Wednesday, 23 November 2011

care for the elderly in their own homes in England is so bad



Basic home care help 'breaching human rights'


Elderly personMinisters have already promised they will be revamping social care

Related Stories

Basic care for the elderly in their own homes in England is so bad it breaches human rights at times, an inquiry says.
The home care review by the Equality and Human Rights Commission highlighted cases of physical abuse, theft, neglect and disregard for privacy and dignity.
It said on many occasions support for tasks such as washing and dressing was "dehumanising" and left people "stripped of self-worth".
The findings have added weight to calls for a complete overhaul of the system.
Campaigners described the situation as "shameful", while councils, which are in charge of providing such services, said without urgent reform services would just get worse.
There are currently nearly 500,000 people who are getting council-funded support in their own homes.
The home care review said about half of people who had given evidence reported real satisfaction with care, but a number of common complaints were made by others. These included:

'Pushed me back'

The physical abuse reported was most often in the form of rough handling or unnecessary physical force.
A 78-year-old woman who lives alone told the commission about her treatment.
She said: "Most of the girls [from the agency] were nasty. They were rough. Rather than say 'Sit in the chair', they'd push me back into the chair, that sort of thing, and I didn't like that.
"I couldn't do anything about it. I can't even walk and I think they know this, you see. They know you're vulnerable."
  • Older people not being given enough support to eat and drink, with some staff arguing health and safety restrictions prevented them preparing hot meals
  • Neglect because care workers stick rigidly to their tasks, such as a case when a woman was left stuck on the toilet because staff were too busy
  • Financial abuse, including money being systematically stolen over a period of time
  • Chronic disregard for privacy and dignity, such as leaving people unwashed and putting them to bed in the afternoon
  • Patronising behaviour, with cases highlighted including staff talking on mobile phones while they tended to clients
  • Physical abuse involving pushing and rough handling
The commission said such problems could be said to be in breach of various parts of the European Convention on Human Rights.
Ann Reid says one of her husband's carers refused to help him go to the toilet, because he was reading the newspaper
In particular, it highlighted article eight, which guarantees respect for dignity and personal autonomy, article three, which covers the prohibition of inhuman and degrading treatment, and article two, governing the right to life.
To rectify the situation, the Equality and Human Rights Commission (EHRC) said the law needed extending to clear up a potential loophole.
Councils are already covered by the Human Rights Act, but as they buy most home care services from the voluntary and private sector, it remains unclear how well protected the elderly are.

Ignoring pleas for help

A number of people complained that services were inflexible with staff keeping rigidly to set tasks. Taken to the extreme, this can result in serious situations being ignored.
A council officer recounted a case where one woman's pleas for help were ignored by her carer.
"I had a lady who was on the toilet when the carer came. She shouted 'I'm stuck, I need some help'. The carer shouted up: 'Can't do that, but I've made you a butty and I'm going now.'"
The commission also called on councils to ensure they balanced quality of service with price when tendering for services.
But it made clear that part of the problem was a basic lack of compassion and common sense among staff, pointing out simple measures such as staff covering someone with a towel while washing them could make all the difference.
Age discrimination was also highlighted as a significant barrier as older people were getting less money towards their care than younger people with similar problems.
But the commission suggested the prospects for the future looked bleak as one in three councils had already cut back on home care spending while a further one in five were planning to.
'Simply unacceptable'
EHRC commissioner Baroness Sally Greengross, who led the report, said it was time home care provided by councils was encompassed by the Human Rights Act.

"And one of the ways to stop it continuing is to close the loophole, which means that any care that's commissioned by a local authority or another public body should come under the Human Rights Act so people are protected from abuse.
She told BBC Radio 4's Today programme: "Two messages came out loud and clear. This poor care mustn't continue.
Linda Stephens, whose mother suffered from dementia and had home care, and who also worked as a carer herself, told the BBC there had been a lack of understanding of people and their needs.
She said: "Although I gave them quite an in-depth idea of what care was needed for mum - a lot of it would have been prompting and support - but unfortunately because of time restraints on them they were task orientated."

