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  1. How inductions benefit new doctors

    New doctors perform significantly better if they undergo inductions before starting work in August, according to a new study.

    Graduates learn to put vital clinical skills into practice on induction days, according to a study by Birkbeck College.

    Inductions are one of a range of measures that hospitals have introduced to try to reduce the effect of new doctors starting work in August.

    According to researcher Dr Caroline Kamau, average hospital efficiency falls by up to 7.2% after the new doctors take up their posts.

    Her study, reported in Clinical Medicine, shows that new doctors who under induction prove substantially better than others at clinical procedure tests.

    Without induction, some 96% of new doctors failed one or more of these tests. These include intravenous line insertion, drug administration, certification of death, prescribing and catheterisation.

    Dr Kamau said: "There is value in scheduling inductions before doctors report for their first day on the job. Doing this can help solve the hospital efficiency problem that is responsible for the August effect.

    "Inductions look like a worthwhile intervention in clinical contexts that, unlike surgery and Intensive Care Units, currently have no stringent buffers against reduced efficiency in August."

    She added: "The NHS and health organisations in other countries should reconsider the timing and content of clinical skills inductions. Inductions before day one on the job could save lives.”

    Clinical Medicine August 2014

  2. Search for new diabetes treatment

    Researchers may have found a new clue to the causes of diabetes - opening up the way to new treatments to prevent the disease, it was announced yesterday.

    The researchers say they could have medicines ready for clinical trials within two years.

    Their findings apply to both type 1 and type 2 diabetes.

    The work has taken 20 years at the University of Auckland, New Zealand, and is being led by a professor at Manchester University, UK, Professor Garth Cooper.

    The pancreas produces insulin but the research has centred on a second hormone produced by the organ - amylin.

    The researchers say the destruction of the pancreas that causes diabetes is caused by toxic clumps of amylin. The accumulation of these clumps is faster in type 1 diabetes, which tends to be developed in childhood.

    The latest findings were published in the FASEB Journal.

    A spokesman for Manchester University said: "Professor Cooper’s group expects to have potential medicines ready to go into clinical trials in the next two years and it is anticipated that these will be tested in both type-1 and type-2 diabetic patients.

    "These clinical trials are being planned with research groups in England and Scotland."

    The pathogenic mechanism of diabetes varies with the degree of overexpression and oligomerization of human amylin in the pancreatic islet beta cells. FASEB Journal 20 August 2014

  3. Hospitals face September asthma surge

    Asthma problems in the UK surge in September as children return to school after their holidays, according to figures published yesterday.

    Hospitals report more than twice as many emergency admissions for the condition in September as in August, according to the new analysis.

    Last year 5% of asthma emergencies were in August and 11% were in September, the Health and Social Care Information Centre figures show.

    Nearly 40% of asthma emergency admissions involve children, more than 20,000 in the last year - and nearly 16% involve children under the age of five.

    The centre said the stark difference between the numbers of emergencies in August and September had been seen every year for the last eight years.

    In 2006 5.6% of admissions took place in August and 9.4% in September. But a total of 62,670 emergency admissions for asthma fell to 54,300 in the year from 2013 to 2014.

    The figures emerged from an analysis of 11 chronic conditions that are usually managed outside hospital. NHS hopes of managing rising cost pressures depend on cutting the rates of hospital admissions for these conditions, which include angina and chronic obstructive pulmonary disease.

    The centre reported a fall of 2.7% in emergency admissions for these 11 conditions in the last year.

    Centre chair Kingsley Manning said: "Today's report provides new focus on conditions that are usually manageable via primary care services but for some reason required hospitalisation."

  4. Scientists search for Marley cancer genetic clues

    British scientists are starting to unlock the genetic secrets of the skin cancer that killed reggae star Bob Marley, it was announced yesterday.

    Marley died from a kind of melanoma, known as acral melanoma, which affects the palms of the hand, the soles of the feet and the skin under the nails.

    The disease is not caused by exposure to the sun - and the latest genetic study confirms that it involves genetic damage that is very different to other kinds of skin cancer.

    The researchers hope their work will help identify the causes of the cancer - together with new treatments.

    Marley died in 1981 at the age of 36.

    The Manchester University researchers have reported their findings in the journal Pigment Cell & Melanoma Research.

    Researcher Professor Richard Marais said: "Acral skin cancer is different because the gene faults that drive it aren’t caused by ultra-violet damage.

    "Pinpointing these faults is a major step towards understanding what causes this unique form of cancer, and how it can best be treated."

    Furney S. et al. The mutational burden of acral melanoma revealed by whole genome sequencing and comparative analysis. Pigment Cell & Melanoma Research 18 August 2014; doi: 10.1111/pcmr.12279


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