The national framework for NHS continuing healthcare and NHS-funded nursing care sets out the principles and processes for deciding eligibility.NHS continuing healthcare is an ongoing package of health and social care that is arranged and funded solely by the NHS where an individual is found to have a primary health need. Such care is provided to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident or illness.
A recent report in the journal Pediatrics suggests a possible link between organophosphate pesticides and increased risk of children developing attention deficit/hyperactivity disorder. The report has some parents wondering if they should stay away from the produce aisle in the grocery store. University of Georgia experts say to learn the facts, thoroughly clean all produce and feed healthful fruits and vegetables to children.“The (United States Environmental Protection Agency) regulates pesticide use and publishes risk assessments associated with their use,” said Steve Brown, an entomologist and assistant dean for Extension with the UGA College of Agricultural and Environmental Sciences. “Food producers are required to follow EPA’s guidelines.”No specific organophosphate, or OP, was identified in the published study. OPs are sometimes used to control insects in agricultural production and indoor pest control. There are more than 900 federally approved pesticides that can be used in the U.S. Of those, 37 are classified as OPs, including malathion and chlorpyrofos. Chlorpyrofos is seldom used on fruit or foliage. Chlorpyrofos, once used for pest control in turfgrass, has not been allowed for use on home lawns for several years, according to UGA Extension turfgrass specialist Clint Waltz. “Until recently it was still labeled for athletic fields and golf courses,” he said. “If everyone is following the label rules, it’s likely no longer in use there either.” Integrated Pest ManagementFor specific use on certain crops, Brown said, OPs are sometimes the best option for growers. “However, we recommend integrated pest management practices for effective insect control in food crops.” Integrated pest management systems, promoted by Cooperative Extension nationwide for decades, incorporate all methods of pest control and suggest using pesticides only when other control methods aren’t sufficient. “Increasing our knowledge about how to prevent pest problems allows us to work with growers to produce the safest food products for consumers, while also minimizing any risk to the environment,” Brown said. Growers eagerly use these integrated systems, he said, because they want to provide safe food in an environmentally sound way. They also increase profits by eliminating chemical usage, which can be expensive. “If there’s a chemical-free way to solve problems, everyone wants to try that first,” Brown said.Testing, monitoring, educatingEPA periodically conducts cumulative risk assessments on food, water and environments at home, work, school and public outdoor spaces. The latest EPA assessment for OPs “underscores EPA’s continued confidence in the overall safety of the nation’s food supply and the benefits of eating a varied diet rich in fruits and vegetables,” the report stated. The assessment concluded drinking water is safe, too.“Through these assessments, EPA quickly determines when a concern arises,” Brown said. “Improved technologies help ensure only the safest practices are used in U.S. food production. When a problem is pinpointed, EPA or FDA moves quickly to revise recommendations and has, over the years, eliminated products from use they consider a risk to food safety. Our job is to help educate growers and get information about those changes out to farmers in Georgia as fast as we can.” Brown says that providing a safe, healthy food supply is vital to U.S. national security and is a major factor in the nation’s economic health. “Agricultural research at the University of Georgia, and at land-grant universities across the country, aims to make sure Americans have ample, affordable food that’s safe to eat,” he said. “Our discoveries in the land-grant system help U.S. farmers meet that demand and provide an increasing share of the world food supply, as well.” Learn the factsHe cautions parents to read the recent report carefully before changing children’s diets. “We take the Harvard study very seriously,” he said, “and are eager to hear of further studies that may explain the results presented. But, the authors admit that no cause-and-effect relationship has been determined and the source of OP exposure in the test subjects is not known. The study does not conclude that fresh fruits and vegetables are responsible for ADHD in children.”UGA Extension food safety expert Judy Harrison agrees. Consumers shouldn’t read too much into the study. “You have to consider that this is a fairly limited study,” she said. “The results are interesting, but don’t identify the source of the residues. Think of the millions of us who go to the grocery store and buy the same food every week, yet neither we nor our children have ADHD.” Harrison believes that more in-depth investigation into the sources of exposure is necessary. “FDA monitors food for safety,” she said. “Most of us have the same food source. Knowing other potential places you can come in contact with organophosphates is important before any conclusions can be drawn.”To help ensure that fruits and vegetables are safe to eat, rinse them thoroughly under cool, running water, while rubbing carefully to clean them. This will help remove dirt, bacteria and other residues. Parents who are overly concerned can peel the produce for added peace of mind.“However, parents need to realize that peeling produce eliminates a good source of fiber and nutrients for children. And, even if they plan to peel it, rinse it first,” she said.