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According to a report by the Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom (London), the number of specialist doctors in the public health work force necessary to deal with major public health problems will have to increase significantly to be effective. Professor Sean Griffiths, faculty president, said that the report indicates that the number of specialists must be increased by at least 40% and "is urgently needed" in order to provide safe and effective public health service. He reported the need for this increase at the opening of the Faculty of Public Health's annual conference last month.

The study, titled "Specialist Public Health Work force in the UK," claims that levels of specialists in areas such as public health services, health protection and academic public health, have not yet met the levels established in 1998. Currently there are 827 public health consultants/specialists in the UK. The report says there needs to be at least 1,472 specialists by 2006 to meet the national target set six years ago. The study highlights a shortage of public health specialists at a time when their role is expanding in importance and scope, Griffiths noted. The result, according to the report, is to make "impossible" the effective delivery of healthcare set by the public health agenda.

Public health services are coming under increased pressure due to soaring obesity levels and sexually-transmitted disease rates, the global threat of SARS, tobacco smoke pollution and threats of chemical attack, the report says. Griffiths said, "If the government is serious about leading the attack on public health problems such as obesity, then it urgently needs to invest in the public health work force." He added: "[O]ur report shows that public health skills are in short supply with widespread reports of staff shortages and significant numbers of vacant director of public health posts. We need investment now." The largest shortfall was seen in Wales, with a 64% increase needed; the smallest in London, requiring a 21% increase.

The report made two recommendations:

That a strategic national work force plan be drawn up to support long-term development of service and academic public health, "taking into account the needs of all countries in the UK."

That "all parties adopt and promote its national target of a minimum of 25 consultants and specialists in public health per million population (a minimum of 2.5 per 100,000 per population at local level) to be achieved by 2006."

Elekta eyes research centers

Elekta (Stockholm, Sweden), a manufacturer of devices for non-invasive brain surgery, said it plans to establish an international network of research centers for work on magnetoencephalography (MEG). Citing its global leadership position in MEG systems with its Elekta Neuromag product, Elekta said it would establish the research centers in order to "assist and speed up the ongoing transformation of MEG technology from pure research applications to routine clinical use."

"Elekta is and has always been dedicated to fighting serious disease and [we] can see a great untapped potential in MEG and want to explore this in collaboration with world leading clinical centers," said Laurent Leksell, president and chief executive officer. "We believe that this will need major efforts from multiple centers around the world and that MEG in the future will contribute in a significant way to further improvements to the diagnostic workup of patients prior to neurosurgical intervention."

Elekta said it would work with interested and qualified neurological, neurosurgical, neurophysiological and psychiatric clinics worldwide to set up Elekta Neuromag centers based on various research and collaborative agreements.

The company said it sees this opportunity as "a clinical research and market development investment that will be ongoing for a number of years. These investments support the development and growth of Elekta's clinical solutions, particularly in minimally invasive neurosurgery."

Elekta Neuromag is used to study the activity in the brain prior to surgical treatment of epilepsy in order to define the epileptogenic zone from which the seizure emanates. Furthermore, said the company, "it is a very accurate tool for non-invasive pre-surgical mapping of eloquent areas of the brain, prior to surgery." Elekta said it believes that MEG technology can be used in conjunction with its Leksell Gamma Knife for a totally non-invasive treatment of epilepsy. It said that clinical applications exist in other functional areas as well as in trauma treatment. There are 27 Elekta Neuromag whole-head systems installed worldwide, out of a total of 69 MEG whole-head systems.

Telemedicine link joins A&E, burn unit

Web-based telemedicine software provided by ComMedica (Woking, UK) will soon speed up treatment of patients with burns and cuts at St. Mary's NHS Trust (Paddington, UK). A new electronic image-sharing link will join St. Mary's Pediatric Accident & Emergency (A&E) department and the specialist Burns Unit at Chelsea & Westminster NHS Trust. ComMedica was formed in 1999 after more than a decade of research by scientists and clinicians at Imperial College (London), to provide a web-based medical imaging and information solution to clinicians, hospitals and healthcare professionals across the enterprise. The company has built on that core technology platform to provide delivery of images with integrated patient records direct to the point of patient care, around the clock, from any PC with a web browser.

ComMedica's software will be used for the instant referral of digital pictures of lacerations and burns, instead of the current practice of patients' injuries being described over the telephone to specialists at the Chelsea & Westminster Burns Unit. With more detail being provided on each case through access to the new digital information, more patients will be treated at St. Mary's under guidance from Chelsea & Westminster's burns specialists and plastic surgeons. The information available via telemedicine will help Chelsea & Westminster better determine which patients need to be transferred for specialist attention, reducing the number of patients they see for fuller diagnosis and treatment.

Ian Maconochie, pediatric A&E consultant at St. Mary's, said, "This system will allow a more informed dialogue in these situations. It's just like the old saying of 'a picture tells more than a thousand words.' Digital technology, and this web-based software, puts the real evidence in front of specialists' eyes sooner. The specialist can send back a detailed report to us in a shorter period of time, adding a new dimension to the patient care process."

