I did not post last week because of a Chemistry EMPA practical and plan to not post this week either for similar reasons!
With the increased workload at this time of year and the upcoming crucial A Level exams I plan to end my blog (most probably permanently) after over a year of posts!
Good luck to anyone else attempting to get into medical school, I hope the exams go well and results day is a good day!
Tuesday, 23 April 2013
Tuesday, 9 April 2013
The 'five-second rule'
A light hearted post this week which loosely relates to health! Have you ever asked yourself is the 'five-second rule' really true? Surely it can't be true...
For those of you that don't know the theory is this: any food that is dropped on the floor is safe to eat as long as it is picked up within five-seconds.
Three specimens were collected, each was then imprinted individually on a culture plate and then incubated for several days.
The results were as follows;
1.) Pizza dropped on the kitchen floor - culture plate covered in bacteria, even some fecal bacteria present.
2.) Apple dropped on the street - Again lots of bacteria present on the culture plate.
3.) Buttered toast dropped on the carpet - Most bacteria of all the specimens!
Furthermore similar results were also recorded for food that touched surfaces for effectively zero seconds.
The conclusion of the experiment as you may have expected was this, (regardless of how long you drop it for) 'if you drop it, chuck it!'
A short video clip, which includes images of the bacteria samples can be found here.
For those of you that don't know the theory is this: any food that is dropped on the floor is safe to eat as long as it is picked up within five-seconds.
Three specimens were collected, each was then imprinted individually on a culture plate and then incubated for several days.
The results were as follows;
1.) Pizza dropped on the kitchen floor - culture plate covered in bacteria, even some fecal bacteria present.
2.) Apple dropped on the street - Again lots of bacteria present on the culture plate.
3.) Buttered toast dropped on the carpet - Most bacteria of all the specimens!
Furthermore similar results were also recorded for food that touched surfaces for effectively zero seconds.
The conclusion of the experiment as you may have expected was this, (regardless of how long you drop it for) 'if you drop it, chuck it!'
A short video clip, which includes images of the bacteria samples can be found here.
Tuesday, 2 April 2013
April Fools
Yesterday marked the first day of the new NHS structures, GP-led groups (clinical commissioning groups) have taken control of local budgets and a new board, NHS England, has started overseeing the day-day running of services.
The NHS is facing a crucial period, for example, it needs to rebuild public confidence after the recent report into the Stafford Hospital scandal.
Bringing clinical expertise to the forefront of decision making will help however structural changes alone will not suffice.
Savings still need to be made and targets met but this must not get in the way of the delivery of 'compassionate care' which has been mentioned so often in recent weeks.
Finally not everyone agrees with the changes, in particular there are fears surrounding the increased role of the private sector. Will this not lead to fragmented patient care and miscommunication rather than better, compassionate care?
The NHS is facing a crucial period, for example, it needs to rebuild public confidence after the recent report into the Stafford Hospital scandal.
Bringing clinical expertise to the forefront of decision making will help however structural changes alone will not suffice.
Savings still need to be made and targets met but this must not get in the way of the delivery of 'compassionate care' which has been mentioned so often in recent weeks.
Finally not everyone agrees with the changes, in particular there are fears surrounding the increased role of the private sector. Will this not lead to fragmented patient care and miscommunication rather than better, compassionate care?
Wednesday, 20 March 2013
Three-person IVF
I was unable to post yesterday as I was playing in the Roslyn Park 7s Tournament and will only be able to post briefly today as I am very busy preparing route cards etc for my D of E Expedition next week so apologises for that!
Three-person IVF features in the news this week as it has done before, in fact it was something I posted about in September 2012.
The time has come round for the Human Fertilisation and Embryology Authority to advise ministers and report on the public consultation they carried out looking into techniques to try and prevent serious and often fatal mitochondrial diseases.
As well as the potential moral and ethical issues surrounding the treatment that I mentioned before one potential problem is that eggs with abnormal mitochondria may have other unknown problems in their nucleus.
If you want to find out more refer to this BBC health article!
Three-person IVF features in the news this week as it has done before, in fact it was something I posted about in September 2012.
The time has come round for the Human Fertilisation and Embryology Authority to advise ministers and report on the public consultation they carried out looking into techniques to try and prevent serious and often fatal mitochondrial diseases.
As well as the potential moral and ethical issues surrounding the treatment that I mentioned before one potential problem is that eggs with abnormal mitochondria may have other unknown problems in their nucleus.
If you want to find out more refer to this BBC health article!
Tuesday, 12 March 2013
fMRI - A more balanced perspective
In November 2012 BBC Panorama showed a research team using functional Magnetic Resonance Imaging (fMRI) to detect hidden awareness amongst patients who may be deemed vegetative by observational assessments. This is something I consequently wrote about here.
The programme claimed 20% of patients in a vegetative state show cognitive responses to fMRI however this isn’t strictly true. In addition, around one in five normal volunteers cannot generate fMRI activity on motor imagery tasks so negative results in patients do not necessarily indicate a lack of awareness.
One thing which wasn’t stressed in the programme was the important difference between patients in a ‘vegetative state’ and those who are ‘minimally conscious’. ‘Patients in a vegetative state have no discernible awareness of self and no cognitive interaction with their environment.’ Whereas patients in a minimally conscious state ‘show evidence of interaction through localising or discriminating behaviours although these interactions occur inconsistently.’
The two patients shown in the programme responding to the fMRI techniques may have been minimally conscious rather than vegetative. The reason for this being that one of the patients was filmed responding to a question from his mother by raising his thumb and the other seemed to turn his head purposefully in response to having his earphones put on.
More than 40% of patients in a minimally conscious state are misdiagnosed initially as being in a vegetative state. Currently in the UK the Wessex Head Injury Matrix (WHIM) and the sensory modality rehabilitation assessment technique (SMART) are used to assess disorders of consciousness.
So again, to finish I ask the same question; In the future will scans such as the one using fMRI be used in addition to observational assessments to decide if someone is in a vegetative state?
The possibility that fMRI might open up potential avenues of interaction with patients with these conditions still exists and the findings are still important however the way in which the tests should be delivered and interpreting the findings still needs to be determined and may not be as significant as originally thought.
Source: Student BMJ
The programme claimed 20% of patients in a vegetative state show cognitive responses to fMRI however this isn’t strictly true. In addition, around one in five normal volunteers cannot generate fMRI activity on motor imagery tasks so negative results in patients do not necessarily indicate a lack of awareness.
