The King's Fund Response To Libdem NHS Blueprint, UK

Commenting on the paper The NHS: a new liberal blueprint published by Liberal Democrat Shadow Secretary of State for Health Norman Lamb MP, The King's Fund acting chief executive Dr Anna Dixon said:



'This Liberal Democrat paper is further evidence of a growing consensus between the parties on health. We will go into the election with more fundamental agreement on the NHS than ever before. So whatever the outcome on polling day, voters can expect the new government to focus on extending patient choice, providing more personalised care and reforming how hospitals are paid to drive improvements in efficiency and quality.



'The main dividing line between the Liberal Democrats and the other parties is their commitment to replace Primary Care Trusts with locally elected health boards. While this could increase local accountability, there is no evidence that this would result directly in improvements in quality of care. While people have strong views about changes to local services that directly affect them - like the closure of a hospital ward - it is not clear how much appetite the public have to play an active role in deciding how money is spent day to day.



'Plans to reduce the number of quangos and regulators might sound appealing - especially when finances are tight - but regulators play an important role in ensuring safety and improving quality. While there is a clear case for regulators to be better co-ordinated and reduce the burden on providers - by sharing and making better use of data for instance - they are often an easy target for politicians.



'Norman Lamb sets out some interesting ideas about engaging staff, encouraging innovations and the smarter use of technology within healthcare. We look forward to seeing more detail about how the Liberal Democrats would turn these ideas into clear actions that the NHS can implement.'

Source
The King's Fund

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The World Medical Markets Fact Book 2008

Research and Markets has announced the addition of the "The World Medical Markets Fact Book 2008" report to their offering.


The need to understand world medical markets, and be able to answer quickly those questions that arise daily, is essential. Therefore an authoritative, current and comprehensive market intelligence source is an invaluable aid for every executive. And that source is The World Medical Markets Fact Book 2008 (published May 2008).


The 332-page Fact Book 2008 brings together a range of often difficult to source information in one single, convenient publication. Keep it near to you at all times, or consider an electronic version to share with colleagues for the search and retrieval of specific information.


EASY ACCESS TO THE LATEST AVAILABLE DATA ON:


World market:


The worldwide medical device market covering key market areas such as demographics, mortality data, health services/resources and medical market values. International comparisons provide unique rankings and key indicators are forecast to 2013.


Regional analysis:


Major world regions providing regional analysis, rankings and forecasts for Americas, Asia/Pacific, Middle East/Africa, Central and Eastern Europe and Western Europe.


National market data:


Detailed national market profiles of 67 countries worldwide from Argentina and Austria to Venezuela and Vietnam.


Company analysis:


The performance of the world's 80 largest medical device and equipment manufacturers is provided in comparative tables.


ANSWERS KEY BUSINESS QUESTIONS SUCH AS...


-- Which country spends most on medical devices in terms of per capita GDP?

-- Which medical markets are growing the fastest?

-- How does the Brazilian market compare with Mexico and Argentina in terms of total health expenditure?

-- What demographic development is affecting the market in Latvia and Estonia?

-- What will the per capita spend on medical devices be in 2013 in South Korea and Thailand?


For more information click here.


Research and Markets


www.researchandmarkets

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Social Costs Of Achievement Vary By Race/ethnicity, School Features

Doing well in school and feeling accepted by your peers are both important challenges during adolescence. Sometimes these don't fit well together, as when teens are ostracized for being smart. A new study has found that such pressures differ for teens in different racial/ethnic groups, and that characteristics of the teens' schools also play a role.



The study, conducted by researchers at Cornell University, appears in the November/December 2010 issue of the journal Child Development.



"This is the first study to clearly show that for adolescents, there are measurable differences in the social costs of academic success across racial and ethnic groups," notes Thomas E. Fuller-Rowell, postdoctoral research fellow in the Institute for Social Research at the University of Michigan; Fuller-Rowell led the study when he was at Cornell. "By doing so, it points to the significance of race and ethnicity in understanding the achievement gap, and can be helpful to those developing programs and policies to address this gap."



The researchers carried out their work using a nationally representative sample of almost 14,000 7th through 12th graders, the National Longitudinal Study of Adolescent Health (also called Add Health). Add Health was designed and funded under the auspices of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and 17 other federal agencies, and is the largest, most comprehensive survey of adolescents ever undertaken.



The students were interviewed once in their homes, then interviewed again a year later. In the interviews, students gave their grade point averages (GPAs) and reported on how much they felt socially accepted. Researchers learned about characteristics of each school from a related Add Health survey completed by almost all students in each school, and from information provided by school administrators.



The researchers found that for African American and Native American teenagers, the higher their GPAs at the start of the study, the more their feelings of social acceptance decreased over the one-year period. In contrast, for White teens and teens of other races and ethnicities, the higher their GPAs at the start of the research, the more their feelings of being socially accepted increased over the year. These differences across groups remained, even after the researchers took into consideration various background characteristics such as the level of education of the teens' parents, whether they lived in single-parent families, the size and type of the school they attended, and the affluence of the school.



The researchers also looked at how specific characteristics of the schools the teens attended affected the social costs of doing well. They found that for African American teens, the social costs of achieving were greatest in higher achieving competitive schools, but only when there weren't a substantial number of same-race peers at the schools. The same happened to students of Mexican descent. Gender was not a factor for high-achieving teens who didn't feel socially accepted.



"Previous research indicates that teachers and school administrators can work to create an environment of 'identity safety' in which students of different racial and ethnic backgrounds feel accepted and respected," according to Fuller-Rowell. "Such approaches are important to achievement. Our study suggests that these kinds of approaches, while valuable in all schools, may be especially important to the achievement of minority students when they are in small numbers within high achieving schools."



Summarized from Child Development, Vol. 81, Issue 6, The Social Costs of Academic Success Across Ethnic Groups by Fuller-Rowell, TE (University of Michigan, formerly at Cornell University) and Doan, SN (Boston University, formerly at Cornell University). Copyright 2010 The Society for Research in Child Development, Inc. All rights reserved.



Source:

Sarah Hutcheon


Society for Research in Child Development

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Suspected Food Poisoning Case Under Investigation

The Centre for Health Protection (CHP) of the Department of Health is investigating a suspected food poisoning case involving 16 people who felt sick after taking lunch in a hotel in Mong Kok.


-- The affected, comprising four men and 12 women aged between 32 and 61, developed diarrhea, abdominal pain, vomiting and fever about six to 34 hours after having lunch buffet in the hotel on July 22.


-- Their symptoms were generally mild. Ten of them sought medical treatment from private doctors or public hospitals. One was admitted to Yan Chai Hospital. They are in stable condition.


-- CHP's initial investigations showed that bacteria could be the likely cause for the outbreak. Further investigation is in progress.


-- CHP reminded members of the public, especially food handlers, to observe good personal and environmental hygiene to prevent food-borne diseases. They are advised to take the following measures:


-- Clean and cook food thoroughly before consumption, particularly crustacean and bivalve seafood such as shrimp, crab, oysters and clams;


-- Wash hands before eating and after going to toilet;


-- Handle raw and cooked food with separate utensils to prevent cross contamination;


-- Keep raw and cooked food separately;


-- Store food in refrigerator (at 4 degree Celsius or below) and adequately reheat leftover food before consumption; and


-- Keep the environment clean.


Hong Kong Department of Health

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SFE 2011: Selling Value With Customer-Centric Strategies

eyeforpharma's SFE 2011, April 27-29, Barcelona was an undisputed success. With over 560 attendees and more than 50 industry leaders including Jane Griffiths (IVP, Janssen Cilag), Charlotte Sibley (SVP, Shire) Javed Alam (VP Sales, Novartis) offering keen insights on all of the latest trends and challenges, it's no wonder 92% of this year's delegates said they would recommend the conference to a friend.



Hot topics, top speakers


Francesco Frattini, Business Development Director, Roche told attendees about his company's initiatives around CSO & outsourcing. He analysed the impact of their sales results and management time - and shared the lessons learned. Francesco explained that with the changing commercial model Roche Italy knew it must focus on differentiation and personalisation to create greater value form stakeholders.



