Overweight teenagers in South Yorkshire could be fitted with gastric balloons, if a trial is approved.
via BBC News – Sheffield hospital plans teenager gastric balloon trial.
Sheffield hospital plans teenager gastric balloon trial
Reply
Daily Archives: October 27, 2011
Fourteen trusts rated worst by first official hospital death rate
via Fourteen trusts rated worst by first official hospital death rate | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Fourteen hospital trusts have been identified as the poorest performers in the first official hospital-wide mortality ratings.
Children’s care quality can be improved – study
via Children’s care quality can be improved – study | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The largest case-based study into children who died after surgery has found there was room for improvement in more than a quarter of cases.
Burnham attacks coalition over ‘catastrophic’ NHS changes
Combining the biggest financial challenge in the NHS with the biggest re-organisation is a “catastrophic error of judgment”, shadow health secretary Andy Burnham said yesterday as he attacked the government’s health reforms.
via Burnham attacks coalition over ‘catastrophic’ NHS changes | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Rising discharge delays blamed on NHS, not local authorities
via Rising discharge delays blamed on NHS, not local authorities | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Delays in discharging patients from acute hospitals are increasingly being blamed on the NHS rather than local authorities, data suggests, despite large cuts to social services budgets.
Alcohol warnings ‘still being ignored’, minister says
Many people still do not accept the harm that alcohol can do to their bodies, despite government warnings, the public health minister has said.
via BBC News – Alcohol warnings ‘still being ignored’, minister says.
Richard Vize on local government taking over responsibility for public health
Richard Vize on local government taking over responsibility for public health
Work for young people and care of elderly people are problems as world’s population hits seven billion
An NHS Athens account may be required to view this in full.
The world’s population will exceed seven billion for the first time in the next few days, just 12 years after it passed the six billion mark. The milestone, expected to be reached on 31 October, is “a challenge, an opportunity, and a call for action,” said Babatunde Osotimehin, executive director of the United Nations Population Fund
Specialist care housing model losing funding
Source: Specialist care housing model losing funding | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Specialist housing integrated with care provision may not survive as a long term model for providing care for older people, a report has warned.
Dilnot social care proposals are ‘regressive’, says Lansley
Source: Dilnot social care proposals are ‘regressive’, says Lansley | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Health secretary Andrew Lansley has told a meeting of councillors that he believes the Dilnot Commission’s proposals on care funding reform are “regressive”, HSJ understands.
Reforms must change to ‘mitigate damage’ – BMA chair
Source:Reforms must change to ‘mitigate damage’ – BMA chair | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The British Medical Association has said significant changes to NHS reforms are still required to “mitigate the damage” they will cause, as peers prepared to debate afresh the government proposals.
Lansley plans increased spot checks to improve elderly care
Source: Lansley plans increased spot checks to improve elderly care | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Plans to “root out” problems in the care of older people will see hundreds of hospitals and care homes subject to higher numbers of unannounced checks.
Large variation in nursing skill mix, figures show
via Large variation in nursing skill mix, figures show | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Figures obtained by HSJ reveal a large difference in staff skill mix between different hospital trusts.
Changes in the socio-demographic patterning of late adolescent health risk behaviours during the 1990s: analysis of two West of Scotland cohort studies
This article is available freely via Open Access. Please click on the above link to view it fully.
Abstract (provisional)
Background
Substance use and sexual risk behaviour affect young people’s current and future health and wellbeing in many high-income countries. Our understanding of time-trends in adolescent health-risk behaviour is largely based on routinely collected survey data in school-aged adolescents (aged 15 years or less). Less is known about changes in these behaviours among older adolescents.
Methods
We compared two cohorts from the same geographical area (West of Scotland), surveyed in 1990 and 2003, to: describe time-trends in measures of smoking, drinking, illicit drug use, early sexual initiation, number of opposite sex sexual partners and experience of pregnancy at age 18-19 years, both overall and stratified by gender and socioeconomic status (SES); and examine the effect of time-trends on the patterning of behaviours by gender and SES. Our analyses adjust for slight between-cohort age differences since age was positively associated with illicit drug use and pregnancy.
Results
Rates of drinking, illicit drug use, early sexual initiation and experience of greater numbers of sexual partners all increased significantly between 1990 and 2003, especially among females, leading to attenuation and, for early sexual initiation, elimination, of gender differences. Most rates increased to a similar extent regardless of SES. However, rates of current smoking decreased only among those from higher SES groups. In addition, increases in ‘cannabis-only’ were greater among higher SES groups while use of illicit drugs other than cannabis increased more in lower SES groups.
