Concern over norovirus increase by Betsi Cadwaladr health board

A microscopic photograph of the norovirusImage copyright Getty Images Image caption Norovirus costs the UK economy £15m every year, Bangor University researchers say

The largest health board in Wales is urging people to be alert to the symptoms of norovirus, amid concerns over a rise in cases this year.

Last November, a major outbreak of the winter vomiting bug hit Wrexham Maelor Hospital and two community hospitals run by Betsi Cadwaladr health board.

The outbreak closed nine hospital wards in north Wales alone.

The sickness bug costs the UK economy £15m every year, according to researchers at Bangor University.

More than 130 patients were affected in north Wales last November and the outbreak resulted in 192 "lost bed days" - occasions where beds were unavailable to new patients.

Tracey Cooper, assistant director of nursing for infection prevention at the health board, said there were already reports of norovirus cases at care homes in north Wales.

"Estimates of the number of people affected are difficult to get because most people who have norovirus stay at home," she said.

'2.9m cases annually'

"We monitor what's happening in the southern hemisphere through the summer, because their summer is our winter and vice versa.

"What we've seen this summer is they've had increasing numbers of norovirus and also increasing numbers of flu and very severe flu.

"Usually what they get in our summer, we then get in winter.

"So we are expecting to see an increased number of people affected by norovirus and an increasing number of people with flu and severe flu."

Researchers at Bangor University in Gwynedd have estimated there are 2.9m cases of norovirus in the UK annually.

They calculate the cost to the economy is £15m every year, although other estimates place the cost much higher.

Humans do not develop immunity to norovirus, meaning people can catch it repeatedly.

It spreads easily, and can be transferred to different surfaces by touch....

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Mental health care for new mothers in Wales 'unacceptable'

Pregnant womanImage copyright Getty Images Image caption Wales' own mother and baby unit was closed in 2013

Calls have been made for a specialist mother and baby unit to open in Wales to help those suffering mental illness.

The lack of in-patient care for women suffering from severe perinatal mental health illnesses has been described as unacceptable by a committee of AMs.

The Children and Young People's committee of the assembly supported calls for the re-opening of a specialist mother and baby unit (MBU).

Wales' own unit was closed in 2013 with mothers sent to units in England.

The Welsh Government said it was committed to providing specialist inpatient care.

The committee's report recommended that a MBU be established in south Wales to provide an all-Wales service.

Given this may not be suitable for mothers and families in mid and north Wales, the committee also called for the Welsh Government to discuss with NHS England setting up a cross-border service in north east Wales.

Medical guidelines state women who need inpatient care for mental health should normally be admitted to a MBU.

Beds are sought in units in England but officials told AMs the process was fraught with difficulties.

About 60-80 women a year are also treated in adult psychiatric wards, the report said, but AMs heard the wards were "not suitable" to treat perinatal mothers given it requires the separation of mother and baby.

"We believe that the provision of inpatient care to mothers with severe cases of perinatal mental illness is wholly inadequate," the report said.

"While we accept that the most specialist of services will sometimes require patients to travel, the current uncertainty of arrangements with England is unacceptable," the report said.

It added:"To minimise the distances women and their families need to travel to access the care they need, specialist in-patient provision needs to be developed within Wales."

Image copyright Thinkstock Image caption Medical guidelines state women who need inpatient care should normally be admitted to a specialist unit

The Welsh Government has announced £1.5m for community-based services in the Welsh NHS - but the committee heard that services among its seven health boards varied.

Staci Sylvan, from Carmarthen, has suffered with mental health problems after both of her pregnancies.

She told BBC Radio Wales' Good Morning Wales programme[1]:"I went from being really happy to have a baby to not really knowing who I was, what I was doing, feeling very scared and not knowing where I could go for help.

"It did develop into having hallucinations after a couple of weeks."

She said she felt health visitors were not properly trained to recognise her symptoms and she reached "crisis point" before being offered a stay at the MBU unit at Cardiff's University Hospital of Wales - which has since closed.

