Monday, 6 September 2010

Diabetes drug still available despite suspension advice

Diabetes drug still available despite suspension advice

Avandia pills GlaxoSmithKline is the world's third largest pharmaceutical company

A drug for type two diabetes is still being prescribed in the UK despite being recommended for withdrawal two months ago, BBC Panorama has found.

Avandia has been linked to a raised risk of heart attacks and heart failure and is under a Europe-wide review.

An expert panel of the UK Medicines and Healthcare products Regulatory Agency (MHRA) said its use should be suspended but it is still available on the NHS.

Manufacturer GlaxoSmithKline (GSK) said it was safe if properly monitored.

'Alternative treatments'

Tens of thousands of patients take Avandia, also known as Rosiglitazone. It was prescribed more than one million times in the UK last year alone.

  • Panorama: A Risk Worth Taking? is broadcast on BBC One, Monday 6 September at 2030 BST or watch again on BBC iPlayer

Pharmaceutical giant GSK said its research programme proved the drug was "safe and effective when it is prescribed appropriately".

Clinicians at the MHRA's advisory body, the Commission on Human Medicines (CHM), voted unanimously in July for Avandia's withdrawal from the UK. But the recommendation was not made public.

The MHRA said following the advice it sent letters to healthcare professionals asking them to "consider alternative treatments where appropriate".

It also said it used the information to push for a UK withdrawal as part of the Europe-wide review by the European Medicines Agency.

The drug is meant to improve life for type two diabetics by helping to regulate blood sugar levels but there is also evidence it could increase the risk of heart failure and heart attacks.

Swelling

"Doctors were advised not to use the tablet in anyone who was at risk of heart failure," said Prof Edwin Gale, a leading UK diabetes expert.

Main types of heart condition

  • A heart attack happens when one of the coronary arteries becomes blocked by a blood clot. This cuts off the supply of blood and oxygen to the heart, causing damage to the heart muscle. This is most likely to happen if you are older, male, a smoker, overweight or have high cholesterol or high blood pressure
  • Heart failure is quite a misleading term and would probably be better called 'heart inefficiency'. It refers to the heart's job as a pump. The heart squeezes a set amount of blood each time it beats. If you have heart failure, the pump is less efficient and cannot cope with squeezing the same amount each time. It does not mean your heart is about to stop at any time - it means it isn't working as well as it should
  • A cardiac arrest is the technical term for when the heart suddenly stops pumping blood around the body. This may be due to an erratic heart rhythm that can sometimes be corrected by defibrillation or 'shocking' the heart.

Source: British Heart Foundation

Prof Gale, who chairs the European Medicines Agency scientific advisory group on diabetes, said Avandia should be withdrawn entirely.

"How long do you wait? How important is it to be absolutely certain and at what point do you start saying - this game isn't worth it, people's lives may be at risk, something should be done about it?" he said.

Clinical pharmacologist Dr Yoon Loke, of the University of East Anglia, said his analysis of the class of drug showed that it doubled the risk of heart failure, regardless of whether or not the patients were considered at high risk before they took the drug.

"Even if you restricted it to patients who don't have heart failure, you will still get patients who newly develop heart failure as a result of Avandia," Dr Loke said.

He has calculated that annually in the UK patients could suffer "about 1,000 extra heart attacks and possibly 600 extra cases of heart failure too as a result of using Avandia".

Launched in Europe 10 years ago, Avandia quickly became the market-leading diabetes tablet, earning GSK billions of pounds.

Usha Patel has diabetes and used the drug to manage her condition. But when she developed painful conditions including swelling in her legs and further tests showed that she had developed heart problems, her GP advised her to stop taking Avandia.

"Because of your heart problems, we don't want you to take any more tablets," her GP told her. "Stop it the next day. Don't take it any more."

'First priority'

Other patients Panorama spoke to have had a more positive experience with their Avandia prescription.

Click to play

US diabetes sufferer Charlene Young said her heart attack "was devastating"

Helen Lovatt was first prescribed the drug by her GP six years ago and thinks that, together with her recent weight loss, it has helped bring her diabetes under control.

"It suits me, doesn't upset me in any way so if it's not broken why mend it?

"I saw in the paper about the possible side effects, but if my doctor's keeping a good check on me, I'm not going to sit and worry about it," she said.

In response to Panorama's findings, GSK said: "Patient safety is our first priority.

"We have carried out an extensive research programme, involving more than 50,000 patients to analyse the safety and benefits of Avandia and continue to believe it is safe and effective when it is prescribed appropriately."

The Europe-wide review by the European Medicines Agency into Avandia will announce findings whether to restrict its prescription or withdraw it completely later this month.

Panorama: A Risk Worth Taking? is broadcast on BBC One, Monday 6 September at 2030 BST.

Saturday, 4 September 2010

Bushmeat is simply meat from wild animals.

Is Africa's wildlife being eaten to extinction?



