Author Archives: markdowe1

Health, Medical, Society

New medical guidelines for dementia patients

DEMENTIA

DOCTORS have been instructed to recognise the “human value” of patients with dementia as part of a major overhaul of care.

Dementia patients should be treated as individuals, have a say in their care and not face discrimination for their age or the severity of the illness, new guidelines say.

While there is currently no cure for dementia, the guidelines stress the importance of diagnosis so that patients and their families can prepare for the future and start treatments to slow its advance. This includes giving patients a controversial spinal tap when doctors are unsure whether they have dementia.

. See also Research reveals a healthy diet helps to stave off dementia

Charities have welcomed the care blueprint but warned that substantial investment would be needed to implement the measures, which include appointing dementia “champions” to advise patients and their families on the care available.

A spokesperson from the Alzheimer’s Society, said: “It’s encouraging to see the steps it’s taking to ensure the needs and rights of people with dementia are met. However, the guideline is just a starting point. What we need now is support to implement these recommendations.”

Recent figures suggest a million Britons are living with dementia. This is expected to double by 2051 due to the ageing population and obesity, which raises the risk of the condition.

Health watchdog NICE drew up the new advice – the first changes to healthcare guidance in a decade – to improve the postcode lottery of care on the NHS following concerns that dementia patients were being failed across the UK.

Ofsted-style ratings carried out in 2016 found that 57 per cent of health boards were giving patients with dementia and Alzheimer’s inadequate care.

Officials found some patients were never diagnosed with dementia, while many of those who were did not receive a check-up for 12 months. Last year, a major study found hundreds of thousands of Britons had dementia but did not know because they were never given a formal diagnosis in case it made them anxious.

For the first time, the guidelines urge doctors to carry out a spinal tap – using a needle to extract spinal fluid from patients whose diagnosis is unclear. However, the procedure is uncomfortable, sometimes painful, and can cause side-effects such as severe headaches and infections.

Other changes include a recommendation for more training for staff such as carers at home, in care homes and GPs to better support people living with dementia. The guidance says people with dementia and their carers should be assigned a health or social care professional to co-ordinate treatment, rather than being left to navigate the options themselves.

Initial assessments should include recording a history – including cognitive, behavioural and psychological symptoms – and how it affects daily life.

This should either come from the patient or a spouse, loved one or carer who knows them well, it recommends.

Alzheimer’s Research UK said: “We’re very happy to see the NICE guidelines give additional attention to how health professionals can help people with dementia get involved in research.”

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Science

Questions of Science: Plant poser

Q: Did all the oxygen in Earth’s atmosphere come from photosynthesising plants? If not, where did it come from?

WITHIN the Earth’s crust, oxygen combines with all the most common atoms to form water, rock, organic compounds and almost everything else around us. Spontaneous free oxygen is about as likely as finding round rocks perched on steep slopes. Such rocks would imply that something had pushed them uphill more strongly than they could roll downhill.

Similarly, any free oxygen about us has been torn from its compounds with more than its bonding force. And that is a lot of force that only a few things are able to produce. Ionising radiation, such as X-rays, can do it, but there is little of that about. Visible light does it laboriously, step-by-step through photosynthesis, the only process that could release the level of oxygen that we see about us. That amount is calculated to be in region of 10¹⁵ tonnes.

How much oxygen plants actually produce is another matter entirely. The chloroplasts used by plants to photosynthesise are thought to have originated as symbiotic cyanobacteria. So, in effect, all our oxygen came from photosynthesising bacteria. Hence, practically all the atmospheric oxygen is of biological origin – and is not from plants but cyanobacteria.

These single-cell organisms, which were present on Earth more than 3.5 billion years ago and pre-date plants, were initially responsible for all oxygen production and are still responsible for more than 60 per cent of current oxygen production.

Cyanobacteria come in many varieties and are sometimes called blue-green algae, although they are not really algae. A species of cyanobacteria present in the ocean, Prochlorococcus marinus, is both the smallest photosynthetic organism known and the most abundant of any photosynthetic species on the planet. It was only discovered in 1988.

Previously Questions of Science: Free the atoms

Science-in-motion: a series of short articles following topics in science.

. Biodiversity

This measures how much variety there is between all the different species of life on Earth, from single-celled bacteria through insects to blue whales, the largest known animal ever to have existed. Biodiversity also describes the genetic diversity within a single species, or even the diversity of ecosystems like wetlands and forests.