Another hot topic was in the training & development track. Kevin Crowe Head of Sales Effectiveness, Merck Serono demonstrated how to implement a coaching culture to enhance your people's negotiation skills, selling technique and product knowledge and how to perpetuate this with continual reinforcement. His take away however was the importance of evaluating the return on investment of your training projects.




Continuing momentum



Kate Eversole, VP Europe of eyeforpharma says research for a bigger and even better SFE event next year is already underway. Based on the key take home messages from this year's conference, she predicts SFE 2011 will include a greater focus on business excellence and ecomminications in addition to more traditional SFE topics.



If you missed the event you can catch a keynote- Tyrone Edwards, SVP, Merck (ret.) 'Boost your sales productivity in today's challenging pharmaceutical market' talk for free here.



The real value in the discussions started at events like SFE Europe 2010 comes in carrying them on beyond the conference. To that end, speakers and chairman including Eric Rambeaux VP Strategy, Abbott will be posting articles and blogging on eyeforpharma's dedicated linked in group: linkedin Group Search: Sales Force Effectiveness



"I learnt a lot - Tyrone's presentation is a great place to start"

Pieter Jan Brouwer, VP, Intervet Schering - Plough



For more information visit eyeforpharma/sales






Source:



Nick Best

VP Marketing

eyeforpharma

T: +44 (0) 207 375 7594 ext 296

E: nbesteyeforpharma

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The Mechanisms Of Self-Control In The Brain Pinpointed By Caltech Researchers

When you're on a diet, deciding to skip your favorite calorie-laden foods and eat something healthier takes a whole lot of self-control - an ability that seems to come easier to some of us than others. Now, scientists from the California Institute of Technology (Caltech) have uncovered differences in the brains of people who are able to exercise self-control versus those who find it almost impossible.



The key? While everyone uses the same single area of the brain to make these sorts of value-laden decisions, a second brain region modulates the activity of the first region in people with good self-control, allowing them to weigh more abstract factors - healthiness, for example - in addition to basic desires such as taste to make a better overall choice.



These findings, which are being published in the May 1 issue of the journal Science, not only provide insight into the interplay between self-control and decisionmaking in dieters, but may explain how we make any number of decisions that require some degree of willpower.



"A very basic question in economics, psychology, and even religion, is why some people can exercise self-control but others cannot," notes Antonio Rangel, a Caltech associate professor of economics and the paper's principal investigator. "From the perspective of modern neuroscience, the question becomes, 'What is special about the circuitry of brains that can exercise good behavioral self-control?' This paper studies this question in the context of dieting decisions and provides an important insight."



That insight was the result of an innovative experiment: A group of volunteers - all self-reported dieters - were shown photos of 50 foods, including everything from Snickers bars to Jello to cauliflower. The participants were asked to rate each of the foods based on how good they thought that food would taste. Afterwards, they were shown the same slides again and asked to rate each of the foods based on its supposed health benefits.



From those ratings, the researchers selected an "index food" for each volunteer - food that fell about in the middle of the pack in terms of tastiness and supposed health benefits.



The participant was then shown the 50 items one final time and was asked to choose between it and the index item. (To keep the choosers "honest" without forcing them to eat 50 different foods in one sitting, the researchers would randomly select a number corresponding to one of the slides, and the participant would have to eat whichever food had been chosen at that point.)



All three viewings of the slides were done with the participant inside an MRI scanner, so that the blood-oxygen level dependent signal (a proxy for neuronal activity) in specific areas of the brain could be measured.



After all the choices had been made, the researchers were able to pick out 19 volunteers who showed a significant amount of dietary self-control in their choices, picking mostly healthy foods, regardless of taste. They were also able to identify 18 additional volunteers who showed very little self-control, picking what they believed to be the tastier food most of the time, regardless of its nutritional value.



When they looked at the brain scans of the participants, they found significant differences in the brain activity of the self-control group as compared to the non-self-controllers.



Previous studies have shown that value-based decisions - like what kind of food to eat - are reflected in the activity of a region in the brain called the ventromedial prefrontal cortex, or vmPFC. If activity in the vmPFC goes down, explains Todd Hare, a postdoctoral scholar in neuroeconomics and the first author on the Science paper, "it means the person is probably going to say no to that item; if it goes up, they're likely to choose that item."



In the non-self-controllers, Rangel notes, the vmPFC seemed to only take the taste of the food into consideration in making a decision. "In the case of good self-controllers, however, another area of the brain--called the dorsolateral prefrontal cortex [DLPFC]--becomes active, and modulates the basic value signals so that the self-controllers can also incorporate health considerations into their decisions," he explains. In other words, the DLPFC allows the vmPFC to weigh both taste and health benefits at the same time.



"The vmPFC works during every decision," says Hare. "The DLPFC, on the other hand, is more active when you're employing self-control."



"This, ultimately, is one reason why self-controllers can make better choices," Rangel adds.



Still, the DLPFC can only do so much. For instance, it can't override a truly negative reaction to a food, notes Hare. "We rarely got people to say they'd eat cauliflower if they didn't like cauliflower," he says. "But they would choose not to eat ice cream or candy bars, knowing they could eat the healthier index food instead."



"After centuries of debate in social sciences we are finally making big strides in understanding self-control from watching the brain resist temptation directly," says Colin Camerer, the Robert Kirby Professor of Behavioral Economics in Caltech's Division of Humanities and Social Sciences and another of the paper's coauthors. "This study, and many more to come, will eventually lead to much better theories about how self-control develops and how it works for different kinds of temptations."



The next step, the researchers say, is to come up with ways to engage the DLPFC in the decisions made by people with poor self-control under normal conditions. For instance, Hare says, it might be possible to kick the DLPFC into gear by making the health qualities of foods more salient for people, rather than asking them to make the effort to judge a food's health benefits on their own. "If we highlight the fact that ice cream is unhealthy just before we offer it," he notes, "maybe we can reduce its value in advance, give the person a head start to making a better decision."



Whether this is indeed feasible remains to be tested. But clearly, the possibilities are tantalizing, since these same sorts of value-based choices are at the root of everything from addictions like smoking to risky financial decisions.



"Imagine how much better life could be if we knew how to flex the willpower muscles in the brain and strengthen them with exercises," says Camerer.



The work described in the Science paper, "Self-Control in Decision-Making Involves Modulation of the vmPFC Valuation System," was funded by the Moore Foundation and the Economic Research Service of the U.S. Department of Agriculture on Behavioral Health Economics Research on Dietary Choice and Obesity.



Source:
Lori Oliwenstein


California Institute of Technology

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The Pancreatic Cancer Action Network And AACR To Award Nearly $3 Million In Pancreatic Cancer Research Grants

The American Association for Cancer Research in partnership with the Pancreatic Cancer Action Network is now accepting applications for the 2011 research grants program. The program is administered using the AACR's rigorous peer-review system to ensure that the highest quality science is supported.


Numerous grants will be awarded in 2011, with a total funding level of nearly $3 million. This represents the largest annual dollar amount disbursed since the Pancreatic Cancer Action Network introduced the program in 2003, and is an almost 30 percent increase in funding over last year.


The grants program is designed to help incubate innovative research projects, grow the number of researchers directly working on pancreatic cancer, nurture collaborations across disciplines and institutions, and expedite scientific progress for patient benefit. In addition to receiving financial support for their research, grantees participate in a mentorship program that connects them with leading scientists in the field. Ongoing career support activities offer opportunities for education and professional development.


"This year's grants program marks a significant milestone as we will have surpassed $10 million in research funding since the program's inception in 2003," stated Julie Fleshman, president and CEO of the Pancreatic Cancer Action Network. "During this time, we have begun to form a community of researchers dedicated to making progress in the fight against pancreatic cancer. For so many years, the pancreatic cancer research community was sparse and underfunded. We are beginning to see a transformation, due in part, to our research and advocacy efforts."


