Dr Samit Joshi of Yale University School of Medicine found changes in bacteria in the mouth preceded the development of pneumonia.

He concluded that this process “suggests that changes in oral bacteria play a role in the risk for developing pneumonia”.

Pneumonia is thought to affect more than 620,000 people in the UK and claims the lives of around five per cent of those who contract the disease. Which means that it kills more than ten times the number of people who die in the UK from road accidents.

Although further research is required to determine the exact relationship between oral health and pneumonia, it is not the first time the two diseases have been linked.

Poor oral health has been associated with respiratory diseases for a number of years, as bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs.

This can cause infections, such as pneumonia, or could worsen an existing condition.

Studies have even suggested a higher mortality rate from pneumonia in people with higher numbers of gum problems.

The findings of the study present further evidence that there’s a significant health risk to the elderly and the young, according to Chief Executive of the British Dental Health Foundation, Dr Nigel Carter.

Dr Carter said: “During the winter months we’re all susceptible to colds, coughs and chesty viruses due to the drop in temperature. What people must remember, particularly those highlighted as vulnerable, is that prevention can be very basic.

“Systemic links between gum disease and overall health have been well documented, and at this time of year keeping up good oral health can really help stave off illness.

“Simply brushing your teeth for two minutes twice a day using a fluoride toothpaste, cleaning in between teeth daily with interdental brushes or floss, cutting down on how often you have sugary foods and drinks and visiting the dentist regularly, as often as they recommend will be a great starting point.

“If you have swollen gums that bleed regularly when brushing, bad breath, loose teeth or regular mouth infections appear, it is likely you have gum disease.

“If any of these symptoms persist, or signs of pneumonia develop, visit your dentist and GP immediately.”

The research was presented at the Infectious Diseases Society of America annual meeting in Boston looked at 37 subjects for a one month period.

The first ever National Audit of Dementia found a “shocking” lack of care delivery.

Data from 210 hospitals in England and Wales was used in the report along with ward level data from a sample of 145 wards, over 2,000 staff questionnaires and observations of care on the wards.

Professor Peter Crome, the co-author of the report and Chairman of the National Audit of Dementia Steering Group, said that the report had “found problems across practically every aspect of care for patients admitted to hospitals with dementia.”

He added: “There were deficiencies in the assessment of people and there were deficiencies in the interaction betweem staff and patients.”

Hannah Clack from the Alzheimer’s Society called the report “shocking” and stressed the need for “a huge and radical shake-up of the way the NHS deals with people with dementia.”

She added: “People are going into hospital and they’re coming out worse in terms of their dementia and in terms of their physical health.”

The report recommended that all staff should have basic training in dementia, and that all hospitals should have Dementia Champions on every ward.

The study, lead by Dr Michelle Harvie, and presented at the San Antonio Breast Cancer Symposium, found that women who followed a diet for just two days of the week lost more weight than those practising a full time diet.

The researchers put 100 overweight female volunteers on one of three diets.

The first diet consisted of consuming just 650 calories a day for several days of the week, with carbohydrates such as potatoes and bread cut out. For the remaining five days of the week the participants, whilst encouraged to eat healthily, could consumer whatever they liked.

Although volunteers on the second diet were also banned from eating carbohydrates for two days in a week, they were not set a specific calorie limit.

They were also allowed to eat as much as they wanted for the remainder of the week. The third and final group followed a more conventional diet, which included avoiding high-fat foods, alcohol and sticking to approximately 1,500 calories every day.

The results of the study showed that after three months the women on the two day diets had lost an average of nine pounds, compared to five pounds of those on the full time diet.

Volunteers who had followed the two day diet had lost nearly twice the amount of weight of those on the more traditional full time diet, and recorded significant improvements in three key areas linked to breast cancer. Their levels of hormone leptin dropped by 40 per cent.

Research professor Gillian Haddock, who also took part in the study herself, has said she would recommend the diet to friends and that she found it an easier diet option.

Mrs Haddock said: “I used to follow the 650 calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

The research, conducted at the Genesis Breast Cancer Prevention Centre at UHSM, was published in the International Journal of Obesity.

Pamela Goldberg, chief executive of the Breast Cancer Campaign said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

The diet that the women followed for only two days a week:

• Breakfast: Fruit tea and a banana, or mug of milky coffee.
• Mid-morning: Can of diet cola, or cup of tea and plum.
• Lunch: Carrot and coriander soup and half pint of milk, or salad, glass of squash and half pint of milk.
• Mid afternoon: Glass of squash, or glass of sparkling water and Satsuma.
• Dinner: Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two vegetables, half pint of milk and cup of tea.
• Supper: Pint of milk, or hot milk with cinnamon and sweeteners.

Patients with hypertension, or chronic high blood pressure, are often given drugs to lower their risk of heart disease and stroke but the medication could also benefit a wider group of patients.

An analysis of 16 studies, covering 70,664 patients, found that treating 169 prehypertensive people with blood pressure-lowering medication for 4.3 years would prevent one stroke from happening.

High blood pressure is the biggest risk factor for stroke, and an estimated 40 per cent of strokes could be prevented if people took steps to control their blood pressure levels.

US data shows that about 10 per cent of Americans have prehypertension, with a blood pressure between 120/80mm Hg and 139/89mm Hg – higher than the upper boundary of “normal” but below the lower limit of hypertension.

Ilke Sipahi of the Harrington-McLaughlin Heart and Vascular Institute in Cleveland, Ohio, who led the study, published in the Stroke journal, said patients would be better off trying to lower their blood pressure through a healthy diet and physical activity than by taking pills.

