Tag: Charity

Public health experts urge universities and schools to ban alcohol industry-funded education programs

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Public health experts are calling for a ban on alcohol industry-funded education programmes in UK universities and schools, which they say normalize drinking and downplay the long-term health risks of alcohol.

They include an industry-backed “freshers’ week survival guide” for university students and a theatre-based educational program in schools funded by Diageo, one of the world’s biggest alcoholic beverage companies, reports an investigation by The BMJ.

The call follows a successful campaign in Ireland that has led to educational programs funded by the alcohol industry being removed from schools.

But in the UK, universities continue to welcome initiatives funded by Drinkaware – a charity funded by major alcohol producers and retailers, venues and restaurant groups – intended to educate students about “responsible” drinking skills.

In universities, for example, Drinkaware materials are distributed to students, including a free cup to measure alcohol units and a wheel with the number of units and calories in popular drinks, while a “freshers’ week survival guide,” advises students to eat carbohydrates or protein before going out and drink plenty of water.

Drinkaware told The BMJ that “the cup and wheel help people understand how much they are drinking.” It added that it had quoted directly from the chief medical officer’s guidelines and that the stated aim of the guidelines is to inform people but not to stop them drinking alcohol, “as it is considered a normal activity.”

But Mark Petticrew at the London School of Hygiene and Tropical Medicine, said this focuses on the short-term effects of getting drunk. “Food has no relevance to the longer-term harms of alcohol, including cardiovascular disease, cancers and fetal alcohol spectrum disorders,” he argues.

May van Schalkwyk at the London School of Hygiene and Tropical Medicine added that the material selectively quotes from the chief medical officer’s advice.

The Department for Education said that universities are private institutions and the government has no remit to review materials distributed to students in England.

In Wales, universities were given a toolkit to assess whether they are keeping students safe from alcohol created by the Welsh government, NUS Wales, and Drinkaware.

But Mark Petticrew criticized the toolkit as “misinformation” given it omits any information about the risks of cancer, cardiovascular disease, injury, and death associated with alcohol. “The framing of the entire document is to preserve the industry reputation and not about protecting young people at universities from harm,” he says.

Karen Tyrell, chief executive of Drinkaware, described its work in UK universities as “a pragmatic and worthwhile contribution to reducing alcohol-related harm across the UK.”

We work with the grain of public opinion and treat people like adults capable of making informed choices. While some may not like it, alcohol is a part of our society and there is currently no public desire to change that. We make no apologies for delivering a range of activities which support our charitable objectives and organizational purpose.”

Karen Tyrell, chief executive of Drinkaware

In the absence of a specific ban, as in Ireland, industry-related alcohol education charities have also been active in schools, providing information to pupils as young as 9, the investigation finds.

There is a concern in the public health community that these industry-backed programs are poorly evaluated, says John Holmes, professor of alcohol policy at the University of Sheffield. Well-designed and effective programs have a role to play.

“Alongside that, we need other measures such as reducing the affordability of alcohol, reducing its availability, and better restriction of alcohol marketing,” he says.

Source:

Journal reference:

Davies, M., et al. (2024). Big alcohol: Universities and schools urged to throw out industry-funded public health advice. BMJ. doi.org/10.1136/bmj.q851.

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April 25, 2024

Hospitals cash in on a private equity-backed trend: Concierge physician care

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Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000 or more for easier access to their doctors.

It’s a trend that began decades ago with physician practices. Thousands of doctors have shifted to the concierge model, in which they can increase their income while decreasing their patient load.

Northwestern Medicine in Chicago, Penn Medicine in Philadelphia, University Hospitals in the Cleveland area, and Baptist Health in Miami are among the large hospital systems offering concierge physician services. The fees, which can exceed $4,000 a year, are in addition to copayments, deductibles, and other charges not paid by patients’ insurance plans.

Critics of concierge medicine say the practice exacerbates primary care shortages, ensuring access only for the affluent, while driving up health care costs. But for tax-exempt hospitals, the financial benefits can be twofold. Concierge fees provide new revenue directly and serve as a tool to help recruit and retain physicians. Those doctors then provide lucrative referrals of their well-heeled patients to the hospitals that employ them.

“Hospitals are attracted to physicians that offer concierge services because their patients do not come with bad debts or a need for charity care, and most of them have private insurance which pays the hospital very well,” said Gerard Anderson, a hospital finance expert at Johns Hopkins University.

“They are the ideal patient, from the hospitals’ perspective.”

Concierge physicians typically limit their practices to a few hundred patients, compared with a couple of thousand for a traditional primary care doctor, so they can promise immediate access and longer visits.

“Every time we see these models expand, we are contracting the availability of primary care doctors for the general population,” said Jewel Mullen, associate dean for health equity at the University of Texas-Austin’s Dell Medical School. The former Connecticut health commissioner said concierge doctors join large hospital systems because of the institutions’ reputations, while hospitals sign up concierge physicians to ensure referrals to specialists and inpatient care. “It helps hospitals secure a bigger piece of their market,” she said.

Concierge physicians typically promise same-day or next-day appointments. Many provide patients their mobile phone number.

Aaron Klein, who oversees the concierge physician practices at Baptist Health, said the program was initially intended to serve donors.

“High-end donors wanted to make sure they have doctors to care for them,” he said.

Baptist opened its concierge program in 2019 and now has three practices across South Florida, where patients pay $2,500 a year.

“My philosophy is: It’s better to give world-class care to a few hundred patients rather than provide inadequate care to a few thousand patients,” Klein said.

