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Sky Medical manufactures the geko™ device, powered by OnPulse™ neuromuscular electrostimulation technology, clinically proven to increase blood circulation for lower limb DVT prevention, the reduction of swelling and the promotion of wounds healing. Bernard Ross, CEO, Sky Medical said: “We are honoured to be shortlisted in the award category ‘Partnership with the NHS’. We are currently collaborating with NHS clinical leads to evaluate the geko™ device in 26 clinical pathways, within 15 UK hospitals. The evaluations are generating clinical trials, case studies and procedure protocols which transfer across our global distribution network generating export sales”. Partnerships of note, include James Cook University Hospital, Mr. Paul Baker, Orthopaedic Consultant, he said: “We saw the potential for the geko™ device to significantly improve current care pathways for our surgically treated ankle fractures. The feasibility evaluation we have done in partnership with Sky Medical Technology suggests the device can be used safely and effectively in this patient population and could help to streamline care”. Mr. Sameh Dimitri, Vascular Consultant and clinical lead for VTE prevention, comments: “Where wounds have been resistant to traditional treatment modalities, intervention with the geko ™device, as an adjunct therapy, has helped to heal wounds, reduce swelling and pain and has been met with excellent compliance”. “The DVT and PE (pulmonary embolism) risk for patients with an acute ischemic stroke resembles that of patients undergoing major surgical procedures”, explains Bernard. “The results of a clinical audit, currently underway, is proving geko™ is well tolerated in stroke patients where the use of other forms of mechanical prophylaxis are impractical or contraindicated. Without the geko™ device these patients would receive no DVT prophylaxis”. The size of a wrist-watch and worn at the knee, the geko™ device is a battery powered, disposable, neuromuscular electrostimulation device designed to increase blood flow in the veins of the leg to reduce the risk of DVT (as approved by NICE) and to prevent the build-up of pre and post-surgical swelling. The geko™ device, through gentle electrical impulses, stimulates the common peroneal nerve activating the calf and foot muscle pumps, increasing venous, arterial and microcirculatory blood flow. The increase in blood flow is similar to that achieved by walking, up to 60%, without a patient having to move. A 2016 study by Professor Andrew Nicolaides and Dr Maura Griffin has measured the effect of the geko™ device on blood flow in the deep veins of the calf. The study has shown significant volume and velocity increases within the gastrocnemius, peroneal and posterior tibial veins - the first time that a mechanical device has reported enhancement to blood flow in the deep veins, and the result of the unique dorsiflexion achieved by the geko™ device. Sky Medical Technology is a UK based medical devices company that has developed a ground-breaking neuromuscular electrostimulation platform, OnPulse™. The company develops a range of products tailored to different medical applications, selling both direct, through partnerships or distributors in each clinical area. Clinical areas of interest include DVT prevention, reduction of swelling, wound healing, elite-sport recovery, and continence. The goal in each clinical area is to improve clinical outcomes and patient care whilst saving health system resources. The geko™ device has secured National Institute of Clinical Excellence (NICE) guidance recommending its use to the NHS for DVT prevention. http://www.gekodevices.com The awards are taking place on 1st March 2017 at Emirates Lancashire Cricket Ground, the afternoon event will recognise the Healthcare excellence across the North West with six awards being celebrated. For further information please visit: http://www.medilinkuk.com/about-us/medilink-uk-awards


Under Mainframe Solutions Transformation Programme, NextGate EMPI replaces legacy system to modernize management of Electronic Health Record EDINBURGH, SCOTLAND and PASADENA, CA--(Marketwired - February 16, 2017) - NextGate, a global leader in healthcare identity management, has secured a multi-year contract with NHS National Services Scotland to replace the existing Community Health Index (CHI) with a modern enterprise master patient index (EMPI) solution that will issue and maintain the unique patient identifiers used by health systems to identify a patient and corresponding electronic health records. By deploying a system that supports multiple legacy identifiers, the aim is to provide the 'single source of truth' for demographics across the service, and for partner agencies. Under the agreement and as part of the Mainframe Solutions Transformation Programme (MSTP), NextGate will deliver its #1 ranked MatchMetrix© EMPI software and services to become the issuing authority for the CHI Number, a number critical to the creation and maintenance of the electronic patient record across NHS Scotland. The deal signals further international expansion by NextGate and acceptance of its identity matching technology as an integral element in accurate patient identification and a cornerstone for the reliable electronic storage and administration of patient data. The new CHI solution will, among other benefits: By providing a modern, well supported solution, Health Boards will be able to generate and reference the most up to date demographics for patients, improve positive patient identification, and, with the increased use of the patient's electronic health record, facilitate patient centred health care delivery. The CHI solution provided by NextGate is built on open standards allowing for integration with the Scottish Child Public Health and Wellbeing System, with other existing legacy systems, and enable co-ordination and co-operation with providers of other services and systems to NHS Scotland. "We are pleased to be working with NextGate, the leader in identity management, to move our MSTP initiative forward," said Andy Robertson, Director of IT at NHS NSS. "The modernization of our CHI system with their technology will help us deliver the highest standards of healthcare to the people of Scotland in a cost effective and efficient manner." "We look forward to helping NHS Scotland transform their use of electronic patient records and enhance the patient experience," said Andy Aroditis, NextGate CEO. "In today's data rich environment, connecting patients to all of their records is a broad and important task that leads directly to more comprehensive quality care." NHS Scotland is the collective name for the 22 Health Boards across Scotland. NextGate helps connect the healthcare ecosystem by accurately identifying and linking patient and provider data from different applications. NextGate's iDAS (Intelligent Data Aggregation Server) solution framework leverages the company's industry-leading identity management technology to organize and relate data from enterprise systems to provide a more complete and accurate view of the total healthcare experience. NextGate's KLAS Category Leader EMPI technology currently manages more than 200 million lives and is deployed by the nation's most successful healthcare systems and health information exchanges. For more information, visit NextGate.com.


