Forces less stressed than police

29 October 2010 Last updated at 10:16 ET By Katia Moskvitch Science reporter, BBC News

UK forces in Iraq are less stressed than police officers or disaster workers, scientists suggest.

A UK team surveyed 611 military personnel and found a fifth showed signs of "mental distress", a lower rate than that seen in the other high-stress occupations.

The British Journal of Psychiatry study was carried out in 2009.

But the charity Combat Stress said it was difficult to compare stress levels in such different occupations.

It is the first major study of the UK armed forces' mental health while on deployment in Iraq.

Neil Greenberg from King's College London, a co-author of the study, said that until now, most research on the psychological well-being of the UK armed forces in that country had been conducted either before or after their deployment.

But little was known about soldiers' mental health during actual service.

The team, led by Kathleen Mulligan, conducted a survey among 611 UK military personnel of different rank and gender serving in the country in 2009. This is about 15% of the total number of the UK armed forces in Iraq that year.

Overall, they found that there was "little overall effect of deployment on mental health", said Dr Greenberg.

Risk factors

The study states 92.6% rated their health as good, very good or excellent, and men as opposed to women were more likely to report good health.

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Raising awareness among staff of the link between personnel reporting sick and having poorer mental health may help identify those in most need of psychological help"

End Quote Neil Greenberg King's College London

Other factors that appeared to help this self-rated well-being included being an officer, having a cohesive unit and supportive leadership.

Age seemed to matter as well: those who were younger reported more levels of stress and poorer health.

Finally, the scientists found that it was important for the armed forces to receive pre-deployment stress brief and to take periods of rest and recuperation.

"Although there is a policy that requires personnel to be given a pre-deployment brief, our study suggested this policy needs to be more rigorously enforced," said Dr Greenberg.

Even though 20% of those surveyed showed signs of mental distress, only 3% were found to possibly have post-traumatic stress disorder (PTSD).

This is lower than among workers in other high-stress occupation, "such as police officers, doctors in emergency departments and disaster workers", the report said.

But a spokesman from a UK charity Combat Stress told BBC News that comparing soldiers in the field to people in other professions was like comparing "apples and peaches".

"The whole military psyche is 'get on, crack on, put up', and there are people rightly or wrongly not willing to express their problems," he said.

"And I think this is an antithesis of the attitude of employees in the public services.

"I think there are cultural things in play here that are perhaps not apparent in the groups that they compared."

Dr Greenberg underlined that it was vital to ensure medical support in military units that covered mental health disorders.

"Improving training, as well as raising awareness among staff of the link between personnel reporting sick and having poorer mental health may help identify those in most need of psychological help," he said.

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Baby P doctor can challenge GMC

29 October 2010 Last updated at 07:10 ET

A doctor accused of failing to spot signs that Baby P was being abused has won the right to legally challenge a General Medical Council disciplinary hearing against her.

Dr Sabah Al-Zayyat is seeking to overturn a GMC ruling that refused to grant her "voluntary erasure" from the medical register on health grounds.

The judge ordered that her challenge be heard in the High Court in November.

The GMC panel must stop its hearing until the challenge is heard, he said.

Dr Al-Zayyat's counsel argued that the panel's decision was "perverse" in the light of medical evidence that the doctor is not well enough to participate in the hearing.

The doctor, who is facing disciplinary action over her conduct, had her application to be removed from the medical register rejected earlier this week.

The GMC ruled that the "serious" allegations against her should be heard in public.

It could ban her from working in the UK.

GMC panel chairman Ralph Bergmann said: "The application for voluntary erasure would avoid a public, and necessary, examination of the facts of this case."

Mr Bergmann added that the doctor's interests were outweighed by the need to maintain public confidence in the medical profession and in the GMC.

Serious injuries

Dr Al-Zayyat saw 17-month-old Peter Connelly at St Ann's Hospital in Haringey days before his death in 2007.

She is accused of failing to carry out an "adequate examination", investigate his injuries or admit him to hospital.

A post-mortem examination found he had probably suffered serious injuries, including a broken back and fractured ribs, before he was examined by Dr Al-Zayyat.

Dr Al-Zayyat is also accused of knowing Peter was on the child protection register.

She had her contract with Great Ormond Street hospital terminated after details of Peter's case came to light.

Dr Al-Zayyat, who did not attend this latest hearing, was originally due to face GMC disciplinary action in February.

The earlier session was adjourned after the panel heard she was "suicidal", unfit to defend herself and had left the country.

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Freeze ovaries to boost fertility

28 October 2010 Last updated at 07:48 ET By Katia Moskvitch Science reporter, BBC News

Young women should freeze parts of their ovaries if they want to postpone motherhood until later in life, a US fertility expert has said.