Conclusion
Marked increases in female substance use and sexual risk behaviours have implications for the long-term health and wellbeing of young women. More effective preventive measures are needed to reduce risk behaviour uptake throughout adolescence and into early adulthood. Public health strategies should reflect both the widespread prevalence of risk behaviour in young people as well as the particular vulnerability to certain risk behaviours among those from lower SES groups.
Honorary and ghost authorship in high impact biomedical journals: a cross sectional survey
This article is available freely via Open Access. Please click on the above link to view it fully.
Abstract
Objectives To assess the prevalence of honorary and ghost authors in six leading general medical journals in 2008 and compare this with the prevalence reported by authors of articles published in 1996.
Design Cross sectional survey using a web based questionnaire.
Setting International survey of journal authors.
Participants Sample of corresponding authors of 896 research articles, review articles, and editorial/opinion articles published in six general medical journals with high impact factors in 2008: Annals of Internal Medicine, JAMA, Lancet, Nature Medicine, New England Journal of Medicine, and PLoS Medicine.
Main outcome measures Self reported compliance with International Committee of Medical Journal Editors (ICMJE) criteria for authorship for all authors on the selected articles.
Results A total of 630/896 (70.3%) corresponding authors responded to the survey. The prevalence of articles with honorary authorship or ghost authorship, or both, was 21.0% (95% CI 18.0% to 24.3%), a decrease from 29.2% reported in 1996 (P=0.004). Based on 545 responses on honorary authorship, 96 articles (17.6% (95% CI 14.6% to 21.0%)) had honorary authors (range by journal 12.2% to 29.3%), a non-significant change from 1996 (19.3%; P=0.439). Based on 622 responses on ghost authorship, 49 articles (7.9% (6.0% to 10.3%)) had ghost authors (range by journal 2.1% to 11.0%), a significant decline from 1996 (11.5%; P=0.023). The prevalence of honorary authorship was 25.0% in original research reports, 15.0% in reviews, and 11.2% in editorials, whereas the prevalence of ghost authorship was 11.9% in research articles, 6.0% in reviews, and 5.3% in editorials.
Conclusions Evidence of honorary and ghost authorship in 21% of articles published in major medical journals in 2008 suggests that increased efforts by scientific journals, individual authors, and academic institutions are essential to promote responsibility, accountability, and transparency in authorship, and to maintain integrity in scientific publication.
CDC panel recommends HPV shot for boys
A US government medical committee has recommended the human papillomavirus vaccine for boys, to tackle the spread of the sexually-transmitted virus.
Pill ‘lowers ovarian cancer risk’
Women who take the Pill for 10 years almost halve their risk of ovarian cancer, according to a study.
Observations: Breast Screening
The NHS breast screening programme needs independent review
An independent review is under way — Richards 343 — bmj.com.
An NHS Athens account may be required to view this in full.
The BMJ has published several articles over the past few years raising concerns about the accuracy and transparency of information provided to women about the benefits and harms of mammography screening for breast cancer. Last month the professor of complex obstetrics Susan Bewley sent us for publication an open letter to England’s cancer tsar. Here we publish the letter and Mike Richards’s response
An NHS Athens account may be required to view this in full.
Quarter of Scots ‘obese’, health survey says
More than a quarter of adults in Scotland are obese, according to official figures
via BBC News – Quarter of Scots ‘obese’, health survey says.
Reform conflict of interest concerning most GPs
Source: Reform conflict of interest concerning most GPs | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Conflicts of interest arising from the government’s NHS reforms are a concern for seven out of 10 GPs, according to a new study.
Health Bill: Lords to debate hospital failure, integration and commissioning bonus
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Members of the House of Lords have tabled dozens of amendments to the Health Bill which would bring about significant policy change if passed.
MPs condemn poor value from hi-tech equipment
A report by MPs says the NHS in England is wasteful over the way it buys and deploys its most expensive equipment.
via BBC News – MPs condemn poor value from hi-tech equipment.
Barriers and strategies for improving communication between inpatient and outpatient mental health clinicians — Stockdale et al. 20 (11): 941 — BMJ Quality and Safety
An NHS Athens account may be required to view this in full.
Abstract
Objectives To explore hospital leaders’ perceptions of organisational factors as barriers and/or facilitators in improving inpatient–outpatient (IP–OP) communication.
Design Semistructured in-person interviews.
Analysis Constant comparative method of qualitative data.
Setting Inpatient psychiatry units in 33 general medical/surgical and specialty psychiatric hospitals in California and Massachusetts (USA).
Participants Psychiatry chair/chief, service director or medical director.
Variables Importance to leadership, resources, organisational structure and culture.
