‘Serious incidents’ at Nottingham maternity units to be investigated

Five “serious incidents” that occurred at a hospital trust’s maternity units are to be investigated.

Independent investigators will look into the incidents, including an infant “born in poor condition”, at Nottingham University Hospitals (NUH) NHS Trust.

It follows plans for a wider review of the trust’s maternity units after a report found dozens of babies had died or been injured.

The trust said offering the best care was a “top priority”.

It comes after the Care Quality Commission (CQC) rated the maternity services “inadequate” in May.

An investigation by Channel 4 News and the Independent also revealed in July the trust had paid out more than £91m in damages and costs.

Through a freedom of information probe, BBC News learned there have been 34 maternity investigations following adverse incidents at NUH since 2018.

The Local Democracy Reporting Service said trust board papers showed that in June, five serious incidents – one of which occurred in 2019 – were declared.

Among them was the birth of an infant “born in poor condition” following a forceps delivery, and a mother who experienced a post-partum haemorrhage.

Two of the incidents will be investigated by the Healthcare Safety Investigation Branch (HSIB).

Another two will be looked at by the Local Maternity and Neonatal System (LMNS), and one will be probed by NUH themselves.

In total, NUH said 16 maternity-related serious incidents were declared over two months, six of which were historic cases.

Serious incidents are now being declared retrospectively to ensure they have been categorised in the right way.

The Department of Health and Social Care previously confirmed NHS England and the Nottingham clinical commissioning group were “finalising the terms of reference for an independent review”, which would go back to 2016. BBC

Covid-19: Vaccine portal for 12 to 15-year-olds in Ireland opens

Children in the Republic of Ireland aged between 12 and 15 can now register to get the Covid-19 vaccine.

They will need consent from a parent or guardian, either when registering online, or at the vaccination centre.

Those eligible can get the jab at vaccination centres and some pharmacies or GPs.

The Irish Health Service Executive (HSE) said that it will try to facilitate parents who are working with later appointment times.

About 280,000 children will be eligible for immunisation with a Pfizer or Moderna vaccine.

The National Immunisation Advisory Committee (NIAC) made the recommendation to extend the country’s vaccination programme in July.

The Irish health service has asked parents to study the expert advice on vaccination for this group and make a decision from there as to what is best for their child. BBC

Australia’s east coast battles rising COVID-19 cases

MELBOURNE, Aug 1 (Reuters) – Australia’s east coast states of New South Wales and Queensland faced an escalating battle against the COVID-19 Delta variant on Sunday, with millions under strict lockdown and authorities urging more testing and vaccinations to rein in the outbreaks.

Sydney and its surroundings, under a stay-at-home order for five weeks already, reported 239 new locally acquired cases of the highly infectious Delta strain, matching the record daily number in the current outbreak that was reported on Thursday.

The city’s 5 million residents and those in neighbouring regional centres spanning 200 km (120 miles) of coastline are to stay home until Aug. 28 at least. The total number of cases in the outbreak, which began in mid-June, has reached 3,427.

“I think what is important to know is that there is no roadmap for the Delta variant,” NSW Premier Gladys Berejiklian said.

“The challenge for us is getting as many people vaccinated in August as possible so by the time 28 of August comes around, we have options as to how we can ease restrictions.”

Australia’s vaccination drive has been sluggish, with only 18% of adults fully vaccinated so far. Brad Hazzard, NSW health minister, said that 70% of the state’s population could be fully vaccinated in about four months.

In neighbouring Queensland, there were nine new locally acquired cases of COVID-19, the biggest daily spike in almost a year. More than 3 million residents were put into a three-day snap lockdown on Saturday.

“It is vital (to get tested), anyone with any symptoms at all, it doesn’t matter where you are, because I don’t know where this virus is at the moment,” Queensland’s chief health officer Jeannette Young said.

Coronavirus: Italy brings in Covid certificate amid spike in infections

Italy is introducing a mandatory Covid vaccination certificate from 6 August, the latest country in Europe to announce such a scheme.

The move will allow those aged 12 and over who have received at least one jab to access a range of venues, including indoor restaurants, cinemas and gyms.

However, after disagreements within the governing coalition, the pass will not be needed for transport.

The virus is surging again in Italy, driven by the delta variant.

The number of new cases doubled over the past week, with more than 5,000 infections reported on Thursday.

About half of Italians are now fully vaccinated – but the summer holiday season is dissuading some to turn up for their appointments, says the BBC’s Mark Lowen, in Rome.

