Why 361 needles are better than one.

baby injection Many adults, as well as children, dislike needles
One in 10 of us are said to have a fear of the hypodermic needle, a necessary but frequently uncomfortable fact of medical life.
While the needle is an efficient way to administer drugs and take samples for analysis, it still involves sticking a sharp bit of metal into the body.
This is problematic for many children, but particularly premature babies.
Since they are typically ill, premature babies are given a lot of medicines. But, because of their vulnerability, doctors need to take frequent blood samples as to ensure they get the right dose.

This could come in the form of regular injections, or the insertion of a permanent cannula, a procedure which is difficult enough to administer in grown adults.
'Like a cat's tongue' Many researchers have tried to find an alternative solution.
Now, Prof Ryan Donnelly from Queens University Belfast and his team think they have come up with a solution. Not one needle, but 361.
The device looks like a small, clear plastic patch about half a centimetre across, which easily sits on the tip of your finger. One side looks quite rough.
Penny microneedle and hypodermic needle Microneedle patch compared to traditional needle
"It's a patch with 361 tiny, individual needles on it," explains Prof Donnelly.
The patch feels slightly rough to the touch, something akin to Velcro or a cats tongue. But the individual needles are extremely hard, and sharp at the tips.
Unlike normal hypodermic needles, these microneedles only penetrate the top layer of your skin. They don't contact the nerves, which is why you feel no pain. Nor do they go into your blood vessels.
Instead they collect the so called interstitial fluid which surrounds the cells in the outer layer of skin.
This fluid contains all the information the doctor requires.
'Very distressed'
baby vaccine injection Crying newborn receives his first vaccination
This is good news for adults, but could be revolutionary for premature babies.
Dr Aaron Brady, a pharmacist recently recruited to the team has direct experience of working in neonatal care.
"Neonates, babies up to 28 days, have a very small blood volume - about the size of a drinks can.

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It's always worse for the parents - you don't want to see your child getting stabbed”
Sofie Backstrom Mother of a premature baby
"Quite often they'll need to have their blood monitored four times a day. If we can use these microneedles instead, we don't have to take any blood at all."
Dr Brady adds: "There are real problems associated with hypodermic needles, such as scarring and bruising.
"Using microneedles instantly eliminates any issues with scaring, bruising and damage to tissue."
Parents are very much in favour of something that could be applied as easily as a sticking plaster because, as Prof Ryan says, they become "very distressed" by the invasive medical procedures their children have to be subjected to.
Sofie Backstrom's daughter Freja has just turned one, but she was born three months prematurely at 26 weeks.
"When she was born she had blood samples taken almost daily for the first three months," says Sofie.
She still has injection scars from that time.
"They're mainly on the back of her hands and feet but on her knees and elbows too - about 20 scars on each."
Sofie would have welcomed a pain-free alternative.
"I think it's always worse for the parents - you don't want to see your child getting stabbed."
Drug delivery Prof Donnelly and his team aren't the only ones developing an alternative to injections. Several groups around the world are working on similar technologies, including Linda Klavinskis, an immunobiologist from Kings College London.
Microneedles can also be used for drug delivery and she is very excited about their potential. "One of the most profound effects will be the ability to deliver vaccines at a reduced cost.
"Microneedles are very simple, you don't need specially trained staff and they won't need any of the paraphernalia of a conventional vaccine."
Compounds can be incorporated into the polymer patches when they are made, and are slowly released into the body once they come into contact with the interstitial fluid.
Keeping cool Prof Donnelly's team have used the patches to administer everything from insulin to ibuprofen.
Microneedles could also do away with the need to refrigerate vaccines.
Most vaccines need to be kept cold to stay effective and to prevent bacterial growth.
Trapped inside the polymer patches the vaccines should be stable in a dry state, even at warm temperatures.
It makes the needles particularly useful for vaccination campaigns in remote areas, where delivering and storing conventional liquid vaccines can be a challenge.
Prof Donnelly says: "Up to 50% of vaccines do not work in the developing world, because they've inadvertently been allowed to warm beyond 38C, or they've been frozen by mistake, which can damage the vaccine.".
If a patient receives a vaccine that hasn't been refrigerated properly it may not work and could lead to septicaemia and even death.
Needle stick injuries
microneedle used Used microneedles are too soft to cause needle stick injuries
The microneedles are also much safer than conventional hypodermics.
Every year, around two million health workers get injured by sharp needles after they've been used. Contracting HIV or hepatitis this way is not uncommon.
The patches are made of hydrogel - similar to the material used in disposable nappies or contact lenses. Although hard when inserted, they soften as fluid is absorbed and can no longer cause injury.
It also prevents them from being used again. The WHO estimates that every year 21 million cases of hepatitis B can be attributed to needle reuse.
"Even after one minute in skin the micro needles are too soft to be reinserted and hence there is no danger associated with them." Prof Donnelly says.
The microneedles are still being developed and need to undergo rigorous clinical trials.
However Prof Donnelly is optimistic that they will soon be a common sight around the world.
bbc.