Simon Myers, lead consultant in burns at Chelsea & Westminster Hospital, said the new equipment would mean that patients receive the most appropriate care quicker than ever before. "Because the digital images are of such high quality, we will be able to give a more detailed diagnosis of a patient's condition to our colleagues at St. Mary's than we could when relying on verbal descriptions. This advancement means that we can now offer more specific care suggestions to staff [there].

Dr. Volker Krause, senior house officer for pediatric A&E at St. Mary's, said the new system would initially be used to handle around 200 cases of lacerations or burns the facility receives each year. The web-based technology shows great potential for use elsewhere in the department, he said. "Two examples where this might happen are in dermatology, because we get a lot of skin rashes in A&E, and for referring ophthalmology injuries to the Western Eye Hospital within our NHS trust group."

ComMedica's technology was selected by St. Mary's NHS Trust following the installation by the company of an electronic image-sharing link between St. Mary's and the National Hospital for Neurology and Neurosurgery, which has allowed speedier diagnosis and treatment of critical head injuries since September 2002.

New alliance focuses on blood safety

Members of patient organizations from across Europe have founded the Pan European Blood Safety Alliance (PBSA; Paris). The alliance is aimed at raising awareness about the importance of blood safety in Europe and, the organization said, "to promote the rights of all patients to receive the safest blood transfusions and the safest blood products possible." Panos Englezos, chairman of the PBSA, said, "Maintaining the safety of the European blood supply is of paramount importance to every European citizen, and our alliance hopes to motivate patients to work with their governments and health professionals to achieve this goal."

The alliance will be an advocate for increased blood safety for those in Europe in need of regular transfusions or acute blood transfusions and blood products. "Safe blood transfusions are dependent on sufficient amounts of safe and ethical donations at any given time," the PBSA said in a statement. It added that "appropriate education of all persons involved in the process of blood donations is needed." The organization said the implementation of and access to "proactive blood safety technologies" for patients across Europe, adequate access to blood transfusion services that are free of charge to the patient and safe procedures at every step in the blood transfusion process "have to be ensured."

The founding members are from the European Hemophilia Consortium, Hemoglobinopathy Association of Counselors, European Cancer Patient Coalition, Thalassaemia International Federation, Foundation of the Promotion of Bone Marrow Transplantation Switzerland, European Organization for Rare Disorders, Hepatitis Aid Austria, International Myeloma Foundation (UK) and Sickle Cell Society UK.

Focusing on health services for disabled

A program focused on improvements for the disabled in healthcare and social care settings has been unveiled in the United Kingdom. Health Secretary John Reid and Bert Massie, chairman of the Disability Rights Commission, last month unveiled a joint Framework for Partnership Action on Disability. They said the partnership framework will help the National Health Service (NHS) comply with the Disability Discrimination Act. The act, which was passed in 1995, requires that service providers not discriminate or provide a poorer quality of service to disabled people because of their disability.

Reid said, "By working closely with the Disability Rights Commission we will be better able to deliver on our joint aim to improve the experiences of all disabled people, both service users and employees, in the health and social care system." Massie added: "One-third of all people using NHS services are disabled, [so] ensuring that they are able to use health services in the same way as everyone else is vitally important." He said the framework that has been developed with the Department of Health "provides clear steps for front-line NHS staff to take to meet their obligations under the DDA and with it deliver high-quality healthcare to all who need [it]."

Among the actions called for under the framework are the design and delivery of a disability equality training strategy for the NHS work force; guidance and support for primary care trusts on improving services for disabled people; and publication of a new leaflet outlining practical measures NHS staff in acute trusts, ambulance trusts and mental health trusts can take to improve hospital services as experienced by the disabled.

First HIFU installation in UK

EDAP TMS (Vaulx-en-Velin, France), a developer of minimally invasive devices for the treatment of urological diseases, said last month that its High Intensity Focused Ultrasound (HIFU) technology for the treatment of localized prostate cancer continues to expand in Europe with the placement of the first Ablatherm system in the United Kingdom. The company said the British market is the third-largest market in Europe, with more than 20,000 new cases of prostate cancer diagnosed annually. It said that market represents "significant potential for HIFU with Ablatherm" and will eventually bring this new therapeutic option to British patients suffering from localized prostate cancer.

The first Ablatherm device in the UK was installed recently at Stepping Hill Hospital (Stockport, England) and has to date successfully treated 10 patients. Dr. Stephen Brown, head of the urology department at the hospital, said, "We are very encouraged by the patients' response so far. The treatment is well tolerated, with minimal side-effects." He added, "The potential for HIFU in the UK is enormous. If the rapidly accumulating data confirms the long-term efficacy of the treatment, many patients will be keen to embrace this minimally invasive treatment option."

White Rose Environmental acquired

Stericycle (Lake Forest, Illinois), a U.S. provider of medical waste management and compliance services for the healthcare community, completed its acquisition of White Rose Environmental (Leeds, UK), a provider of medical waste management services in the UK, for about $52.3 million in cash and $11.5 million in notes. White Rose Environmental provides medical waste management services to customers in England and Wales. In the last fiscal year, it had revenues of approximately $49 million. Andy Hinton, chairman of the board of White Rose, said, "We are pleased to have Stericycle, a well-recognized leader in our industry, as the new owner for our employees, customers and suppliers."

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