'Developing options'

Sally Wilson, 36, who lives near Bangor, Gwynedd, suffered with post-partum psychosis[2] and was treated in the community after she was discharged from an adult psychiatric unit.

Ms Wilson was offered a MBU bed in Manchester but little information was given to her about the benefits of such treatment.

"I think ideally my family and friends should have had enough information to make an informed decision about whether I should have gone into a mother and baby unit, and enough staff and resources to have specialist perinatal mental health professionals working with people that are that ill," Ms Wilson said.

A Welsh Government spokeswoman said:"The Welsh Health Specialised Services Committee has been developing options this year to improve perinatal mental healthcare in Wales and we are committed to providing specialist inpatient care in Wales.

"There are now community teams in each health board in Wales," she added....

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Breast cancer warning from man stunned by 'impossible' diagnosis

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Media captionPortadown man talks of breast cancer shock

When you think of breast cancer, you think of a form of cancer that affects only women.It doesn't.

While breast cancer in men is rare it's still an issue for the 10 men on average who are diagnosed with it every year in Northern Ireland.

Ian Cranston, 70, was diagnosed with breast cancer in May.Two weeks later he had a mastectomy.

The Portadown father-of-two was given the all-clear in June and has decided to speak publicly to make men aware that it's a cancer that doesn't just affect women.

He said "men also need to check their breasts for changes".

Inverted nipple

In May, Ian's wife Elizabeth noticed something wrong when he got out of the shower.

Image copyright SPL Image caption About 10 men in Northern Ireland are diagnosed with breast cancer each year

She told him he had an inverted nipple and needed to see his GP.

"I didn't know what that meant," said Ian.

"Men can't get breast cancer, I don't have to go to the doctor.

"I wasn't aware I had breasts.This is my chest, men don't have breasts, it's impossible," he added.

Eventually his wife persuaded him to go to his GP, who referred him to Craigavon Area Hospital.

Image caption Ian Cranston alongside breast care specialist nurse Annie Treanor

The diagnosis stunned him.

"Men having breast cancer, I couldn't believe it," he said.

"I couldn't do or say anything.My wife Elizabeth cried."

Four days later Ian said he "just broke".

He has decided to help try and raise awareness of the disease, saying that if his speaking out helped one man, it would be worth it.

"I can understand where women are coming from because I've had breast cancer myself," he said.

Signs and symptoms

In the past 23 years, 166 men have been diagnosed with breast cancer, according to the NI Cancer Registry at Queen's University.

While the majority of men diagnosed (99) are aged between 60 and 80, 26 men were under the age of 40.Forty were 80 years old or older.

Annie Treanor, a Southern Trust breast care specialist nurse, said:"Many people don't know that men get breast cancer because they aren't aware that men have breasts.

"But men do have a small amount of breast tissue behind their nipples and this is where breast cancer can develop," she added.

She said signs and symptoms to look out for are similar to that of a female and include:...

  • An inverted nipple
  • A lump anywhere within the breast tissue
  • Nipple discharge
  • Ulceration or swelling

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Restaurant chain 'cut sugary drink sales' with price rise

Pouring drinks at a restaurant tableImage copyright Getty Images Image caption 10p or 3% was added to the price of sugar-sweetened drinks and healthier soft drinks were added to the menu

An increase in the price of sugary drinks in restaurants and the offer of healthier alternatives could encourage customers to cut back on sugar, a study suggests.

In Jamie's Italian restaurants, sales of sugar-sweetened soft drinks declined by 9% following a 10p price rise.

The chain also redesigned the menu and explained that money from the levy would go to charity.

Experts said more research was needed to pin down what measures worked.

Consuming too many sugary soft drinks has been linked to a higher risk of serious health problems such as obesity, type-2 diabetes, heart disease, stroke and tooth decay.

