0 Woman gives birth hours after running Chicago Marathon

Amber Miller said she was happy but called it the "longest day of my life" after giving birth to a daughter following completing the Chicago Marathon

Instead of having a rest after completing the Chicago Marathon, pregnant Amber Miller gave birth.

Mrs Miller, who was nearly 39 weeks pregnant, said "it was the longest day of my life". She gave birth to a healthy 7.7lb (3.5kg) girl, June.
The marathon was the eighth for the 27-year-old, who already had one child. On her doctor's orders she ran half and walked half the distance.
"Lots of people were cheering me on: 'Go pregnant lady'," she said.
"For me, it wasn't anything out of the ordinary. I was running up until that point anyway," she told Associated Press news agency.
"I am crazy about running."
Because she half-walked the race, she finished the 26.2 mile (42.16km) course in 6:25 - slower than her usual pace.
"A few minutes after finishing, the contractions became stronger than normal and I understood what was going on," she said.
"When they became more regular, we had a sandwich and then we left for hospital," Mrs Miller added.

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0 Vitamins linked with higher death risk in older women

A healthy diet should provide enough nutrients without the need for supplements, experts advise

When it comes to vitamins, it appears you could have too much of a good thing, say researchers who report a link between their use and higher death rates among older women.

Experts have suspected for some time that supplements may only be beneficial if a person is deficient in a nutrient.
And excess may even harm, as the study in Archives of Internal Medicine finds.
All of the women, in their 50s and 60s, were generally well nourished yet many had decided to take supplements.
Multivitamins, folic acid, vitamin B6, magnesium, zinc, copper and iron in particular appeared to increase mortality risk.
The researchers believe consumers are buying supplements with no evidence that they will provide any benefit.
Harms vs gains

They are quick to stress that their study relied on the 38,000 US women who took part in it recalling what vitamins and minerals they had taken over the previous two decades.

And it is difficult to control for all other factors, like general physical health, that might have influenced the findings.
But they say their findings suggest that supplements should only be used if there is a strong medically based cause for doing so because of the potential to cause harm.
"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," Dr Jaakko Mursu of the University of Eastern Finland and his research colleagues said.
Less is more In the study, iron tablets were strongly linked with a small (2.4%) increased death risk, as were many other supplements. The link with iron was dose-dependent, meaning the more of it the individual took, the higher their risk was.

Conversely, calcium supplements appeared to reduce death risk. However, the researchers say this finding needs more investigation and they do not recommend that people take calcium unless advised to by a doctor in order to treat a deficiency.

Drs Christian Gluud and Goran Bjelakovic, who review research for the Cochrane Database of Systematic Reviews to evaluate best evidence, said: "We think the paradigm 'the more the better' is wrong."
They say dietary supplementation has shifted from preventing deficiency to trying to promote wellness and prevent diseases, and caution: "We believe that for all micronutrients, risks are associated with insufficient and too-large intake."
Helen Bond of the British Dietetic Association said some people, like the elderly, might need to take certain supplements. For example, vitamin D is recommended for people over the age of 65.
But she said that generally, people should be able to get all the vitamins and minerals they needed from a healthy, balanced diet.
She said some took supplements as an insurance policy, wrongly assuming that they could do no harm. "But too much can be toxic and it is easy to inadvertently take more than the recommended daily amount."

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0 Nurses and midwives urged to get flu jab

A flu jab is recommended annually for those at risk

Nurses and midwives are being urged to get their flu jabs after figures reveal less than a third did last year.

All front-line healthcare workers are meant to be vaccinated to stop them going off sick with influenza and spreading the virus to patients.
Last year only 30% of hospital nursing staff in England got immunised compared with 43% of GP practice nurses, 38% of GPs and 37% of other doctors.
This is the first time the figures have given a breakdown by occupation.
The number of healthcare workers getting the vaccine had increased from 26.4% in the 2009 winter to 34.7% in 2010.
However, the majority of nurses who work with the most critically ill over the winter months and midwives who work with pregnant women, were left vulnerable to flu, its potentially life-threatening complications and passing it on to patients and family, says the Department of Health which released the figures.

Dr Peter Carter Royal College of Nursing

The data also shows that only 25.2% of youngsters aged six months to two years in at-risk groups were vaccinated last winter, compared with 51.7% of those aged 16 to 65.

Those at risk include people with conditions such as asthma, diabetes, heart disease and liver disease, as well as the over-65s and pregnant women.
Last winter people in at-risk groups were 11 times more likely to die from seasonal flu than people with no underlying health problems.
Chief Medical Officer Dame Sally Davies said: "It is never too early to start thinking about flu. So as NHS staff return from their holidays, I urge them to plan ahead and get vaccinated."
Dr Peter Carter, of the Royal College of Nursing, said while NHS staff should not be forced to get immunised, they had a professional duty to do so: "Patients and healthcare staff suffer when nurses are off sick.
"It is vital that nurses do all they can to take responsibility for their own health and of those around them. The RCN will be working with our members to ensure they have access to all of the relevant information to enable them to make the right decision about the uptake of the vaccine."
Louise Silverton, of the Royal College of Midwives, said: "Midwives are strongly advised to encourage all pregnant women to be vaccinated against seasonal flu.
"In addition midwives as key health workers should themselves seriously consider being vaccinated to prevent transmission of influenza to the women for whom they care and also to their own families."
A National NHS Staff Seasonal Flu Vaccination Campaign launches later this month and will use resources like Twitter and Facebook, as well as leaflets, to encourage more healthcare professionals to get vaccinated.

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0 Fewer teenagers drinking alcohol 28 July 2011 Last updated at 08:49 GMT

 

There have been falls in the numbers of teenagers drinking, smoking and taking drugs in England, a survey suggests.