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Sandhurst's sheikhs: Why do so many Gulf royals receive military training in the UK? A parade outside the building at Sandhurst Continue reading the main story In today's Magazine The death list that names 5,000 victims Is this woman an apostate? Voices from a WW1 prison camp The Swiss selfie scandal Generations of foreign royals - particularly from the Middle East - have learned to be military leaders at the UK's Sandhurst officer training academy. But is that still a good idea, asks Matthew Teller. Since 1812, the Royal Military Academy Sandhurst, on the Surrey/Berkshire border, has been where the British Army trains its officers. It has a gruelling 44-week course testing the physical and intellectual skills of officer cadets and imbuing them with the values of the British Army. Alongside would-be British officers, Sandhurst has a tradition of drawing cadets from overseas. Many of the elite families of the Middle East have sent their sons and daughters. Perhaps the most notable was King Hussein of Jordan. Continue reading the main story Find out more Matthew Teller presents Sandhurst and the Sheikhs, a Whistledown production for BBC Radio 4, on Wednesday 27 August 2014 at 11:00 BST It will be available on iPlayer shortly after broadcast Four reigning Arab monarchs are graduates of Sandhurst and its affiliated colleges - King Abdullah of Jordan, King Hamad of Bahrain, Sheikh Tamim, Emir of Qatar, and Sultan Qaboos of Oman. Past monarchs include Sheikh Saad, Emir of Kuwait, and Sheikh Hamad, Emir of Qatar. Sandhurst's links have continued from the time when Britain was the major colonial power in the Gulf. "One thing the British were excellent at was consolidating their rule through spectacle," says Habiba Hamid, former foreign policy strategist to the rulers of Dubai and Abu Dhabi. "Pomp, ceremony, displays of military might, shock and awe - they all originate from the British military relationship." Sheikh Hamad Bin Isa Al Khalifa, King Abdullah, Sultan Qaboos Sandhurst alumni: King Hamad of Bahrain, King Abdullah of Jordan and Sultan Qaboos of Oman It's a place where future leaders get to know each other, says Michael Stephens, deputy director of the Royal United Services Institute, Qatar. And Sandhurst gives the UK influence in the Gulf. "The [UK] gets the kind of attention from Gulf policy elites that countries of our size, like France and others, don't get. It gives us the ability to punch above our weight. "You have people who've spent time in Britain, they have… connections to their mates, their teachers. Familiarity in politics is very beneficial in the Gulf context." "For British people who are drifting around the world, as I did as a soldier," says Brigadier Peter Sincock, former defence attache to Saudi Arabia, "you find people who were at Sandhurst and you have an immediate rapport. I think that's very helpful, for example, in the field of military sales." The Emir of Dubai Mohammad bin Rashid Al Maktoum with his son after his Passing Out Parade at Sandhurst in 2006 Sheikh Mohammad bin Rashid Al Maktoum, Emir of Dubai, with his son in uniform at Sandhurst in 2006 Her Majesty The Queen's Representative His Highness Sheikh Hamad bin Khalifa Al-Thani, The Emir of Qatar inspects soldiers during the 144th Sovereign's Parade held at The Royal Military Academy Sandhurst on April 8, 2004 in Camberley, England. Some 470 Officer cadets took part of which 219 were commissioned into the British Army Hamad bin Khalifa Al-Thani, the Emir of Qatar until 2013, inspects soldiers at Sandhurst in 2004 Emotion doesn't always deliver. In 2013, despite the personal intervention of David Cameron, the UAE decided against buying the UK's Typhoon fighter jets. But elsewhere fellow feeling is paying dividends. "The Gulf monarchies have become important sources of capital," says Jane Kinninmont, deputy head of the Middle East/North Africa programme at the foreign affairs think tank Chatham House. "So you see the tallest building in London being financed by the Qataris, you see UK infrastructure and oilfield development being financed by the UAE. There's a desire - it can even seem like a desperation - to keep them onside for trade reasons." British policy in the Gulf is primarily "mercantile", says Dr Kristian Coates Ulrichsen, of the Baker Institute in Houston, Texas. Concerns over human rights and reform are secondary. The Shard at dusk The Shard was funded by Qatari investors In 2012 Sandhurst accepted a £15m donation from the UAE for a new accommodation block, named the Zayed Building after that country's founding ruler. 