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Tooth decay affects 12% of three year olds

More than one in ten three year olds children have tooth decay according to the first survey of this age group.

Tooth decay affects 12 pc of three year oldsPublic Health England researchers checked the teeth of nearly 54,000 children at nurseries, children’s centres and playgroups. They found that 12% of children had evidence of tooth decay. These youngsters had an average of three teeth that were decayed, missing or filled.

Large variations were found from place to place in the study. In one area – Leicester – 34% of children had tooth decay whereas in others it was only 2%.

Researchers also said that some children had a particular type of decay known as early childhood caries. This affects the upper front teeth and spreads quickly to other teeth. It is linked to the consumption of sugary drinks in baby bottles or sipping cups.

PHE said that parents should give their children sugary foods and drinks in smaller quantities and less often. It also urged them not to add sugar to weaning foods or drinks.

Parents and carers should also start brushing children’s teeth as soon as the first tooth appeared and supervise their brushing until they the age of seven or eight, PHE said.

Previous research by the organisation has shown that by the age of five, one in four children has tooth decay.

Sandra White, director of dental public health at PHE, said while there had been “significant improvements” in oral health over the years, the findings were worrying. Tooth decay is an entirely preventable disease which can be very painful and even result in a child having teeth removed under general anaesthetic, which is stressful for children and parents alike.”

Dr Christopher Allen, of the British Dental Association, said: “Parents and carers may feel that giving sugar-sweetened drinks is comforting, but in reality it’s more likely to cause pain and suffering as it is the major cause of tooth decay in toddlers.

“It’s never too soon to take your toddler to the dentist – ideally no later than 18 months – because dentists can identify and treat tooth decay at the earliest stage and advise parents on tooth brushing and prevention.”

Heart disease warnings missed by most adults

Many adults in the UK are unaware of the risk factors for heart disease, according to new research.

Heart disease warnings missed by most adultsWhile a third of people are worried about getting dementia or cancer, only 2% are afraid of coronary heart disease, a survey by the British Heart Foundation has found and one in ten adults confessed to not knowing how to look after their hearts.

Coronary heart disease (CHD) is responsible for about 74,000 deaths in the UK each year and roughly one in five men and one in eight women die from the condition.

Dr Mike Knapton, associate medical director at the British Heart Foundation, said: “Your heart is the most vital organ in the body, but all too often we take it for granted. Despite being a largely preventable condition, coronary heart disease is still the UK’s single biggest killer, causing unnecessary heartache for thousands of families.”

As well as chest pain, the main symptoms of CHD are heart attacks and heart failure. However, not everyone has the same symptoms and some people may not have any before CHD is diagnosed.

The British Heart Foundation has issued 10 tips to prevent heart disease:

  • Give up smoking
  • If you’re over 40, take up your free NHS health check
  • Maintain a healthy weight
  • Lead an active lifestyle
  • Ditch the salt
  • Eat your “five a day” of fruit and vegetables
  • Cut down on saturated fat
  • Read food labels to find out if something is healthy for you
  • Don’t drink too much alcohol
  • Watch food portion sizes.

The poll was conducted by YouGov and included 1,010 men and 1,089 women.

Meanwhile the World Health Organization (WHO) is calling on countries to take action on salt to cut deaths from heart disease. It wants governments to sign up to reducing global salt intake.

“If the target to reduce salt by 30% globally by 2025 is achieved, millions of lives can be saved from heart disease, stroke and related conditions,” said director Dr Oleg Chestnov.

NICE wants to limit TV watching

Adults and children should consider having TV free days or limiting viewing to no more than two hours a day under new proposals to tackle obesity.

NICE wants to limit TV watchingThe National Institute for Curbing Expenditure (NICE) recommendations also include avoiding drinks with added sugar and limiting takeaways.

The draft guidance- the first on the subject since 2006, is aimed at helping people maintain a healthy weight.

Obesity rates have nearly doubled over the past 10 years in England.

Prof Mike Kelly, director of the Centre for Public Health at NICE, said a healthier diet and being more physically active was important for everyone not just those who were already overweight or obese.

“The general rule for maintaining a healthy weight is that energy intake through food and drink should not exceed energy output from daily activity,” he said.

“We all know we should probably take the stairs rather than the lift, cut down on TV time, eat more healthily and drink less alcohol. But it can be difficult to know the most useful changes that we can make in terms of our weight.”

The guidelines make a number of recommendations that aim to ensure the advice given about maintaining a healthy weight is more specific and based on real evidence.

There are also new recommendations encouraging people to monitor their weight and activity levels, using apps or regular weigh-in sessions.

