You'll only need a single shot of influenza vaccine this year to protect against three strains of the flu, including the H1N1 virus that sparked the 2009 pandemic.

The federal Food and Drug Administration today approved vaccines for the 2010-2011 flu season, and they include drugs to protect against H1N1, another strain of influenza A, Perth, and a strain of influenza B, Brisbane.

The news comes as the Centers for Disease Control and Prevention officials have announced expanded recommendations that urge everyone older than six months get a seasonal flu shot.

Manufacturers expect to produce about 170 million doses of the new seasonal vaccine, which is higher than the 100 million doses offered in a typical flu season, but lower than the nearly 200 million doses of H1N1 vaccine ordered by the government last year, said Tom Skinner, a spokesman for the Centers for Disease Control and Prevention.

Vaccine came too late
Last year, the onset of the H1N1 outbreak started too late to include with production of regular seasonal vaccine, so people needed two separate doses to be protected. This year, just one shot is required. It typically takes six months for flu shots to become available.

"The best way to protect yourself and your family against influenza is to get vaccinated every year," said Dr. Karen Midthun, acting director of the FDA's Center for Biologics Evaluation and Research. "The availability of a new seasonal flu vaccine each year is an important tool in the prevention of influenza-related illnesses and death."

Matching flu vaccines to expected illnesses can be tricky, FDA officials said. There's always a chance that the actual viruses will be different than the ones targeted by the vaccines. Even if they don't match exactly, the vaccine can reduce the chance and the severity of illness, officials noted.

Last year, the government ordered nearly 200 million doses of vaccine to prevent H1N1, also dubbed swine flu, but had to destroy about 40 million doses that expired after demand waned.
Cost of the incinerated vaccine was about $260 million, according to the Associated Press.

"It was just a matter of circumstance that resulted in flu activity peaking before vaccine was widely available," said Skinner, of the CDC.

Between 5 percent and 20 percent of the U.S. population comes down with flu in a typical year, leading to more than 200,000 hospitalizations and about 36,000 deaths. Swine flu turned out to be less deadly than first feared, with about 12,000 deaths.

Calcium supplements taken by many older people could be increasing their risk of a heart attack, research shows.

The study, in the British Medical Journal, said people who took supplements were 30% more likely to have a heart attack.

Data from 11 trials also suggested the medicines were not very effective at preventing bone fractures.

Almost 3m people in the UK are thought to have osteoporosis and many take calcium pills to prevent fractures.

The study recommends doctors review their use of calcium supplements for managing osteoporosis.

The National Osteoporosis Society said most people should be able to get enough calcium through their diets, rather than reaching for the medicine cabinet.

The researchers said those who had a diet naturally high in calcium were at no increased danger.
'Limited benefit'

In all 12,000 people aged over 40 took part in the trials of calcium supplements of 500mg or more a day.
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“Start Quote

It is a balance of risks - people should consider the risks involved and how they apply to their own circumstances and discuss the matter with their GP”

End Quote Dr Alison Avenell Study author

The risk of heart attack was seen across men and women, was independent of age and the type of supplement given.

A small increased risk of death was seen in the study but was not statistically significant, the researchers said.

The reason for the increased risk of heart attack is not clear but it is thought the extra calcium circulating in the blood could lead to a hardening of the arteries.

Calcium in the diet is safe and the Food Standards Agency recommends adults have 700mg of calcium a day from milk, cheese and green, leafy vegetables.

Dr Alison Avenell, from the University of Aberdeen which did the research with colleagues in New Zealand and the US, said the evidence suggests calcium supplements only have a limited benefit in preventing fractures, especially when compared to other treatments available.

"It is a balance of risks - people should consider the risks involved and how they apply to their own circumstances and discuss the matter with their GP," she said.

She added the results did not necessarily apply to younger people with conditions for which they take calcium.

Judy O'Sullivan, senior cardiac nurse at the British Heart Foundation, said the results should be interpreted with caution because the trials did not set out to look at the risk of heart attack.

"However, the research should not be completely ignored," she said.

"Any new guidelines on the prevention of fractures in those most vulnerable to them should take this type of analysis into account."

