For the vulnerable, there’s no place like home | Sri Kalidindi

Imagine this. You’ve suffered a debilitating mental illness, you’re admitted to hospital and, after weeks or months of treatment, you’re finally deemed stable enough to go home. Only, you can’t – the home you need in the community is not available.

As a psychiatrist, this is a situation I and many others around the country encounter almost daily. Even when patients are ready to leave hospital, a notable number don’t have the specialist supported housing they need to take that step.

Currently, around 60,000 people in England live in specialist mental health supported accommodation. They are there because of the severity of their condition, their level of vulnerability and their complex needs, which often include requiring support for everyday activities. Supported housing offers them the freedom to live as independently as possible, while also reducing their use of hospital beds, both in the mental health sector and in the acute, physical health sector.

With the right support from housing care staff alongside secondary mental health care rehabilitation and recovery services, many can and do achieve stability. Along with this, the opportunities to re-engage with family, education, work and their community are more within reach.

Without such provision, many people become stuck in highly restrictive, costly and more institutionalised care, such as hospital wards and care homes. These are often at great distances from their families and communities and require even more public funding. Supported housing provides that crucial interim step for those who need it, between hospital or residential care home, to people moving into their own flats with support coming in. This also often means the difference between living and staying well in the community, to becoming unwell again and requiring yet another hospital admission.

Money can be spent more efficiently when people are in the right setting for their level of need

Providers of supported housing for vulnerable people, including those with mental health conditions, have clearly communicated that the government’s proposed changes to how supported housing is funded will result in the closure of such services. Yet there does not appear to be a viable alternative for those most in need. Providers of supported housing have already been closing accommodation across England and halting the development of new, much needed provision.

The effects are already being seen on acute psychiatric wards, with increasing levels of delayed discharges, resulting in fewer available beds for those requiring acute emergency admission and an increasing number of people being sent hundreds of miles from home.

It has also been found that those who are sent far away for treatment are more likely to take their own lives upon returning home than those who are admitted to hospitals close to them.

The adequate provision of supported housing locally is crucial for many national policies and strategies to be realised. These include the five year forward view for mental health, the Crisp commission on acute adult psychiatric care and transforming care for people with learning disabilities, which all state the central importance of specialist supported housing to aid people’s recovery and to enable successful community living.

The health and social care system is made up of so many parts. The lack of a joined-up policy results in unintended consequences for patients, their families, services, commissioners who pay for care and society as a whole.

Money can be spent more efficiently when people are in the right setting for their level of need. For this to work, a system-wide approach across health and social care with adequate resources at each level, including supported housing, is vital. Especially for those whose lives depend on it.

If health regulators would fund a more joined-up way of working, then every person could receive the right care and support, in the right place, at the right time.

Dr Sri Kalidindi is head of the rehabilitation & social psychiatry faculty at the Royal College of Psychiatrists• Comments will be opened later

For the vulnerable, there’s no place like home | Sri Kalidindi

What you essentially need and the easiest place to find it

There’s this doctor, Dr. Joel Wallach, who wrote a book entitled, “Dead Doctors Don’t Lie”.

In his book, Dr. Wallach frowns upon the corruption of today’s MDs, saying they are all basically hookers for the pharmaceutical industry.

He references diseases like ulcers, cancer, arthritis, Alzheimer’s, kidney stones, varicose veins, stroke, cardio myopathy, cravings, liver or age spots, hyperactive children, low blood sugar, diabetes, baldness, hearing problems, osteoporosis, smell and taste loss, gingivitis, hypertension, high blood pressure, insomnia, muscle cramps, PMS, and low back pain.

Dr. Wallach says that virtually all doctors recommend synthetic chemicals to treat the symptoms of all those illnesses and never once address the cure.

So, throughout his endless verbiage he recommends vitamins and minerals to treat all illnesses. I guess for a doctor that’s a major breakthrough.

His recommendations to, in some way, treat all the above afflictions are the use of carotene, vitamin E, beta-carotene, magnesium, boron, calcium, selenium, chromium, vanadium, zinc, amino acids, and essential fatty acids.

Unfortunately, he never mentioned where all he talked about could be found in food or the mineral sulfur, which would heal just about everything he listed. To take all the other ‘healers” he mentioned, would require spending as much money on them as someone would on the synthetic pharmaceuticals.

So, I got to thinking. I’ve been studying the link between diet and disease since 1975 and was forced, in 2007, to get a Masters degree in nutrition to shut up the MDs that would call in on my radio show asking what my credentials were (I guess telling them I graduated Magna Cum Laude from the School of Hard Knocks fell a bit short).

Anyway, in my mind, I felt that there had to be a more economical way to get all he advised. So, I began researching. What I discovered absolutely agreed with what my mind thought before the process began.

Everything he talked about could be found in food. But the type was a mind-blower.

Vitamin E:
Benefits:
Structural and functional maintenance of skeletal, cardiac, and smooth muscle. Assists in formation of red blood cells. Maintains stores of vitamins A and K. has a positive effect on the immune system and protects against oxidative damage that can lead to heart disease. Has preventative effects against cancer, helps relieve symptoms of Alzheimer’s, and may prevent diabetic-related eye damage.

Sources:
Chard, avocados, peanuts, bell peppers, asparagus, beets, mustard greens, chili peppers, kale, tomatoes, olives, cranberries, raspberries, kiwi, carrots, leeks.

Beta Carotene:
Benefits:
Considered an antioxidant. Helps maintain healthy skin. Plays a vital role in eye health. Lowers risk of heart attacks, stroke, macular degeneration, and other age related diseases.

Sources:
Baked sweet potatoes, carrots, dark leafy greens, romaine lettuce, squash, cantaloupe, bell peppers, peas, apricots, broccoli.

Magnesium:
Benefits:
Relieves headaches, muscle spasms, muscle cramps, anxiety, depression, autism, ADD, Restless Leg Syndrome, insomnia, psoriasis, acne, eczema, asthma, blood pressure, ostoporosis.

Sources:
Dark leafy greens, nuts and seeds, beans and lentils, whole grains, avocados, bananas, dried fruit, and dark chocolate.

Boron:
Benefits:
Monitors blood sugar; aids metabolism; reduces food cravings; regulates fat and cholesterol; prevents hypertension.

Sources;
Almonds, walnuts, avocado, broccoli, potatoes, pears, prunes, honey, oranges, onions, garbanzo beans, carrots, beans and lentils, bananas, red grapes, red apples, raisins.

Selenium:
Benefits:
Controls blood sugar levels.

Sources:
Brazil nuts, whole grain bread, crimini mushrooms, whole grains.

Chromium:
Benefits:
Helps metabolize carbohydrates; monitors blood sugar levels and stabilizes blood sugar; prevents hypertension of high blood pressure; helps in preventing memory loss and in treating Alzheimer’s.
Sources:
Corn (nonGMO), sweet potatoes.

Vanadium:
Benefits:
Helps control blood-sugar levels in diabetics.

Sources:
Green beans, tomatoes, corn (nonGMO), parsley.

Zinc:
Benefits:
Proper functioning of the immune and digestive systems; control of diabetes; stress reduction; energy metabolism; healing for acne and wounds; helpful in pregnancy, hair care, eczema, night blindness, colds, eye care, appetite loss.

Sources:
Toasted wheat germ, spinach, pumpkin and pumpkin seeds, squash and squash seeds, nuts, dark chocolate, beans and lentils, mushrooms.

Amino acids:
Benefits:
Muscle development and immune strength; building and strengthening the central nervous system.

Sources:
Quinoa, soy (nonGMO).

Essential fatty acids:
Benefits:
Formation of healthy cell membranes; proper development and functioning of the brain and nervous system; proper adrenal and thyroid activity; regulation of blood pressure, liver function, immune and inflammatory responses; regulation of blood clotting – omega 6’s encourage clotting and omega 3’s reduce clotting; supports healthy skin and hair; crucial for the transport and breakdown of cholesterol.

Sources:
Hemp, flax, walnuts, dark green leafy vegetables, broccoli, spinach, almonds, whole grain foods, olive oil. Yes, the EFAs are contained in mercury, toxic waste, radiated, and PCB laden fish and a chicken’s period, but who in their right mind want to eat neurologically damaging foods?

Calcium:
Benefits:
Maintaining bone health, dental health, prevention of colon cancer and reduction of obesity.

Sources:
All nuts and seeds, coconut meat and butter, beans and lentils, whole grains, artichokes, asparagus, green beans, beets and beet greens, bok choy, broccoli, cabbage, carrots, cauliflower, celery, collards, corn (nonGMO), dandelion greens, eggplant, kale, leeks, okra, onions, parsnips, peas, lettuce, all potatoes, squash, chard, turnips, zucchini, apples, avocado, banana, berries, cherries, figs, grapes, guava, melons, kiwi, lemon, mango, nectarines, oranges, papaya (nonGMO), peaches, pears, persimmons, pineapple, plums, dries fruits, nonGMO soy milk, rice milk, almond milk, hemp milk, hazelnut milk, tempeh, blackstrap molasses, sesame tahini.

