Wednesday, 14 December 2011

24,000 diabetes deaths a year 'could be avoided'

Up to 24,000 deaths from diabetes could be avoided in England each year, if patients and doctors better managed the condition, a report concludes.

The first-ever audit of patient deaths from the condition said basic health checks, a good diet and regular medication could prevent most of them.

Diabetes UK said it was vital the 2.3 million sufferers had top quality care.

The Department of Health in England said shocking variations in care and an unacceptable death toll were evident.

About a third of people in the UK affected do not realise they have the condition.

It means their bodies cannot use glucose properly. If they do not manage it, they can develop potentially fatal complications like heart or kidney failure.

The report, by the NHS Information Centre, compared information about people with diabetes in England with data from death records.

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Around 70-75,000 diabetic patients die every year.

The study estimated that a third of them were dying from causes that could be avoided if their condition were better managed.

That includes basic health checks from doctors, and patients taking medication and keeping to a healthy diet.

For patients with Type 1, the risk of dying was 2.6 times higher than it was for the general population.

With Type 2, the risk was 1.6 times higher.

But in younger age groups, the risk was far greater. Women between the ages of 15 and 34 with diabetes were nine times more likely to die than other women of the same age.

Men in the same age group were four times more likely to die if they had the condition.

It is the first time there has been such a comprehensive assessment of the number of affected people dying.

The National Diabetes Information Service said the number of people with the condition was rising, so if nothing was done, the number of deaths would also increase.

'Shocking' variations

"Many of these deaths could be prevented," said Dr Bob Young, diabetologist and spokesman for the National Diabetes Information Service.

"Doctors, nurses and the NHS working in partnership with people who have diabetes should be able to improve these grim statistics."

Diabetes UK described the figures as alarming.

"We know that half of people with Type 2 and more than two thirds of people with Type 1 diabetes are not receiving the care they need to stay healthy," said Barbara Young, Diabetes UK chief executive.

"It is imperative we take action now to stop even more lives being needlessly cut short.

"We will be holding the NHS to account wherever it fails to deliver high-quality care."

The Department of Health in England said the audit had revealed shocking variations in care, and an unacceptable death toll.

Care services Minister Paul Burstow said: "I expect the NHS to learn from the best. It's not rocket science - integrated health care can help people manage their diabetes, and stay well and out of hospital.

Sunday, 11 December 2011

substitute for fossil fuels.

Billions of dollars each year are poured into the development of solar, nuclear, biological, and other energies to substitute for fossil fuels. But so far, issues of cost, efficiency, and scalability call into question the arrival of the next era of energy. Can any alternative sources become viably competitive with fossil fuels? What can we -- as individuals, businesses, and governments -- do to accelerate the rise of clean energy?

Selected videos are available above and at right; the full day's recordings will be posted here as they become available.

In this video, Steve Coll talks with Craig Venter about acting on scientific discovery and dramatic changes to come.

low-carbon aviation fuel

Uploaded by ThisIsVirginAtlantic on 11 Oct 2011

We are announcing a world-first, low-carbon aviation fuel with half the carbon footprint of the standard, fossil-fuel alternative. The partnership represents a breakthrough in aviation fuel technology that will see waste gases from industrial steel production being captured, fermented and chemically converted for use as a jet fuel. The revolutionary fuel production process recycles waste gases that would otherwise be flared off into the atmosphere as carbon dioxide -- so is the next step forward from our previous biofuels work. We anticipate that within two to three years, Virgin Atlantic will use the new fuel on its routes from Shanghai and Delhi to London Heathrow, as LanzaTech develop facilities in China and India. We also hope that the technology will be retrofitted to UK facilities, as well as other facilities worldwide, enabling us to uplift a significant proportion of low-carbon fuel across the world.

The LanzaTech Process

The LanzaTech Process can convert carbon monoxide containing gases produced by industries such as steel manufacturing, oil refining and chemical production, as well as gases generated by gasification of forestry and agricultural residues, municipal waste, and coal into valuable fuel and chemical products. The robust process is flexible to the hydrogen content in the input gas and tolerant of typical gas contaminants.

The carbon monoxide containing gas enters the process at the bottom of the bioreactor, and is dispersed into the liquid medium where it is consumed by LanzaTech's proprietary microbes as the reactor contents move upward in the reactor vessel.

The net product is withdrawn and sent to the product recovery section.

The product recovery section makes use of an advanced hybrid separation system to recover the valuable products and co-products from the fermentation broth. The water is recovered and returned to the reactor system, minimizing water discharge from the process. The products and co-products are collected for downstream use.

In some cases, these products can be used directly as fuel or chemical products. In many cases it is also possible to convert products from the LanzaTech process in to common chemicals or ‘drop in’ fuels that are normally derived from petroleum.

The LanzaTech process provides a route from waste gases and solids to valuable fuel and chemical products, reusing carbon along the way to minimize environmental impact.

