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  1. Locum fees soaring - claim

    Hospitals are spending vast sums on temporary staff as they try to maintain nursing numbers on wards, it was reported today.

    In Bristol a hospital paid some £1,800 to a locum agency to provide a single nurse for the day.

    The reports also reveal continued high spending on locum doctors.

    The figures were obtained by Sky News, which investigated how hospitals kept services going on the first May bank holiday, May 5.

    They show that at Shrewsbury and Telford Hospitals in Shropshire, almost one third of nurses working on that day were provided by locum agencies.

    At the Heart of England NHS Trust in the West Midlands, half the doctors working on the day were locums.

    A spokesman for the Department of Health said: “We now have 6,700 more doctors and 6,200 more nurses directly employed by NHS organisations than in 2010.

    “The figures are not a full picture of staffing in the NHS, but we encourage all trusts to maintain a tight grip on their staff costs and we will hold poor performers to account.”

    But Royal College of Nursing chief executive Dr Peter Carter told Sky News: “Many will never have been to that ward before and will probably never be there again.

    “Agency nurses do not provide good value for money. The employers who use these extraordinary levels should be held to account for it."

  2. Iceman clue to heart disease genes

    Scientists have found the oldest human with heart disease - identifying major genetic risks dating back thousands of years, it was revealed last night.

    The so-called Iceman, found in the Tyrolean Alps, lived some 5,300 years ago.

    Now a genetic study has found a gene variation regarded as one of the "strongest predictors" of heart attacks.

    The discovery is one of several highlighting the role of genetics in human heart disease and revealing the risks that go back centuries.

    Heart disease is often regarded as a modern illness, caused by obesity, smoking and inactivity.

    CT scans of the Iceman's mummified body had already revealed calcium deposits in the arteries, suggesting potential heart disease.

    Several studies of ancient heart disease are reported in Global Heart, the journal of the World Heart Federation.

    Researchers led by Professor Albert Zink, of the Institute for Mummies and the Iceman, European Academy of Bolzano/Bozen, Bolzano/Bozen, Italy, say the Iceman was homozygous for the minor allele (GG) of rs10757274, located in chromosomal region 9p21.

    They write: "Even though our human ancestors lived far different lives than we do, their environments and lifestyles were not protecting them against the development of atherosclerosis.

    "Until now, the Iceman is the only ancient human remain in which a genetic predisposition for cardiovascular disease has been detected...future genetic studies of ancient humans from various geographic origins and time periods have the potential to provide more insights into the presence and possible changes of genetic risk factors in our ancestors."

    * A second study in the journal suggests "no difference" in rates of heart disease - or its severity - between modern and ancient Egyptians. The findings come from CT scans and may reflect the wealth of those Egyptians whose mummified remains were available for study.

    Global Heart 30 July 2014

  3. Leave e-cigarettes alone - expert

    E-cigarettes should not be regulated any more strictly than other cigarettes, an expert said today.

    A survey of doctors yesterday found many who believed e-cigarettes should only be available through prescription or pharmacies.

    But, according to Professor Peter Hajek, of Queen Mary College, University of London, there is no evidence for regulating them more tightly than conventional cigarettes.

    He says they are likely to be much less harmful to users and to bystanders than smoked tobacco.

    Writing in the journal Addiction, he says there are still "gaps in knowledge", including their long-term health effects.

    But he adds: "The evidence we currently have is clear: e-cigarettes should be allowed to compete against conventional cigarettes in the marketplace. Health care professionals may advise smokers who are unwilling to cease nicotine use to switch to e-cigarettes.

    "Smokers who have not managed to stop with current treatments may also benefit from switching to e-cigarettes."

    Electronic cigarettes: Review of use, content, safety, effects on smokers, and potential for harm and benefit. Addiction 31 July 2014;109: doi: 10.1111/add.12659. [abstract]

  4. Malaria vaccine hope

    New hope for effective vaccines against malaria have been revealed by a major UK study.

    The discoveries come amid concern about the spread of drug-resistant malaria in Asian countries.

    The latest findings come from a study of children with natural resistance to the disease.

    Researchers say this has led to a number of possible vaccine targets.

    After identifying the children with natural protection against the disease, the researchers set out to identify the antibodies in the immune system that were responsible.

    From there they identified vulnerable proteins in the malaria parasite, Plasmodium falciparum.

    The findings are reported in Science Translational Medicine.

    The research involved the Kenya Medical Research Institute together with the Wellcome Trust Sanger Institute in Cambridge, UK.

    Researcher Dr Faith Osier, from Kenya, said: "Resistance to malaria drugs is an increasing problem so vaccines are desperately needed to battle the Plasmodium falciparum parasite before it has a chance to make people sick.

    “This study presents us with a large number of new vaccine candidates that offer real hope for the future.”

    Researcher Dr Julian Rayner, from the Sanger Institute, said: "Trials for vaccines in the past have focussed on one target at a time and have had limited success; with this approach, we can systematically test larger numbers of targets and identify targets that might work in combination."

    * A second Wellcome Trust backed study last night warned of drug-resistant disease spreading to "critical" border regions in south-east Asia, linking Cambodia, Thailand, Vietnam and eastern Myanmar.

    So far there is no sign of drug-resistant malaria parasites in Africa, according to the study published in the New England Journal of Medicine.

    But researcher Professor Nicholas White, from Oxford University, UK, warned: "It may still be possible to prevent the spread of artemisinin resistant malaria parasites across Asia and then to Africa by eliminating them, but that window of opportunity is closing fast.

    "Conventional malaria control approaches won't be enough – we will need to take more radical action and make this a global public health priority, without delay."

    Osier, F et al. (2014) New antigens for a multicomponent blood-stage malaria vaccine. Science Translational Medicine 30 July 2014; doi: 10.1126/scitranslmed.3008705

    Elizabeth A Ashley et al. Spread of Artemisinin Resistance in Plasmodium falciparum Malaria. NEJM 31 July 2014; 371:411-23. doi:10.1056/NEJMoa1314981


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