Between 2009 and 2010 the percentage of 11-15 year olds who had tried alcohol fell from 51% to 45%.
And 27% of pupils said they had smoked at least once, while 18% had tried drugs.
The NHS Information Centre figures also suggested "a shrinking number think that drinking and drunkenness is acceptable".
The report surveyed 7,296 pupils from 246 schools.
The proportion of those drinking alcohol in the week before the study fell from a peak of 26% in 2001 to 13% in 2010.
When they did drink, six in 10 pupils said they consumed more than four units.
One in 20 pupils said they were a regular smoker and girls were more likely to smoke than boys. Smokers were also more likely to have drunk alcohol or to have taken drugs.
In 2001, 29% of those surveyed said they had used other drugs. That figure has fallen to 18%.
The most commonly used drug was cannabis, taken by 8.2% of pupils.
The survey also suggested a shift in attitudes.
Between 2003 and 2010, the percentage of pupils saying it was "okay" for someone their own age to drink once a week went from 46% to 32%.
Tim Straughan, chief executive of the NHS Information Centre, said: "Our figures point to an increasingly intolerant attitude among young people in today's society when it comes to the use of cigarettes, alcohol and drugs.
"As well as a reduction in the percentage who say they partake in these behaviours; a shrinking number think that drinking and drunkenness is acceptable among their peers."
The chief executive of Drinkaware, Chris Sorek, said: "These statistics are not just encouraging because they show a drop in the number of children who have tried alcohol, but also because they show a positive shift in attitudes.
"To see that fewer children are tolerant of their peers drinking is an early sign of a change in the nation's drinking culture."

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0 Goal to rid world of polio by end of 2012 'off track' 21 July 2011 Last updated at 04:01 GMT

An oral vaccine gives good protection against polio

A plan to rid the world of polio by the end of next year is "off track", say international experts.

India is praised for having had just one case of polio in the first six months of this year.
But the report by independent monitors warns that Pakistan "risks becoming the last global outpost of this vicious disease". It has also resurfaced in four other countries.
There were around 1,000 cases of polio worldwide last year.
The virus remains present in Afghanistan, India, Nigeria and Pakistan and in the countries where it has resurfaced, there have been twice as many cases - 162 - as there were in the endemic countries.
The experts are particularly concerned about new cases in the Democratic Republic of Congo and Chad.
England's former chief medical officer, Sir Liam Donaldson, is leading the board monitoring the efforts of the Global Polio Eradication Initiative, which works to support the goal set in 1988. Sir Liam said: "Polio is a very resilient disease. There was a big impact in tackling it in the first two decades since the goal.
"But we still have this very big rump of cases left behind. Tackling the remaining 1% of polio is the greatest challenge yet.
"India has done something simple - it's run very high quality vaccination campaigns. They have public health leaders who are meticulous in making sure every child is vaccinated.
"If they can do it, why can't other countries?"
Polio is highly infectious - and tends to strike children aged under five. It invades the nervous system, leading to irreversible paralysis.
There is no cure, but a vaccine of mouth droplets can give good protection.
Untrained vaccinators

Sir Liam and his colleagues say strong political and community leadership is important in the countries with polio outbreaks. They also identify a funding gap of £366m.

The report highlights problems that occur within some vaccination programmes. In one part of Pakistan, paid vaccinators had sub-contracted their tasks to untrained children.
And in another campaign, the vaccinators stood passively at their post in the town square, rather than mingling with the crowds and encouraging immunisation.
The monitoring board said: "Our view remains that stopping polio transmission needs to be treated as a global health emergency.
"Fourteen countries have had polio outbreaks since the start of 2010. It is alarming and bad for the programme's morale that there are still these surprises.
"Polio eradication is still possible in the near-term if there is enhanced political commitment, secure funding and strengthened technical capacity."
Rotary International, which is part of the Eradication Initiative, said: "We welcome this frank assessment of the programme.
"We will work with our members in countries affected by polio to follow the board's recommendation of creating a checklist, to enhance the impact of the immunisation teams and ensure standardisation."

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0 Clue to male infertility found 21 July 2011 Last updated at 06:25 GMT

Sperm have to swim through mucus to get to the egg

As many as a quarter of men have a genetic change which makes them less fertile than usual, research suggests.

The discovery could lead to a new screening test to identify those who will take longer to father a child, experts report in the journal Science Translational Medicine.
The change is in a gene that codes for a key protein found on the outside of sperm.
Sperm lacking in the substance find it harder to swim to the egg.
Researchers believe a man with the altered gene can still get his partner pregnant, but this will take longer than usual.
Dr Edward Hollox of the University of Leicester is a co-author of the study.

He told the BBC: "If you've got this gene variant you should allow that little bit longer if your partner's planning to get pregnant.

"It takes two - it's the genetic variation in a man that affects fertility in this particular case."
Molecular events He said the discovery raised the possibility of a new test to identify couples who might need fertility treatment.
"It's another tool in the toolkit of fertility treatment," he said.
The genetic change is in a gene called DEFB126, which codes for a protein that clings to sperm, helping them swim through the woman's body to fertilise the egg.

These sperm look normal but have more difficulty getting to the egg

Researchers believe men with the defective gene have sperm that find it harder to make their way through mucus, causing low fertility.
A study of more than 500 married couples in China found that women who had partners with two copies of the defective gene (one from the mother and one from the father) were less likely to get pregnant.
The women also took longer to get pregnant by a couple of months.
Further studies, carried out in people from the US, UK, China, Japan and Africa, found the gene mutation is common around the world.
About half of all men carry one copy of the defective gene; while a quarter have two defective copies.

Commenting on the study, Dr Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield, said:

"We actually understand very little about the subtle molecular events which occur in sperm as they make their journey through the woman's body to fertilise an egg.
"We know even less about how a man's genes may contribute to how his sperm work, in the absence of an obvious defect that we can see down the microscope.
"Therefore, this paper is an important step forward and makes a significant contribution to our sperm-knowledge."

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0 Mum's stress is passed to baby in the womb 19 July 2011 Last updated at 14:12 GMT

There may be a sensitive window for developing stress responses

A mother's stress can spread to her baby in the womb and may cause a lasting effect, German researchers propose.

They have seen that a receptor for stress hormones appears to undergo a biological change in the unborn child if the mother is highly stressed, for example, because of a violent partner.
And this change may leave the child less able to handle stress themselves.
It has already been linked to mental illness and behavioural problems.
The findings, published in the journal Translational Psychiatry, are based on a small study of 25 women and their children, now aged between 10 and 19.
And the researchers point out that the women involved in the study had exceptional home circumstances and that most pregnant women would not be exposed to such levels of stress day in and day out.
Furthermore, the researchers say the findings are not conclusive - many other factors, including the child's social environment while growing up, might be involved.

But they suspect it is the child's earliest environment, the womb, that is key.

