Having a positive attitude to life may reduce the risk of having a heart attack or stroke a major review of research has found.People who are able to enjoy simple pleasures, have a sunny disposition and positive outlook on life are less likely to have heart attacks and strokes, it has been found.

It was known that stress and depression increase the chances of being unwell and is harmful for the heart but less was known about how positive emotions affect health.

In the first review of its kind, a team at Harvard School of Public Health, in Boston, America, examined 200 separate research studies which looked as psychological wellbeing and cardiovascular health.

The findings were published online in Psychological Bulletin.

Lead author Julia Boehm, research fellow in the Department of Society, Human Development, and Health at HSPH said: “The absence of the negative is not the same thing as the presence of the positive. We found that factors such as optimism, life satisfaction, and happiness are associated with reduced risk of cardiovascular disease regardless of such factors as a person’s age, socioeconomic status, smoking status, or body weight.

“For example, the most optimistic individuals had an approximately 50 per cent reduced risk of experiencing an initial cardiovascular event compared to their less optimistic peers.”

Each of the 200 research papers studied slightly different emotional states using questionnaires and assessments to score individuals’ characteristics and outlooks.

They measured the extent to which individuals consider themselves a happy or unhappy person, satisfaction with their life and the extent to which they experience pleasurable feelings.

Some also looked at optimism and hope, the extent to which individuals have expectancies for positive outcomes in the future and enthusiasm for life.

Senior author Laura Kubzansky, associate professor of society, human development, and health at Harvard, said there are psychological assets, like optimism and positive emotion, that afford protection against cardiovascular disease.

These factors protected people against heart attacks and strokes and also slowed the progression of heart disease and other diseases in patients who had already developed them, it was found.

The research showed that people with a positive outlook on life and who were optimistic about the future tended to lead healthier lives overall.

They were more likely to exercise, eat a good balanced diet, and get enough sleep. Yet even when these factors were accounted for, the happier people were still less likely to develop cardiovascular disease.

It is thought that a positive attitude to life makes people more resilient to stress and helps them recover more quickly after things like preparing for a speech, the researchers said.

In one study that was examined, involving 300 men and women having bypass surgery, those with an optimistic outlook were also 50 per cent less likely to be admitted to hospital for heart problems or surgery complications six months later.

Prof Kubzansky said if future research continued to indicate that higher levels of satisfaction, optimism, and happiness proceeded good cardiovascular health, it would have strong implications for the design of prevention and treatment of heart disease and stroke.

The review found that one study of nearly 2,500 men and women showed that emotional wellbeing, as rated on a depression scale, was linked with a 26 per cent reduced risk of stroke six years later, even after accounting for traditional risk factors and negative mood.

There were similar results on scores of vitality, even after accounting for factors that cause heart disease such as smoking and obesity, it was found emotional vitality was associated with a 28 per cent reduced risk of coronary heart disease.

From: http://www.telegraph.co.uk/Positive-outlook-on-life-linked-to-lower-risk-of-heart-attacks-research

The global war on drugs should be abandoned and they should be legalised an establishment think tank has declared.A study by the International Institute of Strategic Studies found that the global war on narcotics had failed to contain the scourge of illegal stimulants.

The drugs trade has spread to Africa and Eastern Europe in recent decades and entrenched its standing in its traditional strongholds of Asia and the Americas.

Nigel Inkster, the former assistant chief of MI6 and author of the study, said there was a growing revolt against the cost of the fight in developing countries.

Only “vested interests” in countries where illegal drugs are consumed stood in the way of a change in approach, he said.

Research indicated that the authorities would need to stop 70 per cent of all drugs shipments to disrupt the trade. While no figures for the proportion of the trade stopped are available, the figure is almost certainly far below that threshold.

Therefore ramping up the security services fight against drugs is almost certainly doomed to failure.