The rapid growth in the global demand for bushmeat is leaving many African species facing the possibility of being eaten out of existence, says Mark Jones. In this week's Green Room, he calls for western nations to do more to tackle the problem of illegal imports of bushmeat.
Primate bushmeat (Image: Anne-Lise Chaber)
The increasing value of bushmeat has attracted criminal syndicates, with sophisticated and efficient logistical capabilities
We've all heard how the illegal trade in elephant ivory, rhino horn and other high value products is threatening Africa's wildlife.
However, the impact of these products is dwarfed by the trade in bushmeat, defined as meat from Africa's wild animals traded for human consumption.
According to the Bushmeat Crisis Task Force, the hunting of and trade in bushmeat represents "the most significant immediate threat to the future of wildlife in Africa".
Traditionally, bushmeat hunting was a subsistence activity.
It is now a multi-billion dollar international trade involving hundreds of species, from forest herbivores such as duikers and other antelopes to wild pigs, rodents, elephants and primates.
The exponential increase in the trade over recent years is being driven by demand from the exploding and ever more urbanised human population in Africa, and the increasing international value and demand for bushmeat products.
Commercial logging and the associated infrastructure development and expansion have given hunters easy access to previously impenetrable African forests, and ready-made transport routes to towns and cities.
Unsustainable consumption
The term bushmeat is normally used in reference to the illegal trade.
The trade may be illegal because the species concerned is protected under national or international laws, the method of killing is prohibited, or because the animal is taken from a protected area.
The food source was originally exploited because of its low cost, lack of ownership issues, weak law enforcement and the lack of alternatives.
Library picture of a bushmeat market stall in Africa
Bush pigs, duikers, and monkeys for sale at a market in Gabon
Now, the increasing value of bushmeat has attracted criminal syndicates, with sophisticated and efficient logistical capabilities.
Law enforcement agencies in many African countries do not have the resources to keep up, and in some cases high level involvement in the trade may protect it from official interference.
This makes accurate estimates of the trade difficult to obtain, although Central African consumers alone may be eating more than 2.5m tonnes each year.
Many target species have already been extirpated from parts of West Africa. Wildlife in Eastern and Southern African countries is increasingly being targeted, and Kenya is estimated to have experienced a loss of about 50% in its wildlife in recent decades, largely as a result of the bushmeat trade.
A recent study, involving researchers from the Zoological Society of London, estimated that as much as 270 tonnes of bushmeat might be coming through a single airport in Paris annually, destined both for personal consumption and to supply the lucrative trade in high value products.
It is also estimated that more than a quarter of all mammal species hunted for bushmeat are threatened with extinction.
Feeling the loss
Widespread hunting of animals for bushmeat depletes populations of affected species, and can lead to local population crashes or extirpation.
There are, however, much wider potential impacts.
Species have functions: as prey for other species, seed dispersers or forest rebuilders. So reductions in certain species can have far reaching impacts on others, causing a loss of biodiversity and a crisis within ecosystems.
Grasscutter in a cage
Ghanaians started breeding their own bushmeat rather than hunting it
The loss of biodiversity leaves us with a predominance of a few so-called "weedy species", such as those that thrive in continually disturbed, human-dominated environments.
Small populations of highly endangered animals can be disproportionately affected.
Although the number of Great Apes involved in the bushmeat trade is small, their removal can have devastating impacts on populations, and Great Ape species in Africa are thought to be at risk of extinction over the next two decades if the trade continues at its current rate.
The commercial bushmeat trade also threatens the livelihoods and food security of indigenous rural people, which can result in social and political instability.
Bushmeat can also carry potentially devastating diseases - from anthrax to ebola, monkey pox to retroviruses - that may have disastrous impacts on livestock and far-reaching consequences for human health.
Food for thought
For the bushmeat trade to be controlled so that it does not cause further decimation of Africa's wildlife, multi-faceted solutions need urgently to be put in place.
As renowned conservationist Ian Redmond suggests, we need to aim for the trade to be Legal, Sustainable, and Disease Free.
Until recently, most conservation projects concerned with bushmeat have tended to focus on research, education, and enforcement, with few attempts to provide alternative livelihoods or food sources.
Many of the countries central to the trade are poor and suffer from corruption.
Chimpanzee
Chimpanzees carry viruses which can jump to humans
These countries need resources, incentives and training if they are to apply and enforce national and international regulations.
Prosecution of illegal traders often fail because of inadequate availability of resources to identify the type of meat concerned, so laboratories need to be set up to enable simple and inexpensive forensic services.
In importing countries, bushmeat is often not considered a high priority by customs authorities when compared with, for example, drugs or arms; so the profile of bushmeat in the international enforcement arena needs to be raised.
Extensive public awareness programmes are required, aimed at educating people at all levels of the trade.
A number of umbrella organisations have been established in recent years to try and improve local education, such as the Bushmeat-free Eastern Africa Network (BEAN) initiative. Some have been very successful.
However, far more effort is needed, with co-ordination at an international level.
Perhaps most importantly, people who currently rely on the illegal bushmeat trade for their livelihood or as an essential protein source need to be given alternative options; and herein lies arguably the greatest challenge.
Some good initiatives exist, including the development of fish farms, apiaries, and arable agriculture projects. Many more are required if the trade is to be significantly reduced.
Local actions to curb the bushmeat trade need to be resourced through global responses, requiring significant investment at a time of international financial instability and introspection.
If Africa's unique wildlife, and its rural communities, are to survive the impacts of the bushmeat trade, continued well-directed development aid for the poor countries of Africa throughout this period of global financial uncertainty is essential.
Mark Jones is programmes and fundraising director of Care for the Wild International, a UK-based conservation charity
The Green Room is a series of opinion articles on environmental topics running weekly on the BBC News website


Do you agree with Mark Jones? Are a growing number of African species facing the possibility of being eaten out of existence? Do Western nations need to do more to tackle the problem of illegal bushmeat imports? Or are there more pressing issues that are threatening global biodiversity?
I am completely agreed with Mark Jones. The bushmeat trade could eliminate all viable populations of African apes within the next 5-15 years. It is not just confined to Africa, the bushmeat trade is global phenomenon. The demand for bushmeat will continue to rise with the ever increasing populatations. Besides, people have been infected with HIV viruses from consuming primates. So, it is the time to tackle this vulnerable crisis for saving biodiversity.
Engr Salam, LGED,Bangladesh
The 'bushmeat' industry is out of hand. It also spreads to such things as unsustainable extraction of prawns from Lake St. Lucia by overseas syndicates.
Rosanne Clark, Himeville, South Africa
I quite dispute that the term "bush meat" is usually used in reference to the illegal trade of wild animals in Africa. Africa also has a significant number of game reserves to protect and serve as a sanctuary for animals in the wild. Bush meat is rather a common term amongst africans, refering to wild animals typical to some but not all those species mentioned.I would clearly attribute the phrase as wild meat specific for the purpose of consumption eg "game". However a large number are not protected species due to the fact that most of these African countries are truly faced with more pressing issues than passing legislation to protect grass cutters,antelopes including some breed of apes. Even in Africa, protection of wildlife exists prohibiting the sale and export of tigers, elephants, lions and rhino. The exploitation of these animals i have just mentioned is not neccessary for food but are widely sought for their ornamental, symbolic and medicinal value on an international large scale. we should be able to distinguish between "bush meat" and those animal species requiring protection.
Mark Adedeji, London
Yes i agree with Jones report,but what the government and the international community needs to understands is that as long as poverty keeps on increasing this hunting of endangered species will not stopt because as you already know it is a lifly hood for many families in the rural areas especially in Cameroon, Garbon, CAR, Ghana ctc. Beside that government strategy and policies to combate this activities are to weak or insufficient to meet any progress, for example in Cameroon to get a licence and to own a gun its very expensive and difficult as such the hunters or local people prefered to go underground to buy illegal guns to carry on thier illegal activities. A articipatory approach is needed were the hunters or local people are allow to take part in disscussions and meetings concerning the importance of the protection of endangered speciers and they should be given some incentives and motivation if not then give them Jobs so that they can be able to feed thier families.
Tanke Samson, Finland
A sustainable diverse ecology is of paramount importance not only for the mere survival of species but for the next generation to enjoy them as well. It is a legacy that must be preserved as a prosterity. How selfish it is to eat out animals to extintion whilst succeeding generations can only see them in photographs. The athourities should manage the life stock inventory and monitor their hunting or harvesting to curtail animal meat commercialisation.
Mr. Steven Marcial, Arima, Trinidad.
"..the trade in bushmeat, defined as meat from Africa's wild animals traded for human consumption. The term bushmeat is normally used in reference to the illegal trade." Bushmeat is simply meat from wild animals. Simples..as Aleksandr Orlov would say. The article provided a good insight and made a good read. For majority of the people though, it is still a subsistence activity.
JO, Tooting, London

The idea that the world needs to double its food production by 2050 in order to feed a growing population is wrong,

Food figures need a pinch of salt

Isobel Tomlinson
VIEWPOINT
Isobel Tomlinson

The idea that the world needs to double its food production by 2050 in order to feed a growing population is wrong, says Isobel Tomlinson from the Soil Association. In this week's Green Room, she says the misuse of data could be used to allow even greater intensification of the global agricultural industry.

Vegetables (Getty Images)
It is important that scientific research is now done to show how a better future is possible

In the last couple of years, scientists, politicians and agricultural industry representatives around the globe have been using two statistics: the need to increase global food production by 50% by 2030, and for food production to double by 2050 to meet future demand.