Concierge physician practices started more than 20 years ago, mainly in upscale areas such as Boca Raton, Florida, and La Jolla, California. They catered mostly to wealthy retirees willing to pay extra for better physician access. Some of the first physician practices to enter the business were backed by private equity firms.

One of the largest, Boca Raton-based MDVIP, has more than 1,100 physicians and more than 390,000 patients. It was started in 2000, and since 2014 private equity firms have owned a majority stake in the company.

Some concierge physicians say their more attentive care means healthier patients. A study published last year by researchers at the University of California-Berkeley and University of Pennsylvania found no impact on mortality rates. What the study did find: higher costs.

Using Medicare claims data, the researchers found that concierge medicine enrollment corresponded with a 30%-50% increase in total health care spending by patients.

For hospitals, “this is an extension of them consolidating the market,” said Adam Leive, a study co-author and an assistant professor of public policy at UC Berkeley. Inova Health Care Services in Fairfax, Virginia, one of the state’s largest tax-exempt hospital chains, employs 18 concierge doctors, who each handle no more than 400 patients. Those patients pay $2,200 a year for the privilege.

George Salem, 70, of McLean, Virginia, has been a patient in Inova’s concierge practice for several years along with his wife. Earlier this year he slammed his finger in a hotel door, he said. As soon as he got home, he called his physician, who saw him immediately and stitched up the wound. He said he sees his doctor about 10 to 12 times a year.

“I loved my internist before, but it was impossible to get to see him,” Salem said. Immediate access to his doctor “very much gives me peace of mind,” he said.

Craig Cheifetz, a vice president at Inova who oversees the concierge program, said the hospital system took interest in the model after MDVIP began moving aggressively into the Washington, D.C., suburbs about a decade ago. Today, Inova’s program has 6,000 patients.

Cheifetz disputes the charge that concierge physician programs exacerbate primary care shortages. The model keeps doctors who were considering retiring early in the business with a lighter caseload, he said. And the fees amount to no more than a few dollars a day — about what some people spend on coffee, he said.

“Inova has an incredible primary care network for those who can’t afford the concierge care,” he said. “We are still providing all that is necessary in primary care for those who need it.”

Some hospitals are starting concierge physician practices far from their home locations. For example, Tampa General Hospital in Florida last year opened a concierge practice in upper-middle-class Palm Beach Gardens, a roughly three-hour drive from Tampa. Mount Sinai Health System in New York runs a concierge physician practice in West Palm Beach.

NCH Healthcare System in Naples, Florida, employs 12 concierge physicians who treat about 3,000 patients total. “We found a need in this community for those who wanted a more personalized health care experience,” said James Brinkert, regional administrator for the system. Members pay an annual fee of at least $3,500.

NCH patients whose doctors convert to concierge and who don’t want to pay the membership fee are referred to other primary care practices or to urgent care, Brinkert said.

This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

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April 1, 2024

After Appalachian hospitals merged into a monopoly, their ERs slowed to a crawl

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In the small Appalachian city of Bristol, Virginia, City Council member Neal Osborne left a meeting on the morning of Jan. 3 and rushed himself to the hospital.

Osborne, 36, has Type 1 diabetes. His insulin pump had malfunctioned, and without a steady supply of this essential hormone, Osborne’s blood sugar skyrocketed and his body was shutting down.

Osborne went to the nearest hospital, Bristol Regional Medical Center. He said he settled into a wheelchair in the emergency room waiting area, where over the next few hours he drifted in and out of consciousness and retched up vomit, then bile, then blood. After 12 hours in the waiting room, Osborne said, he was moved to an ER bed, where he stayed until he was sent to the intensive care unit the next day. In total, the council member was in the ER for about 30 hours, he said.

Osborne said his ordeal echoes stories he’s heard from constituents for years. In his next crisis, Osborne said, he plans to leave Bristol for an ER about two hours away.

“I want to go to Knoxville or I want to go to Roanoke, because I do not want to further risk my life and die at a Ballad hospital,” he said. “The wait times just to get in and see a doctor in the ER have grown exponentially.”

Ballad Health, a 20-hospital system in the Tri-Cities region of Tennessee and Virginia, benefits from the largest state-sanctioned hospital monopoly in the United States. In the six years since lawmakers in both states waived anti-monopoly laws and Ballad was formed, ER visits for patients sick enough to be hospitalized grew more than three times as long and now far exceed the criteria set by state officials, according to Ballad reports released by the Tennessee Department of Health.

Tennessee and Virginia have so far announced no steps to reduce time spent in Ballad ERs. The Tennessee health department, which has a more direct role in regulating Ballad, has each year issued a report saying the agreement that gave Ballad a monopoly “continues to provide a Public Advantage.” Department officials have twice declined to comment to KFF Health News on Ballad’s performance.

According to Ballad’s latest annual report, which was released this month and spans from July 2022 to June 2023, the median time that patients spend in Ballad ERs before being admitted to the hospital is nearly 11 hours. This statistic includes both time spent waiting and time being treated in the ER and excludes patients who weren’t admitted or left the ER without receiving care.

The federal government once tracked ER speed the same way. When compared against the latest corresponding federal data from 2019, which includes more than 4,000 hospitals but predates the covid-19 pandemic, Ballad ranks among the 100 hospitals with the slowest ERs. More current federal data is not available because the Centers for Medicare & Medicaid Services retired this statistic in 2020 in favor of other measurements.

Newer data tells a similar story. The Joint Commission, a nonprofit that accredits health care organizations, collected this same measurement for 2022 from about 250 hospitals that volunteered the data, finding a median ER speed of five hours and 41 minutes — or about five hours faster than Ballad’s latest annual report.

