Hospital bosses face action over records scandal.

By Marjory Inglis, health reporter   THE UK'S data watchdog was demanding answers last night over the Strathmartine Hospital medical records scandal—and could take enforcement action against NHS Tayside. Bosses at the health authority were under fire again yesterday after confidential documents relating to individual patients were found strewn around the disused hospital.   Several files were found including details relating to the adoption of a young girl giving her real name, address and date of birth and information relating to a baby born an alcoholic.   NHS Tayside's chief executive Professor Tony Wells denied there had been any attempt to "mislead" the Scottish Government or the data watchdog.   His comments came after Public Health Minister Shona Robison said she had received assurances from NHS Tayside that the documents had been cleared from the site when that was clearly not the case.   Last night it emerged that a member of the public made a formal complaint about the situation to the Information Commissioner's Office and similar assurances were given there.   Anybody who is concerned about a breach of the Data Protection Act, which governs the appropriate management and disposal of personal records, can complain to the commissioner.   "The Information Commissioner's Office takes breaches of people's privacy very seriously and it is concerning if personal information, particularly sensitive information such as health records, has not been disposed of securely," Ken Macdonald, assistant commissioner at the ICO, said last night.   "This is a key principle of the Data Protection Act. Following a complaint regarding the disposal of patient health records at the former Strathmartine Hospital in Dundee, we contacted NHS Tayside to establish further details.   "Despite the ICO having received assurances that immediate action had been taken to remove the records from the building, this appears not to be the case.   "We will be contacting NHS Tayside immediately to demand an explanation and, if necessary, we will use our enforcement powers."   A spokesperson for the ICO last night said a breach of the Data Protection Act is not a criminal offence but, if a company or public body is required to meet the demands of an enforcement notice and fails to do so, the breach is a criminal offence and could lead to prosecution.   Yesterday Professor Wells took charge of the renewed effort to clear sensitive information from the hospital, visiting it with specialists called in to do the job which, he said, would take weeks.   Meanwhile, bin bags full of documents removed from the premises were being taken to a secure store until the appropriate way to deal with them had been ascertained. Prof Wells was adamant that he and his colleagues had not misled those making formal approaches regarding the documents.   "Nobody has been trying to mislead anyone," he said. "I think we have acted in good faith and we are trying to investigate just how this situation arose."   Yesterday, Scotland's director general for health Kevin Woods wrote to the chief executives of Scotland's 14 health boards drawing attention to the Strathmartine situation and seeking assurances that "obligations" with regard to the management, retention and disposal of medical records were being met.   He emphasised that the buck stops with the chief executive of each health board.

The link between Obesity, Disease and Sleep

 

Report by Danna Schneider

 

There has been quite a bit of press lately about how sleep, the amount of it and the quality that you get on a regular basis, can affect more than just our moods and our alertness. Now there is gathering evidence that sleep may have a great impact on how much you weigh for a number of reasons.

So, if you think that getting your Z's wasn't affecting your health, then you definitely want to read on, because it could be affecting not only your weight, but also may have a serious impact on your longevity, and your predisposition toward everything from cancer to diabetes.

You may think that this supposition goes only one way. That is, that it's only the lack of sleep that increases your health problems and also may impact overall longevity. However, it also appears to go the opposite way as well, since people who get too much sleep, which is nine hours or more, also experiencing higher rates of health issues, as well as a higher incidence of obesity.

So, what is described as being too little sleep, exactly? Well anything that falls under the absolute minimum of six hours of sleep per night qualifies as very little sleep, but that can vary per study. Some studies claim that the only acceptable range of sleep is about seven to eight hours of solid rest per night.

The consensus does seem to be, however, that anything under six hours per night could be seriously detrimental to your health and that by getting this small amount of sleep on a regular basis may increase your odds of becoming overweight or obese. The thought process behind sleep's relationship to obesity and excess weight goes two fold.

Some researchers believe that those that get little sleep are already predisposed, perhaps genetically or personality-wise, to not get enough sleep by traits such as anxious personalities, depressive disorders, and even people who smoke or drink too much caffeine.

The end result, however, is the same, and that is that there is definitely a correlation between those that get too much or too little sleep and obesity, so it could be assumed that either one causes the other, or vice versa.

Another thought is that lack of sleep, or too much sleep, can trigger certain hormones and chemicals in the brain that make people more hungry and also induce a more insatiable appetite that contains more cravings for foods such as carbohydrates and sweets, to make up for the hormonal imbalance that is caused when someone is getting improper amounts of sleep, whether it be too much or not enough.

I know that I've seen this theory at work in my own life when I've had too much sleep, which for me is nine hours or more, although I can rarely sleep longer than that, or when I've had five or less hours of sleep.

On these mornings and the ensuing day after a bad night's sleep, I almost always find that I have a huge appetite, and that all I want to eat seems to be those "comfort foods" that are always the biggest diet no-no's, like sugary sweet and fatty fried foods. For me, my body has proven to me time and time again that adequate and correct amounts of sleep directly affect my appetite and the types of foods that I crave.

Getting the correct amount of rest, as well as the quality of that rest, every night on a consistent basis has also been studied as a possible cause or at least partial cause of some disease. Take for example a recent study that showed that men who worked the graveyard shift and also women who worked this shift were more prone to getting hormonally based cancers, for men that cancer being in the prostate, and for women the correlation was for breast cancer.

It makes sense that the lack of solid sleep and the kind of rest that coincides with something called the circadian rhythm, which is sleep that is had between certain times which is said to be more effective than sleeping during the day, causes people to be more prone to certain types of cancers as well. This would partially explain the obesity factor as well, since hormones are a delicately balanced presence in our body which greatly dictate our base weight.

They also run almost everything in our lives, from our moods, to our appetites, to the healthy growth, division, and reproduction of cells, so it makes sense that when our sleep is out of wack, it causes great harm to our bodies.

