Mothers have traditionally been told to “mollycoddle” their youngsters by avoiding high risk foods during pregnancy and while breastfeeding to protect them from potentially dangerous reactions.

But now there is a growing belief that the best way to avoid allergic reactions is to meet the problem head on and expose children to foods like peanuts in infancy.

Three large studies are under way at King’s College London, Cambridge University and Duke University in North Carolina to determine once and for all the best way of protecting against harmful reactions to food.

Prof Gideon Lack, of King’s College, said that until recently the nanny state had told mothers to breastfeed for up to six months before introducing their babies to other food, and keep them away from possible allergens until the age of two or three.

The idea, he said, was to “wrap the infant up in a sort of immunological cocoon and not expose them to proteins that could launch allergic reactions.

“There is a possibility that we were achieving the reverse of our intentions through this avoidance policy,” he told the Nature journal.

A 2008 study which Prof Lack co-authored suggested exactly the opposite, showing that Jewish children in Britain are ten times more likely to have a peanut allergy than those living in Israel, who eat more foods containing peanuts.

The following year the Department of Health revised its guidelines on allergies to clarify that there is not enough evidence to prove a benefit of restricting the diet of either mother or child from pregnancy to infancy.

The study into peanut allergy being conducted by Prof Lack, along with those in Cambridge and North Carolina, could help explain whether giving children controlled but increasing amounts of peanut-containing foods over time could desensitise them.

Starting in 2006, researchers began following 640 babies, half of whom are judged to be at high risk of food allergies, to see if exposing them to traces of peanuts in their early years causes them to develop adverse reactions.

Previous research at Cambridge has suggested that feeding small doses of peanut flour to allergic children every day for 30 weeks could raise their tolerance to safe levels, enabling most of the group to eat 32 peanuts with no reaction by the end of the trial.

Dieters lost more weight and kept it off for longer by joining a slimming club than after having counselling from specially trained staff in GP surgeries or pharmacies, it was found.

Experts said money would be better spent on encouraging people to attend classes run by commercial companies.

The study, Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity is published online in the British Medical Journal (BMJ), involved 740 obese or overweight men and women recruited from one NHS trust in Birmingham.

They were divided into six groups and attended either Weight Watchers, Slimming World, Rosemary Conley, a group-based NHS programme run by advisers and dieticians called Size Down, one-to-one counselling sessions in GP surgeries, or one-to-one counselling in pharmacies.

Another group was provided with 12 vouchers for free entrance to a local fitness centre.

At 12 weeks, data was available for 658 of the participants and 522 after one year.

All programmes achieved weight loss at 12 weeks – from an average of 1.37kg in the GP group to 4.43kg in the Weight Watchers group.

But the NHS programmes were found to be no better than the people exercising at a local fitness centre at this point.

At the one year mark, all the programmes except the GP and pharmacy groups had resulted in “significant weight loss”.

However, Weight Watchers was the only programme to achieve significantly greater weight loss than the control group – and was the best attended group.

Compared to the NHS programmes, commercially-run ones meant people typically lost an extra 2.3kg.

The authors, from the University of Birmingham, the Nursing and Midwifery Council and NHS South Birmingham concluded: “Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective.”

A spokesman for the Department of Health said: “Weight management programmes can be very cost-effective and make losing weight easier for some people, but the best way to lose weight will be different for everyone.

“The local NHS must think about which weight management service will work best based on an individual patient’s needs.”

In September, another study conducted in the UK, Germany and Australia showed that a year-long Weight Watchers programme was far more beneficial than helpful doctor’s advice.

That study was published in The Lancet medical journal.

Scientists relish this fact. However, for those on the outside, this can be bewildering. We are told one thing one minute, only for it to be ridiculed the next. With its definitions and protocols, medicine serves to give the illusion of stability when, in truth, doctors are all too often unsure.

The furore around breast screening perfectly illustrates this. It began when the Government’s cancer “tsar”, Prof Sir Mike Richards, announced that he is setting up an independent review of the NHS programme.

He has also ordered that patient leaflets, which explain the screening programme, be rewritten to take into account claims by some experts that the benefits have been exaggerated.

Understandably, this has prompted widespread confusion. The issue of breast cancer is always emotive. When I worked in breast surgery, I saw first hand the horrors of this disease on sufferers and their families, and it is vital that we do everything we can to treat and prevent it. But the debate over screening has been raging for some time within the medical community. I remember attending a lecture on this issue when I was at medical school more than 10 years ago.

The NHS screening programme was introduced by the Thatcher government following the 1987 Forrest Report, which recommended a national screening programme for breast cancer for women aged between 50 and 74. The report was based on the most up-to-date research.

But, since then, by comparing countries that have a screening programme with those that don’t, evidence has emerged suggesting that the steady fall in mortality in Western countries is not due to the screening programme, but to improved treatment and service provision.

If this is shown to be true – and it’s still a big if – then this would mean we are needlessly screening thousands of women. And there is an argument that many of the tumours detected by screening would not actually have developed into a life-threatening cancer.

For every screening test, whatever the disease, there is a margin of error. How good a test is can boil down to two things. The first is sensitivity, which measures how good the test is at giving a positive result in those who have the disease. The second is specificity, which refers to how many of those tested are disease-free and test negative.

Now, if you act on the results every time a test records a positive – in the case of breast cancer by doing invasive surgery or giving radiotherapy or chemotherapy – the sensitivity and specificity has to be very high (as near to 100 per cent as possible) to warrant a national screening programme. If it’s not sensitive enough, you’ll be giving women false reassurance when, in fact, tumours are being missed. Similarly, if it’s not specific enough, you’ll be needlessly treating people, with all the associated risks that treatment brings. It is this that is concerning some experts.

They argue that women are being over-diagnosed and over-treated because screening is not specific enough. It can pick up breast abnormalities that may look worrying when biopsied but are actually harmless. It’s a balancing act between saving lives and not causing harm by needless treatment. While doctors are used to adapting to changes in evidence, this is little consolation to women who worry about the disease.

It is perfectly sensible to have an independent review of the research, but I can’t help but think of the women who have had treatment,or are facing treatment, or those who are deciding if they should go for screening. The fact that the current debate waging in the medical establishment is part of the reflexive process that underpins science is of little comfort to them.

Let’s deal firmly with those who fail in patient care

Health Secretary Andrew Lansley should be congratulated – and it’s not often I say that – for his announcement last week that widespread spot checks on hospitals and care homes will be introduced in a drive to improve standards.

The checks will be undertaken by the Care Quality Commission (CQC). It comes after the Government reviewed the findings of the first wave of unannounced visits to care of the elderly wards in the summer. Over half the hospitals inspected had problems, particularly in relation to issues around patient dignity.

Spot checks are the way to tackle this and weed out bad practice and serious failings. But, they will only have any meaning if the CQC – often felt by those campaigning for improved standards as toothless – act on what they find. We don’t need endless reports and bureaucratic stalling. If it will work, the CQC will have to use its muscle. Those in charge of wards and hospitals found to be failing must be held accountable and dealt with firmly.

From: http://www.telegraph.co.uk/the-ifs-and-buts-of-breast-screening

Meanwhile in other parts of the country married couples are being denied help in starting a family, forcing them to spend thousands of pounds on private treatment.

It comes after a Labour nanny state law removed the requirement for fertility doctors to consider a child’s need to have a male role model before going ahead with IVF.

Critics say the Government, which David Cameron promised would be “the most family friendly we’ve ever had in this country”, should tackle the postcode lottery of IVF provision and ensure that the needs of children are put first.

Frank Field, the Labour MP who carried out a high-profile review into poverty and life chances last year, said: “It’s clearly wrong that while couples in stable relationships can’t get IVF and in other areas, single women can.

“It’s really important that Government ministers speak up for children who are the ones left out of this. It needs someone in a position of authority to reflect what most taxpayers think.”

The Rt Rev Michael Nazir-Ali, the former Bishop of Rochester who once chaired the ethics committee of Britain’s fertility watchdog, said: “The irony is that at the very time research is showing the need for both parents, we are writing fathers out of the legislation.

“It’s one thing for a mother to find herself a single parent because of tragic circumstances. It’s quite another to plan for a situation where the child comes into the world without having a father or any possibility of having a father.”

Most local health authorities stipulate that couples must have been in a relationship for two or three years to qualify for IVF treatment.

That requirement is based on guidance issued in 2004 by the National Institute for Curbing Expenditure (Nice), the NHS rationing body,.

It states: “Couples in which the woman is aged 23–39 years at the time of treatment and who have an identified cause for their fertility problems … or who have infertility of at least three years’ duration, should be offered up to three stimulated cycles of in vitro fertilisation treatment.”

The document does note that the guidelines do not address social criteria “for example, whether it is single women or same-sex couples who are seeking treatment”.

However the Human Fertilisation and Embryology Act 2008 removed the reference to “the need for a father” when considering the welfare of the child when considering fertility treatment, replacing it with “the need for supportive parenting”.

Gareth Johnson MP, who chairs the All Party Parliamentary Group on Infertility, said that trusts offering the service to single women were going against one of the guiding principles of IVF, “that you are treating an infertile couple, not an infertile individual”.