One thing which wasn’t stressed in the programme was the important difference between patients in a ‘vegetative state’ and those who are ‘minimally conscious’. ‘Patients in a vegetative state have no discernible awareness of self and no cognitive interaction with their environment.’ Whereas patients in a minimally conscious state ‘show evidence of interaction through localising or discriminating behaviours although these interactions occur inconsistently.’
The two patients shown in the programme responding to the fMRI techniques may have been minimally conscious rather than vegetative. The reason for this being that one of the patients was filmed responding to a question from his mother by raising his thumb and the other seemed to turn his head purposefully in response to having his earphones put on.
More than 40% of patients in a minimally conscious state are misdiagnosed initially as being in a vegetative state. Currently in the UK the Wessex Head Injury Matrix (WHIM) and the sensory modality rehabilitation assessment technique (SMART) are used to assess disorders of consciousness.
So again, to finish I ask the same question; In the future will scans such as the one using fMRI be used in addition to observational assessments to decide if someone is in a vegetative state?
The possibility that fMRI might open up potential avenues of interaction with patients with these conditions still exists and the findings are still important however the way in which the tests should be delivered and interpreting the findings still needs to be determined and may not be as significant as originally thought.
Source: Student BMJ
Tuesday, 5 March 2013
'UK lagging in Europe health league'
A very short post this week as I have masses of work to be doing this week, as well as dealing with the stress surrounding the upcoming January module results! However I thought it was better to post something rather than nothing. On that note, good luck to anyone collecting results on Thursday...
A study recently published in the Lancet suggests that the UK is worse off on many indicators of poor health when compared to other countries, the full article describing the study can be found here on BBC Health.
The Health Secretary Jeremy Hunt feels '30,000 lives a year could be saved if England performed as well as its European neighbours' and the focus should be on the 'big five avoidable killers'. These diseases are cancer, stroke, heart, respiratory and liver disease.
The majority of which link closely to the risk factors associated with lifestyle that appear in the news far too often, tobacco smoke (including second-hand smoke), obesity, inactivity, alcohol consumption and an unhealthy diet.
Its difficult to say what can be done, because if it were simple it would have been done already! One suggestion is that people pay closer attention to their health and make regular health checks in order to spot diseases earlier.
However ultimately I feel it the responsibility of everyone to try and achieve better health. Although this starts with individuals themselves help should come from government (both central and local), charities and employers for example and it must be remembered that certain individuals may need more help than others to either stay healthy or deal with ill health if it arises.
A study recently published in the Lancet suggests that the UK is worse off on many indicators of poor health when compared to other countries, the full article describing the study can be found here on BBC Health.
The Health Secretary Jeremy Hunt feels '30,000 lives a year could be saved if England performed as well as its European neighbours' and the focus should be on the 'big five avoidable killers'. These diseases are cancer, stroke, heart, respiratory and liver disease.
The majority of which link closely to the risk factors associated with lifestyle that appear in the news far too often, tobacco smoke (including second-hand smoke), obesity, inactivity, alcohol consumption and an unhealthy diet.
Its difficult to say what can be done, because if it were simple it would have been done already! One suggestion is that people pay closer attention to their health and make regular health checks in order to spot diseases earlier.
However ultimately I feel it the responsibility of everyone to try and achieve better health. Although this starts with individuals themselves help should come from government (both central and local), charities and employers for example and it must be remembered that certain individuals may need more help than others to either stay healthy or deal with ill health if it arises.
Tuesday, 26 February 2013
Do hospitals need to do more about junk food?
The “obesity crisis” is a recurring theme in the news and is something I have written about before. I plan to write briefly on it again this week having read an article by a Cardiologist on the BBC news health page.
“A report by the Academy of Medical Royal Colleges called for a range of measures...including improving food in hospitals” to try and tackle the so called obesity crisis. Another “report by the group Sustain has also called for hospital food to meet mandatory nutritional standards.”
After all, shouldn’t hospitals be leading by example?
The clinician speaks of their own experiences and feels it is unacceptable to have “fast food franchises on site and corridors littered with vending machines selling junk food.” I can draw parallels with this as the cardiology ward I volunteer on has a ‘fizzy drinks’ vending machine down the corridor, but by contrast the meals on the ward itself appear to be balanced and the menu follows a fortnightly cycle.
Chief executives and senior managers defend such practices by arguing that the revenue from the sale of these products is used to save lives. But is such practice acceptable? These items may well have contributed to the patients admission in the first place! Most would agree that selling cigarettes to produce revenue to treat patients would be unacceptable. So, how different is selling fast food products to produce revenue?
Hospital staff are also suffering from serious weight problems as well as patients. A recent report from the Royal College of Physicians revealed that “half of the 1.4 million people who work for the NHS are obese”
Shouldn’t NHS staff be leading by example?
The article suggests that education alone will not tackle the obesity crisis and that the food industry (for example advertisements,) has a much greater impact on our eating habits than we realise.
In summary the NHS and health campaigners need to try and capture the attention of the public above the food corporations who are driven by profit rather than good health. However perhaps patients will only listen once the message has reached the NHS staff surrounding them. To achieve this the food industry needs to be regulated more strictly and a good place to start would be hospitals. Finally obesity is an ongoing problem and not one which can be fixed quickly and simply.
“A report by the Academy of Medical Royal Colleges called for a range of measures...including improving food in hospitals” to try and tackle the so called obesity crisis. Another “report by the group Sustain has also called for hospital food to meet mandatory nutritional standards.”
After all, shouldn’t hospitals be leading by example?
The clinician speaks of their own experiences and feels it is unacceptable to have “fast food franchises on site and corridors littered with vending machines selling junk food.” I can draw parallels with this as the cardiology ward I volunteer on has a ‘fizzy drinks’ vending machine down the corridor, but by contrast the meals on the ward itself appear to be balanced and the menu follows a fortnightly cycle.
Chief executives and senior managers defend such practices by arguing that the revenue from the sale of these products is used to save lives. But is such practice acceptable? These items may well have contributed to the patients admission in the first place! Most would agree that selling cigarettes to produce revenue to treat patients would be unacceptable. So, how different is selling fast food products to produce revenue?
Hospital staff are also suffering from serious weight problems as well as patients. A recent report from the Royal College of Physicians revealed that “half of the 1.4 million people who work for the NHS are obese”
Shouldn’t NHS staff be leading by example?
The article suggests that education alone will not tackle the obesity crisis and that the food industry (for example advertisements,) has a much greater impact on our eating habits than we realise.