These figures have come to play a significant role in framing current international policy debates about the future direction of global agriculture.

These apparently scientific statistics have been dominating the policy and media discourse about food and farming, leading almost everyone to assume we need vast increases in agricultural production to feed a population of nine billion people by the middle of this century.

While ensuring an equitable and sufficient future food supply is of critical importance, many commentators are using this to justify the need for more intensive agricultural practices and, in particular, the need for further expansion of GM crops.

Cooking the books

When the Soil Association, in its report Telling Porkies, looked into the reported sources for these figures, none of the sources actually stated that global food production needs to increase by 50% by 2030, or to double by 2050.

Spider's web covered in frost
The food web is complex and tough to break down into simple soundbites

What the reports on which the claims are based do say is that certain sectors, in certain parts of the world, may have to increase food production by significant amounts.

For example, for cereals, there is a projected increase of one billion tonnes annually beyond the two billion tonnes produced in 2005.

For meat, in developing countries only (except China), the reports say that some of the growth potential (for increased per capita meat consumption) will materialise as effective demand, and their per capita consumption could double by 2050.

So this is a projected doubling of meat consumption in some developing countries - not a doubling of global food production.

Indeed, recent calculations show that the key source for the "doubling" claim - a 2006 report from the UN Food and Agriculture Organization (FAO) - implies that global food production for 2006-2050 would need to increase by around 70%, not 100%; a difference that is equivalent to the entire food production of the continent of America.

But while a re-evaluation of the veracity of the claim that food production needs to double by 2050 is to be welcomed, simply switching to the figure of 70% does not solve the problem.

Food for thought

The statistic of a 70% increase is still predicted on the same "business as usual" model as the "doubling" figure and that is problematic for several reasons:

Rice cultivation
Some region will have to produce considerably more food

First of all, the projections reflect a continuing pattern of structural change in the diets of people in developing countries with a rapid increase in livestock products (meat, milk, eggs) as a source of food calories.

However, the continuation of dietary transition in developing countries, as assumed by the modelling work, is likely to cause worsening health problems as such diets are a leading cause of non-communicable diseases including cardiovascular disease, some cancers and Type 2 diabetes.

Secondly, the data used to measure food security focuses attention on the level of agricultural production without considering access to food, distribution, and affordability which are all important in ensuring that people do not go hungry.

Thirdly, the projections assume that the developing world continues to import growing quantities of staple food stuffs when, in fact, increasing local production of staple foods is vital in ensuring food security.

Finally, according to these scientists, meeting these projected food demand targets will not solve food insecurity anyway. Indeed it is predicted that there will still be 290 million under-nourished people worldwide in 2050.

The assumptions and projections in this modelling reflect the authors' vision of the "most likely future" but not necessarily the most desirable one.

At the Soil Association, we now want to have an honest debate about how we can feed the world in 2050 in a way that doesn't lead to the further increases in obesity and diet related diseases, ensures that the global environment is protected, and that puts an end to hunger and starvation.

The misuse of the doubling statistic, based as it supposedly is on just one particular forecast of future demand for food, has prevented alternative visions of food and farming in 2050, which do not rely on the further intensification of farming and use of GM technologies, from being taken seriously in food security policy circles.

It is important that scientific research is now done to show how a better future is possible.

One recent scientific study has examined how we can feed and fuel the world sustainably, fairly and humanely. It explored the feasibility of feeding nine billion people in 2050 under different diet scenarios and agricultural systems.

The study showed that for a Western high-meat-diet to be "probably feasible" would require a combination of massive land use change, intensive livestock production and intensive use of arable land.

This would have negative impacts for animal welfare and lead to further destruction of natural habitats like rainforests.

However, the study also provides evidence "that organic agriculture can probably feed the world population of 9.2 billion in 2050, if relatively modest diets are adopted, where a low level of inequality in food distribution is required to avoid malnutrition".

Isobel Tomlinson is the policy and campaigns officer for the Soil Association, the UK's leading organic organisation

The Green Room is a series of opinion articles on environmental topics running weekly on the BBC News website


Do you agree with Isobel Tomlinson? Is it wrong to suggest that the world needs to double its food production by 2050? Will it lead to the intensification of the globe's agricultural industry? Or do we just have to accept that there is never going to be universal food security, and develop ways to help as many people has possible with the resources we have?

We have to plan infinite things to satisfy one unplanned thing i.e. Growth of human population. Either, there are 'without power' powerful leaders, who can not speak on the most basic issue or there are 'genuine' powerful leaders who are wasting their power in neutralizing the frivolous issues raised by their opposition and media. Most of the places, we are handling the results of the problem. Why do not we hit at the source? Why do not we raise the most basic issue? Why not this issue is getting importance in my own country? Not a single political leader is realizing the abnormal growth of human population.
Sanjay Singh Thakur, Indore,India

If more were done to encourage people to have fewer babies, then, whatever the statistics, less food would be needed to feed the global population.
Venetia Caine, Poitiers, France

The FAO was very quick to adjust their projection to a 70 per cent increase after the initial quote got out and most commentators adjusted accordingly long ago, so it's a bit disingenuous to extend the critique of an estimate that has already been refined and will continue to be. To quibble about how big an increase will be required diminishes the matter at stake, but of course that's the objective of the article. To sum it up: FAO has made a credible forecast; we'll never know for certain until it's all over and we certainly can't wait till then to do something about it. It's our food supply after all. Whether we need to increase production by 50 or 70 or 100 percent is not the point. What's really important is that the population of Europe and the world will continue to increase and food supplies will have to be boosted in the face of critical challenges (climate change, availability of water, environmental protection, biodiversity, distribution, affordability etc). The big question is whether we are going to increase the agricultural land base (and cut down more forests to grow food) or become more productive in a sustainable way on existing farmland. Deforestation is agriculture's single biggest contribution to greenhouse gas emissions and the destruction of biodiversity. It's a fact that organic methods require more land to grow the same amount of food (up to three times) and the crops are by far more susceptible to the pests and disease that have plagued food production throughout human history when the whole of agriculture was "organic". Organic is fine in some circumstances and not in others, but it's not the answer to the food supply challenge, which is very likely the biggest we face. It would be very helpful if every stakeholder in the agricultural and food policy community accepted this cold, hard fact as soon as possible. It's not a matter of the right or wrong ideology of farming. It's about resisting the age-old human solution to hunger which is to expand farmland. It's about efficiency and productivity, quality and affordability, and the full and rational application of science and technology to sustaining the our food supply sustainably. Phil Newton, ECPA (European Crop Protection Association)
Phil Newton, Brussels

One would hope that long before 2050 or even 2030, we in the so-called Developed World will have realised that we are eating far too much. I was born in 1969, and everyone I grew up with was slim during the 1970s and 80s. Now 1 in 3 are overweight or obese. And guess what, our calorie intake is much higher. The answer is to drop back down to a more reasonable level of personal consumption - which will also overcome many of the diseases of excess such as heart disease and tumours. Then make projections on what is likely. The fact is that, much as advertisers would like us to, we don't need to all eat a burger and chips and chocolate diet.
Andrew Smith, Milton Keynes, UK

