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via Health professionals deny Cameron’s claim they back NHS shakeup | Politics | The Guardian.
Prime minister told PMQs that changes had support of ‘Royal College of GPs, the physicians, the nurses’
Source: Second opinions on the health bill | Healthcare Network | Guardian Professional.
The government’s revised NHS reforms, which returned to Parliament yesterday, are assessed by professional associations, unions and expert groups
The number of people in England who use heroin and crack has fallen, according to independent research published by the National Treatment Agency for Substance Misuse (NTA) today.
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Despite more recent non-invasive modalities generating some credence in the literature, intracompartmental pressure testing is still considered the ‘gold standard’ for investigating chronic exertional compartment syndrome (CECS). Intracompartmental pressure testing, when used correctly, has been shown to be accurate and reliable. However, it is a user-dependent investigation, and the manner in which the investigation is conducted plays a large role in the outcome of the test. Despite this, a standard, reproducible protocol for intracompartmental pressure testing has not been described. This results in confusion regarding interpretation of results and reduces the tests’ reliability. A summary of the current understanding of CECS is presented, along with the results of a survey of specialists in Australia and New Zealand who perform intracompartmental pressure testing, which confirms that a uniform approach is currently not used in clinical practice. This highlights the need for a consensus and standardised approach to intracompartmental pressure testing.
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It is important to identify factors that might adversely affect appropriate medical consultation and management of concussion. One factor that might present a barrier to timely intervention is media portrayal of concussion in sporting events, such as professional rugby league. Accordingly, the current study employed a surveillance method of publicly available broadcast information to establish the incidence rate of probable concussion in the National Rugby League’s Telstra Premiership 2010 season and examined how these injury events were shown to be managed with respect to return-to-play procedures. The incident rate for probable concussion was higher than previously reported: 11.10\1000 player hours (95% CI 5.78 to 16.40) and was likely underestimated. Importantly, most injured players were shown to continue playing or return to play despite being visibly concussed and described as such by the commentary team. Although ‘return-to-play decisions’ for professional players are guided by medical assessment, the authors discuss whether the way concussion is portrayed might affect public awareness of appropriate concussion management.
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This study reports the time to sustain a mild traumatic brain injury (mTBI) among a cohort of community rugby union players. Demographic and player characteristics were collected and players followed up for between one and three playing seasons. 7% of the cohort sustained an mTBI within 10 h of game time, increasing twofold to 14% within 20 h. The mean time to first mTBI was 8 h with an SD of 6.2 (median 6.8 h; IQR: 2.9–11.7 h). Players reporting a recent history of concussion were 20% more likely to sustain an mTBI after 20 h of game time compared with those with no recent history of concussion. Players were likely to sustain an mTBI in shorter time if they trained for <3 h/week (HR=1.48, p=0.03) or had a body mass index <27 (HR=1.77, p=0.007). The findings highlight modifiable characteristics to reduce the likelihood of shortened time to mTBI.
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The malleability of mammalian biology during early life, which carries considerable weight throughout the course of the lifespan, may contribute to the creation of a human phenotype ideal for prime physical performance. In this article, the authors consider the East African cohort of exceptional athletes that dominate marathon performance. Since entering international marathon competition in 1960, East Africans have competed at the front of the pack and now hold the top 10 men’s marathon times. The authors present lines of evidence supporting that exposure to factors such as altitude and early metabolic adjustments that are inherent in East African early life exert a strong influence in later life physical performance and may collide with a genetic advantage to induce biological changes that allow for a more robust biological response to training in later life.
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Introduction: Accurate assessment of the incidence of sudden cardiac death (SCD) in athletes is necessary to shape appropriate strategies for its prevention. However, past estimates of SCD incidence vary widely and often utilise limited methodology for case identification.
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Introduction: One of the major challenges facing today’s clinicians is the rising cost of healthcare. Sports and exercise medicine clinicians can address these challenges by making a working diagnosis on clinical grounds and using investigations only selectively. They should also educate their patient about the limits to funding and be prepared to use time as a diagnostic aid.
via Commercial-only finance plans for FTs scaled back | News | Health Service Journal.
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The government has pulled back from plans to stimulate a market for private sector lending to foundation trusts, under which they would have been cut off from all finance other than commercial loans
Source: BBC News – Warning over global cancer levels.
The number of new cancer cases has increased by 20% in under a decade and now stands at 12 million a year, according to the World Cancer Research Fund.
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Service reconfigurations following the failure of a foundation trust could be open to “political pressures” as a result of a proposed change to the Health Bill, lawyers and think tanks have warned.
Source: BBC News – MPs reject call to change abortion advice.
MPs have rejected a bid to change the law on abortion counselling.
Source: BBC News – Private sector have huge NHS opportunity – minister.
The overhaul of the NHS in England presents “huge opportunities” to the private sector, a health minister says
Cognitive assessment of older people — Young et al. 343 — bmj.com.
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Dementia, depression, and delirium are common and serious clinical syndromes in older people that are underdiagnosed in routine care
Formal detection of these syndromes may enable identification of treatable conditions, is associated with better outcomes for patients, and requires routine cognitive assessment
Cognitive assessment requires integration of information acquired from observing the patient and talking with carers, and from the results of an assessment instrument
Cognitive assessment instruments are brief, easy to use, and sensitive to cognitive impairment, but an overall clinical assessment is needed to establish the underlying cause
The character and time frame of cognitive problems are key considerations in establishing an accurate diagnosis and a coherent management plan
Source: Trans fats: chasing a global ban — Coombes 343 — bmj.com.
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They have been repeatedly called the “low hanging fruit” in global prevention of cardiovascular disease. But will this month’s New York health summit deliver the goods and help remove damaging trans fats from the world food chain? Rebecca Coombes reports
Source:New NICE guidelines for hypertension — Ritchie et al. 343 — bmj.com.
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The recent updated guidance from the National Institute for Health and Clinical Excellence (NICE) on the management of hypertension in adults will have far reaching implications for day to day practice in the United Kingdom.
Source: The politics of NHS reconfiguration — Lister 343 — bmj.com.
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Much needed rationalisation of hospital provision is being hampered by public and political concern over loss of local services, Sam Lister reports
Source: Government public health scheme ‘inadequate’, campaign group says | News | Health Service Journal.
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Efforts to improve public health by the government are likely to fail unless major food companies are forced to sign up to tougher guidelines, a children’s health group has warned
World Cancer Research Fund study says disease can be widely prevented as UN prepares to hold summit to tackle soaring rates