Ballad Health spokesperson Molly Luton said in an email statement that, by holding patients in the ER, where they are observed while waiting for a bed, Ballad avoids “overwhelming” its staff. Luton said ER delays are also caused by two nationwide crises: a nursing shortage and fewer admissions at nursing homes and similar facilities, which can create a backlog of patients awaiting discharge from the hospital.

Luton added that Ballad’s ER time for admitted patients has dropped to about 7½ hours in the months since the company’s latest annual report.

“On those issues Ballad Health can directly control, our performance has rebounded from 2022, and is now among the best in the nation,” Luton said.

Luton also noted that Ballad performs better than or close to the national average on several other measurements of ER performance, including having fewer patients who leave without being treated. CMS data shows the national average is about 3%. Ballad reported 1.4% in its latest annual report.

Osborne, the Bristol council member, attributed this statistic to Ballad’s monopoly.

“Just because they aren’t leaving the ER doesn’t mean they are happy where they are,” he said. “It just means they don’t have anywhere else they could be.”

Ballad’s big monopoly

Ballad Health was formed in 2018 after state officials approved the nation’s biggest hospital merger based on a so-called Certificate of Public Advantage, or COPA, agreement. COPAs have been used in about 10 hospital mergers over the past three decades, but none has involved as many hospitals as Ballad’s.

State lawmakers in Tennessee and Virginia waived federal anti-monopoly laws so rival hospital systems — Mountain States Health Alliance and Wellmont Health System — could merge into a single company with no competition. Ballad is now the only option for hospital care for most of about 1.1 million residents in a 29-county region at the nexus of Tennessee, Virginia, Kentucky, and North Carolina.

The Federal Trade Commission warns that hospital monopolies lead to increased prices and decreased quality of care. To offset the perils of Ballad’s monopoly, officials required the new company to commit to a long list of special conditions, including dozens of quality-care metrics spelled out with specific benchmarks.

In its latest annual report, Ballad improved on many quality-of-care metrics over the prior year, including several that the company prioritized, but still fell short on 56 of 75 benchmarks.

ER time for admitted patients is one of those. The benchmark was set at three hours and 47 minutes in the original COPA agreement. Ballad met or nearly met this goal for three years, according to its annual reports. Then the ERs slowed.

In 2022, Ballad reported a median ER time for admitted patients of about six hours.

In 2023, it reported the same statistic at seven hours and 40 minutes.

In the latest report, ER time for admitted patients had reached 10 hours and 45 minutes.

CMS, which grades thousands of hospitals nationwide, warns on its website that timely ER care is “essential for good patient outcomes,” and that more time spent in the ER has been linked to higher complication rates and delays in patients getting pain medication and antibiotics.

Ben Harder, chief of health analysis for U.S. News & World Report, said extensive ER times can be a symptom of slowdowns throughout a hospital, including in the operating room.

“A long delay in getting patients admitted is both a risk in itself, in that a test may not get conducted as promptly,” Harder said. “But it’s also an indication that the hospital is backed up, and that there are problems getting patients moved from one unit to another.”

Bill Christian, a spokesperson for the Tennessee Department of Health, said Ballad’s rising ER times had been “noted” but did not say if the agency had taken or was considering any action. Christian directed questions about Ballad’s latest stats to the company itself.

‘A nightmare for community members’

Ballad has also fallen short — by about $191 million over the past five years — of its obligation to Tennessee to provide charity care, which is free or discounted care for low-income patients, according to health department documents and Ballad’s latest report. The health department waived this obligation in each of the past four fiscal years. Ballad has said it would ask for another this year.

In a two-hour interview last year, Ballad CEO Alan Levine defended his company and said that because the Tri-Cities region could not support two competing hospital companies, the COPA merger had likely prevented at least three hospital closures. Levine attributed Ballad’s failure to meet quality benchmarks to the pressure of the covid pandemic and said charity care shortfalls were partly caused by Medicaid changes beyond Ballad’s control.

“Our critics say, ‘No Ballad. We don’t want Ballad.’ Well, then what?” Levine said. “Because the hospitals were on their way to being closed.”

Some residents see Ballad as a savior. John King, who runs a physical therapy clinic in the core of Ballad’s region, said at a public hearing last June that in multiple visits to Ballad ERs, including one for a stroke, he found their care to be quick and compassionate.

“If it weren’t for Ballad Health, I literally would not be here today,” King said, according to a hearing transcript.

Ballad’s failures to live up to the terms of the COPA agreement were detailed in a KFF Health News investigation last September, and the company faced a new wave of criticism in the months that followed.

Local leaders in Carter County, Tennessee, in October debated but did not pass a resolution calling for Ballad to be better regulated or broken up. Tennessee Attorney General Jonathan Skrmetti, a Republican, said in an interview with the Tennessee Lookout published in November that Ballad must be constantly monitored in light of community complaints. Earlier this month, Tennessee state Rep. David Hawk (R-Greeneville), who represents a region within Ballad’s monopoly, called for Levine’s resignation, according to wjhl.com.

In response, Ballad Health said in a statement it has “strong relationships with the majority of elected officials” in Carter County and welcomed scrutiny from the Tennessee attorney general. Ballad said Hawk’s “opinion certainly does not reflect our broader relationships” within the area. Tennessee lawmakers are also considering legislation to forbid future COPA mergers in the state, which Ballad said “risks putting more hospitals at risk for closure.”

The bill was introduced by state Sen. Heidi Campbell (D-Nashville) and state Rep. Gloria Johnson (D-Knoxville), who is running for the U.S. Senate. Johnson said the bill would end Ballad’s protection from antitrust laws.

“It’s just been a nightmare for community members out there,” Johnson said. “And they have no other option.”

