A Warning by Key Researcher On Risks of BPA Plastic Bottles and Cans in Our Lives

The chemical Bisphenol A, or BPA, has been much in the news lately. BPA is the building block for polycarbonate plastic - the sort of hard, clear plastic often used in water bottles - and it is found in everything from linings of metal cans, to the thermal paper used for cash register receipts, to the dental sealants applied to children's teeth. The chemical mimics estrogen, and in studies involving lab animals, exposure to BPA, even at very low doses, has been linked to a wide variety of health problems, from an increased risk of prostate cancer, to heart disease, to damage to the reproductive system.

Frederick vom Saal, a biologist at the University of Missouri's Endocrine Disruptors Group, is one of the world's leading researchers on the ill health effects of BPA in humans and animals. He is also one of the most outspoken critics of U.S. businesses and regulators for glossing over, or concealing, the major impact that BPA exposure is increasingly having on human health. Vom Staal is irate that even though BPA is quite similar to another synthetic hormone - DES, or Diethylstilbesterol - that caused myriad health problems in thousands of women in the 1940s and 1950s, federal regulators are only now beginning to take seriously the threat from BPA.

In an interview with Yale Environment 360 contributor Elizabeth Kolbert, vom Saal excoriated the U.S. chemical industry for attempting to quash research showing the dangers of BPA and for threatening him and other researchers. Vom Saal was equally critical of regulators from the U.S. Environmental Protection Agency (EPA) and other agencies, whom he says have relied on outdated studies, often funded by industry, to support claims that BPA is safe.

Vom Saal adamantly believes that BPA should be removed from all products as soon as possible, as was done a decade ago in Japan. Although the U.S. Food and Drug Administration (FDA) said earlier this year that the health effects of BPA represent "reason for some concern," the chemical still remains unregulated. Vom Saal maintains that the regulatory system has failed to protect U.S. consumers, adding, "It is a lie. It is a fraud. It is absolutely intolerable that this kind of thing is going on."

World 'Dangerously Close' to Food Crisis, U.N. Says

Global grain production will tumble by 63 million metric tons this year, or 2 percent over all, mainly because of weather-related calamities like the Russian heat wave and the floods in Pakistan, the United Nations estimates in its most recent report on the world food supply. The United Nations had previously projected that grain yields would grow 1.2 percent this year.

The fall in production puts the world "dangerously close" to a new food crisis, Abdolreza Abbassian, an economist with the United Nations Food and Agriculture Organization, said at a news conference last week.

Rising demand and lower-than-expected yields caused stocks of some grains to fall sharply and generated high volatility in world food markets in the latter half of the year. Prices for some commodities are approaching levels not seen since 2007 and 2008, when food shortages prompted riots around the world.

"There is no crisis at this stage, but it could come if we don't act," Mr. Abbassian said. "The numbers are getting dangerously close to what we saw in 2008."

With world stocks depleted, wheat production will need to grow by 3.5 percent and corn production by 6 percent next year to avoid future price shocks, he estimated.

"Just normal production will not do anymore," he said.

Good yields in regions with poor food security like East Africa eased the pain of sharp rises in world grain prices this year, however.

In the long term, however, growing demand for food staples like corn and seed oil for use as biofuels will most likely continue to play a central role in tightening world food supplies, the United Nations warned. Roughly 7 percent of global yields of corn and other coarse grains is being used to make ethanol.

"This is a huge amount that does have an impact on the food markets and on prices," Hafez Ghanem, assistant director general for the Food and Agriculture Organization, told reporters.

In the United States in particular, ethanol production is supported by heavy government subsidies, without which it would be largely uneconomical to manufacture.

Cities, States Start to Adopt Climate Change Survival Strategies

As it becomes ever more clear that Congress has retreatedfrom climate change legislation faster than a Greenland glacier, cities andstates are starting to focus on adapting to the inevitable.

A report released this week by the California Adaptation Advisory Panel laid out themyriad threats climate change poses to the Golden State -- as well as strategies toanticipate and prepare for rising sea levels, along with more wildfires, heat waves, andwater shortages.

"Failure to anticipate and plan for climate variability andthe prospect of extreme weather and related events in land development patternsand in natural resource management could have serious impacts far beyond whathas already been experienced," the report states.

In short, California needs to deploy monitoring technologyalong its 1,100-mile coastline and overhaul its approach to land usedecision-making.

Eight cities and counties across the United States,meanwhile, have joined what is being called the nation's first climate adaptationeffort. The participants are Boston, Cambridge, Mass.,  Flagstaff, Ariz., Tucson, Ariz., GrandRapids, Mich., Lee County, Fla., Miami-Dade County, Fla., and the San FranciscoBay Conservation and Development Commission.

Created by the ICLEI-LocalGovernments for Sustainability, a Washington nonprofit, the ClimateResilient Communities program gives the cities and counties planning and database tools to prepare for rising temperatures and sea levels.

"Local governments have a responsibility to protect people,property, and natural resources, and these leading communities wisely recognizethat climate change is happening now, and that they must begin planning forimpacts that will only become more severe in the coming decades," MartinChávez, ICLEI USA's executive director and a former mayor of Albuquerque, saidin a statement.

The idea is to create a standardized municipal planningprocess to prepare for climate change.

Obama's Cheerleaders Fall on their Faces

The electoral debacle suffered by the Obama Administration and its Democratic Party will be blamed on many things, especially the secret wealth behind the myriad of coordinated campaign front groups dominating TV advertising in the wake of the Supreme Court's horrific decision in the Citizen United case, a Right Wing coup that essentially drove the nail into the money coffin encasing American democracy.

But let the blame be laid instead with the Obama Administration itself, the phony rhetoric of change and populism it embraced to win in 2008, and the betrayal of its promises of fundamental reform, openness and peace, ideals that so excited new and independent voters just two years ago. I've been writing since 2007 about the sell-out of the peace movement by MoveOn and its co-option as a campaign tool by Democratic Party. Web-centric, navel-gazing fundraising operations such as MoveOn and the liberal millionaires behind the Democracy Alliance fooled themselves into thinking that the election of Obama meant the Republicans were vanquished. But the pro-war, pro-Wall Street, anti-Single Payer reform antics of Obama and the Democrats undercut their reform rhetoric and revealed the hypocrisy of Democratic corporate liberals, or "progressives" as they have come to be called.

