At last, NHS GPs told they MUST check for brittle bones in victory for osteoporosis campaigners
Hundreds of thousands of osteoporosis sufferers are to get a better deal from the NHS.
GPs will have to give new priority to identifying and treating patients with the bone thinning disease under changes to their contracts.
The deal is being hailed as a success for campaigns to highlight the terrible toll of the disease by the Duchess of Cornwall, president of the National Osteoporosis Society, and the Daily Mail.
Incentives which come into force in April next year mean for the first time that GPs’ pay will partly depend on checking for osteoporosis among their patients.
They will have to ensure that patients who break a bone no longer go unnoticed but are followed up with a referral to a fracture clinic for diagnosis and treatment.
Only one in three local health trusts runs fracture liaison services to act on the first ‘warning’ break and help prevent it happening again, according to an audit by the Royal College of Physicians.
The changes are expected to lead to GPs giving an important boost to such clinics by insisting on follow-up checks.
The NHS guidelines body, the National Institute for Clinical and Healthcare Excellence, has recommended that the system for determining GPs’ pay includes osteoporosis as a priority.
This would mean recording fractures and drug treatment for patients diagnosed with the disease. But the advice was ignored until recent campaigns hit the headlines.
Camilla, Duchess of Cornwall, told the Mail of her ‘horror’ at watching her mother ‘die a slow and agonising death’ from osteoporosis, a condition she said was often ignored as an ‘old woman’s disease’ by the medical profession.
Osteoporosis causes ‘silent’ loss of bone, often with no obvious symptoms until a simple fall results in a broken wrist, shoulder, spine or hip.
The National Osteoporosis Society said the move will lead to a much more pro-active approach to the diagnosis and treatment of the disease.
NOS chief executive Claire Severgnini said: ‘We are delighted that osteoporosis will be included in the new GP contract. This is absolutely the right decision.
‘Unnecessary fragility fractures will be reduced, premature deaths due to hip fractures will fall, and millions of pounds will be saved by the NHS. At last, common sense has prevailed.’
Osteoporosis affects an estimated three million people in the UK, and every year there are 300,000 fractures due to fragile bones, many of which could be prevented.
Don’t teach the ‘Queen’s English’ to foreign language students, linguist urges
The guy below is off his head. He is right that English is used in many nations in a way that diverges from standard English — but have you ever tried to understand (say) Indian English? It can get close to impossible. I have even seen signs up outside shops in Bombay saying “Indian English only spoken here”. The Indians themselves know the difficulties concerned. If the aim is to communicate with other English-speakers, standard English must be taught, despite small differences between British and American usage.
The very idea of there being a standard English will no doubt arouse great huffing and puffing from the guy below but if there is no such thing, how come these comments written in Australia will be completely understood in the USA, the UK, Ireland, Canada and New Zealand — places literally worlds apart?
Update: I suppose that the “linguist” below MAY simply have been speaking about the accent that is taught, though it does not appear so. Accents CAN indeed be a problem. A Northern English person who visited a shop in the South and asked for “booblegoom” (where “oo” is pronounced as in “look”), could well be not understood at all — even if all he wanted was bubble gum.
But in practice that problem rarely arises. Most English learners outside Britain itself learn a generic version of American English pronunciation
People learning the English language around the world should not adopt the ‘Queen’s English’, a linguist said today.
Dr Mario Saraceni, of the University of Portsmouth, called on native English speakers to ‘give up their claim to be the guardians of the purest form of the language’.
He argued that the ways it has been used and changed by millions of people around the world are equally valid.
Writing in the latest issue of the journal Changing English, he suggests the way English is taught to non-native speakers, but whose mother tongue is English, needs a dramatic change. He said: ‘It’s important the psychological umbilical cord linking English to its arbitrary centre in England is cut. ‘The English are not the only legitimate owners of the language.
‘English is the most dominant language on the planet and though it is spoken widely in the western world, westerners are in the minority of English language speakers.
‘For many around the world, the ability to speak English has become as important as knowing how to use a computer. ‘But the myth of the idealised native speaker needs to be abandoned. ‘How it is spoken by others should not be seen as second best.’
Dr Saraceni, of the School of Languages and Area Studies, said it was time English language teachers abroad took down posters of double-decker buses and Parliament Square from their classrooms and taught English in a purely local context.
He said: ‘Critics might feel uncomfortable with what they see as a laissez-faire attitude but language use is not about getting closer to the ‘home’ of English, and it is not about bowing deferentially and self-consciously to the so-called superiority of the inner circle of the UK, US, Australia and New Zealand.
According to Dr Saraceni, the widely-held view that English has spread around the world from its original birthplace in England can be challenged.