"All cancers are in great need of further investigation and increased funding, but because of its low survival rate, pancreatic cancer is particularly challenging and provides us with an urgent call to action," said Margaret Foti, Ph.D., M.D. (h.c.), CEO of the American Association for Cancer Research. "We are very proud of our strong and ongoing partnership with the Pancreatic Cancer Action Network. Together, through cutting edge scientific research, we feel strongly that we will increase our understanding of this deadly form of cancer and, ultimately, conquer it."


The following grants are open for application:


Pathway to Leadership Grant


The Pathway to Leadership Grant is designed to build future leaders in the pancreatic cancer research community by supporting promising early-career scientists in their postdoctoral positions through the transition to independence. Applicants must have started postdoctoral or clinical research fellowships on or after July 2, 2006 (i.e., must be in the first five years of a fellowship at the start of the grant term). The Pathway to Leadership Grant provides up to five years of support, totaling $600,000.


Fellowship


The Fellowship supports early-career scientists during the mentored research phase. Applicants must have started postdoctoral or clinical research fellowships on or after July 2, 2008 (i.e., must be in the first three years of a fellowship at the start of the grant term). The Fellowship is a one-year grant, totaling $45,000.


Career Development Award


The Career Development Award supports newly independent investigators to develop or strengthen their research programs in pancreatic cancer. Applicants must have completed postdoctoral or clinical research fellowships on or after July 2, 2007 (i.e., must be in the first four years of a full-time faculty appointment at the start of the grant term). This is a two-year grant, totaling $200,000.


Innovative Grant


The Innovative Grant supports creative and cutting edge ideas and approaches, including those successful in other areas of cancer that have justifiable promise for pancreatic cancer. The two-year grant totals $200,000 and is available to independent junior or senior investigators.


The deadline for Letters of Intent for the Innovative Grant is October 4, 2010. Applications for the Pathway to Leadership Grant, Fellowship and Career Development Award are due October 27, 2010. Submissions must be completed online using the proposalCENTRAL website here. Funding decisions will available in March 2011. The grant term begins July 1, 2011.


Since the partnership began with the AACR in 2003, the Pancreatic Cancer Action Network has awarded 56 grants, totaling over $7 million. To learn more about the 2011 grants program, visit here.


Source:

American Association for Cancer Research

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Thyroid And Parathyroid Surgery Outcomes May Be Worse In Pregnant Women

Pregnant women appear to have worse clinical and economic outcomes after thyroid and parathyroid surgery compared with women who are not pregnant, according to a report in the May issue of Archives of Surgery, one of the JAMA/Archives journals.



Thyroid and parathyroid surgery are used to treat cancer and other conditions. The incidence of thyroid cancer has increased by almost 250 percent over the last 30 years, increasing from 3.6 to 8.7 cases per 100,000 persons, according to background information in the article. The rate is almost double in pregnant women, with 14.4 cases per 100,000 persons. "Hyperthyroidism [overactive thyroid] has been reported in 0.1 percent to 0.4 percent of pregnancies. Inadequately treated hyperthyroidism during pregnancy poses significant risks to both mother and fetus," the authors write. "Outcomes after thyroid and parathyroid procedures during pregnancy have not been well characterized in the surgical literature."



SreyRam Kuy, M.D., of Yale University School of Medicine, New Haven, Conn., and United States Department of Veterans Affairs, Washington, and colleagues compared clinical and economic outcomes of thyroid and parathyroid surgery performed on 201 pregnant women (average age 29) and a group of 31,155 age-matched, non-pregnant women from 1999 to 2005. Fetal, maternal and surgical complications as well as in-hospital death, length of stay and hospital costs were measured.



Of the 201 pregnant women, 165 underwent thyroid procedures and 36 underwent parathyroid procedures. "Compared with non-pregnant women, pregnant patients had a higher rate of endocrine [relating to glands that secrete hormones](15.9 percent vs. 8.1 percent) and general complications (11.4 percent vs. 3.6 percent), longer unadjusted lengths of stay (two days vs. one day) and higher unadjusted hospital costs ($6,873 vs. $5,963)," the authors write. "The fetal and maternal complication rates were 5.5 percent and 4.5 percent, respectively," Additionally, pregnant patients had higher surgical complications than non-pregnant patients for benign (27 percent vs. 14 percent) and malignant (21 percent vs. 8 percent) thyroid diseases while undergoing thyroidectomy (the surgical removal of part or all of the thyroid gland).



"Differences between pregnant and non-pregnant women in complication rates were most pronounced by diagnosis, race and hospital size," the authors note. When compared to non-pregnant women of the same race, white pregnant patients had double the complication rate (21 percent vs. 10 percent), black pregnant patients had nearly five times the complication rate (48 percent vs. 10 percent) and Hispanic pregnant patients had an almost three-fold higher complication rate (30 percent vs. 12 percent).



"These data suggest that thyroid and parathyroid surgery during pregnancy should be approached with caution and careful deliberation about whether the risks are outweighed by the benefits," the authors conclude. "Surgeon volume is an important predictor of outcomes, so pregnant women undergoing thyroid and parathyroid procedures should be directed to high-volume surgeons whenever possible. Disparities in outcomes based on race and insurance must be overcome. Optimizing maternal and fetal outcomes requires the collaboration of surgeons, endocrinologists, obstetricians, neonatologists, anesthesiologists, insurers and policy makers."



Arch Surg. 2009;144[5]:399-406.

Source
Archives of Surgery

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Tremendous Economic Toll Of Depression In Wisconsin Workplace

A unique and robust partnership to
address the significant economic burden of depression in the Wisconsin
workplace was announced today by the Charles E. Kubly Foundation of
Milwaukee. This partnership engages Wisconsin Lt. Gov. Barbara Lawton,
Johns Hopkins workplace researcher Alan Langlieb, MD, and Employee Benefits
News, the nation's leading trade publication for benefits managers, to
consider what Wisconsin employers can do to strengthen the state's
workforce and its productivity.



This month a Special Report for Wisconsin Businesses will be mailed to
5100 state leaders in corporations, insurance, health care, government and
public policy. This report, "Sustaining Productivity: Addressing the
Economic Burden of Workplace Depression," is being disseminated as a
supplement to a special issue of Advancing Suicide Prevention, a national
health policy magazine. This issue focuses on male populations at greatest
risk for suicide, and contributing factors including undiagnosed and
untreated depression and substance-use disorders. The initiative is funded
by the Charles E. Kubly Foundation, a Milwaukee-based public charity
committed to improving the lives of those affected by depression.



"As Wisconsin employers seek better ways to maximize workforce
productivity and company-sponsored health benefits, considering the role of
depression is critical," says Denise Pazur, senior editor for the
Sustaining Productivity supplement. "That's because depression, if left
untreated or undertreated, can lead to failed projects and faulty products,
absenteeism and employee turnover, diminished on-the-job safety, flawed
decision making, poor morale and lack of teamwork. The drain on
productivity is significant, to say the least."



Nationally 225 million workdays are lost annually to productivity
decline related to depression, according to recent research; this is more
work loss and impairment than that from diabetes, asthma, arthritis and
other chronic conditions, notes Pazur.



Moreover, employers are in a unique -- and powerful -- role to
positively impact workplace depression, say experts, by improving the
design, delivery, purchase and implementation of behavioral health benefits
they fund. What's more, employers who proactively address depression in
their employees have seen real financial return on that investment. These
include medium-size employer Highsmith, Inc. of Fort Atkinson, Wisconsin,
which has seen health premiums and employee turnover at rates significantly
lower than state or national averages; the Highsmith story is profiled in
the Sustaining Productivity supplement. Also featured is an "Employer Call
to Action" with eight key actions that Wisconsin business and policy
leaders can take to better address the economic and emotional burden of
depression in the workplace.



"Wisconsin employers are uniquely positioned to improve the
productivity of their workforce, and ultimately their own bottom line and
the economic outlook for our state," says Wisconsin Lt. Gov. Barbara
Lawton. "As major purchasers of health care coverage, employers are de
facto health policymakers. They can drive quality and accountability
performance with the decisions they make as collective consumers. And their
influence bears the weight of responsibility for the health and wellbeing
of Wisconsin families, the workplace and our state economy."


