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Wednesday, November 30, 2011

Jamie Oliver in new meals attack

The TV chef Jamie Oliver has accused the Education Secretary Michael Gove of eroding healthy school food standards.

A campaign by the chef led to tough new legal standards for meals in England's schools.

But now caterers are saying that some of England's new academy schools - which do not have to abide by the regulations - are asking for "unhealthy food".

The government says it trusts schools to act in their pupils' best interest.

And it says it has no reason to believe that academies will not provide healthy, balanced meals that meet the current nutritional standards

Jamie Oliver told BBC Breakfast News: "The bit of work that we did which is law was a good bit of work for any government.

"So to erode it, which is essentially what Mr Gove is doing - his view is we let schools do what they want."

The chef led a TV campaign which saw him going in to school kitchens and helping staff to drop fatty foods from their menus in favour of healthier options.

The law was tightened in England for local authority primary schools in 2008 and secondaries in 2009, so that school lunches had to meet strict nutritional guidelines.

Sweets, crisps and fizzy drinks disappeared from vending machines.

The changes were not universally liked, and some parents took to passing their children fast food through the railings of their school.

And in some schools, children are bringing in biscuits and other snacks to sell to pupils.

England's academies are semi-independent schools and as such they do not have to abide by regulations which set out strict nutritional guidelines for school food.

There are currently 1,400 of them and more schools plan on converting to academy-status.

Now the Local Authority Catering Association, which has 700 members across the UK, says it is being asked to bring back some "unhealthy food".

'Return of the sausage roll'

Linda Mitchell, from the association, said: "Our members are telling us that they have been approached by academies to relax the rules and as providers to hundreds of thousands of schools we are concerned.

"They are being asked to put confectionery and other snacks back, especially at mid-morning. It is the return of the sausage roll to schools."

She said caterers were mostly being asked to put snacks in to vending machines in schools.

"It's a very small step before you are seeing the introduction of confectionery and fizzy drinks back in to those machines."

There are guidelines on school food in all parts of the UK, but legal regulations in England only

She suggested schools might be under pressure from pupils and parents to re-introduce certain foods and that some might be tempted by the high profit margins she said there were on sweet or fatty snacks.

A spokesman for the Department for Education in Westminster said the school food regulations were the "benchmark of high standards".

"We trust schools to act in the best interest of their pupils - they know the importance of healthy school dinners and the benefits they bring," he said.

Mr Gove met Jamie Oliver in June. In a letter to the chef afterwards, he wrote: "I would like to reassure you that we have no reason to believe that academies will not provide healthy, balanced meals that meet the current nutritional standards.

"As part of the broader freedoms available to academies, I trust the professionals to act in the best interests of their pupils.

"I understand from the School Food Trust that some of the best schools in terms of attitudes to food and meals are the academies."

Jamie Oliver said the standards should be kept to "keep everyone on their game".

"I think that's a wonderful ambition, that everyone's going to be brilliant, but head teachers are more pushed than ever, expected to do more than ever, now they have to be entrepreneurial caterers as well as everything else they have to do," he said.

"It's not a large amount of paperwork, it really isn't, and for what it's for, which is essentially the future of our country, it's really important."

Sharon Hodgson MP, Labour's Shadow Minister for Children and Families, said: "Michael Gove is effectively throwing away years of hard work and achievement in driving up standards for purely ideological reasons, and without any mandate from parents".

Under regulations in England and Northern Ireland - and guidelines in Scotland and Wales - schools should:

restrict the amount of fatty, sugary and salty foods on the menuincrease the use fresh fruit and vegetablesban the sale of sweets, crisps and fizzy drinks

In England, local authority schools also have to supply meals which comply with strict nutrient standards.

From 2013, Wales intends to enshrine its guidelines in the law too.

England's Department for Education has asked the School Food Trust to carry out a study of some academies to look at their approach to providing healthy school food to pupils.

School Food Trust chairman Rob Rees said he was concerned about the reports of standards being relaxed.

"All the evidence shows that when children eat better, they do better, so this should be a complete and utter no-brainer for any school wanting to do the best for its pupils," he said.

