Englemed News blog

Stop SOPA and PIPA

2012-01-18T16:38:00.001Z

Today we support this campaign which seems to be led by Wikipedia. It's not because we don't support effective copyright legislation. It's our lifeblood!

But by all accounts this US legislation seems weighted in favour of big business and will allow the sort of extra-judicial terrorism favoured by those who can afford corporate lawyers. We're not a big business.

We have a recent example - and it's on YouTube. YouTube appear to be using automatic systems to check for copyright infringement. If your video is the same as someone else's you may get a message accusing you of copyright infringement. On our channel is a video about London Fashion Week, which was posted on Women's News UK. It's never had many views and would not harm us if it was taken down.

However when we had a notice warning us we might be infringing the copyright of another business, our hackles rose. We investigated, challenged - and have never had an acknowledgement from YouTube that we have successfully defended our case.

What happened? The video was supplied by a News Agency on behalf of one of the Fashion Week's sponsors. Somewhat naively we posted it in whole - it was quite well made. The same video was supplied to others - and was posted on YouTube by someone else. No coincidence, no problem.

Had we not contested this, YouTube might have taken down our whole channel. We're not a TV station and rely on submitted videos for video content. We think it enhances on-line news and have our own approach and philosophy about using on-line video.

So we say yes to policing copyright, and no to an automatic assumption of guilt, often made by people who do not understand the business.

And, yes, our copyright has been breached in the past. We do monitor for breaches and we do have access to resources to take action in the case of infringement. But in reality, if you quote one of our articles in an on-line forum, we don't have a problem. All we'd like to see is an acknowledgement and a link, either to us or to the newsfeed, such as Doctors.net.uk, to which we supplied!

Check your weight!

2011-11-09T01:08:00.002Z

Check out our new weight checker widget.

It's courtesy of the US CDC.

Let's Talk About Food

2011-10-16T19:10:00.000+01:00

#BAD11 #worldfoodday Sometimes in medical reporting it feels as if that's all we do talk about. Food. It's good for you, bad for you, keeps you alive and kills you all at the same time.

Cynics say people end up getting a confused message. Well it's not our job to tell you how to live your life. Your doctor will do that. But if you're reading this you're old enough to make up your mind about certain things.

Our feed on diet and nutrition on this site - just a fraction of the reports we do on the topic - gives a flavour of the choices you can make. In a way the message is straightforward. Too little is bad for you, too much is bad for you. Even too little of some of the things we regard as unhealthy may be bad for you - but don't take my word for that. The experts seem to thing the artificial fats you find in cheap food are universally bad for you.

And if you do eat quite a lot, because you live in a rich country or a cold one, maybe you can help yourself by getting the balance of food right. Lots of vegetables and fruit. We don't often get a report saying this will cause a health problem. Not too much sugary stuff. As for whether you want to take your protein as meat or peanuts - we'll leave that one for you.

Today is World Food Day and Blog Action Day - which has been organised by a number of charities to focus on those who don't get enough food in this world. In the rich world there's so much focus on what foods are bad or apparently poisonous, it's easy to forget thousands suffer from malnutrition - and for these people the food rejected by the wealthy will indeed be healthy.

They've made #BAD11 a celebration. We're allowed to talk about what we enjoy. And that's exactly what Stacey Collins at Womens News UK has done. She's shared, yet again, her passion for chocolate, celebrating that here's something that isn't as bad as once was made out - maybe!

Australia joins Europe

2011-06-30T12:39:00.000+01:00

Australia's leading online physician community joins European Alliance

International growth of Networks in Health creates broad geographical physician engagement opportunity

30 June 2011, Oxford: Networks in Health, whose online communities already comprise over 600,000 physicians across Europe, has announced that the leading independent network of medical professionals in Australia has joined the Alliance.

e-healthspace.com.au, which launched less than 12 months ago, has an active membership of over 9,000 physicians - approximately 45 per cent of the entire general practitioner population. Usage of the community is high, and some 40% of members interact with the extensive clinical content, discussion forums, education modules and sponsored resources on a regular basis.

The Australian community, which initially sought to attract GPs, is now rapidly expanding its membership among secondary care physicians from key specialty groups, including oncology and cardiology.

Networks in Health was formed by Doctors.net.uk, the UK's largest online network of medical professionals, in May 2011. It is a unique international alliance of online physician communities which, having established strong affiliations across Europe, is looking to grow by recruiting further communities in key international healthcare markets.

Networks in Health's current partner communities include Egora and LaRevue du Praticien in France, Medcenter in Spain and Portugal, coliquio in Germany, Austria and Switzerland and MedUniverse in Sweden. Further announcements regarding new partners joining the Alliance are likely.

Gareth Thomas, development director of Networks in Health, said: "The launch of this 'network of communities' is answering a real need, especially for organisations wishing to research and engage with physicians internationally. We've been approached by many global pharmaceutical companies and healthcare organisations to talk about the unprecedented access to physicians now offered."

Kamalesh Goswami, Director of Online Solutions of e-healthspace.com.au, said: "We are now able to offer clients a single access point to a huge international physician audience. It opens up enormous opportunities, with international communications, marketing, education and research programmes all capable of being managed and measured in a fully integrated way."

Networks in Health is supported by medeConnect, its market research and insight partner, and independent division of Doctors.net.uk. community-based research - an approach which allows us to reach a broader cohort of physicians than ever before - medeConnect offers a range of new, digitally-based qualitative and quantitative methodologies for gathering insight from these communities.

Note: Englemed is the news provider for Networks in Health

iphone app

2011-06-16T12:53:00.000+01:00

Our news service provided to Doctors.net.uk has been on an iphone app available to doctors for some time now.

I have found this review of the app here:

http://itunes.apple.com/gb/app/medical-news/id339774460?mt=8&ign-mpt=uo%3D2

We'll be launching our own apps for the general public in the near future, for Android and other systems. Watch this space!

Unlocked!

2011-04-11T19:05:00.002+01:00

Site now unlocked and updated

Site locked!

2011-04-11T14:52:00.000+01:00

We've been locked off our site since the weekend because of engineering problems - so no updates here I'm afraid.

Our professional newsfeeds are not affected. You can find updates today at www.doctors.net.uk , www.uknursing.net, http://www.staffnurse.com/nursing-news and www.bloodmed.com. However unless you're a member of doctors.net you will have to wait to read one or two juicy news items that I haven't seen anywhere else today.

Plain red meat?

2011-02-25T23:00:00.000Z

Talk about plain speaking - the British government's campaign to shock, or nudge, the people into taking action against cancer got off to a bad start.

90g of red meat a day is dangerous, we were told. But how much is 90g? Who measures their meat in grammes when they eat?

