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NHS Bolton Library Information Consultancy Evidence Summary Smoking & Pregnancy
Source: Breast Feeding Horizon Scanning.
The latest edition of the Patient Safety Horizon Scanning is out and available. Produced by NHS Libraries North West, Horizon Scanning is : ” Bringing together best practice, innovation and future risks to support the commissioning process and service redesign.”
Please find below a selection of the most relevant and interesting news stories of the past week. Including:
This article is available freely via Open Access. Please click on the above link to view it fully.
The aim of this study was to assess the extent of knowledge of primary health care (PHC) patients about colorectal cancer (CRC), their attitudes toward population-based screening for this disease and gender differences in these respects.
A questionnaire-based survey of PHC patients in the Balearic Islands and some districts of the metropolitan area of Barcelona was conducted. Individuals between 50 and 69 years of age with no history of CRC were interviewed at their PHC centers.
We analyzed the results of 625 questionnaires, 58% of which were completed by women. Most patients believed that cancer diagnosis before symptom onset improved the chance of survival. More women than men knew the main symptoms of CRC. A total of 88.8% of patients reported that they would perform the fecal occult blood test (FOBT) for CRC screening if so requested by PHC doctors or nurses. If the FOBT was positive and a colonoscopy was offered, 84.9% of participants indicated that they would undergo the procedure, and no significant difference by gender was apparent. Fear of having cancer was the main reason for performance of an FOBT, and also for not performing the FOBT, especially in women. Fear of pain was the main reason for not wishing to undergo colonoscopy. Factors associated with reluctance to perform the FOBT were: (i) the idea that that many forms of cancer can be prevented by exercise and, (ii) a reluctance to undergo colonoscopy if an FOBT was positive. Factors associated with reluctance to undergo colonoscopy were: (i) residence in Barcelona, (ii) ignorance of the fact that early diagnosis of CRC is associated with better prognosis, (iii) no previous history of colonoscopy, and (iv) no intention to perform the FOBT for CRC screening.
We identified gaps in knowledge about CRC and prevention thereof in PHC patients from the Balearic Islands and the Barcelona region of Spain. If fears about CRC screening, and CRC per se, are addressed, and if it is emphasized that CRC is preventable, participation in CRC screening programs may improve.
This article is available freely via Open Access. Please click on the above link to view it fully.
Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries. We conducted this systematic review to determine awareness and knowledge of school-going male and female adolescents in Europe of STDs and if possible, how they perceive their own risk of contracting an STD. Results of this review can help point out areas where STD risk communication for adolescents needs to be improved.
Using various combinations of the terms “STD”, “HIV”, “HPV”, “Chlamydia”, “Syphilis”, “Gonorrhoea”, “herpes”, “hepatitis B”, “knowledge”, “awareness”, and “adolescents”, we searched for literature published in the PubMed database from 01.01.1990 up to 31.12.2010. Studies were selected if they reported on the awareness and/or knowledge of one or more STD among school-attending adolescents in a European country and were published in English or German. Reference lists of selected publications were screened for further publications of interest. Information from included studies was systematically extracted and evaluated.
A total of 15 studies were included in the review. All were cross-sectional surveys conducted among school-attending adolescents aged 13 to 20 years. Generally, awareness and knowledge varied among the adolescents depending on gender. Six STDs were focussed on in the studies included in the review, with awareness and knowledge being assessed in depth mainly for HIV/AIDS and HPV, and to some extent for chlamydia. For syphilis, gonorrhoea and herpes only awareness was assessed. Awareness was generally high for HIV/AIDS (above 90%) and low for HPV (range 5.4%-66%). Despite knowing that use of condoms helps protect against contracting an STD, some adolescents still regard condoms primarily as an interim method of contraception before using the pill.
In general, the studies reported low levels of awareness and knowledge of sexually transmitted diseases, with the exception of HIV/AIDS. Although, as shown by some of the findings on condom use, knowledge does not always translate into behaviour change, adolescents’ sex education is important for STD prevention, and the school setting plays an important role. Beyond HIV/AIDS, attention should be paid to infections such as chlamydia, gonorrhoea and syphilis.
Physiotherapists could soon have the right to prescribe medicines to patients, in the same way that nurses and pharmacists are allowed to.
via BBC News – Physiotherapists may get medicine prescribing rights.
Hospital visiting times should be extended so patients’ relatives can become more involved in their care, the Royal College of Nursing has said.
via BBC News – RCN wants longer hospital visiting hours.
Source: Charity challenges government’s plans to scrap legal aid for negligence claims — Dyer 343 — bmj.com.
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The patient safety charity AvMA (Action against Medical Accidents) has launched a legal challenge to UK government plans to axe legal aid for clinical negligence claims in England and Wales.