Left to heat own meals

One of the common complaints was a lack of help the elderly were given eating and drinking.
The report highlighted cases where people unable to feed themselves were given no help or where uneaten meals were left for days.
In one incident a carer watched as a 76-year-old cancer patient struggled from her lounge to her kitchen to microwave her meal because the worker argued they could not help because of health and safety.
The woman's daughter said: "It is hard to think of a reason or excuse big enough adequately to cover such a fundamental lack of care from one adult to another."
Michelle Mitchell, charity director at Age UK, described the findings as "shameful".
"It is simply unacceptable that care in people's own homes, where they can be at their most vulnerable, is often inadequate, disrespectful and lacking in dignity."
Ministers have already promised the whole social care system - including care homes as well as help at home - will be looked at, with initial plans expected to be published in the spring.
This comes after a recent government-commissioned review recommended costs - the system is means-tested - be capped, while the regulator has promised to toughen its inspections of home care providers.
But councils pointed out such promises have been being made for over a decade.
Councillor John Merry, of the Local Government Association, said: "These results are symptomatic of a social care system that is under-funded and in need of urgent reform. The longer ministers procrastinate, the more our population ages and the worse things will become.

Tuesday, 22 November 2011

a very premature baby who died after contracting ESBL E. coli at the city's Singleton Hospital.




Singleton Hospital, where a premature baby has died from suspected E.coli
Singleton Hospital, where a premature baby has died from suspected E.coli
A premature baby has died after contracting a form of E.coli while on the neonatal unit at Singleton Hospital, in Swansea.
Hope Erin Evans died aged just five days after being born "very premature" and contracting the the ESBL strain of E.coli.
Another baby has died and another three people are ill after an outbreak of the same antibiotic-resistant form of the infection.
Health officials were yesterday investigating the five cases which include baby Hope and a new mother in a maternity ward.
The second death happened "in the community" outside the hospital but health chiefs believe the cases were linked.
Doctors are investigating how the cross-infection happened between the two dead babies - the second child wasn't being named.
Admissions to the neonatal unit have now been restricted as a "precaution" to babies born at 36 weeks gestation or more.
Hope was born in the hospital on October 31 but was never taken home by her parents after contracting the illness.
An inquest has been opened. Her father Jonathan gave evidence that she died on November 4 in the hospital.
A hospital spokesman said: "ESBL E.coli is most often found in the gastrointestinal tract but may cause urinary tract infections.
"It is resistant to commonly used antibiotics such as penicillins, but can be treated."
Dr Bruce Ferguson, medical director of Abertawe Bro Morgannwg University Health Board, which runs Singleton Hospital, said: "ABM University Health Board, supported by Public Health Wales, is investigating two cases of ESBL E.coli cross infection in the maternity-neonatal unit at Singleton Hospital.
"Tests have confirmed that in one of these cases the ESBL E.coli infection was contracted in the hospital.
"Sadly, this was a very premature baby who, despite the best efforts of staff, later died. The cause of death of this baby is currently being investigated by the coroner.
"Everyone involved with the unit and in the care of this baby deeply regret this tragic loss."
The second case is understood to involve a mother who tested positive for ESBL E.coli but who has not shown any symptoms and has not required treatment.
It is thought the woman also contracted the infection while in hospital.
These two cases, which are being investigated, are linked to three other confirmed cases of ESBL E.coli where the infection was contracted outside hospital.
Another young baby who contracted the infection also died.
Dr Ferguson said: "These appear to be isolated incidents, which have been contained, and there is no evidence of the infection spreading further.
"Checks have been taken of patients, equipment and areas in the maternity-neonatal unit and no evidence of ESBL E.coli has been found.
"The unit has an excellent record for hand-hygiene and general infection control adherence. Reported infection levels in the unit have been below the national average in recent years.
"Nevertheless we have taken extra precautions. For example, the obstetric theatres have undergone a deep clean and cleaning has been increased in the neonatal and labour wards.
"As a precaution, we have temporarily restricted the neonatal unit to admissions for babies of 36-weeks and over gestation. This is under constant review and we anticipate lifting this restriction shortly.
"All routine full-term births are continuing at the Singleton maternity unit as normal.
"We would like to reassure expectant mothers due to give birth in Singleton Hospital that the maternity unit is open as usual for full-term births.
"However, any mothers-to-be who have concerns or questions should speak to their community midwife in the first place."
Extended-Spectrum Beta-Lactamases (ESBLs) are enzymes which can be produced by bacteria making them resistant to antibiotics widely-used in many hospitals.
A new class of ESBLs have emerged and been detected in E.coli bacteria. ESBL-producing E.coli are resistant to penicillin and cephalosporin antibiotics.
A helpline has been set up for women who are due to give birth at Singleton Hospital and are concerned. It can be contacted on 07747 615 627.