He said: “We do not think that giving blood pressure medicine instead of implementing the lifestyle changes is the way to go … however, the clear-cut reduction in the risk of stroke with blood pressure pills is important and may be complementary to lifestyle changes.”

Dr Sharlin Ahmed of The Stroke Association said: “Making a few simple lifestyle choices, such as eating a healthy diet low in salt, giving up smoking, and exercising regularly can help to keep your blood pressure under control and can reduce your risk of stroke.

“As highlighted in this study, it may also be beneficial for some people with borderline high blood pressure to take blood pressure lowering medication, however this needs to be discussed with your GP.”

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

Dr Guthrie, a member of the Faculty of Sexual and Reproductive Health, was concerned that women could take the pill during these days and wrongly think they would avoid pregnancy.

She said: “There’s very clear evidence showing that it’s not effective in the couple of days running up to ovulation, and probably not very effective in the 36 hours afterwards.”

The aim of the bpas scheme is to cut the number of women seeking abortions over the festive season.

The idea is that women will be able to pop the pill on the morning after accidentally having unprotected sex, rather than having to get an appointment, which can be difficult over the Christmas break.

Part of the rationale is, as bpas puts it, “the sooner the morning after pill is taken after unprotected sex, the more effective it is.”

Dr Guthrie, who works in East Yorkshire, agreed with that, saying that Levonelle should always be taken within 72 hours of sex.

However, she was concerned that women would not be sufficiently informed of Levonelle’s limitations.

While she welcomed immediate access to emergency contraception, she said: “You have to know how effective or ineffective it is.”

Guidance from the faculty, published this August, states that Levonelle “has been shown to be no better than placebo at suppressing ovulation when given immediately prior to ovulation, and is not thought to be effective once the process of fertilisation has occurred”.

Dr Guthrie said that, if a woman has had unprotected sex at this time of the menstrual cycle, she should see a doctor about obtaining another form of emergency contraception.

In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.

The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.

Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.

In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors.

The findings of the research The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK were published in the British Journal of Cancer.

Smoking was the biggest factor, causing nearly one in five of all cancers.

But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.

He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”

Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.

The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.

Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.

Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.

Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.

The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.

Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.

“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”

It wants the Department of Health in England to carry out the first proper review of drinking guidance in more than 15 years, which should follow the example of Scotland in recommending two “dry” days a week.

The MPs also want new rules on what would count as a dangerous night of “binge-drinking”, new lower safe levels for older people and a website where people can work out individual intake based on their age, weight and family history.

They say few people understand what constitutes an alcoholic unit, the basis of the drinking advice, and tell ministers that the guidelines do not seem to change behaviour.

Although the Committee’s report concedes that the drinks industry is needed to help improve labelling on bottles and glasses, it warns of potential conflicts of interest if the Government works too closely with brewers and shops.

Andrew Miller, the Committee’s chairman, said: “Alcohol guidelines are a crucial tool for Government in its effort to combat excessive and problematic drinking. It is vital that they are up-to date and that people know how to use them.

“Unfortunately, public understanding of how to use the guidelines and what an alcohol unit looks like is poor, although improving.

“While we urge the UK Health Departments to re-evaluate the guidelines more thoroughly, the evidence we received suggests that the guidelines should not be increased and that people should be advised to take at least two drink-free days a week.”

The MPs’ report, published on Monday following public hearings and written submissions last year, states that the first Government health advice on sensible drinking was not published until the 1980s.

Originally, the public were told that men could safely have 18 “standard drinks” a week and women half that number, while in 1987 this was revised in favour of weekly “sensible limits” of 21 units for men and 14 for women.

Medical research later suggested that moderate daily alcohol intake could be good for the health, by lowering levels of bad cholesterol in the blood, while giving weekly limits could “mask episodes of heavy drinking”. In 1995, therefore, daily limits were introduced that recommended men should not drink more than three to four units a day, and women two to three.

Some experts, however, raised concerns that this switch from weekly to daily limits appeared to increase the weekly “allowance” of alcohol while also appearing to “endorse daily drinking”.

The MPs say more recent studies have cast doubt on the health benefits of regular drinking, and recommend that England follows Scotland’s lead in urging “at least two alcohol-free days a week”.

They back current specific advice for children and pregnant women, and say “there could be merit” in producing new rules for older people as well as limits for “individual drinking episodes”, but find no evidence for increasing current general safe limits.

The Committee says an expert group, including civil servants as well as scientists, should review current evidence on the health effects of alcohol in order to “increase public confidence”.

They say people should be made aware of the difference between the short-term effects of binge drinking and the long term harm caused by alcoholism, and should be helped to understand how many units are in different drinks.

Officials say the implants – thought to have been fitted in some 52,000 women who wanted larger breasts for cosmetic reasons or after cancer surgery – only need to be replaced if they have ruptured but will also carry out the procedure if the patients are worried about them.

Most independent providers have agreed to provide free surgery for their patients who received implants made by the now-defunct Poly Implant Prothèse (PIP) – which were filled with non-medical grade silicone intended for use in mattresses – at least one is holding out while another has so far refused to reveal its policy.

Transform Cosmetic Surgery said the Government needed to “accept its responsibility” for the problem as the implants had been approved for use by a watchdog, the Medicines and Healthcare products Regulatory Agency.

Transform carries out 6,000 breast augmentation procedures a year, and estimates it has fitted some 4,000 women with PIP implants in recent years.

The clinic is currently refusing to pay for them to be removed and replaced and is charging women £2,800 per procedure, although it insists most implants are not at risk of malfunctioning. Some patients have already been booked in for the operation.