Obama's great email list of over ten million contributors, controlled by the Democratic National Committee and renamed Organizing for America, and the five million strong list of MoveOn, and the hundreds of millions spent in the past half decade by the elite wealthy funders behind the Democracy Alliance, were futile in this election. The phony health care reform bill and the idiotic and suicidal ratcheting up of the war in Afghanistan, a war doomed to failure in the years ahead, sealed the fate of the Democrats as they labored to paint lipstick on the pig that is the health insurance law, while sitting on their hands in the face of the counterproductive escalating war. The economy was put in the hands of Larry Summers and Tim Geithner, a bit like handing Bonnie and Clyde the keys to the bank vault and a new get away car.

Marijuana Legalization: Not If, But When

California's marijuana legalization initiative, Proposition 19, didn't win a majority of votes, but it already represents an extraordinary victory for the broader movement to legalize marijuana.

What's most important is the way its mere presence on the ballot, combined with a well run campaign, has transformed public dialogue about marijuana and marijuana policy. The media coverage, not just in California but around the country and even internationally, has been exceptional, both in quantity and quality. More people knew about Prop 19 than any other measure on the ballot this year -- not just in California but nationwide.

The debate is shifting from whether marijuana should be legalized to how. Public opinion polls in California consistently reveal that a majority of the state's citizens favor legalizing marijuana. One "No on 19" campaign spokesman admitted that even his own supporters were divided between those who oppose legalizing marijuana and those who favor legalization but were wary of either Prop 19's specific provisions or the federal government's threats to block it from being implemented.

Prop 19 both elevated and legitimized public discourse about marijuana. It's the small but growing number of elected officials who endorsed Prop 19 or said they'd vote for it -- and the increasingly frequent private expressions of support by candidates and elected officials who said they wished they could be public about their position. It's the growing number of endorsements by labor unions, including SEIU California, and civil rights organizations, including the California chapter of the NAACP and the National Latino Officers Association.

Why New GIPSA Rules Support Family Farms

The USDA has a law on the books that levels the playing field between family farmers who raise cattle, hogs and poultry and the large meat packers who purchase their livestock and bring it to market. It's called the Packers and Stockyard Act, and its overseen by the USDA's Grain Inspection, Packers and Stockyard Administration or GIPSA. But don't tussle with that mouthful because it doesn't explain what you need to know about the complex livestock market system. Just keep reading. GIPSA makes sure small producers have equal access to market that larger producers do. It's fair competition, which is, of course, the American way.

Sounds great, right? And just in time for the good food revolution. But instead, this law has been gathering dust because the USDA hasn't enforced it. New proposed rules (previously covered here on Civil Eats) amending the act would prevent large meat packers from artificially lowering the price of cattle, hogs and lamb. But four companies control over 80 percent of the U.S. meat market, and these "Big Four" are fighting an effort to strengthen the rule.

For all you urban food geeks who've never ridden the North Dakota range or shoveled chicken manure in central North Carolina, here's some context. When you're raising livestock, timely access to market is critical because a meat animal is a perishable product. When the animal has reached optimal weight, it must be sold in a narrow window of time, typically within two to three weeks. If it cannot be processed, it begins to degrade in quality, and a producer is subject to a significant price deflation. If a packer won't purchase your animals for slaughter, you're stuck selling your animal either too early or too late, competitive bidding isn't possible, and the packer conspires to give you a ridiculously low price for your labors.

Taking the 'Waste' Out of Human Waste

We do it every day.

But how many of us think about what happens after we pull the toilet lever?

Increasingly, people in Chicago and across the world are. They're questioning the sustainability of a system built on using clean water and a lot of energy to process waste, and reimagining the possibilities for what we flush away.

Call it taking the "waste" out of human waste - a movement that includes transforming sewage sludge into fuel, heating buildings with it, using composting toilets to produce fertilizer. It all adds up to a major point: Change is on the horizon, even if that horizon seems far away.

The United States used about 410 billion gallons of water each day in 2005, according to a U.S. Geological Survey report. More than 30 percent of those gallons flush our toilets, which we do five times a day on average, according to the nonprofit American Water Works Association and its Research Foundation in Denver.

Dick Lanyon, executive director of the Metropolitan Water Reclamation District of Greater Chicago, said it costs $747 per million gallons to treat the water. The district serves 5.25 million people.

Added Reed Dring, operations manager for Stickney Water Reclamation Plant, blowers have to pump almost 500,000 cubic feet of air per minute using 20,000 horsepower. "That takes a lot of energy," Dring said. "Our monthly electric bill is $1.8 million."

Though the plant offsets some of its costs by using methane gas generated by sewage sludge to heat its buildings, receiving less water would make the job easier, Dring said. "The less (wastewater) to pump, the less motors I have to run."

Rose George, author of "The Big Necessity: The Unmentionable World of Human Waste and Why It Matters," said one of the problems with the current sanitation model, one she and others believe is unsustainable, is thinking of "human waste as waste and not a resource."

How the Places We Live Make Us Sick, and How They Could Heal Us Instead

The news came out a couple of weeks ago, and then it got swept away in the ongoing torrent of information: The Centers for Disease Control projects that by 2050, one in three American will have diabetes.

One. In. Three.

If we needed any more of a wakeup call about the catastrophic state of American public health, this should provide it.

Why is this happening? According to the report, "These projected increases are largely attributable to the aging of the US population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer."

Fair enough. But why are people -- minority or otherwise -- getting diabetes in the first place? Scientists have proven the link between diabetes and obesity. And we have become a society where the road to obesity is quite literally built into our environment. Studies have shown that more vehicle miles traveled result in more obesity. Our broken food system is another huge contributing factor, but even there, the built environment factors in -- our inner cities are quite often "food deserts" where no healthy nutrition is available.

So if the places we live are making us sick, could they heal us instead -- if only they were designed better?