Calcium depleters:
Flesh protein, caffeine, excess phosphorus (sodas, flesh products), sodium (flesh products, canned or snack foods, tobacco, refined sugar, alcohol, aluminum-containing antacids, drugs such as antibiotics, steroids, thyroid hormones, vitamin A supplements, a sedentary lifestyle. Regarding dairy products, they contain too much calcium. Only 30 percent is absorbed and the remaining 70 percent never makes it past the intestinal wall and simply comes out with the doodoo.

Copper:
Benefits;
A key mineral and central to building strong tissue, maintaining blood volume, and producing energy in your cells. In the foods commonly eaten, there are small amounts of copper and the amount of copper you eat is directly related to the amounts of minimally processed plant foods you get every day. Copper deficiency has a direct link to ALS, also known as Lou Gehrig’s disease. Copper also enhances antioxidant protection, bone and tissue integrity, energy support, and cholesterol balance.
Refined grains have half the copper content as whole grains. Cooking at high temperatures will impair our ability to absorb the copper from those foods. The best solution is raw or lightly steamed.
Oh yeah, the following are symptomatic of low copper: Anemia, high cholesterol, fatigue, low immune function, osteoporosis, slow wound healing, cardiac arrhythmia, arthritis.

Sources:
Nuts and seeds, shiitake and crimini mushrooms, beet greens, soybeans (nonGMO), spinach, asparagus, chard, kale, mustard greens, squash, tempeh, beans and lentils, sweet potato, olives, green peas, grapes, pineapple, flaxseeds, Brussels sprouts, beets, berries, tomato, broccoli, basil, cabbage, sea vegetables, black pepper, miso, eggplant, fennel, leeks, parsley, chili peppers, romaine lettuce, quinoa, whole grains, avocado, buckwheat, oats, pears, onion, raisins, collard greens, papaya (nonGMO), banana, cantaloupe, melons, oranges, carrots, cucumber, cumin, bok choy, figs, peppermint, thyme, tumeric.

If you made it this far I am sure you noticed one predominate factor that Dr. Wallach did not: The essential foods to keep you well are mostly, as much as possible, organic, fruits, vegetables, nuts and seeds and whole grains. In other words, a vegan diet.

So, why if everything can be kept under control by avoiding flesh, dairy, eggs and synthetic chemicals, does the tongue override the intelligence?

As far as supplementing the basics of putting unleaded fuel in the gas tank, organic sulfur crystals, fresh bee pollen, and super foods like Orgain organic protein creamy dark chocolate powder, Rejuvenate: Berries and Herbs and Raw Power (chocolate) Protein Powder from the Natural News store, are the fuel additives that keep my engine running smoothly and do the trick. I kid you not!

Aloha!

Sources:

www.deaddocs.com
www.healthaliciousness.com
www.livestrong.com
The George Mateljan Foundation
www.completenutrition.com
www.downtoearth.org
www.asanediet.com

To learn more about Hesh, listen to and read hundreds of health related radio shows and articles, and learn about how to stay healthy and reverse degenerative diseases through the use of organic sulfur crystals and the most incredible bee pollen ever, please visit www.healthtalkhawaii.com, or email me at heshgoldstein@gmail.com or call me at (808) 258-1177. Since going on the radio in 1981 these are the only products I began to sell because they work.
Oh yeah, going to www.asanediet.com will allow you to read various parts of my book – “A Sane Diet For An Insane World”, containing a wonderful comment by Mike Adams.
In Hawaii, the TV stations interview local authors about the books they write and the newspapers all do book reviews. Not one would touch “A Sane Diet For An Insane World”. Why? Because it goes against their advertising dollars.

What you essentially need and the easiest place to find it

Northern Ireland is happiest place in UK, finds wellbeing survey

Northern Ireland is the most contented region of the UK, while London is the most anxious and least satisfied, according to statistics on local wellbeing published on Tuesday.

It will be little comfort to stressed-out, dissatisfied Londoners that their overall satisfaction has improved faster than other parts of the country.

The survey by the Office for National Statistics (ONS), which is part of the larger labour force survey with 158,000 respondents, asks people to rate out of 10 their overall satisfaction with their life, the extent to which they feel things they do are worthwhile, how happy they felt yesterday, and how anxious they felt the previous day. The national data, published in July, shows wellbeing has improved each year since 2011, but this masks regional differences.

These differences are not large, but taken together they paint a nuanced national picture. In Northern Ireland, for example, people ranked their life satisfaction at 7.85 out of 10 on average. In London this was 7.51. Londoners rated their own anxiety at 3.04 out of 10, while those in the West Midlands put it at 2.75. Those in Northern Ireland put their happiness at 7.70, while for those in the north-east it was 7.36.

The data includes almost every local authority, but sample sizes for many are very small, meaning comparing the regional picture is more reliable. The Northamptonshire town of Corby came bottom on life satisfaction and worthwhile measurements. However this was based on responses from 80 people.

In London ‘the very poor and extremely rich live within sight of one another’. Photograph: Photofusion/Rex Shutterstock

The national “wellbeing index” was one of David Cameron’s flagship policies when he entered Downing Street. “It’s time we admitted that there’s more to life than money and it’s time we focused not just on GDP but on GWB – general wellbeing,” he said, and ordered the ONS to start gathering data.

Annie Quick, who leads inequality and wellbeing work at the New Economics Foundation, a thinktank that has championed the gathering of such data, said London’s gloom may be understandable. “There are real challenges about living in cities,” she said. “Commuting is very bad for wellbeing: the long periods of time spent travelling to work are … bad for our families, and bad for community cohesion.”

The deeply unequal nature of London, where the very poor and extremely rich live within sight of one another, adds to dissatisfaction, she added.

But Northern Ireland’s apparent contentment has the experts confused – one press officer blurted out, “Really?” when the Guardian explained the ONS’s findings.

Quick said: “Northern Ireland is really interesting: if you go to Northern Ireland and talk to them, they are very surprised. We don’t have the answer.”

The local authority of Mid and East Antrim in Northern Ireland tops the table on “life satisfaction” and “worthwhile” measures and is second on the “happiness” measure. Its mayor, Audrey Wales, said she was delighted with the finding.

“Ensuring the good health and wellbeing of our citizens is a key strategic aim for Mid and East Antrim borough council and we are delighted that this survey shows that we are certainly going in the right direction.”

She added: “With a rich heritage and culture, our borough is a beautiful, welcoming and unique place with a huge offering for its citizens and visitors alike. What sets us apart is our strong community spirit and the diversity of our citizens.”

Quick said the things that affect wellbeing are well known: good-quality housing and environment, stable jobs, and functioning communities. Simply asking people how happy they feel incorporates these factors, she said, but “it’s a very sensitive measure that picks up all sorts of other things … The challenge is for local authorities to look at those things.”

Dawn Snape, a quality of life officer at the ONS, said: “We have seen personal wellbeing improving on a UK-wide basis over the past five years. But today’s data paints a richer picture, enabling people to explore what’s been happening in their local area.

“This will help individuals, communities and local authorities to look at wellbeing locally alongside other more traditional measures of progress.”

Quick said the UK is a “world leader” at gathering these statistics. But she added: “We need to embed this thinking into devolution debates: these are often focusing on maximising economic growth but building the economy is a means to an end. What could be more important than making sure we have good quality of life?”

Northern Ireland is happiest place in UK, finds wellbeing survey

How Manchester plans to be the best place for people with dementia

Imagine a pub designed for people with dementia, complete with old beer adverts, games of dominoes and darts, a DJ playing a selection of music from the 50s and regular live entertainment, where people with the diagnosis can feel welcome and those who look after them can receive support.

A pop-up pub like this was set up in Salford recently by the university’s Institute for Dementia as part of Dementia United – the Greater Manchester partnership whose five-year improvement plan aims by 2020 to make Greater Manchester the “best place in the world” for its 30,000 residents with Alzheimer’s and similar conditions. It also wants to reduce dependence on health and care services.

This pub experiment is one of a number of innovations under the umbrella of Dementia United, led by the health and social care trusts enjoying their newly devolved status, and the Alzheimer’s Society. Its 41 partners, including charities, sports organisations and three universities, are working out how to tackle dementia from the perspective of those who live with it.

With 850,000 people living with dementia in the UK (1.3% of the population), according to Alzheimer’s Society figures, the eyes of the UK are focused on Dementia United.

Maxine Power, director of Dementia United, , says: “This is a once-in-a-lifetime opportunity. Dementia is an area with a huge amount of activity, but it is like an orchestra without a conductor. Devolution brings clarity and a focus on care for people in the places where they live, rather than on organisations. Culturally that is a massive shift for our system.”

Dementia United goes way beyond pubs. It is about rejecting a model of care that health professionals agree is neither fit for purpose nor financially viable, and the opportunity to create a new one. Greater Manchester spends £270m a year treating and caring for people with dementia. The figure has not decreased in the past five years, despite many attempts to improve dementia care, and there are 20,000 hospital admissions for the 30,000 people in the area with dementia.