News Article | February 17, 2017
Site: www.theguardian.com

Nearly three-quarters of small companies in London say business rates are the most important issue they face, piling further pressure on the government over the controversial tax. The Federation of Small Businesses (FSB) warned that London was in “serious danger of losing its vital support system of micro and small businesses”. The average micro business, which employs fewer than 10 people, will have to pay £17,000 to cover business rates from April, it added. The trade body’s warning comes a day after the government accused critics of “scaremongering”, saying that three-quarters of firms would see either no change in their business rates or would see them reduced. Other influential trade bodies, including the Institute of Directors and the British Chambers of Commerce, have already called on the government to overhaul the tax. The change in business rates payments from April is down to the revaluation of property in Britain. This is supposed to take place every five years but the previous revaluation was controversially delayed by the government in 2015 for two years, making the revised bills more pronounced. The revaluation is likely to benefit struggling high streets in northern England. London, however, will record an increase of around £9bn over the next five years. A survey by the FSB and trade body Camden Town Unlimited, found that rates were the biggest issue for 74% of small businesses in London, ahead of economic uncertainty and problems in recruiting staff. Four in 10 businesses that are paying rates said they expected a rise of more than 20%, while three in 10 said they were unsure what the changes from April would mean. The FSB and Camden Town Unlimited called for the rates threshold in London to be increased, allowing more small firms to avoid the tax. Sue Terpilowski, the FSB London chair, said: “London is in serious danger of losing its vital support system of micro and small businesses. “The business attraction of London is that it has a strong ecosystem of support services from the micro and small business community. Some of these businesses are the ones that become high-growth companies from a standing start, often in the hi-tech sectors. “We must ensure that this support system remains in place to keep the UK economy and the London economy thriving. We need to realise that the hard costs of operating a business in the capital are starting to outweigh the benefits, which simply does not make economic sense – and so tackling these burdens at the spring budget is critical.” The government defended business rates on Thursday. David Gauke, chief secretary to the Treasury, said: “Far from the picture painted by scaremongering ratings agents, nearly three-quarters of businesses will see no change, or even a fall, in their business rates bills. “The fact is that the generous reliefs we are introducing mean that 600,000 small businesses are paying no business rates at all – something we’re making permanent so they never pay these bills again. “Whether on a town’s high street or in a rural community, we’ve also introduced £3.6bn in support for companies affected by the business rates revaluation – a process that is making the system accurate and fair for everyone.” However, accountants urged the government to reconsider the rates system because of the uncertainty caused. Chas Roy-Chowdhury, head of tax at the Association of Chartered Certified Accountants (ACCA), said: “The government should ensure that this is not introduced at the expense of the competitiveness of UK plc as a place to work and to locate a business. “The system also needs to take account of fairness when some high-street shops will be hit by hikes of over 400% on current rates, while online retailers will see rates cut in many instances. “For many of the productivity-boosting[small to medium enterprises] up and down the country, increases will eat into disposable income which could better be spent on investment, recruitment or research and development. “This is particularly important given the low levels of confidence following the result of the referendum on the UK’s membership of the European Union and looking ahead to the longer-term effect of the devaluation of sterling in increasing supplier costs. “The government should revisit these proposals and carefully consider if the revaluation is the best way to raise revenue from the UK’s thriving small and medium-sized businesses in an era of high uncertainty.” Queen Elizabeth hospital in Birmingham Hospitals face a £322m or 21% increase in their business rates bill over the next five years. The worst affected is the Queen Elizabeth in Birmingham, where the rates bill will more than double to £6.9m a year. Bank of England A £1.4bn, or 33%, rise in business rates for offices in the City of London is threatening to undermine the Square Mile’s drive to remain a key financial centre in Europe after Brexit. For example, the Bank of England faces an increase of more than £1.5m a year on its Threadneedle Street headquarters. Sport Direct warehouse Mike Ashley’s Sports Direct will save almost £900,000 in business rates over the next five years on its warehouse in Shirebrook, Derbyshire, which has been compared to a Victorian workhouse. This saving will almost cover the £1m the company owes in back pay to thousands of workers after admitting it had paid them less than the minimum wage. Nuffield Health hospitals Private hospitals have fared better than NHS hospitals in the government’s revaluation. Their rateable value has increased by 9.6% compared with an extra 19.8% for NHS hospitals. In addition, some private healthcare providers, such as Nuffield Health, also enjoy an 80% discount because they are registered charities. Blackpool high street Struggling town centres with a high proportion of empty shops will benefit. Rates bills for shops on Blackpool high street will fall by around half. The O2 London will suffer an increase in its business rates of more than £9bn over the next five years. The capital’s landmarks are among the buildings most affected, with the O2 set for a 142% rise. Business rates are a tax on non-domestic or commercial properties in Britain. The principles behind the levy originated in the 1601 Poor Relief Act, which charged property owners a tax to help support the poor. It has become one of the Treasury’s biggest sources of income, bringing in nearly £29bn last year. The tax is calculated via the rental value of commercial property and the annual rate of inflation. The overall tax take for the Treasury is supposed to remain flat in real terms, but a revaluation of property every five years is designed to ensure the tax burden moves in line with the economy.