It said it would review its stance this week, but if it remains unchanged it could mean the Government has to step in and pay for these women’s operations, at a cost of up to £11.2m.

Nigel Robertson, the chief executive of Transform Cosmetic Surgery, said in a statement: “Transform is fully committed to supporting the Department of Health in its efforts to end the uncertainty and anxiety of British women affected by the PIP situation and awaits a response to its request for an urgent meeting to discuss the way forward.

“It is important to recognise that this crisis is the result of failed regulation of breast implants, which were approved for use. The Government needs to accept its responsibility for this situation and work constructively with us to find a workable solution.”

The other major clinic yet to announce its decision is The Hospital Group.

It is telling patients there is “no evidence to suggest routine removal” of PIP implants but will replace those that have already ruptured “free of charge”.

Other leading providers including BMI Healthcare, Nuffield Health and Spire have agreed to offer free removal of the PIP implants.

Michelle Victor, a solicitor at Leigh Day & Co, said the firm had already been contacted by women seeking help to make private clinics pay for the replacement of their PIP implants.

She said that although the clinics themselves were not responsible for making them, the implants were “not fit for purpose” and so cosmetic surgery groups should remove them.

From: http://www.telegraph.co.uk/Leading-cosmetic-surgery-group-refusing-to-fund-new-breast-implants

Positive changes have a domino effect meaning people who don’t smoke tend to eat less fatty food and those who quit cigarettes find that they eat more fruit and vegetables.

The study was carried out by the social research experts at the National Centre for Social Research (NatCen) for the Department of Health.

While healthy habits breed more healthy habits, the same was also found with unhealthy habits.

People who regularly ate fried food were more likely to eat too much salt and people who consumed too much alcohol also ate fewer fruit and vegetables.

Chief Medical Officer, Professor Dame Sally Davies said: “The New Year is a great time to renew efforts and give up unhealthy habits, such as smoking, and take up healthier ones, such as regular physical activity, improving our diet and drinking less.

“This NatCen research shows that if you make one healthy resolution this New Year you might get double the benefits as you are more likely to make other positive healthier changes too. So, start thinking about other areas where you can improve your health and set yourself up for a healthier life, for 2012.”

So if you have made a promise to improve your wellbeing in 2012- you now have a double reason to stick to your new lifestyle. Good Luck!

Health Direct wishes you a healthy, happy and prosperous New Year.

We would also like to take the opportunity to thank and support all of those hard working professionals within the NHS- without whom we would all be paddleless.

A large proportion of the patients involved were aged over 75, the figures from the NHS Information Centre show. Illnesses related to such infections led to average stays in hospital last year of 31.1 days.

Experts blamed poor hygiene for the dramatic rise in infections, including superbugs MRSA and Clostridium difficile (C. diff) as well as norovirus and E.coli.

But the Department of Health dismissed the “misleading” figures, published online, saying that officials have “got better and better at tackling hospital infections”.

According to the new figures, supplied by NHS hospitals, the number of patients found by consultants to have hospital acquired infections rose last year reached a record 42,712.

That figure increased from the 31,447 recorded in the previous year and almost double the 22,448 documented in 2008/09.

Last year’s figures were the highest levels recorded in the 13 years in which the records have been publicly available. In 1998/99 there were just 335 such cases. The Centre did not provide a breakdown of illnesses.

It came as the Health Protection Agency said that there were 46 suspected outbreaks of norovirus in hospitals over the past two weeks, with more than half leading to ward closures or admissions restrictions.

The agency said the levels were within seasonal norms.

Commenting on the overall infection levels Joyce Robins, co-director of Patient Concern, said the figures were a “terrifying prospect for vulnerable elderly people who think they are going into hospital to get better”.

“It contrasts sharply with the happy propaganda that has been telling us that infection rates had dropped sharply,” she said.

A DoH spokesman said: “The NHS has got better and better at tackling hospital infections, demonstrated by the record lows we have seen this year.

“Because we are not complacent, we have introduced mandatory reporting of more hospital infections. That means that we have shone a light on the problems previously swept under the carpet.  But patients should be confident that the measures we have taken will continue the downward trend in hospital infections.”

The figures for last year represent an 11 per cent increase on the previous 12 months, when alcohol-related admissions stood at 1,056,962.

Separate information published by Anne Milton, the public health minister, showed that since January an estimated 7,074 under-18s have been admitted to hospital due to alcohol abuse.

A recent report predicted that binge drinking will cost the NHS £3.8 billion by 2015, with 1.5 million A&E admissions a year.

Andrew Lansley, the Health Secretary, blamed Labour’s 24-hour drinking policy and accused the last government of “taking their eye of the ball” on the issue of binge drinking.

He said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge-drinking and long-term excessive alcohol abuse in a minority of people.

“Our alcohol strategy, which we will set out in the new year, will outline what further steps we are taking to tackle this growing problem.”

Recent Local Alcohol Profiles for England figures also show that the number of hospital admissions for conditions attributable to alcohol are rising at a similar rate.

The number of admissions has more than doubled since 2002/03 and increased by nine per cent last year.

In 2002/03 there were 926 admissions per 100,000 people for conditions caused by alcohol, rising to 1,743 per 100,000 in 2009/10 and 1,898 last year.

The biggest increase over the past 12 months was in London, with a jump in admissions of 14 per cent, followed by the East of England with 10 per cent.

Overall confirmed individual cases across the country from July to mid-December are 19 per cent higher than during the same period last year.

Norovirus is extremely contagious and can be lethal to the elderly, very young or very sick patients.

People who have been ill are being asked not to visit friends and relatives in hospital until they are well.

