Complementary medicine research 'ignored'
Friday April 18th, 2008
Evidence supporting complementary medicine is being ignored by sceptical scientists, because journals rarely publish positive results, an expert said today.
This is the view of Professor Edzard Ernst, chair in complementary medicine at Exeter University, UK.
Professor Ernst writes in the journal BMJ Clinical Evidence that this is causing one of the most important questions about complementary medicine - does it generate more harm than good - to remain unanswered.
Complementary medicine encompasses dozens of approaches, some of which are biologically plausible, he writes. "Given this situation, one would assume that most healthcare professionals are keen to know what the evidence tells us."
Yet, "those sceptics who are emotionally opposed to complementary medicine have a knack of ignoring the evidence", he believes. Few positive findings are published, so we the impression is given that very little serious research is being conducted, and that the studies that do emerge find it to be ineffective.
"The truth, however, is more complex," Professor Ernst states. "On average, they compare very well in terms of methodological quality with trials in conventional medicine."
But "by no means does all the evidence demonstrate that the treatment under investigation generates more good than harm."
Supporters are often not fully informed as to what a clinical trial can achieve, and "the loser in these everlasting quibbles and debates is, of course, the patient".
Although many people are happy to pay considerable amounts of money for complementary medicine, they "are being continually and seriously misled by just about every source of information imaginable - even by government-sponsored initiatives", Professor Ernst writes. "Change is necessary, and positive change is best achieved if we begin to produce reliable information specifically for lay people."
Vitamin pills may be harmful
Thursday April 17th, 2008
Vitamin pills probably do not help healthy people to extend their lives - and some may do harm, researchers reported yesterday.
A study by the Cochrane Collaboration rejects earlier findings which suggests vitamin supplements can prolong life.
Researchers identified some 67 properly randomised clinical trials involving more than 232,000 people.
The findings suggest that three vitamins, A, E and beta-carotene increase death rates whilst vitamin C had no impact.
Only the mineral selenium seemed to help prolong life, according to the researchers at Copenhagen University, Denmark.
The researchers stress the findings only apply to supplements, not to the effect of a balanced diet including fruit and vegetables.
They said the findings did not apply to patients diagnosed with specific vitamin deficiencies - nor did they apply when vitamins were applied to specific diseases.
Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD007176. DOI: 10.1002/14651858.CD007176
Midwives hit out at pay gambit
Thursday April 17th, 2008
Midwife leaders have accused the NHS of "bully boy" tactics on pay.
The Royal College of Midwives is opposing the proposed three year deal for NHS staff along with several other unions.
However it has the backing of the Royal College of Nursing and some support from Unison.
But NHS chief executive David Nicholson is warning that rejection of the deal could leave staff worse off.
Mr Nicholson has written a letter stating: "If the proposed agreement is not accepted by union members, the Government reserves the right to review its response to the NHS PRB (Pay Review Body) recommendations and decide whether to accept, stage or abate them in the context of a one year settlement."
RCM general secretary Dame Karlene Davis said: "This is a bully-boy tactic to force midwives and the other unions to submit to a pay deal that will see earnings fall even further behind the real cost of living. This is not a slap in the face to midwives, it is putting a gun to their heads.
"David Nicholson and NHS Employers are doing deals with other unions and dismissing those who are not accepting the pay deal on offer. This is not the way to foster a sense of working in partnership across the NHS.
"There is a chronic and worsening shortage of midwives, and the proposed deal will do nothing to help change this. We need to give people an incentive to join the profession, not one to stop them entering it.
"Yet again – as last year - we are seeing the Pay Review Body having their recommendations circumvented. It only recommended an award for one year, not for three years at levels below inflation."
Chemotherapy may not cause memory loss
Wednesday April 16th, 2008
It may be a common misconception that chemotherapy hinders memory and concentration, researchers reported yesterday.
Dr David Darby of the Australian cognitive testing company CogState Ltd carried out a study to examine this belief.
"People could be making decisions about whether or not to have chemotherapy based on stories they've heard about 'chemofog' or 'chemobrain'," he said. "This is an important issue, particularly as survival rates for breast cancer improve. Hopefully this information will help people make informed decisions."
His study involved 30 women with breast cancer who were given cognitive tests before each cycle of chemotherapy and again one month after the final cycle. Results were compared against 30 healthy women. The women with breast cancer had slight problems in attention and learning skills before chemotherapy started. Chemotherapy itself was linked to only a minor slowing in thinking speed.