That's the fascinating question being raised by the Healing Cities Working Group of planners and health professionals in Vancouver.

Agribiz BFF Bill Northey Defeats Reformer Francis Thicke for Iowa Ag Secretary

Republican Bill Northey was reelected Iowa secretary of agriculture, defeating organic farmer Francis Thicke 63 to 37 percent, despite being roundly criticized for his handling of the Wright County Farms 500 million salmonella-tainted egg fiasco.

As I wrote here in September, if Thicke (pronounced "TICK-ee") managed to unseat Northey, it would have been a huge win not only for sustainable agriculture in Iowa, but for the nation as we begin gearing up for the next Farm Bill. "The triumph of a reform candidate like Francis Thicke would demonstrate to Washington that a change in agricultural policy would in fact be welcome in much of the farm belt," Michael Pollan, food-system journalist and UC Berkeley professor, told me by email.

Well, with a margin that wide, it's safe to say that the opposite message has been sent. Agricultural reform may have been collateral damage from a different kind of cultural war, however: Iowa voters turned out in droves to remove three state Supreme Court judges who had ruled that same-sex marriage was legal. But while they also elected a Republican governor, they mysteriously voted in three Democratic congressmen in contested districts and approved an environmentalist-backed constitutional amendment.

The ag-sec race seems to have been about preserving the status quo. Incumbent Northey is a fourth-generation corn and soybean farmer whose reelection campaign was endorsed by the Iowa Farm Bureau (his grandfather was its president) and also, at the last minute, a Democratic Party power broker and former Monsanto lawyer. Thicke, meanwhile, was endorsed by such sustainable agriculture bigwigs as Pollan, Wendell Berry, Wes Jackson, and former Texas Agriculture Commissioner Jim Hightower, along with Robert Kennedy, Jr. -- which may have ended up hurting him in the eyes of Iowa voters.

Plenty Of Foods Harbor BPA, Study Finds

Some communities have banned the sale of plastic baby bottles and sippy cups manufactured using bisphenol A, a hormone-mimicking chemical. In a few grocery stores, cashiers have already begun donning gloves to avoid handling thermal receipt paper out of fear its BPA-based surface coating may rub off on the fingers. But how's a family to avoid exposure to this contaminant when it taints the food supply?

It's a question many people may start asking in response to data posted online November 1 in Environmental Science & Technology by a team of university and government scientists. Indeed, the last author on the paper is Linda Birnbaum, director of the National Institute of Environmental Health Sciences.

In recent years, she's teamed up with toxicologist Arnold Schecter of the University of Texas School of Public Health on market-basket analyses of foods for various potentially toxic pollutants. Like Birnbaum, Schecter initially gained renown for studying dioxins. Now, both have moved into the BPA arena.

In their team's new paper, the Texas contingent locally purchased three samples of each of 31 types of canned or plastic-packaged foods. Another four examples of fresh meat and eight different types of pet food were also collected. All were analyzed for BPA - and 60 percent of the different food products hosted measurable quantities. Ironically, pet food contained less of the pollutant than did most of the items destined for human consumption.

Where Has All The Water Gone?

Mankind is moving buckets and buckets of water from land to the ocean.

Sometimes science moves slowly and sometimes quickly. This is an instance of quick.

A couple of weeks ago TheGreenGrok covered a paper by Tajdarul Syed of the University of California, Irvine, et al who used hydrologic data to estimate the rates at which water flowed from the continents to the sea. They found that the rate rose over the study period from 1994 to 2006 and that the strongest component of that increase was an increase in evaporation over the ocean. The authors noted that such trends, if they continue into the future, would be evidence of an intensification of the hydrologic cycle, in which increased evaporation over the ocean leads to increased precipitation over the continents and subsequently more river discharge into the ocean.

While I had some reservations about the study -- recognizing, as the authors did, that the time period wasn't sufficiently long enough to draw conclusions about changes in the hydrologic cycle, and finding there were uncertainties in the numbers they derived -- I generally saw the paper as but another confirmation of the fact that our climate is changing. (To be clear, the findings of Syed et al were and are in no way central to the climate change issue but in line with it.)

But a new piece of the puzzle has been added with a report just out in the journal Geophysical Research Letters by Yoshihide Wada of Utrecht University in the Netherlands and colleagues. And that new piece calls into question the conclusions of Syed et al.

The Wada et al paper is about groundwater, but before we get to the specifics, a little background.

What the Midterms Mean for Federal Ag-Policy Reform

The House and Senate ag committees, that two-headed monster that dominates federal ag policy, both have a new look after the midterms.

In short, the Senate committee is getting a new chair, while the rest of it remains largely the same. The House committee's transformation is much deeper -- not only has it shifted from Democratic to Republican leadership, but more than a third of its members were ousted by the electorate.

What does this mean for farm policy ahead of looming 2012 Farm Bill negotiations? First, the details.

The Senate: Power struggle at the top

Senate Committee chair Blanche Lincoln (D-Ark.), a Blue-Dog Democrat with fierce loyalty to her state's industrial meat and cotton interests, is out (as expected).

Associated Press is reporting that her likely successor is either Debbie Stabenow (D-Mich.) or Kent Conrad (D-N.D.). Ben Nelson (D-Neb.), the subject of speculation last week, now has only an "outside chance" of grabbing the gavel, AP reports.

Reducing Urban Water Use Around the World with Compost Toilets

Theodore Roosevelt once noted that "civilized people ought to know how to dispose of the sewage in some other way than putting it into the drinking water." But that's what we're still doing every day.

The one-time use of water to disperse human and industrial wastes is an outmoded practice, made obsolete by new technologies and water shortages. Yet it is still common around much of the world. Water enters a city, becomes contaminated with human and industrial wastes, and leaves the city dangerously polluted. Toxic industrial wastes discharged into rivers and lakes or into wells also permeate aquifers, making water -- both surface and underground -- unsafe for drinking.

