Santa Claus row - we warned you!

No sooner had we commented on the somewhat po-faced responses to the medical oddities in the annual Christmas edition of the British Medical Journal, than events took an even odder turn.

An unfortunate Australian doctor called Nathan Grills was forced to defend himself against the might of the world's media for criticising Santa Claus for being too fat. We understand that editorials were written in newspapers around the world ; some of the more savage picked on the Australians for not having a "proper Christmas" - as their Christmas is celebrated at the blazing height of summer.

Speaking to the Australian Associated Press Dr Grills rushed out an explanation.


"Most of my 'Santa - A public health pariah?' article was meant to be tongue-in-cheek... It's a Christmas spoof," he explained, using a word of one syllable.

He went on: "I hoped to spread a bit of Christmas cheer, but with a tinge of seriousness to provoke a bit of healthy Christmas dinner table conversation."

Finally he stated: "To clarify, I am not a Santa researcher. The article was written in my spare time for a bit of comic relief."

This was our original report on Dr Grill's comments. But, note, we also managed to find some experts in Sweden who shared Dr Grills' purported concerns about Santa's health; and not only does Sweden still have  a proper winter, it also  contains Lapland, which claims to be the home of Santa, so they should know what they are talking about.

May we wish all our readers a very merry, happy and joyful Christmas and a prosperous New Year.

Keeping up appearances...

It was only meant to be a bit of Christmas jollity. Instead everyone has gone very po-faced about some research suggesting you may well be as young as you look.

Here's our report: Appearances may be deceptive. This report makes it clear the article is in the Christmas issue of the British Medical Journal. While not exactly a spoof issue, it is notorious for publishing odd findings and curiosities. Not to be taken too seriously.

Apparently other media took the report seriously and missed the point. Most serious of all was this very detailed report in The Guardian headed Look Young, Live Longer.

This prompted a long ripost from the NHS Choices "health news unspun" pages here. NHS Choices almost gets round to the point that smoking, for instance, is notorious for ageing the skin. If you smoke, you look older and you reduce your life expectancy.

Frankly anybody should be able to read the basic details of this report and spot that it is very, very limited in what it says. All the researchers found is that identical twins aged 70 may show their biological age in their appearance. So it is purely about the environment and the lifestyle of people with identical genes.

In reality, we know we pass judgements on people's ages using all sorts of uncontrollable factors, which may well result from genes - for instance, hair loss, grey hair and even bone structure. The BMJ study says nothing about such things.

Sometimes the NHS Choices analyses are well worth reading. On this occasion it has missed the point.

For the BMJ Christmas issue is always a cocktail of unbelievable reports and unsustainable headlines. It's a chance to read, enjoy, chuckle for a moment and learn a little bit of scepticism about far-flung conclusions.

Alcohol and healthy diets - what's the story?

We've been harping on about the so-called Mediterranean diet for some time. Much of the recent research on this has come from Spain, where researchers seem to have decided to define the southern European diet as an intrinsically healthy one ie one involving vegetables, nuts, fish and minimal animal fat.. According to this story, the Mediterranean countries only eat small amounts of meat and drink in great moderation. I find this hard to believe.

So today's report from Spain is gratifying. It does not exactly say that the Spanish are heavy drinkers but still quite healthy - but that is the implication. For the report says that the more a Spanish man drinks, the healthier his heart. As an aside, the researchers add that Spanish men  drink quite a lot and indeed the country's vineyards and granaries make it the world's third largest producer of alcohol.

There will be a lot of criticism of the findings. The definition of health is quite narrow - heart disease. What about the other problems alcohol may cause, including liver disease and stroke?

I think there's a more interesting question. Is the finding unique to Spain and similar countries? Is there something about Spain that means drinking is linked to better health. Now the researchers tried their best to disentangle drink from other factors but I wonder if they succeeded.

For instance, in a country that takes its alcohol with its meals, good drinking may be linked to good eating. And whereas in the UK, a good meal probably involves steak, chips and a sugary, fat-laden dessert, in Spain it may involve a menu that's a great deal healthier. In northern Europe also, heavy drinking is associated with the ubiquitous beer belly as drinkers also tend to pile on fat. It seems unbelievable that the obesity that many heavy drinkers suffer from does not also lead to heart disease.

So this is yet another plea for some research on the real diets of the southern European countries. These are diets rich in wine, olive oil and yes also vegetables, fruit, nuts and quite a lot of fish. Let's not pretend the Mediterran lifestyle is entirely healthy. But it may offer some clues as to how to enjoy alcohol better.

Folic acid and pregnancy

All women who are considering having a baby are encouraged to take folic acid. Some countries include the vitamin with their flour - to ensure all women get it.

The reason is that it has a dramatic impact in preventing the disability spina bifida and a range of conditions called neural tube defects.

So today's report linking it to the development of asthma in children is potentially alarming - as it might deter women from taking this important vitamin.

The Australian researchers stress their findings only apply to the taking of the vitamin in late pregnancy. To prevent spina bifida, it needs to be taken before conception or in early pregnancy.

However it does raise questions about adding folic acid to flour - as it might lead to women being over-exposed in late pregnancy.

The Englemed report allows you to link through to the original article.

