Home Tags Posts tagged with "British Medical Journal"
British Medical Journal
Scientists have reported the first case of human-to-human transmission of the new strain of bird flu that has emerged in China.
The British Medical Journal said a 32-year-old woman was infected after caring for her father. Both later died.
Until now there had been no evidence of anyone catching the H7N9 virus other than after direct contact with birds.
But experts stressed it does not mean the virus has developed the ability to spread easily between humans.
By 30 June there had been 133 cases of H7N9 bird flu reported in eastern China and 43 deaths.
Most people had visited live poultry markets or had close contact with live poultry in the week or two before they became ill.
Yet researchers found that the 32-year-old woman had become infected in March after caring for her 60-year-old father in hospital.
Scientists have reported the first case of human-to-human transmission of the new strain of bird flu that has emerged in China
Unlike her father – who had visited a poultry market in the week before falling ill – she had no known exposure to live poultry but fell ill six days after her last contact with him.
Both died in intensive care of multiple organ failure.
Tests on the virus taken from both patients showed the strains were almost genetically identical, which supports the theory that the daughter was infected directly from her father rather than another source.
Public health officials tested 43 close contacts of the patients but all tested negative for H7N9, suggesting the ability of the virus to spread was limited.
The researchers said that while there was no evidence to suggest the virus had gained the ability to spread from person to person efficiently, this was the first case of a “probable transmission” from human to human.
“Our findings reinforce that the novel virus possesses the potential for pandemic spread,” they concluded.
Dr. James Rudge, of the London School of Hygiene and Tropical Medicine, said that limited transmission between humans is not surprising and has been seen before in other bird flu viruses, such as H5N1.
He added: “It would be a worry if we start to see longer chains of transmission between people, when one person infects someone else, who in turn infects more people, and so on.
“And particularly if each infected case goes on to infect, on average, more than one other person, this would be a strong warning sign that we might be in the early stages of an epidemic.”
An accompanying editorial in the BMJ, co-authored by Dr. James Rudge, concluded that while this study might not suggest that H7N9 is any closer to delivering the next pandemic, “it does provide a timely reminder of the need to remain extremely vigilant”.
Some statins, drugs taken to protect the heart, may increase the risk of developing type-2 diabetes, according to researchers in Canada.
Their study of 1.5 million people, in the British Medical Journal, suggested powerful statins could increase the risk by 22% compared with weaker drugs.
Atorvastatin was linked to one extra case of diabetes for every 160 patients treated.
Experts said the benefits of statins still outweighed any risks.
Powerful statins increase type 2 diabetes risk by 22 percent
Statins are a group of commonly prescribed drugs that lower the levels of bad cholesterol in the blood. This reduces the chances of a heart attack or stroke.
A team of researchers from hospitals in Toronto said there had been controversy around the risk of diabetes with different statins.
They looked at medical records of 1.5 million people over the age of 66 and compared the incidence of diabetes between people taking different statins.
Their report said: “We found that patients treated with atorvastatin, rosuvastatin, or simvastatin were at increased risk of new onset diabetes compared with those treated with pravastatin.
“Clinicians should consider this risk when they are contemplating statin treatment for individual patients.
“Preferential use of pravastatin… might be warranted.”
Commenting on the study, Prof. Risto Huupponen and Prof. Jorma Viikari, from the University of Turku, in Finland, said: “The overall benefit of statins still clearly outweighs the potential risk of diabetes.”
However, they said, the different statins should be targeted at the right patients.
They said: “The most potent statins, at least in higher doses, should preferably be reserved for patients who do not respond to low-potency treatment, but have a high total risk of cardiovascular disease.”
A new research published in the British Medical Journal suggests that a high potassium diet as well as cutting down on salt will reduce blood pressure levels and the risk of stroke.
One study review found that eating an extra two to three servings of high potassium fruit or vegetables per day was beneficial.
A lower salt intake would increase the benefits further, researchers said.
While the increase of potassium in diets was found to have a positive effect on blood pressure, it was also discovered to have no adverse effects on kidney function or hormone levels, the research concluded.
A high potassium diet as well as cutting down on salt will reduce blood pressure levels and the risk of stroke
As a result, the World Health Organization has issued its first guidelines on potassium intake, recommending that adults should consume more than 4 g of potassium (or 90 to 100 mmol) per day.
The BMJ study on the effects of potassium intake, produced by scientists from the UN World Food Programme, Imperial College London and Warwick Medical School, among others, looked at 22 controlled trials and another 11 studies involving more than 128,000 healthy participants.