Covid vaccine: Eight-week gap seen as sweet spot for Pfizer jab antibodies

A longer gap between first and second doses of the Pfizer-BioNTech Covid vaccine makes the body’s immune system produce more infection-fighting antibodies, UK researchers have found.

Experts say the findings support the UK’s decision on extending dosing intervals from the initial recommendation of three weeks.

An eight-week gap seems to be the sweet spot for tackling the Delta variant.

The UK initially extended the dosing gap to 12 weeks at the end of 2020.

But as the vaccination programme has been rolled out through the age groups – everyone over 18 has now been offered at least their first jab – people have been encouraged to bring their second jab forward and get it after eight weeks.

The government-funded work is published in a pre-print paper not yet peer reviewed.

For the study, the researchers compared the immune responses of 503 NHS staff who received their two shots at different intervals in late 2020 and early 2021, when the Alpha Covid variant, first identified in Kent, was rapidly spreading.

Antibody levels in their blood were measured a month after the second vaccine dose.

The findings suggest:

  • both short and long dosing intervals of the Pfizer vaccine generated strong immune responses overall
  • a three-week schedule generated fewer of the neutralising antibodies that can bind the virus and stop it infecting cells than a 10-week interval
  • while antibody levels dipped after the first dose, levels of T-cells – a different type of immune cell – remained high
  • the longer schedule led to fewer T-cells overall but a higher proportion of a specific type or subset, called helper T-cells, which according to the researchers, supports immune memory

Prof Susanna Dunachie, the joint chief investigator in the Pitch study, at Oxford University, said two doses were better than one but the timing of the second was somewhat flexible depending on the circumstances.

For the UK’s current situation, she said: “Eight weeks is about the sweet spot for me, because people do want to get the two vaccine [doses] and there is a lot of Delta out there right now.

“Unfortunately, I can’t see this virus disappearing, so you want to balance that against getting the best protection that you can.”

Dr Rebecca Payne, one of the study authors, from Newcastle University, said: “Our study provides reassuring evidence that both dosing schedules generate robust immune responses against Sars-CoV-2 after two doses.

“We now need to carry out more follow-up studies to understand the full clinical significance of our findings.”

Real-world data from Public Health England shows the Pfizer vaccine is effective at reducing levels of serious disease, hospital admissions and death, even after one dose

Medics fear surge in winter viruses alongside Covid

A surge in flu and other respiratory viruses could put pressure on people’s health and the NHS this winter, warns a report by leading medics.

They say testing for flu, Covid and a respiratory virus common in children and the elderly – called RSV – may help doctors treat cases more quickly.

The Academy of Medical Sciences report calls for people with any symptoms to isolate and stay at home.

This will help protect against all respiratory viruses this winter.

The report, by 29 leading experts and requested by the government, says there is great uncertainty about what the next few months will hold across the UK, but it urges policymakers to prepare for a challenging winter.

Comeback of winter viruses

During lockdown last winter, the UK population was hardly exposed to the viruses which normally circulate. But they are now set to make a comeback as restrictions lift and society opens up.

Already this summer, there has been a rise in winter viruses in children coming to A&E.

Report author Prof Azra Ghani, from Imperial College London, says their modelling suggests a summer peak of Covid-19 infections “with subsequent local outbreaks over winter”.

But “we can’t completely rule out another winter wave”, she said.

“Whilst we expect the peak in deaths to be considerably lower than last winter, under some scenarios we could see hospital admissions rise to similar levels.”

In a worst-case scenario this could mean around twice the levels of flu and respiratory syncytial virus (RSV) as a normal autumn and winter, the report says.

There are between 10,000 and 30,000 deaths from flu in a normal winter, and about 20,000 children under five are admitted to hospital each year with RSV, which can cause a lung infection called bronchiolitis.

Triple tests

The authors say these viruses often produce similar symptoms, so testing for all three at once would help distinguish between them.

This could be done through Test and Trace or in GP practices, but the turnaround would need to be very fast so that anti-virals could be used to treat flu in the most vulnerable.

Dr Alexander Edwards, from the University of Reading, said the “triple tests” had “great appeal”, but the logistics could be a challenge.

“Whether there will be enough instruments and testing capacity available for this to be available widely in primary care remains to be seen,” he said.