"We need to hear from anyone with concerns that an academy is choosing not to meet the national standards - whether that's adding less healthy foods back on to its menu or bringing back vending of chocolate and crisps."

Just what is middle age?

  People love to talk about the perils of middle age and mid-life crises. But what really happens in our middle years, asks David Bainbridge.

I have a confession to make. I am 43.

I have a belly, reduced skin elasticity, extra hair where I really don't want it, and a sports car. I, in short, am a middle-age cliche. But I am taking it a day at a time.

I still remember the day I went to buy that aged blue Lotus. I was 41 at the time and only too aware of the vast burden of middle-age stereotypes looming over me as I gazed at the car, which was glistening in the late-spring sun. I could hear a middle-aged devil on one shoulder grunt: "Go on - buy it." Then, after a pause, a middle-aged angel on my other shoulder pipe up: "OK, then. Why not?"

So I bought the car, but was I jumping headlong into the world of the so-called mid-life crisis?

We often think negatively about middle age. It is not a stage of life which we await with excitement. It does not get mentioned much in the media - not in a positive light, at least. Yet as certain suspiciously abrupt changes have overtaken me in recent years, middle age has come to fascinate me.

David Bainbridge is a clinical veterinary anatomist at Cambridge University and a science writerHe is the author of Middle Age - A Natural HistoryHis episode of Four Thought is on BBC Radio 4 on 23 November 2011 at 20:45 GMTI am a vet and a reproductive biologist, with a training in zoology, so I suppose I was always likely to end up looking at it in an unorthodox way. Lots of people study childhood, or adolescence, or youth, or old age, but it seemed to be left up to me to study middle age. And because I knew more about animals than people, I studied it as an outsider, as it were.

What I found surprised me.

Middle age does not really exist elsewhere in the animal kingdom. Indeed, it wouldn't make any sense anywhere else in the animal kingdom. We humans usually stop making babies in our early 40s. Any other self-respecting species would take the Darwinian hint and die once that happened.

Yet we humans are exceptional because we don't curl up and die. Far from it. Data from life insurance companies suggests that in the fifth and sixth decades of life you are less likely to die over the coming year than at any other time in your life. Compared with other animals, this seems ridiculous.

The whole process of middle age seems deeply suspicious as it doesn't seem to be about getting old.

People are not demonstrably more stupid and not a whole lot weaker at 50 than they are at 20. And although imaging studies show that middle-aged people may use different brain regions to do the same old tasks, cognitive tests show that apart from brute speed, the brain's abilities are not diminished in middle age. They may be reaching their peak.

Also, although bone mass declines and muscle mass declines, rarely do things get so fragile that they snap. Most important of all, in offices, on construction sites, on football pitches around the world, the great, complex, social, co-operative endeavours which typify our species and make us human, in all of these you find middle-aged people telling supposedly sharper and stronger young adults what to do.

Infantile behaviour

Biologically, the middle-aged human body does not look like something being left to slowly decay. As a counter-example, if machines are left to deteriorate then some of them break down immediately, whereas others function perfectly for a very long time.

Middle-aged humans are simply not like that. They do not vary that much. Almost no-one starts breaking their hip at 40, whereas no-one still looks youthful at 60 - well, not naturally, anyway. If middle age were passive, uncontrolled failure, then it would vary between individuals much more than it does.

In fact, the two examples which buck the trend - the two body systems which do clearly deteriorate in middle age - make my point for me. First, long-sightedness (presbyopia) is almost unknown at 35, yet is universal by 50. I am already running out of arm's length at which to hold my reading matter.

The same is true of reduced skin elasticity. I can almost feel this happening and presumably this process is acceptable as long as I do not look so repulsive or decayed that I actively repel those around me.

So, those changes which do take place in middle age are so precisely controlled and carefully permitted they simply cannot result from creeping failure and decay. In short, the changes of middle age are too abrupt, distinctive of this phase of life, and characteristic of our species for that.

There is a controlling force at work in middle age which allows a few parts of us to suddenly fail, while maintaining the rest of us in good condition.

