NHS patients waiting months for vital bowel cancer tests, figures show

Patients with one of the most lethal forms of cancer are having to wait months to have vital diagnostic tests, in a new sign of the relentless pressure on NHS services.

People suspected of having bowel cancer are facing waits of three months for tests when they should have them within a maximum of six weeks, the latest NHS waiting time figures show.

In March almost half the patients referred for the disease to Mid Yorkshire Hospitals NHS Trust had to wait more than the six weeks set out in the NHS constitution. In all 144 (49.3%) of the 292 patients that month had to ensure waits of several months, and 39 of them were kept waiting for more than 13 weeks.

Campigners warned that patients could die as a result of the delays in patients undergoing either a colonoscopy or flexible sigmoidoscopy, the two tests used to detect bowel cancer.

Prof Colin Rees, vice-president of the British Society of Gastroenterology, said: “By testing the right people at the right time we can save lives and stop people dying needlessly.”

In March 24% of hospital trusts in England missed the six-week target for colonoscopy, which meant that 1,121 patients were kept waiting. In the same month, 18% of hospitals breached the six-week target for flexi-sigmoidoscopy.

Deborah Alsina, chief executive of Bowel Cancer UK, said the waiting times “present a worrying picture for patients”. She identified a lack of diagnotic staff as a key problem and lamented the latest of several delays in Health Education England publishing a plan, first promised in 2015, to boost the NHS cancer workforce.

About 41,000 people a year in the UK develop bowel cancer and around 16,000 die from it. It is Britain’s fourth most deadly cancer after lung, breast and prostate.

Meanwhile, NHS performance against its key waiting times targets is now the highest it has been for five years, NHS Englnd’s latest statistics show.

During 2015-16, 2.5 million people were not treated within four hours of arriving in A&E, and a total of 362,687 patients did not receive planned care in hospital – usually an operation – within 18 weeks.

Another 26,113 waited longer than 62 days for supposedly urgent cancer treatment after being referred by their GP, while 985,583 people with a life-threatening condition waited more than the maximum eight minutes for an ambulance to respond to an 999 call.

“These figures reveal the dismal human cost of the NHS crisis,” said Norman Lamb, the Liberal Democrat health spokesman. “Millions of patients are waiting in distress and anxiety, but Theresa may doesn’t care.”

Responding to the latest monthly statistics, a Conservative spokesman said: “These figures show A&E performance has improved a great deal since the equivalent time last year. Waiting times for an operation again got shorter in March, and crucially patient outcomes continue to improve. Breast cancer survival is at its highest ever level.”

The figures came as the Health Foundation warned that the care patients receive is under threat because of the NHS’s unprecedented financial squeeze.

In a report, the thinktank says: “It is difficult to see how the intense financial pressures on all NHS and social care services will not threaten the quality of care in the near future if nothing changes.

“As OECD analyses have shown, the UK’s performance on quality is middling when compared with other OECD countries, but then so are our funding levels.”

NHS patients waiting months for vital bowel cancer tests, figures show

Less than half of women breastfeed after two months, survey finds

Almost three-quarters of women in England start breastfeeding after giving birth but less than half are still doing so two months later, according to NHS and Public Health England data.

PHE recommends exclusive breastfeeding for the first six months, as does the World Health Organisation, because it boosts a baby’s ability to fight illness and infection. But a comparison of initial breastfeeding rates and those after six to eight weeks in the final quarter of 2015 found that they were 40% lower for the latter (44% compared with 73%).

A survey of 500 mothers commissioned by PHE found that fears about breastfeeding among women included that it could be painful (74%), prevent them taking medication (71%) and be embarrassing in front of strangers (63%).

The PHE’s chief nurse, Viv Bennett, said:“We can all help women feel comfortable breastfeeding their baby wherever they are. Creating a wider culture of encouragement and support will help make a mother’s experience all the more positive.”

PHE has launched an interactive breastfeeding friend chatbot, accessed through Facebook messenger, to provide personal support for breastfeeding 24 hours a day. Bennett said it would help women through the “crucial” initial period, after which things generally became easier.

A study published in the Lancet last year found the UK had the lowest rate of breastfeeding in the world, with only one in 200 women breastfeeding their children after they reach their first birthday.

The WHO recommends that breastfeeding form part of a baby’s diet up to two years of age. As well as reducing the likelihood of babies getting diarrhoea and respiratory infections, breastfeeding also lowers a mother’s risk of ovarian and breast cancer and burns about 500 calories a day.

The PHE survey found that many women were not only embarrassed about breastfeeding in front of strangers, but also their partner’s family (59%) and around siblings and wider family members (49%).

The results, published on Thursday, suggested high-profile figures who promote breastfeeding can have a positive influence on other mothers. Just under half of respondents said the example of household names such as The Only Way is Essex star Sam Faiers, broadcaster Fearne Cotton and actor Blake Lively, who have recently championed breastfeeding on social media, had inspired them to do so themselves. About two-thirds (64%) said they felt more confident to breastfeed in public because of celebrity mums.

Other concerns raised by more than half of women were not being able to tell if their baby was getting enough or too much milk and that it could potentially place restrictions on the mother.

Jacque Gerrard, the director for England at the Royal College of Midwives, said: “Any initiative that goes towards helping mothers start and sustain breastfeeding for longer is positive as we know the health benefits from being breastfed last a lifetime.”

Less than half of women breastfeed after two months, survey finds

Woman, 89, trapped in hospital for six months despite being fit to leave

An NHS trust has launched a formal inquiry after an 89-year-old woman who was medically fit to leave hospital was trapped on a ward for six months, costing the NHS more than £80,000.

Iris Sibley and her family were left feeling “distressed and let down” after she was kept isolated on a hospital ward at Bristol Royal infirmary because the community healthcare provider failed to find her a suitable nursing home place.

The situation put a huge strain on the family and left her 90-year-old husband deeply unhappy, said her son John Sibley. “It’s pretty scandalous,” he said. “It’s not until you get caught up in it that you realise how serious the situation is. I decided to speak out about it because I wanted to stand up for ordinary people like my mum.”

In a case which highlights the deepening social care crisis in the UK, Iris was taken into hospital last June after a fall in her residential home. She was assessed by Bristol Community Health (BCH) on behalf of the South Gloucestershire clinical commissioning group, the NHS body responsible for local healthcare services.

On 11 August, BCH said she needed 24-hour nursing care, which would be covered by the NHS – but a place in a suitable nursing home was only found on 4 January this year, a few weeks after the agencies involved had been contacted by the Guardian for comment about the case.

Her son John Sibley said: “It’s pretty scandalous. It’s not until you get caught up in it that you realise how serious the situation is. I decided to speak out about it because I wanted to stand up for ordinary people like my mum.”

Sibley said the staff who looked after his mother were amazing. “They just don’t stop, they are always working – nothing is too much trouble for them. I call them angels and they are – but they shouldn’t have to do it,” he said.

The family were offered two places, one on 13 September and the other on 4 October, but both were too far for Iris’s husband to visit. The first was also a very poor choice, said Sibley. “I read the CQC report and it was appalling, and when I visited it I thought I wouldn’t put a sick dog in there let alone my mum. It smelt of urine, the paper was peeling off the wall in the room they wanted to put her in. It was disgusting.”

To make matters worse, Iris was diagnosed as being a carrier of C diff, a bacterium that can cause diarrhoea, so spent much of her time alone in a side room. Sibley said the family constantly had to chase for information about her future. According to BCH, the ongoing health team “actively communicated” with the family on nine occasions.

Iris’s physical and mental health deteriorated significantly, Sibley said. “She was mixing with other people [in the residential home], it stretched her mind a bit,” he said. “But in the hospital there is nothing. They are wonderful people, they do the best they can – but my mum was in a hospital, not in a place where she could call home.”

Ambulances wait outside Bristol Royal infirmary. Photograph: Matt Cardy/Getty Images

That was very common in older people whose discharge from hospital was delayed, said Caroline Abrahams, the charity director at Age UK. “People in hospital lose confidence, they lose muscle mass. Their families can see their situation deteriorating before their eyes and that is very distressing,” she said.

Robert Woolley, the chief executive of University Hospitals Bristol NHS foundation trust, said it had launched a formal investigation into the case.

Iris’s protracted hospitalisation – which her family described as “traumatic for all concerned” – cost the NHS £450 a night, approximately £81,000 in total.

Although her experience is extreme, it is not unusual. In a typical week in January, 60 patients at Bristol Royal infirmary were “green to go”, waiting for an assessment or care package for about three weeks. Patients who could not be discharged could result in medical patients occupying surgical beds and surgeries cancelled, said Woolley.

“I’m very sorry for what happened to Mrs Sibley and apologise to her family for the massive frustration that all of us have caused,” Woolley said. “There is a critical interdependency between social care and the NHS and, if we get the capacity wrong in social care, it’s the NHS that bears the consequences, that is plain for all to see.

“We are doing everything we can to deal with a constant and growing demand. I think it is very difficult and we are having to look at more and more radical ways to cope with the pressure.”

