The Medicines and Healthcare products Regulatory Agency (MHRA) has issued new guidance to consumers on the safe use of herbal medicines and how to avoid low quality products that pose a risk to the public. 'Using herbal medicines: Advice to consumers' can be found on the MHRA web site.

This follows up recent MHRA action to require a number of companies to remove from the market unlicensed herbal medicines that made illegal claims:

Dr & Herbs had claimed in an advertisement that an immunity booster was 'effective to fight against tumour'

Real Herbs/Real Dream Ltd advertised that a capsule product could 'inhibit the growth of tumour'

Rena Chinese Medical Centre advertised that clinical trials proved that a capsule product had 'strong effects in controlling HIV'.  It was also claimed that taking the product should improve pneumonia in 6 – 12 hours.

Following a joint investigation with MHRA, Havering Trading Standards prosecuted the Everwell Chinese Medical Centre Ltd over advertising claiming to treat cancer.

Romford magistrates fined the company £1500 for two offences under the Cancer Act 1939.

The new MHRA guidance warns consumers to be wary of unlicensed herbal medicines illegally claiming to treat particular diseases. Other warning signs for consumers are claims that a herbal medicine is '100% safe' or dangerous advice to stop taking a medicine prescribed by a doctor.

Richard Woodfield, Head of Herbal Policy at MHRA, said:

'The MHRA will not hesitate to take firm regulatory action against those who seek to take advantage of the public when they are most vulnerable. The good name of responsible operators in the herbal sector is being brought into disrepute by a minority that disregard laws intended to protect the consumer.'

The Medicines and Healthcare products Regulatory Agency (MHRA) has recently introduced a new scheme to improve and strengthen the regulation of homeopathic medicines in the UK. The National Rules Scheme for homeopathic medicines will enhance consumer confidence with respect to the safety, quality and use of these medicines.

Companies will now be encouraged to register new homeopathic medicines under this scheme, with the option of re-registering certain existing products. For the first time since Product Licences of Right were issued in 1971, companies will be allowed to include information about the treatment and relief of minor, self-limiting conditions based on the use of the product within the homeopathic tradition. For example, labels may indicate that a product may relieve the symptoms of common colds and coughs, hay fever or chilblains. All homeopathic medicines authorised under the new scheme will have clear and comprehensive patient information leaflets to help consumers use their medicines safely and effectively.

Professor Kent Woods, Chief Executive of the MHRA, said, 'This is a significant step forward in the way homeopathic medicines are regulated. Products authorised under the National Rules Scheme will have to comply with recognised standards of quality, safety and patient information.'

Penny Viner, Board Member of the British Association of Homeopathic Manufacturers (BAHM), said, 'The British Association of Homeopathic Manufacturers welcomes the coming into force of this new scheme. This long-awaited regulatory development benefits the ever-growing number of users of homeopathic medicine: its provisions will both encourage growth in the range of products on the market, and enhance the consumer’s understanding of their benefits.'

The General Chiropractic Council (GCC) has begun a detailed consideration of the Department of Health's review of 'The regulation of non-medical healthcare professionals'.

Peter Dixon, Chairman of the GCC said: 'The GCC fuily supports the aim of the review to act in the public interest by making regulation better for patients and the public, and its recognition of the need to maintain professional buy-in for the system of regulation. The GCC will be considering the review's recommendations very carefully indeed. Our response will focus on the public interest and the practicality and effectiveness of the changes that have been proposed'.

The GCC's preliminary consideration of the document has identified the following key recommendations:

• The number of regulators will not be reduced. The GCC, the smallest of the UK healthcare regulators, is deemed to be 'fit for purpose' in carrying out its statutory functions. The effectiveness of this system wili be reviewed again in five years.

• There should be a common definition of 'good character' for applicants for registration, and current registrants, to apply to regulated healthcare professionals.

• A system of revalidation of health professionals should be estabiished. The system may vary from profession to profession and will be informed by the potential risk to patients posed by respective health professions. A proportionate and practical approach appears to be the aim.

