Gene editing: Ethical issues 'should be discussed'

Gene editing: Ethical issues ‘should be discussed’

  • 30 September 2016
  • From the section Health

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Ethical questions around a new gene editing technology need to be considered now – even though its use may be some way off, experts say.

The Nuffield Council for Bioethics was looking into CRISPR – a biological system for altering DNA.

Scientists believe CRISPR could have radical effects on areas as diverse as disease prevention and food security.

The Nuffield Council said discussing ethical issues now would aid public understanding of the new technology.

John Dupre, professor of philosophy of science at the University of Exeter, who is chair of the Nuffield Council Bioethics working party on genome editing in livestock, said: “It is highly desirable to involve the ethical and regulatory considerations as early as possible in the development of a possible transformational technique.

“The example that comes to mind really is GM, where there was very little anticipation of the strength of public feeling.”


Genome editing

Almost all cells in any living organism contain DNA, a type of molecule which is passed on from one generation to the next.

The genome is the entire sequence of DNA or an organism.

Genome editing is the deliberate alteration of a selected DNA sequence in a living cell, A strand of DNA is cut at a specific point and then natural cellular repair mechanisms repair the broken strands.

There are 4,000 known inherited single gene conditions, such as cystic fibrosis. affecting about 1% of births worldwide.


Possible paths ahead

Prof Dupre describes CRISPR as “satnav with scissors”, because it uses proteins to cut DNA at a precise, targeted location.

But there are concerns about the potential consequences in people, such as the potential risks of unintended consequences of changing DNA and the implications for future generations.

Another worry is that research could be used in the engineering of “desirable genetic characteristics” instead of disease prevention.

Prof Karen Yeyng, chair of the Nuffield Council’s working party on human reproductive applications, said: “Genome editing is a potentially powerful set of techniques that holds many future possibilities, including that of altering certain genetic features at the embryonic stage that are known to lead to serious and life-limiting disease.

“In the UK and in many other countries, a long path to legislative change would have to be followed before this could become a treatment option.

“But it is only right that we acknowledge where this new science may lead and explore the possible paths ahead to ensure the one on which we set out today is the right one.”

The Nuffield report says preventing the application of inherited genetic diseases and increasing food production rates in farm animals are two potential CRISPR applications that require urgent ethical scrutiny.

Concerns were raised in 2015 after it was reported that a Chinese team of researchers had corrected disease-causing genetic mutations in non-viable embryos, so they were not allowed to develop.

The UK’s Human Fertilisation and Embryology Authority (HFEA) also granted a licence in February this year to allow genome editing of embryos in the UK.

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One in six young people eat fast food 'twice a day'

One in six young people eat fast food ‘twice a day’

  • 30 September 2016
  • From the section Health

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One in six young people eat fast food twice a day, according to a survey of the nation’s eating habits.

The BBC Good Food Nation Survey found that most people ate fast food on average two days per week.

But in the 16 to 20-year-old category, one in six ate fast food at least twice a day, with one in eight among 21 to 34-year-olds eating as frequently.

The study of more than 5,000 people found that half of them thought “a meal isn’t a meal without meat”.

However, the same proportion were unaware of how much meat is a recommended daily amount.

The Department of Health advises an average of no more than 70g per day, which is the equivalent of two-and-a-half rashers of bacon.

But nearly one in four people thought the recommended amount of meat was at least double that.

The survey found that a fifth of men (21%), and 32% of 16 to 21-year-old men and women, ate meat at least three times a day.

The typical adult now eats meat at least twice a day and has only six meat-free days a month.

Christine Hayes, brand editorial director of BBC Good Food, said it showed it was “easy to be confused about the amount of meat one can enjoy while still eating a healthy, balanced diet”.

She added: “Those who do eat meat can still cook a Sunday roast and eat the occasional steak when balanced with some meat-free dishes.”

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Social media influence

The survey found that two in five people aged 21 to 34-year-olds had posted a photo of a meal they had cooked, on social networking sites such as Instagram.

A third had posted a photo of a meal they had eaten in a restaurant.

And almost one in three have been inspired to cook a meal after seeing a photo on social media.

