Newsbites

Britain cracks down on alternative therapies

The head of a new UK regulator for complementary medicine has promised to clean up the industry and give proper quality assurance to the one in five UK residents who use its services.

Homoeopathic consultation

Maggie Dunn, co-chairwoman of the Complementary and Natural Healthcare Council, said that the new regulator would start a voluntary register of practitioners who operate professional and safe businesses.

To be included, the more than 150,000 complementary medicine therapists working in the country will need to prove that they have appropriate training and insurance and abide by a code of conduct.

“I think most of the profession is operating to good standards, but we know not everyone will be able to register,” Ms Dunn told the BBC. “If that means that people who are not up to scratch are driven out of business, I will not cry for them.”

She added that although registration was not compulsory, the public would soon start to shun those not listed by the regulator. She added that the council would not assess the efficacy of therapies (http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/7828593.stm).

Rising debts threatens access to medicine, UK medical students say

UK government plans to widen access to careers in medicine are threatened by the rising level of medical student debt, the BMA has said. “The spectre of debt hangs over the government’s entire social mobility agenda,” said Louise McMenemy, a member of the BMA’s medical students committee.

She added that medical graduates leave university with average debts of £21,000 (€22,500; $29,000) but that the introduction of potentially higher university fees in the next few years means that this could rise to as much as £37,000.

“Students are already relying on their parents, credit cards, overdrafts, and loans to get them through university, despite many holding down part time jobs,” she said. “If the government fails to lift the debt burden bearing down on medical students its social mobility agenda will fail” (http://web.bma.org.uk/pressrel.nsf/wlu/PGAY-7N9GZK?OpenDocument&vw=wfmms).

Irish junior doctors' hours break European rules

Some junior doctors in Ireland are still working shifts of 36 hours or more, despite the introduction of European Union working time rules, a government report has found.

The Department of Health's report also said that hospitals had found it difficult to put the current 56 hour limit to the working week into practice and that no hospital was entirely compliant. That limit will fall to 48 hours a week from August this year.

“Clearly periods on duty will have to be of much shorter duration in the future,” said Cillian Twomey, a Cork geriatrician who was involved in implementing a pilot scheme to bring working hours into compliance with the EU rules (www.independent.ie/health/latest-news/junior-doctors-still-work-36hour-shifts-1602042.html).

Heart failure linked to mutation common in Indian subcontinent

Researchers have discovered that some 4% of people in the Indian subcontinent carry a mutation in a gene that they say is almost guaranteed to lead to heart problems (Nature Genetics 2008 Jan 18, doi:10.1038/ng.309). They estimate that the mutation, a 25 letter deletion from the gene MYBPC3, is present in about 60 million people worldwide, most of them in the Indian subcontinent.

Carriers of the mutation have seven times the odds of developing heart failure as non-carriers. Carriers usually show few symptoms until middle age, but after that most become symptomatic and have a range of effects due to the build up of abnormal heart protein.

“This research should lead to better screening to identify those at risk and may ultimately allow the development of new treatments,” said Mark Walport, director of the Wellcome Trust. (www.eurekalert.org/pub_releases/2009-01/wtsi-thd011509.php and http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/7833753.stm).

Surgeon's checklist cuts deaths and complications in study

A checklist for surgeons, which includes marking the site for the incision and checking that all swabs are accounted for, almost halved the death rate from operations and reduced complications by a third, researchers in a large international study have found (New England Journal of Medicine 2008 Jan 14, doi:10.1056/NEJMsa0810119).

The checklist was developed by the World Health Organization and was tested in eight cities around the world. Before using the list, 1.5% of 3733 patients studied died within 30 days of surgery and 11% had serious complications. After the checklist was introduced, the death rate fell to 0.8% of 3955 patients and the rate of serious complication to 7%.

Many of the precautions are routine in industrialised nations, and the largest benefits from the checklist were seen in developing countries. The researchers acknowledged the improvements might have been partly due to teams performing better because they were aware their results were being recorded. See “Surgical safety checklists” (BMJ 2009;338:b220, doi:10.1136/bmj.b220) (www.google.com/hostednews/ap/article/ALeqM5jKKEShLOwb9rU7HNN7BUGNfCrPtQD95N6LVO0).

Obama asks television neurosurgeon to fill top public health education job

The US president, Barack Obama, has asked the neurosurgeon and CNN medical correspondent Sanjay Gupta to be the next surgeon general, the country’s leading voice on public health and health education.

The next US surgeon general, Sanjay Gupta

The surgeon general doesn’t set health policy, but past holders of the position have used it to fight smoking and to raise awareness of HIV/AIDS.

In addition to being a television personality, Dr Gupta, aged 39, is a practising neurosurgeon and an assistant professor at Emory University in Atlanta. In the 1990s he worked as a special adviser to Hillary Clinton, writing speeches and helping draft policies (www.washingtonpost.com/wp-dyn/content/article/2009/01/07/AR2009010700261.html and www.reuters.com/article/politicsNews/idUSTRE5057EN20090107 ).

China steps up bird flu precautions

China has stepped up surveillance for new human cases of bird flu around the Chinese new year, when tens of millions of people move between cities and rural areas.

At least two people have died in China from infection with the H5N1 strain of the avian influenza virus this year, and four human cases have been reported.

The health ministry has asked that people minimise contact with poultry. Health centres have been told to strengthen their bird flu prevention efforts.

Since the H5N1 virus resurfaced in Asia in 2003, World Health Organization figures show that 391 people have been infected and 247 have died. China has reported 22 deaths from the virus, but before this year’s deaths there had been none since 2003 (www.google.com/hostednews/ap/article/ALeqM5ghdkIg5knBtGcVm1UfEwvXSnaAPAD95Q9IKG0).

Student BMJ 2009;17:037-080 . ISSN 0966-6494 | February 2009