This is is outrageous, says Power. She is adamant that in five years Dementia United will reduce that figure – mainly associated with unplanned hospital admissions and admissions to care homes – by 20%.

This will be guided by five pledges, to be implemented by 2021: improving the lives of dementia patients and their carers by questioning them about their individual needs; reducing variation in care quality (and a diagnosis rate difference between 63% and 90% across the city); the introduction of a key worker for each person with dementia; the redesign of services around users; and access to the best assistive technology.

Dementia United was set up in late 2015 as an “early win” under the devolution of Greater Manchester’s health and social care.

There is dementia knowledge in Manchester to back it. Its three universities formed a dementia research consortium in May 2016 and Prof Alistair Burns, the national clinical director for dementia, is based at Manchester.

Progress is being made. A measurement tool of “lived experience” has been developed, including numerical and qualitative measures of how people live their lives, which can be shared across Greater Manchester’s health systems. Work is under way on a dementia “dashboard” to allow inter-area comparisons and set standards. External evaluation methods of Dementia United are being developed jointly by the universities of Salford and Manchester.

Discussions are going on with Social Finance – a not-for-profit organisation bringing together government, the social sector and the financial community to tackle social problems – to build in additional financial support.

Assistive technology is advancing apace, with Manchester University’s dementia platform evaluating devices, such as watches with accelerometers to measure movement, to establish value for money. Everything in Dementia United must be supported by a business case.

George McNamara, head of policy for the Alzheimer’s Society, is working with Dementia United to make it a reality across Greater Manchester and is receiving inquiries from politicians worldwide, particularly the US. He says: “We are seeing the devolution of powers and funding on an unprecedented scale. What is significant is the scale and the marrying together of a number of political objectives and cultures into one vision.”

Patrick Hall, a fellow in social care policy for the King’s Fund, admires the ambition of Dementia United, but is concerned about its sustainability given the financial climate.

He says : “The locality focus in Dementia United is very welcome and anything that gives impetus to that for the care of people with dementia would be looked on by the King’s Fund very positively. However it is being set up in the context of unprecedented cuts in social care and a decline in the number of community nurses. Only time will tell whether Greater Manchester has got the model right.”

Maxine Power and George McNamara will discuss devolution and dementia at the NHS Health and Care Innovation Expo in Manchester on 8 September NHS staff can attend free of charge. Click here to register.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

How Manchester plans to be the best place for people with dementia

Assisted dying: this Bill has so numerous flaws I will not know the place to start off

The Residence of Lords is debating, on Friday, a question the answer to which has an effect on every man or woman in the land – must we permit medical professionals to aid and abet the suicides of some of their patients? Because this is what Lord Falconer’s Private Member’s Bill quantities to.

Lord Falconer seems to be below the misapprehension that his Bill has the backing of the Supreme Court. The Court has surely known as for Parliament to take into account whether or not the law must be altered. But, insofar as it has ventured into the dangerous territory of how it may possibly be altered, its pondering seems to be far eliminated from what Lord Falconer’s Bill is proposing.

In his judgment 3 weeks in the past the President of the Court speculated – no a lot more than that – that the balance among providing some individuals the selection of assisted suicide and guarding other people from harm as a result may perhaps be accomplished if (and allow us quote him verbatim) “no support could be given to a particular person who wishes to die except if and right up until a Judge of the Substantial Court has been content that his wish to do so was voluntary, clear, settled and informed”.

My own examination of Lord Falconer’s Bill demonstrates it to be deeply flawed. Its so-known as safeguards are feeble: they are similar to placing up a discover not to go close to the edge of a cliff but not placing a railing there to stop men and women falling above. It defines terminal illness in this kind of a way as to carry huge numbers of people with chronic illnesses and disabilities within its ambit. It has no compliance system. I could go on and on. But, given that the Supreme Court has known as on Parliament to deal with this query and as Lord Falconer’s Bill is on the table, we need to give it our complete consideration.

In this procedure I hope the House of Lords will devote rather significantly less time focusing on philosophical rules, like autonomy, and far more on the challenging practicalities of life that numerous of us face in our every day lives. It is all very effectively for a minority of sturdy-willed and self-assured individuals to assert that they want for themselves what they call (incorrectly, as it presently exists) a “proper to die”. I am far more concerned with the plight of the underdog – of significantly ill and disabled folks who are struggling to cope with existence amid poor social care, inadequate housing and loneliness (that growing ailment of our society) and who do not want to die – but who could all as well easily locate themselves drawn into ending their lives out of depression or despair.

Choice is a wonderful issue but it has to be true choice, and many folks just do not have that. As peers we are used to taking decisions for ourselves, we know how the law operates and we are normally capable to look after our personal interests with no difficulty. But we must remember nowadays that many people’s encounter of lifestyle, specifically the sick and the disabled, is much less about undertaking and far more about becoming completed to. These are the men and women who want our help and safety.

Patronising, some might say. But as legislators we have a duty to ensure that any laws we make do not expose other men and women to harm. That is what leads to me to fret about the notion of supplying help with suicide inside the NHS.

Baroness Grey-Thompson is a crossbench peer

Assisted dying: this Bill has so numerous flaws I will not know the place to start off

How to place the squeeze on gastric bands

In the past, my response to this would have been easy. Great must be mad! All that is necessary, I would have believed, would be to inform these fatties to end guzzling burgers and chips. But of course, such a reaction is woefully simplistic. 1 of the causes why so numerous individuals are body fat is that the food on offer you in all supermarkets – as effectively as the fast-food chains – is filled with sugar. There are 1 and a half teaspoonfuls of sugar in every slice of sliced bread. Every single dollop of ketchup includes a cube of sugar. Go out to Pizza Express for a Margherita and you will be consuming 3 cubes of sugar. Those who eat this muck are not necessarily any greedier than people who eat lentils, raw carrots and yoghurt. But by failing to read the label, they are incorporating to their waistline, and hugely increasing the likelihood that they will produce kind two diabetes – with the threat of blindness, strokes, heart illness and many years of immobility as they sit, like beached whales, in their specially constructed giant armchairs.

You can see the logic of it, but it sounds like defeatism. Absolutely we ought to be concentrating our sources on shifting our approaches. In political terms, this implies that governments ought to be prepared, not only to tax junk meals, but also to inquire themselves critically whether some of the greater quickly-foods shops must be given a franchise to operate in Britain at all. We do not allow the open sale of heroin on the substantial street – but fried chicken, and burgers, and chips soaked in salt and sugar arguably do far much more injury to a far higher amount of men and women, and nevertheless are for sale on each station concourse.

The 1st raft of cash must be reserved for the really younger – sick babies and young children. Thereafter, there ought to be income put aside for treating grave illnesses in the middle-aged – the early detection of cancer in the middle-aged is critical, as we know, and Britain has lagged behind other produced nations in its care of treatable cancer individuals.

When the time and funds have been expended on these urgent classes of patient, then – and only then – must the hospital authorities see how significantly cash there was in the kitty for executing operations on the elderly.

One can see that fitting gastric bands into the guts of the obese will minimize their danger of continuing to swell – though, as numerous sadly grotesque examples in America have shown, this is not constantly the case – real addicts of burgers and fries becoming ready, even with excruciating pain, to go on guzzling unwholesome meals even if it implies literally bursting their guts.

But the moral responsibility does not rest fully with the NHS or the taxpayer. It is patronising to the poor or the sick-educated to think about that they can not see what is occurring to their personal bodies. People of them who begin to burst out of their clothes can’t be unaware of what is occurring. Yes, there need to be far more help accessible – analagous to family members-organizing vans or narcotic treatment or counselling – to enable people to consume wholesome meals. We have all, to some extent, been tricked by the supermarkets into consuming sugar, even when we believed we were doing no more than eating a slice of toast. But once we know that this is the situation, we can definitely – irrespective of our earnings level or our normal of education – do anything about it. You really do not have to buy sliced bread. No person forces you to slurp sweetened drinks. A low cost cut of meat at your local butcher – scrag end of lamb, say – boiled with pearl barley and some vegetables bought at your local industry stall will be far less expensive than any pizza, and will last you for many days, if stored on the boil. You do not have to be posh or clever to realise this. So – by all indicates bind up a number of guts in excessive situations. But for the most portion, would we not all choose public income to be spent on cancer care – and well being training?

There is no single answer to the dilemma of weight problems. We need a combination of solutions. Wellness schooling is the essential – with kids from an early age being taught that a enjoy of fizzy drinks and junk meals is not merely foolish but lethal. But then, once more, at the other finish of the chain, we must get rid of our fear of “nanny state”. If we expect the state to pay out for our health care, out of our taxes, then we ought to not simply tolerate, but demand a nanny state, which taxes sugar and outlaws individuals tremendously strong moneyed chains – of supermarkets and quick-food joints who are, very just, the purveyors of poison.

