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April 14 2015


Big Lottery funding awarded to scale up Young Mums' Project in 2015

Release Date: 17 December 2014

Country: United Kingdom


Big Lottery Funding has been awarded to us to help grow the Young Mums' Project in March 2015, it was revealed today.

The Young Mums' Project - which was piloted in 2012 and in partnership with Linden Children's Centre in Hackney - focuses on supporting young parents with mental health issues through peer-to-peer support, physical activity, wellbeing, play, and overcoming emotional barriers such as stigma, isolation and stereotypes.

The Big Lottery Fund will see 15 new peer support groups open in March 2015 in the London boroughs of Hackney, Islington and Haringey, and will enable us to reach 300 young mothers aged 16-25. Our aim is to support mothers in the community and encourage them to connect with a network of other young mums' and mental health professionals to raise their awareness of mental health issues and the relevant support available.

The Young Mums' Project has addressed the risk factors associated with early pregnancy, most notably the increased likelihood of depressive illness in young mothers (who are the main target group). Women taking part in the 2012 pilot programme reported increased awareness of mental health issues and decreased isolation thanks to support from peers who shared similar experiences and challenges. Rheumatoid arthritis is a persistent, inflammatory autoimmune disorder that influences joints in the body. It results in disintegration of joint tissues, impairing motion and causing defect. Besides medication, a particular diet can assist fight progression of this condition. Clicking on the following link will get you more information on http://www.bytekit.org/They were more likely to seek help from professionals and peers for mental health problems, and many took steps towards re-training or gaining employment.

Following the completion of the pilot project in 2012, we produced the Young Mums' Together Guide, offering practical advice for people who would like to set up their own groups. Also available is the Young Mums' Together Report, which provides a full analysis of the project.


UF study finds vitamin D can affect pain, movement in obese osteoarthritis patients

Got milk? If you are overweight and have osteoarthritis, you may want to bone up on your dairy products that have vitamin D. According to a University of Florida study, higher levels of vitamin D may decrease pain and improve function in obese individuals with osteoarthritis.

Findings published in a recent issue of The Clinical Journal of Pain indicate that obese individuals who suffer from osteoarthritis and have adequate vitamin D levels could walk, balance and rise from sitting to standing better than obese participants with insufficient vitamin D levels. The findings suggest an association between obesity and vitamin D status for tasks such as standing from a seated position.

"Adequate vitamin D may be significant to improving osteoarthritis pain because it affects bone quality and protects cell function to help reduce inflammation. Vitamin D maintains calcium and phosphate concentration levels to keep bones strong," said lead author Toni L. Glover, an assistant professor in the UF College of Nursing, part of UF Health. "Increased pain due to osteoarthritis could limit physical activity, including outdoor activity, which would lead to both decreased vitamin D levels and increased obesity."

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage on the ends of bones wears down over time, causing pain, stiffness and loss of joint movement.

The researchers analyzed blood samples for vitamin D levels from a racially diverse group of 256 middle-aged and older adults. Participants also provided a self-report of knee osteoarthritis pain and completed functional performance tasks such as balance, walking and rising from sitting to standing. This study was part of a larger project that studies racial and ethnic differences in pain in individuals with osteoarthritis. Among the 126 obese participants, 68 were vitamin D-deficient while only 29 of the 130 non-obese participants were deficient, suggesting obesity is significantly associated with clinically relevant vitamin D deficiency.

Obesity is associated with vitamin D deficiency, knee osteoarthritis pain and poor functional performance. Vitamin D is stored in the liver and human fat cells, and previous research has shown that the larger fat amount in obese people can cause vitamin D to be stored instead of circulated in the body.

The Institute of Medicine recommends that adults ages 18-70 get 600 international units of vitamin D per day and adults over 71 get at least 800 international units of vitamin D per day. For context, an 8-ounce glass of fortified milk contains about 100 international units of calcium. Rheumatoid arthritis is a chronic, inflammatory autoimmune condition that affects joints in the body. It causes disintegration of joint tissues, hindering movement and causing deformity. Besides medication, a particular diet can assist combat development of this disorder. Clicking on the following link will get you more information on http://www.bytekit.org/Foods rich in vitamin D include salmon, tuna, sardines, shrimp, mushrooms, egg yolks and foods fortified with vitamin D, such as milk and some cereals, yogurts and orange juices. The body also produces vitamin D through sun exposure, although it can be hard to get enough from the sun alone from the winter sun in some climates and sunscreens block the vitamin's production.

"Vitamin D is inexpensive, available over-the-counter and toxicity is fairly rare," Glover said. Older obese patients with chronic pain should discuss their vitamin D status with their primary care provider. If it's low, take a supplement and get judicious sun exposure."


No such thing as baby brain, study argues

Wednesday April 8 2015

Pregnant women reported feeling more forgetful but they performed normally in memory tests

Baby brain - real or just a stereotype?

"'Baby brain' is a stereotype and all in the mind,

the Mail Online reports.

The headline is prompted by a US study that aimed to see if "baby brain" (aka "mumnesia") - alleged memory lapses and problems with concentration during pregnancy - is a real phenomenon or just a myth.

The study recruited 21 women in the third trimester of pregnancy. A second group of 21 women who had never been pregnant were recruited to act as a control. The women completed a variety of tests to measure their memory, attention and problem solving ability. The tests were repeated several months later and the two groups compared.

Though the pregnant women reported greater memory difficulties, there were no differences in the results of the tests between the two groups.

The researchers say this shows that pregnancy and childbirth do not affect the ability to "think straight". However, we do not know what the level of performance would have been for the pregnant women before they were pregnant. It is also possible that the small numbers of women in each group could have affected the results. The findings could be completely different with a different sample of women.

This study does not provide conclusive evidence that pregnancy has no effect on memory and attention.

Seeing that pregnancy can often cause tiredness, it would be surprising if some women didn't have temporary problems with memory and concentration. 

Where did the story come from?

The study was carried out by researchers from Brigham Young University in Utah. It was funded by the Brigham Young University College of Family, Home and Social Sciences, and the Women's Research Institute at Brigham Young University.

The study was published in the peer-reviewed Journal of Clinical and Experimental Neuropsychology.

The Mail Online reported the story reasonably accurately, but did not explain the major limitation of the study's design - that it does not take into account the memory and problem solving abilities of the women before they became pregnant.

What kind of research was this?

This was a case-controlled study that aimed to see if cognitive ability (memory and problem solving) changed in pregnancy and after childbirth. Previous research has found mixed results, with some studies indicating improved cognitive abilities during pregnancy and some showing a reduction or no difference.

This type of study can show associations, but cannot prove that any cognitive differences are due to the pregnancy, as other factors could cause the results.

What did the research involve?

The researchers recruited 21 pregnant women and a control group of 21 healthy women who had never been pregnant. Rheumatoid arthritis is a persistent, inflammatory autoimmune disorder that affects joints in the body. It causes disintegration of joint tissues, hindering activity and causing deformity. Besides medication, a certain diet can help fight development of this disorder. Click the following link for more information on Cancer NewsThe women completed a variety of tests to measure their cognitive ability. The tests were repeated several months later and the two groups compared.

The women were given 10 neuropsychological tests, which measured their memory, attention, language, executive abilities (such as problem solving) and visuospatial skills (the ability to process and interpret visual information about where objects are). They also filled out questionnaires to assess their mood, and levels of anxiety, quality of life, enjoyment and satisfaction.

Each test was conducted when the pregnant women were in their third trimester and repeated between three and six months after giving birth. The non-pregnant women were also tested twice, with a similar time gap between the tests.