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March 25, 2024

LungVax vaccine uses DNA technology to prevent lung cancer

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Developed by scientists from the University of Oxford, the Francis Crick Institute and University College London, the LungVax vaccine uses technology similar to the highly successful Oxford/AstraZeneca COVID-19 vaccine.

The team will receive funding for the study over the next 2 years to support lab research and initial manufacturing of 3,000 doses of the vaccine at the Oxford Clinical BioManufacturing Facility.

Lung cancer cells look different from normal cells due to having “red flag” proteins called neoantigens. Neoantigens appear on the surface of the cell because of cancer-causing mutations within the cell’s DNA.

The LungVax vaccine will carry a strand of DNA which trains the immune system to recognize these neoantigens on abnormal lung cells. The LungVax vaccine will then activate the immune system to kill these cells and stop lung cancer.

In this study, the scientists are developing this vaccine in the lab to show that it successfully triggers an immune response. If this work is successful, the vaccine will move straight into a clinical trial. If the subsequent early trial delivers promising results, the vaccine could then be scaled up to bigger trials for people at high risk of lung cancer. This could include people aged 55-74 who are current smokers, or have previously smoked, and currently qualify for targeted lung health checks in some parts of the UK.

There are around 48,500 cases of lung cancer every year in the UK. 72% of lung cancers are caused by smoking, which is the biggest preventable cause of cancer worldwide.

Kidani Professor of Immuno-oncology at the University of Oxford and research lead for the LungVax project, Professor Tim Elliott, said:

“Cancer is a disease of our own bodies and it’s hard for the immune system to distinguish between what’s normal and what’s cancer. Getting the immune system to recognize and attack cancer is one of the biggest challenges in cancer research today.

“This research could deliver an off-the-shelf vaccine based on Oxford’s vaccine technology, which proved itself in the COVID-19 pandemic. If we can replicate the kind of success seen in trials during the pandemic, we could save the lives of tens of thousands of people every year in the UK alone.”

When given to people with cancer at its earliest stages, anti-cancer treatments are more likely to be successful.

We are developing a vaccine to stop the formation of lung cancer in people at high risk. This is an important step forward in preventing this devastating disease.”

Professor Sarah Blagden, Professor of Experimental Oncology at the University of Oxford and founder of the LungVax project

Professor Mariam Jamal-Hanjani of University College London and the Francis Crick Institute, who will be leading the LungVax clinical trial, said:

“Fewer than 10% of people with lung cancer survive their disease for 10 years or more. That must change. This research complements existing efforts through lung health checks to detect lung cancer earlier in people who are at greatest risk.

“We think the vaccine could cover around 90% of all lung cancers, based on our computer models and previous research, and this funding will allow us to take the vital first steps towards trials in patients.

“LungVax will not replace stopping smoking as the best way to reduce your risk of lung cancer. But it could offer a viable route to preventing some of the earliest stage cancers from emerging in the first place.”

Chief Executive of Cancer Research UK, Michelle Mitchell, said:

“The science that successfully steered the world out of the pandemic could soon be guiding us toward a future where people can live longer, better lives free from the fear of cancer.

“Projects like LungVax are a really important step forward into an exciting future, where cancer is much more preventable. We’re in a golden age of research and this is one of many projects which we hope will transform lung cancer survival.”

President of CRIS Cancer Foundation, Lola Manterola, said:

“We are at a crucial moment in the history of cancer research and treatment. For the first time, technology and knowledge of the immune system are allowing us to take the first steps towards preventing cancer.

“This groundbreaking study represents a firm step in that direction, and we at CRIS consider it essential to support it.”

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March 22, 2024
Parental touch can relieve acute procedural pain in neonates and parents’ anxiety

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The Neuroimaging Group, at the Department of Pediatrics, in collaboration with Bliss, the charity for babies born premature or sick, has launched a new suite of information resources for parents of neonates, designed to make them feel more confident about being involved in the care of their babies.

While evidence demonstrates that parents can play a positive role in comforting their baby during painful procedures, practice in the UK lags far behind. However new research by the Neuroimaging Group, published in the Lancet Child & Adolescent Health and Pain has brought further proof of the positive impact that being involved in their baby’s care has on parents.

The Parental touch trial (Petal) aimed to assess whether parental touch at a speed of approximately 3 cm/s to optimally activate C-tactile nerve fibres, provides effective pain relief during a heel-prick procedure. While there was no difference in the babies’ brain, behavioural or heart rate response to pain regardless of whether the parent touched their baby before or after the painful procedure, the findings did demonstrate that the majority of parents had positive emotions when involved in their child’s care – such as feeling useful and reassured – and an overall decrease in parental anxiety after their participation.

These new resources, a combination of beautifully curated and informative videos, FAQs and online information content, have been developed in light of the collaboration with parents and healthcare professionals. They are free to access online and set out in detail the many ways that parents can touch and comfort babies of all gestations during painful procedures on the neonatal unit, including skin-to-skin care.

Commenting on the research in an accompanying Lancet Child and Adolescent Health editorial, Ruth Guinsburg, said: “This study is an example of excellence in research. The trial was carefully designed with a clear question, strict inclusion and exclusion criteria, a well-designed and reproducible intervention based on biological plausibility, and defined outcomes, with the strength of using an objective rather than a subjective measure of pain. Only with trials like this might we transform faith in science and test the efficacy of traditional aspects of parental care in order to incorporate them, or not, in bundles to alleviate the pain in neonates.”

Dr. Rebeccah Slater, Professor of Pediatric Neuroscience and Senior Wellcome Fellow at the Neuroimaging Group, said: “Working with parents, babies and healthcare professionals to better understand how we can support premature and sick babies during painful procedures has been a highlight of my career.

