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  1. Artificial pancreas hope

    The artificial pancreas should be available for patients with diabetes within two years, according to experts.

    An analysis in the journal Diabetologia says trials of the devices already show it is better than existing technologies.

    According to the experts from Cambridge University, UK, work is under way to improve the software in the "closed loop" system of the pancreas.

    The second problem is that they may not be able to cope with vigorous exercise - as even fast-acting insulin analogues do not reach peak levels in the bloodstream for at least half an hour.

    The artificial pancreas combines the insulin pump with glucose meters, using software to determine the release of insulin.

    So far the devices have been tested in controlled conditions, such as diabetes "camps."

    Authors Dr Roman Hovorka and Dr Hood Thabit write: "In trials to date, users have been positive about how use of an artificial pancreas gives them 'time off' or a 'holiday' from their diabetes management, since the system is managing their blood sugar effectively without the need for constant monitoring by the user."

    They say that the devices need to be protected against cybersecurity threats.

    There is also research to see if specific populations may benefit most from the devices. These might include the very young and pregnant women with type 1 disease.

    They write: "Prolonged six to 24 month multi-national closed-loop clinical trials and pivotal studies are underway or in preparation including adults and children.

    "As closed loop devices may be vulnerable to cybersecurity threats such as interference with wireless protocols and unauthorised data retrieval, implementation of secure communications protocols is a must."

    Diabetologia 30 June 2016 [abstract]

  2. Leeds ED pleads for junior cover

    Junior doctors in a major teaching hospital have been asked to help cover vacant shifts in its two emergency departments, it has been revealed.

    The appeal for help went to all junior doctors at Leeds Teaching Hospitals Trust last week.

    Doctors were sought for day shifts, night shifts and part-time shifts, the Health Service Journal reported.

    The British Medical Association has threatened to boycott trusts that implement government pay caps for locums - but the Leeds hospital said it had no success in attracting locums even after offering to pay more than the cap.

    An email to doctors from clinical director for urgent care, Wayne Hamer, said previous experience in emergency department care was not necessary.

    Trust chief medical officer Yvette Oade said three doctors volunteered and covered five shifts.

    They had treated patients matching their "experience and skill sets" and were fully supervised by emergency medicine consultants, she said.

    She told the journal: “This is an entirely appropriate course of action taken to ensure that both our sites have adequate levels of staffing in order to meet expected demand.”

    Royal College of Emergency Medicine president Dr Cliff Mann said: “If even a hospital as well-resourced as Leeds is struggling then it does send a bit of a shot across the bows of the rest of the system.

    "When high performing, reasonably resourced hospitals are struggling we can only imagine how difficult it must be for those lower performing, less well-resourced hospitals.”

  3. How health campaigners helped force Alexander out

    Former Labour shadow health secretary Heidi Alexander quit partly because the party set up a team of NHS "policy advisers" without her involvement, it was revealed last night.

    Ms Alexander was the first Labour front-bencher to quit at the weekend after the sacking of shadow foreign secretary Hillary Benn.

    The spate of resignations that followed sparked a vote of no confidence in Labour leader Jeremy Corbyn and a deadlock between MPs and their leader.

    In a series of tweets yesterday Ms Alexander said she had been "undermined" by shadow chancellor John McDonnell.

    Mr McDonnell, in turn, claimed he had merely intervened on complaints she had not done enough to support junior doctors.

    Ms Alexander said that Mr McDonnell had invited a group of NHS campaigners to meet him without her knowledge.

    After she challenged him, she was invited to the meeting and then "shouted at" by some of those present.

    She said Mr McDonnell then invited them to form an advisory group.

    She said: "I found out about this, said it was totally unacceptable and it must not be an advisory group.”

    A spokesman for the shadow chancellor told the Guardian: “John agreed to meet with NHS campaigners after complaints that Heidi Alexander wasn’t doing enough to support the junior doctors and protect the NHS.

    “At a fraught meeting in the House of Commons with Heidi, one of the outcomes of the meeting was to set up an advisory group. At the meeting Heidi was open to the idea but then on afterwards she changed her mind and that was the end of it. This advisory group was never formally established and never met."

  4. Welsh practices advised on extra funds

    Practices in Wales should not expect "large injections" of cash from a government infusion aimed at rescuing general practice, according to senior doctors.

    Some £10 million is being distributed to the 64 primary care clusters in Wales.

    The Welsh government has said it will allocate £43 million in total to general practice.

    The British Medical Association's Welsh GP committee says the money should be used to reduce the pressure on practice cluster leads.

    This would "enable them to get more involved in developing the clusters, with the ultimate goal of improving services available to patients," according to a letter from committee chair Dr Charlotte Jones.

    The letter says doctors could widen availability of pharmacists, improve access to musculoskeletal specialists or consider the use of locums.

    She writes: "It is incumbent on us to use these monies to have their biggest impact on us, as all GPs are facing relentless demands and workload day to day."

    She adds that it is "unrealistic to think that individual practices are going to see large injections of financial resources any time soon into core funding."


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