Thursday, June 8, 2017

Homeless Babies And Starving Parents: The Poverty Seen By Doctors

A survey of 250 Paediatricians reveals a shocking return to old fashioned poverty that will hit future generations

Nearly one in three children in the UK – a total of four million – live in poverty.

It’s a statistic that perhaps many people acknowledge is shocking, but they don’t appreciate its implications.

Living in poverty can have all sorts of damaging effects on a child, not least on their health.

Poverty makes children sick; those living in the most deprived areas have far worse health outcomes than children from the most affluent.

They are more likely to be overweight or obese, suffer from asthma, have poorly managed diabetes and experience mental health problems. Infant mortality is more than twice as high in the lowest socio-economic groups compared with the highest groups.

Such large numbers can be a little abstract and it’s only when these are seen as people and personal stories that the reality hits home.

Comments from more than 250 paediatricians across the UK on the impact of poverty on child health were gathered as part of a survey by the Royal College of Paediatrics and Child Health and Child Poverty Action Group (CPAG). It makes sobering reading.

Poor housing

One doctor in London said that “overcrowded, damp or unsuitable housing among our patients is the rule rather than the exception” – conditions that can cause respiratory problems such as asthma and bronchiolitis.

Another said that one of his patients was a “two-year-old with recurrent seizures, living in a house with no heating”.

Poor housing is one of the main reasons for delays in discharging children.

One paediatrician said they were “unable to discharge a chronically unwell child requiring constant use of electrical equipment as the house only has one socket”, while another said: “I have seen a number of babies being unable to be discharged from the special care babies unit due to parents being homeless.”

Food insecurity

Many respondents said their patients struggled to afford healthy food.

One doctor observed: “Many of [our] patients are from low-income families who rely on food banks.”

Another said: “I see parents in A&E who are limiting their eating to care for their children. Children are worried, scared and upset.”
Worry, stress and stigma

Stress and worry caused by poverty affects not only parents, but children too. One respondent said: “The biggest impact of poverty on the children and parents I encounter is insecurity, inferiority and stress. Through biological and psychological factors these undoubtedly lead to poor health.”

Children who are otherwise healthy are at risk of becoming unhealthy due to poor nutrition and cold, cramped housing conditions.

For children who already have health problems, poverty exacerbates the difficulties.

One doctor said, “For sickle cell patients, cold homes can precipitate painful crises and admission to hospital” while another commented that “overcrowding makes looking after children with learning difficulties or autism next to impossible”.

One of the things that shocked me about the stories from the report is that we are seeing the return of what one might think of as old-fashioned poverty relating to crowding and nutrition for our children.

Political will

If poverty levels were reduced, the impact on child health – and therefore the future health of the nation - would be radical.

Whatever political party holds the reins of power post 8 June, tackling poverty must be a priority.

We need the next government to focus on the creation and maintenance of wealth for all parts of society, with a focus on our children.

Policies such as the restoration of binding national targets to reduce child poverty, backed by a national child poverty strategy and the adoption of a “child health in all policies” approach to decision making and policy development, with the Treasury disclosing information about the impact of the chancellor’s annual budget statement on child poverty and inequality, could make a difference. 

There should also be an immediate reversal of public health cuts to ensure universal early years services, including health visiting and school nursing, are prioritised and supported financially, with additional targeted help for children and families experiencing poverty.

The health of children is a measure of the future health of our society. As one of the doctors who responded to the survey said: “We cannot expect to have a healthy future for the UK if we leave our children behind.”

Source:     The Guardian

Monday, June 5, 2017

Prostate Cancer Trial Stuns Researchers

'It's a once in a career feeling'

Study with ‘powerful results’ finds that combining two existing therapies could extend the life of men with advanced, high-risk prostate cancer by 37%

Combining two existing prostate cancer therapies could extend the life of men with advanced, high-risk prostate cancer by 37%, according to a study presented at the world’s largest cancer conference. The new findings could change how doctors first approach treatment of prostate cancer.

“These are the most powerful results I’ve seen from a prostate cancer trial,” said Nicholas James, the lead author of the abstract presented as the American Society of Clinical Oncology. “It’s a once in a career feeling. This is one of the biggest reductions in death I’ve seen in any clinical trial for adult cancers.”

Researchers combined standard hormone therapy with a drug called abiraterone , which is typically used only for cancer patients whose disease has stopped responding to standard hormone therapy. The research was conducted as part of the Stampede trial, an ongoing randomized trial conducted in the UK and Switzerland.

“Abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%,” James said. “Based on the magnitude of clinical benefit, we believe the upfront care for patients newly diagnosed with advanced prostate cancer should change.”

The study looked at a group of 2,000 men. Patients who received both abiraterone and normal hormone therapy were significantly less likely to die, compared to patients who received only hormone therapy.

Comparatively, 83% of men assigned abiraterone therapy survived versus 76% of men on standard hormone therapy. Researchers also found that patients who received both medications had slightly stronger side effects, especially cardiovascular and liver problems.

One patient who participated in the trial, Alfred Samuels, 59, was diagnosed with advanced prostate cancer in January 2012. “It felt like my world fell apart overnight,” Samuels said. “The doctors explained that surgery wasn’t an option for me because the cancer had spread beyond my prostate.”

“As part of the trial, I started taking abiraterone four times a day and had a hormone injection every eight weeks,” he said. “During the first six months, tests showed that the treatment was working. I’m still on the trial, which I find reassuring and, fortunately, my cancer is being managed well.”

More than 27,000 men in the US and 11,000 men in the UK die of prostate cancer each year, according to the US Centers for Disease Control and Prostate Cancer UK. In the US, aside from skin cancer, it is the most common cancer in men.

“The potential benefits of giving some men abiraterone alongside hormone therapy are clearly impressive and we will be working with all relevant bodies to make sure this treatment becomes an option available for these men via the NHS,” said Dr Iain Frame, director of research at Prostate Cancer UK.

Source:      The Guardian