Ministers under fire over bid to delay publication of air pollution plan

The government is facing renewed pressure after a last-minute attempt to delay the publication of its plan to tackle the UK’s air pollution crisis.

Ministers were under a court direction to produce tougher draft measures to tackle illegal levels of nitrogen dioxide pollution, which is largely caused by diesel traffic, by 4pm on Monday. The government’s original plans had been dismissed by judges as so poor as to be unlawful.

But following the announcement by Theresa May of a general election on 8 June, ministers lodged a lengthy application to the court late on Friday. It is understood it asked judges to allow them to breach the Monday deadline to “comply with pre-election propriety rules”.

The new draft would be submitted in June, after the election, with a full policy not produced until September.

Lawyers from environmental law group ClientEarth, which successfully took the government to court over its air quality plans, said the move was unacceptable, adding it was discussing its next move.

James Thornton, the group’s CEO, said: “The unacceptable last-minute nature of the government’s application late on Friday night, after the court had closed, has meant that we have spent the weekend considering our response.

“We are still examining our next steps. This is a question of public health and not of politics and for that reason we believe that the plans should be put in place without delay.”

The government lodged the lengthy application shortly before 7pm on Friday, which was too late for the court to accept. It was due to be considered by the court on Monday.

But ClientEarth said it was unlikely there would be a hearing on Monday as they would need time to respond to the government’s arguments, although the judge could order an emergency session.

The scale of the air pollution crisis was revealed in a joint Guardian-Greenpeace investigation this month showing hundreds of thousands of children were being educated within 150 metres of a road where levels of nitrogen dioxide from diesel traffic breached legal limits.

Last week figures obtained by Labour showed that more than 38 million people, representing 59.3% of the UK population, were living in areas where levels of nitrogen dioxide pollution were above legal limits.

Research consistently shows that exposure to traffic fumes is harmful to children and adults. Children are more vulnerable because their lungs are still developing and exposure to nitrogen dioxide reduces lung growth, causes long-term ill-health and can result it premature death.

Nitrogen dioxide emissions from diesel traffic cause 23,500 of the 40,000 premature deaths from air pollution each year, according to figures from the Department for Environment, Food and Rural Affairs (Defra). In April last year, MPs said air pollution was a public health emergency.

Thorton said: “Whichever party ends up in power after 8 June will need this air quality plan to begin finally to tackle our illegal levels of pollution and prevent further illness and early deaths from poisonous toxins in the air we breathe. The government has had five months to draft this plan and it should be published.”

A Defra spokesman said: “We are seeking an extension to comply with pre-election propriety rules.”

Ministers under fire over bid to delay publication of air pollution plan

Trump tried to burn down Obamacare. He set his hair on fire instead | Ross Barkan

Burning Obamacare to the ground was always a House Republican obsession that Trump, in the heat of the campaign, took up to spite the president while tossing a little red meat to Republicans. “Repeal and replace” is alliterative, after all: it sounds nice enough on an arena stage. It’s just hard to pull off in the real world, as Donald Trump found out on Friday.

Blessed with total control of government, Republicans can only think of how best to burn the house down – and they’re not even doing a good job at that. The House speaker, Paul Ryan, unjustly heralded as a policy wonk, tried to rush his healthcare bill to the floor for a vote on Thursday, only to find the moderates and extremists in his party rebelling. On Friday, Donald Trump was forced to pull the bill, due to lack of support from his own party.

It was a humiliating defeat, which he tried to blame – unbelievably – on the Democrats.

Paul Ryan on failed healthcare bill: ‘This is a disappointing day’

Ryan’s Trumpcare was a horrendous concoction and should disabuse fawning congressional reporters of the notion that the speaker is a man of deep intellect and self-reflection. Had the bill not fallen flat on its face this Friday, it would have had little chance of passing the Senate.

What remains is the fact that Donald Trump couldn’t close the deal. He is hoping everyone blames Ryan, and Trump is lucky that his supporters might do just that. The diehards, inhabiting his post-factual universe, will simply write Ryan off as a loser – they hated him anyway – and hail their king for the bounties he’s still promising.

But healthcare will ultimately be Donald Trump’s problem. That’s how our politics work. So far, the president has been more fatuous than fascistic, though he belatedly realized what an albatross the bill had become. His negotiating powers, whatever they ever were, failed.

Were Trump the deal-making genius his ego tricked himself into believing he was, he would never have taken up this healthcare venture. A recent Quinnipiac University poll found that only 17% of Americans approved of Trumpcare. Trump’s poorest and least educated supporters had much to lose and nothing to gain from the legislation.

That’s why demolishing Obamacare never made sense. After all, Trump, via Steve Bannon, promised economic nationalism, a robust spending plan for those who he believed deserved it most: the white and native born. Trump wasn’t going to lose any votes by focusing on immigration and infrastructure spending at the expense of Obamacare, which rank-and-file conservatives resent less now that Obama himself has been removed from the equation.

President ‘pulled out every stop’ to pass healthcare bill, Spicer says

Far from upholding the most basic protections for the working-class, the Trump administration has, instead, evolved into one of the most rightwing in recent memory. It is stocked with the kind of appointees (Mick Mulvaney, Tom Price) who could have been plucked from Congress by Presidents Ted Cruz or Marco Rubio.

This is the difference between Trump and someone like the French presidential candidate Marine Le Pen, the Front National leader who identifies closely with the billionaire. Le Pen’s fiscal platform is unapologetically leftist, rejecting the austerity measures embraced by Europe’s financial class.

Trump rages with all the hate of Le Pen and none of the savvy. Blaming Ryan for Trumpcare’s failure will not absolve him of trying to do a very stupid thing. If he chooses to weaken healthcare in other ways – to somehow prove Obama left the country with a self-destructing system – he’ll still be the president when premiums skyrocket as insurers struggle to adapt to this instability.

In 2018, 2019, and 2020, screaming Obama’s name won’t matter anymore. The country will just know President Trump and the damage being done.