BCH, which was charged with finding Iris a nursing home place, said it had contacted 24 homes “sometimes multiple times”. Of these, 11 had no vacancies, 11 were not able to meet Iris’s needs and two were too far away. All were privately run.

Iris’s case was unusual, said chief executive Julia Clarke, BCH’s chief executive. “In Mrs Sibley’s case, we are really sorry she was in hospital for that length of time – it is not what we were working towards,” she said. After an internal investigation, BCH was reviewing its communication with patients and had changed its processes so individual cases were flagged to senior leaders after a few weeks.

Anne Morris, the director of nursing at South Gloucestershire CCG, said Iris’s case was under review and it was “extremely sorry when any patient is kept in hospital any longer than they need to be”.

The Department of Health said it had published guidelines to improve coordination between the NHS and councils and was working with all agencies to improve the transfer of patients from hospitals. A spokesperson said: “We are supporting councils with up to £7.6bn of dedicated funding for social care over the course of this parliament.”

If this is how bad it is now, what is it going to be like in another 20 year​s’ time?

John Sibley

Iris has since been reassessed and her family has been told she no longer qualifies for complete NHS funding. Her care will be funded by the council, but the family – who are appealing against the decision – may face top-up payments.

According to a joint King’s Fund and Nuffield Trust report published in September, about four in 10 people pay for their own social care, with 300,000 fewer people receiving council-funded help than four years ago. According to Age UK, 1.2 million people do not get the social care they need, up 48% since 2010.

The Local Government Association (LGA) estimates the social care funding gap will be about £4bn by the end of the decade, leaving council short by a thirdCllr Izzi Seccombe, who chairs the LGA’s community wellbeing board, said: “The scale of underfunding is placing the care provider market under huge pressure, making it more difficult to discharge people from hospital into care.”

More than 100 care home businesses have collapsed since 2010, and more are struggling after councils’ social care budgets were slashed by up to 50% as the government pressed on with austerity measures.

People who pay for their own care pay more than a local authority for an identical care home placement, which, said Sibley, was leaving people like his mother at the bottom of the pile. “As result, my dear old mum who I love to bits was stuck in a hospital for six months with her dementia getting worse and worse,” he said.

“I don’t want to make this political, but this is a problem that has been waiting to happen for 25 years. Government after government have put their head in the sand. But now we have to make a decision: if this is how bad it is now, what is it going to be like in another 20 years’ time?”

Woman, 89, trapped in hospital for six months despite being fit to leave

NHS trusts overshoot maximum annual deficit in just six months

NHS trusts in England have overshot their maximum deficit permissible for the financial year after just six months despite a £900m emergency cash injection from the government.

NHS Improvement (NHSI) said financial performance information from providers show they are on track to record a year-to-date deficit of £648m in the first half of the year.

The financial regulator described the figures, published on Friday, as “just £22m worse than planned” but they are some way off what health leaders have defined as an acceptable overspend for 2016-17, even by the most generous interpretation.

NHS England’s chief executive, Simon Stevens, and Jeremy Hunt, the health secretary, have pledged to ensure that trusts end the year no more than £250m in the red, while other NHS leaders have said the service can afford to record a figure of £580m without risking major financial problems.

Trusts are forecasting a deficit of £669m for the year, although that is after the £1.8bn sustainability and transformation funding, £900m of which was paid out in the first six months.

Sally Gainsbury, senior policy analyst at thinktank the Nuffield Trust, said: “More and more people need healthcare, yet the money available to provide it is tightly squeezed.

“NHSI’s report shows hospitals and other services are now forecasting a deficit of around £670m by the end of this financial year. That looks like a huge turnaround from last year’s deficit, yet is in fact flattered by the inclusion of an extra £1.8bn of emergency support pumped into the hospital sector, making the real forecast more like £2.5bn.”

NHSI said the deficit could be limited to £580m “if providers met their savings targets in full over the remaining half of the year”, but analysts and trusts expressed doubts.

The King’s Fund’s director of policy, Richard Murray, praised the trusts’ hard work on deficit reduction but warned “the second half of the year is likely to prove more challenging than the first”.

Anita Charlesworth, director of research and economics at the Health Foundation, said: “NHS trusts will have a mountain to climb if they are not to breach the end of year deficit target.”

Chris Hopson, chief executive of NHS Providers, which represents trusts, said its members were already “straining every sinew” to deliver savings.

“Significant risk remains as NHS trusts will have to increase their rate of savings in the third and fourth quarters to enable the sector to meet the target year-end position of a £580m deficit,” he said.

Hopson stressed that given the deficit reduction plan had been significantly aided by sustainability and transformation plan funding, action was needed in the medium and long term to address the “clear and widening gap between what’s being asked of the service and the funding available”.

NHSI lauded a second successive quarter in which fewer trusts reported a deficit against a backdrop of “unprecedented growth in demand”.

The chief executive, Jim Mackey, said: “No one should underestimate the challenge of turning around a very difficult financial position for the NHS. But, thanks to a phenomenal effort by staff across the NHS, we’re one-nil up at half time.”

NHS trusts overshoot maximum annual deficit in just six months

Hospital made patients "wait two months to have their hair washed"

Hospital patients had to wear incontinence pads overnight and wait two months to have their hair washed because hospital staff were too busy to help them, an inquiry by NHS inspectors has concluded.

A&E patients were also being treated in corridors and in chairs because the Queen Elizabeth hospital in Woolwich, south-east London, was under such pressure when the Care Quality Commission (CQC) arrived on an unannounced visit in June.

The watchdog said that the hospital “requires improvement” after encountering a series of problems, including the deterioration of a patient with the deadly infection sepsis during their inspection because of inadequate monitoring.

Some staff were also observed speaking “sharply” and with a lack of kindness to patients, and children attending the A&E were not always given the full range of checks they needed. Patients also faced long waits to receive A&E care.

“This deeply shocking case is yet another example of a health service stretched to breaking point due to underfunding by the Conservatives,” said the shadow health minister Justin Madders.

The CQC’s report into the hospital’s A&E and acute medical units said: “We spoke with a patient on ward 18 who told us they had repeatedly asked staff for a bath or shower and had been told it wasn’t their job to provide this. Two other patients on this ward told us they would like to have their hair washed, but staff told them they were too busy.

“The nurse in charge … said staff were often too busy to provide personal care and this meant some patients could go up to two months without having their hair washed,” it added.

“In the acute medical unit one patient told us they had to use pads for incontinence because staff were too busy to help them use a commode. They said they felt very embarrassed because it meant they went to sleep with dirty pads. The nurse in charge … said patients were encouraged to wear pads because there were not enough staff for the volume of patients who would use commodes.”

Ministers’ “incompetent” decision in 2010 to cut the number of nurse training places had helped create the staff shortages that are common across the NHS, Madders said. “Nurses have been consistently saying for several years that they are so stretched they often find they are unable to complete all the tasks on their shift.”

Lewisham and Greenwich NHS trust, which runs the hospital, said: “We welcome the CQC’s report. The report does note that we have made progress since the last CQC inspection in February 2013, and we are pleased that our staff received a rating of ‘good’ for providing a caring, kind, and compassionate service.

“We recognise there is more to do and we have a detailed programme of improvements to our emergency pathway, and care in our wards,” it added.

The findings emerged as the Commons health select committee warned that hospitals could struggle to cope in the face of a winter that will be “substantially more difficult” than last year’s.

So many hospitals now fail to meet the target of treating 95% of emergency patients within four hours that patient safety is at risk, the cross-party group of MPs warned in a report on how winter pressures affect A&E units.

“The winter of 2015-16 was mild and the flu vaccine worked. We heard of a fear amongst leaders of acute NHS trusts that 2016-17 could be substantially more difficult,” the report said.

Philip Dunne, the health minister, said: “The NHS is better prepared for winter than ever before, with plans in place to help hospitals cope with additional demand – and the NHS is performing well despite the pressure of an ageing population, with nine out of 10 people seen in A&E within four hours.”

Hospital made patients "wait two months to have their hair washed"

Experience: my attempt to go 21 days without a whinge ended up taking six months | Michael Dawson

Sunday 24 July 8.43am. In the midst of the US presidential election, news breaks that WikiLeaks plans to release 20,000 hacked Democratic Party emails that will likely damage Hillary Clinton’s chances, and enhance Donald Trump’s. I read the relevant passage aloud to my wife, before adding my own searing commentary: “I would’ve thought Assange and Co would have the intelligence to realise …” I suddenly pause.

A ripple of panic pulses through me. Am I complaining?

Over the past five months that question is one that has developed the ability to paralyse me. Why? Because I’m in the throes of what has turned out to be an epic challenge. I am trying to go 21 days without complaining. A self-imposed abstinence from grumbling of any kind: no slander of public figures, no whining about the weather. Nothing.

It’s an exercise that I first heard of while listening to a podcast by Tim Ferriss, the productivity expert and quasi self-help guru. Ferriss in turn discovered it after it was popularised by a new age pastor from Kansas City by the name of Will Bowen. And while I identify neither as a member of the self-help set nor the god squad, I was instantly fascinated by the mission.