“As any doctor is told on his first day, you should not just double the dose,” said Mr Inkster, who is the most senior figure to have worked within the fight against narcotics to openly call for a review. “If your initial diagnosis doesn’t work don’t just double the dose.”

The corrosive effects on security of the narco-economy also weighs as an argument for ending the war. “You can’t do counter-insurgency and counter-narcotics simultaneously,” he said. “Our investigation has shown us that the so-called war on drugs fundamentally undermines international security.”

The report, Drugs, Insecurity and Failed States, highlights two alternative systems.

Either decriminalisation of all personal possession, as Portugal instituted a decade ago- or a licensing scheme such as that which brought the gin trade under control in London in the 1700s.

Licensing would also allow states to begin to apply the lessons of antismoking campaigns which have curtailed tobacco use.

Taxation, public health messages and social legislation could marginalise drug use.

A new treatment for prostate cancer can rid the disease from nine in ten men without debilitating side effects, a study has found, leading to new hope for tens of thousands of men.It is hoped the new treatment, which involves heating only the tumours with a highly focused ultrasound, will mean men can be treated without an overnight stay in hospital and avoiding the distressing side effects associated with current therapies.

A study has found that focal HIFU, high-intensity focused ultrasound, provides the ‘perfect’ outcome of no major side effects and free of cancer 12 months after treatment in nine out of ten cases.

Traditional surgery or radiotherapy can only provide the perfect outcome in half of cases currently.

Experts have said the results are ‘very encouraging’ and were a ‘paradigm’ shift in treatment of the disease.

It is hoped that large scale trials can now begin so the treatment could be offered routinely on the NHS within five years.

A larger trial is already recruiting patients and men interested in the treatment should speak to their cancer doctor or GP about being referrred, experts said.

Prostate cancer is the commonest cancer in men with more than 37,000 diagnoses each year contributing to approximately 10,000 deaths.

Current treatments include surgery to remove the whole prostate or radiotherapy. Both of which can effectively treat the cancer but often cause side effects such as incontinence and impotence.

However in many men prostate cancer will not progress to a life threatening disease meaning that radical treatment risks side effects unnecessarily. For this reason, research is now focused on reducing side effects.

Focal HIFU involves careful selection of tumours, as small as a grain of rice, within the prostate gland and targeting them with highly focused ultrasound to heat them and destroy them.

The advantage over previous HIFU and other treatments is that damage to surrounding tissue is minimised, meaning there are far fewer side effects.

In the study Focal therapy for localised unifocal and multifocal prostate cancer published in the journal Lancet Oncology, 41 men were treated with focal HIFU. After 12 months, none were incontinent and one in ten suffered impotence.

The majority, 95 per cent, were free of cancer after 12 months.

Dr Hashim Ahmed, who led the study at University College London Hospitals NHS Foundation Trust andUniversity College London, said: “This changes the paradigm. By focusing just on the areas of cancer we reduce the collateral damage to surrounding tissue.

“Our results are very encouraging. We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side-effects. That could mean a significant improvement in their quality of life.

“This study provides the proof-of-concept we need to develop a much larger trial to look at whether focal therapy is as effective as the current standard treatment in protecting the health of the men treated for prostate cancer in the medium and long term.”

The research programme is led by Professor Mark Emberton, of UCL and UCLH. He said: “Focal therapy offers harm reduction – it is a strategy that attempts to redress the balance of harms and benefits by offering men who place high utility on genito-urinary function an alternative to standard care.

“In fact, the concept is not new – tissue preserving strategies have been used successfully in all other solid organ cancers such as breast cancer by offering women a lumpectomy rather than mastectomy.”

Professor Gillies McKenna, director of the Medical Research Council and Cancer Research UK Gray Institute for Radiation Oncology and Biology, said: “Clinical trials, like this one supported by the MRC, are a fantastic tool for telling us whether experimental new treatments are likely to be effective in the clinic.

“If these promising results can be confirmed in a randomised controlled trial, focal therapy could soon become a reasonable treatment choice for prostate cancer alongside other proven effective therapies.”

