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Wednesday, 19 July 2006 09:24
BNN: British Nursing News Online · www.bnn-online.co.uk
MENOPAUSE HERB MAY CAUSE DAMAGE LIVER
The Medicines and Healthcare products Regulatory Agency (MHRA) warned yesterday that a herb used by millions of women to relieve symptoms of the menopause may cause serious liver damage.

Use of products containing black cohosh, a relative of the buttercup, has risen dramatically since the hormone replacement therapy scares three years ago, with an estimated nine million doses taken every day by women seeking to relieve hot flushes. It is thought that it helps to ease menopause symptoms because it may have a weak oestrogenic effect.

The MHRA has said that all black cohosh products should carry a warning label that says that in rare cases it can damage the liver. They say symptoms must be reported to doctors.

Prof Philip Routledge, chairman of the MHRA Herbal Medicines Advisory Committee, said yesterday: "After reviewing all the available data we have come to the conclusion that black cohosh may be associated with liver disorders. This is rare but it can be serious”.

Prof Kent Woods, the chief executive of the MHRA, said: "The MHRA is working with the herbal sector to ensure that black cohosh products carry updated safety labels.

"These labels will point out the possible symptoms so that appropriate action can be taken without delay”.

A spokesman for the MHRA said: "We are not telling people to stop taking it but if they have any symptoms they should stop and see their doctors straight away”.

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Wednesday, 19 July 2006 09:06
BNN: British Nursing News Online · www.bnn-online.co.uk
HOSPITALS MUST REVIEW PATIENTS' SAFETY
After a publication of a report describing alleged rapes, sexual assaults and sexual harassment, every mental health trust in the country is to be instructed to review its approach to patients’ safety.

Officials have been aware of the report for more than eight months, but published it only yesterday — a week after the newspaper The Times revealed its contents. They said that a separate inquiry had been started into the most serious alleged incidents, which include 11 reports of rapes by NHS staff.

Ministers have faced a barrage of criticism this week for failing to act on the information: no safety alert or progress report was issued, which health campaigners and politicians describe as gross neglect.

The report, With Safety in Mind: Mental Health Services and Patient Safety, describes 122 serious incidents within two years. As well as the 19 rape cases revealed by The Times, there were 20 reported incidents of consensual sex, 13 of exposure, 18 of sexual advance and 26 of touching.

Of the nineteen reported rapes, eight were allegedly carried out by a fellow patient and eleven by a member of staff. The report, compiled by the National Patient Safety Agency, acknowledges the likelihood of underreporting of incidents. It also calls for a new definition of “harm” in incident reports to include psychological trauma.

Responding to the publication yesterday, Louis Appleby, the National Director for Mental Health, said that he had started an inquiry into the most serious allegations and that every mental health trust would be asked to review procedures to protect patients.

“Although the vast majority of NHS patients receive safe and effective care, any incident where the safety of a patient is compromised is one incident too many,” Professor Appleby said. “We must investigate and learn from all these incidents”.

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Wednesday, 19 July 2006 08:56
BNN: British Nursing News Online · www.bnn-online.co.uk
HEART SURGERY SURVIVAL RATES ARE REVEALED FOR HOSPITALS IN SCOTLAND
A website, which was put together by the Healthcare Commission and the Society for Cardiothoracic Surgery, allows patients having heart surgery in Scotland to compare the performance of hospitals and see which units and surgeons have the best survival rates.

New data published yesterday includes information from the four cardiac units in Scotland, alongside statistics for all 37 units in Britain as a whole.

The data showed that all four Scottish units fell below the British average for heart bypass surgery survival at 98.3 per cent, although Edinburgh Royal Infirmary and Aberdeen Royal Infirmary came close at 98.2 per cent.

But the units scored well for aortic valve replacements, with only Glasgow Royal Infirmary falling slightly below the British average of 97.7 per cent survival.

The organisations said the hope was that patients would be able to use the data when considering where they would have their surgery and discuss the information with their GP.

But they stressed that the website, which can be found at heartsurgery.healthcarecommission.org.uk could not tell patients their own chances of survival.
   

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Wednesday, 19 July 2006 08:31
BNN: British Nursing News Online · www.bnn-online.co.uk
OVER-50S CATCHING HIV AND HERPES
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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Wednesday, 19 July 2006 08:14
BNN: British Nursing News Online · www.bnn-online.co.uk
SEVERE MIGRAINE HEART RISK LINK
Researchers from Brigham and Women's Hospital and the Harvard School of Public Health in Boston, claim that middle-aged women who have severe migraines with other symptoms are at an increased risk of potentially fatal heart conditions.

The researchers studied 27,840 women aged 45 or older for 10 years from the early 1990s.