The results showed that increasing potassium in the diet to 3-4 g a day reduced blood pressure in adults.
This increased level of potassium intake was also linked to a 24% lower risk of stroke in those adults.
Researchers said potassium could have benefits for children’s blood pressure too, but more data was needed.
A separate study on salt intake, led by researchers at the Wolfson Institute of Preventive Medicine, Queen Mary, University of London, analyzed the results of 34 previous trials involving more than 3,000 people.
It found that a modest reduction in salt intake for four or more weeks caused significant falls in blood pressure in people with both raised and normal blood pressure. This happened in both men and women, irrespective of ethnic group.
Lower blood pressure levels are known to reduce the risk of stroke and heart disease.
Graham MacGregor, professor of cardiovascular medicine at Queen Mary, who led the study, said that the “modest reduction” in salt intake was equivalent to halving the amount of salt we consume each day.
“In the UK on average our dietary salt intake is 9.5 g, so we are talking about bringing this down to 6g, or if you’re very careful you can get it down to the recommended 5 g – but it’s very difficult because of the amount of salt already in the food we buy.
“Bread is the biggest source of salt in our diet.”
Prof. Graham MacGregor added that a further reduction in salt intake to 3 g per day would have a greater effect on blood pressure and should become the long-term target for population salt intake.
Getting people to eat more fruit and vegetables containing potassium was equally important, he said.
“Salt and potassium work in opposing ways. So a combination of lower salt and higher potassium in our diets has a bigger effect than changing just one of those factors alone.”
The WHO recommends that adults should not consume more than 5 g of salt a day (about one teaspoon).
Experts claim that the longevity Olympians enjoy is within the reach of everyone.
Research published on the British Medical Journal (BMJ) website suggests athletes live 2.8 years longer on average than the average lifespan.
The research indicated those who took part in non-contact sports such as cycling, rowing and tennis enjoyed the longest life of all.
But the general population could have a similar “survival advantage” by doing a little more exercise, experts said.
The conclusion by two public health professors came after they reviewed two studies of Olympic athletes published by the BMJ website.
The studies looked at the lifespan and health of 25,000 athletes who competed in Games dating back to 1896.
Those taking part in contact sports such as boxing had the least advantage, while cyclists and rowers enjoyed the best health.
But the researchers also found those who played lower intensity sports such as golf enjoyed a boost.
Experts claim that the longevity Olympians enjoy is within the reach of everyone
Possible explanations put forward for the finding included genetic and lifestyle factors and the wealth and status that comes with sporting success.
However, the findings prompted public health experts Prof. Adrian Bauman, from Australia’s Sydney University, and Prof. Steven Blair, from South Carolina University in the US, to suggest others could live as long as Olympic athletes.
The recommended level of physical activity for adults is 150 minutes of moderate to vigorous exercise each week.
Studies suggest people who manage that amount or more live for up to several years longer than those that do not.
Writing for the BMJ website, the professors said: “Although the evidence points to a small survival effect of being an Olympian, careful reflection suggests that similar health benefits and longevity could be achieved by all of us through regular physical activity.
“We could and should all award ourselves that personal gold medal.”
But they said governments were still not doing enough to promote the benefits of physical activity, calling it a “public health failure”.
A new research suggests that shift workers are slightly more at risk of having a heart attack or stroke than day workers.
An analysis of studies involving more than 2 million workers in the British Medical Journal said shift work can disrupt the body clock and have an adverse effect on lifestyle.
It has previously been linked to an increased risk of high blood pressure and diabetes.
Limiting night shifts would help workers cope, experts said.
The team of researchers from Canada and Norway analyzed 34 studies.
A new research suggests that shift workers are slightly more at risk of having a heart attack or stroke than day workers
In total, there were 17,359 coronary events of some kind, including cardiac arrests, 6,598 heart attacks and 1,854 strokes caused by lack of blood to the brain.
These events were more common in shift workers than in other people.
The BMJ study calculated that shift work was linked to a 23% increased risk of heart attack, 24% increased risk of coronary event and 5% increased risk of stroke.
But they also said shift work was not linked to increased mortality rates from heart problems and that the relative risks associated with heart problems were “modest”.
The researchers took the socio-economics status of the workers, their diet and general health into account in their findings.
Dan Hackam, associate professor at Western University, London Ontario in Canada, said shift workers were more prone to sleeping and eating badly.
