Obesity Linked To Kidney Cancer

Cancer Research Uk has released figures showing that cases have risen to more than 9,000, up from 3,000 in 1975.This makes kidney cancer the eighth most common cancer in the UK.
The charity says that some of this increase could be due to the greater use of imaging techniques helping to diagnose more kidney tumours.
This taken into account, rising obesity levels are also a factor. After smoking, obesity is one of the main risk factors for kidney cancer, with research suggesting it increases the risk by 70%. 

Figures show that in 2009 there were 9,286 new cases of kidney cancer in the UK. 5,706  in men and 3,580 in women. This represents about 19 new kidney cancer cases for every 100,000 men in the UK and more than 11 new cases for every 100,000 women.

Kidney cancer is now the sixth most common cancer in men and the ninth most common cancer in women.

Health regulator 'still failing' in duty to protect patients

This article has been sourced from the Telegraph and highlights the serious nature of the lagging care system in which we live:

A senior board member at the health and social care watchdog has warned that despite a series of damning reports the regulator is still failing to protect patients from poor treatment in hospitals and care homes.

Kay Sheldon, a psychiatrist and a non-executive director and at the Care Quality Commission spoke to the Daily Telegraph warning that the regulator is still failing to protect patients in care homes and hospitals.
She said: "There are risks to patients because the CQC is not doing its job. There are things happening in care homes and hospitals that are not being picked up.
"The CQC is saying that things have improved but I am not convinced that is real."
She said changes in the pipelines to the inspection system will not improve matters or safeguard patients.
"It will unravel and we need to say stop now, and get some proper leadership in.

"The culture is oppressive and there have been allegations of bullying that have not been investigated. The organisation is in crisis mode and is still concerned with its own reputation."
She said inspectors had failed to detect risks to patients at Furness General Hospital, in Barrow, where seven babies died and only took the issues seriously after the coroner intervened.
Joshua Titcombe died in October 2008, nine days after he was born when midwives failed to diagnose and treat a serious infection.
Five other babies died in 2008, one on Christmas Day in 2010 and one in April 2011. However the CQC had found the unit was compliant with standards in July 2010.
The CQC launched an investigation after the inquest into Joshua's death but only found six areas of concern, none of which were followed up, Ms Sheldon said.
In December last year the foundation trust regulator, Monitor, found 119 problems at the trust, 66 of them marked as 'red' being the most serious.
Ms Sheldon said she raised concerns about the quality of the CQC inspections and the lack of action taken with the CQC board but was told it had been a 'robust' piece of work.
Even when she told the Department of Health of the lack of action at the CQC she was told it had to be dealt with internally by the CQC.
Ms Sheldon, who was awarded an OBE last year for her services to healthcare, She said: "I am concerned that many of the problems persist.
"I am concerned that we are not an effective regulator of health and social care.
"For example, I have serious concerns about how effective the CQC was in identifying and acting on concerns at Morecombe Bay hospital trust in the maternity services and in A&E at Lancaster.
"The inspectors are not specialists in their areas and have heavy workloads so even when they did identify risks to patients those were not followed up on by the CQC.
"It is only when Monitor and the coroner identified the same and more serious problems that the CQC began to take the issue seriously.
"I raised my concerns with the chief executive and the director of operations at the CQC but they did not reply.
"As requested, I then emailed the Department of Health with my concerns and they said the issue should be dealt with within the CQC."

Minimum Alcohol Unit Price

Due to the devastating nature of English binge drinking with causes health problems as well as crime associated issues, the government has unveiled plans for minimum alcohol pricing  of 40 pence per unit in England. 
It is estimated that each year alcohol causes over 1 million NHS hospitalisations and 1 million violent crimes in England, primarily through binge drinking. Earlier this week NHS figures revealed that deaths from liver disease had risen by 25% in less than a decade, mainly driven by alcohol.

The strategy has also called for consultation on multi-buy deals offering cheap alcohol in bulk, as well as a "zero tolerance" approach to dealing with drunken behaviour in A&E departments and new legislation over the licensing of pubs and clubs. The strategy is still at a proposal stage but the government hopes to implement it by 2015.