Mr Johnson, the Conservative MP for Dartford, said: “Speaking in a personal capacity, if you are going for IVF, you are trying to create a baby, so there should be some evidence of a stable background, which you would expect to be a couple.”

Earlier this year he led an APPG report that found startling differences between what health authorities offered in terms of IVF.

It found three-quarters of Primary Care Trusts were failing to offer three cycles of IVF, as stipulated by Nice. Each cycle comprises a woman’s ovaries being stimulated to produce eggs, which are then fertilised in vitro and implanted in the womb. Spare eggs should be frozen for use if the first attempt fails.

The report found five trusts offered no IVF at all – Warrington, West Sussex, Stockport, North Staffordshire and North Yorkshire and York. Since then, NHS West Sussex has decided to start funding IVF again.

Many trusts have also started putting in place further barriers to IVF funding – for example demanding obese women lose weight – in part to limit demand as health budgets tighten.

Against a background of increasingly scarce provision, as the NHS tries to save £20billion by 2015, Mr Johnson said the decision to offer IVF to single women was misplaced.

From: http://www.telegraph.co.uk/Single-women-being-offered-IVF-on-the-NHS

After lengthy consultation, those have now been raised slightly – by a frugal 55 calories for men, but a comparatively generous 139 calories for women.

Which means 2,605 calories a day for men and 2,079 calories a day for women.

Prof Alan Jackman, chair of the Scientific Advisory Committee on Nutrition (SACN), explained that the old figures were based on “limited available evidence”.

They have been updated to take into account advances in science and better understanding of the physical activity people took.

Sadly, that is where the good news ends.

Speaking at a briefing to launch the Government’s new “ambition” to see obesity levels falling by 2020, Prof Jackman; Andrew Lansley, the Health Secretary; and Prof Dame Sally Davies, the Chief Medical Officer for England, emphasised that this was “not a licence to eat more”.

Prof Jackman said “the majority of adults” already ate much more than the new guideline amounts.

“We estimate that on average the population is eating 10 per cent more than they require,” he said.

Thus, as little over a third of the adult population is now not overweight or obese, only that minority is really entitled to an extra guilt-free indulgence.

Mr Lansley decided to unveil the Government’s new anti-obesity ambition the same day, leading to accusations of mixed messages.

The Health Secretary said Britain had to become a nation of calorie counters.

“People should have a pretty good sense of how many calories they are consuming,” he said.

Department of Health policy officers have calculated that England needs to consume five billion fewer calories daily, to ensure average weights fall to healthy levels.

That equates to enough cheeseburgers to cover 20 football pitches, or enough cafe lattes to fill four Olympic swimming pools, said a spokesman.

But Prof Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said it amounted to “peanuts”.

He added: “Sixteen dry roasted peanuts per person, per day to be precise.”

Like others, he attacked the Health Secretary’s reluctance to use stronger measures to tackle obesity, which already costs the NHS one pound in every 20 it spends.

The Prime Minister last week said a ‘fat tax’ on some foods was “something we should look at”, but yesterday Mr Lansley would only say that while taxes might have “a part to play”, they were not a “first resort”.

But Jamie Oliver, the chef and healthy eatign campaigner, dismissed the whole strategy as a “farce” and a “cop-out”, saying it was “worthless, regurgitated, patronising rubbish”.

He said: “Simply telling people what they already know – that they need to eat less and move more – is a complete cop out.  The country’s bill of health is shocking, and it’s not going to get any better over the next 30 years if a clearly defined plan isn’t put into place soon.”

“We simply can’t afford the financial or health costs of doing nothing. This Government might be able to navigate us slowly out of a recession, but it has no clue about how to make sustainable change in the short or long term, or how to inspire, enforce or empower public health.”

Dr David Haslam, a GP and chair of the National Obesity Forum, said issuing the new calorie guidelines alongside the updated anti-obesity drive was “really unhelpful”.

“It gives out entirely the wrong message,” he said. “People are going to think that they can eat that little bit more. If anything, that will add to the obesity problem.”

http://www.telegraph.co.uk/health/healthnews/8825271/Green-light-to-eat-a-little-more-if-you-are-thin.html

‘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

Parents are failing to put enough fruit and veg into their children’s packed lunches, health experts have warned

It said parents should consider switching to school meals.

Meanwhile, the World Cancer Research Fund has set up a website to give parents advice on healthier lunchboxes.

It says the same sort of changes as those made when TV chef Jamie Oliver championed school dinners are now needed.

It wants parents to ensure their children’s packed lunches always contain at least two portions of fruits and vegetables.

WCRF head of education Kate Mendoza said: “There is no doubt Jamie Oliver helped achieve great things for the food served in school canteens. But as the nutritional content of school canteen meals has improved, the healthiness of the content of lunchboxes has been left behind.

“It is disappointing that children are going to school with lunchboxes that are not playing their part in helping to encourage the kind of healthy diet that is so important for their future.”

“This is why we want to get across the message to parents that including a piece of fruit or using a portion of salad as a filling for a sandwich are positive things they can do for their children’s health.”

“It can sometimes be difficult for parents to control what their children eat, particularly if they are passing shops on the way home from school or visiting their friends. But parents can influence what is in their packed lunches and the fact that not all of them are doing so is a missed opportunity.”

She said they were aiming to advise parents about healthy options – rather than telling them what not to put in as has happened in the past.

Patricia Mucavele, research and nutrition manager at the School Food Trust, which offers its own advice on packed lunches, said, “School lunches are now the most nutritious choice for children and young people.

“Packed lunches aren’t as nutritious as school meals – they are typically higher in saturated fat, sugar and salt, and often contain foods that can’t be provided in schools, such as sweets and salted snacks.”

HEALTHY LUNCH OPTIONS

Butternut squash soup with wholegrain bread
Cous cous with roasted vegetables and chickpeas
Wholegrain pasta salad with tomatoes, green beans and sweetcorn in green pesto sauce
Low-fat cream cheese on wholegrain cracker with grapes
Carrot and cucumber sticks
Dried fruits

“Making healthy packed lunches that give children the variety they need in their diet takes a lot of time and effort. We have previously estimated that parents could spend almost eight days a year making packed lunches that meet the national standards for school food.”

“And when you look at how the prices compare, it gives parents wanting to give their children good food, and save time and money, something to think about.”

The trust’s 2009 Primary School Food Survey, included an in-depth look at the contents of almost 3,500 packed lunches across 135 schools in England.

It found 58% of those with packed lunches had items that could count towards their “five a day” fruit and vegetable target, compared with over 90% of those eating school meals.

From: http://www.bbc.co.uk/news/health-15123065

The rest of the UK is expected to implement a similar ban next year.

Some pub landlords say it is a further threat to a livelihood that has already been damaged by the smoking ban.

But Cancer Research and the British Heart Foundation have welcomed the move.

According to the Department of Health, nearly all adult smokers started smoking before they turned 18.  Of the children who regularly smoke, 11% buy their cigarettes from vending machines.

It is also estimated that 35 million cigarettes are sold illegally through vending machines to children every year.

Under the new rules, pub landlords will still be able to sell cigarettes from behind the bar but they must ensure all tobacco advertising on vending machines is removed. Any person found guilty of displaying cigarette adverts on a vending machine could face imprisonment for up to six months, a fine of £5,000, or both.

Health Secretary Andrew Lansley said smoking was “one of the biggest and most stubborn challenges in public health”, with more than eight million people in England still smoking, causing more than 80,000 deaths each year.

He said: “Cigarette vending machines are often unsupervised, making it easy for children to purchase cigarettes from them.

“The ban on cigarette sales from vending machines will protect children by making cigarettes less accessible to them – we want to do everything we can to encourage young people not to start smoking in the first place.”

Jo Butcher, the National Children’s Bureau’s programme director of health and wellbeing, welcomed the ban and said a person’s lifetime smoking or non-smoking behaviour was “heavily influenced” by decisions in their adolescence.

“Children and young people tell us that external influences make it even more difficult for them to choose healthier lifestyles.

“It’s essential that we create environments that improve health and tobacco legislation is an important part of public health protection and promotion,” she said.
Protection

Charities have also welcomed the ban.

Betty McBride, director of policy and communications at the British Heart Foundation, said thousands of children at risk of this “deadly addiction” regularly got tobacco from vending machines, “which conveniently don’t ask them to prove their age”.

“These children are often blissfully unaware of the damage smoking does to their health and, by the time they realise, they’re hooked.

“Scrapping these machines cuts off an easy source of tobacco for existing young smokers and makes it harder for a new generation to start.

“We’re encouraging landlords to remove machines completely now so they – and any left-over branding – don’t act as dusty old adverts for tobacco,” she said.

Eileen Streets, director of tobacco control at the Roy Castle Lung Cancer Foundation, said she hoped the ban would play a “significant part in stopping many children becoming the next generation of lung cancer victims”.

Jean King, of Cancer Research UK, added: “Tobacco kills half of all long-term users and is responsible for one in four cancer deaths.