Trump tried to burn down Obamacare. He set his hair on fire instead | Ross Barkan

Indonesia dismisses study showing forest fire haze killed more than 100,000 people

Indonesian, Malaysian and Singaporean authorities have dismissed research that suggested smoky haze from catastrophic forest fires in Indonesia last year caused 100,000 deaths. Some even contend the haze caused no serious health problems, but experts say those assertions contradict well-established science.

Last year’s fires in Sumatra and the Indonesian part of Borneo were the worst since 1997, burning about 261,000 hectares of forests and peatland and sending haze across the region for weeks. Many were deliberately set by companies to clear land for palm oil and pulpwood plantations.

The study in the journal Environmental Research Letters by Harvard and Columbia researchers estimated the amount of health-threatening fine particles, often referred to as PM2.5, released by the fires that burned from July to October and tracked their spread across south-east Asia using satellite observations.

In Indonesia, a spokesman for the country’s disaster mitigation agency said the research “could be baseless or they have the wrong information”. Indonesia officially counted 24 deaths from the haze including people killed fighting the fires.

Singapore’s Ministry of Health said short-term exposure to haze will generally not cause serious health problems. The study was “not reflective of the actual situation”, it said, and the overall death rate hadn’t changed last year.

In Malaysia, health minister Subramaniam Sathasivam said officials are still studying the research, which is “computer-generated, not based on hard data”. “People have died but to what extent the haze contributed to it, it’s hard to say,” he said. “If an 80-year-old fellow with high blood pressure, diabetes, heart problem and exposure to haze died, what did he die of? This is a hell of a difficult question to answer.”

The dry season fires are an annual irritant in Indonesia’s relations with its neighbours Singapore and Malaysia and the finding of a huge public health burden has the potential to worsen those strains. The 2015 burning season, which was worsened by El Niño’s dry conditions, also tainted Indonesia’s reputation globally by releasing a vast amount of atmosphere-warming carbon.

The Indonesian government has stepped up efforts to prosecute companies and individuals who set fires and also strengthened its fire-fighting response. This year’s fires have affected a smaller area in large part due to unseasonal rains.

Jamal Hisham Hashim, research fellow with the International Institute for Global Health in Kuala Lumpur, Malaysia, said governments should not dismiss the study even if the estimated deaths are arguable.

He said decades of air pollution research that followed London’s killer smog in 1952 has established the relationship between fine particulate matter and premature deaths, particularly in people with existing respiratory and cardiovascular diseases.

“The pollution level that occurred during the haze is severe enough to cause premature deaths. That is indisputable,” he said. “The study is a wake-up call. We need to be shaken; we have become too complacent with the haze.”

Joel Schwartz, an author of the study who is regarded by his peers as one of the world’s top experts on the health effects of air pollution, said authorities in the affected countries have not offered any details of how they reached conclusions critical of the study.

During the haze, Malaysia suffered air pollution at 10 times the level that the World Health Organization says causes premature deaths, he said, while Singapore’s claim that short-term exposure does not have serious effects is factually incorrect.
The Singaporean statement that its death rate was unchanged from 2014 did not demonstrate anything, Schwartz said, due to a worldwide trend for declining mortality. The study’s premise is that deaths are higher than what they would be without the haze rather than a comparison to a particular year, he said.

Separately, Singapore’s health ministry did not respond to a question on why heart disease and pneumonia, both of which can be brought to fatal conclusion by fine particle exposure, had increased as a percentage of deaths in 2015.

Malaysia, meanwhile, does not measure PM2.5 in its air pollution index but has been planning to from next year.

Half a dozen scientists with expertise in air pollution who reviewed the study for the Associated Press said its methodology was sound and its conclusions reasonable. Some cautioned that the estimates of 91,600 deaths in Indonesia, another 6,500 in Malaysia and 2,200 in Singapore are invariably uncertain because aspects of the modelling rely on assumptions and the actual figures could be higher or lower.

The study considered only the health impact on adults and restricts itself to the effects of fine particles rather than all toxins that would be in the smoke.

Philip Hopke, director of the Center for Air Resources Engineering and Science at New York state’s Clarkson University, said air pollution studies have to overcome several challenges because “no one who gets sick or dies comes to the doctor or hospital with a clear label that says airborne particles or ozone did this.” Another problem is the studies typically assume that fine particles are the sole cause of illness or death but smoke from fires contains ozone and a variety of volatile compounds that would also affect health.

“A major event like occurred here is extremely likely to have caused adverse health outcomes in terms of both sickness and deaths,” he said.

Indonesia dismisses study showing forest fire haze killed more than 100,000 people

Millennial Sleep Deprivation: Where there is Smoke, there is Fire

Unlike today, back in the 50s, smoking was glamorized, with famous actors flamboyantly appearing on the big screen with a cigarette in the corner of their mouth. They were surrounded by both smoke and hype, but over time, people started turning their backs on this unhealthy practice. Alas, younger generations endorse a wide array of other harmful behavioral patterns. Today, a fast-paced lifestyle with a lot of social activities and scarce sleep seems to be the new black. So, it is small wonder that Monday morning is one of the most dreaded moments in the life of millennials.

Millennium bug

Their parents used to smoke like chimneys, but millennials have their fair share of problems that impact their wellbeing. Most notably, sleep deprivation is the great plague of this population group, one which prevents them from reaching their full potential. Pay no heed to those trying to justify their bad habits and nurture delusions of being more productive when feeling tired. There is no going around the fact that lack of sleep is a problem which has a profound negative effect on your daily life and health.

When you are weary and down in the doldrums, you cannot be at your best. In fact, you struggle to process simple information, maintain your concentration, and are more prone to anger outbursts and mood swings. With impaired attention and inhibitory control, you cannot hope to nail daily tasks, can you? And that is just the tip of the iceberg, because sleeping problems bring about both depression and raise stress levels. What is more, research has shown that it facilitates drug use and increases cigarette consumption in smokers.