How to place the squeeze on gastric bands

We need to end FGM all over the place, not just in the Uk | @guardianletters

Tanya Barron: ‘Over years, not overnight, we can end this practice.’ Photograph: James Drew Turner for the Guardian

We welcome any new political target on the issue of female genital mutilation – and the media coverage that comes with it (Failure to defend girls from FGM is ‘ongoing national scandal’, MPs say, July 3).

But whilst it is of program essential to get our own residence in purchase and make certain that everything attainable is being carried out to stop FGM in Britain, the straightforward fact is that we will not end the practice right here till it is ended about the globe.

FGM is really a lot a international difficulty it doesn’t exist in a vacuum in the United kingdom. The beliefs and customs that lead to it, as well as the women who are subjected to it, cross borders.

So, as we heard in our latest roundtable discussion at the Guardian, to concentrate efforts exclusively on British legislation and British policy is to practically admit defeat in ending a practice that throughout the world has affected an estimated 125 million ladies and girls.

It’s by means of grassroots operate with communities in the countries across Africa and the Middle East in which FGM is prevalent that, above years, not overnight, we can end this practice.
Tanya Barron
Chief executive, Program United kingdom

• The police are proud of the reality fairly rightly, that they have been ready to prosecute celebrities for past crimes involving sexual abuse. Some of these have gone back almost 40 many years and the police have emphasised that they are inclined to investigate historical crimes what ever the situations or the longevity.

If these concepts are now to be applied to the prosecution of perpetrators of FGM, we can expect a veritable flood of situations involving 1000′s of women of all ages. This will inevitably be observed as the persecution of a cultural minority and possibly disturb race relations for a generation or a lot more. Whither then the goal of multiculturalism, with the state and the police witnessed to be coming down heavily on a broadly accepted cultural practice, even so horrific that practice is considered to be by the great bulk?
Ted Wilson
Stockport

We need to end FGM all over the place, not just in the Uk | @guardianletters

Fears that attacks on statins could place lives at risk

The Nationwide Institute of Overall health and Care Excellence is due to publish ultimate suggestions on prescribing of statins later in July.

Draft proposals recommend cutting the “risk threshold” in half, meaning the vast bulk of men aged over 50 and most females more than the age of 60 would be recommended to get the medication to guard against strokes and heart condition.

Cardiologists and scientists stated the weight of evidence – like 27 clinical trials – demonstrated obviously that the advantages of the tablets outweigh any side-effects, even amongst individuals with a lower possibility of heart assault.

Significantly less than one per cent of patients would suffer side-effects, they explained, although those who took the drugs would normally lessen their threat of heart attack and stroke by 40 per cent.

Prof Adam Timmis, professor of clinical cardiology, Barts and the London NHS believe in, mentioned: “Even in very low-chance groups, the benefits of statins tremendously exceed any identified hazards.”

The group expressed concern that the public had been misled by claims – now withdrawn, after their publication in the BMJ – that 1 in five sufferers on the medicines suffers ill-results.

Prof Rory Collins, head of the Nuffield Department of Population Wellness at Oxford University explained it was frequent for older folks taking statins to suffer aches and pains, but trials had proven these had been just as typical in individuals not taking the drugs.

He said he felt “anxious” that individuals at higher chance of heart assault and stroke may well cease taking the drugs since they believed side-effects have been far higher than is the situation.

Prof Peter Weissberg, healthcare director of the British Heart Basis, stated: “The most significant threat to very good medication is prejudice, belief and anecdote.

“As human beings we are all influenced by our personalized experience. That’s why in medication we need aim proof to guide our prescribing and that comes from the randomised controlled trials.”

He mentioned the principle behind mass use of the drugs was related to that of immunisation, in that numerous individuals have to take medicine for some to be spared a stroke or heart attack.

“What we are dealing with with statins is the balance between visible harms and invisible positive aspects,” he mentioned. “Patients can always inform you about an effect which is down to the drug which they really do not like but they will not be ready to inform you whether or not they are nonetheless alive due to the fact of that drug or not.”

He stated folks could lessen their chance of heart ailment by adopting a healthful life style, and not see statins as a “soft option” to counteract a lifetime of eating burgers.

Prof George Davey Smith, professor of clinical epidemiology at the University of Bristol, said 25 years of analysis had offered definitive and clear evidence to assistance the use of statins.

He said: “The jury is no longer out on the price/benefit ratio for taking these tablets. This is not forcing the tablets down people’s throats .. it is about offering them the evidence on which to make a choice.”

The twists and turns of statins:

1980s: Statins very first licensed in the Uk

2000: New NHS standards for heart illness care advocate that statins must be given to patients assed to have a 30 per cent danger of a heart assault or stroke within a decade

2005: Nationwide Institute for Health and Clinical Excellence (Wonderful) lowers the threshold to twenty per cent

November 2013: United States healthcare guidelines which suggest the drugs for individuals with a 15 per cent threat of heart attacks, halve their thresholds to seven.five per cent. Wonderful confirms it is thinking about the identical proof which brought about the alter in US policy.

February 2014: Wonderful publishes draft proposals which lessen the threshold to 10 per cent – which means one particular in four adults would be recommended to consider statins. The amounts mean the vast bulk of guys aged over 50 and girls aged over 60 will be advisable to get the pills.

March 2014: British Health-related Journal publishes articles or blog posts which recommend that one in 5 men and women on statins will suffer side-results this kind of as liver illness and kidney problems

Might 2014: BMJ withdraws the statements and launches an investigation into whether or not the complete posts must be retracted

June 2014: 9 doctors and academics compose to Jeremy Hunt, the Well being Secretary, criticising suggestions which they say will lead to the “medicaliasation of five million healthy people.” The doctors like the head of the Royal College of Physicians say Great should not enable medical doctors with financial ties with statins to assist to draw up suggestions

1 July 2014: Panel of six top cardiologists say the attacks on statins fly in the face of proof exhibiting their rewards outweigh any dangers

18 July 2014: Great ultimate guidance is due

Fears that attacks on statins could place lives at risk

Ramadan quickly can place Muslims with diabetes at danger

For Muslims around the world, Ramadan is an intensely spiritual time – but issues around fasting are difficult to talk about for many. Photograph: Oded Balilty/AP

Tears ran down the cheeks of an elderly Asian man sitting in his hospital bed during Ramadan last year as he sought reassurance from Muslim chaplain Siddiq Diwan because he could not participate in the annual religious month-long fast.

“I know I am ill and do not have to fast, Imam,” the old man said to Diwan at Manchester Royal Infirmary. “But I have never missed one in seven decades, and I really feel bad about it.”

While this patient had reluctantly accepted that fasting was not an option for him, thousands of Muslims with diabetes in the UK go ahead regardless. Many will put themselves at risk of serious illness and dangerous complications by taking part in the Ramadan fast (beginning on 28 June) when they go without food, water and even medication between sunrise and sunset – despite the fact that the Qur’an makes exceptions for the sick, pregnant women, children and anyone for whom it would cause physical harm.

As an Imam working at the hospital, Diwan sees the Ramadan dilemma from both sides, and works to resolve issues both in local mosques and among the city’s health professionals.

He has also contributed to the UK’s first study on the beliefs and experiences of Muslims with diabetes during Ramadan, being carried out by Manchester University-based psychologist Dr Neesha Patel. The results, published in the journal Health Expectations, highlight the intense pressures felt by individuals with diabetes during the period, from family, culture, religion and their own conscience.

More than half the diabetics in Patel’s study still fasted; many continued to do so through a sense of obligation, the need to conform or a belief that the Qur’an demanded it. Some altered their own medication during the period of Ramadan – mostly without the advice of their GP or practice nurse. Some were put under family pressure to follow the fast, while others felt the need to conceal their decision not to fast by snacking in secret.

This problem will not go away on its own. Patel says: “Ramadan is an annual event – it is going to be with us forever. There is a large Muslim population in the UK and the level of diabetes in some of the communities is many times higher than in the UK generally. This is a big issue. For change to happen there needs to be government support.”

The UK has a population of 2.7 million Muslims, of whom 325,000 have diabetes. The South Asian population has six times the general rate of the condition. This year the holy month of Ramadan falls in the summer, and fasters in parts of the northern hemisphere will face periods without food or water that last up to 21 hours. These long periods of abstinence will feature for the next 10 years.

Fasting in itself can sometimes be beneficial to health and for many people Ramadan is an intensely spiritual time. But many health professionals are worried about a lack of formal guidance from Islamic as well as health leaders.

Vascular surgeon Dr Noreen Khan is a practising Muslim from north London, interested in fasting, who sees people with end-stage diabetes. She believes that diabetics with good glycaemic control can fast safely if GPs revise their medication at least a month before Ramadan, in some cases temporarily substituting longer-acting drugs.

But she says: “In the UK our scholars and theologians have not been prepared to make any rulings. Muslim scholars should give a consensus and provide all GPs with this information, so that they can give patients both medical and religious guidelines.”

GP Dr Faizan Ahmed from Moss Side Family Medical Practice in Manchester agrees there is a need for clarity. He says: “At the moment there is a social stigma in some community groups about not fasting, and the onus is very much on the individual to make a decision.”