VANCOUVER, BC / ACCESSWIRE / March 2, 2017 / New Age Farm Inc. (CSE: NF) (OTC PINK: NWGFF) (FSE: 0NF) (www.newagefarminc.com) ("New Age Farm" or the "Company"), is pleased to announce it has entered into a letter of agreement (the "LOA") with a local contractor (the "Contractor") to begin site preparation work on its Langley facility for the future build out of the planned processing, cold storage, and dry storage warehouse (the "Warehouse"). Under the terms of the LOA, the Contractor will bulk excavate up to 65,000 cubic yards of peat from designated areas, screen it on site and backfill all excavated peat areas with structural fill to support the foot print of the Warehouse. The Contractor estimates approximately 7,900 truckloads of material will be handled at an average cost of $250 per truckload. The Company and the Contractor have further agreed to exchange the equivalent of $2 million of peat value and additional dumpage fees to offset the cost of the excavation, trucking and labour costs. This work is the first step in readying the site for the construction of a 50,000 square foot Tilt-up concrete warehouse structure. Tilt-up concrete construction has been chosen for the Warehouse because of the method's proven advantages that include speed, safety and construction cost benefits. The Warehouse will serve the Langley facilities on site tenant-growers and grower/processors from the surrounding community. Carman Parente, President and CEO of New Age Farm said, "We are pleased to be getting underway with this project which will build value into the Langley facility that will benefit our shareholders now and in the future as construction completes and the planned spin out is finalized later this spring." Through its wholly-owned subsidiary, NHS Industries Ltd. ("NHS"), New Age Farm owns a five and a half acre facility in the lower mainland of BC that includes a 48,000 square foot greenhouse. NHS is in the process of formulating innovative proposals for small scale agricultural facilities for exploring multiple avenues for cash flow processes. Anticipating Canadian federal government regulations regarding the legalization of cannabis for recreational purposes is one avenue that NHS will be exploring. NHS also intends to look at other high value crop possibilities such as hemp and its potential revenue generation. Management's intent is for NHS to achieve positive cash flow as expediently as possible, all the while developing and maintaining multiple product income streams that will foster profitability, rather than relying on a single market sector. Through its Washington State subsidiary, New Age Farm owns two properties, one located in Sumas, WA, and the other in Oroville, WA, where it offers fully built out turnkey service operations to licensed I-502 tenant-growers who will lease the facilities for production and / or processing. With three leases already in place, operations in Washington State have begun and will expand further as the Company completes its build outs. In compliance with state regulatory requirements, New Age Farm's facilities feature 24 hour security that enhances the safety and security of the community, our tenant-growers and their operations. All New Age Farm's tenant-growers hold either Tier 2 or Tier 3 licenses allowing them to produce and / or process marijuana for sale at wholesale to marijuana processor licensees and to other marijuana producer licensees. A Tier 3 license allows for between ten thousand square feet and thirty thousand square feet of dedicated plant canopy while Tier 2 licensees can have up to ten thousand square feet of dedicated plant canopy. Revenue is generated on a base lease rate and the level of service that the tenant-grower requires for its production and / or its processing needs. Sales of marijuana products in Washington State have for the first time surpassed $200 million in a quarter. The News Tribune reports residents and visitors bought more marijuana than ever before in the second quarter of 2016, based on an analysis of purchase and tax records from two state agencies. In the first quarter of 2016 January, February and March people spent $54.8 million mor4e on spirits than marijuana, which includes the cost of the products and its associated taxes. By the second quarter April, May and June that gap closed to nearly $37 million. Those amounts include taxes levied by the state on those products. Spirits sales do not include wine and beer. Marijuana sales include all cannabis products, but not paraphernalia. Marijuana sales in the second quarter of 2016 amounted to nearly $212 million. Spirits sales in the same period amounted to almost $249 million. In July, the state closed medical marijuana shops, making all sales go through licensed recreational marijuana storefronts. Sales at retail pot shops shot up by $66.6 million in the third quarter of the year, to $278.6 million. Washington voters legalized recreational marijuana in 2012. Earlier this month voters in California, Massachusetts and Nevada approved recreational pot. Colorado, Oregon and Alaska have also legalized recreational marijuana. For further information about New Age Farm, please consult the Company's profile on SEDAR at www.sedar.com. Visit the Company's website at www.newagefarminc.com for more information and to view a video of the Oroville facility: http://newagefarminc.com/ On Behalf of the Board Of Directors The Canadian Securities Exchange has neither approved nor disapproved the contents of this news release and accepts no responsibility for the adequacy or accuracy hereof. This news release contains forward-looking statements, which relate to future events or future performance and reflect management's current expectations and assumptions. Such forward-looking statements reflect management's current beliefs and are based on assumptions made by and information currently available to the Company. Readers are cautioned that these forward looking statements are neither promises nor guarantees, and are subject to risks and uncertainties that may cause future results to differ materially from those expected including, but not limited to completion of planned improvements at both the Canadian and US sites on schedule and on budget, the availability of financing needed to complete the Company's planned improvements on commercially reasonable terms, planned occupancy by the tenant-growers, commencement of operations, the ability to mitigate the risk of loss through appropriate insurance policies, and the risks presented by federal statutes that may contradict local and state legislation respecting legalized marijuana. These forward-looking statements are made as of the date hereof and the Company does not assume any obligation to update or revise them to reflect new events or circumstances save as required under applicable securities legislation. This news release does not constitute an offer to sell securities and the Company is not soliciting an offer to buy securities in any jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of such jurisdiction. This news release does not constitute an offer of securities for sale in the United States. These securities have not and will not be registered under United States Securities Act of 1933, as amended, or any state securities laws and may not be offered or sold in the United States or to a U.S. Person unless so registered, or an exemption from registration is relied