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141 records found from year 2006

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Saturday, 22 July 2006 09:10
BNN: British Nursing News Online ·
Sir Liam Donaldson England's Chief Medical Officer has suggested that all newborn babies should be checked for jaundice to prevent unnecessary deaths from a related brain disease.

In his annual report, Sir Liam Donaldson called for more advice for parents about the warning signs of kernicterus.

He also asked the Government to consider offering a screening blood test to all new babies.

Sir Liam said: "We need to raise awareness among health professionals and parents to help tackle this preventable disease.

"I would like to see a national register of kernicterus, education and training programmes for health professionals and explicit advice for parents on what to look out for when they leave hospital and finally I would ask the National Screening Committee to consider the cost effectiveness of a bilirubin blood test to help identify the risk of kernicterus”.

The National Institute for Health and Clinical Excellence is due to publish guidance on postnatal care which will include a section on jaundice recommending surveillance and investigation of any severe cases.

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Saturday, 22 July 2006 09:03
BNN: British Nursing News Online ·
The Government says black teenagers need to be targeted to reduce the high number of pregnancies.

Ministers have asked council and health chiefs in England to target black and mixed race Caribbean youngsters.

Even when social deprivation was taken into account, black girls were still over-represented in the numbers of teenage pregnancies.

Data on teenage pregnancies by ethnic group is hard to come by as it is not recorded at birth registration, the Government's latest guidance on teenage pregnancy said.

However, 2001 census data has showed that rates of teenage motherhood are significantly higher among mothers of mixed white and black Caribbean, other black and black Caribbean ethnicity than other groups.

And in 2004, black ethnic groups accounted for 9% of all under 18 abortions despite representing just 3% of the population.

In a letter to council and primary care trust chief executives, Children's Minister Beverley Hughes and Public Health Minister Caroline Flint said teenage pregnancy levels were at their lowest since the mid 1980s.

However, they warned conception rates were still the highest in Western Europe and while some areas had reduced the rates by over 40% since the strategy was launched in 1999, others had seen it increase by over 40%.

The letter said cutting teenage pregnancy was key to helping tackle poverty and reduce inequality.

"Teenage pregnancy is strongly associated with poor outcomes for both young parents and their children.

"It contributes to the transmission of poverty, inequality and low aspirations between generations”.

Gill Frances, chairman of the Independent Advisory Group on Teenage Pregnancy, said the new government guidance was extremely positive.

"Teenage pregnancy is a complex issue, but we have the solutions. The work is producing results and we currently have the lowest teenage pregnancy rate in 20 years”.

A spokesman for the Black Health Agency added: "It is recognised that young black people have problems accessing sex education and contraceptive services.

"This is because they are not culturally appropriate. Too often agencies do not employ people from these communities and do not research what their needs are.

"This guidance is welcome”.

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Friday, 21 July 2006 09:38
BNN: British Nursing News Online ·
Sheriff James Tierney has criticised the NHS 24 helpline service over the deaths of two people in Aberdeenshire.

The sheriff said that the system had failed Shomi Miah and Steven Wiseman by not identifying their life-threatening conditions.

He claimed that if NHS staff had "erred on the side of caution" during their diagnosis there was a strong likelihood both patients would have survived.

The families of Ms Miah and Mr Wiseman blamed delays in getting treatment for their deaths in 2004.

Sheriff Tierney's findings followed a lengthy joint fatal accident inquiry, which heard from a range of witnesses including NHS call centre staff.

He said the NHS 24 system, which involves making a diagnosis over the telephone, relied on the quality of the nurse advisors' (NAs) clinical judgement and "a strict adherence to the principle of erring on the side of caution".

His report said that while the system was "not inherently defective"; it had failed both Ms Miah and Mr Wiseman.

"It failed to identify the fact that they were each suffering from a life threatening condition or at least from a condition that the NA did not properly understand," it said.

Dr George Crooks, clinical director of NHS 24, said it would carefully assess the sheriff's observations in conjunction with NHS Grampian.

He said improvements made to the service over the past 18 months included advanced training to raise awareness of meningitis symptoms and changes to the method of dealing with repeat calls.

"The most constructive outcome is that the NHS can learn from these events and continue to improve services for patients in the future," he said.

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Friday, 21 July 2006 09:13
BNN: British Nursing News Online ·
Hospital managers from the North Devon Hospital in Barnstaple have apologised to a grieving mother of a dead baby after she was shown the wrong body in a mortuary mix-up.