We've seen some criticism of the research which says the following:
it was conducted by postal survey;
only 76 per cent of women took part.

If that was so, it would make it dangerously flawed as the increase in asthma risk is only about 23 per cent.

However those criticisms only apply to the final stage of the research, when the children were aged five. And no link with asthma was established at this age.

Most of the research was, in fact, done by research nurses who conducted interviews with the women. When the children were aged three, the women were interviewed again and this is the age at which the link with asthma was found. At this point 88 per cent of the original sample were taking part, just four percentage points fewer than the 92 per cent who successfully gave birth.

The numbers involved - just over 500 families - are not enormous so the findings have to be treated with caution. It does not seem they can be dismissed out of hand.

Asthma is quite a common condition in young children and a small increase could affect quite a few children. Ironically, folic acid fortification of flour was introduced in Australia after this research was done.

It will be interesting to see what other analysts make of this and what further research is done. For, yet again, it is thought-provoking research that raises some tricky issues.

Patient views

We've now created a list on the left-hand side for patient and family blogs. Let us know if you have a blog you'd like to be considered for inclusion. We're looking for blogs that are interesting, yes, that share good news and bad alike, yes, and also demonstrate a healthy scepticism about what's in the news and what's pushed at you as cures, treatments and explanations.

That genetic cure for eye-sight

The remarkable story about how doctors have used genetic treatment to restore sight to children came with a great many resources.

This is a graphic that explains the treatment.

And here's another viewing of thevideo of the child demonstrating that he can now find his way round an obstacle course. The following text explains what is happening on the two videos, which were shot three months after treatment: Video 1 shows the child traversing the obstacle course with his left (injected) eye patched. He has difficulty seeing the course and it takes him a long time to complete the test. Video 2, captured within 10 minutes of Video 1, shows the same child traversing a reconfigured obstacle course with right (uninjected) eye patched, using his injected eye for navigation. He has no difficulty completing the test accurately.:



Our news report here

Sympathy for the aggregators?

The UK-based news aggregator NewsNow has published a defence of its place on the web in the face of threats of action from established media.

Interestingly when we published a draft manifesto for e-journalism a few weeks ago we put up for discussion two propositions on this issue as we did not think they should be included. (And in spite of quite a lot of interest, nobody has commented! :-;)

These were that:
a) RSS feeds should only contain original writing.
b) Journalists should withdraw cooperation from news aggregators that carry advertising.

This is in effect what is now being considered by major news organisations, along with some potential legal action, placing the business of organisations such as NewsNow in peril.

You must expect us to have mixed feelings on this. These people do get a free ride on the back of working journalists and have certainly made life difficult for us in past years. However they can also perform a useful function, providing a more efficient service than search engines to enable the browser to scan what's going on in the news.

Unlike search engines, aggregators have been able to market specialist RSS feeds to websites - ensuring that none of the fees paid reach the originators of news. Some have very, very aggressive marketing campaigns.

However as a news provider you don't have to participate - and it is true most news organisations have chosen to use aggegation-friendly formats. Until a couple of years ago we did not participate and used a very simple technique to prevent aggregation. That is to keep multiple stories on a single page - ensuring there is no unique URL per story. Now we have changed our format and some of our content can be aggregated.

Any website owner who thinks they are getting the full range of our output by using a third-party aggregator is simply misguided. The news feeds on this site are deliberately selective - interesting and varied, I hope, but selective. In contrast, aggregated RSS feeds tend to be repetitive and lack depth. A typical feed will contain no more than one or two stories, recycled in different formats by different media - with limited or no access to anything that happened as recently as one or two days previously. It sometimes beggars belief that people actually pay for these.

So, at the end, we left just one provision about aggregators in the draft manifesto.

It was this:
12/ News aggregation organisations should be subject to specific monitoring by regulatory authorities for monopolistic power.

No prizes for guessing that we had Google News in mind.

But should propositions a) and b) also be included?

That drifting Mediterranean diet

Normally we grab hungrily at stories about the so-called Mediterranean diet. Yesterday we chose to ignore one, which has seized the attention of the world's media.

This was the story that the Mediterranean diet can help relieve depression, from research published by a Spanish team in the Archives of General Psychiatry. The nature of journal, part of the American Medical Association group, probably helped stir interest.

There has been a great deal of analysis of the "Mediterranean diet" recently, mostly originating from Spanish researchers. Here is another recent one. It's all interesting material and is not to be dismissed - as it links a good healthy diet to all sorts of benefits. In this instance we noted the funding source:  The Spanish Government Instituto de Salud Carlos III, Fondo de Investigaciones Sanitarias and the Navarra Regional Government project.

This is how the "Mediterranean diet" was defined for the research: high ratio of monounsaturated fatty acids to saturated fatty acids; moderate intake of alcohol and dairy products; low intake of meat; and high intake of legumes, fruit and nuts, cereals, vegetables and fish. A shorter version stated it was "rich in vegetables, fruits, nuts, whole grains and fish."

I've comment on this drift in definition before. It's increasingly looking as if the Mediterrranean diet is being defined by researchers as a standard "healthy" diet - low in meat and saturated fat and containing only moderate alcohol - rather than as a diet that is recognisably Mediterranean. It creates a circular argument - study a diet known to be "healthy", prove it is "healthy" and link it to a specific region of the world.