• A pool of panellists to sit on all regulators' Professional Conduct Committees should be established. It is proposed that they will be appointed based on their competence to fulfil the role. It appears that the preliminary investigative role of the regulators will remain unchanged, though the remit of the Council for Healthcare Regulatory Excellence (CHRE) may be extended to sample decisions taken at this stage.

• It is proposed that Council members will no longer be elected, but appointed. A set of standard competences for the role of Council member should be established and members appointed on the basis of their ability to meet them. The purpose of this appears to be to allay public perception that elected professional members of Council may have a conflict of interest, and so put the interest of their profession before that of the public.

• The proportion of professional to lay Council membership is also under review and comments have been invited.

Peter Dixon concluded: 'The GCC is of course delighted that it will continue in its public protection role, and that after considering the evidence, government has concluded that we've been doing a good job. But we really can't afford to sit around congratulating ourselves about this - and we won't. The news here is that we must continue to work with other health regulators to maintain effective ways to protect the public. In doing this we must engage with patients and the public, and keep the professions on board. There's a lot of serious work to get on with now.'

The UK's 13 Health and Social Care regulators have launched a new leaflet entitled, 'Who reguIates health and social care professionals?

The leaflet is the result of a joint initiative by all of the regulatory bodies including the General Chiropractic Council (GCC).

The leaflet provides useful 'signposting for the general public by explaining which regulatory body is responsibIe for monitoring each profession and what regulation means. It also provides contact details for all of the organisations.

Commenting on what this will mean for the public, Gary Fitzgerald of Action on Elder Abuse said:
'We welcome this initiative as a means of giving important information to a wide audience. We know from the calis to our helpline that when the public are unenlightened it interferes with their ability to raise concerns. This document has a real value in educating the public about who they can turn to with their questions.

Health and social care professionals have a unique and powerful role to play where older people are concerned and it's important that people are confident that these same professionals are accountable. This document has our full support.'

The leaflet is available online at http://www.gcc-uk.org in large print and in 12 languages

Click on http:/www.gcc-uk.org/page.cfm?page_id=516 for a direct iink.

The Princes report, ‘Searching for evidence’, published earlier this year is a marked step forward in the further use and credibility of CAM. The research undertaken by the FIH provides solid evidence for the usefulness and effectiveness of several disciplines within the Complimentary and Alternative Medicine industry.

In 2003 the FIH published another report, 'The Consumer Perspective', detailing their findings from an investigation into the public's consumerism within the CAM sector. The report set out to determine the publics use and preference for alternative medicine by analysing grey or unpublished material between 1988-2001.

From this report, it was clearly identified that popularity and therefore, acceptance of CAM has grown considerably, in particular, those disciplines investigated within the report; Acupuncture, Aromatherapy, Chiropractic, Homeopathy, Hypnotherapy, Herbal Medicine, Osteopathy and Reflexology. However, the report did not scientifically investigate the effectiveness of the treatments offered.

The Consumer Perspective report, interestingly enough, also highlights that a large percentage of the pubic feel let down by conventional medicine, especially in those conditions that have become chronic and are turning to CAM practitioners for treatment.

The conclusions drawn forth from this earlier report also helped to serve as a platform for further research into efficiency, health outcomes and economic implications of CAM.

The latest report, ‘Searching for Evidence’ is comprised of three main sections; Complimentary medicine and woman's health, Pain management and Mental health and complementary therapies. Several research projects for each were undertaken and their methods, results and conclusions put forth in the latest report.

Recently there has been much scepticism and ‘bad press’ concerning Homeopathy. This is largely due to inaccurate studies carried out and rash conclusions drawn hence. The investigations in this latest report by the FIH where homeopathy is involved indicate strongly the effectiveness of homeopathic treatment especially in those studies involving the comparison with a placebo. In these instances, the placebo was shown to have hardly any affect at all in comparison to the homeopathic treatment.

In a study of the effectiveness of homeopathic treatment for women with pre-menstrual syndrome for example, the placebo was shown to have very minimal impact on the condition, failing to generate acceptable changes. The subjects taking the homeopathic treatment were shown to have generally improved well-being, reduced sick days and medications.