He said: ‘The idea seems natural and unquestionable, but if you examine it closer it is patently untrue. ‘It is impossible to identify any point in history or geography where the English language started – one can talk only of phases of development.
‘The origins of English are not to be found in the idea of it spreading from the centre to the periphery, but in multiple, simultaneous origins. ‘The concept of a single version of any language is always questionable.’
Dr Saraceni said that English had been ‘reincarnated’ throughout the world, including in Malaysia, India, China and Nigeria, and therefore England should not be seen as the linguistic ‘garden of Eden’ where the language was pure and perfect.
The de-Anglicisation of English needs to take place primarily in classrooms and the ‘whole mystique of the native speaker and mother tongue should be quietly dropped from the linguist’s set of myths about the language’, he said.
Betrayal of the family: Despite all those Tory promises, fathers and grandparents will still be denied the right to see children after a divorce
Fathers and grandparents will not be given any legal right to see children after a break-up, under the biggest changes to family law in a generation.
In what was immediately denounced as a ‘betrayal’ of the family, a major report today rules against giving men shared or equal time with their children when a relationship ends.
It suggests fathers will even be denied the legal right to maintain a ‘meaningful relationship’ with their families, as this ‘would do more harm than good’.
The review also kicks into touch Coalition pledges to make it easier to maintain contact with grandchildren when parents separate, a problem that usually affects those on the father’s side.
The long-awaited Family Justice Review was branded a ‘monstrous sham’ that undermines David Cameron’s pledge to lead the most family-friendly government in history.
The independent report was commissioned by ministers to examine the case for reform of a family law system repeatedly accused of putting rights of mothers over those of fathers and grandparents.
But its proposals – likely to form the basis of future government family policy – sparked an immediate Cabinet revolt.
Allies of Work and Pensions Secretary Iain Duncan Smith said he would fight to ensure the Government’s response – due to be published in January – will do more for fathers and grandparents.
A source close to the Cabinet minister said that the findings were ‘absurd’, warning that they undermined attempts to tackle the generation of fatherless youths blamed for the summer’s riots.
But Justice Secretary Ken Clarke is expected to back the review, chaired by former civil servant and Marks & Spencer executive David Norgrove.
His report was commissioned by Labour and dismissed by the Tories in Opposition as inadequate but will now form the basis of Coalition legislation.
The review comes against a backdrop of soaring divorce rates and increasing numbers of children being born out of wedlock, often to co-habitees who are more likely to break up than married couples. Last year there were almost three million children aged under 16 living in a lone-parent household – or 24 per cent of the total.
Mr Norgrove’s findings fly in the face of studies showing that it is best for a child to have extensive access to both its father and mother. The report says: ‘No legislation should be introduced that creates or risks creating the perception that there is a parental right to substantially shared or equal time for both parents.’
Mr Norgrove has even watered down his own interim report, published in March, which said there should be a legal presumption that children should have a ‘meaningful relationship’ with both parents.
Mr Norgrove believes that enshrining such rights in law could slow down already lengthy and expensive custody cases. Instead, the courts will simply have to consider the benefits of a meaningful relationship when they decide where children should live and how often they should see each parent.
The final report flatly rejected claims by fathers’ rights groups that the current system is biased – despite figures showing that 93 per cent of custody battles are won by the mother.
Nadine O’Connor, of the Fathers 4 Justice campaign group, said: ‘The review is a monstrous sham and a bureaucratic exercise in improving the efficiency of injustice. It will feed the epidemic of mass fatherlessness and lead to further social unrest. ‘This report condemns children to a life without fathers with catastrophic social consequences.’
The report also contradicts pledges by senior officials earlier this year that grandparents would be given far greater rights. Instead, they will still have to apply to court twice to see their grandchildren: once for the right to begin a case and then to seek access to their loved ones. The Norgrove panel merely issued a tepid recommendation that their role should be ‘emphasised’.
Instead of legal protections for fathers and grandparents, the Norgrove report laid out plans to encourage parents to settle disputes before they get to court.
All parents will be given advice on drawing up ‘parenting agreements’ to divide the care of their children.
James Deuchars, of Grandparents Apart UK, said: ‘The Tories said before the election that grandparents were going to have more rights. This is a betrayal of that promise. It was all a con and a gimmick. ‘This report is trying to do away with the traditional family. The result will be more bitter and disillusioned young boys who join gangs.’
A source close to Mr Cameron said the Government has ‘certainly not’ pledged to adopt all the report’s recommendations. But a source close to Mr Clarke described it as ‘an authoritative account of the problems and a thoughtful look at the solutions’.