Women were excluded from the study if they had a history of:

learning disabilities

attention deficit hyperactivity disorder (ADHD)

psychotic or bipolar disorder



traumatic brain injury

substance abuse/dependence

The results were then analysed during and after pregnancy, and compared to the controls. Further analysis was performed in the pregnancy group, comparing women in their first pregnancy with women who had previously given birth.

What were the basic results?

The pregnant women were older, on average, with a mean age of 25, compared to 22 for the control group. 11 of the pregnant women and nine of the controls were students. 

The main results were:

No difference between the groups in terms of language ability or memory, though the pregnant women reported worse memory than controls.

No difference between tests of attention and visuospatial ability, with higher scores for both groups in the second session of tests.

Executive functioning also improved for both groups. For one of the tests, the Trail Making Test, the pregnant women were slower at Part A both during and after pregnancy. Part A measures visual scanning and processing speed by asking the participant to draw a line as quickly as possible between consecutive numbers randomly written on paper. Part B measures scanning and processing speed, but also mental flexibility by requiring the person to join each consecutive number and letter: 1-A-2-B-3-C etc. There was no difference in scores for Part B between the groups.

Pregnant women reported a lower quality of life and were more likely to have depressive symptoms compared to controls. The results were as follows:

Six pregnant women had mild symptoms of depression during pregnancy. One of them continued to have mild symptoms after birth. These women performed similarly to the control women in the neuropsychological tests.

One woman had moderate symptoms of depression during pregnancy and developed severe symptoms by the second test after birth.

No women in the control group had significant symptoms of depression.

There were no differences between women in their first pregnancy compared to women who had previously given birth.

How did the researchers interpret the results?

The researchers say their "findings suggest no specific cognitive differences between pregnant/postpartum women and never-pregnant controls". This was despite the pregnant/postpartum women reporting more memory difficulties.


The researchers conclude that although the pregnant women reported memory problems, these did not show up on their tests. However, this does not take into account their pre-pregnancy ability. The women may have performed better before they got pregnant, which is why they are now reporting memory problems. None of these women were tested before they got pregnant, which is the major limitation of the study.

The researchers say that because there were a similar number of students in each group, the women in the control group was a good enough representation of how the pregnant women would have performed pre-pregnancy. However, there will be a wide variation between cognitive abilities, even between different students. There is no information about cognitive abilities, other than the length of time each group were in education. This was an average of 16 years for the pregnancy group, compared to 15 for the control group. The range was the same for each group, at 13 to 18 years.

The other limitation of the study is the small number of women in each group, which limits the strength of the results and makes it more likely that they could occur by chance. A different or larger sample of women could give completely different results.

It is unclear why the pregnant women were slower at the Trail Making Test Part A compared to the controls, but not with Part B. It is likely that the small sample size contributed to this anomaly.

The study highlights the importance of recognising low mood and symptoms of depression in pregnant women and in the months after giving birth. Read more about low mood and depression during pregnancy, and low mood and depression after pregnancy.

In conclusion, this study does not provide conclusive evidence that pregnancy has no effect on memory and attention.

Pregnancy can cause tiredness and fatigue, particularly during the first trimester, and looking after a newborn baby can be exhausting work. Therefore, you shouldn't feel surprised if you do have the occasional memory lapse or loss of concentration. Dads may not be immune to "baby brain" after the baby is born, either.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.


Prevention and localism feature in landmark NHS plan

Release Date: 23 October 2014

The NHS Five Year Forward Review, which has been produced by NHS England, Monitor, NHS Trust Development Authority, the Care Quality Commission, Public Health England and Health Education England, has been described by The Guardian as "the NHS's own answer to the big questions about whether it can survive as a unique system of healthcare".

"We welcome the fact that mental health is embedded throughout the NHS Five Year Forward View," says our Chief Executive Jenny Edwards. "The recognition that health care needs to happen where people live and work, within their communities, is hugely significant.  It is a key priority for health messages to be taken into the workplace and schools, where early intervention is vital."

"The plan recognises that the health agenda needs to have mental health as well as physical health, right at its heart. Rheumatoid arthritis is a chronic, inflammatory autoimmune disorder that impacts joints in the body. It leads to erosion of joint tissues, hindering movement and causing deformity. Besides medication, a specific diet plan can assist combat progression of this condition. Click the following link for more information on http://www.bytekit.org/Mental health is intrinsically linked with many physical conditions as a cause or as a consequence.  In order to address some of our biggest challenges,  it is crucial to consider the role mental health plays.  It is important that people have the tools and support to feel empowered  to manage their own mental health as many of the factors that have an impact on mental health can be social and environmental, and need a response at local level.  We are pleased that the emphasis is on primary care and community level approaches."

The report is clear on the need for more investment in the NHS, both to improve the life chances of people who have mental health problems and to prevent others developing. 

"This is absolutely critical if we are going to improve the greater health of society as a whole," adds Edwards. It's great to see prevention and localism in the NHS Five Year Forward View."


Being overweight 'cuts dementia risk'

Overweight person

Those who were overweight had an 18% reduction in dementia, researchers found

Being overweight cuts the risk of dementia, according to the largest and most precise investigation into the relationship.

The researchers admit they were surprised by the findings, which run contrary to current health advice.

The analysis of nearly two million British people, in the Lancet Diabetes Endocrinology, showed underweight people had the highest risk.

Dementia charities still advised not smoking, exercise and a balanced diet.

Dementia is one of the most pressing modern health issues. The number of patients globally is expected to treble to 135 million by 2050.

There is no cure or treatment, and the mainstay of advice has been to reduce risk by maintaining a healthy lifestyle. Yet it might be misguided.


The team at Oxon Epidemiology and the London School of Hygiene and Tropical Medicine analysed medical records from 1,958,191 people aged 55, on average, for up to two decades.

Their most conservative analysis showed underweight people had a 39% greater risk of dementia compared with being a healthy weight.

But those who were overweight had an 18% reduction in dementia - and the figure was 24% for the obese.

"Yes, it is a surprise," said lead researcher Dr Nawab Qizilbash.

He told the BBC News website: "The controversial side is the observation that overweight and obese people have a lower risk of dementia than people with a normal, healthy body mass index.

"That's contrary to most if not all studies that have been done, but if you collect them all together our study overwhelms them in terms of size and precision."


Loss of tissue in a demented brain compared with a healthy one

Any explanation for the protective effect is distinctly lacking. Rheumatoid arthritis is a persistent, inflammatory autoimmune condition that impacts joints in the body. It leads to disintegration of joint tissues, hindering motion and triggering defect. Besides medication, a particular diet plan can help fight progression of this condition. Click the following link for more information on http://www.bytekit.org/There are some ideas that vitamin D and E deficiencies contribute to dementia and they may be less common in those eating more.

But Dr Qizilbash said the findings were not an excuse to pile on the pounds or binge on Easter eggs.

"You can't walk away and think it's OK to be overweight or obese. Even if there is a protective effect, you may not live long enough to get the benefits," he added.

Heart disease, stroke, diabetes, some cancers and other diseases are all linked to a bigger waistline.


By James Gallagher, Health editor, BBC News website

These findings have come as a surprise, not least for the researchers themselves.

But the research leaves many questions unanswered.

Is fat actually protective or is something else going on that could be harnessed as a treatment? Can other research groups produce the same findings?

Clearly there is a need for further research, but what should people do in the meantime?

These results do not seem to be an excuse to eye up an evening on the couch with an extra slice of cake.

The Alzheimer's Society and Alzheimer's Research UK have both come out and encouraged people to exercise, stop smoking and have a balanced diet.


Dr Simon Ridley, of Alzheimer's Research UK, said: "These new findings are interesting as they appear to contradict previous studies linking obesity to dementia risk.