upon. VANCOUVER, BC / ACCESSWIRE / March 2, 2017 / New Age Farm Inc. (CSE: NF) (OTC PINK: NWGFF) (FSE: 0NF) (www.newagefarminc.com) ("New Age Farm" or the "Company"), is pleased to announce it has entered into a letter of agreement (the "LOA") with a local contractor (the "Contractor") to begin site preparation work on its Langley facility for the future build out of the planned processing, cold storage, and dry storage warehouse (the "Warehouse"). Under the terms of the LOA, the Contractor will bulk excavate up to 65,000 cubic yards of peat from designated areas, screen it on site and backfill all excavated peat areas with structural fill to support the foot print of the Warehouse. The Contractor estimates approximately 7,900 truckloads of material will be handled at an average cost of $250 per truckload. The Company and the Contractor have further agreed to exchange the equivalent of $2 million of peat value and additional dumpage fees to offset the cost of the excavation, trucking and labour costs. This work is the first step in readying the site for the construction of a 50,000 square foot Tilt-up concrete warehouse structure. Tilt-up concrete construction has been chosen for the Warehouse because of the method's proven advantages that include speed, safety and construction cost benefits. The Warehouse will serve the Langley facilities on site tenant-growers and grower/processors from the surrounding community. Carman Parente, President and CEO of New Age Farm said, "We are pleased to be getting underway with this project which will build value into the Langley facility that will benefit our shareholders now and in the future as construction completes and the planned spin out is finalized later this spring." Through its wholly-owned subsidiary, NHS Industries Ltd. ("NHS"), New Age Farm owns a five and a half acre facility in the lower mainland of BC that includes a 48,000 square foot greenhouse. NHS is in the process of formulating innovative proposals for small scale agricultural facilities for exploring multiple avenues for cash flow processes. Anticipating Canadian federal government regulations regarding the legalization of cannabis for recreational purposes is one avenue that NHS will be exploring. NHS also intends to look at other high value crop possibilities such as hemp and its potential revenue generation. Management's intent is for NHS to achieve positive cash flow as expediently as possible, all the while developing and maintaining multiple product income streams that will foster profitability, rather than relying on a single market sector. Through its Washington State subsidiary, New Age Farm owns two properties, one located in Sumas, WA, and the other in Oroville, WA, where it offers fully built out turnkey service operations to licensed I-502 tenant-growers who will lease the facilities for production and / or processing. With three leases already in place, operations in Washington State have begun and will expand further as the Company completes its build outs. In compliance with state regulatory requirements, New Age Farm's facilities feature 24 hour security that enhances the safety and security of the community, our tenant-growers and their operations. All New Age Farm's tenant-growers hold either Tier 2 or Tier 3 licenses allowing them to produce and / or process marijuana for sale at wholesale to marijuana processor licensees and to other marijuana producer licensees. A Tier 3 license allows for between ten thousand square feet and thirty thousand square feet of dedicated plant canopy while Tier 2 licensees can have up to ten thousand square feet of dedicated plant canopy. Revenue is generated on a base lease rate and the level of service that the tenant-grower requires for its production and / or its processing needs. Sales of marijuana products in Washington State have for the first time surpassed $200 million in a quarter. The News Tribune reports residents and visitors bought more marijuana than ever before in the second quarter of 2016, based on an analysis of purchase and tax records from two state agencies. In the first quarter of 2016 January, February and March people spent $54.8 million mor4e on spirits than marijuana, which includes the cost of the products and its associated taxes. By the second quarter April, May and June that gap closed to nearly $37 million. Those amounts include taxes levied by the state on those products. Spirits sales do not include wine and beer. Marijuana sales include all cannabis products, but not paraphernalia. Marijuana sales in the second quarter of 2016 amounted to nearly $212 million. Spirits sales in the same period amounted to almost $249 million. In July, the state closed medical marijuana shops, making all sales go through licensed recreational marijuana storefronts. Sales at retail pot shops shot up by $66.6 million in the third quarter of the year, to $278.6 million. Washington voters legalized recreational marijuana in 2012. Earlier this month voters in California, Massachusetts and Nevada approved recreational pot. Colorado, Oregon and Alaska have also legalized recreational marijuana. For further information about New Age Farm, please consult the Company's profile on SEDAR at www.sedar.com. Visit the Company's website at www.newagefarminc.com for more information and to view a video of the Oroville facility: http://newagefarminc.com/ On Behalf of the Board Of Directors The Canadian Securities Exchange has neither approved nor disapproved the contents of this news release and accepts no responsibility for the adequacy or accuracy hereof. This news release contains forward-looking statements, which relate to future events or future performance and reflect management's current expectations and assumptions. Such forward-looking statements reflect management's current beliefs and are based on assumptions made by and information currently available to the Company. Readers are cautioned that these forward looking statements are neither promises nor guarantees, and are subject to risks and uncertainties that may cause future results to differ materially from those expected including, but not limited to completion of planned improvements at both the Canadian and US sites on schedule and on budget, the availability of financing needed to complete the Company's planned improvements on commercially reasonable terms, planned occupancy by the tenant-growers, commencement of operations, the ability to mitigate the risk of loss through appropriate insurance policies, and the risks presented by federal statutes that may contradict local and state legislation respecting legalized marijuana. These forward-looking statements are made as of the date hereof and the Company does not assume any obligation to update or revise them to reflect new events or circumstances save as required under applicable securities legislation. This news release does not constitute an offer to sell securities and the Company is not soliciting an offer to buy securities in any jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of such jurisdiction. This news release does not constitute an offer of securities for sale in the United States. These securities have not and will not be registered under United States Securities Act of 1933, as amended, or any state securities laws and may not be offered or sold in the United States or to a U.S. Person unless so registered, or an exemption from registration is relied upon.


