Source: http://feedproxy.google.com/~r/ft/westminster/~3/n3OHj-b799g/
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Source: http://feedproxy.google.com/~r/ft/westminster/~3/n3OHj-b799g/
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Source: http://www.annuityratesuk.info/win-a-copy-of-medical-ethics-today/
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Regulation of medical devices such as hip implants is a mess, with low approval standards and no public access to clinical data
The Medicines and Healthcare products Regulatory Agency (MHRA) announced yesterday that 49,000 out of 65,000 patients who have received metal-on-metal hip replacements will need annual tests for the life of their implants to monitor for problems.
While the additional vigilance is welcome it has come far too late for many patients. An investigation by the BMJ and the BBC's Newsnight programme has highlighted all that is wrong with the current regulation of medical devices.
It has been shown that metal-on-metal hip implants are failing at astonishingly high rates ? in some case series, half of all hip replacements had to be removed after six years. In addition, failing hips are leaking chromium and cobalt into the surrounding tissues and the bloodstream at far higher rates than have been seen before. This has caused substantial concerns over increasing cancer risk, which has led to the need for follow-up blood tests on patients for life.
One of the metal-on-metal hip implant manufacturers knew of the risk of cancer as far back as 2005. Deborah Cohen's investigation in the BMJ states: "A DePuy internal memo from July 2005, says: "In addition to inducing potential changes in immune function, there has been concern for some time that wear debris may be carcinogenic."
The MHRA discussed this increased cancer risk in 2006 at their device safety meeting, but they did little about the problem despite mounting data pointing to growing concerns.
The authority's line is that clinical data is required to get European CE approval and so studies must be undertaken prior to a device coming on to the market. But can you get hold of this clinical data? Any attempt to gain access to clinical data held by the regulators, known as "notified bodies", will prove futile due to concerns about commercial confidentiality and other problems with transparency.
In the US, where regulatory data and the clinical data are publicly accessible, the situation is completely different.
The absurdity of the current system is highlighted by the minutes of a meeting of the MHRA's safety of devices committee in 2009 which states:
It was also noted that MHRA does not see the clinical data that is generated from a clinical trial prior to it being submitted to a Notified Body as part of a conformity assessment process. The only way they see it is if there is an adverse event or concerns raised. It is not mandatory for manufacturers to present their final report to the Competent Authority.
This leaves us in a situation where no one really knows, including the regulators, what data was submitted by whom, and on what date, for a device to be allowed access to the European market.
Criteria for approval of devices are radically different in Europe than America. For example, in Europe the "GuardWire" developed by PercuSurge for use during angioplasty procedures (to facilitate placement of a stent in the vessels of the heart) required a study involving only 22 patients and no control group in Europe for approval. By contrast in the US, the US Food and Drug Administration (FDA) required a multicentre randomised trial involving 800 patients before it would grant approval.
Even in the US, hip replacements are giving rise to substantial regulatory problems. Last month the FDA accused Johnson & Johnson subsidiary DePuy Orthopaedics of selling 14 different types of medical device without the necessary approval.
Jeffrey Shuren, the FDA's medical device regulator director said yesterday "the agency needs more power to block unsafe products and prevent repeats of faulty hip implants."
Meanwhile there is little appetite for change in Europe.
The major issue with the current system is the use of "equivalence" for approval of devices. That is, if my device is similar to another manufacturer's device on the market, then I don't need clinical trials and can settle for a lower level of data for regulatory approval.
A search among the European device directives reveals the real meaning of "clinical data". First, it is left to the discretion of the notified bodies as to the extent and nature of clinical data required for the approval of even the highest-risk devices. Second, clinical data can refer to "a critical evaluation of the relevant scientific literature currently available relating to the safety, performance, design characteristics and intended purpose of the device".
The current regulatory situation is a mess. A change in regulatory policy is needed. It seems the US gets it, but as for the EU, who knows.
Source: http://www.guardian.co.uk/science/blog/2012/feb/29/hip-implant-fiasco-regulatory-failings
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I recently had a conversation with the practice manager of a large GP practice in the West Midlands. We had recently advised the practice on several development areas, both NHS and non-NHS revenue related.
One result of this investment was the furnishing of a state of the art conference room and suite. The practice took advantage of the 2011 Annual Investment Allowance.
