Cervical cancer link to early sex as sexually transmitted infection, HPV, causes most cases

Having sex at an early age can double the risk of developing cervical cancer, a study of 20,000 women suggests.

The investigation into why poorer women have a higher risk of the disease found they tended to have sex about four years earlier than more affluent women.

Previously, it had been thought the disparity was the result of low screening uptake in poorer areas.

The International Agency for Research on Cancer findings are published in the British Journal of Cancer.

Although the difference in cervical cancer incidence between rich and poor – across the world – had been noted for many years, it was not clear why this is the case.

Especially as rates of infection with human papillomavirus (HPV) – the sexually transmitted infection linked with the vast majority of cervical cancers – seemed to be similar across all groups.

The study confirmed that the higher rates of cervical cancer were not linked to higher HPV levels.
   
But what it did reveal is that the two fold increased risk was largely explained by women from poorer backgrounds starting to have sex at a younger age.

The age at which a woman had her first baby was also an important factor. Screening was found to have some effect on the level of risk.

But the number of sexual partners a woman has and smoking did not account for any of the difference.

Study leader, Dr Silvia Franceschi, said the findings were not restricted to adolescence and the risk of cervical cancer was also higher in women who had their first sexual intercourse at 20 rather than 25 years.

“In our study, poorer women had become sexually active on average four years earlier. So they may have also been infected with HPV earlier, giving the virus more time to produce the long sequence of events that are needed for cancer development.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said the study raised some interesting questions.

“Although women can be infected by HPV at any age, infections at a very young age may be especially dangerous as they have more time to cause damage that eventually leads to cancer.

“Importantly, the results back up the need for the HPV vaccination to be given in schools at an age before they start having sex, especially among girls in deprived areas.”


So after a dozen years of nanny state sex lectures the current crop of school leavers are worse off- as are the UK taxpayers.

From:
http://news.bbc.co.uk/1/hi/health/8420690.stm

Government departments waste £4m on website redesigns

Labour government departments have spent £4 million of public money revamping their existing websites over the past two and a half years.

Much of the money has gone to external consultants and contractors.

In total, £3.96 million has been spent on redesigns and upgrades since June 2007. The figure does not include the estimated £220 million annual cost of running the government sites.

David Davies, Conservative MP for Monmouth who asked for the information in a string of parliamentary questions, said: “Dfid ministers should be giving financial support to the poorest people in the world not the wealthiest web designers.

“The money spent on a web upgrade could have paid the wages of 100 nurses in one of the poorest African nations for a year, but for Labour ministers, internet propaganda is far more important.

The Central Office of Information (COI) is conducting a study, to be published in June, into whether government websites offer value for money. The investigation was prompted by a National Audit Office report that said over one quarter of government organisations did not even know the running cost of their own websites, making it impossible to assess whether they provide value for money.

The NAO also found that one in six government bodies had no data about how their websites were being used.

Matthew Elliot, the campaign director for The TaxPayers’ Alliance, said: “This astonishing £4 million figure shows departments must concentrate on content rather than the appearance of government websites. Many of these sites look a lot better than they actually are.”

What departments said they spent on redesigns since June 2007:

Department for International Development £970,419
Department for Business, Enterprise and Regulatory Reform £528,912
Department of Health £513,000
Intellectual Property Office £355,000
Electoral Commission £283,744
Department for Environment, Food and Rural Affairs £181,000
Ministry of Defence £150,000
Electoral Commission voter information site £140,600
Serious Fraud Office £113,309
Office of Rail Regulation £107,169
Department for Innovation, Universities and Skills £105,167
British Army £75,000
Crown Prosecution Service £60,085
Attorney General’s Office £59,184
Revenue and Customs Prosecution Office £58,741
Office of Government Commerce £54,000
Bona Vacantia £42,598
UKTI Defence and Security Organisation £42,000
National School of Government £27,683
National Measurement Office £20,649
Government Actuary Department £19,461
Scotland Office £12,880
Disposal Services Authority £12,000
Wales Office £10,500
NI Organised Crime Office £6,825
Forensic Science NI £6,187
NI Youth Justice Agency £4,802
Treasury Pre-Budget £4,578
TOTAL £3,965,493


From:
http://www.telegraph.co.uk/Government-departments-spend-4m-on-website-redesigns

NHS faces potentially serious problems from wrong prescriptions on the NHS

Patients face potentially serious problems because of the piecemeal training given to young NHS doctors in giving out prescriptions, claim medicine experts.