The lesson here? Well, it's that sleep is a lot more important than many of us think. It used to be something of a luxury to get the right amount of it, however, research is pointing to the fact that we have to make it as much of a priority to get the right amount if we want to live longer, disease free, and happier lives.

 

---

 

Danna Schneider is the founder of several websites dedicated to natural treatments and remedies for common, everyday health issues and concerns. You can find information on an effective herbal insomnia remedy and sleep aid here at Melatrol review, and also a natural anti anxiety and depression remedy here at natural depression remedy.

Insomnia Affects Sleep Quality - How To Overcome It.

 

We all know sleep is important because our bodies' systems undergo repair and maintenance during our sleep.

But during our lives, we will experience some sleepless nights which are considered normal. But for some people, poor quality sleep is a recurring or even a lifelong problem.

When your sleep quality is affected, the end results could well be feelings of fatigue during the day, irritability, poor memory, loss of productivity and loss of interest in family and social life.

Therefore, achieving quality sleep is very important to your physical and emotional health. The quality of sleep is associated with number of sleeping hours. Doctors normally recommend that adults should need 7 to 10 hours of sleep daily and children would require more hours. But it varies among individuals. What matters is, for the duration you sleep, are you achieving the right quality of sleep?

Insomnia, or the inability to sleep well, is a common problem which could affect anyone at one time or another. A person with insomnia may have difficulty falling asleep or staying asleep, wake up frequently during the night, or wake up earlier than desired the next morning.

Insomnia generally falls into two categories, acute insomnia and chronic insomnia.

Acute insomnia, which can last from one night up to several weeks, may be caused by:

1. A single stressful event

2. A period of emotional stress

3. Illness

4. Temporary pain or discomfort

5. Disturbances in the sleeping environment such as noise, light or sleeping in a different bed

6. A change in the normal sleep pattern, caused by jet lag or working in a late shift

This kind of insomnia usually doesn't last long once the root cause(s) is resolved. But it could be dangerous during the healing period as lack of sleep over a reasonable period could affect your concentration, leading to serious consequences such as accidents while driving or at work.

Chronic insomnia is more serious as it can last for months or even years. The likely causes are:

1. Mental or emotional conditions, such as depression or anxiety, or stress.

2. Poor sleep habits, such as watching television programmes in bed or going to bed at different times.

3. Too much stimulants intake such as coffee or cigarettes.

4. Excessive drinking

5. Lack of regular exercise

6. Existing medical health problems such as breathing or heart problems, hormonal or digestive disorder, or chronic pain

7. Side effects of certain drugs

8. A different sleep disorder such as sleep apnea.

Before we go on, a little more explanation is required here for sleep apnea. It is a condition whereby a person regularly stops breathing, or has slowed breathing during sleep for 10 seconds or longer. Depending on the frequency the breathing stops (apnea) or slows (hypopnea), we classify the condition as mild, moderate or severe.

A person suffering from sleep apnea may snore loudly, and have restless sleep with difficulty breathing. As a result, he may wake up with a headache and tiredness which last the whole day. However, sleep apnea may improve with changes in sleeping habits. Sometimes, doctors may suggest use of devices to help easier breathing during sleep or even surgery.

Insomnia can be cured as long as the victim develops a regular sleeping habit.

Here are some remedies to help you ease or eliminate your sleeping disorder:

1. Reserve your bedroom for sleeping and sex only i.e. avoid eating, working, computers, TV, video or loud music in the bedroom

2. Create a clean and comfy environment for sleeping – soft lights, good ventilation, appropriate room temperature, good support pillows, sufficient comforters

3. Avoid caffeine drinks such as coffee, tea, soft drinks or chocolate drink and/or cigarettes after 7pm in the evening. Also avoid snacking before bedtime.

4. Improve your diet by reducing meat intake and eating more fruits and vegetables especially kiwi, berries, green leafy vegetables, whole grains and cereals.

5. Switch off your mobile phones, blackberries, MSN or Yahoo! Messenger, ICQ etc after a certain time at night.

6. Drink a glass of warm drink such as soymilk or herbal tea before going to bed. But remember to visit the bathroom right before bed to reduce the chances of needing to get up later to do it.

7. If you find you can't sleep after half an hour in bed, get up and read a book or listen to some soothing music. Use warm tungsten reading lamp instead of florescent lamp and don't read books which are stimulating. Avoid watching TV, VCDs or DVDs as the light from these devices are bright and will affect the body's biological clock, worsening your sleeplessness condition. You can return to bed as soon as you feel sleepy.

8. Exercise regularly does help to release tension, aiding sleep. But note not to do it late at night as this can result in insomnia.

9. Train your body to sleep and wake up at the same time every day regardless of whether it is a weekend or public holiday. The ideal time to get into bed is between 9 to 11pm so as to achieve the desired 8 hours of sleep.

10. If you need to nap during the day, try to keep it within 45 minutes which is sufficient to rejuvenate you. Napping too long may result in groggier mind and adversely affect your nocturnal sleep.

11. If you're working at home, stop work at least two hours before bedtime to allow your mind to unwind and relax.

With all these measures, doctors sometimes still need to prescribe hypnotics for sleep as treatment for insomnia But these medications are meant for short term only while patients try to find solutions to their various acute stressful problems.

---

Laura Ng is passionate in providing quality nutritional facts and health tips, plus recommending 100% toxic-free vegan recipes to anyone who cares about his/her health. Join her iOneHealth Club now to receive more health secrets and freebies available to her members only. You'll gain plenty but lose nothing. Promised. Visit http://www.ionehealth.com now.