The report also recommends booster Covid vaccines alongside flu vaccines this autumn to reduce the spread of the virus, which is already being planned by the NHS for the over-50s, and improving infection control in hospitals. BBC

What the new CDC guidance for schools means for children

(CNN)Five full days a week, every week: After more than a year of remote learning, hybrid schedules and missed experiences, getting back to school — “normal” school — is all many parents and students want. But with Covid-19 surging again in some US states and concerns over new virus variants growing, what classrooms will look like exactly in the fall is still evolving.The US Centers for Disease Control and Prevention issued new guidance last week on the importance of having all schools opened for in-person, full-time instruction in the fall. To safely keep schools open, the CDC recommended what it calls “a layered mitigation strategy.” This is a systematic strategy involving multiple interventions to reduce risk, such as including the use of indoor masks for unvaccinated students and teachers.

What happens if schools reopen but don’t enforce these procedures? For example, what should parents do if schools don’t require masks? Should vaccinated children over 12 feel comfortable removing their masks in schools? And when might vaccines be available for younger children?

What is Piles?

Piles refer to a physiological condition whereby there is an inflammation of the vascular structures guarding the anal canal. Owing to the inflammation of the hemorrhoids or blood vessels guarding the anal passage; the pathogenic condition of piles develops.

Causes of Piles

  • A number of factors are responsible for the development of piles.
  • Irregularity in bowel movement with susceptibility towards constipation and diarrhea is one of the causes.
  • Constipation aids the condition of piles by giving way to prolonged straining.
  • Absence of fiber, imbalanced diet with insistence on junk food contributes towards piles.
  • Hereditary factors may also be responsible for the pathogenic condition of piles.
  • Pregnancy may well give rise to the condition of piles with the developing fetus exerting pressure on the vascular structures.
  • Obese people and those prone to long hours of sitting are also more likely to develop piles.
  • An obstruction or abnormal growth on the way to the anal canal can also lead to piles.
  • Other factors contributing to the pathological condition of piles include age and vascular structure guarding the anal passage lacking in valves.

Types of Piles

  • Piles can be broadly classified into two broad kinds on the basis of their locations.
  • The ones located internally.
  • The ones located externally.

Symptoms of Piles

  • Piles which tend to affect elderly people, often turns out to be a major source of irritation.
  • The one located externally are more painful than the internal ones.
  • The external ones exist as painful inflammation or swelling.
  • Internally located piles can be a source of extreme irritation when they tend to hang out through the anal passage.
  • The ones located internally are susceptible to take on a necrotic form, whereby they develop into clots of blood. Necrotic ones are however quite painful.
  • One of the most common clinical features of piles includes passage of blood along with stool.
  • Along with bleeding itching and irritation may also persist.

Diagnoses of Piles

  • The piles which exist in prolapsed form can be usually diagnosed by means of an external examination of areas surrounding the anal cavity.
  • Proctoscpy usually serves to highlight the presence of internal piles.
  • By means of proctoscopy the presence of tumors or polyps and that of an inflamed prostate are also detected as the detection is valuable in determining the line of treatment.
  • Proctoscopy or anoscopy is usually performed with patients being subject to sedation.

Treatment for Piles

  • The course of treatment which follows the findings of rectal examination includes the administration of anti inflammatory drugs of non steroidal nature.
  • Traditional line of treatment is geared to the increased consumption of dietary fibers.
  • If constipation happens to be the underlying cause, insistence is given on the inclusion of green and yellow vegetables apart from being well hydrated by increasing the fluid intake.
  • Certain topical formula and suppositories are also available as treatment options; but long drawn usage of the same should be discouraged on account of their tendency to cause localized irritations.
  • Generally surgical removal of the inflamed vessels is resorted to as the last possible alternative.
  • Means based on cauterization and cryosurgery has also been found to be quite effective.
  • Ligation with the help of rubber band is also resorted to so that the blood supply to the inflamed tissues can be cut off.
  • Decartelization using an ultra sound Doppler has also been used so as to rectify the prolapsed structure of piles.
  • Resectioning of the inflamed tissue which involves partial surgical interference is also made use of so that one can avoid the intensely painstaking procedure of total removal.