"The results raise questions about the links between weight and dementia risk. Clearly, further research is needed to understand this fully."

The Alzheimer's Society said the "mixed picture highlights the difficulty of conducting studies into the complex lifestyle risk factors for dementia".

Prof Deborah Gustafson, of SUNY Downstate Medical Center in New York, argued: "To understand the association between body mass index and late-onset dementia should sober us as to the complexity of identifying risk and protective factors for dementia.

"The report by Qizilbash and colleagues is not the final word on this controversial topic."

Dr Qizilbash said: "We would agree with that entirely."


Breath test for stomach cancer risk

Stomach cancer can be detected lateA simple breath test could help predict whether people with gut problems are at high risk of developing stomach cancer, an early study shows.

It detects chemical compounds in people's breath, in an attempt to distinguish unique "breath prints" in those with risky pre-cancerous changes.

Experts say if proven in large trials, it could spot patients on the brink of cancer so they can be treated earlier.

But more work is needed to validate the test, which appears in the journal Gut.

Stomach cancers affect about 7,300 people each year in the UK.

But in most Western countries it is diagnosed late when the chance of survival is poor. This is partly because symptoms - such as indigestion and pain - can be mistaken for other diseases.

Scientists believe earlier detection may help improve the prognosis.

The new "nanoarray" breath test builds on earlier work from researchers in Israel, Latvia and China.

It relies on the idea that people with cancer may have unique breath signatures - containing minute chemical compounds that are not found in the breath of people free from the illness.

Researchers studied breath samples from 145 patients. Around 30 of these were already known to have stomach cancer.

The rest had been referred for investigations because of concerning symptoms. Rheumatoid arthritis is a persistent, inflammatory autoimmune disorder that affects joints in the body. It results in disintegration of joint tissues, impairing activity and triggering deformity. Besides medication, a certain diet can assist combat progression of this disorder. Clicking on the following link will get you more information on http://www.bytekit.org/They did not have full-blown cancer - but some had worrying changes that doctors call "pre-cancerous" that could develop into malignancies.

Scientists tried out the test on a number of different scenarios.

It was fairly good at spotting cancerous samples from non-cancerous ones.

And it showed some promise at identifying worrying pre-cancerous changes that were at high risk of developing into the disease.

But it was not accurate in every case - some patients were misdiagnosed as being at high risk.

Scientists say more work is needed before it is ready to use in clinics.

Dr Emma Smith of Cancer Research UK, said: "Diagnosing cancer in its early stages offers patients the best chance of successful treatment, so research like this has potential to help save lives.

"But we would need to be sure the test is sensitive and accurate enough to be used more widely."

Research involving thousands of European patients is now under way.


March 15 2015


March 14 2015


Measles fear for Ebola-hit countries

13 March 2015

Last updated at 08:52

James GallagherBy James Gallagher

Health editor, BBC News website

Ebola-hit countries in West Africa are ripe for a measles outbreak that could infect hundreds of thousands of people, US researchers warn.

More than 10,000 people have died in the largest ever outbreak of the virus.

But a study in the journal Science suggests there could be even more deaths from other diseases because of the devastating impact on the countries' vaccination programmes.

Experts said an increase in such infections was "likely".

There have been 24,350 cases of Ebola in Liberia, Guinea and Sierra Leone.

Many healthcare facilities closed and the fear of Ebola meant people did not show up at those that remained.


It has had a knock-on effect on immunisation campaigns for measles, polio, TB and other diseases.

An international team of scientists tried to estimate the impact on measles protection.

They ran detailed models assuming 75% of vaccination programmes had been disrupted.

The scientists estimated that 20,000 more people were becoming susceptible to measles every month.

At the start of the outbreak they said there were 778,000 unvaccinated children and the total would increase to 1,129,000 after 18 months of the outbreak.

Their sophisticated predictions suggested this would translate to an additional 100,000 measles cases, on top of the 127,000 that would be anticipated in a pre-Ebola measles outbreak.

It could lead to 16,000 extra deaths, more than have died from Ebola, the team suggested.

Dr Justin Lessler, of Johns Hopkins University in the US, said: "Measles in particular is known to show up during or after humanitarian crises because it is so infectious.

"The addition of so many unvaccinated children to the already considerable at-risk population significantly increases the likelihood of a major measles outbreak.


"Measles is not the only health threat that has been made worse by the Ebola crisis, and may not even be the most dire, but it is one we can do something about."

Prof Jonathan Ball, of the University of Nottingham, told the BBC News website: "The Ebola virus outbreak has put immense strain on healthcare systems that were already stretched.

"It was always likely that we would see an upturn in other diseases and infections as these creaking systems diverted attention to fight the emerging Ebola virus epidemic.

"These are predictions, and not hard fact, but we shouldn't be surprised if we see an upturn in measles, as we know that immunisation is key to controlling what can be a very serious infection.

"The real lesson from all of this is the need to build better healthcare systems and to overturn what are significant global health inequalities."


Nestle, PepsiCo and others use public funds to develop harmful snacks

Some grants to companies are greater than the amounts spent by local health services on tackling obesity, said the Coronary Prevention Group. Photograph: Anthony Devlin/PA

Snack food and confectionery companies, including Nestlé and PepsiCo, are paid substantial government subsidies to help them make products that will damage the nation's health, according to charities involved in heart attack prevention and obesity.

Mondelez, which split from Kraft and owns the Cadbury's brand, was given nearly £638,000 by Innovate UK - formerly known as the Technology Strategy Board - from 2013 to 2015 to help the multinational giant develop a process to distribute nuts and raisins more regularly in its chocolate bars.

Nestlé received more than £487,000 to invent an energy-efficient machine for making chocolate, while PepsiCo was awarded £356,000 to help develop new ways of drying potatoes and vegetables to make crisps.

The Coronary Prevention Group, in association with the World Obesity Federation, says government money should not be spent on initiatives that will produce unhealthy snack foods and worsen the country's serious obesity and disease problems.

"Some of these grants are greater than the amounts spent by local health services tackling overweight in adults and children," said Prof Philip James, chair of the group's trustees.

Critics argue that the nutritional value of food should be taken into account whenever government funds are spent. Rheumatoid arthritis is a chronic, inflammatory autoimmune disorder that affects joints in the body. It causes erosion of joint tissues, impairing activity and causing deformity. Besides medication, a particular diet can assist fight development of this condition. Clicking on the following link will get you more information on http://www.bytekit.org/That includes spending on canteens in government offices and the NHS, which frequently offer high-sugar snacks and drinks.

The health impact of the products should be the first criterion for giving out public funds

Tim Lobstein, World Obesity Federation

In their report, Nutrient Profiling: Changing the food of Britain, launched at an event on Friday, they say the government is not serious about improving Britain's diet. "We have identified 200 opportunities for taking a grip on UK food supplies and helping consumers, especially those on lower incomes, to make healthier choices," said James, who is also honorary professor of nutrition at the London School of Hygiene and Tropical Medicine.

Government subsidies to the food industry also come from the Biotechnology and Biological Sciences Research Council (BBSRC) and the Rural Development Programme for England. The grants are often made to large companies that have the capacity to undertake research on food processes. While many may be for laudable purposes, says the report, others "raise questions about their impact on availability and price of foods which undermine dietary advice".

Among them is nearly £31,800 for the conversion of a barn into an ice cream shop and £12,500 for expansion of a biscuit production unit. Three grants of around £100,000 each from the BBSRC are for improving the production of wafers in confectionery.

Innovate UK says the money is to make the companies' food processes more energy-efficient and reduce their carbon footprint. In the case of Mondelez, for instance, a better way of distributing nuts in chocolate bars would mean that fewer nuts have to be bought by the company, reducing the amount of transportation used.