Since 2010, his practice has invited all patients known to be Muslim for a pre-Ramadan review of their health and medication. This he described as a “watershed”, with fewer patients ending up in A&E since, and some taking the decision for the first time not to fast because of their health problems.

In the absence of national health guidelines, Diabetes UK, in collaboration with the Muslim Council of Britain, has produced culturally-sensitive material for people who want to fast, and scripts for Imams. This year the charity is sending volunteers into five largely Islamic areas during Ramadan, with the aim of reducing diabetic complications.

Maslaha – an organisation which aims to help Muslims with the dilemmas of living in a western society – has produced award-winning medical and Islamic information in partnership with Tower Hamlets primary care trust about safe fasting.

Medical training does not cover Ramadan. Trainee GP Dr Iyegbe Iredia admits that as a Catholic she was taken aback by her first patient queries about Ramadan: “I would encourage people to fast if they want to, but the advice is all a bit ad hoc at the moment. GPs need clear guidelines, and it would be good to have somewhere to send complex Muslim patients for expert advice.”

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Ramadan quickly can place Muslims with diabetes at danger

Beleaguered wellness believe in place into specific measures

As part of the special measures, NHS regulator Monitor will appoint an improvement director whose role will be to provide support and expertise but also to hold to account the trust which runs Furness General Hospital in Barrow-in-Furness, Royal Lancaster Infirmary, Westmorland General Hospital in Kendal and Queen Victoria Hospital in Morecambe.

An inspection team which included doctors, nurses, and hospital managers, trained members of the public, CQC inspectors and analysts spent three days at Furness General Hospital, Royal Lancaster Infirmary and Westmorland General Hospital in February.

They examined the care provided in accident and emergency, medical care, surgery, intensive/critical care, maternity and family planning, children’s care, end of life care and outpatients. Inspectors also visited Royal Lancaster Infirmary and Furness General Hospital out of hours unannounced.

Inspectors acknowledged that care in some services, such as maternity and A&E, had improved since previous inspections but in other areas – despite previous concerns being raised by CQC – care had still not been addressed effectively, said the CQC.

Overall, the inspectors conclude that the quality of care provided by Furness General Hospital and the Royal Lancaster Infirmary both required improvement, while the Westmorland General Hospital overall was providing a good service.

Sir Mike said: “There is a long history of concern with the quality of service provided by University Hospitals of Morecambe bay NHS Foundation Trust – so it is disappointing to report that a number of the issues that have been identified in the past remain unresolved.

“I do not believe that the trust is likely to resolve its challenges without external support. This is why I am recommending that the trust is placed in to special measures. I am looking to Monitor and the other organisations responsible for healthcare in the area to work together to support improvement.

“Despite the reorganisation of the trust’s clinical services, we have found a lack of clarity about the trust’s plans for the future that has left the staff feeling disengaged and remote from the executive team.”

Sir Mike added: “The trust and partner agencies will be developing an action plan to address the identified shortfalls and my inspectors will return to the trust to follow up on improvements in due course.”

Adam Cayley, regional director at Monitor, said: “The trust has co-operated with Monitor in making some improvements in recent years but the Chief Inspector of Hospitals has reported on wider failings in care that must be addressed.

“The level of care and the quality of senior leadership at this trust has not been good enough, that’s why we’ve put Morecambe Bay into special measures.

The regulator said it would take further action if improvements were not made.

An independent inquiry into care provided by the trust’s maternity and neonatal services from January 2004 to June last year is currently taking place following a “high number of serious untoward incidents” including patient deaths.

The report from chairman Dr Bill Kirkup is due to be submitted to the Secretary of State for Health in the autumn.

David Morris, Conservative MP for Morecambe and Lunesdale, said: “Naturally I am disappointed to read the contents of this CQC report. I regularly meet with the chief executive and the Secretary of State for Health and I do feel that the University Hospitals Morecambe Bay NHS Foundation Trust is making progress. I should state that the trust has experienced considerable pressures since it was granted foundation trust status in 2010 under the previous Labour government, a status that Andy Burnham should not have allowed to be granted.”

Mr Morris added: “Baroness Young, former chair of the CQC, has said that Mr Burnham withheld information prior to the 2010 election allowing trusts to self-assess, instead of being properly investigated. I discovered this last summer, as a result the CQC was restructured which I welcome.”

The trust’s chief executive, Jackie Daniel, said: “We are all incredibly disappointed to receive the overall (inadequate) rating for the trust. The reports reflect the fact that we are part-way through a process of significant improvement which is still going to take a number of years to complete.

“It isn’t an overnight job to change the culture of a large complex organisation, but through the hard work and commitment of our staff, governors and partners, our hospitals are now much safer, with improved standards of care in a number of areas from two years ago when we started to turn them around.”

She added: “Over the last two years we have seen significant improvements in areas such as mortality, staffing levels, A&E, complaints management, maternity, record keeping and appointments, many of which are recognised in these reports. It isn’t all fixed and there is much more to do but I am confident that we have progressed, although at times not at the pace needed.

Beleaguered wellness believe in place into specific measures

Longitude Prize 2014: Water, water all over the place?

However, in the West, we frequently take this most treasured of all-natural assets for granted, despite the many campaigns we are exposed to reminding us that a single in ten of the world’s population has no entry to risk-free consuming water. If you don’t have clean water, you can’t grow healthful foods, and you are far more very likely to be sick and unable to perform or go to school, which implies you are much more likely to be trapped in poverty, with all the societal and protection problems that poverty brings. Globally, one in 5 deaths of children beneath 5 is due to dirty water.

I think our aim need to be to explore the improvement of new and emerging reduced-power and renewable power-driven desalination technologies, targeting a reduction in the distinct power consumption of seawater desalination to attain two kWh/m3 in the close to term, and developing a lot more sustainable desalination processes that are much less dependent on conventional vitality sources and that, consequently, are far more environmentally pleasant.

But there are so a lot of other questions we need to locate solutions to. What are the novel technologies for water desalination and reuse that we need to have to develop and exploit? How can we optimise and hybridise desalination and reuse technologies to supply enhanced overall performance?

How do we encourage (and incentivise?) water technologies for sustainable urban, agricultural and industrial applications? What study into urban and all-natural hydrologic techniques is necessary to boost our knowing and management of water sources?

And how do we make sure that the results of this study reach the widest achievable audience so that we can start to handle these problems on a global scale?

If we can answer some of these concerns and find a way to supply clean, safe water to everyone, irrespective of geographic and economic constraints, then we will, with no doubt, increase the wellness, properly-becoming, life possibilities and prosperity of billions of men and women.

Water protection is the most significant challenge we face. The Longitude Prize 2014 can be the catalyst that helps us to do something about it.

LONGITUDE PRIZE 2014

The Longitude Prize offers a £10 million prize fund for an innovation that will remedy one particular of the key problems of our time. And we can all assist to choose which of 6 themes the prize should target on. The 6 problems are:

• To support folks with dementia dwell independently for longer

• To assist prevent the rise of resistance to antibiotics

• To assist us to be capable to fly without having damaging the environment

• To assist make sure everyone has nutritious, sustainable food

• To aid restore motion to those with paralysis

• To support make certain everybody can have access to secure and clean water

You can vote for the challenge you consider the Longitude Prize need to pursue at bbc.co.united kingdom/horizon. Voting closes at seven.10pm on June 25 2014. The winning challenge will be announced on June 25 and will grow to be the target of the £10 million prize fund. The Longitude Committee will then finalise the criteria for how to win the prize, and from September ideas can be submitted. The Longitude Prize will run for up to 5 years.

Longitude Prize 2014: Water, water all over the place?

Doctors urge WHO to rein in e-cigarettes market place

An e-cigarette. Photograph: Tim Ireland/PA

A lot more than a hundred leading public overall health physicians and professionals from about the world have signed a letter to the director basic of the Planet Wellness Organisation, Margaret Chan, calling for new controls on e-cigarettes and warning that they may possibly be a stalking horse for the tobacco industry.

The authorities want the WHO to deliver e-cigarettes beneath the exact same tight controls as tobacco products, with bans on advertising and promotion. They say there is inadequate evidence so far that e-cigarettes are harmless and can aid folks to quit smoking.

Their most significant concern is that, if advertising and advertising are allowed, smoking will be “renormalised”, undermining public smoking bans and undoing decades of work to marginalise cigarettes and persuade people of the harm they do.

“By moving into the e-cigarette market, the tobacco sector is only maintaining its predatory practices and escalating earnings,” says the letter. It says the WHO must not be misled by the industry’s efforts to current itself as a partner, as it did with filters and “reduced-tar” cigarettes in the past before scientists showed that these issues did not minimize harm.

“If the tobacco sector were committed to minimizing the harm triggered by tobacco use, it would announce target dates to end manufacturing, marketing and advertising and selling its far more damaging products rather than just including e-cigarettes to its item mix and rapidly taking more than the e-cigarette market place.

