Doctors have called for a ban on smoking in all vehicles because of a rise in the incidence of asthma in children but are confusing new laws really the way to help?

Passive smoking causes childhood asthma but does that mean it should be banned in all vehicles?

On the subject of the report, it found that smoking around children leads to:

  • 300,000 appointments with GPs
  • 9,500 hospital admissions
  • A cost of £23.3m each year

The figures are shocking but is banning smoking in cars really going to make much difference, is it not just going to lead to laws which are difficult to police?

Health promotion is a difficult task. There are two ways of preventing conditions developing. The first involves educating a person with facts, so explaining to parents the effect smoking has on their children.

This was done fantastically with this video:

The second way is to force people into making choices with laws, but without accomplishing the first method the laws will be difficult to enforce. People need to know that there is evidence supporting why a law should exist or they simply won’t abide by it.

The problem is that the Royal College of Physicians (RCP) who made the report don’t just call for a ban on smoking around children but for all drivers regardless of if a child would never sit in their car.

There is obviously no scientific proof that banning smoking in a vehicle that doesn’t carry kids is going to prevent childhood asthma so Prof Britton from the RCP justified a full ban by saying that if a driver doesn’t ferry kids around they should still get out of the car before lighting up for road safety issues.

Now I’m not saying that smoking while driving is 100% safe but surely if a law is going to be made it should be in line with the research available?

Image: Salvatore Vuono / FreeDigitalPhotos.net

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Days after Alan Johnson announced a ban on the former legal high mephedrone another member of the Advisory Council on the Misuse of Drugs (ACMD) has stepped down, bringing the total to seven since Professor Nutt’s dismissal.

Another expert has quit over a ban on the legal high, mephedrone.

A few days ago Dr Polly Taylor, the veterinary expert on the ACMD panel stepped down saying that laws shouldn’t reflect the media’s mood of the day.

Despite the panel being short of the veterinary expert it required Alan Johnson went ahead with a ban saying that he had taken advice from the ACMD.

Today Eric Carlin who is also the Chair of the English Drug Education Forum announced he is quitting the council. He reproduced his resignation letter on his blog, in it he wrote:

“We had little or no discussion about how our commendation to classify this drug would be likely to impact on young people’s behaviour. Our decision was unduly based on media and political pressure.”

The council, which only contains 23 members has lost seven since Professor Nutt’s dismissal.

After the deaths of two teenagers who had taken mephedrone there were calls to ban the drug.

The ACMD needed to collect and analyse research before giving the government advice. Eric Carlin’s resignation does little to reassure the public that the government took advice from scientific evidence and not the media.

For every two lives saved through breast cancer screening one woman has unnecessary treatment according to new research.

Breast cancer screening saves two lives for each unnecessary treatment. Photograph: Yongjiet

This would come as a shock to people who believe that screening is faultless. Screening programmes do save lives but they also have disadvantages.

Screening detects the onset of a disease which gains an advantage from early treatment. In the case of breast cancer, if detected early it can be treated successfully with less aggressive management.

But to successfully diagnose the early stages of a disease there needs to be an agreed cut off for those who do have the disease and who do not. The people that test positive can then go on to have further investigations and treatment.

The problem is that having an agreed cut off means that there are people either side of the fence. People who test positive that don’t have the disease (false positives) and people who test negative that actually do have the disease (false negatives). Falling into either category can cause problems:

False positives lead to invasive tests, treatment and the associated anxiety of a cancer diagnosis.

False negatives lead to false reassurance, which can cause late presentation of a condition which may have become untreatable.

Obviously given the choice someone would rather have a false positive than a false negative, and so cut offs tend to be waited towards providing more false positives than false negatives.

So what do today’s results mean? Well although it sounds as if the new research is highlighting the disadvantage of breast screening it is actually a welcomed result.

This is because critics had claimed that for every one woman saved, ten underwent unnecessary treatment. Now women can be reassured that the screening is doing more good than harm.

Image: Youngjiet

The bacteria which causes the STI gonorrhoea is becoming resistant to antibiotics, with few alternatives available does the treatment need to start becoming more aggressive before it’s too late?

Gonorrhoea is becoming resistant to treatment. Photograph: ecastro

The current treatment is a single dose of an antibiotic, either cefixime or ceftriaxone, but the bacteria is starting to find ways of adapting.

The two antibiotics are effective but resistance is emerging against cefixime according to a speaker at the Society for General Microbiology conference.

Other countries have started to react to this emerging resistance with Japan increasing the dose.

The speaker stated that a reduction in resistance could be achieved by using the two antibiotics together.

Ultimately something needs to be decided so the World Health Organization are discussing drug-resistant gonorrhoea at a meeting next week.

