Category Archives: Psoriasis

Brain tree: why we replenish only some of our cells | Daniel Glaser

We are being treated to a spectacular display of autumn colour this year, but it isn’t only trees that share this pattern for periodic shedding and regrowth. Our own skin cells, for example, are renewed every month or so, but we replenish less than 10% of our bone each year. Certain types of human cells do not seem to regenerate at all and this includes brain cells. With a few exceptions (such as the hippocampus), we are born with all the brain we’ll ever have. Over childhood and into adolescence, extensive pruning of the connections between cells takes place. This neural topiary shapes all the systems of the brain. But once into adulthood, although some new connections are formed, the main structural change is the steady death of our brain cells.

Many aspects of life cause our cells to die off, including trauma, drug use, environmental pollutants, strokes… and that’s before we start on age-related diseases such as Alzheimer’s. Yet the quality of our brain function doesn’t decline for most of adulthood. Maybe as our cells decrease we learn to adapt, picking up tricks to help us to make the best of what we’ve got.

Dr Daniel Glaser is director of Science Gallery at King’s College London

City of Sydney sparks anger after publicising anti-vaccination event

The City of Sydney council has been criticised for publicising an anti-vaccination event on the “what’s on” part of its website, with politicians and doctors demanding it be removed.

The $ 15 “Let’s talk about vaccines” information night is scheduled for Monday and promises to answer questions such as: “Government, media and the medical community are pushing more and more vaccines on us. Why?”

The event is to feature a talk by vocal anti-vaccination activist Dr Judith Wilyman and was organised by the No Jab No Pay No Way – Freedom of Choice anti-vaccination group.

On the council’s website, anyone wanting to attend the talk was advised that a text or email containing the venue address would be sent out three hours before it started.

Outcry on social media was swift, with doctors, politicians and members of the public calling on the council to pull promotion of the event.

Dr Brad McKay (@DrBradMcKay)

“Let’s talk about vaccines” isn’t an info night – it’s an event designed to share misinformation & spread scaremongering anti-vaccine propaganda. @cityofsydney need to take this down now! https://t.co/STxpJSBTyR #skepticon

November 19, 2017

Among those demanding the talk be removed from the council website was Tanya Plibersek, deputy Labour leader and MP for Sydney, who asked: “Who approved of this idiocy?”

Tanya Plibersek (@tanya_plibersek)

Who approved this idiocy???
I want my rates refunded. https://t.co/9jCnTu3z72

November 19, 2017

Greens MLC David Shoebridge said the council was not helping the fight against anti-vaccination propaganda.

The link was removed on Sunday after it was brought to the attention of the lord mayor, Clover Moore, and councillor Linda Scott.

Clover Moore (@CloverMoore)

Thank you for alerting me to this event – I have spoken with staff and asked for it to be removed immediately.

November 19, 2017

Scott said on Twitter: “The science is settled, vaccines save lives!”

The City of Sydney said in a statement the event was removed from its listings section because it was “contrary to our values”. “This event should not have been included in the City of Sydney’s ‘what’s on’ listings and it has been removed. This is not a City of Sydney event.”

The statement said that part of the site was a “free events portal” that could be used by people to publicise their events but that “only violent or pornographic material is censored”.

Luke Weston (@lukeweston)

Not an official event, but how does an event by professional anti-vaccination cultists get endorsed and posted on the city of Sydney events website? Surely some screening has to be applied to private events.

November 19, 2017

Wilyman made headlines in 2016 when the University of Wollongong eventually accepted her thesis, which argued against Australia’s pro-vaccination policy. Her work came under heavy criticism, including from those in the medical profession, after she suggested the World Health Organisation and pharmaceutical industry were conspiring to promote vaccinations.

Wilyman has also published research proposing a disproven link between the whooping cough vaccine and autism.

Hospitals attack ‘barking mad’ NHS target to manage winter crisis

Health service chiefs have been declared “barking mad” for ordering hospitals to ensure no patient is treated in a corridor or languishes on a trolley for hours when this year’s winter crisis hits.

NHS England’s instructions, intended to avoid a repeat of hospitals’ descent into the sort of meltdown seen last year, also say that patients should not have to wait more than 15 minutes in the back of an ambulance outside an A&E unit as they wait to be handed over to hospital staff.