“It would also right away desist from its aggressive opposition to tobacco manage policies such as tax increases, graphic health warnings and plain packaging,” says the letter, whose signatories incorporate Prof John Ashton, president of the United kingdom Faculty of Public Well being (FPH) Prof Rifat Atun, of the Harvard College of Public Wellness and Prof Robert Beaglehole, of the University of Auckland.

Supporting the public well being medical professionals are authorities in paediatrics and cardiovascular disease, such as Dr Hilary Cass, from Guy’s and St Thomas’ NHS trust in London, and Prof Helmut Gohlke, of the German Cardiac Society. Other signatories consist of Dr Jay Berkelhamer, of Emory University School of Medicine in the US, and Prof Frank Chaloupka, director of the Well being Policy Centre at the University of Illinois.

URL:

The situation is controversial even inside the public overall health local community. This month, 53 scientists who consider a diverse view wrote to Chan (pdf), saying that regulating e-cigarettes in the very same way as tobacco items would expense lives by decreasing the variety of people making use of them to quit smoking.

“These items could be amid the most important health innovations of the 21st century – maybe conserving hundreds of hundreds of thousands of lives. The urge to manage and suppress them as tobacco items should be resisted,” they wrote.

But Simon Capewell, professor of clinical epidemiology at Liverpool University, speaking on behalf of the FPH, said its members were concerned by the boom in e-cigarette use and the feasible commercial interests behind it.

“The FPH is deeply concerned about the superficial evaluation of e-cigarettes and that the possible harms of e-cigarettes have been systematically underestimated,” he said. “The faculty is also concerned that the tobacco industry is cynically using discussions around e-cigarettes to undermine productive tobacco controls.”

He said the market was claiming e-cigarettes were solely a device to aid folks stop smoking, but the addition of flavours this kind of as strawberry and bubblegum to the nicotine vapour suggested youngsters have been being targeted. It was attainable that they might assist some people to quit, but a lot more evidence was essential, he explained. “From the faculty’s point of view, that is the single achievable worth they may well have.”

Prof Robert West, from University University London, whose recent study showed e-cigarettes were far more powerful than nicotine substitute therapy at helping individuals stop smoking, was a signatory to the earlier letter asking the WHO not to clamp down.

“The explanation I was keen to join in with the original letter is that what ever policies are suggested by WHO or any individual else, the crucial issue is they need to be based mostly on a dispassionate evaluation of the evidence and what is worrying is that that is not what they are receiving,” he mentioned.

He felt, even so, that concern about the tobacco industry’s involvement was valid. “That is a properly genuine argument as prolonged as no one is making an attempt to pull the wool in excess of anyone’s eyes,” he mentioned.

Doctors urge WHO to rein in e-cigarettes market place

"We know the place Jack the Ripper lived" - authorities

Canadian criminologist Dr Kim Rossmo and Steve Le Comber of Queen Mary, University of London, used a mathematical model to find the spot.

Speaking at the Cheltenham Science Festival Dr Rossmo explained: “All the victims lived quite shut to Flower and Dean Street.

“The last victim was noticed less than a block away choosing up a client, and that was almost certainly her last customer, probably the Ripper.

“So it is risk-free to say it was none of the Royal family as folks have speculated. It is unlikely they would have frequented an region like that, and we think the Ripper is an individual who lived on that street.”

Two victims Catherine Eddowes and Elizabeth Stride had been killed on the same evening, September thirty 1888.

Eddowes apron was found in nearby Goulston Street alongside a message, believed to be written by the Ripper which go through: “The Juews are not the males that will not be blamed for nothing at all.”

Dr Rossmo claims that if a line is drawn in between the area of the victim’s bodies and he apron it suggests the Ripper was heading towards Flower and Dean Street.

“It seems to be like he was on his way residence,” said Dr Le Comber.

The approach functions due to the fact most criminals operate in predictable spots, usually not also far from their property, family members or their workplace. But they also set up a ‘buffer zone’ about their homes in which they will not commit crimes. The model predicts in which they dwell

It previously been utilised to track down the serial rapist Clive Barwell and is becoming employed by anti-terrorist police.

Dr Le Comber also believes the formula can be used to locate the origin of disease outbreaks such as malaria, so that epidemics can be stopped ahead of they even began.

He believes that the origin of an infectious ailment could be located with the addresses of just five folks who have been infected.

It follows on from the function of John Snow, who in 1844 mapped all circumstances of cholera in central London and identified the source was a water pump in Broad Street, Soho. When he closed the pump, individuals stopped dying.

“Snow’s genius was to map it,” explained Dr Le Comber, “Nobody has taken that approach with conditions because then.

“In Malaria paper right after paper will inform you crucial it is to find exactly where the contaminated mosquitoes are breeding, but no one will tell you how to find those areas.

“And the problem with mosquitoes is they will breed anywhere. In puddles, in water in abandoned car tyres. So this is precisely the dilemma we are trying to fix.

“We can use this technique in quite a great deal of biological information and hopefully use it in the long term to benefit public overall health.”

Dr Le Comber utilized the model to demonstrate that he could have spotted the origin of a devastating malaria outbreak in Cairo.

"We know the place Jack the Ripper lived" - authorities

Funeral of Stephen Sutton requires place at Lichfield Cathedral

The 19-yr-outdated succumbed to several tumours on May 14 soon after a determined battle – provoking an outpouring of grief, and prompting Prime Minister David Cameron to say: “His spirit, bravery and fund-raising for cancer study were all an inspiration.”

1000′s turned out above each days to file past Stephen’s white coffin as it lay in a place of honour inside the cathedral in what Dean of Lichfield the Extremely Reverend Adrian Dorber named a “phenomenal” display of human unity, for the guy he mentioned “has grow to be everybody’s favourite son”.

Funeral of Stephen Sutton requires place at Lichfield Cathedral

Pet subjects: I don"t want to place my puppy in boarding kennels

A: Canine parks are normally discovered in nations where the default place is for dogs to be stored on the leash at all instances apart from when in designated regions. The opposite is the case in the United kingdom, with the common view that it is acceptable for canines to be off the leash in public locations as extended as owners are responsible about choosing up waste and controlling them. Organisations like the Kennel Club and Canines Trust are concerned about the concept of canine parks, seeing them as a symptom of elevated restrictions on canines. Unacceptable puppy-relevant problems are very best dealt with by encouraging responsible puppy ownership and just penalising the couple of irresponsible owners rather than making an attempt to fence off all canines. In the United kingdom, canines accompany individuals on about half of all visits to the countryside and urban green area: general, this is nonetheless a canine-friendly country, and there is no require for specific dog parks.

Q: Final week, my 16-year-outdated dearly loved cat, following currently being quite nonetheless and quiet all day, went out the back door to the backyard. I let him out but due to the fact it was raining, I brought him back in. He sat at the back door seeking out and a number of hours later on, he started howling, then died. Need to I have let him go out once again? I have heard that animals like to head off to select a quiet location to die.

JM, by e-mail

A: I’m sorry to hear about your pet’s death. I don’t feel that animals have a sense of their approaching death, deliberately picking to discover a quiet spot to die. It is a lot more probably that they have a sense of currently being unwell, and they seek somewhere to settle peacefully in the hope that they may recover. The threat of making it possible for an unwell pet to wander off on their own is that they may finish up distressed with no person to support them. If any animal is behaving in an uncommon way, it can make far more sense to preserve them in a safe, comfortable region in which you can observe them. Then if they do become distressed, you can seek prompt veterinary assist for them rather than permitting them to endure for a prolonged time period.

Q: We have wished to breed from our two-yr-previous pet guinea pig Lettuce for a although but worry that we could have left it as well late. Would pregnancy or the birth of a litter place her wellness in danger due to her age?

GH, Cheshire

A: I would be wary about advising anybody to breed from a pet guinea pig: there is already a surplus of guinea pigs in the Uk, with a lot of rescues overflowing with animals that want homes. Non-breeding guinea pigs live long, satisfied lives if cared for appropriately: they really do not need to be mated or to have offspring for fulfilment. In addition, pregnancy and offering birth does involve some risk: one particular specialist has been quoted as saying that breeding a female guinea pig implies a twenty per cent danger that she will die. There is a particular danger for an older guinea pig like Lettuce. Once guinea pigs grow older than 12 months, the ligaments around the pelvis turn into much less flexible. If their 1st litter is delayed until finally soon after this, there is a increased danger of birthing problems which may possibly end result in the require for an expensive and risky caesarean part.