“Night shift workers are up all the time and they don’t have a defined rest period. They are in a state of perpetual nervous system activation which is bad for things like obesity and cholesterol,” he said.
The authors say that screening programmes could help identify and treat risk factors for shift workers, such as high blood pressure and cholesterol levels.
They add that shift workers could also be educated about what symptoms to look our for, which might indicate early heart problems.
Jane White, research and information services manager at the Institution of Occupational Safety and Health, said there are complex issues surrounding shift work.
“It can result in disturbed appetite and digestion, reliance on sedatives and, or stimulants, as well as social and domestic problems.
“These can affect performance, increase the likelihood of errors and accidents at work, and even have a negative effect on health.”
She said the effects of shift work needed to be well-managed.
“Avoiding permanent night shifts, limiting shifts to a maximum of 12 hours and ensuring workers have a minimum of two full nights sleep between day and night shifts are simple, practical solutions that can help people to cope with shift work.”
Ellen Mason, senior cardiac nurse at the British Heart Foundation, said the increased risk to an individual shift worker “was relatively small”.
“But many Brits don’t work nine to five and so these findings becomes much more significant.
“Whether you work nights, evenings or regular office hours, eating healthily, getting active and quitting smoking can make a big difference to your heart health.”
An anonymous author who works in the pharmaceutical industry wrote several anonymous editorials in this weeks British Medical Journal in which they claim:
“Some of the [post-marketing] studies I worked on were not designed to determine the overall risk/benefit balance of the drug in the general population. They were designed to support and disseminate a marketing message.”
According to the writer the process begins as doctors are recruited to find patients who will demonstrate the best results for the company. The doctor is told exactly what to tell patients they should expect and that information is meant to plant the seed of support in the patients mind.
What’s worse, the whistleblower claims that the studies are often molded to fit the expectations of the drug company.
“We occasionally resorted to <<playing>> with the data that had originally failed to show the expected result,” he says.
“This was done by altering the statistical method until any statistical significance was found.”
Drug maker employee claims the company is falsifying study results to sell its products
Negative results are then omitted when it comes to harmful side effects since post-marketing studies do not face the same public scrutiny of pre-approval studies.
The other notes that the false reports are based on a company’s desire to make money over the ten-year period in which their drug is under control of strict patent laws.
Nature examined the authors work and believes they may come from a diabetes background as the editorials focus on post-marketing studies involving insulin drugs meant to fight diabetes.
News of bait-and-switch campaigns involving “post-marketing” studies are nothing new, researchers for years have complained about these so-called “studies” which attempt to overturn accepted problems with drugs that were discovered in pre-study tests.
In the meantime, the companies involved in the authors attacks such as Norvo Nordisk continue to stick behind their products, claiming that their studies involved real-world case studies.
Experts say a common chiropractic treatment for neck pain, which involves applying thrusts to the neck area of the spine, should be abandoned.
Writing in the British Medical Journal, Neil O’Connell from the Centre for Research and Rehabilitation at Brunel University and colleagues say that cervical spine manipulation carries a low risk of stroke, resulting from damage to the major neck arteries.
They say the technique is “unnecessary and inadvisable”.
But other experts believe it is a valuable addition to patient care.
Spinal manipulation can be used to treat neck and back pain or other musculoskeletal conditions. It is a technique used by physiotherapists, osteopaths and most commonly by chiropractors.
Neil O'Connell from the Centre for Research and Rehabilitation at Brunel University and colleagues say that cervical spine manipulation carries a low risk of stroke, resulting from damage to the major neck arteries
Cervical spine manipulation focuses on the neck and involves a range of high-speed manual manoeuvres that stretch, mobilize or manipulate the upper spine in order to relieve pain.
Neil O’Connell and colleagues argue that cervical spine manipulation “may carry the potential for serious neurovascular complications”.
They also say that studies “provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation.”
Such injuries include tearing the lining of the vertebral artery, which is located in the neck and supplies blood to the brain, and stroke.
O’Connell and colleagues refer to a Cochrane review of randomized trials of neck manipulation or mobilization which found that as a stand-alone treatment, the technique provides only moderate short-term pain relief.
They point to other recent, high-quality trials which suggest that manipulation is no better than other treatments such as physical exercise.
In their view, the risks of using manipulation for neck pain outweigh the benefits.
They conclude: “The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain.”
However, not all experts agree.
Writing in the same edition of the BMJ, Professor David Cassidy, from the University of Toronto, and colleagues argue that cervical spine manipulation should not be abandoned as a treatment for neck pain.
