then surfaced in a 2005 report by environmental group WWF - a report that is cited in the IPCC's 2007 assessment, known as AR4.

An alternative genesis lies in the misreading of a 1996 study that gave the date as 2350.

AR 4 asserted: "Glaciers in the Himalayas are receding faster than in any other part of the world... the likelihood of them disappearing by the year 2035 and perhaps sooner is very high."

Dr van Ypersele said the episode meant that the panel's reviewing procedures would have to be tightened.

Slow reaction?

The row erupted in India late last year in the run-up to the Copenhagen climate summit, with opposing factions in the government giving radically different narratives of what was happening to Himalayan ice.

Rajendra Pachauri

IPCC chief Rajendra Pachauri has been criticised by Jairam Ramesh

In December, it emerged that four leading glaciologists had prepared a letter for publication in the journal Science arguing that a complete melt by 2035 was physically impossible.

"You just can't accomplish it," Jeffrey Kargel from the University of Arizona told BBC News at the time.

"If you think about the thicknesses of the ice - 200-300m thicknesses, in some cases up to 400m thick - and if you're losing ice at the rate of a metre a year, or let's say double it to two metres a year, you're not going to get rid of 200m of ice in a quarter of a century."

The row continues in India, with Environment Minister Jairam Ramesh calling this week for the IPCC to explain "how it reached the 2035 figure, which created such a scare".

Meanwhile, in an interview with the news agency AFP, Georg Kaser from the University of Innsbruck in Austria - who led a different portion of the AR4 process - said he had warned that the 2035 figure was wrong in 2006, before AR4's publication.

"It is so wrong that it is not even worth discussing," he told AFP in an interview.

He said that people working on the Asia chapter "did not react".

He suggested that some of the IPCC's working practices should be revised by the time work begins on its next landmark report, due in 2013.

But its overall conclusion that global warming is "unequivocal" remains beyond reproach, he said.

BBC News - UN climate body admits 'mistake' on Himalayan glaciers

Wednesday, 20 January 2010

Voodoo a Legitimate Religion

Voodoo a Legitimate Religion, Anthropologist Says

Brian Handwerk
for National Geographic News
October 21, 2002

Voodoo is widely regarded as a mysterious and sinister practice that's taboo in many cultures. The mere word conjures images of bloody animal sacrifices, evil zombies, dolls stuck with pins, and dancers gyrating through the hot night to the rhythm of drums.

But experts on voodoo beliefs say there are many misconceptions about the practice, which is performed in various forms worldwide.


"Voodoo is not some kind of dark mystical force, it is simply a legitimate religion," says anthropologist Wade Davis, a National Geographic Explorer-in-Residence who has studied voodoo extensively in the Caribbean nation of Haiti.

Haiti is ostensibly a Catholic country, but voodoo is widely practiced there. In his best-selling book The Serpent and the Rainbow, Davis wrote: "As the Haitians say, the Catholic goes to church to speak about God, the vodounist dances in the hounfour to become God."

Yet voodoo goes even beyond religion—it's a world view, Davis says in the National Geographic Channel program Taboo: Voodoo, which airs in the United States on Monday, October 21, at 9 p.m. ET.

"It's not just a body of religious ideas," Davis says, "but a notion of how children should be raised, a notion of what education means, an awareness of politics."

Honoring Ancestors

The exact origins of voodoo are unknown, but it's generally agreed that its roots lie in West Africa. The nation of Benin, once known as Dahomey, is considered the cradle of voodoo, which means "spirit" in the local language.

A "spirit" religion, voodoo likely evolved from ancient traditions of ancestor worship and animism.

Once banned, voodoo is now an official religion in Benin, with about four million adherents in that nation alone. Forms of voodoo are also practiced in other African nations, the Caribbean, South America, New Orleans, and elsewhere.

Voodoo beliefs spread from Africa's shores to America on slave ships. Subjected to forced labor and expected to adopt a foreign Christian religion in their new land, enslaved Africans turned to the familiar spirits of their ancestors to help them survive a painful transition.

In the process, voodoo underwent major changes.