Results A majority of hospital leaders rated the IP–OP communication objective as highly or moderately important. Hospitals with good IP–OP communication had structures in place to support communication or had changed/implemented new procedures to enhance communication, and anticipated clinicians would ‘buy in’ to the goal of improved communication. Hospitals reporting no improvement efforts were less likely to have structures supporting IP–OP communication, anticipated resistance among clinicians and reported a need for technological resources such as electronic health records, integrated IT and secure online communication. Most leaders reported a need for additional staff time and information, knowledge or data.
Conclusions For many hospitals, successfully improving communication will require overcoming organisational barriers such as cultures not conducive to change and lack of resources and infrastructure. Creating a culture that values communication at discharge may help improve outcomes following hospitalisation, but changes in healthcare delivery in the past few decades may necessitate new strategies or changes at the systems level to address barriers to effective communication.
The clinical governance development index: results from a New Zealand study
An NHS Athens account may be required to view this in full.
Abstract
Background Clinical governance is seen as pivotal to improving healthcare quality, yet there are few available tools for tracking progress on its implementation. With this in mind, the authors developed a Clinical Governance Development Index (CGDI) designed to track performances between healthcare organisations and over time.
Methods A survey on implementation of government policy on clinical governance was sent to 3402 New Zealand public hospital specialists. Responses to seven survey items were weighted and combined to form the CGDI. Final scores for each of New Zealand’s 21 District Health Boards were converted to percentages.
Results The mean CGDI score was 47.3%, with significant differences in performances across the 21 District Health Boards (F(20, 1178)=3.233, p=0.0000). Scores were higher in boards where respondents perceived governing boards and management worked to support clinical leadership.
Conclusion The CGDI offers a simple method for measuring the extent to which a healthcare organisation is working to develop clinical governance. Its use in New Zealand provides a baseline for tracking clinical governance over time. The CGDI could be easily adapted for use in other healthcare systems.
Characteristics of general practices associated with emergency-department attendance rates: a cross-sectional study
An NHS Athens account may be required to view this in full.
Abstract
Background Strategies are needed to contain emergency-department attendance. Quality of care in general practice might influence the use of emergency departments, including management of patients with chronic conditions and access to consultations.
Aim The aim was to determine whether emergency‐department attendance rates are lower for practices with higher quality and outcomes framework performance and lower for practices with better patient reported access.
Design A cross-sectional study.
Setting Two English primary-care trusts, Leicester City and Leicestershire County and Rutland, with 145 general practices.
Method Using data on attendances at emergency departments in 2006/2007 and 2007/2008, a practice attendance rate was calculated for each practice. In a hierarchical negative binomial regression model, practice population characteristics (deprivation, proportion of patients aged 65 or over, ethnicity, gender) and practice characteristics (total list size, distance from the emergency department, quality and outcomes framework points, and variables measuring satisfaction with access) were included as potential explanatory variables.
Results In both years, greater deprivation, shorter distance from the central emergency department, lower practice list size, white ethnicity and lower satisfaction with practice telephone access were associated with higher emergency-department attendance rates.
Conclusions Performance as indicated by the quality and outcomes framework did not predict rates of attendance at emergency departments, but satisfaction with telephone access did. Consideration should be given to improving access to some general practices to contain the use of emergency departments.
Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program
This article is available freely via Open Access. Please click on the above link to view it fully.
Abstract (provisional)
Background
Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program.
Methods
762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models.
Results
Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a ‘high-risk’ baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to ‘low risk’ WC at the end of the program.
Conclusions
While employees with ‘high-risk’ WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement were generally indicators of better baseline health. These results indicate that employees who started with better health, potentially due to lifestyle or recent behavioural changes, were more likely to respond positively to the program. Future health program initiators should think innovatively to encourage all enrolees along the health spectrum to achieve a successful outcome.
Young people’s views on the potential use of telemedicine consultations for sexual health: results of a national survey
Abstract (provisional)
Background
Young people are disproportionately affected by sexually transmissible infections in Australia but face barriers to accessing sexual health services, including concerns over confidentiality and, for some, geographic remoteness. A possible innovation to increase access to services is the use of telemedicine.
Methods
Young people’s (aged 16-24) pre-use views on telephone and webcam consultations for sexual health were investigated through a widely-advertised national online survey in Australia. Descriptive statistics were used to describe the study sample and chi-square, Mann-Whitney U test, or t-tests were used to assess associations. Multinomial logistic regression was used to explore the association between the three-level outcome variable (first preference in person, telephone or webcam, and demographic and behavioural variables); odds ratios and 95%CI were calculated using in person as the reference category. Free text responses were analysed thematically.