They point to high quality evidence that “clearly suggests that manipulation benefits patients with neck pain” and raises doubt about any direct relation between manipulation and stroke.
But they want to see more research into the pros and cons of this and other techniques with the aim of identifying safe and effective treatments.
A new research suggests that combining exercise with conventional treatments for depression does not improve recovery.
In the NHS-funded study – published in the British Medical Journal – some patients were given help to boost their activity levels in addition to receiving therapy or anti-depressants.
After a year all 361 patients had fewer signs of depression, but there was no difference between the two groups.
Current guidelines suggest sufferers do up to three exercise sessions a week.
The National Institute for Health and Clinical Excellence (NICE) drew up that advice in 2004.
At the time it said that on the basis of the research available, increased physical activity could help those with mild depression.
“This is a huge disappointment because we were hoping exercise would help lift depression. But we need to bear in mind that these were patients already on medication, so it considers exercise on top of medical care. It did not look at mild depression nor did it consider exercise as an alternative to medication.
“The message mustn’t be to stop exercising. Exercise has so many other benefits – it is good in terms of heart disease, lowers blood pressure, has a beneficial effect on the balance of fats in the blood, strengthens muscles, and burns up calories. A lot of people who have depression may have other problems too. And an active body helps to produce a healthy mind,” said Prof. Alan Maryon-Davis, professor of public health, King’s College London.
A new research suggests that combining exercise with conventional treatments for depression does not improve recovery
The latest study, carried out by teams from the Universities of Bristol and Exeter, looked at how that might actually work in a real clinical setting.
All 361 people taking part were given conventional treatments appropriate to their level of depression.
But for eight months some in a randomly allocated group were also given advice on up to 13 separate occasions on how to increase their level of activity.
It was up to individual patients what activity they chose to increase and by how much.
This approach produced good results in terms of encouraging people to do more over a sustained period of time – something which could have benefits to their general physical health.
But at the end of a year, researchers found no additional reduction in the symptoms of depression in the more active group.
Prof. John Campbell, from the Peninsula College of Medicine and Dentistry, which also took part in the study, said: “Many patients suffering from depression would prefer not to have to take traditional anti-depressant medication, preferring instead to consider alternative non-drug based forms of therapy.
“Exercise and activity appeared to offer promise as one such treatment, but this carefully designed research study has shown that exercise does not appear to be effective in treating depression.”
But he added that GPs were often faced with patients with a number of health problems for whom encouraging an active lifestyle might be of overall benefit.
“The message of this study of course is not that exercise isn’t good for you, exercise is very good for you, but it’s not good for treating people with what was actually quite severe depression.
“That buzz we all get from moderate intensity of exercise is certainly acknowleged but it’s not sustained and it’s not appropriate for treating people with depression.”
At present, the NHS can refer patients for a course of supervised exercise sessions as part of treatment for a number of illnesses, including depression.
These findings are therefore likely to be taken into account when NICE next reviews its guidelines.
The research was funded by the National Institute for Health Research, a British government-backed programme.
British scientists suggest that about 4,600 lives in England could be saved by reducing alcohol intake to just half a unit a day.
The Oxford University report warned that alcohol consumption is a risk factor for many chronic diseases.
The government recommends that men drink no more than three to four units per day and women no more than two to three.
But the current guidelines are “not compatible with optimum protection of public health”, the researchers said.
Ill health linked to alcohol is estimated to cost the NHS in England £3.3 billion ($5 billion) every year.
British scientists suggest that about 4,600 lives in England could be saved by reducing alcohol intake to just half a unit a day
The Oxford University team used data from the 2006 General Household Survey looking at weekly drinking patterns of 15,000 adults in England.
The researchers used a mathematical model to study death rates from 11 illnesses known to be linked to long-term alcohol use, the British Medical Journal reported.
These included coronary heart disease, stroke, high blood pressure, diabetes, cirrhosis of the liver, epilepsy and five cancers.
Dr. Melanie Nichols, lead author of the paper, said: “Over 4,000 deaths from cancer, heart disease, stroke and liver disease in England could be prevented if drinkers reduced their average level of alcohol consumption to half a unit per person per day – a level much lower than current UK government recommendations.
“Half a unit of alcohol is as little as a quarter of a glass of wine, or a quarter of a pint.”
But the researchers said they were not trying to lecture people, just give them the information so they could make an informed decision.
They added there was a widespread belief that alcohol protects against heart disease.