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Source: http://www.pensionsuk.info/pension-forecast-2/
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Source: http://henrytapper.com/2012/02/17/the-language-that-we-use/
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Source: http://www.can-i-retire.info/annuity-credit-card-for-poor-credit-capital-one/
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We have received the new tiered employee contribution rates for 2011/12. If there is to be a change to the rates it will apply to officer (and practice staff) new joiners and to practitioners (and non-GP providers). NHS employers will be informed of any changes as soon as NHS Pensions is made aware.
The guidance is split into three parts and applies to members of both the 1995 section and the 2008 section of The NHS Pension Scheme (England & Wales).
Source: http://www.lse.co.uk/blogs/expert/resident-ifa-blog/m8mv5k/
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Source: http://blogs.bma.org.uk/pensions/2012/02/14/sign-the-e-petition-now/
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Source: http://www.can-i-retire.info/nhs-pension-scheme-find-the-new-tiered-employee-contribution-rates-6/
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A technique that involves turning the brain into 'soup' and counting the nuclei of nerve cells reveals that we're 14bn short
How many neurons are there in the human brain? It was a question that scientists thought they had nailed ? and the answer was 100bn (give or take). If you went looking you would find that figure repeated widely in the neuroscience literature and beyond.
But when a researcher in Brazil called Dr Suzana Herculan-Houzel started digging, she discovered that no one in the field could actually remember where the 100bn figure had come from ? let alone how it had been arrived at. So she set about discovering the true figure (HT to the excellent Nature neuroscience podcast NeuroPod).
This involved a remarkable ? and to some I suspect unsettling ? piece of research. Her team took the brains of four adult men, aged 50, 51, 54 and 71, and turned them into what she describes as "brain soup". All of the men had died of non-neurological diseases and had donated their brains for research.
"It took me a couple of months to make peace with this idea that I was going to take somebody's brain or an animal's brain and turn it into soup," she told Nature. "But the thing is we have been learning so much by this method we've been getting numbers that people had not been able to get ? It's really just one more method that's not any worse than just chopping your brain into little pieces." She told me that so far, she has only looked at four brains, all of them from men.
The method involves dissolving the cell membranes of cells within the brain and creating a homogeneous mixture of the whole lot. You then take a sample of the soup, count the number of cell nuclei belonging to neurons (as opposed to other cells in the brain such as glia) and then scale up to get the overall number. The great advantage of this method is that unlike counting the number of neurons in one part of the brain and then extrapolating from that it gets over the problem that different brain regions may have more or less densely packed neurons.
So what is the number?
We found that on average the human brain has 86bn neurons. And not one [of the brains] that we looked at so far has the 100bn. Even though it may sound like a small difference the 14bn neurons amount to pretty much the number of neurons that a baboon brain has or almost half the number of neurons in the gorilla brain. So that's a pretty large difference actually.
This leads to the bigger question of what makes human brains special.
Herculan-Houzel says our brains are rather standard primate models, except for the fact that we have a massive number of brain cells compared to other species. That is energetically very expensive to maintain. She estimates that 20% to 25% of our total energy budget goes on running our brains, a figure which she describes as "extraordinary". How do we manage it?
"We can afford such a huge number of neurons. That difference might actually be related to a shift to a cooked food diet and that allows us to have far more calories per day. And with that we can afford a much larger number of neurons that other animals probably could not."
That is a reference to Prof Richard Wrangham's ideas about how the invention of cooking had a crucial impact on human evolution.
There is a beautiful, if slightly grisly, elegance to Herculan-Houzel's method and her work embodies the constantly questioning attitude that is what makes science so powerful. But what I find interesting is how this 100bn neuron myth became lodged in the collective scientific consciousness in the first place, and why it continued to propagate.
Does anyone have any insight into where it came from?
Source: http://www.guardian.co.uk/science/blog/2012/feb/28/how-many-neurons-human-brain
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Source: http://www.pension-release-uk.info/campaign-focuses-on-the-woman-behind-the-cancer/
Source: http://henrytapper.com/2012/02/18/i-phone-spy-keeping-kids-happy-with-foursquare/
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Source: http://blogs.bma.org.uk/pensions/2012/02/23/taxing-rumours/
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The Government has now published the draft regulations for its Junior ISAs. A brief summary is:
Source: http://feeds.lexblog.com/~r/MercerHole/TaxPlusBlog/~3/ghMjknI7MKs/
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Source: http://www.annuitycomparison.info/hedge-funds-private-equity-funds-and-erisa-pension-plans-6/
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Source: http://www.pensionsuk.info/electric-cars-off-to-a-slow-start-3/
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Source: http://www.pensions-advisory-service.info/factcheck-is-the-coalition-protecting-the-nhs-2/
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Source: http://www.retirementcalculatoruk.info/tesco-calls-on-govt-to-drop-compulsory-work-experience-2/
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Rolling coverage of all the day's political developments as they happen
10.57am: I'm off to the Number 10 lobby briefing now. I'll post again after 11.30am.