The rules are ostensibly simple: put an elastic band on one wrist. Every time you complain, switch it over to the other wrist. Repeat, until the band has remained on one wrist for three weeks.

The simplicity is compelling, but the moment you start it becomes awfully complex. It turns out that “Am I complaining?” can be a very hard question to answer, because what is a complaint? There’s obviously the dictionary definition: an expression of discontent about a person or state of affairs, something like that. But in practise it gets murky. Consider the following three phrases.

1. “It’s cold.”


2. “Damn it’s cold.”


3. “Damn this cold.”

I think we could all agree that (1) is probably not a complaint. Assuming the weather is actually cold, it’s just a statement of fact. And we could reach a similar consensus that (3) definitely is a complaint. But what about (2)? What about (1) said in a slightly whiny tone of voice? What if someone else says (3) and you agree with them?

Or how about this: “I would’ve thought Assange and Co would have the intelligence to realise that a Trump government will not be good for people like him.” Is that a complaint, a pointed observation, or merely the expression of a dashed expectation?

On that particular Sunday morning, I decide it is not a complaint. I turn the page and leave the worn-out hair elastic clinging to my left wrist.

Monday 25 July 11.19am. The following day I meet my wife for coffee. As we approach the cafe, I spot a former colleague waiting at the counter. Let’s call him Gary. I’m not a fan of Gary’s. I mean, I wish him no specific harm. He’s not a bad person – he just has an awful sense of humour. Dad jokes and cries of “Taxi!” when a glass breaks are the cornerstones of his comedic oeuvre. Now I’ll have to endure some of it and, worse, my sweet wife will be subjected to it. For a moment I forget myself. As I spot The Gazmeister I let out a big sigh and two words slither out after it: “This idiot.”

That sentence isn’t even a sentence. It doesn’t have a verb. But the moment I utter it, I know the truth. It’s a complaint. I change the elastic band over and brace myself for some punny pleasantries. It stings, because at that point I was into my fourth consecutive day without complaint. And in five long months of trying, the longest I have gone is six days.

Not complaining is really, really hard. Until you try to stop, you’ve no idea how often you do it. It’s not a question of whether you’re an inherently positive person or a negative one. Complaint is a pivotal part of all conversation – it can be used for good as well as evil. A lot of the time, we complain as a way to connect. A shared moan is a time-honoured technique for relating to a co-worker, fellow traveller or life partner. Who hasn’t felt the warm rush of catharsis that occurs when you discover that someone else hates that thing you hate? Bellyaching is bonding.

So it’s wrong to say that complaints are wholly negative. In fact, some can be extremely positive. In a certain light, you could even view the whole of human progress as the result of complaints. Complaints about slow horses, or polio. Complaints about apartheid, or gender inequality.

We need complaints, and we need negativity. But for me at least, this challenge is not about disputing that fact. Nor is it about worshipping at the altar of positivity. The reality is you can perform some verbal gymnastics that allow you to express negative sentiments without complaining. “This traffic sucks” can become “I would love it if this traffic would clear.”

But in order to do that you’ll need to pause and really think about your choice of words. This is where the challenge becomes fascinating, because you start to realise how little thought we give to what comes out of our gob. The words just tumble out, like goods being looted from a supermarket. By focusing the mind on complaints, you employ someone to work the checkout. And why is that of any benefit? Well, it becomes a sprawling and highly effective exercise in mindfulness.

Mindfulness, in case you missed it, is approaching the status of full-blown fad – pretty impressive for something that is a few millennia old. One description is that it’s the practice of being present in any given moment. If that smells a bit too much like smouldering sandalwood for your liking, try “being aware of what you’re doing and what’s happening around you”.

Buddhists long ago observed what they call the “monkey mind”, the idea that the mind is inherently a bit restless and fidgety. If you don’t give it a clear task, it will either keep a running commentary, or wander off on tangents. Your head becomes filled with an endless, meandering chatter – a din that has been blamed for everything from anxiety to insomnia. The solution, say the Buddhists, is to give the monkey a job. It could be watching your breath come and go (meditation), or it could be keeping a keen eye on what you’re doing (mindfulness).

The claimed benefits are as varied as they are numerous: improved focus, anger management, treatment of depression, lower blood pressure, stress relief, general wellbeing. It’s a laundry list of advantages that has seen mindfulness teachings adopted by everyone from captains of industry to captains of football teams. All sorts are trying to experience the benefits of silencing their simian. There are countless ways to do it, but I’ve found one of the best ways to shut him up is to have him monitor your moaning.

27 July. Mid-morning a colleague and I travel to a meeting in his 2006 Toyota, a vehicle he calls Sonia Kluger, after the Australian media personality. I ask him how he feels now that his people mover has become associated with calls to ban Muslim immigration. He says there’s not much he can do about it. But our conversation has taken a turn, and we make some very pointed observations about Isis and the state of the world. I come dangerously close to complaining, but stop just short.

It’s not until later that evening that things fall apart. Over dinner a family member tells us she’s recently discovered that her former boss underpaid her entitlements. The business is no longer trading, so she’s unlikely to see the money owed. I simply can’t participate in the conversation without making negative comments about the person in question. It occurs to me that if I have any chance of making it to 21 days, I’ll need to recognise these situations immediately, and turn mute.

It’s that recognition that is the hard part though. That’s what makes it so different from other abstinences. When someone breaks their commitment to Dry July, they do so consciously. I’d imagine very few people get halfway through a beer and suddenly remember that they’re meant to be off the sauce. But that is exactly how it is with complaints. By the time you realise a gripe is in the vicinity, it’s usually too late.

5 August. Seven days and counting, a new record. I call the bank about two errors it has made, and manage to correct both without complaining. Instead, I simply state that I “can’t understand” why these things occurred when I was led to believe they would not occur. Sure I sound like a robot, but who cares? I’ve completed a task with a high degree of difficulty. If not complaining were figure skating, the bank call would be equivalent to a triple axel. I might not have shown much grace through the air, but I stuck the landing.

12 August. It’s at this point that I could veer off on a tangent about the general level of whingeing in the world. I could note that social media has amplified gripes about everything from overpriced avocados to sluggish Wi-Fi. I could write about how millennials are profuse whingers, surpassed only by non-millennials when you get them on to the topic of those wretched millennials. I could do all that, but I won’t. That would be a meta-whinge, and I’m 14 days without complaint. I’m into the home stretch and I’m not about to slip up now.

19 August. I took on whining, and I won. Were there some 50/50 calls that went in my favour? You bet there were. But when it’s all said (or weirdly bottled up) and done, I achieved my objective. Thrust into all manner of less-than-stellar scenarios, I summoned the strength to stifle my disapproval. I came, I saw, I concurred. Not only that, I did it at a time when the Pokémon GO frenzy was at its peak.

So how do I feel? Well, unsurprisingly, there’s not some powerful benefit that is unlocked on the 21st day. Rather there is an accumulation. I definitely think my focus has improved, along with general calmness. But perhaps the most noticeable benefit is a greater sense of control. You might think your level of control is just fine as it is – I certainly did – but it can be much better. If you try to stop complaining you’ll see what I mean.

Turning off autopilot is hard to do, and you’ll find those muscles that steer the plane have atrophied. But if you pump them up for a few weeks, the flight becomes more interesting and engaging.

How do I feel? Can’t complain.

Experience: my attempt to go 21 days without a whinge ended up taking six months | Michael Dawson

Non-Hodgkins Lymphoma, Stage 4 — How One Young Woman Reversed It in 4 Months

Stage 4 Non-Hodgkins lymphoma is not supposed to be this simple to reverse, is it? We make no claims, we’re just reporting what happened, which was confirmed by a family member.

What is shocking is that Non-Hodgkins lymphoma usually only appears in those in their 60s or older. This case occurred in a 34 year old mother of three.

Stage 4 is a designation for a cancer that has metastasized, in this case to all of her lymph nodes, and beyond to an organ or two.

In doing some research on non-Hodgkins lymphoma, we find that immune-suppressive drugs appear first on the list of causes. Did she use them? No, she didn’t (although her chemo drug (Rituxan), interestingly, has an immune-suppressive effect). Why, one wonders, would an immune-suppressive effect be useful in treating a cancer of the immune system?

The Mayo Clinic Website tells us that prior infections with HIV and Epstein-Barr are risk factors, as well as the bacteria Heliobacter pylori, which is often thought to be the cause of ulcers. (These were not a factor in this woman’s case.)

Pesticides and herbicides are believed to play a role in causing Non-Hodgkins lymphoma. Toxic chemicals are poisons and shouldn’t cause any surprise when they are linked to the causation of a cancer of our lymphatic system which is a partner with our immune system that protects and detoxifies poisons we come in contact with.

So, we know what we need to avoid, but — once we get Stage 4 Non-Hodgkins Lymphoma — how might we get rid of it, in a natural way?

Here’s what one woman did:

She did some research on the Internet and talked to a friend who had successfully beat his own cancer.

She stopped the chemo treatments after her second session. 

She started a mostly Raw Organic-Only Diet.

Here’s the regimen she used:

“No dairy, no gluten, no eggs, NO Sugar!

Waiting in between meals — no food combining!