If you go to a cheap restaurant you can buy steaks of six ounces, eight ounces, ten ounces even more. Surely a small steak is okay?

We posted a calculator on this blog sometime ago and we are able to establish rapidly that 90g is no more than a little over 3.5 ounces. The recommended daily limit of 70g is just 2.5 ounces.

No wonder the government press release did not mention steak. It did mention two beefburgers or a single lamb chop. Was it too much to ask that somebody could do the conversion into the traditional British measurement? After all there is not a lot that is more traditional than British roast beef.

As for daily limits, they do not really help when they are so small. My guess is that the experts could also agree a weekly limit . But if they can, they haven't told us. Now that would allow you to eat a 14oz steak, two sausages and two burgers a week. But nothing else.

Here's our full report. We'll put it on the site later.

Daily steak dangerous - Davies
People who eat steak daily are massively increasing their risk of developing bowel cancer, the British government warned yesterday.

The government wants people to cut their daily helpings of red meat to 70g - just 2.5 ounces.

It says eating 90g or more of red meat a day increases the risk of cancer.

The limit is about half the minimum size of a steak in a steak-house - of about six ounces.

The announcement is part of a government plan to "nudge" people into taking action to stop cancer.

The new advice says two beef burgers a day are within the limit - as is a single lamb chop or two slices from a roast joint.

Some 16,500 people a year die from bowel cancer and twice that many contract the disease.

Some 42 per cent of men are thought to exceed the recommended daily limit for meat consumption - and just 12 per cent of women.

Interim chief medical officer Professor Dame Sally Davies said: "Following simple diet and lifestyle advice can help protect against cancer.

"Red meat can be part of a healthy balanced diet. It is a good source of protein and vitamins and minerals, such as iron, selenium, zinc and B vitamins.

"But people who eat a lot of red and processed meat should consider cutting down. The occasional steak or extra few slices of lamb is fine but regularly eating a lot could increase your risk of bowel cancer."

Peter Baker, of the Men's Health Forum, said men need to ensure that large helpings of meat are an "occasional" event.

He said: "Men who enjoy regular breakfast fry-ups or roast beef dinners will be surprised to learn that eating too much red or processed meat might increase their risk of bowel cancer.

"This is a health benefit surely worth giving up a few sausages for."

Link to an analysis of the statistics

Link to a fish cookbook

Which US cities are higher than Ben Nevis?

2011-01-17T20:58:00.000Z

There's a serious point to this question. We were intrigued by the research linking high-living (up a mountain) with mental health problems.

So when writing the story, our writer tried to google some facts, ie this question: which US cities are higher than Ben Nevis? You'd think it was the sort of strange fact you'd find on wiki-answers - but, no, it was not there.

We knew that Denver was high - and sure enough it is in fact about a mile above sea-level. Ben Nevis in Scotland - the highest mountain in the UK - is just 4,409 feet high - well below a mile high.

The US research linked high living to suicide risk and the researchers were not just talking about loners living in shacks on mountainsides. They had also taken in statistics from cities such as Denver.

The findings are interesting but may well not apply to the UK, where the population mostly lives a lot lower than Colorado. In fact there must be a whole clutch of cities on the Rocky Mountains higher than Ben Nevis. How many? Does anyone know?

In fact it's hard to think of any British cities with any sort of altitude at all. There are many very hilly cities, such as Edinburgh, Bristol and especially in Yorkshire. But they all cluster on river beds or on the coast. I've googled cities such as Bradford in Yorkshire and the altitude is clearly so unremarkable it does not even appear on Wikipedia.

So here's another question for anyone interested. Are there any British cities 2,000 feet above sea level?

Losing weight

2011-01-04T23:44:00.000Z

Here's a great video just released by the American Heart Association on losing weight. If it's your New Year resolution, take a peek!

Facebooking

2011-01-03T15:51:00.000Z

Our Facebook page is picking up - after being in the doldrums for quite a while. Stories from this site and one or two of our related sites now feed into it automatically. It's building up a base of fans.

It's a great way to comment on stories, to follow our feeds and to rate them. And two or three postings a day is not intrusive on your Facebook feed. You can find the Facebook page here.

Happy Christmas!

2010-12-25T18:30:00.000Z

May we wish all our readers a very happy Christmas.
#xmas #christmas

Have they cracked the secret of a healthy lifestyle?

2010-12-03T12:44:00.000Z

In the last few days we've had the ideal body weight and the ideal diet. All we are waiting for is the perfect exercise regime - and we probably had that a few months ago. Are researchers really fine-tuning the secrets of healthy living?

This is a personal opinion - that we are actually a long way off. These major global studies give average results. They mix men and women. They may give good guidance - but may also mix individual factors that are critical to my - or your - health.

The Danish diet findings are intriguing. Intuitively they feel right: eat lean protein, whether meat, fish or something vegetarian, because they make you feel full, saturated. Avoid carbohydrates and eat low-sugar vegetables and fruit. It is a healthy version of the Atkins low-carb diet. But the results of the study barely back it up - they show is that this is a good way of keeping your weight down once you've been on a crash diet. And healthy diet is about more than weight, isn't it? It can have a direct impact on risk of heart disease, cancer and other illnesses - possibly.

So what about the distinction between meat and fish. Is that important? Or meat and soy? Or one kind of fat and other?

In some ways the US study of perfect body weight backs the Danes. The researchers say that if you live a healthy lifestyle, then there is a perfect body mass index to aim for. But talk to a health adviser and they may prevaricate. Does this "healthy lifestyle" include being fit or superfit? Body mass may be fat or may be muscle. Doesn't that make a big difference?

We know that weight, diet and fitness all go together. But isn't a little frustrating when sometimes we are told it's the weight you have to get right, sometimes it's the diet and sometimes it's the fitness? Of course the answer is a bit of each - and it's worth paying attention to all these bits and pieces of research. But do we really know why homo sapiens in a large chunk of the world is living for a lot longer than ever before?

Perhaps what we need is a study that tells us whether being a vegetarian bantam-weight body-builder really is the secret of long life and health.

Quality charter

2010-11-10T01:26:00.000Z

I have just reviewed our quality charter, which was drawn up nearly a decade ago.

I am pleased to say that only one thing has changed substantially in all those years - the address. Memo to me - change it, ASAP!

To be frank - one other item may have changed. The charter states we do not sell items - it is strictly correct, we do not currently sell directly but we do subscribe to a number of affiliate schemes, which we believe offer appropriate goods; and we do support some local historians who sell their own books. We are also considering selling second-hand books. But that is a story for another time.