Also, 43% in that age group used the internet on their mobile phones to find a recipe while 26% will follow a video recipe on their phone.

The same proportion of people were influenced by YouTube when purchasing food.

Skipping meals

Among the other findings of the survey, more than a quarter of adults always or almost always skipped eating breakfast.

When it came to the 21 to 34-year-old age group, one in four said they missed breakfast most of the time.

This age group was also the one most likely to skip eating lunch.

However they were the generation most likely to exercise regularly, with 86% claiming they did so.

The 21 to 34-year-olds were also the age group most likely to be vegetarian (15%) or vegan (7%).

And they were also the age group least likely to be concerned about fat content when buying food (18%), while only half considered the issue of quality when choosing food.

The survey found only 6% of young people were satisfied with their current eating habits.


What foods do our bodies need to stay healthy?

The foods we need to eat can be divided into five separate groups.

Food Group Main nutritional benefits How much should we have each day?
Fruit and vegetables(Includes fresh, frozen, juiced, dried or tinned fruit and vegetables) Vitamins, minerals and fibre Five portions
Starchy foods(Includes bread, rice, pasta and potatoes) Energy, fibre, and vitamins and minerals A third of everything we eat
Meat, fish, eggs and beans(Includes fresh meat, fresh and tinned fish, eggs, nuts and pulses) Protein and vitamins and minerals Two to three portions (one portion is an egg or a serving of meat/fish the size of a deck of cards)
Milk and dairy foods(Includes milk, cheese and yoghurt) Protein and calcium Two to three portions (one portion is a small pot of yoghurt or glass of milk)
Foods containing fat and sugar(Includes cakes, biscuits and fizzy drinks) Energy A maximum of one portion (two biscuits or a small chocolate bar)

The average household spent £54.65 a week on food, about £20 on eating out, and £10 on takeaways, the survey found.

That was a fall from £57.30 a week spent on food shopping in 2015 – a difference of £137.80 annually.

The results of the survey also revealed that 49% of respondents ate fresh food less than once a day in an average week, with nearly one in 10 eating fresh food no more than once a week.


Sarah Toule, head of health information at World Cancer Research Fund, said the survey results were worrying.

“It’s frightening that people, especially younger generations, are eating so much junk food loaded with fat, sugar and salt, but offers little nutritional value.”

“Especially high in calories, junk food leads to unhealthy weight gain – which in turn increases the risk of 11 cancers later in life.

“It’s also worrying that people don’t know they’re eating a dangerous amount of red meat,” she added.

She called on the government to include stronger policies in its childhood obesity plan to improve things.

“Having junk food splashed across our television screens before the 9pm watershed only helps feed the unhealthy food environment we live in – especially in the eyes of children”, she said


Favourite meals

The poll found that classic British dishes such as fish and chips and a full English breakfast had dropped out of the nation’s top five favourite meals.

The top five meals in 2016, according to the survey, were:

  1. Sunday roast
  2. Curry
  3. Pizza
  4. Pasta
  5. Steak and chips

However among the 16 to 20-year-olds the top five meals were:

  1. Pizza
  2. Curry
  3. Pasta
  4. Burger
  5. Steak and chips

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Thailand confirms first Zika-linked microcephaly in Southeast Asia

By Aukkarapon Niyomyat
| BANGKOK

Thailand reported on Friday the first confirmed cases in Southeast Asia of microcephaly linked to mosquito-borne Zika, as the World Health Organization urged action against the virus across the region.

The confirmation of two case of microcephaly, a birth defect marked by small head size, came a day after U.S. health officials recommended that pregnant women postpone non-essential travel to 11 Southeast Asian countries because of the risk of Zika.

“We have found two cases of small heads linked to Zika, the first cases in Thailand,” Prasert Thongcharoen, an adviser to the Department of Disease Control, told reporters in Bangkok.

He declined to say where in Thailand the cases were found but officials have said they were not in Bangkok.

The World Health Organisation (WHO) said the cases were the first of Zika-linked microcephaly in Southeast Asia and the virus infection represented a serious threat to pregnant women and their unborn children.