Surely the true Mediterranean diet is certainly rich in grain, fruits and vegetable - but specifically it contains large amounts of olive oil, olives and wine. If my memory serves me correctly, this was the kind of diet studied in the original research that defined this diet many years ago. As for the meat content, yes, coastal communities tend to eat fish but do they not raise sheep and goats in the mountains? Choose your dish, Greek moussaka, Italian spaghetti bolognese - it's made with mince from meat.

Arch Gen Psychiatry. 2009;66[10]:1090-1098
Here's our newsfeed on diet and nutrition in health.

A tough week for health reporting

Two news stories this week in Britain have stirred up some old controversies about the quality and merits of popular reporting on medical matters.

The tragic death of a 14-year-old girl after receiving the new cervical cancer vaccine stirred up all sorts of issues.

So it wasn't long before the critics emerged from the woodwork and accused the media of getting everything wrong or pursuing private agendas (yes, sometimes some newspapers do have their own agendas). Here is a report from The Guardian criticising the reporting of the death of a 14-year-old girl after receiving the HPV vaccine.

A second story has also upset quite a few people - because it implied that households with parents who work full time weren't looking after their children properly. We tucked the report away as four paragraphs in the middle of a round up of child health here. Instinctively, we felt it raised all sorts of social issues rather than establishing any direct health links between parents working and their children's lifestyles. Some British newspapers made a big thing of it and upset many of their readers. Here is blogger Jayne Howarth, (who occasionally writes for Englemed)  letting rip at the research.

The problem with these controversies is it begins to sound as if  some people think these stories should not be reported. For when they are reported, there is always scope for misunderstanding and distortion of facts, on the part of headline writers and editors as well as readers.

I'm not sure that the critics of the reporting of the cervical cancer vaccine story really get the problem. It appears, according to statements released yesterday, that the teenager had an underlying and hidden medical condition - it emerges today it was a cancer in the area of the heart.  Nobody yet knows whether the vaccine - or the shock of vaccination - triggered her collapse. The vaccine is being offered to every teenage girl in the country - so if it is going to cause fatal reactions to hidden "underlying medical conditions", that surely seems a legitimate question of public policy.  And it is a real concern for parents, unless they can be reassured their child does not have "hidden" conditions that won't also cause a big reaction.

The story about working parents is more problematic. Instinctively, it seemed a story that needed treating with caution. Usually in these instances, you can spot the flaw quickly - not many people in the study, other factors, eg smoking, not properly accounted for, dodgy source.  In this instance the number of children involved was quite large, about 12,500 and the source reputable - but it felt as if the phrase "working parents" stood for a load of other issues. Instead we focused on a story from Sweden, published in the same journal, the Journal of Epidemiology and Community Health, about pecking order in the playground. And we took pains the highlight the main query about that particular study - it was from Sweden, which may well not be like other countries.

The NHS Choices analysis of the working parents story was particularly interesting and detailed. It seems to boil down to how the findings are interpreted.

Sometime ago I blogged about some guidelines for assessing medical stories. Dr Alicia White apparently provides analysis for NHS Choices and has published her own guidelines for "reading" medical news, which expand on the theme, stressing, for instance, the difference between studies involving humans and those involving laboratory animals.

In our last posting, about the new world of news reporting on the web, we suggested that writers start learning to show greater respect for the intelligence and education level of their readers.

The problem with debunking all medical reports and all scary headlines is that it gives out a rather old-fashioned and patronising message - that only the experts can make sense of the evidence. That's not the world we live in now - the public is thirsty for information and doesn't always trust 'experts', knowing they are not always right. Sometimes it is true people flit - or tweet - from headline to headline. But if they are interested in a topic, they will dig deep, checking sources and challenging conclusions.

Both readers and writers need to understand one simple thing about medical news: it is that very, very few individual pieces of research change understanding of health and medicine.

Those that do, tend to involve very large numbers of people  - hundreds of thousands. Good doctors and the public health specialists who assess evidence pull together and assess large numbers of pieces of research. Sometimes they are slow to do so and sometimes they get it wrong. Look how long it took for all the problems with hormone replacement therapy to emerge. And how long it took for British government scientists to put a stop to cattle being fed the brains of other cattle. And I'm still not convinced (and here) that British medicine isn't over-reliant on drugs to treat blood pressure when overwhelming evidence from the USA and elsewhere suggests that fitness and good diet can be effective.

So it's no wonder that the public want faster information and they want a chance to decide for themselves. From a reporting point of view, the most helpful medical organisations are those that get in fast with response and explanation. Full praise here to the British Heart Foundation who were quick to challenge a study that could have been read as disputing that eating fish is good for the heart. Report here. But it didn't happen in the case of the Coventry death - and public statements continue to be erratic and poorly sourced.

Another study involved 39,000 people in 29 Asian countries and we blogged on it a few months ago. And it reached the curious and surprising conclusion that those who "trust" the media are the healthiest. A rogue study? Perhaps.Or perhaps an argument for more rather than less health reporting.