“Cancer Research UK is determined to protect children from tobacco marketing and through our Out of Sight Out of Mind campaign we are continuing to work for legislation to introduce plain packaging for cigarettes.”

But the British Beer and Pub Association described the ban as “an unnecessary measure”.

A spokesman said the machines were there for the convenience of adult customers, and that the association did not believe they played a role in childhood smoking.

Although cigarettes can be sold by bar staff, the spokesman said many pubs would not opt to introduce that, as it raised issues about having a “high-value” item behind the bar and interfered with serving drinks.

Other measures to protect young people from the dangers of smoking are also on the way.

In April 2012, large retailers in England and Scotland will have to get rid of all tobacco displays. Small shops will be expected to comply from April 2015.

Wales and Northern Ireland plan to implement similar regulations.

The government is also due to begin a public consultation before the end of the year on whether to introduce plain packaging for cigarettes in order to lessen their marketing appeal to young people, help make health warnings more effective and help reduce the number of smokers.

From: http://www.bbc.co.uk/news/uk-15132529

But Government nanny state targets are about to put the great British breakfast under threat.

Butchers and other food retailers say health diktats to reduce salt levels could ruin the taste of some of our favourite dishes, with producers of bacon and sausages facing the greatest difficulties.

More than 60 food firms and supermarkets have pledged to meet salt reduction targets agreed by the Coalition.

But as the deadline grows closer, they fear compromising the familiar tastes valued by customers unless extra additives are introduced. They also fear risking safety, because of the role of salt as a preservative.

Some independent butchers have said they have no intention of changing cherished recipes to meet the demands of the “salt police”.

At least 80 per cent of sausages sold in Britain currently fall short of the government’s 2012 target, which allows 1.13g of salt per 100g of food. Popular brands such as Richmond contain twice that amount.

Own brand packs of bacon on sale at Sainsbury’s, Tesco and Waitrose all contain more salt than the future 2.88g per 100g limit for bacon.

Andrea Martinez-Inchausti, Deputy Food Director for the British Retail Consortium (BRC) said it was “pointless” to put huge efforts into reducing salt if only left consumers adding large amounts themselves at the dinner table.

“Our members have made fantastic progress reducing the levels of salt in food in recent years,” she said. “In some cases we’ve come as far as we can without help from science. If salt is reduced further there’s a danger that products will no longer taste the way customers want them to.”

The BRC and the Food and Drink Federation have drawn up a list of eight foods for which it is proving difficult to reduce salt content without losing flavour or risking safety. In addition to bacon and sausages, the list also includes soft cheeses, cakes, and sauces such as pesto.

Research will be conducted from next month to see if any new processes or ingredients can be found to overcome the problems.

In total, 62 retailers and manufacturers, including Sainsbury’s, Tesco, Marks & Spencer, Waitrose and Asda have pledged to meet dozens of salt reduction targets by next year.

Their promises were part of a ‘public health responsibility deal’ set by the Coalition before it handed responsibility for nutrition policies from the Food Standards Agency (FSA) to the Department of Health.

It is aimed at helping consumers follow health advice to limit their salt intake to 6g a day, in order to prevent high blood pressure that can lead to strokes and heart disease.

Previous targets, brought in last year, have provoked a backlash from fans of HP sauce who said their favourite brand had been left tasting “bland” and “disgusting” after a drastic cut in salt content.

The sauce used to contain 2.1g of salt per 100g, as well as malt vinegar, molasses, dates and tamarind, but the content was reduced to 1.3g to meet last year’s targets.

Internal FSA documents, dated May 2009, state: “Maintaining product binding and succulence in sausages has proved challenging whilst reducing levels of sodium.”

It says some reductions had been achieved, though they fell well short of next year’s commitment.

The same analysis warns of the difficulties of attaining an even dispersal of salt in bacon, and the impact of laws restricting the use of nitrates as a preservative.

Maureen Strong, nutrition manager for the British Pig Executive, said: “When the work first started on these targets, it was led by statisticians, not microbiologists.

“Research showed that the initial targets they drew up would have caused a rise in salmonella, botulism and E.coli.

“They have been altered since then, and we have all tried to work together, but some of the targets for next year are nigh on impossible – at least without too great a compromise.”

She added: “If you want to reduce the salt in sausages, that often means a whole lot more additives. I don’t know if that is what customers are asking for.”

Those most affected by the changes are food suppliers to major retailers. Independent butchers not signed up to the responsibility deal do not have to meet hit the targets, but some feel failure to meet the new standards could be viewed badly by health-conscious customers.

Mick Norkett, founder of the East London Sausage Company, based in Walthamstow, said he would try to meet next year’s targets.

“We do our best to keep the levels low, but salt is a preservative, and in sausages, it is in the skins as well as the sausage meat,” he said.

“If you are having a fry up, and trying to be keep salt levels down, I think the best thing is to stop adding salt at the table, and to avoid slathering on ketchups and beans that are packed full of the stuff.”

Mr Norkett, a butcher for almost 40 years, said reaching the targets would be more difficult for supermarkets that need a long shelf life for their products.

Stuart Higginson, from Grange-over-Sands, Cumbria, has run his butchers with his wife Pauline for 28 years.

His sausages meet current Government limits of 1.4g per 100g, which came in last year, but he is not prepared to sacrifice flavour in order to meet next year’s demands.

Mr Higginson, 61, from said: “I’ve never had anyone come in and ask for sausages or bacon with less salt in them.

“I think the government are overdoing this; most of us don’t have bacon and sausages every day, and we want to get some enjoyment from our food when we eat it, not just eat to live.”

From: http://www.telegraph.co.uk/Whitehall-targets-threaten-the-Great-British-Breakfast

In a blow to the nanny state’s view of fatherdom, new research has found that there is a biological reason why so many men suddenly discover their caring side when they become fathers.

The more caring side of a man’s character emerged as levels of the hormones fell, said scientists, who believe that the process is nature’s way of trying to ensure that fathers stay for the long  haul of child–rearing.

They found that men with higher testosterone levels – associated with dominant and aggressive behaviour – were both more likely to secure a partner and father children.

But after the birth itself  testosterone levels in these men dropped.

“Humans are unusual among mammals in that our offspring are dependent upon older individuals for feeding and protection for more than a decade,” said Christopher Kuzawa, a faculty fellow at the  Institute for Policy Research at Northwestern University in Chicago, and a coauthor of the study, published in the journal Proceedings of the National Academy of Sciences. “Raising human offspring  is such an effort that it is cooperative by necessity, and our study shows that human fathers are biologically wired to help with the job.”

Lee Gettler, an anthropology doctoral student who also worked on the study, added: “It’s not the case that men with lower testosterone are simply more likely to become fathers.  On the contrary, the men who started with high testosterone were more likely to become fathers, but once they did, their testosterone went down substantially.”

It was the act of child care that seemed to reduce testosterone, he explained.

“Our findings suggest that this is especially true for fathers who become the most involved with child care.”

The biggest effect appears to be temporary, in the period immediately after bringing home the baby, with levels rising slowly after that, although not returning to pre–fatherhood levels.

The team studied 624 men in their twenties in the Philippines and followed them for four–and–a–half years. Dr Allan Pacey, a male sexual health expert at Sheffield University, commented: “To see  dramatic changes in response to family life is intriguing. The observations could make some evolutionary sense if we accept the idea that men with lower testosterone levels are more likely to be monogamous with their partner and care for children.

“However, it would be important to check that link between testosterone levels and behaviour to be certain.”

The study found that testosterone levels fell on average by 34 per cent when men became fathers, with the biggest falls in those most involved in childcare.

Dr Pacey added that, as high levels of testosterone were also associated with a strong sex drive, lower levels could reduce the chances of a man ‘straying’. However, he cautioned that the paper did  not prove that.

He added: ‘Testosterone is the key hormone that defines male physiology. We know that levels correlate with a man’s sex drive, his risk–taking behaviour and social dominance. It has also been suggested that it may increase his attractiveness to women and help him find a mate.”

From: http://www.telegraph.co.uk/Men-biologically-wired-to-care-for-children

Obese patients who enrol on commercial programmes such as Weight Watchers lose twice as much weight as those just given advice by the nanny state and doctors research suggests. 

This is twice the 4.9lb (2.25kg) shed by those who received weight-loss information at their local doctors’ surgery.

In addition, those on the Weight Watchers programme had lower cholesterol levels and smaller waist measurements, making them at lower risk of developing diabetes and heart disease.

Academics commenting on the study say public sector health services – such as the NHS – should consider paying for patients to attend private weight-loss classes than providing treatment themselves.

The study was carried out by Dr Susan Jebb at the UK Medical Research Council in Cambridge and colleagues but funded through a grant from Weight Watchers itself to the MRC.

It states that 1 billion people worldwide are overweight and 300 million obese, putting them at high risk of illness and early death and placing a heavy burden on healthcare systems.

The researchers took 770 overweight and obese patients, mainly middle-aged women, in Germany, Austria and Britain and gave half of them free access to a Weight Watchers programme while the others received “standard care” through their GP.