3,500 fewer nurses working in the NHS

As the NHS struggles with quality of care standards, budget cuts and a reformation that threatens to damage it even further we learn of shocking figures regrading the cutting of nursing posts.

An NHS workforce census has shown that there are 3,500 fewer nurses working in the NHS than in 2010 and the number of managers has also dropped significantly. It is the biggest fall in staff figures for a decade and comes as the NHS is making £20 billion in efficiency savings by 2014/15.

Managers saw their numbers falling by 8.9 per cent to 38,214 in the year to September last year, NHS support staff fell to 219,624, a fall of 5.9 per cent since 2010, while the number of hospital and community health service nurses fell by 3,411, or one per cent.
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said the loss of qualified nurses was "incredibly worrying. These figures are yet further evidence of the rising scale of cuts to NHS jobs and services and tally up with the RCN's findings which in November revealed at least 56,000 NHS posts are to go across the UK. Yesterday's NHS staff survey shows clearly the impact of these cuts, with two thirds of respondents saying that there are not enough staff to allow them to do their jobs properly. Despite the rhetoric, we know that frontline jobs are not being protected and NHS trusts must stop making cuts in a quick fix attempt to save money. Put bluntly, the idea that cutting hundreds of jobs from a hospital will not affect the care of patients is ludicrous. There is no doubt that the impact of these cuts, combined with the upheaval created by the Health and Social Care Bill, means that the NHS is becoming seriously destabilised. We know that savings need to be made, but cutting frontline staff and services that vulnerable patients rely on is just not the way to do it."

6 Million Deaths From Tobacco

Global death figures from smoking top 6 million (80% were from low- and middle-income countries, according to new research from health lobby campaigners) as Revenues from global tobacco sales are estimated to be close to £316bn.

British American Tobacco and Imperial are two of the biggest companies. Whilst BAT sells very few cigarettes in the UK, it is a big player in many emerging economies. In Turkey it sells Viceroy and Pall Mall brands; its Kent cigarettes are big sellers in Russia, while Gold Flake and John Player Gold Leaf are popular in Pakistan. Rothmans in Nigeria and Kent and Montana in Iran are also important for BAT. India, Vietnam, Bangladesh, Iraq, Egypt and Yemen are also promising markets for the company. 

A British American Tobacco spokesperson said: "There is constant speculation that we're breaking into emerging markets to avoid regulation. But this is not true. We didn't invent smoking, nor 'export' it anywhere, and we have been in many of these developing markets for hundreds of years – in the case of Africa, India and Brazil, since the early 1900s.
"As disposable income grows around the world, particularly in developing countries, more smokers are upgrading to premium brands rather than low quality local alternatives – and this doesn't just apply to cigarettes."
Health lobby campaigners produced a study regarding tobacco which identified it as the No 1 killer in China, where smoking is said to cause 1.2 million deaths annually. It is also blamed for more than a third of male deaths in Kazakhstan and in Turkey – other major smoking nations.

Antibiotic Crisis

A report by the World Health Organization (WHO) setting out ways to fight the growing problem of antimicrobial resistance (AMR) has brought to light the possibility that we are facing an antibiotic crisis that could make routine operations impossible and a scratched knee potentially fatal. AMR occurs when bacteria and viruses adapt to treatments and become resistant to them. 
The report also stated that increasing use of antibiotics can lead to the formation of “superbugs” that resist many of the antibiotic types we currently have. It outlined a variety of measures that are vital for ensuring we can still fight infections in the future and described how other major infectious diseases, such as tuberculosis, HIV, malaria and influenza, could one day become resistant to today’s treatment options.

However gloomy this news is, Dr Margaret Chan, director general of WHO, said: “much can be done. This includes prescribing antibiotics appropriately and only when needed, following treatment correctly, restricting the use of antibiotics in food production to therapeutic purposes and tackling the problem of substandard and counterfeit medicines.” 