Draft manifesto for e-journalism

Here it is, with some trepidation, a draft manifesto for e-journalism, 17 points, just like the other internet manifesto for journalism.  It contains controversial sections, in particular 9-12. There's quite a lot of agreement with the original internet manifesto - we just think if you're doing a manifesto it needs to set out things that can be done. It's now starting to dawn on the world at large that there is a desperate need to sort out the economics of journalism on the web and deal with the twin issues represented currently by Google and the BBC...

1/ News production always costs someone. Good quality news costs the most.

2/ The internet enhances the ability to attribute and link to sources. Linking may not always be feasible but should be part of news writing.

3/ Other web users should respect news-gatherers and link to original reports where possible.

4/ A substantial proportion of users will be educated to a high level and will have, at the least, basic knowledge of probability and statistics. Journalists should show respect for the numeracy of their on-line readers.

5/ The traditional distinction between news and comment must be retained.

6/ Traditional news media have decades of experience of editing, presenting and sifting news that can be brought to the new world.

7/ Human ability to create interesting and readable packages of news and other journalism will not be exceeded by AI devices in the foreseeable future.

8/ Public scrutiny and ability to comment and challenge news reporting enhances news quality.

9/ State or tax-financed news sites should not attempt to be comprehensive and should only contain material directly gathered and produced by the organisation in question.

10/ News and pictures collected by state or tax financed news organisations should be made available to other news organisations with free licence, possibly on a geographical basis.

11/ News organisations reproducing news licensed by state or tax-financed organisations should always identify the source.

12/ News aggregation organisations should be subject to specific monitoring by regulatory authorities for monopolistic power.

13/ Those who provide news stories to journalists are entitled to have embargo times respected. Embargoes continue to be useful devices to allow journalists time to evaluate and balance stories and continued use should be encouraged.

14/  Providers of news, ie press officers and PR organisations, need to look beyond the traditional media outlets, making their source material available to all in a timely and accessible fashion.

15/ The web massively enhances the competition to be first with the news. It should also enhance the competition to be different about the news, both in presentation and content.

16/ The nature of breaking news may lead to reports being up-dated constantly. Changes should be acknowledged so far as possible, and new formats explored, but live reporting should not be hampered by efforts to impose complex technological protocols.

17/ Copyright is essential and should be enforced and enforceable. Law-makers may need, however, to reflect that attribution (and linking) is a defence against plagiarism.

Ideas considered and rejected:
a) RSS feeds should only contain original writing.
b) Journalists should withdraw cooperation from news aggregators that carry advertising.

Our own manifesto for journalism

So disappointed (link to last posting on the subject) by the Internet Manifesto for Journalism that we've started on our own. It's a great deal harder-hitting and suggests some simple ways in which the news business could be kept viable and vibrant in the 21st century.

It's based on more than ten years of experience of running an e-journalism business. We've got 12 points so far and cannot exceed 17.

Add your thoughts here before it's completed....

The biz!

Just a reminder of what our main business is. The reports on these pages are just a fraction of what we produce. We can provide a specialist news service for your health or medical site. If your site is very specialist, we'll search out the stories that the large news organisations may not bother with.

Long-standing clients include www.doctors.net.uk and www.bloodmed.com.

All our reports are written to house style by our team of experienced journalists and writers. That includes referencing and good sourcing of stories. We don't recycle press releases or copy other people's work. Our range is global although we are based in the UK and are well-placed to provide feeds that include UK-oriented news.

Yes, a specialist service costs - but we can be very competitive.

On this site we provide a limited selection of general interest news.

Interested? Drop an email to newsroom @ englemed.co.uk .

A manifesto for journalism?

A declaration called the Internet Manifesto for Journalism has attracted a lot of interest, partly because, I suspect, of the crisis facing the traditional news business.

It's disappointing - and I can claim a bit of authority on this, as Englemed was one of the pioneers of web-based journalism for well over a decade.

It's primarily, it seems to me, aimed at the traditional media. It doesn't really set out what journalism can and should do on the web. Nor does it offer many clues as to how it will pay for itself.

The manifesto challenges what it calls the "gatekeeper" model of news ie that newspapers and broadcasters select news and that's what the public gets. That's true but one problem with that old model was that the media followed itself round in packs. However it you want to find out about allergy, for instance, you won't get much a range of material if you use Google news. You will get a thousand variations on the same current story. So I do think the micro-sites we are developing - with a selection of news going back over a period (here's allergy) have a role. Time will tell.

The manifesto does not distinguish between news and comment. Normally that's lesson one in journalism school but never mind. Comment and discussion is predominantly going to be free and unpaid in the new world. A very small number of bloggers make a living - but their numbers are nothing compared with the paid columnists in newspapers and pundits on broadcast media. The balance will change - but no significantly.

News, in contrast, is not free to produce and can be very expensive. The best news reporting is usually the most expensive to do. State funding (including license fees), as we've commented before, can pay for good journalism but can also undermine independent journalism in this new economy. The manifesto makes no comment, so far as I can see (some of the language is a little dense) on the ethics of state-funded news reporting.

In my view we're in a phony war at the moment. We enjoy diversity of news provision because the printed media - newspapers - still exist. There will continue to be money around, advertising money, to pay for something. Advertising investment will probably grow but advertisers will increasingly use technology to target users rather than publications. It may be that Google will have to pay directly for diversity by contracting with the main news agencies as well as the BBC, ultimately cutting out the middle person, the newspapers and websites that simply recycle agency copy.