You can't believe anything when it comes to food. We're all on a healthy eating kick now. Due to the large number of centenarians in the Mediterranean countries, we've been coerced and bullied into changing our diet. Now we find that most of these 104 year olds have been dead for decades while their families continued to claim their pensions.
Alan, UK

Food equality is the key issue. Global production of food in vegetable form is twice what is needed to feed the world's population - 4,200 calories per person per day. But it's not so unequally distributed, and much is wasted. E.g. about 40% of global food production is fed to animals not people, and the meat produced contains less than a third of the calories of the animal feed. So I think we urgently need an open debate on alternatives to "business as usual". We don't need high-tech, but we do need high-ethic.
Phil Entwistle, Beverley

Nobody should take any prediction that far into the future seriously. On the other hand, the Soil Association wants to move the world backwards in agriculture, not forwards. They and the rest of the anti-technology anti-GM comfortable middle class (i.e. rich) are part of the problem, not part of the solution.
W Boucher, Cambridge, UK

It's certainly a question of how food is produced, rather than just focusing on how much is produced. As mentioned recently on BBC News - looking at bees shows a clear indication of increasing broad scale mono-culture is unhealthy, and ultimately unsustainable. Here in Australia, there are many examples of farmers applying ecological perspectives in land management, utilising natural services and producing greater yields more "naturally".I also agree that much of the western diet and food management creates both needless health problems and excessive waste. Isobel is correct in saying that we need to "have an honest debate about how we can feed the world in 2050 in a way that doesn't lead to the further increases in obesity and diet related diseases, ensures that the global environment is protected, and that puts an end to hunger and starvation." There is great potential for improvement which should lead to greater efficiency (and ultimately reduction in cost of food, plus health related issues). However, the problem is as much social - where it's cheaper to grow (often with transport being cheap, this leads to what seems odd choices), what is culturally desired etc. Eventually you'll find that you're no longer looking at food production, but how we choose to live. Asking questions here will lead to even greater resistance. But again - real debate and discussion, based on solid evidence, is the only way forward. I also feel it premature to rule out GM as playing any role - not that I'm advocating GM over all else, but I do feel that it must play an important role in some way.
Tim Lubcke, Adelaide

I think the most important thing is to tell some countries and people stopping produce more human beings, slowing down the depletion our limited resources, recycling everthing as much as we can. Don't chase the luxury life, have a comfortable and happy life.
Caren Wang, China

I have mixed feelings,it is very essential to explore how globalization, broadly conceived to include international human rights norms, humanitarianism, and alternative trade, might influence peaceful and food secure outlooks and outcomes. It should review studies on the relationships between (1) conflict and food insecurity, (2) conflict and globalization, and (3) globalization and food insecurity. Next, it would be analyzed country level, historical contexts where export crops, such as coffee and cotton, have been implicated in triggering and perpetuating conflict. It suggest that it is not export cropping per Se, but production and trade structures and food and financial policy contexts that determine peaceful or belligerent outcomes. Export cropping appears to contribute to conflict when fluctuating prices destabilize household and national incomes and when revenues fund hostilities.
Engr Salam, LGED, Bangladesh

Stephen Hawking's argument in his new book that science can explain the Universe's origin without invoking God,

Daily View: Stephen Hawking's Universe theory

Clare Spencer | 10:01 UK time, Friday, 3 September 2010

Stephen Hawking

Commentators discuss physicist Stephen Hawking's argument in his new book that science can explain the Universe's origin without invoking God, instead arguing that the existence of gravity means the Universe can create itself from nothing.

Chief Rabbi Lord Sacks says in the Times [subscription required] that Stephen Hawking's idea is both unoriginal and that he doesn't understand that religion and science answer different questions:

"What would we do for entertainment without scientists telling us, with breathless excitement, that 'God did not create the Universe', as if they were the first to discover this astonishing proposition? Stephen Hawking is the latest, but certainly not the first. When Napoleon asked Laplace, two hundred years ago, where was God in his scientific system, the mathematician replied, Je n'ai pas besoin de cette hypothèse. 'I do not need God to explain the Universe.' We never did. That is what scientists do not understand.

"There is a difference between science and religion. Science is about explanation. Religion is about interpretation. Science takes things apart to see how they work. Religion puts things together to see what they mean. They are different intellectual enterprises."

In the New Scientist Roger Highfield dismisses the newness of the theory:

"Media furore over Stephen Hawking's new book, The Grand Design, has made it the biggest science news story of the day. But it's not like Hawking has suddenly given up a religious belief - let alone proved that God doesn't exist...

"As Hawking's long-suffering assistant dealt with a deluge of enquiries from journalists from around the world, she told me how the furore says more about the silly season than any change of mind. It also says much about how God is used to sell science to the public."

The Guardian imagines the relationship between Stephen Hawking and God:

"One accepts that if God were to choose one day to explain the universe to Hawking, the professor would be one of the few people on the planet with any serious chance of understanding the conversation. But spontaneous creation is, for most folk, just a contradiction in terms. God may or may not find all this amusing. The thing is - how to put this gently to Professor Hawking? - that God does not necessarily follow the ins and outs of our many arguments about His existence."
In the Catholic Herald Quentin de la Bedoyere argues that there is still a gap in Stephen Hawking's explanation of the creation of the Universe:

"Most particularly it would not touch the question of how something existing comes out from nothing. That is a question which science cannot answer, and will never answer, because nothingness is not within its domain. Hawking apparently does not address this question - which is the true and ultimate Theory of Everything."

In the Daily Mail John Lennox describes himself as a scientist and a Christian who teaches maths as Oxford university. He argues that Stephen Hawking is wrong to think they can't live alongside each other:

"Much of the rationale behind Hawking's argument lies in the idea that there is a deep-seated conflict between science and religion. But this is not a discord I recognise. "For me, as a Christian believer, the beauty of the scientific laws only reinforces my faith in an intelligent, divine creative force at work. The more I understand science, the more I believe in God because of my wonder at the breadth, sophistication and integrity of his creation.

"The very reason science flourished so vigorously in the 16th and 17th centuries was precisely because of the belief that the laws of nature which were then being discovered and defined reflected the influence of a divine law-giver."

In the Telegraph Graham Farmello is sceptical about the reasons behind scientists getting involved in the question of God:

"The science-religion relationship, in so far as there is one, continues to be a crowd-pleaser. It seems to be a fundamental law of PR that the God-science debate is a sure-fire source of publicity. Always welcome when one has a book to sell."

Friday, 3 September 2010

Link between bone drugs and oesophageal cancer

Link between bone drugs and oesophageal cancer

Osteoporosis The drugs work by strengthening the bones

Long-term use of bone-strengthening drugs - used to treat fractures - may boost the risk of oesophageal cancer, Oxford University research suggests.

The study of 3,000 people found taking bisphosphonates for five years upped the risk from one in 1,000 to two in 1,000 for 60 to 79-year-olds.

The researchers said the risk was small, but reliable information on risks and benefits was needed.

But experts said for many, the case for taking the drugs "would be strong".

The findings, published in the British Medical Journal, were based on an analysis of anonymised GP records.

They contrast with previous research which found no increased risk for the bone-strengthening drugs.

'Talk to doctor'

Start Quote

Anyone who is taking these drugs and is worried about their risk of cancer should talk to their doctor”

End Quote Dr Laura Bell Cancer Research UK

It is not known why the risk may be increased, although the drugs are known to irritate the oesophagus.