Medical bosses at hospitals across the country are working to prevent the condition spreading and to reopen wards that were closed yesterday.

Nationally data from the Health Protection Agency released last week shows that norovirus rates remain below the level expected for this time of year, possibly reflecting the mild weather until now.

The HPA declares norovirus season has started when 4.8 per cent of calls to NHS Direct are about vomiting. Last week there were 4.2 per cent of calls about vomiting.

The first sign of Norovirus is usually a sudden sick feeling followed by forceful vomiting and watery diarrhoea. Other symptoms include a raised temperature, headaches, stomach cramps and aching limbs.

The data showed that last week the North East and South West were the worst affected.

Three hospitals reported that 124 beds are unavailable as a result of the ward closures. It is thought that the true number across all eight hospitals will be more than 200.

Wards were also closed to new patients at Montagu Hospital in South Yorkshire while 82 beds were closed on two wards at Northwick Park in Harrow, north London.

Croydon Health Services said it had one ward closed to new admissions.

Two wards were also closed at Warwick Hospital and the Richard Wells Ward was shut at Bedford hospital to contain a bout of gastroenteritis.

Director of nursing and patient services at Bedford hospital, Eiri Jones, warned visitors not to sit on hospital beds and not to visit at all if they had been ill in the preceding 72 hours.

Queens Hospital in Burton had one ward temporarily closed after a number of cases of diarrhoea and vomiting while the Countess of Chester Hospital had visiting restrictions in place at four wards to contain the outbreak.

A 14-bed ward at the University Hospital Southampton Trust was closed and County Durham and Darlington said it had seen isolated cases but had not had to close any wards.

Visitors to Northern Devon hospitals were warned only close relatives should visit patients and Mid Essex Hospital Trust said it had closed wards last weekend because of a similar outbreak.

The Royal College of GPs say the virus has not been a major problem so far this year – although outbreaks can occur very quickly, as the complaint is extremely infectious.

A statement from the Health Protection Agency said: “Norovirus is highly contagious and can be transmitted by contact with an infected person; by consuming contaminated food or water or by contact with contaminated surfaces or objects. The virus spreads rapidly in closed environments such as hospitals, schools, nursing and residential homes.

“Anyone who thinks they may have norovirus should not to go to their doctor’s surgery or A&E as this could spread the illness to vulnerable people and health care workers.”

Blood sugar, which can rise as a result of an unhealthy diet or lack of exercise, was already known to cause ill health but the study is believed to be the first to link high levels to appearance.

Researchers found that every additional millimole per litre increase in blood sugar, which in healthy people is usually between five and six mmol/l, adds five months of ageing to their facial features.

They measured the blood sugar of 602 people, while a group of 60 independent assessors studied two photographs of their faces to come up with a “perceived age” score.

Healthy people with low blood sugar typically looked a year younger than those with high readings, and a year-and-a-half younger than diabetics, the study published in the Age journal found.

The ageing could be caused by a build-up of sugar which sticks to collagen – a protein in the skin which keeps it supple – and is difficult for the body to remove.

Alternatively, the glucose could hamper insulin production which is believed to play a central role in ageing, researchers said.

David Gunn, who led the Unilever study, said: “The higher glucose people had, they started looking older. Diabetics looked older again, and they have had the worst exposure to high glucose levels.

“This adds extra evidence that there is another reason to have a healthy lifestyle – because it is going to affect your appearance as well as your health.”

Diana van Heemst, of Leiden University in the Netherlands, who contributed to the paper, said: “The results from this study further underscore how important regulation of blood glucose levels is for wellbeing and health in advanced middle age.

“The associated benefit of looking younger might provide an extra motivation to bring about healthy lifestyle changes in 50-to-70 year olds.”

From:  http://www.telegraph.co.uk/High-blood-sugar-speeds-up-ageing

The annual study carried out across England is a detailed survey of the “postcode lottery” in NHS treatment.

Ministers say the results will help identify “unjustified” disparities and drive up standards resulting in “consistently high quality care”.

The report shows a stark contrast in the rate of prescribing anti-dementia drugs.

Patients in north Lancashire are being described 25 times as many treatments and tablets to help “temporarily improve or stabilise symptoms” than in Kent.

The report suggests that one possible reason is the lack of awareness some GPs have about how to spot early symptoms of Alzheimer’s disease – a concern shared by campaigners for those living with the illness.

It also highlights worries that some breast cancer patients are staying in hospital too long in some parts of the country as compared with others.

The survey notes that most patients undergoing breast cancer surgery can be “safely managed as day cases or with a single overnight stay” but that currently more than 20 primary care trusts have average lengths of stay “in excess of three days”.

For example, the same surgery carried out in parts of south Wales resulted in patients staying in hospital for a few days where in Hertfordshire they stayed only one night.

Access to care homes – paid for by the NHS for those receiving end-of-life care or round-the-clock intensive care – also varied considerably.

In Devon and Cornwall, with its high elderly population, the admission rate for those aged over 74 to care homes funded by the NHS was just under three per 100,000 of the population. The figure in Northumberland was 190.

Meanwhile the rate of angioplasty operations – which tackle blocked and narrowed arteries – was three times higher in Peterborough than County Durham.

The report measures 71 key indicators, including hospital admission rates, what treatments health trusts choose to fund, and how children are managed in the NHS.

It attempts to map the “utilisation of healthcare services that cannot be explained by variation in patient illness or patient preferences”.

Health minister Lord Howe said: “The Atlas of Variation lets us look at how the local NHS is meeting the clinical needs of their local population.

“This will help commissioners to identify unjustified variations and drive up standards so patients are receiving consistently high quality care throughout the NHS.