Friday, 9 December 2011

There is a gold rush going on

The state of Nebraska is almost the size of the entire UK, with a population smaller than

Manchester's. It is classic "over-fly" country, ignored by the rest of the US - which, it turns out, is a big mistake.

The rest of America may be having a miserable time. But if you want to be rich, come to Nebraska and be a farmer. There is a gold rush going on, and it is because of corn.

The price of corn has tripled in the last decade. Why? Because places like India and China simply cannot get enough of the stuff.

'A really good time'

Brandon Hunnicutt, chairman of the Nebraska Corn Growers' Association, loves his new combine harvester - which is just as well because it cost three times the price of a large family house here.

Equipped with an on-board computer, an iPad, a satnav and an Android phone, this high-tech monster cuts the corn that feeds the pigs that fill the stomachs of Asia. It also makes the ethanol for American petrol.

There's been a lot of ebbs and flows, but nothing this good.Brandon Hunnicutt, corn farmer

Brandon Hunnicutt admits that he and farmers like him have never had it so good.

"The short time I've been around on this planet, the really good time was right when I was a baby," he says. "And now, 38 years later, this is another really good time.

"So there's been a lot of ebbs and flows, but nothing this good."

And Brandon is a post-modern farmer, which means he is on Facebook, LinkedIn and Twitter. His finger is never off the racing pulse of commodity prices and land values - which keep going up in this part of America.

The price of land in the region has increased fourfold in five years. Land prices in the rural Midwest are doing the opposite to house prices in the rest of America. They continue to shoot up, even prompting whispers of a bubble.

'Phenomenal income year'

There is a ton of extra cash here, and not all of it from the grain shipped in freight trains. Astonishingly, the farming community of states like Nebraska and neighbouring Iowa is still receiving billions in indirect subsidies on products like corn for ethanol, as well as direct payments to each farming family.

It is a legacy of the depression, which in this part of the country now seems like a very distant era.

We have a pehomenal income year that is beyond record.Prof Bruce Johnson, Nebraska-Lincoln University

"No question about it, we have a phenomenal income year that is beyond record," says Professor Bruce Johnson of the University of Nebraska-Lincoln.

On the subject of farming subsidies, Professor Johnson admits that for local farmers to continue to receive them "gets to be a questionable call".

And Brandon Hunnicutt admits that he does not need the $60,000 annual subsidy he receives in direct payments. In fact, those direct payments could be scrapped by the end of the year.

But the fact is that the American dream is being kept alive nowadays not in an industrial powerhouse or in Silicone Valley, but here in a small-town America, back on the farm where it all started.

high-risk surger

Care for high-risk surgery 'falling short'

The expert panel described the findings as "disturbing" after reviewing nearly 20,000 patients in England, Wales and Northern Ireland.
The National Confidential Enquiry into Patient Outcome and Death found four in 10 got poor or inadequate treatment.The care given to high-risk surgery patients is falling short of acceptable standards, an independent review says.

In particular, it highlighted a lack of pre-op checks and insufficient use of critical care facilities after surgery.

Those designated as high-risk patients tend to be drawn from groups who have a number of other health conditions, such as diabetes and heart disease; age and weight are also factors.

Death risk

They are estimated to make up about 10% of the surgical workload, but 80% of deaths.

Of the 20,000 cases looked at by the review team across 300 hospitals, nearly 4,000 involved high-risk patients having either emergency or elective surgery.

Of these, they carried out in-depth reviews on 829.

Over all, the team judged the care in 43% of cases to be poor or inadequate. Of the rest, 48% got good care and for 9% there was insufficient data to make a proper assessment.

Where care was not up to scratch there were some common themes, the report said.

A fifth whose surgery was planned were not seen in a pre-assessment clinic, which led to higher death rates among this group.

And only 22% of high-risk patients were sent to critical care following surgery. The rest were sent to other wards and had a death rate more than three times higher.

Experts also found patients were not being told about their risk of death, with fewer than a tenth of high-risk patients having their estimated risk put in their notes.

In conclusion, the report recommended introducing a nationwide system for identifying patients who are at high-risk of dying or suffering complications after surgery.

It also called for all high-risk patients to be seen and "fully investigated" in pre-assessment clinics.

Katherine Murphy, of the Patients Association, described the report as "shocking".

"The NHS needs to be far more open and transparent about the risks patients are exposed to," she said.

NHS medical director Prof Sir Bruce Keogh said: "The vast majority of operations performed by the NHS are safe and successful, but all patients, especially those at high risk, should receive good care and all the information that they need about their treatment - anything less is simply unacceptable."

Tuesday, 6 December 2011

staple crop virus

UN warns of 'epidemic'

Farmers may think crops are healthy until harvest; the signs only show on roots

Cassava is one of the world's most important crops providing up to a third of the calorie intake for many people.UN scientists are warning that a virus attacking the cassava plant is nearing an epidemic in parts of Africa.

The food and agriculture organisation of the UN says the situation is urgent and are calling for an increase in funding for surveillance.