Thursday, 14 January 2010

Pregnant women were prescribed the drug

Apology to thalidomide survivors

Mike O'Brien: "Government wishes to express sincere regret"

The government has expressed its "sincere regret" and "deep sympathy" to the victims of the thalidomide scandal.

Health minister Mike O'Brien made the apology in a statement to MPs - it comes after he unveiled a compensation package for survivors in December.

Pregnant women were prescribed the drug in the 1950s and 1960s as a treatment for morning sickness or insomnia.

It was withdrawn from sale in 1961 after babies were born with limb deformities and other damage.

Mr O'Brien said: "The government wishes to express its sincere regret and deep sympathy for the injury and suffering endured by all those affected.

THALIDOMIDE
Developed in Germany in the 1950s
Prescribed as a 'wonder drug' for insomnia, coughs, colds, morning sickness and headaches
Link with birth defects shown in 1961 leading to the drug being taken off the market
Affected babies commonly suffered missing or deformed limbs and severe shortening of arms or legs
The drug also caused malformations of the eyes and ears, heart, genitals, kidneys and digestive tract
Scientists believe the drug harmed the growth of new blood vessels in the developing embryo

"We acknowledge both the physical hardship and the emotional difficulties that have faced both the children affected and their families as a result of this drug, and the challenges that many continue to endure often on a daily basis."

His public statement follows the decision by the government to make more money available to the 466 thalidomide survivors in the UK.

The drug's UK manufacturer, Distillers Biochemicals, paid around £28m compensation in the 1970s following a legal battle by the families of those affected.

This has been subsequently topped up over the years by successor companies, although the average payout to the 466 survivors in the UK remains below £20,000 a year.

The government's £20m funding package is on top of this and will be shared out over the next three years.

It reflects the fact that survivors are living longer than expected and as a result will have increasing health needs.

Needed

The UK was the second biggest user of the drug after Germany. About 2,000 babies were born with problems linked to the drug with half of them dying within months of birth.

Another 5,000 were born elsewhere in the world.

Guy Tweedy, of the Thalidomide Trust, which distributes aid to survivors, described the apology as "absolutely wonderful".

Thalidomide campaigners' reaction to the decision

"I'm highly delighted and so glad that it actually came, 50 years too late but never mind.

"It's an apology not just to thalidomide victims but to the parents who lost their children in the early days."

Mr Tweedy added the apology "means as much in some ways as the money".

Nick Dobrik, a thalidomide victim and campaigner, added the apology was "very significant".

He said in particular it meant a lot to the parents of children who had died as it was a way of saying it was the "government's fault, not theirs".

Stephen O'Brien, the Conservative health spokesman, said: "I welcome the minister's remarks. Many thalidomiders have indeed waited a long time for this."