Alcohol Concern chief executive Eric Appleby said that government guidelines must offer the public a realistic way of reducing the risks associated with drinking.
“As alcoholic drinks have started to vary in strength we use ‘units’ to measure alcohol intake but it can be very difficult for people to understand what this means in practical terms.”
But Henry Ashworth, chief executive of the Portman Group, which also represents UK drinks producers, said: “78% of people in the UK drink within recommended low risk guidelines – as set by the chief medical officers.
“Drastically cutting everyone’s consumption to half a unit a day (i.e. one large glass of wine a week) is not the way to reduce harms in the smaller groups who are misusing alcohol and need specific and targeted help”.
A British Medical Journal analysis has found that dieting in pregnancy is safe for women and does not carry risks for the baby.
The review looked at the findings from 44 previous studies involving more than 7,000 women.
The London-based team said following a healthy diet – and not eating for two – prevents excess weight gain and cuts the risk of complications.
But current guidelines do not advocate dieting or weight monitoring.
The advice from the National Institute for Health and Clinical Excellence (NICE), published in 2010, says: “Dieting during pregnancy is not recommended as it may harm the health of the unborn child.”
However, women are advised to aim to reach a healthy weight before conceiving.
Half the UK population is either overweight or obese and the rates are rising.
And in Europe and the US, between 20% and 40% of women gain more than the recommended weight during pregnancy.
A British Medical Journal analysis has found that dieting in pregnancy is safe for women and does not carry risks for the baby
High weights are linked to complications such as pre-eclampsia, diabetes and high blood pressure as well as early delivery.
This review, funded by the National Institute of Health Research (NIHR), compared diet, exercise or a combination of the two.
Dietary advice was based on limiting calorie intake, having a balanced diet and eating foods such as whole grains, fruits, vegetables and pulses.
The researchers then examined how much weight women gained during their pregnancies and if there were complications.
While each approach reduced a woman’s weight gain, diet had the greatest effect with an average reduction of nearly 4 kg (8.8 lbs).
With exercise, the average reduction in weight gain was just 0.7 kg (1.5 lbs). A combination of diet and exercise led to an average reduction of 1 kg (2.2 lbs).
Women following a calorie-controlled diet were significantly less likely to develop each of the complications considered, but the researchers say those findings need to be repeated in larger studies.
Babies’ birth weights were not affected by dieting.
Dr. Shakila Thangaratinam, a consultant obstetrician at Queen Mary, University of London who led the study, said: “We are seeing more and more women who gain excess weight when they are pregnant and we know these women and their babies are at increased risk of complications.
“Weight control is difficult but this study shows that by carefully advising women on weight management methods, especially diet, we can reduce weight gain during pregnancy.
“It also shows that following a controlled diet has the potential to reduce the risk of a number of pregnancy complications.”
She added: “Women may be concerned that dieting during pregnancy could have a negative impact on their babies. This research is reassuring because it showed that dieting is safe and that the baby’s weight isn’t affected.”
But in a commentary in the journal, women’s health experts from St Thomas’ Hospital in London – including Lucilla Poston who helped develop the NICE guidance, said it would be “premature” for the current guidance, which only recommends women be weighed at their first pregnancy check-up, to change.
Dr. Janine Stockdale, research fellow at the Royal College of Midwives, said: “We should be careful to note that the researchers are not advising women to lose weight during pregnancy; this is about managing excessive weight or weight gain.
“If a woman is on target to gain the right amount of weight during her pregnancy, then <<dieting>> and <<calorie-controlled dieting>> as we commonly understand these terms, is not for her.
“We need to reassure women that under the care of a midwife or other health professional, weight management is safe.”
Francesca Minerva, a research associate at Oxford University, has claimed that doctors should have the right to kill newborn babies if they are disabled, too expensive or simply unwanted by their mothers.
Francesca Minerva, a philosopher and medical ethicist, argues a young baby is not a real person and so killing it in the first days after birth is little different to aborting it in the womb.
In an article, published by the British Medical Journal group, Francesca Minerva states that even a healthy baby could have its life snuffed out if the mother decides she can’t afford to look after it.
The journal’s editor has defended the piece, saying the publication’s role is to present well-reasoned arguments, rather than promote one particular moral view.
But the article has angered other ethicists, peers and campaigners. They have described the call for legalized infanticide as chilling and an “inhumane defense of child destruction”.
Dr. Francesca Minerva has received death threats and hate calls telling her that she will “burn in hell”, and she said the last few days since publication have been “the worst of my life”.