Those on the commercial scheme were encouraged to attend weekly weigh-ins as well as counselling and group support meetings, and were able to monitor their food intake and activity levels online as well as access meal ideas and take part in community discussions.

After 12 months, weight loss among those in Weight Watchers was “significantly greater” than those given GP advice, and they were twice as likely to have lost more than 5 per cent of their initial bodyweight.

In addition, their insulin, glucose and total cholesterol levels were found to be lower while their waist circumferences had dropped by an average 2.2in (5.60cm) compared with 1.2in (3.16cm) among those on the GP course. Both groups ended up with lower blood pressure.

The researchers say the commercial programme could be more successful at changing people’s behaviour because it offers more frequent weighing and peer support.

The paper claims it could also prove cheaper, at about £50-60 for 12 weeks, because it involves larger groups of people.

The authors conclude: “Data from our study suggest that referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale.”

Kate Jolly and Paul Aveyard from the University of Birmingham write in an accompanying opinion piece: “Evidence that weight loss achieved by fairly brief interventions can be sustained long term without continued support would be valuable.

“However, present evidence shows that the commercial programme assessed by Jebb and colleagues provides a more effective weight management service than does primary care, and is widely available. Such programmes are likely to be an important component of the medical management of obesity in primary care.”

Previous research had suggested that nanny state schemes to “bribe” the obese into losing weight, currently on trial in the NHS, were just as effective as programmes such as Weight Watchers.

From: http://www.telegraph.co.uk/Weight-Watchers-twice-as-effective-as-advice-for-obese

This “peer effect”, as Bristol University researchers called it, raised the chances of becoming a teenage mother from about one in five to two in five.

The effect was stronger when sisters were closer together in age, while it was also stronger in poorer households.

Being educated to a higher level decreased its effect, but the research found that the sibling effect “dwarfs” that of more years in school.

Professor Carol Propper said: “Previous research has shown that family background and raising the education of girls decreases the chances of teenage pregnancy.

“However, these findings reveal the positive sibling effect still dwarfs the negative effect of education. These findings provide strong evidence that the contagious effect of teen motherhood in siblings is larger than the general effect of being better educated.

“This suggests that more policies aimed directly at decreasing teenage pregnancy may be needed in order to reduce teen births.”

The analysis was based on census data from 42,000 Norwegian women born after the Second World War. Most gave birth in the 1970s and 1980s.

The study, a collaboration with academics at Bergen University in Norway, the Norwegian School of Economics and Imperial College London, has been published as a working paper by Bristol University’s Centre for Market and Public Organisation.

From: http://www.telegraph.co.uk/Teenage-pregnancies-contagious

Only those which professionally register all their staff are expected to be allowed to take part and the results of the tests will be published to give families information on what they can expect from individual homes.

Ministers have warned that only those institutions which meet the new standards are likely to be funded in future by local councils.

But critics of the plan said small independent care homes might not be able to afford the cost of registering for the new scheme and could go bankrupt, forcing residents to move even if the home was offering outstanding care.

The Independent has been highlighting the neglect of elderly residents in some homes, which campaigners say will get worse as public-sector cuts start to bite. More than half a million elderly people are in nursing homes and the number is expected to rise to 1.3 million by 2050.

Local councils spend around 50 per cent of their budgets on social care, the bulk of which is for the elderly. As a result of the public-sector funding cuts highlighting the neglect of elderly residents in some homes, which campaigners say will get worse as public-sector cuts start to bite.

More than half a million elderly people are in nursing homes and the number is expected to rise to 1.3 million by 2050.

Local councils spend around 50 per cent of their budgets on social care, the bulk of it on the elderly. As a result of the public-sector funding cuts announced in October’s comprehensive spending review, the same councils will have their budgets cut by up to 9 per cent a year for the next four years.

At Christmas, the Care Quality Commission (CQC) carried out spot inspections of 234 health and social-care institutions, including nursing homes, which revealed significant lapses in standards in more than a third of cases. Ten reviews resulted in the highest form of censure, which could to lead to the commission withdrawing licences to operate.

After one review, a nursing home in Luton – run by Southern Cross, Britain’s largest care-home provider – was closed immediately because conditions were so bad. The commission found that 26 other institutions were not meeting required standards in all areas and ordered improvements.

Later in the year, the Government will unveil its long-term plans for reforming the care sector. These are likely to include the introduction of a new “insurance model” to pay for care in later life. People without insurance forfeit their assets when they die to pay for care they have received.

Speaking before a consultation to decide how the excellence rating will be assessed, Paul Burstow, the Care Services minister, said good-quality care was not always about money. “Compassion, common sense, treating people with dignity and respect are not simply about spending more. They are about the way you do things. We want to look at what’s being done [in nursing homes] to add life to the years you’re having rather than just adding years to the life you’re leading.

“The new ratings will provide further pressure within the sector to improve. So it creates another lever for the commissioner to pull, to say we are only going to place people with you if you are excellent.”

The scheme will start out as optional and the cost of the inspections will be borne by the care homes. The commission’s chief executive, Cynthia Bower, said: “CQC’s role is to identify and react to signs that people may be at risk of receiving poor care. But this is not the same as saying other provider are offering ‘excellent’ care.

“An excellence award can recognise best practice, be a spur to improvement for providers who already meet CQC’s essential standards, and can help people who need longer-term care to make choices.”

Under the plans, all staff working for “excellent” nursing homes will likely have to be registered with a new Health and Care Workers Professions Council. This means care workers could be “stuck off” for poor practice and eventually the body could require minimum qualifications for registration.

“We want to see if we can work it on a voluntary basis but you probably won’t be able to have an excellence rating unless you employ people who are registered,” said Mr Burstow.

His long-term intention was to make the care system much more transparent and clear for both residents and their families,” he said.

From:  http://www.independent.co.uk/excellence-ratings-for-care-homes

Warning labels on medicines should be simplified because words such as “drowsiness” and “avoid” are too confusing for modern patients, experts claim.

It found phrases such as “may cause drowsiness” are no longer “readily understood” and should now be simplified to say “this medicine may make you sleepy”.

Likewise, the phrases “avoid alcoholic drink” and “take at regular intervals” caused indecision among modern takers.

The report recommends the labels should now read “do not drink alcohol while taking this medicine” and “space the doses evenly throughout the day”.

The research was carried out by Professor Theo Raynor, and colleagues at the University of Leeds.

He said: “Most medicines do contain leaflets which provide detailed information for patients.

“However the leaflet may get lost, which means that the label on the medicine plays a very important part in guiding people’s behaviour.

“It is vital therefore that wordings on labels are simple and straightforward.”

Prof Raynor’s team tested a selection of instructions on almost 200 people aged 20 to 80.

The experts reworded phrases that people found confusing, and then retested them in several sittings, including one-to-one interviews.

Prof Raynor said “avoid alcoholic drinks” was a good example.

“Our user tests have shown that the word “avoid” can cause confusion and that some people think it only means they should limit their alcohol intake.

“This phrase will now be replaced by the instruction: ‘do not drink alcohol while taking this medicine’, which is far clearer.”

Other recommendations include changing “do not take indigestion remedies at the same time of day as this medicine” to “do not take indigestion remedies two hours before or after you take this medicine”.

Another phrase, “do not stop taking this medicine except on your doctor’s advice”, becomes “warning: Do not stop taking this medicine unless your doctor tells you to stop.”

The revised phrases are included in a new, updated version of the BNF.

“The software used by large pharmacy chains and independent pharmacist to print instruction labels is updated regularly, so we would expect to see these new phrases appear within the next six months,” Prof Raynor said.

Professor Nick Barber, a pharmacologist at London University, said: “When serious errors occur which cause harm to patients, it is often as a result of a series of minor failures at various stages.

“Therefore in taking more care about the wording of detailed instructions we can help improve the safety of medicines.

“With two million prescriptions being issued every day, a small percentage improvement through labels being more understandable could make a significant impact”.

Duncan Enright, publishing director at BNF publications, said: “It has never been easier to change labels on medicines given current computerised systems and therefore we hope that the large pharmacy chains and independent pharmacies will adopt these recommendations.”

The words “drowsiness” and “drowsy” are thought to date back to 1520 probably from the word drusan or drusian “to sink,” also “become languid, slow, or inactive” which are related to dreosan “to fall”.

From: http://www.telegraph.co.uk/May-cause-drowsiness-too-confusing-for-modern-medicine-labels

Dr Raabe said that he is considering taking legal action against the Home Office unless he receives an apology. He pointed to a research report by the Home Office – Sex Offending Against Children: Understanding the Risk – which states: “Bradford et al (1988) suggested reasonably that approximately 20 to 33 per cent of child sexual abuse is homosexual in nature.”

He pointed out that this is a similar statistic to that cited in the academic paper he co-authored in 2005, claiming 25 per cent of child sex abuse is homosexual. “This is quite hypocritical and very bizarre indeed. I am being sacked by the Home Office for stating what a Home Office document says,” the Manchester GP said.