In summary the NHS and health campaigners need to try and capture the attention of the public above the food corporations who are driven by profit rather than good health. However perhaps patients will only listen once the message has reached the NHS staff surrounding them. To achieve this the food industry needs to be regulated more strictly and a good place to start would be hospitals. Finally obesity is an ongoing problem and not one which can be fixed quickly and simply.
Tuesday, 12 February 2013
Stafford Hospital Scandal
Data shows there were between 400 and 1,200 more deaths than would have been expected at Stafford Hospital from 2005 to 2008. However it is impossible to say all of these patients would have survived if they had received better treatment.
But one thing that it is clear is that many were let down by a culture that put cost-cutting and meeting targets ahead of the quality of patient care.
Examples include patients being so thirsty that they had to drink dirty water from vases and at times receptionists were left to decide which patients to treat in A&E.
You may have read about investigations into the scandal before because there have actually been five major investigations into care at Stafford Hospital.
The first investigation began in May 2008 and was prompted by complaints and statistics showing unusually high death rates at the hospital. The March 2009 report following this investigation brought the scandal to national prominence for the first time.
The most recent investigation, the public inquiry, was looking at how the lapses could have been allowed to take place and why they were not picked up sooner. The commissioning and regulation of the trust at the time was also being looked at as this is something campaigners felt had not been looked at properly before.
The resultant report argued for "fundamental change" in the culture of the NHS to make sure patients were put first.
The report made a total of 290 recommendations, including making it a criminal offence to hide information about poor care, introducing laws to oblige doctors to be open with patients about their mistakes, a code of conduct for senior managers and an increased focus on compassion in the recruitment, training and education of nurses.
It was also announced that a new post of ‘chief inspector of hospitals’ will be created in the autumn.
However the fundamental change needed does not mean more reorganisation of the NHS. In fact, the report suggests that one of the factors behind the problems at Stafford Hospital was the constant upheaval the NHS is under.
Despite calls from relatives for the individuals involved in the scandal to face sanctions the report states that the board is ultimately responsible. ‘It was the board which took the decision to pursue a cost-cutting drive to achieve foundation trust status and it was the board which refused to listen to the complaints of patients and at times staff.’
But one thing that it is clear is that many were let down by a culture that put cost-cutting and meeting targets ahead of the quality of patient care.
Examples include patients being so thirsty that they had to drink dirty water from vases and at times receptionists were left to decide which patients to treat in A&E.
You may have read about investigations into the scandal before because there have actually been five major investigations into care at Stafford Hospital.
The first investigation began in May 2008 and was prompted by complaints and statistics showing unusually high death rates at the hospital. The March 2009 report following this investigation brought the scandal to national prominence for the first time.
The most recent investigation, the public inquiry, was looking at how the lapses could have been allowed to take place and why they were not picked up sooner. The commissioning and regulation of the trust at the time was also being looked at as this is something campaigners felt had not been looked at properly before.
The resultant report argued for "fundamental change" in the culture of the NHS to make sure patients were put first.
The report made a total of 290 recommendations, including making it a criminal offence to hide information about poor care, introducing laws to oblige doctors to be open with patients about their mistakes, a code of conduct for senior managers and an increased focus on compassion in the recruitment, training and education of nurses.
It was also announced that a new post of ‘chief inspector of hospitals’ will be created in the autumn.
However the fundamental change needed does not mean more reorganisation of the NHS. In fact, the report suggests that one of the factors behind the problems at Stafford Hospital was the constant upheaval the NHS is under.
Despite calls from relatives for the individuals involved in the scandal to face sanctions the report states that the board is ultimately responsible. ‘It was the board which took the decision to pursue a cost-cutting drive to achieve foundation trust status and it was the board which refused to listen to the complaints of patients and at times staff.’
Finally there are still certain questions which remain unanswered for me, for example; Why wasn't the alarm raised earlier? Could an incident like this happen again? Perhaps some of these questions will be answered in the full response to the inquiry due to released next month.
Tuesday, 5 February 2013
The Great Abortion Divide
A short post this week on a programme I watched on BBC1 last night, ‘Panorama: The Great Abortion Divide’
The Abortion Act was passed in 1967. Technically the law did not legalise abortions, but rather provided legal defence for those carrying them out. Under the act abortions can be performed legally (in England, Scotland and Wales) under certain conditions. For example if continuing with the pregnancy involves a greater risk to the physical/mental health of the woman than having a termination.
In the UK each year about 200,000 abortions are carried out - as a result some people question whether the legislation passed in 1967 is being abused, did it intended to sanction so many procedures?
When discussing or thinking about medical ethics I try to think back to the four main ethical principles; autonomy, beneficence, non-maleficence and justice - how can these be applied to abortion?
As i’m sure you are aware there are two main groups in the ‘abortion divide’, pro-life and pro-choice and both are mentioned and represented in the programme. Something I found interesting was that there was very little talk of the foetus itself in the programme, what about the rights of the ‘child’? However this relates to the most complex issue in the debate - when does life begin, when does the foetus become a human being?
Another interesting aspect of the programme was just how different things are in Northern Ireland. Despite being in the UK a woman cannot get an abortion, even in cases of rape.
The legislation dates from 1861 and a woman can only access abortion services if her life is at risk.
The programme describes two options available to women in Northern Ireland with an unwanted pregnancy, a trip to England for a private procedure or breaking the law by taking abortion pills with the knowledge they could be charged with murder.
So, currently there are two very different laws governing abortion within the UK but perhaps this will change in the future? What about a reduction in the number of weeks after which you can have an abortion? (Something the Health Secretary Jeremy Hunt revealed he would favour last year.)
If you can watch the programme on BBC iPlayer!
The Abortion Act was passed in 1967. Technically the law did not legalise abortions, but rather provided legal defence for those carrying them out. Under the act abortions can be performed legally (in England, Scotland and Wales) under certain conditions. For example if continuing with the pregnancy involves a greater risk to the physical/mental health of the woman than having a termination.
In the UK each year about 200,000 abortions are carried out - as a result some people question whether the legislation passed in 1967 is being abused, did it intended to sanction so many procedures?
When discussing or thinking about medical ethics I try to think back to the four main ethical principles; autonomy, beneficence, non-maleficence and justice - how can these be applied to abortion?
As i’m sure you are aware there are two main groups in the ‘abortion divide’, pro-life and pro-choice and both are mentioned and represented in the programme. Something I found interesting was that there was very little talk of the foetus itself in the programme, what about the rights of the ‘child’? However this relates to the most complex issue in the debate - when does life begin, when does the foetus become a human being?
