The Greatest Breakthrough Since Lunchtime #16 – Alzheimers / Perio disease link.

Reports in two of the UK national dailies of research from UCLAN linking Alzheimers disease with poor oral hygiene.

The Independent – Poor dental health and gum disease may be linked to Alzheimer’s disease, a study suggests.

Brains of dementia patients were found to contain Porphyromonas gingivalis, the bug responsible for unhealthy gums. Scientists believe that when the bacteria reach the brain they trigger an immune response leading to the death of neurons. This could help drive the changes typical of Alzheimer’s.

The findings by a team at the University of Central Lancashire are reported in the Journal of Alzheimer’s Disease.

The team has also confirmed in animals that P. gingivalis in the mouth finds its way to the brain.

The Telegraph – A study of brain samples from deceased dementia patients found that they contained unusually high levels of Porphyromonas gingivalis, a type of bacteria which causes gum disease.
Although the bacteria live in the mouth, they can enter the bloodstream during eating, chewing, tooth brushing or dental surgery, and potentially reach the brain, experts explained.
Inflammation caused by gum disease-related bacteria has already been linked to various health problems including diabetes, heart disease and stroke.
Their arrival in the brain could prompt the immune system to release chemicals which kill brain cells, resulting in the type of changes seen in the brains of Alzheimer’s patients and causing symptoms like memory loss and confusion, experts said.
The new findings, by researchers from the University of Central Lancashire (UCLan), back up a previous study by US researchers which showed that failing to brush your teeth at least daily significantly increases the risk of dementia.Dr Sim Singhrao, one of the authors of the study published in the Journal of Alzheimer’s Disease, said: “We are working on the theory that when the brain is repeatedly exposed to bacteria and/or their debris from our gums, subsequent immune responses may lead to nerve cell death and possibly memory loss.
“Thus, continued visits to dental hygiene professionals throughout one’s life may be more important than currently envisaged with inferences for health outside of the mouth only.”
Prof StJohn Crean, dean of the school of medicine and dentistry at UCLan, added: “Our hypothesis is that this is a chronic assault. It is not happening overnight, it is a build-up over years.
“But all we have shown so far is that bacteria from the gum region get into the brain. We haven’t proven that they cause Alzheimer’s disease.”
The researchers studied brain tissue from ten deceased dementia patients, and compared them against samples from ten patients who died without dementia.
Significant signs of the gum disease virus were found in the dementia patients’ brains but not the controls, the researchers reported.
Previous studies had linked dementia to other bacteria and viruses, such as the Herpes simplex virus type 1, but the new study is the first to identify Porphyromonas gingivalis in the brains of dementia patients.
Dr Simon Ridley, of Alzheimer’s Research UK, said: “We don’t know whether the presence of these bacteria in the brain contributes to the disease and further research will be needed to investigate this.
“We know that there are likely to be many risk factors for Alzheimer’s and we need to investigate these in more detail to help develop new preventions or treatments.”

Dreadful photo illustrating the Telegraph piece but the “below the line” writing ie the comments are worth a look.

For the history of this “TGBSL” series read here

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NHS England has published its new “Mid-year and year-end reconciliation and financial recovery policy”.

NHS England has published its new “Mid-year and year-end reconciliation and financial recovery policy”.

My thanks to Alexander Hall from Meade King LLP for sharing this.

At paragraph 28 under the sub-heading “Transitional arrangements 2013/14 only” it has confirmed:

“As this is the first year of the policy it has been agreed that there will be transitional arrangements in place for 2013/14 only.  This will allow contractors to become familiar with the new arrangements and ensure that no one is disadvantaged or businesses destabilised.”

The policy goes on to confirm at paragraph 29 that in 2013/14 “No breach notices will be issued for under-delivery”, though it does confirm that despite that, it will “financially recover all monies to 100% where a contractor has delivered less than 96% of the contractual UDAs”.

This is an enlightened approach and a national published formal stance that should be kept in mind.

It is clear already that not all Area Teams are enforcing the new policies consistently or at all in some cases, so it would not be unexpected for some to receive a breach notice in breach of the policy. For those who do, there is a good argument that the notice should be withdrawn.

Paragraph 30 onwards discusses the policy from 2014/15 and speaks of “re-basing” or contract reduction. The fact that it is not mentioned in the transitional year paragraph suggests implicitly that re-basing will not be considered this year either (or it could certainly be argued that way).

It is also of note that NHS England seems to recognise that the service of breach notices can disadvantage or destabilise businesses. Certainly it can introduce uncertainty and cause certain specific problems for those who are trying to sell their practices. If destabilisation is a risk, perhaps this may be used in the future to convince NHS England not to serve a notice (carefully avoiding the suggestion that the practice may fall into financial danger entitling NHS England to consider termination so as to protect its financial interests).

The policy can be found at the NHS England website.

Alexander Hall
Partner – Healthcare & Dentists
Meade King LLP
DDI:    0117 9234050
Mobile: 07960 177 337
Tel:      0117 9264121
Email:  ajh@meadeking.co.uk

Claimants will have to pay a fee if they want to take their employer to employment tribunal.

The Government has confirmed that from today, claimants will have to pay a fee if they want to take their employer to employment tribunal. Currently, it costs nothing for a claimant to make a claim. However, in a bid to weed out the weak and vexatious attempts by the claimant to have their day in court, a two stage fee will be charged. If the fee is not paid, or the claimant does not apply for ‘remission’, the claim will not be
considered.