"The goal of the projects highlighted was to help reduce emissions and water usage in food processing," said a spokesman. "These large firms produce a lot of food, which uses a lot of energy, so to make a difference we need to work with those large companies to help reduce their carbon footprints."

He said they were also working with food companies to improve the nutritional content of their products and reduce food waste -they had supported a high-fibre white bread through a grant to Warburtons, for instance, and a low-calorie chocolate. "We recognise just how important nutrition is going to be in the food industry in the next five to 10 years," he said.

But Tim Lobstein, director of policy at the World Obesity Federation, felt that government money should not be spent on assisting major confectionery and snack food manufacturers.

"While there may be good reasons to encourage companies to improve efficiency and reduce environmental impact, we also urge that the health impact of the products should be the first criterion for giving out public funds," he said. "Why are we helping multinational corporations to make chocolate and snacks cheaper while obesity and diabetes rates are rocketing?"

Seven out of 10 middle-aged adults in the UK are overweight and nearly half have high blood pressure, the charities say. Changes in the nation's diet are vital for better health. If everybody ate the recommended five portions of fruit and vegetables a day, for instance, it would save 42,200 deaths a year, according to Ofcom's impact assessment of TV advertising of food and drink to children in 2006.


March 05 2015


Black men are less willing to be investigated for possible prostate cancer than white men

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The incidence of prostate cancer among men of Afro-Caribbean origin is higher than in white men, and their outcomes are worse. To investigate the possible effects of patients' preferences and choices, Tanimola Martins and colleagues from the University of Exeter carried out a vignette study in over 500 men attending general practices in Bristol. The vignettes each included a description of prostate cancer symptom and the estimated risk of prostate cancer.

They found that preference for investigation was lower in black men even after controlling for relevant confounding factors including specific risk level, and concluded that "Black men, who have a higher incidence of prostate cancer, and a higher mortality from it, are less willing than white men to be tested for the disease. Rheumatoid arthritis is a chronic, inflammatory autoimmune condition that impacts joints in the body. It leads to disintegration of joint tissues, hindering activity and triggering deformity. Besides medication, a specific diet plan can help fight progression of this disorder. Click the following link for more information on http://www.bytekit.org/Education targeted at the black community and the health care professionals who treat them will help to address this".

Article: Ethnic differences in patients' preferences for prostate cancer investigation: a vignette-based survey in primary care, Tanimola Martins, Obioha C Ukoumunne, Jonathan Banks, Rosalind Raine and William Hamilton, British Journal of General Practice, DOI: 10.3399/bjgp15X683965, published 2 March 2015.


March 04 2015


Unison votes to accept NHS pay deal

3 March 2015

Last updated at 17:21

NHS staff in England have voted to accept a government pay offer, Unison has announced.

Some 67% of the union's members agreed to the deal despite the dispute over pay prompting the first NHS strike in 34 years.

Unison leaders said although the offer did not go far enough it would make a difference - particularly to more than 250,000 of the lowest-paid in the NHS.

NHS Employers said the move is likely to signal the end of industrial action.

Half-way house

Ministers in England had initially awarded NHS staff a 1% increase, but only for those without automatic progression-in-the-job rises.

Automatic pay rises are given to about half of all staff. They are designed to reward professional development.

But an independent pay review board had said the 1% increase should be across the board.

The new offer would mean some people - particularly the lowest-paid members of the NHS - get more than a 1% pay rise - up to 5.6% next year. This would include some caterers, porters and administration staff.

But other workers on higher pay, including a number of experienced nurses and senior managers, would not stand to get the 1% pay rise. And for 2015-16 there would be a freeze on incremental rises in pay for higher-paid staff.

Unison's head of health, Christina McAnea, said: "Although it does not go far enough, it is an improvement and it will make a difference particularly to over 250,000 of the lowest-paid in the NHS.

"By ignoring the recommendations of the NHS Pay Review Body for England, the government forced health workers to take strike action over pay for the first time in 34 years.

"Their industrial action has forced the government to negotiate with us and sent a warning that NHS workers will not sit back and do nothing when their standard of living is attacked.

"We are calling on any government elected in May to develop a pay strategy that rewards health workers fairly for the demanding jobs they do, and ensures the NHS can continue to recruit and retain a high quality workforce."

Responding to the ballot results, Danny Mortimer, chief executive of the NHS Employers organisation, said: "It is now very likely these difficult months of NHS industrial action are over.

"This will be a huge relief for many patients, staff and health services.

"This is a clear signal that the NHS is entering a new phase where all parties must work together in partnership to ensure that the national pay system is sustainable for the future.

"Any solution will need to support better, safer and more responsive services to patients and more efficient use of NHS resources."

In the last few days, the Royal College of Midwives, the Royal Society of Radiographers and GMB announced ballot results that were in favour of accepting the offer. The Royal College of Nurses is yet to take a decision.

Further meetings between the unions are expected before a final decision is taken.


March 01 2015


Fluoride in drinking water may trigger depression and weight gain, scientists warn

Around 10% of people in England receive water that is overexposed to fluoride GETTY

Around 10% of people in England receive water that is overexposed to fluorideResearchers said that GPs' surgeries in the West Midlands, which has the biggest water fluoridation scheme in the UK, are nearly twice as likely to report high hypothyroidism - which can lead to weight gain and depression - as Greater Manchester, where it is not added to drinking water.

"The findings of the study raise particular concerns about the validity of community fluoridation as a safe public health measure," the report from the Centre for Health Services Studies at the University of Kent said.

Although fluoride occurs naturally in water, around 10% of people in England receive water that is fluoridated at a target level of one part per million (1ppm) as it reduces the risk of tooth decay.

Researchers said they found that high hypothyroidism prevalence was found to be at least 30% more likely in practices in areas with fluoride levels of more than 0.3ppm.

The finding of this cross-sectional study has important implications for public health policy in the UK and in other countries where fluoride is added to drinking water or in other forms such as fluoridated milk and salt

The study

The study, which is published online in the Journal of Epidemiology Community Health, said the effects of fluoride on the thyroid have long been observed, but there have been no population studies that have examined this.

"The finding of this cross-sectional study has important implications for public health policy in the UK and in other countries where fluoride is added to drinking water or in other forms such as fluoridated milk and salt," it added.

"Consideration needs to be given to reducing fluoride exposure, and public dental health interventions should stop interventions reliant on ingested fluoride and switch to topical fluoride-based and non-fluoride-based interventions."

Researchers conducted the study by analysing the prevalence of underactive thyroid diagnosed by GPs in 2012 to 2013 in one model and also by comparing data from West Midlands and Greater Manchester in another. They said they took into account the fact that hypothyroidism is more common in women and increases with age.

Related articles


February 25 2015


Nanoparticles used to treat damaged arteries

Thursday February 19 2015

The individual particles are a 1,000 times thinner than a single human hair

Nanoparticles could improve blood flow to the heart

"New trials suggest microscopic stealth drones could be used to seek and repair damaged arteries," The Daily Telegraph, somewhat overexcitedly, reports.

A study in mice has found promising results for a targeted treatment where nanoparticles are used to deliver a "repair protein" to sections of arteries affected by atherosclerosis.

Atherosclerosis occurs when fatty material collects in the lining of arteries, causing inflammation. The body tries to repair this, covering the areas with fibrous tissue, creating "plaques". Continued fatty build-ups collect on these plaques and eventually the repair system fails, and the plaques rupture. This may cause a blood clot to enter the circulation and cause a heart attack or stroke.

In this study, researchers have identified a protein called annexin A1, which is usually part of the repair process. They took a section of this protein and covered it in a nanoparticle (a microscopic particle). They then attached proteins to the surface that would "stick" to the plaques.