Urgent checks of abortion clinics ordered by the health secretary last month cost £1 million and meant hundreds of other inspections were cancelled.The Care Quality Commission (CQC) said the request at short notice from the Department of Health meant 580 pre-planned inspections were cancelled.

Time spent on planning and inspecting equated to 1,100 days, it said.

The department said the inspections had been agreed between the CQC and the health secretary.

It added that if the regulator had said more money was needed, it would have been provided.

The inspectors visited nearly 300 abortion providers in England over three days in March, and found about 50 were not complying with laws or regulations.

Several doctors were referred to the General Medical Council, and police have been investigating too, to establish whether criminal offences have been committed.

In a letter to the Department of Health, CQC chairwoman Dame Jo Williams said the urgent inspections have had “a considerable impact on our capacity to deliver our annual targets”.

“Such a request at short notice entails Operations management time in planning the visits, cancelling pre-planned inspections as well as the compliance inspector time in carrying out the visits and drafting the reports.”

Dame Jo outlined the impact on scheduled activity in the letter, saying that 320 locations would require visits, with the total number of days required – including for planning and management – being 1,100.

“This equates to a total of 580 inspections foregone and a total of 16 inspectors being utilised on a full year basis at an estimated cost of £1.0 million,” she wrote.

She also asked that the department take into account such an impact on planned work “when considering future requests and delivery within a time limited period”.

The work of abortion clinics first came under the spotlight in February when the Daily Telegraph secretly filmed doctors and alleged some were agreeing to terminate foetuses when women did not want their baby because of its gender.

Police are investigating the allegations.

A ban on tobacco displays is coming into force in England today – with ministers promising it will help curb the number of young people taking up smoking.Cigarettes and other products will have to be kept below the counter in large shops and supermarkets, while small outlets are exempt until 2015.

Other parts of the UK are planning similar action to drive down smoking rates.

Andrew Lansley Health Secretary said: “Firstly, it reduces the visibility of tobacco and smoking to young people. And, of course two thirds of smokers started smoking before they were eighteen.

“So, if we can, literally, arrive at a place where young people just don’t think about smoking and they don’t see tobacco and they don’t see cigarettes – then I hope we can make a big difference.”

He said the government recognised the pressures on retailers to comply with the ban but added: “We want to arrive at a place where we no longer see smoking as a normal part of life. We’re doing it by stages with constant active pressure.”

A fifth of adults smoke – a figure which has remained steady in recent years after decades of rapid falls.

A plan to force manufacturers to put cigarettes into plain packets is also expected to be put out to consultation later this year.

The display ban will apply to shops of more than 280 sq m (3,014 sq ft).

Public health minister Anne Milton cited evidence from Ireland which suggested the measure could play an important role in discouraging young people in particular from smoking.

“We cannot ignore the fact that young people are recruited into smoking by colourful, eye-catching, cigarette displays.  Most adult smokers started smoking as teenagers and we need to stop this trend.”

Jo Butcher, of the National Children’s Bureau, agreed: “It’s essential that we create a culture that promotes and protects public health and tobacco legislation is a significant factor in making this happen.”

Jean King, of charity Cancer Research UK, said the ban would help stop children who are attracted to brightly coloured tobacco packaging from taking up smoking but further action was still needed.

“Of course we want to see the pack branding taken away as well. This is not a normal consumer product, it kills people. We want to protect the next generation of children,” she said.

Andrew Opie, from the British Retail Consortium, said it was wrong to believe the legislation would have a major effect on young people and it was supermarkets and other shops which were bearing the brunt of the costs needed to comply with the ban.

He said the organisation had calculated that it cost more than £15 million to ensure everything was sorted out before the ban came into place.

He said: “Children are more likely to smoke when they’re in a household where parents smoke and also they tend to get their cigarettes from either parents, or older peers, not directly from supermarkets.