Points 15 and 16 of the manifesto discuss quality, 7 and 8 I think refer to sourcing. Point 16 is dead right:
"The Internet debunks homogenous bulk goods. Only those who are outstanding, credible and exceptional will gain a steady following in the long run." It could have said more, in particular about sourcing. A manifesto could say that news reports should acknowledge, report and link to sources, where possible. With one or two exceptions, many print-to-web sites do very little of this. There isn't the recognition that you can do more with the traditional "reverse triangle" of news reporting. This states that you put catch headlines and summaries at the top of a story and then progressively flesh it out. On the web many readers will simply flick through headlines and summaries - just as newspaper readers do. Others will want to know more - and too often that extra is not provided (a partial exception is the BBC). Bloggers are encouraged to put in links - traditional journalists are not. If you have read this far, there are several links throughout this piece you can follow!


Jon Hunt

Struck off nurse in line for award

A nurse struck off the register for whistleblowing is in line for a major professional award, it was announced today.

Margaret Haywood was struck off by the Nursing and Midwifery Council for helping the BBC Panorama film on her ward - exposing poor standards of care.

Her removal has been challenged by the Royal College of Nursing and now she has been short-listed
by the Nursing Standard for its Patient's Choice award.

The winner of the award is decided by a public vote.

Ms Haywood was a nurse at the Royal Sussex Hospital in Brighton and she was nominated by a Sussex woman.

The nominator, "Janet", said: "Mrs Haywood felt so strongly about the standards of care she was witnessing to put her job on the line…Maybe her decision to approach Panorama was questionable, but no one can deny that it was probably the most effective way to instigate change, which would immediately benefit patients.

"In nominating Mrs Haywood, I would like to help send the message to the NMC that they are out of touch with the wishes of the public they deem to protect."

In removing Mrs Haywood's registration the NMC conceded that conditions on the ward were "dreadful" but said she had jeopardised patient privacy.

Five have been chosen from more than 250 nominations, by an expert panel of judges including Nursing Standard Editor- in-Chief Jean Gray.

Ms Gray said: "Nursing Standard is delighted to give patients and their loved ones the opportunity to nominate the nurse who they believe is the best in the country.

"Reading the testimonies has been a moving experience, demonstrating the real difference that nurses are making every day in their patients' lives. Now it's over to members of the public to choose our ultimate winner."

At a ceremony held at The Dorchester Hotel in London on November 9, the winning nurse will be named and awarded 1,000 UK pounds prize money.

Other finalists include Helena Corcoran, a health visitor based at the Maghull Health Centre in Merseyside, who is nominated for her crucial support during bereavement.

Margo Duffy, a community paediatric nurse at Warren Children's Centre, in Lisburn, Antrim, was put forward by two mothers for her practicality and sense of humour.

Kate Hendy, a community psychiatric nurse at Avon and Wiltshire Mental Health Partnership in Bristol, was chosen for her compassion towards the family of a dementia patient.

And Acosia Opoku, a community mental health nurse at Camden and Islington NHS Foundation Trust, was nominated as "a rare gem of a nurse".

Votes can be made over the phone, by text, or on the award's website www.patients-choice.co.uk . Voting closes on October 28.

Englemed's nursing news feeds are carried by www.uknursing.net and www.staffnurse.com

Criticising Auntie

Criticising the BBC is rather like criticising the Queen or the National Health Service. The British don't like doing it.

Sadly there is a problem - and at last the unthinkable is being said. In the case of the NHS the British chose to marginalise privately run health services and have the state run the service.

You can also argue they made similar choices over radio and television when the BBC was established. Undoubtedly few people have attempted to think through the implications of the BBC using the licence fee - that is levied with the force of law on almost every British household - to create a web presence.

Small operators like Englemed have known about this for a long time. When the BBC started putting news on-line, the market for news collapsed. Now the mainstream British media is waking up as local newspaper after local newspaper folds. And national newspapers are struggling - and there's one simple reason. There is a new generation that will not pay for news and expects everyone to provide it for free.

Although the opposition is inevitably led by the Murdoch family, who have always had a strong anti-BBC viewpoint, others, who might be expected to be sympathetic are joining in. This blog from Peter Preston of the Guardian group says it all.

Where has this left Englemed? Our revenue-earning business now is predominantly providing specialist services for medical and nursing websites. When the business was originally established we thought our own web-site would become like a health magazine. Then other websites came to us and asked for our services - so we parked that idea. The reality is that now we do not provide services to any consumer-oriented website.

So, as discussed previously on this blog, we decided to develop this site again.

For there is one aspect of the BBC news services - and other British media - that is little appreciated. That is that many of their reports come from the main press agencies. This affects the choice of news and the content. It also means that much of the BBC on-line content is not really originated by its own journalists but is bought in from a handful of agencies.

We've always thought there was room for alternatives. Mostly we make our own choice of news from primary sources. We also think an increasingly well-educated readership will want to see news on different levels. Yes, they want headlines and straightforward language to tell them what a story's about. But they may also want to read deeper - study the facts and statistics and check original sources. Even down-page stories don't have to be constrained by the quantity of newsprint or time allotted for broadcasting.