The report also said no childcare case should last more than six months and recommended the creation of a Family Justice Service to focus the work of all agencies for the 500,000 children and adults caught up in the family courts each year.
British selective schools win the freedom to expand: Rule change could see 50 per cent more pupils in them
Huge demand for taxpayer-supported selective schooling, not least because an academic ability test before admission would screen out the most disruptive children, usually of African ancestry
Grammar schools are expected to expand their intake by as much as 50 per cent by 2018. Ministers announced yesterday that powers allowing councils to cap the number of places state schools can offer will be scrapped.
As a result many grammars, which dominate league tables for GCSE and A-levels, are expected to boost their intake by at least a sixth by 2013. By 2018 they are predicted to rise by up to 50 per cent from current numbers, equivalent to each grammar taking on three extra classes in each year.
The lifting of the cap in the new schools admissions code is also expected to see a surge in the number of ‘titan’ primary schools: schools which teach 800 pupils or more.
The announcement caused dismay among education experts who believe the optimum number of pupils at a primary is around 400. They criticised the Coalition’s ‘pack them in and pile them high’ approach to education.
The predicted expansion of grammar schools is likely to harm private schools, because many parents send their children to a fee-paying school only after they have failed to gain a free place at a grammar school. The most popular grammars, or selective state schools, currently have up to ten applications for every place.
There are 158,000 pupils currently at grammar schools – nearly 5 per cent of the secondary school roll. A 50 per cent increase in pupils would see them overtake private schools.
At present the number of places grammars can offer is restricted by local councils, which fear the expansion of selective state schools will mean more of the brightest pupils are cherry-picked, making comprehensives in the area less successful.
The scrapping of these powers from 2013, announced by schools minister Nick Gibb, is likely to reignite the bitter row over grammars within Tory ranks. Despite pressure from the Tory backbenches, the Coalition has refused to increase the number of grammar schools in England – currently 164.
Another major impact of the new admissions policy is predicted to be a rise in the number of children educated in titan primary schools.
A surging population fuelled by immigration is placing increasing strain on schools, and it is predicted that 350,000 extra primary places will be needed by 2015 and 500,000 by 2018.
Based on a typical roll of 400 pupils, the Coalition would need to build some 1,250 primaries by 2018, costing an estimated £5.2billion.
This prohibitive cost will, it is argued, lead to more pupils being squashed into existing schools, turning them into titan schools.
Currently schools must battle red tape and bureaucracy to increase their capacity – often to have the plans vetoed by their local authority.
Professor Alan Smithers, director of the Centre for Education and Employment Research at Buckingham University, said of the change: ‘It is unclear how we are going to cope with this increase. But it would be very sad if packing them in and piling them high is the sole solution. ‘Youngsters need to receive individual attention. Young people can get very lost in enormous schools. What we desperately need is more schools, not larger schools.’
At present, there are some 20,000 youngsters taught in titan primaries, up from 9,000 in 1997 when Labour took power and up 43 per cent in the last year.
The Department for Education insisted the changes to the admissions code were not intended to solve the shortage of places.
Thousands of Welsh, Scottish and Irish lives could be saved if residents followed the English diet, claims research
This assumes that the Celtic fringe is the same as England genetically — a claim that would be heartily denounced in the Celtic nations concerned. It also assumes that the climate is the same, which it is not. Large numbers of English people live in the climatically mild South whereas the climates in the Celtic fringe are generally more severe. The dietary differences mentioned are NOT associated with increased overall mortality. Salt and fat are good for you or at least harmless. See the sidebar here
Many thousands of fatal illnesses could be avoided in Scotland, Wales and Northern Ireland – if they would only adopt the diet of their English neighbours.
As many as 80 per cent of preventable deaths from the biggest killer diseases would be eliminated if the rest of the UK followed England’s nutritional habits, according to new research.
But experts say that this does not give the English ‘bragging rights’, as even they are not eating a very balanced diet. They have proposed a ‘fat tax’ to improve the diet of the UK as a whole and reduce regional inequality in health.
The research showed that people in Scotland, Wales and Northern Ireland consistently eat more calories, more fat and more salt than those living in England, and fewer fruit and vegetables.
Eight out of 10 unnecessary deaths from cancer, heart disease and stroke in Wales and Northern Ireland – and four in 10 of those in Scotland – could be prevented if people ate the ‘average’ diet in England.
Analysis of diets between 2007 and 2009 found that, on average, people in Scotland and Northern Ireland also ate 7.5g of salt daily compared to 7g in England, while those in Wales ate 7.4g.