The display ban was announced by the government last year as part of its tobacco control strategy.

Although the legislation allowing it to happen was actually put in place by the Labour government before it lost power in 2010.

A number of countries, including Canada, Ireland, Iceland and Finland, have already introduced similar bans.

Prof David Hammond from the University of Waterloo in Ontario, said the ban led to a decline in smoking – especially among the young – in Canada.

“The declines were greatest in the provinces where the ban had been implemented the longest. And that’s consistent with the idea that when you remove something like marketing, it takes some time for the residual marketing to wear out.”

From: http://www.bbc.co.uk/news/health-17626133

The most senior doctor in the NHS is demanding that hospitals have a full complement of doctors at weekends to make the health service more convenient to access as “people get sick seven days a week”.Sir Bruce Keogh, Medical Director of the NHS, criticised the culture in hospitals of only treating emergency cases at the weekend with little or no routine surgery or diagnostic testing done outside normal office hours.

He said the current system ‘lacks compassion’ because patients are forced to wait for investigations or take time off work or arrange childcare in order to be seen.

Studies have shown that patients are around 16 per cent per cent more likely to die if they are admitted to hospital at the weekend due to a lack of senior staff.

His comments come as a survey revealed that four in ten doctors are opposed to hospitals operating a seven-day service saying they would need extra pay to work unsocial hours.

Sir Bruce is attempting to reform NHS hospital working hours by talking to hospital chief executives around the country to identify which services can be opened at the weekend first.

He said: “What other industry shuts down for two and half days a week? People get sick seven days a week, they need help seven days a week.

“I want to get to a position where the NHS is indistinguishable on a Saturday from a Wednesday but we won’t get there overnight.

“Twenty years ago there was a debate about Sunday trading and the situation has changed quite substantially. Now in a secular world, the prime occupation on a Sunday is shopping.

“There is a really powerful moral and professional argument for seven day routine services. It would contribute to people’s lives, to the economy and bring a bit of convenience into healthcare.”

In London alone it is estimated that 500 lives a year could be saved if mortality rates at the weekend matched those in the week.

A poll conducted by the website, Doctors.net, has found that four in ten doctors are opposed to such a move.

A seven day working week would mean senior doctors would have to be paid more for working at the weekend and that services would be reduced in the week when staff needed days off in lieu, they said.

Some claimed the NHS is unable to afford proper staffing for a five-day working week, let alone seven days. Childcare issues were also raised as a major stumbling block to doctors working all week.

Currently hospital wards are staffed mostly by nurses and junior doctors often covering hundreds of patients each with consultants and other senior staff on call from home.

Research commissioned by Sir Bruce found that NHS patients were ten per cent more likely to die if they were admitted on a Saturday compared with a Wednesday and 16 per cent more likely to die if they were admitted on a Sunday.

Not all of the deaths were emergency cases, showing that patients seen routinely were at greater risk too.

Chairman of the British Medical Association’s Consultants Committee, Dr Mark Porter, said: “This snapshot poll reflects consultants’ abiding concern for the quality of patient care. Some patients clearly need acute specialist care on a 24/7 basis with appropriate diagnostic and support teams.

“It may be appropriate for other departments to have an on-call consultant available out-of-hours, rather than having a senior doctor present at all times. Hospitals have to be flexible to patients’ needs.

“This is a complex issue and we need to look at the evidence and determine what works best for different areas of medicine.

“The ongoing cuts in NHS resources at present make a consultant-based service more difficult as the NHS is often at full tilt just covering emergencies at weekends.”

Sir Richard Thompson, president of the Royal College of Physicians, which has called for weekend working said: “It is good news that doctors are recognising and supporting the need for seven-day working.

“In December 2010, the Royal College of Physicians called for consultant physicians to be available to care for very sick patients at least 12 hours a day, seven days a week.

“I am worried that patients are still not getting the best care that they deserve at night and at weekends. Too many junior doctors are covering too many very ill patients, and this has to change.