Self care and Natural Remedies for Piles

  • Person suffering from piles should take all necessary steps so as to have his system well toned up.
  • Apart from overcoming the draw backs of a sedentary life style by means of exercising and resorting to a few yogic postures, he should ensure for himself a regulated life style consisting of balanced diet, normal sleep and regularized bowel habits.
  • Sufficient helpings of fruits, yellow and green vegetables will help to overcome the conditions of constipation- a condition which aids the existence of piles.
  • Besides these a number of natural options, which particularly serve to overcome the painful conditions of piles are also available.
  • One such herbal option includes the use of dry figs and that of chebulic myroblan. There are others making use of a wide variety of natural stuffs including mango seeds, grated radish and turnip.
  • As part of the naturopathic option, diet centering merely on fruits is also recommendable. The fruit centric diet serves significantly in overcoming the malady of constipation besides giving rest to the digestive system.
  • Regular consumption of unsweetened curd , avoiding spicy food items and those of synthetically flavored drinks also rank amongst some of the healthy options so that the menace of piles can be avoided.

‘Miraculous’ mosquito hack cuts dengue by 77%

They used mosquitoes infected with “miraculous” bacteria that reduce the insect’s ability to spread dengue.

The trial took place in Yogyakarta city, Indonesia, and is being expanded in the hope of eradicating the virus.

The World Mosquito Programme team says it could be a solution to a virus that has gone around the world.

Few people had heard of dengue 50 years ago, but it has been a relentless slow-burning pandemic and cases have increased dramatically.

In 1970, only nine countries had faced severe dengue outbreaks, now there are up to 400 million infections a year.

Dengue is commonly known as “break-bone fever” because it causes severe pain in muscles and bones and explosive outbreaks can overwhelm hospitals.

The enemy of my enemy

The trial used mosquitoes infected with Wolbachia bacteria. One of the researchers, Dr Katie Anders, describes them as “naturally miraculous”.

Wolbachia doesn’t harm the mosquito, but it camps out in the same parts of its body that the dengue virus needs to get into.

The bacteria compete for resources and make it much harder for dengue virus to replicate, so the mosquito is less likely to cause an infection when it bites again.

The trial used five million mosquito eggs infected with Wolbachia. Eggs were placed in buckets of water in the city every two weeks and the process of building up an infected population of mosquitoes took nine months.

Yogyakarta was split into 24 zones and the mosquitoes were released only in half of them.

The results, published in the New England Journal of Medicine, showed a 77% reduction in cases and an 86% reduction in people needing hospital care when the insects were released.

“It’s very exciting, it’s better than we could have hoped for to be honest,” Dr Anders told the BBC.

The technique has been so successful the mosquitoes have been released across the whole city and the project is moving to surrounding areas with the aim of eradicating dengue in the region.

Dr Anders, who is also the director of impact assessment at the World Mosquito Programme, said: “This result is groundbreaking.

“We think it can have an even greater impact when it is deployed at scale in large cities around the world, where dengue is a huge public health problem.”

Wolbachia are also spectacularly manipulative and can alter the fertility of their hosts to ensure they are passed on to the next generation of mosquitoes.

It means once Wolbachia has been established, it should stick around for a long time and continue to protect against dengue infection.

This is in sharp contrast to other control methods – such as insecticides or releasing large numbers of sterile male mosquitoes – that need to be kept up in order to suppress the blood-suckers. BBC News.

Three Colorado police officers ‘no longer employed’ after arrest of 73-year-old woman with dementia


U.S. NEWS

Three Colorado police officers ‘no longer employed’ after arrest of 73-year-old woman with dementia

A fourth officer, Sgt. Philip Metzler, was also placed on administrative leave but was not among those who lost their jobs.00:06 /02:37TAP TO UNMUTE

Body camera video shows police force 78-year-old woman with dementia to ground

April 30, 2021, 6:52 PM GMT / Updated April 30, 2021, 11:28 PM GMTBy Minyvonne Burke

Three Loveland, Colorado, police officers are no longer employed with the department after their involvement in the arrest and booking of a 73-year-old woman with dementia.

Karen Garner suffered a dislocated shoulder, fractured arm and sprained wrist after she was slammed to the ground and hogtied during a June 26 arrest, according to a federal lawsuit.

The altercation was captured on police body camera video and shared by Garner’s attorney, Sarah Schielke.

Officers Austin Hopp, Tyler Blackett and Daria Jalali were placed on administrative leave over the incident, along with Sgt. Phillip Metzler. Another sergeant, Antolina Hill, was reassigned.

Loveland Police Chief Robert Ticer said at a news conference Friday that Hopp, Blackett and Jalali “are no longer employed” with the department but declined to specify whether they resigned or were terminated.

It’s unclear why Metzler and Hill were not among those no longer with the department.