The current engineering concept for dealing with human waste is to use vast quantities of water to wash it away, preferably into a sewer system, where it may or may not be treated before being discharged into the local river. The "flush and forget" system takes nutrients originating in the soil and typically dumps them into the nearest body of water. Not only are the nutrients lost from agriculture, but the nutrient overload has contributed to the death of many rivers and to the formation of some 405 "dead zones" in ocean coastal regions. This outdated system is expensive and water-intensive, disrupts the nutrient cycle, and can be a major source of disease and death. Worldwide, poor sanitation and personal hygiene claim the lives of some 2 million children per year, a toll that is one-third the size of the 6 million lives claimed by hunger and malnutrition.

Sunita Narain of the Center for Science and Environment in India argues convincingly that a water-based disposal system with sewage treatment facilities is neither environmentally nor economically viable for India. She notes that an Indian family of five, producing 250 liters of excrement in a year and using a water flush toilet, contaminates 150,000 liters of water when washing away its wastes.

How Lead Gets Into Urban Vegetable Gardens

If you're a vegetable gardener in a lot of older cities, there's a fair chance you have a significant amount of lead in your soil. One common mitigation approach is to build a raised bed and fill it with freshly composted, low-lead soil from elsewhere, right? Maybe not, according to researchers studying the mysterious case of the lead contamination found within raised beds in community gardens in the Boston communities of Roxbury and Dorchester.

"Raised beds are surrounded by a sea of contaminated soil," said Daniel Brabander of Wellesley College. Brabander, his students and colleagues have been studying the lead in 144 backyard gardens in coordination with The Food Project, an organization committed to food security, nutrition and sustainable urban agriculture. Eighty-one percent of the gardens they studied were found to have lead levels above the U.S. EPA limits of 400 micrograms of lead per gram (µg/g) of soil.

To solve that problem, raised wooden beds with freshly composted soil were installed in backyard and community gardens by the Food Project. But the researchers have found that the soil in raised beds that starts with as little as 110 micrograms of lead per gram of soil rose to an average of 336 µg/g of lead in just four years.

Just how this is happening is the focus of a Nov. 1 presentation by Emily Estes at the meeting of the Geological Society of America in Denver.

"We're trying to get a better handle on the mode of transport and the source," said Estes. That means some pretty detailed monitoring and chemical analyses of the minerals in the soils as well as the kind of lead that's in the soil.

USDA Issues Draft Environmental Assessment of GM Sugar Beets

The US Department of Agriculture (USDA) has prepared a draft environmental assessment (EA) of genetically modified sugar beets, including an option to permit planting of the beets under certain conditions.

A federal district judge ruled in August that the planting of GM sugar beets should be halted until the USDA completes an Environmental Impact Statement (EIS), expected to be completed by the end of May 2012. However, the USDA said that it would allow limited planting of the sugar beets while the EIS was prepared and issued permits to four companies, which are understood to have already planted seedlings to produce seed for the 2012 crop - a move that the court ruled was illegal last month.

The USDA said its EA has been drafted in response to a request from KWS SAAT AG and Monsanto - currently the only supplier of GM sugar beets - for administrative action to allow continued cultivation of Roundup Ready sugar beets under certain conditions.

Deputy administrator for the USDA's Animal and Plant Health Inspection Service APHIS biotechnology regulatory services Michael Gregoire said in a statement: "APHIS takes its role in protecting plant health very seriously and is well aware of the importance of this decision for sugar beet growers and processors. We are issuing this environmental assessment to share our decision-making process as transparently as possible and allow for public comment."

Three alternatives

The draft EA puts forward three alternatives: Deny the request for partial deregulation or similar action, halting production until the EIS is completed; authorize production under APHIS-imposed conditions to limit potential plant pest risks; or allow partial deregulation "under conditions imposed by Monsanto/KWS through technology stewardship agreements, contracts or other legal instruments."

Under this third alternative, APHIS would no longer regulate Roundup Ready sugar beets. 

Language boost

Parents who use different languages with their children might give them better cognitive powers Bilingual children are less easily confused and are less likely to develop Alzheimer's when they grow up.

These are just some of the claims to emerge from recent studies on bilingualism which the American scientist and author Jared Diamond has reviewed for an article in the journal Science.

Globally, people who speak two or more languages are believed to outnumber those who speak only one language. But up until the 1960s, research appeared to show that bilingual children acquired language more slowly.

According to Professor Diamond, who is now learning his 12th language, such assumptions are now outdated, with more recent work suggesting no great differences in the cognitive and linguistic progress of multilingual vs monolingual children.

But there are areas, he says, where more languages might be better.

Puppet show

He points to work by Ágnes Kovács and Jacques Mehler. They tested the responses of infants who were being brought up by parents who each spoke different languages to their children, with infants who were only exposed to one parental language.

What they found was the "bilingual" children adjusted more quickly to changes, and were more quickly anticipating on which side of the screen the puppet would appear based on the speech clue.

They devised a game with a puppet appearing on different sides of a screen, but with the puppet's appearance preceded by a different nonsense word.

Mental health patients' big wait

One in five people diagnosed with mental illnesses have to wait over a year to get counselling therapy from their doctors. This is according to the mental health charity Mind.

The charity says that getting treatment within three months of going to the doctor can help get people back into work more quickly.

Jenny was diagnosed with bipolar disorder in the same week she discovered she was pregnant. She then developed post-traumatic stress disorder when her son was born. Despite being a high-risk patient, Jenny was told she would have to wait eight months for cognitive behaviour therapy.

'Cutting targets saves lives'

New hopes for a 'Cinderella' service For years NHS care has been driven by the need to meet an array of targets.

But in this week's Scrubbing Up Jane Hanna, director of the charity Epilepsy Bereaved, argues that removing such strictures could create a more level playing field for the rationing of health resources and save lives.

Like everyone working in the health services today I am well aware of the pressures on services and the ever-present fear of cuts.

For years there have been targets, targets and more targets - and that has meant some areas being neglected.

Patient safety first

But could there be a change in the wind? There could be new hope, and perhaps an opportunity for some of the more neglected conditions in healthcare.