Charles E. Kubly Foundation

charlesekublyfoundation

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Unison Calls For Good Leadership To Save Stagnant Trust, UK

As the future of Bedfordshire and Luton Mental Health and Social Care Partnership hangs in the balance, UNISON has made an urgent call for "good leadership and management" to turn the Trust around.


The UK's largest public sector union believe that patients and staff suffer have suffered because of the Trust's drawn-out attempt to obtain Foundation Trust status, at the expense of sorting out the Trust's financial problems.


The chair and non-executive team have now stood down to make way for a Foundation Trust takeover.' which UNISON says will lead to a worse service for local mental health users. In addition, the union points out that, the candidates currently under consideration will fail to turn-around the Trust, because they either have no experience in mental health, or are because based out of the county.


Karen Jennings, UNISON's Head of Health, said:


"Bedfordshire and Luton Mental Health and Social Care Partnership has suffered because the management have focused their attention on obtaining Foundation Trust status for too long.


"Time and attention now needs to be focused on the patients and staff, who are worried about the future of mental health care locally.


"The Trust needs good leadership and management instead of a takeover by a Foundation Trust. Mental health services are often the poor relation and the Trust is in real danger of getting swallowed up by the Acute Trust in Bedford, which no experience of mental health, or by a Trust miles away, in the case of the Essex based Hertfordshire Partnership.


"It would be best for patients and staff to leave the Trust in local hands, bring in quality management and leadership and allow them to get on with the job of delivering a quality service."

UNISON

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TB Or Not TB? - A Question Of Child Health, UK

Tuberculosis, or TB, is not generally an illness which tops anyone's worry list. In fact, if pressed, most people in the UK would say it was an affliction consigned to a distant Victorian past, characterised by crowded slums, poor sanitation and dirty drinking water.


So how surprising would the same people find it to discover that, in 2003, Health Protection Agency (HPA) figures show that reported incidences of TB in the London Borough of Brent, at 117 per 100,000 of population, were almost twice as high as Brazil (at 64 per 100,000) and also greater than China?


Probably both surprising and shocking. But not to Dr Sam Walters, who runs what is generally considered to be the UK's largest paediatric TB clinic. Based at St Mary's Hospital Paddington, part of the Imperial College NHS Healthcare Trust, the clinic now treats around 50 children a year who are infected with TB, and another 30 who have full blown symptoms of the disease.


Dr Walters, one of the country's leading infectious diseases paediatricians, is worried about the way things are going. "This used to be a pretty rare disease, but now we run a clinic here every Wednesday morning, and the numbers require it to be every week. As well as the children we treat, we screen another 150 each year for the disease."


Clinical nurse specialist Anne Marie Hatton, who works closely with Sam Walters to provide joined up care for adults and children with TB at St Mary's, says there are several ways that children will come into the service. "Many paediatric cases come to us because their parents have been diagnosed; they will first be seen in our TB walk in clinic. The most common symptoms are persistent coughing, fevers, night sweats and weight loss, usually spanning several weeks. The worry is it can be weeks or even months before a child gets to the clinic."


So what is the prognosis if you are found to be infected with TB? "The good news is that, with treatment, kids can quite quickly become much better.

We do get difficult cases referred from across the country and we are happy to see children from anywhere. Once diagnosed, it would be very unusual for this to be fatal in children, and it is many years since we had a TB death in a child," says Walters.


"The hardest thing about TB for parents is that they sometimes find themselves having to give a protracted course of drugs to their child, who screams and kicks or spits out medicine because they don't like the taste," he says.



Around the world, TB is on the march again. This disease of the respiratory system is now the biggest killer of women, according to new research from the World Health Organisation. Figures show that 8.8 million people worldwide are infected with the disease and it is estimated that two million deaths resulted from TB in 2002 alone.


The HPA has reported that there has been a small decrease in UK Tuberculosis (TB) cases in 2007, compared to 2006. These provisional UK figures were released for World TB Day, but experts warn the number is still too high.


Ibrahim Abubakar, Head of the Tuberculosis Section at the Health Protection Agency's Centre for Infections, says: "This year's report 'Tuberculosis in the UK' shows that in 2006 both the number of TB cases and the rate were very similar to 2005. It is too early to judge, however, whether this is a sign of a slow down in the long term increase which we've seen over the last two decades.


"Although levels of TB among the general population continue to be low, in some areas of the UK , such as the inner cities, it is clear that rates of TB remain high. The majority of TB cases in the UK occurred in young adults aged 15-44 years with the London region accounting for the largest proportion of cases (40%) and the highest rate (44.8 per 100,000)," he says.


The St Mary's team run teaching sessions to get the prevention and treatment message across to communities in London that can be hard to reach. "The epidemiology is that this disease is more prevalent in kids from sub-Saharan Africa, especially Ethiopia and Somalia. There is still a huge stigma attached to TB amongst these communities, added to which sometimes we are trying to help kids whose families have a temporary residential status which might inhibit them from coming forward with a health problem," says Walters.


As tough a challenge as this might be, Walters says there are darker storm clouds gathering on the horizon. MDR TB has been in the news a lot recently. This is a highly resistant strain driven by poorly followed treatment or misprescribed drugs, two issues which make the original problem much worse.


He points to the countries of the former Soviet Union as being in 'meltdown' with newer, drug resistant strains of TB where standard medication simply won't work because of bungled healthcare treatment. "In terms of public health, imperfect healthcare for TB is worse than no healthcare," he emphasises.


So what is his advice for parents who might be worried their child has been exposed? "If you know your child has been exposed to TB, see your GP or contact your nearest TB clinic. This disease is curable if you treat it seriously. "


And treating it seriously is just what he and colleagues like Ann Marie Hatton are doing at St Mary's.


Notes


TB is a disease caused by a germ usually spread in the air. It is caught from another person who has TB of the lungs when that person coughs or sneezes. TB usually affects the lungs, but can affect other parts of the body. Infection with the TB germ may not develop into TB disease. Only some people with TB in the lungs are infectious to other people and even then, you need close and prolonged contact with them to be at risk of being infected. TB disease develops slowly in the body, and it usually takes several months for symptoms to appear. Any of the following symptoms may suggest TB:


- Fever and night sweats

- Persistent cough

- Losing weight

- Blood in your sputum (phlegm or spit) at any time

Imperial College Healthcare

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The Role Of The Royal Society Should Be Reviewed, The Lancet

The Royal Society today has contributed little to medical science and should undergo an
urgent review of its purpose and programmes, states an editorial in this week's issue of
The Lancet.


During recent times, the Royal Society has produced little of public value in medicine and
public health. It has launched inquiries into non-human primate research and pharmacogenetics.


But these weak outputs do little to justify the esteem with which the Society is held,
nor the investment made in it by government, states the editorial.


Martin Rees, the UK's Astronomer Royal and Master of Trinity College, Cambridge, is the new
President of the Royal Society. The Lancet urges him to begin his Presidency with a wideranging
review of the Royal Society's purpose, programmes, and aspirations.


The Lancet comments: "The Royal Society began as a radical idea-a place to discuss the
subversive subject of science and to witness remarkable experiments . . . But the Royal Society
today is a lazy institution, resting on its historical laurels. Instead of being the intellectual hub
of European scientific culture, it has reinvented itself as something far more self-serving and
parochial. It is little more than a shrill and superficial cheerleader for British science. Its modern
mission is about domestic image rather than international substance."


thelancet

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To Move Forward Emotionally, Step Back

When you're upset or depressed, should you analyze your feelings to figure out what's wrong? Or should you just forget about it and move on?



New research suggests a solution to these questions and to a related psychological paradox: Pocessing emotions is supposed to facilitate coping, but attempts to understand painful feelings often backfire and perpetuate or strengthen negative moods and emotions.



The solution is not denial or distraction. According to University of Michigan psychologist Ethan Kross, the best way to move ahead emotionally is to analyze one's feelings from a psychologically distanced perspective.