Around 1.75 million species of living organisms have been identified on Earth so far, mostly small ones like bacteria and insects, and estimates suggest the true number could be as high as 100 million. But in recent centuries, there has been a rapid increase in the rate of species extinctions due to human activities such as habitat destruction for farming.

Between 1500 and 2009, international organisations documented more than 800 species becoming extinct, including the Javan tiger that died out completely in the 1980s, but the vast majority of disappearances probably go unnoticed. Conservationists grade the vulnerability of species according to a continuum scale that runs from ‘extinct’ to ‘least concern’.

Biodiversity is of huge significance. The development of new medicines, for example, is inhibited during rainforest destruction, of which many tiny organisms are either destroyed or not even previously discovered.

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Britain, Defence, Government

The Royal Navy’s £6bn fleet that hardly ever went to sea

DEFENCE

BRITAIN’S six Type 45 destroyers, described as the backbone of the Royal Navy, spent 80 per cent of last year in dock.

The ships, costing £1billion each, need a multi-million-pound refit after repeatedly breaking down in the Persian Gulf. But the work is not due to start until 2020.

Two of the cutting-edge warships, HMS Dauntless and HMS Defender, did not go to sea at all during 2017 – which had been hailed by officials and ministers as “the year of the Navy”.

All six warships, which entered service from 2008, were made with an engine system which cuts out in warm seas, leaving sailors stranded for hours in total darkness. This led to fears that these key vessels – designed to shield the rest of the fleet from air or missile attacks – had become “sitting ducks”. HMS Dragon spent 309 days in Portsmouth last year, followed by HMS Daring with 232 days and HMS Diamond with 203.

HMS Duncan spent the most time at sea, but was still in dock for 197 days.

From January to March this year, HMS Daring, HMS Dauntless and HMS Defender have not left port.

Shockingly, engine-makers Rolls-Royce claim the Ministry of Defence did not tell them the 8,000-ton vessels would spend long periods in warm waters, so they were not designed to operate in the heat.

Insiders say a shortage of manpower, leave for sailors and routine maintenance had also been factors that kept the ships docked at Portsmouth.

Lord West, former head of the Navy, said: “It is a disgrace that work on these ships has not been done as a matter of urgency. We have so few frigates and destroyers that we should have moved heaven and earth to get the work done.

“If there was a national emergency we can’t rely on them.”

Whitehall sources, who blame the delays on cuts in maintenance contracts, say Defence Secretary Gavin Williamson has since ordered deployments and four of the ships are currently at sea. However, last December Britain had no major warships on operations anywhere in the world for the first time in living memory. The absence of any of the Navy’s 19 frigates and destroyers overseas was described as a “strategic embarrassment for the country.”

Defence ministers and service chiefs are pushing for more spending after years of cuts and a budget review is now underway. The problem first became public knowledge in 2016 when it emerged that two Rolls-Royce turbines on each ship slow down in warm waters and the engine fails to generate enough power.

The system does not recognise this and “trips out” the ship’s generators, resulting in total electricity failure.

The problem does not occur in the North Sea because the engine can generate more power in colder temperatures. The MoD has set aside £160million to correct the problem by installing extra diesel generators to enhance the power and propulsion systems.

This could involve cutting a giant hole in the side of each ship but work on the first one is not due to start until 2020, followed by sea trials a year later.

A spokesperson for the MoD said: “The Royal Navy has a truly global presence with 25 ships and submarines currently at sea.

“Since 2016, our Type 45 destroyers have proved indispensable on global missions to protect commercial shipping in the Gulf, support coalition attacks on Daesh, prevent the smuggling of weapons into Libya, and lead the NATO maritime task force in the Black Sea and Mediterranean.”

See also UK commits to defence spending of 2 per cent of GDP for next five years…

. MPs Demand £20bn Boost for Defence

THE Armed Forces need more cash to meet the resurgent threat from states like Russia, an MP’s report has warned.

The Commons defence committee called on the Government to start the process of moving the level of defence spending from 2 per cent to 3 per cent of total GDP.

That would mean additional funding of around £20billion a year, bringing investment in defence to levels similar to those seen between the end of the Cold War and the mid-90s.

The report said failure to finance the military on a sustainable basis makes it “very difficult” to implement a long-term strategy for defence needs. Financial stability is the “only solution” at a time when the UK faces a renewed threat from Russia, as well as increasing challenges from terrorism and cyber-warfare, MPs said.

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