Sugar tax

To help tackle obesity, the UK government is introducing a tax on high-sugar soft drinks such as Coca-Cola, Pepsi and Irn-Bru in April 2018 - and Jamie Oliver had been vocal in his support of the plan.

This study[1], in the Journal of Epidemiology and Community Health, analysed sales of sugary non-alcoholic beverages at 37 of Jamie Oliver's national chain of restaurants after a 10p levy was introduced in September 2015.

Low-sugar fruit spritzers (fruit juice mixed with water) were also added to the menu, which clearly explained why the levy was being introduced.

Image caption Jamie Oliver urged the government to be bold on a sugar tax

After 12 weeks, sales of sugary drinks per customer had declined by 11%, and after six months they had gone down by 9.3%.

But the study did not look at any other restaurant chains to compare sales figures.

The study also showed there was a general decrease in the number of soft drinks sold per customer, including diet drinks and bottled waters.

The researchers, from the London School of Hygiene and Tropical Medicine (LSHTM) and the University of Cambridge, said more people could have chosen tap water, but these figures had not been recorded.

Sales of fruit juices had increased by 22% six months after the changes were introduced.

Changing behaviour

Prof Steven Cummins, lead study author and professor of population health at LSHTM, said:"A small levy on sugar-sweetened drinks sold in restaurant, coupled with complementary activities [such as redesigning the menu], may have the potential to change consumer behaviour."

But he said it was not possible to say that the price increase alone had caused the decline in sales of sugar-sweetened drinks.

There was also no separate data on what adults and children ordered.

Image copyright Getty Images Image caption Customers may have ordered tap water instead of sugary drinks

Prof Kevin McConway, emeritus professor of applied statistics at the Open University, said it was plausible that the levy "played an important role" but he also called for "more investigation, in other restaurants, and with a longer follow-up period, to try to pin down more clearly what really works".

Prof Susan Jebb, professor of diet and population health at the University of Oxford, said the findings were "encouraging news for public health".

But she said there was a disappointing lack of data on alcohol sales, which could have increased over the same period....

References

  1. ^ This study (jech.bmj.com)

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Hip implant patients sue manufacturer

doctor examining a hip x-rayImage copyright Getty Images

Hundreds of people who received allegedly faulty hip replacements are suing the manufacturer at the High Court.

The hearing is thought to be one of the largest product liability group actions ever heard in the UK.

DePuy denies that its metal-on-metal implants were defective and caused some patients to need more surgery than was necessary.

Sales of the Pinnacle Ultamet device were discontinued in August 2013.

Lawyers claim their clients were affected by the release of metal particles from the implants, which can damage the surrounding tissues and cause symptoms such as pain and swelling.

Some 312 people who were fitted with the Pinnacle Ultamet hip joint say they have had to have remedial surgery after it failed prematurely.

During the first day of the hearing, the court was told that after 10 years the metal joint involved had a failure rate up to six times higher than alternatives made from other materials.

Wear over time

Metal-on-metal implants replace the hip joint with a metal ball and cup.

Hundreds more metal-on-metal claims against a number of other manufacturers are said to be on hold pending the outcome of the trial, which is expected to last until the end of January.

DePuy said:"We have no greater responsibility than to the patients who use our products.The device is backed by a strong record of clinical data showing reduced pain and restored mobility for patients suffering from chronic hip pain.We are committed to the long-term defence of the allegations in this litigation."

Earlier this year, the Medicines and Healthcare products Regulatory Agency said every patient with a metal-on-metal prosthetic hip should have regular check-ups to spot any complications.

The watchdog had previously recommended that only patients with particular types of implant, or troublesome symptoms, undergo tests.

"Although the majority of patients with these metal-on-metal devices have well-functioning hips, it is known some may develop soft tissue reactions related to their implant.

"The clinical advice we have received indicates patients will likely have the best outcomes if these problems are detected early, monitored and treated if necessary," the MHRA said when it updated its advice.

About 56,000 UK patients have had a metal-on-metal hip device implanted....

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