“We are committed to improving results for patients and our new NHS Outcomes Framework will hold the NHS to account for this. Commissioners will be able to apply contractual penalties if any organisation is failing to deliver improvements for patients.”

It has accused the Care Quality Commission for failing to follow up a whistle blower’s warnings of alleged abuse of patients at the Winterbourne View care home near Bristol, of failing to “provide value for money”.

The CQC was established by Labour and cam into being in April 2009, bringing together three predecessor organisations – the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.

But the NAO report said work on inspecting health and social care organisations “fell significantly” after April 2009, “due to the Commission’s decision to prioritise registration over compliance”.

Besides checking institutions, the CQC also has responsibility for registering them.

The report found the CQC “diverted resources in a bid to meet the statutory timetable for registration”.

As a result, it completed just 47 per cent of its target number of compliance reviews of standards of care between October 2010 and April 2011.

Government recruitment restrictions meant 14 per cent of staff positions were vacant last September, with serious shortages of registration assessors and compliance inspectors.

The CQC was established with a budget six per cent lower than the money given to the organisations it replaced, the NAO noted.

Amyas Morse, the Auditor General, said the CQC has had “an uphill struggle to carry out its work effectively and has experienced serious difficulties”.

Margaret Hodge, chairman of the House of Commons’ Public Accounts Committee, said of the CQC: “This report raises serious concerns about whether it is up to scratch.”

Cynthia Bower, the CQC’s chief executive, said it was now “firmly on the right track”.

From: http://www.telegraph.co.uk/Care-home-checks-fell-significantly-under-CQC-warns-NAO

When a BBC Panorama programme contacted 85 hospital trusts with PFI deals, it found 80 of them said they were having to make increased payments due to inflation.

When most of the deals were set up, inflation was low and the outlook was for that to continue well into the future.

Most trusts decided not to protect their debts from rising inflation, against the advice of the Treasury.

By contrast, the companies building the hospitals insured themselves against losses due to inflation.

The PFI deals, under which companies build hospitals to be leased back by the NHS, typically run for 30 years.

Margaret Hodge, the Labour MP who now chairs the Public Accounts Committee, admitted to the programme: “We should have been much more transparent about the costs. I think we got the balance wrong.”

Richard Bacon, a Conservative member of the committee, said he thought taxpayers were being “ripped off”.

A spokesman for the Treasury said that protecting PFI debts against inflation was “not mandatory … because it is subject to individual authorities undertaking their own project assessments”.

He added said: “The Government has consistently expressed concerns about the misuse and costliness of PFI. That is why, less than two weeks ago, the Government launched a fundamental review of the PFI model, which will see the end of PFI as we know it.”

Eating fish could protect against Alzheimer’s disease and memory loss – but only if it is baked or grilled, researchers have claimed.

But it is essential that the fish is cooked in a manner that preserves the vital Omega-3 fatty acids which help protect the brain, researchers said.

Grilling or baking the meat provides the maximum levels of Omega-3, which increase blood flow to the brain, reduce inflammation and limit the build-up of harmful plaques which precedes Alzheimer’s.

In contrast fried fish has very low amounts of Omega-3 and consequently offers no protection whatsoever against dementia and age-related memory loss, known as Mild Cognitive Impairment (MCI).

Researchers from the University of Pittsburgh studied a group of 260 healthy volunteers with an average age of 76.

In a study Eating Fish Reduces Risk of Alzheimer’s Disease to be presented at the Radiological Society of North America annual meeting they questioned the participants about how regularly they ate fish.

Brain scans carried out ten years later showed that those who did not eat fish regularly had suffered much more shrinkage in key areas of the brain linked to working memory.

A further five years on, they found that 31 per cent of non-regular fish eaters had gone on to develop Alzheimer’s or MCI, compared with between three and eight per cent of those who ate fish at least once a week.

Dr Cyrus A. Raji, who led the study, said further studies could help identify whether Omega-3 supplements yielded similar effects, and whether some types of fish offered better protection than others.

He said: “We know from other studies that salmon gives the maximum amount of Omega-3 fatty acids so it is very possible, but we did not look at which fish people were eating in the study.

“Studies like this definitely justify trials that will look at Omega-3 fatty acid supplements. Having said that, I would speculate that taking supplements is no substitute for a lifetime of eating fish.”

Dr Simon Ridley, head of research at Alzheimer’s Research UK, said: “This study suggests that eating fish on a weekly basis may reduce the risk of cognitive decline, but it is not clear whether other underlying factors may have contributed to the lower risk in people who eat fish.

“As a number of controlled studies using fatty acids from oily fish have failed to show benefits for dementia, there is a clear need for more conclusive research into the effects of dietary fish on our cognitive health.”

Dr Anne Corbett, research manager of the Alzheimer’s Society, added: “This moderately sized study adds weight to existing evidence suggesting that eating fish reduces your risk of developing cognitive decline.

“However, this research did not account for lifestyle factors such as other foods or exercise which could also have had an effect. The best way to lessen your chance of developing dementia is to eat a healthy diet including fruit and vegetables along with taking regular exercise and giving up smoking.”

The figure is far worse than most other countries.

By comparison, 12.7 per cent of Frenchwomen are overweight, 14.4 per cent of Spaniards and just 9.3 per cent of Italians.

Experts from the European Commission, which compiled the figures for the year 2008/9, are concerned at the number of young British women who are obese.

Across most of Europe, very few 18- to 24-year-olds are obese but in Britain 16.6 per cent of young women are too fat.

The data comes from the European Health Interview Survey (EHIS) published by Eurostat, the EU’s statistical office- Overweight and Obesity BMI Statistics.

