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Wednesday, 26 July 2006 08:45
BNN: British Nursing News Online ·
According to a survey by nursing union the Royal College of Nursing (RCN) Scotland one in five nurses in Scotland has been bullied at work in the past year.

The Breaking Point survey found that 18 per cent of nurses reported being bullied in the past year, 19 per cent suffered harassment and 11 per cent reported discrimination.

Jane McCready, the RCN Scotland board chair, condemned the findings.

She said: "Nurses are trained to deal with stressful situations. However, it is unacceptable that many are placed under further pressure because of intimidation from managers or colleagues. No-one should have to work under such conditions”.

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Wednesday, 26 July 2006 08:35
BNN: British Nursing News Online ·
It emerged yesterday that babies at one of Scotland's leading neonatal units have been found to be carrying the MRSA superbug.

NHS Lothian said four babies were discovered to be carrying the bug on their skin at the Edinburgh Royal Infirmary unit during April and May.

It followed two previous "clusters" in the past year which did not emerge until yesterday.

Dr Alison McCallum, director of public health at NHS Lothian, said these clusters were dealt with by the unit, which admits around 700 babies a year, and the problem appeared to be over. But the third cluster prompted a detailed plan to address infection control issues.

Dr McCallum, speaking at the board's annual review meeting with Andy Kerr, the health minister, said this had resulted in a "deep clean" of the unit. She said babies were now also screened for MRSA on admission to the unit and weekly. "We are now content that all the steps that should have been taken have been taken," Dr McCallum said.

"None of these babies was unwell as a result of the presence of MRSA and none has required additional treatment."

The health board was questioned over the MRSA clusters by Mr Kerr as he reviewed the progress over the past year, and he said the issue was "such a significant matter of patient confidence" that it needed to be taken seriously.

But the minister said that while the unit had faced some "big challenges", he had been reassured by the measures taken.

"The changes they have made are about best practice, on matters such as the way the unit was used, the proximity of cots to each other and so on," he said.

"I don't think there are grounds to be worried about the unit. They probably have the best healthcare-associated infections-handling system in Scotland now, because of the measures that have been taken”.

Christine Perry, of the Infection Control Nurses Association, said infants in neonatal intensive care were at particular risk from infections.

"The nature of intensive care means using drips and drains, which puts babies at greater risk of any infection. MRSA in neonatal units is something that hospitals take very seriously," she added.

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Tuesday, 25 July 2006 09:23
BNN: British Nursing News Online ·
According to a new report the Government has provided "no evidence" that controversial Independent Sector Treatment Centres (ISTC) have greater benefits than any NHS-run service.

ISTC had been established in England to drive down waiting lists and increase choice.

The Commons Health Committee says waiting lists have fallen but this is more likely to be due to extra money in the NHS than the impact of the ISTCs.

It also warned that the programme could lead to cuts in services at hospitals.

To date 21 ISTCs have been set up, although a number of NHS centres have also been established.

Committee chairman Kevin Barron, a Labour MP, said: "It is difficult to say how the ISTCs have affected either patients or the NHS due to the lack of any systematic assessment”.

But he added the "ideological" opposition to using ISTCs must end.

Paul Miller, chairman of the British Medical Association's consultants committee, said doctors had been worried about the effect of ISTCs for years.

"I am delighted that the Health Committee agrees NHS hospitals are more likely to give better integrated care and to be cheaper," he said.

And Liberal Democrat health spokeswoman Sandra Gidley added: "This is yet another example of the Government introducing powerful forces into the NHS without any prior assessment of the impact they will have on patient care”.

Shadow health secretary Andrew Lansley said: "The whole purpose of ISTCs was to increase capacity and introduce competition but they have failed on both accounts”.

Health Minister Lord Warner said ISTCs have "increased choice, offered earlier treatments and driven down prices".

And he added the Government had already made moves to gather more information about ISTCs by asking the Healthcare Commission to conduct an audit of the centres.

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Tuesday, 25 July 2006 09:11
BNN: British Nursing News Online ·
Researchers at the University of Dundee in Scotland have discovered a fat-controlling protein which could lead to breakthrough treatment for cystic fibrosis.

The researchers found that the protein which regulates fat levels is defective in people affected by the life-threatening lung condition, who are characteristically very thin.

They also discovered links between the defective protein and people suffering from cancer and diabetes – diseases which cystic fibrosis sufferers often develop.

It is now hoped treatments can be developed which could help cystic fibrosis patients put on weight, and increase their life expectancy and quality of life.

The international research team which made the discovery is headed by Dr Anil Mehta, head of the Cystic Fibrosis Database at Dundee University. "It has long been known that cystic fibrosis patients suffer significant variations in weight - they tend to be very thin and can suffer very fast weight loss when they fall ill - but we did not know why this was the case," he said.