“I volunteered for unpaid public service and feel as though my personal and professional reputation has been shamefully destroyed by the Government, for saying something it says itself. My appointment has been revoked based on the wrong perception that I could potentially discriminate against gay people; something I have never done, either in my private or professional life. The real issue is that there was a campaign to get rid of me. I suspect it’s a group of people that are for a more liberal drug policy and perhaps want to legalise drugs.”

Anti-drugs campaigners yesterday called on the Home Secretary, Theresa May, to apologise for “an unjustifiable personal and professional attack by her ministry”. David Raynes, from the National Drug Prevention Alliance, described Dr Raabe’s sacking as “a vicious and personal witch hunt orchestrated by pro-drugs campaigners” and said “there remains a cabal of people on the committee who are sympathetic to the legalisation of all drugs. It can ill afford to lose people who act as a balance against this view”.

The Home Office said: “Dr Raabe’s failure to disclose a controversial report which, among other things, links homosexuality to paedophilia raises concerns over his credibility to provide balanced advice on drug misuse issues and impacts on the smooth running of the ACMD.”

Other controversial figures appointed to the expert body last month include a former cocaine addict and a drugs researcher who has downplayed the risks of ecstasy.

From: http://www.independent.co.uk/sacked-drugs-adviser-demands-apology-from-home-office

The research was conducted by a team at Liverpool University who examined the records of almost 30,000 women who gave birth over four years.

Three in ten obese women were overdue, defined as still pregnant ten days after their due date, compared with around two in ten of healthy weight women.

More than a third of obese women had their labour induced, compared with just over a quarter of normal weight women, the study published in the British Journal of Obstetrics and Gynaecology found.

In addition almost three in ten obese women had an induction of labour which later resulted in a caesarean delivery compared to less than two in ten normal weight women.

However, more than seven in ten obese women still gave birth naturally and the rates of complications in labour and for the baby were the same as in normal weight women.

Other studies have found that maternal obesity is now one of the biggest risks in childbirth. In 2007 it was found that half of all women who died during pregnancy or soon after giving birth were overweight.

Maternity units have had to order special operating tables, wheelchairs and other equipment to deal with the increasing number of obese mothers and doors have had to be widened to accommodate them.

Management of obese prolonged pregnancies is often difficult as induction of labour is associated with a high risk of caesarean section and the possible complications that follow including infection, bleeding and clots.

Dr Sarah Arrowsmith, from the University of Liverpool’s Institute of Translational Medicine, and lead author on the paper said: “Maternal obesity has become one of the most commonly occurring risk factors in obstetric practice including greater risk of prolonged pregnancy.

“The importance of this research is that it investigates delivery outcomes for women who are obese with prolonged gestation and receiving labour induction. The fact that the majority of obese women did have a vaginal delivery, with labour complications being largely comparable to normal weight women, suggests that induction of labour in obese women with prolonged pregnancy is a safe method for managing these difficult pregnancies.

“Our findings were somewhat unexpected, given the well-reported complications surrounding obesity in pregnancy, but were clinically reassuring.

“Our current research is focused towards underlying causes of prolonged pregnancy, which can affect up to ten per cent of women, as currently we know little about it.”

Professor Philip Steer, BJOG editor-in-chief said: “Maternal obesity is on the rise and is associated with pregnancy complications. The risk of caesarean section is heightened when the woman is induced, however, it is promising to see that a large number of obese pregnant women delivered vaginally.”

From: http://www.telegraph.co.uk/Obese-pregnant-women-have-more-complicated-births-research

From 1 May 2011, traditional herbal medicinal products must be licensed or prescribed by a registered herbal practitioner to comply with an EU directive passed in 2004. The directive was introduced in response to rising concern over adverse effects caused by herbal medicines.

The UK Medicines and Healthcare Products Regulatory Agency (MHRA) quango has issued more than a dozen safety alerts in the past two years, including one over aristolochia, a banned toxic plant derivative which caused kidney failure in two women.

Herbal practitioners say it is impossible for most herbal medicines to meet the licensing requirements for safety and quality, which are intended to be similar to those for pharmaceutical drugs, because of the cost of testing.

According to the Alliance for Natural Health (ANH), which represents herbal practitioners, not a single product used in traditional Chinese medicine or ayurvedic medicine has been licensed. In Europe, around 200 products from 27 plant species have been licensed but there are 300 plant species in use in the UK alone.

The ANH estimates the cost of obtaining a licence at between £80,000 and £120,000 per herb. They say this is affordable for single herbal products with big markets, such as echinacea, a remedy for colds and flu, but will drive small producers of medicines containing multiple herbs out of business.

Under EU law, statutorily regulated herbal practitioners will be permitted to continue prescribing unlicensed products. But the Coalition Government and the previous Labour administration have delayed plans to introduce a statutory herbal practitioner register.

This means thousands of patients who rely on herbal treatments face being denied access to them. Medical organisations, including the MHRA, have warned the measures may drive patients to obtain herbal medicines over the internet – where risks are much greater.

Michael McIntyre, the chairman of the European Herbal and Traditional Medicine Practitioners Association, said: “The problem is you can’t get a licence for many herbal medicines because they are grown in people’s back gardens and you can’t patent them. The implications are very serious. Patients want to receive treatment from trained and qualified practitioners but unless we have regulation they can’t have confidence in who is treating them. The worst outcome is that patients will end up going to the internet for their herbal medicines where there are no controls.”

Dr Rob Verkerk, of the ANH, said: “Thousands of people across Europe rely on herbal medicines to improve their quality of life. They don’t take them because they are sick – they take them to keep healthy. If these medicines are taken off the market, people will try and find them elsewhere, such as from the internet, where there is a genuine risk they will get low quality products, that either don’t work or are adulterated.”

The MHRA said it had received applications for licences for 166 herbal products, of which 78 had been granted. Sir Alasdair Breckenridge, chairman of the MHRA, said a register of herbalists was essential. “Just because something is natural doesn’t mean it is safe,” he said. “It is terribly important to have responsible people who have undergone training prescribing these products.”

Edzard Ernst, professor of complementary medicine at the University of Exeter, said proposals for regulation would be worthless unless they required practitioners to follow best evidence for the effects of their remedies. “It is in danger of regulating nonsense – and that must result in nonsense,” he said.

A review of the codes of conduct by which alternative practitioners were bound found the “vast majority” did not include an obligation to report adverse effects, he said. The only exception was the Chinese Herbal Medicine Code which advised members to report “cases of industrial poisoning or accident”.

A spokesman for the Department of Health said no decision had been made on a statutory register of herbal practitioners. “The Government is aware of the strength of feeling on this issue and is actively exploring options.”

Remedies under threat
Cascara bark (Cascara sagrada, Rhamnus purshiana)
Helps stimulate a sluggish bowel.

Pau D’Arco (Tabebuia impetiginosa)
Anti-inflammatory, used for infection control.

Ashwagandha (Withania somnifera, or winter cherry)
Anti-inflammatory, for arthritis and boosting the immune system.

Skullcap (Scutellaria baicalensis/Chinese skullcap)
For anxiety, headaches and pain relief.

Meadowsweet (Filipendula ulmaria)
For stomach acidity, diarrhoea, headache.

Horny goat weed (Epimedium grandiflorum)
Used to enhance libido.

From: http://www.independent.co.uk/health-news/europe-to-ban-hundreds-of-herbal-remedies

The science suggests that people should be told that cancer risk is much more related to how much you smoke, eat and drink rather than what you eat.

The review, published in the British Journal of Cancer, looks at a decade of evidence on the links between fruit and vegetables and the development of cancer, but it concludes that the evidence is still not convincing.

The only diet-related factors that definitely affect cancer risk are obesity and alcohol, they discovered.

Tobacco is still the single biggest cause of cancer.

While smoking increases the risk of cancer by as much as 50 fold, even large consumptions of fruit and veg will only reduce the risk by a maximum of 10 per cent.

Professor Tim Key, an epidemiologist from Oxford University, said that while there are undoubted benefits in eating fruit and vegetables there is little hard evidence that they protect against cancer.

But the evidence is indisputable that cancer is strongly linked to being overweight or obese, and drinking more alcohol than the recommended daily limits.

He said: “Fruit and vegetables are an important part of a healthy diet and a good source of nutrients.

“But so far the data does not prove that eating increased amounts of fruit and vegetables offers much protection against cancer.

“But there’s strong scientific evidence to show that, after smoking, being overweight and alcohol are two of the biggest cancer risks.”

Overweight people produce higher levels of certain hormones than people of a healthy weight and this can contribute to an increased risk of breast cancer.

Being overweight can increase your risk of other common cancers like bowel and also hard-to-treat forms of the disease like pancreatic, oesophageal and kidney cancer.

When alcohol is broken down by the body it produces a chemical which can damage cells increasing the risk of mouth, throat, breast, bowel and liver cancers.

In the UK 15,000 cases of cancer are caused by alcohol, it is believed, and 19,000 cases of cancer are caused by being overweight or obese.

Sara Hiom, director of health information at Cancer Research UK, said: “Too few people know about the significant cancer risks associated with obesity and drinking too much alcohol.

“While stopping smoking remains the best way to cut your chances of developing cancer, the importance of keeping a healthy weight and cutting down on alcohol shouldn’t be overlooked.