Thousands of stomach and colorectum cancers were also studied, but no increased risk was found.

Lead researcher Dr Jane Green said even if the findings were confirmed by other studies "few people" taking bisphosphonates would ever develop the cancer.

"Our findings are part of a wider picture. Bisphosphonates are being increasingly prescribed to prevent fracture and what is lacking is reliable information on the benefits and risks of their use in the long term."

About 600,000 people in the UK are currently taking the drugs - including a tenth of all women over the age of 70.

Dr Laura Bell, from Cancer Research UK, agreed the findings should be treated with caution, pointing out the risks were "still small".

"Anyone who is taking these drugs and is worried about their risk of cancer should talk to their doctor."

The National Osteoporosis Society said: "It is a case of balancing the reduced risk of fractures against the side effects of treatment.

"When you consider the fact that there are 230,000 osteoporotic fractures every year in the UK and 1,150 hip-fracture-related deaths every month, the case for treatment is strong."

Wednesday, 1 September 2010

If I'd proposed solving the pension problem by compulsory euthanasia for every fifth pensioner I'd have got less trouble for it

Blair's memoirs: Key quotes

Tony Blair's memoirs have been published. We will be updating this page showing some of the key quotations from the book. ELECTION NIGHT 1997

This was not a win. It was a landslide. After about two hours for a time I actually became worried. The moving line at the bottom of the TV screen was showing over a hundred Labour seats. The Tories had just six. I began to think I had done something unconstitutional.

IN POWER

On 2 May 1997, I walked into Downing Street as PM for the first time. I had never held office, not even as the most junior of junior ministers. It was my first and only job in government.

DEATH OF DIANA, PRINCESS OF WALES

Through it all, we were trying to work out how it should be managed. I know this sounds callous. I was genuinely in grief. I liked her and I felt desperately sorry for her two boys, but I also knew that this was going to be a major national, in fact global event like no other. How Britain emerged was important for the country internally and externally. I was prime minister; I had to work out how it would work out. I had to articulate what would be a tidal wave of grief and loss, in a way that was dignified but also expressed the emotion and love - not too strong a word - people felt for her.

PRIME MINISTER'S QUESTIONS

If I did seem to be enjoying it, then it was a supreme instance of acting. I hated it.

9/11 ATTACKS

At that moment, I felt eerily calm despite being naturally horrified at the devastation, and aware this was not an ordinary event but a world-changing one. It was not America alone who was the target, but all of us who shared the same values. We had to stand together.

GEORGE W BUSH

I had come to like and admire George. I was asked recently which of the political leaders I had met had the most integrity. I listed George near the top. Some people were aghast... thinking I was joking. He had genuine integrity and as much political courage as any leader I ever met. He was, in a bizarre sense... a true idealist.

IRAQ - BEREAVED FAMILIES

Do they really suppose I don't care, don't feel, don't regret with every fibre of my being the loss of those who died? To be indifferent to that would be inhuman, emotionally warped.

DEATH OF DR DAVID KELLY

I will never know precisely what made Dr David Kelly take his own life. Who can ever know the reason behind these things? It was so sad, unnecessary and terrible.

ON WIFE CHERIE

She was a rock to me, strong when I was weak, determined when I was tempted to falter, and fierce in her defence of the family.

ON DRINKING

By the standards of days gone by I was not even remotely a toper, and I couldn't do lunchtime drinking except on Christmas Day, but if you took the thing everyone always lies about - units per week - I was definitely at the outer limit. Stiff whisky or G&T before dinner, couple of glasses of wine or even half a bottle with it. So not excessively excessive. I had a limit. But I was aware that it had become a prop.

ROWS WITH GORDON BROWN

I'm afraid I stopped taking his calls. Poor Jon [an adviser] would come in and say: "The chancellor really wants to speak to you." I would say: "I am really busy, Jon." And he would say: "He is really demanding it." Then I would say: 'I'll call him soon." And Jon would say: "Do you really mean that, prime minister?" And I would say: "No, Jon."

ON GORDON BROWN'S FOLLOWERS

The curse of Gordon was to make these people co-conspirators, not free-range thinkers. He and Ed Balls and others were like I had been back in the 1980s, until slowly the scales fell from my eyes and I realised it was more like a cult than a kirk.

THE FINANCIAL CRISIS

I profoundly disagree with important parts of the statist, so-called Keynesian response to the economic crisis; I believe we should be projecting strength and determination abroad, not weakness or uncertainty.

DAVID CAMERON

David Cameron was clever and people-friendly but he had not gone through the arduous but ultimately highly educative apprenticeship I had gone through in the 1980s and early 90s.

ED BALLS

I've had some harsh things to say about Ed Balls - I thought he behaved badly at points, and was wrong on policy - but I also thought he was really able, and a talent that any political party should be grateful to have.

FOX HUNTING BAN

If I'd proposed solving the pension problem by compulsory euthanasia for every fifth pensioner I'd have got less trouble for it.

IAN PAISLEY AND NORTHERN IRELAND PEACE DEAL

Once, near the end, he asked me whether I thought God wanted him to make the deal that would seal the peace process. I wanted to say yes, but I hesitated; though I was sure God would want peace, God is not a negotiator.

Friday, 27 August 2010

Nine Primary Care Trusts have agreed a contract with NHS SBS - a partnership of the Department of Health and IT firm Steria - with some work going to

NHS records move in East Midlands sees some 90 jobs cut

Cancer screening NHS bosses have insisted information such as cancer screening correspondence will not go abroad

NHS patient record services in the East Midlands are being outsourced, with the loss of about 90 jobs.


Health officials said the move will save up to £9m over six years and will not impact on patient care.

But unions said staff had been "sold out" and having some tasks sent to India risked vital information.

The move will see payment processing, cervical and breast cancer screening correspondence, medical records and patient registration done by the new firm.

Clinical data

NHS staff have been told the current workforce of about 150 will be reduced to 65, based at offices in Leicester and Derby .

Officials insisted sensitive information would not be sent abroad.

Andrew Booth, of NHS Derby City, said: "There are some services which are being provided from India but the majority of services will be located in this country.

"No clinical data will be in India, it is all based in servers here.

"From an information governance side, for accessing data there, which I know has been a concern, actually the Indian operation has been independently validated as being as good as, if not better, than in this country."

Privatisation fear

But Scott Kingswood, from Unison, said: "There could be hiccups in transfer of information, data protection.

"But the crux of it, despite all that, is that the job still exists, the people who are currently doing those jobs are being told those jobs are no longer theirs and having it taken away from them.

"In my book that is privatisation of the NHS and staff who have spent many years working for the NHS are feeling let down and sold out."

The reorganisation is due to be completed by the summer of 2011.

The nine Primary Care Trusts involved are NHS Bassetlaw, NHS Derby City, NHS Derbyshire County, NHS Leicester City, NHS Leicestershire County and Rutland, NHS Lincolnshire, NHS Northamptonshire, NHS Nottingham City and NHS Nottinghamshire County.

the 6km-long (3.75-mile) long dam will threaten the survival of indigenous groups,

Brazil government gives go-ahead for huge Amazon dam

Indigenous people campaign against the construction of the Belo Monte dam in Brasilia (26 August 2010) The proposal to build a dam on the Xingu river has long been a source of controversy

Brazil's government has given the formal go-ahead for the building on a tributary of the Amazon of the world's third biggest hydroelectric dam.