“Developing these resources with Bliss has placed families at the heart of all the research we do, and has directly improved our engagement with families and the quality of our research. We will continue to find new ways to support parents and their babies when painful procedures form an essential component of neonatal care.”

The Petal trial has highlighted the importance of involving parents in the provision of care and comfort for relieving their child’s pain. Future studies can build upon the insights gained from this trial including the positive parental experiences observed in this study. Prospective research might, for example, exercise a more spontaneous approach to delivering the gentle touch, such as allowing parents to stroke their child at their own pace, for as long as they need to calm and comfort their child, rather than a more mechanical and precise application.”

Dr. Roshni Mansfield, a Pediatrics trainee and NIHR Academic Clinical Fellow in the Pediatric Neuroimaging Group

Dr. Maria Cobo, a postdoctoral researcher who managed the trial, added: “Another positive aspect of the study was the high degree of involvement by both fathers (35%) and mothers (65%) in delivering the parental touch to their babies. This contrasts with many studies, where only mothers’ opinions and involvement have been sought.”

Caroline Lee-Davey, Chief Executive of Bliss, said: “We are thrilled to have worked alongside the amazing team of researchers at the University of Oxford to further our understanding on the importance of parental involvement in their babies’ neonatal care. We know that babies have the best chance of survival and quality of life when their parents are empowered to be partners in their care but, sadly, we hear all too often that parents are not informed about their babies’ procedures or the role that they can have in comforting their baby. The outcomes of this research have directly shaped a new suite of Bliss information for parents and healthcare professionals which will help to validate what families often instinctively know to be true – that no matter how unexpected or strange the neonatal environment can feel, they are still their baby’s parent and they have a vital role to play in their comfort and care.”

Additional funding from the Wellcome Trust enabled Bliss to develop these valuable resources for families, including new information, video content filmed at John Radcliffe Hospital’s neonatal unit giving precious insight into neonatal care, as well as translated flyers for neonatal units and a webinar for healthcare professionals on how to support parents to be involved in their babies’ procedures. These resources were created in collaboration with parents and healthcare professionals, and included a listening event with the Raham Project, a CIC supporting ethnic minority families, where four mothers shared their neonatal stories.

Source:

Journal reference:

Hauck, A. G. V., et al. (2024). Effect of parental touch on relieving acute procedural pain in neonates and parental anxiety (Petal): a multicentre, randomised controlled trial in the UK. The Lancet Child & Adolescent Health. doi.org/10.1016/s2352-4642(23)00340-1.

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March 13, 2024
Study reveals the impact of olfactory disorders on personal safety and emotional well-being

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More than a third of people who self-identify as having a smell disorder have had at least one gas safety scare in the last five years, according to new research.

The study, led by the University of East Anglia (UEA) in collaboration with the charity Fifth Sense, asked people who cannot smell well what safety concerns they had and if they had experienced any hazardous events.

A total of 432 people responded to the online survey, which was conducted from February 25 to September 28, 2022, and distributed via the charity.

It revealed that a significant majority of participants (85.9pc) are concerned about safety, particularly regarding gas leaks, smoke, and spoiled food.

The study highlights that over five years, a substantial number of respondents encountered hazardous events related to their condition, emphasizing the impact of smell loss on personal safety and emotional wellbeing.

During the previous five years, 32.2pc of respondents had experienced a safety concern related to food, 14.8pc a gas incident in which someone was hurt, 34.5pc a gas scare and 18.5pc a safety incident at work.

This study underscores the critical importance of addressing safety concerns for individuals with olfactory dysfunction.

The findings show that smell loss significantly affects personal safety and emotional wellbeing. But we can help by finding ways to make things safer for them.

We could teach people about the risks and make tools like ‘scratch and sniff’ cards1 to help them recognize dangerous smells.”

Dr Liam Lee, Lead Researcher

Before 2020, more than three million people in the UK (5pc of the population) were estimated to be affected by smell loss.

Now around a further one million people are also thought to have persistent problems following a Covid-19 infection.

Some people lose their sense of smell completely (anosmia). Others may experience a reduced sense of smell (hyposmia), unpleasant distorted smells (parosmia) or smell hallucinations (phantosmia).

These changes may be accompanied by loss of or changes to the sense of taste.

A total of 95 people who responded to the survey (22pc) reported a Covid-19 infection as the cause of their olfactory dysfunction.

Co-author Professor Carl Philpott, of UEA’s Norwich Medical School, said: “While most respondents reported not experiencing any adverse events, it’s noteworthy that among those without any gas-related incidents, a common reason cited was the deliberate avoidance of living in environments with gas installations due to fear and anxiety of potential accidents.”

Prof Philpott helped to found Fifth Sense with Duncan Boak, who is chief executive of the charity which supports people affected by smell and taste disorders.

Mr Boak said: “This research highlights an important, yet unrecognised, public health issue with serious safety implications.

“Yet there are a lack of treatment options for these sensory impairments and only a handful of specialist smell and taste clinics in England, with none in Scotland, Wales or Northern Ireland.

“Another issue is that we don’t routinely test the sense of smell which means that these problems often get missed with people not getting the care they need, or support and information to help them stay safe at home.

“I hope that our research serves as a prompt for policymakers and the NHS to start working with us to address what is a major health inequality”.

In 2016, Hannah Martin experienced a gas scare that could have had serious consequences. The 32-year-old, who works in financial services and lives in Littlehampton, lost her sense of smell after a viral infection when she was 18.

However, she felt comfortable using all her family’s gas appliances as she had always cooked with her mum from when she was very young.