Junior doctors on average fill out five or six prescription forms during their whole time in medical school only to have to complete dozens on their first day on the wards.

The inadequate preparation helps contribute to almost one in 10 prescriptions containing errors that could harm patients, it was said.

Now the British Pharmacological Society (BPS) is calling on the doctors to take an exam called the National Prescribing Assessment before being qualified.

They also want a “prescribing simulator” to be introduced to the curriculum so that medics are better prepared when they start in hospitals.

Professor Simon Maxwell, chairman of the BPS, said: “Everybody thinks that the system should and can be overhauled.

“We would not accept this kind of error rate in other industries such as aviation. It is a recipe for problems.”

The call for change, outlined in a blueprint by the BPS, comes after the General Medical Council revealed that 10 per cent of all prescriptions issued by doctors contained errors.

The mistakes included omitting drugs, wrong doses, not taking account of a patient’s allergies, illegible handwriting or ambiguous orders.

When the hospital doctors were interviewed about their mistakes, some admitted that they used pharmacists or nurses as a “safety net” to correct them afterwards.

The most senior doctors made the fewest mistakes, while doctors in their second year after qualifying made the most, it was found.

In the study, 124,260 prescriptions were checked by pharmacists in 19 hospital trusts in north-west England and 11,077 errors were detected.

While doctors are trained in a “piecemeal way” on symptoms and treatments, they rarely actually fill out a prescription forms before they start work, said the BPS.

A recent survey showed that in training they filled out as little as one a year whereas on the job that jumped to 50 or 60 a day.

That meant that doctors were ill prepared, it concluded.

Prof Maxwell, and his chairman Dr Jeff Aronson, said that it was hoped that the new assessment would be ready for the 2011 intake of medical students.

It was also hoped that an online training programme – including a prescription simulator complete with virtual patients – would be ready by the following year.

Prof Maxwell said: “It doesn’t take to much of a wrong dose or too long for the monitoring to be left before there are potentially serious problems. There is a big push now to eliminate this high risk.”


From:
http://www.telegraph.co.uk/NHS-faces-potentially-serious-problems-from-wrong-prescriptions-on-the-NHS

Nanny state libel laws gag doctor over drug risks

General Electric, one of the world’s biggest corporations, is using the London libel courts to gag a senior radiologist after he raised the alarm over the potentially fatal risks of one of its drugs.

The multinational is suing Henrik Thomsen, a Danish academic, after he described his experiences of one of the company’s drugs as a medical “nightmare”. He said some kidney patients at his hospital contracted a potentially deadly condition after being administered the drug Omniscan.

GE Healthcare, a British subsidiary of General Electric, has run up more than £380,000 in legal costs pursuing Thomsen.

“I believe the lawsuit is an attempt to silence me,” he said last week. “It’s dangerous for the patient if we can’t frankly exchange views.”

The company admits its product has been linked to serious side effects in some patients, but said Thomsen accused the company of suppressing information in a presentation at a scientific congress in Oxford in October 2007.

A summary of Thomsen’s presentation for the High Court writ, provided by GE Healthcare, appears to show that it was an even-handed account of his clinical experience.

When asked by The Sunday Times to highlight any part of the presentation that explicitly stated wrongdoing by GE Healthcare, a spokeswoman for the company was unable to do so. The writ states that the defamation may have been “by way of innuendo”.

His case will trigger a fresh row over the draconian use of Britain’s libel laws to stifle scientific debate and silence critics. Thomsen now refuses to discuss the possible risks of the drug in any UK public forum.

Evan Harris, a former hospital doctor and the Liberal Democrat science spokesman, who is leading the parliamentary campaign to reform the libel laws, said: “It is hard to conceive a stronger public interest than scientists and clinicians being able to discuss freely their concerns about drugs or devices used on patients. Libel laws should not be used in this way.”

More than 48m doses of Omniscan have been given worldwide and it is safe for the vast majority of people. It is one of a number of “contrast agents” containing the potentially toxic metal gadolinium, which are used to enhance images for magnetic resonance imaging scans.

Omniscan and other products have been linked with a skin condition in kidney patients, known as nephrogenic systemic fibrosis. Sufferers can be confined to a wheelchair and may even die from related causes.