Findings were presented at a meeting of the American Academy of Neurology held in Chicago, USA, on April 15. Dr Darby believes that the stress of diagnosis may be behind the problems.
A second study looked at the same issue among 40 women with newly-diagnosed breast cancer, 27 women who had recently had a breast biopsy that was not cancerous, and 20 breast cancer survivors whose treatment was completed at least one year earlier.
The first two groups were slower and less accurate on tests of memory and learning than the survivors. Results did not appear to fall when chemotherapy began.
"These results suggest that cognitive difficulties experienced by women with a new breast cancer diagnosis may be related to stress as a result of the diagnosis and other quality-of-life factors," said researcher Dr Michael Boivin of Michigan State University, USA.
Professor warns of exhaust fumes toll
Tuesday April 15th, 2008
Vehicle exhaust fumes kill as many people every year as the notorious London smog of 1952, a veteran environmental disease expert warned today.
The mode of death is pneumonia - and at least 15,000 deaths a year from the disease are linked to volumes of traffic, according to Professor George Knox, of Birmingham University.
The new study links heavy traffic to illnesses such as peptic ulcer, heart disease and lung and stomach cancers.
But Professor Knox argues the link between lung disease and vehicle pollution is so strong this suggests the pollutants "directly" damage the lung tissue.
Professor Knox studied atmospheric emission levels in 352 local authority areas alongside causes of death between 1996 and 2004 for the study, reported in the Journal of Epidemiology and Community Health.
He found 390,000 deaths from pneumonia - with 54,000 of them concentrated in 35 local authority areas.
Professor Knox said: "Total annual losses as a result of air pollution probably approach those of the 1952 London smog."
J Epidemiol Commun Health 2008; 62: 442-7
Depression pills questioned again
Tuesday April 15th, 2008
The effect of new anti-depressants on suicide rates may be much smaller than has been claimed, according to a new study published today.
A study of more than two million people, conducted in Denmark, suggests that the new drugs are responsible for just one tenth of reductions in suicide rates -at most.
Researchers studied people over the age of 50 between 1996 and 2000.
According to the report in the Journal of Epidemiology and Community Health, suicide rates amongst older men in Denmark fell by 10 per 100,000 people during the period - but only one per 100,000 involved people taking anti-depressants.
Rates fell by 3.3 among women - but only 0.4 of this involved people taking the drugs.
Denmark saw a big six-fold increase in sales of anti-depressants during the 1990s while suicide rates among older people more than halved.
Researcher Dr Annette Elangsen, of the University of Aarhus, Denmark, says: "Current antidepressant treatment accounts for only a fraction of the falls in suicide rates among older people."
She adds: "Nevertheless more should be done to pick up and treat depression among older people."
J Epidemiol Commun Health 2008; 62: 448-54
Fathers "excluded" after birth
Monday April 14th, 2008
Childbirth has moved on since the days when fathers waited by the telephone to be told the sex of their baby - but they are still not involved enough, a campaign group claimed today.
The Fatherhood Institute claims that many fathers do not get "encouragement or support" to be involved with the birth of children.
And it says a small minority of uninterested fathers are allowed to "drift away".
The findings were rejected by the Royal College of Midwives today. It said midwives were "women's advocates".
The institute published a 12-point plan to improve the involvement of fathers, including a call for midwives to be trained on how to engage men.
It said more effort should be made to ensure fathers signed birth certificates - citing practice in Australia where inquiries are made if a father does not turn up to sign.
It says some 86 per cent of fathers now attend at birth - and argues that men can play a key role in pregnancy health.
The report calls for men to be allowed to stay overnight in hospital with the mother and baby after birth.
Duncan Fisher, of the Fatherhood Institute, said: "Research clearly shows that the positive involvement of fathers right from the start is crucial; and that when professionals engage with fathers, particularly young or otherwise vulnerable dads, this makes a huge difference to mother and baby.
"What actually happens now is that while the mother?s responsibilities are reinforced at every opportunity, the first message many fathers get after the birth is: 'leave this place now!' The father needs to be held as responsible as the mother for their child's wellbeing, which means staff taking every opportunity to inform, help or challenge him (as they do with mothers) rather than brushing him aside."
Janet Fyle, of the RCM, said: "Midwives are women's advocates. They will continue to serve and promote the interests of mothers and babies so that women have a positive outcome to their pregnancy and birth.
"The midwife's primary role is to the mother and baby; however, we see the inclusion of the nuclear and extended family as key to supporting mothers and their children."
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