Chris and Lynsey Summers' baby Jenson was born 25 weeks premature and died in their arms.

Lynsey asked to see his body but knew she was brought the wrong baby because he was smaller and slightly deformed.

Mr Summers, 36, said: "It was stressful seeing a partly-deformed child. The error went past three staff and they said it had not happened in 30 years”.

A midwife who had brought the box from the mortuary insisted it was the right baby until the mother pointed out that the name on the tiny coffin was different.

Mrs Summers, 32, who is seeing a counsellor, said: "To see another baby was just terrible. I have had emotional problems”.

Brian Aird, of North Devon Healthcare Trust, wrote to apologise, saying the mortician did not have enough training.

He said: "We are truly sorry for both sets of parents and we will be taking appropriate action”.

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Wednesday, 19 July 2006 10:27
BNN: British Nursing News Online ·
Leading pharmacologists said yesterday that patients are being put at risk from adverse reactions to drugs because doctors are not properly trained in prescribing drugs.

Top doctors said the problem was being caused because the General Medical Council (GMC) was placing less emphasis on pharmacology in UK medical schools.

They also said the risk was being compounded by the use of more complex medicines in the health service.

Recent research suggests that about one in 16 hospital admissions is caused by adverse reactions to drugs, most of which are avoid-able. One recent study put the cost of the problem to the National Health Service at £466 million.

Prof Sir Michael Rawlins, the chairman of the Government's medicines watchdog the National Institute for Health and Clinical Excellence (Nice) blamed the GMC, which is responsible for undergraduate medical education, for falling levels of knowledge.

Prof Rawlins, who is a professor of clinical pharmacology at Newcastle University, said: "There has been a decline in the teaching of pharmacology and that has an effect on basic drug safety. The competence of young doctors in prescribing is a very serious problem. Frankly, the GMC have not made sure that young doctors are taught to prescribe safely”.

Prof David Webb, the chairman of the Scottish Medicines Consortium and a professor of therapeutics and clinical pharmacology at the University of Edinburgh, said medical students were privately expressing concerns at their own lack of prescribing knowledge.

He said: "Patients are becoming ill and some are dying as a result of poor prescribing. There is no doubt about that. A substantial proportion of that is undoubtedly avoidable. Our medical schools could be training much better and safer doctors.

"The increasing focus on performance targets within the health service has marginalised specialities such as CPT where performance is difficult to measure. Distinct courses and assessments in CPT, formerly a staple in the curriculum, are disappearing”.

A study published two years ago found that at two hospitals on Merseyside, 1,225 patients aged 17 or over out of 18,820 were admitted as a result of adverse drug reactions. Other research has suggested that between five and 10 per cent of all hospital inpatients experience an adverse drug reaction during their stay.

A spokesman for the GMC said: "We refute the suggestion that medical undergraduates are failing to learn to prescribe properly. It is clearly stated in our guidance that medical students must be taught to prescribe safely and effectively”.

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Wednesday, 19 July 2006 08:31
BNN: British Nursing News Online ·
Health Protection Scotland (HPS) have reported that the number of over-50s contracting HIV and other sexually transmitted diseases has more than trebled in the last five years.

HPS found infections such as chlamydia and herpes among senior citizens are among the most rapidly rising in Scotland.

Health workers are concerned that older couples are not heeding the safe sex message.

The rise in sexually transmitted diseases (STDs) has been put down, in part, to the increasing numbers of older people beginning new sexual relationships following a divorce or the death of a partner.

Health workers claim that, as this age group is unlikely to have received sex education, many are having unprotected intercourse unaware of the dangers.

Figures show that the number of HIV cases among over-50s have trebled from 0.7 to 2.2 per cent of those tested in the last five years. In over-60s, the figure jumped from 0.6 to 1.6 per cent.

Chlamydia leapt from 43 in 2000 to 91 in 2005. And reported cases of herpes trebled from 32 to 107 during the same period. Sexual health consultant Dr Ruth Holman said evidence showed older people were swapping partners more than ever.

Dr Holman, of NHS Ayrshire and Arran, said: "You hear about swingers and about women going abroad to pick up men.

"These things would not have happened a few years ago.

"Also people are more frequently having relationships at older ages with more partners and more sexual experimentation”.