Free services

2010-06-29T10:38:00.000+01:00

Our web-site manager is at Glastonbury and the rest of us are concentrating on a major new contract. So apologies that free news feeds are not currently running on their normal daily basis.

All contracted services continue as normal - and in fact are being stepped up.

Normal service will resume after Glastonbury (we hope).

Fattism or fatism?

2010-04-16T23:13:00.000+01:00

A new word surfaced today - fatism. Or is it fattism?

The authors of the word spelt it as above: fatism. We think that would be pronounced fay-tism when they really want a word pronounced fat-tism. In those circumstances English convention is to double the last consonant. For instance "ratting" not "rating" means chasing rats, "matting" not "mating" means making mats and you are "hatted" not "hated" if you wear a hat. That gives us "fattism".

In case you're in any doubt, it means prejudice against overweight people. Here's the story.

Curiously in the age of tweeting, English is becoming more like German with more and more portfolio words emerging. Does it matter? Probably not but we're resisting some of them - like "underway" and "healthcare". We'll generally write "under way" and "health care".

Citizen news editors?

2010-01-20T11:45:00.000Z

We've had it in mind for some time - they talk about citizen journalists but what about citizen news editors? The news feels instant these days but much of it takes time to prepare, especially if it's to have any depth and balance. A news editor's job involves selecting the stories worth working on .

Yesterday seemed the ideal chance to invite the e-world into our virtual newsroom - to help us to select the stories to write up.

There was a flurry of press releases during the morning, some for instant release, some with embargoes attached. There were all on different topics. Quite a few were government announcements - maybe we should just have planned a single story headed "government announcements". By mid-morning it was clear we were in a news fog and that choices would have to be made about the most significant news. What better solution than to ask potential readers?

We'd led in the early morning with some big stories on children getting the wrong drug doses, on maternity service problems and on a new meningitis vaccine - and also of course on Haiti. We were not behind with the news but we now found ourselves with many story proposals to sift.

So using the blog and using Twitter we rushed to implement the half-formed plan. The initial story-list had about 16 stories on it. We could not give details of embargoed stories but indicated the topics. What visitors did not know was that some topics included several possible stories - see today's big roll-up on pregnancy and diet.

We invited the world at large to be citizen news editors and help us to decide the most important stories, before we wrote them - even before we did any more work on them in some cases.

Here was how the day worked out, with regular updates on Twitter:

at 1pm we announced the poll and within minutes we'd added a 17th story to the story list;
several people retweeted the announcement (thanks for the RTs!);
by 3pm we reported there were enough votes for us to identify a couple of stories for extra work;
by 5pm we reported the exercise had prompted some people to send us extra material. We added one more topic on GP issues;
at 6pm we added two more topics on heart care and health-funding.
At midnight we closed and deleted the poll.
By 2am some of the selected stories we appearing on our newsfeeds.

The results? In fact, not a large number of votes after the initial flurry. Surprisingly a very small proportion of those who clicked through seem to have voted. I'd like to know if votes weren't being recorded and if there is a problem with the polling gadget on blogger.

Four topics came out level-pegging - medical training, alcohol policy, transplants and psychiatric drugs. We have written up the first three and they can be found on our news feeds. Given the nature of the news, we might not have done alcohol policy and transplants. But we have - and Britain's new alcohol policy is now today's lead item on Englemed and also at doctors.net.uk.

The vote did not dictate everything we did

Why did visitors not vote? It would be interesting to know. There may have been too many topics and they may not have been specific enough.

An exercise which involved a smaller number of very specific stories might attract votes. It would also be a problem. One result would be to tip off our competitors about stories we are working on. It would also mean we could not highlight embargoed reports - and there were plenty of those. We're not ready for that yet.

Could this be done routinely? Probably not. But we'll certainly attempt it again sometime when circumstances seem right. Yesterday it was worth doing - it helped us to see through a great fog of news, much of it with potential and much of it half-formed.

Tonight's story list - quick poll!

2010-01-19T12:47:00.000Z

We've had a large number of announcements about all sorts of topics today.

So here's your chance to help us decide the priorities for our news feeds and writers. Use our poll on the left to tell us which you think are likely to be the most important. You can cast multiple votes but please don't vote for more than half a dozen.

Don't forget we've already reported some of the stories you may see as headlines today - such as the drug errors that endanger child patients, maternity crisis in Milton Keynes.

Some of the stories on our story-list are embargoed until midnight - so we can only publish scanty details.

The poll will end at midnight, today Tuesday, GMT.

1/ NHS Constitution comes into law
2/ Protection for vulnerable adults
3/ New organ donation drive in Scotland
4/ Government drive against health inequality
5/ Regulation of medical education and training
6/ Psychiatric drug collaboration launch
7/ Personalised care plans announced for cancer survivors

The following topics are likely to be the subject of embargoed press releases about new research findings:
8/ cervical cancer
9/ smoking
10/ pregnancy
11/ nursing practice
12/ heart diagnosis
13/ fall prevention
14/ Benefits of the apple

Some more stories breaking today:
15/ Fitness criteria for assisted reproduction treatment
16/ UK drive announced against alcohol abuse

Slots reserved for more breaking news today
17/ Embargoed story on GP issues
18/ Embargoed story on heart patient care
19/ Embargoed story on health funding
20/

If you know of other news we should be looking at for our newsfeeds tomorrow, use the comment option.

* Poll now closed

Santa Claus row - we warned you!

2009-12-23T16:17:00.000Z

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...

2009-12-15T12:52:00.000Z

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?

2009-11-19T12:42:00.000Z

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

2009-11-05T11:53:00.000Z

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

2009-10-27T13:51:00.000Z

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

2009-10-27T12:10:00.001Z

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?

2009-10-21T13:59:00.000+01:00

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

2009-10-06T23:09:00.000+01:00

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

2009-10-01T10:58:00.000+01:00

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

2009-09-17T17:27:00.000+01:00

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

2009-09-13T15:49:00.000+01:00

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!

2009-09-12T12:00:00.000+01:00

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?

2009-09-09T11:54:00.000+01:00

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

2009-09-02T00:29:00.000+01:00

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

2009-09-01T15:24:00.000+01:00

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?

2009-08-18T15:04:00.000+01:00

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

2009-08-17T12:53:00.000+01:00

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!

2009-08-13T11:46:00.000+01:00

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

2009-08-11T02:31:00.001+01:00

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?

2009-08-07T22:58:00.000+01:00

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

2009-05-06T10:47:00.000+01:00

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

2009-04-27T09:39:00.001+01:00

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

2009-04-21T15:41:00.000+01:00

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

2009-04-21T15:04:00.000+01:00

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

2009-04-21T15:01:00.000+01:00

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

2009-04-21T14:57:00.001+01:00

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

2009-04-21T14:57:00.000+01:00

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!