Read More http://www.walesonline.co.uk/news/wales-news/2011/11/22/two-babies-die-after-contracting-new-strain-of-e-coli-at-singleton-hospital-91466-29821677/#ixzz1eStLkH13

Two babies die, three other E. coli cases in Swansea


Singleton HospitalSingleton Hospital's maternity unit is still open for full-term births
Two babies have died after an E. coli infection, health officials in Swansea have confirmed.
One was a very premature baby who died after contracting ESBL E. coli at the city's Singleton Hospital.
The other baby died in the community but doctors say the cases were linked. How the cross-infection occurred is being investigated.
As a precaution the unit, which has undergone a deep clean, is only open for full-term births.
An inquest has been opened and adjourned into the death of one of the babies, Hope Erin Evans from Aberdare, south Wales, who was just five days old when she died at the hospital on 4 November.
'Tragic loss'
Three other non-fatal cases have been confirmed but Abertawe Bro Morgannwg (ABM) University Health Board said they appeared to be isolated incidents.
The board's medical director Dr Bruce Ferguson said: "Tests have confirmed that in one of these cases the ESBL E.coli infection was contracted in the hospital.

What is ESBL E. coli?

  • ESBL E. coli is not the same as the E.coli O157 which causes food poisoning
  • ESBL stands for Extended Spectrum Beta Lactamose
  • ESBL E. coli is most often found in the gastrointestinal tract but may cause urinary tract infections
  • ESBL E. coli is resistant to commonly-used antibiotics such as penicillin, but can be treated
  • In most people ESBL E. coli does not cause harm but in vulnerable individuals it can cause serious infections
  • Source: ABM health board
"Sadly, this was a very premature baby who, despite the best efforts of staff, later died.
"The cause of death of this baby is currently being investigated by the coroner. Everyone involved with the unit and in the care of this baby deeply regret this tragic loss."
The other baby contracted the infection outside the hospital.
Dr Ferguson reassured expectant mothers due to give birth in Singleton Hospital that the maternity unit is open as usual for full-term births.
As a precaution, the health board has temporarily restricted the neonatal unit to admissions for babies of 36 weeks gestation, or longer.
"These appear to be isolated incidents which have been contained, and there is no evidence of the infection spreading further," Dr Ferguson added.
"Checks have been taken of patients, equipment and areas in the maternity/neonatal unit and no evidence of ESBL E. coli has been found.
"Very saddened"
"The unit has an excellent record for hand-hygiene and general infection control adherence. Reported infection levels in the unit have been below the national average in recent years."

