Brain virus kills ‘depressed’ woman
A British woman died from a rare brain virus after being told by doctors that she was simply depressed because she had not had a baby, a coroner’s investigation heard.
Jane Harrop, 30, went to the hospital in February last year with severe head and neck pains after collapsing suddenly but was told she had a migraine, the Birmingham Mail reported overnight.
In the months leading up to her collapse, Harrop complained of violent headaches nine times to doctors, who gave her antidepressants and did not refer her for tests, Birmingham Coroner’s Court heard.
“The (doctor) thought she was depressed because she was trying for a baby and hadn’t had one. Jane was a happy-go-lucky character – I didn’t think she was depressed. She said her brain felt like it was being crushed,” according to Harrop’s mother, Linda Cook.
Harrop, who cared for multiple sclerosis patients in their homes, died eight days after she was taken to Good Hope Hospital in Sutton Coldfield, where a brain scan was delayed for five days because she felt claustrophobic and staff had no way of sedating her.
She was not transferred to a specialised brain unit at a nearby hospital because of a lack of beds, the court was told.
Pathologist Dr Martin Carey said Harrop’s death was caused by inflammation of the brain and spine by a virus that took hold over a period of at least two months. Headaches are the first sign of sub-acute meningo-myeloencephalitis, Dr Carey said.
Another patient on the ward, Jean Paul, said nurses ignored Harrop’s screams of pain during her final night alive. “She was screaming in pain and shouting for help, but no one came to her,” said Mr Paul. “I was disgusted at the way the poor woman was left.”
Are NHS dentists yanking out teeth just to save cash?
When Kate Reeve went to her NHS dentist with a problem tooth two years ago, she was told the only option was to have it removed. The molar in the top left of her mouth was crumbling after a filling had partly fallen out and become infected.
‘I had left it a bit too long before going to the dentist,’ says Kate, 36, a designer from Oxford. ‘I could see the filling was crumbling, but it hadn’t fallen out. ‘My tooth was hurting and I couldn’t eat on that side, but I wasn’t able to get to the dentist for a month.’
After he’d cleaned it out, the dentist told Kate the only treatment available on the NHS was to have the tooth removed, at a cost of £40 plus £200 for a bridge. However, if she spent £400 she could save the tooth by having root canal treatment privately.
‘I am only in my 30s and the thought of having a gap in my teeth was unthinkable,’ she says. She thought paying for a bridge seemed pointless if by spending a bit more she could save the tooth. ‘So I decided to have the treatment privately.’
Kate’s experience is far from unique. Two million people have a tooth removed on the NHS every year, but leading dentists are concerned that some teeth are being taken out unnecessarily. They argue that keeping your own teeth is better for your oral health and often cheaper.
The problem is partly that many people are unaware that infected teeth can be saved. ‘When a tooth is compromised, root canal treatment can be a really good way of saving it,’ says Dr Susie Sanderson of the British Dental Association.
However, there is anecdotal evidence that some dentists are not offering it on the NHS because of the cost and time it takes.
The treatment involves a two-hour procedure (in one or two sessions) under local anaesthetic. The pulp section of the tooth (a hollow section where the nerve is) is cleared out, disinfected and filled with a material based on latex.
The procedure removes the nerves and blood supply from inside the tooth, so it is effectively dead and more brittle afterwards — that’s why a crown or cap is often advised to strengthen it.
A million of these procedures are performed every year on the NHS, costing £47 each, plus £204 if you go on to have a crown or denture to strengthen the tooth. Privately, it costs between £650 and £1,800. If the tooth has to be removed, the gap is often filled by a bridge, denture or implant.
But the Saving Teeth Awareness Campaign argues that anything artificial in the mouth can cause problems. A denture, which is taken in and out of the mouth, can become dirty and infected, and to have a bridge put in, the teeth on either side have to be drilled to fasten it into place and this can damage them.
The problem is that an NHS dentist in England receives the same payment — between £45 and £75 — if they remove a tooth or carry out root canal treatment. However, an extraction takes between ten and 15 minutes while root canal treatment may involve several visits, requiring X-rays, consultations and treatment using expensive equipment.
This disparity in the amount of time and expertise it takes to carry out the treatments has led some dentists to offer only tooth removal on the NHS. ‘There is not a financial incentive to sit the patient down and say let’s save the tooth,’ says Dr Malcolm Harbour, a dentist from Ipswich with 30 years’ experience in the NHS and privately. ‘However, most dentists will try to do the best for the patient irrespective of financial pressures.’
Indeed, experts accept that some patients will opt for removal because they see it as a quick and easy way of getting rid of pain. ‘People who are anxious will often avoid dental treatment and want to have teeth extracted rather than attend the extra appointments needed for root canal,’ says Tim Newton, Professor of Psychology as applied to Dentistry at Kings College London.
Evidence also suggests that if the only option is private dental treatment to save a tooth, many patients will opt for an extraction because it is cheaper.
The good news is that the NHS dental system is set for change. A new approach is being piloted in 62 practices across England that assesses the time spent with patients and the quality of the care they receive, instead of only counting the number of treatments, which some say has led to a ‘drill and fill’ approach. The new system will pay dentists according to the quality of care they provide rather than the number of treatments carried out.