Regulators in Europe and the US are now taking action over the potential risk from Omniscan and two similar products.

Five people in Britain have died from possible side effects after being administered Omniscan, according to the Medicines and Healthcare Products Regulatory Agency.

Patients have launched legal actions in America involving more than 170 deaths where it is claimed Omniscan and similar drugs may have been a factor. Safety problems with the drugs have been highlighted in the US by the independent investigative news organisation ProPublica.

Paul Flynn, the Labour MP, said, “It is a scandal that a company should take action against someone acting in the interests of patients.”

GE Healthcare said it had launched a libel action against Thomsen as a “last resort”. It is also suing Thomsen for an article in a medical magazine published in Brussels, but he said his name had been put on an article that he had not written.

From:
http://business.timesonline.co.uk/tol/business/law/article6962865.ece

Labour doesn’t want you to have a High Christmas as more legal drugs are banned

More legal high drugs are banned in UK by the nanny state as several drugs known as “legal highs” has come into force.

The substances, including GBL and BZP, become Class C drugs, with a possible two year jail sentence for possession.

Labour ministers moved to classify them after a recommendation from the Advisory Council on the Misuse of Drugs and fears they are a threat to user health.

GBL was linked to the death of medical student Hester Stewart, 21, in Brighton last April. Her mother, Maryon, campaigned nationally for the ban.

So called legal highs are typically man made chemical substances designed to act like banned drugs.

Scientists, officials and police officers have been concerned for several years that GBL, BZP and other so-called “legal highs” have been sold openly across Britain and on the internet, despite evidence that they can be harmful to health.

GBL, which metabolises in the body into the already banned drug GHB, will become a Class C drug carrying maximum jail terms of two years for possession and 14 years for supply.

Piperazines, of which BZP is the most popular, are also being made Class C drugs.

This group of drugs is popular on the club scene as an alternative to ecstasy and amphetamines.

Synthetic cannabis has also been banned and become a Class B drug. Possession of products such as “spice”, a herbal mixture laced with psycho-active chemicals, now carries a maximum five-year jail term.

Fifteen anabolic steroids, associated with drug abuse in sport, have also been classified as Class C.

Police chiefs say their response will be proportionate and focused on dealers.

Home Secretary Alan Johnson said the government was committed to raising awareness of the dangers of psychoactive substances through its Frank campaign, but also wanted to send a clear message to those thinking of using the drugs.

“We are cracking down on so-called ‘legal highs’ which are an emerging threat, particularly to young people,” said Mr Johnson.

“That is why we are making a range of these substances illegal from today with ground- breaking legislation which will also ban their related compounds.”

Scientists at the Forensic Science Service laboratories have recently discovered that drug dealers in London have been using one of the newly-banned drugs to manufacture fake “crack cocaine”.

Piperazines were first developed as a worming agent and are also used in some manufacturing processes. The FSS says “legal highs” based on the chemical have become more prevalent than ecstasy.

Friday’s ban is unlikely to be the last. The Advisory Council on the Misuse of Drugs will next year consider a new wave of so-called “legal highs”, which are based on a group of chemicals known as cathinones.

However, the recent controversy over the sacking of the council’s chairman, Professor David Nutt, and the subsequent resignation of council members in protest, could mean any final recommendations are delayed.

From:

http://news.bbc.co.uk/1/hi/uk/8427439.stm

Ban on hospital flowers over MRSA fears are wrong

Many hospitals have banned fresh flowers on wards amid concern that they could harbour potentially harmful bacteria or pose a health and safety risk like MRSA and superbugs.

But new research and a survey among staff and patients at the Royal Brompton Hospital and the Chelsea & Westminster Hospital, both in London, found there is little evidence to support some of the concerns around the presence of blooms on wards.

In a study by Giskin Day and Naiome Carter of Imperial College London, and published in bmj.com, it was even claimed flowers could help improve a patient’s health and recovery.

One of the reasons given to support the ban was that flower water contained high levels of bacteria, but subsequent research has found no evidence to suggest that it has ever caused a hospital acquired infection.

Southend University Hospital recently imposed a ban on flowers on the grounds that they posed a health and safety risk around high tech medical equipment.

But the report argues that flower vases are no more risky than having crockery containing drinks or food around bedsides.