Analysis

The investigation into these cases will concentrate on the history of contact between all five people involved.
This means looking at any links they have in the community as well as what happened at Singleton Hospital.
It will be vital to establish whether any of the regular infection control measures used in neonatal units have been breached.
This was the suspicion in the last major outbreak of ESBL e.coli in 2008 at Luton and Dunstable Hospital.
An official report concluded that the bacteria there spread via the hands of staff or shared equipment, although no definitive evidence was found.
Managers in Swansea have already stressed their 'excellent record for hand-hygiene and general infection control'. They will need to be sure that every possible precaution was taken.
Microbiologist Prof Hugh Pennington told BBC Radio Wales ESBL E. coli caused problems for young babies because their immune systems were not well-developed.
"These bugs . . . are really quite good at getting about and once they get into something like a neonatal unit, history tells us with other related bugs they can be really quite difficult to eradicate.
"I'm sure that the people at Singleton are doing their utmost to make sure that there aren't any problems.
"They have restricted admission to the very young babies because they are the ones really at risk from this particular nasty bug. It's a very reasonable approach to take."
Health Minister Lesley Griffiths said she was "very saddened" to hear of the two deaths.
Conservative health spokesman Darren Millar AM expressed his condolences for the families involved, adding: "This is obviously an incredibly serious case and I urge the health minister to update us on the current situation and the next planned steps as soon as possible.
"While I recognise these infections appear to be isolated and contained, those using the hospital will expect regular reassurances from the Welsh government in the immediate future."
Anxious people
Welsh Liberal Democrat leader Kirsty Williams said the deaths were a "terrible tragedy".
"While the unit is temporarily closed for some patients, pregnant women in the area who are expected to deliver at the unit need to be reassured that there are alternatives set in place," she added.
"Guarantees are needed that other units that will have to take pre-term mothers have the resources to cope.

More on This Story

From other news sites

The BBC is not responsible for the content of external Internet sites

personalised cancer treatment’ experimental project



Monday November 21 2011
The project will look at the DNA of both patients and tumours

A new initiative to develop ‘personalised cancer treatment’ has today been launched. The experimental project has been designed to develop a screening program to test tumours for key genetic changes. It is hoped that in the future the results of such tests would influence treatment programmes, helping doctors choose the best drug for each person.
The new initiative, called the Stratified Medicine Programme, is being led by Cancer Research UK, the UK Technology Strategy Board and the pharmaceutical companies AstraZeneca and Pfizer. It is hoped that the work will lay the foundations for genetic testing of both patients and tumours to become standard practice, allowing the use of specialised drugs that target specific genes and mutations that can cause or influence the development of cancer.
In addition to laying the foundations for a genetic testing service, the information collected during the programme may be useful for research into new treatments; for example, by identifying new targets and by seeing how genetics affect people’s responses to various cancer drugs. Although people taking part in the early stages of this programme are unlikely to directly benefit, in time it is hoped that in the long-term patients will be provided with individually tailored treatments that ultimately prove more effective.

What is the project looking at?

The project will initially look at mutations in breast, bowel, lung, prostate as well as ovarian cancer and melanoma. These cancers were chosen due to how common they are and because of the range of drugs available and in development that might potentially be used to treat them.
The project aims to collect samples from 9,000 patients treated at seven Experimental Cancer Medicine Centres around England, Wales and Scotland. This small-scale project will develop the best way of running a genetic testing service, which could then potentially be rolled out over the whole NHS.

How might this help fight cancer?

Although the process is still at an early exploratory phase, in the long term it is hoped that the programme will allow patients to be treated according to the specific genetic faults in their tumour.
As new drugs targeting cancers with specific mutations become available, they could be prescribed based on the genetic faults in the tumour and a person’s genetics, and potentially produce improved results. It might also reduce ineffective treatment, where the cancer does not respond.
Understanding how certain genes control cancer and determining how the disease evades treatment is another aim of cancer research. The genetic information collected will also provide a unique source of information to help guide future projects and drug development.
Cancer Research UK is currently involved in a number of other genetics-based research projects that might shed light on topics such as what makes certain people genetically susceptible to cancer, what genes and mutations cause cancer to progress aggressively once it does develop and how genetics govern the way some people respond to treatment.