Give it a rest

On the other hand, with plenty of rest, you turn into a bundle of energy and face each new day with a wide smile. Yes, even when sleep deprived you may manage to get things done, but is that really the point? Scientific studies have confirmed that sleep is a powerful performance enhancer, that it affects our happiness, boosts creativity, and safeguards our health. So, it is clear that deprivation in the sleeping department can seriously affect your work performance, social life, self-esteem, grades and school, and mental health.

Of course, many millennials undermine sleep unwillingly, with a wide range of bad habits or by worrying about day-to-day troubles. Well, there are many ways to prevent these things from spilling over to your bedroom. First off, the time we go to bed is of the utmost importance for good sleeping habits. Adjusting it for an hour or two usually does the trick and elevates your energy levels. Sometimes, there are other objective hurdles present. This is the case, for example, with health issues that inhibit your good sleeping habits.

Well, this no longer has to pose a problem: purchase a humidifier in order to do away with humidity, a climate in which respiratory infections and allergies thrive. Moreover, there are many stunning solutions that aid in getting a good night’s sleep. My personal favorites are sleeping masks that feature LED lights on the inside. Namely, when the silent alarm kicks in, they gradually increase light intensity and ensure you do not wake too suddenly.

At last, although millennials seem to be born with a gadget in hand, they should consider declaring the bedroom off limits to electronic devices. When you need to melt your stress away, the last thing you need is an avalanche of text messages, emails, alerts, and social notifications. They only push you away from the dreamland, back into the distracting reality. Instead, come up with your own personal, relaxing ritual before going to sleep, and go to bed feeling satisfied. A hot bath with candles or a chapter of a favorite book can do miracles for setting the right sleeping tone.

Rise and shine

If you crave the feeling of waking up fully recharged, bear in mind that adjusting your lifestyle and turning to healthy habits makes all the difference. This is also a matter of education and bringing the negative effects of sleep deprivation to light. Just as people have tarnished the reputation of smokers back in the olden days, today we must raise awareness about proper sleeping habits. If you do not want to go up in smoke, you’d better get your sleeping hours in order. Drift away to dreamland on a tide of positive emotions and return from there rejuvenated and ready to take on any life challenge.

Millennial Sleep Deprivation: Where there is Smoke, there is Fire

New pharmaceutical conduct code under fire for not going far enough

Up to date drug company transparency suggestions will not deter doctors from accepting 1000′s of dollars which probably influence their prescribing habits, the peak entire body representing healthcare buyers says.

The Buyers Wellness Forum chief executive, Adam Stankevicius, stated pharmaceutical code of perform reforms proposed by the business physique Medicines Australia did not go far enough to give consumers confidence in the medicines they had been prescribed.

The guidelines will for the first time force pharmaceutical firms to disclose how much they invest on individual medical doctors, but people medical doctors can decide on to stay anonymous.

The expenditure on the unidentified medical professionals would rather be reported as a complete figure alongside the number of physicians it relates to. Buyers going on-line to find payments made to person medical professionals would be in a position to uncover only individuals who had consented to the data currently being made public.

“As a end result, senior medical authorities will nevertheless be in a position to receive tens of thousands of dollars in speakers’ costs, sponsored travel and other perks from a drug firm in return for providing talks about that company’s merchandise, without having these individual practitioner payments being disclosed,” Stankevicius said.

“Such undisclosed perks and remuneration undermine the independence of healthcare practitioners and the confidence of consumers in relation to medicines prescribing.”

Individuals should know if medical doctors were getting perks from the organizations that manufactured the medicines their doctors prescribed to them, he stated. “The code should need that practitioners forgo or repay payments from drug businesses if they are not ready to be named as recipients.

“One can reasonably question why the pharmaceutical sector would shell out millions of dollars a 12 months to Australia’s health care practitioners, if they are not expecting some return on that investment.”

But Medicines Australia chief executive Dr Brendan Shaw said the tips reflected best practice and had been created on the advice of the Australian privacy commissioner.

“[He] confirmed that it is best practice for a healthcare skilled to be asked for their consent just before personalized details relating to payments and transfers of value from pharmaceutical companies is published,” Shaw explained.

“Other legal authorities have suggested that businesses should obtain permission from doctors as a end result of commonwealth privacy legislation. We want to perform with the professions and health-related groups to inspire healthcare experts to supply consent.”

He mentioned relations in between pharmaceutical companies and healthcare experts had been suitable and useful, and that physicians ought to have no cause to want to hide that data.

“The pharmaceutical market and healthcare professional organisations previously every single encourage ethical collaboration, by way of self-regulatory codes of practice and guidelines,” he explained. “It is important that the two the business and healthcare professionals can demonstrate that these relationships are acceptable and ethical.”

The reforms would also allow up to $ 120 to be invested on a meal and beverages for personal medical doctors at occasions. “This greatest would only be suitable in exceptional circumstances, such as a dinner at a realized society conference with significant educational content material,” the recommendations say.

The transparency reforms have been submitted to the Australian Competitors and Client Commission for authorisation, a approach which will take up to 6 months.

If authorised they will get effect early next 12 months and apply to all Medicines Australia members, who provide virtually 90% of medicines accessible to patients.

New pharmaceutical conduct code under fire for not going far enough

Mobile Cardiovascular Screening Packages Come Underneath Fire

It seems like a no brainer. Cardiovascular screening is the #1 killer in the world so broad screening of the general population must be a good idea, right? Wrong, says the consumer group Public Citizen, at least when such screening is performed indiscriminately. Somewhat surprisingly, Public Citizen, which is often held at arm’s length by mainstream medicine, gained some support for its position from a major cardiology organization.

In its statement Public Citizen urged 20 hospitals to sever their involvement in a mobile cardiovascular screening program. The HealthFair Cardiovascular Screening Packages are unethical, mislead consumers, and do more harm than good, said Public Citizen.