Dentists will have to monitor patients’ dental health and show it is improving. And up to 10 per cent of their pay will be determined by the quality of the work they carry out.
This approach should mean dentists have greater freedom to use their clinical judgment to decide what’s in their patients’ best interests, rather than being driven by targets.
However, until any changes are introduced (in 2014, if the pilot scheme is successful), experts hope that by giving patients more information about the choices available will mean more people should keep their teeth.
For Kate, root canal treatment meant two visits to the dentist. While she is delighted she opted for it, she believes it’s unfair that in some cases only people who can pay can save their teeth. ‘For many people, it’s a lot of money that they can ill afford. Everyone should have the option of being able to keep their own teeth.’
So prison DOES work: Criminals who spend longer behind bars are less likely to reoffend
Prisoners who spend longer behind bars are less likely to return to crime when they are let out, a report revealed last night. Reoffending rates fell sharply when criminals were sentenced to up to four years instead of just one or two, a Ministry of Justice study found.
The report will reignite the row about whether ‘prison works’. Defenders of tougher sentences said the study – the first of its kind – showed prison had a powerful ‘deterrent effect’.
Dr David Green, director of the Civitas think-tank said: ‘This seems to show that for people who merit prison, the longer you keep them there the better. As well as protecting the public while they are there, there is also a deterrent effect on release.
However, the report also provides backing for Justice Secretary Kenneth Clarke, who has criticised the failure of prisons to rehabilitate inmates jailed for short periods.
The report found the highest reoffending rates were among inmates given sentences of up to 12 months and who do not have access to prison rehabilitation programmes.
Last night Mr Clarke said it was a ‘national scandal’ that nearly half of all offenders reoffend within a year of release. He said: ‘Prisons need to be places of hard work, not idleness, and both prison and non-custodial sentences need to do much more to properly address the serious underlying causes of crime such as drugs and mental illness.’
The report compared offending by ‘like for like’ criminals jailed for similar offences.
Nearly 60 per cent of those sentenced to less than a year behind bars in 2008 committed another crime within a year of release. That compared to a 51 per cent of those given community service. Criminals handed terms of between one year and two had reoffending rates of 43 per cent. But the likelihood of committing further crimes was seven per cent lower for those handed longer terms of up to four years.
Mr Clarke has promised a ‘rehabilitation revolution’ aimed at cutting reoffending and he wants to expand the use of community service. But critics have branded him ‘soft on crime’ and attacked moves to reduce the prison population by 3,000 by 2015.
Blair Gibbs, the head of crime and justice at the Policy Exchange think-tank, said: ‘These figures – although only a partial picture – do confirm that the longer the prison sentence the lower the reoffending rate after release.
British employment tribunal jackpots face axe: Plan to limit discrimination at work claims
Excessive payouts in sex, age or race discrimination cases could be reined in under Government plans. Employment minister Ed Davey will today float plans to end the tribunal jackpot system, which can see businesses crippled by penalties running to hundreds of thousands of pounds.
And, in a major review of workplace law, he will outline plans to slash the amount of time employers have to consult staff before making them redundant.
But, in a move likely to alarm businesses, the Lib Dem minister will announce that the right to request flexible working and shared parental leave will be brought in by 2015 – much earlier than thought.
Just two months ago, his boss, Business Secretary Vince Cable, indicated that the plan had been shelved. Mr Cable has already announced plans to make it much harder for workers to claim compensation for unfair dismissal in employment tribunals.
Now ministers are to extend the restrictions to claims for workplace discrimination on the basis of employees’ race, sex, disability or sexuality.
Mr Davey will announce plans to reconsider awards that ‘encourage people to take weak, speculative or vexatious cases in the hope of a large payout’. Payouts are presently unlimited. The biggest was £729,347 in a disability discrimination case. For sex discrimination the top award was £442,266, and the most successful race discrimination claimant won £374,922.
Last year saw a 36 per cent increase in claims for age discrimination, 40 per cent up for race, 18 per cent up for discrimination on sexual orientation, and 20 per cent for religion or religious belief.
The average payout for race discrimination is £18,600, £19,500 for sex discrimination, £52,100 for disability discrimination, £4,900 for religious discrimination, £20,400 for sexual orientation discrimination and £10,900 for age discrimination.
Just one mistake by a small company can see them having to make a huge payout – putting their future under threat. The proposals could risk a battle with the unions. But the Coalition argues that disgruntled staff and their lawyers are exploiting the lax rules to make exorbitant claims.
Mr Davey will say: ‘The areas we are reviewing are priorities for employers. We want to make it easier for businesses to take on staff and grow. ‘We will be looking carefully at the arguments for reform. Fairness for individuals will not be compromised – but where we can make legislation easier to understand, improve efficiency and reduce unnecessary bureaucracy, we will.’
Plans could include imposing a limit on payouts, or making employees pay a fee before bringing a tribunal claim. The review will also look at reducing the length of consultation over collective redundancy, which currently has to last a minimum of 90 days.