News Article | February 15, 2017
Site: www.theguardian.com

The government is under growing pressure to stop a sharp increase in business rates for hospitals that threatens to increase the strain on the NHS. Changes to the business rates system mean that the 1,249 NHS hospitals liable for the property tax will see their bills increasing by £322m, or 21%, over the next five years from April. However, a growing number of politicians are calling for the government to reconsider the tax hike for hospitals, including making them eligible for the same 80% discount that charities enjoy. Some private healthcare providers, such as Nuffield Health, already enjoy an 80% discount because they are registered as charities. Furthermore, the business rates that the 581 private hospitals do pay will not increase as much as it will for hospitals. The rateable value of private hospitals has increased by 9.6% in the last revaluation while NHS hospitals have seen a 19.8% rise, according to research by the property consultant CVS. The cross-party group of politicians who have already expressed concern about the tax rise for hospitals include Steve McCabe, Labour MP for Birmingham Selly Oak, Royston Smith, Conservative MP for Southampton Itchen, and Annie Wells, Conservative and Unionist MSP for Glasgow. The hospitals facing the most severe increases include the Queen Elizabeth hospital in Birmingham, which will see its business rates bill more than double, from £2.8m a year to £6.9m. McCabe has posted a series of written questions to Jeremy Hunt, the health secretary, asking whether the NHS would be provided with extra funding to cover the additional costs and whether he had done an assessment of the potential impact of the tax hike on the services offered by hospitals and GPs. In response, Philip Dunne, the health minister, admitted the Department of Health had not done an assessment and would not provide extra funding He said: “Each NHS organisation is responsible for ensuring their current rating assessments and any recent changes thereto are correct and for challenging them if necessary. As with other ratepayers, NHS bodies may be able to seek transitional relief. “The department has not made a national assessment of the overall impact, and no specific additional funding is being provided beyond the £10bn of real terms growth by 2020/21. “The ministerial team has not met with counterparts at the Department for Communities and Local Government to discuss revaluation.” Smith, the Southampton MP, has written to the Chancellor, Philip Hammond, about the tax rise, warning of the “significant financial challenges” facing the NHS. More than 100 NHS trusts, roughly half of the acute trusts in the country, wrote to local authorities last year claiming they should be eligible for the 80% discount and a £1.5bn rebate. The trusts are being represented by Bilfinger GVA, a property consultancy. Although their request was rejected, they are now understood to be considering legal action in what could become a major test case. The increase in business rates is a result of a revaluation of property in Britain. This is supposed to take place every five years but the previous revaluation was controversially delayed by the government for two years, making the change in bills from April more pronounced.