10.47am: You can read all today's Guardian politics stories here. And all the politics stories filed yesterday, including some in today's paper, are here.
As for the rest of the papers, here are some stories and articles that are particularly interesting.
It's work experience but not wage experience, and looking back at your first, lousiest jobs you must admit that both kinds mattered. It was good to be doing something the world found useful, but also it was good to know you'd earned your money. The scheme offers only half of that satisfaction.
It would no doubt be an administrative nuisance, not least owing to the mandatory minimum wage, if the system offered employers the equivalent of the benefits but told them to give the work-experience kids a proper payslip. Or, still better, told them to add a minimum tenner a week and feel free, without paperwork, to slip in a further bonus for hard work. I gather that some small participants do this out of petty cash, and goodness knows how the paperwork deals with that. Or more likely, doesn't.
? Mary Ann Sieghart in the Independent says Nick Clegg has little hope of achieving Lords reform.
"It's one of the most unpopular causes of all time," says a Tory minister about Lords reform. A Cabinet minister professes himself baffled that Clegg is prepared to expend so much time, energy and political capital on it. Another claims to be delighted that the Liberal Democrats will be indulging in displacement activity for the next couple of years. "It means they can't disrupt things elsewhere. From our point of view, it keeps the children occupied while we can get on with something else. They'll talk about House of Lords reform, and we'll talk about things that matter to voters, like the economy and welfare."
Michael Gove, the Education Secretary, Oliver Letwin, the Cabinet Office minister, and Steve Hilton, the Prime Minister's chief policy guru, called for Britain's official child poverty measure to be scrapped amid signs that it would produce a string of bad headlines for the Government.
The trio argued that the measure was too crude and concentrated on an arbitrary "poverty line", according to sources. Children living in households that live on 60 per cent of Britain's median income are deemed to be living in poverty under the legal measure set up by Labour.
However, the plan was met by fierce resistance from Nick Clegg and Sarah Teather, the Child Poverty Minister, who said that any attempt to stop publishing information on the number of children living in relative poverty would be seen as a cynical attempt to "fiddle the figures" ....
A compromise over child poverty has now been reached within the coalition. The income measure will be retained, but others will be added to create a more "nuanced" picture of child poverty in Britain. They are likely to concentrate on a child's access to education and health services.
Ed Matthew, of Transform UK, said: "More people die every year in the UK from living in a cold home than die on our roads. Millions more struggle to make ends meet in the face of high energy bills. This is a national scandal."
Some 30 families are receiving �1,500 a week ? three times what they would be earning on a national average wage ? to pay their rent while another 60 are receiving up to �5,000 a month, according to the Department for Work and Pensions ...
In total 130 families are given more than �1,000 a week, including 80 who receive at least �1,100 a week, according to figures obtained under the Freedom of Information Act.
The move, which would lead to thousands of people from the Armed Forces being driven into the commercial property market, is part of a plan to reduce Services accommodation under a "New Employment Model".
It indicates a potential shift away from the tradition of encouraging soldiers to move with ease around the country and overseas with their spouses and children.
Subsidised military housing for those with families is a career-long entitlement and has been referred to as a "staunch pillar" of the military covenant that the coalition has pledged to uphold. The MoD is discussing ending the right to a home after eight years of service.
10.28am: The Leveson inquiry is starting a new strand of its investigation today, looking at links between the media and the police. Talking about this on Radio 5 Live this morning, the Labour MP Chris Bryant said News International almost "owned" the Metropolitan police.
What ended up happening at News International is they almost felt that they owned the Metropolitan Police. They had such a close relationship with senior figures at the Met, right the way up to commissioner that they felt that it was pretty easy to make sure a full investigation into the News of the World never came to pass.
10.13am: It should be an important day at the Leveson inquiry. There are full details at our Leveson live blog.