Image: ecastro

Today Dr Polly Taylor, the veterinary medicine expert on the Advisory Council on the Misuse of Drugs (ACMD) quit just hours before Alan Johnson was expected to ban the legal high mephedrone.

An expert has quit over a ban on the legal high, mephedrone.

In her resignation she told the home secretary:

“I feel that there is little more we can do to describe the importance of ensuring that advice is not subjected to a desire to please ministers or the mood of the day’s press.”

Since Prof Nutt quit the council six members have stood down, seemingly because they are giving the government the scientific advice they require and the government isn’t listening.

The council advise the government on the dangers of drugs which in turn allows laws to be made. However when Prof Nutt was in charge the research proved that tobacco and alcohol were more dangerous than the class A drug ecstasy, which isn’t reflected by law.

Dr Taylor’s resignation echoes that of the previous panel members. It looks as if the research backing a ban on the legal high mephedrone doesn’t exist yet, but despite this the home secretary planned on announcing a ban.

So what choice do the panel members have? Well they can either watch the government ignoring their advice and keep their jobs or they can tell the public what their research shows (like Prof Nutt did) or they can quit as Dr Taylor has done.

Sacrificed herself to science

In quitting Dr Taylor has put a hold on a ban, the ACMD needs a veterinary medicine expert, and it will take a few weeks to find another one, she has sacrificed herself to science.

The deaths linked to mephedrone are not proven, there isn’t a scientific basis to say that mephedrone kills yet, they have been linked by the media.

The government needs to please voters, especially before an imminent election but allowing the media to dictate science over a panel of experts is not justified. As Dr Taylor says laws should not exist to please the mood of the day’s press.

Last week the so called Dr Death entered the UK for the purpose of providing “Safe Suicide Workshops”, he did so as a climate of fear hit doctors after new guidelines stated that doctors could be prosecuted for assisting their patients with suicide.

New guidelines on assisted suicide have put doctors at risk of prosecution

The guidelines which were released last month provide a list of circumstances which will be taken into account when deciding if cases should be brought.

So where do the new guidelines leave doctors?

Well the new proposals include a section arguing in favour of the prosecution of doctors, which was not included in the original proposals.

Also if someone is unknown to a victim and assisted by providing specific information to assist someone in committed suicide, then a prosecution is more likely.

Furthermore it is more likely if someone gives assistance to more than one victim who are not know to one another.

So not only do these guidelines risk prosecuting doctors who run workshops on suicide but it also places the average general practitioner in a very difficult position.

Patients could ask doctors for advice about suicide, they must not engage in discussion or prosecution could potentially be brought.

Also patients with chronic or deliberating illness may require a medical report before they can travel. If they are requesting this so they can travel to a country where euthanasia is legal then the doctor has effectively assisted their suicide and could be prosecuted.

Dr Nick Clements head of medical services at MPS told Pulse Magazine:

“We are advising GPs who have even the slightest suspicion that their patient may be planning an assisted suicide to proceed with extreme caution and not to comply with requests for medical or travel reports in these cases.”

But will the risk of prosecuting doctors not lead to further problems? Doctors have a position of trust, if they are constantly questioning the chronically ill whenever they want to travel out of the country is it not going to create more harm than good?

The government intends to force tobacco companies to sell their product in plain packaging

The latest government proposal to prevent people smoking is to sell cigarettes in plain packaging. Now I’m happy for the government to do whatever they feel is necessary, but how is plain packaging going to help?

Maybe I am overestimating society but I really don’t believe people pull out their cigarette packet to the gasps of those around them and the admiration which comes with smoking such a “cool” brand of cigarettes.

Maybe I am mistaken: perhaps packaging is for cigarettes what the ipod is for mp3 players, but I doubt it.

Smoking is an atrocious habit. Whenever I sit a medical exam and I’m asked for an aetiological factor for a disease I can guarantee I’ll get a mark if I put smoking… gastric ulcers, hypertension, colon cancer… smoking causes literally everything.

The smoking ban is probably one of the best initiatives the current government has implemented. But they are clearly scraping the barrel for ideas with this one.

Not that the tobacco companies are completely logical, instead of drawing the evidence together that changing the packaging is going to have little effect on the prevalence of smokers. Gareth Davis, chief executive of Imperial Tobacco claimed a lack of packaging would allow the illicit counterfeiting cigarette trade to grow.

I’m sorry but my initial reaction is so what? Counterfeiting is usually dangerous as products can be cut with dangerous chemicals. Anybody who places a legitimate brand of cigarette in their mouth is already exposing themselves to a significant risk to their health.

Image: Maggie Smith / FreeDigitalPhotos.net

Andrew Wakefield was found to have acted unethically in his controversial research

Finally the biggest controversy in medicine of the last two decades is coming to an end.