"Similarly it has been known that cystic fibrosis patients suffer a higher rate of cancer than normal and again we did not know why. In equal measure, almost half of these patients develop an unusual form of diabetes.

"What our research has uncovered are the genetic links, through this cellular fat controller, which we believe lead to these differences in fat metabolism and cancer. There are also significant links here to diabetes”.

Dr Mehta said the findings could have a "major impact" on research into cystic fibrosis and the other conditions as well as the treatment of patients. "The implications of this are that we have opened up a whole new area of research which links all of these conditions," he added.

"From here on in researchers looking at cancer, diabetes, obesity or cystic fibrosis should all be working with each other and looking at what the other is doing, because it is all linked together. We believe that these results could have a significant impact in terms of the treatment of patients with the three diseases - cystic fibrosis, some forms of childhood cancer and adult onset diabetes - and hence, their potential life expectancy”.

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Tuesday, 25 July 2006 08:53
BNN: British Nursing News Online ·
Scientists from America claim that women who take a male sex hormone to boost their sex drive in middle age could be increasing their risk of breast cancer.

They found that hormone replacement therapy that combines testosterone and oestrogen can more than double a woman's chances of having the disease.

Although testosterone is normally associated with men, it also drives libido in women.

Their study enrolled more than 120,000 nurses, of whom 4,610 developed breast cancer over 24 years.

Just 29 were taking oestrogen plus testosterone, but they had a 77 per cent higher risk of developing breast cancer than those who had never used hormone therapy.

The findings, published in the Archives of Internal Medicine, say: "Although menopausal therapies may provide improvement to sexual functioning, general wellbeing and bone health, the increased risk of breast cancer may outweigh these benefits”.

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Tuesday, 25 July 2006 08:47
BNN: British Nursing News Online ·
A study that was led by Dr Cinzia Maraldi from the Institute on Aging at the University of Florida, Gainesville has shown that having a daily drink or two can improve your health.

The research found that adults in their seventies who drank up to seven alcoholic beverages a day were likely to live longer and have fewer heart attacks.

In their study 2,400 adults in their 70s answered questions on their drinking habits and underwent a health check every year.

They were classified as "never or occasional" drinkers who consumed less than one drink a week, "light to moderate" (one to seven drinks) or "heavier" (more than seven).

Over an average 5.6 years of follow-up, 397 volunteers died and 383 experienced a cardiac event such as a heart attack or heart failure.

Compared with "never or occasional" drinkers, those who drank lightly to moderately had a 26 per cent lower risk of death and an almost 30 per cent reduced risk of cardiac events.

But you can have too much of a good thing, the researchers found. Heavy drinkers were more likely to die or experience a cardiac event than those who drank the least.

They wrote in the journal Archives of Internal Medicine: "The net benefit of light to moderate alcohol consumption may vary as a function of sex, race and background cardiovascular risk.

"From this point of view, recommendations on alcohol consumption should be based, as any medical advice, on a careful evaluation of an individual's risks and benefits, in the context of adequate treatment and control of established cardiovascular risk factors”.

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Tuesday, 25 July 2006 08:16
BNN: British Nursing News Online ·
According to new figures released by the Health Protection Agency (HPA) cases of Clostridium difficile infection in patients aged 65 years and above increased by 17.2% in England over the last year, from 44,107 in 2004 to 51,690 in 2005.

C. difficile is a common hospital-acquired infection which usually causes diarrhoea but can lead to fevers or more serious infections.

Older people are particularly at risk, but the figures show that approximately around 13,000 cases were also recorded among younger patients.

Almost 30% of samples in 2005 were caused by C. difficile ribotype 027, which has previously been associated with major outbreaks.

The HPA said there were concerns that 027 was linked to increased severity of symptoms and increased rates among younger people.

The latest figures also show cases of MRSA in England fell by 2.5% to 3,517 in the six months ending March 2006.

Sir William Stewart, Chairman of the Agency, said:"This is the first time that the Health Protection Agency has published these figures together, and they provide a detailed picture of the challenge posed by healthcare associated infections. This data will play a vital role in helping hospitals measure their performance. Rates are not the same across the country. Some hospitals are doing an outstanding job, others have much to do".

Dr Georgia Duckworth, head of the Agency's HCAI Department, said:"Nationally the increase in C. difficile and limited decrease in MRSA cases indicate there is much work to be done, but today's figures show some encouraging signs. Individual trusts, such as the six who reported no MRSA blood poisoning cases at all and others with significant reductions in cases are leading the way in reducing healthcare-associated infection."

"The MRSA enhanced surveillance figures will be especially useful in identifying where the MRSA was acquired, allowing a more targeted approach to control. These figures will help us further understand the problem and show how we can best tackle the disease."