Concerns about doctors

The General Medical Council (GMC) regulates doctors in the United Kingdom (UK). We register doctors to practise in the UK and have the powers to either issue a warning to a doctor, remove the doctor from the register, suspend or place conditions on a doctor's registration. Complaints and the role of the GMC Read information on the GMC's role in dealing with complaints – what do we do, what don't we do. View the Complaints and the role of the GMC page. Making a complaint Read information about how to make a complaint. See our Making a complaint section. Doctors under investigation This section is for doctors who have been referred to the GMC, and includes advice on our procedures. View our Doctors under investigation section. Employers information The GMC has published guidance for employers relating to doctors under investigation and going through our Fitness to Practise procedures. View our information for employers. The investigation process This section explains our procedures after a complaint comes in, throughout our investigation – and when we decide to conclude an investigation with a Warning. See our investigation process section. Hearings and decisions The hearings and decisions section explains about our Adjudication process – that is, when a doctor appears before the GMC to answer allegations. You can also find out about Interim Order Panels, and search for results of GMC Fitness to Practise hearings. See the Hearings and decisions section. Legal framework for Fitness to Practise procedures The legal framework for our Fitness to Practise procedures is set out in Medical Act 1983 and the Fitness to Practise Rules 2004. You can view the legislation and supplementary information on the Legislation page in the About Us section of the website.

Moods - Dr. Liz Miller

source: System X Psychology

 

Have you ever wondered why some days you can leap out of bed and get everything done by 11 am, and other days, you can hardly get out of bed to make a cup of coffee? Somedays start off well and go bad, and other days, somehow with a bit of determination everything comes right in the end.

Welcome to your mood!!

Everyone always has a mood, all of the time. Not just when you notice it, but all of the time. You don't always notice it because the body has a habit of adapting. When nothing new happens we take things for granted and stop noticing whatever we are seeing, thinking or feeling.

Let me give you an example. Rub the back of your hand with your first finger, you can feel the skin under your finger moving. Stop moving your finger and hold it still. After a minute you can no longer feel the skin under your finger. Move your finger again. This is because the body has adapted to the feel of your skin.

You only notice your mood if it changes, or if it stopping you doing what you want to do. You may notice that you feel better or worse than you did first thing in the morning. You notice you are anxious about an up and coming event, when you want to settle down quietly and read. You may not notice it so much if you are milling around with a lot of other people who are also anxious.

Everyone has a mood, every minute of every hour of every day. No one can escape their mood. Which is good, because with practice you can learn to recognise your own mood and change it if you need to. You can also learn to recognise other peoples' moods. This helps you know how they are feeling, even before they tell you and to build better relationships.

To conclude, in the short term, mood tells you how a person feels, thinks and is likely to behave. Children are the best mood monitors on the planet. They never give bad news when their parents are in a bad mood. They wait until everything is quiet and peaceful before they drop their bombshell. That way, even if someone gets angry, he or she will be a lot less angry than if they had given the bad news to a someone who was already in a bad mood.



Copyright (c) Dr. Liz Miller

http://www.drlizmiller.co.uk

Tick box training

Tick box training

Tick box training is about completing assignments, ticking the box and then being considered trained.

It has benefits and disadvantages

Tick box training means you know what you are meant to be learning - at it best it lays out in plain English exactly what you are meant to be able to do, to know or to understand. Then when you have convinced another human being that this is the case, they tick your box.

You wander around, or even march in the direction you need to go to get all your boxes ticked. It is a bit like a treasure hunt. Go to the crossroads by the pub, where you can see a white horse and under a sign hidden by a tree, you will find the next clue. Once you have collected twenty clues, or ticked twenty boxes you will be a fully trained gherkin.

Tick box training is great - it gives everyone something to work towards, its fair, its politically correct, and there is no time limit. No bonuses for getting all your boxes ticked in the first six months of a seven year training and no penalties for staying on for a decade. For the game player, timing their ticking means that they can be in position for the best job. Waiting to throw their final double six just at the very moment the big prize goes past on the conveyor belt of job opportunity and employment.

The benefit of tick box training is that once you have ticked a particular box of competencies, you never need to think about it again. You have done it, you have got your tick, you are competent, your brain can move onto better things. In the meantime you can hope fervently you will never need that training at a time you don't have a) a scapegoat b) senior colleague present or c) someone who actually knows what they doing in that competency to keep you out of the doodoo and stop your name being dragged through the streets of incompetence.

Where does it stand legally? One or two poor doctors got dragged through the mud for giving Ledward, fastest gynaecologist in the West a reference. Maybe, this is a way of finding a scapegoat. X does Y, badly because they are incompetent even though they have five competency ticks. Why did X cock up? because X is an incompetent but managed to make four people feel sufficiently involved with him or her that they ticked his box. The fifth person felt guilty, and that they should not hold X back just because X was having a bad day. The other four had felt the same but were unable to tell X that.

Outstanding people stand out, choosing the middle ranks is difficult. The difference between excellent and good is not difficult, the difference between good and satisfactory is harder. SHould satisfactory people be allowed to succeed, in a high risk specialty?? probably not! But is it politically correct to discriminate against someone who with a bit of extra training might be able to do a perfectly adequate job?




Copyright (c) Dr. Liz Miller

http://www.drlizmiller.co.uk

TV celeb Leslie Ash wins 'super bug' payout

Lawyers for actress Leslie Ash have confirmed she is close to settling a compensation case after she contracted a hospital superbug.

 

Ash, famous for her roles in Men Behaving Badly and Merseybeat, contracted MSSA at Chelsea and Westminster Hospital three years ago.

 

The settlement is reportedly in the region of £500,000.

 

Lawyer Janice Gardener said: "Matters are at a delicate stage but we can confirm that we are no longer going to court. The case will be settled in full this week."

 

Ash, 47, who now walks with a stick, was admitted to hospital after suffering two cracked ribs after falling off her bed on to a table at the home she shared with her husband, the former footballer Lee Chapman.

 

The NHS Trust initially agreed a payment of £250,000 after the hospital admitted breach of duty.