Indeed, it has become very clear to me the changes of middle age represent a developmental stage of life, as distinct and real as infancy or adolescence. Middle-aged development is programmed into each of us. We each possess the genetic recipe for long, healthy, human middle age. And we owe that genetic inheritance to hundreds of thousands of years of human history, during which - contrary to what you might think - humans frequently lived into their fifth and sixth decades.

Emotional flux

But can this newfound understanding of middle age - its biological basis, its evolutionary origins - help us understand the belly, the inelastic skin, the sports car parked on my drive?

I believe the answer is yes. It is time to take a journey deep into the dreaded male mid-life crisis. It's painfully close to home for some, I know, and perhaps even unpalatable, but this challenge simply must be faced. Men fear it and women joke about it, but what is it exactly?

We humans are an 'information economy' and middle age is the time when we pass on most of that information - this is why middle-aged people like being listened to”

End Quote Well, the concept is only a few decades old but it has always been an elusive thing to define. Common versions of the "crisis" frequently involve a variable mix of three phenomena occurring some time in the male 40s.

First, a degree of emotional flux and uncertainty - an "intrapsychic" reorganisation. Second, humiliating urges to seek out the romantic attentions of younger women. Third, a tendency to revert to childish behaviours, interests and recreational activities.

All in all, it is remarkable how undefined the mid-life crisis seems when we all think we know exactly what it is. Let us take those elements one at a time.

First, the emotional flux and uncertainty. As it turns out men are no more likely to become depressed in their 40s than at any other time. If anything, questionnaire studies suggest that our mood seems to improve slightly. Also, we are no more likely to experience what we think of as "life-turning points" at this stage of our lives.

Similarly, we are less likely to get divorced than earlier in life - what a reliable, constant bunch we are. And finally, we, unlike women, consistently underestimate our proximity to our own death. This, of course, makes us even more happy. In summary, there is little evidence of a crisis here, certainly no specific "intrapsychic reorganisation".

Crisis myth

Next, the lusting after inappropriately young women. Did I really buy that Lotus to lure young women attracted to chubby, greying men in tiny blue cars?

In fact, studies of age preference in lonely hearts ads and dating websites have told us a surprising amount.

At 16, boys seek women who are roughly two years older than them. This age gap narrows to zero by the time we are 24 and thereafter we prefer younger women, with the age gap progressively increasing to only 12 years by our own old age.

Thus, there is no obvious evidence of middle-aged men suddenly hunting down young women, although it is certainly true that men who remarry do tend to marry partners younger than their first spouses - as women who remarry also do.

And there is good evidence that marrying a younger woman extends men's lifespan. Although this, strikingly, is not true in reverse. And finally, it is of course a simple arithmetical fact that there are no much-younger women in men's 20s - they do not yet exist.

Third, the infantile behaviour. I am afraid this is the point where I will go all anecdotal and unscientific - with two assertions.

First, having watched a son grow up, I believe that, on average, boys often have fundamentally different interests from girls - wheels, running around, machines, making things, breaking things, hitting each other - generally "doing stuff".

Second, I claim that men's interests do not change fundamentally between the ages of eight and 60 - with the exceptions of romance and sex. Instead, all that happens in middle age is that we become once again free to indulge ourselves. We have more money, some time and less fear of ridicule by others.

All I know is that when I play Lego with my son I am not enjoying it in some ironic, post-modern way, I am enjoying it in exactly the same way I did when I was 10. So, these pastimes and preferences of middle age are not new-found, they are our same old pastimes and preferences.

Complex lives

And, having demolished these three pillars of the so-called mid-life crisis, we can see the final nail in its coffin comes when people are asked if they have experienced such a crisis. They turn out to be just as likely to say they experienced the crisis in their 30s or 50s as in their 40s. And worst of all, women are just as likely to report a mid-life crisis as men.

How vague and lacking in evidence does a phenomenon have to be before we accept that it is not real?

So, we have a dichotomy between middle age and the mid-life crisis.