Interviews with staff in this study however found that nurses were generally more concerned about the practical implications of managing flowers than risks of infection.

Other studies report that flowers have immediate and long term beneficial effects on emotional reactions, mood, social behaviours, and memory for men and women alike.

One trial found that patients in hospital rooms with plants and flowers had reduced systolic blood pressure and heart rate; lower ratings of pain, anxiety, and fatigue; and had more positive feelings.

The authors of the report said given that flowers and herbs have been used as remedies in the earliest hospitals, and as a means of cheering up the hospital environment for at least 200 years, it seems remarkable that flowers still tend to be treated in an ad hoc fashion in hospitals.

Although flowers undoubtedly can be a time consuming nuisance, the giving and receiving of flowers is a culturally important transaction, the report concludes.

In an accompanying editorial, Simon Cohn, a medical anthropologist at Cambridge University argues that flowers have fallen victim to new definitions of care.

Describing the decision to ban flowers, he said: “[The decision] seems to reflect a much broader shift towards a model of care that has little time or place for more messy and nebulous elements.”

Katherine Murphy, director of the Patients Association, said: “Most patients love flowers. The job of nurses is to be the patient’s advocate and carer. Surely it is not beyond management capabilities in a trust to ensure that the needs of patients and staff are accommodated.

“If flowers on wards pose such a problem, it’s no wonder that critical patient safety issues appear to be insoluble.”

Flowers are just one of the items to have fallen foul of strict hospital health and safety regulations.

Mobile phones have long been forbidden on many hospital wards, even though a government report in 2007 said there was no justification for a blanket ban.

Doctors were banned from wearing watches and jewellery last year because of fears that they were an infection hazard.

An NHS Trust in Sheffield also banned nurses from wearing Crocs shoes at work, as the static electricity they generated could disable hospital equipment.

Perhaps the strangest ban, though, was at the Fazakerly Hopsital in Liverpool, where the controversial ITV television programme The Jeremy Kyle Show has been banned after complaints that it was upsetting patients. Well you win some, you lose some.


From:
http://www.telegraph.co.uk/health/healthnews/6824574/Hospital-flowers-not-harmful-report-claims.html

Labour’s nanny state failing poor children as child obesity trends show class divide is growing

A widening class gap is likely to be seen in the coming years in childhood obesity, new research suggests.

Previous research has suggested rates in England may be levelling off. But the University College London team found this was happening most in children aged two to 10 from wealthier backgrounds.

Researchers said obesity rates among the lower classes were likely to be significantly higher by 2015 – for girls the levels may even be double.

They analysed data gathered by the government-funded Health Survey for England.

Currently 6.9% of boys and 7.4% of girls are obese – with the difference between the lower and higher classes 0.6% and 1.5% respectively for boys and girls.

But using historical trends, they predicted that by 2015 obesity rates could be above 10% for boys and 8.9% for girls.

Depending on the extent of the “levelling off” reported last month, the overall rates could be even lower.

However, it is the findings for social class that have shed even more light on the obesity problem. The obesity rates for girls are likely to diverge from now on, the team said.

Among those from lower classes it is expected to keep rising to 11.2%, while for those from professional backgrounds it is likely to fall to 5.4%.

Among boys, both groups are likely to see a rise, but it will be faster in the lower class group, meaning 10.7% of this class boys will be obese compared with 7.9% of those from wealthier backgrounds.

Similar trends will also be seen in older aged children, the report in the Journal if Epidemiology and Community Health found.

Lead researcher Dr Emmanuel Stamatakis said: “This highlights the need for public health action to reverse recent trends and narrow social inequalities in health.”

“The widening socio-economic gap may be partly due to difficulties to reach and communicate health messages to families from lower socio-economic groups.”

Tam Fry, of the National Obesity Forum, agreed awareness was more likely to be greater among wealthier families.

But he added: “It is also often quite expensive and time-consuming to buy healthy food and that puts wealthier parents at an advantage.”

He said it was not clear why the differences were so marked in girls, although he said he suspected it was partly to do with the fact that boys tend to be more active generally.

From:
http://news.bbc.co.uk/1/hi/health/8412796.stm

Number of NHS staff at record high

Employment in the National Health Service jumped by another 23,000 jobs to a record high in the third quarter of this year, in spite of the squeeze to come on spending under the next government.