Andrew Wakefield was found to have acted unethically, dishonestly and irresponsibly by the General Medical Council (GMC) in his controversial research which linked the MMR vaccine to autism.

From April the GMC will decide if he showed serious professional misconduct and what sanctions should be imposed, which could include being struck off.

The hearing that lasted for two and a half years didn’t attempt to prove or disprove a link between autism and MMR but to detail if he acted ethically in his methods of research.

So just what did they find…

He had communicated with a solicitor who was representing those who had allegedly suffered harm due to the MMR vaccine. Not only that, but Wakefield had his research funded by the Legal Aid Board which the solicitor had applied for.

He was also involved with a patent for a safer vaccine which could replace MMR.

Furthermore he failed to mention the disclosable interests of the legal aid and patent to the Lancet, the paper which originally published the paper.

Wakefield admitted to being aware that the paper he wrote would form a link between autism and MMR and that this would have public health implications.

He was dishonest in the paper by stating that the children in the study had come from a normal referral pathway i.e. referred from a GP to the paediatric gastroenterology department. However four of the children were referred for investigated into the role of MMR in the development of their autism. And another four were actively referred by Wakefield. Together this produced a biased selection of patients.

Andrew Wakefield was also found to have taken blood from children at his sons birthday party and paid each child £5. He then joked about this incident and said he would do it again. This represented a callous disregard for the distress and pain the children suffered and abused his position of trust.

When Wakefield linked autism to MMR the rate of vaccination fell and children started to suffer from the three deadly infectious diseases. He has since moved to Austin, Texas, where he doesn’t practice medicine but does receive a high salary for his involvement with a centre for autism.

The rates of vaccination have never recovered.

Image: m_bartosch / FreeDigitalPhotos.net

Breast-feeding benefits are exaggerated.

A study this week found that the myths surrounding breast-feeding are dependent on hormones and not breast-feeding.

A Norwegian university reviewed 50 studies and found that breast-feeding is in fact a confounding factor to the advantages.

The level of male hormones, known as androgens are the real reason for the benefits.

The higher the amount of androgens in pregnant women the less likely a woman would be able to breast-feed. The androgens also lead to an increased risk of obesity, type 2 diabetes and polycystic ovary syndrome in the child.

The study also found no signs of the asthma and allergies in children who were not breast fed as mothers are warned. It found minor advantages such as a small IQ advantage.

For the last few years the government has put a huge effort into pushing the benefits of breast-feeding, employing staff to specifically deal with breast-feeding,. These employees come equipped with statements that the evidence points to breast-feeding reducing the risk of chronic diseases such as asthma.

Mothers are often left desperate at the poor start they are giving their offspring if they have difficulty feeding their child. It can lead to already exhausted mothers who have just given birth to feel guilty.

The research suggests women should focus on enjoying their child regardless of their ability to breast feed and not worry about the exaggerated consequences.

Vulnerable British citizens are not protected from the law of other countries despite possessing mental illnesses.

A British man who suffers from a mental illness has been sentenced to death in China and may be put to death as soon as Tuesday.

Akmal Shaikh travelled to China following the delusion that he could become a pop star. The charity, Reprieve are claiming that his mental illness left him susceptible to people who tricked him into carrying heroin.

His family have travelled to China to insist a full mental health evaluation should be performed. But why hasn’t he undergone a psychiatric examination already?

How can a person with a past history of bipolar disorder and delusions be treated as a healthy individual who has maliciously committed a crime?

And just why can’t Britain look after its own?

According to reports Gordon Brown and David Miliband have attempted to prevent the execution. But it seems that China is still going to go ahead and kill a delusional man.

The song Akmal Shaikh recorded beleiving it would bring him fame.

This video belongs to the charity Reprieve

The case runs in parallel with that of Asperger’s sufferer Gary McKinnon. Gary hacked into US military computers whilst looking for evidence of UFO’s. America applied to have him extradited for trial. The high court failed to prevent his extradition. And now his only hope lies with the European Court of Justice.

If the Brit is sent to America he could face 60 years in prison. More worryingly Gary has suicide tendencies and the stress he is under could lead to him attempting to end his own life.

So just why does Britain lack the ability to protect it’s vulnerable citizens? Does the rest of the world have so little respect for the UK that countries can do as they wish with our mentally ill?

You have to question just what the rest of the world currently thinks of the UK.

Bill Clinton made an unexpected trip to North Korea earlier this year. He travelled back to the States with two American journalists who had been imprisoned for entering the country illegally.

And Gordon Brown can’t even prevent a mentally ill British national from being put to death.

Image: Salvatore Vuono / FreeDigitalPhotos.net