'Bad science' should not be used to justify NHS reforms

Following months of arguments and negative press and sheer panic around the future of the NHS comes this article from the Guardian questioning the accuracy of the reports published by several academics who are supporting the reforms:

The drip-feed of pro-competition arguments from economists Julian Le Grand and Zack Cooper at the London School of Economics raises serious questions about the independence and academic rigour of research by academics seeking to reassure government of the benefits of market competition in healthcare.
Last July, Cooper and several colleagues released an unpublished paper to coincide with the prime minister's announcement that he was setting up a forum in response to concerns about his health bill. The authors were sufficiently persuasive for David Cameron to declare "Put simply: competition is one way we can make things work better for patients. This isn't ideological theory. A study published by the London School of Economics found hospitals in areas with more choice had lower death rates."
The study in question claimed that competition in the NHS saved lives. The authors claimed that if heart attack mortality rates were used as an indicator of quality, mortality rates fell more quickly and therefore quality improved for patients after competition between hospitals was introduced to the NHS in their area. But if you examine the evidence it is clear thatcompetition had nothing to do with it. The intervention that the authors claimed reduced deaths from heart attacks was patient choice – a proxy for competition. In 2006, patients were given choices of hospitals, including private providers, for some selected treatments, mainly non-emergency surgery. Yet there is no biological mechanism to explain why having a choice of providers for cataract, hip and knee operations could affect the overall survival rate from heart attacks. These are emergencies where patients do not exercise choice over where they are treated and are usually treated in the NHS.
As the government's own cardiac tsar Roger Boyle explains. "Patients can't chose where to have their heart attack or where to be treated. It is bizarre to choose a condition where choice by consumer can have virtually no effect. Patients suffering severe pain in emergencies clouded by strong analgesia don't make choices. It's the ambulance driver who follows the protocol and drives to the nearest heart attack centre." 
So among the numerous problems with this study the authors have made the cardinal error of confusing minor statistical associations with causation. Deaths from acute heart attacks are not a measure of the quality of hospital care as a whole, as they claim, but rather a measure of access to and quality of cardiology care. Gwyn Bevan, professor of management science at the London School of Economics, who carried out a review of patient choice and competition in the BMJ commented on the paper's shortcomings. He subsequently went on to say that he was "perplexed" by Andrew Lansley's emphasis on the role of choice and competition because "the evidence is very weak and contested".
"In fact, I would argue that we don't have any strong evidence of that effect. To my mind, the jury is at best still out on whether choice and competition will improve quality of care in the NHS." 
Cooper and colleagues were at it again in February, press releasinganother as yet unpublished paper, once again coinciding with an important NHS event – Cameron's summit on the NHS bill. This time the authors claimed that length of stay fell more rapidly in NHS hospitals experiencing greater competition, but appeared to be unaware that lengths of stay differ between the four conditions they chose to examine. These were elective hip replacements, knee replacements, hernia repairs and arthroscopies (keyhole examination and sometimes surgery to repair joint damage), for which lengths of hospital stay vary widely. Arthroscopy may be done as an outpatient or day case procedure and therefore may not be recorded in statistics derived from admissions to hospital. Hernia repair usually involves admission as a day case although this varies according to the type of procedure and median lengths of stay range between one or two days. In contrast, for hip and knee replacements the median lengths of postoperative stay are four or five days depending on the procedure. 
So, if providers switched to doing more arthroscopies and hernia repairs and fewer hip and knee replacements they will appear to have shortened their pre-operative and post-operative length of stay to less than a day. Length of stay should also take account of other factors such as whether patients are fit for discharge, especially if they live alone, and the need to avoid readmissions due to complications or premature discharge. So if hospitals switch to operating on patients who are well and healthy or to easier procedures they will also appear to have shortened their length of stay.
Equally, the authors did not look at how clinical coding changed following the introduction of the "payment by results" tariff in 2006, which was modelled on the payment system used in the US. Gaming, upcoding and diagnostic drift are widely recognised in research in the US where providers seek to improve and increase their payments through fraudulent billing and accounting by claiming for work that hasn't been done, or for making out that patients were sicker and more complicated and expensive than they are.
Even without fraud, in the NHS arthroscopy which may previously have been coded as an outpatient activity or not at all (ie it would not have been counted as an admission) may now be recorded separately as a daycase inpatient procedure. Similarly, patients undergoing simple surgical hip replacements might be billed as more complex.
These changes in coding distort measures of productivity so that providers appear to be more efficient as they appear to do both more cases and more complex operations and procedures in the time period.
Le Grand and Cooper call themselves "empiricists" and all those that disagree with them "intuitivists". Yet unlike scientists, they do not appear to have carried out real life observational work in general practice or on the wards, nor have they thought through how financial incentives can change the data. Neither do they appear to have tested their theories with experiments, or adapted their models to see if they are also compatible with different explanations from the many that could be derived from historical data. While their data dredging has generated weak statistical associations, they have made the cardinal error of assuming these associations were causal. Bad science makes bad policy, bad policy leads to careless talk and careless talk costs lives.