But she warned over-50s needed to be taught more about safe sex.

She said: "In the past, the assumption was that if you are over 50, then you are definitely not having sex”.

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Saturday, 15 July 2006 10:05
BNN: British Nursing News Online ·
International researchers claim that smoking is to blame for half of the difference in male death rates between men in the top and bottom social classes.

In England, Wales, the US, Canada and Poland, men of lower social class, income or education have a two-fold increased risk of dying earlier.

More than half of this involved differences in smoking-related death risk, they found.

Experts said the Lancet study showed the impact stopping smoking could have.

Professor Sir Richard Peto, co-author from the University of Oxford, said: "Widespread cessation of smoking could eventually halve the absolute differences between these social strata in the risk of premature death”.

Focusing on smoking cessation might be a quicker and simpler fix than tackling other causes of social inequalities.

Michael Marmot, from the International Institute for Society and Health at University College London, said: "The conclusion might be to forget social conditions, neighbourhood deprivation, employment conditions, early childhood and subsequent adult disease, just focus on getting the smoking rates down in people of low status”.

Cancer Research UK's medical director Professor John Toy said: "All men who smoke play Russian roulette with their lives but the odds are heavily stacked against those in lower income groups as they are much more likely to smoke.

"This study, part-funded by Cancer Research UK, shows that social inequality in death rates demands attention, concentrating on ways to help less privileged people to stop smoking”.

Sir Richard and colleagues estimated the number of deaths among men aged 35-69 that could be attributed to smoking and those not attributed to smoking in three social bands in four countries using mortality data from 1996.

They found on average a 19% difference between the highest and lowest social strata in the risk of dying in each country and about half of the difference was due to the risk of being killed by smoking.

Ian Wilmore, of Action on Smoking and Health, said: "Smoking is the number one contributor to health inequalities because it accounts for at least half of the difference in life expectancy between the social classes.

"If you are a man in social class E, the poorest social group, your chance of surviving until the age of 70 is about one in two. If you’re a man in social class A, the highest group, your chance is about two in three.

"Encouraging people to quit is the number one public health intervention that will help to deal with health inequalities. That is why comprehensive smoke-free legislation is needed”.

A spokesman for the British Heart Foundation, said: "We know there are black spots of heart disease in deprived areas, and it's increasingly clear that smoking is a major cause of these variations.

"We're supporting projects to encourage smokers to quit right across the country,

"We will continue to call on the government to offer tailored smoking cessation services to give smokers the best possible chance to quit”.

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Saturday, 15 July 2006 08:59
BNN: British Nursing News Online ·
Prof Sir Liam Donaldson, the chief medical officer has proposed tougher regulation of doctors and a reduction in the powers of the General Medical Council (GMC).

The new system, which will cost around£150 million, double the present one, aims to detect failing doctors sooner and, crucially, lowers the standard of proof from criminal standard to the lesser civil level.

The GMC would continue to prosecute doctors but no longer be their judge as well and it would also lose its influence over medical education. More power would be given to the royal colleges.

Sir Liam said his report, "Good doctors, safer patients", would go through a four-month consultation and was the first comprehensive review of medical regulation for more than 30 years.

"The vast majority of doctors deliver care to patients with skill and compassion," he said. "The proposals are designed to help these doctors to maintain their standards, as much as they are designed to identify poor practice.

"Patient safety has been my primary concern. There must be a robust re-validation process. At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise; an airline pilot would face over 100 checks over a similar time."

The report follows the inquiries by Dame Janet Smith into Harold Shipman, the GP who murdered about 250 patients. Dame Janet widely criticised the GMC.

Sir Liam said: "Patients put their trust in their doctors. They are right to do so but my review has shown that the public and doctors think that this trust must be underpinned by a strong system to assure safe care."

The British Medical Association said doctors were likely to be "hugely critical" of the proposal to change the burden of proof in misconduct cases. "No one wants to put people at risk by bad practice," said James Johnson, the chairman. "But it seems wrong to be able to take away a doctor's livelihood because of something found on a balance of probability. It opens the door to miscarriages of justice”.

Mr Johnson, a surgeon, said the BMA welcomed the recommendation that the majority of GMC members would still be doctors, that cases would be dealt with more quickly and locally and that there would be increased focus on rehabilitation and retraining. But it was concerned that members would be appointed not elected.

