Monday, November 22, 2010

Toddlers to get 'six in one' jabs

Young children are to be immunised against six diseases at once, the Government has confirmed.

After their first birthday toddlers will be offered a single appointment to have three injections to guard against measles, mumps, rubella, two types of meningitis and a form of pneumonia.

This replaces the existing NHS policy for England and Wales of spacing the vaccines over a couple of months.

The change is designed to boost vaccination rates.

Writing to all GPs concerned, the Chief Medical Officer Professor Dame Sally Davies said the new policy should be "brought in as soon as practicable for your area".

Currently around 85% of all toddlers turn up to get immunised.

Boosting uptake

Although this is more than in previous years, experts are still having to work hard to get the figure up to the 95% level that is necessary to effectively stop the spread of the disease in the community.

"Start Quote

Independent scientific research has shown that providing these vaccines at the same time is safe, effective and more convenient for parents"

End Quote Department of Health spokeswoman

The vaccination rate has been well below this level for several years, ever since the Lancet medical journal published controversial research about the MMR vaccine in 1998.

The study has since been discredited, but confidence has been slow to return in the combined measles, mumps and rubella vaccine.

Government advisors believe simplifying the immunisation schedule will help boost vaccine uptake by making it easier for parents to get their children vaccinated.

While some parents will welcome one fewer visit to the doctor, others may be concerned about exposing their children to so many vaccines in one sitting.

But experts say combining the vaccines should not pose any additional risk.

A Department of Health spokeswoman said: "Independent scientific research has shown that providing these vaccines at the same time is safe, effective and more convenient for parents."

Children will still be offered the usual series of baby vaccinations as well as their pre-school booster jabs after their third birthday.



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TV mental health portrayal rapped

Many depictions of mental illness on TV are frightening and misleading, a government-backed report says.

The study, commissioned by the Department of Health, found nearly half of all mentally ill characters were portrayed as dangerous to others.

Its author said the "axe-wielding maniac" stereotype should be ditched.

Mental health charity Mind said progress had been made in dramas such as EastEnders and Shameless, but more improvement was needed.

Television and films have been using the "madman" as a dramatic device for decades, but in reality, the vast majority of people with mental health problems pose no risk to others.

The Glasgow Media Group, working on behalf of a Department of Health campaign called "Shift", examined dozens of popular dramas and comedies to see how mental illness was presented to the viewer.

It found that most references to mentally ill people were insulting, examples being the terms "crackpot", "basket case" or "a sad little psycho".

In addition, 45% of storylines involving people with mental health problems found them posing some kind of risk to others.

Recent examples were a character in ITV soap Emmerdale who drugs the village vicar, or a schizophrenic killer in the popular US show CSI: Miami.

'Improve perceptions'

Even in BBC One soap EastEnders, which was praised for a realistic portrayal of bipolar disorder with character Stacey Slater, had the same character eventually commit murder.

"Start Quote

There is still much work to be done until we are at a stage where accurate depictions are the norm rather than the exception"

End Quote Paul Farmer Mind

Professor Greg Philo, who led the research, said: "Fictional film characters like Hitchcock's Norman Bates in 'Psycho' have long established the idea of the 'mentally ill' as crazed and dangerous in the public mind; television has been doing the same thing for decades.

"Great progress has been made in recent years, but we've some way to go before we see more of the everyday realities of living with a mental health problem properly represented and stereotypes like the axe-wielding maniac take a back seat."

Almost half of programmes did offer sympathetic portrayals, although these often showed the character as a "tragic victim", the researchers said.

The depiction of another character with bipolar disorder on Channel 4's Shameless won praise for accuracy and sensitivity.

Paul Farmer, the chief executive of Mind, said that improvements over the past decade had been due to the willingness of scriptwriters and programme producers to involve people with personal experience of mental health problems while carrying out research.

He said: "It is also clear, however, that there is still much work to be done until we are at a stage where accurate depictions are the norm rather than the exception.

"I hope this report will encourage programme makers to follow these examples of good practice to create accurate, well-rounded characters that can improve perceptions of mental health."



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Sunday, November 21, 2010

Genes give clue to early puberty

At least 30 genes appear to play a role in the age at which girls reach puberty, according to an international group of scientists.

The team scanned the genetic code of more than 100,000 women, reporting their findings in the journal Nature Genetics.

In the UK, girls as young as 10 are now showing the first signs of puberty.

A specialist said early puberty was linked to an increased risk of female cancers later in life.

The reasons why girls are going through puberty several years earlier than a century ago are not well understood by scientists.

Some have suggested a relationship between early puberty and obesity, and the latest research, carried out by the Reprogen consortium of scientists from the US, Europe and Australia, supports this idea.

Among the 30 genes highlighted by their genome research were some already linked to fat metabolism and weight regulation.