The increase– the seventh successive quarterly rise in NHS employment taking it to above 1.6m people for the first time– took even seasoned observers by surprise following an 18,000 rise in the second quarter.

Most had been predicting at least a levelling off in the workforce despite continued growth in spending, as health authorities and hospitals prepared for the real-terms freeze that is to come.

Nigel Edwards, policy director for the NHS Confederation, said: “We suspect this is the last stage before the tanker slows down and finally turns.”

The confederation runs a website on which most NHS jobs are advertised and the numbers on it at any one time have fallen from 10,000 at the turn of the year to 7,500. “People still do have growth money this year,” he said, “and they are pursuing targets and other government objectives. 

Furthermore, some of this recruitment will have been taking place before people had fully woken up to the scale of the problem to come. We think the decline in the number of jobs advertised, however, is significant.”

The increase, however, leaves the NHS across the UK employing 1,601,000 people, according to the Office for National Statistics: 400,000 more than when Labour took office. The growth follows a study in England by McKinsey, which said the NHS might need to shed 10 per cent of its workforce to keep the books in balance.

The bigger the workforce when the money starts to run out in 2011, the greater the efficiency gains that will be needed if it is not to shrink in the face of a real-terms freeze in spending.

The NHS in England has 5.5 per cent revenue growth for this year and next. However, David Nicholson, NHS chief executive, has ruled that at least 2 per cent of next year’s money must be spent on capital and other projects to transform the way care is delivered in subsequent years.

The rise in staff numbers was the driver for an overall rise of 23,000 in public sector employment in the third quarter of this year to 6.093m. Local government shed 3,000 jobs and public corporations employed 5,000 fewer people.

Civil service employment rose 4,000, driven chiefly by a rise of 7,000 in the numbers employed by Jobcentre Plus to deal with rising unemployment.

From:

http://www.ft.com/cms/s/0/87df4c06-ea9e-11de-a9f5-00144feab49a.html?nclick_check=1

USA is legalising marijuana on the quiet

You know things are shifting in America when Fortune magazine, the bible for business journalism, runs a cover story titled “Is pot already legal?”. 
You also know it when Barack Obama’s Department of Justice publishes a long expected memo signalling that the federal government will no longer raid medical marijuana dispensaries if they are legal under state law. That happened formally last month.

It was not, moreover, a symbolic gesture. Marijuana for medical reasons— to tackle chemotherapy- induced nausea or Aids-related wasting or glaucoma, among other conditions — is now legal in 13 states, including the biggest, California. 

Next year, 13 more states are planning referendums or new laws following suit. Last month a California legislative committee held the first hearings not simply on whether medical marijuana should remain legal, but on whether all marijuana should be decriminalised, full stop. The incentive? The vast amounts of money the bankrupt state could raise by taxing cannabis.

Now look at the polling on the question. In 1970, 84% of Americans supported keeping marijuana illegal. Today, that number has collapsed to 54%. The proportion believing that marijuana should be legal has gone from 18% at the end of the 1960s to 44% today. 

On current trends, a majority of Americans will favour legalisation by the end of Obama’s first term. In the western states, 53% already favour legalising and taxing the stuff. Support for legalisation is strongest among the young — the Obama generation — but has climbed among self-described Republicans as well.

But the reality is already ahead of the polls. Take a trip, so to speak, to Los Angeles today, where one would be forgiven for thinking that marijuana was already legal. There are more than 800 marijuana dispensaries in the city — and an estimated 7,000 in the state of California as a whole (many times more than in Holland).

Getting a doctor’s recommendation for marijuana is easier than getting health insurance — just look at the ads in the papers, where a consultation costs about $200. The dispensaries range from the dime store to elaborate palaces of capitalist taste. Seminars are held for entrepreneurs who want to start a business selling medical cannabis. On display are sophisticated strains that can provide exquisitely tailored effects: some best for countering nausea, some for building appetite, others for going to sleep, others for staying alert or for watching movies or for general relaxation.

The concentration of THC, the active compound, is much higher than in the past. But since no one has ever overdosed on marijuana, it’s difficult to say why that matters. Yes, if someone has a history of mental illness, it’s not that smart to experiment with the cannabinoid receptors in the brain. But it isn’t smart for such people to take any drugs — or too much alcohol — for that matter. For most people, stronger pot merely translates into a need for less of it to get the same effect. 