1tbs of apple cider vinegar (with the “mother”) twice throughout day

Wake up to 1 ounce of wheatgrass juice followed by raw vegetable juice of choice — either greens, carrots, or beets.

To each juice I added lemons, ginger, turmeric root, and lots more.

2 hours later I’d have Ezekiel bread with avocado, tomatoes, and whatever other veggies you like.

3 hours later I’d blend the juice of  young Thai coconut with the meat and add whichever fruits I like. My favorite combo is bananas, dates, cinnamon, almonds, flax powder.

These are the supplements I took: probiotics, Vitamin D,  Multi-vitamins, Curcumin (tumeric capsules).

2 to 3 hours later you can have a huge salad of your choice. Then again, 2 hours later, another fresh raw juice — at least 18 ounce or more.

For snacks in between you can eat all kinds of nuts or fruits.

You can make fruits a meal as well.”

Here are some more useful tips this cancer survivor offered, which are good health tips we’ve seen elsewhere…

“No eating 3 hours prior to bed.

You can drink teas with dates if you feel like having something sweet but, No sugars!!!

Ezekiel bread has gluten but I was allowed because it’s mostly grains.

4-6 months of this program is completely raw, depending on each case

Then you can eat cooked foods every other day, such as organic brown rice, quinoa, salmon, soups, brown rice pasta etc… “

After four months of nothing but this diet, there was no sign of the cancer.”

It should also be noted that things happen for a reason and warnings from our body usually precede them, if we are listening. Out of our billions of cells, many are being replaced every moment of the day and night. Some of these might mutate and begin to develop into a cancer tumor. This is usually in response to the presence of some level of toxins in our body or some other stressor.

Fortunately, our body has natural systems to attack and destroy mutated cells before they begin to cause us trouble. Naturopathic doctors tell us that, if we supply our immune system the nutrients it needs to do this important work, it is quite capable of doing the job. The problem is, they say, that our modern food and eating habits are not supplying ALL the nutrients our body is known to need on a daily basis.

As I understand it, when our body reaches its limit of toxicity and stress, cancer begins to take over. The process used here to apparently reverse it is to remove as much of the toxicity that our food choices may be causing and give our cells super nutrients in mega-doses, in a raw, organic form, together with high-ORAC spices like turmeric — and some supplements, for good measure.

Imagine how you would feel if you ate this way all the time!

Author Paul Kemp successfully resisted being pushed into becoming a doctor, but instead has made the study of how to live a long, healthy life without intrusive medical interventions a primary goal. At age 67, he is winning and loving it!

Non-Hodgkins Lymphoma, Stage 4 — How One Young Woman Reversed It in 4 Months

"Soft-touch" physicians create 10m needless prescriptions a 12 months, says Wonderful

About a single in 4 prescriptions issued for antibiotics in England each and every 12 months – about 10m in all – are probably to be pointless as individuals deliberately search for “soft-touch” doctors who give in to their demands for the medicines, a foremost well being official has stated.

Mark Baker, director of clinical practice at the National Institute for Health and Care Excellence (Great), has warned that the increasing crisis of antimicrobial resistance, in which profligate use of medicines has permitted bacteria to develop resistance, threatened healthcare and the “whole basis of medicine”. He also explained infections would have to be handled by surgical treatment if drugs no longer worked.

Baker is director of clinical practice at the National Institute for Wellness and Care Excellence (Great), whichNice on Tuesday published advice on the concern for medical professionals, dentists, podiatrists, pharmacists and other experts.

Expectations of getting antibiotics have been now “entrenched”, stated Baker. “There are men and women who are addicted to the concept of possessing antibiotics. If they know there is a soft-touch doctor then they go to them.” If they did not realize success with one medical professional, they would attempt yet another or even search the internet to supply the medicines, he said.

Except if the most recent advice was translated into action, he explained there would have to be a rethink in practice “because we have invested 60 years assuming that most infections will be cured by antibiotic drugs”.

If these no longer worked, explained Baker, “then we will have to rediscover and relearn how to treat infections surgically and I do not feel anyone desires to be in that position”.

Associated: Considering of asking your medical professional for antibiotics? Consider once again | Sarah Boseley

The advice calls for prescribers to examine with individuals the very likely nature of their condition, the positive aspects and harms of quick prescribing, and choices this kind of as “watchful waiting” or delayed prescribing, when prescriptions are issued only soon after microbial samples taken from individuals have been examined.

It demands much more rigorous neighborhood policing of prescribing practice, with expert teams monitoring and evaluating information from distinct hospitals, GP practices and other prescribers.

Cases of very high, escalating or reduced volumes of prescribing ought to be examined.

Baker stated an open and transparent culture must permit well being specialists to query colleagues’ prescribing practices when they had been not in line with local or nationwide tips and no causes have been given for those choices.

There was a lot of really great practice, stated Baker, but examples of undesirable practice may, as a final alternative, be referred to skilled regulators this kind of as the Basic Healthcare Council (GMC).

Tim Ballard, vice-chair of the Royal University of GPs, mentioned the guidance “to give the appropriate antibiotic at the proper dose at the appropriate time” was wise.

“But we can come underneath enormous pressure from individuals to prescribe antibiotics, even when we know they are not the correct course of action. People need to realise that this is hazardous for every single and everyone of us, not just ‘other people’.”

He explained it may be counterproductive and unhelpful to involve disciplinary procedures when GPs already faced “very tough and demanding conversations” with individuals.

The college would be searching to regulators to support GPs who refused to prescribe unnecessary antibiotics and then faced complaints from patients.

Separate advice for patients, probably backed up by NHS public education campaigns, is anticipated following yr.

The Division of Health mentioned: “Tackling the overuse of antibiotics is a global issue that has an effect on everybody – government, patients, physicians, dentists and vets treating animals – not just GPs.

“In buy to make certain we have effective antibiotics for generations to come, we are raising worldwide awareness of the dangers of resistance to antibiotics and offering resources for GPs to support prescribing choices.”

Niall Dickson, chief executive of the GMC, said doctors should only prescribe if they had been pleased that this would serve the patient’s requirements.

“Where they take into account that the treatment method would not benefit the patient, they do not have to offer it.”

However, the GMC saw the Wonderful recommendations as “being a lot more about modifying the norms of practice typically than pursuing person doctors”.

Connected: Resistance is not futile – how to tackle drug-resistant superbugs

The dangers of antibiotic resistance initial grew to become a significant situation in the Uk in the late 1990s when they were raised by Sir Liam Donaldson, the then chief health care officer. His successor, Dame Sally Davies, took up the cudgels in 2013, with David Cameron calling for international action the following yr.

Professionals worry the crisis is deepening, with no new class of antibiotics or other major scientific growth in 30 many years.

A total of 41.6m prescriptions have been issued in England in 2013-14, costing the NHS £192m.

Prior Good guidance on the use of antibiotics to deal with respiratory tract infections, issued in 2007, was aimed at cutting prescribing by 22%. After an first dip, it started to increase once more.

A survey final year suggested more than a quarter of physicians prescribed antibiotics even when they have been not certain they were medically required, and nine in 10 felt underneath strain from individuals to prescribe them. Other figures suggest practically all individuals who inquire for antibiotics get them.

"Soft-touch" physicians create 10m needless prescriptions a 12 months, says Wonderful

Atkins Ciwem environmental movie of the 12 months 2014: the toxic price of leather - video

On the banks of the Ganges River in northern India lies Kanpur, the largest producer of leather goods in the country. Its good results comes at important environmental and social price, with toxic chemical substances launched into neighborhood waterways poisoning farmland and causing residents an array of well being problems

• Supply: Sean Gallagher


• Length: 9min 05sec


• theguardian.com


• Thursday 26 June 2014

Atkins Ciwem environmental movie of the 12 months 2014: the toxic price of leather - video

"I had to purchase two new wardrobes following a 12 months on the 5:two diet"

Roger had half-heartedly slimmed in the past – regimes like the Atkins protein-hefty diet program. But as we all know, he says: “You go on and for a week or two it is wonderful. But then, you end losing fat, it feels pointless, you cease, and the excess weight piles back on.”

Even when he was diagnosed with high blood pressure, and place on medication, Roger couldn’t shift adequate fat to make a variation.

And then came his daughter’s guide. ‘I began in the January and by the end of month 1, I had misplaced seven pounds. I felt: ‘This is working’.’

He fasted two days a week regularly for the subsequent six months, and was delighted to discover he had lost two stone and 9 lbs. He was 14 stone – and at the halfway mark.

“Now of program I had to encounter the downside of dieting,” he laughs. “I had to get my jackets re-tailored, plus new trousers and new shirts.”

Each Monday and Thursday, adjusted sometimes for his social life, Roger fasted until finally Christmas when he hit his 12 stone 7lb target. “And on New Year’s Eve, my delighted cardiologist buddy advised me he believed I could lose another half a stone safely. So I did.”

By the begin of this year, not only had Roger lost 4 stone and nine pounds. He was advised his blood strain had fallen to normal levels so he no longer essential to get medication.