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Changes of policy on provision of services to drug users risk forcing thousands of people into detoxification and abstinence programmes before they are ready, a primary care specialist in drug misuse has warned. The potential consequences could be fatal.
Source: Exclusive: CCG leaders: Gerada is ‘misleading’ over GP commissioning | News | Health Service Journal.
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Fourteen clinical commissioning groups have accused the Royal College of GPs’ chair of causing “confusion” and “anxiety” by claiming GPs face a conflict between commissioning services and their duty to patients
Source: Welsh health minister plans to make the NHS more accountable — Dobson 343 — bmj.com.
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Major changes are being planned for the NHS in Wales over the next five years. Services have to be safe, sustainable, effective, and fair, the Welsh Assembly Health minister, Lesley Griffiths, said in her first major speech
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Objective To evaluate the ability of international point of care information summaries to update evidence relevant to medical practice.
Design Prospective cohort bibliometric analysis.
Setting Top five point of care information summaries (Clinical Evidence, EBMGuidelines, eMedicine, Dynamed, UpToDate) ranked for coverage of medical conditions, editorial quality, and evidence based methodology.
Main outcome measures From June 2009 to May 2010 we measured the incidence of research findings relating to potentially eligible newsworthy evidence. As samples, we chose systematic reviews rated as relevant by international research networks (such as, Evidence-Based Medicine, ACP Journal Club, and the Cochrane Collaboration). Every month we assessed whether each sampled review was cited in at least one chapter of the five summaries. The cumulative updating rate was analysed with Kaplan-Meier curves.
Results From April to December 2009, 128 reviews were retrieved; 53% (68) from the literature surveillance journals and 47% (60) from the Cochrane Library. At nine months, Dynamed had cited 87% of the sampled reviews, while the other summaries had cited less than 50%. The updating speed of Dynamed clearly led the others. For instance, the hazard ratios for citations in EBM Guidelines and Clinical Evidence versus the top performer were 0.22 (95% confidence interval 0.17 to 0.29) and 0.03 (0.01 to 0.05).
Conclusions Point of care information summaries include evidence relevant to practice at different speeds. A qualitative analysis of updating mechanisms is needed to determine whether greater speed corresponds to more appropriate incorporation of new information.
Source: DH stockpiles 400,000 doses of flu jab | News | Health Service Journal.
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The government has purchased a stockpile of 400,000 flu vaccine doses in order to try and head off any supply problems similar to those encountered last year.
Source: £625m synthetic insulin had ‘no clinical benefit’ | News | Health Service Journal.
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The NHS has spent hundreds of millions of pounds on synthetic insulin unnecessarily over the past decade, according to a report published today.
This article is available freely via Open Access. Please click on the above link to view it fully.
Since stress is hypothesized to play a role in the etiology of obesity during adolescence, research on associations between adolescent stress and obesity-related parameters and behaviours is essential. Due to lack of a well-established recent stress checklist for use in European adolescents, the study investigated the reliability and validity of the Adolescent Stress Questionnaire (ASQ) for assessing perceived stress in European adolescents.
The ASQ was translated into the languages of the participating cities (Ghent, Stockholm, Vienna, Zaragoza, Pecs and Athens) and was implemented within the HELENA cross-sectional study. A total of 1140 European adolescents provided a valid ASQ, comprising 10 component scales, used for internal reliability (Cronbach alpha) and construct validity (confirmatory factor analysis or CFA). Contributions of socio-demographic (gender, age, pubertal stage, socio-economic status) characteristics to the ASQ score variances were investigated. Two-hundred adolescents also provided valid saliva samples for cortisol analysis to compare with the ASQ scores (criterion validity). Test-retest reliability was investigated using two ASQ assessments from 37 adolescents.
Cronbach alpha-values of the ASQ scales (0.57 to 0.88) demonstrated a moderate internal reliability of the ASQ, and intraclass correlation coefficients (0.45 to 0.84) established an insufficient test-retest reliability of the ASQ. The adolescents’ gender (girls had higher stress scores than boys) and pubertal stage (those in a post-pubertal development had higher stress scores than others) significantly contributed to the variance in ASQ scores, while their age and socio-economic status did not. CFA results showed that the original scale construct fitted moderately with the data in our European adolescent population. Only in boys, four out of 10 ASQ scale scores were a significant positive predictor for baseline wake-up salivary cortisol, suggesting a rather poor criterion validity of the ASQ, especially in girls.
In our European adolescent sample, the ASQ had an acceptable internal reliability and construct validity and the adolescents’ gender and pubertal stage systematically contributed to the ASQ variance, but its test-retest reliability and criterion validity were rather poor. Overall, the utility of the ASQ for assessing perceived stress in adolescents across Europe is uncertain and some aspects require further examination.
A collection of letters for the BMJ for the week ending 26th September 2011
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