Dr Sherman Silber told the American Society for Reproductive Medicine meeting in Denver a woman could freeze her ovary at 19 to use when she was 40.

Dr Silber, who says the procedure would work better than egg freezing, did the first full ovary transplant in 2007.

But UK experts warned ovary freezing had not been sufficiently tested.

Women are most fertile when they are young, with the chances to become pregnant diminishing with age, he said.

Although egg-freezing techniques are currently available at clinics in the UK, they usually harbour only a handful of eggs at a time.

It is far from enough to guarantee that a woman would be able to conceive when she decides to re-implant them in future.

Storing a part of an ovary may yield as many as 60,000 eggs, Dr Silber, who is based at the St Luke's clinic in Saint Louis, said.

He added: "The question is, how many cycles of egg retrieval do you need to feel comfortable and secure that you have enough eggs?"

"There's no absolute answer. Women who do egg freezing can't just have one cycle and think they've got it all solved."

And those who opt for several rounds of egg retrieval have to pay for every single procedure, making it "prohibitively expensive", he added.

But he said that removing and then freezing around a section of the ovarian tissue meant "one procedure and the whole thing is done".

'Too early'

Although there are already seven centres around the world that offer the storage of frozen ovarian tissue, there are none in the UK.

Tony Rutherford, chairman of the British Fertility Society, said the research was still very recent and much more needed to be done to ensure the procedure's effectiveness, especially in how successful the re-grafting of the ovarian tissue when a woman was ready to try and conceive would be.

"We don't know how many people have grafts and therefore we don't know how many have been successful and how many have failed," he said.

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People need to know that it is not a guarantee"

End Quote Susan Seenan Infertility Network UK

"We need to see clear evidence of [the method's] effectiveness and that's what we don't have at the moment."

Dr Silber claimed his hospital in Saint Louis has so far managed to carry out three successful ovarian tissue transplants using frozen tissue, which resulted in three births.

There have been 23 babies born from ovary or ovarian tissue transplants worldwide.

Fertility 'epidemic'

Dr Silber added: "We are in the middle of a fertility epidemic across the developed world and the reason our society is changing," he said.

"People are not trying to have children or are not even thinking about getting married until they are 35."

But Susan Seenan of Infertility Network UK told BBC News there was no guarantee that any of the currently used methods, including IVF, would ensure a woman could conceive.

"People should be very careful not to rely on this as a guarantee of success in the future, because you can't actually ensure your fertility.

"There could be other fertility issues, such as blocked tubes or an infertile partner.

"People need to know that it is not a guarantee."

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Councils 'slow' on care budgets

27 October 2010 Last updated at 20:48 ET <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Arvinda Patel says the use of personalised budgets has enhanced her mother's care

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Many councils are struggling with moves to give individual people their own budgets to spend on social care, a watchdog claims.

The Audit Commission warns some need to make significant efforts to meet targets agreed for England last year.

In particular, people with mental health problems could miss out, it claims.

The Department of Health welcomed the report, urging councils to speed up reform.

"Personal budgets" are designed to give people who use social care, and their carers, more choice and control over how their services are provided.

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Some have achieved dramatic things but the progress in others raises questions"

End Quote Richard Humphrey King's Fund

The money to pay for them can be provided directly to the user in cash, or held and used on their behalf by a council or private care firm.

The policy, launched in 2007, was backed by the coalition government in May this year.

Challenges

However, the Audit Commission, an independent body which looks at the effectiveness of public bodies in England, says that while some local authorities are on course to meet a target by offering 30% of eligible people their own budget by April 2011, most are not.

Only six of the 152 councils are currently meeting it, the watchdog adds.

What is more, a survey earlier this year showed only 6% of total spending on adult social care had so far been allocated to personal budgets.

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Andy McKeon from the Audit Commission says the system worked well for his own father

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The latest report, compiled using national statistics and in-depth analysis of 12 councils, suggests that local authorities face various challenges when introducing personal budgets to the thousands of local people who need them.

Not only do they have to decide exactly how much money to give each "budget-holder", but they have to change their financial systems to cope with the new system, and provide information to people on how to use it, while making sure that there is a local "market" in social care where the budgets can be spent.

Andy McKeon, managing director of health at the Audit Commission, said: "Introducing this radical change in the funding of social care is a challenging, and ongoing process.

"The rationale behind personal budgets is not saving money, but empowering service users. Personal budgets mean personal choice."

Richard Humphrey, from the King's Fund think-tank, said that the response of some councils had been "disappointing".