A study into the effects of homeopathy on the symptoms of the menopause showed the homeopathic treatment was very effective, giving positive short-term benefits to the symptoms of the menopause. This study was carried out over a two and a half year period, commencing in October 1998 in the city of Sheffield. Following the results of this study, homeopathic treatment became fully integrated into the Sexual & Reproductive Service Directorate. The homeopathy service continues to be funded by the PCT as part of the PMS/menopause service to the city of Sheffield.

Acupuncture has had more that its fair share of scepticism over the years too. But due to the increase in popularity and several studies and experiments over the years it is on its way to being firmly accepted with some of its aspects scientifically proven.

The latest report by the FIH includes a study into the safety and effectiveness of acupuncture for women with nausea and vomiting in the early stages of pregnancy. This experiment was carried out with 593 women randomly allocated into four groups; Traditional acupuncture; PC6 acupuncture; sham acupuncture; no acupuncture control. The results indicate that after the six week testing period (being every seven days) the woman having acupuncture all experienced less dry retching and less nausea than the women in the no acupuncture group. However, no differences in vomiting were shown between the groups. The study concluded acupuncture to be a safe and effective treatment option for women suffering from nausea and dry retching in early pregnancy.

Acupuncture studies for migraine and chronic tension headache were shown to be extremely effective leading to persisting, clinically relevant benefits to patients especially to those with migraine. The treatment of low back pain was also indicated very effective through acupuncture and also very cost effective.

Further investigation still needs to be carried out in many areas of acupuncture, including the treatment of acupuncture in female infertility. Many acupuncture practitioners achieve very good results in this area however the treatment has yet to be established fully although evidence is now becoming more substantial. The underlying mechanisms and effects of acupuncture will be under investigation for a long time.

Osteopathy, one of the more firmly established disciplines was subject to a cohort analysis of 800 patients seen at The British School of Osteopathy Expectant Mothers Clinic between 1985 - 2000. The aim of the treatment primarily was pain relief and, secondly, to prepare the patient for the remainder of the pregnancy and for labour.

The results show more than 68% of patients benefited from a high degree of symptomatic relief within 2-6 treatments. This study not only showed that osteopathic treatment was very effective with dealing with this group of patients but it is also very cost effective for the NHS. There are also no contraindications regarding the foetus.

An interesting study into the effectiveness of Bowen Technique (BT) of patients suffering from frozen shoulder showed great improvements even for patients with a longstanding history of the condition. Patients reported a significant decrease of pain, as well as a significant increase in mobility. Patients initially either expressed being open minded to the treatment or expected little or no change from BT. However, during the therapy they said they prefer the treatment over physiotherapy, exercise and cortisone injections as Bowen Technique is not painful and is relaxing. Overall the participants were highly satisfied with the therapy.

Magna Jewellery Limited, a company which sells jewellery and other products containing magnets that are marketed as a form of pain relief, has agreed to change its advertising following action by the OFT.

The OFT considers that a number of the company's advertising ciaims were misleading under the Control of Misleading Advertisements Regulations. Magna Jewellery Ltd and its officers, Jeffrey Frankel and Laura Neal, have given binding undertakings to the OFT that they will not make advertising claims stating or giving the impression that:

• magnetic products have a therapeutic effect caused by a specified physiological mechanism, such as an increase in circulation.
* the therapeutic effect of magnetic products is established or proven by scientific trials.
• products have a therapeutic effect due to their magnets (or magnetic fields) and/or will in all cases produce a therapeutic effect for those who wear them.
• The undertakings also restrict the publication of advertisements using customer testimonials which repeat any of the above ciaims.

Magna Jewellery Limited, Mr Frankel and Ms Neal have not admitted that their advertising claims are misleading.

The Medicines and Healthcare products Regulatory Agency (MHRA) has recently started to publish manufacturers’ Field Safety Notices on its website. This will enable public access and provide greater transparency concerning the MHRA’s role in assessing manufacturers’ corrective actions.

Field Safety Notices are issued by a manufacturer when a medical device needs to be recalled for technical or medical reasons. An MHRA investigation is also initiated at the same time; its status from start to finish can now be monitored on the website through this dedicated web page.