Salt increases blood pressure and the risk of heart disease and stroke. Those in Northern Ireland, Scotland and Wales also ate more fat and saturated fat and less fruit.
People in Scotland ate about 951g of vegetables a week, while those in Northern Ireland ate 902g, compared to the higher 1,190g in England.
Experts from the University of Oxford and the John Radcliffe Hospital in Oxford also looked at 10 cancers associated with diet, including those of the gullet, bowel, and stomach.
They noted that death rates for heart disease, stroke and cancer are higher in Scotland, Wales, and Northern Ireland than they are in England.
Calculations showed that between 2007 and 2009, just under 22,000 more people died in Wales, Scotland, and Northern Ireland from stroke, heart disease and diet-related cancers than would be expected if death rates were as low as in England.
Over the period, 3,005 deaths in Wales, 6,353 in Scotland and 1,890 in Northern Ireland could have been ‘delayed or averted’ if the English diet was adopted, the study found.
The authors concluded: ‘Diet has a substantial impact on geographical variations in mortality from coronary heart disease, stroke and various cancers within the UK.’
They said identifying ‘fiscal initiatives aimed at increasing the cost of foods high in saturated fat (so called “fat taxes”) may be best placed to reduce geographical inequalities in health if they are paired with subsidies for fruit and vegetables.’
Victoria Taylor, senior dietician at the British Heart Foundation, said: ‘This research isn’t about bragging rights to the English or tit-for-tat arguments about how healthy our traditional dishes might be.
‘Saying the rest of the UK should follow England’s lead to cut heart deaths isn’t a foolproof solution – a quarter of English adults are obese and only 30 per cent eat their five-a-day.’ [Five a day is a goal made up in an American advertising agency. It has no double-blind support]
Cherry juice can help get a good night’s sleep
This is a small study over a short period of time: A pilot study only. A full study would need to address habituation and side-effects. The stuff could for instance contain a lot of anti-oxidants, which have been shown to shorten lifespans. See the sidebar here
Drinking cherry juice can help you sleep an extra 25 minutes a night, a study has found.
The research also found that people who have regularly consume cherry juice have improved quality of sleep.
Researchers from the School of Life Sciences at Northumbria University have found that Montmorency cherry juice significantly increases the levels of melatonin in the body, the hormone which regulates sleep.
Their findings could benefit those who have difficulty sleeping due to insomnia, shift work or jet lag.
In the study, led by Dr Glyn Howatson, 20 healthy volunteers drank a 30ml serving of either tart cherry juice or a placebo juice twice a day for seven days.
Urine samples were collected from all participants before and during the investigation to determine levels of melatonin, a naturally occurring compound that heavily influences the human sleep-wake cycle.
During the study the participants wore an actigraphy watch sensor which monitored their sleep and wake cycles and kept a daily diary on their sleeping patterns.
The researchers found that when participants drank cherry juice for a week there was a significant increase in their urinary melatonin (15-16%) than the control condition and placebo drink samples.
The actigraphy measurements of participants who consumed the cherry juice saw an increase of around 15 minutes to the time spent in bed, 25 minutes in their total sleep time and a 5-6% increase in their â€˜sleep efficiency’, a global measure of sleep quality.
Cherry juice drinkers reported less daytime napping time compared to their normal sleeping habits before the study and the napping times of the placebo group.
According to Dr Howatson, this is the first study to show direct evidence that supplementing your diet with a tart Montmorency cherry juice concentrate leads to an increase in circulating melatonin and provides improvements in sleep amongst healthy adults.
Dr Howatson, an exercise physiologist, said: “We were initially interested in the application of tart cherries in recovery from strenuous exercise. Sleep forms a critical component in that recovery process, which is often forgotten.
These results show that tart cherry juice can be used to facilitate sleep in healthy adults and, excitingly, has the potential to be applied as a natural intervention, not only to athletes, but to other populations with insomnia and general disturbed sleep from shift work or jet lag.”
The study’s co-authors are fellow Northumbria University academics Dr Jason Ellis, director of the Centre for Sleep Research, School of Life Sciences PhD students Jamie Tallent and Phillip Bell; Benita Middleton of the Centre for Chronobiology at University of Surrey; and Malachy McHugh of the Nicholas Institute of Sports Medicine and Athletic Trauma in Lenox Hill Hospital, New York.
Dr Ellis said: “Although melatonin is available over the counter in other countries, it is not freely available in the UK. What makes these findings exciting is that the melatonin contained in tart cherry juice is sufficient to elicit a healthy sleep response.
“What’s more, these results provide us with more evidence surrounding the relationship between how we sleep and what we consume.”
The findings will be published this week in the online edition of the European Journal of Nutrition,