“To support this change, consultants will need diagnostic and other support services, such as radiography and support from junior doctors. We will also need changes to workforce planning and working patterns.

President of the Royal College of Surgeons, Norman Williams, said: “The evidence continues to mount that we need to rethink how surgical care is delivered for patients’ seven-days-a-week. In particular, mortality and complication rates vary widely for patients admitted as emergencies at the weekend.

“In order to address this, clinicians and managers must work together to reconfigure hospital services in a way that strengthens the quality of care given to patients regardless of when they are admitted.”

From: http://www.telegraph.co.uk/Hospitals-should-operate-seven-days-a-week-NHS-top-doctor

A third of older people are at an increased risk of dying because they do not fully understand the instructions on medicine labels, a study has found.Researchers at University of College London asked almost 8,000 adults over 52 to take part in a test of how well they could read and understand a basic medicines label, for a mocked-up aspirin product.

It comprised of four simple comprehension-style questions, such as ‘What is the maximum number of days you may take this medicine?’ and ‘List three situations for which you should consult a doctor’. The answers were on the bottle’s label.

A third failed to answer all four questions correctly. One in eight got two or more answers wrong.

The academics then followed the health of the volunteers for five years, all of whom were part of the English Longitudinal Study of Ageing project. Over that period 621 died.

They found those with poorer literacy – who got more answers wrong – were more likely to have died, the research published in the British Medical Journal found.

Specifically, 16 per cent of those who got two or more answers wrong died, nine per cent of those who got one wrong died, while only six per cent of those who answered all questions correctly did so.

Sophie Bostock, a research associate at UCL’s Department of Epidemiology and Public Health, said: “You can’t say the higher death rates are due to these people not reading medicines labels – the reasons for them dying early are complex – but poor literacy is certainly an indicator that they are more vulnerable.

“We do think there’s something specific about underlying literacy that has an impact on mortality.”

She noted that failing eyesight and dementia were not reasons for people being unable to read or comprehend the labels, and that the study was designed to examine fundamental literacy.

Despite poor literacy usually being a lifelong, intractable problem, she said there were ways to ensure such people lived longer, by targeting them with campaigns to make them understand their health problems better.

The team’s research chimes with recommendations made by Sir Michael Marmot, a Government advisor on health inequalities. He has said that improving children’s literacy is one of the most powerful ways of bettering public health.

Poor underlying literacy has long been known to be related with premature death, partly because those who fail to develop their reading skills at school are more likely to take up unhealthy habits like smoking and over-eating as adults.

However, there have been few attempts to quantify the scale of the problem or how it impacts on life expectancy.

From: http://www.telegraph.co.uk/Misreading-medicine-labels-puts-elderly-at-risk-of-dying

Overseas visitors to Britain are to be offered free HIV treatment on the NHS for the first time.Ministers are backing calls for non-UK residents to be treated for the condition as part of efforts to protect the wider public.

Foreign students, workers and victims of human trafficking are among those expected to benefit.

The Department of Health said that safeguards would be introduced to prevent “health tourism”.

Currently treatment for HIV is only available to people officially resident in Britain, excluding migrants.

But Lord Fowler, a former Conservative Cabinet minister who has campaigned on Aids, has called for free treatment to be extended to those who have been in Britain for six months.

The proposal, contained in an amendment to the Health and Social Care Bill currently before the Lords, will be accepted by the Government but introduced in a Statutory Instrument rather than as part of the legislation.

The move comes amid concerns about rising levels of HIV infection and the cost to the NHS of not treating it early. Foreigners are thought to be dissuaded from seeking help because of the cost of treatment.

Public Health Minister Anne Milton said: “This measure will protect the public and brings HIV treatment in to line with all other infectious diseases. Treating people with HIV means they are very unlikely to pass the infection on to others.

“Tough guidance will ensure this measure is not abused.”

Chief Medical Officer Professor Dame Sally Davies said that effective treatment of HIV reduced its spread by up to 96%.