InChelsea Magazine : The Effects Of Stress

Level 4: INSIGHT by Dr. Liz Miller

There is another level of insight, beyond seeing the effect of your behaviour on other people. It may go alongside but maybe at a higher level. Seeing yourself in other people, seeing their effect on other people, seeing how you might also have that effect and then making similar adjustments 

For example, you might be a very forthright individual. Level 1 you know you are forthright, Level 2 you know people see you as forthright, Level 3 you know the effect of forthrightness on the people around you, Level 4 you see forthrightness in other people, you see the effect it has on people around you and you modify your own forthrightness in the light of that effect. 

It might also be 'anxiety'. Level 1 You know you are anxious. Level 2 You understand that other people see you as anxious Level 3 You understand the effect of your anxiety on the people around you - either they also get anxious, or they get irritated by your obsession with details. Level 4 you see other anxious people and see the effect they have on the people around them and modify your own behaviour accordingly 

Level 4 is the start of rounded behaviour - the ability to see all sides of the problem, to understand how you relate to the people around, how you affect them and how they affect you. And to modify your behaviour accordingly...... 

With the mastery of  levels, comes transcendency 

Copyright (c) Dr. Liz Miller

NHS database 'could be targeted'

Checks on data-sharing must be "robust", MPs heard The man in charge of setting up the NHS medical records database has admitted that "you cannot stop the wicked doing wicked things" with information.   Richard Jeavons, director of IT implementation at the Department of Health, said there were instances where staff "abuse their privileges". These had to be "pursued", he told the Commons home affairs committee.   The plan to put 50 million patients' records on the database is part of a £12bn NHS IT overhaul. The scheme has raised concerns over cost and the security of information.   A poll for the Guardian suggests that 59% of GPs in England are unwilling to upload any record onto the database without the patient's specific consent.   Three quarters of more than 1,000 doctors questioned believed medical details would become less secure when they are put on a database that will eventually be used by the NHS and social services.   'Misuse' Mr Jeavons, who was appointed in May, said the Department of Health did not itself hold many people's personal records but added that it provided guidance to NHS trusts on how to handle data. At a committee hearing, Labour MP Margaret Moran said to him: "Even if we get the technology right, the problem is abuse by people or misuse of data.   "How confident are you that there won't be problems over data and privacy?"   If we can avoid setting up large-scale citizens' databases, that would be a wise thing to do John Suffolk Chief information officer Mr Jeavons replied: "You cannot stop the wicked doing wicked things with information and patient data...   "Of course, we have examples where staff do abuse their privileges and have to be pursued through disciplinary procedures."   He added that the government had to "make sure" that people who abused the system knew they were "going to get caught".   The NHS scheme is intended to "modernise" the service. By 2014, 30,000 GPs in England will be linked up to nearly 300 hospitals giving the NHS a "21st century" computer network.   It involves an online booking system, Choose and Book, a centralised medical records system, e-prescriptions and fast computer network links between NHS organisations.   It is said to be the most ambitious computer project in the world and represents the largest single investment in IT in the UK.   'Surveillance' Opponents say it is too expensive and will compromise the confidentiality of records.   The home affairs committee is looking at whether the UK has become a "surveillance society".   In its hearing, it senior civil servants working in the education, transport and justice fields were also questioned.   The MPs were told different departments could not share information without legal guidelines being followed and rights of access clarified.   Clare Moriarty, constitution director at the Ministry of Justice, said efforts to make data protection as "robust" as possible were essential.   Questioned as to whether information had sometimes gone between departments unofficially, she replied: "I'm not aware of any department sharing data by stealth."   'Foolhardy' Government chief information officer John Suffolk told the MPs that setting up a nationwide database going across Whitehall departments and other government agencies would create more problems.   He said: "When you work at a national scale, to continue to put more eggs in a single basket is a foolhardy approach."   Mr Suffolk added: "The more and more you put it into a large database, with more and more people having access, it becomes more complex... "If we can avoid setting up large-scale citizens' databases, that would be a wise thing to do."   The Information commissioner last year warned the UK risked "sleep-walking into a surveillance society".   The committee's inquiry will include the impact of identity cards, the expansion of the DNA database and the rise in the use of CCTV cameras.

The Cult Called A.A.

by Paul Roasberry

Reprinted from Matrix, Denver Mensa, Janet Roder, Editor

When we think of cults, we usually think of bizarre religious sects, armed compounds, mind control and eccentric leaders. Most of us do not think of Alcoholics Anonymous (A.A.) as a cult, but I do.

Three years ago, I was in the grips of a serious drinking problem. Like most alcoholics, I rationalized my drinking, citing the many terrible circumstances in my life. Then, almost three years ago, I stopped drinking. Period. By myself.

Oh, I attended a half dozen or so A.A. meetings at the time, upon the advice of someone recommended by a friend. The woman who suggested A.A. to me was a licensed psychologist. She was a "recovered alcoholic" and was very active in A.A.

What I found at the meetings was a weird mixture of the deplorable and the laughable. It didn"t take long to notice that something was not quite level with this organization.
I was tipped off to A.A.'s strong cult qualities when the lady psychologist made a somewhat curious remark during the first week or two of my sobriety.

I had an uncle then (he died this past January) who had been an alcoholic prior to 1960. Uncle Ralph consumed, by his own subsequent admission, about a quart of whiskey a day. He stopped drinking without the assistance of A.A. when he met my aunt. It was a condition of their marriage that he stop drinking, and he did.

I remember my Uncle Ralph as a sweet, generous man during the thirty-odd years he was married to my aunt. He was not abusive or cruel, he worked hard, and made an excellent stepfather to my three girl cousins. When I mentioned Uncle Ralph to the lady psychologist, stating that he'd quit drinking on his own, she immediately dismissed my observation with, "Oh, well, he's just a dry drunk." She of course had never met my uncle Ralph, knew positively nothing about his character and yet claimed to be able to diagnose him as a "dry drunk" strictly on the information that he hadn't progressed through the A.A.'s widely touted "twelve step program." Bear in mind, this was a licensed psychologist making an incredibly spurious, rash judgment.