Critics have described the plans, outlined in a four-page letter sent to hospital chiefs as “la-la land”, “totally unrealistic” and an attempt “to create Narnia”. Hospital bosses say they regularly have to use all the three tactics which the NHS wants to ban in order to help them cope with the influx of patients created by winter weather and seasonal infections.

“We all aspire to avoiding doing any of those things. But trying to flog a dead horse, or to create Narnia, through a new set of executive instructions isn’t going to help us,” said Dr Taj Hassan, president of the Royal College of Emergency Medicine, which represents A&E doctors.

“Our urgent and emergency care system is under extreme stress going into winter. Given that hospitals are underbedded and underfunded, and emergency departments are understaffed, trying to deliver performance in that climate is nigh-on impossible. We have to define reality rather than delude ourselves about the scale of this problem of caring safely for patients during winter.”

One NHS trust chief executive, who spoke on condition of anonymity, said: “They are barking mad. Patients are waiting on corridors already. This will only get worse as we progress through winter. Twelve-hour trolley breaches in some hospitals are no longer unusual, and for some no longer cause distress or outrage as they are viewed as inevitable. The demands are not realistic.”

Disclosure of NHS England’s attempt to impose a detailed series of duties on hospitals comes amid claims by senior insiders that its leadership is in a state of panic over winter.

Theresa May has told Simon Stevens, the organisation’s chief executive, that he is “personally responsible” for how the NHS performs during what most expect to be a very tough winter, with a flu outbreak feared. Some NHS bosses believe that the prime minister’s move is intended to protect Jeremy Hunt, the health secretary, who they blame for underfunding it and presiding over huge staffing problems.

The regulator NHS Improvement warned last week that the service was already under such pressure, with hospital wards too full after the failure of a £1bn exercise to free up 2,000-3,000 beds, that it was in an “extremely challenging” position.

NHS England’s plans are laid out in a letter sent to all 233 NHS trusts and 209 clinical commissioning groups on 7 June by Pauline Philip, its national director of urgent and emergency care, headed “Winter briefing one: operational management of winter – expectations and communication”. Philip sets out actions “to consistently ensure that safety is maintained during times of significant pressure”. They include an edict that “clinical escalation will need to ensure that patients are not cared for on hospital corridors; 12-hour trolley waits in the emergency department never happen; [and] patients do not wait more than 15 minutes in ambulances before being handed over to the hospital”.

But hospital bosses claim their struggle to keep up with the sheer demand for care over winter, while maintaining patient safety, forces them to deploy the three practices Philip wants to end. Another chief executive said: “This is totally la-la land thinking. The pressure is mounting now. I don’t think any of the areas ‘to be avoided’ will be. Many chairs and non-executive directors of trusts are in complete disbelief about NHS England’s tone and approach.” Serious doubts have been raised about the ability of hospitals to do what Philip has asked. For instance, 1,597 patients had to wait at least 12 hours in an A&E unit to be admitted into the hospital itself in January to March this year, when cold weather caused a spike in illness that led to the NHS experiencing its most pressurised winter ever. So many hospitals struggled so much last January that the British Red Cross called the situation “a humanitarian crisis”.

NHS England, working alongside NHS Improvement and Public Health England, have made unprecedented joint efforts to ensure the health service can withstand this winter’s rigours. For example, NHSE has put £237m into a campaign to offer free flu jabs to a record 21m people including expanded numbers of primary schoolchildren and, for the first time, care home staff.

Chris Hopson, chief executive of NHS Providers, which represents trusts, said hospitals would do everything they could to avoid trolley waits or patients being treated on corridors, and minimise patient handover times between ambulance and A&E staff. But he added: “The indications are that flu may cause more problems than we have seen in recent years. And a prolonged cold spell – often linked to falls and respiratory problems – could make matters worse. So we need to be realistic and honest.

“Trusts cannot guarantee that these problems will not happen. What they can do – and are doing – is to have strong and well developed plans in place to identify when they are struggling to cope, so they can call on support to ensure patients get the best care possible.”

Cross-party MPs request urgent non-partisan debate on future of NHS

Ninety MPs including several senior Tories have urged Theresa May to launch a cross-party convention on the future of the NHS and social care in England.