For their study, they looked at the genes of the mums and the adolescents to find any unusual patterns.
Some of the teens had changes to one particular gene - the glucocorticoid receptor (GR) - that helps regulate the body's hormonal response to stress.
Such genetic alterations typically happen while the baby is still developing in the womb.
And the scientists believe they are triggered by the mum-to-be's poor state of emotional wellbeing at the time of the pregnancy.
Sensitive window In the study, these mums had been living with the constant threat of violence from their husband or partner. And it would appear this continued stress took its toll on the pregnancy.
When the babies were followed up one to two decades later as adolescents, they had changes in the genetics of their GR that other teenagers did not.
This "methylation" of GR appears to make the individual more tuned in or sensitised to stress, meaning that they will react to it quicker both mentally and hormonally.

Stress hormones are regulated by the brain's hypothalamus

As people, they tend to be more impulsive and may struggle with their emotions, explain the researchers, who carried out detailed interviews with the adolescents.
Professor Thomas Elbert, one of the lead researchers at the University of Konstanz, said: "It would appear that babies who get signals from their mum that they are being born into a dangerous world are faster responders. They have a lower threshold for stress and seem to be more sensitive to it."
The investigators now plan to carry out more detailed investigations following larger numbers of mothers and children to see if they can confirm their suspicions.
Dr Carmine Pariante, an expert in the psychology of stress at the Institute of Psychiatry, King's College London, said: "This paper confirms that the early foundation years start at minus nine months."
He added: "Pregnancy is uniquely sensitive to a challenging maternal psychosocial environment - much more than, for example, after the baby is born. As we and others have been advocating, addressing maternal stress and depression in pregnancy is a clinically and socially, important strategy."

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0 Nudge not enough to change lifestyles - peers 19 July 2011 Last updated at 00:54 GMT

The government is pilot the nudge theory in a number of areas including smoking cessation

Plans to get people to adopt healthier lifestyles will not work unless the government is more prepared to use legislation, peers believe.

The House of Lords science and technology committee said ministers seemed to be mistaken in their use of what is known as the nudge theory.
Nudging people is about getting them to change their behaviour without necessarily banning activities.
But the group said that did not mean legislation should not be used at all.
Both the prime minister and Health Secretary Andrew Lansley are known to be admirers of the nudge theory.
It formed a key part of the government's public health strategy which was set out at the end of last year.
A unit has also been established in the Cabinet Office to push ahead with policies. Pilots to get people to quit smoking and increase organ donor registration have already been arranged.
'Important lever' But the cross-party group of peers suggested there was confusion within government over what nudging actually involved, as they had been given different definitions by officials.
The peers also said the government's pursuit of non-regulatory steps had created an environment whereby nudge was being seen as something that did not require legislation.

But they said this was not always the case, recommending the government took steps to ensure traffic light labelling appears on food.

This contrasts with the government's tactics to date which have been more focused on using voluntary agreements.
For example, earlier this year ministers launched the "responsibility deal" which saw more than 170 companies put their names to a series of pledges covering physical activity, alcohol, health at work and food.
The committee is also calling for an independent chief social scientist to be appointed to provide government with "robust" advice.
Committee chairman Baroness Neuberger said: "There are all manner of things that the government want us to do - lose weight, give up smoking, use the car less, give blood - but how can they get us to do them?
"It won't be easy and this inquiry has shown that it certainly won't be achieved through using nudges, or any other sort of intervention, in isolation."
Professor Lindsey Davies, president of the UK Faculty of Public Health, said it was a "welcome and timely report".
"The public health profession has long argued that 'nudging' is but one aspect of a wide programme of interventions to help people make changes in their lives which promote good health and wellbeing."
A Cabinet Office spokesman said the recommendations would be considered.
But he added: "We are glad that they recognise that that the application of behavioural insights continues to be an important policy lever for government. These often complement other, more traditional policy tools."

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0 Painkillers 'may ease agitation' in dementia patients 18 July 2011 Last updated at 00:08 GMT

Dementia often causes agitation

Many dementia patients being prescribed "chemical cosh" antipsychotic drugs could be better treated with simple painkillers, research says.

The British and Norwegian study, published on the BMJ website, found painkillers significantly cut agitation in dementia patients.
Agitation, a common dementia symptom, is often treated with antipsychotic drugs, which have risky side effects.
The Alzheimer's Society wants doctors to consider other types of treatment.
Experts say that each year about 150,000 patients in the UK are unnecessarily prescribed antipsychotics, which have a powerful sedative effect, and can worsen dementia symptoms, and increase the risk of stroke or even death.
They are often given to patients whose dementia makes them aggressive or agitated.
But researchers from Kings College, London, and Norway speculated that the behaviour may sometimes be caused by pain, which patients were unable to express in other ways.
They studied 352 patients with moderate or severe dementia in nursing homes in Norway.
Half were given painkillers with every meal, the rest continued with their usual treatments.
Supervised treatment 'key'
After eight weeks, there was a 17% reduction in agitation symptoms in the group being given painkillers - a greater improvement than would have been expected from treatment with antipsychotics.
The researchers concluded that if patient's pain was properly managed, doctors could reduce the number of prescriptions for antipsychotic drugs.

Click to play

Prof Clive Ballard, Alzheimer's Society: "Simple painkillers... had a a very, very substantial impact”

Professor Clive Ballard, one of the report authors and director of research at the Alzheimer's Society, said the finding was significant.
"At the moment, pain is very under-treated in people with dementia, because it's very hard to recognise," he said.
"I think this could make a substantial difference to people's lives - it could help them live much better with dementia."
However, he said painkillers should only be given to patients under the supervision of a doctor.
The Alzheimer's Society is issuing new guidance calling on doctors to think much harder before prescribing antipsychotics, and to look at prescribing pain medication instead.
The National Care Association said the study highlighted some of the complexities of dementia.
"Pain in itself is debilitating, so to identify it as the route cause of agitation and aggressive behaviour is a major breakthrough which will enable us to support people appropriately," said its chairman, Nadra Ahmed.
A government programme to reduce the inappropriate prescription of antipsychotic drugs is already under way in England.
The care services minister Paul Burstow welcomed the study.
"It should act as a further call for GPs to carefully examine the reason why those with dementia display agitated behaviour, rather than immediately resorting to antipsychotic medication," he said.

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0 Security increased in Stepping Hill Hospital deaths inquiry 16 July 2011 Last updated at 02:48 GMT

The contamination of the saline was not restricted to a single ward, the hospital said

Police have stepped up security at a Stockport hospital where a batch of saline was deliberately contaminated.