She said: “This particular evening I was preparing dinner for my mum and I, I ensured the eye-level grill had lit and then turned my back in order to prepare the next part of the meal.

“I’m unsure how much time passed but all of a sudden, my mum came running down the stairs and yelled ‘don’t touch anything that may cause an ignition, I can smell gas all the way on the next floor up’.”

When they checked they found the grill had gone out and Hannah had no idea, even though she had been in the kitchen the entire time.

Hannah said: “I felt horrified when this happened as if I had managed to blow up the kitchen, we have a household of five people on each side of us and there would’ve been no way to warn them at the time. The thought of injuring all those innocent people absolutely terrified me.

“The incident made me lose confidence in myself as from then on I always had to make sure that there was somebody in the kitchen with me if I planned to use any of our gas appliances to prevent it from happening again.”

The scare led to her family finding the Fifth Sense charity, whose safety information they followed diligently, such as ordering detectors to keep Hannah and everyone in the household safe. It helped her to regain her confidence in the kitchen and be able to cook independently again.

She said: “It has majorly impacted my mental health and Fifth Sense’s safety information has literally saved my life. My quality of life would not be what it is without the work that Duncan and his team do. My only regret is that I didn’t find them sooner.”

Fifth Sense is working in partnership with Cadent, the UK’s largest gas distribution network, to highlight this issue and ensure that people with a poor, altered or no sense of smell have the information and support they need to stay safe and well at home.

Mark Belmega, Director of Social Purpose and Sustainability at Cadent, said: “It’s really important that we help keep those with anosmia and other smell disorders, safe around gas.

“We know cases have increased following the Covid-19 pandemic and so we’re proud to work in collaboration with Fifth Sense to amplify key gas safety tips, including regularly servicing gas appliances, joining the Priority Services Register and getting gas and CO detectors fitted at home.”

The researchers noted a limitation of the study was that the data was self-reported and there could also be a sampling bias of charity members who are already seeking support.

Source:

University of East Anglia

Journal reference:

Lee, L., et al. (2024) Impact of olfactory disorders on personal safety and well-being: a cross-sectional observational study. European Archives of Oto-Rhino-Laryngology. doi.org/10.1007/s00405-024-08529-9.

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March 11, 2024
Creative play sessions offer powerful support for new parents

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Socially prescribed creative play helps children and their parents develop new skills and promotes wellbeing, a new study has found.

The University of Leeds-led study evaluated a five-week program of arts-based play, including singing and music-making, for families of children aged up to three. It found that parents benefited from developing social networks and sharing experiences with each other, as well as learning creative approaches to parenting. The families also gained vital information about their child’s developmental milestones.

The program, which was developed by leading children’s arts charity Theatre Hullabaloo to address concerns about parental wellbeing following the pandemic, is the first known socially prescribed creative play intervention for families with children of this age.

Social prescription is an approach enabling health professionals to refer people in need of help to address their health and wellbeing for non-medical support like local group activities. It can be an effective alternative to medication or other interventions.

Study author Dr Paige E. Davis, Lecturer in Developmental Psychology in the University of Leeds’ School of Psychology, said: “Social prescription is usually thought to be focused on older and elderly individuals. Recently there has been a push to facilitate different life transitions through social prescription. The transition to parenthood has been neglected in the past in terms of support offered, despite the importance of the relationship between parent and child in the first 1,001 days.”

“Our study shows that social prescribing for parents and children has benefits for both. Parents believe it improves their wellbeing, while giving them opportunities to build social networks and learn new ways to play creatively. Parents also perceive that it improves their children’s ability to develop new skills.”

Miranda Thain, Artistic Producer at Theatre Hullabaloo, said: “We see the positive effects of playing creatively with your little one and feeling confident to use those skills in your parenting – whether it be reading, singing or music making – in our work with families every day. Social prescription provides an important route for families who might need extra support and care to take part in programs of this type.

“This research, which demonstrates the value in terms of the wellbeing of both parent and child, is hugely important as we make the case for better investment in early years creativity, giving families the tools to be the best they can be for each other.”

The program consisted of a one-hour session which had a clear, yet flexible structure. Activities included sensory and imaginary play installations, play stations with age-appropriate toys, books and sensory activities, and more structured ‘Sing and Play’ sessions followed by ‘independent creative play’ time, where children played together while their parents were offered a hot drink. Each session culminated with gentle live music played on the flute and ukulele, sensory lights, bubbles, lullabies and a goodbye song.

Parents noted key differences between the sessions and typical play groups, which they said could be chaotic and overwhelming. The same group of people attended the study sessions week on week, which parents said was better for developing new connections than typical playgroups, which are open to one-off drop-ins.

Especially important to parents was their trust in the prescribers and organization, and the sense of calm that the intervention fostered, because this enabled them to be receptive to practical parenting knowledge and new social relationships.

Parents believed that the socially prescribed creative play positively impacted their children’s development and their own mental health and knowledge.

Further research is needed to evaluate the longer-term impact on children’s development and the interactions between parents and their children, the authors say.

Source:

Journal reference:

Davis, P. E., et al. (2024). My favourite part was learning different ways to play: qualitatively evaluating a socially prescribed creative play programme. Public Health. doi.org/10.1016/j.puhe.2024.01.032.

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March 9, 2024
New animation series launched to improve parental understanding of brain development in premature infants

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Professor Caroline Hartley, Principal Investigator, and Dr Marianne van der Vaart, Postdoctoral Researcher, in the Paediatric Neuroimaging Group at the Department of Paediatrics, have today launched a series of animations aimed at improving parental understanding of brain development in premature infants, and the effect it has on breathing and apnoeas (the cessation of breathing).