“Countries across the region must continue to strengthen measures aimed at preventing, detecting and responding to Zika virus transmission,” Dr Poonam Khetrapal Singh, the WHO’s regional director, said in a statement.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, which can lead to severe developmental problems in babies.

VIRUS SPREADING

The connection between Zika and microcephaly first came to light last year in Brazil, which has confirmed more than 1,800 cases of microcephaly that it considers to be related to Zika infections in the mothers.

Zika has spread extensively in Latin American and the Caribbean over the past year or so, and more recently it has been cropping up in Southeast Asia.

Thailand has confirmed 349 Zika cases since January, including 33 pregnant women, and Singapore has recorded 393 Zika cases, including 16 pregnant women.

Some health experts have accused Thai officials of playing down the risk of Zika to protect its thriving tourist industry, but Prasert dismissed that.

“Thailand is not hiding anything and is ready to disclose everything,” he said, adding that other countries in Southeast Asia might also have cases of Zika-linked microcephaly that they have not disclosed.

The WHO said Thailand’s response was an example for the region.

“Thailand’s diligence underscores the commitment of health authorities to the health and wellbeing of the Thai public, and provides a positive example to be emulated,” Singh said.

The U.S. Centers for Disease Control and Prevention (CDC) said on Thursday people should consider postponing travel to Brunei, Myanmar, Cambodia, Indonesia, Laos, Malaysia, Maldives, Philippines, Thailand, Timor-Leste (East Timor), and Vietnam.

The CDC has already issued a “travel notice” for Singapore, and said such a warning would be considered for the new countries if the number of cases rose to the level of an outbreak.

Thailand’s confirmation of Zika-linked microcephaly comes ahead of China’s week-long “Golden Week” holiday with Thailand expecting 220,000 Chinese visitors, up from 168,000 for the week in 2015, Tourism Authority of Thailand governor Yuthasak Supasorn told Reuters.

NO VACCINE

There is no vaccine or treatment for Zika. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

There are also no specific tests to determine if a baby will be born with microcephaly, but ultrasound scans in the third trimester of pregnancy can identify the problem, according to the WHO.

Zika is commonly transmitted through mosquitoes but can also be transmitted sexually.

Another Thai health ministry adviser urged everyone to work to stop the spread of mosquitoes but said people should not panic.

“Don’t have sex with a Zika-infected person. If you don’t know if they are infected, then use a condom,” the adviser, Pornthep Siriwanarangsan, told reporters. “We can’t stop women from becoming pregnant … but we mustn’t panic.”

Health authorities in the region said they were stepping up monitoring, but there has been little testing and officials said the real number of cases was bound to be higher than the confirmed figure.

“We do not test everybody, we test only those who are symptomatic,” said Paulyn Jean Rosell-Ubia, health secretary in the Philippines, which has reported 12 Zika cases.

“Yes, we are positive that the number is higher because we are not testing everyone.”

Malaysia, which has reported six cases of Zika, including two in pregnant women, said it would seek information from Thailand on the particular strain of the Zika virus there.

“We are taking serious notice of the reports in Thailand, and we will reach out to the Thai authorities for more information … so that we can be more prepared,” Malaysia’s health minister, Subramaniam Sathasivam, told Reuters.

Authorities in Vietnam, which has reported three cases of Zika, ordered stepped up monitoring of pregnant women.

In Indonesia’s capital, Jakarta, head of disease outbreak and surveillance Dwi Oktavia said there had been no sign of any increase in birth defects there. Indonesia had one Zika case in 2015 but has confirmed none since then.

Microcephaly in babies can lead to respiratory problems related to malformation of the brain, a serious threat to the lives of babies. Children with microcephaly face lifelong difficulties, including intellectual impairment.

Zika was first identified in Uganda in 1947 and first isolated in Asia in the 1960s. It was unknown in the Americas until 2014.

(Additional reporting by Amy Sawitta Lefevre, Juarawee Kittisilpa and Panarat Thepgumpanat, Kanupriya Kapoor in JAKARTA, Roxanna Latiff in KUALA LUMPUR, Karen Lima in MANILA and Pham Thi Huyen My in HANOI; Writing by Robert Birsel; Editing by Alex Richardson)


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Regeneron's Eylea combination therapy fails mid-stage study

By Natalie Grover

Regeneron Pharmaceuticals Inc said a combination therapy containing its flagship eye drug, Eylea, was inferior to Eylea alone in a mid-stage trial involving patients with wet age-related macular degeneration (AMD), a leading cause of blindness in the elderly.