In a blog post, the president of the American College of Cardiology. Patrick O’Gara, said that “the questions raised about screening have some merit…. we do not recommend broad and untargeted screening.”

The program, says Public Citizen, “peddles inexpensive cardiovascular disease screening packages to people living near the hospitals and institutions without identifying who has relevant risk factors that would make each of the screening tests medically appropriate. HealthFair’s basic cardiovascular screening packages include six tests that, among other things, take pictures of the heart, measure its electrical activity and look for blockages in arteries.”

“The promotions rely on fearmongering and erroneously suggest that for most adults in the general population, these screening tests are useful in the prevention of several potentially life-threatening cardiovascular illnesses – including heart attacks, strokes and ruptured abdominal aortic aneurysms – and make them sound like an appealing bargain,” according to Public Citizen. Among the harms cited by Public Citizen are false-positive results or the discovery of inconsequential abnormalities. ”Both circumstances can lead to additional unnecessary and risky tests and treatments that will harm some people, cause unfounded anxiety, and cost patients and insurance companies.”

Here is O’Gara’s statement about the issues raised by Public Citizen:

“The questions raised about screening have some merit. The American College of Cardiology and American Heart Association have joint guidelines that offer recommendations to guide physicians in making decisions with individual patients about their risk for heart attack and stroke. Other than assessing blood pressure and serum cholesterol, being attentive to diabetes and promoting a healthy weight with regular exercise, we do not recommend broad and untargeted screening. Decisions about the need for additional testing should be based on each patient’s circumstances.

“The American College of Cardiology participates in the Choosing Wisely campaign, which encourages physicians and patients to discuss the costs and benefits of often overused tests and procedures.”

Ethan Weiss, a cardiologist at the University of California at San Francisco, sent the following explanation for the counter-intuitive perspective on the dangers of screening:

Conceptually, people (including many doctors) believe that we should do everything we can to discover occult disease like heart disease. The assumption is that if we look hard enough, we can find disease and intervene to change the outcome in a positive way. People may ask, “What’s the harm?” However, for cardiology at least, there is no evidence to support this assumption outside of screening for hypertension, lipid abnormalities and diabetes. This situation is worsened when options such as executive physicals are offered, which harden the perception that there must be some health benefit, but you just need money to access it. Again, sadly, this is not supported by evidence.

There can be serious consequences to false positive results. Usually the harm is limited to unnecessary anxiety caused by false-positive tests, but there are also costs (many of these tests are not reimbursed) and the rare cases where false positives result in more tests that lead to complications and very serious medical consequences.

Here is another anecdote: I once had a symptomatic patient with well-managed risk factors who insisted on having a nuclear stress test annually. It had been something started by a colleague of mine who had seen him before me — a very senior and respected doctor — and it was hard for me as a young doctor to overcome the perception that I did not know what I was talking about.

I kept doing the stress tests for a few years, but all the while I tried to convince him it was a mistake. I finally resorted to telling him that I was concerned about all the radiation he was getting. He continued to insist on the tests because he believed (firmly) that this was helping him and could not harm him.

One summer, I got an urgent call from him from the U.S./Canada border where he was being detained —he had set off the Geiger counter crossing the border a few days after his stress test. He was shaken. I reassured him and convinced the border patrol that he was not a terrorist. The next time he came to see me, he agreed to stop having stress tests and has not had one since.

I do believe that we can and will eventually improve our prediction tools. Right now blood pressure, lipids, and diabetes are the only validated — and thus, recommended — things to screen. This does not mean that we don¹t talk about other factors such as
weight, body composition, nutrition, and exercise with our patients. The truth is that the evidence basis for these factors are pretty flimsy too, but we make the assumption that it can’t hurt, and I try to remind patients where we have strong evidence and where we do not.

The bottom line for me is to be honest with patients about what prediction and prevention tools we have and what the evidence basis is for each of them. Going forward, we need to work on more robust and careful studies from which we can learn how to better identify at-risk individuals and also validate whether the new tools do what they should. Finally, we should work to show that the information we learn from these tools can help improve clinical outcomes.

Mobile Cardiovascular Screening Packages Come Underneath Fire

Mobile Cardiovascular Screening Plans Come Underneath Fire

It seems like a no brainer. Cardiovascular screening is the #1 killer in the world so broad screening of the general population must be a good idea, right? Wrong, says the consumer group Public Citizen, at least when such screening is performed indiscriminately. Somewhat surprisingly, Public Citizen, which is often held at arm’s length by mainstream medicine, gained some support for its position from a major cardiology organization.

In its statement Public Citizen urged 20 hospitals to sever their involvement in a mobile cardiovascular screening program. The HealthFair Cardiovascular Screening Packages are unethical, mislead consumers, and do more harm than good, said Public Citizen.

In a blog post, the president of the American College of Cardiology. Patrick O’Gara, said that “the questions raised about screening have some merit…. we do not recommend broad and untargeted screening.”

The program, says Public Citizen, “peddles inexpensive cardiovascular disease screening packages to people living near the hospitals and institutions without identifying who has relevant risk factors that would make each of the screening tests medically appropriate. HealthFair’s basic cardiovascular screening packages include six tests that, among other things, take pictures of the heart, measure its electrical activity and look for blockages in arteries.”

“The promotions rely on fearmongering and erroneously suggest that for most adults in the general population, these screening tests are useful in the prevention of several potentially life-threatening cardiovascular illnesses – including heart attacks, strokes and ruptured abdominal aortic aneurysms – and make them sound like an appealing bargain,” according to Public Citizen. Among the harms cited by Public Citizen are false-positive results or the discovery of inconsequential abnormalities. ”Both circumstances can lead to additional unnecessary and risky tests and treatments that will harm some people, cause unfounded anxiety, and cost patients and insurance companies.”