2009-04-16T11:23:00.000+01:00

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?

2009-04-01T10:31:00.000+01:00

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!

2009-03-16T17:16:00.000Z

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

2009-02-05T01:19:00.001Z

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

2009-02-04T13:06:00.000Z

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

2009-01-29T13:05:00.001Z

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?

2009-01-22T10:45:00.000Z

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.

Merry Christmas?

2008-12-30T21:54:00.000Z

No I didn't forget it was last week. I wanted to point out there is a tradition of jollity in the world of medical news that is in danger of being fractured by the advent of e-publishing.

The way it worked was this. The press releases for each week's British Medical Journal and Lancet would be issued, embargoed, for publication every Friday. It meant that both eminent journals released their Christmas issues the Friday before Christmas - and the Christmas issue was traditionally pretty wacky.

Over the last year the embargoed Friday press releases have all but ceased. Articles are published on the internet first. Embargoes are enforced but they can be any day of the week.

This year's Christmas British Medical Journal stories were released on Thursday 18th and they were certainly a crazy mixture. We headed the story Head-bangers, texting, Twist and Slam.There was a second one about common medical myths. It is true that some of the reports contain a germ of seriousness - but it was interesting that so far ahead of Christmas a number of reporters seemed to report some of these items with po-faced seriousness.

And of course the Lancet did not come out the same day. In fact it does not seem to have had a comparable collection of stories - although a series of reports trickled out. There was the one about the woman who fainted after eating sandwiches. And another one about sneezing emerged so late that we did not bother to report it.

A dose of our own medicine

2008-11-29T10:58:00.000Z

A report this week struck right at the heart of what we do. Yes. it was another analysis of the world's medical journalism.

There was a conflict of interest but we did not hold back. We reported the story.

Like most such analyses, it concluded that most medical journalism in the mainstream media is flawed. That's no surprise. But the study, from Alberta, Canada, did make some interesting points.

It suggests four kinds of basic information that should be included:

the number of patients;
the methods used;
the doseage;
conflicts of interest.

Tania Bubela, who conducted the research, seemed to want to make the case that reporting is biased against alternative therapy. So I think that was why dose was important in her mind - as it is less standard in, say, herbal medicine than in mainstream.

Methods is an interesting challenge. Yes we always try and report the methods used. Frankly its tedious for the writer and the reader. The problem is that the "gold standard" is the randomised control trial. This means that neither the doctor nor the patient knows whether they are receiving the real pill or a fake - known as a placebo. As we saw in the case of acupuncture, creating a placebo can be problematic. It's okay with pills but with other therapies, how do you fake them?

There are other statistical methods, mainly involving the analysis of populations. These will tend to tell you about the impact of diet and lifestyle. They are rarely conclusive on their own but taken together, over the years, they can be pretty convincing. It was that kind of analysis that proved that smoking causes lung cancer - it took a long time.

And that's where numbers come into it. Yes, we would always report the number of people in a trial. It's very important. If percentage differences between a treatment working and not working are close, you want to see large numbers - thousands. If they are overwhelming smaller numbers, say hundreds, will do. The trouble is we still live in a world where some people have done statistics (and hence standard deviation etc) at school and others have not. Increasingly the younger generation, certainly in Britain, will have at least a smattering of statistics.

Finally there's conficts of interest. I touched on this in a recent posting. Frankly it's not always easy to know. But yes there are some stories which are disseminated actively by commercial interests. We are more cautious of these than others, perhaps. And we see sourcing as important. If we report a therapy, the report will generally come from a journal or a conference, possibly via a university. We will identify that source in detail. That's not usual in the mainstream media.

Is acupuncture harmful?

2008-11-15T18:52:00.000Z

There's a curious story we've written which may appear on this site quite soon. It is about acupuncture and reports a Chinese study of the impact of acupuncture on fertility treatment.

The researchers in Hong Kong set out to be scientific in their research and used standard medical research techniques. And that causes the problem.

The research compared fake acupuncture with real acupuncture. In fake acupuncture, treatment is given with fake needles which retract when pressed against the skin. This was meant to be the same as the use of a placebo in drugs trial. A placebo is a dummy pill meant to make the patient think they might be receiving treatment. So the psychological impact of receiving treatment is taken into account.

So if a drug works, patients taking the real drug fare better than those taking the placebo. If a drug is harmful, patients fare worse on the real thing. And if a drug is totally ineffective, both placebo and drug are about the same.

What Dr Ernest Ng and his colleagues concluded was that women who received fake acupuncture were more likely to get pregnant than those receiving the real thing. The women were received IVF treatment and 55 per cent of those in the first group were successful - compared with 45 per cent of those getting fake acupuncture.

What can be concluded from this? Almost certainly that acupuncture for fertility treatment does not work. But does fake acupuncture work? And is real acupuncture actually harmful, as you might conclude?

And how on earth do you write the story?

It would be a great deal easier if acupuncture had been compared with nothing. You could then conclude that acupuncture wasm harmful. But it is also possible that fake treatment is beneficial. It involved applying gentle pressure to acupuncture points - and maybe that is better than inserting a needle when a woman is trying to get pregnant.

It's been said that journalism is the first draft of history. Our story reads:
Pretend acupuncture may help boost fertility - and is better than the real thing, according to new findings.
That was not our first draft and it is just about tenable. The researchers certainly believed that the placebo effect was genuine - that fake treatment had helped to stimulate the women in some way.

It's also possible that real acupuncture was harmful to these women.

And it is even possible the whole thing is a statistical freak. The research involved just 370 women - and that is not a great deal when you are seeking a statistically robust result.

An advertising policy

2008-11-10T12:05:00.000Z

If you go to our page on services and policies, you will find our policy on accepting advertising is "currently under review". It's said that for ten years - as that has been the case for ten years. The Englemed site became largely a showcase for potential clients and we drifted away from our original idea of providing a news site for the public.

Now that's changed following a major revamp. And, after some consideration and research, we even have an advertising policy - which you can see reflected on the site!

We hope the site is now more useable and that it contains useful information.

The problem we had with advertising was not to compromise the independence of our news service. We are almost unique in that we do not draw from the main news agency sources that feed all media, papers, TV and web - mainly Reuters and the Press Association. You can see that today in our very different take on the story about statins and heart disease.

If we provide a service to another website there's a good chance they may be taking pharmaceutical sponsorship or relying on selling health products. When we agree a contract we negotiate carefully so they can reassure their users the news service is unbiassed. When there's been pharmaceutical sponsorship our experience has varied - but at the very least it tends to mean some restriction on what is published. One approach is simply to agree not to report about any marketed drugs. It means the news is about other issues, lifestyle, causes etc. That's fine - but we get unhappy if we come under constant pressure to identify, say, a particular cause when there may not be medical consensus about it.