Regeneron’s shares fell 3.6 percent, and were the biggest drag on the Nasdaq biotech index. Shares of Ophthotech Corp, which is evaluating combinations of its experimental drug with Eylea or rival drugs, also fell.

Eylea sales, which have powered Regeneron’s explosive growth since late 2011, have been slowing in recent quarters, raising concerns about the biotechnology company’s growth prospects.

The blockbuster injection, which was developed with Germany’s Bayer AG to treat macular degeneration and other eye disorders, generated U.S. sales of $831 million in the second quarter.

Macular degeneration accounts for almost 50 percent of all cases of blindness in the developed world. It usually affects people over 50. Wet AMD, which is less common than dry AMD, is generally caused by abnormal blood vessels that leak fluid or blood into the retina.

Patients who received the combination of Eylea and experimental platelet-derived growth factor (PDGF) inhibitor rinucumab were able to see 5.8 more letters on an eye chart test at 12 weeks, compared with a 7.5 letter improvement in those who were given Eylea alone.

The main goal of the study was to show an improvement in visual clarity after three months of treatment. The combination therapy proved to be inferior and was associated with more side effects than the monotherapy.

Data will be evaluated at 28 weeks and 52 weeks, when the study is completed, Regeneron said on Friday.

Eylea belongs to a class of drugs considered the standard of care in AMD as their use makes patients less likely to go blind or move into long-term care.

Ophthotech Corp is evaluating combinations of its PDGF inhibitor, Fovista, with either Eylea, Roche Holding AG’s Avastin or Novartis AG’s Lucentis.

Positive results from Ophthotech’s late-stage trials, expected to read out this year, could see Regeneron lose market share to rival therapies, Leerink’s Geoffrey Porges wrote in a client note.

Ophthotech’s stock was down about 14 percent at $46.49 in early trading, while Regeneron’s shares slipped about 3 percent to $393.43.

(Reporting by Natalie Grover in Bengaluru; Editing by Don Sebastian)


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ASTRO: Benefit Seen for High Dose SBRT in Prostate Ca

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  • For newly diagnosed prostate cancer, stereotactic body radiotherapy (SBRT) is safe, with a low rate of serious side effects, and cancer control rates very favorable compared to historic data, according to a multi-instouttional study.
  • Note that SBRT, which can precisely deliver high doses of radiotherapy to tumors in a small number of treatments, is a fairly new approach to prostate cancer treatment that has shown promising results in single institution studies.

BOSTON — High dose stereotactic body radiotherapy (SBRT) for men newly diagnosed with low- or intermediate-risk prostate cancer results in shorter treatment times, low cancer recurrence rates, and few severe side effects, according to research presented here.

A multi-institutional trial found that at 5 years follow up, 97% of patients treated with SBRT remained cancer free, while just 2% experienced any serious side effects.

SBRT — which can precisely deliver high doses of radiotherapy to tumors in a small number of treatments — is a fairly new approach to prostate cancer treatment, and one that has shown promising results in single institution studies, Robert Meier, MD, Swedish Cancer Institute, Seattle reported at the annual meeting of the American Society for Radiation Oncology (ASTRO).

“Prostate cancer should be ideally suited for SBRT,” said Meier. “Higher doses may translate into better cancer control rates, while the accurate targeting avoids the bladder, the rectum and the sex organs that are immediately adjacent to the prostate. This should reduce side effects.”

Meier also pointed out that SBRT is more cost effective than intensity modulated radiation therapy (IMRT), and more convenient for the patient, since the treatment is completed in just five visits.

While individual institutional studies involving SBRT have been promising, Meier and his colleagues wanted to see whether a multi-institutional study would demonstrate that SBRT could be both effective at controlling cancer and be safely delivered to patients.