Anyone entering Stepping Hill Hospital may now be searched as police investigate whether it is linked to the deaths of two men and a woman.
Police will also attempt to interview every medical professional and patient over the weekend.
Eleven other patients were found to have been affected in the incident but not seriously harmed.
Police were called in on Tuesday after an experienced nurse reported a higher than normal number of patients with low blood sugar levels.
An initial inquiry concluded saline ampoules had been "interfered with" - with the contamination thought to have involved the use of insulin.
It has been revealed that of the three patients, the woman, aged 44, and a 71-year-old man were terminally ill. The nature of the 84-year-old man's illness has not been disclosed.
'Protect our patients' Chris Burke, Stockport NHS Foundation Trust's chief executive, said: "We have increased security both in terms of access to the hospital and access to medicines and already replaced all saline ampoules across the hospital.
"We are doing all we can to protect our patients and ensure their safety while under our care."
Assistant Chief Constable Terry Sweeney, of Greater Manchester Police, said: "We have someone deliberately contaminating saline in the one place that people should feel they are being most cared for.
"I want to reassure everyone connected to the hospital - staff, patients, visitors and the wider community - that we are determined to prevent further harm and to bring the offender to justice."
Mr Sweeney said police were still waiting to find out if the contamination of the saline "contributed to the deaths of these three people".
He added: "We are working very closely with the hospital to improve the security of the patients and staff at the hospital."

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0 Health charity says four in 10 people will get cancer 14 July 2011 Last updated at 02:01 GMT

Cancer charity says four in ten will get the disease

Rising cancer rates mean four in 10 people in the UK get the disease at some point in their lives, a health charity says.

Macmillan Cancer Support says the figure has risen significantly in the past decade.
The charity says the rise poses a "massive challenge" for the NHS.
Ministers in England say they are working to improve cancer survival rates and the quality of life after diagnosis and treatment.
Macmillan Cancer Support says a decade ago about a third of people, or 33%, developed cancer at some point in their lives. The charity says that figure has risen to more than 40%.
The estimates are drawn from projections published two years ago in the British Journal of Cancer, which concluded that at the end of 2008 there were two million cancer survivors in the UK and that the figure was rising every year.
Macmillan also looked at recent cancer incidence and mortality statistics for the UK, indicating that 310,000 people were diagnosed with cancer in 2008.
About 157,000 people died from the disease, and 89,000 who had been diagnosed with cancer died from other causes, making a total of 246,000 who died "with" cancer.
The charity says this accounted for 42% of total deaths in the UK - which stood at 580,000.
Macmillan says the increase is partly down to an ageing population - older people are more likely to develop cancer. It says lifestyle factors, such as diet and exercise, and improved diagnosis have also contributed to the rise.
'Massive challenge'

Continue reading the main story

“Start Quote

We have a massive challenge ahead if we are to keep up with the relentless toll cancer takes on people's health, and the NHS must rise to it”

Ciaran Devane Macmillan Cancer Support

The chief executive of Macmillan Cancer Support, Ciaran Devane, said the calculations had important implications for the health service.

"It is really alarming that the number of people who will get cancer is now well past one in three and that there are so many more people with cancer today than even 10 years ago," he said.
"There are currently two million people living with cancer in the UK and that number is doubling to four million over the next 20 years. Yet no-one thinks the country can afford to double its spending on cancer. We've therefore got to become twice as effective in how we spend that money."
The charity says there is growing evidence of the long-term health problems many cancer patients are experiencing long after initial diagnosis and treatment. It says there is a need for more services to help people stay well at home, rather than waiting until they require emergency hospital treatment.
Major issue
The Care Services Minister for England, Paul Burstow, said it was absolutely right for Macmillan to raise this as a major issue.
"We agree with Macmillan. That's why we are working to deliver more personalised care and more help to keep people well in their own homes. We are investing more than £750m over four years to improve cancer outcomes," he said.
The chair of the Royal College of GPs, Dr Clare Gerada, said the figures highlighted the increasing impact of cancer on many people's lives.
"What is clear from this study is that cancer survival is not the whole picture. All healthcare professionals have a duty to see that patients receive the best possible care, and aftercare, following a diagnosis of cancer, and to ensure their patients are not just living, but living well," she said.

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0 Why do Americans die younger than Britons? 11 July 2011 Last updated at 10:06 GMT

New life expectancy figures show Americans some way behind countries like Canada, the UK and Australia. Why?

Living in the world's richest country comes at a price, and it's measured in life years.

Men in the US are on average aged 75 when they die. That is 1.5 years younger than men in the UK and 3.5 years younger than men in Australia, says a new study.
American women live on average to just under 81 - about three years younger than the average Australian woman.
While life expectancy in the US continues to improve, says the report by researchers at University of Washington in Seattle and Imperial College, London, it is not increasing as quickly as in other Western countries, so the gap is widening.
"The researchers suggest that the relatively low life expectancies in the US cannot be explained by the size of the nation, racial diversity, or economics," says the document, which ranks the US 38th in the world for life expectancy overall.
"Instead, the authors point to high rates of obesity, tobacco use and other preventable risk factors for an early death as the leading drivers of the gap between the US and other nations."

"We weren't surprised that we had lower life expectancies than other countries, but we were surprised by the fact that we were falling further behind," says Dr Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington.

Take a country like Australia, he says. "It also has a nation of immigrants. It also is a relatively young country. It has similar socioeconomic characteristics.
"It has an obesity problem, and yet it has continued to improve in life expectancy and remains one of the healthiest nations in the world."
So how should the US address these risk factors?
Smoking alone is responsible for one out of every five deaths in the US, the professor says, yet the US has not been as tough as Australia in restricting tobacco advertising and public smoking.
Australia also has a greater focus on primary care - which helps with health education, and early treatment of any problems - and it has done a good job reducing the number of road traffic accidents, he adds.
The US could also save 100,000 lives a year by reducing salt in people's diets, since high blood pressure kills one in six people, Dr Mokdad says.

