Health On The Net questionnaire

Health Direct have been accredited by the Health on the Net Foundation since 2008 and we have been asked if you would kindly help them by completing a short questionnaire to find out your views on finding health information online.

A survey on search behavior conducted by HON for the KHRESMOI EU project What is your ideal search engine?
Health On The Net questionnaire

We would like to inform you that Health On the Net Foundation is currently participating in a European Union project KHRESMOI which aims to develop a search engine for health and medical information search to meet the needs of general population, MDs and radiologists. In this project, the Foundation and the Society of physicians in Vienna aim to better understand the needs of users (citizens and doctors) searching health information on the Internet. Currently a survey addressing the needs of the citizens is available online.

Help us by participating in our general public survey up until the 17th of April !

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English version: Not happy with your online health information search results ?
>> Participate in our survey. Our goal: 500 responses by the 17th of April 2011.

How do you search for health-related information on the Internet?

  • The survey is intended for the representatives of the general public who are looking for health information online at least once a month.
  • The questionnaire was developed by the Health On the Net Foundation, an independent Non-Governmental Organisation dedicated to improving the quality and accessibility of online health information, in collaboration with the Society of physicians in Vienna in the framework of the European Project KHRESMOI – project 2010-2014.
  • Your participation will contribute to better understanding on how the general population is searching for online health information, what are the preferences and difficulties. The results of the survey will contribute to the creation of a new search engine specifically designed for search of health content.
  • You will need around 20 minutes to complete the questionnaire.
  • All the information collected is used exclusively for the purpose of the study. We do not collect personally identifiable information without your consent. More information on the Confidentiality and data privacy usage.
  • All the results will be available on-line for free.
  • Contributions from around the world are welcome.

High costs put patients off from going to the dentist

The cost of NHS dentistry is prompting some patients to delay treatment or opt for cheaper care, a survey suggests.
High costs put patients off from going to the dentistThe NHS Information Centre poll of more than 11,000 people in England, Wales and Northern Ireland found a fifth had put off treatment over price.

The Adult Dental Health Survey, which is carried out every decade, also found a quarter said cost influenced the kind of treatment they opted for.

NHS dental care is subsidised, but patients still pay towards their care.

There are three price bands ranging form £16.50 for a basic check-up to £198 for complex procedures, including crowns.

Pregnant women, those on low incomes and children are exempt from paying.

As well as highlighting cost, more than one in 10 said extreme anxiety deterred them from the dentists, while a fifth cited dissatisfaction with previous treatments.

Of those surveyed, 58% said they had tried to make an NHS dental appointment over the past three years, of which 92% were successful. However, that does not mean the rest did not have dental treatment as some would have paid for private care.


HIV infection rates double in UK

A doubling of new HIV infections in the UK in the past decade is leading experts to tell GPs to offer testing to all adult male patients in some areas.
HIV infection rates double in UKThe Health Protection Agency data shows new UK-acquired cases rose from just under 2,000 in 2001 to nearly 3,800 in 2010.

Many of these new cases are among men who have sex with men and it is this group that campaigners hope to target.

The National Institute for Curbing Expenditure (NICE) has launched new guidelines for doctors in England.

NICE says GPs should now offer and recommend HIV testing to all men who register with a practice in an area with a large community of men who have sex with men or an area that has a high prevalence of HIV – meaning more than two diagnosed cases per 1,000 people.

Increased testing should help stop the spread of HIV by identifying men at risk, NICE believes.

Men who have sex with men remain the group most at risk of becoming infected with HIV.

New diagnoses in this group alone have increased by 70% in the past 10 years.

There are more than 30,000 men who have sex with men living with HIV in the UK and experts estimate nearly a third of these are currently undiagnosed and unaware that they are infected.

Another high-risk group that would benefit from increased HIV testing, according to NICE, is the black African community living in England.

In 2009, more than 2,000 black Africans were diagnosed with an HIV infection, one-third of all new diagnoses in the UK.

Some of the Primary Care Trusts in England where HIV prevalence greatly exceeds two per 1,000

* Brighton And Hove City PCT
* Camden PCT
* City And Hackney Teaching PCT
* Hammersmith And Fulham PCT
* Islington PCT
* Lambeth PCT
* Newham PCT
* Manchester Teaching PCT
* Southwark PCT

Professor Mike Kelly from NICE said: “HIV is still a serious problem in this country, with a large proportion of people unaware they are infected.