News Article | February 24, 2017
Site: www.theguardian.com

The relentless growth of urban populations is driving city and national governments to increase access to healthcare while tackling the root causes of poor health. According to Oxford Economics [pdf], the world’s largest 750 cities will be home to 2.8 billion people by 2030 – more than a third of the global population. They will account for almost a third of the world’s jobs and more than half its consumer spending. More than a dozen cities will have populations greater than 20 million. Rapid, uncontrolled urbanisation strains many aspects of city life that determine health. Traffic, factories, generators and construction poison the air, meanwhile water supplies can become contaminated, poor housing harms the health of children, and food supply and quality can be compromised. Unplanned urban growth drives poverty. About 900 million people worldwide live in urban slums, where overcrowding encourages the spread of infectious diseases such as tuberculosis, dengue fever and cholera. The United Nations estimates that by 2030, roughly 60% of city inhabitants will be under the age of 18, which puts huge numbers of children at risk from illnesses such as diarrhoea and pneumonia, the leading causes of global childhood death. Health services, particularly in developing countries, are concentrated in cities. As Mark Britnell notes in his study of global healthcare, many developing countries such as China, Indonesia and India suffer from a chronic shortage of health workers. This creates big disparities in care between cities and the countryside; doctors are reluctant to work in rural areas because pay is poor, career choices are limited, hospital facilities are often inadequate and primary care tends to be underdeveloped. Meanwhile, in the cities, hospitals become overcrowded because patients know that is where the best doctors, research and technology are found. The dominance of hospital care in cities often means primary care is neglected, which according to the World Health Organisation (WHO) [pdf] can lead to unregulated, unsafe and ineffective private services. In some African cities, public primary healthcare has almost disappeared. Britnell highlights some of the efforts being made to bridge the shortfalls. Brazil has announced new medical schools to train thousands of additional doctors, and training is being extended to include two years working in public service posts. This could add up to 36,000 working students to the system by 2021. Compulsory training in public hospitals was inspired by the NHS. In addition, Brazil has recruited at least 10,000 doctors from Cuba to work in the poverty-plagued favelas on the peripheries of cities, as well as in remote areas. The chronic shortage of clinicians is encouraging countries to make better use of volunteers and community workers. India is trying to boost its services in slums through the National Urban Health Mission, which emphasises reproductive health and works with women’s health committees. Toronto [pdf] has been trying to bring together its primary and hospital services to provide joined-up care for patients with several health conditions. This includes individual care plans, one point of contact, and multidisciplinary teams supporting high-risk patients after they have been discharged from hospital. The city’s Ageing at Home programme aims to make it easier for older people to continue to live at home after illness. Toronto also provides impressive support for people living on the streets with mental illness. Its Streets to Homes programme includes incentives for private landlords to offer accommodation. Several thousand people have moved into their own home since 2005, and about 80% of them remain there for at least a year. Yet for many people, access to healthcare depends on the ability to pay, which excludes swathes of the population. Increasingly, countries such as China, Thailand and Indonesia are addressing this problem by pursuing universal healthcare. At present around two in five countries have some form of universal healthcare. Britnell argues that its expansion is being driven by two opposing forces: capitalism and globalisation have grown a middle-class demanding more from governments, while about 1 billion people lack access to basic healthcare and 100 million are impoverished every year through catastrophic healthcare costs. Providing more equal access to health services strengthens social cohesion and promotes economic growth. But while developing countries are increasing the proportion of their wealth spent on healthcare, urban populations are expanding so quickly that it is all but impossible to provide the health infrastructure and staff to keep pace. Faster progress can be made, however, in improving the environment, such as providing cleaner air and water. For this reason, the WHO believes local government – and particularly executive mayors – are central to improving city health. Beijing and Shanghai, for example, have introduced tough anti-smoking laws. In 2013 Mexico City became the first in the world to levy a tax on sugary drinks, which had been a factor in Mexico having among the world’s highest obesity and diabetes rates. Kuwait City has reduced salt content in bread to tackle high blood pressure. London and Paris were among the first cities to attempt to cut traffic pollution and increase exercise by offering free bicycle use. Poor road safety takes many urban lives. Fatal traffic accidents [pdf] cost about 21 lives per 100,000 population annually in Brasilia and 18 in Nairobi, compared with 1.3 in Tokyo. Cutting road deaths depends on many factors – higher population density actually reduces deaths compared with sprawling areas. São Paulo (Brazil), Bogotá (Colombia) and Accra (Ghana) are among cities pursuing safer road design. The health of city populations is becoming a central concern of local and national governments and international institutions. Affordable access to health services is just part of the story. Local government in particular recognises that improving the health of city populations depends on everything from ensuring water quality to designing safe roads and controlling air pollution. But there is a chasm between cities where growth is controlled and those where the relentless quest to find work is creating polluted, overcrowded slums. Join the Healthcare Professionals Network to read more pieces on issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.