“This change is in line with the UK Chief Medical Officers’ Expert Advisory Group’s advice, and offering NHS treatment will encourage testing, resulting in fewer undiagnosed HIV infections and therefore ensuring that there is less chance of passing on infection to the wider population.”

Yusef Azad, the director of policy at the National Aids Trust, said: “If someone is tested and treated early, it is much cheaper than them presenting themselves in hospital with a much more serious, complex condition that can cost tens of thousands of pounds to treat.”

Dementia should be made a top health priority on a par with cancer and lung disease, a leading expert has said, after it has become the next global “time bomb”.Professor Peter Piot, former Under-Secretary General of the United Nations, compared dementia to the AIDs epidemic and said one person is diagnosed with the mental illness every seven seconds.

The population of sufferers, which currently stands at 36 million, is set to double by 2020 worldwide.

He is now calling on the World Health Organisation to add dementia to their list of top priority diseases to fund research and treatment across the globe.

He said: “It’s not adding years to your life, but life to your years.”

Despite his calls to improve diagnosis, Prof Piot admitted it may not always be ethical to diagnose the condition, in parts of the world where treatment is not yet available.

He told BBC Radio4’s Today programme that developing countries in Asia and Latin America were seeing the greatest rise in dementia sufferers, as better healthcare led to people living longer.

Prof Piot, director of the London School of Hygiene and Tropical Medicine, said: “The figures speak for themselves. We are really going into the next global health time bomb.

“I have worked for the last 30 years on AIDs. That was a time bomb several decades ago and it’s still not over.

“But the figures are there. Today 36 million people are living with dementia. Every seven seconds there is a new case and we will see a doubling in the number of people by 2020.

“People in the emerging economies, like Asia and Latin America, are living longer and dementia is progressing fastest there in terms of the numbers.

“It’s affecting, families, communities and of course the people themselves.”

He added that the idea dementia was an inevitable part of aging is a “myth” and that early diagnosis would allow sufferers to make legal, financial and care arrangements.

The World Health Organisation list of priorities currently comprises of cancer, lung disease, diabetes and chronic heart disease.

From: http://www.telegraph.co.uk/Dementia-is-next-global-health-time-bomb

A new pill costing only £1.40 a day that could save the lives of thousands of heart failure patients every year has been approved by European regulators.New data on Ivabradine suggested it could cut death rates by up to 39 per cent, while experts said it could prevent between 5,000 and 10,000 deaths a year.

The drug was also found to reduce the need for patients to be treated in hospital for heart failure, which affects about 900,000 people in Britain, by 30 per cent.

The drug has been approved by European regulators but has yet to be assessed for widespread use on the NHS as the killer quango NICE has yet to approve it.

It costs £1.40 a day and is already prescribed for patients in this country with angina.

It could reduce the risk of death from all types of cardiovascular disease by 17 per cent and the risk of death from all causes by 17 per cent.

In addition, the drug, which slows down the heart rate, was found to cut the risk of heart failure patients requiring treatment by 30 per cent. The study involved 6,505 people in 37 countries, including Britain.

Heart failure occurs when the organ becomes too weak to pump blood efficiently round the body, leading to fatigue, breathlessness, a higher heart rate and other problems.

Prof Martin Cowie, a consultant cardiologist and specialist in heart failure at the Royal Brompton Hospital in central London, and the British lead investigator for the study, said: “Heart failure is a very common problem, affecting approximately 1 per cent of the population.

“The decision to approve this new indication for ivabradine is great news for both doctors and patients, and is a significant step forward in the management of heart failure.”

Prof Cowie added: “While Ace inhibitors and beta-blockers remain very important in the treatment of this condition, the results of the trial demonstrate the value that a reduction in heart rate with ivabradine can bring both in terms of improving symptoms and preventing disease progression, but also in helping patients return to normal daily activities and increasing their enjoyment of life.”