'By subscribing to our email alerting service key contacts in Health Trusts/PCTs will be informed immediately by email if a manufacturer has issued a Field Safety Notice. Trusts will then be able to take appropriate action promptly.

'We encourage subscription to our new service on our home page http://www.mhra.gov.uk'

Enforcement officers from the Medicines and Healthcare products Regulatory Agency (MHRA) in a joint operation with Cleveland Police on 15.08.06 seized tens of thousands of tablets believed to be ‘pep’ pills.

The seizures were carried out in relation to the alleged illegal sale and supply of medicines under the Medicines Act 1968. Two residential and three commercial premises were searched in Middlesbrough. The street value is thought to be in excess of £200,000. Five local men were also arrested and taken into police custody. £23,000 of cash was also recovered and is believed to be proceeds of crime.

‘Pep’ pills contain the active ingredient piperazine / benzylpiperazine. Piperazine can be found in medicines in the UK to treat worm infections and as such is a Prescription-only medicine (POM). Benzylpiperazine has no licensed use in the UK as a medicine.

Investigations are continuing.

Nature's Answer® has announced the acquisition of the Frog International Inc. line of superfoods under the brand name Greens Today®.

Family-owned and operated, Nature's Answer® is one of America's largest manufacturers of nutraceuticals, since 1972. The company introduced the first alcohol-free herbal extracts, and continues to bring to market traditional remedies, vitamins and minerals, by incorporating advanced knowledge of scientific techniques and phytopharmaceutical manufacturing.

Frank D'Amelio, Jr., Executive Vice President of Nature's Answer® stated, ‘We are very pleased to add the Greens Today® line of Super Foods to the Nature's Answer® family of products.

‘We are confident that the products meet the high standards set by Nature's Answer® and we are looking forward to significant growth for the brand in 2007’.

Web: http://www.naturesanswer.com

Solgar Vitamin and Herb has announced its return to the company's founding principles. Under new ownership, the management and staff are committed to enhancing the company to many of its founding principles, which had led to the success of Solgar. First things first, Customer Care harkens back to the early days at the company when it was clearly understood that the individual needs of retailers came first.

‘Solgar's reputation for quality in products and service continues to be legendary in the Natural Products Industry. We are bringing back the personal touch that Solgar was founded on,’ said Mike Shuck, Solgar Vice President of Sales. ‘We want to show our retail partners how much we appreciate them.’

‘Customer Care, formerly known as Customer Service, is strongly committed to making certain that every interaction between Solgar and its customer is a pleasant and friendly experience. Service-oriented improvements at Solgar have already begun. Callers to the company are now hearing a friendly receptionist answering the telephone, instead of the automated system that was more recently in place.

‘Solgar has also enhanced the Technical Product Information Centre for anyone who has questions concerning the 400-plus products that Solgar manufactures.
Continuous professional training is being provided for call centre associates.

‘Solgar is reimplementing an inventory control system that allows for, at most times, 100% complete product order shipments. Returning to the system has greatly improved our service levels in a rather short time. Solgar is dedicated to continuing this level of service.

‘After careful review of the current natural products marketplace, Solgar is making certain adjustments in order to better support our health food store partner. Solgar has adjusted prices of certain key products in order to allow our health food retailers to be more competitive under current market conditions. Solgar has reduced the minimum prepaid shipping order from $150 to the original $75 to allow more flexibility in ordering.’

Solgar was founded in 1947 and was independently owned and operated by the Skolnick family until Wyeth Consumer Healthcare acquired it in 1998. NBTY (NYSE: NTY), a leading vertically-integrated global manufacturer and distributor of a broad range of nutritional supplements, purchased Solgar in August 2005. Solgar is an independent operating unit of NBTY with worldwide headquarters and state-of-the-art manufacturing and laboratory facilities located in Bergen County, New Jersey, USA.

Web: http://www.solgar.com

October 24th has been selected as Acupuncture and Oriental Medicine Day, a designation recognised by leadership organisations in the field of acupuncture and Oriental medicine, and spearheaded by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM). The purpose of the designation is to raise awareness about the benefits of acupuncture - a viable form of medicine with a 3,000-year history - and how consumers can find certified professional practitioners to ensure better care, better treatment, and better outcomes.