He had also lost practically ten points from his Physique Mass Index (BMI) – the index calculated on height to weight which medical doctors use to assess our health. “I went from a BMI of 33.09, which is termed obese, to a BMI of 24.six, which is regular.”

He adds: “Mimi describes it as me dropping a child of eight.” Mimi herself has explained she is thrilled to throw her arms close to her Daddy’s waist and uncover they meet.

Roger is even now following her diet regime – fasting one day a week for upkeep. “I’ve totally altered my consuming routines,” he admits. “I don’t consume cakes or biscuits any more, and I don’t know how Frys remain in company now I have stopped eating its Chocolate Crèmes.”

Mimi has now written an additional book – The Quickly Seashore Diet, a six week kick-start off to the diet plan – which I am following for the Every day Telegraph.

So for me, and all the other five:two-readers, what’s the secret, Roger?

“Do not believe about it all the time,” he cautions. “There are instances you look to go backwards – analyse them – what did you do?”

He adds: “Be lively – go for a stroll or get immersed in work you will uncover time has flowed.”

Roger is, of course, proud as punch of Mimi (and her sister Debbie – who with Julie – contributed to the recipes for each books). But there has been 1 downside.

All people new and re-tailored clothes from final summer season – Roger has had to replace and renew his wardrobe a second time. I do not think he would have it any other way.

The Quick Beach Diet program by Mimi Spencer (Quick Books, RRP £6.99) is obtainable to buy from Telegraph Books at £3.99 + £1.10 p&ampp. Call 0844 871 1514 or pay a visit to books.telegraph.co.uk

"I had to purchase two new wardrobes following a 12 months on the 5:two diet"

How would you cope if you only have a couple of months to live?

I stopped currently being invited to items, and buddies do not tell me as considerably about their lives any more – they think I have sufficient on my plate. But it is good to hear about every day difficulties. And in a strange way, it’s great to see their tears, too. I want to share their emotions.

After the initial shock I commenced to believe, what am I going to do about this? I felt like it wasn’t my time. Was I going to waste my final six months hunting desperately for more possibilities? I was ready to take the danger. I study up and researched as a lot as I could, and buddies printed items off the internet for me. I contacted the charity Target Ovarian Cancer, who have been amazing. They advised me about Prof Stan Kaye at the Royal Marsden Hospital, and I asked my GP if I could be referred to him for a 2nd opinion. Following some tests, which uncovered a gene mutation had brought on my cancer, I embarked on a series of medicines trials.

I’m on my third drug trial at the moment. The tumour in my lung has gone, and the one in my pelvic area is displaying some shrinkage. But the medication have side results. I feel tired a great deal of the time, and the one particular I’m on at the moment tends to make me delicate to sunlight. But I’ve defied my 6-month prognosis, by a prolonged way. I was in New York with close friends the day that it came about. I’m constantly undertaking something when I can – abseiling, jumping out of planes, raising funds for Target Ovarian Cancer… really just pushing myself to do items I didn’t consider I could do.

In the meantime, life goes on and I make new buddies, although most of the individuals I meet are at the Royal Marsden so are in the exact same boat. Elsewhere, I have a tendency not to inform people for a while about my predicament – I don’t like ruining their day. When I do inform them they can not believe it because I really do not look sick.

I have to think I’m even now right here for a cause, no matter whether that is to raise awareness and money for ovarian cancer or for one thing else I’m not sure of nevertheless. I really don’t know what my recent prognosis is: I may possibly have lived beyond the 6 months but the truth is I have incurable cancer, even though I really don’t come to feel terminally unwell. For now the medicines I am on are retaining me going. But this will not final for ever. Becoming given 6 months produced me realise that we all say, ‘That can wait’, ‘I’ll do that up coming year’, ‘I’ll save up for that’. I really do not have a bucket list, I just have a list of things that I want to do: I maintain including to it, and ticking items off. For me, now, none of it can wait.

^{Photograph: Lydia Goldblatt}

Andrew Culliford (over)36, is married to Donna and has a 4-yr-previous daughter, Isla. They dwell in Poole, Dorset. He was diagnosed with motor neurone illness in 2011

I employed to be a genuine fitness fanatic. I’d had a handful of investigations due to the fact I played tennis and my backhand had grow to be weak. If I’d been significantly less energetic, I most likely wouldn’t have even spotted the changes but I worked as a firefighter so these things have been a lot more noticeable.

‘It’s bad news,’ the physician mentioned when I went to get my test results. He advised me I had ALS, the most widespread sort of motor neurone ailment, and that there was absolutely nothing they could do. More than time almost everything with muscle involvement would cease functioning. So I asked them a query I didn’t want the answer to, ‘How long do I have?’ They informed me that about thirty per cent of individuals survive longer than two years.

I had my household with me in that horrible room. Looking all around at them, the men and women I adore, seeing tears rolling down their faces, I felt an overpowering require to be robust. So I did not break down. It felt like I was viewing a movie about a person else.

Following my diagnosis, I just felt numb. The worst issue at that level was that I was still quite fit. There was no background of this in the household they don’t know what brings about it. It was hard to think about what was going to take place to me. I keep in mind going out for a run about 4 weeks soon after my diagnosis. A lorry passed me, and just for a second I looked at those large wheels and imagined about throwing myself beneath them.

I’m glad I didn’t. Because in a way, the three many years because my diagnosis have been the worst component of my daily life – and the ideal. I utilized to wonder if I died whether or not anyone would come to my funeral. Now I know they will. I feel really loved, and if it hadn’t been for this sickness, I don’t know if I would have ever felt like that. My family members, my buddies, they’ve all been there for me, supporting me, telling me how a lot I mean to them. If I’d just gone under the wheels of that lorry, I never would have felt so wished.

Right after the diagnosis, I stopped doing sport and I consider my health deteriorated, but when I commenced education again I felt greater. The illness has slowly gathered power, affecting my limbs over the very first yr. I’ve been ready to carry on operating for the fire service – my employers have been excellent. I’m even now completely employed and assist out with instruction.

I have trouble swallowing and talking, and I’ve lost the use of the two arms and the power in 1 leg. I try out to keep good, but it is tough. I can see my Donna feeling helpless. I know it’s challenging for her. And I know it is challenging for my friends, as well, but they’ve been incredible. They deal with me precisely the same, taking the mickey – and that’s what I want. I really do not want men and women tip-toeing all around me.

A terminal diagnosis has manufactured me realise what’s crucial. I wouldn’t say to any individual, dwell each day as if it’s your final, that does not make sense. But what I would say is, if you are satisfied, you are undertaking some thing appropriate.

^{Photo: courtesy of Laura Walker}

Laura Walker 39, lives in London. Her father, David, was given a life expectancy of 6 months in late 2012, and died aged 70 in April 2013

My dad was sick for about a yr just before he was diagnosed. He was losing excess weight and the medical professional didn’t feel it was critical, but we felt something was actually wrong. We acquired a second opinion and were appropriate: he had cancer – leukaemia – and was offered between 6 months and a yr to dwell. We have been angry because if the authentic GP had picked it up, it may have been treatable.

The physicians advised my mum initial, and she broke the news to my dad. He said to her that he needed to be on his very own and have time to feel. He wasn’t genuinely the kind of person to display feelings – it was just the way he’d been brought up. My mum and I agreed that we would preserve as optimistic about it in front of him as we could. She put on a brave face, but beneath I knew she was frightened.

They lived in Spain, and had carried out for about ten years, so I flew over to check out as usually as I could. Apart from the missed diagnosis, we imagined the wellness care in Spain was great. The only problem was the language barrier. There were occasions when we wished we have been back in the Uk as issues can get misplaced in translation.

A terminal diagnosis is so difficult for relations. You want to know how long you have left with your loved one particular. But as the doctors explained to us, cancer has an effect on every single person in a different way, which is why it is so challenging for them to be precise in terms of a prognosis. It’s tough to comprehend how you can go from ‘six months to a year’, to ‘a matter of weeks’, but that is what took place in early 2013.

My dad wasn’t responding to the treatment method, and the cancer was aggressive. At 1st, we did not want to tell him that he did not have long left. We thought he may just give up, so we left it as late as feasible. Then my mum informed him. He was really quiet for a number of days: I think he essential to get his head about the fact that he was going to die.

He did not want to, he mentioned he wasn’t prepared. Then he appeared to enter one more stage, wanting to make the most of the time he had left. He made a decision he wished to die at home, in his own bedroom, with the blinds and windows open, and the sunlight streaming in. He wanted a glass of wine, and he wanted to go along the seaside in his wheelchair.

I arrived in Spain the day before he died. It was April, just above 4 months right after his terminal diagnosis. The consultant had mentioned on his final property check out a number of days ahead of that there wasn’t prolonged left. I’ll by no means forget strolling into the bedroom and seeing him. He was drugged up but I know he recognised me. He looked like a tiny bird, so fragile. My mum and I sat on the bed hunting at previous photos and speaking to him. We just wanted him to hear our voices, and know we had been there.

The following evening, we each took it in turns to examine up on him. I checked, and then for some cause a minute later on believed I’d examine again. When I went into the bedroom I knew he wasn’t with us any much more. About five minutes later in the backyard, we saw a large butterfly. It was with us, and then it had gone, flown away.