With University of California, Berkeley, colleague Ozlem Ayduk, Kross has conducted a series of studies that provide the first experimental evidence of the benefits of analyzing depressive feelings from a psychologically distanced perspective. The studies were supported by funding from the National Institutes of Health.



"We aren't very good at trying to analyze our feelings to make ourselves feel better," said Kross, a faculty associate at the U-M Institute for Social Research (ISR) and an assistant professor of psychology. "It's an invaluable human ability to think about what we do, but reviewing our mistakes over and over, re-experiencing the same negative emotions we felt the first time around, tends to keep us stuck in negativity. It can be very helpful to take a sort of mental time-out, to sit back and try to review the situation from a distance."



This approach is widely associated with eastern philosophies such as Buddhism and Taoism, and with practices like Transcendental Meditation. But according to Kross, anyone can do it with a little practice.



"Using a thermostat metaphor is helpful to many people. When negative emotions become overwhelming, simply dial the emotional temperature down a bit in order to think about the problem rationally and clearly," he said.



Kross, who is teaching a class on self-control this fall at U-M, has published two papers on the topic this year. One provides experimental evidence that self-distancing techniques improve cardiovascular recovery from negative emotions. Another shows that the technique helps protect against depression.



In the July 2008 issue of Personality and Social Psychology Bulletin, Kross and Ayduk randomly assigned 141 participants to one of three groups that required them to focus (or not focus) on their feelings using different strategies in a guided imagery exercise that led them to recall an experience that made them feel overwhelmed by sadness and depression.



In the immersed-analysis condition, participants were told, "Go back to the time and place of the experience, and relive the situation as if it were happening to you all over again…try to understand the emotions that you felt as the experience unfolded…why did you have those feelings? What were the underlying causes and reasons?"



In the distanced-analysis condition, they were told, "Go back to the time and place of the experience…take a few steps back and move away from your experience…watch the experience unfold as if it were happening all over again to the distant you… try to understand the emotions that the distant you felt as the experience unfolded…why did he (she) have those feelings? What were the underlying causes and reasons?"



In the distraction condition, participants were asked to think about a series of non-emotional facts that were unrelated to their recalled depression experience. Among the statements: "Pencils are made with graphite" and "Scotland is north of England."



After the experience, participants completed a questionnaire asking how they felt at the moment, and wrote a stream-of-thought essay about their thoughts during the memory recall phase of the experiment.



Immediately after the session those who used the distanced-analysis approach reported lower levels of depression than those who used immersed-analysis, but not distraction. Thus distraction and distanced-analysis were found to be equally effective in the short-term. Participants then returned to the lab either one day or one week later. At that time, they were asked to think about the same sad or depressing experience, and their mood was reassessed.



Those who had used the distanced-analysis approach continued to show lower levels of depression than those who had used self-immersed analysis and distraction, providing evidence to support the hypothesis that distanced-analysis not only helps people cope with intense feelings adaptively in the short-term, but critically also helps people work-through negative experiences over time.



In a related study, published earlier this year in /i>Psychological Science, Ayduk and Kross showed that participants who adopted a self-distanced perspective while analyzing feelings surrounding a time when they were angry showed smaller increases in blood pressure than those who used a self-immersed approach.



In future research, Kross plans to investigate whether self-distancing is helpful in coping with other types of emotions, including anxiety, and the best ways of teaching people how to engage in self-distanced analysis as they proceed with their lives, not just when they are asked to recall negative experiences in a laboratory setting.



###



Established in 1948, the University of Michigan Institute for Social Research (ISR) is among the world's oldest academic survey research organizations, and a world leader in the development and application of social science methodology. ISR conducts some of the most widely-cited studies in the nation, including the Reuters/University of Michigan Surveys of Consumers, the American National Election Studies, the Monitoring the Future Study, the Panel Study of Income Dynamics, the Health and Retirement Study, and the National Survey of Black Americans. ISR researchers also collaborate with social scientists in more than 60 nations on the World Values Surveys and other projects, and the Institute has established formal ties with universities in Poland, China and South Africa. ISR is also home to the Inter-University Consortium for Political and Social Research (ICPSR), the world's largest computerized social science data archive. Visit the ISR web site at isr.umich.edu/ for more information.



Source: Diane Swanbrow


University of Michigan

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Sex Equality Linked To More Satisfying Sex Lives

According to new research, couples enjoy better sex lives in countries where sex equality is best. Austria and Spain seem to have the most satisfied couples, while the Middle-East and parts of Asia have the least.


The study researched into the sex lives of 27,000 people from 29 countries. Western European countries which had greatest sex equality, and the USA and Canada, seemed to come out on top.


You can read about this study in the journal Archives of Sexual Behaviour.



According to the researchers, most couples are sexually active well into their eighties. Participants had to fill in a questionnaire.


The findings revealed vast differences between satisfaction rates of men and women.


Lack of foreplay seems to be more of a problem for women who live in male dominated societies. In order to reach a climax, foreplay is more important for women than for men.


Women who are in a relationship where things are not going well tend to switch off more from sex than men. The researchers suggested this may be a way of regulating pregnancy and protecting children.


Men's perceptions of women's level of satisfaction seems over-optimistic. 45% of the men in this study thought their partners always had an orgasm. However, only 26% of the women confirmed this.


The study revealed that Austria has the most satisfied couples in the world. 80% of Austrian men and 63% of Austrian women were either extremely or very satisfied with their sex lives. Spain came second. Japan came bottom.


60-80% of couples who live in countries with greatest equality were satisfied with their sex lives. In male-dominated societies, such as parts of the Middle East and some parts of Asia, satisfaction rates ranged from 20-50%.


As you can see from the lists below, Mexico came up among the top ten. Even though it is known as a male dominated society, satisfaction rates are high. Spain used to be very male dominated, over the last thirty years Spanish society has changed a great deal.


Top Ten Countries

% of people satisfied with their sex lives


-- Austria - 71.4%

-- Spain - 69.0%

-- Canada - 66.1%

-- Belgium - 64.6%

-- United States - 64.2%

-- Australia - 63.6%

-- Mexico - 63.2%

-- Germany - 62.0%

-- Sweden - 60.5%

-- United Kingdom - 59.8%


Bottom Five Countries

% of people satisfied with their sex lives


-- Thailand - 35.9%

-- China - 34.9%

-- Indonesia - 34.0%

-- Taiwan - 28.7%

-- Japan - 25.8%

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Sex And Depression Study Finds Most Teens' Mental Health Unaffected By Nonmarital Sex

For a decade, the legislative push for "abstinence only" sex education has suggested that nonmarital sex negatively affects a teen's mental health. But a new study shows that the negative mental side effects of a teen's loss of virginity are confined to a small proportion of those who have sex -- specifically, young girls and both boys and girls who have sex earlier than their peers and whose relationships are uncommitted and ultimately fall apart.



Using data from the National Longitudinal Study of Adolescent Health, Ann Meier, University of Minnesota assistant professor of sociology, studied 8,563 seventh- through 12th-graders over an 18-month period, measuring for depression and low self-esteem. Meier compared the mental health of teens who didn't have sex to teens who were virgins at the beginning of the study, but who lost their virginity during the 18-month period.



She found that while the majority of teens did not experience depression as a result of first-time sex, some did -- those being the youngest teens (girls who had sex before age 15 and boys who had sex before 14) and whose relationship was not emotionally close and dissolved after sex. Girls in this group were particularly vulnerable to depression.



Meier believes it's the combination of these factors that make young teens most vulnerable to depression or low self-esteem after first-time sex. "Being female or younger than the average age at first-time sex among your peers increases the chance of depression, as does a lack of commitment or intimacy within the relationship and what happens to the relationship after first-time sex," said Meier. "For girls in uncommitted relationships, ending a relationship with sex has more of an impact on mental health than ending that same relationship if it did not involve sex."



The risk of suffering mental health problems from having sex as a teen is relatively low, but Meier said low risk still represents a large group of teens affected, as half the teen population is having sex. She cautioned that the study does not suggest that positive effects result from first-time sex among teens and said she hopes it will help policy-makers focus help on those most vulnerable rather than promoting a one-size-fits-all approach.