At the beginning of the study, 5,125 women (18.4%) reported that they had a history of migraine.

Of the 3,610 who had experienced migraine in the previous year, just under 40% reported aura symptoms.

During the course of the study, there were 580 major cardiovascular events such as heart attack, stroke and angina. There were 130 deaths from cardiovascular disease.

Women who currently experienced migraine with aura had a significantly increased risk of stroke, heart attack, other serious heart conditions and death from CVD caused by narrowed arteries.

When age was taken into account, there were 18 additional CVD events which could be directly linked to migraine with aura per 10,000 women per year.

Dr Tobias Kirth, who led the study, said: "Since migraine without aura is far more common than migraine with aura, our data demonstrate no increased risk of CVD for the majority of migraine patients.

"Future research should focus on a better understanding of the relationship between migraine, aura status, and cardiovascular event”.

In an editorial in the Journal of the American Medical Association, Dr Richard Lipton and Dr Marcelo Bigal, from the Albert Einstein College of Medicine said the same genetic flaw - linked to a increased levels of homocysteine - an amino acid in the blood - is seen in CVD and migraine with aura - but not in migraine without aura.

They added: "For patients with migraine with aura, clinicians should have heightened vigilance for modifiable cardiovascular risk factors, such as high blood pressure, high cholesterol, and smoking”.

The doctors said further research would be needed to determine if migraine with aura was itself a modifiable risk factor for CVD, and if medicines to prevent migraine might cut CVD risk.

Ellen Mason, a cardiac nurse at the British Heart Foundation, said: "Female migraine sufferers need not be alarmed by this study.

"However, it does highlight the need for further scientific research into why migraine sufferers who experience an aura are at increased risk of cardiovascular disease”.

She added: "It would be wise for women who experience migraines with aura to keep their lifestyles as healthy as possible to try to offset any small increase in risk from heart disease due to migraine”.

A spokeswoman for the Migraine Association, said: "The results of this study are interesting.

"Migraine is such a complex neurological condition that the more we can understand from research such as this, the better equipped sufferers can be, as well as healthcare professionals, when it comes to preventative treatment options and lifestyle considerations”.

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Wednesday, 19 July 2006 07:59
BNN: British Nursing News Online · www.bnn-online.co.uk
RUBBING SUNCREAM INTO THE SKIN DRASTICALLY REDUCES ITS EFFECTIVENESS
A study by the Restoration of Appearance and Function Trust (RAFT) found that rubbing suncream into the skin drastically reduces its effectiveness.

The alarming research by the RAFT charity found that sunscreens work properly only if they are used in a thick 'buttery' layer.

Lead researcher Dr Rachel Haywood said: "Most people prefer to rub the cream into the skin.

"They find it more pleasant and comfortable.

"However, our research shows for the first time that if the cream is rubbed in, the protection is minimal”.

Sara Hiom, from the charity Cancer Research UK, said: "The one message people should take from this research is that you cannot rely on sunscreen alone to protect you from skin cancer.

"Sunscreen should be the last - not the first - line of defence against the sun's harmful rays.

"The most important thing is not to burn and we recommend that people should spend time in the shade between 11am and 3pm when the sun is at its height and they should cover up with a T-shirt, hat and sunglasses.

"Factor 15 plus sunscreen with added UVA protection should be applied generously and reapplied often on any exposed skin.

"People with fair skin who burn easily or who have lots of moles or freckles or a family history of skin cancer should be particularly careful in the sun as they are at the highest risk of the disease”.

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Tuesday, 18 July 2006 10:55
BNN: British Nursing News Online · www.bnn-online.co.uk
NHS CHARGES A COMPLETE MESS
A powerful committee of MPs claims that patient charges in the NHS are a "complete mess".

They warned that prescriptions, dentistry and eye test charges have developed without any "comprehensive, underlying principles", causing them to be "full of anomalies”.

A report from the health select committee identifies £78 million raised by hospitals from parking, of which £63 million is paid by visitors. Parking income ranges from £200 to £2,000 per space a year.

The report also found that a third of opticians do not sell any glasses that are cheap enough to be covered by the NHS voucher scheme. It costs £7 million a year to administer the "particularly confusing" prescriptions system.

Bedside television use can cost up to £3.50 a day and incoming phone calls to patients can cost up to 49p a minute.

The MPs say that in future some other treatments may have to be charged for and that the Government should establish consistent criteria for charging.

Kevin Barron, the chairman of the committee, said: "The system of NHS charges needs to change, but first we need to know how the charges interact with health. At present the evidence base is not strong enough. One of our key recommendations is that this be addressed.

"In the short term, parking fees should be reduced, or eliminated, for patients attending hospital regularly. It is unacceptable that people have to pay hundreds of £to attend for necessary treatment”.