Claimants will be required to pay an initial fee (the ‘issue fee’) at the issue of a claim, and a further fee (a ‘hearing fee) 4 – 6 weeks before the tribunal hearing.

The amount of the fee will depend on the type of claim being made. To bring a Type A claim, the claimant must pay a £160 issue fee, and then a ‘hearing fee’ of £230. Type A claims include unlawful deductions, failure to pay redundancy pay; failure to provide statement of terms and conditions; failure of employer to allow worker to take or be paid for annual leave etc.

To bring a Type B claim, the issue fee is £250 and the hearing fee is £950. Type B claims include unfair dismissal, discrimination, failure to comply with rest break rules, failure to allow certain types of time off etc.

The cost to make a claim to Employment Appeal Tribunal will be a £400 issue fee and a £1200 hearing fee.

Fees will also apply to other procedural elements of the tribunal system e.g. £100 for an application for a review.

The tribunal will have the power to order that fees paid by the successful party be reimbursed by the unsuccessful party, though this will not be an automatic occurrence.

A remission system will be in place for those who cannot afford to pay the fees, and upon evidence of this, either the whole or part of the fee will be waived.

From Peninsula who have added this clarification

The introduction of paying fees to make a tribunal claim is here.
In Scotland, an interim interdict (which would have meant that fees could not be charged from 29th July 2013) was refused. However, a full judicial review will be held later on in the year. If the decision is that fees should not be introduced, all fees paid until that time will be refunded.
Whilst in England, trade union Unison has also tried to block the fees. We will watch this space.
In the meantime, the Government provided some clarification on details. Firstly, it admitted there had been a drafting error in the legislation when the fee for equal pay claims was set in the higher tier (total fee £1250). It should have been set at the lower fee figure (total £390) and legislation will be changed to reflect this.
It was also confirmed that preliminary hearings at tribunal will not attract a hearing fee, and multiple Employment Appeal Tribunal claims will only attract one single fee.

Peninsula’s MD Peter Done wrote in yesterday’s the Sunday Times.

The Monday Morning Quote #226

“One had to cram all this stuff into one’s mind for the examinations, whether one liked it or not.

This coercion had such a deterring effect on me that, after I had passed the final examination, I found the consideration of any scientific problems distasteful to me for an entire year.”

– Albert Einstein

Sign Child Oral Health Petition

Sign child oral health petition dental professionals urged

Dental professionals are being urged to add their names to a petition that calls for robust action to address child oral health inequalities.

The petition has been launched as part of the BDA’s recently-announced Make a meal of it campaign. The campaign aims to tackle the damage being done to children’s teeth by sugary and acidic food and drink, particularly when consumed outside normal meal times. It seeks restrictions on the advertising and display of harmful products and a tax on sugary, carbonated drinks.

The petition can be signed here.

make-a-meal-landing-pageThe campaign also encourages dentists to get involved by identifying examples of shops that display harmful products at checkouts to appeal to children, hospitals and sports centres that host vending machines stuffed full of such products, and cinemas that sell only unhealthy alternatives. Find out more on the campaign web page.

Launching the campaign BDA Scientific Adviser Damien Walmsley said:

“Despite a steady improvement to oral health in recent years an unacceptable number of children in the UK still suffer with tooth decay. Regrettably, some retailers insist on putting profits before health, disregarding the potential ill effects of their products and dangling temptation in front of children. A more responsible approach must be adopted by such organisations to help address the poor oral health that dentists see in communities across the UK. I urge all members of the dental community to get behind this campaign.”

The Monday Morning Quote #225

“You are the same today that you’ll be five years from now except for two things: the people you meet and the books you read.”

― Mac McMillan (attrib)

The Weekend Read – 9 Things Successful People Do Differently by Heidi Grant Halvorsen

Whether it’s the time of year or the time of life but I am becoming increasingly tired of B***S**T, whether it comes from politicians, media people, sportsmen or the proliferation of dental “experts” feeding on the fear initiated by those from the acronym farms CQC, GDC, etc. More and more I am reflecting on the advice given to me by Roy Higson in Bolton more than 25 years ago “K.I.S.S.” – “Keep It Simple Stupid” or as Einstein said “Everything Should Be Kept As Simple As Possible But No Simpler.”

41igIe-RDxL._SL210_For the summer days a short book by Heidi Grant Halvorsen.

Dr Halvorsen is a motivational psychologist and researcher. She writes about the scientifically-tested strategies we can use to be more effective reaching our goals at work and in our personal lives. The author of Succeed: How We Can Reach Our Goals (Hudson Street Press). She is also the co-editor of the academic handbook, “The Psychology of Goals,” a regular contributor to the BBC World Service’s “Business Daily,” an expert blogger for Fast Company and Psychology Today, and a guest blogger for Harvard Business Review. Her website is www.heidigranthalvorson.com.

This is a great little book which helps find a way to deal with goal achievement and I don’t know anyone who will not gain from reading it.

Here are some of the reviews from the Amazon website which say everything.

I immediately put the framework into practice and processed my big 5 goals for this year through it. I’ve got a clear vision on my goals but know through effort, important actions I will succeed!”

“Simple and concise
Easy to read and understand
Very believable
I would recommend this book to everyone who wants to add value to their lives”

“The book is a very short read and easy to take in. Each of the 9 “things” is put across clearly and concisely without all the added waffle that some authors throw into similar books. Highly recommend read for anyone looking to gain some insight into how they could increase their chances of success in whatever they take on.”

You can buy it via our store on Amazon here definitely a fiver well spent.

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