Wednesday, 13 January 2010

Tony Blair's genuine belief

Alastair Campbell defends 'every word' of Iraq dossier


Alastair Campbell: "Tony Blair's genuine belief was that Iraq had to be confronted"
Tony Blair's ex-spokesman Alastair Campbell has said he "defends every single word" of the 2002 dossier on Iraq's weapons of mass destruction.
He told the UK's Iraq war inquiry that parts could have been "clearer" but it did not "misrepresent" Iraq's threat.
The UK should be "proud" of its role "in changing Iraq from what it was to what it is now becoming", he argued.
But he said Mr Blair told President Bush privately in 2002 the UK would back military action if necessary.
Critics of the war have called for private correspondence between the two leaders about their views on Iraq to be published.
Countdown to war
Mr Campbell is the most prominent figure to appear so far before the inquiry, which is looking at UK policy before and after the 2003 war.
The BBC's Security Correspondent Frank Gardner said he had given a defiant performance, showing no contrition over the controversial decision to go to war or the arguments used to justify the action.
CAMPBELL FACTS
An ex-journalist, Alastair Campbell was Tony Blair's press secretary between 1994 and 2003 and No 10 director of communications from 1997 to 2003.
As it happened: Campbell grilled
Analysis: No regrets
Mr Campbell said the prime minister recognised the deep opposition to military action amongst much of the British public but believed there would be a "bigger day of reckoning" to come with Saddam if he was not confronted at the time.
As No 10 director of communications between 1997 and 2003, he played a key role in the drawing-up of the government's September 2002 dossier on Iraq's alleged weapons of mass destruction, containing the controversial claim that they could be deployed within 45 minutes.
"Could things have been done differently, almost certainly," he said of the March 2003 invasion.
"Any decision, you can go back over it, but on the big picture, on the leadership that he [Tony Blair ] showed, on the leadership that the British government showed on this issue, I was privileged to be there and I'm very very proud of the part that I was able to play."
He added: "I think that Britain, far from beating ourselves up about this, should be really proud of the role that we played in changing Iraq from what it was to what it is now becoming."
Mr Campbell said he was "very close" to the prime minister but stressed that Mr Blair fully consulted other key ministers on Iraq policy - including the then Chancellor Gordon Brown.
Mr Campbell, who has given evidence to three previous inquiries on Iraq, said claims that Mr Blair endorsed regime change after a meeting with President Bush at his Crawford ranch in April 2002 were not true.
AT THE INQUIRY
Peter Biles
BBC World Affairs correspondent Peter Biles
Officials of the Iraq Inquiry completely under-estimated the length of time needed to question Alastair Campbell.
It had been expected that a three hour morning session would suffice. In the event, the hearing rolled on for another two hours into the afternoon, with Mr Campbell having ample opportunity to defend Tony Blair's premiership and the decision to take Britain to war in Iraq.
At this rate, two days rather than one will be needed when Mr Blair arrives to present his evidence in two or three weeks' time.
The former Downing Street spin-doctor was generally at ease as he faced the Inquiry. Interestingly, the Chairman, Sir John Chilcot, took little part in today's session, and left the questioning to his four colleagues.
For once, there were some quite lively exchanges as the committee sought to square Mr Campbell's version of events with some of the earlier evidence heard.
British policy was still focused on disarming Iraq and getting it to abide by UN resolutions, he argued, as Mr Blair "genuinely believed" Iraq's pursuit of weapons of mass destruction must be dealt with.
Mr Blair was clear that military action should be regarded as a last resort if the diplomatic process failed and still hoped that the issue could be "peacefully resolved" right up to the eve of war.
"You seem to be wanting me to say that Tony Blair signed up to saying, regardless of the facts and WMD, we are going to get rid of this guy," he said. "It was not like this."
But he revealed that Mr Blair had written to President Bush during 2002 about the disarmament strategy, saying: "If that cannot be done diplomatically and it is to be done militarily, Britain will be there. That would be the tenor of the communication to the president."
The Lib Dems, who opposed the invasion, have called for the letters to be published, saying Mr Campbell's evidence cast further doubt on the legality of the war.
Former Conservative Foreign Secretary Sir Malcolm Rifkind, who opposed the invasion, said the letters would show the extent to which Tony Blair and George Bush were "hand in glove" over the issue and should be available to the public.
Asked about weapons of mass destruction, Mr Campbell said Tony Blair believed Iraq posed a "unique threat" because Saddam Hussein had used them before and there was no means of dialogue with him.
Mr Campbell said he had provided "presentational" support on the key September 2002 dossier but, at no stage, did No 10 try to "beef up or over-ride" the judgements of the intelligence agencies.

Watching Campbell dealing with this enquiry is just awe-inspiring
Rob, Lichfield
Describing it as a "cautious" assessment, he insisted it had not been designed to present the "case for war" but to highlight why Mr Blair was increasingly "concerned" about the threat posed by Iraq.
"I don't believe the dossier in any sense misrepresented the position."
The dossier included a foreword by Mr Blair in which he wrote that he believed the intelligence had established "beyond doubt" that Saddam Hussein had continued to produce chemical and biological weapons.
Sir John Scarlett, chairman of the Joint Intelligence Committee, told the inquiry last month that the foreword was "overtly political" and "quite separate" from the rest of the dossier.
45-minute claim
Mr Campbell, who drafted the first version of the foreword - ultimately approved by Mr Blair - said no-one in intelligence challenged this statement which, he added, never suggested Saddam Hussein "was able to do something terrible to the British mainland".
On the 45-minute claim, which was retracted after the war, he said the dossier "obviously" could have been clearer about it referring to battlefield munitions.
But he insisted Mr Blair put forward a balanced argument in the House of Commons on the issue and the 45-minute claim was only given "iconic" status by the press.
INQUIRY TIMELINE
January-February: Tony Blair, Jack Straw and other politicians to appear before the panel
March: Inquiry to adjourn ahead of the general election campaign
July-August: Inquiry expected to resume with Gordon Brown and 

