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Monday, 24 July 2006 10:58
BNN: British Nursing News Online ·
European ministers that are meeting in Brussels were urged not to follow in the footsteps of the United States by banning funding for research into human embryonic stem cells.

Last week the American President George W Bush used his veto for the first time to limit federal funding for the research. He is against the use of public funds for research which destroys embryos.

There are now fears that European backing for ESC research could be halted by a minority of European Union states.

Germany, Slovakia, Slovenia, Poland, Malta, Luxembourg, Austria and Lithuania are opposed to the continuation of central European funding for research on surplus embryos from fertility treatment.

Under existing rules, they need 90 votes to block support for ESC research from the European Framework Programme of funding. Between them, adding together the votes allocated to each country, they can muster 91. Such a dispute could seriously delay approval of the funding programme for all areas of science, worth 54 billion euros (£37 billion).

Lord Rees, president of the Royal Society, Britain's leading academic institution, stepped into the controversy with a strong plea to save European-funded stem cell research.

In a letter to Science Minister Lord Sainsbury, who will represent the UK at the meeting, he wrote: "Last week the United States decided to stay in the slow lane on stem cell research, hindering the global race to develop therapies that could benefit millions of people. It now appears that some countries wish to force the European Union as well into the slow lane alongside the United States.

"While a ban on the use of European Framework support would not prevent national funding for this research, it would still deliver another big blow to the hopes of patients worldwide. It may also encourage researchers to look outside the European Union to carry out important work on human embryonic stem cells”.

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Monday, 24 July 2006 10:48
BNN: British Nursing News Online ·
An inquiry by The Healthcare Commission found that serious failings in infection control were responsible for the deadly spread of a hospital bug at Stoke Mandeville Hospital, part of Buckinghamshire Hospitals NHS Trust.

Overall, 334 patients contracted the infection and at least 33 people died in the outbreaks which took place between October 2003 and June 2005. These patients had acquired the infection while being treated in hospital.

The Commission says that the Trust did not pay sufficient attention to the management of clinical risk. Only the involvement of the Department of Health, which dispatched a senior microbiologist to advise on the outbreak, and national publicity changed the Trust’s approach.

Anna Walker, Chief Executive of the Healthcare Commission, said: "This is a sad and distressing story. It is a tragedy for the families, for the hospital and for the NHS as a whole. Our first thoughts must be with those who have lost relatives.

"Let me be absolutely clear about the main message from this report: nothing can be more important than the safety of patients.

"At Stoke Mandeville, the leadership of the trust compromised the safety of patients by failing to make the right decisions, even though they had the benefit of experience from the first outbreak. They rejected the proper advice of their own experts.

"Let me also be clear that targets are not to blame for the Trust’s leaders taking their eye off the ball. Managers always have to deal with conflicting priorities and plenty of organisations do it successfully.

"We fully recognise that these outbreaks are not easy to control. But we also know that trusts can minimise the spread of infection so long as they follow established advice on infection control.

"Trusts must ensure that they rapidly isolate patients suspected of having the infection. They need to pay meticulous attention to cleanliness and hygiene and they should never forget best practice on antibiotic prescribing”.

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Monday, 24 July 2006 10:27
BNN: British Nursing News Online ·
Ministers in Scotland are proposing to abolish the distinct roles of district nurses and health visitors, leading to fears that thousands of patients will not receive the specialist care they need.

The plans, outlined in a draft report, follow a major review of the community health sector for the health minister, Andy Kerr, under the plans, the extensive range of titles currently used by more than 8000 NHS nurses who work outwith hospitals would merge into one new "community health" job.

But nurses' representatives fear the plans would lead to a dilution of professional skills. Gavin Fergie, professional officer of the Community Practitioners and Health Visitors Association, said it would be like asking a chemistry teacher to teach French.

He said: "We doubt the ability of these proposed community nurses to cover the full clinical range found in community nursing. Thousands of Scottish families won't necessarily get the nursing specialist they need for a particular problem".

Anne Thomson, acting deputy director of the Royal College of Nursing in Scotland, said: "We would clearly have concerns about such a radical change. We will be consulting widely with our members and working closely with the Scottish Executive to implement the outcomes”.

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Monday, 24 July 2006 10:14
BNN: British Nursing News Online ·
An internal policy review conducted by the Department of Health, which was leaked to the newspaper The Independent, show that government targets to cut NHS hospital waiting times are putting patients at increased risk of infection with the superbug MRSA.