The draft suggestions include:

  • Walking or cycling to school or work
  • Reducing TV viewing with strategies such as TV-free days or setting a limit of no more than two hours a day in front of the TV screen
  • Cutting down on calorific foods, such as fried food, biscuits, sweets and full-fat cheese
  • Adopting a Mediterranean diet high in vegetables, fruit, beans and pulses, whole grains, fish and olive oil
  • Avoiding drinks sweetened with sugar, including fizzy drinks, sports drinks and squash
  • Limiting the amount of fast food and takeaways
  • Limiting the amount of alcohol consumed, as alcoholic drinks are a source of extra calories

Last month, health leaders called for an emergency taskforce to be set up to tackle childhood obesity in England.

In an open letter to the chief medical officer for England, Prof Dame Sally Davies, they said “an entire generation is being destroyed by a diet of junk food and sugary drinks”.

And last week, the head of NHS England, Simon Stevens, said obesity was “the new smoking” in terms of the impact on health and the cost to the NHS- which Health Direct posted at: Obesity is new smoking says NHS boss

NHS whistleblowing problems persist

NHS Whistleblowers still face real problems in speaking out in the health service – despite the drive to create a more open culture.

NHS whistleblowing problems persistPromoting whistleblowing was a key recommendation of the public inquiry into the Stafford Hospital scandal.

A number of steps have since been taken in England, but Patients First warned that a “culture of fear” still existed. It has produced a dossier of 70 cases, highlighting problems like bullying and mismanagement of complaints.

The document is being handed in as part of Patients First’s submission to an independent review of whistleblowing, which was set up by the Department of Health in England and is being led by Sir Robert Francis, who was in charge of the Stafford public inquiry.

Nearly half the cases are continuing, but Patients First said all had suffered some loss either professionally, personally or financially.

In 79% of cases, the whistleblower had experienced bullying and in a fifth of cases the individual had run out of money or was unable to access legal advice according to the dossier.

It concluded there was a “real and continuing problem over the treatment of those who raise concerns”.

The warning comes after a range of measures were put in place to try to encourage whistleblowing.

Ministers have spoken out about the use of “gagging orders”, while the Nursing and Midwifery Council has issued new guidelines to help staff speak out.

A national whistleblowers’ telephone hotline has also been established and the government is now introducing a “duty of candour” to force the NHS to be open and honest about mistakes.

But Patients First chairwoman Dr Kim Holt said: “There has not been any real progress. I have been shocked by the number of people who come to us who are having problems. For me, bullying is the major issue.

“We need to get employers to take this seriously and implement the policies they have to give whistleblowers proper support. That is the only way of changing this.”

Patients First are nurses, doctors, managers and other staff who have made patients their first concern by raising concerns about poor standards of care and unsafe practice and in doing so, have often suffered reprisals in the workplace for highlighting such concerns.

Patients First is a network of such health professionals & their supporters who work to protect whistleblowers and create an NHS where they are no longer needed.

Obesity is new smoking says NHS boss

Obesity is the new smoking in terms of the impact on health and the cost to the NHS says the head of the NHS.

Obesity is new smoking says NHS bossA quarter of adults – up from 15% 20 years ago – and one in five schoolchildren is obese, figures show and the problem is estimated to already cost the NHS £9 billion a year. Someone with a body mass index (BMI) – a height-weight ratio – of more than 30 is considered to be obese, according to NHS Choices.

But NHS England chief executive Simon Stevens said if obesity rates kept rising it could even threaten the sustainability of the health service.

Speaking to the Public Health England annual conference in Coventry on Wednesday, Mr Stevens said: “Obesity is the new smoking. It represents a slow motion car crash in terms of avoidable illness and rising health care costs.

“If, as a nation, we keep piling on the pounds around the waistline, we’ll be piling on the pounds in terms of future taxes needed just to keep the NHS afloat.”

He said, unchecked, the result of growing obesity rates would be a “huge rise” in disability and illness, such as diabetes.

His comments come ahead of the the publication of his five year plan for the NHS next month.

One of the proposals being discussed is whether more should be spent on lifestyle intervention programmes rather than bariatric surgery and offering incentives to employers to get them to encourage their staff to become healthier.

The NHS, in particular, should take a lead on this with staff becoming “health ambassadors” in their local communities, it has been suggested.

Another option under consideration is giving local councils extra powers to make local decisions about issues such as fast food, alcohol and tobacco.

Dementia patients face unfair care tax

Dementia patients in the UK face an “unfair care tax” because they have to pay for most of the care they need themselves say experts.

Dementia patients face unfair care taxThe Alzheimer’s Society found that on average, the equivalent of £32,242 a year was spent on care per patient, but the researchers said on average only a third – £10,784 – came from NHS or council funds, leaving a shortfall.

The charity said it was unfair as those with cancer or heart problems got their care free on the NHS.

The research was carried out by the London School of Economics and Kings College London and was carried out to update figures compiled by the charity in 2007.

Experts looked at care provided by the NHS and paid for by councils as well as the private care market and amount of unpaid support provided by family and friends.