Questions about Mr Campbell's role in the dossier were at the centre of a post-war row with the BBC culminating in the death of the government weapons expert Dr David Kelly and the subsequent Hutton inquiry.
Mr Campbell said he was "never in doubt" that Iraq would be found to have weapons of mass destruction and the realisation that they did not was "very difficult".
On the invasion's aftermath, he said it became clear within a week that things were not going well and there was a lack of "grip".
He argued that Secretary of State for International Development Clare Short, who resigned shortly after the invasion in protest about post-war strategy, was "difficult to handle" and suggested there was a fear she might leak things she did not agree with.
Former Defence Secretary Geoff Hoon and former Foreign Secretary Jack Straw will give evidence to the inquiry next week with Mr Blair expected to appear at a later date.
His successor as prime minister, Gordon Brown, will not give evidence until after the general election, expected to take place in May.
The SNP have called for Mr Brown to give evidence before the election as it was he, as chancellor, who "bankrolled" the military campaign.
The Iraq Inquiry's final report is due to be published by early next year.

Sunday, 10 January 2010

Tavistock farmers' market

Tavistock farmers' market cancelled due to snow and ice

A Saturday farmers' market in Tavistock, Devon, has been cancelled for the first time in nearly a decade.

The ice, snow and sub-zero temperatures led to the decision being made on safety grounds.

The market's manager said for many of the farmers who come from rural areas, road conditions were simply too dangerous.

"It's disappointing, but we didn't want to put anyone at risk," Maria Jones told BBC News.

Ms Jones said it was hoped the next farmers' market would be held on 23 January.

Royal charter

The severe weather has also affected the town's pannier market, which was forced to close on Wednesday and Thursday, again for the first time in at least eight years.

The market was granted a Royal Charter in 1109 and has continued almost without a break for more than 900 years.

Manager Eddie Carruthers said: "It's very unusual, but some traders live out in places like Princetown and they just couldn't get in."

The pannier market has now reopened, but only 35 of the usual traders are operating.

"We're hoping the worst of it is over now, but we'll just have to play it by ear."

Friday, 8 January 2010

Ponies have been put to work on Dartmoor for centuries

Pulling power for Dartmoor ponies

Dartmoor pony puling tree
The ponies have special harnesses to pull the trees off the moorland

Twenty-six Dartmoor ponies are being put back to work to help the moorland and increase their own value.

The ponies, owned by local farmers, are being run by Dartmoor Pony Heritage Trust at Bellever under a stewardship agreement with the Forestry Commission.

They are grazing the site and trampling the rank grasses to create room and light for sensitive plants.

The ponies have also been given special harnesses to remove spruce trees which have seeded on the open moorland.

Archaeological clearance

"They're just as good as any quad bike - in fact they're better," trust spokeswoman Drew Butterfield said.

"There's no diesel involved, so it's a cleaner, greener way of conserving Dartmoor."

Natural England has awarded a funding grant to the trust to pay for harnessing equipment required to carry the project out over the next 10 years.

The trees will be taken to other areas of the moor, where they will be allowed to rot down naturally and return nutrients to the earth.

Ponies have been put to work on Dartmoor for centuries, but there are now about 1,200 ponies born every year and farmers are not allowed to keep them all.

Some can make as little as £12 when they are sold at market.

"We're looking at lots of different ways to add value because in recent years we've seen prices fall with changes in legislation and horse passports, etc," Ms Butterfield said.

Following meetings with Dartmoor National Park, the herd will also be used to clear thick tussocky grass from important archaeological sites.

Food and water fears for ponies

Dartmoor pony
Grazing land is covered with snow which has then frozen solid

Concerns have been raised that even hardy Dartmoor ponies are suffering during the severe wintry weather.