Helping tawny owls in problems

The RSPCA West Hatch Wildlife Centre in Taunton, Somerset, is coping with a wave of orphaned tawny owls. In the previous month, there has been the equivalent of one tawny owlet admission per day and the centre is packed with the youthful nestlings and fledglings. The centre has been caring for wildlife casualties and rescued pets from all in excess of southern England for over 50 many years. To support their perform, please visit http://options.rspca.org.united kingdom

Rescue pet of the week

Cayla is a seven-12 months-outdated boxer looking for a quiet house. Speak to Jenny Cole on 01452 535373 or electronic mail jenny.cole@hcbw.org.uk

To discover out the outcomes of the rescued pets featured in this column, see petsubjectsrescue.petethevet.com

Send pet troubles to pete.wedderburn@telegraph.co.uk. All sick animals need to, of course, be taken to a vet

Pet subjects: I don"t want to place my puppy in boarding kennels

The Saatchi health care innovation bill will place individuals at the mercy of quacks | David Hills

The government has lately consulted on the health-related innovation bill – the so-referred to as “Saatchi Bill”, which – if passed – would fundamentally change the way in which medical doctors can provide remedy. This bill is meant, in its very own words, “to encourage responsible innovation in health-related remedy (and accordingly to deter innovation which is not responsible).” In accordance to the bill’s promoters, the point that is currently stifling innovation is that medical doctors are reluctant to deviate from standard treatment method for concern of litigation.

In a current write-up for the Guardian website Occam’s Corner, Richard P Grant imagines a conversation in between a helpless GP and a desperate patient with an untreatable illness. Mr Grant’s characters rail towards a system that will not allow them consider promising new remedies due to the fact of the concern of getting sued. Grant is truthful in admitting he has no idea whether this story is true. We will shortly see that it is not.

The Saatchi bill, driven by a slick social media campaign and its very own Twitter account, has been touted as the signifies by which we will uncover a remedy for cancer, as nicely other currently incurable conditions. It is claimed to have wide help across the healthcare profession and patient groups. Regrettably, evidence shows otherwise, and the professional-Saatchi campaign has been marred by regular and repeated accusations with regards to lack of openness or honesty, either about the campaign and its assistance, or the true impact this bill would have if passed into law.

The campaign has been carried out in PR terms rather than on real evidence, and there is a massive gulf between what the supporters claim the bill says, and what it really says, which outcomes in a comparable gulf in between the claimed effect and what would very likely take place in reality.

The bill would seem exclusively written to defend a physician who makes a selection that none of their skilled colleagues would assistance. So, if a doctor decides to do anything their colleagues say is stupid, wrong or even dangerous, he or she can nevertheless do it, and be protected by this bill. As Robert Francis QC, writer of the two enquiries into Mid-Staffordshire NHS Basis Believe in, says, “It explicitly frees the medical professional to offer treatment which has no help from accountable healthcare viewpoint.”

Campaigners declare that the patient is protected since, “The patient’s health care medical professional will be obliged to go over the patient’s case with professionals and authorities, usually within their own hospital or clinic, in search of consensus from them about the ideal course of action for the patient.” They should also talk about it with the patient.

But this is not stated in the actual bill. It does suggest that 1 of the variables the medical professional may possibly get into account is consultation with a multidisciplinary crew of colleagues, but it doesn’t oblige them to do so. There’s also no restriction on whom those colleagues could be, or on the qualifications or skills of stated colleagues, no necessity they ought to be independent and therefore free to disagree, and if the multidisciplinary staff all disagree more than the treatment method, the doctor can nonetheless go ahead anyway.

This is no safety towards irresponsible therapy. According to the GP, writer and broadcaster Dr Margaret McCartney, “to pretend that this offers sufferers any safety from naked quackery would be misguided.”

Also, although it might be intended for use only in severe situations where there is no recent treatment, there is nothing in the bill to restrict it to this kind of instances. It could be utilised for any therapy, minor or significant, regardless of no matter whether there is an successful treatment currently offered.

Discussions with patients may appear like a means to avoid abuse of the law, but certainly patients themselves can’t be expected to act as the barrier to abuse of patients. In the situation of critical illnesses with no remedy, the patient is most likely to be desperate, ready to try anything. It is not the time to count on them to think dispassionately about their own safety. This is not parochialism the patient shouldn’t be anticipated to comprehend entirely the complicated information of an revolutionary treatment when even the doctor’s colleagues may not recognize it.

The Saatchi bill campaigners declare that enacting it will assist locate a cure for cancer. I have blogged about this, but in essence the bill cannot accomplish this aim. In truth, investigation use is exclusively banned in the bill, as is stated by the following passage:

8) Nothing at all in this area permits a doctor—

(a)to provide treatment without consent that is otherwise required by law,

or

(b)to carry out therapy for the purposes of investigation or for any objective other than the patient’s best interests.

So we can not use it to get feedback on whether or not an experimental therapy performs. Worse, we also will not get feedback to tell us if it is hazardous.

The story that medical doctors are prevented from innovating simply because of dread of litigation is just that, a story. Doctors in fact innovate all the time, and there is a sturdy framework to shield them. The Royal University of Radiologists said “we have no evidence that medical professionals are deterred from innovation by fear of litigation.” Cancer Investigation Uk, The Royal College of Physicians, the Academy of Royal Medical Schools, the Academy of Health care Sciences, Healthcare Study Council and Wellcome Believe in, the British Health care Association, the Association of Health care Study Charities, the British Pharmacological Society, the Healthcare Defence Union, and the Motor Neurone Disease Association all struggle to find a difficulty with fear of litigation stifling innovation. Numerous of these bodies question whether or not, even if there have been a problem with innovation, legislation would be the way to solve it. The General Healthcare Council requires the see that “legislation is each needless and undesirable.”

The health-related innovation bill campaign seems heavily dependent on wishful thinking. Firstly, the concept that brilliant new treatments are there for the taking if only we’d be permitted to attempt them. Those treatments, if they exist at all, are vastly outnumbered by indifferent, ineffective and downright dangerous ones. We have no way of telling the big difference. Then there’s the belief that the bill would only be utilized as meant. There is no reason to suppose this will be the case, and that quack or incompetent medical professionals won’t exploit it, endangering patients.

The Royal College of Radiologists says the bill “risks exposing vulnerable and desperate sufferers to false hope, futile and probably harmful (and expensive) therapies.” The British Health care Association “strongly believes that this bill should not grow to be law.” The Motor Neurone Condition Association says “The bill would be bad law.” They are not alone.

While the Saatchi campaign has ground on, with a glowing puff piece in the Telegraph written by Dominic Nutt (in which he failed to point out that he is communications director for the bill) with repeated claims that only attorneys oppose the bill (not correct, as we have observed), it would be effortless for onlookers to acquire a false impression of the bill and then support it.

On top of this, the Saatchi campaign also ran their own “consultation”, which likely had the impact of diverting unwitting respondents away from the government consultation in the direction of their own internet webpage. When they talk about obtaining a lot more than 18000 optimistic responses, it truly is uncertain whether they are referring to the government consultation or their very own, and nobody else has witnessed their data. This sours the debate.

There are important real difficulties in the advancement of new therapies, in how we encourage and fund investigation, how we operate our clinical trials and the ethics committees that help them. None of these difficulties will be solved by this bill, and analysis might in truth be harmed.

In accordance to Robert Francis QC, the bill is very likely to improve the amount of litigation, rather than lowering it. Fixing the manifold issues in the bill would efficiently leave us with no bill at all.

I consider it would be correct to say that everyone supports accountable medical innovation. I’d definitely like some of that, please. We’ve all lost a relative to cancer, we’re all probably to face, at some level in our lives, the insurmountable barrier of a condition that medical science cannot treat. But the reality is that the health-related innovation bill will not lead us towards a cure for anything at all.

We require to quit contemplating about the meant consequences of this bill in an ideal planet and start off pondering about the real consequences in the real one particular.

David Hills blogs about the Saatchi Bill at The Wandering Teacake, and tweets through @WanderinTeacake

The Saatchi health care innovation bill will place individuals at the mercy of quacks | David Hills

GP out of hrs services place patients at danger

In one service it was found that physicians had been employed with no criminal records checks and references had not been looked at..

An additional inspection identified medicines stored in a fridge at unsafe temperatures that had not been spotted by personnel meaning patients who had obtained them had to be contacted.

A third inspection found controlled medication had been not kept securely.

The inspection report for South Essex Emergency Physicians Services, based at Thurrock Local community Hospital and Basildon Hospital: “The support needs to boost the way in which it recruits physicians to make certain that its staffing arrangements allow risk-free delivery of care.

“The supplier had not carried out criminal records bureau (CRB) or disclosure and barring service (DBS) checks on medical doctors employed by SEEDS who had been not members of the cooperative.

“Nor had it obtained references for any of the doctors not already identified to the cooperative. This meant there was a threat that unsuitable physicians might be employed by the services to deliver patient care.”

The inspection of M-Doc Restricted, which covers Bedfordshire discovered a faulty fridge had not been spotted by employees which means delicate drugs have been exposed to temperature ranging from freezing to 26 degrees.

The report explained: “When we alerted one particular of the directors of the support to the dilemma they immediately started the task of identifying which sufferers had been given medicines from the fridge and assessing the risk to their well being.

“M-Doc advised us that they would record this incident as a serious adverse event and understand lessons from it. We realize that a new fridge was obtained the day after our inspection.”

An inspection of PELC Ltd gives out-of-hrs cover for in excess of one.one million patients registered to GP surgeries in Waltham Forest, Redbridge, Havering, Barking &amp Dagenham and West Essex found medicines and prescription pads had been not secure.