Dr Claire Bowring, of the National Osteoporosis Society, said: "We've always recommended that people should aim to get the calcium they need from their diet to help build stronger bones.

"If you get all of the calcium that you need from your diet and adequate vitamin D from exposure to sunshine, then a supplement will not be necessary."

She said there were still questions to be answered about the treatment of osteoporosis but advised people taking calcium supplements to talk to their GP, especially if they have a heart condition.

Drinking alcohol can not only ease the symptoms of rheumatoid arthritis it appears to reduce disease severity too, research suggests.

Scientists at the University of Sheffield asked two groups of patients with and without the disease to provide details of their drinking habits.

They found that patients who had drunk alcohol most frequently experienced less joint pain and swelling.

Experts say this should not be taken as a green light for drinking more.

In the study, 873 patients with rheumatoid arthritis (RA) were compared to 1,004 people who did not have it.

Both groups were asked how often they had drunk alcohol in the month running up to the start of the study.
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“Start Quote

It's possible that the anti-inflammatory and analgesic effects of alcohol may play a role in reducing the severity of symptoms”

End Quote Dr James Maxwell consultant rheumatologist

Patients completed a detailed questionnaire, had X-rays and blood tests, and a nurse examined their joints.
'Less damage'

Dr James Maxwell, consultant rheumatologist and lead author of the study, explained the findings.

"We found that patients who had drunk alcohol most frequently had symptoms that were less severe than those who had never drunk alcohol or only drunk it infrequently."

X-rays showed there was less damage to their joints, blood tests showed lower levels of inflammation, and there was less joint pain, swelling and disability in those patients, the researchers found.

They say they do not yet understand why drinking alcohol should reduce the severity of RA, and people's susceptibility to developing it.

Dr Maxwell said: "There is some evidence to show that alcohol suppresses the activity of the immune system, and that this may influence the pathways by which RA develops.

"Once someone has developed RA, it's possible that the anti-inflammatory and analgesic effects of alcohol may play a role in reducing the severity of symptoms," he added.

The authors say that further research is needed to confirm the results of the study and to investigate how and why alcohol has an effect on rheumatoid arthritis.
Risk and rewards

Previous studies have shown that alcohol may reduce the risk of developing the disease in the first place.

Similarly, in the current study non-drinkers were four times more likely to develop RA than people who drank alcohol on more than 10 days a month.

A spokeswoman for Arthritis Research UK, which co-funded the research, said: "We would not want people with RA to take this research to mean that they should go out and start drinking alcohol frequently and in large amounts as this could be detrimental to their health."

She said some RA treatments, like the immunosuppressant drug methotrexate, can damage the liver when taken with large amounts of alcohol.

The patients in the study did not drink more than the recommended limit of 10 units of alcohol a week.

The UK has one of the best systems for end of life care, a global study says.

The analysis by the Economist Intelligence Unit looked at access to services, quality of care and public awareness in 40 countries.

It found the UK performed particularly well on issues such as obtaining pain killers and quality of support

Along with Australia, it received 7.9 out of 10, well ahead of nations such as Denmark, on 5.1 and Italy, on 4.4. India came bottom on 1.9.

TOP FIVE COUNTRIES
Continue reading the main story UK - 7.9 out of 10
Australia - 7.9
New Zealand - 7.7
Ireland - 6.8
Belgium - 6.8
The researchers, part of the group which publishes the Economist magazine, talked to health professionals in 40 countries as well as looking through official data.

They concluded access to drugs and carers were the two most pressing issues for all involved.

They also said that most health systems, no matter how well funded, relied to some extent on charities and philanthropic bodies to offer support to patients, particularly through networks of hospices.

David Praill, chief executive of Help the Hospices in the UK and co-chairman of the Worldwide Palliative Care Alliance, said the result was "heartening" for the UK.

BOTTOM FIVE COUNTRIES
Continue reading the main story India - 1.9 out of 10
Uganda - 2.1
Brazil - 2.2
China - 2.3
Mexico - 2.7
But he added: "The system is far from perfect and there remains huge disparity."

He also said urgent action was needed in those countries with the worst systems.

"Hospice and palliative care is still unavailable to many of those in need, especially in the developing world with millions of people dying in pain and distress every year."