"It is also important to remember that not all healthcare-associated infections are preventable. Some of these infections are the price we pay for advances in medicine which allow patients to survive who would have been unlikely to survive their illness a few years ago”.

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Tuesday, 25 July 2006 07:14
BNN: British Nursing News Online ·
In a response to yesterdays news on Boots providing GP services in their stores Dr Hamish Meldrum, chairman of the BMA’s GPs committee said:

“If Boots merely intends to rent out spare space in their stores to NHS doctors, we have far fewer concerns than if the company intends to directly employ GPs and other doctors and run the surgeries itself for the NHS. However, we have concerns this is symptomatic of the government’s agenda to increase the amount of private sector involvement in the NHS. That may lead to increasing fragmentation of the health service and adversely affect the well liked and respected continuity of care that is so much an integral part of UK general practice”.

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Monday, 24 July 2006 11:53
BNN: British Nursing News Online ·
Scientists have warned that a widely hailed cancer drug can damage cardiac tissue and may lead to heart failure.

The cancer drug Glivec has boosted survival rates for people with chronic myeloid leukaemia and extended life expectancy for people with a rare type of stomach tumour.

But new evidence from American scientists reveals Glivec has side-effects that can lead to heart failure. The investigation was sparked by ten leukaemia sufferers who developed heart failure while taking Glivec.

They suffered sudden, severe, heart failure after starting their course of treatment. The findings are published today in the journal Nature Medicine.

Professor Thomas Force, from Thomas Jefferson University in Philadelphia, who led the research, said:

"We're trying to call attention to the fact that Gleevec [the drug's US name] and other similar drugs coming along could have significant side effects on the heart and clinicians need to be aware of this. It's a potential problem, because the number of targeted agents is growing rapidly”.

Dr Laura-Jane Armstrong, of the charity Cancer Research UK, said Glivec saved many lives a year.

"It is worth noting that other cancer drugs, including targeted therapies such as Herceptin, also carry some risk of heart problems, but they are still used, as the benefits of treating the cancer far outweigh the heart risks”.

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Monday, 24 July 2006 11:41
BNN: British Nursing News Online ·
The BBC has learnt that pressure for surgery to treat obesity is so high that in some areas NHS lists are being closed to all but the most serious cases.

In these areas, only people significantly above the minimum obesity measure are considered for operations.

Weight is defined using the body mass index (BMI) measure, calculated by dividing weight in kilograms by the square of height in metres.

A BMI of 18.5 to 25 is classed as an ideal weight.

The National Institute for Health and Clinical Excellence (NICE) says patients with a BMI of 40, or 35 with an additional condition, are eligible for gastric banding or gastric bypass operations to reduce the size of the stomach.

But a patient group has said some areas have had to close their lists to patients with a BMI of less than 60.

Dr Roger Ackroyd, a consultant general surgeon and bariatric (obesity) specialist at both the Royal Hallamshire hospital and at the BMI Healthcare Thornbury hospital in Sheffield, said that his area has had to restrict its NHS list to patients with a BMI of 50, or 45 with additional problems, because there was no more capacity.

He said that, while the UK has 70 specially trained doctors in the field, only about half of them regularly carry out surgery.

"There are about 1.2 m people who fit the NICE criteria for obesity surgery in the UK, and there is no way that the NHS can cope with that with just 20-30 surgeons to carry out the work.

"I carried out about 400 of these operations last year and I will do the same number this year, or more. But I am just scratching the surface."

Dr Ackroyd added: "I don't think there is any easy answer. One of the answers would be to get people to eat better and exercise more, but the chances of this are unlikely."

His local primary care trust consortium, South Yorkshire/North Derbyshire and Bassetlaw PCTs, agreed the criteria had to be changed and said the situation was being kept under review.

Janet Edmond, director of British Obesity Surgery Patient Association (BOSPA), said that since surgery had been recognised as a viable option, this had led to increased pressure.

"We have heard of one PCT which says it will not accept patients with a BMI of less than 60”.

But Dr Ian Campbell, medical director of the charity Weight Concern, blamed the NHS.

"The NHS is failing people because our job is to provide care and the supply of care is woeful.

"There are tens of thousands of people who would benefit from this sort of surgery, but are not getting it either because they are not aware of it, their surgeons are not aware of it or they do not meet the criteria”.

A spokeswoman for the Department of Health stressed it was aware of the problems.

But she added: "Tackling obesity is not just about helping those who are already overweight; it is about preventing obesity in the first place and halting the year-on-year rise to protect our future.

"We have made significant progress in developing and increasing the size of the surgical services workforce but it is up to primary care trusts to decide what the local priorities are for their community and what services they should offer”.

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