Sarah Wollaston, chair of the Commons health committee, organised a letter in conjunction with the Liberal Democrat former care minister Norman Lamb and Labour’s former shadow care minister Liz Kendall, that has been sent to the prime minister and the chancellor, Philip Hammond.

The MPs say the health system has been failing patients and they call on Hammond to ensure any moves to lift the public sector pay cap for NHS workers is not funded by raiding existing health budgets.

The signatories, one-third of whom are Conservative MPs, have said only a non-partisan debate can deliver a “sustainable settlement”. They say the failure of normal party politics to secure the future of the system means a non-partisan approach is the only way to ensure action is taken, particularly given that the government does not command a majority.

“The need for action is greater now than ever,” say the MPs, who include about 30 former ministers. “We understand that fixing this is immensely challenging and involves difficult choices.

“We all recognise, though, that patients and those needing care are too often failed by a system under considerable strain. We believe that together we owe a duty of care to the people of this country to confront the serious challenges to the NHS and the social care system.”

The Tory signatories include the former education secretary Nicky Morgan, the former international development secretary Andrew Mitchell, George Freeman, a former policy adviser to May, and the party grandee Sir Nicholas Soames.

The Labour MPs who have signed include Kendall, Chuka Umunna, Hilary Benn, Frank Field and Caroline Flint. Liberal Democrats signatories include the party leader, Sir Vince Cable, as well as Ed Davey and Tim Farron.

In a series of tweets Wollaston said:

Sarah Wollaston (@sarahwollaston)

. Govt also needs to focus on the long term, stop planning for health & social care in separate silos as this approach is setting us up for failure. Finance & workforce need urgent attention for the here & now but also for the long term & MPs from all Parties ready to engage

November 18, 2017

Sarah Wollaston (@sarahwollaston)

Current plans to kick social care into the long grass (again) & to separate planning for young and older adults creates even further fragmentation . Essential to think about whole system of NHS & Care

November 18, 2017

In the letter, MPs argue that only a cross-party NHS and social care convention where there can be a non-partisan debate can ensure a long-term settlement.

This was echoed by Wollaston in further comments in which she said: “The simple reality of a hung parliament means that all our constituents will be failed if long-term plans for NHS and [social] care funding do not command cross-party support.”

She added: “It’s better to take a joint approach to planning from the outset and actually deliver.”

Although MPs recognised that the challenge facing the government involved making difficult choices, they say “patients and those needing care are too often failed by a system under considerable strain”.

Lamb said: “Tribal politics has failed to provide a solution to the existential challenges facing the NHS and social care. We know that the current situation is unsustainable, and these pressures will only get worse as we contend with an ageing population and rising demand for care and treatment.

“This letter shows the strength of cross-party support for a new approach based on cooperation instead of political point-scoring. The fact that so many senior MPs and former cabinet ministers support this initiative is remarkable. Now the government must act on it.”

Kendall said: “Our population is ageing, more people need help and support and our care services desperately need more money to cope, yet any party that comes up with a significant proposal for funding social care risks their political opponents destroying them.

“We could carry on like this for yet another parliament, and yet another election, or we could face up to reality: we will only get lasting change if we secure a cross-party approach.”

According to NHS England chief executive, Simon Stevens, the fall per head in NHS funding means the health service will not be able to meet its routine waiting-time commitments.

Representatives from the Nuffield Trust, Health Foundation and King’s Fund said this year that austerity combined with increasing demand for services had created a “mounting toll on patient care”. They said there was growing evidence that access to some treatments was being rationed and that quality of care in some services was being diluted.

Solving the problem would mean a “steadily increasing share of national income would need to be spent on providing these services,” they said.

The UK spends 9.9% of GDP on the health budget – a considerably lower percentage than many other European nations.

Niall Dickson, chief executive of the NHS Confederation, which represents various organisations in the healthcare system, said promises to reform funding were being “kicked down the road”.

He said: “The government promised reform before the election, then said there would be a green paper before Christmas. Now it has been put off until summer next year – and even then we are not being promised firm commitments.”

A government spokesperson said: “We have announced a cross-government green paper on care and support for older people with input from a group of independent experts. We recognise that there is broad agreement across parliament that reform for social care is a priority and look forward to hearing a range of views.”