Too much and you’ll likely nod off — and wake up later with no hangover. If pubs served pot rather than beer, crime rates would plummet.

Americans, for whom the use of marijuana is almost a rite of passage in most colleges, know all this. And at some point they stopped pretending otherwise. The past three presidents smoked marijuana in their earlier days, even if only one has openly written about it. (Obama, when asked the Clinton question — if he had inhaled — responded: “I thought that was the point.”) In an online press conference with his younger supporters, the first question was about whether legalising and taxing pot would be a good thing to help raise revenues. Obama laughed it off. With an annual deficit of more than a trillion dollars, he may not be able to laugh it off much longer.

The key to the shift has been the emphasis on marijuana’s medical properties. Human beings have used marijuana as medicine for millennia. It was once sold in the States by Eli Lilly, the pharmaceutical manufacturer. Allowing this compassionate use for a few soon revealed, accidentally, how harmless it is. It is not chemically addictive, although some mild withdrawal can happen if you are a regular pot-smoker and go cold turkey. 

Its side-effects are minimal compared with those of most authorised drugs for similar conditions. It is far less addictive than tobacco or alcohol. It leads to no measurable degree of antisocial behaviour, as is the case with, say, crystal meth or cocaine or heroin. Many of its users are successful, productive members of society who simply prefer it to alcohol as a relaxant in the evening or as a way to get through cancer treatment.

Denying Aids patients a tool to stay alive tips the balance. I have one friend who would never have been able to tolerate the medications that saved his life without it. That’s pretty persuasive stuff and lots of people have similar first-hand experiences. A gateway drug? Yes, many users of hard drugs smoked pot in the first place. 

But almost all started out with alcohol as well — and that is not illegal.

Of course, nothing is inevitable. The police still police it and hundreds of thousands of Americans — disproportionately black and poor — are in jail for it. Los Angeles’s failure to regulate adequately its hundreds of dispensaries may lead to connections with organised crime that could come back to delegitimise the whole thing.

I give it a couple of years to become a non-issue or to go into reverse. And my bet is that in a decade’s time, the banning of cannabis will seem as strange as the banning of alcohol. In the end, unnecessary prohibition undermines itself. And this time around, there are millions of cancer and HIV patients who are on the side of legalising and some truly desperate branches of government looking to see what they can tax next. In fact, I’ll go further: sooner rather than later, marijuana may be more acceptable than tobacco.

The need for taboos is eternal. But the object of the taboo is always shifting. The age of tobacco may be ending; and the millennium of marijuana may be about to begin.

From:

http://www.timesonline.co.uk/tol/news/world/us_and_americas/article6897958.ece

Santa promotes obesity and drink-driving, claims nanny state health expert

Traditional images of Santa Claus set a bad example and could promote obesity and drink driving, a public health expert has warned.


Dr Nathan Grills said the idea of a fat Father Christmas gorging on brandy and mince pies as he drove his sleigh around the world delivering presents was not the best way to promote a healthy and safe lifestyle among the young.

Writing on bmj.com, Dr Grills said: “Santa only needs to affect health by 0.1 per cent to damage millions of lives.”

He said the image of a healthier Santa could be very effective in promoting a positive message about diet and lifestyle to the young.

Dr Grills carried out a review of literature and web based material to assess Santa’s potential negative impact on public health.

The investigation revealed very high Santa awareness among children, with children in America stating he was the only fictional character more highly recognised than Ronald McDonald.

Dr Grills also claimed the image of Santa was often used to promote unhealthy products such as soft drinks.

He wrote:”Like Coca-Cola, Santa has become a major export item to the developing world.”

While Santa is now banned from smoking, images of him enjoying a pipe or cigar can still be found on Christmas cards.

Father Christmas could also potentially promote drink driving, argued Grills, referring to the tradition of leaving Santa Claus a brandy to wish him well on his travels.

And in a further blow to one of the central symbols of Christmas, Dr Grills claimed Santa also had the potential to spread harmful diseases.

“If Santa sneezes or coughs around 10 times a day, all the children who sit on his lap may end up with swine flu as well as their Christmas present,” he said.

From:

http://www.telegraph.co.uk/Santa-promotes-obesity-and-drink-driving-claims-health-expert.html