How will the project work?

The first-phase of the project involves seven clinical centres and three genetic technology centres. Blood and tumour samples will be collected from patients treated at Experimental Cancer Medicine Centres to gather sources of both normal DNA and tumour DNA. The DNA sequences will then be examined to see if certain mutations are present in the tumour. The results will be linked to patient records, and anonymously placed in a central database to guide future research.
During this phase of the programme, the results will not influence treatment. However, they may show that a patient is eligible to participate in a clinical trial of one of the new targeted therapies, although this is likely to affect only a small number of patients.

Does the NHS presently examine genetics in cancer patients?

As some existing drugs are designed to treat cancers with certain mutations, genetic testing for single mutations is carried out in the treatment of some cancers. For example, the drug trastuzumab (Herceptin) is designed to treat breast cancers with high levels of the Her2 protein on the surface, which can be identified through genetic testing.
However, genetic testing of tumours to test for multiple genetic defects is not yet available on the NHS. At the moment there is no centralised way of testing samples, and therefore it is often done on a few samples at a time rather than on a large scale.
The aim of this programme is to develop a nationwide service, reducing variations and making results more comparable across the country.

Links to the headlines

Cancer DNA database could revolutionise treatmentThe Daily Telegraph, November 21 2011

Further reading

Cancer Research UK Science Blog: Our Stratified Medicine Programme – what is it and how will it work?. November 21 2011
Cancer Research UK: Stratified Medicine Programme

Sunday, 20 November 2011

FAO and World Vision to join forces Partnership to boost global food security



FAO and World Vision to join forces

Partnership to boost global food security

Photo: ©FAO/Giulio Napolitano
Laurent Thomas (left) and Walter Middleton signing the FAO-WVI Agreement
15 November 2011Rome - FAO and World Vision International (WVI), one of the world’s largest non-governmental humanitarian organizations, are joining forces in promoting global food security under an agreement signed at FAO Headquarters today.

The Memorandum of Understanding, signed by Laurent Thomas, FAO Assistant Director-General, Technical Cooperation Department, and Walter Middleton, WVI Partnership Leader for Food Security and Livelihoods, lays out terms and conditions for joint actions and projects for the  promotion of food security over a three-year period. Areas of potential collaboration include agricultural development projects, land tenure management, food price volatility and gender and nutrition programmes.

"As we sign this agreement today, hunger continues to threaten the lives of millions of women, men and children in the Horn of Africa," said Thomas. "It is an acute reminder of the need for cooperation and long-term solutions. This agreement is about working together to implement those solutions."

Fostering improvements

The Memorandum of Understanding focuses on fostering improvements in early warning systems, preparedness in emergency responses, and gender and nutrition programmes - particularly field collaboration on nutrition issues.

"World Vision works in nearly 100 countries worldwide, and we have seen the devastating effects of malnutrition on children under the age of five, and their families, for more than 60 years," said Middleton. "It shapes their entire lives.

This partnership will improve end-to-end support for food-insecure communities; from global agricultural policy decisions through to field-level agricultural livelihood projects that are sustainable, effective and resilient."

New opportunities

Thomas said the agreement leveraged the strengths of the two organizations, presenting new opportunities for both.

"We believe there are tremendous opportunities for joint work on agriculture development projects targeting improvements in productivity, sustainability and resilience, as well as issues of land tenure, watershed management and other natural resource management," he declared.

"Ultimately this memorandum of understanding is about providing tangible improvements to the lives of children and communities hurt by hunger and malnutrition. The shared focus between the two organizations stands the partnership in good stead," Middleton added

Featured post

More patients in Scotland given antidepressants

More patients in Scotland given antidepressants 13 October 2015   From the section Scotland Image copyright Thinkstock Image ca...