News Article | February 21, 2017
Site: www.theguardian.com

In the 1990s, it was cool to have a pager. When the beep sounded in your bag or on your belt, it delivered one message to you and another to those nearby: that you were so rich or important that people needed to contact you all the time. Now we’re all rich and important, thanks to mobile phones, but a few of us still use pagers. On Tuesday, it was announced that Vodafone, one of the last two paging providers, had agreed to sell its business to Capita, the other one. Subject to the regulators’ approval, this means about 1,000 customers will be switching over, after which there will be one provider left to rule all of Britain’s pager users. But who are these people exactly? Put simply, they are anyone who needs the one remaining technical advantage that pagers have: slightly more reliability. Where mobile phone networks can be patchy, or slow, or overloaded, the separate paging network offers a modest improvement in reception and reach, especially in rural areas. Compared with modern smartphones, pager batteries also last much longer. Thus some infrastructure companies, such as EDF Energy, use pagers to alert their staff when there is problem nearby. Some new pagers also contain GPS trackers, and allow users to reply, which is invaluable for lifeboat crews. Paging services, such as Rare Bird Alert or Bird Information, have also been popular with birdwatchers for many years, delivering information about new sightings as soon as they’re recorded, even to birders in the field. Most pager users, however, are medics or emergency responders like Liam Lehane, who is assistant director of operations in resilience for the London Ambulance Service. “They’re really good for pushing messages out,” he says. “It’s a system that the NHS uses quite widely.” In fact, the LAS deploys a belt-and-braces-and-another-belt approach by sending texts and emails along with its pager messages. Staff can then reply with their phones or their radio if necessary. Ambulance pagers also deliver messages in three levels, summarised by Lehane as green (“for information”), amber (“I might need to do something”) and red (“I need to deal with it”). “I’m on call currently,” he says, “and it’s gone off about half a dozen times this morning already, with various things that are going on around London.” Perhaps the main advantage of pagers is not technical at all, but about how they influence behaviour. “When people get a pager message, because it’s not a normal phone call or SMS message, they tend to take notice of it,” Lehane says. This does not merely grab people’s attention, it also saves them embarrassment. While someone might assume you were being rude if you started reading your phone, Lehane explains, they are much more understanding if they see you check your pager. “It just changes people’s attitude and perception,” he says. Though they might think you’re an obsessive birdwatcher, of course.


News Article | February 23, 2017
Site: www.prfire.com

With the advent of the EU Data Protection regulation in May 2018, it’s time to ensure your business meets all the necessary requirements. The information security management company KMD Neupart UK have launched Secure GDPR, a software solution for companies to keep an overview and control of their data protection procedures. . For many, the task of keeping the sensitive information they handle safe, is nothing new. What is new is that the EU GDPR sets a requirement that you must be able to describe how keeping data safe is intended before you go about doing it. Then, it must be possible to show on-going compliance with your own policies, procedures and guidelines. Certain private companies and most public agencies will also require a Data Protection Officer. KMD Neupart’s Secure GDPR ensures an organisation meets all requirements for compliance whilst ensuring employees are not placed under an enormous administrative burden. Editors Notes: KMD Neupart UK was established during 2016 following rapid growth in Denmark and Scandinavia. KMD Neupart UK works with clients such as NHS Christie Trust, FDM Group, The Royal Blind School and Phoenix. The UK office is headed by Harshini Carey. http://www.neupart.com/


News Article | February 22, 2017
Site: www.theguardian.com

The findings of a new NCT report, which revealed that tens of thousands of women were having to seek help at accident and emergency (A&E) departments or with their GP because they cannot reach a midwife, do not come as a surprise to Hannah Harvey. Harvey has been a midwife for five years. She says that while she and her colleagues care deeply about the women they look after, a nationwide shortage of midwives and government cutbacks to training bursaries mean they often struggle to provide the necessary support to new mums. According to the report by the NCT (pdf) and National Federation of Women’s Institutes, 36% of women who were not able to see a midwife as often as they required postnatally said that it caused them a great deal of concern while almost a third (31%) said that it resulted in a delay of a health problem (for them or their baby) being diagnosed and treated. The Royal College of Midwives (RCM) estimates England has a shortfall of 3,500 midwives. “It’s really difficult,” says Harvey, who works in West Sussex. “Of course [as midwives] we want to provide round-the-clock care, to spend two or three hours with a new mum teaching her how to breastfeed, and offering the other support she needs, but there’s just not the capacity to do it. We’ve got to look at other ways of helping people.” It was this challenge, alongside spotting a review that found high numbers of pregnant women use the internet to search for advice, that prompted Harvey to take matters into her own hands. In July 2016, she launched Ask the Midwife, an app that enables mums-to-be to contact midwives for advice. “I [wanted to] create something where users could ask questions and get a fast response from a midwife, instead of using Google or parenting forums, where you’re not getting professional advice,” says Harvey. “I saw it as a way of helping the women, [somewhere] they could go and access advice and the extra care they needed and they wanted. It’s also a platform to alleviate the pressure on the NHS and the midwives working in the community and the hospitals, who don’t have the time to spend with people who might want a bit more help with their newborn baby.” Harvey initially used £10,000 of her own savings and raised £50,000 from friends and family to help develop and launch Ask the Midwife on iOS last year. Eight months after starting the business, the app has 4,000 users across the UK, and a network of 45 registered midwives. Harvey initially found the midwives by advertising for consultant positions, even receiving 500 applications in three days. Each midwife gets paid 25% commission per question or chat they answer. Many of the midwives still work for the NHS but use Ask the Midwife to earn extra money. Harvey estimates that 15-20% of conversations need to be escalated to an in-person consultation. For the expectant mothers, there’s a small charge (from 99p) to ask a question, increasing to £19.99 a month for support during the nine months of pregnancy and up to 12 weeks postnatally. This includes unlimited use of the “ask” and live chat services, with responses from a registered midwife promised within an hour. Midwives are available seven days a week, 14 hours a day, with plans to make it a 24-hour service in the near future. “We get a lot of early pregnancy questions, after someone goes to their GP but before they have their first midwife appointment at eight to 10 weeks. And then, postnatally, we get a lot of breastfeeding and feeding questions. If you’ve never had a newborn baby before, you don’t know what is normal.” Digital technology is rising in popularity among expectant mothers. According to the NCT’s study, 34% of women are choosing to use an app to support their pregnancy – two thirds (65%) used apps to track milestones, such as when the baby kicked or to track contractions, and a third (32%) used digital technology to access information about diet, lifestyle or health issues. Popular apps include BabyBump, What to Expect (from the authors of What to Expect when you’re Expecting), and My Pregnancy Today, although the majority available have been developed in the US. Jacque Gerrard, the RCM’s director for England says such digital technology can be useful, as long as the advice is backed up by evidence-based information and carries a health warning. “Women have access to mobile phones, the internet and they want instant answers, so I think [such digital technology] is a positive step,” she says. “But what I would say is it has to be used with caution. Sometimes women do need access to a midwife or a doctor and that’s got to be the first point of contact. The NHS does provide access to a midwife 24/7, 365 days of the year, no matter where you are in the country.” The RCM is itself currently developing a hub for pregnant women, including a live help function. Harvey is in talk with NHS trusts who are considering piloting her service in their areas, and says she’d eventually like to be able to offer the service for free – although finding funding will be the first priority; she’s currently plotting an investment round with angel investors. There are also plans to expand into other countries once the market is established in the UK. But it’s been a learning curve for the midwife, who still juggles working night shifts with developing the business. “It’s completely different to my NHS work,” she says. “I’ve never been an entrepreneur, but the fact that I’m getting that feedback from people saying this is something they want is keeping me going and giving me that drive and determination to make sure it succeeds.” Harvey says the feedback so far has been very positive and the app recently won best parenting app and best educational app at the Mumii Family awards. “[Entrepreneurship] has been the best experience I’ve had,” she says. “I was at a baby show in London recently and somebody said she’d used my app in early pregnancy and it was the best money she’d ever spent. She had been really worried she was losing her baby, her GP hadn’t reassured her and she didn’t know where to go. She had a 10-minute chat with one of the midwives and felt really reassured. Then she realised I was the one she’d spoken to and she burst into tears, giving me a hug. That for me felt like the icing on the cake – this is why I’m doing it, this is why I’ve put all the hard work in.” Sign up to become a member of the Guardian Small Business Network here for more advice, insight and best practice direct to your inbox.