“Keeping alcohol intake to a maximum of one small drink a day for women and two small drinks per day for men and keeping weight within the healthy limits can have an enormous impact.”

The British research mirrors the findings of an American study published in April.

For every extra two portions consumed the risk of cancer reduced by just three per cent, the research conducted by a team at Mount Sinai School of Medicine, in New York suggested.

From: http://www.telegraph.co.uk/Five-a-day-will-not-stop-cancer

Prior to the ban ME patients could give blood provided they were in remission.

But the cyclical “relapsing-remitting” nature of this chronic condition means people can become ill again.

NHS Blood and Transplant says the ban is “a precaution to protect the donor’s safety by ensuring their condition is not made worse by donating blood”.

They say the move brings ME blood donation policy into line with other relapsing conditions or neurological conditions of unknown or uncertain origin, such as multiple sclerosis and Parkinson’s Disease.

But the ME Association believes there is another reason for the ban – to protect blood recipients from a potentially blood-borne illness. Although they agree with the ban, they say the public should be made aware of all of the reasons for it.

Experts do not know what causes ME.

But US scientists recently linked the condition to a retrovirus – known as XMRV – after finding it in the blood of many patients.

The Whittemore Peterson Institute team found XMRV (xenotropic murine leukemia virus-related virus) in 67% of ME patients compared to under 4% of the general population.

However since the 2009 discovery, published in the journal Science, other research teams, including experts in the UK, have failed to demonstrate such a link.

A spokeswoman from NHS Blood and Transplant said: “Currently there is no epidemiological evidence of a link between XMRV and CFS in the UK.”

Although the evidence is patchy, the ME Association say it is enough to advise caution and recommend a ban on blood donations from ME patients.

The American Association of Blood Banks put in place a similar blood ban in June of this year as an interim measure until the true risk of transfusion transmission of XMRV is known.

The ME Association’s medical advisor, Dr Charles Shepherd, said this was a well-judged approach.

“In the current state of uncertainty about a possible viral link a ban is a perfectly sensible measure to take in case it is caused by a retrovirus.

He said the UK ban should not leave a big gap in the blood donor pool.

“Although people with ME often want to donate blood, they make up a small number of the many thousands of donations the NHS receives each year.”

Seven thousand units of blood a day are needed to meet the demand of NHS Blood and Transplant alone.

The ME donor ban applies across all four of the UK’s Blood Services.

From: http://www.bbc.co.uk/health/me-patients-banned-from-blood-donations

Over the past years, the number seeking help for cocaine, crack cocaine and heroin use all fell.

But this was largely down to large reductions in the under 25 age group, as the number of over 40s actually increased.

The NTA believes this reflects the fact the “Trainspotting” generation who got hooked in the 1980s are now ageing and increasingly developing problems linked to their sustained drug use.

The findings also chime with British Crime Survey figures which show overall drugs use has been steadily falling in recent years.

Less than 1% of the population use the most harmful drugs – crack cocaine and heroin.

The NTA figures showed that over the past year the number of people needing treatment for cocaine fell by 15% to 7,304, for crack cocaine by 17% to 3,686 and for crack and heroin together by 16% to 21,341.

This is almost entirely due to large falls in the under 25s seeking treatment as the over 40s have been rising in recent years.

For example, the number of over 40s being treated for crack cocaine or heroin use has risen by a third over the last four years.

The report, compiled with the help of Glasgow University, warned there was some anecdotal evidence of a move towards synthetic compounds known as legal highs, such as mephedrone, among younger age groups.

However, the NTA said it had yet to see many people wanting treatment for these, although it warned that could happen in time.

Peter Kelsey, of Lifeline Redcar and Cleveland, which helps drug users, said: “People hear the word legal and they think safe. Yet it’s anything but.

“We’re seeing a big rise in people coming to use because of legal highs, which we think may be down to the poor quality and price of coke and the legal aspect.”

The government has already responded to the use of so-called legal highs.

Mephedrone – also known as Meow, Bubbles and M-Cat – was banned and made a class B drug in April.

The Home Office has also announced plans for year-long bans that could be introduced quickly if new drugs take off.

NTA chief executive Paul Hayes said the agency now had to “refocus” the treatment system in response to these trends.

From: http://www.bbc.co.uk/news/health-11493247

Staff who are dyslexic, have taken a large number of sick days or who look after disabled and elderly relatives will also find it easier to win unfair dismissal cases under the new law.

Other provisions will allow bankers to compare salaries, and guarantee mothers the right to breastfeed their babies in public.

Experts fear the significant strengthening of anti-discrimination law will lead to a surge in employment tribunal claims as well as increasing the burden of red tape on businesses when they are struggling to recover from the recession.

However some of the most controversial elements of the single Equality Act – driven through by Hattie Harperson just weeks before the general election – have not yet been implemented by the Coalition. These include the requirement for large organisations to publish the gap in pay between male and female employees, and the right of employers to use “positive action” to recruit more female or ethnic minority staff.

The Act aims to make rights simpler by bringing together nine pieces of legislation, and creating a list of “protected characteristics” on which it is unlawful to discriminate: age, disability, gender, gender reassignment, race, religion, sexual orientation, marriage and maternity.

Business leaders, lawyers and personnel experts agreed that the most significant change is the new ban on questions about a prospective employee’s health at first interview.

Until now, employers have routinely asked about the medical background of job applicants but under the Equality Act they will be breaking the law unless they can prove their questions were designed to monitor diversity, or check whether the interviewee can carry out an essential task.

It will be illegal to ask how much time off work a prospective employee has taken, while one HR expert claimed managers will not even be allowed to ask: “How are you this morning?”

However bosses will be able to screen by health after making an offer or drawing up a short-list.

The British Chambers of Commerce estimates it will cost £189million for business to implement the Equality Act. David Frost, its director-general, said: “At a time when the Government is trying to create as many jobs as possible in the private sector this legislation will put people off for fear of getting it wrong. The Equality Act is a very complex bit of employment legislation. If small businesses get this wrong they end up in an employment tribunal.”

A spokesman for the Institute of Directors said: “The health provision is undoubtedly an extra burden on businesses. All business will need to be very clued up on the ramifications of what the new regulations are – if you have a whole HR team that’s fine, but a lot of our members are small businesses and they don’t have that.”

Deborah Casale at Gannons Solicitors said: “This will no doubt become a grey area in the law and may open the door to more disability discrimination claims.”

However supporters of the law believe it could help injured veterans who are seeking work after leaving the Armed Forces, as well as people who have a history of mental illness.

The Equality Act will make it easier for staff to claim they were discriminated against because of a disability. This is because they no longer have to prove they were treated less favourably than non-disabled colleagues.

It is expected to lead to discrimination claims from dyslexic workers who have been barred from carrying out certain tasks because of their tendency to make spelling mistakes.

An employee who had been disciplined for taking a lot of sickness leave could also claim they had been treated unfairly.

The law also introduces the category of “discrimination by association”, which allows carers of disabled children or elderly parents to claim they suffered in the office as a result of their responsibilities at home.

Edward Wanambwa, employment and discrimination specialist at Russell Cooke Solicitors, said: “The Equality Act 2010 is the most ambitious and overarching piece of discrimination legislation for decades. Its purpose is to harmonise and clarify existing law; the impact of which will perhaps most significantly be felt by the 6million carers across the UK who now have an unambiguous right to sue for discriminatory conduct experienced as a result of an association with a disabled person.”

Another category, combined discrimination, could see staff claim they were treated badly because of a combination of their age and their gender – where an allegation under a single area would have failed.

It also becomes illegal to discriminate against someone for the “perception” that they are homosexual, for instance, even if they are not. Transsexuals are protected from discrimination even if they are not undergoing “gender reassignment” treatment.

Employment tribunal judges will be able to recommend changes to the practices of a business rather than just concentrating on the experience of the individual who brings a claim.

Elsewhere, the Act specifically allows nursing mothers to breastfeed their baby in public places. Managers in shops or cafes will not be allowed to ask a mother to stop breastfeeding, move to somewhere more private or leave because they are breastfeeding.

The new law also stops colleges from preventing teenage girls at school who are pregnant or who have had a baby from taking their A-levels.

The legislation does not cover breast feeding at work, however a mother who is discriminated against for feeding would likely have a case for sex discrimination because of existing laws, experts say.

Under the new legislation, staff particularly in the financial sector will be free to discuss their pay, and can claim victimisation if they are disciplined for sharing information about wages or bonuses.

Rachel Dineley, employment partner at law firm Beachcroft, warned that small firms were likely to be caught out, and forecast a rise in cases brought in front of tribunals.

DLA Piper, the law firm that employs Nick Clegg’s wife, said detailed guidance on the new law had only been published in the past month.

Sandra Wallace, the firm’s head of equality and diversity, said: “Unfortunately, by issuing the implementing legislation so late in the day, and not incorporating all elements of the Act, businesses have been left with a halfway house that will potentially confuse them even more than they already were, and risk protracted legal wrangles in employment tribunals that are already overstretched with a general increase in claims.”