New Vacancy:
Nursery Nurse - £7.50 per hour - South East London

Processed Meat Increases Death By A Fifth

A study was carried out by the Harvard School of Public Health and followed the diets of over 120,000 people over a period of up to 28 years. The diets were assessed every four years and marked the development of any heart problems or cancer.
Eating red meat, in particular processed meat is associated with a significantly higher risk of dying prematurely. Each 85 gram daily serving of unprocessed red meat (equivalent to about three thin slices of roast beef) was associated with a 13% increase in death risk during the study period, while one daily serving of processed meat (one hot dog or two slices of bacon) was associated with a 20% increased risk.

The researchers think that 9.3% of early deaths in men and 7.6% in women in the study could have been prevented if all the participants had consumed fewer than 0.5 servings a day (about 42 gram a day) of red meat.

Nurses Could Be Set Patient Limits

Following the deaths of hundreds of patient due to massive failures in care at the Stafford Hospital and also a governmental review of nursing , ministers are debating whether to set guaranteed levels of staffing. So either a maximum number of patients per nurse or a ratio of healthcare assistants to qualified nurses working on any shift.

The Royal College of Nursing (RCN) is calling for changes as nurses on many wards have become seriously overstretched, with too heavy reliance on cheaper unqualified assistants. This is very visible on wards caring for elderly patients.

Research has found that on wards for the elderly, the average nurse is caring for at least 11 patients - three more than on units which care for general patients.

New Treatment For Heart Failure

The drug Procoralan which costs £1.40 a day could save the lives of thousands of heart disease patients. European drug regulators have just approved it for the treatment of chronic heart failure
In heart failure, the heart is unable to pump sufficient blood to the limbs and organs, causing a range of unpleasant symptoms such as weakness and breathlessness.The drug is already used to treat cases of Angina. The National Institute for Health and Clinical Excellence recommends it for angina sufferers that cannot take beta blockers or calcium channel blockers.

However, before it is available on the NHS, its treatment effects and cost effectiveness will need to be assessed by the National Institute for Health and Clinical Excellence (NICE).

BMA Call For Action Against NHS Bill

The British Medical Association has called for GP's to take an active stand against the Government's proposed NHS reforms to prevent private companies from controlling the NHS budgets.The BMA have sent   22,000 GP'S a letter warning that the reforms will cause irrevocable damage and will be almost impossible to implement successfully given the widespread opposition within the NHS workforce.

 The BMA state that the Bill will widen health inequalities and be detrimental to patient care.

The letter scripted by DR Laurance Buckman, chair of the BMA'S GPS' committee, sums up the Bill as complex,incoherent and not fit for purpose.

The Real Dangers of Sleeping Pills

A US study has reported that people prescribed sleeping pills "Hypnotics" run a threefold increased risk of death. 

People prescribed hypnotics, even at very low doses, were more likely to die than those not prescribed hypnotics. 

It also found that people prescribed high doses (more than 132 pills a year) were more likely to develop any 


Researchers studied eight different types of hypnotic separately (zolpidem, temazepam, eszopiclone, zaleplon, 

triazolam, flurazepam, barbiturates and antihistamines. They estimate that hypnotics may have been associated 

with 320,000 to 507,000 excess deaths in the USA.