“This new guidance from NICE makes a number of practical recommendations which aim to increase HIV testing by encouraging healthcare professionals to offer it routinely to people in areas where there are a high number of people living with HIV.”

This would include parts of large cities like London and Manchester, as well as areas like Brighton and Hove.

Dr Valerie Delpech, head of HIV surveillance at the HPA, said: “These expanded HIV testing policies should be prioritised for implementation as soon as possible.

“The impact of late diagnosis is clearly demonstrated when you look at deaths among people with HIV – three out of five of HIV-positive individuals that die are diagnosed too late to gain the most health benefits from their treatment, like increased life expectancy.”

HIV charities said the guidelines were a “vital step forward”.


Foreign health tourists face government crackdown

The government is putting in place measures to prevent the National Health Service from becoming an international health service, and is undertaking a wider review of current practice in charging non-residents for care to create a fairer system.
Foreign health tourists face government crackdownFollowing consultations last year on a package of proposals on charging visitors for NHS hospital care, the government has decided to instill tougher measures in a bid to tackle health tourism, a practice by which some patients come to the UK to access healthcare without paying, costing the country millions of pounds every year.

One such measure involves preventing anyone owing the health service £1,000 or more from staying or entering the UK until their debt is paid off, and as such the NHS will be expected to pass details of foreign patients who have failed to pay for treatment on to the UK Border Control Agency.

According to the government, this action alone should capture 94% of outstanding charges owed to the health service.

In other changes for NHS patients in England, the time UK residents can stay abroad and keep their entitlement to free hospital treatment has been extended from three to five months.

In addition, the small number of failed asylum seekers co-operating on registered Home Office support schemes will be exempt from charges, while all unaccompanied children under local authority care will also be guaranteed free hospital treatment.

However, the government feels that the existing system is still too complex, generous and inconsistently applied, and so has launched a wider review of practice.

This, it says, will look at changing the residency criteria for treatment, whether GPs should and other ex-hospital services should charge non-residents, and whether visas should be dependent on health insurance, in order to ensure that the system is both fair and affordable.

According to health minister Anne Milton, the changes will “begin the process of developing a clearer, robust and fairer system of access to free NHS services which our review of the charging system will complete”, with the aim of creating a system that “maintains the confidence of the public while preventing inappropriate free access and continuing our commitment to human rights and protecting vulnerable groups”.


A dirty weekend away really could kill you

With the weekend coming up- a word of warning- a dirty weekend away could really kill you, a study suggests, after finding that having sex only occasionally puts you at more than twice the risk of suffering a heart attack.A dirty weekend away really could kill youExercise is generally considered good for you as it decreases your overall risk of heart disease and generally makes you healthier.

But the new research suggests that spikes in physical activity – such as during sex – can also have the opposite effect – triggering heart attacks and cardiac arrests.

The increased risk – as much as 2.7 times higher than normal – applies mainly to people who are otherwise unhealthy and can be reduced by regular physical activity.

But a small risk does apply to everyone.

The scientists at Tufts and Harvard Universities in Boston reviewed the results of a number of previous studies to come up with the findings.

They found that “episodic activity” was associated with more than a two and a half times increased risk of heart attack and sudden cardiac death (SCD).

However regularly indulging in exercise – including sex – offset the increased risk by almost half for each additional time per week it was carried out.

“Regular physical activity has been identified as strongly associated with a decreased risk of cardiovascular disease and related mortality,” the researchers wrote.

“Despite the well-established benefits of regular physical activity, anecdotal evidence has suggested that physical activity, as well as other acute exposures, such as sexual activity and psychological stress, can act as triggers of acute cardiac events.”

The researchers looked at more than 14 studies looking at what caused heart attacks and found that a small but significant number happened during physical and sexual activity.

They found that all kinds of physical activity accounted for three and a half times increased risk and sex 2.7 times.

Researchers said that most importantly the risks could be modified by “habitual physical activity” and that those who indulged regularly were much less likely to have a heart attack triggered by sex.

Heart and circulatory disease is the biggest killer in Britain and heart disease alone causes 91,000 deaths a year.

The study was published in the latest issue of the journal JAMA.