It had considerable reservations about the plan to take adjudication of cases away from the GMC and give it to another, as yet unnamed, body. Mr Johnson said a further recommendation to make medical students register with the GMC and sit a national examination in addition to graduating was likely to draw strong opposition.

Sir Graeme Catto, the president of the GMC, welcomed many of the proposals but, considering that fitness to practise procedures had been enhanced recently, wondered whether the case for change had been made.


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Friday, 14 July 2006 11:04
BNN: British Nursing News Online ·
Researchers from Guy's and St Thomas' Hospital in south London, suggest that twice as many children may be affected by autism and similar disorders than previously thought.

The researchers studied 56,946 children in south London and found that almost 0.4 per cent had "classic" childhood autism and just below 1.2 per cent had autism spectrum disorders (ASDs), including Asperger's and milder forms.

Until the 1990s, the generally accepted figure in Britain was four to five cases of autism per 10,000 - 10 times lower than the rate suggested in the new study.

The researchers extrapolated their findings to suggest one in 100 British children may have some form of autism.

Professor Gillian Baird, who led the research, said: "Prevalence of autism and related ASDs is substantially higher than previously recognised.

"Whether the increase is due to better ascertainment, broadening diagnostic criteria or increased incidence is unclear.

"Services in health, education, and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population”.

Similar increases in autism and related disorders have been reported from around the world, but the reasons remain unclear. In a commentary on the latest finding, Hiroshi Kurita, of the Zenkoku Ryoiku Sodan Centre in Tokyo, said genetic factors were the most important cause of autism, but "no study has ever clarified the rising prevalence of pervasive developmental disorders from this aspect".

Two suspects among possible environmental causes are the measles mumps and rubella (MMR) vaccine, and thimerosal, a vaccine preservative containing mercury.

But Dr Jurita rejects these explanations. "Among many other compelling lines of evidence, the continuous increase in the incidence of pervasive developmental disorders after cessation of use of MMR vaccine in a northern district of Yokohama, Japan, and of thimerosal-containing vaccine use in Denmark, is a strong and overwhelming refutation," he said.

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Friday, 14 July 2006 09:10
BNN: British Nursing News Online ·
Sue Roff, from the Centre for Medical Education at Dundee University Medical School, has urged that people should be allowed to sell body parts in Britain to address the shortage of donor organs and stop the black market trade overseas.

She has argued for people to be paid for donating a kidney, with payments of about £22,000 recommended.

She said as evidence for the safety of part liver and lung transplants were available, these operations too could be added to a market model.

Writing in the British Medical Journal, Mrs Roff argued that there was already a legal trade in other body parts with values put on blood and sperm donations.

The UK's Criminal Injuries Compensation Authority also puts a cost on bodily parts.

"We sell other parts of our bodies in Europe and the US," she said.

"We also use the body as a whole for payment to take part in drug trials so we have gone a long way to valuing different parts.

"It does not seem a huge step to apply this process to kidneys, where most of us have a spare one and can get through life with just one.

"People should be allowed to choose if they want to do this. A payment of about £22,000 is a substantial amount - a year's average wage in industrialised society. It is a new car, a course of university fees or a down payment on a mortgage”.

She said human eggs and sperm were already traded and these had "the awesome power of creating new human life", which seemed more shocking than selling a kidney.

The researcher said vulnerable people overseas were being exploited when they sold kidneys, but if they were paid a fair price then the process was more acceptable and would help desperate people in need of a transplant.

"It is not really so grotesque a concept," Mrs Roff said. "Some people will always find it disagreeable but they do not have to take part”.

The researcher was supported in her call by Kuldip Anand, Ajit Kashyap and Surekha Kashyap - a group of doctors in India.

They argued that the regulated sale would bridge the gap between demand and supply of kidneys for transplant. "It will reduce if not abolish the rampant illegal kidney trade," they added.

"We know that patients from rich countries visit poor countries for purchase of kidneys and renal transplantation”.

But Dr Raj Mohindra, a heart specialist in Newcastle, warned that a fixed price compensation model may increase the supply of organs but it would not prevent a black market trying to undercut the price.

Professor Stephen Wigmore, of the British Transplantation Society, also warned that the sale of organs was unethical and underestimated the risks. "It tends to be the poorer people who become the donors and the richer people who are the recipients," he said. "But donating a kidney is not without its risks and one in 1,000 kidneys donors die”.

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