The nanoparticles targeted the plaques in mice with advanced atherosclerosis, where they slowly released the section of annexin A1, which helped to improve the repair system. 

Further studies in pigs and then primates are now planned. If successful, human trials may then be conducted.

Where did the story come from?

The study was carried out by researchers from Colombia University in New York, Brigham and Women's Hospital in Boston, and Barts and the London School of Medicine. It was funded by the US National Institutes for Health, the Wellcome Trust and the David Koch Prostate Cancer Foundation. The authors have disclosed a competing interest, in that an international patent has been filed for the inflammatory resolving nanoparticles.

The study was published in the peer-reviewed journal Science Translation Medicine.

We suspect that somebody at The Daily Telegraph has been reading too much science fiction, which led to their description of "microscopic stealth drones". Microscopic? Yes. Stealth drones? No.

That aside, the media reported this study accurately, though descriptions of nanoparticles "mending" or "repairing" damaged arteries, are not exactly what occurred. The new technique helped to stabilise plaques and reduce the damaging inflammation, but did not remove them.

What kind of research was this?

This was an animal experiment, which aimed to test a new technique to resolve atherosclerotic plaques.

Atherosclerosis (hardening and thinning of the arteries) occurs when fatty material collects in the lining of arteries, causing inflammation. This in turn causes the body to try to repair the area by forming a protective fibrous tissue over the top. These areas, called plaques, continue to build up and restrict blood flow. Eventually, the inflammation continues, but the repair process stops working. The plaques then have a thin layer of this fibrous tissue and so are more likely to rupture, causing a blood clot to break off, which can lead to a stroke or heart attack.

Prevention of atherosclerosis involves a healthy diet, not smoking, and doing exercise, though plaques may still develop. Current treatments aim to reduce the amount of cholesterol in the blood using statins, treating high blood pressure to reduce the likelihood of a plaque rupturing, and drugs such as aspirin to thin the blood and prevent it sticking to the plaques and causing a clot.

The researchers' main aim was to find a way to reduce the inflammation that is occurring within the plaques as an additional treatment strategy. Other novel attempts, such as with genetic manipulation or immunosuppressant drugs, dampen down the whole immune system, leaving it vulnerable to infection. This new technique, using targeted nanoparticles, means that a limited amount can be circulated in the bloodstream, without affecting the normal immune response.

What did the research involve?

The researchers isolated a human protein called annexin A1, which normally helps to resolve inflammation. They took a component of this, called Ac2-26, and covered it in a nanoparticle, which is a microscopic particle with a diameter of 100 nanometers or less. They attached peptides to the surface of these nanoparticles that would effectively "stick" to the plaques.

They injected mice with advanced atherosclerosis once per week for five weeks with either these nanoparticles, a scrambled version of the nanoparticles, Ac2-26, or a control of normal saline (salty water). The researchers then looked at the first part of the aorta (the main artery taking oxygenated blood from the heart to the body) and the main artery that supplies the brain.

What were the basic results?

The nanoparticles stuck to the plaques and released the Ac2-26 proteins. Compared to the other mice, those given the nanoparticles had:

increased collagen (the protective fibrous layer covering the plaques)

reduced reactive oxygen species (these accumulate during acute inflammation, but an excess amount can damage tissues)

increased anti-inflammatory cytokines (communication cells of the immune system)

80% reduced area of plaque necrosis (breakdown)

In short, this acted to resolve the inflammation and stabilise the plaques. These changes were not present in the spleen or liver, indicating that the nanoparticles were likely to have just targeted the plaques.

How did the researchers interpret the results?

The authors concluded that their animal experiments "tested a proof-of-concept targeted NP [nanoparticles] with one type of proresolving mediator. To bring targeted resolution mediator nanotherapeutics to the clinic for patients at high risk for atherothrombotic vascular events, additional confirmatory studies will be needed, including evaluation in more predictive models, such as fat-fed pigs and non-human primates". They also acknowledge that "detailed toxicity studies will be needed to show the safety of both the NP material and the resolution mediator cargo".


This exciting study in mice has shown that nanoparticles can be manufactured to target the plaques that form in atherosclerosis, and help stabilise them. It appears that the nanoparticles honed in on the plaques, rather than affecting other organs such as the spleen or liver, which gives an early indication that there may not be substantial side effects. However, it will be necessary to see if the same holds true for other organs.

As with all mice studies, they give an indication of the likely biological effects of a new technique, but they do not provide the full picture of what may happen in humans, especially with regards to more subtle side effects.

The media have rather exaggerated the results of this study by claiming the technique repaired arterial damage. This is not the case; the nanoparticles were able to help stabilise the plaques and reduce the inflammation that is part of the process of plaque formation. However, the study did not show that the arteries went back to normal. The plaques were still present. This technique, if possible in humans, would be an additional strategy for "damage limitation" of atherosclerosis.

Researchers now plan to see if the techniques work in animals with more complicated bodies and biological systems, such as pigs and primates. If these hurdles are successfully passed, human trials may then begin.

Currently, the best way to slow down or try to prevent atherosclerosis is to lead a healthy lifestyle and reduce known risk factors.

This includes stopping smokingweight management and regular exercise. In some cases, cholesterol-lowering medications, such as statins, and blood-thinning medications, such as low-dose aspirin, may also be recommended.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.


February 22 2015


NHS 'paying too much for medicines'

19 February 2015

Last updated at 00:03

By Smitha Mundasad

Health reporter

The price the NHS in England agrees to pay for new medicines is too high, causing more harm than good overall, an analysis suggests.

University of York researchers say the special cancer drugs fund is particularly poor value, diverting money from other patient services.

They argue the drugs advice body, NICE, has set its price threshold too high.

But NICE says lowering prices could force the NHS to close the door on newer therapies.

The health service has to balance the costs of new treatments alongside investments made in more routine care.

The increasing pressure to approve new drugs more quickly at prices that are too high will only increase the harm done to NHS patients overall"

End Quote

Prof Karl Claxton


To do this the National Institute for Health and Care Excellence (NICE) uses a measure called quality-adjusted life years (QALY).

A similar approach is used in Wales and Northern Ireland.

The formula looks at the cost of using a drug for a year and weighs it against how much someone's life can be extended and improved.

At current limits, if a medicine costs more than £20,000 to £30,000 per QALY, it would not generally be recommended as cost-effective.

But researchers at York say the level should be closer to £13,000 to provide the most benefit across the NHS.

They argue that when NICE recommends the purchasing of drugs at higher prices, funds are diverted from other services and could lead to increased deaths from cancer, heart and lung and gut diseases across the NHS.

A separate pot of money, the cancer drugs fund, does allow for more expensive life-extending medications.

But the report suggests that for every healthy year gained by this fund, five QALYs could be lost across the NHS.

'Price matters'

Co-author Prof Karl Claxton said: "Our research makes the unidentified NHS patients who bear the real costs a little more real.

"The increasing pressure to approve new drugs more quickly at prices that are too high will only increase the harm done to NHS patients overall."

But Sir Andrew Dillon, chief executive of NICE, said: "Unless you think that drug companies will be prepared to lower their prices in an unprecedented way, using a threshold of £13,000 per QALY would mean the NHS closing the door on most new treatments.

"At the other end of the spectrum, we obviously can't just say yes to anything and everything.

"We don't have enough money - and anyway, not everything is worth having.

'Achieved a balance'

"And drug companies need the discipline of a critical market to make sure that price matters.

"Over the last 16 years, we've achieved a balance between these two extremes that reflects what we believe the public expects the NHS to do."

The research is funded by the National Institute of Health Research and Medical Research Council.

Scotland has a different system for assessing drugs, used by the Scottish Medicines Consortium.