After several failed legal challenges, President Luiz Inacio Lula da Silva signed the contract for the Belo Monte dam with the Norte Energia consortium.

Critics say the project will damage the local ecosystem and make homeless 50,000 mainly indigenous people.

But the government says it is crucial for development and will create jobs.

Bidding for the project had to be halted three times before a final court appeal by the government allowed Norte Energia, led by the state-owned Companhia Hidro Eletrica do Sao Francisco, to be awarded the contract.

Start Quote

Luiz Inacio Lula da Silva (26 August 2010)

We will persuade them that we took seriously into account the environmental and social issues”

End Quote Luiz Inacio Lula da Silva Brazilian president
'Death warrant'

At the contract signing ceremony in Brasilia on Thursday, President Lula said he himself had criticised the dam before he learnt more about it.

"You cannot imagine how many times I spoke against Belo Monte without even knowing what it was about, and it is precisely during my government that Belo Monte is being unveiled," he said.

"I think this is a victory for Brazil's energy sector.

"We will persuade them that we took seriously into account the environmental and social issues," he added.

The proposal to build a hydro-electric dam on the Xingu river, a tributary of the Amazon in the northern state of Para, has long been a source of controversy.

The initial project was abandoned in the 1990s amid widespread protests both in Brazil and around the world.

Environmental groups say and the lives of up to 50,000 people could be affected as 500 sq km (190 sq miles) of land would be flooded.

Map showing Belo Monte dam proposals

Officials have dismissed the criticism and promised the winning consortium will pay $800m to protect the environment.

"The government has signed a death warrant for the Xingu river and condemned thousands of residents to expulsion," local Indian leaders said on Thursday.

The 11,000 MW dam would be third largest in the world, after the Three Gorges in China and Itaipu, which is jointly run by Brazil and Paraguay.

It is expected to cost between $11bn and $17bn, and provide electricity to 23 million homes.

With Brazil's economy continuing to show signs of growth, ministers say hydro-electric plants are a vital way to ensure power supplies over the next decade - and at least 70 dams are said to be planned for the Amazon region.

Critics say the Belo Monte plant will be hugely inefficient, generating less than 10% of its capacity during the three to four months of the year when water levels are low.

Thursday, 26 August 2010

Broccoli 'boosts' healthy gut



Broccoli is high in vitamins and minerals
Extracts of broccoli and banana may help in fighting stomach problems, research suggests.
Laboratory studies show fibres from the vegetables may boost the body's natural defences against stomach infections.
BroccoliTrials are under way to see if they could be used as a medical food for patients with Crohn's disease.
Crohn's disease is an inflammatory bowel disease that causes symptoms such as diarrhoea and abdominal pain.
It affects about 1 in 1,000 people, and is thought to be caused by a mixture of environmental and genetic factors.
The condition is common in developed countries, where diets are often low in fibre and high in processed food.
Scientists at the University of Liverpool looked at how roughage from vegetables influenced the passage of harmful bacteria through cells inside the gut.
They found that fibres from the plantain, a type of large banana, and broccoli, were particularly beneficial. But a common stabiliser added to processed foods during the manufacturing process had the opposite effect.
Dr Barry Campbell, from the University of Liverpool, said: "This research shows that different dietary components can have powerful effects on the movement of bacteria through the bowel.
"We have known for some time the general health benefits of eating plantain and broccoli, which are both high in vitamins and minerals, but until now we have not understood how they can boost the body's natural defences against infection common in Crohn's patients.
"Our work suggests that it might be important for patients with this condition to eat healthily and limit their intake of processed foods."
M-cells
The research, published in the journal Gut, and carried out in collaboration with experts in Sweden and Scotland, investigated special cells, called M-cells, which line the gut and ward off invading bacteria.
Work was carried out in laboratory-grown cells and tissue samples from patients undergoing surgery for stomach problems.
Clinical trials are now underway in 76 Crohn's patients to find out whether a medical food containing plantain fibres could help keep the disease at bay.
"It may be that it makes sense for sufferers of Crohn's to take supplements of these fibres to help prevent relapse," said Professor Jon Rhodes of the University of Liverpool.
Commenting on the study, a spokesperson for Crohn's and Colitis, which represents patients with inflammatory bowel disorders, welcomed further insight into how the gut combats bacteria like E.Coli.
"Knowledge of the M-cell role offers a more detailed explanation as to why a healthy diet can improve the health and well being for people with Crohn's disease and healthy individuals alike," she said

Religion may influence doctors' end-of-life care

Religion may influence doctors' end-of-life care


Guidelines stress doctors should discuss treatment with their patients
Doctors with religious beliefs are less likely to take decisions which could hasten the death of those who are terminally ill, a study suggests.
The survey of nearly 4,000 doctors found those with a strong faith were also less likely to discuss end-of-life treatment options with their patient.
The London University research urges greater acknowledgement of how beliefs influence care.
HandsDoctors and campaigners described the findings as "concerning".
Dr Clive Seale of Barts and the London School of Medicine analysed 3,733 responses from doctors practising in a wide variety of fields, with a particular focus on those who worked in palliative care and with the elderly.
The General Medical Council, which regulates the profession, says that while doctors should start from the assumption that life should be prolonged, this should not be at any cost.
While it is illegal to give drugs with the deliberate intention of ending someone's life, doctors may administer morphine or other medication to relieve pain or distress which may have the effect of shortening life - so-called deep sedation.
The GMC also advises that discussions surrounding end-of-life care, including issues such as tube-feeding, hydration and resuscitation, which can all cause avoidable distress, be started with those who are terminally ill well in advance of their dying days.
Patient communication
Those who described themselves as very or extremely non-religious were about 40% more likely to sedate than religious doctors, the study in the Journal of Medical Ethics reported.


Whilst entitled to their beliefs, doctors should not let them come in the way of providing patient-centred care at the end of life”
End Quote Dr Ann McPherson Dignity in Dying
Being very or extremely religious was also associated with significantly fewer discussions of decisions with patients around treatment at the end of life.
More than 12% of the doctors surveyed described themselves as very or extremely religious, compared with just over 6% of the UK general population - as documented in the last national survey of attitudes.
However one in five described themselves as very or extremely non-religious, slightly higher than the general population.
The UK medical population differs in ethnic profile from the population as a whole, with a higher proportion of doctors from South Asian backgrounds.
The survey showed that specialists in the care of the elderly were more likely to be Hindu or Muslim than other doctors, while palliative care doctors were slightly more likely to be white and Christian.
The British Medical Association said: "Decisions about end-of-life care need to be taken on the basis of an assessment of the individual patient's circumstances - incorporating discussions with the patient and close family members where possible and appropriate.
"The religious beliefs of doctors should not be allowed to influence objective, patient-centred decision-making. End-of-life decisions must always be made in the best interests of patients."
Deeply troubling
Professor Mayur Lakhani, chair of the National Council for Palliative Care, said he was concerned by the findings of the paper.
"Core training in palliative care should be mandatory for all doctors to ensure consistency of decision-making, based on best practice and current evidence.
"Decisions must be taken in partnership with people approaching the end of life and those close to them.
Dr Ann McPherson of the charity Dignity in Dying added that while there was growing awareness of the need to put patients' wishes first, the research indicated there was "still some way to go".
"The fact that some doctors are not discussing possible options at the end of life with their patients on account of their religious beliefs is deeply troubling.
"Whilst entitled to their beliefs, doctors should not let them come in the way of providing patient-centred care at the end of life."
David Praill, chief executive of Help the Hospices said the findings highlighted "the maze of complex moral and legal dilemmas that doctors can face when caring for patients at the end of life".
"Doctors need support to ensure that they have the information, skills and confidence necessary to make the best end of life care decisions with their patients."