They said MPs would be consulted on social care before the green paper policy statement next year. The government had already provided an additional £2bn to social care over the next three years, the spokesperson said, adding that the government was committed to making the sector sustainable.

No, there hasn’t been a human ‘head transplant’, and there may never be

In February 2015, Sergio Canavero appeared in this very publication claiming a live human head will be successfully transplanted onto a donor human body within two years. He’s popped up in the media a lot since then, but two years and nine months later, how are things looking?

Well, he’s only gone and done it! As we can see in this Telegraph story from today, the world’s first human head transplant has been successfully carried out. Guess all those more timid neurobods who said it couldn’t be done (myself included) are feeling pretty foolish right now, eh?

Well, not quite. Because if you look past the triumphant and shocking headlines, the truth of the matter becomes very clear, very quickly. In the interest of full disclosure, I do not know Dr Sergio Canavero, he’s done nothing to me directly that I’m aware of. However, I’m now seriously doubting his motivations. I’ve discussed my reasons for this elsewhere before now, but here they are again in one place for ease of reading.

Monster, Monster1931: British actor Boris Karloff lowers his eyes as the Monster in a promotional portrait for director James Whale’s film, ‘Frankenstein’. (Photo by Hulton Archive/Getty Images)


Even the fictional Dr Frankenstein had a better success rate. Photograph: Hulton Archive/Getty Images

These “successful” procedures are anything but

Many of Canavero’s previous appearances in the media have been accompanied by claims of successful head transplant procedures. But, how are we defining “successful” here? Canavero’s definition seems to be extremely “generous” at best.

For instance, he recently claimed to have “successfully” performed a head transplant on a monkey. But did he? While the monkey head did apparently survive the procedure, it never regained consciousness, it was only kept alive for 20 hours for “ethical reasons” and there was no attempt made at connecting the spinal cord, so even if the monkey had survived long-term it would have been paralysed for life. So, it was a successful procedure, if you consider paralysis, lack of consciousness and a lifespan of less than a day as indicators of “success”.

There was also his “successful” rat head transplant, which involved grafting a severed rat head onto a different rat, a living one that still had its head. Exactly how this counts as a “transplant” is anyone’s guess. It’s adding a (functionally useless) appendage onto an otherwise healthy subject.

And this recent successful human head transplant? It was on corpses! Call me a perfectionist if you must, but I genuinely think that any surgical procedure where the patients or subjects die before it even starts is really stretching the definition of “success” to breaking point. Maybe the procedure did make a good show of “attaching” the nerves and blood vessels on the broad scale, but, so what? That’s just the start of what’s required for a working bodily system. There’s still a way to go. You can weld two halves of different cars together and call it a success if you like, but if the moment you turn the key in the ignition the whole thing explodes, most would be hard pressed to back you up on your brilliance.

Perhaps the techniques used to preserve the heads and attach them have some scientific value, but it’s still a far cry from the idea of someone wandering around with a fully functional body that isn’t the one they were born with. Canavero seems to have a habit of claiming barnstorming triumph based on negligible achievements, or even after making things much worse. He seems to be the neurosurgical equivalent of the UK Brexit negotiating team.

Note Pad With White Pages and Pen. Isolated on WhiteAMGFCK Note Pad With White Pages and Pen. Isolated on White


You’d expect copious details when it comes to performing a successful head transplant. Thus far, they’re strangely absent. Photograph: Alamy

The crucial details are strangely overlooked

The human body is not modular. You can’t swap bits around like you would Lego blocks, take a brick from castle and put it onto a pirate ship and have it work fine. There are copious obstacles to contend with when linking a head to body, even when they’re the same person’s. Doctors have, in recent years, “reattached” a severely damaged spinal cord in a young child, but the key-word is “damaged”, not “completely severed”; there’s enough connection still to work with, to repair and reinforce. And this is with a young child, with a still-developing nervous system better able to compensate. Even taking all this into account, and the advanced state of modern medicine, the successful procedure was considered borderline miraculous.