South West Equine Protection fears the prolonged cold is affecting the ponies, which are known for their resilience in bleak conditions.

With frozen snow covering the moor, some ponies have been seen pulling bark off trees for food.

The charity said, more importantly, water troughs were frozen too solidly for the animals' hooves to break.

There are currently more than 1,000 ponies on the moor, mostly owned by farmers who are battling with the snow and ice to look after their farms and livestock.

The National Farmers' Union said the Dartmoor pony was a tough breed which had survived severe winters in Devon for centuries.

But Louise Cummins from the equine charity said if the current conditions continued, some ponies would have no food or water.

Frozen water trough
Walkers are being asked to break the ice on frozen water troughs

"I understand the farmers are busy with cattle, sheep and other work on the farm, but all they need to do is pop out a little bit of hay just to keep the ponies going with a small amount of nutrition," she said.

"The ponies need water as a main lifeline - they can survive a couple of days without food, but not without water."

The charity has asked anyone out walking on Dartmoor, or common ground where there are ponies, to check water troughs and if possible break the ice.

Tuesday, 5 January 2010

ME virus discovery raises hopes

ME virus discovery raises hopes

Weary woman
Some sufferers of ME have such severe symptoms they are confined to bed

US scientists say they have made a potential breakthrough in understanding what causes the condition known as chronic fatigue syndrome (CFS) or ME.

Their research in the journal, Science, suggests that a single retrovirus known as XMRV does play a role in ME.

They found the virus in 67% of ME patients compared to under 4% of the general population.

But experts cautioned that the study did not conclusively prove a link between XMRV and ME.

ME is a debilitating condition that affects an estimated 17 million people worldwide.

The discovery raises hopes of new treatments for the condition.

Retroviruses are known to cause neurological symptoms, cancer and immunological deficiencies.

Contributing factor

The Whittemore Peterson Institute in Nevada, said they had extracted the DNA from XMRV in the blood of 68 out of 101 patients with the condition.

ME FACTS
Causes chronic fatigue and muscle pain
Impairs immune system
Does not improve with sleep
More women than men suffer from it
Condition controversial in 1980's when some medical authorities doubted whether it was a genuine physical illness

Cell culture experiments revealed that the patient-derived XMRV was infectious.

The researchers said these findings raise the possibility that XMRV may be a contributing factor to ME.

XMRV is also known to have a role in some prostate cancers.

Dr Judy Mikovits, who led the study, said: "It's a blood borne pathogen that we contract through body fluids and blood transmission.

"The symptoms of ME - chronic fatigue, immune deficiencies, chronic infections - are what we see with retroviruses.

"This discovery could be a major step in the discovery of vital treatment options for millions of patients."

Tony Britton, of the ME Association said: "This is fascinating work - but it doesn't conclusively prove a link between the XMRV virus and chronic fatigue syndrome or ME.

"Many people with ME/CFS say their illness started after a viral infection, and a number of enteroviruses and herpes viruses have also been implicated in the past.

"ME/CFS is an immensely complex illness, with many possible causes and there are up to 240,000 sufferers in the UK desperate to get better."

Invest in ME are enormously encouraged by the current research which shows a potential new cause for this devastating neurological illness. More importantly it promises a diagnostic test is within reach.

A spokesman for Invest in ME said: "This is a huge step achieved in such a short time and will bring hope to all people with ME and their families.

"We now call on the UK government, the Chief Medical Officer and the Medical Research Council to support our view that only a research strategy based on adequately funded and coordinated biomedical research into ME will succeed in creating treatments and eventually a cure for this devastating neurological illness. "

Dr Richard Grunewald, a consultant neurologist at the Sheffield Teaching Hospitals NHS Foundation Trust who is also on the panel that gives advice to NICE on CFS, said he had reservations about the research.

He said: "The idea that all CFS can be caused by a single virus doesn't sound plausible to most people who work in the field.

"A lot of the symptoms of CFS are not those of a viral infection."

Sir Peter Spencer, chief executive of Action for ME, said: "It is still early days so we are trying not to get too excited but this news is bound to raise high hopes among a large patient group that has been ignored for far too long.

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