The services was told to make urgent improvements.

The report mentioned: “We saw boxes of medicines that had been prepared for distribution to the major care centres and GPs’ visiting bags. These have been not sealed with tamper proof tape, and have been not stored in the obtainable lockable cupboards.

“This increased the risk of unauthorised folks having access to medicines. We brought this to the provider’s attention, who later on confirmed all the boxes had been moved into the lockable cupboards.

“We saw that despite the fact that managed medicines were stored securely, entries in the managed medication register had been incomplete.

“This meant that managed medicines might not be appropriately accounted for, which increased the threat of managed medicines being misappropriated.”

Chief Inspector of Standard Practice, Professor Steve Field mentioned: “These inspections mark the 1st phases in the changes that we are creating to inspections of principal medical services, the outcomes of these very first inspections display that some companies are serving their communities well but other folks even now have some function to do.”

“We’ll take what we have realized from these first inspections to help us create and enhance the process they have been especially helpful in shaping our pondering on ratings, which we will start off to give to out and in hours GP services from October this year. We will also publish a complete report on all out-of-hrs inspections undertaken in this first wave of inspections later in the summer.”

Jamie Reed,Shadow Overall health Minister, explained: “Patients will be concerned to hear about these failings. The reports risk driving even much more patients to turn to A&ampE out of worry, when hospitals have already had their worst year in a decade.

“This is indisputable evidence that NHS companies are going downhill on David Cameron’s observe.

“He wasted billions on a reorganisation that no person desired and placed NHS finances on a knife-edge. Beneath this Government, care difficulties are becoming a lot more probably, not significantly less.

“Ministers have to get a grip – sufferers deserve reputable choices to A&ampE.”

Jeremy Hunt, Well being Secretary, said: “Labour produced the disastrous choice to abolish professional led inspections which we have now reversed. Inevitably when you impose a a lot more rigorous inspection regime you uncover far more troubles but it is in the best interests of patients to acknowledge the place there is poor care instead of trying to cover it up.”

GP out of hrs services place patients at danger

Nation diary: Llangynidr: Here lies the rough ground the place politicians should tread

A small waterfall on the river Usk at Llangynidr bridge. Photograph: P Tomlins/Alamy

Handful of valleys in Wales are much more verdant than that of the Usk, its river heron-sentried, swift and graceful in between banks lapidary with primrose, stitchwort and bluebell. Fallen trunks wedged high over the water bear witness to winter floods. Two sandpipers pulse and dip in time to the whistling diminuendo of their calls. A robin shrills its alarm. From the hump-backed and cut-watered medieval bridge the riverside way winds a long, engrossing mile east to the confluence pool of the Nant Cleisfer, up which impetuous moorland stream my journey lies. At the final settlement of Blaen y Cwm, abandoned to sheep and entropy now, wood sorrel’s flowering beneath mossed walls. I select a leaf, nip and chew at its apple astringency.

Ring ouzels scud ahead and larks falter skyward on ladders of song as I climb to a ford exactly where the path from Tredegar arrives from the south. The substantial plateau among Usk and Taf has prolonged fascinated me. It’s arduous terrain, deep heather pitted with hollows that mark the place underground chambers have collapsed. Some of the most tough problems in British caving lie deep beneath its surface in techniques the identified lengths of which are extended each 12 months by committed and hardy-humorous devotees of a sport in comparison to which mountaineering seems secure and effete. Also hard now for an old man like me, I consider, with a wry smile of gratitude and a host of recollections of exquisite crystal beauties that lie darkly in the rock far under my feet.

This barrier landscape of moon-like austerity amongst the wealthy nation of the Southern March and publish-industrial desolation of the mining valleys holds other resonances. Half a mile south-west of the ford at the head of the Nant Cleisfer is the Chartists’ Cave, exactly where pikes of the insurrectionists have been stored just before their 1839 attack on Newport. Far more just lately inside of the radical tradition, Aneurin Bevan and his buddies often walked up here from his Tredegar house, discussing as they went the political venture that should be his enduring legacy – the NHS, the dismantling of which we are now despairing witnesses. The three excellent stones, neglected and vandalised, that comprise his monument lie just beyond the moor at the back of Waun-y-Pound industrial estate. I would like to see our politicians walk this rough ground to it, quietly, in mindful pilgrimage.

Nation diary: Llangynidr: Here lies the rough ground the place politicians should tread

Homeopathy awareness can make the planet a healthier, happier place | Michael Marshall

Planet Homeopathy Awareness Week – the yearly promotional campaign organised by homeopaths about the world – kicked off on Thursday. This yr, rather than disregard it, moan about it or condemn it, scientists and sceptics alike should join in.

This may appear relatively perverse – particularly given the comprehensive evisceration of homeopathy earlier this week at the hands of the Australian National Overall health and Medical Analysis Council, which concluded “there is no trustworthy proof that homeopathy is effective”. Yet what homeopaths are in search of – consideration and awareness – is precisely what they ought to steer clear of. As any person who has explained the baffling approach of homeopathic dilution to an incredulous colleague will attest, raising awareness of homeopathy is by far the quickest way to dispel any belief in it.

With this in thoughts, the Great Contemplating Society (a charity that promotes rational considering) has launched its personal homeopathy awareness week website: homeopathyawarenessweek.org. The internet site highlights twelve points that homeopaths appear surprisingly unwilling to make individuals conscious of, like examples of exactly where homeopathy has critically harmed sufferers.

Apologists for homeopathy will argue that due to the fact the tablets include nothing at all but sugar, they can’t be harmful. Although their chemistry may be exact, their conclusion definitely is not. For example, there is the situation of Penelope Dingle, a bowel cancer patient in Australia who followed the tips of her homeopath husband, and as a consequence suffered a agonizing and unnecessary death.

Equally tragic is the story of Gloria Thomas, a child whose homeopathically handled eczema became so badly contaminated that it led to her death at the age of 9 months. The public ought to also be aware that homeopaths often provide ineffective homeopathic “alternatives” to vaccines that put children at threat of serious disease. You won’t discover these stories on any other homeopathy awareness websites.

It is alarming to note that homeopaths all around the globe are appropriate now claiming to treat a assortment of significant circumstances, this kind of as malaria, AIDS and even the Ebola virus. Indeed, Homeopaths Without Borders – a group of doubtlessly nicely-that means folk – are flying into areas of crisis in the building world carrying suitcases total of homeopathic tablets that contain nothing but sugar. It is not so much Médecins Sans Frontières as Médecins Sans Medicine.

Of course, belief in homeopathy is not merely a curio identified solely on foreign soil – it is effectively represented, for illustration, on the shelves of high street pharmacies in the United kingdom. Boots – the company whose otherwise exceptional reputation made it the target of demonstrations towards homeopathy in 2010 – nonetheless unapologetically stocks homeopathic goods on its shelves in thousands of retailers up and down the nation.

Luckily, there are constructive signs. In 2010, when I first became involved in alternative wellness activism, the NHS funded no fewer than five homeopathic hospitals nowadays all have both closed or faced a severe risk to their existence. Latest figures, obtained via a freedom of information request by the Nightingale Collaboration, demonstrate an encouraging swing away from homeopathy, with prescriptions falling from a substantial of 170,000 per annum in 1996 to just over 10,000 final 12 months.

Clearly, demand is falling. Provide, too, is on shaky ground. When Nelson’s homeopathic pharmacy – sugar pill supplier of option for Boots and Holland &amp Barrett – explored the likelihood of exporting to the US, the resulting FDA inspection reached a startling conclusion. In accordance to the report, the succussion method (the vigorous shaking that apparently activates the “vibrational memory” of water) meant that in a single out of every 6 homeopathic vials observed, the magical drop of homeopathic liquid missed the sugar tablets fully.

“The lively ingredient was rather seen dripping down the outdoors of the vial assembly. [Nelson’s] lacked controls to guarantee that the energetic ingredient is delivered to every bottle.”

In other phrases, 1 in six vials of homeopathic capsules from the greatest supplier of substantial street homeopathy incorporate no homeopathy at all. That no customers seem to be to have observed speaks volumes for the efficacy of homeopathy.

Maybe most surprising and encouraging of all is just how mainstream this discussion has turn into. Homeopathy is now the butt of mainstream comedians’ jokes and Television sketch displays, and homeopaths have grow to be a watchword for anachronistic thinking, overtaking the Flat Earthers. And, judging by the responses on Twitter to our homeopathy awareness web site, these days practically everybody has their very own “homeopathy is ineffective” gag.

So, I say: deliver on higher awareness … but awareness in its truest sense. Awareness that homeopathy has no scientific basis, is a waste of your income and has the prospective for great harm. If we can continue to spread this type of awareness, we’ll consign homeopathy to the historical past books where it belongs.

Michael Marshall is the undertaking director for the Good Considering Society. As vice president of the Merseyside Skeptics Society, he is also one of the organisers of QEDcon, which starts tomorrow. He tweets as @MrMMarsh

Homeopathy awareness can make the planet a healthier, happier place | Michael Marshall