Of course, all cults have this in common: they reject and label as untouchables any who do not embrace their particular version of "Truth." To died-in-the-wool communists, non-believers are "bootlickers of the capitalists," or "counter-revolutionary hooligans." To the born again fundamentalist Christian, non-believers are "agents of Satan." To Moslems, Christians are "devils," and to Nazis, Jews are "swine." To the Alcoholics Anonymous membership, anyone who stops drinking without chanting the mantras of cult founder Bill W. are "dry drunks," pure and simple. You don't even need to know anything more about the self-quitters -- the fact that they quit drinking without A.A. makes them dry drunks, a priori.

Don't get me wrong. I do not advocate suppressing A.A. or any other cult. I simply want you to know, in case you are a problem drinker and are toying around with the idea of quitting, that it's O.K. to develop your own solution to your own problem. The last thing you need when you undertake a major, radical transformation in your life is to be accused by a bunch of self-righteous fanatics of being "a dry drunk," whatever the hell that is.

The whole A.A. program hinges upon the alcoholic's acceptance of what A.A. calls a "higher power." Conversely, adherents to the twelve-step program are expected to renounce any personal responsibility for, or control over, their problem. This blatant renunciation of the concept of free will is also a characteristic of every single other cult I can think of -- the individual counts for nothing, while the non-existent, the illusory, the hypothetical, is all. Self-respecting, proud, analytical achievers do not make good cult members. A cult follower must be stripped of his sense of individual worth -- in many sects, he is humiliated sexually, deprived of sensory stimuli, sequestered from the larger community, or otherwise manipulated to look upon himself as degraded and worthless. In A.A., you are plopped in a ring of cultists every evening and pressured to place your entire destiny in the hands of some "higher power."

When I began to ask hard questions about the nature of this "higher power," half expecting to hear some gibberish about "god," I learned (no kidding!) that one member even had his motorcycle represent his "higher power." What form of silliness is this that empowers motorcycles to cure us of alcoholism, I wondered.

At A.A. meetings, everyone sits around in a big circle. There are readings from "the Big Book," a not-very-well-written compendium of home-spun philosophy and anecdote authored by Bill W. and his colleagues some decades ago. Every cult needs its sacred writings, its revealed word. Members start talking about themselves and their alcoholism, and oddly, this sounds more like "self-criticism" under Mao's cultural revolution than anything therapeutic. In fact, it's all directed toward precisely the same end as "confession" in the Catholic church and Maoist "self-criticism" -- de-emphasis of the individual and a concomitant glorification of the ethereal, the other-worldly, the imaginary.

At some point, if you begin to question this "program" of A.A.'s, the talk gets tough and they start to lean on you. You are told that you can never recover on your own, that you are doomed to lapse over and over again into drinking binges, or at best, become a "dry drunk." (This is supposedly someone who has stopped drinking but still manifests all the unconscionable traits of a drunk: all the sociopathy, all the abusiveness, all the manipulative behaviors.)

The more you try to trot out examples of persons who have transformed their own lives under their own steam, the more the party line is thrown back at you: you are powerless against drink. Powerless. Any so-called examples of alcoholics who quit drinking without the twelve steps are in reality only examples of "dry drunks."

When I left A.A., I made the comment to someone that if I were indeed "powerless," I might as well commit suicide, because a life without any control over my destiny would be pointless and absurd. I stated again my conviction that I did not regard myself as powerless, and I went about my recovery in the most sensible way I could imagine. I removed alcohol from my home, I found some healthy pastimes to pursue (mountain climbing, writing, and painting) and, in the whirlwind breakup of my marriage, I devoted myself to staying afloat financially, making my new company prosper, and seeking out some like-minded companionship -- that was when I re-joined Mensa.

So, if you are determined to quit drinking, you can save yourself about three hundred sixty-five hours a year, plus travel time.

Try the "one-step" program, instead: just stop drinking. Believe me: you can do it.

I did.

Medical matters dominate papers

Medical Matrix

Medical stories are a dominant theme across Saturday's papers. In particular, much attention is given to new plans to allow nurses to decide over resuscitating patients.   The front pages of the Daily Mail, the Times and the Daily Telegraph all go with the news that nurses will be able to decide whether to resuscitate patients. The idea is anathema to the Daily Mail. It reports the views of one patients' group under the headline, "Nurses to have the power to end a life".   The Times is in favour, noting that nurses are closer to patients than doctors.   In the Telegraph, a Christian Medical Fellowship spokesman says it is unfair to place the responsibility on nurses.   Together in death There are more medical matters in the Sun, one of many papers to relate the demise of Lionel and Rosemary Owen.   The elderly couple's daughter claims they both died from Clostridium Difficile at the Royal Devon and Exeter Hospital, only a few minutes apart.   Nina Griffith tells the Sun the hospital knew her mother had the superbug but allowed her to visit for treatment, and she gave it to her husband.   She tells the Daily Express her mother believed in the NHS but it failed her.   The hospital tells the Sun it is investigating the "complex" circumstances surrounding the deaths.   Brain injury fear A Guardian exclusive reveals the Ministry of Defence is holding a major study into brain injuries in troops returning from Iraq and Afghanistan.   The report says the soldiers may have suffered the injuries after being exposed to high-powered bomb blasts.   Troops are at risk due to increased use of road-side bombs, the paper explains, and even the most advanced helmets cannot protect the brain from the shock waves.   Victims suffer symptoms such as acute memory loss and flashbacks, it says.   Galloping prices The Financial Times is preoccupied with the price of oil. It says the price of crude has hit a new record, jumping above 92 dollars for the first time.   According to one futures trader quoted in the paper momentum in the oil market is like "riding on a galloping horse".   "Scotland-10, England-nil", reads the inflammatory headline on the front of the Independent.   The paper looks at how life has changed for Scots since devolution, and concludes that they have never had it so good.