So, to attach a completely severed spinal cord, a fully developed adult one, onto a different one, one that’s maybe been dead for days? That’s, what, at least four further miracles required? And that’s not to take into account immune rejection, the fact that we don’t really know how to “fix” damaged nerves yet (let alone connect two unfamiliar halves) and the issue that everyone’s brain develops in tune with their body. The latter point means the “interface” between the two is relatively unique. You put the head of musician on the body of a builder, it may well prove to be like trying to play an Xbox game on a PlayStation. Except, infinitely more traumatic.

We don’t know for certain of course, because nobody has ever tried it. Canavero seems convinced he can do it, but thus far he’s offered no feasible explanation or science for his claims to be able to overcome these hurdles, beyond some token stuff about preserving tissues and ensuring blood supply during procedures. That’s a bit like someone claiming they can build a working fusion reactor and, when asked how, explains how they’re going to plumb in the toilets for the technicians. Arguably a useful step, but clearly not the main issue here.

TED X Brooklyn Event Karl Chu speakingBYR6N4 TED X Brooklyn Event Karl Chu speaking


TED Talks. Slick, inspiring, interesting, not exactly peer-reviewed. Photograph: Alamy Stock Photo

Hype before substance

I’ve said this before, even in a Wired article about Canavero’s previous claims, to the extent where I am considering trademarking it as “Burnett’s law”. Simply put; if someone’s making grand scientific claims but hasn’t provided robust evidence for them, yet they have done a TED talk, alarm bells should be ringing.

I don’t know what Canavero’s confidence is based on. Nobody seems to. He hasn’t published anything that would warrant it thus far. Note his recent “successful” human head transplant claims, which you can read about in the Telegraph before he’s published the actual results, as stated in the article.

Why do that? Why tell the newspapers before you tell your peers? If your procedure is rigorous and reliable enough, the data should reflect that. When scientists, particularly self-styled “mavericks”, court publicity but desperately avoid scrutiny, that’s never an encouraging sign.

Going by the Telegraph article, Canavero claims that the next step will be to attempt a transplant with someone in a vegetative state or similar. He also claims to have plenty of volunteers for this. Exactly how coma patients actively volunteered for this radical procedure is anyone’s guess.

There’s no mention yet of attempting it in a conscious person, despite there being actual volunteers for that. I strongly suspect there never will be. Trying it with a conscious, thinking person means it absolutely has to be 100% effective for them to remain in this state after the transplant is done. This would mean finding workable solutions to all the considerable obstacles presented by the very concept of a head transplant.

If I’m wrong about this then I’ll gladly take back everything and apologise, but nothing Canavero has said or done thus far leads me to think he has any idea about how to do this.

Dean Burnett is fully aware that the procedure should logically be called a “body transplant” but that’s not how it’s usually described, so has used the more common terms. His book The Idiot Brain is available now, in the UK and US and elsewhere.

Owning a dog cuts risk of heart attacks and other fatal diseases, study shows

Never mind the chewed slippers, the hair on the sofa, and the inexplicable barking at 3am. Having a dog in the home substantially reduces the risk of heart attacks and other fatal conditions, a major study has shown.

Researchers found that dog ownership had a dramatic effect on people who live alone, cutting the risk of death from cardiovascular disease by 36%. In households with more people under the same roof, dogs had less of a positive impact, but still lowered deaths from heart disease by 15%, the work reveals.

The findings emerge from a study of more than 3.4 million people in Sweden whose medical and pet ownership records were analysed to investigate the potential health benefits of dog ownership. Those who took part in the study were aged 40 to 80 years old and were followed for up to 12 years. Just over 13% had pet dogs.

Tove Fall, professor of epidemiology at Uppsala University, and owner of a five-month-old Kooikerhondje puppy, said the health benefits of dog ownership appeared to be starkest for people who otherwise lived alone. “We see effects in the single households that are much stronger than in multiple-person households,” she said. “If you have a dog you neutralise the effects of living alone.”

Last month, the leader of Britain’s GPs, Helen Stokes-Lampard, warned that loneliness was as bad for human health as a long-term illness. The estimated 1.1 million lonely Britons are 50% more likely to die prematurely than those with good social networks, making loneliness as harmful to the nation’s health as diabetes. While people who live alone are not necessarily lonely, many in the Swedish study seemed to benefit disproportionately from having a dog around.