None of the varieties of cassava being distributed to farmers in Africa appears to be resistant to the virus.

Cassava is a global food source of particular importance in Africa as it does well on poor soils with low rainfall.

But like many crops it is threatened by a number of pests and diseases that hinder its production. Viral infections have periodically wiped out the crop in some regions leading to famine.

Now the UN's Food and Agriculture Organization (FAO) says that another virus is threatening the crop in large parts of East Africa.

The scientists say the Cassava Brown Streak Disease (CBSD) is on the verge of becoming an epidemic. It first appeared in Uganda in 2006 but in the past few months has been found in Burundi and the Democratic Republic of Congo for the first time.

According to Mike Robson, a plant production and protection officer with the FAO it's hard to know exactly where the virus is as surveillance systems are poor.

"It is hard to say precisely but we're finding it where we go looking for it "

Robson says that a particular problem with this virus is that farmers may think they have a healthy crop until the harvest, as the symptoms only show on the roots.

"That's a particularly distressing situation where a farmer thinks he has a healthy field of cassava but when they come to uproot it, their expectations of food are not going to be met."

But there are some strategies that can help reduce the impact of the infection, according to Mike Robson.

"The main ways of controlling are to try and control the movement of planting material. Cassava is propagated from cuttings and if you move a cutting that has the infection you're effectively moving it to a new area"

"The other thing that farmers can do if they suspect they have the disease is to harvest early. They will get smaller roots of cassava but they will be less affected by the disease - it shows up late in the production cycle."

The FAO scientists say they are in a race against time with this particular strain of virus. They are calling for a rapid increase in funding to improve surveillance. They also want to improve training for farmers and they want to ban the distribution of infected plants between districts.

Some eight varieties of the crop are under development by the International Institute of Tropical Agriculture which show some level of resistance to CBSD - It is hoped that these varieties could be made widely available within two years.

Friday, 2 December 2011

Chicken liver food poisoning

Chicken liver food poisoning link

Chicken liver pate is a popular dish at weddings

Over 90% of cases of a common form of food poisoning seen this year were due to people eating undercooked chicken liver pate, often at weddings, infection experts have said.

The Health Protection Agency (HPA) analysed 18 outbreaks of Campylobacter in 2011 across England.

In all, 443 people became unwell and one had to be hospitalised.

The Food Standards Agency (FSA) has reminded caterers to cook poultry livers to prevent infection.

Campylobacter is the most common cause of bacterial food poisoning in Britain - there were estimated to have been more than 600,000 cases in 2010 in England and Wales.

Symptoms include diarrhoea, stomach pains and cramps, fever, and generally feeling unwell. Most people are only ill for a few days.

In 2008 there were just three outbreaks linked to undercooked chicken liver pate, but that rose to nine in 2009 and 14 in 2010.

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It's really important that chefs cook livers thoroughly to kill any bacteria, even if recipes call for them to be seared and left pink in the middle.”

Bob MartinFood Standards Agency

Poultry livers carry a particularly high risk of Campylobacter as the bacteria can be present throughout the liver, not just the surface as is the case for other poultry meat, and may remain a source of infection if they are not cooked sufficiently.

Of the 18 outbreaks, 14 occurred in catering venues, and 13 of these were linked to chicken or duck liver pate.

Seven were linked to wedding receptions at hotels, banqueting venues or public houses and six were associated with catering at other functions such as hotels, clubs and restaurants.

The HPA found that livers used to make the parfait or pate were undercooked allowing the liver to remain pink in the centre.

It said caterers can reduce the risk of their people becoming infected by ensuring that Campylobacter is killed through proper cooking and by avoiding cross-contamination to other foods.

'Inadequate cooking'

Dr Christine Little, an expert in gastrointestinal infections at the HPA, said: "The increase in outbreaks which are due to the consumption of chicken liver pate has been steadily increasing over the last few years.

"Not only is this dish popular in food recipe magazines, it is being served in a variety of different catering venues.

"Illness occurs because the livers are only cooked until they are pink, and inadequate cooking will not be sufficient to kill the bacteria.

"Both the public and the catering industry need to be aware that undercooking this product can result in food poisoning."

She said anyone planning a wedding, or other special event, should be aware of the risks if they were having chicken liver pate to prevent people becoming unwell.

The FSA issued updated advice to caterers on the safe handling and cooking of livers twice in 2010, but Campylobacter outbreaks associated with the consumption of chicken liver pate have continued to occur.

Bob Martin, head of foodborne disease strategy at the FSA, said: "Unfortunately, levels of Campylobacter in most raw chicken are high, so it's really important that chefs cook livers thoroughly to kill any bacteria, even if recipes call for them to be seared and left pink in the middle.

"The only way of ensuring the pate or parfait will be safe to serve to your guests or customers is by cooking the livers the whole way through.

"Caterers should also follow good general hygiene practices when cooking and handling poultry livers, to avoid cross contamination with Campylobacter."

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