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Over the years donations like this have saved the UK taxpayer a considerable amount of money." But what happens when Sandhurst's friends become enemies? In 2001, then-prime minister Tony Blair visited Damascus, marking a warming of relations between the UK and Syria. Shortly after, in 2003, Sandhurst was training officers from the Syrian armed forces. Now, of course, Syria is an international pariah. Journalist Michael Cockerell has written about Libyan dictator Colonel Gaddafi's time at the Army School of Education in Beaconsfield in 1966: "Three years [later], Gaddafi followed a tradition of foreign officers trained by the British Army. He made use of his newfound knowledge to seize political power in his own country." Ahmed Ali Sandhurst-trained Ahmed Ali was a key player in the Egyptian military's removal of Islamist President Mohammed Morsi That tradition persists. In the 1990s Egyptian colonel Ahmed Ali attended Sandhurst. In 2013 he was one of the key figures in the Egyptian military's removal of Islamist President Mohammed Morsi, now rewarded by a post in President Sisi's inner circle of advisers. In the late 1990s there were moves by the British government under Tony Blair to end Sandhurst's training of overseas cadets. Major-General Arthur Denaro, Middle East adviser to the defence secretary and commandant at Sandhurst in the late 1990s, describes the idea as part of the "ethical foreign policy" advocated by the late Robin Cook, then-foreign secretary. Tony Blair and Robin Cook Tony Blair and Robin Cook at one point planned to end Sandhurst's training of overseas cadets The funeral of King Hussein in 1999 appears to have scuppered the plan. "Coming to that funeral were the heads of state of almost every country in the world - and our prime minister was there, Tony Blair," says Major-General Denaro. "He happened to see me talking to heads of state - the Sultan of Brunei, the Sultan of Oman, the Bahrainis, the Saudis - and he said 'How do you know all these guys?' The answer was because they went to Sandhurst." Today, Sandhurst has reportedly trained more officer cadets from the UAE than from any other country bar the UK. The May 2014 intake included 72 overseas cadets, around 40% of whom were from the Middle East. "In the future," says Maryam al-Khawaja, acting president of the Bahrain Centre for Human Rights, "people will look back at how much Britain messed up in the [Middle East] because they wanted to sell more Typhoon jets to Bahrain, rather than stand behind the values of human rights and democracy." "It's one thing saying we're inculcating benign values, but that's not happening," says Habiba Hamid. Sandhurst is "a relic of the colonial past. They're not [teaching] the civic values we ought to find in democratically elected leaders." line Who else went to Sandhurst? Princes William and Harry, Winston Churchill, Ian Fleming, Katie Hopkins, Antony Beevor, James Blunt, Josh Lewsey, Devon Harris (From left to right) Princes William and Harry Sir Winston Churchill Ian Fleming, creator of James Bond (but did not complete training) Katie Hopkins, reality TV star Antony Beevor, historian James Blunt, singer-songwriter Josh Lewsey, World Cup-winning England rugby player Devon Harris, member of Jamaica's first bobsleigh team line Sandhurst says that "building international relations through military exchanges and education is a key pillar of the UK's international engagement strategy". Sandhurst may be marvellous for the UK, a country where the army is subservient to government, but it is also delivering militarily-trained officers to Middle Eastern monarchies where, often, armies seem to exist to defend not the nation but the ruling family.

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