Working with her colleague, Mwenya Mubanga, on records from Sweden’s national registries, Fall also looked at deaths from any cause and found that people who lived alone with their dogs were a third less likely to die over the study period than those without dogs. For those in larger households, the risk of death was 11% lower among dog owners, the researchers write in Scientific Reports.

The study cannot explain how dogs have a health-boosting impact, but the company alone may reduce stress and motivate people to live healthier lifestyles. In the study, Fall analysed the effects of different breeds and found that owners of dogs originally bred for hunting, such as terriers, retrievers, and scent hounds, had the lowest risk of cardiovascular disease.

People who buy hunting dogs may be more physically active in the first place, because the dogs require so much exercise. The relationship may work both ways though, with livelier dogs effectively demanding that their owners do not slip into an overly-sedentary lifestyle.

But Fall does not believe that getting more exercise explains all, or even most, of the health effects that come with dog ownership. “My impression is that this has to do with social support,” she said.

Other explanations have been put forward, too. Having a dog around the house might influence what varieties of microbes take up residence on and in human bodies, and these may influence our health for the better, Fall said. In previous research, she showed that having a pet dog reduced a child’s risk of asthma by 15%, lending support to the “hygiene hypothesis” which suggests that living in too clean an environment can increase susceptibility to allergies.

Fall hopes to have more answers soon. One key question is whether dogs protect humans against heart disease by reducing blood pressure or through some other effect. “It may be that dog owners like to be outdoors more, or are more organised, or more empathic,” she said.

NHS cash squeeze forces hospitals to postpone non-urgent operations

The NHS is under fire for forcing patients who need surgery to wait at least three months before they can have an operation in order to save money.

NHS clinical commissioning groups (CCGs) in Lincolnshire have provoked sustained criticism after deciding to introduce minimum waiting times for non-urgent surgery including cataract operations and joint replacements.

They have adopted the policy as a result of the NHS-wide cash squeeze and also because they insist that some patients’ condition clears up while they wait.

A Liberal Democrat MP, Norman Lamb, a former health minister, said the move was “a shameful indictment of the under-funding of the NHS” that would prove unfair and divisive. “It undermines the core principles of the NHS: that everyone should get compassionate treatment, as early as possible, when they need it. Those who can afford it will go private to skip the wait, while others will be left waiting in pain and discomfort. This is simply impossible to justify.”

Trafford CCG in greater Manchester has confirmed that it is also considering bringing in a similar policy, according to the Health Service Journal (HSJ), which first reported on the plans.

NHS England oversees all 209 CCGs which between them spend over £60bn of the NHS’s £125bn annual budget. It appeared to back minimum waits, despite the controversy they have aroused.

A spokesman for NHS England said that with health budgets so squeezed that NHS bodies face “difficult choices” about what they spend their money on. However, there are doubts about whether it is legal for any CCG to bring in minimum waits for care, given that patients are supposed to be guaranteed in the NHS constitution that they will be treated as soon as possible.

Lincolnshire West CCG told HSJ that it had “a responsibility to ensure public money is spent effectively and efficiently”. It added that “there is evidence that some conditions do get better over time and that, in some cases, surgery may be unnecessary” though did not specify to which conditions it was referring.

The commonest non-urgent operations hospitals perform include removal of cataracts, replacement of a worn-out hip or knee and the repair of a hernia.

The Royal College of Surgeons (RCS) said making patients wait at least 13 weeks for treatment was “arbitrary” and “ethically wrong” because patients would suffer.

Sue Hill, the college’s vice-president, said: “We strongly urge all these CCGs to reconsider this decision. Patients in Trafford currently wait an average of 7.2 weeks for any type of treatment. If this policy were to go ahead average waiting times in Trafford would double and it is difficult to see how these targets coud be achieved.”

While the RCS appreciates the severe financial pressures facing CCGs, “introducing an arbitrary minimum waiting time for surgery is unlikely to save money in the long-term and is ethically wrong. Delaying surgery can mean a patient’s condition worsens, and can make surgery more difficult and less successful,” added Hill.

Cambridgeshire and Peterborough CCG was the first to bring in minimum waits for non-urgent surgery, also for 12 weeks. But it recently abandoned the policy two months after it was brought in.