The statistics showed British men are not far behind, with 22.1 per cent being classed as overweight, coming second only to Malta.

They found the share of overweight and obese people increases with age in all of the 19 member states for which data was available.

The figures also show the proportion of women who are obese or overweight falls as the educational level rises.

The high levels of obesity in the UK are in stark contrast to those in countries such as Romania, where just 8 per cent of women were classed as obese along with 7.6 per cent of men.

Obesity is defined as having a Body Mass Index of over 30. BMI is calculated by dividing one’s weight in kilograms by the square of one’s height in metres.

Earlier this year, a report by the World Health Organisation found that British men were among the fattest in Europe and that, as a nation, we do less exercise than almost every other.

The study ranked British men as the third fattest in Europe, with 67.8 per cent of males aged 15 or older either overweight or obese – only Greece (77.5 per cent) and Malta (73.3 per cent) were fatter.

The report also found that Britain is the ninth least active nation in the world, with 63.3 per cent of adults taking less than 30 minutes of moderate exercise five times a week.

Cardiovascular disease is Britain’s number one killer, accounting for more than 191,000 deaths every year.

Body mass index (BMI) and waistline also were reduced, while all three measures were unchanged in untreated control monkeys.

Imaging studies also showed a substantial decrease in body fat among treated animals.

A research team led by scientists at The University of Texas MD Anderson Cancer Centre carried out the study.

Co-senior author Professor Renata Pasqualini, at the David H. Koch Centre for Applied Research of Genitourinary Cancers, said: “Development of this compound for human use would provide a non-surgical way to actually reduce accumulated white fat, in contrast to current weight-loss drugs that attempt to control appetite or prevent absorption of dietary fat.”

She said previous attempts to treat obesity have predominantly focused on drugs aimed at suppressing appetite or increasing metabolism, but these efforts have been hampered by their toxic side-effects.

The MD Anderson group designed a new drug, which includes a homing agent that binds to a protein on the surface of fat-supporting blood vessels and a synthetic peptide that triggers cell death.

Their blood supply gone, fat cells are reabsorbed and metabolised.

Co-senior author Professor Wadih Arap, said: “Obesity is a major risk factor for developing cancer, roughly the equivalent of tobacco use, and both are potentially reversible.”

In earlier preclinical research, obese mice lost about 30 per cent of their body weight with the drug, now called Adipotide.

The drug acts on white adipose tissue, the scientific name for the unhealthy type of fat that accumulates under the skin and around the abdomen, and is a disease and mortality predictor.

Prof Pasqualini said: “Most drugs against obesity fail in transition between rodents and primates.  We’re greatly encouraged to see substantial weight loss in a primate model of obesity that closely matches the human condition.”

The primate model also shares other physiological features associated with human obesity, such as metabolic syndrome, characterised by an increased resistance to insulin, which can lead to the development of type 2 diabetes and cardiovascular disease.

Adipotide-treated monkeys showed marked improvements in insulin resistance – using about 50 per cent less insulin after treatment.

Now the research team are preparing for a clinical trial in which obese prostate cancer patients would receive daily injections of Adipotide for 28 consecutive days.

Prof Arap said: “The question is, will their prostate cancer become better if we can reduce their body weight and the associated health risks?”

He said some prostate cancer treatments, such as hormone therapy, cause weight gain.

Greater weight can lead to arthritis, which in turn causes inactivity that leads to more weight gain.

Fat cells also secrete growth hormones that cancer cells thrive on.

Weight, BMI and abdominal circumference all continued to drop for three weeks after treatment ended before turning back up during the eighth week of the study.

Treated monkeys’ abdominal fat levels fell by 27 per cent during the study. Fat levels increased slightly in the control group.

Lean monkeys did not lose weight in a separate study to test for potential effects of the drug in non-obese animals, indicating that the drug’s effect may be selective for obese subjects.

Monkeys in the studies remained bright and alert throughout, interacting with caretakers and demonstrating no signs of nausea or food avoidance.

This is potentially an important finding since unpleasant side-effects have limited the use of approved drugs that reduce fat absorption in the intestines.

The principal side effects were noted in the kidneys.

Study first author Dr Kirstin Barnhart, a veterinary clinical pathologist said: “The renal effect was dose-dependent, predictable and reversible.”

The results were published in the journal Science Translational Medicine.

It finds people in Britain have among the fastest access to GPs, the best co-ordinated care, and suffer from the among the fewest medical errors, of 11 high income countries surveyed.

The countries examined were: the UK, France, Germany, Switzerland, Sweden, Norway, the Netherlands, the US, Canada, Australia and New Zealand.

Britain and Switzerland were consistently among the best performers, found the analysis of answers from over 18,000 adults with chronic and serious illness.

For example, the Washington DC based organisation reported: “UK and Swiss patients reported more positive health care experiences than sicker adults in the other countries: they were more likely to be able to get a same- or next-day appointment when sick and to have easy access to after-hours care, and they were less likely to experience poorly coordinated care.”

The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US.

The Commonwealth Fund is a private foundation which claims to support “independent research on health policy reform”.

However, it is widely seen in the US as being strongly in favour of President Obama’s health reforms.

Today’s report is highly critical of current US healthcare. Karen Davis, its president, says the country “practically stands alone when it comes to people with illness or chronic conditions having difficulty affording health care and paying medical bills”.

A spokesman for the Royal College of General Practitioners said the survey “shows yet again that the excellent work carried out by GPs in the UK is recognised worldwide, leading the field in ease of access, coordinated care and good patient doctor relationships”.