In the United States, the use of acupuncture and Oriental medicine is at an all-time high. According to a recent study conducted by the National Institute for Health's National Centre for Complementary and Alternative Medicine (NCCAM), an estimated 36 percent of U.S. adults use some form of alternative therapy, and 25 percent have tried acupuncture. According to recent research, 64 percent of physicians have referred patients to certified practitioners of alternative therapies, including acupuncture and Oriental medicine, and more than $17 billion is spent on the therapies annually.

Knowledge is power when it comes to making informed healthcare decisions. NCCAOM has not only established a website in honour of AOM Day at http://www.nccaom.org, but the NCCAOM website at http://www.nccaom.org, hosts an excellent source for consumers to locate certified and good-standing acupuncturists and practitioners of Oriental medicine worldwide.

More than one in four U.S. hospitals now offer alternative and complementary therapies, such as acupuncture, homeopathy, and massage therapy.

A new survey of nearly 1,400 U.S. hospitals shows more mainstream medical institutions are providing complementary and alternative therapies to meet growing demand.

‘More and more, patients are requesting care beyond what most consider to be traditional health services,’ say researchers Sita Ananth of Health Forum, an affiliate of the American Hospital Association, and William Martin, PsyD, of the College of Commerce at DePaul University in Chicago, in a news release. ‘And hospitals are responding to the needs of the communities they serve by offering these therapies.’

Complementary and alternative medicine (CAM) includes therapies not based on traditional Western medical teachings and may include acupuncture, chiropractic, homeopathy, diet and lifestyle changes, herbal medicine, and massage therapy, among others.

A 2002 CDC survey showed that more than half of Americans thought combining CAM with conventional medicine would be helpful.

Alternative Medicine Going Mainstream
The survey, conducted and published by the American Hospital Association every two years, shows the percentage of hospitals offering one or more CAM services increased from 8% in 1998 to 27% in 2005.

Contrary to popular belief, researchers found that complementary and alternative medicine offerings were most common in the Midwest (Illinois, Indiana, Michigan, Ohio, and Wisconsin) and less common on the West Coast. The least common areas to offer CAM services were in the South (Alabama, Kentucky, Mississippi, and Tennessee).

The top six complementary and alternative medicine services offered on an outpatient basis among hospitals offering CAM were massage therapy (71%); tai chi, yoga, or chi gong (47%); relaxation training (43%), acupuncture (39%); guided imagery (32%), and therapeutic touch (30%).

Top inpatient services were massage therapy (37%), music/art therapy (26%), therapeutic touch (25%), guided imagery (22%), relaxation training (20%), and acupuncture (11%).

Other findings of the survey include:
* Most hospitals that offered CAM were in urban areas and were large or medium-sized (more than 100 beds).
* Teaching hospitals accounted for 36% of hospitals responding to the survey and offering CAM services, perhaps reflecting the finding in a 2004 study that more than 3/4 of medical schools require a course in CAM.
* Most hospitals offered their CAM services at other locations while 37% provided them in a hospital wellness or fitness center.
* Most CAM services are paid for by patients as an out-of-pocket medical expense.

The survey was mailed to more than 6,000 U.S. hospitals

Calcium supplements for children may not be as effective in preventing bone fractures as has been thought, according a new study.

Researchers at the Menzies Research Institute in Australia analysed the findings of 19 different studies involving 2,859 children collectively aged between three and 18 to find out the effects of calcium supplementation on bone density in healthy children.

They included randomised trials of calcium supplementation in healthy children that lasted at least three months and which measured bone outcomes after at least six months of follow-up.

The scientists found that kids taking such supplements have only small improvements in bone density, which are unlikely to reduce fracture risk.

The researchers found that kids taking the supplements only had 1.7 percent better bone density in their upper limbs than children not taking the supplements.
They concluded that the small effect of calcium supplements on bone density was unlikely to reduce risk fracture of kids, either in childhood or adulthood.

'The small effect of calcium supplementation on bone mineral density in the upper limb is unlikely to reduce the risk of fracture, either in childhood or later life, to a degree of major public health importance,’ the BMJ quoted the researchers, as saying.