Some groups said the Government should have gone further and implemented all of the parts of the Act drawn up by Labour. It is estimated that 90 per cent of the law comes into force today.

Ceri Goddard, chief executive of the Fawcett Society, said: “Rowing back on the requirement for big business to publish and take action on any differences in pay between men and women employees – so to conduct gender pay audits – is tantamount to endorsing the shocking gender pay gap.”

The Government likened the advance in employment rights guaranteed under the Equality Act to an equal pay campaign launched by female factory workers in 1968, commemorated in a film that opens in cinemas today.

Theresa May, the Equality Minister, said: “Thanks to pioneers like the women who feature in Made in Dagenham, the workplace is much fairer than it was in 1968, but there is still plenty of room for improvement.

“In these challenging economic times it’s more important than ever for employers to make the most of all the talent available. When a company reflects the society it serves, it’s better for the employer, the employees and the customers, so being a woman should never be a barrier to being treated fairly at work.

“From today the gagging clauses that stop people discussing their pay with their colleagues will be unenforceable, allowing women and men to find out if they’re being paid unfairly.

“This move towards transparency is just one part of the Equality Act, which also makes it easier for businesses to comply with discrimination law by streamlining the equality laws, and provides more protection to disabled people.”

From: http://www.telegraph.co.uk/Equality-Act-firms-must-not-ask-job-applicants-about-health

NICE the killer quango wants to waste taxpayers money by suggesting that the NHS should bribe fat people to lose weight and smokers to quit, and give children toys for eating their fruit and vegetables.

Now during the credit crunch nice want to waste millions of taxpayers pounds bribing people when earlier pilot studies showed that there were high drop out rates and up to 80% failed to reach their targets.

The advice, which will be published by the National Institute for Curbing Expenditure, has been greeted with anger by critics who claimed such “bribes” were draining the public purse of money which could be better spent elsewhere.

The study examined a series of schemes, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting the habit.

It also looked at programmes in Oxford, Manchester, London and Bangor in Wales, where schools have been given toys such as juggling balls, stickers and pencils to children who have eaten their fruit and vegetables.

Fiona McEvoy, from the TaxPayers’ Alliance, said state funds should not be used to pay people to change their lifestyles,

She said: “Bribing people to lose weight or quit smoking is nothing but a quick fix which patronises the individuals in question and drains much-needed money away from the public purse. At a time when cancer drugs are being denied to sufferers due to lack of funds, many will be disgusted to learn that NICE are considering such a costly approach.”

Other schemes examined in the report include a pilot in Manchester which rewards overweight parents for walking their children to school.

As part of a £30m project, supermarket points are given to unfit people who attend keep-fit classes, weight loss clubs or go for a run in the park.

Overweight people gain credit points they can cash in for groceries just for turning up, with extra rewards depending on how much weight they lose.

In Newcastle, Bristol, Torbay, Manchester and Bury St Edmunds, those aged 16 to 22 are given subsidised gym membership if they visit at least once a week.

However, the report found limited evidence about whether the schemes make a difference.

In the Scottish antismoking project, for instance, the study acknowledged that four fifths of the women in the £43,000 scheme were smoking again within three months of giving birth.

The recommendations from NICE’s independent citizens council do not constitute its official advice to the NHS. Its board will launch a public consultation on the matter before considering the paper, which would inform future guidance.

However, the rationing body has already supported financial rewards for heroin addicts.

Originally NICE recommended that addicts who attended treatment programmes should be given the chance to win prizes, such as televisions and MP3 players.

The body dropped the idea following a public outcry but instead recommended that shopping vouchers worth up to £10 could be awarded to those who completed programmes, or showed they were clear of drugs.

NICE has been widely criticised for refusing to pay for dozens of cancer drugs on the grounds of cost. Medicines rejected include the drugs Avastin for advanced bowel cancer and Nexavar for advanced liver cancer.

Last year the institute fuelled controversy when it ruled marriage guidance counselling should be funded by the NHS, and supported the use of acupuncture for back pain, despite finding there was no good evidence it worked.

The report follows a three day meeting of NICE’s citizens council, where members were asked to vote about the use of incentives.

“More than 60 per cent said they were in favour of such schemes, as long as they were only used as a “last resort” and were not exchangeable for tobacco or alcohol.

Sir Michael Rawlins, the chairman of NICE said: “We clearly face several public health challenges in today’s society, some more obvious than others, and we must seek to improve these in ways that are likely to achieve the best outcomes to those affected.

“The majority of the council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue”.

Public consultation on the report starts today.

From:

http://www.telegraph.co.uk/NICE killer quango taxpayers-bribes-for-obese-and-smokers.html

Health Direct finds this new waste of taxpayers money a disgrace. Research in pilot studies has clearly showed that bribing people to lose weight and stop smoking DOES NOT WORK in the vast majority of cases.

On June 10, 2010 Health Direct published research :Nanny state cash bribes for good health fail three quarters of patients at http://www.healthdirect.co.uk/2010/06/nanny-state-cash-bribes-for-good-health-fail-three-quarters-of-patients.html

A Department of Health spokesman has already described them as an undesirable use of money and should only be adopted as a “last resort”.

If you would like to tell the killer quango NICE what you think of this scheme, comments should be sent to Clifford Middleton, Research and Development Project Manager at clifford.middleton@nice.org.uk by 5pm on Friday, 26 November 2010.

If email is a problem for you, please send your comments in a letter to Clifford Middleton at:

NICE,
MidCity Place,
71 High Holborn,
London WC1V 6NA.

Writing in the Observer, Field, chairman of the Royal College of General Practitioners, backs the controversial call by Andrew Lansley, the health secretary, for Britons to take more responsibility for protecting their health.

“The truth is that too many of us neglect our health, and this is leading to increasing levels of illness and early death,” Field writes. Soaring levels of diabetes, much of it caused by obesity, and the medical consequences of heavy drinking, which are affecting ever-younger people, illustrate this widespread failure, he adds.

Discussion of the harmful medical consequences of ill-advised personal behaviour is curtailed because of its sensitivity, Field argues.

“Too many people do not face up to the hard facts, as they perceive them to be an attack aimed, in particular, at the poorer members of society. But it is impossible to argue on medical or ethical grounds that such behaviour is acceptable.”

While arguing for health prevention to become an individual duty and start at home, Field makes it clear that he does not want people to be left to make lifestyle changes on their own or to see personal responsibility as a total solution. Those who seek to alter their behaviour need continuing NHS and government help, he adds.

“So please don’t take offence if we [GPs] tell you to lose weight or stop smoking or drinking. You need to face facts and take responsibility. Support is out there and it could save your life – and save the NHS a fortune.”

Anne Milton, the public health minister, said greater personal responsibility was vital. Many senior doctors also agreed, but stressed that government action was needed to help create a climate in which people could swap healthy for unhealthy behaviour, such as by monitoring big food companies.

Lansley has alarmed senior doctors by saying the coalition will use much less regulation than Labour did to tackle problems such as obesity and smoking.

GPs seek to help people live healthy lives “but every day we are confronted by the harm caused by smoking, excessive alcohol consumption and the ‘tsunami’ of obesity”, adds Field, the leader of the country’s 40,000 GPs.

Irresponsible parents are damaging their children’s health by smoking around them, feeding them unhealthy food and failing to act as good role models, he says. Mothers and fathers who smoke in cars carrying their offspring – who Field says “are committing a form of child abuse” – and at home in front of their children kill more young people than do accidental injuries.

Parents who give their children unhealthy food, or serve them large portions are storing up huge problems for them, says Field. “Unless parents exert more control over their children’s diets, they are risking a lifetime of health problems, and even premature death – death before their parents, which is almost too sad to contemplate,” he adds.

Parents’ failure to safeguard their children from sunburn and using sunbeds can also lead to them developing skin cancer, he argues. Mothers who smoke while pregnant risk causing their child’s death through cot death syndrome, asthma, lung infections or house fires. Would-be mothers and women who are already expecting need to control their weight because maternal obesity can harm the mother or her baby.

Instead of becoming obese and then asking the NHS to provide liposuction or gastric bands, “it would be better if people didn’t become fat in the first place”, by eating better and exercising more.

Agreeing with Field, Milton said: “We need a new public health movement, owned by everyone, for everyone’s benefit. A movement that transforms the way in which the public’s health is improved, but also revolutionises the way we think about it. As Field points out, personal responsibility is a key part of this.”

However, Milton added: “The government recognises that it cannot force people into behaving in a certain way. But we can help people make informed decisions and ensure that they are enabled and supported to make healthy choices.”

Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, agreed some parents let down their children. “Of course paediatricians agree that people should take responsibility for their own lives. But young children cannot do that. What they eat and the environment they live in are determined by their parents. There is a role for society to protect young children from promotion of unhealthy foods and passive smoking. Would all parents strap young children into a car seat if it was left to choice rather than law?”

He urged a twin-track approach of exhorting parents to care for children well but society also intervening to help by, for example, limiting advertising of unhealthy foods.