Middle age - those two healthy decades after the babies stop - is very real. Only humans have it, we evolved it, and we have enjoyed it for much of our species' history. And why? We evolved middle age because we have always lived more complex lives than other animals - in the ways we acquire resources, socially and technologically.

Many animals are pre-programmed with almost all the information they will ever need, yet a human child is almost a blank slate. Acquiring huge volumes of information is essential if any of us are to cope in the complex world which we humans create for ourselves.

So unlike most animal parents, we don't just give our children genes and calories, we give them our culture. That takes time, and quality time, too, which we cannot dilute by churning out yet more babies. We humans are an "information economy" and middle age is the time when we pass on most of that information - this is why middle-aged people like being listened to.

So middle age is a very real and distinctive phenomenon, one central to the success of our species - which places it in stark contrast to the mid-life crisis, which turns out not to exist at all.

So why do we persist with the male mid-life crisis, talk about it, believe in it? I believe we retain, even love the crisis myth because it is a great story.

It is a narrative on which we can hang part of our lives. It is inherently funny and women like making fun of men, and men like distracting attention from real issues by making fun of themselves. And of course, I play along with this too. I often call the car my "malemenopausemobile" as a way of avoiding having to explain why I spent so much good money on it.

In other words, the mid-life crisis is a fable - but we all love fables, don't we?

Lansley defends looped NHS video

 Andrew Lansley is offering a bedside message to hospital patients - whether they want it or not Andrew Lansley has defended a welcome message played on a continuous loop in English hospitals in which he tells patients their care "really matters to me".

His face appears on bedside screens every few minutes, asking people to thank staff looking after them.

Patients can switch the screens off but the health secretary says it is a "useful message".

One NHS campaign group says his face is the "last thing" patients want to see.

Those who do not turn it off are greeted by the health secretary saying: "Hello, I'm Andrew Lansley, the Health Secretary.

"I just want to take a few moments to say that your care while you're here in hospital really matters to me. I hope it's as good quality care as we can possibly make it and I do hope you'll join me in thanking all the staff who are looking after you while you're here."

But Geoff Martin, chairman of campaign group Health Emergency, said: "The last thing anyone recovering from surgery or illness needs is the health secretary on a permanent loop like some pro-privatisation big brother.

"Perhaps this is some cynical government ruse to speed up discharge of patients by driving people out of the wards as they try and escape the permanent misery of an Andrew Lansley TV message."

The former Labour health secretary Alan Milburn joked that Mr Lansley's hospital appearance was his "secret weapon" to cut hospital waiting lists.

"He wants to prevent people getting into hospital - what a deterrent - and he wants to get them out quickly - what an incentive," he told the BBC's Daily Politics.

He said he had not appeared on the screens, although it is believed that a successor of his - Andy Burnham - did appear on the screens until Labour lost power at the 2010 election.

Patients in 50,000 hospital beds across England see Mr Lansley - although his face is not shown to those in accident and emergency or intense care wards.

It appears as part of a looped video repeated every three to five minutes as part of a bedside entertainment system of TV channels, the internet and films.

Patients pay between £2.50 for a couple of hours to £5 per day for the services - but Mr Lansley's message is free.

"No complaints"

Mr Lansley told BBC Radio 4's Today programme it was useful as he wanted people to realise "we want them to have as comfortable and as high quality a stay as possible", to thank staff and give feedback.

"They only have to see me once," he said.

"They can also turn on the radio and get radio for free."

But he also sees the funny side.

"It can be even worse - one constituent told me their baby's first experience of life was to see me on a monitor, which he found rather unnerving. He wasn't sure about the baby."

A spokeswoman for Hospedia, which provides the service, says Mr Lansley's message could easily be removed.

"If Mr Lansley asked for the video to be removed, we would of course accede to his request," she said.

"We continually monitor patient satisfaction levels, we have received no complaints about Mr Lansley."

The company, not the government, paid for his message to be recorded, she added.

Looking himself after face transplant

  Strangers would stare at him in the street and children would say the monster was coming and run away, but earlier this year Mitch Hunter underwent a face transplant that promises to transform his life.

When I knocked on Mitch Hunter's door in the suburbs of Indianapolis, I really didn't know what to expect.