###



Meier's study, "Adolescent First Sex and Subsequent Mental Health," was published in the May issue of the American Journal of Sociology.



Contact: David Ruth


University of Minnesota

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Teacher-Student Relationships Key To Learning Health & Sex Education

When it comes to learning life-changing behaviors in high school health classes, the identity of the person teaching may be even more important than the curriculum, a new study suggests.


For years, many high schools around the country have been relying on outside experts to teach sensitive subjects such as the human immunodeficiency virus (HIV) infection and pregnancy prevention. But a recent study by researchers at Ohio State University and the University of Kentucky found that students learn more about such issues when taught by their regular classroom teacher.


The reason: students may be more inclined to learn life-changing behaviors from someone they know and trust.


"The actual person teaching makes a difference in how students learn. When there is a good relationship, that really facilitates learning and motivation. And we found that in almost every area, the regular classroom teachers were more effective, they were better," said Eric Anderman , co-author of the study and professor of educational psychology at Ohio State.


The study is available online and will appear in an upcoming issue of the journal Health Promotion Practice.


Strong student-teacher relationships have been linked to many positive outcomes, including better behavior in classrooms and improvement in learning. Because of the established relationship regular classroom teachers have with their students, it may be easier for adolescents to talk with and learn from someone who already knows them as individuals.


"The relationship between the teacher and the student, particularly during adolescence, is very important. It was easier for the kids to talk about personal stuff with someone they knew. It was easier for them to absorb the material and become more interested in what they were talking about with their regular teacher in the classroom," Anderman said.


Nearly 700 high school students in central and northern Kentucky participated in the study. Students from seven similarly sized high schools were given the same curriculum and were taught by either their regular classroom teacher or a temporary educator.


Students were surveyed prior to beginning the course and three to four weeks after completion about their experience. Students were asked about attitudes toward having sex and condom use, their goals and expectations toward the class, if they valued class material, and if they felt their health teachers were credible and likeable.


In almost every category, the regular classroom teachers had the more positive results. Students often expect to be tested more often by their regular teacher than by a temporary educator. As a result, they may be more motivated to learn the material, to achieve high grades on tests, and to appear knowledgeable during classroom discussions.


More importantly, students in classrooms led by their regular teachers valued the course material more than did others. Instead of simply hearing a lecture on sex education, students were motivated to pay attention because they felt the class offered important information.


"When you have kids who simply memorize material for the test and two weeks later don't remember any of it, you're not getting anywhere. But if you can get the kids to care and learn because they think it's important, that's something that will last a lifetime," Anderman said.


Students who had a sexual partner also participated in more classroom discussions with the regular teacher. These students valued the discussions, reporting that the discussions were higher in quality and more frequent overall.


"Students who had a sexual partner were more likely to say that there was class discussion going on with the regular teacher than those taught by the outside person. These kids were more likely to feel like there was discussion of these issues, rather than just the teacher lecturing to them," he said.


Regular classroom teachers were also perceived as more credible than their temporary counterparts. Students felt their regular teachers were more knowledgeable, but also liked their regular teacher more. Students felt comfortable with these teachers and were able to joke around and laugh with the teachers, but also took them more seriously, he said.


Despite the positive results, Anderman cautions that not all teachers will have the same impacts as those in the study. Every teacher in this study, both temporary and permanent, received professional training prior to entering the classroom. In reality, not all teachers will have the same training and know-how, and decisions should be made based on who is the best fit for each class.


"School is the absolute best way to get information out to adolescents, no matter who is teaching. The important thing is getting the teacher to make a connection. If the teacher can make the right connection with one kid, you've saved one person from getting HIV, you've saved one person's life," he said.


Research was conducted at the University of Kentucky and continues at Ohio State. Co-authors of the study include Derek Lane and Pamela Cupp of the University of Kentucky's Department of Communication, Valerie Phebus of the Department of Pediatrics-Neonatology at the University of Kentucky, and Rick Zimmerman, center director for the Pacific Institute for Research & Evaluation's Louisville, KY location.


The study was funded by the National Institute of Nursing Research.


Jenna McGuire

Ohio State University

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The Killing Of Bin Laden Worsened Americans' Views Of US Muslims

Instead of calming fears, the death of Osama bin Laden actually led more Americans to feel threatened by Muslims living in the United States, according to a new nationwide survey.



In the weeks following the U.S. military campaign that killed bin Laden, the head of the terrorist organization Al Qaeda, American attitudes toward Muslim Americans took a significant negative shift, results showed.



Americans found Muslims living in the United States more threatening after bin Laden's death, positive perceptions of Muslims plummeted, and those surveyed were less likely to oppose restrictions on Muslim Americans' civil liberties.



For example, in the weeks before bin Laden's death, nearly half of respondents described Muslim Americans as "trustworthy" and "peaceful." But only one-third of Americans agreed with these positive terms after the killing.



Most of the changes in attitude happened among political liberals and moderates, whose views shifted to become more like those of conservatives, the survey found.



The shift in views can be explained by the fact that bin Laden's death reminded some Americans of why they may fear Muslims in the first place, said Erik Nisbet, assistant professor of communication at Ohio State University, and one of the leaders of the survey project.



"The death of bin Laden was a focusing event. There was a lot of news coverage and a lot of discussion about Islam and Muslims and Muslim Americans," Nisbet said.



"The frenzy of media coverage reminded people of terrorism and the Sept. 11 attacks and it primed them to think about Islam in terms of terrorism."



In fact, while prior to bin Laden's death only 16 percent of respondents believed a terrorist attack in the United States was likely in the next few months, 40 percent believed an attack was likely after the killing.



"That is going to have a negative effect on attitudes," Nisbet said.



The researchers' ability to find out how American attitudes changed after bin Laden's death was accidental, Nisbet said. Nisbet and Ohio State colleague Michelle Ortiz, also an assistant professor of communication, had commissioned the Survey Research Institute of Cornell University and the University of New Hampshire Survey Center to jointly conduct a national telephone poll of Americans beginning in early April. The survey focused on perceptions and attitudes about Muslim Americans.



Interviews started on April 7, 2011, and 500 interviews were conducted prior to May 1, when bin Laden was killed. The remaining 341 interviews were conducted following the death.



Many of the survey responses changed significantly after the killing, Nisbet said.



After bin Laden's death, 34 percent of Americans surveyed agreed that Muslims living in the United States "increased the likelihood of a terrorist attack." That was up from 27 percent prior to the killing. The percentage of respondents agreeing the Muslims in the United States are supportive of the country dropped from 62 percent to 52 percent.



Americans were less likely to oppose restrictions on Muslim American civil liberties after the killing, Nisbet said. For example, public opposition to profiling individuals as potential terrorists based solely on being Muslim dropped from 71 percent to 63 percent. Likewise, opposition to requiring Muslims living in the United to register their whereabouts with the government dropped from two-thirds of respondents to about one-half.



Changes in attitudes were not related just to preventing a possible terrorist attack, but also included attitudes about religious tolerance of Muslims. For example, nearly one in three respondents surveyed after bin Laden's death agreed that "Muslims are mostly responsible for creating the religious tension that exists in the United States today." That was up from about one in five respondents before the killing. Correspondingly, opposition to a nationwide ban on mosque construction in the United States fell to 57 percent from 65 percent.



The negative feelings even carried over to personal relationships. The percentage of respondents who said they were unwilling to have a Muslim as a close friend doubled after the death, going from 9 percent to 20 percent.



"That's important because research has shown that the best way to reduce prejudice and improve intergroup relations is through personal contact," Nisbet said. "That won't happen if people avoid contact with Muslim Americans."



Many of the changes in attitudes after Bin Laden's death were almost entirely due to political liberals and moderates changing their opinions about the threat posed by Muslims in the United States, the survey found.



The percentage of liberal respondents who agreed that Muslims in the United States "make America a more dangerous place to live" tripled after bin Laden's death, going from 8 to 24 percent. The percentage of moderates believing this increased from 10 percent to 29 percent.