We'd like to do more and over the years have explored different kinds of newsgathering. Unlike other small journalistic ventures we've not veered off into PR or inhouse magazines. We've stayed in the news business. But like most organisations must operate within the funds available. We've developed partnerships with retailers based on an ethical advertising policy. Now we must encourage our visitors to support this and visit our partners!

Fantastic Voyage?

 I've not been able to resist comparing the technological breakthrough announced by a London-based research team with the classic Sci-Fi movie Fantastic Voyage.

Now August is known in media circles as the silly season - just when journalists are desperate for a story about an amazing medical breakthrough.

So there is a danger we grab at any breaking story and hype it up. How significant is the news from London?

Well it's still a long way from the 1966 movie, which starred Raquel Welch.The movie and a later movie inspired by it Innerspace involved the miniaturisation of human beings in their physical form. Nobody believes that will ever be possible.

But it's a big step towards the dream. The dream is that doctors will one day be able to board a vessel and navigate inside the human body to make repairs at cellular and atomic level.

They have been getting progressively closer, using wires and fibre optic cables. What's been done now doesn't involve wires and is much smaller in scale. A nanometre is one billionth of a metre - that's one millionth of a millimetre. So in laboratory conditions, doctors have successfully injected individual cells - stem cells - and guided them to a specific destination.

The technique has been tested as a treatment for the arteries but it is also the ultimate destination for cancer researchers - the possibility of planting drugs directly inside a cancer or directly on a cancerous cell circulating in the blood stream.

According to  Professor Quentin Pankhurst, of the London Centre for Nanotechnology: “Magnetic particles have been used as MRI contrast agents for more than a decade, and are both safe and convenient for use in the body.

"Using them as tags on cells and using external magnets to capture them in the bloodstream is, however, an entirely new prospect which may open the door to many new possibilities for targeted cell and drug delivery.”

So the new technique gives doctors a way of steering the craft, the Proteus, in the movie. It doesn't yet give them an improved way of piloting it ie a new set of eyes within the body.

But it's now possible to think of the Fantastic Voyage taking place through VR ie that a doctor will sit in a cabin manipulating cells, drugs and minuscule surgical tools within the body. It may not be long coming!

Here's the Englemed report on the research.

Press officers

A few years ago when I worked on a newspaper I found myself in the office of a press officer of a large hospital. On the wall was a list of all the stories I had written - and one or two by other people - rated according to whether they were positive or negative about the hospital. Sadly most were negative.

I believe that's the way professional media relations people work. They tot up column inches and subtract the negative from the positive.

I wonder how people like that are coping with the 21st century. My feeling is that many are coping badly. Chatting to professionals sometimes you find it is not their fault. Often their bosses are more concerned about whether they appear in The Times or some prestigious local paper than if they are really getting the message out.

This is a longish preamble to the fact that I am using the dog days of August to tidy up our own list of contacts, in particular I am chasing down those people who have ceased to send us stuff , have never contacted us or have failed to respond to previous requests. In time I may even name and shame.

Because Englemed is a new-fangled beast, a web-based agency, created from scratch on the web, not everyone takes us seriously. Some are more comfortable dealing pretty well solely with the Press Association and the BBC - with Reuters and the national newspapers on an occasional basis. After all we have only been around for, well, longer than a decade.

Sometimes the opposite happens and an energetic press officer moves from one job to another taking their contacts list with them and we find ourselves getting news from an entirely new source. Too often, sadly, the opposite happens and news just dries up, often from quite busy organisations. Someone's had a "tidy up" and we mean nothing to them - they may not even have worked in the health and medical sector before.

Who loses? They do, because they lose the chance to convey stories to a large audience and often we can pick up those off-beat stories that do not make the national "press".

We're on Twitter!

We've now gone on twitter! Our user name is jon@englemed and nickname is @ukmednews. You find us by searching for ukmednews

Mouth cancer alarm

Here's Hazel Nunn, of Cancer Research UK, talking today about the dramatic increase in rates of mouth cancer in the UK. Full report here.

Is dairy healthy?

A few years ago, a common sight on English door-steps was that of garden birds pecking through the tin foil tops of milk bottles. It no longer is - for the milk in the bottles no longer contains a top layer of cream. This is mainly because most families have moved to semi-skimmed or even skimmed milk, low in cream.

There have been other changes. On the table you may find cream and butter substitutes. One popular butter substitute is made from olive oil, another from pine tree oil. As we have frequently reported, olive oil and similar vegetable oils are the height of healthy eating. Farm products - milk, butter, cheese, cream, meat and eggs - are regarded with suspicion or as occasionally luxuries or treats, even though they have been a staple part of human diet for thousands of years.

In the 1970s the withdrawal of free school milk from schools was a big issue. When free food was returned to schools in the 1990s, it was fruit, not milk.

Now a remarkable study in the journal Heart suggests this view may be flawed. The evidence is powerful because it has been collected over 70 years and is based on a pioneering study of British eating habits. Researchers set out to relate the fate of the people in the study to their childhood eating habits - which had been well documented. The findings show no evidence that children who were stuffed with full-cream milk products had unhealthy hearts or circulation. And in fact they had the lowest death rates of any of their generation - and also enjoyed low death rates from stroke.