Tuesday, 24 August 2010

Venezuelan village key in search for Huntington's cure

Venezuelan village key in search for Huntington's cure

The village of Barranquitas in Venezuela has the highest concentration of Huntington's disease, a devastating brain condition, in the world. The BBC's Will Grant accompanies a US scientist there as she continues her life's work to find a cure.

Nancy Wexler (right) hugs her old friend Angela in Barranquitas Dr Nancy Wexler has been coming to Barranquitas for many years

Angela staggers across Barranquitas under the blistering sun to reach the children's lunch hall, her matchstick-thin legs struggling to support her frail frame.

Although it is a small village, it is hard work crossing it when your limbs won't do what you tell them to.

But Angela is determined to make the effort because an old friend has just arrived.

HUNTINGTON'S DISEASE

  • Hereditary neurological disorder
  • Causes progressive degeneration of cells in brain
  • Slowly impairs ability to walk, talk, think, or reason
  • Symptoms usually appear between age 30 and 50
  • Person has 50% change of inheriting the gene if a parent has HD
  • No cure to date

That friend, American scientist Nancy Wexler, has been travelling to Barranquitas for more than 30 years.

She is sure it holds the key to an answer she has been looking for her entire adult life: a cure for Huntington's disease (HD).

For Dr Wexler this is more than an academic pursuit or a career goal, it's a family obsession.

"My mother died of Huntington's and she was a scientist. My father was a scientist too, and so we said 'let's find a cure','" said Dr Wexler.

"And we still say that. You can't get up in the morning without having hope and confidence that the cure is just around the corner."

As the daughter of an HD sufferer, she has a one-in-two chance of carrying the fatal genetic flaw herself.

Huntington's is an incurable and fatal hereditary disease which causes the sufferer to lose control of their muscles.

Click to play

Nancy Wexler explains what motivated her to seek a cure

It develops into serious problems with swallowing and many patients die from choking or malnutrition. Beyond the physical symptoms, deep depression can often take hold.

It affects 1 in 10,000 people, but in Barranquitas, a remote location where over the years there has been much inter-marrying between few families, the rate is more like 1 in 10.

Some 1,000 villagers already have fully-blown Huntington's; many more carry the gene.

Such a high concentration of Huntington's patients made it the backbone of Dr Wexler's research.

Her research in Venezuela was crucial for the breakthrough in 1993 when the abnormality that causes HD was identified: a single defective gene on chromosome 4.

map

Ciro Soto is one of the villagers whose DNA and family history helped that discovery.

Dr Wexler met Mr Soto when he was just eight years old. Now almost 40, his body twitches uncontrollably from the disease.

"Ciro was a wonderful drummer, very athletic, a beautiful fisherman," said Dr Wexler.

"Both of Ciro's parents had Huntington's," she explained. "There were 14 siblings and 10... have Huntington's. Some of them have unfortunately already died of the disease."

Tough life

Despite the breakthrough, the team had not been back to Venezuela since 2002 given the strained ties between the Bush administration and President Hugo Chavez.

There is still no formal protocol with the Venezuelan government for removing the DNA samples Dr Wexler needs.

But in a positive development, the Venezuelan Health Ministry sent a representative to Barranquitas to meet her.

"I think Dr Wexler's persistence has been admirable," said Dr Federico Savinon.

Nancy Wexler comforting a patient in Casa Hogar Casa Hogar is a care home looking after some 50 people

While acknowledging there been some "difficulties in working together", Dr Savinon said that "the ministry and the health minister herself, Col Eugenia Sader, are completely disposed to reopening a space for joint work with Dr Wexler".

However, Dr Wexler and the people of Barranquitas have heard such promises before.

Successive health ministers have voiced support for the research, but the New York-based team are yet to see any serious progress on the signing of the protocol for the research.

Life in Barranquitas is tough. The government has provided new housing for some families, including Ciro's.

But most Huntington's sufferers still live in deep poverty while simultaneously trying to deal with the fatal illness.

In 1999, Dr Wexler co-founded a care home for HD patients outside the state capital, Maracaibo.

Built on the site of the "roughest bar in town", the Casa Hogar is a haven for more than 50 people whose families can no longer cope.

Everyone who works there has relatives with Huntington's sufferers. Many of them don't know if one day they may develop the disease too.

Nancy Wexler holds a child in Barranquitas - archive photo from the 1980s Dr Wexler's long association with Barranquitas gives her hope

The Casa Hogar is facing a chronic lack of funding, possibly even closure. Still, Dr Wexler remains confident that one day it won't be needed.

"We never know when some miraculous discovery is going to be made," she said.

"There are science breakthroughs on the horizon and happening now so I am very hopeful about the cure in the near future."

When Angela made it to the lunch-hall, she was greeted with a huge hug by Dr Wexler.

Despite the setbacks, Dr Wexler is optimistic that Angela's grandson, who is also at risk of the disease, will have more of a chance at a cure than she did

Saturday, 21 August 2010

NHS spends more than £300m on consultancy services

Computer keyboard IT, project management and human resources were included in the consultancy bill

NHS trusts in England spent more than £300m on external consultancy services last year, figures show.

The money was used to pay for advice on a range of issues, from legal contracts to human resources and media work.

The NHS Confederation, which represents trusts, says taxpayers' money should not be wasted but that outside help was often needed to deliver reform.

The figure represents less than half of 1% of the NHS budget but the health secretary described it as "staggering".

Overall, primary care trusts (PCTs) and strategic health authorities (SHAs) spent £313.9m on consultancy services in the financial year 2009/2010.

Pounds and pence

London areas spent nearly three times more per head on consultancy services than any other part of the country.

Camden PCT spent more than £12m, in excess of £50 per head of the local population, although they stressed much of this was down to a large spend on a body providing support to help achieve value for money and efficiency in commissioning services.

In contrast, Bournemouth and Poole PCT spent just 20p per head.

The government's health White Paper, released last month, includes measures to abolish SHAs and PCTs and replace them with GP-led consortiums.

Start Quote

There are currently more managers within the NHS than at any point in its history, so why are SHAs and PCTs buying in additional expertise?”

End Quote Royal College of Nursing

Health Secretary Andrew Lansley said he was "staggered by the scale of the expenditure", adding that he had asked PCTs and SHAs to reduce their management costs by 46% over the next four years.

"This will root out unnecessary bureaucracy and any expensive duplication of functions," he said. "Every penny saved will be re-invested in improving patient care, meeting demand and driving up quality."