They found that caring for dementia patients cost the UK the equivalent of £26.3 billion overall, but estimated that £17.4 billion – two-thirds – came from private care services or in the form of unpaid care.

For the individual, that works out at £32,242 a year – £21,322 of which was not from the state.

Alzheimer’s Society chief executive Jeremy Hughes said the figures were “staggering” and the lack of paid-for care was, in effect, a “dementia care tax”. If you have cancer or heart disease you can quite rightly expect that the care you need will be free.

“That is just not the case for people with dementia. Families are forced to break the bank to pay for basic care for a loved one.”

As well as the cost of care, researchers looked at the number of cases of dementia.

They found that over the last seven years there had been no change in the proportion of older people getting the disease – it has stayed at 7.1% of over-65s but they predicted the overall numbers would rise from 850,000 now to more than two million by 2051 because of the ageing population.

The report said there had been a rise in younger adults with the disease – up from 17,000 to more than 40,000. But researchers said that rather than there having been a real increase, the previous study had underestimated the scale of the problem.

Health Secretary Jeremy Hunt said the government was prioritising dementia care, pointing out the Prime Minister’s dementia challenge was launched in 2012 to help improve care and research.

Since it was launched diagnosis rates have started to rise, while investment has been made in services such as memory clinics. On top of that, from 2016 care costs will be capped at £72,000.

NHS cancer services struggling warns charity

NHS cancer services are at a “tipping point” after years of efficiency savings and the recent NHS reforms warns Cancer Research UK.

NHS cancer services struggling warns charityTheir new report, the charity suggests services need urgent investment or cracks will appear- and the analysis calls for greater funding towards cancer diagnosis in order to meet the “looming demands” of an ageing population.

More than 1.4 million patients in England were referred by their GPs with suspected cancer in 2013-14 – a 50% increase from 2009-10.

But there is no longer the capacity to respond to this demand, according to the report, commissioned by Cancer Research UK and conducted by experts at the University of Birmingham and the company ICF CHK Consulting.

Researchers say there should be an urgent review into the leadership of services and how they are commissioned across the NHS.

Harpal Kumar, Cancer Research UK’s chief executive, said: “In many ways NHS cancer services have held up remarkably well. Staff have bravely dug in and done their best in the face of overwhelming change, increased demand, squeezed budgets and fragmented leadership.”

“But that cannot continue indefinitely. More people are surviving cancer than ever before – survival rates in the UK have doubled in the last 40 years because research is delivering better diagnosis and treatments.”

“But the number of cases is also going up as the UK population ages. The NHS will need to be fit to meet that purpose and that needs increased investment, planning and leadership now.”

Sean Duffy, national clinical director for cancer at NHS England, said: “The NHS is successfully seeing 50% more patients than four years ago and survival rates have never been higher.

“Almost nine out of 10 patients say their care is excellent or very good. But Cancer Research UK is right to highlight the need for more integrated commissioning between specialist and local services.”

Brain stimulation helps in stroke treatment

Stimulating the part of the brain which controls movement may improve recovery after a stroke new research suggests.

Brain stimulation helps in stroke treatmentStudies showed firing beams of light into the brains of mice led to the animals moving further and faster than those without the therapy.

The research, published in Proceedings of the National Academy of Science, could help explain how the brain recovers and lead to new treatments.

The Stroke Association said the findings were interesting.

Strokes can affect memory, movement and the ability to communicate. Brain cells die when their supply of oxygen and sugars is cut off by a blood clot.

Stroke care is focused on rapid treatment to minimise the damage, but some recovery is possible in the following months as the brain rewires itself.

The team at Stanford University School of Medicine investigated whether brain stimulation aided recovery in animal experiments.

They used a technique called optogenetics to stimulate just the neurons in the motor cortex – the part of the brain responsible for voluntary movements – following a stroke. After seven days of stimulation, mice were able to walk further down a rotating rod than mice which had not had brain stimulation. After 10 days they were also moving faster.

The researchers believe the stimulation is affecting how the wiring of the brain changes after a stroke. They detected higher levels of chemicals linked to the formation of new connections between brain cells.

Lead researcher Prof Gary Steinberg said it was a struggle to give people drugs to protect brain cells in time as the “time window is very short”.

However he said that aiding recovery could be easier: “The advantage of treating during the recovery period is it’s longer, potentially it could be years, so it has huge potential. I predict that the kind of study we’re doing will help to push stimulation as a therapy for stroke and you can image how import that would be for the millions of stroke patients with disability.”

Optogenetics uses an optic fibre to send light into the brain, which specifically activates cells that are genetically engineered to respond to the light. It allows precision stimulation of parts of the brain in experiments.