The policy shows that there is a direct link between the number of patients in hospital - measured by bed occupancy - and MRSA rates. Ministers have denied there is a link.

The findings of the review are considered so sensitive that two attempts by The Independent to obtain the report under the Freedom of Information Act were rejected. Reducing bed occupancy in all NHS trusts to a maximum of 85 per cent would save 1,000 cases of MRSA a year, it says.

The latest figures for 2004-05 show that 88 NHS trusts in England, one fifth of the total, had occupancy rates over 90 per cent and almost half (45 per cent) had occupancy rates over 85 per cent.

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Monday, 24 July 2006 09:58
BNN: British Nursing News Online ·
Thousands of women with early breast cancer could get life-saving treatment with the official recommendation today that Taxotere should be given to patients after surgery.

Taxotere, a chemotherapy drug already given to women with late-stage breast cancer, will be given to certain women in the early stages of the disease, under draft guidance to be issued today by the government's drugs watchdog, the National Institute for Health and Clinical Excellence (Nice).

The guidance comes nine months after the Scottish equivalent of Nice, the Scottish Medicines Consortium, approved the use of Taxotere for Scottish women in the early stages of the disease.

David Miles, consultant oncologist at London Bridge hospital, said: "If Taxotere is routinely available in the UK it has the potential to prevent the deaths of hundreds of women with breast cancer each year.

"We welcome this landmark [ruling] from Nice, which represents an important step forward for the treatment of early stage breast cancer in the UK. Results from numerous clinical trials confirm that Taxotere-containing regimens are the foundation for effective treatment strategies at every stage of breast cancer”.

The guidance is still open to consultation, but the final version is not expected to be changed when it is published next month.

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Monday, 24 July 2006 09:36
BNN: British Nursing News Online ·
The chemist's chain Boots is planning to put NHS GP surgeries and hospital consultants in its stores in a radical attempt to bring the health service to the high street.

Under the deal which the health and beauty retailer has been discussing with primary care trusts Boots will rent out space on commercial terms.

The chemist's chain has been liaising with Paul Corrigan, Tony Blair's senior policy adviser on health, about the plans. On Wednesday Mr Blair is expected to underline his support for the initiative in a speech on healthcare he is due to deliver in Nottingham - home to the Boots head office. Richard Baker, Boots' chief executive, is hosting the event. The prime minister will also hold a private meeting with senior executives.

Mr Blair's speech is one of a series entitled "Our Nation's Future", which are designed to kick off debate on a range of issues. On Wednesday he is expected to encourage people to take more responsibility for their health, and emphasise the role of the commercial sector in helping to provide "convenient healthcare".

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Monday, 24 July 2006 09:08
BNN: British Nursing News Online ·
18 months ago the Government was warned of serious shortages in the supply of a powerful drug used to relieve the pain of cancer, heart attacks and severe injuries, but to date the drug is still in limited supply.

In December 2004 the Department of Health asked doctors to ration supplies of diamorphine to save doses for those who were dying.

But even now the Department of Health says supplies are not expected to rise until next year.

The national shortage is again in the spotlight after a woman from Nottingham, Isabelle Fortescue, died in agony from cancer when her carers were unable to get her diamorphine for the last two days of her life. Her former husband Joe Fortescue, 49, said she had wanted to die in peace at home with her family.

"That didn't happen," he said. "My wife kept crying out for something for the pain. But we couldn't tell her they had run out of the drug”.

Following Mrs Fortescue's death, Gedling Primary Care Trust in Nottingham is setting up a scheme to make sure supplies are available in emergencies.

Andrew Lansley, the shadow health secretary, said: "Doctors are still looking to diamorphine to treat patients in extreme pain.

"That the Government has known about these deficiencies for some time, and yet has not secured the right supply level, is unacceptable.

"We cannot have a situation in this country where patients are suffering because the Government did not do enough to secure adequate provision of this drug”.

Dr Helen Clayson, vice-chairman of Help the Hospices and medical director of the Hospice of St Mary of Furness, in Ulverston, Cumbria, said there was concern that use of the drug would be allowed to diminish.

"It would be a great shame if diamorphine disappeared from use," she said. "It is used a great deal in palliative care medicine and it is extremely useful. In addition there is a wealth of experience in using it”.