He added: “If the current reform of the NHS is to achieve anything, it must preserve and build on the strengths of general practice by producing more GPs, who are trained for longer so that they can do even more to improve the health of their patients.

“The NHS stands out internationally as an example of excellence, and general practice is what makes the NHS safe, fair and value for money.”

With the clocks going back and nights getting longer, some specialists are arguing that coffee bars, which provide high-strength lighting along with their lattes, might help the one in five people who suffers from seasonal affective disorder (SAD), a type of depression triggered by lack of light in winter.

Light cafés have taken off in Sweden, which has nearly a million SAD sufferers and where winter gloom is a far greater problem than in the UK. Stockholm, for example, gets only five hours of daylight in the winter months. But the city’s commuters can stop off in cafés, such as the Iglo, and sit bathed in UV-free lighting to the strength of 3,000 lux (the technical measure of brightness).

This intense light, which compares with the 200-500 lux emitted by domestic or office lighting, simulates natural light and is thought to correct the hormone imbalance that causes SAD, although its effectiveness has not been conclusively proved.

Dr Victoria Revell, an expert in chronobiology (the study of circadian rhythms) at the University of Surrey, says that the cafés would benefit British SAD sufferers.

“They are beneficial both physiologically and socially. Using light therapy in this way can help our sleep patterns, energy levels and performance.”

Dr Revell explains: “One key role of light is to synchronise our circadian body clock to the 24-hour day.” SAD sufferers, she says, require a higher light intensity to regulate their body clocks. In the winter, when light levels are lower, they produce too much melatonin (the hormone which helps us sleep) and less of the “feel-good” hormone, serotonin.

The latest thinking is that the disorder has genetic origins. In America, for example, research suggests that mutations in a gene associated with melanopsin – a light-sensitive pigment in the retina of the eye thought to help regulate our circadian rhythms – may be involved.

Not all doctors agree: the Royal College of Psychiatrists recommends 30 minutes to one hour of light therapy daily, which some studies show is effective for 50-85 per cent of cases. Commercial lightboxes vary in price from £35 to £200, depending on the light intensity delivered, but 2,500 lux is the minimum needed to work. Some light devices are portable for travel or office use.

SAD sufferers are also advised to spend as much time as possible outside in natural daylight and to keep active.

The Seasonal Affective Disorder Association; sada.org.uk/

The figure increased as the girls developed, with almost two thirds of Year 10s, aged 14 to 15, questioned wanting to lose weight. Only 32% of the age group were happy with how they were.

The issue was not so prevalent with boys but the study did find that on average 31% of those in Years Six to 10 wanted to lose weight.

The report, based on data collected from more than 83,000 pupils in Years Six, Eight and 10 across the UK, revealed that almost a third of Year 10 girls had nothing to eat for breakfast on the day they were questioned.

Of those who skipped breakfast, 24% said they also missed lunch the previous day.

Dr Laura Wyness, a senior nutrition scientist at the British Nutrition Foundation, said: “Popular media has a large influence on young people’s body image, placing a great deal of pressure on obtaining the ‘ideal’ body shape.

“This often leads to young girls adopting unhealthy practices such as smoking, skipping meals, especially breakfast, severely reducing perceived fattening foods in their diet, such as red meat and dairy produce, which are important sources of protein, iron, zinc and calcium, and adopting very low energy diets.

“Having a healthy breakfast every day is important for providing essential nutrients. There is some evidence that eating breakfast may improve cognitive function.

“Breakfast clubs in schools have been found to have a small but positive impact on a selection of educational outcomes.

“Evidence suggests that eating breakfast may have a protective effect against becoming overweight or obese, however as the evidence is mainly from observational studies, causality should not be assumed based on these findings.”

The report also said that as pupils get older, fewer eat fruit and vegetables daily despite Government recommendations that five portions should be consumed each day.

On average, 41% of the boys questioned did not eat fresh fruit, salads or vegetables on “most days”, compared to 31% of girls.

Of the girls and boys questioned from Year Six, 40% said they ate no protein “on most days”. However, around a quarter enjoyed crisps, sweets or chocolate regularly.

The study also revealed that three quarters of girls aged 14 to 15 drank less than a litre of water on the day before they were questioned and 12% drank none at all.

The NHS recommends people drink about 1.2 litres of fluid every day to stop dehydration.

The data also found that the number of girls who exercised regularly decreased as they grew older.

More than 70% of Year Six girls exercised three time or more in the last week compared to 46% of Year 10 girls.

Football, cycling, jogging and going for a walk were popular choices as activities outside school and many said they took part in these at least weekly.

However, almost 20% of 14- to 15-year-old girls and 15% of boys of the same age had done no active sports outside school in the last 12 months.

From: http://www.telegraph.co.uk/Teenage-girls-skip-meals-amid-weight-concerns-report-shows

Three out of four nurses lack the time to talk to patients, a major survey of NHS trusts has revealed.

A quarter admit they are too busy to administer drugs on time and more than 40 per cent said at least one patient under their care had suffered a serious fall in the last month.

The findings were based on unannounced inspections at 100 hospitals to check elderly patients were given enough to eat and drink and were treated with dignity.

In some instances, watchdog’s inspectors saw patients rattling bedrails or banging on water jugs in an effort to attract the attention of nurses.

The report also claimed that some hospitals were “putting paperwork over people” with patients being left for more than ten hours without a drink.

The latest study involving 2,943 nurses looked at 31 NHS trusts across England. Researchers found there was an absence of humanity as without regularly talking to their patients nurses had no way of knowing their needs.

The survey revealed that 76 per cent of nurses did not have enough time to talk to or comfort patients and 40 per cent of staff were too busy to carry out necessary checks such as taking their temperature.