Continue reading the main story“Start QuoteThose with epilepsy are being denied the help they need”

End QuoteJane Hanna Epilepsy: Your comments Health secretary Andrew Lansley has acknowledged that national targets ignored some conditions. Now he promises a relaxation in the use of targets and that patient safety will be at the heart of the NHS.

A policy shift away from number-crunching to a focus on patient safety must surely be positive news for people with a life-threatening condition.

Take epilepsy. Epilepsy patients do not benefit from specific national targets because "only" half a million people have epilepsy and "only" 1,200 people die from epilepsy each year.

It is "only" the fifth leading cause of avoidable years of life lost in males and "only" the eighth in females.

Epilepsy-related deaths in the UK have remained static since 1993 reflecting a lack of focus by policy makers.

Continue reading the main story Scrubbing Up 'Why sperm donors should be paid more' Hidden cuts Interpreting need Selling organs During the same period the total number of deaths from all preventable causes has been falling reflecting successful public health initiatives and research spending aimed at the top 10 causes of preventable death.

Numbers game

A NICE (National Institute for health and Clinical Excellence) audit of deaths in 2002 found that 40% of epilepsy-related deaths were potentially avoidable through better medical care and treatment - but in the numbers game we and other "smaller death" totals lose out.

Those with epilepsy are being denied the help they need.

About 69,000 people are estimated to be living with unnecessary seizures not only exposing them to risk, but limiting employment and every day opportunities.

Aiming to achieve seizure-freedom is not rocket-science. Drugs for epilepsy are relatively cheap and can offer seizure-control for 70% of patients.

The crux of the matter is being seen promptly by an epilepsy specialist who can diagnose and recommend the right medication.

Specialist nurses and specialist GPs can be a cost-effective part of the clinical team, especially where there are not enough consultants with expertise in epilepsy.

People with epilepsy want information and sign-posting to the voluntary sector. People who continue to have seizures need prompt re-referral for review of diagnosis and treatment options.

But dealing with epilepsy in the community has not benefited from risk management techniques used in other conditions such as asthma.

More cash to fund research to develop case management for people with epilepsy at risk of emergency care or premature death would be likely to reduce these risks and cut the costs of emergency admissions.

Since 2000 there has been progress, but mainly in the creation of patient expectations and clinical guidelines on the epilepsy.

The government produced an action plan on epilepsy. On the ground, however, access to resources was not dependent on legitimate patient expectation, but whether there were national targets enforced from the centre. People with epilepsy lost out.

This is not to say that there has been no improvement for people with epilepsy. There are pockets in the country where mainly due to the efforts of epilepsy champions and support from the voluntary sector services have moved forward.

If primary care practitioners are to be responsible for commissioning epilepsy services in the future they need to be well informed of the issues.

They need to move beyond the tick-box exercise for epilepsy in the GP contract and look seriously at the potential for achieving more positive outcomes for patients and a more cost-effective health service. People with epilepsy and those close to them must play a part in this process.

Kilimanjaro climbers 'risking health'

The study found drugs or rest days did not have a major effect on whether people fell ill Climbers scaling Mount Kilimanjaro are taking unnecessary risks with their health, experts have warned.

Travel firms have seen an increase in bookings following the successful summit by nine celebrities for last year's Comic Relief campaign.

But Edinburgh University scientists warned many climbing Africa's tallest peak "know little or nothing" about high altitude, which can be fatal.

Scientists camped out to test altitude sickness in more than 200 climbers.

The researchers camped for three weeks on the mountain at a height of 4,730m - not far below the 5,895m summit.

Continue reading the main story“Start QuoteUndertaking an acclimatisation trek before attempting to summit Mount Kilimanjaro offers climbers the best chance of a safe, successful summit”

End QuoteStewart JacksonEdinburgh University academic They assessed climbers using the Lake Louise consensus scoring system, which records symptoms such as headache, sickness and fatigue.

The academics found almost half, or 47%, of those who had climbed Kilimanjaro, were suffering from altitude sickness before they reached the summit and most were ascending too high, too quickly.

Signs of sickness include vomiting, headaches, difficulty sleeping and sometimes problems with co-ordination.

Effects can be felt from as low as 2,500m above sea level and 75% of people will have mild symptoms at 3,000m or higher, the study said.

Reserachers said the best way to acclimatise was to climb slowly and some trekkers incorporate acclimatisation rest days.

Some also opt for anti-sickness drugs, although there is controversy in the mountaineering community about whether they are effective.

However, the experts found that neither altitude-sickness drugs nor rest days had a major effect on whether people got ill.

Continue reading the main storyALTITUDE SICKNESS SYMPTOMS Headache Tiredness Nausea or vomiting Loss of appetite Dizziness Sleeping difficulties They concluded that climbers were going up so rapidly, the drugs could not protect against the harmful effects of altitude.

It also did not matter which route people took, suggesting "the rate of ascent on any itinerary is sufficiently fast to cause acute mountain sickness in a large proportion of climbers".

However, climbers who had managed to acclimatise beforehand on nearby high mountains were less likely to suffer from sickness, the research said.

Risk dying

Stewart Jackson, who conducted the study, published in the journal High Altitude Medicine and Biology, said: "We found that many climbers knew little or nothing about altitude sickness and did not have previous experience of being at high altitude.

"This research emphasises the need to increase awareness of the risks of altitude sickness and the importance of taking your time to acclimatise.

"Undertaking an acclimatisation trek before attempting to summit Mount Kilimanjaro offers climbers the best chance of a safe, successful summit."

Severe altitude sickness can lead to serious complications, including shortness of breath at rest, inability to walk, decreasing mental alertness and a build up of fluid on the lungs which can result in a "gurgling" sound when breathing.

People with these symptoms must descend the mountain quickly or risk dying.

High altitude cerebral oedema and high altitude pulmonary oedema are rare, but deadly. In both cases, the lack of oxygen results in leakage of fluid into either the lungs or the brain.

How dark chocolate may be good for diabetics

Bars of dark chocolate can contain more than 200 calories and 16g of fat An ingredient of dark chocolate may help diabetics control dangerously high cholesterol levels, it is claimed.

Chocolate with high levels of cocoa solids is rich in polyphenols, which other studies suggest can reduce the risk of heart disease.