On this site we think you need to be sure we won't hold back from reporting good or bad news about a treatment. So we don't want to be reliant on pharmaceutical sponsorship - even if it were possible (and there are legal issues involved too). Nor do we want to promote herbal remedies, vitamins, dietary supplements or alternative therapies. The news about these treatments tends to be mixed and you need to be sure you are getting it fairly. They may crop up on google ads which appear on blogs. That's fine - their appearance is largely out of our control although we can and will block a repeat advertiser who is clearly disreputable.

We have for some time promoted a limited range of books from reputable organisations and authors. And thanks to the wonders of affiliate schemes, we can now promote other relevant material to our visitors. We've always had a strong family focus. This is a feature we did on pregnancy issues some time ago. And our redesign gives fresh emphasis to this.

So if you're having a baby, there's maternity wear. There's toddler and baby safety devices. And there are those hard to find gifts for all the family and special occasions. There's even a garden centre! We think this is the right kind of ethical advertising for this site - so readers can be assured they are getting real news!

In praise of newspapers

2008-10-21T12:11:00.001+01:00

I worked on newspapers for nearly two decades before seeing the potential of the internet and becoming one of the first full-time on-line journalists.

It's ironic that in Britain the BBC should have become the main on-line news player. We can't pretend they are not - they dominate. For it is newspaper values, not broadcasting values that dominate web-publishing.

Consider what newspapers did:

They offered readers an instant selection of news, a kind of visual menu. It's not just the cramming of stories onto pages, it is the use of headlines. Over decades sub-editors perfected the art of writing short, snappy, intriguing headlines that caught the reader's eye and led them to that particular article. The art of the sub was refined by the constraints of the page. The sub was only allowed so many letters per headline - and often not many.

Newswriting was the same. The first sentence, the intro, has to sum up the whole story. It also has to be snappy and interesting. In a tabloid, it's more snappy, in a broadsheet it contains more detail. But the reader has to be able to take it in at a glance.

The same techniques are applied to the whole story.

Then the newspaper as a whole and each page is laid out with the same intent. The main headline, the big one in large print, is designed to be spotted by the casual browser passing by a newsagent or a newstand.

It's just the same as the web. Your readers are passing by. You have to catch their attention with a headline, with an intro. You have a fraction of a second to do so. The headline must be different and interesting. The first few words of the story must tell them it's interesting.

These are techniques and crafts that were built up over a century. If you worked on newspapers they were hammered into you.

That's why we prize newspaper experience at Englemed. We like good writing and good headlines. I always believed that newspapers, not the TV or radio, provided the template for the web. I was never sure they would adapt well - and the jury is still out on that. Many are struggling. Yet while the BBC, backed by licence fee cash, may dominate, it's had to learn newspaper ways and probably recruit newspaper journalists.

Englemed writer wins award

2008-10-06T10:54:00.000+01:00

Congratulations to our Australian correspondent Leigh Parry who has won a major award in her home country for her writing.

Leigh's work in medical journalism came to the attention of the judges through her feature articles in a local magazine, the Medical Observer.

Here are the full details of her success:

Awards recognise outstanding contribution to medical journalism
Leigh Parry and Helen Signy recognised with RACGP Media Awards
2 OCTOBER 2008 - The Royal Australian College of General Practitioner (RACGP) is presenting two awards tonight recognising contributions to Australian medical journalism.

Dr Vasantha Preetham, outgoing RACGP President, will be presenting the awards tonight at the Academic Session of the Wonca Asia Pacific Regional Conference/RACGP Annual Scientific Convention 2008 in Melbourne.

The awards recognise the excellent work of medical journalists in the areas of general practice news journalism and general practice clinical journalism.

“The media plays an important role in communicating key health care messages to the public. This means that journalists have a critical role in ensuring their reports are accurate, balanced and responsible,” said Dr Preetham.

“The RACGP is a champion of quality and excellence in general practice, so it is no surprise that we have extended this to health journalism! Congratulations to Leigh and Helen,” said Dr Preetham.

The winners for 2008 are:

RACGP Award for General Practice Clinical Journalism
2008 Winner: Leigh Parry (Medical Observer)
This award recognises the medical journalist whose work displays the specialist skills required for accurate reporting of clinical medical issues and whose work has had a significant impact on Australian general practice over the past year. The winner’s work has been judged as having consistently met high standards through appropriate research, balanced reporting and demonstrating respect for their audience, and whose work has supported high standards of general practice care for the people of Australia. In particular, Leigh is being recognised for her Medical Observer feature stories, which are balanced and well researched.

Drugs or lifestyle - which is Britain serious about?

2008-09-29T12:22:00.000+01:00

I find the comments made for World Heart Day yesterday quite disturbing. The European Society of Cardiology is concerned that health services are failing to take simple steps to reduce the risk of heart disease.

In other words, across Europe doctors and community nurses are failing to give basic but firm advice to patients - that they are too heavy, they should not smoke and they should improve their diet and take more exercise.

"The vast majority of high risk patients in Europe are not provided with a professional lifestyle and risk factor management programme," according to Professor David Wood.

It will be interesting to see how British doctors react to the statements. for there has been an increase emphasis in modern general practice, backed by contractual incentives, on preventing disease. If you smoke, you will certainly be encouraged to give up. If you visit your doctor, you are likely to have your blood pressure taken.

But then what?

As someone with relatives with high blood pressure I perceive a problem. For the Americans several years ago established that good diet and low salt levels can be almost as effective as drugs as reducing blood pressure. This was a massive study called DASH.

So should not every patient with high blood pressure be referred to a dietician? In my experience this does not happen. And just in case, I checked the latest guidelines from the National Institute for Health and Clinical Excellence. It turns out they are purely "pharmacological". All about drugs. There is no requirement to do anything about diet - so little gets done. Here's the link.

You won't get the same official guidance in the USA. There the National Heart Lung and Blood actively promotes the DASH diet. Here's the link. It even includes recipes.

You can sense the frustration in the European Society of Cardiology. They have done similar studies and yet governments are not rushing to take up their guidelines. In Britain it is the same government that complains frequently and bitterly about the rising cost of prescriptions. Why?

It also tells people to lose weight and urges "five a day". Yet the system fails to link this well-meaning advice directly to the diseases that people suffer and the drugs they are required to take. Is this a result of our paternalistic health system or just a conspiracy? Is it just a shortage of dieticians? Or am I wrong?!!