The trial enrolled 309 men newly diagnosed with prostate cancer from 21 community, regional, and academic hospitals across the U.S. Of those patients, 172 had low-risk disease (CS T1-T2a, Gleason 6, PSA<10), while 137 had intermediate-risk prostate cancer (CS T1c-T2b with either Gleason 7 and PSA<10, or Gleason 6 and PSA 10-20).

All the patients received SBRT via a robotic linear accelerator, with a radiation dose to the prostate of 40 Gy administered in five treatments of 8 Gy each.

Patients were followed an average of 5.1 years. Less than 2% experienced serious side effects during the course of the follow-up period, far less than the 10% rate deemed excessive by the researchers.

“This is another example of how advanced technology has radically improved our ability to target cancer,” Meier said.

No grade 4 or 5 toxicities were reported, while just five grade 3 genitourinary (GU) toxicities were reported, More than half of the patients did experience less serious side effects — 53% and 59% for grade 1 GU and gastrointestinal (GI) toxicities, and 35% and 10% for grade 2 GU and GI toxicities, respectively — but most of were usually temporary, the researchers reported.

As far as the efficacy of treatment, using the definition of a 2-point increase in PSA as defining cancer recurrence, Meier and his colleagues found that in the entire group of 309 patients, 97.1% did not experience cancer recurrence after 5.1 years, while the rates were 97.3% and 97.1% for the low- and intermediate-risk groups respectively. Overall actuarial 5-year survival for the entire population was 95.6%.

For the low risk group, the recurrence rate “proved superior to the 93% historical control we compared against,” Meier said, adding that the results for the intermediate-risk group matched the best results for radiotherapy “and look better than dose-escalated IMRT.”

“For men with newly diagnosed prostate cancer, when appropriate technology and planning is employed, SBRT is safe, with a low rate of serious side effects,” Meier concluded. “Cancer control rates are very favorable compared to historic data, thus SBRT is a suitable option for low-and intermediate-risk prostate cancer and may be preferable to other treatment approaches.”

Colleen Lawton, MD, vice-chair of the Department of Radiation Oncology at the Medical College of Wisconsin, Milwaukee, commented that the study is encouraging because it includes multi-institutional data.

“This certainly suggests that [SBRT] may become a standard treatment in time,” she said. “We certainly need more data, but we are headed in the right direction.”

Meier reported research funding from Accuray. Other authors declared they had no relevant financial interests.

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The Medicare Current Beneficiary Survey: Celebrating Our 25th Anniversary and a Bright Future Ahead

September 29
by CMS

By Niall Brennan, Chief Data Officer, CMS

This year marks the 25th anniversary and the one millionth beneficiary interview for the Medicare Current Beneficiary Survey (MCBS), a survey that the Centers for Medicare & Medicaid Services (CMS) first fielded in 1991. This in-person survey of 15,000 Medicare beneficiaries collects valuable information about aspects of the Medicare program that cannot be analyzed based on CMS administrative data alone.  In particular, the MCBS gathers information on self-reported health status, satisfaction with care, and functional limitations.  The MCBS also collects information on beneficiaries that is key to understanding patient-centered care.   Beneficiary’s out-of-pocket spending and source of payment for medical services received outside the Medicare program provides a window into the “invisible” and missed costs of health care. One unique aspect of the MCBS is that it includes beneficiaries who reside in institutional settings, such as a nursing home, as well as those in the community.

The MCBS is used across CMS to provide important insights that support internal program analyses.  For example, over the past several years, the MCBS has become a key resource for evaluating the impact of CMS Innovation Center demonstration models as well as for approving Medicare Advantage and Prescription Drug Plan benefits.

The MCBS also serves as the foundation for thousands of health policy analyses across a diverse external user community.  To date, we know of more than 1,000 peer-reviewed papers based on MCBS data in leading publications such as the New England Journal of Medicine, the Journal of the American Medical Association, Journal of Health Economics, and the Journal of the American Geriatrics Society.

Today, I want to acknowledge a number of important efforts CMS has undertaken to ensure the MCBS remains a valuable resource for the agency and external stakeholders.  We have made the data more accessible, releasing the first ever MCBS public use file in May of this year.  While MCBS data files have always been available for a relatively nominal fee, we heard that this fee was a barrier to entry for certain users such as students.  We believe that increased access through this freely available public resource will expand the MCBS user community, and thus help cement its importance as a critical tool in the evaluation of systemic changes in the US health care delivery system.