Results
A total of 662 people completed the questionnaire. Overall, 85% of the sample indicated they would be willing to have an in-person consultation with a doctor, 63% a telephone consultation, and 29% a webcam consultation. Men, respondents with same-sex partners, and respondents reporting three or more partners in the previous year were more willing to have a webcam consultation. Imagining they lived 20 minutes from a doctor, 83% of respondents reported that their first preference would be an in-person consultation with a doctor; if imagining they lived two hours from a doctor, 51% preferred a telephone consultation. The main objections to webcam consultations in the free text responses were privacy and security concerns relating to the possibility of the webcam consultation being recorded, saved, and potentially searchable and retrievable online.
Conclusions
This study is the first we are aware of that seeks the views of young people on telemedicine and access to sexual health services. Although only 29% of respondents were willing to have a webcam consultation, such a service may benefit youth who may not otherwise access a sexual health service. The acceptability of webcam consultations may be increased if medical clinics provide clear and accessible privacy policies ensuring that consultations will not be recorded or saved.
Loss of interest, depressed mood and impact on the quality of life: Cross-sectional survey
This article is available freely via Open Access. Please click on the above link to view it fully.
Abstract (provisional)
Background
Depressive symptoms and chronic disease have adverse effects on patients’ health-related quality of life (H-RQOL). However, little is known about this effect on H-RQOL when only the two core depressive symptoms, loss of interest and depressed mood, are considered. The objective of this study is to investigate H-RQOL in the presence of loss of interest and depressed mood at a general medical outpatient unit.
Methods
We evaluated 553 patients at their first attendance at a general medical outpatient unit of a teaching hospital. H-RQOL was assessed with the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Depressed mood and loss of interest were assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Questionnaire. A physician performed the diagnosis of chronic diseases by clinical judgment and classified them in 13 possible pre-defined categories. We used multiple linear regression to investigate associations between each domain of H-RQOL and our two core depression symptoms. The presence of chronic diseases and demographic variables were included in the models as covariates.
Results
Among the 553 patients, 70.5% were women with a mean age of 41.0 years (range 18-85, SD 15.4). Loss of interest was reported by 54.6%, and depressed mood by 59.7% of the patients. At least one chronic disease was diagnosed in 59.5% of patients; cardiovascular disease was the most prevalent, affecting 20.6% of our patients. Loss of interest and depressed mood was significantly associated with decreased scores in all domains of H-RQOL after adjustment for possible confounders. The presence of any chronic disease was associated with a decrease in the domain of vitality. The analysis of each individual chronic disease category revealed that no category was associated with a decrease in more than one domain of H-RQOL.
Conclusion
Loss of interest and depressed mood were associated with significant decreases in H-RQOL. We recommend these simple tests for screening in general practice.
Assessing the patient safety competencies of healthcare professionals: a systematic review
This article is available freely via Open Access. Please click on the above link to view it fully.
Abstract
Background Patient safety training of healthcare professionals is a new area of education. Assessment of the pertinent competencies should be a part of this education. This review aims to identify the available assessment tools for different patient safety domains and evaluate them according to Miller’s four competency levels.
Methods The authors searched PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, psycINFO and the Education Resource Information Center (ERIC) from the start of each database to December 2010 for English-language articles that evaluated or described tools for the assessment of the safety competencies of individual medical and/or nursing professionals. Reports on the assessment of technical, clinical, medication and disclosure skills were excluded.
Results Thirty-four assessment tools in 48 studies were identified: 20 tools for medical professionals, nine tools for nursing professionals, and five tools for both medical and nursing professionals. Twenty of these tools assessed the two highest Miller levels (‘shows how’ and ‘does’) and four tools were directed at multiple levels. Most of the tools that aimed at the higher levels assessed the skills of working in teams (17 tools), risk management (15 tools), and communication (11 tools). Internal structure (reliability, 22 tools) and content validity (14 tools) when described were found to be moderate. Only a small number of tools addressed the relationship between the tool itself and (1) other assessments (concurrent, predictive validity, eight tools), and (2) educational outcomes (seven tools).
Conclusions There are many tools designed to assess the safety competencies of healthcare professionals. However, a reliable and valid toolbox for summative testing that covers all patient safety domains at Miller’s four competency levels cannot yet be constructed. Many tools, however, are useful for formative feedback
Doctors call for change to alcohol advice
Doctors call for change to alcohol advice.
NHS Choices examines the science behind the newspaper headlines.
Links to the headlines
Avoid alcohol three days a week, doctors warn. BBC News, October 23 2011
Avoid alcohol three days a week, doctors warn. The Daily Telegraph, October 23 2011
Doctors say alcohol free days needed to protect liver. BBC News, October 23 2011
New guide for safe drinking. The Independent, October 23 2011
Don’t drink on 3 days a week. As the liver crisis deepens, leading doctors warn of the dangers. Daily Mail, October 23 2011