Another interesting aspect of the programme was just how different things are in Northern Ireland. Despite being in the UK a woman cannot get an abortion, even in cases of rape.
The legislation dates from 1861 and a woman can only access abortion services if her life is at risk.
The programme describes two options available to women in Northern Ireland with an unwanted pregnancy, a trip to England for a private procedure or breaking the law by taking abortion pills with the knowledge they could be charged with murder.
So, currently there are two very different laws governing abortion within the UK but perhaps this will change in the future? What about a reduction in the number of weeks after which you can have an abortion? (Something the Health Secretary Jeremy Hunt revealed he would favour last year.)
If you can watch the programme on BBC iPlayer!
Tuesday, 29 January 2013
Meningitis B vaccine gets European licence
But isn’t there already a vaccine for meningitis? Yes, there are many vaccinations against bacterial meningitis however a vaccine for meningitis B has not been available. Until now...
The ‘Bexsero’ vaccine is the first to cover meningococcal B meningitis
To begin with here are some facts and figures about meningitis B in particular:
- About 1870 people contract the infection each year and one in ten die as a result
- However around a quarter of all survivors are left with life altering side effects such as brain damage or limb loss
- This is caused by inflammation of the cell membranes of cells in the brain and spinal cord caused by the bacterial infection.
Secondly some more information about the ‘Bexsero’ vaccine itself:
- Developing a vaccine against meningitis B has been particularly challenging as it is caused by thousands of subtly different strains of bacteria. This consequently makes it very difficult to find a single jab that could cover them all.
- As a result the genetic structures of the varying strains were analysed in search of a common shared feature which could be targeted
- The product is a jab likely to be effective against 73% of the different variations of meningitis B
Finally when (and even if) the vaccine will be introduced in the UK is unknown, however now the vaccine has obtained a licence a decision may be made to introduce the vaccine into the childhood vaccination schedule in the UK. Meningitis Trust feel it should be introduced as quickly as possible but we will have to wait and see what happens
(Source: NHS Choices)
Tuesday, 22 January 2013
Clever bacteria
I plan to write very briefly this week as I am in the middle of exams and should be revising! I hope everyone else’s exams have/are going well.
Infectious bacteria have for the first time been caught performing "biological alchemy" to transform parts of a host body into those more suited to their purposes, by a team in Edinburgh.
The study showed leprosy-causing bacteria turning nerve cells into stem cells and muscle cells.
Furthermore as these stem cells are “self” they can reach their desired location undetected by the immune system.
It is hoped that findings such as these could lead to new ways of developing stem cells in humans and/or improve the treatment of bacterial disease. However views on the clinical relevance of these findings are mixed.
Infectious bacteria have for the first time been caught performing "biological alchemy" to transform parts of a host body into those more suited to their purposes, by a team in Edinburgh.
The study showed leprosy-causing bacteria turning nerve cells into stem cells and muscle cells.
Essentially these bacteria are transforming nerve cells, which are static, into something which is more valuable to them. These stem cells can then be grown and transported around the body.
Furthermore as these stem cells are “self” they can reach their desired location undetected by the immune system.
It is hoped that findings such as these could lead to new ways of developing stem cells in humans and/or improve the treatment of bacterial disease. However views on the clinical relevance of these findings are mixed.
Nonetheless the finding is very interesting and shows just how complex the interactions between humans and bacteria can be! You can read the full article here…
(Alchemy: The medieval forerunner of chemistry, based on the supposed transformation of matter, esp. that of base metals into gold.)
(Alchemy: The medieval forerunner of chemistry, based on the supposed transformation of matter, esp. that of base metals into gold.)
Tuesday, 15 January 2013
The Social Care Question
Evidence suggests around three quarters of us will need some form of support in our old age, combine this statistic with the fact that our population is “ageing” and it is clear that care of the elderly is a very important issue.
Unlike NHS care, such help and support is not free - there is simply not enough money for it to be free..
So, how much should such care cost an individual? And how is it/how should it be regulated?
Well, essentially that is 'the social care question'...! The degree of care needed (part time/full time), savings and the availability of care home spaces/carers are all considered. To see a more interesting and detailed breakdown of how the system works click here (Source: BBC)
Unlike NHS care, such help and support is not free - there is simply not enough money for it to be free..
So, how much should such care cost an individual? And how is it/how should it be regulated?
Well, essentially that is 'the social care question'...! The degree of care needed (part time/full time), savings and the availability of care home spaces/carers are all considered. To see a more interesting and detailed breakdown of how the system works click here (Source: BBC)
For one in 10 people these care costs could amount to more than £100,000 over a lifetime. Costs like these mean that some people are forced to sell their homes or use up their life savings to pay for help in their old age.
The government’s intention is to cap the costs - at £75,000 - however this is more than double the £35,000 suggested cap based on careful consideration and calculation by an independent commission two years ago.
Although still a considerable amount, it is believed that at £35,000 people would engage and begin to plan for old age however at £75,000 there is a danger that the public might not do so as the figure is simply too high and they’re better off running the risk of not investing.
If people began to invest the insurance industry would follow suit, developing policies knowing that any catastrophic costs would be covered by the government.
To conclude, the economics is over my head in truth but I think the problem in question is very simple - how are we going to provide care and support for the elderly in the future? The current government hopes to address this growing problem and I am interested to see what their final suggestions will be. It is thought that a plan will be mapped out properly in the next month.
Tuesday, 8 January 2013
Tackling unhealthy eating
In my previous post I mentioned that the coalition
government will target ‘unhealthy habits’ in this new year to try and improve
health nationally and this would consequently lead to treatment savings within the NHS.
This is something which has featured in the news
this week (week one of the new year!), the ‘unhealthy habit’ being unhealthy eating, one of the main causes
of obesity. “Obesity costs the NHS £5bn each year and the latest figures from
the Department of Health show that the number of children who are overweight or
obese doubles during their time at primary school.”
‘Healthy’
food can often be the more expensive option and therefore access to such food
in certain areas or certain families can be difficult and limited. As a result
certain food firms are involved in a recent scheme by ‘Change4Life’ and offers
on their food products will be available at more than 1000 Asda, Aldi and
Co-Operative food stores across the UK.
Although a “responsibility deal” is currently in
place (as well as schemes such as Change4life) and has managed to improve food content
and labelling, a labour representative has asked whether a legal limit on the
amount of fat, sugar and salt should be established. Especially in foods aimed
at children given the statistic above for example. Essentially, is the current voluntary approach doing
enough to regulate what our food contains or is it time for the introduction of
legislation?