The Hull University study found cholesterol fell in a small number of diabetics given bars rich in this ingredient.

But Diabetes UK said the high fat and sugar content would outweigh benefits.

High cholesterol levels are a particular problem for many diabetes, and are linked strongly to an increased risk of heart disease.

The Hull study, published in the journal Diabetic Medicine, tested the theory that chemicals found in cocoa beans could influence this.

Continue reading the main story“Start QuoteThe tiny health benefit of this compound found in cocoa-rich chocolate would be hugely outweighed by the fat and sugar content.”

End QuoteDr Iain Frame Diabetes UK A total of 12 volunteers with the type II form of the condition were given identical chocolate bars, some enriched with polyphenols, over a 16 week period.

Those given the enriched bars experienced a small improvement in their overall cholesterol "profile", with total cholesterol falling, and levels of so-called "good" cholesterol rising.

Sensible approach

Professor Steve Atkin, who led the study, suggested that it could mean a reduction in heart risk.

He said: "Chocolate with a high cocoa content should be included in the diet of individuals with type II diabetes as part of a sensible, balanced approach to diet and lifestyle."

However, there were some concerns from researchers at Diabetes UK that the message would be interpreted as a "green light" to eat more chocolate.

They pointed out that even bars with the highest levels of cocoa solids would contain high levels of fat and sugar, and could end up doing more harm than good.

Regular bars of two of the UK's best selling varieties of dark chocolate each contain more than 200 calories and up to 16 grams of fat.

Dr Iain Frame, director of research at leading health charity Diabetes UK, said he was unconvinced by talk of health benefits.

"On no account should people take away the message from this study, conducted in only 12 people, that eating even a small amount of dark chocolate is going to help reduce their cholesterol levels.

"The tiny health benefit of this compound found in cocoa-rich chocolate would be hugely outweighed by the fat and sugar content.

"The design of the study is also somewhat unrealistic as they asked participants to eat only around half the size of a normal, dark chocolate bar every day for eight weeks.

"It would, however, be interesting to see if further research could find a way of testing whether polyphenols could be added to foods which weren't high in sugar and saturated fat such as chocolate," Dr Frame said.

Hospital reforms too risky - BMA

Dr Mark Porter says the 2014 foundation trust deadline is "foolish". Patient care in England faces serious risks if the government pushes through planned hospital reforms, the British Medical Association (BMA) has warned.

The government wants all NHS hospital trusts to have achieved foundation trust status, which offers them greater independence, by 2014.

But the BMA has branded the timetable "foolish" and warned it will cause unavoidable and unacceptable risks.

Health Secretary Andrew Lansley insisted patient care will not suffer.

Continue reading the main story“Start QuoteWhy is there a risk to patients? I simply do not accept that at all”

End QuoteAndrew LansleyHealth secretary Dr Mark Porter, chairman of the BMA consultants' committee, said: "The push to foundation trust status for all is something that carries with it the unavoidable risk that the leadership of an NHS organisation will be focused on that above all.

"And that risk for patients I think goes too far."

In an interview for BBC Radio 4's File on 4, he added: "I feel really quite strongly that these artificial constraints imposed on the structure of NHS organisations are both wrong and detract from the primary mission which is the delivery of safe and effective health care to the local population."

'Dangerous'

Dr Porter's concerns have been echoed by Roy Lilley, a former NHS trust chairman, who called the coalition government policy "barmy" and "dangerous".

The foundation trust model was first introduced in England seven years ago. Scotland, Wales and Northern Ireland do not have the same system.

The aim was to give hospital managers, who were able to satisfy certain requirements, more financial autonomy and independence.

Continue reading the main storyListen to the programme

File on 4 is on BBC Radio 4 on Tuesday 19 October at 2000 BST

Listen via the BBC iPlayerDownload the podcast But a number of trusts which have already achieved foundation status are struggling with massive debts, management issues or failing patient care.

According to the health watchdog, the Care Quality Commission, of the 22 trusts where problems with care have been highlighted, 12 are foundation trusts.

And Monitor, the body in charge of assessing whether NHS trusts comply with the requirements of foundation trust status, said it had highlighted issues of concern with 17 trusts.

Health secretary Andrew Lansley hit back at the BMA, saying he did not believe patient care would suffer.

'Freedoms'

"Why is there a risk to patients? I simply do not accept that at all," he said.

Commenting on Care Quality Commission figures he added: "The Care Quality Commission is applying essential standards of quality and safety as part of their registration process and they apply exactly the same standards to NHS trusts as they do to foundation trusts.

"I believe in foundation status but I don't believe the purpose is as a badge of clinical quality.

"It's about them having freedoms, the corporate governance and financial strength to be able to improve their services in the longer term because of their financial and corporate strengths."

He has given NHS trust bosses until the end of next month to explain how they are going to achieve foundation status within the time scale.

File on 4 is on BBC Radio 4 on Tuesday 19 October at 2000 BST. Listen again via the iPlayer or download the podcast.

Violent images 'boost aggression'

The longer the boys watched the videos, the less they responded to the violence within them Repeated viewing of violent scenes in films, television or video games could make teenagers behave more aggressively, US research suggests.

The National Institutes of Health study of 22 boys aged 14 to 17 found that showing dozens of violent clips appeared to blunt brain responses.

Dr Jordan Grafman said it might make aggression feel more "acceptable".

However, a UK expert said the reasons behind violence were too complex to be explained by laboratory research.

Continue reading the main storyRelated storiesCall for child screen-time limitGames 'don't lead to violence' The effect of violent imagery on young people has been debated from the early days of television, and, more recently, that debate has expanded to include video games.

Various studies have suggested that exposure appears to have an effect on the way that the brain processes emotional responses, yet it is unclear whether this can have a direct impact on behaviour.

The US study, published in the journal Social Cognitive & Affective Neuroscience, involved 60 violent scenes from videos being collated, mostly involving street brawling and fist fights.