Writing in the Journal of Medical Ethics, Dr. Francesca Minerva and co-author Alberto Giubilini, a University of Milan bioethicist, argue that “after-birth abortion” should be permissible in all cases in which abortion is.
They state that like an unborn child, a newborn has yet to develop hopes, goals and dreams and so, while clearly human, is not a person – someone with a moral right to life.
In contrast, parents, siblings and society have aims and plans that could be affected by the arrival of the child and their interests should come first.
The article, “After-birth abortion: why should the baby live?”, first addresses scenarios in which parents are unaware their child is disabled until after it is born.
The piece argues that, though the child may be happy, it will not reach the potential of a normal child.
“To bring up such children might be an unbearable burden on the family and on society as a whole…On these grounds, the fact that a foetus has the potential to become a person who will have an (at least) acceptable life is no reason for prohibiting abortion.”
The ethicists are also in favor of the infanticide of a healthy baby when the woman’s circumstances have changed and she no longer has the time, money or energy to care for it.
They argue that while adoption might be an option, it could cause undue psychological distress to the mother.
As the hate calls came in, Dr. Francesca Minerva had not been expecting the overwhelmingly negative reaction.
She said she believes her argument was taken out of its academic and theoretical context, and that: “I wish I could explain to people it is not a policy – and I’m not suggesting that and I’m not encouraging that.”
Dr. Francesca Minerva believes the majority of threats have come from religious or Pro-Life groups.
Some of the hate messages told her that she would be punished by God, while others suggested she should “burn in hell”.
Francesca Minerva, a research associate at Oxford University, has claimed that doctors should have the right to kill newborn babies if they are disabled, too expensive or simply unwanted by their mothers
The article also provoked responses from religious and Pro-Life groups.
Rev. Joanna Jepson came to public attention when she spoke out against a late abortion that had been carried out in 2001.
Doctors are permitted to carry out abortions beyond the 24-week legal limit if they believe a baby’s disability is serious enough, but Rev. Joanna Jepson argued that a cleft palate was a minor physical flaw, not a severe abnormality.
She revealed that, until surgery at the age of 19, her own face was disfigured by a congenital defect. Her upper jaw overhung her lower jaw, which receded into her neck, and posed the question: “Would it have been right to abort me?”
She said: “It’s misleading to call this ‘after birth abortion.” The pregnancy is already over, there is nothing to abort. What is being discussed is infanticide.
“There is a logic to their point – if we consider it acceptable to abort a baby up until birth then why not allow it to die afterwards? It is just a difference in geography – within or outside the mother’s body.
“Of course, I would see this a compelling reason to abolish late-term abortion, if infanticide is morally repulsive then abortion is too.
“If a baby, because of it’s physical disabilities, is seen as being <<incompatible with life>> then we need to let life and death take its course. Becoming agents of death fundamentally changes doctor’s role as healer and physician, and it also has massive repercussions on society’s conscience shifting what is understood to be morally and socially unacceptable to become acceptable.
“Of course motherhood is inconvenient, physically, emotionally, psychologically, financially – but this inconvenience is not allowed to become acceptable grounds for abandoning one’s child.
“If a child or an adult has a life-changing accident or illness, do we suggest we’ll put them down because their goals and dreams now have to change?
“My brother, Alastair, has great and huge goals and he goes after them with great courage. His Downs Syndrome does not stand in the way.
“They are very different dreams and goals to my own but no less valuable or of contribution to society. At what level would Dr. Minerva assign somebody’s meaning and value to be worth a life?”
Trevor Stammers, a lecturer in medical ethics and former chairman of the Christian Medical Fellowship, described the viewpoint as “chilling”.
Gill Duval, of the ProLife Alliance, said every life is precious and added: “Everybody talks about what women want but women wouldn’t want this.”
Julian Savulescu, the journal’s editor, said that the article’s argument has been made before by eminent figures.
He added: “I’m not defending practicing infanticide. I’m defending academic and intellectual freedom.”
Julian Savulescu said that Dr. Francesca Minerva has a “loose relationship” with Oxford and her main position is at the University of Melbourne.
History of infanticide
While infanticide may seem an inhumane concept for many people, there have been periods in history where it has been accepted behavior – and even a legal obligation.
In Roman culture, disabled infants were often abandoned after birth by parents who did not want or could not afford the financial burden.
The child would simply be left outside to die from starvation and the elements in a practice known as “exposure”. It was an established and acceptable procedure.