Parents should avoid using household teaspoons to give children medicine as sizes can vary widely, leading to both under- and overdoses, a study warns.

US and Greek researchers looked at teaspoons in 25 households and found that the largest was three times the size of the smallest.

They also found that when asked to use 5ml medicine spoons, people poured in varying quantities.

To avoid dosage differences, the team urged parents to use syringes.

The study in the International Journal of Clinical Practice looked at more than 70 teaspoons collected from 25 homes in Greece.

Low risk

The team from the Alfa Institute of Biomedical Sciences in Athens suggested that a parent using the largest domestic teaspoon would be giving their child nearly three times as much medicine as the smallest.

Most households in the study had between one and three different teaspoons, but two women had six.

"We not only found wide variations between households, we also found considerable differences within households," said Professor Matthew Falagas, the lead author.

In addition, when they asked five people to measure out medicine in a calibrated 5ml spoon, they found that only one gave the correct dose.

Syringes are increasingly given out with over-the-counter medicines such as child paracetamol and ibuprofen.

The risks of harm occurring as a result of parents giving too much of these products in a single dose is thought to be very small indeed.

The NHS in England is to undergo a major restructuring in one of the biggest shake-ups in its history, the government has announced.

Hospitals are to be moved out of the NHS to create a "vibrant" industry of social enterprises under the proposals.

And, as expected, GPs are to take charge of much of the budget.

The move will lead to the abolishing of all 10 strategic health authorities and the 152 management bodies known as primary care trusts.

THE KEY CHANGES
Continue reading the main story
GPs - Asked to get together in groups to take on responsibility for spending much of the NHS budget
Hospitals - Encouraged to move outside the NHS to become "vibrant" industry of social enterprises
Patients - More information and choice, including ability to register with any GP they want to
Managers - Strategic health authorities and primary care trusts face the axe
The new structure will be held accountable by an independent NHS board which would be free from political interference, the government said.

Meanwhile, responsibility for public health will be passed to local authorities.

In many ways, the plans outlined in a White Paper go further than expected. The coalition agreement had promised no top-down reorganisations.

But Health Secretary Andrew Lansley said he had decided to go further than first envisaged to rid the health service of bureaucracy.

He said the proposals would be challenging and turn the NHS "upside down" but in doing so help reduce management costs by nearly a half within four years.

He added: "The government's ambition is for health outcomes - and quality services - that are among the best in the world."

'Experiment'

The GP move had long been championed by Mr Lansley - and in recent months the British Medical Association had indicated it was willing to work with him on the idea.

The plans mean GPs working in groups will be in charge of a vast collection of hospital, mental health and community services - although specialist services and dentistry will not fall under their remit.

ANALYSIS
Continue reading the main story
It had been clear for some time that Andrew Lansley was planning big changes.

But it is a mark of how far-reaching the White Paper actually is that many experts are still shocked by the scale of the proposals.

At a time when the NHS is having to find savings of up to £20bn by 2014, the proposals are being seen as a huge gamble for the service itself and the health secretary personally.

At the heart of the plans are GPs. They, Mr Lansley believes, are better placed than managers to make decisions about services.

Buffeted by years of criticism over what have been perceived as excessive pay rises, GPs now find themselves in the curious position of being given the keys to the NHS safe.

The question on everyone's lips now is: Can they spend it wisely?
Under the new system, the independent board will sit above as many as 500 consortiums of GPs to set standards and hold the groups to account.

Another key aspect of the changes involves giving patients more information and choice. To achieve this, a new body, HealthWatch, will be set up to compile data on performance, while GP boundaries will be abolished to allow patients to register with any doctor they want.

Mr Lansley also announced he expected all NHS trusts, which run hospitals and mental health units, to get foundation status by 2013.

He also said he would be relaxing the rules which cap the amount of income a trust can make outside the NHS, opening the door to them seeing more private patients.

He said this would allow them to innovate and widen the scope of what they did, but he also admitted it would mean those which were not financially viable could go under.

The government will now consult on its plans before rolling them out over the next three years.