Here are five potential food 'targets' that could be affected by such legislation if it were introduced:
1.) Breakfast cereals - reduce sugar content
2.) Fruit juice - not pure fruit juice but the ones which are not pure fruit juice and can have large amounts of sugar added
3.) Ready meals - stop the addition of too much salt in certain brands
4.) Crisps - reduce salt levels
5.) Biscuits, cookies and cakes - rethink with regards to fat levels
To give a more detailed example, the party says measures could
include a 30% cap on sugar content in cereals aimed at children – significantly
lower than in several well-known brands.
To give an example of legislation elsewhere,
in French schools all food and drink is controlled, following the introduction
of these measures studies have shown that the number of overweight children
have decreased from 18.1% in 2000 to 15.5% in 2007. How telling is this statistic? Is the decrease really that significant and what changes have occurred since 2007...
Finally a few thoughts on the idea, for example is such a scheme realistically controllable? Would legislation have its desired effect, just because the healthy food is more readily available does not mean it will be purchased by families and would the products be affordable for all families? Could the money be invested elsewhere, perhaps education or accessible exercise facilities? Compulsory education on healthy eating with examples of which meals are 'healthy' in all secondary schools in the UK?
Source: BBC Health News
Monday, 31 December 2012
Things to look out for in 2013
Given the time of year the BBC health page looks to year the ahead this week and I thought I would do the same. So here is a list of three things (all hyperlinked) to look out for:
1.) The report of the public enquiry into the treatments of patients at Stafford Hospital and the trust involved. Preliminary data suggest that between 2005 and 2008 four hundred patients died unnecessarily because of poor care. Even more extreme is the data suggesting that thirsty patients had to resort to drinking from vases and receptionists were left to assess patients in A&E. What will the outcome of the enquiry be, will legislation be put in place to stop such mismanagement happening again?
2.) Public health initiatives to tackle unhealthy habits, for example will banning the display of tobacco products in shops in England occur and later be followed by the introduction of plain packaging for cigarettes? Australia are the only country to have taken this step so far.
-- A minimum price for alcohol, 45p/unit? Before the decision is made campaigns are taking place to increase the suggested price to 50p/unit as agreed in Scotland already as research suggests this relatively small increase in price can save a more significant number of lives.
3.) 1st April 2013: the NHS Commissioning Board will take over the day-day running of the health service (some of their targets can be seen in a previous post) and the majority of the budget will come under the control of GPs. Although these structures have been operating in the shadows for sometime next year they will be properly introduced. Will the transition go unnoticed with small changes here and there over time or will significant changes take place immediately?
To conclude, keep your eyes peeled and Happy New Year!
1.) The report of the public enquiry into the treatments of patients at Stafford Hospital and the trust involved. Preliminary data suggest that between 2005 and 2008 four hundred patients died unnecessarily because of poor care. Even more extreme is the data suggesting that thirsty patients had to resort to drinking from vases and receptionists were left to assess patients in A&E. What will the outcome of the enquiry be, will legislation be put in place to stop such mismanagement happening again?
2.) Public health initiatives to tackle unhealthy habits, for example will banning the display of tobacco products in shops in England occur and later be followed by the introduction of plain packaging for cigarettes? Australia are the only country to have taken this step so far.
-- A minimum price for alcohol, 45p/unit? Before the decision is made campaigns are taking place to increase the suggested price to 50p/unit as agreed in Scotland already as research suggests this relatively small increase in price can save a more significant number of lives.
3.) 1st April 2013: the NHS Commissioning Board will take over the day-day running of the health service (some of their targets can be seen in a previous post) and the majority of the budget will come under the control of GPs. Although these structures have been operating in the shadows for sometime next year they will be properly introduced. Will the transition go unnoticed with small changes here and there over time or will significant changes take place immediately?
To conclude, keep your eyes peeled and Happy New Year!
Monday, 24 December 2012
Radiotherapy court case
A very brief post given the time of year, and consequently the travelling and present exchanging that is going on! Despite this I felt I could not ignore the recent court case involving seven year old Neon Roberts.
The case is unusual for a number of reasons. The fact that Neon's mother is refusing treatment for her son itself but also the fact that the identity of the boy has been revealed. Under normal circumstances names would not be given in order to protect the identity of the youngsters involved. However in this particular case the mother went into hiding which was delaying both the court case and important medical treatment so the police felt it was necessary to release names and photos to try and speed up the relocating process!
Neon had previously undergone two operations to remove a cancerous brain tumour and nodule before the most recent hearing however his mother did not want him to have radiotherapy. Her reasoning for this was the potential side effects of the treatment including lowered IQ, infertility and shorter life span. Neon's father (who is separated from the mother) had agreed to his son having radiotherapy.
Perhaps there are alternatives that could be considered? If this was the case then both parties would have their needs met, Neon would receive treatment but not radiotherapy so his mothers fears would be put at ease. However the medical experts involved say there are no other realistic alternatives available, nothing has undergone rigorous clinical trials and shown similar positive outcomes.
If Neon were to receive radiotherapy what would his prognosis be? Without further treatment there is a very strong chance that Neon will die. By contrast the survival rate for children with radiotherapy is between 80%-86%. As such the stressful treatment would not be an unnecessary 'gamble', there is a strong chance the treatment will work for Neon.
It was both of these reasons as well as the risk-benefit balance being strongly in favour of treatment that the court ruled against the mothers wishes. Neon is to undergo radiotherapy to try and prevent the cancer from spreading and will live with his father for the duration of the treatment.
Was the outcome of the trial ever in doubt, could the court of granted the mothers appeal? Probably not. Before reaching such decisions I think a number of things should be/are considered: the prognosis of the patient, availability of alternative treatments, the reasoning of the patient/relative and finally the capacity of the person in question to make such a decision. Cases involving children are particularly tricky as the child may be too young to give consent or lack the capacity to give consent. What do you think of the situation?
Finally it's all very well discussing the situation however I/we must not forget about how difficult these times must be for Neon's mother, having a child whom you love dearly suffer from a life threatening condition yet the only potential solution is aggressive and invasive treatment.
Wednesday, 19 December 2012
Proposed changes to the NHS
'Everyone counts: Planning for patients 2013/2014' is the title of a document published by the NHS Commissioning Board yesterday outlining the incentives that will be used to improve NHS services from April 2013, the first year of the new NHS, where improvement will be driven by clinical commissioners.