^{Photo: Lydia Goldblatt}

Tim Oliver is a consultant oncologist and professor emeritus of health-related oncology, St Bart’s and the London School of Medication, QMUL, and a trustee of the male cancer charity Orchid Cancer Appeal

When it comes to terminal diagnoses it’s usually not until finally late in the day that I’m certain about the timescale. And even though I’m always honest about the circumstance from the commence, I never ever consider to place an precise amount of weeks or months on factors, due to the fact I’m not God.

I attempt to make confident that the patient understands the idea of the median, rather than typical. The current median expectation, when 50 per cent of us may die, is at least 82 in males and 85 in women. If you’ve got cancer that can’t be treated, it’s clearly less – but the very same principles apply. Offered a three- or 6-months existence expectancy, you could die inside of the week but there is a 50/50 chance you will dwell longer than 3 or six months. It’s greater to travel hopefully than worry that every single day may possibly be the last.

The first conversation I have with a patient about a terminal diagnosis is by no means effortless. I consider to get an notion of what they would be organizing if it weren’t for their diagnosis – and how significantly of this will even now be achievable. Then I go into specifics of medians and targets, verify that they have acquired their existence in order, and aid them set some achievable goals. I try to uncover anything about the predicament that can raise a smile or a laugh, as a way of diffusing tension. Last but not least, I recommend they go home and observe their favourite comedy movie.

I’ve come across 3 distinct attitudes to an incurable diagnosis. Some individuals go into a state of anxiety, worrying and striving to solve the issue. Others flip into ‘fighters’, receiving out there and doing as a lot as their bodies can do, to try and minimise interference in their lives from the cancer. Each these states of mind are associated with far better survival odds.

The third variety of patient, nonetheless, the passive ‘punchbags’, feel that they are constantly unlucky and are less very likely to exceed expectations when it comes to survival. These sufferers may possibly benefit from expert mental health input, medication or psychotherapy – although often it may be that discovering and getting rid of a reversible anxiety, this kind of as work or marriage problems, can lead to dramatic enhancements.

There may come a time when far more intensive care from a hospice or home care group is necessary. I feel it helps to make positive the patient understands this will be accessible. But, even at the end, it’s critical to try out to engage in positive planning, such as household events. There is strong proof that death ‘takes a holiday’ for specific occasions such as birthdays and Christmas – men and women often ‘hold on’ when there is something like that to appear forward to.

Offering out bad news is a tough portion of the task, and every single person patient is a challenge. But the key to getting a excellent death is guaranteeing it is a two-way procedure, made better by great communication amongst every person concerned.

How would you cope if you only have a couple of months to live?

It truly is Not Just Vets Who Wait Months For Doctors. You Do Too

Amid the resignation of Eric Shinseki as secretary of the Veterans Affairs Department Friday, mismanagement at the VA’s network of hospitals and outpatient services has targeted in portion on months and months of wait occasions for veterans to see a physician.

But even just before the rollout of the Reasonably priced Care Act to millions a lot more sufferers with insurance coverage, all Americans are waiting for than two weeks to see a physician and in some markets a month or much more.

A survey earlier this 12 months by physician staffing and consulting firm Merritt Hawkins showed sufferers are waiting an typical of 18 days to schedule an appointment for a doctor, according to a examine of appointments for typically employed specialty physicians in 15 key U.S. cities.

The longest wait to see a physician was in Boston in which the common wait was 45.5 days to schedule an appointment with a family members physician, dermatologist, cardiologist, orthopedic surgeon or obstetrician/gynecologist. The survey came from a sampling late last 12 months of practically 1,400 medical offices across the country.

Even though portion of the issue comes as much more Americans acquire well being care advantages. It is also due to shortages in distinct specialties like major care doctors such as internists, pediatricians and family medical doctors.

The survey showed that an average appointment for a family members physician in the 15 metropolitan markets Merritt Hawkins evaluated took 19.five days.

“As the illustration of Boston illustrates, entry to overall health insurance coverage does not always guarantee entry to a physician,” authors of the Merritt Hawkins report said. “In addition, the survey demonstrates that many if not most doctors in the 15 markets examined are not accepting Medicaid as a form of payment.”

The report indicated that Congress requirements to pay much more consideration to the doctor shortage from enhanced payments to medical doctors to enhanced money for medical doctors in training.

“As millions of the previously uninsured obtain healthcare coverage by means of the ACA, methods will need to be located to ensure accessibility to doctors, via increases in the amount of health-related residency positions available nationwide, via the use of modern staffing

models that redistribute some of the work previously dealt with by doctors to other clinicians, by means of equitable payments to physicians, by way of the use of online and mobile technological innovation, and by means of other techniques.”

Congress has observed the Merritt Hawkins report and it was portion of a Senate hearing carried out by U.S. Sen. Bernie Sanders of Vermont in the final 12 months. Here’s a website link to Sanders world wide web page and his statements on the situation.

Asking yourself how Obamacare will influence the medical doctor shortage? ayour overall health care? The Forbes eBook Within Obamacare: The Repair For America’s Ailing Well being Care Method answers that question and a lot more. Accessible now at Amazon and Apple.

It truly is Not Just Vets Who Wait Months For Doctors. You Do Too

five.5m babies a 12 months die without having birth or death certificate

Far more than 70% of deaths could be averted, as could 54% of deaths of mothers, according to the Lancet papers. Photograph: Paula Bronstein/Getty Images

A lot more than 5.five million babies are born and die every yr without a birth or death certificate– an indication that the planet does not care sufficient to make the required effort to conserve their lives, an expert says.

“To me, the reality that we have 5.five million infants entering and leaving the planet with no collecting a birth or death certificate signifies that they never count and there is an acceptance of these deaths. It is part of a larger image of men and women not mourning these deaths,” mentioned Joy Lawn, professor of maternal, reproductive and kid overall health at the London College of Hygiene and Tropical Medicine and lead author of a five-paper series published in the Lancet.

Three million of the deaths are between newborns and 2.six million far more babies are stillborn. Almost all the deaths are preventable, with half occurring for the duration of labour. Lawn blames fatalism, insufficient care and lack of investment.

The variety of deaths is much more than that from Aids, Lawn says, which brought on the deaths of two.three million in the peak 12 months of 2005. The death toll from Aids is falling thanks to medical professionals and activists who campaigned for far better treatment method, but the exact same does not take place for newborn and stillborn infants, she says.

A lot more than 70% of deaths in the very first 28 days of daily life – 1.9 million infants – could be averted, as could 54% of deaths of girls in pregnancy and childbirth, according to the Lancet papers. The largest value is for “facility-based mostly care” – enabling pregnant girls to give birth in health centres with qualified midwives who can deal with problems that can kill or disable mothers and infants. The expense would be almost $ two,000 (£1,190) for every life saved.

The Millennium Growth Objectives have succeeded in bringing down the numbers of deaths of young children beneath the age of 5, but the rate of reduction of newborn deaths is about half that of the rest. In most areas of the world, newborn deaths sum to half of youngster deaths.

Brendan Cox, director of policy and advocacy at Conserve the Youngsters, stated the Lancet series “supplies terrifying evidence of the perils of birth with no skilled midwife existing, a reality for half of all mums in sub-Saharan Africa and the cause of higher newborn mortality and stillbirths”.

“At this week’s Globe Overall health Assembly, Jeremy Hunt, on behalf of the British government, have to make a robust commitment to making sure that this lamentable failure to supply basic wellness services to mums is redressed in even the poorest nations and that the Uk will perform its component in helping.

“This is an opportunity to export Britain’s best model of very good practice – the NHS. We celebrated it in the course of the Olympic ceremony. Now let’s flip that into a true, lasting legacy in which we share our knowledge and commit to the ambitious objective of assisting poor nations to finish all preventable newborn deaths by 2025. In this day and age, no baby ought to born without having a trained overall health worker on hand to aid save the existence of both mum and little one.

“Exactly where the world has stumbled is with the extremely youngest, most vulnerable young children,” stated Dr Mickey Chopra, head of Unicef’s international well being programmes. “This group of young children needs attention and assets. Focusing on the critical period amongst labour and the first hrs of life can exponentially enhance the possibilities of survival for both mother and kid.”

five.5m babies a 12 months die without having birth or death certificate

twelve Million Americans Misdiagnosed Each and every 12 months, Examine Suggests

Synthesizing the final results of 3 separate research, researchers from Houston Veterans Affairs Healthcare Center and Baylor University of Medicine estimate that 12 million Americans a 12 months, or more than five % of all individuals, are misdiagnosed as a result of medical professionals failing to adhere to up on “red flags” for cancer and other serious illness.

“We estimate the frequency of diagnostic error to be at least five% in US outpatient adults, a quantity that entails a significant patient safety danger,” writes lead author Hardeep Singh, MD, who holds dual appointments in the Area of Health Solutions Investigation at Baylor University of Medicine and at the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Security.

“This population-based estimate should supply a foundation for policymakers, healthcare organizations and researchers to strengthen efforts to measure and lessen diagnostic errors.”