They now suggest that other approaches, such as increasing vitamin D concentrations and eating more fruit and vegetables could be more beneficial.

‘It may be appropriate to explore alternative nutritional interventions, such as increasing vitamin D concentrations and intake of fruit and vegetables,’ they added.

Reports of a traditional Chinese medicine having beneficial effects for people suffering from type 2 diabetes now has some scientific evidence to back up the claims. A collaboration between Chinese, Korean, and Australian scientists at Sydney's Garvan Institute, has revealed that the natural plant product berberine could be a valuable new treatment.

Berberine is found in the roots and bark of a number of plants used for medicinal purposes including wound healing and treatment of diarrhea. It has also been documented in Chinese literature as having a glucose lowering effect when administered to people with diabetes; yet, until now, its mode of action was unknown.
Garvan scientist Dr Jiming Ye says: ‘Our studies in animal models of diabetes show that berberine acts in part by activating an enzyme in the muscle and liver that is involved in improving sensitivity of the tissue to insulin - this in turn helps lower blood sugar levels. In addition, it seems berberine can help reduce body weight’.

Current medicines for treating type 2 diabetes include metformin and the TZD group of drugs. However, a large number of patients cannot tolerate metformin and the TZDs can cause undesirable weight gain. Therefore, it is critical to develop new therapies to treat type 2 diabetes, which is a growing health problem.

‘Berberine has been used for decades, if not centuries, with few reported side effects. Given the limitations of existing medicines we are excited to have evidence that berberine may be a helpful new treatment for type 2 diabetes; however, despite its widespread use in traditional medicine practices, it will still have to be evaluated properly following the defined clinical trials process’, said Professor James, head of the Garvan's Diabetes & Obesity Research Program and co-author of the Diabetes paper.

The next step is to investigate how berberine activates the enzyme that mediates these 'insulin-sensitising' effects.

NOTES:
This study was published in the August issue of 'Diabetes'. The title is: Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin resistant states. Yun S. Lee, Woo S. Kim,Kang H. Kim, Myung J. Yoon, Hye J. Cho, Yun Shen, Ji-Ming Ye, Chul H. Lee, Won K. Oh, Chul T. Kim, Cordula Hohnen-Behrens, Alison Gosby, Edward W. Kraegen, David E. James, and Jae B. Kim

http://www.Acupuncture.com/newsletters/m_sept06/main2.htm

The U.S. Food and Drug Administration reports that organic spinach from a California produce company may be to blame for an E. coli outbreak.

At least 96 cases have been reported in 20 states, The New York Times said. One victim, a 77-year-old woman in Wisconsin, has died.

Natural Selection Foods of San Juan Bautista, Calif., announced a national recall of pre-bagged spinach and other salad greens in its Earthbound line as well as ones that it packages for other companies.

The FDA recommended that consumers avoid bagged fresh spinach and seek medical attention if they experience symptoms of illness after consuming the produce.
‘Given the severity of this illness and the seriousness of the outbreak, FDA believes that a warning to consumers is needed. We are working closely with the U.S. Centers for Disease Control and Prevention and state and local agencies to determine the cause and scope of the problem,’ said Dr. Robert Brackett, director of FDA's Centre for Food Safety and Applied Nutrition.

‘The E. coli bacteria causes diarrhea, often with blood in the stools. E. coli can cause hemolytic uremic syndrome, a form of kidney failure, in children and the elderly. The syndrome can cause kidney damage and death, especially in the elderly and young children.’

Once upon a time there was a house of confinement in London where curious onlookers could while away an afternoon by staring and laughing at the inmates many of who were mentally unwell.

The authorities made a healthy profit by persuading their captives to parade their obvious unhappiness in the midst of squirm-inducing self-destruction. How the audience tittered.

The practice of laughing at these inmates was suddenly stopped because the government realised it 'tended to disturb the tranquillity of the patients' by 'making sport and diversion of the miserable inhabitants'.

That was at the Bethlehem Hospital of St Mary's - better known as 'Bedlam' - in 1770. Our question is this. Why - some 236 years later - has Channel 4 been permitted to revive the practice of poking fun at mental inadequacy for profit in its offensive new series of Big Brother?