Here's the link to the latest Euro-heart guidelines, which set out not just what patients should do but what professionals should do.

The Mediterranean diet - again

2008-09-11T23:44:00.000+01:00

Another big story on the so-called Mediterranean diet today. This time researchers say it seems to help protect against chronic diseases.

The latest research picks up Parkinson's disease and Alzheimer's disease as well as heart disease and cancer. That makes it interesting so this time we are reporting it.

But as in May, I still have a problem with the medical definition of a Mediterranean diet. "Rich in olive oil, grains, fruits, nuts, vegetables, and fish", yes. But low in alcohol? Whatever happened to the grape and the wine that appears on dinner tables throughout the continent. The only really distinctive feature of the diet described here is olive oil, which by all accounts is pretty healthy. But nothing about the juice of the grape?

Again the latest findings ought to have credibility as they emanate from Florence, Italy. Florentines should know!

Newsfeeds

2008-09-07T20:50:00.000+01:00

Just a reminder of what we can do for your website. For a decade we have provided very specialised news feeds for a number of medical and health websites. When you sign up you deal directly with the editorial team and we can discuss exactly what kind of news and what frequency you want.

We can also support much broader newsfeeds, as with our collaboration with Doctors.net.uk. Although the web may seem to offer dozens of free health newsfeeds most originate with two or free major providers. Ours our distinctive, written knowing who are customers are. We've always been keen on sourcing and encouraged by the medical community we can provide quite detailed sources for material. This is important on the web and most major news organisations don't do this. Sometimes you can read a report and it's quite difficult to identify the quality of the research you are reading about.

Topics we have covered over the years include hepatitis C, haematology, allergy, oncology, technology, psychiatry, gastroenterology.

If you want to chat about this get in touch through newsroom (at) englemed.co.uk

A tenth anniversary

2008-09-06T00:36:00.000+01:00

Congratulations to our long-standing partner Doctors.net.uk now celebrating its tenth anniversary with a splash of balloons.

We're a little older and celebrated our tenth last year.

That was Web1 that Was

2008-08-08T16:24:00.001+01:00

One more blast from the past by way of introducing a discussion on the future of news on the web.

This was a series we did on hormone replacement therapy over a period of five years from 1997 to 2002. At the beginning of the period the first reports of side effects of this treatment were emerging. By the end, doctors were ceasing to prescribe it as a routine treatment.

For two years from 2000 to 2002, we backed this up with a discussion page. It was all done by hand. At the time you could not use an off-the-shelf discussion forum, let alone set up a blog. Comments were posted and laboriously added to the page by hand. This was a subject that has affected many women and comments continued to come in years after we ceased to maintain this micro-site in 2002 when the issue was all but settled.

Here's a flavour of the comments that came in later:
2004: Sylvia: "I took hrt for 19 years and felt good. I thought that I would try a period without it. I am 65. I came off it for two years and felt depressed,
very low, extremely tearful and lost my 'get up and go'. I am now back on it and I feel really great again. I intend to always take it."

2004: Diane: "I had a hysterectomy (including my ovaries) approximately six years ago. I have been on hrt for all of this time but unfortunately cannot say
that I feel good. I no longer feel like a woman. I feel that I have lost my looks, my hair has lost its shine and my skin looks really dull and I feel
lethargic all the time. Does anybody have any advice they can offer me in how I can feel better and feel better about myself. "

2003: Lynsey: "I take climagest 2mg I am 44 and I now feel very worried what to do. Either to stop or continue I have been taking HRT for 12 months."

2003: Des: "My mother has recently recoverd from breast cancer, she used HRT for a few years. I am very concerned that she was never told the dangers of taking these drugs, although they did make her feel better the risks long term could have been, and still could be life threatening. I would also like to know if there is anything being done to help these people who like my mother have suffered possibly unecessarily."

2003: Charlotte: "I had a hysterectomy at age 24 have been on hrt since that time, I am now 45. Found a lump in my breast 6 months ago, so far it's nothing. I am going to quit the hormones, and am wondering if coming off slow is better then just stopping."

People like to talk about their health and there's quite a few discussion forums around the web where they do that. They also like to check out information and rumours. If a report is in the newspapers they like to know what substance there is to it.

We felt at the time that by compiling a series of reports over a significant length of time, we gave readers a chance to get a flavour of how a medical debate was panning out. It was the same with the question about oils and fats in the previous posting. Individual reports may say something unexpected but when they saw the whole saga, reasonably intelligent reader would reach a single conclusion.

Now you can do this by means of a search engine....except that it will return an awful lot of results and building up the story is not always at all easy.

Next I want to take a look at the NHS Choices website. The British government plans to spend a whopping £80 million on this over the next three years. It has some interesting ideas ... but can it really become the ultimate consumer health site?

Human engine oil!

2008-08-07T11:43:00.000+01:00

Our fellow blogger, Reluctant Allergy Sufferer, has recently switched to a fish only diet. You have to read RAS's blog to understand the reasons!

There seems to be plenty of cheerful news for RAS in recent news stories. This is a subject that Englemed took an interest in from the start - and in some ways the flow of scientific stories about healthy eating seems to have slowed down in the last decade. That may be because the matter was largely settled - and our conclusion at the time was that the healthiest oil was olive oil, the key component of the so-called Mediterranean diet. As we reported recently here, this particular diet continues to attract interest. There is not universal agreement about what's in it but olive oil is definitely an ingredient.

RAS can't eat olive oil and uses rapeseed oil instead - that may well be just as healthy.

One story this week suggests that fish-eating helps maintain the health of the brain.Interestingly this finding does not apply to fried fish, such as traditional British fish and chips. I wonder whether this might depend on how the fish is fried. Traditionally it would be fried in animal fat and the chances are that modern shops use sunflower oil, which is not the healthiest of vegetable oils.

A second report last week looked at the Japanese lifestyle, which is based on fish. The Journal of the American College of Cardiology doesn't put a number on the benefit but instead reports on studies of Japanese men which suggest their arteries are in incredibly good shape.

Here's a link to our original feature, entitled Human Engine Oil, which dates from as long ago as 1998 in the very early days of the world wide web. The overall conclusions probably have not changed much in a decade although some of the paradoxical individual stories would seem to hold little water. For instance the theory that meat was better at preventing stroke than vegetable oil needs to be treated with utmost caution.

The way scientists talk about oils and fats has changed however. There's more emphasis on the difference between omega-3 and omega-6 and less on the concepts of polyunsaturated, saturated and monounsaturated.

Grammes and pounds

2008-07-12T18:58:00.000+01:00

Although metric weights and measures have been used in science for donkey's years, they continue to pose problems for the writing of English. Habits may be slowly changing in the face of official intransigence, but English families do expect to be told the weight of a baby in pounds and ounces and to measure the height of their children in feet and inches.