In contrast, the percentage of conservatives who believed this were essentially unchanged - 30 percent before bin Laden's death and 26 percent following.



"Liberals and moderates essentially converged toward conservatives in their attitudes about Muslim Americans," Nisbet said.



Nisbet said it is unclear whether these changes in attitudes would last long-term or not. But research suggests these negative feelings can be dangerous even if they are short-lived.



"Every time these anti-Muslim feelings are activated by media coverage, it makes them that much easier to get reactivated in the future," Nisbet said. "These feelings and attitudes become more constant the more you experience them."



The telephone survey involved adults in the continental United States, including cell-phone only homes, and was designed to be representative of the U.S. population. All percentages reported here were adjusted to control for differences in the characteristics of survey respondents interviewed before and after bin Laden's death. The researchers controlled for age, gender, race, education, political ideology, whether the respondents were evangelical Christians, and their knowledge about Islam.



That means any differences in attitudes between respondents polled before and after the death are not the results of any difference on these personal attributes.



In addition to Nisbet and Ortiz, the survey was conducted by Yasamin Miller, director of the Survey Research Institute at Cornell and Andrew Smith, associate professor and director of the University of New Hampshire Survey Center.



Source:

Erik Nisbet


Ohio State University

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Welcome For Mental Health Film

The British Psychological Society has warmly welcomed a new public information film to tackle mental health discrimination in the work place unveiled yesterday by Minister for Disabled People, Ann Keen.


The film addresses an issue which has been highlighted by Clinical Psychologists for many years, and identified as a significant barrier to recovery for people with mental health problems.


Chair of the British Psychological Society's Division of Clinical Psychology, Dr Jenny Taylor said;


"The stigma associated with mental health problems can in themselves be debilitating, affecting so many aspects of the person's life. This film aims to challenge people's preconceptions and ask whether they would employ someone who had mental health issues.


Our hope, as Clinical Psychologists, is that the film will make employers and work colleagues think more about applicants for jobs or workmates who have a mental health problem and that as a result we will see greater acceptance of people with mental health problems in the workplace. Together we should all aspire to a society where discrimination and prejudice towards people with mental health problems is as unacceptable as sexism or racism."


The British Psychological Society

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The Royal Pharmaceutical Society Appoints New Director For Scotland

The Royal Pharmaceutical Society (RPS) announced the appointment of Alex
MacKinnon as Director for Scotland.


Mr MacKinnon is currently Head of Corporate Affairs at Community Pharmacy Scotland, where
he has worked in a variety of high profile roles since 2005. Prior to this he held roles within
Lloydspharmacy and originally qualified as a community pharmacist in 1975. He will lead the
Society's work in Scotland from its Edinburgh base from 4th October 2010.


Chair of the Scottish Pharmacy Board Sandra Melville said: "We warmly welcome Alex as
Director for Scotland. This is a hugely exciting time for pharmacy and we look forward to
working closely with him for the benefit of all pharmacists across the country."


RPSGB Chief Executive Helen Gordon said: "I am delighted to welcome Alex to the Society as
it becomes the new professional leadership body. Alex's extensive knowledge of pharmacy in
Scotland, his experience of contract negotiation and public affairs skills will be invaluable in
developing services for members."


Alex MacKinnon said: "I am very much looking forward to taking up my new position with the
Royal Pharmaceutical Society. Pharmacy practice in Scotland has advanced greatly over the
last decade and it is vitally important that we support the innovative approach to practice that
now exists.


"Now more than ever, the profession needs a leadership body that will represent pharmacy at
the highest level. It is vital that the voices for pharmacy are aligned and that they are heard if
we are to secure the future of the profession.


"It will be a privilege to continue the excellent work undertaken by Lyndon Braddick during his
period as Director for Scotland and I wish him well in his retirement. I would also like to thank
my colleagues and the Board of Community Pharmacy Scotland for their support and
encouragement over recent years."


Notes


Biographical details


- Alex graduated in 1975 from Strathclyde University, Glasgow. With many years experience
working in community pharmacy he was appointed Regional Manager for Lloydspharmacy
in 1995, a position he held until 2003. He then became Head of Government Relations for
Lloydspharmacy in Scotland before joining the Scottish Pharmaceutical General Council in
2005.


- He was a member of the Standing Committee of SPGC from 2001 to 2004 and Vice
Chairman of SPGC in 2004. He was also a member of the SPGC contract negotiating team
during that period.


- In 2005 he was appointed as Head of Parliamentary and Corporate Affairs for SPGC and
Company Secretary of SPGC Property Ltd.


- When SPGC rebranded to Community Pharmacy Scotland in 2007 he was appointed Head
of Corporate Affairs.


Source:

Royal Pharmaceutical Society

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Voluntary And Regulatory Measures Needed To Reduce Conflicts Of Interest In Medical Research, Education, And Practice

New voluntary and regulatory measures can strengthen protections against financial conflicts of interest in medicine without hindering patient care or the advancement of medical knowledge, says a new report by the Institute of Medicine. The report tackles conflicts of interest across the spectrum of medicine, from biomedical research to clinical care and from the training of new doctors to the continuing education of physicians. It recommends several actions to improve disclosure of financial ties between the medical community and industry, limit company payments and gifts, and remove industry influence from medical education and the development of practice guidelines.


"It is time to end a number of long-accepted practices that create unacceptable conflicts of interest, threaten the integrity of the medical profession, and erode public trust while providing no meaningful benefits to patients or society," said Bernard Lo, chair of the committee that wrote the report and professor of medicine and director of the program in medical ethics, University of California, San Francisco. "We also need more specific disclosure of the financial relationships that doctors and researchers have with medical industries. This report spells out a strategy to protect against financial conflicts while allowing productive relationships between the medical community and industry that contribute to improved medical knowledge and care."


All academic medical centers, journals, professional societies, and other entities engaged in health research, education, clinical care, and development of practice guidelines should establish or strengthen conflict-of-interest policies, the report says. Disclosure by physicians and researchers not only to their employers but also to other medical organizations of their financial links to pharmaceutical, biotechnology, and medical device firms is an essential first step in identifying and managing conflicts of interest and needs to be improved. The committee noted substantial variations in institutions' conflict-of-interest policies and shortcomings in physicians' and researchers' adherence to policy requirements. The format for disclosure and categories of relationships should be standardized to help institutions judge the risk that a relationship poses and to ease the burden for individuals who must report information to multiple organizations with different policies.


In addition, Congress should require pharmaceutical, biotechnology, and device firms to report through a public Web site the payments they make to doctors, researchers, academic health centers, professional societies, patient advocacy groups, and others involved in medicine. A public record like this could serve as a deterrent to inappropriate relationships and undue industry influence. It also would provide medical institutions with a way to verify the accuracy of information that physicians, researchers, and senior officials have disclosed to them.















The report calls on researchers, medical school faculty, and private-practice doctors to forgo gifts of any amount from medical companies and to decline to publish or present material ghostwritten or otherwise controlled by industry. Consulting arrangements should be limited to legitimate expert services spelled out in formal contracts and paid for at a fair market rate. Physicians should limit their interactions with company sales representatives and use free drug samples only for patients who cannot afford medications. Several professional organizations and industry groups have set new limits on gift giving and other relationships between industry and the medical community, but it is too soon to gauge the effects these changes, the committee noted.


Greater transparency and accountability are needed in the development of clinical practice guidelines, which advise physicians on how to best provide care. Groups that develop guidelines should not accept direct industry funding for this work and generally should exclude individuals with conflicts of interest from the panels that draft guidelines, the report says. In addition, the current system for financing accredited continuing medical education relies too heavily on industry support and needs to be overhauled to be free of industry influence and provide high-quality education.