"Some have achieved dramatic things but the progress in others raises questions - in one council, 60% of eligible people have a budget, while in another, it's just 13%.

"Councils have all signed up to this - now they need strong leadership to get on with the job."

One of the problems highlighted by the watchdog is social care for people with mental health issues.

Providing personal budgets would mean disentangling money not just from local authority funds, but from NHS funds as well.

'Financial risk'

Many authorities questioned did not provide budgets for these people - with some saying there was a "financial risk" in giving individuals with mental health problems control of their own funding.

Simon Lawton Smith, from the Mental Health Foundation, said that it was not a "good omen" for the future.

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LGA's Richard Kemp: "We think this report is out of date"

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However, a spokesman for the Local Government Association, which represents councils, said that the report was "somewhat outdated", with significant progress made since its figures were gathered.

Local authorities remained committed to personal budgets, and a fresh agreement between all the bodies involved in social care would be announced at a conference next week.

A Department of Health spokesman said that the report echoed its own messages to councils.

He said: "This should help those councils that still need to get to grips with their financial systems to pick up the pace of reform."

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�600m cancer drug fund announced

26 October 2010 Last updated at 19:35 ET

Patients in England will benefit from a �600m fund to improve access to cancer drugs over the next three years, the government has confirmed.

The move is to address the UK's poor record of cancer treatment provision compared with the rest of Europe.

Health Secretary Andrew Lansley said cancer patients were already getting extra treatments thanks to an interim fund of �50m which began in October.

From next April, the first of three annual �200m sums will be available.

Mr Lansley said this would enable NHS doctors to buy drugs for their patients that can extend life or improve its quality.

"This �200m a year funding over three years for cancer drugs is a crucial step forward in addressing the disparity in patients' access to cancer drugs in England compared to other countries.

"My aim is to truly empower patients."

Greater availability

A recent analysis ranked the UK 12th out of 14 developed countries - which included much of Western Europe, North America, Australia and New Zealand - on access to cancer drugs that have come onto the market within the past five years.

Experts said part of the reason was because some of the newer cancer drugs had not been approved by England's drugs regulatory body, the National Institute for Health and Clinical Excellence (NICE).

The extra money should make it easier for doctors to prescribe treatments even if they have not yet been approved by NICE.

Mr Lansley said NICE would continue to appraise most significant new drugs, and would have "an important part to play" in longer-term plans to introduce "value-based pricing" for new medicines.

Hilary Tovey, of Cancer Research UK, said: "This cancer drugs fund could make a real difference for some cancer patients, allowing them to get the treatments they need.

"It's crucial that cancer patients have easy access to the best drugs and that the way this happens is transparent and easy for doctors and patients to understand.

"How this fund operates will be crucial to its success. All patients - wherever they live - must be able to access this fund in a clear and consistent way.

"Its use will need to be carefully monitored, so we can be sure it's being used in the way that benefits patients most."

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Tall men risk testicular cancer

26 October 2010 Last updated at 19:34 ET

Taller men may have a higher risk of getting testicular cancer, say experts in the United States.

After looking at data on more than 10,000 men, researchers found that for every extra two inches or 5cm in height above average, the risk went up by 13%.

But experts stressed the lifetime risk of developing this cancer is low - one in 210 for men in the UK.

So even for men exceeding the average height of British men (5ft 9ins), the risk would remain relatively small.

And the National Cancer Institute researchers still do not understand how increased height raises a man's risk of testicular cancer.

Other factors, like family history, carry more of a risk, they told the British Journal of Cancer.

Fewer than 2,000 new cases of testicular cancer are diagnosed each year in the UK, accounting for just 1% of male cancers.

Height link

The data the US team analysed came from 13 different studies investigating testicular cancer.

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"Start Quote

Tall men should not be alarmed by this research since fewer than four in 100 testicular lumps are actually cancerous"

End Quote Sara Hiom Cancer Research UK

All of these studies, spanning the last decade, included both figures on the cancer's incidence and height records of the men involved.

Dr Michael Blaise Cook and his team looked at the data to see if cancer risk might tally with height and weight measurements.

They found no link between body weight and the cancer but a trend emerged with height, with taller men at increased risk of testicular cancer.

Sara Hiom, director of health information at Cancer Research UK, said: "Tall men should not be alarmed by this research since fewer than four in 100 testicular lumps are actually cancerous.

"But it is still important for men to be aware of any changes to the size and weight of their testicles and not delay seeing their GP if they are concerned. This is particularly true for young men as the disease is more common with under-35 year olds.

"The outlook for testicular cancer is also one of the best for all cancers - even after the disease has spread, patients can be cured."

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