Continue reading the main story

Snapshot from Mississippi

"We have high rates of poverty and high rates of uninsured or people lacking access to care. We have fewer primary care providers and fewer physicians per person than most states. And high rates of low education.
"We have the highest rate of obesity in the country and therefore one of the highest rates of diabetes. A relatively high rate of tobacco use and high rates of cardiovascular disease, stroke and cancer.
"It's going to take a long time to make progress, but we have 40 communities that have banned indoor smoking in public buildings, and the percentage of high school smokers is falling. In other ways, we are making being healthy an easier choice."
Dr Mary Currier, Mississippi health officer

Then there's the big issue - about one in three adults is classified as obese. That's about 10 times as many as in long-living countries like Japan, according to OECD figures.

But the US is a big country, and while parts of Mississippi have a male life expectancy of 67, behind nations like the Philippines, women in areas of Florida live as long, on average, as the Japanese, who top the longevity rankings.
It is precisely this kind of inequality that goes some way to explain why the US - and the UK to a lesser degree - lag behind other countries, according to Danny Dorling, a professor of human geography at the University of Sheffield in the UK.
He believes a more even distribution of wealth, even if the average were lower, could mean longer lives for everyone.
"I think stress is a part of it - this is the key thesis of Michael Marmot and his book on the status syndrome. People get worn out faster with greater inequality.
"However there is much more. If you have most health spending just going on a few people who have the best health to begin with - [as in] the US system - that is hardly efficient.
"In a more unequal rich country more doctors are working on things like plastic surgery. More dentists whiten teeth than fix bad teeth and so on."
Infant deaths
While it is not surprising that poor Americans lose out from inequality, Prof Dorling argues that the rich may suffer too.

Several of the world's oldest people have been from Japan

"Top income groups are badly affected because their doctors are not necessarily mainly interested in their health but work for organisations that have to make an income," he says.
"I am not suggesting it is deliberate but you make more money out of a patient who spends more on many drugs and investigatory operations than one who lives longer with less intervention.
"In a more equal system the rich who are well get less intervention - and they live longer in the UK than the US."
Growing income inequality in the UK, since the 1970s, has has helped to push it down the European life expectancy rankings, says Mr Dorling.
However, life expectancy is not just about forecasts made for newborn babies.
When you look at life expectancy at 65, the US does perform well, says Svetlana Ukraintseva, research scientist at the Center for Population Health and Aging (CPHA) at Duke University in North Carolina.
Elderly Americans have a higher chance of surviving heart disease and many cancers than their counterparts in other rich countries, she says. Where the US lags behind is what happens at a much younger age. Infant mortality rates are high, she points out.
"So it's not the medical system itself that is the problem but access to it," she says.
"Medical insurance for all might help."
This is one goal of the healthcare reform signed into law in March 2010, which will oblige American adults to have health insurance when it comes into force in 2014.
However, this remains a controversial idea in the US and the legislation could yet come unstuck.
Challenges to the constitutionality of the law are working their way through the courts, and fierce opponents in the Republican Party make no secret of their desire to repeal the legislation if the opportunity arises.

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1 Breast cancer prostate drug hope, 25 June 2011 Last updated at 01:25 GMT

Breast cancers can be driven by oestrogen

Drugs used to treat prostate cancer in men may also be useful for difficult-to-treat breast cancers in some women, a Cancer Research UK study suggests.

Hormone treatments like tamoxifen and aromatase inhibitors are ineffective against up to 30% of breast cancers.
But laboratory research in Cambridge, reported in The EMBO Journal, suggests some of these tumours may respond to drugs for male cancers.
Cancer Research UK said the findings were a "great surprise".
Hormones can switch on genes which lead to cells dividing uncontrollably and developing into tumours.
In women, breast cancers can be driven by the female sex hormone oestrogen. In men, prostate cancer can be driven by male sex hormones - androgens.
Breakthroughs have been made in treatments for breast cancer by developing drugs which interfere with the oestrogen's action, halting the tumour's progress.
However, tumours which are not driven by the hormone have been harder to treat.
Prostate to breast

Dr Caitlin Palframan Breakthrough Breast Cancer

Researchers at the Cancer Research UK Cambridge Research Institute found that some of these oestrogen negative tumours were instead influenced by male hormones.

The same genes which were switched on by female sex hormones in oestrogen responsive tumours were activated by the male sex hormones.
It raises the prospect that drugs already developed for prostate cancer could help some women.
While androgens, such as testosterone, are typically associated with male development, they are also present in women.
The lead researcher Dr Ian Mills said: "This important discovery suggests that patients with a type of oestrogen-receptor-negative breast cancer may potentially benefit from therapies given to prostate cancer patients, which could transform treatment for this patient group in the future.
"But at the moment this laboratory research is still at an early stage."
Researchers said this could apply to up to 5% of all breast cancers.
Dr Lesley Walker, from Cancer Research UK, said: "Prostate cancer depends on the androgen receptor for growth so it's a great surprise that a type of breast cancer might also be fuelled by this protein."
Dr Caitlin Palframan, policy manager at Breakthrough Breast Cancer, said: "This fascinating research opens the door to personalised treatment for a small group of breast cancer patients.
"Women with oestrogen receptor negative disease have fewer treatment options and new ways to tackle it are urgently needed."

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0 Common medicines for elderly linked to death, 24 June 2011 Last updated at 00:07 GMT

Taking multiple common drugs has been linked to brain decline and death

Commonly used drugs - for conditions such as heart disease, depression and allergies - have been linked to a greater risk of death and declining brain function by UK researchers.

They said half of people over 65 were prescribed these drugs.
The effect was greatest in patients taking multiple courses of medication, according to the study in the Journal of the American Geriatrics Society.
Experts said patients must not panic or stop taking their medicines.
The researchers were investigating medicines which affect a chemical in the brain - acetylcholine. The neurotransmitter is vital for passing messages from nerve cell to nerve cell, but many common drugs interfere with it as a side effect.
Eighty drugs were rated for their "anticholinergic" activity: they were given a score of one for a mild effect, two for moderate and three for severe. Some were given by prescription only, while others were available over the counter.

A combined score was calculated in 13,000 patients aged 65 or over, by adding together the scores for all the medicines they were taking.