Here is O’Gara’s statement about the issues raised by Public Citizen:

“The questions raised about screening have some merit. The American College of Cardiology and American Heart Association have joint guidelines that offer recommendations to guide physicians in making decisions with individual patients about their risk for heart attack and stroke. Other than assessing blood pressure and serum cholesterol, being attentive to diabetes and promoting a healthy weight with regular exercise, we do not recommend broad and untargeted screening. Decisions about the need for additional testing should be based on each patient’s circumstances.

“The American College of Cardiology participates in the Choosing Wisely campaign, which encourages physicians and patients to discuss the costs and benefits of often overused tests and procedures.”

Ethan Weiss, a cardiologist at the University of California at San Francisco, sent the following explanation for the counter-intuitive perspective on the dangers of screening:

Conceptually, people (including many doctors) believe that we should do everything we can to discover occult disease like heart disease. The assumption is that if we look hard enough, we can find disease and intervene to change the outcome in a positive way. People may ask, “What’s the harm?” However, for cardiology at least, there is no evidence to support this assumption outside of screening for hypertension, lipid abnormalities and diabetes. This situation is worsened when options such as executive physicals are offered, which harden the perception that there must be some health benefit, but you just need money to access it. Again, sadly, this is not supported by evidence.

There can be serious consequences to false positive results. Usually the harm is limited to unnecessary anxiety caused by false-positive tests, but there are also costs (many of these tests are not reimbursed) and the rare cases where false positives result in more tests that lead to complications and very serious medical consequences.

Here is another anecdote: I once had a symptomatic patient with well-managed risk factors who insisted on having a nuclear stress test annually. It had been something started by a colleague of mine who had seen him before me — a very senior and respected doctor — and it was hard for me as a young doctor to overcome the perception that I did not know what I was talking about.

I kept doing the stress tests for a few years, but all the while I tried to convince him it was a mistake. I finally resorted to telling him that I was concerned about all the radiation he was getting. He continued to insist on the tests because he believed (firmly) that this was helping him and could not harm him.

One summer, I got an urgent call from him from the U.S./Canada border where he was being detained —he had set off the Geiger counter crossing the border a few days after his stress test. He was shaken. I reassured him and convinced the border patrol that he was not a terrorist. The next time he came to see me, he agreed to stop having stress tests and has not had one since.

I do believe that we can and will eventually improve our prediction tools. Right now blood pressure, lipids, and diabetes are the only validated — and thus, recommended — things to screen. This does not mean that we don¹t talk about other factors such as
weight, body composition, nutrition, and exercise with our patients. The truth is that the evidence basis for these factors are pretty flimsy too, but we make the assumption that it can’t hurt, and I try to remind patients where we have strong evidence and where we do not.

The bottom line for me is to be honest with patients about what prediction and prevention tools we have and what the evidence basis is for each of them. Going forward, we need to work on more robust and careful studies from which we can learn how to better identify at-risk individuals and also validate whether the new tools do what they should. Finally, we should work to show that the information we learn from these tools can help improve clinical outcomes.

Mobile Cardiovascular Screening Plans Come Underneath Fire

When to Fire Your Doctor

Parting methods with a physician is inconvenient. 1st you have to transfer your data. Then you have to inform your story all above once more to someone new. Nevertheless, there are times when it really is far better to go than to keep. Here are some aspects to weigh.You can read through the full story here.

When to Fire Your Doctor

Exploding e-cigarette sets barmaid"s dress on fire

Element of it also hit at buyer at the Buck Inn Hotel, in Richmond, North Yorks, and left him with a red mark on his abdomen.

Miss Baty mentioned: “I was about to give someone their alter and I heard the bang. I could see the fire coming at me and I felt the heat as I ran away.

“I started crying hysterically and my arm was all black. My dress caught on fire as I ran away and I just did not know what was happening.

^{Ross Parry}

“A client came and took me in to the bathroom to calm me down. She washed down my arm which was all black and I even now didn’t know what had happened.”

Miss Baty, who has worked at the pub for nearly two years, was badly shaken by the explosion on Saturday.

She added: “I thought the fuse-box had blown up or a firework had gone off.

“Everyone was just so shocked.”

The e-cigarette belonged to fellow barman Stewart Paterson, 21, who has been trying to quit smoking since December final year.

Video courtesy Ross Parry

Exploding e-cigarette sets barmaid"s dress on fire

Contact for foreign personal companies to get more than NHS hospitals comes under fire

Hinchingbrooke hospital, Cambridgeshire, which is run by a private overall health company, was cited by the CQC boss as a model that other hospitals could comply with. Photograph: John Robertson

The ex-Conservative MP who chairs the overall health services care regulator is underneath fire right after calling for foreign private health companies to be permitted to take more than failing NHS hospitals.

David Prior, the boss of the Care Top quality Commission (CQC), mentioned European or American “hospital chains” should be given the chance to turn close to what he said could be as numerous as thirty NHS hospital trusts in England that have run into trouble by the finish of 2014.

That is more than double the 14 trusts that are at the moment in “specific measures” simply because of difficulties involving bad care, precarious finances or both.

Prior, a former deputy chair and chief executive of the Tory party, acknowledged in remarks to a well being seminar in London on Thursday that his suggestion would make controversy. “I know this will not go down well in some quarters, but truly there are some great continental [European] hospital chains as properly, fantastic American hospital chains,” he mentioned.

“Why do not we use their management – hold the hospitals as element of the NHS – but why will not we appeal to them to come above and help us flip round these failing hospitals?”, the Wellness Services Journal (HSJ) reported on Friday.

“We ought to carry the greatest achievable managers in the globe into the NHS,” he extra.

Prior cited Hinchingbrooke hospital in Cambridgeshire, the only NHS hospital so far currently being run by a private well being firm – in this situation, Circle – as a model that could be followed if such takeovers have been ever approved by ministers.

He told the HSJ that overseas companies could turn out to be involved in running NHS organisations for the first time by becoming given long-phrase management contracts, although hospitals’ assets would remain inside of the NHS and any this kind of companies would be “operating within the very same rules as the rest of the NHS”.