The research, published on the web April 17 in BMJ Quality and Safety, The Worldwide Journal of Healthcare Improvement, provides only an estimate, based mostly on an extrapolation. Nevertheless, it is an intriguing one, specifically when you appear at how Hardeep and colleages came up with it.

And it provides an additional piece of an previously devastating puzzle, coming just months soon after a examine out of Johns Hopkins University found that 160,000 individuals a 12 months die or suffer permanent harm as a outcome of healthcare error.

Hardeep and group combined data from 3 prior research, which they chose because they used comparable definitions of what constitutes a medical error.  (There is surprising variation in how this term is utilised.) All 3 studies concerned health care mistakes that had been unveiled by a patient’s later diagnosis.

The very first examine employed laptop algorithms to detect uncommon patterns of return visits following a patient was witnessed by a principal care medical professional. The second examine also utilized electronic algorithms to uncover lack of stick to-up after abnormalities have been detected in colorectal cancer screening. The third review, similar to the 2nd, involved lung cancer cases which did not receive sufficient follow-up and remedy after preliminary screening.  “Diagnostic errors have been confirmed by way of chart overview and defined as missed possibilities to make a timely or proper diagnosis based mostly on obtainable evidence,” create the authors.

The researchers then mixed the outcomes of the studies and extrapolated the price of outpatient diagnostic error to the whole U.S. grownup population, coming up with an yearly price of 5.08%, or about 12 million American adults a year.

“Based on preceding operate, we estimate that about half of these mistakes could potentially be harmful,” the authors publish.

Looking much more closely, the researchers in fact came up with three diverse diagnostic error percentages. For primary care misdiagnoses, the rate was five.06 percent, even though for lung cancer it was just .013% and for colorectal cancer an even smaller sized .007 %. Translated, this indicates you can possibly fret much less about physicians missing indicators of cancer than indicators of other illnesses.

Nonetheless, the authors note, since even modest delays can have a profound effect on the good results of cancer remedy, missed cancer diagnoses are the “most harmful and costly types of diagnostic error in the outpatient setting.” In other phrases, when it comes to cancer, even .007 % is not great.

twelve Million Americans Misdiagnosed Each and every 12 months, Examine Suggests

Trial to see how personalised treatment method can battle cancer set to begin this 12 months

Scientists will use the genetic understanding of each lung tumour to recognize individuals who are much more probably to benefit from a particular drug. Photograph: Stefan Wermuth/Reuters

A medicines trial made to uncover how personalised remedy can assist in the battle towards cancer commences later on this year. Cancer Research United kingdom has joined forces with pharmaceutical organizations AstraZeneca and Pfizer to develop a pioneering clinical trial for patients who have superior lung cancer, the UK’s greatest cancer killer.

Scientists from Cancer Research United kingdom will use the genetic understanding of every single lung tumour to identify modest groups of sufferers who are more most likely to benefit from a certain drug since of the distinct genetic changes triggering their cancer.

Researchers will be provided access to up to 14 medicines which target specific and usually rare mutations, that means that they could offer you hope for those who would otherwise have very constrained remedy possibilities.

During the trials, researchers will look for indicators of improvement, this kind of as improved survival, tumour shrinkage or an alleviation of signs. If the medicines show promise, they could be quick-tracked into more substantial trials. The charity has said the partnership marks a new era of study into personalised medicines. Funding for the trial – from the charity and the two pharmaceutical companies as nicely as assistance from the NHS – represents £25 million of investigation.

Harpal Kumar, Cancer Investigation UK’s chief executive, stated the trial is an essential phase forward in the battle towards cancer. “This partnership is fascinating because we’re making an attempt to obtain anything that none of us could manage alone – targeting treatments towards the patients who we know are the most probably to advantage. It is also a programme that can uniquely be carried out in the United kingdom simply because of our Nationwide Health Service and the network of centres across the country supported by Cancer Analysis United kingdom.

“We know that each patient’s cancer is distinctive so we’re now moving away from a one-dimension-fits-all technique and as an alternative striving for more personalised remedy. Critically, we are shifting the emphasis from designing a trial close to a particular drug to designing it around selecting from a selection of medication for a distinct patient.”

The trial will be led by Prof Gary Middleton in conjunction with the early drug development staff at the charity’s clinical trials unit in Birmingham. It will construct on the very first phase of the charity’s medication programme which established a way for NHS hospitals to routinely test tumour samples and use this details to assist match cancer patients to the most acceptable therapy.

Prof Middleton said that the trial will mean cancer medicine in the Uk gets a key worldwide player in the search for more efficient targeted therapies. He extra: “For our individuals, it really is a tremendous possibility to accessibility a broad-assortment of therapies tailored exclusively to their certain kind of lung cancer. For men and women caring for lung cancer individuals in the United kingdom, it’s fascinating to be ready to offer you these therapies to patients when they are even now at a quite early stage of clinical development.”

The wellness secretary, Jeremy Hunt, welcomed the news and mentioned that he looked forward to the advantages it would deliver for cancer sufferers. “By investing £11.five million a day into study and development for the lifestyle sciences we have created this country a single of the best spots in the planet to carry out and invest in clinical trials, which has made ground-breaking programmes like this feasible.

“Cancer Analysis UK’s stratified medication programme will see top scientists operate with market and the NHS to collaborate on modern, life-saving analysis, and I seem forward to the positive aspects this will deliver for cancer sufferers and their households.”

Trial to see how personalised treatment method can battle cancer set to begin this 12 months

Is It Protected To Consider A Cruise? eight Virus Outbreaks In 3 Months

Yesterday, reports hit the information of one more Princess Cruise with a boatload of sick passengers. This time it was the Crown Princess, on a weeklong voyage along the coast of Southern California and Mexico, with an outbreak of norovirus.

The Crown Princess pulled into port in San Diego Thursday with far more than a hundred passengers and crew sick with the gastrointestinal bug, which spreads simply in tight confines.

Eleven passengers elected to disembark in San Diego (paying a $ 300 per man or woman charge, according to an ABC news report) but the ship and its a lot more than 3100 other passengers are now back at sea following the planned itinerary.

Also this week came the news that two consecutive trips on the Royal Caribbean ship Grandeur of the Seas departing to the islands from Baltimore had been afflicted with outbreaks of norovirus, one of them  affecting more than one hundred passengers. What’s going on?

Cruise Ship Sickness in the Headlines

It is been a hard yr so far for the cruise business.

• In late February and early March, two virus outbreaks, one of them definitively norovirus, afflicted Holland America’s ships ms Maasdam and ms Veendam whilst on 7-day journeys by way of the Caribbean.

• In early February a norovirus outbreak sickened more than 600 folks, producing it one of the largest this kind of outbreaks on any cruise ship in the final 20 years. That journey, a Royal Caribbean voyage aboard the luxurious Explorer of the Seas, was minimize two days brief.

• Just prior to that, the Caribbean Princess also had a norovirus outbreak that affected close to 200 men and women, and that journey also ended two days early, although Princess Cruises cited fog as the official reason for the early return.

In all, according to CDC information, epidemics of gastrointestinal illness have broken out on eight cruise ships so far in just the initial 13 weeks of 2014. Of these, norovirus is the established lead to of the outbreak in at least five.

For comparison, the CDC lists only 9 gastrointestinal outbreaks for all of 2013, of which eight had been due to norovirus. (In other phrases, it’s a excellent guess that much more of the 2014 outbreaks will sooner or later be attributed to norovirus.) Nonetheless 2012 was worse, with 16 cruises going through condition outbreaks, all of them due largely to norovirus.

It is critical to note that the CDC’s data include only cruise ships that participate in the agency’s official Vessel Sanitation System (VSP) ships in this program are needed to report the variety of individuals who saw a medical professional for gastrointestinal (GI) sickness even though on board.

Whilst Princess, Royal Caribbean and Holland America seem to be to be possessing the bulk of the bad luck this 12 months, they aren’t the only cruise lines coping with norovirus. in 2013, Celebrity Cruises had four boats infected with the bug and Cunard, Crystal, Prestige, and Lindblad Expeditions have all had issues with outbreaks too.

Like nursing homes, hospitals and other institutions that have grappled with norovirus in current years, cruise ships are vulnerable since of the massive variety of individuals confined to a restricted room whilst dining and mingling collectively, specialists say.

The Navy prevents norovirus by right away quarantining sick sailors, one thing that is significantly more challenging for a cruise ship to call for of its guests.

Is It Protected To Consider A Cruise? eight Virus Outbreaks In 3 Months

Improved Survival For Males With Localized Prostate Cancer: 6 Months Hormonal Therapy Combined With Radiation

Based mostly on new research, guys with localized prostate cancer but at substantial risk for metastasis, have far better outcomes if they are taken care of with radiation combined with androgen deprivation treatment which decreases testosterone, thus decreasing opportunity for tumor spread and growth.

The investigation was presented at the 33^rd conference of the European Society for Radiotherapy and Oncology (ESTRO-33) in Vienna on April seven. Findings from the research could represent a new strategy to remedy of localized prostate cancer that is at higher danger for spread.