And the chances are that these children enjoyed a full cream diet. In the 1930s, if you could afford it, you could have a full cream pudding on your table every day - notably blancmange and rice pudding. There was also sago pudding, tapioca pudding, ground rice pudding.

Now, of course, this study does not compare the 1930s diet with a more modern diet. But it does chronicle a generation of Britons that has lived for longer and more healthily than ever before. It may be that those brought up on semi-skimmed milk and olive oil butter substitutes will do even better.

So for this 1930s generation, a childhood rich in full cream did no harm. One possibility is that it also had a big impact on the health of the bones - rendering dairy eaters less prone to bone breakages, falls and orthopaedic operations. That might explain their reduced death rates.

The big question about the research is whether dairy products were the only healthy factor in the children's diets. Maybe they consumed more milk and cheese because their families were wealthier than others. Perhaps a healthy level of calcium in the diet was an indication of a proper diet - as opposed to the restricted diet that poorer families might have lived on in the turbulent 1930s.

The detailed breakdown of the findings tends to bear this out. About 25 per cent of the children ate at least twice as many dairy products as others. These tended to come from high status social groups and to be taller and better fed than other children, getting about 20 per cent more energy than others in their daily diet. However they did not necessarily eat as many vegetables or as much fat as other children.

So although it is true that the high calcium levels in the children's diets probably reflected their families' greater wealth than others, it does not disprove the benefits of calcium and milk products. For, if wealth leads to better health, there must be a way this is achieved. And it is the high intake of dairy products - of all those milk puddings, rather than of fruit and vegetables - that stands out as a key feature of these 1930s families.

The researchers write: "Dairy products are important contributors to children’s intake of protein, vitamins and minerals and they play an important role in the maintenance of bone health.

"The beneficial effects of dairy and calcium intake suggested by this study were seen at estimated intake levels that are similar to the currently recommended intake amount for dairy and calcium in children."

More reports on diet and health here.

New osteoporosis guidelines

This is a post to allow readers to discuss the item:

Experts update osteoporosis guidelines

Englemed has no more information about this item than is reported in the story or is available in other related news items and cannot give advice.

Swine flu alarm

This is a post to allow readers to discuss the swine flu public health emergency.

Here's a list of our reports on this issue to date:

Full story of the swine flu epidemic here:

Early stories:
Complacency warning as swine flu spread slows
Swine flu cases pass thousand
Pigs catch swine flu from man
Hundreds in flu testing
Swine flu alerts raised as spread continues
Swine flu spreads - causes mild illness
Swine flu travels the globe
New flu vaccine hope
swine flu alarm.



Englemed has no more information about this item than is reported in the stories or is available in other related news items and cannot give advice.

Music - the food of the heart

This is a post to allow readers to discuss the item:

Music - the food of the heart

Englemed has no more information about this item than is reported in the story or is available in other related news items and cannot give advice.

Broccoli and the stomach

This is a post to allow readers to discuss the item:
Broccoli fights deadly stomach bug

Englemed has no more information about this item than is reported in the story or is available in other related news items and cannot give advice.

Bananas and blood pressure

This is a post to allow readers to discuss the item
Banana boost for blood pressure

Englemed has no more information about this item than is reported in the story or is available in other related news items and cannot give advice.

Tanning injections

This is a post to allow readers to discuss the news item:

Tanning injections bring health risks

Englemed has no more information about this story than is reported in the news item and cannot give any advice.

Comment

This is a post to allow readers to post comments on the news service in general or ask for a discussion thread on a particular news topic. We're going to set up some discussion threads on some of our most popular news items.

We're on Facebook!

I've never been sure about this thing, Facebook, but recently took a tentative step into it. On my personal page friends rapidly accumulated and chit chat flowed. So there's now a page for Englemed on Facebook. It brings together some of our material - mainly that of interest to the youngish group who use Facebook - so the emphasis will be on family health news.

We'll also add occasional links to other articles of interest. For instance Andrew Wadge of the UK Food Standards Agency runs an impressive blog - which we link to from here.

You find it simply by searching for "Englemed" within Facebook. If you're a Facebook regular it's an easy way to check out some of our material - stories will simply appear on your "wall" if you sign on as a fan.

April Fools?

So far no sign of a good medical April Fool today. Perhaps everyone has learnt their lessons.

Reading the daily welter of health and medical headlines, you can of course never be sure.

Doctors may be feeling their pay rise announcement is a joke - but strictly speaking that was announced yesterday.  Both our lead stories - an allergenic substance in shampoo and a new treatment for MRSA - were announced yesterday so they also are safe.

There's a welter of announcements from the UK Department of Health to mark the new financial year. I think they are meant to be serious although most wise people are avoiding making announcements today.

The BMJ has published a deadly serious story today - no chance of it being a spoof - and I happen to know that the lead author Chris Ham is a real person.

Aah, now here's a possible spoof on the Beeb: donkey milk and nine other ways to live to 100. The tips include fried egg and sausage sandwich. They've covered themselves by quoting from apparently real centenarians - so no evidence that these diets will help the ordinary Joe Bloggs.

Lifestyle the key - it's a secret!

There's new evidence this week that European medicine is failing to tackle unhealthy lifestyles. Back in September we had a big grumble about the state of British medicine.