The team at Stanford argue using optogenetics will allow them to uncover exactly what changes in the brain as it recovers from stroke,

Prof Steinberg said: “We’re also looking to see if optogenetically stimulating other brain regions after a stroke might be equally or more effective. The goal is to identify the precise circuits that would be most amenable to interventions in the human brain, post-stroke, so that we can take this approach into clinical trials.”

However, optogenetics cannot be used in people yet.

It would require genetic modification of the target cells, but Prof Steinberg argues “it may not be too far in the future that you’re doing refined and elegant stimulation” with optogenetics.

Dr Shamim Quadir, from the Stroke Association charity, said: “This is a very interesting study using light to stimulate specific brain cells of genetically altered mice in the early days after a stroke. Using this optogenetic technique could be helpful in improving our understanding of the mechanisms driving stroke recovery, however it is too early to tell exactly how this research might be developed for the treatment of human stroke patients.”

Hair loss reversed for alopecia sufferers

Scientists have completely reversed hair loss in three people by giving them a drug normally used to treat bone marrow disorders.

Hair loss reversed for alopecia sufferersThe patients had alopecia areata – a condition that can cause severe, patchy baldness that is difficult to treat and after five months of taking the medication ruxolitinib, all three saw total hair re-growth.

The findings from Columbia University Medical Center are published in the journal Nature Medicine.

Alopecia areata affects around two in every 1,000 people in the UK and is thought to be caused by the immune system attacking hair follicles.

The US scientists had previously identified a set of immune cells involved in the destruction of hair and conducted a number of successful trials in mice.

They then gave three patients with moderate to severe alopecia areata a twice daily dose of ruxolitinib.

This medication is already approved for use in bone marrow conditions in the United States and European Union.

All three patients had lost at least a third of their hair but saw dramatic hair growth within five months of therapy.

Lead researcher Dr Raphael Clynes said: “We’ve only begun testing the drug in patients, but if the drug continues to be successful and safe, it will have a dramatic positive impact on the lives of people with the disease.”

Prof David Bickers, a dermatologist at Columbia University who has treated many patients with the disease, said: “There are few tools in the arsenal for the treatment of alopecia areata that have any demonstrated efficacy. This is a major step forward in improving the standard of care for patients suffering from this devastating disease.”

Researchers say more work is now needed to see if the drug can be offered more widely.

Alopecia areata can occur at any age but is most often seen in teenagers and young adults.

It is not related to the more common male-pattern hair loss that is thought to be driven by hormones.

Scientists say as the mechanisms behind this condition are different, the therapy is less likely to prove effective for this more common problem.

Alcohol tax suggested to fund rehab and health service for addicts

Drink and drug addicts should be treated in rehab treatment centres paid for with a new tax on alcohol.

Alcohol tax suggested to fund rehab and health service for addictsThe Centre for Social Justice (CSJ) said that by 2024, a ring-fenced “treatment tax” would put up the cost of alcohol bought in shops by 2p per unit- it is among a number of measures recommended to tackle addiction.

The Department of Health said councils’ £5.4 billion public health budgets would help them address alcohol harm.

The CSJ, which seeks to tackle poverty and its causes wants the government to fund treatment centres for 58,000 addicts per year by 2024.

Its report says 300,000 people in England are addicted to opiates and/or crack, 1.6 million are dependent on alcohol and one in seven children under the age of one lives with a substance abusing parent.

The measures set out in its Ambitious for Recovery report include:

  • Scrapping the drug advice site FRANK, which it says does not send “a strong signal to young people about the risks of experimenting with drugs”
  • Involving job centres in identifying and helping addicts, with jobseekers “screened for addiction”
  • Offering benefit claimants with addiction problems support and “abstinence-based” treatment with the threat of sanctions if help is refused
  • Piloting a charge card for long-term unemployed parents with serious addiction problems to restrict how they spend any income support to essential items only
  • Doing more to tackle so-called legal highs and educate young people and parents about their dangers

The treatment tax proposal would see a levy of 1p per unit of alcohol added on drinks purchased outside pubs by the end of the next Parliament, rising to 2p by 2024, the CSJ said.

This could mean about 18p added to the price of a bottle of wine after 2024.

The think tank estimated it would raise £155 million a year from 2015, rising to about £520 million a year from 2024.

A Department of Health spokesman said: “We are not considering a tax on particular drinks.  Instead, we are reducing alcohol harm by giving local authorities a £5.4 billion budget to help them manage public health issues including alcohol and drug services. We have also banned sales of the cheapest cut price alcohol.”

Local authorities had the best understanding of local needs to be able to assess, plan and deliver alcohol and drug services and treatment in their areas, he added.

Sally Marlow, an alcohol addiction specialist, said there were “problems with the proposal”.

But she added: “If we’re going to sell it, if we’re going to legitimise it and say we sanction alcohol then we have a duty also to say to the people who get into trouble with it, ‘we’ll help you with it – we’ll help you get out of the trouble that you’re in’.”