A spokesman for the Department of Health said the circumstances surrounding Mrs Fortescue's death were tragic. "We wish to express sympathy for the family," she said.

"Discussions between the department, the NHS Purchasing and Supply Agency and suppliers commenced as soon as we became aware of problems with the manufacture and supply.

"One of the suppliers responded by immediately increasing its production of diamorphine, but they are unable to completely fill the gap”.

The department said it had made available more supplies of morphine, the nearest alternative, and other painkillers.

"We continue to work very closely with manufacturers to increase the availability of diamorphine.

"However, they must overcome significant technical production and legal barriers associated with the manufacture of this controlled drug.

"Very few countries worldwide permit the use or handling of diamorphine”.

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Sunday, 23 July 2006 10:36
BNN: British Nursing News Online ·
US scientists believe that early dementia could be detected with a simple eye test, similar to those used to test for high blood pressure and diabetes.

The test, developed by a team led by Dr Lee Goldstein, of Brigham and Women's Hospital, Boston, uses a non-invasive laser to study the lens of the eye.

It checks for deposits of beta-amyloid - the protein found in the brains of those with Alzheimer's disease.

The scientists believe the technology, known as quasi-elastic light scattering, may detect the very earliest stages of amyloid deposits in the lens, even when they appear completely clear to the naked eye.

The amyloid deposits appear as unusual cataracts. These are different from common, age-related cataracts.

Dr Goldstein told the International Conference on Alzheimer's Disease and Related Disorders in Madrid: "Amyloid in the lens can be detected using extremely sensitive, non-invasive optical techniques.

"This makes the lens an ideal window for early detection and disease monitoring in Alzheimer's”.

The scientists acknowledge that much more work is needed before such a test could be available to use in patients.

Professor Clive Ballard, of The Alzheimer's Society, said: "This exciting study uses a new imaging technique which has enormous potential as a relatively inexpensive and non-evasive way to chart the growth of amyloid, the protein at the core of the plaques which develop in the brain in a person with dementia.

"But we are long way from eye scans being regularly used to diagnosis someone with dementia.

"More research is needed to show exactly how the amount of protein in the eye relates to development of dementia”.

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Sunday, 23 July 2006 10:17
BNN: British Nursing News Online ·
UK doctors have revealed that they have been able to repair heart attack damage without using open-heart surgery.

The King's College Hospital London team used a 10mm-long device to plug a gap in the heart wall of a 75-year-old man.

Heart surgeon Mr Wendler and Dr Jonathon Hill carried out the procedure at King's after the patient's quadruple heart bypass.

After normal blood supply had been restored, the tiny device - made of rolled up metal mesh - was placed into the hole in the heart wall via an incision in the right heart.

It was then unfolded so it formed umbrella shapes on either side of the wall, with a segment in the middle filling the hole.

The patient was taken off the mechanical ventilator the next morning and was able to return home a few weeks later.

Mr Wendler said: "This represents a huge step forward in treatment of heart rupture.

"Until now, the only way we had of treating inner rupture to the heart was the conventional open-heart surgery, with its high risk.

"Because we are now able to use this less invasive approach we hope to have better results in the future.

"We are encouraged by this outcome and we will be exploring the possibility of establishing this as a regular procedure for suitable patients”.

Dr Mike Knapton, director of prevention and care at the British Heart Foundation, said: "This is a welcome advance in the surgical treatment of ventricular wall rupture, which is an uncommon but devastating complication of heart attack.

"Surgical treatment to repair the rupture is required and this new procedure reduces the trauma to the already damaged heart”.

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Sunday, 23 July 2006 10:11
BNN: British Nursing News Online ·
Talks aimed at ending industrial action by doctors in Germany have broken down.

In the past three weeks around 70,000 doctors in up to 700 municipal clinics have been involved in the dispute, which is over pay and working conditions.

Each day, some 10-15,000 doctors have staged rolling strikes.

The doctors' union, the Marburger Bund, has insisted that emergency care provision will not be affected by the industrial action.

The doctors are demanding a pay rise of up to 17% and better working conditions.

According to the Marburger Bund, a German doctor works on average 60 to 80 hours a week, which is double the number set out in their contract, and these extra hours are often unpaid.

The last round of talks between the union and the local governments broke down this week.

A spokesman for the Employers' Association blamed the doctors' union for not showing any willingness to make a compromise.

Union leaders are now threatening to extend the strikes, but they still say they are ready to get back to the negotiating table.

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