Labour reacted with displeasure to Prior’s remarks, which stick to his call in a Sunday Telegraph report last month for private firms to be given a larger function in supplying NHS companies. “Labour does not share David Prior’s evaluation and will vigorously oppose these moves,” mentioned Andy Burnham, the shadow health secretary.

Prior’s arrival at the CQC has prompted concern in some quarters that ministers are appointing political allies to crucial positions in and close to the NHS. In January the well being secretary, Jeremy Hunt, appointed Baroness Hanham, a Tory peer who was a minister until last autumn, as the interim chair of Keep track of, the NHS’s economic regulator. Nonetheless, each Prior and Hanham have previously chaired NHS hospital trusts, so have substantial expertise of the support.

Prior also voiced his support for nicely run, profitable NHS trusts taking above underneath-performing ones to create “hospital chains”. Hunt not too long ago appointed David Dalton, the extensively admired chief executive of Salford Royal NHS Basis Believe in, to search into this possibility, even though he is not examining no matter whether private hospital operators could do so.

Dr Mark Porter, chair of council at the British Health-related Association, the doctors’ union, created clear it would oppose any further Circle-design takeovers. “Satisfactory funding, understanding from ideal practice and management and workers doing work collectively to deliver the ideal attainable patient care is what hospitals in difficulty need, not a takeover by private suppliers, foreign or otherwise, who are by definition driven by profits, not by the public support ethos to care for patients,” Porter stated.

Burnham demanded that Hunt “urgently clarify whether or not the suggestion that the NHS demands widespread privatisation of solutions is government policy. There is a expanding suspicion between patients and staff that the NHS is currently being repeatedly run down to prepare public opinion for greater privatisation of solutions.”

Contact for foreign personal companies to get more than NHS hospitals comes under fire

Morwell coalmine fire: medical professionals warn residents face significant health dangers

Doctors have warned of serious overall health risks to people living about the Morwell coalmine fire, due to a carcinogenic air pollutant reaching levels up to twenty instances the average level.

The Medical doctors for the Setting Australia (DEA) group, which spoke to a rally of Morwell residents on Sunday, is also renewing calls for federally regulated monitoring and reporting demands to warn folks of growing hazards as they happen.

Thousands of Victorians are getting affected by smoke from the coal which has been burning for three weeks and looks to continue for a lot of months to come. The fire was found to have been deliberately lit for the duration of one particular of Victoria’s most serious fire conditions considering that Black Saturday.

The Victorian fire companies commissioner, Craig Lapsley, on Friday advised residents it would be at least 10 days before the fires stopped generating significant ash and smoke over the area, and the state’s chief well being officer Dr Rosemary Lester advised at-danger groups in South Morwell to temporarily relocate.

The government has supplied cost-free travel and relocation payments for some people as residents depart the region. There have been some complaints that the relocation payments are not obtainable to all residents.

On Sunday, the DEA, an environmental campaign group of medical doctors and medical students, warned the burning coal was producing an abnormally high level of particle PM2.five, which has been classified as a class one particular carcinogen alongside tobacco smoke and asbestos.

PM2.five is formed in a quantity of approaches, specifically in fossil fuel combustion, Dr Merryn Redenbach, study and liaison officer for DEA explained.

“In basic in Australia we have a daily regular exposure advisory restrict of 25 micrograms per metre cubed per day,” mentioned Redenbach.

“But there have been peaks of all around or in excess of 500 since the fires began at Hazelwood.”

In the fast short phrase, exposure to the substantial amounts of PM2.five was a danger to vulnerable groups such as young children, the elderly, and men and women with pre-present illnesses which includes heart and lung conditions, Redenbach said.

“For illustration on days when particulate matter is greater, we see much more hospital presentations with heart failure, heart arrhythmias,” said Redenbach.

“Long-phrase exposure of PM2.5 is related with increased mortality charges, but also with rates of lung cancer.”

In response to the fires, the Victorian atmosphere protection authority began hourly monitoring and publication of PM2.five, PM10 and carbon monoxide amounts from the long term monitoring station at Traralgon, two further stations at Morwell, and mobile monitoring equipment.

The EPA’s devoted web site for this ongoing scenario exhibits the air good quality index about South Morwell reaching above among 800 and 1100 on Thursday. Any reading over 150 is regarded “very poor”.

Whilst this degree of monitoring is providing concerned residents with continuous updates, the EPA does not routinely monitor fine particle pollution about coal mine communities, stated Redenbach, and the DEA is calling for federally regulated national monitoring and reporting requirements.

“It is unfortunate that Australia lags behind other countries in collecting and reporting on levels of fine particle pollution, as this is one particular of the most important methods we can recognize well being impacts,” mentioned Redenbach.

The Australian Health care Association put forward a submission to the Senate inquiry into the influence of air good quality on health in March last yr also calling for standard monitoring. The Senate inquiry advised buffer zones all around communities, and pollution monitoring close to key pollution sources.

President of the AMA Dr Steve Hambleton told Guardian Australia it would like to see not just regular monitoring and reporting demands of averages, but also of hotspots – for illustration all around railway lines, near factories and coal mines the place off-road diesel autos and building gear generate larger levels that on street autos.

”We would be very considerably in favour of [monitoring specifications],” explained Hambleton.

“How do we know there is a dilemma if we really don’t seem for it? Typical ranges really don’t tell us what we need to know.”

Hambleton also suggested systems ought to be in spot to warn folks if conditions adjust, so residents – and colleges and hospitals – could be told if a wind change was sending substantial amounts of the particles in the direction of them.

The DEA on Sunday also named for a move in direction of cleaner energy sources, as PM2.five is formed in many techniques, which includes grinding and crushing processes.

“This fire highlights the hidden expenses of electricity from coal which tend to fall disproportionately on some communities, and this is taking place now to the Latrobe Valley residents,” mentioned Redenbach.