The document includes a clear set of outcomes against which to measure such improvements and outlines five offers:
1. Move towards a seven-day a week working for routine NHS services
2. Greater transparency and choice for patients
3. More patient participation
4. Better data to support the drive to improve services
5. Higher standards and safer care
I will now look at points one and two in more detail as these points in particular featured in the news over the weekend.
The idea of a seven day service follows research which suggests patients are more likely to die if they are admitted to hospital over the weekend. In fact the study showed that patients in England were 16% more likely to die if they were admitted on a Sunday rather than mid-week.
Staffing - in particular the absence of senior doctors - has been highlighted as a key reason for this.
Although such a scheme would be ideal and may be successful there are obvious obstacles that must be overcome, for example a reluctance to work on the weekend due to family commitments. What incentives or schemes could there be to try and overcome this reluctance? Bearing in mind the NHS is trying to save money whenever possible so lucrative salaries are probably not the answer... Not only are there obstacles but solutions that work for one speciality may not work for another!
Secondly the greater transparency and choice for patients, for example the provision of surgeons' data. Such data on heart surgeons is already available but the aim is to enable access to data belonging to a number of other specialities for example vascular and orthopaedic surgeons.
As well as enhancing patient choice the data would allow surgeons to compare "performance" and consequently this might lead to competition and an incentive or pressure to improve performance.
The primary concern amongst surgeons and other medical professionals with releasing this data is that it may give a misleading impression and may be misinterpreted. For example surgeons performing more difficult, high risk, complex surgery may look to be performing worse and labelled as "bad" surgeons when in fact they are the best surgeons but the nature of their work is extremely high risk.
To conclude Sir David Nicholson, the chief executive of the NHS Commissioning Board said the following about the proposed changes: “At the heart of our approach is local control over decision making. We want to put power in the hands of clinicians who know their patients best. We want to give them the money, information and tools to do the job. And we want the public to have the information they need to make choices and participate fully in the development of their health services.”
The document includes a clear set of outcomes against which to measure such improvements and outlines five offers:
1. Move towards a seven-day a week working for routine NHS services
2. Greater transparency and choice for patients
3. More patient participation
4. Better data to support the drive to improve services
5. Higher standards and safer care
I will now look at points one and two in more detail as these points in particular featured in the news over the weekend.
The idea of a seven day service follows research which suggests patients are more likely to die if they are admitted to hospital over the weekend. In fact the study showed that patients in England were 16% more likely to die if they were admitted on a Sunday rather than mid-week.
Staffing - in particular the absence of senior doctors - has been highlighted as a key reason for this.
Although such a scheme would be ideal and may be successful there are obvious obstacles that must be overcome, for example a reluctance to work on the weekend due to family commitments. What incentives or schemes could there be to try and overcome this reluctance? Bearing in mind the NHS is trying to save money whenever possible so lucrative salaries are probably not the answer... Not only are there obstacles but solutions that work for one speciality may not work for another!
Secondly the greater transparency and choice for patients, for example the provision of surgeons' data. Such data on heart surgeons is already available but the aim is to enable access to data belonging to a number of other specialities for example vascular and orthopaedic surgeons.
As well as enhancing patient choice the data would allow surgeons to compare "performance" and consequently this might lead to competition and an incentive or pressure to improve performance.
The primary concern amongst surgeons and other medical professionals with releasing this data is that it may give a misleading impression and may be misinterpreted. For example surgeons performing more difficult, high risk, complex surgery may look to be performing worse and labelled as "bad" surgeons when in fact they are the best surgeons but the nature of their work is extremely high risk.
To conclude Sir David Nicholson, the chief executive of the NHS Commissioning Board said the following about the proposed changes: “At the heart of our approach is local control over decision making. We want to put power in the hands of clinicians who know their patients best. We want to give them the money, information and tools to do the job. And we want the public to have the information they need to make choices and participate fully in the development of their health services.”
Tuesday, 11 December 2012
ENCODE Project
The Encyclopedia of DNA Elements (ENCODE) project is a research project involving a number of organisations from around the world. The project is looking into the entirety of the human genome, it began in 2003 and recently (September 2012) some very important results were published. The results featured in major journals such as 'Nature' - take a look if you can get hold of them!
The areas of the human genome that do not code for protein (98% of the genome) were previously considered to be regions of "junk DNA" with no specific purpose however this project has shown that these non-coding regions are in fact functional and play a very important role. Their primary role is to control gene expression, something I picture as on/off switches.
It is thought that many of these expression regions could be causally linked to disease. Previous research showing similarities or mutations in these non-coding regions may have been ignored because the regions were believed to contain "junk DNA" - if this is the case much of this research will have to be reconsidered and reinterpreted.
What about the future? These recent findings are only an initial exploration of the non-coding regions of the genome and further research will have to take place. This research will focus on trying to find true causal genetic links and to do so will need to consider a wide number of cell types.
Continuing with the topic of genetics, an article on the BBC today describes a plan to sequence the entire human genome in up to 100,000 patients with cancer and other rare diseases. The article does not mention ENCODE but perhaps the decision has come about following the research project?
The Prime Minister has set aside £100m for the sequencing. The ultimate aim is to give a better understanding of a patients genetic make up and how it differs with disease. This will hopefully then lead to better targeting of medicines in the treatment or prevention of disease. Currently there are tests for diseases caused by a single gene however much less is known about diseases involving complex relationships between genes and such relationships may even be influenced by lifestyle/the environment. It is understanding and targeting these relationships that will be a major challenge for geneticists and doctors over the coming years!
(Source: BBC Health)
The areas of the human genome that do not code for protein (98% of the genome) were previously considered to be regions of "junk DNA" with no specific purpose however this project has shown that these non-coding regions are in fact functional and play a very important role. Their primary role is to control gene expression, something I picture as on/off switches.
It is thought that many of these expression regions could be causally linked to disease. Previous research showing similarities or mutations in these non-coding regions may have been ignored because the regions were believed to contain "junk DNA" - if this is the case much of this research will have to be reconsidered and reinterpreted.
What about the future? These recent findings are only an initial exploration of the non-coding regions of the genome and further research will have to take place. This research will focus on trying to find true causal genetic links and to do so will need to consider a wide number of cell types.
Continuing with the topic of genetics, an article on the BBC today describes a plan to sequence the entire human genome in up to 100,000 patients with cancer and other rare diseases. The article does not mention ENCODE but perhaps the decision has come about following the research project?