It's a particular problem when you are dealing with obesity because the concept of body mass index is based on the weight, in kilogrammes, divided by the height, in metres squared. That's very hard to calculate when your original information is based on imperial measures.

This is a roundabout way of confessing I was caught out late one night last week. I don't like admitting this because we pride ourselves on our numeracy, our ability to make sense of percentages, probabilities, weights and measures etc. I will tell how it happened and to make sure it does not happen again have placed a metric to imperial converter on the left hand column of this blog.

Quite late I realised that a good story on the survival of frozen embryos had not been written. The press release informed me - or so I thought - that these babies weighed on average about 200g. I reckon to be able to do this calculation in my head. One kg is 2.2 lbs. 200g is one fifth of this - and out the other end came seven pounds. Why? Well like every good primary school child I was using estimation. The report told us that these babies were quite healthy - which to my mind means between 2lb and 12lb. So our initial reports states that the babies weighed about 200g - or seven pounds.

In the cold light of day somebody pointed out the mistake and we set out to correct it. For 200g is more like six ounces - but that seemed incredible. Far too small for a new-born baby to survive.

So back to the original press release and this is what is said: birth weight was also higher – about 200 grams – in the FER group.

What it means to say was: birth weight was also higher – by about 200 grams – in the FER group.

So I can lay some of the blame at the European Society of Human Reproduction and Embryology, which put this out. I'll also double-check the conversions on the calculator. But the journalistic lesson is, as always, if you don't trust something, don't print it.

And here's a link to a US government site which allows you to compute BMI from imperial measurements (feet, inches, stones and pounds)

The poly-gone that didn't bark in the night

2008-07-01T00:47:00.000+01:00

Pity us poor journos. What are we to do when the Darzi report on the future of the NHS appears to offer none of the controversy we were promised?

Most noticeably - and I have checked - it does not mention the word "polyclinic" once.

It ought to be a gift for headline writers.

For a start there's the polly that didn't bark in the night. ( A reference to a Sherlock Holmes story for the unlearned)

Then there's the old joke about "polly gone" or in this case "poly gone" - clearly a story with many sides.

But most of all you long to do something with that Monty Python sketch. Is it a "dead polly" or a polly that's no more? And of course all these headlines don't really make sense. So today we've settled for "poly-plan gone" and "Is poly-plan no more?". I wonder if anybody else will do better.

Then there's the question of the content of the report. Even yesterday morning the papers were warning of outrage as general practice was handed over to private, nurse-run companies.

The report was published - with apparently none of that. Or is it buried in there somewhere?

Now reports of this kind are notorious for this kind of misinformation. Expectations and alarms are raised and then damped - everyone breathes a sigh of relief and welcomes all the good intentions. And there do appear to be many interesting ideas in this report.

Or has the Royal College of Nursing appeared to have spotted what the BMA and the Royal College of GPs missed. This was a modest proposal to allow nurses to transfer to the private sector by taking their NHS pensions with them. Welcome news to the RCN but not necessarily GPs. So is that the real meat (sorry, the parrot) of the report?

What exactly is a Mediterranean diet?

2008-05-30T01:54:00.001+01:00

Here's one we didn't do today. Normally a story about the so-called Mediterranean diet is a must for any newsroom.

It's the perfect storm. A diet redolent of lazy holidays overlooked by olive groves, of salads and exotic moussaka or pavlava or squid, and all topped off by excellent cheap wine. And it is really, really good for you, little doubt about that.

Today's story in the British Medical Journal purports to link the Mediterranean diet to a reduced risk of developing type 2 diabetes - that is the type of diabetes usually contracted later in life and caused by overeating and being overweight.

It originates from the Mediterranean country of Spain, home of olives and paella and on the coast of excellent sea-food.

There's only one problem with the story - the definition of the Mediterranean diet. Rich in olive oil, fruits, nuts, vegetables and fish, yes. But low in meat and alcohol?

Certainly not low in alcohol and when you think of moussaka or a traditional Italian meal you must question whether southern Europeans are really that averse to meat. Not when a standard meal consists of a pasta course - topped off with a meat sauce - followed by a meat course.

Yes, it's a healthy diet, I'm just not sure it's a Mediterranean diet, not without copious quantities of wine.

Embargoes in danger

2008-05-08T01:09:00.000+01:00

How long can the system of embargoed media stories survive the internet?

My question is provoked by the publication of the Commons health select committee's report on last year's junior doctor training fiasco. As expected the report did not spare individuals or organisation in its robust condemnation of what happened.

The report was embargoed until one minute past midnight today and we went to some lengths to get reports ready for publication on Doctors.net.uk at the crack of midnight.

Why did we bother waiting up? At 11.30pm on Wednesday a link to the report was posted on a DNUK discussion forum. That meant the committee had broken its own embargo - because of course it would rely on IT technicians to ensure the full report popped up at the correct time.

No matter because the on-line version of The Times carried the story at 9pm on the Wednesday, breaking the embargo with three hours to spare.

This is now a regular occurrence. Embargoes are particularly important in medical journalism because details of most medical journals are released in advance of publication of the journal. The Lancet and the British Medical Journal appear at one minute past midnight every Friday for instance. Except that the embargoes are routinely broken, without punishment, by on-line versions of the newspapers which appear on the web before midnight.

The newspapers should take care as it is embargoes that help them give their print editions an appearance of being fresh. You can release a story at 5pm and the chances are it will not make it into print the next day unless it is a major breaking story. It would be no problem for our service nor for many bloggers. The broadcast media might not be happy because they like time to compile interviews.

Having come from the world of newspapers we understand embargoes and observe them. It is to our advantage to do so - yet we would also benefit from fewer of them. We frequently report interesting health stories before they filter into the mainstream media!

Hard to avoid a comment

2008-03-06T00:57:00.000Z

Hard to avoid a comment on today's medical news feed.

A new poll, commissioned by the Royal College of Physicians, finds that yet again doctors are the most trusted professionals in the public eyes.

A doctor rates as trustworthy to 90 per cent of people, a professor to 78 per cent and a government minister to 20 per cent.

Then up pops Ara Darzi, who is a lord, a professor and a government minister. He is also a pioneer in surgical robotics and yesterday was opening a new robotics centre at Imperial College.

So what would be his personal rating? Or does it depend whether you are his patient, his student or a member of the public. I suspect so.