NHS satisfaction at record high

Public satisfaction with the NHS has reached record levels, according to a leading health economist.
NHS satisfaction at record highWriting on the BMJ website, Professor John Appleby said 64% of people were either very or quite satisfied with the NHS.

Critics have questioned why the government is reorganising the NHS when the public is happy with it.

The Department of Health said reform was necessary to sustain the future of the NHS.

Professor John Appleby was quoting data from the latest annual British Social Attitudes Survey.

It shows satisfaction is at the highest level since the survey began in 1983 and much higher than their levels of 39% in 2001.

Professor Appleby, of the King’s Fund think tank, said: “The NHS must have been doing something right to earn this extra satisfaction, something even Conservative supporters have noticed, and something probably not unadjacent to the large rise in funding since 2000.”

Much of the NHS budget is to be handed to GPs as part of healthcare reforms in England.

In the survey, satisfaction with GPs was at 80%, just short of its peak in the 1990s.

A Department of Health spokesperson said: “We welcome the findings which show public satisfaction levels are good, particularly with GPs. Our reforms will empower GPs, not bureaucrats, to commission services.

“If we want to sustain the NHS in the future, we need to modernise it now.”

Last week the British Medical Association called on the government to halt to its overhaul of the NHS.

“With survey results like this you have to question why the government feels it is necessary to embark on such a radical and costly re-organisation of the NHS right now, particularly when you take into account the financial pressure the service is already under”, a spokesperson said.

Professor Appleby concluded: “Future British Social Attitudes surveys will reveal how satisfied the public remain as funding for the NHS is squeezed and the government’s proposed reforms take shape on the ground.”

War on drugs has failed say former heads of MI5, CPS and BBC

The “war on drugs” has failed and should be abandoned in favour of evidence based policies that treat addiction as a health problem, according to prominent public figures including former heads of MI5 and the Crown Prosecution Service.
War on drugs has failed say former heads of MI5, CPS and BBCLeading peers – including prominent Tories – say that despite governments worldwide drawing up tough laws against dealers and users over the past 50 years, illegal drugs have become more accessible.

Vast amounts of money have been wasted on unsuccessful crackdowns, while criminals have made fortunes importing drugs into this country.

The increasing use of the most harmful drugs such as heroin has also led to “enormous health problems”, according to the group.

The MPs and members of the House of Lords, who have formed a new All-Party Parliamentary Group on Drug Policy Reform, are calling for new policies to be drawn up on the basis of scientific evidence.

It could lead to calls for the British government to decriminalise drugs, or at least for the police and Crown Prosecution Service not to jail people for possession of small amounts of banned substances.

Their intervention could receive a sympathetic audience in Whitehall, where ministers and civil servants are trying to cut the numbers and cost of the prison population. The Justice Secretary, Ken Clarke, has already announced plans to help offenders kick drug habits rather than keeping them behind bars.

The former Labour government changed its mind repeatedly on the risks posed by cannabis use and was criticised for sacking its chief drug adviser, Prof David Nutt, when he claimed that ecstasy and LSD were less dangerous than alcohol.

The chairman of the new group, Baroness Meacher – who is also chairman of an NHS trust – told The Daily Telegraph: “Criminalising drug users has been an expensive catastrophe for individuals and communities.

“In the UK the time has come for a review of our 1971 Misuse of Drugs Act. I call on our Government to heed the advice of the UN Office on Drugs and Crime that drug addiction should be recognised as a health problem and not punished.

“We have the example of other countries to follow. The best is Portugal which has decriminalised drug use for 10 years. Portugal still has one of the lowest drug addiction rates in Europe, the trend of Young people’s drug addiction is falling in Portugal against an upward trend in the surrounding countries, and the Portuguese prison population has fallen over time.”

Lord Lawson, who was Chancellor of the Exchequer between 1983 and 1989, said: “I have no doubt that the present policy is a disaster.

“This is an important issue, which I have thought about for many years. But I still don’t know what the right answer is – I have joined the APPG in the hope that it may help us to find the right answer.”

Other high-profile figures in the group include Baroness Manningham-Buller, who served as Director General of MI5, the security service, between 2002 and 2007; Lord Birt, the former Director-General of the BBC who went on to become a “blue-sky thinker” for Tony Blair; Lord Macdonald of River Glaven, until recently the Director of Public Prosecutions; and Lord Walton of Detchant, a former president of the British Medical Association and the General Medical Council.