Continue reading the main story“Start QuoteThe suggestion is that, over a period of time, people can develop a kind of tolerance to these images - but another word for that is just boredom”

End QuoteProfessor David BuckinghamDirector of the Centre for the Study of Children, Youth and Media The violence was ranked "low", "mild" or "moderate", and there were no "extreme" scenes.

The response of the boys as they watched the clips was measured in a number of ways.

They were asked to rate whether they thought each clip was more or less aggressive than the one which preceded it, and were brain scanned using functional magnetic resonance imaging, which shows in real time which areas of the brain are active.

In addition, electrodes attached to the fingers detected increasing sweat - a sign of an emotional response.

The longer the boys watched videos, particularly the mild or moderate ones, the less they responded to the violence within them.

In particular, an area of the brain known as the lateral orbitofrontal cortex, thought to be involved in emotional processing, showed less activity to each clip as time went on.

'Social problem'

Dr Grafman said: "Exposure to the most violent videos inhibits emotional reactions to similar aggressive videos over time and implies that normal adolescents will feel fewer emotions over time as they are exposed to similar videos."

He said that this could actually produce more violent reactions from the teenager.

"The implications of this include the idea that continued exposure to violent videos will make an adolescent less sensitive to violence, more accepting of violence, and more likely to commit aggressive acts since the emotional component associated with aggression is reduced and normally acts as a brake on aggressive behaviour."

However, another academic said it was almost impossible to explain violence in these terms.

Professor David Buckingham, the director of the Centre for the Study of Children, Youth and Media, said that violence was a "social problem" with many contributing factors, not simply a matter of looking at how the brain worked.

"The suggestion is that, over a period of time, people can develop a kind of tolerance to these images - but another word for that is just boredom.

"This debate has been going on since before we were all born. In the 19th Century people were panicking about the effect of 'Penny Dreadfuls'.

"If we are truly interested in violence and aggression, rather than blaming the media for everything wrong in the world, we need to look at what motivates it in real life."

Cycle schemes 'need evaluation'

Cycling schemes appear to have only a modest effect on the number of bike journeys Community programmes that are designed to encourage people to take up cycling appear to only have a modest effect.

Research published in the British Medical Journal looked at 25 campaigns in seven countries.

Most schemes showed an increase of 3.4% in household trips made by bike.

However even these gains could have a positive impact on health by increasing physical activity, say the report authors.

It is recommended that adults undertake 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week.

Continue reading the main storyRelated storiesCycle schemes boost use of bikesCycle scheme: One reader's verdict But most adults in the UK and other developed countries do not achieve this target.

Cycling is linked to increased cardio-respiratory fitness in both adults and children, helping reduce the risk of heart disease, type 2 diabetes, some cancers and various other chronic conditions.

Unlike many other types of physical activity, cycling can be incorporated relatively easily into everyday life; for instance swapping a daily car commute to one by bike.

This lifestyle change would not only bring health benefits, but could also reduce congestion, air pollution and carbon emissions, say experts.

'No clear message'

The research looked at 25 different schemes in Australia, Denmark, Germany, the Netherlands, Sweden, the UK and the USA.

The programmes varied from campaigns that targeted individuals to much wider schemes that incorporated city wide cycling initiatives.

Continue reading the main story“Start QuoteThere is no clear message that one approach is better than another”

End QuoteDr David OgilvieInstitute of Public Health, Cambridge The analysis showed that a variety of interventions showed promise but that more research is needed to determine the effect the schemes were having on cycling.

Most schemes were associated with a 3.4% increase in household trips made by bike.

Dr David Ogilvie, from the Institute of Public Health in Cambridge, an author of the paper, told BBC News: "There is no clear message that one approach is better than another."

He said: "Further controlled evaluative studies incorporating more precise measures are required, particularly in areas without an established cycling culture."

When new policies are being proposed, then a way of determining how effective they are must also be incorporated into their design, the researchers said.

Only then will it be possible to establish which approaches actually increase levels of cycling.

Scenes of nature 'reduces pain'

Looking at Victoria Falls could make it easier to deal with pain, researchers say Cancer patients who have to endure excruciating procedures on a daily basis may be able to lessen their pain - by being transported to Zambia.

The patient need not even leave their bed.

Continue reading the main storyRelated storiesChildren can 'imagine away' painWoman under hypnosis for surgery Just simply showing relaxing pictures of idyllic scenes and playing out relaxing sounds at a patient's bed is enough reduce the feeling of pain for many patients.

This is according to researchers from Johns Hopkins University in Baltimore, United States.

They set up a series of tests analysing patients undergoing bone marrow aspiration and biopsy (BMAB) - known to be a particularly painful form of cancer treatment.

A large needle is inserted into the back of the pelvic bone and bone marrow is drawn out. It can sometimes take up to ten minutes, and is often performed with just a local anaesthetic.

For some cancer sufferers, BMAB is a regular unwanted experience - and techniques such as hypnosis or sedation have been tested to try and help patients deal with the pain.

Fracture warning over bone drugs

Bisphosphonates slow down bone turnover US regulators are warning patients that drugs used to protect brittle bones may increase fracture risk in rare cases.

The Food and Drugs Administration (FDA) says all drugs in the bisphosphonate class must carry an alert on their label about this unusual side effect.

They say patients should keep taking the pills unless they are told by their doctor to stop.

In the UK, only one bisphosphonate drug - alendronate - carries the warning but regulators are reviewing this decision.

Continue reading the main storyRelated storiesBone drug linked to cancer risk Nearly three million people in the UK have osteoporosis, a condition that makes the bones brittle and causes about 230,000 fractures a year.

Bisphosphonates are given to more than half a million of these patients in a bid to strengthen their bones and reduce their risk of a fracture.

But experts are becoming increasingly concerned that the drugs may cause the very thing they are trying to prevent after finding a link between their use and an unusual type of leg fracture.

Continue reading the main story“Start QuoteAt present it is uncertain whether these fractures are directly related to treatment but an association has not been excluded”

End QuoteA spokesman for the National Osteoporosis Society The FDA says it is not clear whether bisphosphonates are the cause of these thigh bone breaks, but they are concerned enough to tell manufacturers to add warnings to medication packets.