“It is time to transition away from polluting coal to more healthy, cleaner power sources.”

Morwell coalmine fire: medical professionals warn residents face significant health dangers

Morwell mine fire: vulnerable residents suggested to relocate

Vulnerable individuals residing close to a raging coalmine fire in Morwell, even now burning three weeks right after it was deliberately lit on 9 February, have been advised to leave their homes.

Speaking in Morwell on Friday, Victoria’s chief health officer Dr Rosemary Lester recommended “particularly at-threat groups” in south Morwell, like pregnant women, the elderly, youthful kids and anyone with a pre-present lung problem, to temporarily relocate from the area.

“We are not presently seeing significant health effects from the smoke, such as an boost in ambulance callouts or hospital attendances,” she explained. “Health impacts could adjust if vulnerable men and women proceed to be exposed to smoke.”

She extra that the tips was precautionary and that there had been no important improve in air danger.

The Victorian premier, Denis Napthine, stated there was “no compulsion” for folks to depart, and stressed that no evacuation had been called, but said that some residents’ wellness may be in danger “based on the prolonged exposure to the smoke and the prospect of more exposure”.

The premier said he understood the “frustration” of Morwell’s 13,000 residents, facing their 19th day residing beneath a fog of smoke and ash. “The government is leaving no stone unturned to repair the problem, to offer assistance for the community, to give help for families, to seem following the wellbeing of the men and women Morwell, and to tackle the fire,” he said.

Earlier, fire providers commissioner Craig Lapsley advised reporters the fire would carry on to belch thick smoke over the location for days. “We nonetheless think if almost everything progresses well the greatest-case scenario is yet another ten days before that fire is to a position that it won’t place up considerable smoke or ash in excess of Morwell,” he explained.

Victoria’s Division of Human Companies will make grants offered to those Morwell residents who want to move, and additional police will be named in to guard their residences.

Political fallout from the fire seems to be set to linger extended following the smoke blanketing the rural Victorian town lastly clears. Speaking in Morwell on Thursday, Victorian deputy premier Peter Ryan stated an inquiry was required to “get to the bottom” of the origins of the massive fire, which is anticipated to carry on burning for at least two weeks.

“We require to get to the bottom of why it has designed in the initial spot and all the contributing variables to it and we want to learn from this,” he said.

“I have no doubt inquiries will be conducted in wonderful detail by respective companies to make sure we get to the bottom of all of this.”

Earlier, the Setting Defenders Office (EDO) named for an independent public inquiry into what it labelled a “major pollution and public overall health incident”.

“It’s time the nearby local community about the mine and the Victorian public have been given some answers as to how this has been allowed to occur,” Felicity Millner, EDO principal solicitor, stated.

High smoke alerts remained in place on Friday with air quality measured at about 767, according to Victoria’s Environmental Safety Authority, an improvement on scores of over one,000 late on Thursday. A reading through over 150 is regarded quite poor.

Authorities have given 25,000 face masks to locals but Lester, said on Thursday that carbon monoxide amounts have been not but high adequate to set off an evacuation.

Morwell residents have organised a rally on Sunday to demand compensation from mine proprietor GDF Suez Australian Vitality.

5 hundred people are expected to attend the demonstration at Immigration park in Morwell, where organisers will gather particulars on overall health concerns and the fiscal influence of the fire to kind the basis for a possible class action towards the mine owners.

A rally organiser, Nerissa Albon, explained the disused part of the mine that was at the moment ablaze was supposed to be covered with soil and grass to avoid flammability.

She stated she had visited a solicitor about legal action on behalf of Morwell residents.

“I was advised to have a class action or royal commission, that we need to have to have data from the individuals of Morwell,” Albon explained.

“We want to be compensated for reduction of earnings, compensated for overall health troubles more than the final two weeks.”

GDF Suez stated the mine’s rehabilitation, including the capping and covering of disused coal pits, was “ongoing”, and that huge parts of the area presently on fire had already been “grassed” as part of the system.

Police on Wednesday gave chilling information of the enormous fire’s origins. Victorian police chief commissioner Ken Lay explained it was believed the firebug lit a “test fire” in Hazelwood on 28 January to review its behaviour, ahead of setting one more in the spot on the morning of 9 February.

The arsonist then set 3 fires on the Strzelecki Highway at Driffield, near Morwell, all around 1.30pm on the Sunday, which spotted into the Hazelwood open-cut coalmine and continues to burn.

“This fire was set on the worst fire day for this yr and had the prospective to trigger an huge sum of damage and reduction of life,” Lay advised reporters.

Police think the individual accountable was probably to be an individual who lives or performs in the Latrobe Valley or wider Gippsland area, with the fires lit along grime tracks top into plantations behind the highway which also offered simple getaway routes.

“This was someone with a vehicle, a mode of transport, to set three sets of fire within a 15-minute time period,” Inspector Mark Langham explained.

The check fires lit two weeks earlier had been also in comparable locations, set inside of a handful of kilometres of every single other on substantial fire-danger days, he stated.

“We think that there is a bit of a systematic arsonist and we actually want to place a quit to this particular person really speedily,” Langham said.

A police spokeswoman explained on Friday that investigations have been ongoing.

Morwell mine fire: vulnerable residents suggested to relocate

NHS below fire in excess of redundancy payment to wellness chiefs

An NHS manager acquired a £370,000 redundancy payoff even however he went on to work in the wellness services for a diverse wellness believe in, it emerged last evening.

Rob Cooper, a former deputy chief executive at Yorkshire and the Humber Strategic Wellness Authority, was paid redundancy of among £370,000 and £375,000, The Occasions reported.

By the time the body was abolished he was working as director of finance for South London Healthcare NHS Trust and now works as interim finance director at Barking, Havering and Redbridge University NHS Trust, 1 of the worst-doing in the nation.