9.55am: Ken Livingstone has gone to Downing Street to deliver a letter to David Cameron saying that the law should be changed to stop the London mayor having a second job.
It's his way, obviously, of highlighting the fact that Boris Johnson earns a reported �250,000 a year writing a column for the Daily Telegraph. Here's an extract from the letter.
In 2009, ahead of the general election, you said that members of your shadow cabinet would have to give up their outside interests, in order to concentrate on politics.
It ought to the case that if that principle applies to your senior Parliamentary team, it should also apply to the Conservative mayor of London, Boris Johnson. Even without you prevailing upon him to do so, I believe that Boris
Johnson should have responded in keeping with the mood of the times and clear direction of travel, and ditched his second job.
The mayor's role is now so significant that he or she can affect the quality of life of millions of people, from fares to policing and crime. Those who are affected by those decisions should have full confidence that the person making them is fully committed to the job.
Yet Boris Johnson not only earns more as Mayor of London than you do as prime minister, he also holds a second job that pays him even more money. He is paid �250,000 a year for his column for the Daily Telegraph, an amount of money that he has described as 'chicken feed.
Livingstone's team have also launched a chickenfeed.org.uk website to publicise this.
9.48am: What would an independent Scotland actually be like? My colleagues at Reality Check are doing a five-day special on the subject this week. James Ball is kicking it off today with a look at how much debt an independent Scotland would have.
9.27am: Having elected police commissioners could bring corruption into policing, a chief constable has warned. Sir Norman Bettison, the West Yorkshire chief constable and a vice president of the Association of Chief Police Officers, made the claim in an interview in the Yorkshire Post. Here are his key quotes.
I am reminded of the adage that absolute power corrupts absolutely. There will be a lot of people appealing for the public vote simply because they want to make the world a better, safer place. Those people are to be celebrated. My fear is that [in other cases] it could be the door that unlocks corruption and anything that does has the potential to destroy public trust in policing ...
There is the potential for some corruption with a small 'c'. What I mean is not the problem of huge frauds and secret bank accounts in Monaco. An election brings with it the sense of obligation to people who have helped win the election or might help win a future election, and this is someone who can be elected on a frequent and recurring basis. My fear as a 40-year veteran is that a single person who has limited accountability to any other body runs the risk of looking to ensure that the people that can help him or her get elected are assuaged ...
To an old and crippled chief constable like myself, any hint of being required to do anything other than with integrity will be rebuffed. I can imagine that with younger chiefs with mortgages to pay, however, there is the danger or the risk or the fear of them being influenced.
9.14am: Jamie Reed, the shadow health minister and coordinator of Labour's Drop the Bill campaign, has written an article for PoliticsHome. It's rather more hard-hitting than Ed Miliband's. (See 9.00am.) Reed describes the bill as "the largest, most aggressive and ideological reorganisation of the NHS since it was created". And he says that the Liberal Democrats will face electoral "oblivion" if they do not oppose the bill.
For the Liberal Democrats, unless they can summon the required courage to oppose this bill, only oblivion and ignominy beckons. They may yet save themselves, more importantly, they may yet help the people of this country, the medical professions and the Labour Party to save the NHS. No number of amendments will suffice, for the NHS as we know it to survive, this bill must be dropped.
Reed also claims that, in opposing the bill, Labour are also putting the national interest ahead of their party interest.
Labour's political and electoral interests would be best served by the passage of this bill, yet so damaging would the consequences of this bill be for the NHS, if enacted, that we are doing everything we can to ensure that this bill is dropped.
9.00am: David Cameron's health bill misery continues. Peers are debating the bill again this week and, as Nicholas Watt reports for the Guardian, Andrew Lansley, the health secretary, is preparing to announce further concessions. And Ed Miliband, the Labour leader, has written an article for today's Times (paywall) renewing his attack on the bill.
For reforms to work, they must bring greater clarity ... The bill does the opposite. It creates a vast structure of Byzantine complexity. Estimates suggest that the number of statutory organisations will rise from 163 to 521. No wonder the NHS Confederation has warned of potential "paralysis in the system".
In the tightest spending settlement for a generation, when the NHS must make �20 billion of efficiency savings, the focus should be on patient care. Instead, staff are being distracted by a vast top-down bureaucratic reorganisation.
Years of upheaval lie ahead and patients will get a worse service.
The Lords debate starts at about 3pm. I'll be keeping an eye on it, but I think we will providing detailed coverage on our separate health bill live blog.