The Prime Minister has set aside £100m for the sequencing. The ultimate aim is to give a better understanding of a patients genetic make up and how it differs with disease. This will hopefully then lead to better targeting of medicines in the treatment or prevention of disease. Currently there are tests for diseases caused by a single gene however much less is known about diseases involving complex relationships between genes and such relationships may even be influenced by lifestyle/the environment. It is understanding and targeting these relationships that will be a major challenge for geneticists and doctors over the coming years!
(Source: BBC Health)
Tuesday, 4 December 2012
Organ donation
In recent weeks/months the Welsh government have proposed an "opt-out" organ donation scheme, if passed the scheme would be the first of its kind in the UK and would be likely to start in 2015.
As the name suggests people will be deemed to have consented to becoming organ donors unless they "opt-out" of the organ donation register.
The proposed scheme will leave families with no official "legal veto" against donation by a deceased loved one. However politicians stress that families will be able to stop organs being removed in practice, and such cases will be looked into carefully as they arise.
The scheme would include all those over 18 that have lived in Wales for six months or more.
The current situation where people must die in hospital to be eligible as a donor, even if they are on the register, will stay the same.
Very briefly, of those that die in hospital there are two types of donors, heart beating and non heart beating. Heart beating donors are those that were on ventilation before death, as such the heart continues to pump and blood flows after death keeping vital organs such as the heart itself supplied with oxygen. By contrast non heart beating donors are those that were not on ventilation before death, as a consequence only certain organs can be donated, the kidneys for example.
Most recently the press has questioned whether such a scheme is really necessary? Currently 60% of families of potential donors approached after death by a specialist nurse agree to donation. The scheme in question could in fact have a negative effect, one causing people to feel organ donation is being 'forced' upon them and therefore becoming reluctant to donate and choosing to "opt-out."
So, what alternative solutions are there? Perhaps the government could invest in campaigns aiming to increase awareness about the importance of organ donation instead to try and increase the number of voluntary donors.
What are the reasons for the 'lack of donors'? Why don't more people opt in to organ donation currently? Here are a few potential reasons:
- Confusion and fear due to a lack of explanation regarding the process. For example, will a doctor fight to save me or will they fight less because I am an organ donor?
- How will the doctor know I am dead and what's to stop them rushing into taking my organs?
- What happens after death, might I need my organs for some reason? This is something I certainly cannot answer myself! What do you think?
The reasons behind those willing to donate are perhaps more obvious, for example:
- As an act of kindness which would better and potentially save someones life
- A personal or family experience in which someone received an organ (as an act of thanks) or did not receive an organ (to prevent others going through a similar situation)
Finally the article mentions the importance of speaking to loved ones about your wishes after death, what would you want to happen to your organs if you were to die? If this has been done then families are much less likely to refuse organ donation as they would know what their loved ones wishes were..
(Source: BBC Health)
As the name suggests people will be deemed to have consented to becoming organ donors unless they "opt-out" of the organ donation register.
The proposed scheme will leave families with no official "legal veto" against donation by a deceased loved one. However politicians stress that families will be able to stop organs being removed in practice, and such cases will be looked into carefully as they arise.
The scheme would include all those over 18 that have lived in Wales for six months or more.
The current situation where people must die in hospital to be eligible as a donor, even if they are on the register, will stay the same.
Very briefly, of those that die in hospital there are two types of donors, heart beating and non heart beating. Heart beating donors are those that were on ventilation before death, as such the heart continues to pump and blood flows after death keeping vital organs such as the heart itself supplied with oxygen. By contrast non heart beating donors are those that were not on ventilation before death, as a consequence only certain organs can be donated, the kidneys for example.
Most recently the press has questioned whether such a scheme is really necessary? Currently 60% of families of potential donors approached after death by a specialist nurse agree to donation. The scheme in question could in fact have a negative effect, one causing people to feel organ donation is being 'forced' upon them and therefore becoming reluctant to donate and choosing to "opt-out."
So, what alternative solutions are there? Perhaps the government could invest in campaigns aiming to increase awareness about the importance of organ donation instead to try and increase the number of voluntary donors.
What are the reasons for the 'lack of donors'? Why don't more people opt in to organ donation currently? Here are a few potential reasons:
- Confusion and fear due to a lack of explanation regarding the process. For example, will a doctor fight to save me or will they fight less because I am an organ donor?
- How will the doctor know I am dead and what's to stop them rushing into taking my organs?
- What happens after death, might I need my organs for some reason? This is something I certainly cannot answer myself! What do you think?
The reasons behind those willing to donate are perhaps more obvious, for example:
- As an act of kindness which would better and potentially save someones life
- A personal or family experience in which someone received an organ (as an act of thanks) or did not receive an organ (to prevent others going through a similar situation)
Finally the article mentions the importance of speaking to loved ones about your wishes after death, what would you want to happen to your organs if you were to die? If this has been done then families are much less likely to refuse organ donation as they would know what their loved ones wishes were..
(Source: BBC Health)
Tuesday, 27 November 2012
The Liverpool Care Pathway (LCP)
This week I plan write about the LCP,
something which has featured in the news in recent weeks. Its aim is to provide
a sustained quality of care amongst all patients in their last hours/days of life to ensure a peaceful
and comfortable death.
It is described as the “best practice model for care of the dying” and can be used to support patients in care homes and their own homes as well as hospitals.
So, why was it introduced? In the 1990s end-of-life care was somewhat “patchy” for example some hospitals provided excellent care whilst others did not meet the same standards. Areas of particular concern were that firstly patients were often subject to invasive testing/treatment that offered no chance of preventing death and secondly that the patient was caused unnecessary pain and suffering by needlessly prolonging life.
Any medication that is not helpful at this time may be stopped. In addition it may not be appropriate to continue some tests at this time, for example blood tests, blood pressure and temperature monitoring.
Finally patient comfort must be considered, monitoring bed position to prevent bed sores, the potential use of a special mattress and regular mouth care.
2. The diminished need for food and drink.
Such a need could be a physical sign that their condition is not going to improve. The patient may neither want nor need food/drink and decisions about the use of artificial fluids should be made in the patient’s best interests.
3. Religious/spiritual needs.
Discussion with the relative and where possible the patient to ensure that the desires at the time of or after death are met.
As a result of the recent accusations Care and Support Minister Norman Lamb said he would appoint an independent chair to report on the issue. He said,
"It is clear that everyone wants their loved ones' final hours of life to be as pain free and dignified as possible, and the Liverpool Care Pathway is an important part of achieving this aim. However, as we have seen, there have been too many cases where patients were put on the pathway without a proper explanation or their families being involved. This is simply unacceptable.”