However, it is still not clear whether being obese or overweight in childhood is itself the cause of early puberty, or just another consequence of a different mechanism.

In addition, the study does not show how much of the risk is due to genes, and how much other environmental factors such as diet and upbringing are responsible.

Fat stores

One author, Dr Ken Ong, from the Medical Research Council Epidemiology Unit in Cambridge, said: "We know that girls who are overweight are more likely to go through puberty at young ages.

"Start Quote

You need to be aware that you may be laying down your future risk from childhood"

End Quote Professor Anthony Swerdlow, Institute of Cancer Research

"If rates of childhood obesity continue to rise we will see many more girls with puberty at young ages."

Dr Anna Murray, another of the researchers from Exeter University, suggested that holding larger stores of fat might signal to the brain that it had the resources to start a woman's reproductive life.

She said: "We found that the timing of puberty is related to fatty acid metabolic pathways - there is evidence that the brain can sense these types of body fats."

Aside from the confusion experienced by young children entering puberty, it carries other health risks in the longer term.

Professor Anthony Swerdlow, from the Institute of Cancer Research, said that early puberty meant a higher risk of female cancers, particularly breast cancer.

This was possibly due to a higher lifetime exposure to sex hormones such as oestrogen.

He said that good diet and exercise, or the lack of it, in early childhood might be crucial to health many decades later.

He said: "What we increasingly believe is that, at least for breast cancer, the risk starts very, very young, even before puberty.

"If you are to prevent it, you need to be aware that you may be laying down your future risk from childhood."



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Saturday, November 20, 2010

Plain cigarette packets proposed

Cigarette packets should have plain packaging to make smoking less attractive, ministers have suggested.

The government is currently planning to ask retailers to cover up their displays of cigarettes from next year to protect children.

But now cigarette packets could also be made a standard colour like grey, rather than the existing bright colours.

Campaign group ASH says this is "an enormous leap forward".

The Department of Health is considering the idea of asking tobacco firms to put only basic information and health or picture warnings on their packets.

Making the cigarette packets a plain colour would protect children from taking up smoking in the first place, it suggests.

It would also help support people who are trying to give up smoking, the department said.

'Costs too high'

Health Secretary Andrew Lansley, said it was time to try a new approach.

"Start Quote

Young smoker

The industry use packaging to seduce our kids and mislead smokers"

End Quote Martin Dockrell ASH

"The evidence is clear that packaging helps to recruit smokers, so it makes sense to consider having less attractive packaging. It's wrong that children are being attracted to smoke by glitzy designs on packets.

"We would prefer it if people did not smoke and adults will still be able to buy cigarettes, but children should be protected from the start.

"The levels of poor health and deaths from smoking are still far too high, and the cost to the NHS and the economy is vast. That money could be used to educate our children and treat cancer," Mr Lansley said.

"We will shortly set out a radical new approach to public health in a White Paper."

Martin Dockrell, director of policy and research at ASH, (Action on Smoking and Health), said the industry calls packaging "the silent salesman".

"They use it to seduce our kids and mislead smokers into the false belief that a cigarette in a blue pack is somehow less deadly than a cigarette in a red one.

"By helping smokers who want to quit and protecting our children from the tobacco ad men this will be an enormous leap forward for public health, perhaps even bigger than the smoking ban," he said.

"The government accepts that packaging and tobacco displays influence young people, so there is no time to waste. It may take years to pass a new law on plain packs but the law on tobacco displays is already on the statute books and comes into force next year."

Recent research published in Tobacco Control showed that putting tobacco out of sight in shops not only changes young people's attitude to smoking, it also doesn't result in retailers losing money.



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Pope's condom comments welcomed

Catholic reformers and groups working to combat HIV have welcomed remarks by Pope Benedict that the use of condoms might not always be wrong.

The Pope said their use might be justified on a case by case basis to prevent the spread of HIV/Aids.

The remarks, due to be published in a book next week, mark a softening of his previously hard line against condoms in the battle against HIV, analysts say.

The Vatican has long opposed condoms as an artificial form of contraception.

This has drawn heavy criticism, particularly from Aids campaigners,who say condoms are one of the few methods proven to stop the spread of HIV.

'Significant shift'

Pope Benedict said during a visit to Cameroon last year that handing out condoms might actually make HIV infection worse, drawing criticism from several EU states.

In his latest comments, however, he said the use of condoms might be justified in exceptional circumstances.

He gave the example of male prostitutes where, he said, using condoms to prevent the spread of AIDS could be seen as an act of moral responsibility, even though condoms were "not really the way to deal with the evil of HIV infection".

This marks a significant shift in his previously implacable opposition to the use of condoms, says the BBC's religious affairs correspondent, Robert Pigott.