We are also implementing changes to the MCBS questionnaire and survey design.  Revising and improving the survey questions is underway.  We have added new relevant content including an updated dental utilization module, a module on care coordination, and new questions on food security.   Enhancing the sampling methodology to include newly enrolled beneficiaries in the first year of their Medicare enrollment, conducting an oversample of Hispanic beneficiaries, and, beginning in 2017, conducting an oversample of low-income beneficiaries increase our ability to conduct disparities research and improve our survey estimates.

We are also committed to a more rapid data release schedule, with improved user documentation and file structure.  The 2015 MCBS files will be the first to have many of the improvements discussed above. We anticipate releasing the 2015 data file in the 2nd quarter of 2017, more than one year earlier than the previous file release schedule.   The release of the 2015 data will also include improved chart books to accompany data releases and more intuitive naming conventions and file layouts with modern file formats for SAS, Stata, and R use.  However, to accommodate these long overdue innovations, we had to make the difficult decision not to release 2014 data files.

As we celebrate our 25th anniversary of the MCBS, we are renewing our commitment to providing the most useful and relevant information about the Medicare program and, more importantly, the health and satisfaction of its beneficiaries.

We hope that you’ll visit us on our MCBS webpage at https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/MCBS/index.html where you can also subscribe for important updates and announcements.

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Young women at 'highest mental health risk'

Young women at ‘highest mental health risk’

  • 29 September 2016
  • From the section Health

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Young women are the highest risk group for mental health problems, according to new data released by NHS Digital.

One in five women reported a common mental disorder such as anxiety and depression in 2014 compared to one in eight men, according to the survey of Mental Health and Wellbeing.

Young women also have high rates of self-harm, post traumatic stress disorder and bipolar.

Mental health charities said the figures showed “nothing had improved”.

One in six adults in England has a common mental disorder (CMD), according to the survey.

The National Study of Health and Wellbeing has been carried out every seven years since 1993. This latest report is based on research on 7,500 members of the public – just over 300 of them were women aged 16-24.

The 2014 data showed the gender gap in mental illness had become most pronounced in young people, and has increased since the first survey.

In 1993, 19% of 16-to-24 year old women surveyed reported symptoms of CMD compared to 8% of men of the same age.

In a snapshot, 26% of women aged between 16-24 reported symptoms of common mental disorders in one week, compared to 9% of men in the same age group.

More women in every age group reported symptoms in one week compared to men of the same age.

Self-harm

In 2014, symptoms of anxiety and depression were almost three times as commonly reported by women aged 16-24 than men – 26% compared to 9%.

Post-traumatic stress disorder was seen in 12.6% for women of that age compared with 3.6% of men.

CMD rates have steadily increased in women and remained largely stable in men, since the last survey in 2007.

Women were also more likely than men to report severe symptoms – 10% of women surveyed reported severe symptoms compared to 6% of men.

The proportion of the population reporting self-harming was 6% up from 4% in 2007 and 2% in 2000. Researchers suggest the increase could be due to increased reporting.

In 2014, one in five 16-to-24 year old women (25.7%) reported having self-harmed at some point.

That is about twice the rate for men in this age group (9.7%) and women aged 25-to-34 (13.2%).

The reports authors say this is the first cohort to come of age in the context of social media, and call for more research about its impact.

Young women and mental health in England

26%

of young women (16-24) reported a common mental health disorder (9% of young men)

  • 26% of young women have self-harmed (10% of young men)

  • 13% of young women screened positive for post-traumatic stress disorder (4% of young men)

  • 4% of young women screened positive for bipolar disorder (3% of young men)

Source: NHS Digital, 2014 figs

SPL

Accessing treatment

One in three adults with anxiety or depression were accessing mental health treatment in 2014, up from one in four in 2007.

The study found medication was the most common form of treatment for all conditions, being taken by 10% of those interviewed, with 3% receiving psychological therapy.

The data showed people who were white British, female, or aged 35 to 54 were more likely to receive treatment.