Nigel Edwards, acting chief executive of the NHS Confederation, said: "Any spending of taxpayers' money has to be justified, and the NHS has been asked by successive governments to perform tasks for which internal expertise was not present or needed to be developed. Dismissing all this spending as wasteful is unfounded."

He added that the proposed overhaul would likely increase the need for consultants' services.

"External advice will be necessary if NHS organisations are to deliver change and, with the financial challenges and size of the current reform programme, it is probable NHS organisations, especially new GP consortia, will require external help to deliver what the government wants," he said.

But the Royal College of Nursing described the figures as "shocking and nothing short of a scandal".

"It is extremely difficult to see how spending more than £313m on consultancy services in one year can be justified. There are currently more managers within the NHS than at any point in its history, so why are SHAs and PCTs buying in additional expertise?" said its chief executive Dr Peter Carter.

"At a time when nurses and other staff are seeing front line services cut and being asked to accept a pay freeze, these organisations need to clearly demonstrate they are getting good value for money from the taxpayer's health pounds."

Shadow health secretary Andy Burnham said: "We were already acting to bring consultancy spend down by one-third but Mr Lansley's reforms will give consultancy firms a field day.

"What he seems not to understand is the NHS needs good managers. By wiping away the expertise currently in primary care trusts, he is opening the door to consultancy firms who know that hundreds of new, untested GP groups won't have the experience to go it alone."

This is the first time the figures have been collected in this way. Estimates published by the Conservatives in 2006 suggested trusts had spent £172m on external advice that year

Friday, 20 August 2010

Green leafy veg 'may cut diabetes risk

Green leafy veg 'may cut diabetes risk'

Green leafy veg Green leafy veg, rather than a healthy diet in general, were linked to benefits

A diet rich in green leafy vegetables may reduce the risk of developing diabetes, UK research says.

In an analysis of six studies into fruit and vegetable intake, only food including spinach and cabbage was found to have a significant positive effect.

A portion and a half a day was found to cut type 2 diabetes risk by 14%, the British Medical Journal (BMJ) reports.

But experts urged people to continue to aim for five portions of fruit and vegetables a day.

Start Quote

This study suggests that green leafy vegetables seem to be particularly important in terms of preventing diabetes”

End Quote Professor Melanie Davies University of Leicester

The researchers from Leicester University reviewed data from the studies of 220,000 adults in total.

They found that eating more fruit and vegetables in general was not strongly linked with a smaller chance of developing type 2 diabetes but "there was a general trend in that direction".

Yet when it came to green leafy vegetables, which the researchers said also includes broccoli and cauliflower, the risk reduction was significant.

The team calculated that a daily dose of 106g reduced the risk of diabetes by 14% - a UK "portion" is classed as 80g.

It is not clear why green leafy vegetables may have a protective effect but one reason may be they are high in antioxidants, such as vitamin C and another theory is that they contain high levels of magnesium.

Study leader Professor Melanie Davies, professor of diabetic medicine at the University of Leicester, said the message to eat five portions of fruit and vegetables a day remains an important one.

But she added: "People like very specific health messages.

"We know that intake of fruit and vegetables is important, but this study suggests that green leafy vegetables seem to be particularly important in terms of preventing diabetes."

The team are now planning a study in people at high risk of developing the condition to see if increasing their intake of vegetables like spinach and kale can help to reduce their chances of being diagnosed with diabetes.

Fruit and veg

In 2008/09, the National Diet Nutrition Survey showed that, although fruit and vegetable intake has risen over the past decade, only a third of men and women eat the recommended five-a-day.

In an accompanying editorial in the BMJ, Professor Jim Mann from the University of Otago in New Zealand, stressed that the message of increasing overall fruit and vegetable intake must not be lost "in a plethora of magic bullets," even though green leafy vegetables clearly can be included as one of the daily portions.

Dr Iain Frame, director of research at Diabetes UK said: "We already know that the health benefits of eating vegetables are far-reaching but this is the first time that there has been a suggested link specifically between green leafy vegetables and a reduced risk of developing type 2 diabetes."

But he warned the evidence was limited and it was too early to isolate green leafy vegetables and present them alone as a method to cut the chances of developing the condition.

"We would be concerned if focusing on certain foods detracted from the advice to eat five portions of fruits and vegetables a day, which has benefits in terms of reducing heart disease, stroke, some cancers and obesity as well as type 2 diabetes."

Diabetes UK is currently funding research into whether fermentable carbohydrates found in foods such as asparagus, garlic, chicory and Jerusalem artichokes could help weight loss and prevent Type 2 diabetes.

Wednesday, 18 August 2010

Dark chocolate can be good for the heart,

Dark chocolate can be good for the heart, study says

Dark chocolate Higher cocoa content in the chocolate is associated with greater heart benefits

Older women who eat dark chocolate once or twice a week could be lowering their risk of heart failure, says a US study.

It found those eating chocolate once or twice a week cut the risk of developing heart failure by a third, but those eating it every day did not benefit.

The Boston study, in a journal of the American Heart Association, looked at nearly 32,000 Swedish women aged between 48 and 83 over nine years.

Dieticians say eating chocolate too often can be damaging and unhealthy.

The study notes that one or two 19 to 30 gram servings of dark chocolate a week led to a 32% reduction in heart failure risk.

This fell to 26% when one to three servings a month were eaten.

But those who ate chocolate every day did not appear to reduce their risk of heart failure at all.

Start Quote

Whilst antioxidants in chocolate may be helpful to your heart, they can also be found in fruit and veg - foods which don't come with the saturated fat and high calories”

End Quote Victoria Taylor British Heart Foundation

The researchers conclude the protective effect of eating chocolate reduces as more or less is eaten than the optimum one to two servings a week.

'Flavanoids'

Too much chocolate is unhealthy because it contains high levels of sugar and fat which can make people put on weight, the researchers say.

But chocolate also contains high concentration of compounds called flavonoids which can lower blood pressure and protect against heart disease, previous studies have found.

The researchers behind this study say this is the first time long-term effects related specifically to heart failure have been shown.

Dr Murray Mittleman is study leader and director of the Cardiovascular Epidemiology Research Unit at the Beth Israel Deaconess Medical Centre in Boston.

He said: "You can't ignore that chocolate is a relatively calorie-dense food and large amounts of habitual consumption is going to raise your risks for weight gain.

"But if you're going to have a treat, dark chocolate is probably a good choice, as long as it's in moderation," Dr Mittleman said.

Cocoa content

Differences in chocolate quality will affect the study's implications, the authors say. Higher cocoa content is associated with greater heart benefits.

Although the chocolate consumed by the Swedish women in the study was milk chocolate, it contained a high concentration of cocoa solids - about 30%.

This is equivalent to dark chocolate by UK standards.

Dark chocolate can contain as much as 75% cocoa while standard milk chocolate may have 25% or less cocoa.

Victoria Taylor, senior dietitian at the British Heart Foundation, said the study showed the importance of finding the right balance in our diets.

"Before you rip open those sweet treats, remember that whilst antioxidants in chocolate may be helpful to your heart, they can also be found in fruit and veg - foods which don't come with the saturated fat and high calories that chocolate does," she said.

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