Current MPs on the group include Peter Bottomley, who served as a junior minister under Margaret Thatcher; Mike Weatherley, the newly elected Tory MP for Hove and Portslade; and Julian Huppert, the Liberal Democrat MP for Cambridge.

The group’s formation coincides with the 50th anniversary of the United Nations Single Convention on Narcotic Drugs, which paved the way for a war on drugs by describing addiction as a “serious evil”, attempting to limit production for medicinal and scientific uses only, and coordinating international action against traffickers.

The peers and MPs say that despite governments “pouring vast resources” into the attempt to control drug markets, availability and use has increased, with up to 250 million people worldwide using narcotics such as cannabis, cocaine and heroin in 2008.

They believe the trade in illegal drugs makes more than £200 billion a year for criminals and terrorists, as well as destabilising entire nations such as Afghanistan and Mexico.

As a result, the all-party group is working with the Beckley Foundation, a charitable trust, to review current policies and scientific evidence in order to draw up proposed new ways to deal with the problem.


Life expectancy on the rise despite obesity epidemic

Life expectancy in the UK is on the rise, despite fears over the impact of obesity a population expert has said.
Life expectancy on the rise despite obesity epidemicAnalysing trends from the past 40 years, Professor David Leon credited a decline in deaths from heart disease for the continued rise.

People in the UK are also living longer than those in the US, he says.

His analysis is published in the International Journal of Epidemiology.

Professor Leon, from the London School of Hygiene and Tropical Medicine, points out that in the last five years most European countries have been going in a “positive direction” for the first time in decades.

Despite concern that health problems arising from obesity would affect life expectancy in high-income countries, such as the UK, there is no evidence of this to date.

Professor Leon said that deaths from cardiovascular disease in the UK have seen, “some of the largest and most rapid falls of any Western European country, partly due to improvements in treatment as well as reductions in smoking and other risk factors.”

But he admits that it may to be too soon to see the impact of increasing obesity rates.

“We are yet to see the impact of a generation of people who have been obese from childhood through to adulthood. We can’t predict how that will affect life expectancy figures in the future.”

“We are definitely seeing type-2 diabetes occurring more in teenagers due to obesity, but this is not immediately being translated into mortality rates.”

“This is because of decreased rates of cardiovascular disease and concerted efforts to reduce risk and modify weight,” Professor Leon said.

In 2007, the US was found to be at the same level for life expectancy as the lowest of any Western European country (Portugal for males and Denmark for females).

Its life expectancy rate for women has been increasing at a much slower pace than Western Europe since the 1980s.

Life expectancy in the US was 78 years in 2007, compared with 80 years in the UK.

Professor Leon writes: “This observation underlines that gross domestic product (GDP) and health care expenditure per capita are not good predictors of population health within high-income countries.”

The latest figures from 2009 show that life expectancy in the UK is 82.6 years for women and 78.4 years for men.


Killer quango NICE bans another cancer drug

It is looking increasingly likely that PharmaMar’s Yondelis will not be available on the National Health Service for patients with ovarian cancer, after cost regulators again rejected the drug on questions over efficacy.
Killer quango NICE bans another cancer drugThe National Institute for Curbing Expenditure (NICE) has republished draft guidance turning down the use of Yondelis (trabectedin), in combination with pegylated liposomal doxorubicin (PLDH), as a treatment for ovarian cancer that has returned six months or more after initial treatment with chemotherapy, including platinum for platinum-sensitive disease.

Ovarian cancer is the fifth most common cancer in women in the UK, with more than 6,500 patients diagnosed every year.

In around 80% of cases the cancer will return following first-line treatment, and it is estimated that just over two fifths of these could be eligible for treatment with Yondelis, a marine-based anticancer drug derived from the sea-squirt that attacks cancer cell DNA to prevent cell growth and spread.

But the Institute’s Appraisal Committee said it has serious concerns over how Yondelis’ effectiveness compares to that of other treatments available on the NHS. Crucially, PharmaMar did not submit any evidence comparing its drug to platinum-based chemotherapy regimens in treating relapsed disease, despite the latter being the gold standard therapy in such cases.

“This means that we cannot be sure that [Yondelis] extends patients’ lives for longer than the most routinely used treatments,” explained NICE chief executive Andrew Dillon.