“Although we need to have longer comply with-up to assess the influence on these men’s overall survival”, said Dr. Michel Bolla, a professor of radiation oncology at Grenoble University Hospital, “these findings require to be taken into account in everyday clinical practice.”

“They display that three-dimensional conformal radiotherapy,” Bolla explained, “whether intensity modulated or not, and regardless of the dose degree, has to be combined with short-term androgen deprivation therapy in purchase to receive a significant lessen in the danger of relapse”. “Therefore, for the duration of multidisciplinary crew meetings to examine a patient’s treatment method, this combined remedy technique ought to be one particular of the alternatives proposed for males with localized prostate cancer that has an intermediate or higher risk of increasing and spreading,” additional Bolla.

Intensity modulated radiotherapy (IMRT) is a model of three-D radiation therapy that employs computer-generated photos to demonstrate the dimension and shape of the tumor. This allows the size, form, and intensity of the radiation beam to be altered to conform to the dimension, form, and spot of the patient’s tumor, decreasing injury to close by healthful tissue.

Bolla and colleagues evaluated 819 men at 37 web sites in 14 countries. The patients had early stage prostate tumors (as confirmed by amounts of prostate specific antigen (PSA) and biopsy) that had been at moderate or high danger of metastasis.

The sufferers had been randomized to obtain both radiation alone or radiation and two injections of luteinizing hormone-releasing hormone analogues (LH-RH analogues), which minimize ranges of testosterone to result in reversible chemical castration. Every single drug injection lasted three months the very first drug was provided on the first day of radiation and the 2nd three months later.

When LH-RH analogues are at first administered, testosterone increases for a brief period prior to dropping to reduced ranges. This leads to ranges to sharply enhance, (referred to as flare”. To decrease this response, individuals took an oral anti-androgen (bicalutamide, 50 mg per day) for 15 days before the first injection.

In the research, treating doctors picked amongst 1 of three irradiation doses, 70, 74 or 78 Grays (Gy).  Follow-up was for an typical of seven.2 many years. Findings indicate that the 403 males who had been taken care of with radiation combined with anti-androgen treatment had been significantly less probably to have suffered a relapse and progression of their cancer than the 407 men who had been handled with radiation alone, irrespective of the radiotherapy dose and no matter whether it was intensity modulated or not.

Compared to guys treated with radiation only, sufferers who acquired the combined method had nearly half the danger (47%) of biochemical progression of their condition. In contrast with 201 males in the radiation only group, only 118 males in the combined remedy group had a biochemical progression of their disease. (Biochemical progression is defined by PSA values being elevated above the lowest level plus two nanograms per ml).

Soon after five years, males in the combined treatment group were faring considerably greater. “They had far better survival without biochemical progression,” stated Bolla. “Among these obtaining the combined treatment method, 17.five% had progressed compared to thirty.seven% receiving radiotherapy alone.”

In contrast with 80.eight% of men obtaining radiotherapy alone, results  from the review demonstrated that 5 many years after treatment method, 88.7% of the men in the combined therapy group had not progressed.

Urinary troubles had been observed in 5.9% of patients acquiring the combined treatment versus three.six% of individuals on radiation alone. Erectile dysfunction was greater in the mixed treatment method group, versus radiation alone. (27% versus 19.4%.

“These final results demonstrate that, in men with localized prostate cancer that is at chance of recurring and spreading, the addition of 6 months of hormonal remedy to radiotherapy improves the time these males survive without having their disease progressing,” stated Bolla. “It is essential to guarantee that the radiation treatment is of the very best quality further clinical study is required to optimize radiation strategies and to find new hormonal treatment options.”

Improved Survival For Males With Localized Prostate Cancer: 6 Months Hormonal Therapy Combined With Radiation

Public overall health, one 12 months on: highs and lows for neighborhood government

How profitable have councils been in strengthening the well being of their residents? Photograph: Joe Wigdahl / Alamy/Alamy

Public well being became a neighborhood government obligation in April last yr for the very first time given that the 1970s. Councils took above commissioning services to assist folks quit smoking, get rid of bodyweight and tackle other important wellness concerns. But, a single yr on, what is been accomplished?

Guardian journalist Richard Vize spoke about the options connected with the move in an report final 12 months. He explained that even though acquiring to grips with council politics and processes will be tough, public overall health teams ought to discover the move to local government “a liberating knowledge”. He wrote: “Although NHS culture is hierarchical, centralised and inward seeking, neighborhood government is outward searching, community focused and rebellious.”

Nevertheless, councils came under fire from the British Healthcare Journal (BMJ) who explained they were diverting public wellness money for other use. The Regional Government Association (LGA) described this report as “completely misleading”, adding that paying ranges on public overall health remained consistent.

Here are your views on the highs and lows of the year, with public overall health now firmly in the neighborhood government remit.

What successes are there to shout about?

Public wellness is now at the heart of commissioning

– Joanne Roney is chief executive of Wakefield council.

Improving wellness and wellbeing is component of the local financial growth agenda

– Rob Walsh is chief executive of North East Lincolnshire council.

Councils are operating on some really wonderful projects

Southwark have just announced they are producing all their sports activities centres totally free they also do universal totally free college lunches. Get Match Birmingham is an interesting scheme as is Nicely London wellness champions which operates in a quantity of boroughs. Ipswich banned super powerful lagers and ciders.

– Edward Davie is communications and engagement office for the NSUN network for psychological health and and chair of Lambeth council’s overall health and adult social companies scrutiny committee

Our span of influence is have to better

We have brought other departments beneath public overall health, so community safety (e.g crime, anti-social behaviour, vulnerable communities) emergency planning (e.g floods and extreme weather, events and public order concerns), environmental health and regulatory solutions (e.g alcohol licensing, noise, pest, air quality and so forth) all now sit underneath public health. We lead on the intelligence function for the authority.

Asides from assimilating other solutions we have a considerably closer functioning relationship with colleagues in housing, transport, planning, rewards, children’s services and have started out lots of great initiatives.

– Tom Scanlon is director of public well being at Brighton &amp Hove city council.

Joined up working in London has been a good results

Boroughs have been joining up companies each inside of their organisations and with wider partners, and they have been implementing initiatives that give communities the tools and sources to address their own health wants.

Public health is turning out to be integrated into every facet of London nearby government, from housing and licensing to leisure and environmental overall health, and its position will only become more essential as councils look for to provide high quality companies with much less.

– Teresa O’Neill is executive member for well being at London Councils.

What perform is there to be completed?

Public well being resources are still so unfairly distributed

The greatest failure of the new public overall health program is that resources are so unfairly distributed. City of London, Westminster and Kensington and Chelsea, the country’s richest boroughs with some of the best existence expectancy, are obtaining by far the most public wellness cash per head.

City of London receives £192 per head, much more than double spots such as Lambeth, Manchester and Liverpool which have far larger levels of illness and deprivation.

This is compounded by the fact that the councils serving the poorest residents, and for that reason people with the highest rates of sick overall health, have had their general budgets disproportionately minimize. This signifies that it is tougher for these councils to tackle the pre-determinants of sick-health by supplying respectable housing, employment, leisure and training options.

Councils such as Lambeth have had their spending budget lower by 50% whilst fairly healthful and wealthy West Oxfordshire, which occurs to be David Cameron’s neighborhood council, has had a three% improve.

– Edward Davie

A challenge is the quantity of vacant director of public health posts

Provided nearby government’s new role in public overall health concerned the merger of two distinct cultures, it seems to have gone quite effectively so far. Currently a single sees councillors lining up with their directors of public overall health to argue the situation for pondering about the public wellness impacts of council policies usually, and we know that 72% of authorities say that Public Well being England, only a year outdated, is supporting them effectively. A challenge is the number of vacant director of public health posts – and whether that is a signal of a problem or lack of consideration by regional government.

– Ben Webpage is chief executive of Ipsos Mori.

The problems most often talked about by our members are the scale of financial cuts to council budgets, the influence of economic downturn and welfare modifications on people’s overall health, and considerations about getting in a position to recruit and retain the skilled workforce they require to do the job efficiently. About one in 4 director of public well being posts are at the moment filled by acting or interim arrangements and there are also higher ranges of vacancies in public overall health teams. Robust, stable public well being leadership is crucial if we are to accomplish the full likely of public well being moving into councils.

– Janet Atherton is president at Association of Directors of Public Health.

There are longer phrase problems about public overall health coaching and conditions of employment

I feel there are longer phrase problems about public wellness instruction, regional authority terms and circumstances of employment, and the willingness of medically experienced public well being experts to perform in such environments. I would also struggle to do this task in an upper tier authority – when a lot of actual public wellness sits in reduce tier, borough or unitary authorities – or where I had to go via yet another director to get to a chief executive, or did not have the very same budgetary management. I think if that were the situation, I may well search elsewhere.

– Tom Scanlon

• Public health: how landscape can increase the overall health of residents
• Councils have possibility to demonstrate effectiveness in public wellness
• Public health 2014: most significant topics for the year ahead

If you have a lot more thoughts to include then get in touch with sarah.marsh@theguardian.com or leave comments in the thread under.

Public overall health, one 12 months on: highs and lows for neighborhood government