Doctors 'misused figures to back abortions'

By Gordon Rayner

Doctors may have misled the Government in order to keep the 24-week abortion limit, it has been claimed. Your View: Should the 24-week abortion limit be lowered? The Tory MP Nadine Dorries said yesterday that the Royal College of Obstetricians and Gynaecologists (RCOG) had submitted evidence to ministers showing the survival rate at 23 weeks was just 10-15 per cent, when some hospitals recorded survival rates of 40 per cent at 23 weeks and 66 per cent at 24 weeks. Mrs Dorries also criticised the British Medical Association (BMA) for "working it" so that only pro-abortion motions were discussed at its annual conference. Her allegations came before Dawn Primarolo, the minister for public health, appeared before a parliamentary science and technology committee inquiry into abortion. Miss Primarolo told the committee that the Government did not believe there was enough evidence to reduce the upper abortion limit, citing the low survival rate. But Mrs Dorries challenged her, saying there were units where the rates were much higher. She asked: "Do you still feel 24 weeks is the right limit?" Miss Primarolo said: "The [scientific] consensus is still clear with regard to survival rates under 24 weeks. There are improvements in care but the advice is still the same in terms of survival rates." The minister said the Department of Health had been given evidence by a range of organisations, including the RCOG and the BMA. On her internet blog, Mrs Dorries claimed the RCOG had quoted an average UK figure, omitting figures showing that at "good neonatal units" a high proportion of 23-week babies would live. An RCOG spokesman strongly denied misleading the committee. He said: "What we have provided is scientific evidence, which the committee will look at. [Mrs Dorries], on the other hand, has just provided her own opinion." Mrs Dorries argued that Hope Hospital in Salford and University College Hospital in London had survival rates of 42 per cent at 22 weeks and 66 per cent at 24 weeks. However, a consultant at the UCH neonatal unit later told The Daily Telegraph that the figures did not apply to all births at the hospital — only those admitted to intensive care. The number of extremely early babies was very small, making percentages very unreliable. The inquiry paves the way for the Human Tissues and Embryos Act, expected next month, at which both sides of the abortion debate will attempt to amend the 1967 Abortion Act.

Flu vaccines are not helping elderly patients

The Flu jab

 

Flu vaccines are not helping elderly patients and, despite vaccination programmes, the number of hospital admissions due to flu is not being reduced, reported The Times and other newspapers. The study by the Health Protection Agency "will fuel doubts over the effectiveness of the vaccine in older people" the newspaper said, and although the researchers are not recommending an end to the vaccination programme, they suggest other measures should be considered which might reduce hospital admissions such as treating chest infections, improving housing and promoting giving up smoking.

 

This story is based on a study that suggests the influenza vaccination programme in the elderly should be an area for further research. However, this study looked only at people who were already ill, and at the current time there is insufficient evidence from this study alone to conclude that influenza vaccinations are unnecessary for a vulnerable group of the population during the winter period.

 

Where did the story come from? The research was carried out by Dr Rachel Jordan of the Health Protection Research and Development Unit of the Health Protection Agency (based at the University of Birmingham) and other colleagues from the HPA and at Universities and hospitals in Birmingham, Nottingham Derby, and Aberdeen. The main sponsor of the study was the British Lung Foundation. It was published in the peer-reviewed medical journal Vaccine.

 

What kind of scientific study was this? This was a case-control study of sick, elderly people, which aimed to compare those who were admitted to hospital with an acute respiratory illness (cases) with those that presented to the GP with an acute respiratory illness but did not require hospital admission (controls). The participants were part of a larger study that was examining the risk factors for winter hospital admissions due to respiratory illness.

 

The researchers used a group of elderly people aged between 65 and 89 years old who went to the GP with an acute respiratory illness (or acute worsening of a pre-existing condition) between October 2003 and March 2004. The researchers selected six controls for each hospitalised case and these were matched as closely as possible in terms of sex, age and date of GP consultation. They examined GP records to obtain information about medical diagnoses, pneumococcal vaccinations, and whether the patient had received the recommended influenza vaccination for that winter in the three weeks prior to the start of the study.

These results do not "negate the need for influenza vaccine". Rachel Jordan, lead author

All patients included in the study were invited for interview with a nurse to look at social, medical and lifestyle factors. The study excluded patients with dementia and those who were unable to take part in the interview. Of the potential 3,970 people included in the original group, 157 cases and 639 controls were interviewed and included in the study analysis.

 

What were the results of the study? The researchers found there to be no difference in the rates of vaccination between those who were hospitalised for their illnesses and those who weren't; 74.5% of the hospitalised patients had been vaccinated compared with a vaccination rate of 74.2% in patients who weren't hospitalised. The difference remained non-significant even when adjusting for potential contributing factors such as chronic obstructive pulmonary disease (COPD), other medical illnesses, smoking and age.

 

What interpretations did the researchers draw from these results? The researchers conclude that in ill people, influenza vaccine did not reduce the number of hospital admissions due to respiratory illness during a typical winter.

 

What does the NHS Knowledge Service make of this study?

Although this study can provide some data on the effect of flu vaccination on the numbers of hospital admissions due to a respiratory illness over a winter period, several points must be kept in mind when interpreting the study. Newspaper headlines such as "flu jabs fail to cut illnesses" may lead you to believe that this study was looking at whether the vaccination could prevent infection with the influenza virus, which is not the case.

• The study only enrolled people who had presented to their GPs with "an acute episode of respiratory infection or acute exacerbation of pre-existing disease", i.e. people who were already sick. As such, it was designed to answer a very specific question about whether the influenza vaccination reduces "respiratory admissions" (which could include flu or not) to hospitals in those who are ill. The study could not and did not intend to determine whether the influenza vaccination can prevent infection.

 

• Grouping people under a broad definition of presentation – "acute respiratory illness or acute exacerbation of a pre-existing respiratory disease" – means that those with a wide variety of both viral and bacterial infections such as upper respiratory tract infections (coughs, colds, sore throats), influenza, acute bronchitis, infective exacerbations of COPD, and pneumonia would have been included. Through this method, it isn't possible to separate those patients who were admitted specifically for influenza. As the researchers conclude, their study shows that "influenza is not the sole driver of winter respiratory admissions".