The series, called My Baby’s Brain, has been developed to support parents of premature babies, enabling them to understand why premature babies have apnoeas, the treatment they receive, and the equipment that is used.

My Baby’s Brain is a free, online resource that was created in collaboration with parents of premature babies alongside SSNAP (Supporting sick newborn and their parents), a charity based in the Newborn Care Unit at the John Radcliffe Hospital in Oxford.

Lauren Young, mother to Georgie, (age 7 and born at 40 weeks) and to Rosie (age 3 and born at 24 weeks), and also part of the Family Care Team at SSNAP, was part of the parent group that led to the creation of the series. She had a “traumatic, exhausting and long hospital stay of nearly 6 months” following the birth of her youngest daughter, and proactively wanted to help neonatal research and development. She said: “In my role with the Family Care Team for SSNAP I see so many parents trying to navigate all the information they receive from the medical teams. I feel strongly that anything helping parents to process the information, feel more comfortable with their surroundings and the care that their child is receiving, can go a really long way to helping them on the journey.”

“These animations will be so helpful to parents and families with premature babies. They will help them to understand the reasons their baby is needing the care they receive and give a very clear picture of equipment used, as well as a soft introduction to language and terminology they may hear along their journey. My Baby’s Brain will help parents feel more in touch with their babies’ care and help them to build confidence in the neonatal setting.”

Professor Hartley said: “In the UK, 1 in 13 babies is born prematurely. Apnoea of prematurity is a common problem in neonatal care, affecting around 50 percent of premature infants. Apnoeas are well-managed by the clinical team but can be worrying for parents. These animations have been put together with parents in mind, to give parents of premature babies a better understanding of how their baby’s brain is developing, how apnoea is linked to the immaturity of a premature infant’s brain, and the techniques researchers use to investigate brain development. Working together so closely with SSNAP and parents on this project has been extremely rewarding and enjoyable and has greatly enriched the animations which we hope will be a valuable resource for parents.”

We are delighted to be able to support the creation of My Baby’s Brain which will be an indispensable tool to all parents to premature infants on neonatal units here in the John Radcliffe Hospital, and across the country. They have been made with parents in mind to ensure the information is accessible and easy-to-understand. The videos can be accessed using QR codes making them available on mobile devices, allowing parents to choose a time that best suits them to watch and process the information: This could be cotside with their baby, in the quiet of their home, or even sharing them with other family members. Viewers are also able to choose from bite-sized clips or longer videos which helps manage what can be an exhausting time of processing so much new information.”

Martin Realey, Charity Lead for SSNAP

My Baby’s Brain was funded by the Wellcome Trust Enriching Engagement programme, an initiative created to support researchers’ public engagement outreach. This series is the public engagement activity of Professor Hartley’s core research project into the relationship between apnoeas and brain development in premature infants.

Professor Hartley is a Sir Henry Dale Fellow at the Department of Paediatrics.

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March 7, 2024
UK lags in cancer treatment compared to other countries
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People in the UK were treated with chemotherapy and radiotherapy less often than in comparable countries and faced long waits for treatments, according to two new studies published in The Lancet Oncology.

In the first research of its kind, investigators at University College London examined data from over 780,000 people with cancer diagnosed between 2012 and 2017 in four comparable countries (Australia, Canada, Norway and the UK). Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer.

The two studies by the International Cancer Benchmarking Partnership (ICBP) are the first to examine treatment differences for eight cancer types in countries across three continents. Building on previous research, the findings provide further insights into why cancer survival in the UK lags behind internationally.

The research concluded that:
- There was stark variation in the treatment of all eight cancer types and people with cancer in the UK received chemotherapy and radiotherapy less often than other countries. Fewer lung cancer patients in the UK (27.7%) were treated with chemotherapy compared to Canada (35.0%), Norway (45.3%) and Australia (41.4%)
- Older patients were least likely to be treated with chemotherapy and radiotherapy, particularly in the UK. For example, 2.4% of UK patients aged 85 and over received chemotherapy, compared to 8.1% in Australia and 14% in Ontario, Canada
- Countries with better cancer survival typically had higher use of chemotherapy and radiotherapy and shorter waits to start treatment in this study. For example, 5-year net survival for stage 3 colon cancer was higher in Norway (70.7%), Canada (69.9%) and Australia (70.1%) than in the UK (63.3%)
- Overall, people living in Norway and Australia started chemotherapy and radiotherapy in the quickest time
- Patients in the UK faced long waits for treatment, and this varied depending on where people live. The average time to start chemotherapy was shortest in England (48 days) and longest in Scotland (65 days). Northern Ireland had the shortest average time to start radiotherapy (53 days) and Scotland (79 days) and Wales (81 days) had the longest
The UK should be striving for world-leading cancer outcomes. All cancer patients, no matter where they live, deserve to receive the highest quality care. But this research shows that UK patients are treated with chemotherapy and radiotherapy less often than comparable countries.

When it comes to treating cancer, timing really matters. Behind these statistics are people waiting anxiously to begin treatment that is key to boosting their chances of survival.

We can learn a great deal from other countries who have stepped up and substantially improved cancer services. With a general election on the horizon, the UK Government has a real opportunity to buck the trends we see in this research and do better for people affected by cancer.”

Michelle Mitchell, Chief Executive, Cancer Research UK

Although not every patient will require them, chemotherapy and radiotherapy are key treatment options – it’s estimated around 4 in 10 people with cancer in the UK should receive radiotherapy as part of their care. With cancer cases projected to rise in the UK, demand for these treatments will substantially increase. And a wider range of people, including older people with more complex healthcare needs, will require cancer treatment.