News Article | February 17, 2017
Site: www.eurekalert.org

Researchers exploring why there has been a substantial increase in mortality in England and Wales in 2015 conclude that failures in the health and social care system linked to disinvestment are likely to be the main cause. There were 30,000 excess deaths in 2015, representing the largest increase in deaths in the post-war period. The excess deaths, which included a large spike in January that year, were largely in the older population who are most dependent on health and social care. Reporting their analysis in the Journal of the Royal Society of Medicine, the researchers from the London School of Hygiene & Tropical Medicine, University of Oxford and Blackburn with Darwen Borough Council, tested four possible explanations for the January 2015 spike in mortality. After ruling out data errors, cold weather and flu as main causes for the spike, the researchers found that NHS performance data revealed clear evidence of health system failures. Almost all targets were missed including ambulance call-out times and A&E waiting times, despite unexceptional A&E attendances compared to the same month in previous years. Staff absence rates rose and more posts remained empty as staff had not been appointed. Professor Martin McKee, from the London School of Hygiene & Tropical Medicine, said: "The impact of cuts resulting from the imposition of austerity on the NHS has been profound. Expenditure has failed to keep pace with demand and the situation has been exacerbated by dramatic reductions in the welfare budget of £16.7 billion and in social care spending." He added: "With an aging population, the NHS is ever more dependent on a well-functioning social care system. Yet social care has also faced severe cuts, with a 17% decrease in spending for older people since 2009, while the number of people aged 85 years and over has increased by 9%." "To maintain current levels of social care would require an extra £1.1 billion, which the government has refused." Professor McKee continued: "The possibility that the cuts to health and social care are implicated in almost 30,000 excess deaths is one that needs further exploration. Given the relentless nature of the cuts, and potential link to rising mortality, we ask why is the search for a cause not being pursued with more urgency?" "Simply reorganising and consolidating existing urgent care systems or raising the 'agility' of the current A&E workforce capacity is unlikely to be sufficient to meet the challenges that high levels of admissions of frail elderly people and others who are vulnerable are likely to present this winter and in future winters." The researchers say that there are already worrying signs of an increase in mortality in 2016. Without urgent intervention, they say, there must be concern that this trend will continue. Commenting on the analysis, Professor Danny Dorling, University of Oxford, added: "It may sound obvious that more elderly people will have died earlier as a result of government cut backs, but to date the number of deaths has not been estimated and the government have not admitted responsibility." Why has mortality in England and Wales been increasing? An iterative demographic analysis (DOI: 10.1177/0141076817693599) and What caused the spike in mortality in England and Wales in January 2015? (DOI: 10.1177/0141076817693600) by Lucinda Hiam, Danny Dorling, Dominic Harrison and Martin McKee, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Friday 17 February 2017. The JRSM is the flagship journal of the Royal Society of Medicine and is published by SAGE. It has full editorial independence from the RSM. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi. Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1,000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company's continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. http://www.

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