Minimum long waits for treatment were banned when the coalition was in office through a ruling in 2011 by the now defunct Cooperation and Competition Panel. However, it appears that that applied only to primary care trusts, which CCGs replaced, and not to CCGs, which hold the NHS budget across England.

Jon Ashworth, the shadow health secretary, urged the government to prevent NHS bodies from using the tactic. “I’m demanding Jeremy Hunt intervenes, enforces the NHS constitution and bans these minimum waiting times. Secondly, in the budget Theresa May must provide the NHS with the money it needs to end this postcode lottery of care that has developed under the Tories.”

An NHS England spokesperson said: “CCGs face difficult choices about what can be afforded within the funds parliament has made available, recognising the priority being accorded to emergency care, mental health, cancer and GP services. Last month 1.3 million patients started consultant-led elective treatment and the vast majority of patients wait less than 18 weeks.”

Can brain training reduce dementia risk? Despite new research, the jury is still out

More than 30 million people worldwide live with Alzheimer’s disease, and while researchers are pushing hard to find a cure, their efforts so far have met with failure. With no effective treatment on the horizon, prevention has become the only game in town. But what can be done to reduce the risk of dementia, now the leading cause of death in England and Wales?

In research published on Thursday, US scientists claim that a form of computer-based brain training can reduce the risk of dementia by 29%. The training was designed to speed up people’s visual information processing, for example by having them spot a car on a screen, and a truck on the periphery of their vision, at the same time. Those who are claimed to have benefited trained for an hour, twice a week, for five weeks, and some went on to have booster sessions at the end of the first and third years. To see if the training made any difference, the participants sat tests up to 10 years later.

There are good reasons to be cautious about the results, which appear in the journal Alzheimer’s and Dementia: Translational Research and Clinical Interventions. The study wasn’t designed to examine dementia, and the scientists didn’t rely on a clinical diagnosis when they totted up who had the dementia at the end of the trial. Instead, they opted for a broader definition and allowed people to self-report that they had the disorder. “If you’re going to say you are preventing dementia, you want that defined to the nth degree,” said Peter Passmore, an Alzheimer’s researcher at Queen’s University in Belfast.

The scientists actually tested two other kinds of brain training too. These were designed to strengthen memory and mental reasoning respectively. A decade after training began, the scientists found that 22.7% of people in the speed training group had dementia, compared with 24.2% in both memory and reasoning groups. In a control group of people who had no training, the dementia rate was 28.8%.

But in studies like these, scientists have to take into account whether an intervention might look good or bad simply by chance. The results for the memory and mental reasoning brain training failed this statistical test. More importantly, the effect linked to visual processing was at best at the very edge of statistical significance. Scientific convention has it that if the chance of a result being a fluke is greater than 5%, it is not worth taking seriously. For visual speed training, the figure was 4.9%.

“We’re lacking high quality evidence to show that brain training has any impact on the risk of dementia, and based on current studies we can’t recommend people take it up,” said Clare Walton, research manager at the Alzheimer’s Society. “What we do know is that keeping the body and brain active across life can go someway towards reducing the risk.”

There are some risk factors for dementia that we cannot change, such as age, genetic makeup, gender and ethnicity. And it may be too late to do much about others. Spending more years in education as a child, for example, has a protective effect against dementia, but whether returning to education later in life helps is unclear.

Until effective treatments are found, the most promising way to reduce dementia risk is through lifestyle changes. Smokers are estimated to be 30-70% more likely than nonsmokers to develop dementia, so quitting immediately is a good start. High blood pressure in midlife seems to raise the risk too, and better control of blood pressure may be one reason the rate of new cases of dementia in Britain has dropped in recent years.

Alzheimer’s researchers often say that what’s good for the heart is good for the brain. The basis for the claim comes largely from research on exercise and diet. It shows that regular aerobic exercise can reduce dementia risk by 30-40%, while eating a healthy Mediterranean-style diet rich in fruit, vegetables and oily fish, and low in red meat and sugar, can potentially halve the risk of dementia.

Walton advises people to take up a hobby that hits a number of risk factors all at once. Joining dance classes or a table tennis club is a way to get exercise, to challenge the brain by learning new skills and to socialise, for example. “The best thing is to find activities that do all three,” she said.

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”