Mr Davey will say this can hinder firms’ ‘ability to restructure effectively and retain a flexible workforce’, leading employers to ‘worry about how long they need to keep paying staff after it has become clear that they need to let them go’.
The review will look at rules which protect employees’ terms and conditions when a business is transferred from one owner to another.
And Mr Davey wants to introduce rules to make work more flexible. His plans to extend the right to request flexible working and introduce shared parental leave would make it easier to work while bringing up a family.
Munro Review: British social workers ‘to face random checks’
It’s a start
Social workers will face random checks under major Government plans to improve England’s failing child protection system. A review published today will recommend unannounced inspections of social services units in an attempt to prevent a repeat of the Baby P tragedy.
The report by Prof Eileen Munro will also call for swathes of paperwork currently completed by social workers to be axed to give staff more time with families and vulnerable children.
Experienced social workers will also be kept on the front line – instead of being given back office jobs – to take a lead on the most demanding cases and supervise junior staff.
The overhaul comes in a wake of a series of high-profile child deaths in recent years. This includes the killing of Baby P – Peter Connelly – who was tortured to death in Haringey, north London, despite being seen by 28 different social workers, doctors and police officers.
In today’s report, Prof Munro, an expert in social policy at the London School of Economics, will criticise the amount of central bureaucracy in the system, saying staff spend too much time “ticking boxes” rather than working in the community.
Existing guidance that social workers must follow is now 55 times longer than it was in the mid-70s, her report says. “Too often questions are asked if rules and procedures have been met but not whether this has helped children. Everyone in the profession can think of meetings and forms that don’t actually make a child safer,” said Prof Munro.
Her report will call for unannounced inspections of social services units by Ofsted to prevent departments spending weeks preparing for visits. Ofsted will also be stripped of the power to scrutinise official reports into the suspicious deaths of children because its approach is too formulaic.
Greater scrutiny will be made of so-called serious case reviews by making them open to the public for the first time, she will say, although they will also be monitored by a new expert panel.
Her review came as Theresa May, the Home Secretary, confirmed on Monday that the policing body responsible for protecting children is to merge with the new National Crime Agency. But in a key concession, the Government insisted the Child Exploitation and Online Protection agency (Ceop) agency would retain its own identity following concerns that child safety could be put at risk.
Jim Gamble, Ceop’s previous head, resigned in protest over the planned move last year warning it was not in the “best interest” of vulnerable children.
Concerns were also raised by Gerry and Kate McCann, the parents of missing Madeleine McCann, and Sara Payne, the mother of murdered eight-year-old schoolgirl Sarah.
Despite the merger, Ceop will now retain its name, operational control and a separate budget and governance structure.
How a good education can keep you younger for longer
As usual, we have below hasty assumptions about the direction of causation. A more reasonable explanation comes from the fact that IQ seems to be one aspect of general biological fitness. On average, high IQ people have it all healthwise and live longer too. And IQ is highly correlated with educational success. So high IQ people stay longer in the educational system but it is not education that leads to longer life. High IQ does
Your parents and teachers will no doubt have lectured you on the value of a good education. But it seems the advice may apply to more than just career prospects. Those who pass more exams before leaving formal education stay biologically younger than their years, according to researchers.
In contrast, those who leave education with fewer qualifications are prone to age more quickly, with their lack of achievement leaving a lifelong mark.
The pattern is not changed by social and economic status later in life, the findings suggest. The study, by researchers from University College London, examined the length of ‘telomeres’ from around 450 office workers. Telomeres are protective strips of DNA that form tiny ‘caps’ on the ends of chromosomes, protecting against ageing processes.
They have been called the ‘chromosomal clock’ because they appear to be central to biological ageing. Longer telomeres are a sign of being biologically younger and healthier.
Participants were separated into four groups according to whether they had no qualifications, or, when leaving formal education, had O-levels, A-levels or a degree. The results showed people with lower educational attainment had shorter telomeres, suggesting they may age faster.
The study found telomere length increased with each stage of educational attainment, suggesting ageing slows and health improves the more qualifications are attained.
The study, funded by the Medical Research Council and the British Heart Foundation, is published online today in the journal Brain, Behavior, and Immunity.
Professor Stephen Holgate, chairman of the MRC’s Population and Systems Medicine Board, which funded the research, said the study backed up the longstanding message that ‘your experiences early in life can have important influences on your health’.
Andrew Steptoe, BHF professor of psychology and the lead author of the study, added that ‘long-term exposure to the conditions of lower status’ was behind faster cellular ageing, not current income.
The researchers were based primarily at UCL, but also collaborated with Professor Jorge Erusalimsky from the University of Wales Institute, Cardiff and Professor Elizabeth Blackburn from the University of California, San Francisco.
The subjects of the study were drawn from participants in the Whitehall II study, set up in 1985 to investigate the importance of social class for health by following more than 10,000 men and women working in the civil service.
Professor Jeremy Pearson, associate medical director at the BHF, said: ‘This research reinforces the need to tackle social inequalities to combat ill health.’