While some cancer patients need time to prepare for treatment, others are forced to wait too long. This can result in people’s cancers continuing to grow and spread, potentially impacting the success of their treatment and further exacerbating their stress and anxiety levels.

Cancer Research UK said that concerning delays to begin treatment in the UK are partly a result of the UK Government’s lack of long-term planning on cancer in recent decades. Countries with more robust cancer strategies backed by sufficient funding have seen larger improvements in survival than the UK.

There are a range of factors driving international differences in the use of chemotherapy and radiotherapy. Cancer Research UK said that workforce and capacity pressures across the UK health system are barriers to delivering world-class treatment for patients.

As outlined in the charity’s recently published manifesto, ‘Longer, better lives’, the UK’s cancer crisis could be turned around with a long-term plan to deliver investment and reform needed in the NHS.

As part of this, Cancer Research UK is calling for a strategic approach to addressing treatment variation. Better data collection and investment in clinical audit and quality improvement would help us understand and tackle why access to timely, quality treatment differs.

Clinical lead for the International Cancer Benchmarking Partnership and an ovarian cancer surgeon, Dr John Butler, said:

“For many aggressive cancers – such as ovarian, lung and pancreatic cancer, it’s vital that people are diagnosed and start treatment as soon as possible. Lower use of chemotherapy and radiotherapy in the UK could impact people’s chances of survival, especially for older patients.

“Although we have made progress, the last benchmark showed that cancer survival in the UK is still around 10 to 15 years behind leading countries. This study captures missed opportunities for patients in the UK to receive life-prolonging treatment.

“The next phase of our research will explore these treatment differences in more depth and look to understand the impact of the Covid pandemic on cancer patient’s care.”

Lead researcher from University College London, Professor Georgios Lyratzopoulos, said:

“This study builds on over a decade of ICBP research into how cancer diagnosis and care varies internationally. We already know that the cancer survival in the UK has fallen behind countries like Australia and Canada, and this analysis of two key cancer treatments highlights one of the likely reasons.

“With cancer cases projected to rise in the UK, the NHS must be equipped to deliver the best care for patients. The cancer treatment landscape is changing at pace, but capacity issues and system pressures mean that not all patients can feel the benefit of specialist cancer treatments.

“To improve the UK’s cancer outcomes, we need to continue to investigate what is driving international variation in treatment – better data collection is key to this.”

Source:

Journal reference:

McPhail, S., et al. (2024) Use of chemotherapy in patients with oesophageal, stomach, colon, rectal, liver, pancreatic, lung, and ovarian cancer: an International Cancer Benchmarking Partnership (ICBP) population-based study. The Lancet Oncology. doi.org/10.1016/S1470-2045(24)00031-7.
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February 27, 2024
Repeat PlGF testing for pre-eclampsia not beneficial, research finds

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A single test to speed up diagnosis of a serious disease in pregnant women does not need to be repeated, new research has found.

Results from the PARROT-2 trial, published today in the Lancet by researchers from King’s College London and funded by Jon Moulton Charitable Trust, Tommy’s Charity and the National Institute for Health and Care Research, has ruled out the need for routine repeat placental growth factor-based testing (PIGF) for all women with suspected pre-eclampsia.

PARROT-2 is a large, multi-center UK trial in 1,252 women with suspected preterm pre-eclampsia, a life-threatening condition for pregnant women, and their babies, that can lead to major complications, such as stillbirth and neonatal death, as well as longer hospital stays.

PIGF testing is a blood test that can detect levels of placental growth factor and soluble flt-1, which are biomarkers for pre-eclampsia. An abnormal result will identify those women and babies at higher risk of adverse outcomes, who need intensive surveillance, whilst a normal result means women can be safely discharged home to continue with normal antenatal care. Use of an initial test in pregnancy was rolled out across much of England in 2021.

The findings show that repeat testing enabled faster diagnosis of pre-eclampsia, but this did not translate into better outcomes for women or their babies.

Dr Alice Hurrell, first author of the study from King’s College London, said: “This large trial has major implications for policy, practice, and guidelines. Universal, routine repeat testing, as recommended by some international groups, is not supported by our findings. However, the clinical benefit of a one-off placental growth factor-based test when pre-eclampsia is first suspected, remains clear.”

Professor Lucy Chappell, NIHR Senior Investigator from King’s College London, said: “Pregnant women repeatedly tell us the value of having greater certainty on diagnosis. These trial results should further lower the barriers to widespread equitable adoption of initial placental growth factor-based testing, improving maternal health outcomes globally. With an estimated 5% of all women affected by preterm hypertension in pregnancy (around 7 million pregnancies worldwide), this is now a pivotal time to ensure that placental growth factor-based testing can reach widespread implementation across healthcare settings.”

These are really important findings showing that once the first test has been done, there is nothing to be gained from further testing. A single test can assure women with certainty if they are likely or unlikely to get pre-eclampsia. We look forward to completion of roll-out of placental growth factor-based testing across England, with an urgent call for implementation in the devolved administrations across all four nations. These new results also provide a timely opportunity to tackle the higher burden of adverse outcomes due to pre-eclampsia in global settings.”

Marcus Green, CEO of Action on Pre-eclampsia

Kath Abrahams, Chief Executive of Tommy’s, said: “This important study funded by Tommy’s is a significant and positive step forwards in the drive to reduce the harm caused by pre-eclampsia.

“Following the breakthrough made by the previous Tommy’s funded PARROT study, we hope it will pave the way for PlGF testing for all women and birthing people who are thought to be at risk of pre-eclampsia, so that those most in need can be offered vital extra monitoring and support.”

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February 9, 2024