A patient taking one severe drug and two mild ones would have an overall score of five.
Deadly consequences Between 1991 and 1993, 20% of patients with a score of four or more died. Of those taking no anticholinergic drugs only 7% died.
Patients with a score of five or more showed a 4% drop in ratings of brain function.
Other factors, such as increased mortality from underlying diseases, were removed from the analysis.
Dr Chris Fox, who led the research at the University of East Anglia, said: "Clinicians should conduct regular reviews of the medication taken by their older patients, both prescribed and over the counter, and wherever possible avoid prescribing multiple drugs with anticholinergic effects. Dr Clare Gerada, chairman of the Royal College of GPs, said the findings of the study were important.
She told patients: "The first thing is not to worry too much, the second thing is to discuss it with your doctor or the pharmacist, and the third thing is do not stop your medicines without taking advice first."
She said doctors reviewed medication every 15 months and were aware of the risks of combining different drugs.
Dr Fox said he wanted to conduct further research to investigate how anticholinergic drugs might increase mortality.

Electrical signals cannot cross the gap between brain cells; neurotransmitters pass the message on

A more modern study is also thought to be desirable. Practices and drugs have changed since the data was collected two decades ago.
Ian Maidment, an NHS pharmacist in Kent and Medway, believes the situation may now be even worse.
He said the use of anticholinergic drugs had "probably increased as more things are being treated and more drugs are being used."
Brain decline Reduction of the neurotransmitter acetylcholine has already been implicated in dementia.
The drug Aricept is given to some patients with Alzheimer's disease to boost acetylcholine levels.
Dr Susanne Sorensen, head of research at the Alzheimer's Society, said a 4% drop in brain function for a healthy person would feel like a slow, sluggish day.
"If you are at a level where one little thing pushes you over into confusion, then that is much more serious," she added.
"However, it is vital that people do not panic or stop taking their medication without consulting their GP."
Rebecca Wood, chief executive of Alzheimer's Research UK, said: "This comprehensive study could have some far-reaching effects. The results underline the critical importance of calculated drug prescription."

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0 NHS changes: GPs want 'more concessions', 9 June 2011 Last updated at 09:30 GMT

The government has indicated it is willing to make changes to its overhaul of the NHS

GPs have urged ministers to make more concessions in their re-think of the NHS plans for England.

Earlier this week David Cameron outlined changes to the coalition's original plans, to win over critics.
But doctors at the British Medical Association's annual GPs conference said the steps were still not enough to win their backing.
The union's leaders warned a further climbdown was needed over competition in the NHS in particular.
During the opening session of the two-day meeting in London a series of critical motions were passed warning patient care was under threat and services could become fragmented if the changes were introduced.
The conference is taking place just two days after the prime minister set out a number of concessions he was planning to make.
Under Health Secretary Andrew Lansley's original plans consortia of GPs would be given much more responsibility for spending the NHS budget in England, while greater competition with the private sector would be encouraged.
But on Tuesday Mr Cameron indicated his willingness to include hospital doctors and nurses on the consortia alongside GPs and also said the NHS regulator would have a duty to promote co-operation as well as competition.

Click to play

Dr Laurence Buckman, of the British Medical Association, says reform must not be a 're-spray' job

But in his speech to open the union's conference, Dr Laurence Buckman, the chairman of the BMA's GPs committee, said: "He has still not taken away the duty to promote competition. I want politicians of every stripe to understand that we do not need competition to run the NHS. It creates duplication that is wasteful.
"This bill whether substantially amended or not is going to alter the face of the English NHS forever."
He said it was now important that ministers go further.

Continue reading the main story

Analysis

Nick Triggle Health correspondent, BBC News

There are a little over 400 GPs at the British Medical Association's conference. That is just over 1% of the entire family doctor workforce in England.
And like any union event, those attending the London meeting probably have a more hard-line view than the average GP.
Nonetheless, coming less than 48 hours after the prime minister set out the concessions he was willing to make about the controversial NHS plans, it gives a good indication of the challenge facing the government.
By pausing the changes, ministers have accepted they have to get more people on side. The BMA is undoubtedly one of the key bodies.
And what Thursday's events show is that there is still a long way to go before the union can be said to be on-side.

More details are expected to emerge next week of how the plans could change when the panel set up to carry out the recent listening exercise hands in its report to cabinet.

Dr Buckman said: "My plea is please do not let this exercise just be a respray job to try to persuade us to accept the unacceptable."
Concerns were also expressed about the potential conflict of interest doctors could face in making decisions about the budget, while doing their best for individual patients.
Fears have also been voiced about whether expanding the membership on consortia to other professionals could dilute decision-making.
Dr Simon Hodson, a GP from Shropshire, said: "This pause can only be seen as a sham."
And Dr Tim Bland, who works in Barking and Havering, London, said: "I believe the health bill is the greatest threat to the NHS since its inception."
But not everyone was so opposed. There was even a motion - voted down - that said the plans were a "great opportunity".
Dr Phil Garnett, from North Yorkshire, said GPs had a "responsibility" to work with the government as the NHS was facing some difficult decisions because of tightening budgets.
"We are in the best position to make these decisions because we talk to patients on a daily basis," he said.
Shadow health secretary John Healey said the criticisms once again showed that there was widespread opposition to the changes.
He added: "David Cameron is desperately trying to sell his 'I live the NHS' image but he still wants to force through his ideological reorganisation."
But a Department of Health spokesman said the plans had received support from other NHS groups.
She also defended the role of competition.
"It's not an end in itself, but it will bring in fresh thinking and different ways of doing things, which not only deliver better but also mean better value for money."

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0 MPs condemn NHS regional variation in IVF provision , 7 June 2011 Last updated at 00:43 GMT

alth correspondent, BBC News

MPs say IVF treatment on the NHS is a postcode lottery

More than 70% of NHS trusts and care providers are ignoring official guidance on offering infertile couples three chances at IVF, according to a report by an all-party group of MPs.

Some primary care trusts have stopped offering IVF altogether.
Others are placing tough restrictions on who can qualify.
The MPs say the result is a postcode lottery of care and are calling on trusts to implement the official guidelines properly.
In 2004 the National Institute for Health and Clinical Excellence (NICE) said couples, where the woman is aged 23 to 39, should be given up to three cycles of IVF on the NHS.
In the UK's devolved healthcare system this guidance applies to England and Wales, but will also be taken into account in Scotland and Northern Ireland.

Gareth Johnson MP All Party Parliamentary Group on Infertility

The All Party Parliamentary Group on Infertility sent freedom of information requests to primary care trusts (PCTs) in England, health boards in Scotland and Wales, and health and social care trusts in Northern Ireland.

