Sleep loss 'worse for extroverts'

31 October 2010 Last updated at 20:32 ET

Outgoing people appear to suffer worse from the effects of lack of sleep, US army researchers suggest.

They kept 48 volunteers awake for 36 hours, with some allowed to mix with others, the journal Sleep reports.

Those defined as introverts did better at staying awake and in reaction tests.

And those extroverts who were denied social contact also did well, suggesting it is "social stimulation" that tires out the parts of the extroverts' brains linked to alertness.

The study involved 48 people aged 18 to 39, who were divided into two roughly equal groups following personality type screening, which defined whether they were natural extroverts or introverts.

After a good night's sleep, they remained awake for a day and a half, with various tests each hour to measure the effects of lack of sleep.

Some of the test subjects - both introverts and extroverts - were allowed to take part in group discussions, and play board games and puzzles for 12 hours of the 36. The others were not allowed any such social interaction.

First of all, the test subjects who were "socially enriched" in this way were tested to see if there was any difference between the natural extroverts and introverts.

While there was little difference in one of the tests, in which volunteers had to push a button as soon as possible in response to a light, introverts fared better in a "maintenance of wakefulness test", which checks whether sleep-deprived people are able to stay awake over a set period of time.

The extroverts in that group did badly in the test, but the extroverts in the second group - those denied social contact - performed markedly better.

Perception

The researchers, from the Walter Reed Army Institute in Maryland, said the results suggested that personality type might not only have a bearing on ability to cope with military tasks which required being awake for long period, but also with shift work.

They reported: "Overall, the present results might also be interpreted more generally to suggest that waking experiences, along with their interaction with individual characteristics, influence vulnerability to subsequent sleep loss."

Continue reading the main story

"Start Quote

The extrovert is more likely to be influenced by a perception of what is going on in the group"

End Quote Professor Mark Blagrove, University of Swansea

One possibility, they said, was that intense social interactions might lead to fatigue in brain regions which also played a role in alertness.

Conversely, they said, it was possible that introverts might always have a relatively high level of activity in parts of the brain affected by social situations.

On a day-to-day basis, it is suggested this could mean that social contact leads to "over-stimulation", explaining why introverts would withdraw or shy away.

However, the constant activity might also make their brains better placed to fight the effects of sleep deprivation, they said.

One UK academic said that there might be a simpler explanation for the different impact of sleep deprivation.

Professor Mark Blagrove, a neuroscientist from the University of Swansea, has published similar research into effects of sleep deprivation on the mood of introverts and extroverts.

Again, he found extroverts more vulnerable to mood changes driven by lack of sleep.

He said: "We suggested that extrovert people might be more heavily influenced by the sleep-deprived appearance of people in the group around them.

"They found no differences in the objective test of alertness they used, but did find differences in the wakefulness test, which is a slightly less objective measure of how someone is feeling.

"This supports a slightly simpler argument - that the extrovert is more likely to be influenced by a perception of what is going on in the group."

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Miniature livers 'grown in lab'

30 October 2010 Last updated at 14:30 ET

Scientists have managed to produce a small-scale version of a human liver in the laboratory using stem cells.

The success increases hope that new transplant livers could be manufactured, although experts say that this is still many years away.

The team from Wake Forest University Baptist Medical Center presented its findings at at conference in Boston.

UK experts said it was an "exciting development" but it is not yet certain a fully-functioning liver is possible.

The demand for transplant livers far exceeds the number of available organs, and in recent years, research has focused on ways to use cell technology to support failing organs in the body, or even one day replace them.

Their building block is the stem cell, a "master cell" which can, in certain conditions, can divide to produce different types of body tissue.

However, constructing a three-dimensional organ from stem cells is a difficult task.

'Technical hurdles'

The method used by the Wake Forest researchers, and other teams around the world, is to form new liver tissue on a scaffold made from from the structure of an existing liver.

In this case, a detergent was used to strip away the cells from the liver, leaving only the collagen framework which supported them, and a network of tiny blood vessels.

Continue reading the main story

"Start Quote

Whilst 'off the shelf' new livers are clearly still a long way off, this work gives a glimmer of hope that this is no longer just the stuff of science fiction"

End Quote Dr Mark Wright, Southampton University

The new stem cells - in this case immature liver cells - and endothelial cells, to produce a new lining for the blood vessels, were gradually introduced.

After a week in a "bioreactor", which nurtured the cells with a mixture of nutrients and oxygen, the scientists saw widespread cell growth within the structure, and even signs of some normal functions in the tiny organ.

Professor Shay Soker, who led the research, said: "We are excited about the possibilities this research represents, but must stress that we're at an early stage, and many technical hurdles must be overcome before it could benefit patients.

"Not only must we learn how to grow billions of liver cells at one time in order to engineer livers large enough for patients, we must determine whether these organs are safe to use."

UK researchers welcomed the findings, which are being presented to the American Association for the Study of Liver Diseases. Professor Mark Thursz, from Imperial College London, said the results were "encouraging".

"The report suggests that the authors have overcome one of the major hurdles in creating an artificial liver - to generate functioning human liver cells in a 'natural' liver structure.

"It is clear that the cells are growing well, but the next step is to show that they are functioning like normal human liver tissue."

Dr Mark Wright, from Southampton University added: "In an era of increasing liver disease and death with a chronic shortage of liver transplants this represents an exciting development in an important field of work.

"The researchers appear to have made the step of combining stem cell technology with bioengineering as a first step to producing artificial livers.

"Whilst 'off the shelf' new livers are clearly still a long way off, this work gives a glimmer of hope that this is no longer just the stuff of science fiction."

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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.

Continue reading the main story

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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.

Continue reading the main story

"Start Quote

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.

Continue reading the main story

"Start Quote

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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