Stephen Buckley, head of information at the mental health charity Mind, said: “Young people are coming of working age in times of economic uncertainty, they’re more likely to experience issues associated with debt, unemployment and poverty, and they are up against increasing social and environmental pressures, all of which affect well-being.

He said there had been a “surge” in the use of social media since the last survey in 2009.

“It can help people feel less isolated, particularly those who struggle to make and maintain relationships or who find it difficult to leave their homes.

“But it also comes with some risks. Its instantaneous and anonymous nature means it’s easy for people to make hasty and sometimes ill-advised comments that can negatively affect other people’s mental health.”

Marjorie Wallace, chief executive of the mental health charity SANE said the report painted a “disturbing picture”.

“Perhaps the most shocking finding is the escalation in both the extent and severity of self-harm, particularly amongst young women. At SANE, the number of calls from people who are self-harming or experiencing suicidal thoughts has almost trebled in the last 10 years.”

Health Secretary Jeremy Hunt said: “We want to make sure that everyone, regardless of gender, age or background, gets the mental health treatment they need.”

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Common painkillers 'increase heart failure risk'

Common painkillers ‘increase heart failure risk’

  • 29 September 2016
  • From the section Health

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Science Photo Library

Taking a common kind of painkiller is linked to an increased risk of heart failure, a study suggests.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen and diclofenac, are commonly used to treat pain and inflammation.

The British Medical Journal study looked at 10 million people, aged 77 on average, who took the drugs.

UK experts said the findings had little relevance for most under-65s but were a possible concern for elderly patients.

The study analysed data for the 10 million users – who were from the UK, the Netherlands, Italy and Germany – and compared them with people who did not take the drugs.

The researchers, from University of Milano-Bicocca in Italy, found taking NSAIDs increased the risk of being taken to hospital with heart failure by 19%.

Since most people in the study were older – and those on NSAIDs were, in general, in poorer health – UK experts said the findings had very little relevance for most under-65s but may be a concern for elderly patients.

Media captionShould you worry about the heart risk from common painkillers? Helen Williams explains.

‘Use with caution’

The British Heart Foundation (BHF) said patients should be on the lowest dose possible of NSAIDs for the shortest possible time.

Prof Peter Weissberg, medical director at the BHF, said: “This large observational study reinforces previous research showing that some NSAIDs, a group of drugs commonly taken by patients with joint problems, increase the risk of developing heart failure.

“It has been known for some years now that such drugs need to be used with caution in patients with, or at high risk of, heart disease.

“This applies mostly to those who take them on a daily basis rather than only occasionally.

“Since heart and joint problems often coexist, particularly in the elderly, this study serves as a reminder to doctors to consider carefully how they prescribe NSAIDs, and to patients that they should only take the lowest effective dose for the shortest possible time.

“They should discuss their treatment with their GP if they have any concerns.”

Younger patients

Helen Williams, consultant pharmacist for cardiovascular disease at the Royal Pharmaceutical Society, told BBC Radio 4’s Today programme that the focus needed to be on older patients with conditions or diseases that might put them at increased risk of heart failure anyway.

“Hypertension, diabetes, maybe kidney problems – it’s in those patients when we add these drugs on top that there might be a small increase in their risk,” she said.

Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “The consequence is that it is of very little relevance to most people below age 65 taking painkillers, but in the very elderly, say, above 80, that the effects are of more relevance.”

Ms Williams said that younger patients who took short courses of ibuprofen, for example, should not be worried. However, she did warn against young people taking the drugs regularly.

“If you take a very occasional course – it’s like most people will do for aches and pains, sports injuries etcetera – then there’s no need to worry.”

But she added: “I think I would say if you’re a young person who is regularly going to buy these drugs, and effectively taking them all the time, you probably should be supervised by a clinician because there are other issues with these drugs and we might want to keep an eye, for example, on your kidneys.”

Ms Williams also said it was important to use over-the-counter painkillers for the right reasons.

She said: “Ibuprofen are anti-inflammatory drugs so if you’ve damaged your muscles where there’s likely to be inflammation, then ibuprofen might be appropriate.

“If you’ve got a headache, it’s unlikely that there’s going to be an inflammation issue and paracetamol is fine.”


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