Their answers revealed 70% of the authorities contacted were ignoring the NICE guidance and putting in place strict limits on who can get the treatment.
Restrictions on smokers For example, at the time of the survey Bury PCT only allows women to be treated between the ages of 39 and 40, with a similar picture in many Welsh Health Boards.
Others have restrictions on access for smokers, those who are overweight or if one of the couple already has a child - even if that child does not live with them.
At the time of the survey, five PCTs - Warrington, Stockport, North Yorkshire and York, North Staffordshire and West Sussex - offered no IVF at all.
A spokeswoman at NHS West Sussex said: "In line with NHS trusts across the country, we did have to face some tough decisions last year to ensure that we met our legal duty to break even financially.
"Now we are in the new financial year, the decision we made last year on fertility treatment has been reviewed and funding has been reinstated for all eligible cases."
Too young In 2006, Clare Dando went to her PCT in Hampshire after realising that she would need IVF.
But she was told that at the age of 33 she was too young, as the local policy was to restrict NHS treatment to those over 36 - even though her chances of success would reduce the older she got.
Sher said: "Eventually we realised that time was ticking away so we re-mortgaged our house to raise £15,000. We had to pay for three IVF cycles ourselves and the last one in September 2007 worked.
"Our little boy Alex will be three next week."
The Hampshire guidelines have now changed, so now one IVF cycle is funded for women aged between 30 to 35.
Gareth Johnson, the Conservative MP for Dartford, is the chairman of the All Party Parliamentary Group on Infertility.
He said: "It's clear that many PCTs are not giving IVF the priority they should. There are instances where it is being lumped in with tattoo removals.
"There is always going to be a limit to what you can provide but the guidance from NICE says three cycles.
"That's a fair balance between the needs of the patient and the burden placed on the taxpayer."
Funding problems Infertility Network UK has campaigned for more equal access to IVF treatments and says providers must follow the guidance from NICE.
In a foreword to the report, Health Minister Anne Milton said many PCTs had made good progress towards implementing the NICE recommendations.
"I am aware, however, that a small number of PCTs with historical funding problems have temporarily suspended provision of IVF services.
"I have already expressed my concerns about this approach and would encourage all PCTs to have regard to the current NICE guidance."
NICE is currently reviewing its guidance and will publish a report in 2012.

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0 UN urges more funds for early HIV treatment, 4 June 2011 Last updated at 10:56 GMT

In India, the rate of new HIV infections fell by more than 50%, according to UNAids

The UN Programme on HIV/Aids (UNAids) has called for increased funding for the early treatment of people with HIV.

The head of the agency, Michael Sidibe, said a new study showed it could reduce the risk of HIV transmission by 96%.
He said the challenge was to expand access to drugs, and deal with social factors which stigmatise the disease.
On Thursday, a UN report said there had been a nearly 25% decline in new HIV infections and a reduction in Aids-related deaths during the past decade.
It was published ahead of the 30th anniversary on Sunday of the first official report on Aids by the US Centers for Disease Control and Prevention.
The General Assembly is to meet at UN headquarters to discuss the epidemic next week, with 20 world leaders and more than 100 ministers expected to attend.
An estimated 34 million people were living with HIV at the end of 2010 and nearly 30 million have died from Aids-related causes since 1981, the report said.
'Shunned disease'

In India, the rate of new HIV infections fell by more than 50% and in South Africa by more than 35%; both countries have the largest number of people living with HIV on their continents.

The report found that in the third decade of the epidemic, people were starting to adopt safer sexual behaviour, reflecting the impact of HIV prevention and awareness efforts. But there were still important gaps, it warned, with young men more likely to be informed about HIV prevention than young women.
There has also been significant progress in preventing new HIV infections among children as increasing numbers of mothers living with HIV have gained access to antiretroviral prophylaxis during pregnancy, delivery and breastfeeding.
About 6.6 million people in low- and middle-income countries were receiving antiretroviral drugs at the end of 2010, a nearly 22-fold increase since 2001.
"Thirty years ago this mystery disease was called a gay plague - it was a shunned disease, people were scared about each other," Mr Sidibe said. "Now it's a completely different world - we've been breaking the conspiracy of silence."
However, the report found that at the end of last year nearly nine million people who needed treatment were not getting it, and that treatment access for children was lower than for adults.
And while the rate of new HIV infections has declined globally, the total number of HIV infections remains high, at about 7,000 per day.
The report also noted that there had been an increase in the rate of new HIV infections in Eastern Europe and in the Middle East and North Africa, and that HIV was the leading cause of death among women of reproductive age.
'Game-changer' UNAids also said that while funding for HIV treatments in low- and middle-income countries had risen 10-fold between 2001 and 2009, international resources had declined in 2010. Many states remain dependant on external financing.

Continue reading the main story

“Start Quote

Access to treatment will transform the Aids response in the next decade”

Michael Sidibe Executive Director, UNAIDS

"I am worried that international investments are falling at a time when the Aids response is delivering results for people," Mr Sidibe said. "If we do not invest now, we will have to pay several times more in the future."

He stressed the importance of a recent trial, which found that if a person living with HIV adhered to an effective antiretroviral regimen, the risk of transmitting the virus to their uninfected sexual partner could be reduced by 96%.
"Access to treatment will transform the Aids response in the next decade. We must invest in accelerating access and finding new treatment options.
"Antiretroviral therapy is a bigger game-changer than ever before - it not only stops people from dying, but also prevents transmission of HIV to women, men and children," he added.
Mr Sidibe said the challenge was to expand access to drugs, and deal with social factors that in some countries continue to stigmatise the disease and make women particularly vulnerable.
To do this, UNAids believes an investment of at least $22bn is needed by 2015, $6bn more than is available today. It estimates such funds would stop 12m new HIV infections and 7.4m Aids-related deaths by 2020.

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0 Measles outbreak prompts plea to vaccinate children, 27 May 2011 Last updated at 00:52 GMT

Measles can be highly dangerous and in some cases fatal

Parents in England and Wales are being urged to have their children vaccinated after a tenfold rise in measles cases in the first three months of the year.