Shadow Health Secretary Andy Burnham: "reorganisation is last thing the NHS needs"
Professor Chris Ham, chief executive of the King's Fund think-tank, said: "It is a very radical programme. We have never seen anything like this since the inception of the NHS in 1948."

But he said the moves were not without risk, pointing out some GPs would not have the skills to manage the budget.

Shadow health secretary Andy Burnham went further, describing the changes as a "political experiment".

"It is a huge gamble with a NHS that is working well for patients."

There was a mixed reaction from NHS staff. Unison said the changes could lead to "chaos", but the BMA said they could benefit patients and it was looking forward to working with ministers.

Katherine Murphy, of the Patients Association, called for more clarity over how and what information would be provided to patients.

"We need more details," she added.

Many Vietnamese have diabetes but are unaware of it - and the condition is spreading fast in South East Asia, scientists have warned.

A study by Australian and Vietnamese scientists found about 11% of men and 12% of women in Vietnam's Ho Chi Minh City had undiagnosed type 2 diabetes.

This was in addition to the 4% of people who had been diagnosed.

The scientists, from Australia's Garvan Institute of Medical Research, blamed changing lifestyles and fast food.

"Dietary patterns have been changing dramatically in Vietnam in recent years, particularly in the cities as they become more Westernised," said Professor Tuan Nguyen of the Sydney-based institute.

"There are fast food outlets everywhere," he said, adding that similar studies in Thailand reinforced the link.

"Because of that, we feel very confident that we can extrapolate our findings to other parts of South East Asia including Malaysia, Singapore, Cambodia and Laos," he said.

The study was based on a sample of more than 2,000 people.

The condition is caused by high levels of sugar and fat in the diet and inadequate exercise.

The most common form of diabetes can lead to heart disease, vision loss and kidney failure.

Pregnant teenagers are more likely to give birth prematurely and have a small baby than women in their 20s, says an Irish research team.

Fourteen to 17-year-olds were also more likely to give birth early if they were having a second child, a study of more than 50,000 women in England found.

The findings, reported in BMC Pregnancy and Childbirth, highlighted the importance of routine medical checks.

The team said more studies were needed to find out why the young were at risk.

The study included all women aged between 14 and 29 who had given birth in north-west England over a two-year period.

Continue reading the main story
We are particularly keen to emphasis the importance of post-natal follow-up, support and adequate counselling regarding contraception for teenagers
Professor Louise Kenny

Study leader
In all, 3,600 of those were aged between 14 and 17, the researchers said.

More than a third of them came from the most socially deprived areas.

The study also found teenage mothers were also more likely to be underweight.

Those aged under 17 were 21% more likely to have a premature baby with their first pregnancy and 93% more likely to have their second baby early.

There was also a link with younger mothers and having a baby with a low birth weight.

Researcher Dr Ali Khashan, from University College Cork, in the Republic of Ireland, said it might be that the risk of premature birth in the young teenagers was related to "biological immaturity".

"It is also possible that the increased risk of poor pregnancy outcome in the second teenage pregnancy is related to numerous complicating factors such as greater social deprivation and less prenatal care," he added.

The team said teenagers needed to be given proper medical checks during pregnancy and also said more needed to be done to promote contraception after a teenager had their first baby.

Second child

Professor Louise Kenny, consultant obstetrician and gynaecologist at Cork University Maternity Hospital and study leader, said more research was needed to find out the exact cause of premature babies in teenage girls.

She said one issue was that teenage mothers tended to turn up to health services later in their pregnancy than older mothers and were more likely to miss check-ups.

"It's not clear why the risk is greatest for teenagers having their second child," she said.

"It might be that pre-existing risk factors are increased by the physical and psychosocial demand of another pregnancy during teenage years - but again more research is needed."

She added: "We are particularly keen to emphasis the importance of post-natal follow-up, support and adequate counselling regarding contraception for teenagers."

Professor Steve Thornton, spokesman for the Royal College of Obstetricians and Gynaecologists, said he suspected there were a host of complex social and behavioural reasons behind the findings.

"The nice clear message here is that it is even more important for pregnant teenagers to have their antenatal checks to identify if there are any problems."