The recent series featured:
* A man on suicide watch - who is at greater risk because the programme has disappointed his expectations and who has now received a largely negative audience-response which will follow him wherever he goes
* A man with a disorder causing tics and language difficulties who may misguidedly believe he is helping the cause of Tourette's sufferers but in this context is just as likely to invite ridicule
* An increase in the psychological and territorial pressures of confinement as the inmates are compelled to share beds, enjoy less privacy and survive for longer in the precincts of what is nothing less than a human zoo.

The British Association for Counselling and Psychotherapy is an charity charged with educating the public about therapy but above all ‘to meet the needs of those members of society where development and participation in society is impaired by mental, physical or social handicap or disability’. In this light we have two final questions for Channel 4, and an observation:

* Under what circumstances would psychotherapists recommend confinement in the Big Brother house as the treatment of choice for a range of borderline personality disorders?
* And for what crime in modern Britain would a citizen receive a punishment similar to an incarceration in the Big Brother house?

The Channel 4 producers consistently defend their actions by saying they have 'screened' all applicants who have 'consented' to appear. This suggests to us they have more faith in so-called psychological personality profiling than the evidence could ever warrant (the same tests are used to release violent offenders into the community a percentage of whom continue to offend and sometimes kill). Secondly, consent by itself is morally insufficient. That consent must be -informed which means all the possible negative outcomes are spelled out first, and it must be given by someone who is balanced enough to consent in the first place - both emotionally and intellectually. Judging from the evidence, this is sometimes in doubt.

Alan Jamieson, Deputy Chief Executive Officer of BACP said: ‘We don't want to see people who need help, and who seek help, being made fools of in public’.
BACP's ‘Guidelines for Producers of Reality TV Programmes’ can be downloaded from the website: http://www.bacp.co.uk/media/pr/035.htm

British dog owners are shunning traditional medicine and instead turning to alternative therapies to keep their pet in good mental and physical health.

According to new research from Direct Line Pet Insurance, over three quarters of a million (14 per cent) of the UK's dog owners use alternative or complementary treatments - with 30 per cent doing so on recommendation from their vet.

The market for complementary treatments for pets has certainly taken off as dog owners have shelled out a collective £29.6 million in the past two years on alternative methods.

Owners are choosing to address a variety of problems in this way. More than half of those who have used complementary therapy (54 per cent) do so to tackle ailments, a third (34 per cent) to relieve pain, and 29 per cent as a stress buster. And fed up with the Barbara Woodhouse school of training, five per cent use alternative therapy to correct bad behaviour.

Nearly thirty years after phasing out the widespread use of indoor spraying with DDT and other insecticides to control malaria, the World Health Organisation (WHO) announced on 15th September that this intervention will once again play a major role in its efforts to fight the disease. WHO is now recommending the use of indoor residual spraying (IRS) not only in epidemic areas but also in areas with constant and high malaria transmission, including throughout Africa.

‘The scientific and programmatic evidence clearly supports this reassessment,’ said Dr Anarfi Asamoa-Baah, WHO Assistant Director-General for HIV/AIDS, TB and Malaria. ‘Indoor residual spraying is useful to quickly reduce the number of infections caused by malaria-carrying mosquitoes. IRS has proven to be just as cost effective as other malaria prevention measures, and DDT presents no health risk when used properly.’

WHO actively promoted indoor residual spraying for malaria control until the early 1980s when increased health and environmental concerns surrounding DDT caused the organisation to stop promoting its use and to focus instead on other means of prevention. Extensive research and testing has since demonstrated that well-managed indoor residual spraying programmes using DDT pose no harm to wildlife or to humans.

‘We must take a position based on the science and the data,’ said Dr Arata Kochi, Director of WHO's Global Malaria Programme. ‘One of the best tools we have against malaria is indoor residual house spraying. Of the dozen insecticides WHO has approved as safe for house spraying, the most effective is DDT.’

Indoor residual spraying is the application of long-acting insecticides on the walls and roofs of houses and domestic animal shelters in order to kill malaria-carrying mosquitoes that land on these surfaces.