The Health Protection Agency reported 334 cases compared with 33 in the similar period last year.
The outbreak is thought to be linked to an epidemic in France, where 7,000 cases have been reported since January - more than in the whole of 2010.
The HPA says it is "crucial" that those at risk are fully immunised.
It says the latest cases are mainly among unvaccinated people under 25 years old and are centred on "small clusters in universities, schools or families or associated with travel abroad".
Worst-hit are London and the South East, with 104 and 102 confirmed cases respectively in the first quarter of this year.
Recently the Health Protection Agency sent out letters to some primary schools and further education colleges in London warning of the risks of taking children who are not fully immunised to mainland Europe.
'Potentially dangerous' Dr Mary Ramsay, head of immunisation at the Health Protection Agency, warned parents and young adults of the importance of immunisation.
"Although MMR coverage has improved over the last few years, we cannot stress enough that measles is serious and in some cases it can be fatal.
"Measles is a highly infectious and potentially dangerous illness which spreads very easily.

"Whether you stay here in the UK or travel abroad, it is crucial that individuals who may be at risk are fully immunised."

In the UK, two doses of the MMR vaccine are usually given, the first at around 12 months and the second around the time of starting school.
The HPA advises parents to contact their GP as soon as possible if their child is over a year old and has never had the MMR jab.
Two doses of the MMR vaccine are required to provide the greatest protection against measles.
HPA figures show that the number of toddlers getting the MMR vaccination is climbing steadily, but is still far from the 95% uptake rate needed to stop the spread of the disease in the community.
In December 2010, 89.4% of two-year-old children in the UK had received their first dose of the MMR vaccine.
For five-year-olds, the uptake rate had risen to 92.8%.
Controversial research The vaccination rate had been well below 95% for several years, ever since The Lancet published controversial research about the MMR vaccine in 1998.
The study has since been discredited, but confidence in the combined measles, mumps and rubella vaccine has been slow to return.
In Scotland, there have been 12 confirmed cases of measles between January and April, compared with no cases at all for the same time last year.
Since the start of 2011 Northern Ireland has had one confirmed case of measles.
In France, the figure of 7,000 cases so far this year already exceeds the 5,090 recorded in the whole of 2010.
The World Health Organization said France was taking immediate steps to control the outbreaks by vaccinating infants at nine months and offering the vaccine to all unimmunised or under-immunised people over that age.
Other European countries reporting an increase in cases of measles are Belgium, Denmark, Finland, Germany, Norway, Romania, the Russian Federation, Sweden and Switzerland.

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0 Less childhood sleep has fat risk,27 May 2011 Last updated at 06:34 GMT

Lack of sleep when young can lead to higher weight and attendant health risks

Children who get insufficient sleep at night are more likely to become overweight, according to researchers in New Zealand.

A study, published on the BMJ website, followed 244 children between the ages of three and seven.
It said more sleep was linked to a lower weight, which could have important public health consequences.
UK experts said there was "no harm" in drawing attention to the link between reduced sleep and ill health.
The children were seen every six months when their weight, height and body fat were measured. Their sleeping habits and physical-activity levels were recorded at ages three, four and five.
The researchers found that those children who had less sleep in their earlier years were at greater risk of having a higher Body Mass Index at age seven.
This link continued even when other risk factors, such as gender and physical activity, were accounted for in their research.
'Health risk' Suggested reasons for the link include simply having more time to eat and changes to hormones affecting appetite.
In an accompanying analysis, Professors Francesco Cappuccio and Michelle Miller, from the University of Warwick, said future research should "explore and validate new behavioural, non-drug based, methods to prolong children's and adults' sleeping time.
"In the meantime it would do no harm to advise people that a sustained curtailment of sleeping time might contribute to long-term ill health in adults and children."
Dr Ian Maconochie, from the Royal College of Paediatrics and Child Health said: "Children under five generally average at least 11 hours sleep at night and in daytime naps.
"However, 20% of children at this age experience problems sleeping, and we already know that inadequate sleep has a significant impact on attention, memory, behaviour, and school performance. This paper is a useful addition to our knowledge of children's sleep patterns."

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0 Health bill may have to be withdrawn - doctors,26 May 2011 Last updated at 05:00 GMT

The doctors' union has concerns about the changes

The government's health plans for the NHS in England need changing so much that the entire bill may need to be withdrawn, doctors say.

The British Medical Association called for a series of changes as part of its submission to the listening exercise.
In particular, the union has demanded the duty on the regulator to promote competition be dropped, something other critics have called for.
Nick Clegg and Labour's John Healey are to make speeches about the plans later.
The deputy prime minister's speech is keenly anticipated because he has been outspoken about the need to make significant changes to the proposals in recent weeks.
'Dog-eat-dog' The Lib Dem leader is expected to say that change is needed and he is determined to see the "right reform" introduced.
He will point out that while the NHS has always benefited from a mix of providers, including the private sector and charities, he will not allow the NHS to be "flogged off to the highest bidder".
"People want choice - over their GP, where to give birth, which hospital to use," he will say. "But providing that choice isn't the same as allowing private companies to cherry-pick NHS services.
"It's not the same as turning this treasured public service into a competition-driven, dog-eat-dog market."
Mr Healey, the shadow health secretary, is expected to say that the government has mishandled the NHS in its first year in power, reflecting badly on the prime minister himself.
He will say: "David Cameron is a PR man looking for a PR answer."
Upheaval The attacks come as the government's listening exercise is drawing to a close. This week marks the end of the six-week process, which was launched last month as the government deferred its plans amid mounting criticisms.
During the process - effectively a second consultation after one last autumn - more than 200 events have been held, with ministers promising to use the suggestions put forward to improve the bill.

Continue reading the main story

“Start Quote

The listening exercise is a genuine opportunity to improve our plans, and we look forward to hearing views from all who want to safeguard our NHS for the future”

Department of Health spokeswoman

But the BMA's intervention illustrates just how tricky getting consensus is going to be.

As well as calling for the duty to promote competition to be dropped, the union said timetables needed to be relaxed and duties placed on GP consortia to involve other clinical staff.
There should also be much more stress on collaboration and integration, the BMA added.
BMA chairman Dr Hamish Meldrum said: "While change is necessary, this major upheaval is not."
But the government has received more backing from a number of other groups, including Reform, a pro-market think tank, and the NHS Confederation, which represents managers.
Both argued to varying degrees in their submissions that greater competition was needed to improve care.
But the NHS Confederation said the case for the breadth of the reforms "had yet to be clearly made", while the changes were not "sufficiently focused" on the problems facing the NHS, such as the financial squeeze and variation in standards.
A Department of Health spokeswoman said ministers had made it clear "substantive changes" would be made.
"The listening exercise is a genuine opportunity to improve our plans, and we look forward to hearing views from all who want to safeguard our NHS for the future."

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