I had seen photos of him as a young soldier and photos of him after 10 years of plastic surgery, but now I was about to meet him - four months after he had received one of the world's first full face transplants.

He opened the door with his 18-month-old son, Clayton, in his arms and I was stunned.

Mitch is not the handsome young man he once was, but the transformation from the face he had just six months ago is astonishing. Looking from Mitch to his young son, I could even see the family resemblance.

Mitch was 20 years old when a car he was a passenger in crashed into a pole containing a 10,000 volt electrical cable.

He tried to rescue a fellow passenger, but while doing so got the full blast from the electrical cable through his leg and face. He lost the leg and most of his face was burnt off. Over the next 10 years, surgeons tried to rebuild his face, but the results were patchy.

Scaring children

It was the birth of his son Clayton that made Mitch finally decide to have a full face transplant, only the third ever performed in the United States.

"I've had kids hide and run behind their moms because they were so scared when they saw me," he explained.

"That was hard to cope with because my friends started having kids, then my brother had a kid. Then I had Clayton and I didn't want kids to be afraid of me any more."

Mitch's operation was funded by an unusual collaboration between the Brigham and Women's hospital in Boston and the US military.

There are so many soldiers coming back home from the conflicts in Afghanistan with severely mutilated faces and bodies that the military has decided to fund research into novel ways of repairing them. This includes paying for hand and face transplants.

Dr Bohdan Pomahac, who works at the Brigham and Women's hospital, has now done three full face transplants and, with military funding, is preparing to do another five. Mitch, who he operated on in April 2011, was his second patient.

To qualify for the surgery the patient must be missing at least 25% of their face. Dr Pomahac thinks there must be at least 200-300 veterans who would be eligible and he is hoping some will put their names forward.

Continue reading the main story A major problem with face and hand transplants is patients have to take drugs to suppress their immune system or the body will reject the organ. This makes patients more vulnerable to infection and can precipitate conditions like diabetes. A new technique aims to re-educate the body's immune system to accept the transplanted organ by an infusion of bone marrow from the donor.Known as the Pittsburgh Protocol, it was developed at the University of Pittsburgh. London's Royal Free Hospital is keen to adopt the technique, with director of surgery and trauma Professor Peter Butler hoping to establish UK expertise in arm and face transplants.Finding a donor is, surprisingly enough, not that difficult. Dr Pomahac said he would prefer the donor to be young and of the same sex, though computer reconstructions suggest that a female face transplanted onto a male would look all right, although it has not yet been tried.

The full thickness of the face is transplanted, but what really determines how a patient will look afterwards is the underlying bone structure of their faces.

The operation itself went smoothly. A team of surgeons removed Mitch's old face before the new face was carried into the operating theatre by Dr Pomahac.

They joined up arteries from Mitch's body to the new face, and also connected three nerves. Finally the new face, with nose, lips and muscle, was stitched into place. The whole operation took 14 hours, somewhat less than his first.

"We have planned on simplifying it, making it more reproducible and easier for people to do and I think we have accomplished that goal," said Dr Pomahac. "But with every operation we learn an enormous amount."

Recovering senses

Initially there was a lot of swelling. "It looked like the face of a 200lb (90kg) guy, it was that swollen," Mitch told me, but as the swelling went down, his old features started to come through.

Mitch's brother Mark, who is older by a year, says he could see the old Mitch from day one.

"I didn't know how I was going to react, but when I walked through the door of the hospital it was him, my brother."

Katerina, Mitch's partner, is an old school friend, and they got together several years ago, long before the transplant.

She said she quickly got used to the fact that he had a damaged face and accepted him for who he was, though she realised Mitch was unhappy and avoided going out.

Her reaction to the transplant? "I think it's just crazy - the fact that medical science has come this far, what they are able to do. It's just amazing."

When I asked her if it was strange kissing the lips of a dead man, she replied: "I had never kissed him with lips before."

Mitch says sensation is returning and he can now do things like raise his eyebrows, purse his lips and smile. He expects these improvements to continue.