Professional societies, government agencies, and the groups that accredit medical schools can encourage adoption and implementation of conflict-of-interest policies by publicizing which institutions have adopted the recommended policies and which have not. This publicity could motivate institutions to close gaps in their conflict-of-interest policies or to justify why they disagree with the recommendations. For example, groups that accredit and certify medical schools could set standards for the adoption of conflict-of-interest policies and publicly list the institutions that follow those standards. Similarly, the World Association of Medical Editors could publicize which journals have adopted authorship and other policies consistent with its conflict-of-interest statements. The report also calls for more research on the impact of conflict-of-interest policies so that future policies can be based on more rigorous evidence.


Although the report calls for some new legislation and regulations, it also emphasizes the role of voluntary efforts by medical groups, industry, and individual professionals. Voluntary action is more likely to reinforce professional values and foster policies that minimize unintended consequences and administrative burdens. However, the report warns, if the industry and the medical community fail to strengthen their conflict-of-interest policies, practices, and enforcement, more policymakers may turn to legislative solutions, as officials in some states have.


Interactions between industry and the medical community have evolved over decades, becoming commonplace today and producing both benefits and concerns. Research collaborations have yielded new cancer drugs, HIV/AIDS therapies, prosthetic heart valves, tools to monitor anesthesia, and many other advances in the prevention, diagnosis, and treatment of illness, the report notes. At the same time, legal and media investigations into relationships between industry and the medical community have led to embarrassing revelations about lack of disclosure and dubious relationships, congressional legislative proposals, and prosecutions. Although data are limited on the extent to which conflicts result in biased decision making or harm, such conflicts can erode trust in doctors and the research enterprise, the report concludes.



The study was sponsored by the National Institutes of Health, Robert Wood Johnson Foundation, Greenwall Foundation, ABIM Foundation, Burroughs Wellcome Fund, and Josiah Macy Jr. Foundation. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.


Source
National Institutes of Health

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St. Jude Children's Research Hospital And Washington University Team To Unravel Genetic Basis Of Childhood Cancers

St. Jude Children's Research Hospital and Washington University School of Medicine in St. Louis, announced an unprecedented effort to identify the genetic changes that give rise to some of the world's deadliest childhood cancers. The team has joined forces to decode the genomes of more than 600 childhood cancer patients treated at St. Jude, who have contributed tumor samples for this historic effort.


The St. Jude Children's Research Hospital Washington University Pediatric Cancer Genome Project is the largest investment to date estimated to cost $65 million over three years aimed at understanding the genetic origins of childhood cancers. Scientists involved in the project will sequence the entire genomes of both normal and cancer cells from each patient, comparing differences in the DNA to identify genetic mistakes that lead to cancer. Kay Jewelers, a long-standing supporter of St. Jude Children's Research Hospital, has committed to providing $20 million as lead sponsor of this project.


"We are on the threshold of a revolution in our understanding of the origins of cancer. For the first time in history, we have the tools to identify all of the genetic abnormalities that turn a white blood cell into a leukemia cell or a brain cell into a brain tumor," said Dr. William E. Evans, St. Jude director and chief executive officer. "We believe it is from this foundation that advances for 21st century cancer diagnosis and treatment will come."


St. Jude is home to one of the world's largest and most complete repositories of biological information about childhood cancer. The collection dates to the 1970s and includes more than 50,000 tumor, bone marrow, blood and other biological samples. These samples are essential to efforts to understand the origins of cancer. The tissue bank has also helped St. Jude scientists develop the experimental models expected to be important for determining which mutations drive cancer's development and spread.


The collaboration focuses on childhood leukemias, brain tumors and tumors of bone, muscle and other connective tissues called sarcomas. St. Jude will provide DNA from tumor and normal tissues of patients, Washington University's Genome Center will perform the whole genome sequencing, and both will participate in validation sequencing. Researchers at both institutions will collaborate to analyze the data and make the information publicly available once validated. Prior research by this group and others indicates that the many genetic abnormalities in childhood cancers will differ from those found in adult cancers.


"This extraordinary partnership will add a new dimension to our understanding of childhood cancers," says pediatric geneticist Dr. Larry J. Shapiro, executive vice chancellor and dean of Washington University School of Medicine. "A genome-wide understanding of cancer offers great promise for developing powerful new approaches to diagnose and treat cancer or perhaps even to prevent it. In the short term, the project will yield key genetic information that may ultimately help physicians choose the best treatment options for young cancer patients."















Scientists at Washington University's Genome Center pioneered whole-genome sequencing of cancer patients' genomes. In 2008, they became the first to decode the complete genome of a cancer patient a woman with leukemia and trace her disease to its genetic roots. They have since sequenced the genomes of additional cancer patients, including those with breast, lung and ovarian tumors and glioblastoma, a type of brain tumor. These studies have identified intriguing and unexpected genetic connections between patients with different types of cancer that likely would not have been discovered using conventional approaches.


Earlier research to identify cancer mutations has typically focused only on the few hundred genes already suspected of being involved in the disease. While a few recent studies have involved sequencing the 20,000 or so protein-coding genes in the genome, the whole-genome approach involved in this collaboration provides a more detailed and complete picture of all the mutations involved in a patient's cancer by examining both the protein-coding genes and the long stretches of DNA between genes, which may influence the ways the genes work. Such complete genomic sequencing is now possible because of recent advances that have made the technology faster and far less expensive.


Researchers involved in the project also will investigate how pediatric cancer is influenced by variations in the genome, including epigenetic changes, which alter the expression of genes but not the genes themselves. They also will use DNA sequencing data to identify genetic markers that can help physicians decide the best treatment options for cancer patients, based on the genetic profile of their tumors.


The project's scope and design reflects the philosophies and talents of the institutions involved. St. Jude and Washington University have a history of scientific collaboration and a track record of innovation in patient care. They also share a commitment to excellence and openness in research. The pediatric genome project will include a public database where information, once validated, will be shared with the international scientific community, with the goal of accelerating progress against childhood cancer.


While great progress has been made in treating childhood cancer, it is still the leading cause of death from disease among U.S. children over one year of age, and cure rates for some childhood cancers remain below 50 percent.


St. Jude Children's Research Hospital


St. Jude Children's Research Hospital is internationally recognized for its pioneering research and treatment of children with cancer and other catastrophic diseases. Ranked the No. 1 pediatric cancer hospital by Parents magazine, St. Jude is the first and only NCI-designated Comprehensive Cancer Center devoted solely to children, and has treated children from all 50 states and from around the world. St. Jude has developed research protocols that helped push overall survival rates for childhood cancer from less than 20 percent when the hospital opened to almost 80 percent today. St. Jude is the national coordinating center for the Pediatric Brain Tumor Consortium and the Childhood Cancer Survivor Study. In addition to pediatric cancer research, St. Jude is also a leader in sickle cell disease research and is a globally prominent research center for influenza.


Founded in 1962 by the late entertainer Danny Thomas, St. Jude freely shares its discoveries with scientific and medical communities around the world, publishing more research articles than any other pediatric cancer research center in the United States. St. Jude treats over 5,400 patients each year and is the only pediatric cancer research center where families never pay for treatment not covered by insurance. St. Jude is financially supported by thousands of individual donors, organizations and corporations without which the hospitals' work would not be possible.


Washington University School of Medicine and its Genome Center


Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish Hospital, currently ranked ninth among the nation's best hospitals by U.S. News & World Report, and St. Louis Children's Hospital, named among the nation's elite pediatric hospitals by U.S. News & World Report, the School of Medicine is linked to BJC HealthCare. Washington University and Barnes-Jewish Hospital are also home to the Siteman Cancer Center, a federally designated Comprehensive Cancer Center.



The Genome Center at the Washington University School of Medicine in St. Louis is a world leader in high-speed, large-scale sequencing of genomes, from primitive bacteria to complex humans. The Center played a key role in the Human Genome Project, contributing 25 percent of the finished sequence. The Center currently receives substantial funding from the National Institutes of Health for research that includes the Cancer Genome Atlas Project, to sequence the DNA of adult cancer patients and their tumors to identify the genetic changes important to cancer; the Human Microbiome Project, to sequence the genomes of bacteria involved in human health and disease; and the 1,000 Genomes Project, to catalog the immense human variation written into the genetic code.


Source: St. Jude Children's Research Hospital

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