Now European researchers have concluded that just one third of high risk patients are referred to lifestyle programmes - by that they mean people with high blood pressure, high cholesterol and too much weight.

Instead doctors and health systems rely on treating patients by drugs, according to the EuroAspire report. This was my comment back in September.

It is in fact the same team whose work formed the basis of my September posting and at the time they did not mention the over-reliance on drugs. But they could already see evidence that European medicine, including Britain, has not taken on board the evidence about lifestyle collected by the Americans.

I still think they are right. British primary care is now finely organised to find high risk patients and this is likely to get better. But the answer, when a problem is found, is usually pills. To be fair, not always. Where I live they are now giving people free passes for the gym and swimming - but not much dietary advice. And the free passes are being snapped up by the worried well.

Are Professor David Wood and his team wrong? What do you think?

Another embargo break

Where now for embargoes? Today sees another major break in the dam. The culprit so far as my monitoring can tell is The Times - that is the Times of London, for non-UK readers.

Another indication that something is afood is that The Times has gone to a lot of trouble to break a non-story. Their headline today - published at 11.11pm GMT on the web, is "Vitamin D is ray of sunshine for multiple sclerosis patients". This is not new and the latest research, which was due to be published at 10pm GMT on Thursday seems to be merely a scientific study explaining why this seems to be the case. Vitamin D generally requires sunshine and those of us who live in the northern half of the northern hemisphere do not get as much exposure as others.

A sad memo arrives from the publisher PLos Genetics: "Dear Colleagues, Please note that the embargo on this article has now been lifted due to an embargo break. We apologize for any inconvenience.
*****************************************************************************************************************
* * * * * EMBARGO: Thursday, 5th February 2009 * * * * * *
2PM PDT/ 5PM ET/ 10PM GMT ."

Please don't apologise. It's not your fault! As the release had been posted in the embargoed section of Eurekalert! you have to wonder what the fall out will be.

Dog eats dog over embargo row

Last year we predicted that embargo policies were going to come under increasing pressure because of on-line news (Englemed respects embargoes but with difficulty) and also because of the difficulty of observing US Time zones.

Yes, that's what has happened - and an almighty transatlantic row has broken out. The American Association for the Advancement of Science is affronted at European and British, in particular, attitudes and has been busy suspending or removing local outlets from access to its well-established Eurekalert! database. I'm told that organisations as diverse as The Telegraph, Die Welt and Ansa News have been suspended. The biggest row seems to be over the removal of the tabloid Sun newspaper from Eurekalert! over a science story Life on Mars.The Sun was later reinstated as a freelance had supplied the story.

Now the Association of British Science Writers is apparently to conduct a review of embargo policies. The UK Press Gazette has the story and the ABSW blog has some insights into the whole saga. More on this later maybe.

Meanwhile here's another embargo breach today, this time by the venerable old BBC. Wonder whether they will have their access suspended? You have to look at the times and dates - there is a 90 minute discrepancy.

Christmas confusion lasts for decades

A curious example of the kind of confusion caused by those light-hearted Christmas medical journals cropped up this week.

The British Medical Journal printed a letter in which a doctor admitted making up a condition some 30 years ago. The condition, dubbed Cello Scrotum, was supposed to be an injury acquired by cellists. It was a fiction, a prank.

Nevertheless there it was in a respected medical journal. So in December it was recycled in a further light-hearted article in the BMJ about musical maladies. It must be hard enough being a cellist without having to worry about damage to your manhood.

So at last the authoress of the original letter owned up. By now she has risen to great heights and is Baroness Elaine Murphy, a member of the British House of Lords.

The Baroness owned up but in an unrepentant kind of fashion. She stated: "We have been dining out on this story ever since. We were thrilled once more to be quoted in 'A symphony of maladies.'"

Trusting the media?

A fascinating study from Japan today where researchers argue that the mass media actually improves health.

The press release was headed "Trust me, I'm a journalist." The implication is that where people have faith in their mass media, they tend to absorb healthy living messages and improve their health.

The findings come from a major survey of 29 Asian countries involving tens of thousands of people, so they should not be sneezed at. In fact you would expect me to agree with them. After all the whole point of a health news service is to ensure everyone is better informed - and that readers and users learn to make sensible judgements about what's good and bad for you.

However there's a question of cause and effect here. Do the people of the Maldives trust the media because it is trustworthy - or because they are a little naive? And what makes the people of Hong Kong cynical? Their history?

So what's not clear from this study is whether it is the quality of the local media that makes a difference. Or whether it is the willingness of the public to take in the messages disseminated by mass media of all kinds that improves health. After all in Britain the experience is that the "mass media" can do enormous harm as well as good. Measles is currently on the rampage because of a false scare about the MMR vaccine.

You would have thought that a certain amount of informed scepticism would be the right way to treat media messages. Certainly not outright cynicism. Intelligent readership will recognise that every breakthrough, every scare, every bit of new advice may be wrong - but it also may be right. Without the mass media, people might not recognise the dangers of obesity, of poor diet and of smoking. It's no coincidence that the Asian researchers also linked health to educational levels.

Recognising that no single report can be taken in isolation, we try to present a complete news service here.