‘Indoor spraying is like providing a huge mosquito net over an entire household for around-the-clock protection,’ said U.S. Senator Tom Coburn, a leading advocate for global malaria control efforts. ‘Finally, with WHO's unambiguous leadership on the issue, we can put to rest the junk science and myths that have provided aid and comfort to the real enemy - mosquitoes - which threaten the lives of more than 300 million children each year.’

Views about the use of insecticides for indoor protection from malaria have been changing in recent years. Environmental Defense, which launched the anti-DDT campaign in the 1960s, now endorses the indoor use of DDT for malaria control, as does the Sierra Club and the Endangered Wildlife Trust. The recently-launched President's Malaria Initiative (PMI) announced last year that it would also fund DDT spraying on the inside walls of households to prevent the disease.

‘I anticipate that all 15 of the country programs of President Bush's $1.2 billion commitment to cut malaria deaths in half will include substantial indoor residual spraying activities, including many that will use DDT,’ said Admiral R. Timothy Ziemer, Coordinator of the President's Malaria Initiative. ‘Because it is relatively inexpensive and very effective, USAID supports the spraying of homes with insecticides as a part of a balanced, comprehensive malaria prevention and treatment programme.’

Programmatic evidence shows that correct and timely use of indoor residual spraying can reduce malaria transmission by up to 90 percent. In the past, India was able to use DDT effectively in indoor residual spraying to cut dramatically the number of malaria cases and fatalities. South Africa has again re-introduced DDT for indoor residual spraying to keep malaria case and fatality numbers at all-time low levels and move towards malaria elimination. Today, 14 countries in Sub-Saharan Africa are using IRS and 10 of those are using DDT.

At the recent news conference, the World Health Organisation also called on all malaria control programmes around the world to develop and issue a clear statement outlining their position on indoor spraying with long-lasting insecticides such as DDT, specifying where and how spraying will be implemented in accordance with WHO guidelines, and how they will provide all possible support to accelerate and manage this intervention effectively.

‘All development agencies and endemic countries need to act in accordance with WHO's position on the use of DDT for indoor residual spraying,’ said Richard Tren, Director of Africa Fighting Malaria. ‘Donors in particular need to help WHO provide
technical and programmatic support to ensure these interventions are used properly.’

Indoor residual spraying is one of the main interventions WHO is now promoting to control and eliminate malaria globally. A second is the widespread use of insecticide-treated mosquito nets. While the use of bed nets has long been encouraged by WHO, the recent development of ‘long-lasting insecticidal nets’ (LLINs) has dramatically improved their usefulness. Unlike their predecessors, the long-lasting nets need not be re-dipped in buckets of insecticide every six months as they remain effective for up to five years without retreatment.

Finally, for those who do ultimately become sick with malaria, more effective medicines are increasingly becoming available. Unlike previous antimalarials that have been rendered useless in many regions due to drug resistance, Artemisinin Combination Therapies (ACTs) are now recommended. These lifesaving medications are becoming more widely available throughout the world. In January of this year, WHO took stringent measures to help prevent future resistance to antimalarial medicines by banning the use of malaria monotherapy. An example of the negative consequences of drug resistance is apparent in the threat it poses to intermittent preventive treatment in pregnancy (IPTp), a crucial strategic intervention to protect pregnant women from the consequences of malaria.

Potential funding to scale up the availability of all three of these strategic interventions has dramatically increased over the past few years through the inception of the Global Fund to Fight AIDS, TB and Malaria, World Bank plans to significantly increase its funding for malaria, and the launch of the President's Malaria Initiative.

‘With serious money finally becoming available to fight malaria, it is more imperative than ever that WHO provides sound technical guidance and programme assistance to ensure timely and effective use of these resources,’ said Dr Kochi.

Each year, more than 500 million people suffer from acute malaria, resulting in more than 1 million deaths. At least 86 percent of these deaths are in sub-Saharan Africa.
Globally an estimated 3,000 children and infants die from malaria every day and 10,000 pregnant women die from malaria in Africa every year. Malaria disproportionately affects poor people, with almost 60 percent of malaria cases occurring among the poorest 20 percent of the world's population.

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