 

• There are different types of influenza infection. Influenza is a virus, and different strains circulate during different seasons. Vaccinations are prepared before the flu season starts and are designed to protect against the strains that are predicted to be predominant. It is not always possible to get this 100% correct and the vaccination is always more effective in seasons where it matches well with the strains of virus that are causing infection. The researchers themselves note that "in the 2003–2004 season, the circulating virus showed antigenic drift compared with the vaccine strain". This means that the vaccine would not offer full protection against flu that season. This study cannot be generalised to predict what happens in seasons where the vaccine is fully matched to the viruses that are causing infection in the population.

 

• Controls were matched for age, sex and date of consultation but there are many other factors that could impact upon whether hospitalisation could be required for a respiratory illness, such as presence of asthma, COPD, or having a series of repeated infections.

This study suggests that influenza is not the "sole driver" of admissions to hospital for respiratory infections and that relying on a vaccine to prevent flu in order to reduce the winter bed pressures in hospitals is not sufficient.

 

This study was not set up to determine whether the vaccination works to prevent influenza infection in the elderly. The researchers themselves say that their results do not "negate the need for influenza vaccine, as other studies show small but demonstrable benefits in reducing both infection (an outcome this study did not look at) and subsequent morbidity and mortality in the elderly, particularly in a season where the vaccine is well-matched and there is high viral circulation". The efficacy of the vaccination in preventing infection is a separate issue and we support the call for further well-designed research to answer this question once and for all. The elderly should continue to be vaccinated against flu while this research is being conducted.

 

Sir Muir Gray adds... Hospital admission is determined by many factors, of which the incidence and severity of disease are but two. This does not mean that immunisation should be stopped; if you are offered an immunisation this study should not influence your decision, immunisation does much more good than harm and is still to be recommended.

Links to the headlines

Flu jab 'failing to save the elderly'. The Times, October 24 2007

Flu jabs 'fail to cut illnesses'. The Daily Telegraph, October 24 2007

Winter flu jabs for pensioners 'don't reduce hospital admissions'. Daily Mail, October 24 2007

No point giving flu jabs to over-65s, say doctors. Daily Express, October 24 2007

Flu jab is 'no use' for the old. The Sun, October 24 2007

Links to the science

Original study Jordan RE, Hawkerb JI, Ayres JG, et al. A case–control study of elderly patients with acute respiratory illness: Effect of influenza vaccination on admission to hospital in winter 2003–2004. Vaccine 2007; Sep 21 [Epub ahead of print]

Further reading Rivetti D, Jefferson T, Thomas R, et al. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2006, Issue 3

Analysis by

Edited by NHS Choices

Latest Headlines

Previous articles

• Aspirin works just for men
• New asthma drug on way
• Antibiotics are often unnecessary
• Hope for malaria vaccine
• Alzheimer's blood test breakthrough

Useful links

NHS Choices - flu jab

MEDICAL MATRIX is part of RED CUBE MEDIA LIMITED © 2007, All Rights Reserved. Company No.: 6309631 VAT No.: GB 863 7338 95.

The epidemiology of depressive disorders

Recently, the issue of whether depression is overdiagnosed has been discussed, by two leading Australian authorities, in the British Medical Journal ^1,2,. This timely debate has reignited the controversy about how depressive disorders are diagnosed, and whether the diagnostic criteria are sufficiently accurate, robust and reliable. Few reading this article have not suffered unhappiness at some time. Often such emotional discomfort can be a normal "physiological response" to major stresses and life events. The invisible line, beyond which such sadness becomes pathological, is notoriously difficult to identify. This article considers the arguments for and against the proposition that depression is over diagnosed.

Diagnostic precision may be possible in other branches of medicine; however defining mental ill health continues to pose challenges. Sophisticated investigations, relying on imaging or assays, do not have a role in diagnosing depressive illnesses. The diagnostic and statistical manual (DSM-III)^, published by the American Psychiatric Association, provides the basis for diagnosis in modern clinical psychiatry. DSM-III lists inclusion and exclusion criteria for the diagnosis of mental health disorders. Such a checklist approach, familiar to readers of "pop medical" questionnaires, may be based upon assumptions, and the reliability of DSM-III has been challenged ^{3, 4।}

Over diagnosis risks exposing those who are unhappy to potentially harmful effects of antidepressants, psychotherapy and electroconvulsive therapy¹.

Hickie argues that depression is not over diagnosed and that evidence suggests that prompt intervention can reduce the incidence of suicide ⁵, whilst proving cost-effective^{6, 7}. Therapeutic intervention relies on diagnostic tools with high degrees of specificity and sensitivity. "Tightening" diagnostic criteria, may appeal to epidemiologists and clinical scientists, however it risks denying treatment to the marginalised, who's suffering does not fulfil rigid tick box diagnostic criteria. Hickie cites evidence that increased diagnosis has improved treatment outcomes, leading to improved physical health, social functioning and employability with reduced levels of substance misuse). More widespread recognition of depressive illness may improve understanding about depression, helping to destigmatising mental illness⁸.

Summary

There can be no doubt that depression can be incorrectly diagnosed; conversely, there are many in whom depressive disorders continue to elude health professionals. The pharmaceutical industry will seek to promote new therapeutic agents in their quest to maximise profits. Meanwhile, governments struggle to contain the rising costs of healthcare, and rationing decisions are becoming more explicit. In many nations, as few as 10% of those suffering from depression ever receive treatment⁹. It is critical that we remember that this debate is about real people who are suffering. The government have identified mental health a key priority; mental health has been a Cinderella service for too long. It is essential that the NHS continues to fund treatment for those who may benefit from treatment.