Baby P medic 'failed in his duty'
Page last updated at 13:52 GMT, Thursday, 8 July 2010 14:52 UK
E-mail this to a friendPrintable version Dr Ikwueke has been appearing before the GMC Baby Peter's GP Dr Jerome Ikwueke has been found guilty of a serious breach of professional duty, the General Medical Council has ruled.

Peter, from north London, died in August 2007 after sustained abuse.

Dr Ikwueke saw the toddler more than a dozen times before his death and told the GMC he had agonised over whether he could have done more to help him.

Peter's mother, her boyfriend and his brother were jailed last year for causing or allowing his death.

The GMC panel ruled Dr Ikwueke was guilty of a series of failings.

They said the crucial appointment was on July 26 - eight days before his death.

Child abuse

Despite admitting that Peter was a "sorry sight", Dr Ikwueke had failed to examine him or talk to social workers or health visitors afterwards.

The panel said that Peter's changed appearance and demeanour coupled with all he knew should have pointed to the "serious likelihood" of child abuse.

He also failed to reply to a request from social services for a report on Peter in early July.

Dr Ikwueke is the second doctor to face GMC allegations over Peter's care.

Consultant paediatrician Sabah Al-Zayyat is accused of failing to spot that he was suffering abuse two days before his death.

She was due to face a GMC disciplinary panel in February but did not turn up.

The hearing was adjourned until a later date after she was said to be "suicidal".

Researchers have challenged the assumption that a lack of exercise causes children to put on weight.

An 11-year study of more than 200 children in Plymouth suggests the effect is the other way around - that getting fatter makes them inactive.

The paper, published in the Archives of Disease in Childhood, concludes that programmes to tackle obesity may need to focus more on food than exercise.

However, some other experts have questioned the findings.

The paper says there is no disputing the association between physical activity and body fat. And there is no suggestion that exercise is not good for children. But it does question its value as a way of tackling obesity.

Continue reading the main story
What we shouldn't do is take the paper at face value and allow lean children to be as lazy as they please
Dr David Haslam
National Obesity Forum
The researchers at the EarlyBird Diabetes Study, based at the Peninsula Medical School in Plymouth, has been following a group of more than 200 city school children for the past 11 years.

As part of the long-term study, they monitored body fat and exercise at regular intervals over three years.

They found no indication that doing more physical activity had any effect on weight, but they did find that children who put on weight did relatively less exercise.

The findings indicate that 10% more body fat in a seven-year-old leads to four minutes less moderate or vigorous exercise each day. The lead author, Professor Terry Wilkin, says this may not sound a lot, but it adds up over time.

"Moderate and physical activity only occupies in boys a little less than an hour a day and in girls about 45 minutes.

"So it's a not insubstantial amount of activity that is gained by having the lower body mass.

"And that of course is energy expenditure day in day out, week in week out, month in month out so the balance is changed substantially."

The paper suggests that overweight children may perceive their body image negatively, and as a result choose not to join in sports and exercise. It also argues that children who put on too much weight may suffer discomfort and pain during exercise more quickly.

Professor Wilkin says the policy implications are far-reaching, indicating that nutrition, rather than ever-increasing doses of physical activity, is the key to tackling childhood obesity.

However many experts believe that exercise does have a role to play in helping children to lose weight. Professor Andy Ness from Bristol University, who has also examined activity and obesity in children, says the EarlyBird findings are "partly right".

Academic debate

"In our study we can see evidence that physical activity is predictive of a change in fatness," he said. "But that doesn't mean there's not something going on the other way. We think it's a combination."

Dr David Haslam from the National Obesity Forum says the wider health benefits of exercise for children must not be overlooked.

"The EarlyBird team really force us to question our comfortable assumptions regarding childhood obesity.

"What we, as clinicians must do, is nod reverently at their work, learn lessons from it, and re-appraise our own practices accordingly.

"What we shouldn't do is take the paper at face value and allow lean children to be as lazy as they please, as that would be a catastrophic mistake!"

In a statement the Department of Health in England said the EarlyBird study provided some "useful messages".

A spokesperson said: "We will consider this evidence alongside other research which has different findings on the link between physical activity and weight when we are developing our policy to produce better public health outcomes."