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Clinical Handover - Critical Communications
The lead article in a special supplement on clinical handover in the Medical Journal of Australia relates a tragic case in which an elderly man died for want of effective handover.

Nebraska Legislature Advances Ultrasound Viewing Bill
The Nebraska Legislature on Wednesday voted to advance a bill (L.B. 675) that would require abortion providers who perform ultrasounds on women seeking the procedure to tell women that a view of the fetus will be available and display the screen in a way that the image can be easily seen, the AP/Lincoln Journal Star reports. The bill also would require the state to compile a list of clinics that offer no-cost ultrasound services. State Sen. Brenda Council (D) criticized that particular provision, saying it would force the state Department of Health and Human Services to spend more taxpayer money.Lawmakers advanced the bill by voice vote after approving an amendment to clarify language surrounding the qualifications of health professionals performing ultrasounds. Advocates for the bill claim it would provide more information to women seeking abortion procedures, while opponents of the bill argue that it would allow the government to interfere in a private procedure. The bill faces a final vote before going to Gov. Dave Heineman (R). If the bill becomes law, Nebraska would join more than a dozen states that have similar laws, the AP/Journal Star reports (Ortiz, AP/Lincoln Journal Star, 5/27).
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Long-Distance Brain Waves Focus Attention
Just as our world buzzes with distractions - from phone calls to e-mails to tweets - the neurons in our brain are bombarded with messages. Research has shown that when we pay attention, some of these neurons begin firing in unison, like a chorus rising above the noise. Now, a study in the May 29 issue of Science reveals the likely brain center that serves as the conductor of this neural chorus.
Diagnostics

Campaign Welcome Parliamentary Report Exposing Serious Failings In Treatment For Alcohol Dependents Across England

UK Advocates (UKA), a new charitable campaign group dedicated to helping the still suffering alcoholic achieve lasting sobriety, has welcomed the All Party Parliamentary Group (APPG) on Alcohol Misuse report published which calls for urgent action to address serious shortcomings in the treatment of alcohol dependents in England. UKA was set up to lobby and hold to account health professionals and policymakers at both national and local level who are presiding over a failing system of treatment for people with chronic problems with alcohol at a time when there is widespread concern over out of control binge drinking, particularly among women and the young. Recent estimates put the proportion of the population affected directly or indirectly by alcohol addiction at 14 per cent, alcohol-related admissions to hospitals are touching the 1 million mark annually at a cost of almost £3 billion to the taxpayer and experts now believe up to 40,000 deaths are caused by alcohol abuse every year. UKA is campaigning to shift the emphasis of treatment away from short-term, often chemical-orientated interventions and controlled drinking programmes - both of which can prove dangerous to the sufferer - towards free at point of access, structured, long-term abstinence programmes. Although there is a serious lack of official figures comparing the relative effectiveness of different treatments for alcohol dependency, many experts in the field, including the World Health Organisation (WHO), consider abstinence by far the most likely means to securing lasting sobriety for those affected by alcoholism. For instance, the programme of Alcoholics Anonymous is widely accepted as the most successful of its kind and now boasts over two million members worldwide, 60,000 of them in London alone. The APPG inquiry was set up to investigate the state of alcohol treatment services in England following recent critical reports on the care of alcohol misusers by the National Audit Office and Alcohol Concern, and took evidence from practitioners, treatment providers and experts in the field of addiction. The subsequent report confirms UKA"s assertion that the current system is in a state of chaos and urgently needs radical reshaping and reform. The APPG report notes "a general lack of capacity and variety in alcohol treatment services, due to poor levels of funding and, in some cases, a harm reduction agenda driven largely by crime and disorder rather than health considerations" and points to the fact that despite 1.1 million people being classified as alcohol dependent nationally only 1 in 18 enter any sort of specialist treatment every year. Spending on illegal drug addiction still heavily outweighs that on alcohol dependency, despite the burgeoning size of the problem and figures that show that for every £1 spent on alcohol treatment, £5 is saved elsewhereÂð. The APPG report also reveals a huge discrepancy between the stated goals of the Department of Health (DoH) on the provision of alcohol treatment and how this is met, or not met, at local level by the autonomous Primary Care Trusts (PCTs) that they fund. It says: "Ò€¦the Department has been powerless to insist that local alcohol treatment is either considered or provided, even where the need has been most transparent. This lack of strategic focus has meant that alcohol treatment provision at the local level has been left largely unplanned, under-funded and undervalued." Bob Beckett, founder of UKA, said: "Government policy has failed to recognize the difference between a problem drinker and an alcoholic who has a disease. For the alcoholic it is a bit like the gherkin which can never be a cucumber again. "The consequences of this mistake are a constant flow of over one million people every year being admitted to NHS hospitals with alcohol-related diseases at a cost to the taxpayer of almost £3 billion a year. "We need a complete and urgent rethink of the whole system if we are to make any inroads into this national catastrophe." UKA is currently carrying out an audit of the treatment provided by individual PCTs across the country and assessing whether the treatment they provide clients meets the WHO"s definition of alcoholism and its proper treatment. Legal action will be taken against those it believes have been negligent by failing to offer proper care for those diagnosed with the disease. Current funding through PCTs for abstinence-based treatments, often residential, is haphazard to the say the least and often not offered at all. Many suffers are forced to pay privately, meaning thousands who cannot afford it slip through the net completely. UKA is also compiling evidence of individual alcoholics who have been put on controlled drinking regimes or prescribed powerful psycho-active medication while still drinking, often contrary to the strict guidelines laid down by the manufacturers and licensing authorities. It intends to issue proceedings in the Administrative Division of the High Court against PCT"s and clinicians who may be proven to have acted negligently. However, the picture is not universally bleak. Nottingham, which has historically been at the forefront of alcohol treatment since Beckett opened the original Nottingham Priory under private/public partnership in 1989, have recently opened a new abstinence day treatment centre with funding from the local PCT in partnership with Mimosa Healthcare and the East Midlands-based Alcohol Problems Advice Service (APAS). UKA hope that Nottingham"s example will be followed by other PCTs and treatment agencies across the country. Note - Bob Beckett, the founder of UK Advocates and a recovering alcoholic of 21 years, helped open the original Nottingham Priory in 1989 and has acted as an advisor on alcohol treatment both in the UK and the US for the past 20 years References: Âð. National Treatment Agency (2006) Review of the Effectiveness of Treatment for Alcohol Problems UK Advocates


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