"Today I have committed to appoint an independent chair to review how end-of-life care is working and oversee the reviews into the LCP. This will report back to me in the new year." (Source: BBC News)
It is described as the “best practice model for care of the dying” and can be used to support patients in care homes and their own homes as well as hospitals.
So, why was it introduced? In the 1990s end-of-life care was somewhat “patchy” for example some hospitals provided excellent care whilst others did not meet the same standards. Areas of particular concern were that firstly patients were often subject to invasive testing/treatment that offered no chance of preventing death and secondly that the patient was caused unnecessary pain and suffering by needlessly prolonging life.
Information regarding the pathway on
the Marie Curie Palliative Care Institute website is split up into three main areas…
1. Medication/treatment review.Any medication that is not helpful at this time may be stopped. In addition it may not be appropriate to continue some tests at this time, for example blood tests, blood pressure and temperature monitoring.
Finally patient comfort must be considered, monitoring bed position to prevent bed sores, the potential use of a special mattress and regular mouth care.
2. The diminished need for food and drink.
Such a need could be a physical sign that their condition is not going to improve. The patient may neither want nor need food/drink and decisions about the use of artificial fluids should be made in the patient’s best interests.
3. Religious/spiritual needs.
Discussion with the relative and where possible the patient to ensure that the desires at the time of or after death are met.
The pathway has featured in the news
throughout November, it has faced criticism and scrutiny from many newspapers. For some its
use has become controversial, with relatives reportedly claiming it has been
used without consent and others have reported it being used inappropriately to
meet targets.
However the LCP has been standard
practice for a number of years now, so whilst there have been recent allegations
of individual failings within the procedure (mainly due to lack of
communication between those involved), the model of care itself appears to be both appropriate and
humane. As a result of the recent accusations Care and Support Minister Norman Lamb said he would appoint an independent chair to report on the issue. He said,
"It is clear that everyone wants their loved ones' final hours of life to be as pain free and dignified as possible, and the Liverpool Care Pathway is an important part of achieving this aim. However, as we have seen, there have been too many cases where patients were put on the pathway without a proper explanation or their families being involved. This is simply unacceptable.”
"Today I have committed to appoint an independent chair to review how end-of-life care is working and oversee the reviews into the LCP. This will report back to me in the new year." (Source: BBC News)
Tuesday, 20 November 2012
Randomised controlled trial showing spinal cord regeneration (in dogs)
A research team in Cambridge recently undertook the first double blind trial (neither the researchers or the pet owners knew which pets were receiving the real treatment) to test a transplant technique involving olfactory ensheathing cells in "real-life" spinal injuries suffered by dogs. Real life in the sense that the dogs were injured spontaneously and accidentally rather than in the controlled environment of a laboratory. The treatment was also given sometime after the injury occurred.
The transplant consisted of olfactory ensheathing cells* being removed from the lining of the nose. These were then grown and expanded for several weeks in the laboratory.
*The only part of the body where nerve fibres continue to grow in adults is the olfactory (smell) system. Olfactory ensheathing cells (OEC) which are found in the back of the nasal cavity surround the receptor neurones that enable us to smell and convey these signals to the brain. These nerve cells need constant replacement which is promoted by the OEC.
It has been thought for some time that OEC may be useful in spinal chord repair and this recent study supports this.
The trial provides "proof of concept", of the 34 dogs involved 23 had OEC transplanted into their injury site - the remainder were injected with a neutral fluid (a placebo). The results were positive, many of the dogs which received transplant cells showed considerable improvement and were able to walk on a treadmill with the support of a harness. As expected no improvement was seen in the control group.
The transplanted cells regenerated nerve fibres across the damaged region of the spinal cord. As a consequence the dogs were able to regain the use of their back legs and more importantly co-ordinate movement with their front limbs.
However these new nerve connections did not occur over the long distances that would be required to connect the brain to the spinal cord, something which would be crucial for human spinal injury patients who had lost sexual function and bowel/bladder control. Given that in a survey of spinal injury patients these two factors were rated higher in importance than improved mobility.
So how significant is this research and what are its possible clinical implications/benefits for the future? Well, Prof. Geoffrey Raisman who discovered olfactory ensheathing cells in 1985 said "this is not a cure for spinal cord injury in humans - that could still be a long way off. But this is the most encouraging advance for some years and is a significant step on the road towards it." Furthermore despite the recovery seen amongst the dogs in the trial, in humans "the much harder range of higher functions lost in spinal cord injury - hand function, bladder function, temperature regulation, for example - are yet more complicated and still a long way away."
(Source: BBC Health News - also click here to see a video of the transformation from immobility to unassisted mobility in one of the dogs)
The transplant consisted of olfactory ensheathing cells* being removed from the lining of the nose. These were then grown and expanded for several weeks in the laboratory.
*The only part of the body where nerve fibres continue to grow in adults is the olfactory (smell) system. Olfactory ensheathing cells (OEC) which are found in the back of the nasal cavity surround the receptor neurones that enable us to smell and convey these signals to the brain. These nerve cells need constant replacement which is promoted by the OEC.
It has been thought for some time that OEC may be useful in spinal chord repair and this recent study supports this.
The trial provides "proof of concept", of the 34 dogs involved 23 had OEC transplanted into their injury site - the remainder were injected with a neutral fluid (a placebo). The results were positive, many of the dogs which received transplant cells showed considerable improvement and were able to walk on a treadmill with the support of a harness. As expected no improvement was seen in the control group.
The transplanted cells regenerated nerve fibres across the damaged region of the spinal cord. As a consequence the dogs were able to regain the use of their back legs and more importantly co-ordinate movement with their front limbs.
However these new nerve connections did not occur over the long distances that would be required to connect the brain to the spinal cord, something which would be crucial for human spinal injury patients who had lost sexual function and bowel/bladder control. Given that in a survey of spinal injury patients these two factors were rated higher in importance than improved mobility.
So how significant is this research and what are its possible clinical implications/benefits for the future? Well, Prof. Geoffrey Raisman who discovered olfactory ensheathing cells in 1985 said "this is not a cure for spinal cord injury in humans - that could still be a long way off. But this is the most encouraging advance for some years and is a significant step on the road towards it." Furthermore despite the recovery seen amongst the dogs in the trial, in humans "the much harder range of higher functions lost in spinal cord injury - hand function, bladder function, temperature regulation, for example - are yet more complicated and still a long way away."
(Source: BBC Health News - also click here to see a video of the transformation from immobility to unassisted mobility in one of the dogs)
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