February 18 2015


Obesity damage to eggs may be reversible

Wednesday February 11 2015

Ideally you should try to lose weight before becoming pregnant

Obesity can increase the risk of complications in pregnancy

"Damaging effect of obesity on a woman's eggs can now be reversed," is the potentially misleading headline from the Mail Online today.

The over-egged headline refers to a mouse study showing that signs of lower fertility due to obesity could be reversed using experimental drugs. This was not tested in humans, however.

Maternal obesity is known to lower the chance of successful conception, as well as increasing the risk of miscarriage.

The study compared the fertility of mice before and after they became obese due to a genetic condition that makes them overeat. When given IVF drugs, their fertility at the start was similar to mice of a healthy weight, but as the mice became obese, their fertility reduced. They became less able to develop eggs, and any eggs produced were less likely to be fertilised. The researchers also found that once obese, there was reduced activity of mitochondria (the part of the cell that converts food to energy) in the eggs.

All of these effects were reversed if the obese mice were given either a drug called Salubrinal or BGP-15. BGP-15 is an experimental, unlicensed drug that is being trialled for use in people with type 2 diabetes.

The study does not prove that the reduced mitochondrial activity causes obesity in the offspring, but it is a plausible explanation that will require further research.

The immediate impact of this research to women is minimal, as this is very early stage research. However, the study does reinforce the message that women should maintain a healthy weight before pregnancy.

Where did the story come from?

The study was carried out by researchers from the University of Adelaide, Monash University, and the Baker IDI Heart and Diabetes Institute in Melbourne. It was funded by the National Health and Medical Research Council of Australia, the Operational Infrastructure Support Program of the Government of Victoria, and the Women's and Children's Hospital Foundation. 

The study was published in the peer-reviewed journal Development.

In general, the media headlines implied that these drugs have been tested on women, when this is not the case. For example, the Mail Online's article did not mention that the research was carried out on mice, and had not actually been tested for this use in humans. This means we don't know if the drug would have the same effect in people as it does in mice.

The Independent's coverage was more balanced. It acknowledged the mouse origins of the research, but could have done more to spell out why this was a limitation. The article usefully included a quote from Professor Adam Balen, "a leading expert in reproductive medicine at the University of Leeds, and chair of the British Fertility Society" who said: "while any drug treatment was a long way off, the findings were 'very interesting'". He added that the important message to take away from this study is that: "women [need] to be nutritionally healthy before they get pregnant".

What kind of research was this?

This was an animal study looking at the effect of obesity on fertility in mice.

Previous animal studies have indicated that obesity affects the metabolism and growth of offspring, and rat studies have shown that obesity alters the egg before fertilisation. The authors also highlight that overweight women are more likely to require assisted reproduction, and the success rates are lower.

The researchers had already done studies using obese female mice to investigate what biological changes obesity might be causing. They found that mice fed high-fat diets had eggs with signs of intracellular stress. This included higher fat content, increased reactive oxygen species and altered mitochondria. Mitochondria are the parts of the cell that convert food to energy and feature heavily in the debate on whether three-parent fertility technology can or should be used in the UK.

In this study, they wanted to see whether this alteration in mitochondria was associated with reduced fertility, whether it is passed on to the offspring, and whether it affected the weight of the growing foetus. They also wanted to find out if the use of two experimental drugs that reduce intracellular stress could reverse these changes.

What did the research involve?

The researchers compared the fertility of obese mice with healthy-weight mice in a variety of experiments.

Mice with a genetic disorder similar to Alstrom syndrome in humans were used, and compared to mice of a healthy weight. This syndrome causes overeating that leads to severe obesity, increased insulin and diabetes, despite eating a low-fat diet.

The mice were given IVF drugs to stimulate their eggs to become ready for fertilisation. The following aspects were measured, comparing mice before and after they had become obese with healthy-weight mice:

the number of eggs stimulated by IVF drugs

the level of mitochondria activity in the eggs

the number of eggs able to be fertilised

weight of the growing foetus when implanted into mice of a healthy weight

The researchers then repeated the experiments after giving obese mice an experimental drug once per day for four days, to see if this could reverse the effects of obesity on the eggs and their development. The drug was either:

Salubrinal - an experimental drug that reduces cell stress responses

BGP-15 - an experimental drug that has been shown to protect against obesity-induced insulin resistance in mice. It is currently undergoing human trials for type 2 diabetes

What were the basic results?

Before the mice were obese, the same number of eggs developed after stimulation with IVF drugs as in healthy-weight mice. After they were obese, a reduced number of eggs were produced. This indicated that the fertility of the mice was affected by obesity, rather than the syndrome.

When obese mice were given either Salubrinal or BGP-15 for four days before the IVF drugs, the number of eggs developed more than doubled and was almost the same as for the healthy-weight mice. The number of eggs also increased when these drugs were given to healthy-weight mice.

The eggs of obese mice had indications of higher levels of intracellular stress and decreased mitochondrial activity. Obese mice given either drug did not have reduced mitochondrial activity.

Fewer fertilised eggs from obese mice survived compared to healthy-weight mice by four hours after fertilisation, or two days later. The same numbers survived if they were given IVF before they had become obese, or if obese mice had been given either Salubrinal or BGP-15.

When they implanted the fertilised eggs into normal-weight mice, compared to foetuses from healthy-weight mice:

foetuses from obese mice were significantly heavier

foetuses from obese mice given Salubrinal or BGP-15 were the same weight

How did the researchers interpret the results?

The researchers concluded that eggs from obese mice give rise to foetuses that are heavier and have reduced mitochondrial activity. They say that obesity causes intracellular stress in the eggs. They found that if either of two experimental drugs were given before fertilisation, this could reverse the following effects of obesity:

reduced response to IVF drugs

reduced mitochondrial activity

reduced fertilisation rate

developing foetus of increased weight


This mouse study has shown that obesity reduces fertility, but the exact mechanism remains unclear. It found that eggs from obese mice had reduced mitochondrial activity compared to when the mice were of a healthy weight, and this reduced mitochondrial activity is evident in the growing foetus. The researchers give a plausible explanation that it is the damaged mitochondria that causes the reduced fertility and increased weight; however, this is just a theory. The study does not prove that obesity causes reduced mitochondrial activity or that this would cause the offspring to be obese. The weight of the growing foetuses of obese mice was greater, but none were born.

Strengths of the study include the type of obese mice used (which are known as "Blobby mice" in Australia). Mice with this syndrome become obese regardless of the type of food they eat, because of the volume they consume. In this experiment, the researchers did not want to compare healthy-weight mice with obese mice that had become so because of just eating a high-fat diet, as this could confound the results.

While studies of other mammals such as mice are useful, they cannot tell us exactly what happens in humans. It is known that fertility rates improve when women who are overweight or obese lose weight, and this can be achieved through small changes such as increasing your activity levels and reducing your intake of calories.

The drugs in this trial are not yet available for humans, other than BGP-15 in a trial for type 2 diabetes. Neither of them have been tested in any fertility trials on humans. For further tips on improving your fertility, see our fertility pages.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.


February 15 2015


Blood lust: why period sex shouldn't be taboo in Hollywood or anywhere else | Chelsea G Summers

The room doesn't have to start red to end up that way. Photograph: Jamie Grill/Getty Images

I am a big fan of period sex.

Part of my enjoyment is that I came of age in a place (Vermont, renowned for its woodsmen and its hippies) and a time (the late 70s and early 80s) that were conducive to being matter-of-fact about female bodies. The very first time I had sex during my period was on the floor of a nearly-empty college apartment with a guy I was dating; I had no idea that I had gotten my period while we were shagging. I went to the bathroom and, in the greenish cast of the fluorescent lights, I saw the blood. I thought it was pretty cool.