In 1912, Yewsden Villa was excavated in Hambleden in Buckinghamshire, and researchers were shocked to find the bodies of 97 babies in a mass-grave.
The babies had apparently all been killed shortly after birth, and the prevailing theory is that the site was near a brothel.
With a lack of contraception in Roman times, unwanted pregnancies would likely have been much more common, and the mass grave is another example that infanticide did not pose such an ethical dilemma in that era.
Archaeologists believe Romans did not consider infants to be “full” human beings until about the age of two, and babies who died before that age were not buried in cemeteries, but instead in public or domestic areas.
However a Roman couple was entitled to raise a disabled child. In Sparta, there was little choice in the matter.
Newborns were seen as the property of the state and all babies were inspected by a community leader. If the child showed signs of deformity or ill-health, the parents were ordered to expose it.
Many parents in ancient Greeks would also expose their newborns because of sickness, financial pressure, or simply for being the “wrong” sex in the male-dominated society.
Many religions did not raise moral objects to infanticide, although Christianity and Islam notably rejected it.
Leaving the child to the elements was the preferred method to “dispose” of the child, because it meant the child died of natural causes, which was a more “moral” death than directly killing the child.
The practice generally died out, and was outlawed in the last years of the Roman Empire. However there are references to infanticide in many cultures in every historical era, and is believed to still take place in certain parts of India, Africa, and China.
China’s controversial “one-child” policy leads to many children being abandoned after birth.
US researchers found that the speed of someone’s walking may predict the likelihood of developing dementia later in life.
The scientists also told a conference that grip strength in middle-age was linked to the chance of a stroke.
They said more studies were needed to understand what was happening.
Experts said the findings raised important questions, but more research was needed.
Suggestions of a link between slow walking speed and poor health have been made before.
A study, published in the British Medical Journal in 2009, said there was a “strong association” between slow walking speed and death from heart attacks and other heart problems. A Journal of the American Medical Association study suggested a link between walking faster over the age of 65 and a longer life.
Dr. Erica Camargo, who conducted the latest study at the Boston Medical Centre, said: “While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren’t sure until now how it impacted people of middle age.”
US researchers found that the speed of someone’s walking may predict the likelihood of developing dementia later in life
Brain scans, walking speed and grip strength were recorded for 2,410 people who were, on average, 62 years old.
Results presented at the Academy of Neurology’s annual meeting said that 11 years later, 34 people had developed dementia and 79 had had a stroke.
The researchers said slower walking speeds were linked to a higher risk of dementia and stronger grip with a lower risk of stroke.
Dr. Erica Camargo said: “These are basic office tests which can provide insight into risk of dementia and stroke and can be easily performed by a neurologist or general practitioner.
“Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength.”
The findings have not yet, however, been published in a peer-reviewed academic journal.
A research team from Massachusetts General Hospital, Boston, suggests that women who take certain ulcer drugs have a small increased risk of hip fractures in later life, particularly if they smoke.
The study, published in the British Medical Journal, found a link between long-term use of proton pump inhibitors and bone fractures in smokers.
Proton pump inhibitors (PPIs) are used to treat heartburn, reflux and ulcers.
The research tracked almost 80,000 nurses in the US aged between 30 and 55.
They were followed up in later life to see how many had developed hip fractures after the menopause.
A research team from Massachusetts General Hospital, Boston, suggests that women who take certain ulcer drugs have a small increased risk of hip fractures in later life, particularly if they smoke
The researchers found that smokers or ex-smokers taking proton pump inhibitors (PPIs) had a 50% increased risk of hip fracture compared with women not taking the medication.
The experts wrote in the British Medical Journal: “Chronic use of PPIs is associated with increased risk of hip fracture, particularly among women with a history of smoking.”
Commenting on the study, Dr. John Stevenson, who sits on the medical advisory council of the British Menopause Society, said it had been suspected for some years that proton pump inhibitors increased the risk of hip fracture.
“This large study confirms that suspicion. However, the absolute risk is small, with the drugs causing an additional five hip fractures per 10,000 women per year.
“Women should not be put off using proton pump inhibitors if they are needed, but these results provide yet another reason not to smoke.”
The brain’ skills can start to decline as early as 45, much earlier than previously thought, suggests a study published in the British Medical Journal.
A major study shows the brain’s capacity for memory, reasoning and comprehension starts waning in middle age rather than in the 60s.