Dr John Middleton, vice-president of the UK Faculty of Public Health, said: “A significant amount of ill-health is due to people’s lack of personal responsibility. The NHS would have fewer burdens on it if people were more physically active, cut their alcohol consumption and ate a lower-fat, lower-sugar diet. The government and the NHS cannot do everything. But someone trying to give up smoking will find it easier if they get counselling and nicotine replacement therapy on the NHS, for instance.”

The government had a key role to play in promoting health, as shown by its crackdown on smoking and its fluoridisation of water supplies, said Professor Dinesh Bhugra, president of the Royal College of Psychiatrists. People who insisted on smoking despite all the warnings about it should retain their freedom to do so, he added.

But Tam Fry, National Obesity Forum spokesman, suggested Field was being naïve. “If Professor Field wants a world where everyone assumes personal responsibility, he is living a dream. He appears to have forgotten the 35-40% of our population who live in the same obesogenic environment as he does but simply can’t cope with it or have long since given up the unequal struggle. They are the people who are quite unequipped to resist the 24/24 battering of junk food promotion and are easy prey for the marketing men.”

However, “certainly the 40% of women entering pregnancy either overweight or obese do so simply because they have never had role model lessons in parenting from either their own mothers or health professionals”, Fry added.

From: http://www.guardian.co.uk/public-health-attitudes-leading-gp

The pills could be placed beside the salt, pepper and tomato ketchup to encourage people to pop one after their meal.

The suggestion is made in a paper by Dr Darrel Francis, a cardiologist at Imperial’s National Heart and Lung Institute, and colleagues published in the American Journal of Cardiology.

The idea was criticised by leading doctors, who said the study could encourage ill-health by prompting even greater consumption of junk food and increasing the belief in “a pill for every ill”.

Francis said: “Statins do not cut out all of the unhealthy effects of burgers and fries. It’s better to avoid fatty food altogether. But in terms of your likelihood of having a heart attack, taking a statin can reduce your risk to more or less the same degree as a fast food meal increases it.”

People eat fast food despite knowing that it is bad for them. Given that, said Francis: “It makes sense to make risk-reducing supplements available just as easily as the unhealthy condiments that are provided free of charge. It would cost less then 5p per customer – not much different to a sachet of ketchup.”

The proposal was in line with other established risk-reducing measures such as wearing a seatbelt or buying filtered cigarettes, Francis argued.

Professor Steve Field, chairman of the Royal College of General Practitioners, denounced the proposal. “This paper just amazes me,” he said. “Let’s get real; we should be encouraging healthy lifestyles, not pill popping. This is an unwelcome addition to the ‘pill for every ill’ attitude that’s already much too common. The danger of this research is that some people will become even more complacent about eating fatty food and high calorie food, and might even increase their intake of them.”

While statins were generally safe they could increase the risk of muscle weakness and, in rare cases, of kidney failure, cataracts and liver problems, Field added.

Millions of Britons who have dangerously high cholesterol levels, and those with existing heart problems, take statins regularly to reduce the risk of a heart attack or stroke.

Professor Peter Weissberg, medical director of the British Heart Foundation, said: “The suggestion that the harmful effects of a junk food meal might be erased by taking a cholesterol-lowering statin tablet should not be taken literally. Statins are a vital medicine for people with, or at high risk of developing, heart disease. They are not a magic bullet.”

From: http://www.guardian.co.uk/fast-food-free-drugs-heart-disease

It follows the publication of guidance by the nanny state’s National Institute for Curbing Expenditue (NICE)  that sex education should be introduced from the age of five.

Trevor Stammers, chairman of the Christian Medical Fellowship and a GP in south London, told The Sunday Times: “If sex education is introduced in primary schools in the way being proposed, we will see many more 11-year-old girls seeking contraception without pointing out the risks…. We are going to make matters worse.”

He added: “These figures illustrate the fact that the UK is facilitating the sexualisation of young people at an ever younger age.”

The latest figures came from the General Practice Research Database, which collects information on medical records from 500 GP practices.

The data also shows that at least 58,000 15-year-olds were on the pill last year – more than double the number in 1999.

By law, doctors are bound by a duty of confidentiality towards children – even if they are under the legal age of consent – unless they suspect abuse.

From: http://www.telegraph.co.uk/Huge-rise-in-11-year-olds-on-the-pill

The statistics are part of wider research on the experiences of 18-year-olds in England, published by the Department for Education.

The responses of thousands of 18-year-olds questioned for the Youth Cohort Study and the Longitudinal Study of Young People in England were analysed.

The findings show that of the 18-year-old girls questioned about pregnancy, 18 per cent had been pregnant at least once.

Of these, almost eight in 10 (79 per cent) had been expecting a baby on just one occasion, nearly one in five (18 per cent) had been pregnant twice, and 3 per cent had been pregnant at least three times.

The survey concluded there was a “noticeable trend” between the young women who fell pregnant by 18, and their GCSE results.

A third (33 per cent) of those who gained between one and four GCSEs at grades D-G had been pregnant at least once by the time they were 18, compared to just 6 per cent of those who scored eight or more GCSEs at Grades A*-C.

Teenage girls who were eligible for Free School Meals – a measure of poverty – at age 16, or who had parents who left school at 16, were also more likely to get pregnant by the age of 18, the figures showed.

According to figures published by the Office for National Statistics, there were 25.3 births for every 1,000 women under 20, in 2009.

Girls aged 15 to 19 accounted for 39,020 abortions carried out in England and Wales in 2009.

The figures show that 18 per cent of girls who said they were sexually active had been pregnant by the age of 18.

More than eight in ten (83 per cent) of the boys and girls questioned said they were sexually active by the time they turned 18.

From: http://www.independent.co.uk/a-fifth-of-girls-pregnant-by-18-survey-reveals-2032952

Children at risk through lack of training for doctors and nurses, report warns

Consultants who took part in the study were most damning about the impact of the changes on their trainees.

Among responses from more than 500 senior surgeons taking part were repeated warnings that the rules were creating a generation of “clock-watchers” with a “lazy work ethic” who no longer felt personal responsibility for their patients.

Trainees were now spending so little time in operating theatres that they would lack the “cutting skills” required to perform safely when they became consultants, many warned.

College president John Black urged the Government to take urgent action to address the concerns, having pledged in its Coalition agreement that it would work to limit the application of the EU rules in the UK.

He described the situation facing the NHS as “acutely urgent”.

Mr Black said: “Without action we are going to see a generation of specialists with less experience than any that have gone before.”

Many consultants responding to the survey said the changes – which began in 2007 when a 56 hour maximum working week was introduced, following EU legislation – were already changing the attitude of young doctors, who were becoming too detached from the patients in their care.

Marjan Jahangiri, Professor of Cardiac Surgery at St George’s Hospital in London said: “We have created a generation of surgeons who lack technical skills and operate within a “clocking off” culture where they do not feel personal responsibility for their patient.”

The surgeon said the change in attitude was “as fundamental and dangerous” as the lack of expertise among junior doctors, who now received far less training than their predecessors.

She said: “We have now got a system where trainees begin keen and motivated, become restless from a lack of training opportunities, and they will end up lazy and unskilled”.

The heart surgeon, 48, said that by the time she became a consultant, nine years ago, she had undertaken 900 cardiac operations. The current generation were likely to become senior doctors after performing less than 300, she said.

Consultants who used to do most of their surgery assisted by trainees said they were now often forced to operate alone.

While some juniors ignored the rules and came in on their days off, most had far less time in the operating theatre because of strictures limiting them to a maximum of 48 hours, including all time on call, as well as their night shifts, and time on wards and in Accident and Emergency departments.

One respondent to the survey described the directive as the “single most damaging factor affecting training and continuity of care”.

The surgeon added: “The most insidious problem is that it fosters the concept that you are responsible for a patient only for a shift.

“A consultant surgeon has a particular and continuing responsibility – we are training clock watchers whose work life balance is more important than anything else.”

More than half of the 982 consultants and trainees polled said they were not truly complying with the rules, with many saying they lied about the true hours they worked because of pressure from NHS managers.

Among consultants who did comply with the 48 hour limit, 56 per cent said they had only done so at the expense of patient safety.

Many of the risks came from the increased numbers of “handovers” from one shift to another, and the use of inexperienced locums to cover gaps in rotas.

While some respondents in the anonymous survey said only luck had avoided serious incidents, others described specific errors which they attributed to the new system – such as the removal of an eight year old’s ovary, instead of her appendix, by an inexperienced doctor.

Mr Black said the NHS was “skating on very thin ice” under the current system, given that most doctors said they were still working longer than the 48 hours,

Doctors described handover procedures between teams which were unsafe, inadequate and in some cases, non-existent.

Trainees also described despair about the system, with many saying their training had suffered, and others saying they were only managing to improve their skills by lying about their hours and working on their days off.

Estimates suggest the current generation of trainees will have spent about half as much time in training or on call as those who became consultants before the EU rules were introduced.

A consultant summed up the training problems as a “complete disaster”, adding: “I just hope my colleagues can look after me when I get old. The only problem is they are going to be getting old too.”

From: http://www.telegraph.co.uk/EU-rules-are-making-our-doctors-lazy-clock-watchers