FDA medical officer Theresa Kehoe said they would continue to monitor the safety of the drugs, adding: "In the interim, it's important for patients and health care professionals to have all the safety information available when determining the best course of treatment for osteoporosis."

The FDA says patients should keep taking their medication unless they are advised by their doctor to stop.

Under review

The UK's drug regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA), said it had begun to look at the possible increased risk of fractures in patients taking bisphosphonates in case it was an effect common to all members of that drug family, not just alendronate.

A spokeswoman said: "The committee will now review all available data thoroughly, including published data, non-clinical and clinical data, and post-marketing reports, to clarify whether atypical stress fractures are a class effect of bisphosphonates, and will assess their impact on the balance of risks and benefits of these medicines."

A spokesman for the National Osteoporosis Society said: "At present it is uncertain whether these fractures are directly related to treatment but an association has not been excluded.

"Bisphosphonates slow down the rate at which bone is destroyed and replaced, by reducing the activity of osteoclast cells that break down bone.

"Although this is a useful process to prevent bone loss and fractures, there are concerns that over a prolonged period of time, this may result in bones becoming 'older' and more brittle."

He said it should be remembered that these unusual fractures are rare and that in the vast majority of patients the benefits of treatment will far outweigh the risks.

A recent study, published last month in the British Medical Journal, linked bisphosphonate use to cancer of the gullet.

Ex doctors' leader denies claims

Mr Johnson was BMA chairman from 2003 to 2007 A surgeon and ex head of the British Medical Association has denied putting representing doctors above patients.

James Johnson is facing a General Medical Council hearing over operations on 14 patients in Cheshire.

He is also alleged to have accidentally struck a needle into the forehead of a female doctor who was assisting him.

He told the hearing he did the same amount of surgery as his colleagues - despite working a "100-hour week most of the time" to include his BMA duties.

Time-consuming

Mr Johnson told the GMC panel in Manchester: "It was certainly a busy life.

"But colleagues at Halton hospital were used to my rather unusual way of life.

"I always made myself available. We had a well-honed system for dealing with problems.

"The work I did for various organisations was very time-consuming, but my first loyalty was and is to my patients.

"If I had to choose between them, without the slightest shadow of a doubt, I would have chosen the clinical work, which I always found rewarding and highly satisfactory."

Mr Johnson was BMA chairman from 2003 to 2007, when he resigned amid a row about a controversial new system for allocating junior doctors to training posts.

The panel has heard claims that the stresses on his time meant his patients missed out on care.

He was said to have behaved "like a caricature of surgical arrogance".

Mr Johnson, who has been a vascular surgeon since 1985, denies this and is continuing to give evidence in his defence.

Call to ban smoking in vehicles

The charity also calls for unbranded packaging for tobacco products An anti-smoking charity has called for a consultation on banning smoking in vehicles in Scotland.

Ash Scotland made the call, along with 32 other recommendations, as part of a strategy to tackle "Scotland's biggest killer".

The charity said the change would highlight the impact of second-hand smoke on others.

However, the Tobacco Manufacturers' Association said such a move would be a "step too far".

Latest figures suggest a quarter of all adult deaths in Scotland can be attributed to smoking-related diseases.

Continue reading the main storyRelated storiesOne in four Scots still smokingSmoke ban blamed for pub closures Setting out their "Beyond Smoke Free" document, Ash Scotland said the country had taken major steps to cut smoking in the past six years, but that more needed to be done.

The document calls for a consultation on introducing legislation to ban smoking in vehicles and the development of "robust" intermediate and endpoint targets to reduce the effects of passive smoking in the home and in vehicles.

Other proposals in the document include calling for a UK law to require standardised, unbranded packaging of tobacco products and encouraging the UK government to increase tobacco industry accountability.

Organ donation errors 'avoidable'

There are over 17m people on the UK's donor register An independent review finds avoidable errors led to the wrong organs being removed from 25 NHS donors in the UK.

Sir Gordon Duff, who led the review, says the blunder was due to faulty computer software used by UK Transplant to record donor wishes.

As many as 800,000 people on the UK donor register may have had their preferences about which organs they wished to donate recorded incorrectly.

He said new measures should avoid another error occurring.

Continue reading the main storyRelated storiesOrgans 'removed without consent'Scrubbing Up: organ donations Sir Gordon praised the actions already taken by NHS Blood and Transplant (NHSBT) to safeguard the system.

But he said in his report that the longer-term solution would be to enlist the help of experts to create a more secure, interactive system with better data verification and cross reference functions.

With over 17 million registrants, there is a growing need for the register to become more interactive, he said, and urged the NHSBT to have a redesign "as soon as resources allow".

The error originated when faulty data conversion software was used to upload data on donation wishes from the Driver and Vehicle Licensing Agency (DVLA) when it moved to a new computer system.

Continue reading the main story“Start QuoteWe would like to take this opportunity to reiterate our unreserved apologies to the families of those people”

End QuoteNHS Blood and Transplant The issue only came to light in 2009 when NHS Blood and Transplant started to write to donors to check their organ donor preferences in the event of death - some withhold consent for certain parts of the body like the eyes, for example.

Many donors wrote back to say their information was incorrect.

Regrettable

Sir Gordon Duff said: "People who generously agree to donate their organs should be reassured that the error has been dealt with effectively and that steps have been taken to minimise the risk of it happening again."

Public health minister Anne Milton said: "Organ Transplants are vital and I know that NHS Blood and Transplant will make sure such a situation never arises again."

NHSBT said it sincerely regretted that the error was not uncovered earlier and that the donations of 25 individuals were affected by it.

A spokesman said: "We would like to take this opportunity to reiterate our unreserved apologies to the families of those people.

"After discovering the error, the NHSBT Board carried out its own investigations resulting in a detailed remedial action plan.

"We accept in full the recommendations of Professor Sir Gordon Duff, which will contribute significantly to strengthening the Organ Donor Register and public confidence in it as a way to record organ donation wishes.

"Since the error related to the way in which we received data from one of our partners, our immediate focus has been to take forward those actions that relate to our working arrangements with partner organisations."