I walked out and told the guy. "Oh," he said, looked down at his crotch, and offered me a beer. It was no big deal to him.

Period sex has rarely has been a big deal to the men I sleep with - and, if it is, we go our separate ways. I couldn't love a man who doesn't approach my menstruation with the same pragmatism I do. Sex feels good, menstruation is a fact of my life, and, as far as I'm concerned, period sex is what dark towels were made for.

Many women - and men - didn't have the benefit of growing up in a place and during a time in which either women's bodies or our bodies' natural processes were viewed without horror. These people often need reassurance that their bodies in their natural states are as sexy to others as they feel to themselves.

Reassurance is why the scene in Fifty Shades of Grey that begins, "'When did you start your period, Anastasia?'" is one of the most beloved, most celebrated erotic moments in EL James' book. It inflamed imaginations when the book came out, but Hollywood chose not to film the scene; the director, Sam Taylor-Thompson, said, "It was never even discussed".

But do a quick Google search for "50 Shades tampon scene", and you'll get almost 20,000 results - a number that suggests that even if the film's makers didn't want to discuss it, lots of other people do.

Hollywood doesn't like to mix its blood and its love - it likes to reserve blood for horror and, while horror movies will show sex, they inevitably end with someone bloody and dead (usually the woman). James' response to the scene's omission - that "first and foremost a romantic love story" - further elucidates the supposed incompatibility between love and blood: Hollywood decrees that you have your love over here, and your blood over there, and never the twain shall mix.

That, as most happy, loving couples of at least one female-bodied human can tell you, is pure fiction. Many women love menstrual sex - and, even if they don't, the controversy over its omission in the movie testifies to its power on women's imagination. The question isn't whether women often eroticize their periods; the question is why?

The key might be in the utter banality of the visual of got cut. "He reaches between my legs and pulls on the blue string ... what! And ... gently pulls my tampon out and tosses it into the nearby toilet", Anastasia narrates in the novel. The erotic frisson of Christian Grey removing Anastasia's tampon derives not merely from the fact that, faced with her menstruation, Christian proceeds with his erotic education of young Anastasia; it's that he removes her tampon himself and then boinks her against the vanity.

The prosaicism of the gesture is the symbolic lynchpin of the whole erotic enterprise; it both the thing that grosses out some readers, and the thing that enchants many more. In removing Anastasia's tampon himself, Christian embodies a desire for women that transcends the disgust that culture has made men and women feel about female bodies. This is what is so very riveting, so very sexy, and so very transgressive.

Any erotic depiction that erases the shame that women feel about their periods is a good thing. Periods are not a "curse". Menstruation is not "woman trouble" - or even "being touched by the goddess". Periods are a routine fact of most women's lives; and period sex is a joy, not a horror. It not only should be discussed, it ought to be depicted.


February 11 2015


10 crucial steps to prevent falls

Falling can have serious consequencesALAMY

Falling can have serious consequences

For many of us, starting to worry about falling over is a sign we are getting older and becoming frail. Falling can also be embarrassing so it can be difficult to accept there is a problem. Yet it isn't one we can safely ignore in the hope it will just go away.

Falls in the home are the most usual reason for hospital admission among over-65s and the largest cause of accidental deaths in the over-75s.

Around a third of people over 65 and half of those aged over 80 will fall every year and this can have very serious consequences. Ninety-five per cent of hip fractures are caused by falls and the NHS estimates that one in three patients dies within a year of such an injury often due to resulting conditions.

Yet that doesn't mean we should accept that falls are an unavoidable consequence of ageing. The good news is that up to 60 per cent of accidents can be predicted and prevented. The risk of falling is increased if you have fallen before, have problems with walking, use a walking aid or have conditions such as a previous stroke, Parkinson's disease, dementia or arthritis.

The risk can be increased for those who take four or more medications as combinations of different drugs can often cause dizziness. You are also at risk if you have a fear of falling, poor vision, problems with continence and balance. Another problem is low blood pressure which can lead to fainting and blackouts.

The golden rule to prevent falls and strengthen bones is to work on maintaining or improving your strength and balance

With recent icy weather warnings and the recommendation to avoid going to A&E unless absolutely necessary it is vital to take preventative measures to reduce your risk of falling.

These can be as simple as having regular sight tests, wearing properly fitting clothing or using protective devices such as hip protectors to mitigate the impact if you do take a tumble.

Here are my tips for things you can do to reduce your risk:

1 The golden rule to prevent falls and strengthen bones is to work on maintaining or improving your strength and balance.

There are a number of exercise options that can help you achieve this such as joining a tai chi or postural stability class. Visit your library to find out about exercise classes close to you or look online.

Many health authorities also have details on sessions that aim to boost strength and balance as well as the NHS falls prevention page at nhs.uk.

2 If you have a history of falls or haven't been as active in recent years see your GP or physiotherapist for a prescribed exercise programme. This may include exercises such as squats to strengthen leg muscles or standing on one leg to improve balance.

Tai chi is good for stabilityGETTY

Tai chi is good for stability

3 Minimise the amount of time you spend sitting and being sedentary for extended periods. You should aim to be active every day and do 150 minutes of moderate intensity activity each week, in bouts of 10 minutes.

If you have any medical conditions this should be done after checking with your GP or practice nurse.

4 Contact your local authority or GP to request a hazard assessment on your home. A healthcare professional will come to your house to assess any potential risks of falling such as loose carpets or trailing leads and advise on measures that can be taken to reduce them.

5 Wear well-fitting and sturdy shoes and avoid loose-fitting clothing that may trip you up while walking around the house.

6 Avoid long walks outside in winter if the conditions are wet or icy. Ask someone to accompany you or drive you to where you want to go.

7 Have regular sight tests. Impaired vision will greatly increase the risk of falling.

8 If you live in a care home and need help to move about ask your activities co-ordinator to start a new activities programme tailored to your needs. This should take account of medical conditions you have and build on what you can already do.

9 If you are taking medication make sure you have a regular review in case side effects result in a higher risk of falling. Speak to your GP to schedule reviews.

10 Wearing protective devices such as hip protectors can greatly reduce the risk of serious injury by lessening the impact of a fall on your hips, preventing possible fractures. Hip Impact Protection (hips-protect.com) offers devices that are affordable, comfortable and discreet.

o Dr Emma Stanmore is a lecturer at the School of Nursing, Midwifery and Social Work, University of Manchester. More information at profound.eu.com

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February 08 2015


Babies' eye movement autism link

6 February 2015

Last updated at 15:28

Frequent eye movements in babies could be a clue to whether they will develop an autism spectrum disorder, a Medical Research Council study suggests.

Using eye-tracking technology, researchers measured 100 six-month-old babies looking at a static image.

Those later diagnosed with ASD moved their eyes around more often, which could be a cause of learning problems.

Autism charities said the findings could help identify children at risk of autism.

It could be that when these babies look at something they are not engaging with it in the same way as other children tend to"

End Quote

Dr Sam Wass

MRC cognitive brain sciences unit

Dr Sam Wass, lead author of the study from the MRC's cognitive brain sciences unit, said this was a new finding that needed to be checked with more research on more babies.

The study stressed that eye movement on its own was not a reliable indicator that a child could be diagnosed with autism in the future.

But it could be a subtle early indicator of behavioural difficulties and a different way of processing visual information, Dr Wass said.

"Adults with autism spectrum disorders can sometimes process visual information more rapidly than other people, and perhaps that was happening for infants in our study.

"Alternatively, it could be that these babies need a higher level of stimulation, so they move their eyes more frequently to get more stimulation.

"Or it could be that when they look at something they are not engaging with it in the same way as other children tend to."