Web resources

www.mind.org.uk

www.rcpsych.ac.uk

References

1. Parker G. Is depression overdiagnosed? Yes. BMJ 2007;335:328



2. Hickie I. Is depression overdiagnosed? No. BMJ 2007;335:329



3. Kirk SA, Kutchins H. The selling of DSM. The rhetoric of science in psychiatry. New York: Aldine De Gruyter, 1992.



4. Parker G. Beyond major depression. Psychol Med 2005;35:467-74



5. Ludwig J, Marcotte D. Anti-depressants, suicide, and drug regulation. J Policy Analysis Manage 2005;24:249-72



6. Simon G, Revicki D, Heiligenstein M, Grothaus L, Von Korff M, Katon, et al. Recovery from depression, work productivity and health care costs among primary care patients. Gen Hosp Psychiatry 2000;22:153-62



7. Sanderson K, Andrews G, Corry J, Lapsley H. Reducing the burden of affective disorders: is evidence-based health care affordable? J Affect Disord 2003;77:109-25



8. Pirkis J, Hickie I, Young L, Burns J, Highet N, Davenport T. An evaluation of beyondblue Int J Mental Health Promotion, Australia's national depression initiative



9. Lee S, Fung SC, Tsang A, Zhang MY, Huang YQ, He YL, et al. Delay in initial treatment contact after first onset of mental disorders in metropolitan China. Acta Psychiatr Scand 2007;116:10-6

Australian has 'world-first' conscious brain surgery

Mon Sep 24, 5:20 AM ET

 

An Australian man was conscious and spoke to his medical team during life-saving brain surgery in what doctors are claiming as a world-first procedure with cutting-edge technology.

 

John James said it was a strange experience to hear the doctors and nurses talking to each other as he lay on the operating table with a 1.5-centimetre (half-an-inch) hole in his head.

But he said he was confident throughout the April surgery to remove an aneurysm from his brain, which threatened to burst and kill him.

 

"The nurses looking after me, they were talking to me," the retired bus driver told a press conference in Canberra. "I could only see bits because I couldn't move my head at all."

"I wasn't worried whatsoever.... I was quite confident all the way through."

 

Doctors asked James to read the words and numbers on flashcards shown to him during the surgery so they knew they were not affecting his vision.

 

The team believes the combination of the technology and the small size of the hole in James's head, as well as the fact he was conscious throughout the operation, makes it a world first.

 

"As far as I'm aware reading the literature, this kind of thing done as a package has never been done before," Canberra Hospital neurosurgeon Vini Khurana said.

"So we were pleased. The result was obviously very good."

 

Virtual reality software, which created a three-dimensional image of James's brain, was used to allow the team to rehearse the operation to drain the blood from the aneurysm.

 

During the surgery, Khurana had a 3-D image of the brain projected onto one side of his eyepiece. On the other side he could see a close-up view of the brain through a microscope.

 

An ultrasound probe was also used to ensure that no more blood was flowing through the aneurysm after the drainage was completed.

 

"The technology we used was quite extraordinary," Khurana said.

 

"It's like GPS navigation that you use in the car being injected into your sunglasses as you drive."

 

James, who has since turned 78, initially went to the doctor because of problems with his vision and dizzy spells and scans revealed the potentially deadly aneurysm.

 

Surgery was required but because the aneurysm was behind his right eye the operation could have blinded him, which is why the doctors wanted him awake during the procedure.

 

The great-grandfather, who was sent home two days after the operation, said he felt fine after the surgery.

 

"I had to sit for an hour to make sure everything was alright," he said. "I just came back to normal after that."

PM in pledge to beat hospital bugs

 

Press Assoc. - Sunday, September 23 06:02 am

 

Gordon Brown has set the stage for his first Labour Party conference as leader with a pledge that every hospital in the country will undergo a ward-by-ward "deep clean" in a bid to drive out superbugs from the NHS.

A buoyant Prime Minister arrived in Bournemouth on Saturday amid a swirl of speculation that he will capitalise on his opinion poll lead to call a snap general election this autumn.

 

That speculation was intensified by an ICM poll for the Sunday Mirror which put Labour on 39%, six points ahead of the Tories on 33%, with the Liberal Democrats on 19%.

 

The findings suggest that Labour has emerged from the Northern Rock crisis with its reputation for economic competence intact.

 

Chancellor Alistair Darling will tell the conference that through its "strength of purpose" the Government has built "one of the strongest economies in the world".

 

The confidence coursing through the party was graphically illustrated by Foreign Secretary David Miliband, who suggested that it was now looking forward to a second decade in power.

 

"We didn't solve all the problems of the world in 10 years in government. Well, this is a party that is planning how it is going to use the next 10 years to go further towards solving them," he told The Observer.

 

The Prime Minister refused to be drawn on whether he intended to go to the country this autumn, telling The Sunday Times: "My focus is and will remain on the work that needs to be done".

 

He was, however, swift to launch his first policy initiative, promising that over the next 12 months all hospitals would be restored to a pristine state of cleanliness to rid them of MRSA and C-difficile.

 

Officials said that it would be up to individual NHS trusts to decide how the cleaning programme was implemented. However, it is thought wards could be closed for a week at a time while they are systematically cleansed.

MEDICAL MATRIX readers can you assist with TV documentary?

Tiger Aspect productions are one of the UK's leading independent television production companies, responsible for respected and varied factual output (the Monastery, Seaside Parish, Diet Doctors and more).

We are currently focusing on a feature dealing with people who suffer from excess sweating (hyperhidrosis). We are looking for case studies who would be willing to discuss with us the issues they have faced and the treatments they have used to combat the problem. We are looking for a variety of experiences. If you suffer from the problem or have a story relating to excess sweating we would love to hear from you.

Of course we understand that this is a delicate subject and we can confirm that any contact with ourselves is in strict confidence, there is no obligation to be part of the program and no information will be shared or broadcast without permission from the case study.

Please email - duncanthompson@tigeraspect.co.uk

Alternativly please call Duncan Tompson on: 0207 434 6909