The report says: "The system of NHS charges is a mess. Age and income exempt some people but this does not apply across the board. People with diabetes who require insulin receive free medicines for all conditions while people with diabetes controlled by diet must pay for medication."

MPs criticise the high cost of incoming calls to hospital bedside telephones, televisions and computer units.

"Incoming calls are a source of anger and distress. They are charged at a very high rate. A recorded message, which cannot be skipped, makes incoming calls even more expensive”.

They also urge hospitals to make better use of the high-tech units. "It is an utter waste for these units, which could contribute significantly to the transfer of information within hospitals, to be used as little more than glorified telephones and televisions”.

The MPs recommend that all pharmacies, hospitals and GP and dental surgeries make available to patients information on charges to which they might be liable, eligibility for exemption, and possible assistance with costs associated with receiving treatment.

A spokesman for the Department of Health said: "We will study the recommendations of this report carefully. We are absolutely committed to NHS treatment remaining free at the point of delivery.

"We don't agree with the committee that the prescription system is in a mess. More than 87 per cent of all NHS prescription items are dispensed free of charge and there is help available to many patients on low incomes.

"We think hospitals should continue to be able to charge for parking but trusts should not fleece patients unfairly.

"We will also be asking trusts to make their policies on mobile phone use clear to patients. Any savings made should be reinvested into patient care”.
   

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Tuesday, 18 July 2006 10:37
BNN: British Nursing News Online · www.bnn-online.co.uk
INDOOR SWIMMING POOL USE LINK TO ASTHMA
A study, by the Catholic University of Louvain, Brussels suggests that children who use an indoor swimming pool may be at increased risk of developing asthma.

In the latest study across 21 countries in western and eastern Europe which involved 190,000 13 and 14-year-olds. It found that the incidence of wheezing rose by 3.39 per cent for every indoor swimming pool per 100,00 population while the incidence of asthma rose by 2.73 per cent.

The study, conducted by Prof Alfred Bernard lent credence to the theory that the bi-products of chlorine in pools were an irritant when mixed with urine.

Writing in the journal, Occupational and Environmental Medicine, the researchers say they found more asthma and wheezing in children from western European countries where the availability of indoor pools is higher. In Western Europe there was an indoor pool on average for every 50,000 inhabitants compared with one for every 30,000 in Eastern Europe.

The are now calling for a thorough evaluation of the long-term effects of chlorine on children's lungs, regulation of levels of chlorine by-products, and proper ventilation of pools.

"The prevalence of childhood asthma and availability of indoor swimming pools in Europe are linked through associations that are consistent with the hypothesis implicating pool chlorine in the rise of childhood asthma in industrialised countries," Prof Bernard said.

A spokesman for Asthma UK said swimming was an excellent form of exercise for children with asthma. "We do recognise, however, that the chemicals present in heavily-chlorinated pools may be important in making the airways more irritable."

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Tuesday, 18 July 2006 10:10
BNN: British Nursing News Online · www.bnn-online.co.uk
28,000 PEOPLE WAIT TO SEE A PHYSIOTHERAPIST IN SCOTLAND
According to the first ever official survey over 28,000 people are waiting for their initial appointment with a physiotherapist in Scotland.

The unprecedented investigation found patients can face delays of up to a year for their first treatment session.

Lewis Macdonald, Deputy Health Minister, called for health boards to examine therapy services in light of the information and drive waiting times down.

Kenryck Lloyd-Jones, policy officer in Scotland for the Chartered Society of Physiotherapy, said: "We're concerned patients might be waiting for such periods before seeing a physiotherapist. Early intervention is so often essential in restoring function. We want progress to address patient need”.

Hundreds of physiotherapy students and graduates from across the UK are expected to gather in London today to protest at the lack of NHS jobs for newly qualified staff.

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Tuesday, 18 July 2006 09:58
BNN: British Nursing News Online · www.bnn-online.co.uk
THE WELSH AMBULANCE SERVICE CARDIAC SURVIVALS RISE
An internal clinical audit report for the Welsh Ambulance Service shows a 170% increase in people arriving in hospital alive after cardiac arrests.

The audit report found 79 patients arrived alive compared with 29 when statistics for two months in 2006 were compared with 2005.

The service said the improvement was the result of a number of factors, including the use of automatic chest compression devices, improved data collection, adoption of new treatment protocols and sending helicopters to cardiac arrest cases.

The report said that due to the increase in patients arriving alive at hospital, it was likely "that the number of patients surviving alive to hospital discharge will have increased".

The service's interim chief executive Anton van Dellen said: "We are delighted with the improvement in the number of lives saved as a result of the hard work of our staff and the new ways of working.

"Further work is needed to improve upon these impressive results, especially in conjunction with the receiving hospitals”.

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