Researchers say the finding is important because younger people should be encouraged to boost their brain power with healthier living, while some may benefit from medicines to stave off further decline.
Centre for Research in Epidemiology and Population Health in France and University College London in the UK studied more than 7,000 people over a 10-year period.
The study participants were civil servants aged between 45 and 70 working in London when cognitive testing began in 1997 to 1999.
Cognitive function was measured three times over 10 years to assess memory, vocabulary, hearing and visual comprehension skills.
Tasks included recalling in writing as many words beginning with the letter S as possible and as many animal names as could be thought of.
All cognitive scores, except vocabulary, declined among all age groups during the study, and there was evidence of faster decline among older people.
The brain' skills can start to decline as early as 45, much earlier than previously thought, suggests a study published in the British Medical Journal
The study found that, in men group, there was a 3.6% drop in reasoning after 10 years among those who were aged 45 to 49 at the start of the study and 9.6% among those aged 65 to 70. In women group, the decline was 3.6% and 7.4% in the same age groups.
Dr. Archana Singh-Manoux, who led the study, said there had been debate over when mental skills started failing, with some researchers concluding there was little evidence of problems before 60.
But this was disproved by the study findings, she added.
Dr. Archana Singh-Manoux said: “Cognitive decline is already evident in middle age, between 45-49 years.
“The results for all tests, except vocabulary, showed significant declines in all age categories in both men and women.”
The study says diseases such as dementia are believed to take at least 20 to 30 years to develop but promoting healthy lifestyles and good heart health could help.
“There is emerging consensus that ‘what is good for our hearts is also good for our heads, making aggressive control of behavioural and cardiovascular risk factors as early as possible key targets for clinical practice and public health” it said.
Medicines and other medical interventions are more likely to work at an earlier age, so could be used in people whose cognitive decline is faster than the average, it said.
Previous research suggests around half of people with diagnosed mild cognitive impairment (MCI) develop Alzheimer’s.
In cases of MCI, a person has cognitive or memory problems which are more marked than typical age-related memory loss, but not yet as severe as those found in Alzheimer’s disease.
Dr. Anne Corbett, research manager of the Alzheimer’s Society in UK, said: “This large, important study adds vital information to the debate over when cognitive decline begins.
“However, the study does not tell us whether any of these people went on to develop dementia, nor how feasible it would be for GPs to detect these early changes.
“More research is now needed to help us fully understand how measurable changes in the brain can help us improve diagnosis of dementia.
“An early diagnosis is essential as it can provide access to support and potential treatments which can vastly improve people’s quality of life.”
People who ate more chocolate had lower incidents of cardiovascular disease and stroke compared to those who ate less, a study finds.
Eating chocolate could benefit the heart, possibly lowering heart disease by 37%.
The results coming from a meta-analysis were released online this week in the British Medical Journal.
Researchers from the United Kingdom and Colombia focused on 7 studies looking at the link between eating chocolate and a reduction in heart disease that included 114,009 people.
Eating chocolate could benefit the heart, possibly lowering heart disease by 37 percent
Of those 7 studies, 5 showed an association between higher levels of chocolate consumption and a lowered risk of cardiometabolic illness. The highest levels were linked with a 37% drop in cardiovascular disease and a 29% reduction in stroke, compared to the lowest levels.
There was no significant association seen between chocolate consumption and heart failure, and only one study drew a link between eating chocolate and a lowered risk of diabetes.
None of the studies, including the meta-analysis, were funded by a chocolate company or a related industry.
However, the study authors caution about eating chocolate with abandon. After all, they point out, chocolate isn’t exactly calorie-free. Although the participants in the studies ate a variety of chocolate products, including chocolate bars, drinks, nutritional supplements and desserts, all chocolate is not created equal, and eating too much of the stuff that’s filled with fat and sugar can put on pounds, possibly upping the risk of high blood pressure and diabetes — the very stuff that can lead to cardiovascular problems.
The study authors noted that among the studies there was no obvious dose-response relationship between chocolate and the risk of cardiometabolic disorders, so for now, everything in moderation, as they say.
And although the studies reviewed did control for a number of factors, including age, body mass index, physical activity, smoking and aspects of diet, there still may be other factors at work causing the heart benefits.
If chocolate is the root of these heart-healthy advantages, it may be due to its polyphenol content, anti-oxidants that could improve endothelial function (which may affect the risk of stroke and heart attack) as well as have a positive effect on blood pressure and insulin resistance.
More studies are needed, the authors wrote, to go beyond just an association and determine causation.