Thirty-nine per cent admitted they did not have enough time to record details about patient care such as whether they had been given anything to eat or drink.

Twenty-six per cent said they were too busy to administer drugs on time and 24 per cent had not been able to check skin for signs of pressure sores.

A further 44 per cent admitted that in the past month at least one patient under their care had suffered a serious fall.

And 26 per cent said that at least one patient in the same period had been given the wrong dose of drugs or developed bed sores.

Professor Peter Griffiths, of the national nursing research unit at King’s College London, told the Daily Mail: “Talking and comforting patients is very important as nurses need to know how they are and how they feel.

“It’s about having humanity, having a relationship with people. It’s important to understand what patients need. Sometimes staff feel that paperwork has to come first.”

The Royal College of Nursing admitted it was “not surprised” that so many nurses lacked the time to talk to patients.

Janet Davies, its executive director of nursing and service delivery, said: “We know many nurses are wilting under the strain of longer working hours, taking on the burden on unfilled vacancies and reduced staffing levels.”

FroM: http://www.telegraph.co.uk/Three-in-four-nurses-dont-have-time-to-talk-to-patients

While they are less likely to be attracted to or sexually satisfied by their husbands, women who take the pill are happier with other aspects of their marriage such as financial support and faithfulness, making the couple less likely to split up.

Taking a contraceptive pill makes a woman’s hormones more balanced over a month, remaining at levels which occur during the non-fertile stages of the natural monthly cycle.

Not using the pill means hormone levels are allowed to change, causing a change in emotions which make physical attraction a higher priority.

Researchers questioned 2,500 women from a number of countries including Britain about various aspects of their relationship with the biological father of their first born child.

The study, published in the Proceedings of the Royal Society B journal, suggests that using the pill could have an influence on a woman’s choice of husband.

Dr Craig Roberts, of Stirling University, who led the study, said: Our results show some positive and negative consequences of using the pill when a woman meets her partner. Such women may, on average, be less satisfied with the sexual aspects of their relationship, but more so with non-sexual aspects.

“Overall, women who met their partner on the pill had longer relationships – by two years on average – and were less likely to separate. So there is both good news and bad news for women who meet while on the pill. One effect seems to compensate for the other.”

From: http://www.telegraph.co.uk/Women-who-meet-husbands-while-on-pill-have-happier-and-longer-marriages

People who ate 66g per week – about a bar and a half – were 20 per cent less likely to suffer a stroke, while those who consumed 8g a week or less were at the highest risk.

The findings, published in the Journal of the American College of Cardiology, add further weight to previous studies which highlight the health benefits of eating chocolate and cocoa.

Earlier this year Cambridge University experts found that regular doses of chocolate can reduce the risk of heart disease by a third, while a separate study suggested it can be as good for the health as exercise.

Scientists from the Karolinska Institute in Stockholm questioned 33,372 women about their eating habits in 1997 and over the next decade about 1,600 suffered strokes.
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Susanna Larsson, one of three researchers, said: “We followed 33,000 women over the course of 10 years, and we found that those who ate most chocolate had a much lower risk – 20 per cent lower – of suffering a stroke.”

Chocolate was expected to help protect against stroke because it lowers blood pressure, thereby reducing a key risk factor, she added.

The women who took part were not asked whether the chocolate they ate was dark or light, a distinction which would have helped establish a firmer connection between cocoa – the protective agent in chocolate – and stroke risk.

The researchers will now carry out a similar study in men, and expect to find similar results.

From: http://www.telegraph.co.uk/Chocolate-cuts-stroke-risk

‘Nudging’ people to lose weight by thinking about their lifestyle shows little evidence of success, an analysis of published data suggests.

The report, by The Cochrane Library, looked at studies involving nearly 4,000 people around the world.

The method, known as the transtheoretical model (TTM) stages of change, is used to encourage people to move towards more healthy forms of behaviour.

The five step process encourages people to see the need to change and then give it a go.

It has been shown to be successful in helping people quit smoking, and has also been used in alcohol and drug addiction.

The analysis looked at five trials – in the UK, US, Netherlands, Canada, and Australia – involving 1,834 overweight or obese patients, and 2,076 people of normal weight.

The authors, led by Professor Azeem Majeed and Dr Nik Tuah of Imperial College London, found no convincing evidence of any sustained or significant weight loss.

Professor Majeed: “Changing people’s dietary patterns is very difficult – that’s why we’ve got such a problem with obesity.”

Dr Tuah added: “This review does not necessarily challenge the notion that diet and exercise are effective weight loss strategies, but instead raises questions about how to approach lifestyle changes for individuals who want to adopt them.”

The report concluded: ” The use of TTM SOC resulted in minimal weight loss (about 2 kg or less) and there was no conclusive evidence for sustainable weight loss amongst participants.”

The report’s abstract is at: Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults

Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, analysis by the polling firm Gallup has found.

Those who were overweight or obese and had three or more chronic health problems took 12 times as many sick days as healthy weight individuals with no health problems, or 18 compared to 1.5.

The survey was conducted by Gallup and Healthways, a firm that runs fitness centres.

It also found obesity alone counts for six lost work days per worker each year – or over £1,200 in lost productivity.

Ben Leedle, president and chief executive of Healthways, said it showed that the level of chronic disease in the UK workforce was at “alarming levels”.

He said: “Employers who recognize the importance of improving well-being at the workplace are most likely to gain a competitive advantage.”

From: http://www.telegraph.co.uk/Obesity-and-chronic-disease-cost-UK-PLC-20bn-a-year