UNAIDS, the United Nations programme on HIV/Aids, welcomed the comments as a "significant and positive step forward".

"This move recognizes that responsible sexual behaviour and the use of condoms have important roles in HIV prevention," said UNAIDS Executive Director Michel Sidibe.

The Kenya Treatment Access Movement (KETAM), which works to combat the spread of HIV, welcomed what it said was the Pope's acceptance of reality that abstinence did not always work.

"It's accepting the reality on the ground," said David Kamau, head of the KETAM. "If the Church has failed to get people to follow its moral values and practice abstinence, they should take the next best step and encourage condom use."

The Catholic reform group We Are Church said the comments showed the Pope was able to learn from experience.

The British gay rights campaigner, Peter Tatchell, told the BBC the Pope's comments were significant but needed "clarification".

'Not a moral solution'

The new book - Light of the World: The Pope, the Church and the Signs of the Times - is based on a series of interview the Pope gave the German Catholic journalist, Peter Seewald, earlier this year.

When asked whether the Catholic Church was not opposed in principle to the use of condoms, the Pope replied: "She of course does not regard it as a real or moral solution, but, in this or that case, there can be nonetheless, in the intention of reducing the risk of infection, a first step in a movement toward a different way, a more human way, of living sexuality."

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Pope Benedict said the "sheer fixation on the condom implies a banalisation of sexuality" where sexuality was no longer an expression of love, "but only a sort of drug that people administer to themselves".

Although Pope Benedict reiterated the Church's fundamental opposition to contraception, and repeated his view that condoms were not the answer to curbing HIV, he added that there was much in the area of sexual ethics that needed to be pondered and expressed in new ways.

Austen Ivereigh, coordinator of the Catholic Voices group, said that while this was the first time the Pope had voiced such an opinion on condoms, it was in line with what Catholic moral theologians have been saying for many years.

"The Church's teaching on contraception predates the discovery of Aids," Mr Ivereigh told the BBC news website.

"The prevalence of HIV raised the question of whether condoms could be used to prevent the transmission of the virus.

"If the intention is to prevent transmission of the virus, rather than prevent contraception, moral theologians would say that was of a different moral order."

But Clifford Longley, who writes for The Tablet, a British Catholic newspaper, said the development was far more significant than a nuanced change in attitude.

He said the "small concession... could easily become a collapse in the whole edifice of Catholic teaching on contraception".

"The implication seems to me to be much vaster than even the Pope anticipates," said Mr Longley.

The Vatican newspaper, L'Osservatore Romano, published excerpts of the book in its Saturday edition.



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GP leader warns over NHS reform

Doctors could be faced with angry patients questioning spending decisions if NHS reforms go ahead, the new leader of the Royal College of GPs has warned.

Clare Gerada criticised plans to put �80bn of annual funding into the hands of GPs as part of widespread reform.

Patients could end up begging doctors for life-saving drugs while drug companies lobby GPs, she warned.

The NHS has been told by Health Secretary Andrew Lansley to make up to �20bn of savings by 2014.

Mr Lansley believes GPs know what works best and wants to tap into their entrepreneurial spirit to drive improvement.

'Begging letters'

The plans move the responsibility of deciding who gets treatment from the National Institute for Health and Clinical Excellence and primary care trusts in England to GPs, from 2013.

"At worst, the negative impact for GPs could be patients lobbying outside their front door, saying 'You've got a nice BMW car but you will not allow me to have this cytotoxic drug that will give me three more months of life'," she told the Guardian newspaper.

"I'm concerned that my profession, GPs, will be exposed to lobbying by patients, patient groups and the pharma industry to fund or commission their bit of the service. There could be letters from MPs and patient groups, and begging letters from patients."

She added: "Patients might think that the decision made about their healthcare will be based on self-interest - GPs saving money for themselves rather than spending it on patients."

"Start Quote

I think it is the end of the NHS as we currently know it"

End Quote Clare Gerada Royal College of GPs

Currently about 80% of the budget is held by local managers working for the 151 primary care trusts in England.

Ministers want to transfer much of that responsibility to GPs working in consortiums across the country, phasing out primary care trusts and regional bodies known as strategic health authorities over the next few years.

NHS break-up

But Dr Gerada predicted the demise of the NHS through such reform.

"I think it is the end of the NHS as we currently know it, which is a national, unified health service, with central policies and central planning, in the way that (Aneurin) Bevan imagined," she said.

A Department of Health spokeswoman said the reform was "a necessity", not an option.

"We share a common goal with the RCGP that we all want patients to get the best health and care services," she added.

Shadow health secretary John Healey said the plans were "signalling a break-up of the NHS that will see it move away from a consistency of service that can be accessed whatever people's means."

He accused Mr Lansley of not listening to warnings from doctors, nurses and health experts "to slow down on his high-cost, high-risk plans."



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