He was one of 3 managers paid a complete of nearly £1 million even even though they never ever stopped doing work in the NHS in accordance to a response given to Steve Barclay, a Tory member of the Public Accounts Committee in solution to a Parliamentary query.

Mr Barclay explained: “This is normal of the revolving-door culture that follows publicly funded redundancy payouts and displays a culture inside the NHS which stays cavalier with public money.”

Mr Cooper advised The Occasions: “While I have continued to perform in full-time employment in the NHS because March 2013, I have only charged 75 per cent of my time, which I think reflects the spirit of the letter from Sir David.”

There is no suggestion that any of the managers have broken any principles, but MPs condemned the way the NHS dealt with the redundancies.

Margaret Hodge, chairwoman of the committee stated: “It also seems as if the NHS has misled the two the National Audit Office and the taxpayer to the tune of above a single million lbs. It is not acceptable.”

A Department of Well being spokesperson stated: “We are looking at introducing hard new ideas to cap redundancy payouts for senior managers and claw back all or portion of the payment if they return to work for the NHS inside of a year of becoming manufactured redundant.”

NHS below fire in excess of redundancy payment to wellness chiefs

Fire Cider: Excellent Winter Tonic

I keep in mind the very first time I walked into a little herb and essential oil merchant retailer. The shelves all lined with glass jars containing the delicate herbs and oils in so numerous colours and scents.  I just felt exhilarated and it felt like a coming property.  Anything drew me in and produced me really feel a lot more alive just becoming there surrounded by these earthy treasures.  You know you have discovered your passion when the sights and smells of anything tends to make your heart sing.  That is how I come to feel about natural treatments and helping people come to feel much better.

Here’s a excellent example of a normal treatment that has a ton of healing positive aspects packed into an easy to use tonic.

Fire Cider: Fantastic Winter Tonic

• ½ cup Garlic (the all-organic antibiotic)


• ½ cup Horseradish (wonderful for heart overall health and digestion)


• ½ cup Onions (circulation support)


• ¼ cup Fresh ginger (breaks up mucus and also offers digestive support)


• ¼ tsp Cayenne to taste (fantastic for circulation)


• Honey to taste


• Apple Cider Vinegar.(Unpasteurized and Unfiltered)

Chop fresh garlic, onions, and horseradish into small pieces and then grate the ginger. The amounts and proportions recommended can fluctuate in accordance to your personal tastes and preferences. You can often change amounts employed and dominant flavors sought after in your up coming batch. Spot these prepared ingredients into a wide mouth quart jar and cover with Unpasteurized Natural Apple Cider Vinegar (this kind of as Braggs)  The vinegar should be about two to 3 inches above the herbs. Include cayenne to taste but not too considerably or it will be also hot. Allow the mixture sit two to 3 weeks in the covered jar. Strain and discard herbs. Add honey to the liquid to taste.  Fire Cider will be sizzling, spicy and sweet all at the identical time.

Here’s the link to Rosemary on Youtube generating this concoction

Rosemary says, I loved to take little shot glasses as a tonic and often individuals use it as salad dressing and/or on rice or steamed vegetables. It’s very tasty!

This recipe comes to us from the infamous Rosemary Gladstar. She has been inspiring herbalists for virtually 40 many years and I consider of her as the Julia Childs of the herbal globe. When you view her video lessons, you are right away drawn in by her great passion for her perform and her gentle, peaceful spirit. Through her many books, programs, conferences and herbal goods she has inspired numerous budding herb fanatics. I adore that she encourages you to take her recipes and then make them your own.  Add your very own bit of flare and creativity to them.  Mingle in your very own tastes and desires for the outcome and you now have one thing of hers but also one thing you have ownership in.

Be Properly,

Beth

Get more wonderful recipes from Rosemary Gladstar: Newbies Guide: 33 Medicinal Herbs to Know, Expand and Use

Fire Cider: Excellent Winter Tonic

Tyre fire at Yorkshire recycling plant seen from room - video and pictures

Taken by @djsalt1 by way of Instagram at Sherburn Aero Club on Thursday

A fire involving 15,000 tonnes of tyres at the Newgen Recycling plant in Sherburn-in-Elmet, near Leeds blanketed York in black smoke with heights of up to six,000ft.

The fire started out Thursday at around 08:forty GMT but the lead to of the huge blaze is however unknown. 

Photograph: @NorthYorksFire

Smoke from the fire was picked up by a Nasa satellite picture displaying the enormous plume of smoke towering over Yorkshire and the north of England.

A dark column of smoke was captured by a Nasa satellite – shown at the bottom right of the image Photograph: Nasa

Thick plume of black smoke witnessed from the Hull to Manchester train on Thursday. Photograph: Jonathan Cooke

North Yorkshire County Council recommended thirteen schools to maintain staff and pupils inside on Thursday, even though there have been no reviews of sick-well being as a outcome of the fire. 

Taken from Sherburn Higher School by @chelsmariexox on Instagram

Neighborhood residents had been suggested to keep indoors and maintain their windows and doors closed on Friday until additional notice. Public Health England’s Yorkshire &amp the Humber Centre said that the risk of long term health effects is likely to be really reduced with “publicity in excess of lengthy time period normally essential for harm to happen.”

@jblandy88 took this photo from his house in Brayton, Selby

North Yorkshire Fire and Rescue Support announced Friday morning that they were making it possible for the fire to burn up out: “We are scaling down our attendance but several fire crews continue to be at the scene, including two fire engines.”

Speaking to the BBC, North Yorkshire’s fire chief Nigel Hutchinson said that the fire is most likely to ”go on for days.”

North Yorkshire Fire and Rescue announced they were scaling back operations Friday morning, with officers on site still functioning to stop the fire spreading. Photograph: @NorthYorksFire

A substantial volume water pump is relaying water from a pond at the edge of the web site. Water curtains protected the recycling plant overnight. Photograph: @NorthYorksFire

View our video report

Tyre fire at Yorkshire recycling plant seen from room - video and pictures