GPs speak out

2008-02-14T22:32:00.000Z

Here's a great YouTube posting from two GPs, seeking to explain the current conflict between their profession and the government. It's done in the hard guy, soft guy format of the kind used by comics Mitchell and Webb:

Wind Blows Over NHS

2007-10-25T16:03:00.000+01:00

Wind blows over NHS - September news review
It's been that season of high politics when leaders head to the remotest corners of the country, make speeches and encourage their troops.

From Blackpool, Bournemouth and Brighton the wind has wafted a series of announcements and proposals about the future of the NHS.

In a few weeks, months or even years the public will be invited to pass judgement at the ballot box.

So new Prime Minister Gordon Brown was keen to pledge his commitment to the service.

He revealed how he suffered an eye injury playing rugby as a teenager, and spent five years in treatment.

He stated: "I learned that with a simple twist of fate life can change.

"It was the skills of a surgeon, the care of the wonderful nurses, the attention and yes, the love and care of the NHS staff that managed to save one of my eyes.

"And it is because of the NHS that I can see the words I read today."

Some have detected a change of emphasis in Mr Brown's government, a shift away from using the private sector.

Certainly Mr Brown has proved himself a master politician, taking simple concepts and putting himself at the helm. On health he has had two themes - hospital infection and GP hours.

Last month he personally announced - twice - his plans to deep clean every hospital. He did not leave a great deal to Health Secretary Alan Johnson but it was left to Mr Johnson to explain exactly what the government was going to do about GPs.

"We need more GPs in our most deprived communities. Not just curing illness but working with other healthcare professionals on prevention as well," Mr Johnson stated.

He went on: "GP surgeries should be open at times and in locations that suit the patient, not the practice."

So that's clear enough. Will it be done by extending private companies' role in primary care? Not quite so clear.

But it's definitely one of Mr Brown's big themes. Before setting off for his conference, he told a gathering of some 1,000 citizen jurors in Birmingham: "What I am hearing, and what I am going to act upon is that people want more access to the GP out of hours, and at weekends."

Mr Brown's mastery of his craft was highlighted by the Conservative response the next week. They too announced plans to sort out primary care out of hours services.

Shadow Health Secretary Andrew Lansley, in fact, proved he had a plan to achieve it. His intention is to hand the budget back to practices and renegotiate the GP contract.

The Conservatives also pledged to allow patients to choose a GP - whether close to home or work. It's not clear whether this will extend to allowing patients to register with multiple GPs - at home and work - as expounded by the Confederation of British Industry.

Meanwhile the results of the citizen's jury project are awaited. Will it endorse government health policy?

Nobody is holding their breath - not if blogger Dr Ray is to be believed. Dr Ray had a spy in Birmingham who found out that some jurors were being paid £75 each for attendance. That excluded the one third of the audience who were working doctors or health staff. The payments were later confirmed by the Department of Health - suggesting that Dr Ray did indeed have a spy at the meeting.

The spy also reported the jury voting by two thirds in favour of government policy at every turn. This included: "Would you prefer gynaecological surgery to be carried out in your GP practice even if it meant the closure of your DGH facility?"

Quote of the month therefore goes to Dr Ray: "I can only say that the way the voting was done makes the Blue Peter voting fraud seem like, well, Blue Peter."

Back in the real world, efforts to sort out the medical training fiasco continue.

Both RemedyUK and the BMA have been putting forward points of view to a consultation being undertaken by the Department of Health.

Sir John Tooke's inquiry is due to report this month but the Department of Health did not wait for its findings before quietly launching its own in-house consultation with "stakeholders".

According to the department, Sir John's recommendations will be used to design a new system for 2009 - as the scope for change next year is "very limited".

RemedyUK in its response favoured a return to a deanery based system and confirmed the need to use CV-based applications.

The BMA's Junior Doctors' Committee (JDC), with new chair Ram Moorthy at the helm, suggested even smaller geographical units for applications. It called for multiple entry points for training and piloting of any new ideas. Finally it called for a UK-wide coordinated timetable - and pressed for this to be announced as soon as possible.

The consultation document provides some insights into choppy waters ahead. Amongst options for ST1 shortlisting, it highlights an "invigilated shortlisting test that is machine-marked, similar to the Clinical Problem Solving test used for GP training selection."

It reports JDC opposition to this but states there is good national evidence for its "validity" and "reasonable support" from stakeholders. So it proposed to run pilots of it next when it can get a deanery and speciality to agreed to do so.

A second method that looks as if it will be piloted involves "invigilated assessments for shortlisting (such as those typically used at selection centres) with interview at second stage. Assessments could include written, interactive exercises and/or simulations that have been piloted and validated. " It suggests that selection centres could screen out about half of all applicants.

In effect, these pilots would become part of the local processes of shortlisting that would be available to deaneries and specialties.

As to whether a national MTAS-style computer system will be used again – the question remains open. “The MMC England Programme Board does not currently have an agreed preference on this issue,” it states.

Some archive material

2007-10-25T16:02:00.000+01:00

Every month we produce a news review for doctors.net.uk. We try to make it interesting, readable and provocative to reflect the quality and passion of the discussion on this site.

They soon disappear from view on DNUK so I propose to post them up here as archive material, starting with last month's. They will not be as topical as when they appear on DNUK but may still retain some relevance. Comments are of course welcome.

Jon Hunt, publisher

Ten years and counting

2007-10-02T15:22:00.000+01:00

Englemed Health and Medical News went live on August 8th 1997.

Our news stories came from Australia, London, Scotland, Finland and Europe.

It wasn't the first news service on the web but it may have been the first specialist service of its kind. There was certainly little happening in Britain and it was a couple of years before the BBC launched a fully fledged web news service.

We'd spotted that the web was an ideal medium for health and medical issues. People around the world share the same concerns and interests when it comes to staying alive and being healthy.

We also wanted to bring our experience of newspaper journalism to the web. There are many more sophisticated ways now of achieving the kind of lay-out which we trialled - but

When it started we had our own ideas about how it would develop. We thought it would be stand-alone news site with paying subscribers and adverts.

That's not what happened for we went on to forge partnerships with a number of other sites, most notably doctors.net.uk.

During the internet bubble of 1999-2000, we avoided the temptation to seek to raise large amounts of cash and develop ambitious and unrealistic business plans. Instead we concentrated on the business of journalism, pioneering packages of reports from a number of major conferences.

We're British based but have always been international with links and clients in countries as diverse as Australia, Denmark, Canada and the USA.

We now think of Englemed as a news portal, bringing together a number of specialist sites, all sharing a common interest in providing users with a good quality and distinctive news service.

We're going to post our original pages from 1997. Looking back you get a clue as to how much the world has changed in just ten years.

However although people call blogs like this Web2, they're harking back to the original spirit which enabled individuals to branch out and test new ideas. So on to the next ten years!