Evidence ‘not robust’

New evidence considered did suggest that Yondelis might be most effective in women with ‘partially platinum-sensitive’ ovarian cancer, i.e. when the disease comes back between six and 12 months after initial platinum chemotherapy.

However, the Committee said it was not sure that the effectiveness of the drug in this subset of patients was “genuinely different from that seen in the wider group of patients for which the drug is licensed”, and so concluded that the data were not robust enough.

Taking all the uncertainties into account, the Committee calculated that the incremental cost-effectiveness ratio (ICER) for Yondelis could be higher than £95,000 per QALY gained for the entire eligible population, and £68,000 for the partially platinum-sensitive subgroup, despite a proposed patient access scheme under which PharmaMar offered to pick up the tag for treatment with its drug following the fifth cycle of treatment.

“Even when taking into consideration the Patient Access Scheme, through which the manufacturer limited the total cost of the drug, the committee concluded that the cost of trabectedin was too high relative to the uncertain benefits it may provide patients,” Dillon said.

Meanwhile, the Institute has announced that Sir Professor Sir Michael Rawlins has been reappointed as its chair for another year’s term, until March 31, 2012.

Professor Rawlins has held the position since NICE was created by the then Labour government in 1999 to curb the NHS’s expenditure on drugs.


Swine flu- labour’s spin led to sensationalised reporting say MPs

It is “absolutely essential” that the coalition government improves how it communicates risk and uncertainty to the public and the media, say MPs, reporting on Ministers’ handling of the H1N1 (swine flu) pandemic.
Swine flu- labour's spin led to sensationalised reporting say MPsOn July 16, 2009, when Chief Medical Officer Sir Liam Donaldson held a press briefing that led to media reports suggesting that in a “worst-case scenario” 65,000 people in the UK could die from swine flu, the number of deaths at that time actually stood at around 30 and, by the time the pandemic was over in April 2010, had reached 460 in total, says a report published today by the House of Commons Science and Technology Committee on the use of scientific advice and evidence in emergencies.

The “reasonable worst-case scenario” of around 65,000 deaths communicated by the government was useful for emergency responders such as the NHS but led to sensationalised media reporting, say the MPs, who suggest that it would be better for the government to establish a “most probable scenario” with the public. Improvements in how risk and uncertainty are presented to the public and media are “absolutely essential for allaying fears,” they add.

It is equally – if not more – important for central government to communicate effectively with emergency responders, say the Committee members, who had been told by the British Medical Association (BMA) that doctors had felt “overwhelmed” by the volume of information about the swine flu pandemic issued by various bodies, including government, and that key advice had been lost within the large quantity of emails received, which often duplicated information.

The Committee suggests instead that a single portal of information should be set up for every emergency along the lines of in the US, for use by the public as well as emergency responders. This should be the primary source of all information, linking to other websites as necessary.

The swine flu pandemic was also the first emergency in the UK for which a Scientific Advisory Group for Emergencies (SAGE) was convened to advise the government, and the MPs have concerns about the operations of such groups. Their report finds that SAGEs  “tended towards an unnecessarily secretive way of working, thus closing doors to the wider scientific community, and did not appear to adhere to any published guidance or code of conduct.”

A SAGE “should not be given carte blanche to operate however it pleases simply because an emergency is occurring,” say the MPs, and they call on the government to provide greater clarification as to the codes, principles and guidance which cover the operations of such groups. “The Government Office for Science should take responsibility for ensuring that all future SAGEs operate in a more organised, transparent and accessible manner and adhere to a published code – existing or new,” they add.

Experience with the swine flu pandemic also points to the need for a better international mechanism for data-sharing, particularly for raw epidemiological data, say the MPs, and they suggest that the UK should propose the formation of an international working group within the World Health Organisation (WHO) to discuss how epidemiological data can be shared effectively between countries in the run-up to a new pandemic.

As well as the H1N1 pandemic, the Committee also examined the role played by scientific advice and evidence in the government’s handling of the April 2010 volcanic ash disruption, space weather and cyber attacks. The experience has, they say, left them with the impression that “while science is used effectively to aid the response to emergencies, the government’s attitude to scientific advice is that it is something to reach for once an emergency happens, not a key factor for consideration from the start of the planning process.”

“This is not trivial,” the MPs stress, concluding: “we urge the government to do better at embedding scientific advice and an evidence-based approach in risk assessment and policy processes before emergencies occur.”