Rapid scanning

The research, carried out at Birkbeck, University of London, found that while most babies moved their eyes about twice a second, babies who were later diagnosed with ASD tended to move their eyes more often - about three times a second.

Although the difference was small, it was still significant, Dr Wass said.

The babies with more frequent eye movements were scanning the image more rapidly than the others.

Babies who were at higher risk of ASD in the study also showed little variation in their frequent eye movements compared with the low-risk group.

Dr Judith Brown, head of autism knowledge and expertise at the National Autistic Society, said babies could develop very differently.

"Parents of children with autism frequently tell us that they knew at a very early stage that their baby did not respond to the world around them in the same way as their peers.

"This study increases our understanding of the differences in visual attention in infants who go on to develop autism and may provide us with an extra diagnostic tool in the future which will help parents access the right support for their child at the right time."

Dr Simon Wallace, research director at Autistica, a charity for autism research, said the study was useful.

"This research is adding to growing evidence about very early brain and behavioural differences that indicate whether an infant is at elevated risk for autism."


February 04 2015


Half of people in Britain born after 1960 will get cancer, study shows

Cancer is primarily a disease of old age and because more people are living longer, more are likely to get it, says Cancer Research UK. Photograph: Brian Harris/Rex Features

One in two people will be diagnosed with cancer in their lifetime, according to Cancer Research UK, which says more effort must be made to prevent people getting the disease and that the NHS must plan to treat more patients.

Until now, CRUK's scientists have estimated that one in three people would get cancer at some point. The new figure, from a paper published on Wednesday in the British Journal of Cancer, is derived from a more accurate way of calculating the risk, says the charity. It means that half of those born after 1960 can now expect a diagnosis at some point in the future. For those born earlier, the risk remains at one in three.

More people are getting cancer mainly because they are living longer. "Cancer is primarily a disease of old age, with more than 60% of all cases diagnosed in people aged over 65," said the author of the paper, Prof Peter Sasieni, based at Queen Mary University London. "If people live long enough, most will get cancer at some point."

The new calculation comes from a different way of assessing people's lifetime risk of cancer. In the past, it has been worked out on the assumption that the risk people are born with remains the same throughout their life. This paper takes into account the changes in the population into the future - principally more people growing older, but also changes in people's eating, drinking, smoking, and other lifestyle habits that have an effect on cancer rates. It finds therefore that the risk of cancer for somebody born before 1960 is lower than that of somebody born after that date, which will be partly because those born later are likely to live longer.

The lifetime risk for women is lower than that for men, at 47.5% compared with 53.5%, the paper says.

CRUK and Sasieni point out that many cancers are preventable. "There's a lot we can do to make it less likely - like giving up smoking, being more active, drinking less alcohol and maintaining a healthy weight," said Sasieni.

"If we want to reduce the risk of developing the disease we must redouble our efforts and take action now to better prevent the disease for future generations."

While more people may get cancer, more are beating it as well. Cancer survival has enormously improved, says CRUK, doubling since the 1970s through earlier detection and improved treatment. Half of those newly diagnosed with cancer will survive for at least 10 years. But chief executive Harpal Kumar said there would never be a single cure for cancer. There are 200 types of cancer and they are all quite different, he said. "There will never be one single magic bullet that ... cures all cancers. I cannot foresee a time when that's going to be the case. But already we're able to cure a number of cancers now."

However, the burden of new cases on the NHS will be severe, says the charity. "We're living longer, and that means we're more likely to develop a range of age-related health issues," said Kumar. "We need to plan ahead to make sure the NHS is fit to cope. If the NHS doesn't act and invest now, we will face a crisis in the future - with outcomes from cancer going backwards.

"As [NHS chief executive] Simon Stevens set out in the NHS Five Year Forward View, we need better planning and innovative design of services. We also need to ensure the health service is adequately funded if we're to deal effectively with the growing burden of cancer and offer all patients the best chance of long-term survival."

Prevention is key to saving lives and saving money, he said. More than four in every 10 cancers could be prevented by changes in people's lifestyles.

Chief medical officer Dame Sally Davies said that cancer survival rates had improved to record levels in Britain.

Ellie Rose, public affairs manager at Macmillan Cancer Support, said the latest figures pose "a herculean challenge for the NHS and for society. With cracks already beginning to show, the NHS will soon be unable to cope with the huge increase in demand for services - meaning the support that organisations like Macmillan provide will become even more critical.

"Whichever party is voted in at this year's election will need to make sure the NHS is ready to support the colossal wave of people who will be diagnosed with cancer during their time in power."


February 01 2015


Child obesity rates 'levelling off'

30 January 2015

Last updated at 00:04

Person on scales

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Dominic Hughes reports: "It may be that finally the messages on healthy eating and lots of exercise are starting to take hold"

The rise in childhood obesity, which has left one in three children overweight, may be beginning to level off in the under-10s, a study suggests.

It found a steady rise in the proportion of overweight children in England in 1994-2003, but in the past decade it has remained at about 30%.

The King's College London researchers add obesity rates among 11- to 15-year-olds are still rising, however.

And Public Health England said there was no room for complacency.

Experts believe that being significantly overweight is responsible for a wide range of health problems such as heart disease, type 2 diabetes, some cancers and infertility.

The number of obese people in the UK has more than trebled in the past 25 years.

Obesity levels among children have also been rising during this period. One in three children in the UK is now overweight, while one in five is obese.

But data from other sources had previously suggested that childhood obesity levels were now starting to plateau or even fall slightly.

Age-group trends

This study, published in the Archives of Disease in Childhood, used GPs' electronic health records in England to monitor trends over 20 years.

Weight, height and body mass index (BMI) measurements for more than 370,000 children from 1994 to 2013 were analysed.

The findings show that the rate of growth of overweight and obesity levels, which was 8% each year up to 2003, has slowed substantially in the past 10 years, to 0.4%.

Trends were similar for both boys and girls, but differed by age group.

Overweight and obesity levels among two- to five-year-olds stayed relatively stable at 25% for boys and 23% for girls between 2003 and 2013.

In six- to 10-year-old girls and boys, about 30% were overweight or obese during that time.

The highest figures were seen in 11- to 15-year-olds, where overweight and obesity levels ranged from about 26% in 1996 to 35% in 2003.

Among this group, overweight and obesity levels have continued to rise - to 37% - in the past decade.

The study defined overweight as equivalent to a BMI (body mass index) at or above the 85th centile and obesity as above the 95th centile.

'Vulnerable group'

Dr Cornelia van Jaarsveld, from the department of primary care and public health sciences at King's College London, said there were several possible reasons for the "recent stabilisation of childhood overweight and obesity rates".

She said public health campaigns and initiatives could be starting to work.

But another explanation could be that a ceiling or "saturation point" had been reached with obesity rates.

However, she said it was clear that the 11- to 15-year-olds were still a "vulnerable and difficult group".

Colin Michie, chair of the nutrition committee at the Royal College of Paediatrics and Child Health, said the good news was that things were not getting worse.

"But it still leaves us with lots of problems, particularly among teenagers, who are not easily directed, at a sensitive time in their lives," he said.

"It is a disappointment that even more children are overweight and obese at the end of primary school than at the beginning.

"Prevention works better in younger age groups, so we have to focus on cutting calories and encouraging a more active, healthy lifestyle in children."

Eustace de Sousa, national lead for children, young people and families at Public Health England, said that overall childhood obesity rates had remained stable since 2010.

"However for children from the poorest households levels have continued to worsen, so there is no room for complacency.

"Obese children are more likely to experience bullying, low self-esteem, anxiety, depression and have a higher risk of developing type 2 diabetes and heart disease in later life."

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