"There is still a little extra skin in places," he said, "but I'm told that when everything is said and done and finalised, I will look a lot like I used to."

Dr Pomahac agrees that things should steadily improve, particularly sensation. "The first sensation develops within a month or two. It's very crude. But it continues to improve and in about 18 months I would expect that Mitch is going to be feeling near normal."

Michael Mosley presents the second episode of Frontline Medicine on BBC Two at 21:00 on Sunday 27 November 2011. Watch via iPlayer (UK only) and catch up on episode one at the above link.

'Missed Olympic opportunity' to get children exercising

In this week's Scrubbing Up, Dr Andrew Franklyn-Miller says the build-up to the London 2012 Olympics offers the perfect chance to encourage children to be more active - but that it is an opportunity being missed.

If our children are struggling in maths or English, we are aware because of poor performance in tests, and the child gets appropriate help.

But what about physical development, cardiovascular fitness or coordination?

Where are the assessments of "physical literacy" alongside numeracy and literacy?

How do we recognise physical limitations due to shortness of breath or low glucose causing problems, and step in before it becomes too late?

'Let it be competitive'

Society has deemed it acceptable to aspire to participate rather than achieve, to hope that vaguely defined skills might maintain fitness rather than test our children against benchmarks.

Continue reading the main story
We need to make exercise a normal part of day-to-day life, not a weekly obligatory trip to the gym ”

End Quote Dr Andrew Franklyn-Miller Our national curriculum for PE talks of "aspirations of stringing together movements", floating in a swimming pool and "achievements" of participation and understanding.

I quite understand the reluctance to test further in school and increase the burden on teachers, but we risk neglecting the physical competence of our future generations from a fear of failure, challenge and aspiration we do not see in other aspects of education.

Surely part of the Olympic legacy should be that we give future generations the benefit of experience that our Olympians give in achievement, aspiration and success?

They all compete on a daily basis in training and in competition - even to maintain funding - and ultimately will compete for a medal at London 2012.

Where will our next generation be without the competition and physical literacy goals as they develop?

Let us achieve future success now by building in a PE curriculum that embraces push, pull, squat, brace, rotate, accelerate and change of direction.

Let it be competitive and let us test our children against each other and identify those who need support from the network of doctors trained in sport and exercise medicine as an existing Olympic legacy.

Teachers and parents need support with training and a curriculum that builds on the lessons learnt in athlete development, and sport talent identification, not to build potential superstars but to change a lifestyle.

We need to make exercise a normal part of day-to-day life, not a weekly obligatory trip to the gym.

Surely we need to act now to help those millions otherwise destined for obesity?

Mum with cancer has healthy baby

 Sarah Best from Leamington Spa gave birth to a healthy baby boy just hours after completing radiotherapy treatment

A Warwickshire mother is one of only a handful in the world to undergo cancer treatment while pregnant and go on to have a healthy baby.

Sarah Best, 30, from Leamington Spa, gave birth to Jake after going into labour on the final day of treatment.

She had undergone chemotherapy for a type of mouth cancer after being diagnosed when four months pregnant.

The tumour was removed in a pioneering operation at University Hospital Coventry and Warwickshire (UHCW).

According to UHCW, chemotherapy for pregnant women is incredibly rare and Jake is thought to be the first baby to be born in the UK after such treatment, and one of only eight in the world.

'Complex treatment'

"It was devastating really," said Ms Best, who gave birth in April.

"Because I thought pregnancy was supposed to the happiest time... you're supposed to feel wonderful.

"And it didn't really... I had other things I had to cope with because of this cancer.

"The hospital [staff] worked so well for me. They were like my best buddies."

Gary Walton, the surgeon who led the UHCW team, said: "This type of treatment is complex at the best of times and is very rarely carried out on pregnant women, so we had to stay in close contact with the maternity team throughout.

"I am delighted that Sarah has responded so well to the treatment, especially now that she has Jake to look after too."

The downside of the operation was that Ms Best was unable to receive any gas-and-air pain relief during labour, but that did not stop her from giving birth to a healthy 4lb 10oz (2.1kg) baby boy.

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