Here's the full agenda for the day.
9.30am: Conservative MPs from the Free Enterprise Group launch their pre-budget plan for growth.
10am: The Leveson inquiry resumes. Sue Akers, the Metropolitan police deputy assistant commissioner who is leading the phone hacking inquiry, Lord Prescott, the former deputy prime minister, and Brian Paddick, the Lib Dem candidate for London mayor, are giving evidence.
10am: Ken Livingstone, Labour's candidate for London mayor, visits Number 10 to hand in a letter saying the London mayor should not have a second job.
1pm: Academics give evidence to the Commons Scottish affairs committee about the Scottish independence referendum.
2.30pm: Michael Gove, the education secretary, takes questions in the Commons.
3pm: Peers resume their debate on the health bill.
4.35pm: Nick Clegg, the deputy prime minister, and Mark Harper, the constitutional reform minister, give evidence to the joint committee on Lords reform. I'll be covering this hearing in detail.
As usual, I'll be covering all the breaking political news, as well as looking at the papers and bringing you the best politics from the web. I'll post a lunchtime summary at around 1pm and another in the afternoon.
If you want to follow me on Twitter, I'm on @AndrewSparrow.
And if you're a hardcore fan, you can follow @gdnpoliticslive. It's an automated feed that tweets the start of every new post that I put on the blog.
Source: http://www.guardian.co.uk/politics/blog/2012/feb/27/clegg-lords-reform-health-bill
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Prospect is to set up a network of workplace pensions champions to help members handle the many retirement choices they now face. Conference backed a proposal by the national executive to give full support to the TUC's pensions champions project.
People now understood pensions issues much better than in the past, but how they actually work is less well understood, said Audrey Uppington, moving the NEC motion. The TUC project aimed to explain to members at work the options available to them, she said. It includes a pensions website and the facility for members to build up their own personal pensions profile.
Source: http://www.pensionschampions.co.uk/?q=node/59
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Source: http://blogs.channel4.com/factcheck/factcheck-is-loneliness-worse-than-smoking/9470
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Source: http://touchstoneblog.org.uk/2012/02/how-has-welfare-to-work-turned-into-workfare/
This course will help union reps to:
For details on course timings and course registration please contact the provider from the list that you can download here.
Source: http://www.pensionschampions.co.uk/?q=node/50
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Hang out with us @GuardianUS on Twitter this Sunday for an evening of Oscars trivia and red-carpet snark
Calling all jaded and/or lonely Oscar-viewers: have you seen it all when it comes to the Academy's finest night? Do you have the mind of an elephant when it comes to who-wore-what and who-said-what? Does the name Robert Opel mean anything to you? How about Sacheen Littlefeather?
Don't let your memories (or indeed your booze) go to waste. Bring them to our Oscars night! Join us @GuardianUS on Twitter for an evening of quizzes, competitions and Hollywood trash talk. We'll bring the trivia questions and the red-carpet snark, you bring your depth of historical Oscar knowledge and cheap white wine.
And when the show gets under way, help us endure the interminable experience ? sorry, revel in a night of cinematic splendor ? with our "shorter speeches" game. Watch the award-winners' speeches and recast what they said ? or what they meant ? in 140 characters or less.
As an example, for Natalie Portman winning best actress in 2011 for Black Swan:
Natalie Portman: I danced til my toes bled & didn't eat for 9 months. Did I mention I'm pregnant? Give me my statue before I pop #oscars140
— Ruth Spencer (@onthewag) February 24, 2012
For Sandra Bullock winning best actress for the Blind Side in 2010:
Sandra Bullock: I love my mom. I don't take this very seriously. My Husband is A CREEP. youtu.be/-hTTwSQPmMo #oscars140
— Ruth Spencer (@onthewag) February 24, 2012
And this works for pretty much any Meryl Streep speech:
Meryl Streep: My maturity is the secret to my success. Take that, Hollywood. #oscars140
— Amanda Michel (@amichel) February 24, 2012
You get the idea. And while we're all hanging out on Twitter, our top Oscars live-blogger Xan Brooks will have comprehensive coverage on the website.
Xan, Peter Bradshaw and Catherine Shoard have already picked their wins for Sunday ? you can watch them discuss their predictions here.
See you Sunday.
Source: http://www.guardian.co.uk/film/filmblog/2012/feb/24/oscars-2012-twitter-party
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